Chiropractic (General)

"Relationships in Transition: The Consumer and the White Coat"

Orazio Trevisan, DC

A paper was recently sent to the chiropractic executive of New South Wales called, "Relationships in Transition: The Consumer and the White Coat." The paper's objective was obtaining a definitive measure of the key attitudes and behavioural practices of 18-65 year-olds as they relate to health and health care. This study was to provide a benchmark against which to monitor future shifts in attitude and community health care focus.

The quantitative part of the study consisted of a door to door survey across Sydney and Melbourne, utilising a sample size of 406 females and males (18-65 years), who were responsible for their own health care. Table I shows how the numbers were broken down. The sample was drawn to ensure adequate representation in the suburbs of white and blue collar workers.

 

Table I

 18-24 38 38 76 25-34 55 57 112 35-44 47 49 96 45-54 31 33 64 55-64 25 27 52 196 204 400 
This study has described the 90s as the "age of reconciliation"; the "caring '90s." The paper states that health no longer is solely confined to the treatment of physical ailments and conditions, but increasingly assuming holistic proportions. A preventative approach to health is starting to take hold as the aging population starts to look at diet and nutrition. They are beginning to realise the value of foods they eat and how these can contribute to inner health and better quality of life. Also they are starting to look at alternative medicine more closely and what they want in a health care practitioner.

The paper states that what is happening in the '90s is of great significance compared to what happened in the previous four decades, which were marked by a different health care focus. During these four decades there has been a shift from "illness to wellness," from a "cure it/fix it" mentality to a "care for it/maintain it" health approach and the notion of wellness. While this shift has been a gradual one, there are many implications.

The main health problems in the survey varied according to age and lifestyle (Table II):

 

Table II Main Health Problems -- Self ...........................|........|........|......|.......|........|...... AGE

 18-24 25-44 45-65 Total Years Years Years MALE FEMALE Base: Those whose (62) (9) (26) (27) (32) (30) health is fair to poor. % % % % % % 

Average No. 1.71 1.89 1.38 1.96 1.66 1.77

Table III COMPLAINTS ..........................|..............|...............|..................

Base Total Sample TOTAL REGULAR OCCASIONAL (406) (406) (406) % % % Back pain 34 14 20 Headaches 33 6 26 Tiredness 33 11 22 Stress 26 6 20 Period pain 25 9 16 Allergies 23 8 15 Weight problems 20 11 9 Sinus 19 6 14 Arthritis 15 6 9 High blood pressure 11 5 6 PMT 11 6 5 Recurring pain 10 5 4 Migraine 9 2 7 Depression 9 1 7 Bronchitis 9 1 8 Asthma 8 2 6 Anxiety 8 3 8 Menopause 7 4 3 Haemorrhoids 7 1 6 High cholesterol 6 3 3 Bladder problems 5 2 3

 

NONE 14 51 25 AVERAGE NO: 3.28 1.06 2.10

Attitudes towards alternative medicine in the population are increasing and in this study, as seen in Table IV, 40 percent look to alternative medicine rather than relying on drugs and medication.

 

 Table IV ATTITUDES TOWARDS HEALTH Total Strongly Tend to No Tend to Strongly Total Agree Agree Agree Opinion Disagree Disagree Disagree % % % % % % % .|........|.........|........|.........|...........|........|....... 58 18 40 19 16 7 23 49 12 37 23 19 8 27 40 18 22 24 24 11 35 28 8 20 26 31 15 46 56 16 40 26 11 6 17 63 26 37 27 8 3 11 55 12 43 30 11 4 15 49 17 32 39 9 3 12 44 12 32 39 12 5 17 39 14 25 28 22 11 33 37 10 27 58 4 1 5 35 11 24 41 18 7 25 32 9 23 38 22 9 31 30 8 22 38 23 9 32 26 9 17 35 26 13 39 25 9 16 28 32 16 48 19 7 12 34 31 16 47 

ROLE OF ALTERN. MED.

More comfortable with
conventional med. than
alternative/natural.

View conventional med.
as complement to
alternative med.

Look more towards
natural alternatives
than relying on
conventional med.

Have become increasingly
disillusioned with
conventional med.

Think there is something
to alternative med.

Worries me that there are
no regulations governing
who can practice
alternative medicine.

More people turning to
alternative med. because
conventional med. failed them.

Quality and skills of
alternative practitioners
is highly variable.

Value of alternative practitioners
is that they look at the whole
person and what affects them,
rather than just symptoms.

I'm increasingly interested
in philosophies and practices of
alternative med.

Alternative practitioners
take the time to talk to
the person.

Too much quackery to
alternative med.

Alternative med. and
practices can do more
harm than good.

Alternative practitioners
are better equipped than
MDs to deal with lifestyle
and stress related problems.

Alternative med. is a bit
of a fad.

Don't believe in alternative
medicine.

Place more value on philosophies
and practices of alternative
med. than conventional med.

The survey asked the participants to rate whom they considered alternative medicine practitioners (Table V). The majority of those surveyed considered chiropractic as no longer alternative, but mainstream.

 

Table V PERCEPTIONS AS TO WHAT CONSTITUTES ALTERNATIVE MEDICINE

AGE
 18-24 25-44 45-65 Base: TOTAL Years Years Years MALE FEMALE Total respondents (406) (77) (210) (119) (200) (205) % % % % % % Homeopath 81 82 79 85 81 82 Herbalist 81 81 80 81 81 80 Iridologist 79 77 78 82 76 82 Naturopath 72 71 67 82 75 69 Acupuncturist 68 68 67 71 70 66 Osteopath 58 64 52 66 57 60 Chiropractor 32 24 25 50 35 30 NONE 4 4 5 3 5 3 
The incidence of usage of the various health care practitioners can be seen in Table VI.

 

Table VI INCIDENCE OF EVER USAGE OF ALTERNATIVE HEALTH CARE

AGE
 18-24 25-44 45-65 Base: TOTAL Years Years Years MALE FEMALE Total respondents (406) (77) (210) (119) (200) (205) % % % % % % Physiotherapist 41 27 43 45 46 37 Chiropractor 36 25 38 40 37 35 Naturopath 20 18 22 17 16 24 Acupuncturist 17 5 20 22 16 20 Homeopath 10 1 13 10 10 11 Osteopath 8 4 9 8 8 8 Herbalist 7 1 9 8 5 9 Have been to at 52 52 64 64 62 61 least one. Have not been 38 48 36 36 38 39 to any. Average no. 1.40 .82 1.54 1.51 1.36 1.43 ever visited (pop'n). Average no. 2.26 1.34 2.40 2.37 2.18 2.35 ever visited (users). 
Many of those survey were motivated to visit a chiropractor because nothing their doctor was doing was helping.

 

Table VII MOTIVATIONS FOR VISITING A CHIROPRACTOR

AGE
 18-24 25-44 45-65 Base: TOTAL Years Years Years MALE FEMALE Those who ever used. (147) (19) (80) (48) (74) (72) % % % % % % Nothing Dr. recommended 39 32 36 46 36 40 helped/nothing to lose Felt had to be a 32 37 33 29 24 40 better way than drugs/ surgery Not satisfied with 16 16 14 19 18 14 treatment Dr. recommended Agree with philosophies 13 5 18 8 12 14 of altern. med. Recommended by Dr. 11 21 10 8 12 10 Table VIII OVERALL RATING OF THE IMAGE AND REPUTATION OF CHIROPRACTORS 
AGE
 18-24 25-44 45-65 Base: TOTAL Years Years Years MALE FEMALE Total respondents (406) (77) (210) (119) (200) (205) % % % % % % Very good 12 12 12 11 11 13 Good 33 38 30 33 32 33 TOTAL POSITIVE 45 50 42 44 43 46 Fair 15 21 14 13 18 13 Poor 3 3 4 2 3 4 Very poor 4 1 4 5 4 4 TOTAL NEGATIVE 7 4 8 7 7 8 DON'T KNOW 34 26 35 36 34 34 Table IX RATING OF CHIROPRACTORS BY CHIROPRACTIC PATIENTS 
AGE
 18-24 25-44 45-65 Base: User TOTAL Years Years Years MALE FEMALE (146) (19) (80) (48) (74) (72) % % % % % % Very good 18 16 16 21 16 19 Good 48 63 46 46 42 54 TOTAL POSITIVE 66 79 62 67 58 73 Fair 16 21 15 17 22 11 Poor 2 - 3 2 3 1 Very poor 7 - 8 8 8 6 TOTAL NEGATIVE 9 - 11 10 11 7 DON'T KNOW 9 - 13 6 9 8 
Chiropractic is perceived less as an alternative medicine but more mainstream in this study. This perception in Australia will only continue to get better and with the recent advertising campaign in Western Australia, Victoria, and now New South Wales, the message of chiropractic is getting to a wider audience.

George Dragasevich, B.Sc., DC
Orazio Trevisan, B.Sc., DC
Dee Why, New South Wales
Australia

November 1995
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