• Smith M
• Carber LA

• Chiropractors
• Delivery of Health Care
• Health Occupations
• Subluxation
• Terminology as Topic

Objectives: This paper provides new information that describes chiropractors’ professional identity relative to their concept of subluxation in chiropractic practice and education.

Methods: We performed a pragmatic, descriptive, cross-sectional survey of state-board licensed chiropractors in the US during 2002-03 to assess their attitudes and behaviors about their use of “subluxation” in practice. We did not define nor specifically operationalize, a priori, the term “subluxation”, but instead allowed each individual doctor of chiropractic to self-define the concept “subluxation” in their survey responses.

Results: Of all US state-board licensed DCs (N=67,217), 5,931 were surveyed. Nearly 50% of those surveyed responded. Many surveyed chiropractors generally agreed that their chiropractic education and clinical approach is “subluxation-centered”, that the concept of “subluxation” is important to their clinical care decisions, and that they use the term “subluxation” when communicating with patients, other healthcare providers, and third-party payors.

Discussion/Conclusion: Based upon those surveyed, chiropractors seem to embrace “subluxation-based” terms as well as other clinical approaches to describing their care for chiropractic patients. Understanding the complex nature of chiropractic approaches to health care provision may carry implications for current initiatives to advance evidence-based chiropractic practice and clinical training, enhance successful and comprehensive biopsychosocial management of the multicausal and complex health concerns of chiropractic patients, and improve overall delivery of optimal integrative health care. Further inquiry on this topic should focus methodological and conceptual attention to differentiating how contemporary chiropractors self-define and clinically apply the concept of subluxation.

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