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Open Access Highly Accessed Research article

Differentiating intraprofessional attitudes toward paradigms in health care delivery among chiropractic factions: results from a randomly sampled survey

Marion McGregor1*, Aaron A Puhl2, Christine Reinhart2, H Stephen Injeyan1 and David Soave1

Author Affiliations

1 Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3 J1, Canada

2 Private Practice, Able Body Health Clinic, 1212 3rd Avenue South, Lethbridge, Alberta, T1J 0 J9, Canada

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BMC Complementary and Alternative Medicine 2014, 14:51  doi:10.1186/1472-6882-14-51

Published: 10 February 2014



As health care has increased in complexity and health care teams have been offered as a solution, so too is there an increased need for stronger interprofessional collaboration. However the intraprofessional factions that exist within every profession challenge interprofessional communication through contrary paradigms. As a contender in the conservative spinal health care market, factions within chiropractic that result in unorthodox practice behaviours may compromise interprofessional relations and that profession’s progress toward institutionalization. The purpose of this investigation was to quantify the professional stratification among Canadian chiropractic practitioners and evaluate the practice perceptions of those factions.


A stratified random sample of 740 Canadian chiropractors was surveyed to determine faction membership and how professional stratification could be related to views that could be considered unorthodox to current evidence-based care and guidelines. Stratification in practice behaviours is a stated concern of mainstream medicine when considering interprofessional referrals.


Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. Less than 20% of chiropractors (18.8%) were aligned with a predefined unorthodox perspective of the conditions they treat. Prediction models suggest that unorthodox perceptions of health practice related to treatment choices, x-ray use and vaccinations were strongly associated with unorthodox group membership (X2 =13.4, p = 0.0002).


Chiropractors holding unorthodox views may be identified based on response to specific beliefs that appear to align with unorthodox health practices. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms. Understanding the profession’s factions is important to the anticipation of care delivery when considering interprofessional referral.

Chiropractic; Factions; Interprofessional relations; Health care teams; Attitude of health personnel