MOTIVATIONS, TRAINING OUTCOMES, AND CLINICAL PRACTICE CHARACTERISTICS OF NORTH AMERICAN CHIROPRACTORS: A
Gannon Brochin1, Marc T Edwards1,2
1Department of Physical Medicine and Rehabilitation, The University of North Carolina at Chapel Hill, Chapel Hill, NC.
Objective:
To describe chiropractors' motivations for training, perceived training outcomes, and current practice characteristics in a North American respondent sample, and to explore associations with practice orientation and selected clinical behaviors.
Methods:
Cross-sectional, web-based survey of licensed and retired chiropractors in the U.S. and Canada recruited via professional organizations. The instrument included 7-point end-anchored items on motivations, training outcomes, and practice characteristics. Practice orientation subgroups were defined a priori based on subluxation definitions ("Do not use," "Biomechanical/modern," "Vitalistic"). Nonparametric analyses included Kruskal-Wallis with Dwass-Steel-Critchlow-Flinger (DSCF) pairwise post hoc testing, Spearman's ρ, and Wilcoxon signed-rank tests.
Results:
Of 330 responses, 303 completed at least one outcome block and were included in analysis. Motivations were predominantly prosocial and meaning-oriented with low endorsement of status or extrinsic motives. Training outcomes were strongest for clinical reasoning, communication, and lifestyle counseling. Practice characteristics included high autonomy, adequate visit time, and reliance on history and physical examination over routine testing. Practice orientation tracked behavior: higher manipulation frequency among "Vitalistic" respondents and lower new-patient x-ray use among "Do not use" and "Biomechanical" respondents (ρ=0.25 and -0.31, respectively; both p<0.001), with lower education satisfaction among more biomedically aligned respondents (ρ=-0.27, p<0.001). Current health did not differ from pre-training health (p=0.84) but was associated with current stress levels (p<0.001).
Conclusion:
Our chiropractor sample's purpose-driven motivation profile aligns with reported strengths in reasoning, counseling, and communication within time-rich, autonomous practice settings. Pairing meaning-centered recruitment and curricula with rigorous evidence-based practice and communication training provides actionable inputs for recruitment messaging, curricular emphasis, professional development, and imaging stewardship initiatives. Findings are limited by nonprobability sampling, self-report, and cross-sectional design. Probability and longitudinal studies are warranted.
