A longitudinal analysis of the chiropractic profession from 1996 to 2007

Abstract

Aim: To explore the relative attractiveness of chiropractic in Ontario, Canada from 1996-2007. Methods: We conducted a longitudinal cohort study using administrative registration data from 1996-2007. Stickiness and Inflow concepts acted as proxy measures for relative attractiveness. Survival analysis was employed to identify practitioner groups more likely to leave practice. Results: Chiropractors grew from 1,955 to 4,185 from 1996-2007 in Ontario. Increases occurred in the proportions of female, and foreign-trained chiropractors. Stickiness indicators averaged changes of 0.29/year from 1997-2003, but from 2004-2007 the average was 8 times greater, at 2.42 points/year. Survival analysis showed that certain groups, like newer practitioners were at greater risk of leaving practice (HRR 1.33, p<0.05; CI 1.04-1.73). However, time-varying analysis showed a post-delisting, increase in profession-wide likelihood of leaving. Conclusion: The chiropractic profession became less attractive in synchrony with government policy decisions. Following delisting in 2004, the likelihood of leaving practice increased for most chiropractors.