tisdag 5 november 2013

An interesting document:  http://www.wfc.org/website/images/wfc/WHO_Submission-Final_Jan2013.pdf

Important quotes from the documment:

"Today, approximately 120 years later, there are chiropractic educational institutions in many countries and chiropractors practicing in over 100 countries in all world regions. Ninety of these countries have national associations of chiropractors that are members of a World Federation of Chiropractic (WFC) which has been a non- governmental organization in official relations with the World Health Organization (WHO) since 1997."

"The largest numbers of chiropractors are found in the United States of America (75,000), Canada (7,250), Australia (4,250), and the United Kingdom (3,000), which were the first countries to establish chiropractic schools. Other countries with more than 250 chiropractors are Brazil (700), Denmark (550), France (450), Italy (400), Japan (400), the Netherlands (400), New Zealand (400), Norway (600), South Africa (400), Spain (300), Sweden (400), and Switzerland (275)."

"There is legislation to recognize and regulate the profession in 48 countries, usually on a national basis but sometimes by state or region within the country (e.g. Canada, Switzerland, and USA). Different approaches to legislation include a separate chiropractic act (e.g. Cyprus, Denmark, Hong Kong SAR China, Israel, most Canadian provinces and USA states), a chiropractic act under an umbrella law for various mainstream health care disciplines (e.g. Cayman Islands, Iran, Switzerland, some Canadian provinces and USA states), and a chiropractic act
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under an umbrella law for complementary and alternative health care disciplines (e.g. Belgium, France, the Philippines, and South Africa)."

"Common international standards of education have been achieved through a network of international accrediting agencies that began with the US Council on Chiropractic Education (CCE), recognized by the US Office of Education since 1974. These standards have been adopted by WHO in its Guidelines on Basic Training and Safety in Chiropractic (2005)."

"Entrance requirements vary according to country, but are a minimum of three years university credits in qualifying subjects in North America. The chiropractic college undergraduate program has a minimum of 4 full-time academic years and is followed by mandatory postgraduate clinical training and/or licensing exams in many countries. Table 2 summarizes the subjects taught in a typical chiropractic undergraduate education program."

"Whereas most chiropractic schools in the USA are in private colleges, most of the newer schools internationally are within the national university system (e.g. Australia, Brazil, Canada, Chile, Denmark, Japan, South Korea, Malaysia, Mexico, South Africa, Spain, Switzerland, and the UK). In some of these programs, for example, at the University of Southern Denmark in Odense and the University of Zurich in Switzerland, chiropractic and medical students take the same basic science courses together for three years before entering separate programs for clinical training."

"For a number of reasons, which include the popularity of chiropractic health care with patients and much new research on safety and cost-effectiveness, the past generation has seen significant international growth of the profession and chiropractic education."

"D. Practice and ResearchChiropractic practice emphasizes the conservative management of disorders of the neuromusculoskeletal system without the use of medicines and surgery. Management includes joint and soft-tissue manual treatments, rehabilitation exercises, patient education and lifestyle modification, and the use of physical therapy modalities and orthotics and other supports."

"Spinal manipulation is also recommended in recent practice guidelines from the American College of Physicians and American Pain Society.6
Recent randomized controlled trials in Canada7 and the UK8 have reported that chiropractic management in accordance with the above guidelines, and the addition of spinal manipulation to medical care, are more effective and cost-effective than usual medical care."

"Neck Pain and Headache. There are now similar studies and evidence-based guidelines supporting the safety and effectiveness of chiropractic management of patients with neck pain and cervicogenic headache."

"A recent large trial funded by the US National Institutes of Health reports that each of chiropractic management and a regime of exercises are more effective than usual medical care for patients with acute and sub-acute neck pain.11"

"Cost Effectiveness. Cost effectiveness and patient satisfaction are areas of growing research and importance to government and private health care plans because of rapidly increasing costs and limited resources for health care. Comprehensive new studies in North America report the cost effectiveness of chiropractic services compared with medical services with respect to LBP and neck pain16 and all neuromusculoskeletal (NMS) disorders.17-19"

"In a 2004 study of four years’ data from a large California HMO published in the American Medical Association’s Archives of Internal Medicine, the 700,000 plan
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members with chiropractic and medical benefits had lower overall costs per person than the 1 million plan members with identical medical benefits – but medical benefits only."

"Chiropractors are found in multidisciplinary spine care clinics, for example, in the Middle East (e.g. Saudi Arabia and the United Arab Emirates) and Latin America (e.g. Brazil and Chile). In Denmark chiropractors are fully integrated into spine care hospital departments and their services there and in primary care are viewed by the government and health authorities as mainstream.20"

"Development of Research Capacity and Output. Although the profession’s research capacity remains modest compared with the medical and allied professions, the past 10 years have seen greatly increased research capacity as a result of more graduates with post-graduate degrees and university appointments, and first significant public funding for research particularly in Europe and North America. This has resulted in the publication of good-quality clinical research that has provided a much stronger evidence-base supporting chiropractic health care."

"Acceptance, Collaboration and Integration. Historically the profession has grown because of public support, often in the face of opposition or exclusion from national health systems. The past decade has seen the first significant level of collaboration between the chiropractic and medical professions in research, development of clinical guidelines, and practice based upon an increasingly common approach to the prevention and treatment of non-specific spinal pain and disability. This new level of mutual cooperation, both in informal collaboration and formal integration of practices, is seen not only in countries where the profession is long-established but also where it is relatively new."

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