Chiropractic in The Netherlands: a survey of Dutch chiropractors.
BACKGROUND
In the Netherlands, there is increasing public and political interest in chiropractic treatment. There is, however, very little descriptive information available in the Netherlands on the chiropractic profession. Therefore, a survey was conducted among all Dutch chiropractors.


METHODS
A questionnaire was sent to all members of the Netherlands' Chiropractors Association (n = 59). It contained questions on (postgraduate) education, practice management, diagnostics (including radiology use), treatment, interprofessional cooperation and referral.


RESULTS
The response was 88%. Chiropractic is growing rapidly: the number of chiropractors has doubled in five years. Chiropractors primarily treat back and neck pain, with an average of 8 treatments. Conventional orthopedic and neurological examination along with motion palpation are the cornerstones of physical examination. The respondents stressed the importance of direct access to radiography and specialized (hospital) diagnostics. Fifty-eight percent of the chiropractors have their own X-ray equipment. The most frequent reason for taking new X-rays was the absence of cooperation with radiology departments. Self-referral is the largest source of patients. The referral rate to other health care professionals is low.


CONCLUSIONS
The number of chiropractors is growing rapidly. They have an exceptional position in the Dutch health care system. Access to X-ray and more specialized diagnostics are presently the most important political issues.
Assendelft
W J
WJ
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Pfeifle
C E
CE
Bouter
L M
LM
D002684:Chiropractic / Q000193:education / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D009426:Netherlands; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires