The Chiropractic Profession in Norway

SOURCE: Chiropractic & Manual Therapies 2014 (Dec 8) 22 44

Ole C Kvammen and Charlotte Leboeuf-Yde

Private practice,
Fokus Helse og Trening,
Aagaards pl. 5,
Sandefjord 3211, Norway

Background The chiropractic profession in Norway has increased five-fold in the last two decades. As there is no academic graduate program in Norway, all chiropractors have been trained outside of Norway, in either Europe, America or Australia. This might have given Norwegian chiropractors heterogenic characteristics concerning practice routines and clinical settings. However, little is known about what characterizes this profession and how it compares to other chiropractic professions in Europe. The aim of this survey was to describe major characteristics of the chiropractic profession in Norway.

Method Two surveys were distributed to all 530 registered chiropractors in Norway in 2011. One survey was for all chiropractors (Survey 1) and the other for clinic owners (Survey 2). Results have been reported as tables and as approximate percentages in the text for ease of reading.

Result Response rates were 61% (Survey 1, N = 320) and 71% (Survey 2, N = 217). More than two-thirds of the chiropractors in Norway had been in practice for under a decade. Only one in four chiropractors worked in solo practice and the majority shared premises with at least one colleague, typically at least one physiotherapist and one additional health practitioner. Today, only one in five clinics possessed radiologic equipment and one in ten had access to diagnostic ultrasound equipment. The majority of the chiropractors reported to apply mainly similar treatment modalities. More than 90% reported to use manipulation techniques on most patients, with soft tissue techniques and exercise modalities being almost as common. More than 3/4 of the profession reported that their clinical practice was in accordance with available clinical guidelines and about one third were positive about participating in future clinical research.

Conclusion The Norwegian chiropractic profession is relatively young and members report being satisfied with their work conditions. There is a clear difference from the earlier practice pattern in that intra- and inter-professional collaboration is more common and it is considered desirable. The profession seems to follow the modern trends in evidence-based practice by using X-rays more sparingly than previously, adhering to guidelines and being positive about research.

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Introduction

Chiropractors all over the world practise under different legislations and circumstances. In Norway, the first chiropractor started his practice in 1922 [1] and the Norwegian Chiropractors’ Association was established in 1935, consisting of 20 individuals [2]. At the time, chiropractors practised under the so-called quackery law.

Legislation for chiropractors in Norway was introduced in 1989 [3]. Between 1974 and 2006, partial reimbursement was possible only if the patient had been referred by a medical practitioner. Since 2006, however, the profession has been authorized to practise as primary contact practitioners and their patients qualify for partial reimbursement from the national health care system [4]. With the new authorization, chiropractors are able to provide sick-leave and they can refer patients directly to radiological procedures or to other medical specialists for further assessment.

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