Self-reported recognition of undiagnosed life threatening conditions in chiropractic practice: a random survey

The study design was a postal, cross-sectional, epidemiological self-administered survey. Two thousand Doctors of Chiropractic in the US were randomly selected from a list of 57878. The survey asked respondents to state the number of cases from the list where they were the first physician to recognize the condition over the course of their practice careers. Space was provided for unlisted conditions.The response rate was 29.9%. Respondents represented 11442？years in practice and included 3861 patients with a reported undiagnosed LTC. The most commonly presenting conditions were in rank order: carcinoma, abdominal aneurysm, deep vein thrombosis, stroke, myocardial infarction, subdural hematoma and a large group of other diagnoses. The occurrence of a previously undiagnosed LTC can be expected to present to the chiropractic physician every 2.5？years based on the responding doctors reports.Based on this survey chiropractic physicians report encountering undiagnosed LTC’s in the normal course of practice. The findings of this study are of importance to the chiropractic profession and chiropractic education. Increased awareness and emphasis on recognition of LTC is a critical part of the education process and practice life.There are several different definitions of what constitutes a primary care physician [1,2]. Most of these definitions incorporate the concept of “assumption of longitudinal responsibility for the patient regardless of the presence or absence of disease” [3]. Based on this definition a physician, at a minimum, has the moral and legal responsibility to be able to identify and refer, when necessary, conditions which if left unrecognized and untreated may result in serious and even deadly consequences to the patient.There is an ongoing controversy within the healthcare community regarding role of the chiropractic physician as well as debates on this issue within the chiropractic profession itself. There are three basic positions argued; primary care, neuro