Association Between Chiropractic and Allopathic Classroom Hours of Nutrition and Physical Activity with Lifestyle Modification Counseling Practice Patterns for Patients with Hypertension and Cardiovascular Disease in the US Between 1994 and 2014

Objective: The Association of American Medical Colleges’ Center of workforce studies indicated a shortage of 45,000 primary care physicians in the next decade with the expectation of one-third of all physicians retiring, which is a public health concern. The purpose of this study is to simply compare the classroom hours of nutrition and physical activity between chiropractors and allopathic doctors in relation to lifestyle modification counseling for patients with hypertension and cardiovascular disease.

Methods: A search of the available database to track down practice patterns for both chiropractors and allopathic physicians was performed using the key words: nutrition, diet, maintenance, counseling, chiropractor, physician, hypertension and cardiovascular. Only studies between 1994 and 2014 were included. Classroom hours of nutrition and active care were calculated by performing a search of the chiropractic school catalogs. Postgraduate hours were not accounted for in this study. For allopathic training, data from three published studies were used.

Results: Chiropractors receive over five times the amount of hours in nutrition and physical activity compared to allopathic doctors. 58% of chiropractors provided nutritional counseling, 56% provided cardiovascular exercise counseling as maintenance care compared to allopathic doctors who counseled 33%.

Conclusion: A positive correlation between practice patterns and hours of training was observed. Since this is an observational study, causal inference is not claimed. Given the increased demand for primary care providers, chiropractors can play a role in the co-management of stage 1 hypertension.  Other studies with other cohort groups are indicated to confirm these findings.