Retention and attrition of chiropractors in Australia: the Workforce Retention and Attrition Project
Timothy Lathlean

A
B
Abstract
This study aims to understand workforce retention and attrition of chiropractors in Australia.
An online survey of chiropractors in 2024 and a retrospective analysis of 10 years of Australian Health Practitioner Regulation Agency (Ahpra) registration data were undertaken.
Of 1513 surveyed chiropractors, 80.0% intended to continue in the profession, 6.6% intended to leave (excluding retirement), 6.7% were unsure, and the remainder were retired. Seventy percent of those intending to leave planned to do so within 1 year. Top reasons included unsatisfactory remuneration (35.4%), lack of recognition/feeling undervalued (31.3%), work no longer professionally satisfying (31.3%), work no longer fulfilling/meaningful (29.2%), and retirement (29.2%). Those with limited registration status, working outside 20 to 49 h per week, and on casual or temporary contracts are also more likely to not renew or be unsure. Australian Health Practitioner Regulation Agency (Ahpra) data (2014–2023) showed a 12.2% increase in registered chiropractors per 100,000 of the Australian population and a 15.8% rise in replacement rate (with fluctuations).
The overall number of chiropractors has increased from 2014 to 2023, and the replacement rate increased from 2015 to 2023. This highlights growth in the profession despite some issues in workforce stability, particularly among those with limited registration, non-standard work hours per week, and casual/temporary contract status. Addressing intrinsic and workplace factors such as remuneration, workplace recognition, and job satisfaction may improve retention.
Keywords: Australia, chiropractic, chiropractors, health profession, health regulation, health workforce, regulated health workforce, retention.
References
1 Leach MJ. Profile of the complementary and alternative medicine workforce across Australia, New Zealand, Canada, United States and United Kingdom. Complement Ther Med 2013; 21(4): 364-78.
| Crossref | Google Scholar | PubMed |
2 Xue CC, Zhang AL, Lin V, Myers R, Polus B, Story DF. Acupuncture, chiropractic and osteopathy use in Australia: a national population survey. BMC Public Health 2008; 8: 105.
| Crossref | Google Scholar | PubMed |
3 Brown BT, Bonello R, Fernandez-Caamano R, Eaton S, Graham PL, Green H. Consumer characteristics and perceptions of chiropractic and chiropractic services in Australia: results from a cross-sectional survey. J Manipulative Physiol Ther 2014; 37(4): 219-29.
| Crossref | Google Scholar | PubMed |
4 Stochkendahl MJ, Rezai M, Torres P, Sutton D, Tuchin P, Brown R, Côté P. The chiropractic workforce: a global review. Chiropr Man Therap 2019; 27(1): 36.
| Crossref | Google Scholar | PubMed |
5 Chiropractic Board of Australia. Chiropractic workforce: snapshot as at 30 June 2023. 2023. Available at https://www.ahpra.gov.au/About-Ahpra/What-We-Do/Data-access-and-research/Health-profession-demographic-snapshot-reports.aspx
6 Chiropractic Board of Australia. Registrant statistics. 2024. Available at https://www.chiropracticboard.gov.au/About-the-Board/Statistics.aspx
7 World Health Organization. Health workforce and labor market dynamics in OECD high-income countries: a synthesis of recent analyses and simulations of future supply and requirements. 2024. Available at https://apps.who.int/iris/handle/10665/259361
8 McPake B, Mahal A. Addressing the Needs of an Aging Population in the Health System: The Australian Case. Health Syst Reform 2017; 3(3): 236-47.
| Crossref | Google Scholar |
9 Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014; 73(7): 1323-30.
| Crossref | Google Scholar |
10 Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014; 73(6): 968-74.
| Crossref | Google Scholar |
11 World Health Organization. Health workforce. 2024. Available at https://www.who.int/health-topics/health-workforce#tab=tab_1
12 Australian Institute of Health and Welfare. Australia’s health 2024: in brief. 2024. Available at https://www.aihw.gov.au/reports/australias-health/australias-health-2024-in-brief/summary
13 Australian Health Practitioner Agency (Ahpra). Chiropractors - a snapshot as at 30 June 2023. 2024. Available at https://www.ahpra.gov.au/documents/default.aspx?record=WD24/33619&dbid=AP&chksum=XK8pOCQaIuXnitI1zEydHQ%3d%3d
14 Castro Lopes S, Guerra-Arias M, Buchan J, Pozo-Martin F, Nove A. A rapid review of the rate of attrition from the health workforce. Hum Resour Health 2017; 15(1): 21.
| Crossref | Google Scholar | PubMed |
15 Foreman SM, Stahl MJ. The attrition rate of licensed chiropractors in California: an exploratory ecological investigation of time-trend data. Chiropr Osteopat 2010; 18: 24.
| Crossref | Google Scholar | PubMed |
16 Mirtz TA, Hebert JJ, Wyatt LH. Attitudes of non-practicing chiropractors: a pilot survey concerning factors related to attrition. Chiropr Osteopat 2010; 18: 29.
| Crossref | Google Scholar | PubMed |
17 Cosgrave C, Malatzky C, Gillespie J. Social Determinants of Rural Health Workforce Retention: A Scoping Review. Int J Environ Res Public Health 2019; 16(3): 314.
| Crossref | Google Scholar | PubMed |
18 Darbyshire D, Brewster L, Isba R, Body R, Basit U, Goodwin D. Retention of doctors in emergency medicine: a scoping review of the academic literature. Emerg Med J 2021; 38(9): 663-72.
| Crossref | Google Scholar | PubMed |
19 Hallett E, Simeon E, Amba V, Howington D, McConnell KJ, Zhu JM. Factors Influencing Turnover and Attrition in the Public Behavioral Health System Workforce: Qualitative Study. Psychiatr Serv 2024; 75(1): 55-63.
| Crossref | Google Scholar | PubMed |
20 Russell DJ, McGrail MR, Humphreys JS. Determinants of rural Australian primary health care worker retention: A synthesis of key evidence and implications for policymaking. Aust J Rural Health 2017; 25(1): 5-14.
| Crossref | Google Scholar | PubMed |
21 Rigney CT, Grace S, Bradbury J. Chiropractic Profession Attrition: A Narrative Review of Studies Over the Past 30 Years. J Chiropr Humanit 2023; 30: 9-15.
| Crossref | Google Scholar | PubMed |
22 Tan J, Divakar R, Barclay L, Bayyavarapu Bapuji S, Anderson S, Saar E. Trends in retention and attrition in nine regulated health professions in Australia. Aust Health Rev 2025; 49(2): AH24268.
| Crossref | Google Scholar | PubMed |
23 Qualtrics XM. Survey software. 2024. Available at https://www.qualtrics.com/en-au/strategy/research/survey-software/
24 Australian Government Department of Health and Aged Care. Modified Monash Model. 2024. Available at https://www.health.gov.au/topics/rural-health-workforce/classifications/mmm. [cited 17 May 2024].
25 Paynter S, Iles R, Hodgson WC, Hay M. Career intentions and satisfaction influences in early career Australian physiotherapists. Physiother Theory Pract 2024; 40(9): 2065-82.
| Crossref | Google Scholar | PubMed |
26 Bacopanos E, Edgar S. Identifying the factors that affect the job satisfaction of early career Notre Dame graduate physiotherapists. Aust Health Rev 2016; 40(5): 538-43.
| Crossref | Google Scholar | PubMed |