Whether or not chiropractors are considered primary healthcare professionals is considered by some as central to the identity of the profession, yet little research exists on the primarv care activities of chiropractors in the UK. This study aimed to address professional issues through obtaining the opinions of chiropractors on the role of the chiropractic profession in healthcare within the UK, and the perceived ability of chiropractors to fulfil this role.

This study focuses on a range of unexpected outcomes experienced by a sample population of patients following chiropractic treatment. In particular, it considers how those who experience such outcomes make sense of, and attach meaning to, them. To provide a suitable context for this research, attention is also given to chiropractic as a profession. The origins and evolution of chiropractic are therefore described and its internal struggle for professional legitimacy within the mainstream medical model is discussed. In addition, as a preliminary stage of research, views emanating from a focus group of practicing chiropractors from the United States and Canada, regarding unexpected outcomes of treatment, are reported. However, thus enquiry is chiefly concerned with the accounts provided by patients who reported having personally experienced outcomes they believed to be the unexpected results of chiropractic treatment. Through paying close attention to the personal stories presented by a sample population of such patients throughout a series of interviews, this thesis explores how they attempted to make sense of, and assign meaning to, the unexpected outcomes they described. Data gathered during these interviews is analysed using Interpretative Phenomenological Analysis as a means of discovering emergent themes. These are then considered within the context of contemporary models of health in order to develop understanding of how people struggle to find meaning in health care interventions through creating narratives in order to orient their experiences of these within the greater context of their life experience. In particular, therefore, this work considers the value of unexpected occurrences following chiropractic treatment in relation to those who directly experience them. However, alongside this, it explores the potential for such unexpected outcomes to facilitate better understanding of how people make sense of, and assign meaning to, health care experiences in general. It concludes that unexpected experiences such as those discussed here not only have the potential to offer insights into the chiropractic field, but may also have implications within the field of healthcare in general. This thesis indicates that careful listening is required by healthcare professionals in order for the full potential benefit of the practitioner/patient relationship to emerge. In essence, honouring the totality of human experience through listening to patients' stories allows the healthcare encounter to function as an agent of change beyond the isolated effects of a particular intervention

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In June 2001 the title ‘chiropractor’ came to be protected under British law and those who called themselves chiropractors attained a position of increased legitimacy within British society. Yet the details of chiropractic’s journey to statutory recognition have not been thoroughly explored in contemporary literature. The origins and development of chiropractic in Britain have received meagre attention from historical scholars. This thesis uses a neo-Weberian approach to explore the history of chiropractic in Britain through the lens of ‘professionalisation’. It investigates the emergence of chiropractic in Britain, and details how and why chiropractic developed in the way that it did, assessing the significance of processes and events in respect to chiropractic’s professionalisation, and examining intra- and inter-occupational tensions. The thesis is primarily a product of documentary research, but is also informed by interviews undertaken to provide oral testimonies. Although the origins of chiropractic are usually traced back to the 1890s, to Davenport, Iowa, and to the practice of Daniel David Palmer, it is argued in this thesis that it is misleading to claim that chiropractic was ‘discovered’ by Daniel Palmer, or that chiropractic in Britain was entirely an ‘import’ from the United States. Instead, chiropractic’s origins were complex and multifarious and form part of a broader history of manipulative practices. With regard to the development of chiropractic in Britain, chiropractic’s history is intertwined with that of osteopathy, and has involved medicalisation. This study demonstrates that through the course of its evolution chiropractic was subject to processes that can usefully be described in terms of professionalisation, sharing features in common with the professionalisation of other occupational groups described in historical and sociological literature. Even so, chiropractors did not attain the social presence or cultural authority of archetypal professionals such as medical doctors or lawyers. Although protection of title was achieved, many problems have remained, including divisions within the occupation.