Dissertation submitted in partial compliance with the requirements for a Master’s Degree in Technology: Homeopathy, Durban University of Technology, 2007. / The aim of this study was to assess the perceptions of registered chiropractors towards homeopathy in South Africa. The aim was to establish the knowledge and perceptions of homeopathy and to facilitate greater understanding, co-operation and communication between chiropractors and homeopaths. A questionnaire as a measuring tool was used to carry out this study. The questionnaire was modified from Langworthy and Smink (2000), Maharajh (2005) and Tatalias (2006). A questionnaire was mailed to all chiropractors registered with the Allied Health Professions Council of South Africa currently practising in South Africa. The data for this study was derived from 170 (45%) questionnaires. The data obtained was analysed using the SPSS® for Windows™ and Excel® XP™ statistical package. Descriptive statistics using frequency tables and bar charts were used to study the data. Correlation analysis was performed using Pearson’s Chi Square Test, Phi coefficient, Kendall Tau coefficient and Cramer’s V coefficient to determine whether there was any significant association between the factors collected in the responses. Dendrograms were used to analyse questions that had more than one response. On analysing the results it was found that the majority of respondents were white (89.4%). The majority of respondents were between the ages of 25 and 35 and had been practicing for less than 5 years. The majority of chiropractors had a high level of knowledge of the status of homeopathic education in South Africa. 95.3% perceived that homeopathy is legally recognised in South Africa, 91% perceived that homeopathy has a scientific basis and 98% perceived that it is a legitimate form of medicine. The majority of respondents (87.1%) had consulted with a homeopath before and 12.9% of respondents had not. The majority of respondents perceived that homeopathy is suitable for use in conjunction with chiropractic treatment (95.3%). Communication and co-operation between homeopaths and chiropractors was considered to be moderate to good (68.2%). The majority of chiropractors had referred patients to homeopaths and most homeopaths had made referrals to chiropractors. Most chiropractors gave feedback on referred patients to a homeopath and said that they would like feedback on a referred patient. It can be concluded from the study that chiropractors perceive that homeopathy has a role to play in the health care system of South Africa.

Dissertation submitted in partial compliance with the requirements for a Master’s Degree in Technology: Homeopathy, Durban University of Technology, 2007. / The aim of this study was to assess the perceptions of registered chiropractors towards homeopathy in South Africa. The aim was to establish the knowledge and perceptions of homeopathy and to facilitate greater understanding, co-operation and communication between chiropractors and homeopaths. A questionnaire as a measuring tool was used to carry out this study. The questionnaire was modified from Langworthy and Smink (2000), Maharajh (2005) and Tatalias (2006). A questionnaire was mailed to all chiropractors registered with the Allied Health Professions Council of South Africa currently practising in South Africa. The data for this study was derived from 170 (45%) questionnaires. The data obtained was analysed using the SPSS® for Windows™ and Excel® XP™ statistical package. Descriptive statistics using frequency tables and bar charts were used to study the data. Correlation analysis was performed using Pearson’s Chi Square Test, Phi coefficient, Kendall Tau coefficient and Cramer’s V coefficient to determine whether there was any significant association between the factors collected in the responses. Dendrograms were used to analyse questions that had more than one response. On analysing the results it was found that the majority of respondents were white (89.4%). The majority of respondents were between the ages of 25 and 35 and had been practicing for less than 5 years. The majority of chiropractors had a high level of knowledge of the status of homeopathic education in South Africa. 95.3% perceived that homeopathy is legally recognised in South Africa, 91% perceived that homeopathy has a scientific basis and 98% perceived that it is a legitimate form of medicine. The majority of respondents (87.1%) had consulted with a homeopath before and 12.9% of respondents had not. The majority of respondents perceived that homeopathy is suitable for use in conjunction with chiropractic treatment (95.3%). Communication and co-operation between homeopaths and chiropractors was considered to be moderate to good (68.2%). The majority of chiropractors had referred patients to homeopaths and most homeopaths had made referrals to chiropractors. Most chiropractors gave feedback on referred patients to a homeopath and said that they would like feedback on a referred patient. It can be concluded from the study that chiropractors perceive that homeopathy has a role to play in the health care system of South Africa. / M

A dissertation presented to the Faculty of Health, Durban University of Technology, for the Masters Degree in Technology: Chiropractic, 2009. / Background: The International Classification of Diseases (ICD) provides codes to classify diseases in such a manner, that every health condition is assigned to a unique category. Some of the most common diagnoses made by chiropractors are not included in the ICD-10 coding system, as it is mainly medically orientated and does not accommodate these diagnoses. This can potentially lead to reimbursement problems for chiropractors in future and create confusion for medical aid schemes as to what conditions chiropractors actually diagnose and treat. Aim: To determine the level of compliancy of chiropractors, in South Africa, to the ICD-10 coding procedure and the factors that may influence the use of correct ICD-10 codes. As well as to determine whether the ICD-10 diagnoses chiropractors commonly submit to the medical aid schemes, reflect the actual diagnoses made in practice. Method: The study was a retrospective survey of a quantitative nature. A self-administered questionnaire was e-mailed and posted to 380 chiropractors, practicing in South Africa. The electronic questionnaires were sent out four times at two week intervals for the duration of eight weeks; and the postal questionnaires sent once. A response rate of 16.5% (n = 63) was achieved. Raw data was received from the divisional manager of the coding unit of Discovery Health (Pty) Ltd. in the form of an excel spreadsheet containing the most common ICD-10 diagnoses made by chiropractors in South Africa, for the period June 2006 to July 2007, who had submitted claims to the Medical Scheme. The spreadsheet also contained depersonalised compliance statistics of chiropractors to the ICD-10 system from July 2006 to October 2008. SPSS version 15 was used for descriptive statistical data analysis (SPSS Inc., Chicago, Ill, USA). Results: The age range of the 63 participants who responded to the questionnaire was 26 to 79 years, with an average of 41 years. The majority of the participants were male (74.6%, n = 47). KwaZulu-Natal had 25 participants (39.6%), Gauteng 17 (26.9%), Western Cape 12 (19%), Eastern Cape four (6.3%), Free State and Mpumalanga two (3.1%) each and North West one (1.5%). The mean knowledge score for ICD-10 coding was 43.5%, suggesting a relatively low level of knowledge. The total percentage of mistakes for electronic claims was higher for both the primary and unlisted claims (3.93% and 2.18%), than for manual claims iv (1.57% and 1.59%). The total percentage of mistakes was low but increased marginally each year for both primary claims (1.43% in 2006; 1.99% in 2007; 2.33% in 2008) and unlisted claims (0% in 2006; 2.61% in 2007; 3.07% in 2008). CASA members were more likely to be aware of assistance offered, in terms of ICD-10 coding through the medical schemes and the association (p = 0.131), than non-members. There was a non-significant trend towards participants who had been on an ICD-10 coding course (47.6%; n = 30), having a greater knowledge of the ICD-10 coding procedures (p = 0.147). Their knowledge was almost 10% higher than those who had not been on a course (52.4%; n = 33). Most participants (38.1%; n = 24) did not use additional cause codes when treating cases of musculoskeletal trauma, nor did they use multiple codes (38.7%; n = 24) when treating more than one condition in the same patient. Nearly 70% of participants (n = 44) used the M99 code in order to code for vertebral subluxation and the majority (79.4%; n = 50) believed the definition of subluxation used in ICD-10 coding to be the same as that which chiropractors use to define subluxation. According to the medical aid data, the top five diagnoses made by chiropractors from 2006 to 2007 were: Low back pain, lumbar region, M54.56 (8996 claims); Cervicalgia, M54.22 (6390 claims); Subluxation complex, cervical region, M99.11 (2895 claims); Other dorsalgia, multiple sites in spine, M54.80 (1524 claims) and Subluxation complex, sacral region, M99.14 (1293 claims). According to the questionnaire data, the top five diagnoses (Table 4.24) were: Lumbar facet syndrome, M54.56 (25%); Lumbar facet syndrome, M99.13 (23.3%); Cervical facet syndrome, M99.11 (21.7%); Cervicogenic headache, G44.2 (20%) and Cervicalgia, M54.22 (20%). Conclusion: The sample of South African chiropractors were fairly compliant to the ICD-10 coding system. Although the two sets of data (i.e. from the medical aid scheme and the questionnaire) regarding the diagnoses that chiropractors make on a daily basis correlate well with each other, there is no consensus in the profession as to which codes to use for chiropractic specific diagnoses. These chiropractic specific diagnoses (e.g. facet syndrome) are however, the most common diagnoses made by chiropractors in private practice. Many respondents indicated that because of this they sometimes use codes that they know will not be rejected, even if it is the incorrect code. For more complicated codes, the majority of respondents indicated that they did not know how to or were not interested in submitting the correct codes to comply with the level of specificity required by the medical aid schemes. The challenge is to make practitioners aware of the advantages of correct coding for the profession.

A dissertation presented to the Faculty of Health, Durban University of Technology, for the Masters Degree in Technology: Chiropractic, 2009. / Background: The International Classification of Diseases (ICD) provides codes to classify diseases in such a manner, that every health condition is assigned to a unique category. Some of the most common diagnoses made by chiropractors are not included in the ICD-10 coding system, as it is mainly medically orientated and does not accommodate these diagnoses. This can potentially lead to reimbursement problems for chiropractors in future and create confusion for medical aid schemes as to what conditions chiropractors actually diagnose and treat. Aim: To determine the level of compliancy of chiropractors, in South Africa, to the ICD-10 coding procedure and the factors that may influence the use of correct ICD-10 codes. As well as to determine whether the ICD-10 diagnoses chiropractors commonly submit to the medical aid schemes, reflect the actual diagnoses made in practice. Method: The study was a retrospective survey of a quantitative nature. A self-administered questionnaire was e-mailed and posted to 380 chiropractors, practicing in South Africa. The electronic questionnaires were sent out four times at two week intervals for the duration of eight weeks; and the postal questionnaires sent once. A response rate of 16.5% (n = 63) was achieved. Raw data was received from the divisional manager of the coding unit of Discovery Health (Pty) Ltd. in the form of an excel spreadsheet containing the most common ICD-10 diagnoses made by chiropractors in South Africa, for the period June 2006 to July 2007, who had submitted claims to the Medical Scheme. The spreadsheet also contained depersonalised compliance statistics of chiropractors to the ICD-10 system from July 2006 to October 2008. SPSS version 15 was used for descriptive statistical data analysis (SPSS Inc., Chicago, Ill, USA). Results: The age range of the 63 participants who responded to the questionnaire was 26 to 79 years, with an average of 41 years. The majority of the participants were male (74.6%, n = 47). KwaZulu-Natal had 25 participants (39.6%), Gauteng 17 (26.9%), Western Cape 12 (19%), Eastern Cape four (6.3%), Free State and Mpumalanga two (3.1%) each and North West one (1.5%). The mean knowledge score for ICD-10 coding was 43.5%, suggesting a relatively low level of knowledge. The total percentage of mistakes for electronic claims was higher for both the primary and unlisted claims (3.93% and 2.18%), than for manual claims iv (1.57% and 1.59%). The total percentage of mistakes was low but increased marginally each year for both primary claims (1.43% in 2006; 1.99% in 2007; 2.33% in 2008) and unlisted claims (0% in 2006; 2.61% in 2007; 3.07% in 2008). CASA members were more likely to be aware of assistance offered, in terms of ICD-10 coding through the medical schemes and the association (p = 0.131), than non-members. There was a non-significant trend towards participants who had been on an ICD-10 coding course (47.6%; n = 30), having a greater knowledge of the ICD-10 coding procedures (p = 0.147). Their knowledge was almost 10% higher than those who had not been on a course (52.4%; n = 33). Most participants (38.1%; n = 24) did not use additional cause codes when treating cases of musculoskeletal trauma, nor did they use multiple codes (38.7%; n = 24) when treating more than one condition in the same patient. Nearly 70% of participants (n = 44) used the M99 code in order to code for vertebral subluxation and the majority (79.4%; n = 50) believed the definition of subluxation used in ICD-10 coding to be the same as that which chiropractors use to define subluxation. According to the medical aid data, the top five diagnoses made by chiropractors from 2006 to 2007 were: Low back pain, lumbar region, M54.56 (8996 claims); Cervicalgia, M54.22 (6390 claims); Subluxation complex, cervical region, M99.11 (2895 claims); Other dorsalgia, multiple sites in spine, M54.80 (1524 claims) and Subluxation complex, sacral region, M99.14 (1293 claims). According to the questionnaire data, the top five diagnoses (Table 4.24) were: Lumbar facet syndrome, M54.56 (25%); Lumbar facet syndrome, M99.13 (23.3%); Cervical facet syndrome, M99.11 (21.7%); Cervicogenic headache, G44.2 (20%) and Cervicalgia, M54.22 (20%). Conclusion: The sample of South African chiropractors were fairly compliant to the ICD-10 coding system. Although the two sets of data (i.e. from the medical aid scheme and the questionnaire) regarding the diagnoses that chiropractors make on a daily basis correlate well with each other, there is no consensus in the profession as to which codes to use for chiropractic specific diagnoses. These chiropractic specific diagnoses (e.g. facet syndrome) are however, the most common diagnoses made by chiropractors in private practice. Many respondents indicated that because of this they sometimes use codes that they know will not be rejected, even if it is the incorrect code. For more complicated codes, the majority of respondents indicated that they did not know how to or were not interested in submitting the correct codes to comply with the level of specificity required by the medical aid schemes. The challenge is to make practitioners aware of the advantages of correct coding for the profession.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2018. / Background Currently, chiropractic is not incorporated into the South African public healthcare sector despite its emphasis on the values of wellness and health. This is due to a poor relationship with mainstream medical practitioners, the construct of chiropractic education and its long standing isolation within the healthcare system within South Africa. The public healthcare sector in South Africa is strained. Low back pain is one of the main reasons patients seek medical attention from primary medical doctors. A growing body of evidence is now emerging which supports the role of chiropractic in post-­surgical rehabilitation and the treatment of extraspinal non-­pathological musculoskeletal conditions. Based on the findings of these studies, an argument could be made for the transition of chiropractic from a mainly private practice base to one that would enable it to reach to the wider population in the public healthcare sector. Aim The aim of the research study was to explore and describe the perceptions that chiropractors have about the integration of the chiropractic profession into the South African public healthcare sector. Method A descriptive exploratory qualitative approach was used to guide the study. In-­ depth interviews were conducted with ten chiropractors within the eThekwini municipality. The main research question for this study was “What are the perceptions of chiropractors in the eThekwini Municipality on the integration of chiropractic into the public healthcare sector of South Africa?” The data was analysed through thematic analysis. Results The main themes that emerged were the role of chiropractic in the healthcare system, the integration of chiropractic into the healthcare sector and the challenges facing chiropractors in the healthcare system. The themes and sub-­ themes were as follows;; • Theme 1 Role of chiropractic in the healthcare system Sub-­theme 1.1 Primary contact for neuromuscular medicine. • Theme 2 Integration of chiropractors into the public healthcare sector Sub-­theme 2.1 Relief of overworked healthcare workers. Sub-­theme 2.2 Decrease costs in surgical and medication use. Sub-­theme 2.3 Increased learning opportunities. Sub-­theme 2.4 Use of chiropractic in post-­surgical care. Sub-­theme 2.5 Need for pre-­surgical assessment. Sub-­theme 2.6 Integration facilitated by the Chiropractic Association of South Africa (CASA). • Theme 3 Challenges facing chiropractors in the public healthcare sector Sub-­theme 3.1 Opposition from medical doctors. Sub-­theme 3.2 Opposition from within the chiropractic profession. Sub-­theme 3.3 Inability to function as the primary practitioners. Sub-­theme 3.4 Unfamiliar structure of the public health care sector. Conclusion A lack of clarity on the identity and role of chiropractic in the public healthcare sector emerged from the findings of this study. Individual chiropractors, the professional body (CASA) and the Allied Health Professions Council of South Africa (AHPCSA) need to engage in active roles in the integration of chiropractic into the public healthcare sector of South Africa. / M

Dissertation presented to the Faculty of Health at Durban University of Technology in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, 2008. / Aims and Objectives: To assess the demographics, career paths and factors affecting chiropractic graduates of Durban University of Technology (DUT) from June 1994 to June 2007. Method: A retrospective qualitative survey was conducted on 62 chiropractic graduates of DUT. The sample represented 25.5% of the total chiropractic population. Raw data regarding the demographics, respondents’ perception of their education, current career paths, the factors responsible for affecting these career paths, as well as a profile of chiropractic practices in South Africa (SA) was obtained. All data acquired was assessed using SAS (Statistical Analysis System) version 9.1.3. The data was purely descriptive, describing respondents’ career paths and their experiences, and no specific hypothesis was investigated. Results: The average respondent was found to be a married, white male who started his chiropractic career at age 25-26 years. A total of 98.4% (n = 61) of the respondents were currently in practice, with 80.6% (n = 50) indicating career satisfaction. The majority (62.9%; n = 39) of respondents perceived there to be a growing acceptance of chiropractic within the medical community, whilst 98.4% (n = 61) stated that they are currently part of an active referral system between various other medical practitioners. 46% (n = 23) listed DUT as their preferred choice of chiropractic institution. Conclusion and Recommendations: The majority of respondents’ indicated DUT as the preferred choice of chiropractic institution due to its location and the system of chiropractic taught (diversified). However, shortcomings in the education were highlighted to be a lack of practically applicable knowledge taught at undergraduate level, most especially business skills and speciality areas and that respondents’ perceived the qualification not to be as versatile and widely accepted as other international chiropractic qualifications. Factors responsible for positively affecting the career paths of chiropractic graduates were indicated to be the personality type of the graduate, the means to finance a practice, support from parents and spouse or partner and the level of acceptance graduates received from the public and other professions within the medical sector. A recommendation for future studies is that a longer time period be given for questionnaires to be returned and a larger sample group be established in order to ensure that the sample group and total population is homogenous.

Submitted in partial compliance for a Masters Degree in Technology: Chiropractic, Durban University of Technology, 2009. / The aim of this study was to investigate patient management protocols of low back pain (LBP) by chiropractors in the greater Durban metropolitan area. In this investigation a more generalized approach was chosen to investigate trends within the field of patient management and education for LBP. The study population of 80 chiropractors in the greater Durban metropolitan area, required a minimum response rate of 70% to obtain statistical significance (Esterhuizen, 2008), which was achieved. This study involved a quantitative descriptive design utilizing a questionnaire developed and validated by the researcher and focus group. The questionnaire was comprised of three sections, including personal information, treatment protocols and patient management with advice and education. Statistical analysis involved the use of SPSS version 15.0 (SPSS Inc., Chicago, Illinois, USA), a data analysis tool. Descriptive objectives were analysed with frequency tables and cross-tabulation tables (Esterhuizen, 2008). Demographic variables and practice variables were assessed for association with responses to the questionnaire using Pearson’s Chi square test in the case of categorical demographics and responses (Esterhuizen, 2008). Bar graphs were included to reflect the treatments that were always or frequently used by respondents (Esterhuizen, 2008). There appeared to be a wide range of influences on practice philosophy and methods, independent of demographics and training institute. A chiropractor’s age was regarded as significant with regard to philosophical orientation. However, the majority of these chiropractors obtained their qualifications from international colleges. vi Spinal manipulations directed at quadratus lumborum myofascial trigger points were strongly advocated by respondents. Specific short lever manipulations were the preferred manipulation technique for treatment of LBP. Sacroiliac joint manipulation was also considered important by a significant proportion of respondents. Respondents most commonly recommended the use of mobilizations and cryotherapy when contra-indications to manipulation were evident. There was consensus in the number of days before the first follow-up after an initial treatment for a presentation of acute LBP, where 96.42% of respondents recommended follow-up at day 1 or 2. In chronic LBP first follow-up after initial treatment was recommended by 41.1% of respondents on day 2; 28.6% day 3 and 8.9% on day 1. Management protocols for acute LBP appeared to be more uniform when compared to management of chronic LBP. Despite the variances in philosophy and management protocols amongst respondents, there remains consensus that manual articular manipulation remains the mainstay in chiropractic treatment protocols for both acute and chronic LBP.

Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology, Durban University of Technology, 2010. / It is well documented that the chiropractic profession has been searching for a unified professional identity. Acknowledging this need for a professional identity relevant to the public, the World Federation of Chiropractic (WFC) attempted to address these concerns by conducting an international questionnaire based Identity Consultation. However, of the 3689 chiropractors who responded, only 34 were from South Africa. Therefore this study aimed to determine the perception of South African chiropractors regarding their public identity and to compare the results with those from international studies. Objectives: To determine the demographic profile of South African chiropractors, and how they perceived their professional identity relative to their own opinions, those of the public and those of medical doctors. This study investigated how South African chiropractors saw their profession relative to physiotherapy and South African chiropractor’s knowledge of the WFC Identity Consultation. Method: The study was a population based demographic study making use of a descriptive, observational, cross sectional design. It was a quantitative selfadministered questionnaire distributed to those South African chiropractors meeting the inclusion criteria (n=398). The WFC Identity Consultation questionnaire was modified and developed by the researcher to suit a South African audience after permission was obtained from the chairperson of the WFC. Results: A response rate of 30.15% was obtained. Ninety percent of South African chiropractors felt that it was important for their profession to have a clear identity. However, only 1.7% agreed that it did have a clear identity. When asked how the public viewed chiropractic, 45% felt that the public had no clear perception of the profession, with 92.5% viewing it as Complementary and The Perceptions of South African Chiropractors, Regarding Their Professional Identity iv Alternative Medicine (CAM). However, 89.2% of South African chiropractors would like the public to perceive chiropractic as mainstream medicine. When asked how chiropractic was viewed by South African chiropractors relative to physiotherapy, it was agreed that they were two separate professions each with their own identity (74.2%). The chiropractic adjustment was seen as a strong brand advantage over physiotherapy. When asked how they thought medical doctors viewed chiropractic, 73.3% felt that they did not have a clear perception of the profession, with 96.7% considering medical doctors to view chiropractic as CAM. Medical doctors’ perceptions were considered to be very important with respect to inter-professional relations. Just over half (54.2%) of South African chiropractors knew about the WFC identity, less than half of whom (47.5%) agreed with it. Conclusions: The study revealed that there was a significant difference between how South African chiropractors thought the public and medical doctors currently perceived chiropractic and how they would like to be perceived. It revealed that like their international counterparts chiropractors in South Africa are striving for a unified identity that is different to the way they are currently perceived by the health care stakeholders.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / The Chiropractic profession has made significant progress with regard to the production of high quality and clinically relevant research in the last 20 years. This correlates with a spike in development within the chiropractic profession as well as its acceptance by the medical fraternity and public. The responsibility for continuing this positive trend is dependent on the chiropractic graduates and practitioners of the future. Therefore, it is important to establish the current perceptions and utilization of research by Chiropractors, so that future research can be built around the needs and requirements of today’s practitioners, thereby ensuring the profession’s continued development and future in health care. The aim of this study was to determine the perceptions that Chiropractors have of research and its relevance / utilization in practice. Method: The study was a quantitative questionnaire based, self administered survey. The sample group included all Chiropractic practitioners currently practising in South Africa (N=515). Results: There was a response rate of 35% (n=174). The results indicated that the perception of research was very positive overall, with the strongest positive response being that research adds credibility to the profession. However, most respondents disagreed with the statement that chiropractors who had done research had an advantage above those who had not. There was a positive, albeit weak correlation between perceptions and utilization of research, indicating that as perceptions increased, so did utilization of research. The area of greatest concern was that even though a high degree of research utilization was reported by chiropractors, research was least likely to be used to change conditions, policies or practices in practice. v Conclusion: The most significant factors associated with positive perceptions and utilization were found to be publishing in a journal and receiving referrals from other health care practitioners. Chiropractors who indicated an interest in doing research again were also very positively linked to utilization. It would seem that even though chiropractors perceive research positively, their implementation into practice has some hurdles that impede the full integration of research into practice. As very few demographic and personal attributes of the South African chiropractor were found to be primarily responsible for low utilization of research in practice, it can be hypothesised that the factors impeding research implementation are most likely environmental in nature.

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Objectives: Collaboration between health care practitioners has many advantages including a focus on disease prevention and health promotion, improving service access and the provision of multidisciplinary health care teams. To achieve this ideal health care provision, understanding the current landscape of referral/interaction between practitioners and the factors which influence this network are important. This enables effective delivery of health care demanded by the public. As identified factors impacting the inter-referral of patients between practitioners are contextual, they differ in different contexts. Thus, this study aimed to investigate the factors affecting the referral of patients between chiropractors and physiotherapists in the eThekwini municipality.