"All is flux, nothing stays still." -- Heraclitus (540-580 B.C.)
"The ever-whirling wheel of change on which all mortal things doth sway." -- Edmund Spenser (1590)
Veteran chiropractors talk about how practice used to be. The tendency to talk about bygone days is natural enough, but how exactly has the chiropractic practice changed over the last few decades?
The American Chiropractic Association (ACA) has been surveying its members on various aspects of chiropractic practice for decades. Some of the data goes back to the '60s, but the majority of it dates back about 20 years. And while the responses of the ACA members do not necessarily speak for the entire profession, they're indicative of some interesting trends.
Gender of U.S. Doctors of Chiropractic |
| | | |
| | Female % | Male % |
| | | |
| 1972 | 3.3 | 96.7 |
| 1997 | 16.3 | 83.7 |
| | | |
| % of DCs Using Computers |
| | | |
| 1981 | 8.1 | |
| 1994 | 81.9 | |
| | | |
| Principle Form of Practice |
| | | |
| Solo Practice | |
| 1972 | 79.5% | |
| 1997 | 70.0% | |
| | | |
| Group or Partnership Practice | |
| 1972 | 15.6% | |
| 1997 | 22.7% | |
| | | |
| Employed by Another DC | |
| 1972 | 1.3% | |
| 1997 | 5.1% |
| Patient Flow Per Week |
| | | |
| Average Number of Patient Visits Per Week / New Patient Visits |
| | | |
| 1979 | 103.9 | 8.7 |
| 1980 | 107.1 | 8.5 |
| 1981 | 113.2 | 8.5 |
| 1982 | 116.3 | 8.0 |
| 1983 | 108.8 | 7.6 |
| 1984 | 115.5 | 7.6 |
| 1985 | 109.2 | 6.2 |
| 1986 | 111.8 | 6.9 |
| 1987 | 111.8 | 6.4 |
| 1988 | 116.0 | 6.6 |
| 1989 | 124.1 | 6.9 |
| 1990 | 130.2 | 6.9 |
| 1991 | 127.9 | 6.8 |
| 1992 | 124.7 | 7.5 |
| 1993 | 129.4 | 6.9 |
| 1994 | 109.2 | 5.6 |
| 1995 | 120.7 | 5.6 |
| 1996 | 108.5 | 5.8 |
Chiropractic Patient Characteristics | | | | |
| | | | | | | | |
| Gender of Patients | | | | | |
| | | | | | | | |
| | Female | Male | | | | | |
| | | | | | | | |
| 1980 | 56% | 44% | | | | | |
| 1997 | 58% | 42% | | | | | |
| | | | | | | | |
| Age of Patients | | | | | | |
| | | | | | | | |
| | Under 16 | 17-44 | 45-64 | Over 65 | | | |
| 1977 | 8.0% | 40.0% | 34.0% | 17.0% | | | |
| 1997 | 10.0% | 41.0% | 33.0% | 16.0% | | | |
| | | | | | | | |
| Conditions | | | | | | |
| | | | | | | | |
| | NMS | Viscerosomatic | Vascular | Other | | | |
| 1972 | 74% | 10.6% | 1.5% | 13.9% | | | |
| 1994 | 88.6% | 7.2% | 2.7% | 1.5% | | | |
| | | | | | | | |
| Sources of Income | | | | | |
| | | | | | | | |
| | Cash | Private Insurance | Work Comp | Medicare | Medicaid | HMO/PPO | Auto |
| | | | | | | | |
| 1975 | 70.7% | 13.2% | 8.6% | 1.6% | 1.7% | | |
| 1995 | 27.7% | 28.6% | 10.8% | 8.4% | 1.2% | 8.6% | 14.5% |
| | | | | | | | |
| Average Income | | | | | |
| | | | | | | | |
| | Gross | Net | % (Net/Gross) | | |
| | | | | | | | |
| 1980 | $83,572 | $43,457 | 52% | | | | |
| 1989 | $216,366 | $101,423 | 46.8% | | | | |
| 1991 | $234,192 | $91,965 | 39.3% | | | | |
| 1997 | $228,236 | $86,519 | 37.9% | | | | |
| | | | | | | | |
| Perceived Supply of DCs | | | | | |
| | | | | | | | |
| | Need More | Right Number | Too Many | |
| | | | | | | | |
| 1975 | 41.0% | | 51.0% | | 8.0% | | |
| 1997 | 7.6% | | 60.4% | | 32.0% | | |
| | | | | | | | |
| Student Loan Amounts at Graduation | | | | |
| | | | | | | | |
| 1979 | $15,227 | | | | | | |
| 1997 | $82,731 |
The ACA data presents some interesting realities:
• The number of women in chiropractic is steadily increasing (currently almost 20%).
• Almost every chiropractic practice has a computer.
• Patient visits rose to a high of over 130 per week in 1990, but fell back to almost where they were in 1979. New patient visits have dropped by 1/3 over the same period.
• While U.S. chiropractors are caring for more neuromusculoskeletal complaints, the makeup of the average chiropractic patient hasn't changed appreciably.
• Cash now accounts for less than 28% of practice income, as opposed to over 70% 20 years ago.
• Net income for the chiropractic practice reached a high of over $101,000 in 1989 with gross income reaching its high in 1991 at over $234,000. Unfortunately, both figures have since fallen. But the real story lies in the percentage of net income derived out of gross. In 1980, DCs took home 52% of their gross income. In 1997, that percentage dropped to below 38%.
• Over 92% of the profession surveyed believes there are either enough DCs or too many in the U.S. Our chiropractic colleges need to carefully address the supply and demand equation for chiropractors and make the students aware and prepared for that competitive business environment.
• The average chiropractic student loan amount in 1997 was over five times greater than the student loans of 1979.
Editor's note: Our thanks to the American Chiropractic Association for supplying this information to be shared with the chiropractic profession. A copy of the full report is available from the ACA at (800) 368-3083. The member price is $49.95; the nonmember price is $149.95.
