A Chiropractic Therapist Profession in the United States?

Editor’s Note: This article was updated after the print / digital issues went to press.

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The revelation that the American Chiropractic Association (ACA) and Texas Chiropractic College (TCC) are in collaboration with non-accredited practitioners practicing as chiropractors in Japan has many doctors of chiropractic in the U.S. and around the world extremely frustrated and disturbed. Some ACA members in particular are feeling betrayed, believing their actions are a threat to public safety and the chiropractic profession.

As a review, TCC offers unqualified people from Japan (who have not earned a chiropractic degree from an accredited program) an advanced two-week seminar on chiropractic theory, anatomy, dissection, physiology, pathology, neurology, examination methods and chiropractic techniques, apparently taught by TCC faculty.^1-3

These individuals use this training from an American chiropractic college to begin practicing in Japan under the term Zenkenkai, selling products for the Nippon Chokuhan Group, a retail company that develops “bedding, equipment, and health foods necessary for Zenkenkai chiropractors’ treatment activities, and also take orders and ship products.”^4-5

In an effort to join this very lucrative business deal, the ACA announced last year that it also would recognize as international members these Zenkenkai / JCA members (who are essentially chiropractic therapists), going so far as to place both organizations’ logo on the ACA corporate membership page. This was apparently done in an effort to bolster ACA’s declining membership.⁶ When asked about this, the ACA responded:

“The American Chiropractic Association has for many years offered international memberships. These members, like all ACA members, have access to continuing education programs and other resources on our website and through live programs and events, which help them to learn and grow, build leadership skills, and connect with others. Our mission is to inspire and empower members to elevate the health of their communities.”⁷ (Emphasis added)

In late February 2025, the ACA published a letter to its members that attempted to clarify the ACA’s position.⁸ Prior to the letter, Zenkenkai and JCA were each listed as ACA corporate members on the ACA website. The ACA’s latest position can be summarized in the following excerpt from that letter:

“We take seriously the concerns recently expressed by members and have determined that our relationship with the JCA has become a distraction from our mission. As a result, we have mutually agreed to end the JCA's organizational membership while continuing to serve our individual members in Japan. (Emphasis added)

This statement seems rather confusing in that it appears the ACA has rescinded the JCA corporate membership, but makes no mention of the Zenkenkai corporate membership (although both logos no longer appear on the ACA’s corporate membership page).

In an effort to clarify the ACA’s position, Dynamic Chiropractic sent newly elected ACA President, Dr. Marcus Nynas, the following questions:

• What is the ACA going to do specifically to prevent these individual members from Japan, as well as the JCA and Zenkenkai, from continuing to use the ACA’s name, logo, educational resources and affiliation to deceive Japanese consumers into believing that they are qualified chiropractors?
• Is the ACA planning to work with associations or individual practitioners in other countries that lack a chiropractic degree in addition to Japan? Please explain what the ACA's position is regarding awarding ACA membership to non-DCs.
• What assurances can the ACA give its member doctors of chiropractic, chiropractic national associations worldwide and doctors of chiropractic generally that the ACA will cease from any activities that would potentially undermine the development of a legitimate profession of chiropractic doctors in other countries?

Dr. Nynas provided the following response:

“The ACA Board of Governors takes seriously the concerns recently expressed by members and has taken steps to address those concerns. We determined that our relationship with the JCA has become a distraction from our mission; and after discussions, the mutual decision was made with JCA to end their organizational membership.

“Our membership opportunities remain the same as they have been for many years. We have categories of membership for doctors of chiropractic, for retired DCs, as well as for non-DCs who work within the chiropractic industry or wish to support our advocacy of it. All ACA members, no matter where they live, are expected to conduct themselves with integrity, which includes representing themselves in an honest and professional manner.”

Sadly, Japan now has over 12,000 chiropractic therapists (Zenkenkai/JCA chiropractors), dramatically outnumbering the fewer than 700 DCs who have graduated from accredited chiropractic educational programs. Backed by Nippon Chokuhan Group, these chiropractic therapists have a clear economic and political advantage that makes appropriate chiropractic legislation nearly impossible.

What If It Happens?

What if this same thing happened in the U.S.? There would be significant winners and losers:

Winners

• Third-party payers – who could utilize chiropractic therapists instead of DCs at a lower cost.
• Hospitals, networks and MDs – who could easily hire a chiropractic therapist in their hospital/network/office, just like a PT or massage therapist.
• The American Medical Association – which would enjoy having a much smaller U.S. chiropractic profession with which to compete.
• Students – who want to practice chiropractic, but don’t want to spend the time and money to become doctors.

Losers

• DCs – the advent of chiropractic therapists would drastically reduce the number of DCs required, as they would only handle the complicated cases, mostly by referral.
• U.S. chiropractic colleges – which would need to expand into training chiropractic therapists or go out of business.
• State associations – which would dwindle and disappear as the number of DCs declined.

All It Would Take

Assuming this can’t happen in the U.S. is naïve at best. Three things would be required to create a chiropractic therapist profession in the United States:

• Education – TCC already has a similar educational program in place, which would need to be expanded to 500 hours as is required for massage therapists.
• Credibility – The ACA already provides international member benefits including the use the ACA logo, branding and access to their continuing-education programs like their DC members.
• Licensure – With chiropractic therapists focusing on product sales, distributors like those in Japan would be lining up to fund chiropractic therapist legislation in each state.

TCC and the ACA are already poised to take advantage of a chiropractic therapist profession in the U.S. for reasons that seem more than obvious. As mentioned in previous articles, over the past four years, TCC’s average number of DC graduates is under 73 per year, with an average of 19.4% not licensed six months after graduation.⁹ ACA’s full dues-paying general membership is also declining, falling to less than 4,000 for the first time.

Zenkenkai and JCA leaders reportedly participated in the ACA’s 2025 annual meeting in January. Both Zenkenkai and the JCA were ACA corporate members. With the ACA only having 18 total corporate members at the time, their combined contributions might very well have make them the largest financial contributors to the ACA, causing some to ask: “Was this Zenkenkai’s first step in taking over the ACA, similar to what it has done with the JCA?”

As part of its two-week chiropractic program, TCC provides participants with an “America Dissection and Adjusting Technique Completion Certificate” that includes the TCC logo and that of the JCA. This could easily be changed to something like a “Chiropractic Therapist Training Certificate” for those completing an extended version of this program who wish to practice in the U.S. TCC could keep its logo on the left of the certificate and replace the JCA logo on the right with the ACA logo, assuming ACA wants to be part of the program in the U.S. like it is in Japan.

According to the Zenkenkai press release regarding the Zenkenkai/JCA meeting with ACA leadership at the ACA General Assembly in 2024, “At this meeting, there was a lot of discussion about the current state of chiropractic in Japan, the efforts of the JCA, and future activities. It was promised that ACA will continue to support the development of [Zenkenkai] chiropractic not only in Japan, but throughout Asia.”¹⁰ [Clarification added]

Given its financial superiority, how long before Zenkenkai chiropractic comes to the United States?

None of what the ACA is doing is illegal, although some DCs question whether it is ethical. There is no agency that can stop the creation of a chiropractic therapist profession in Japan, Asia or the U.S. Only the voice of doctors of chiropractic like you can make a difference.

Don’t Stay Silent

If you disagree with the actions of the ACA, please take a moment to make your thoughts known in an email to ACA President Dr. Marcus Nynas at memberinfo@acatoday.org.

References

1. “Chiropractic at Risk Globally.” Dynamic Chiropractic, January 2025. Read Here
2. Training in America. https://www.zenkenkai.jp/seminar-usa
3. About JCA Education Program. https://www.japan-chiropractic.jp/program/
4. Japan Direct Sale Headquarters company information. Read Here
5. What Is Chiropractic? Read Here
6. “ACA Welcomes Japanese Members.” ACA Today, May 7, 2024. Read Here
7. Personal communication with Annette Bernat, vice president branding and communications, American Chiropractic Association, on Nov. 13, 2024.
8. ACA letter to members regarding international membership, February 2025. Read Here
9. TCC Educational Outcomes: DC Completion Rates. Read Here
10. “ACA, the Largest Chiropractic Industry Association in the United States, and JCA, the Largest Chiropractic Industry Association in Japan, Hold a Meeting in Washington, D.C.!” PR Times, March 13, 2024. Read Here

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Editor’s Note: As suggested in previous articles in this discussion, several of the links above should be opened in a browser that allows for translation to English.