Every five years the National Board of Chiropractic Examiners (NBCE) conducts a massive nationwide survey of doctors of chiropractic called the Practice Analysis of Chiropractic. The primary reason for this effort is to ensure its licensing exams “accurately reflect the necessary knowledge and skills expected of a licensed practitioner.”
While the survey provides this information, it also gives a snapshot of our profession, allowing us to see how we are changing and progressing. Even though a sample size of only 1,000 DCs was required for a 95% confidence level, the NBCE went the extra mile with a goal of 3,000 respondents to ensure the sample would adequately represent the profession.
Signs of the Times
The first Practice Analysis was reported in 1991. Here are just some of the changes that have occurred since then:
Gender Balance – from 87% male in 1991 to 63% male currently. For DCs under 30 years old, the current mix is 50%/50%.
Race & Ethnic Diversity – from 97% white to 69% white over the past 33 years, with Hispanic/Latinx (3% to 6%), Black or African American (1.6% to 3%) and Asian/Pacific Islander (2% to 5%) doubling in the past five years.
More Years in Practice – The number of years DCs have been in practice is still increasing. Compared to the 2020 Practice Analysis, the percentage practicing for more than 25 years has risen from 38.9% to 44%. Likewise, the percentage practicing for 16 to 25 years has increased from 23% to 30%.
Fewer Sole Proprietors – Compared to 2020, the percentage of doctors practicing as sole proprietors has dropped from 64% to 55%. At the same time, the number of associates/employees has increased from 17% to 23%.
Less in-Office Diagnostic Imaging – Between 2020 and 2025, the percentage of doctors offering diagnostic imaging in their offices slid from 47% to 41%.
Reimbursement – The percentage of DCs who have cash or private-pay patients increased from 36.3% in 2020 to 41% in 2025. The percentage of DCs seeing private health insurance patients also increased from 25.4% to 37%. Note that payment categories were not mutually exclusive.
New to the 2025 Practice Analysis
Income – Two-thirds (66%) of DCs earn more than $100,000 per year, with 20% earning more than $250,000 per year.
Primary Practice Setting – Less than half (49%) of chiropractors work in a single-DC office. Just over a third (36%) work in a multi-DC office, with 12% working in a multidisciplinary health care facility.
Adjustment Type – Only 7% of DCs perform manually adjustments only, with only 6% performing instrument-assisted adjustments exclusively. The remaining 87% perform both.
Number of Patient Visits Per Week – Nearly three-quarters (71%) of DCs see at least 50 patients a week. Thirty-nine percent see more than 100 patients a week, with 18% seeing over 150 per week.
Editor’s Note: The 2025 Practice Analysis of Chiropractic is accessible on the NBCE website. Click Here
Recent laws in New Jersey and California represent a disturbing trend that will negatively impact a practice’s ability to collect monies from patients, as well as expose them to significant penalties if the practice does not follow the mandatory guidelines to a T. Please be aware that a similar law may be coming to your state. The time to act is before the law is passed.
With estimates showing over 30 million Americans affected by peripheral neuropathy – and a significant portion underdiagnosed – it’s increasingly likely that chiropractors are already treating these patients. What’s missing is structured recognition, comprehensive management and targeted tools to slow progression, improve function and support systemic health.
Each year, ICD-10-CM is updated on Oct. 1. For 2026, there are 74,179 total codes, with 487 additions, 28 deletions and 38 revisions. Code changes are based on date of service, not the claim submission date. Services performed on/after Oct. 1 must use the new codes. While no changes affect the common spinal or extraspinal codes most frequently used by DCs, several updates may still affect your claims – particularly for comorbidities, referred pain, or trauma cases.
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