Continuing education is meant to serve a simple purpose: to help healthcare professionals remain current, competent and responsive to evolving evidence. When done well, it strengthens clinical judgment and improves patient care. When done poorly, it becomes a box-checking exercise that consumes time and resources without delivering meaningful benefit.
Unfortunately, for many chiropractors, continuing education has increasingly become the latter.
Having spent years organizing and participating in multi-state educational programs, I have seen firsthand how fragmented and inefficient our continuing-education system has become.
Regulatory Roadblocks
While the intent of regulation is to protect the public, the current structure often functions more as an administrative obstacle course than a quality-assurance mechanism.
Today, the same educational program may be approved easily in one state, delayed for months in another and rejected outright in a third – not because of content deficiencies, but because of procedural technicalities. Providers are frequently required to submit duplicate applications, pay multiple approval fees, navigate inconsistent reporting platforms, and wait indefinitely for decisions that may arrive after an event has already occurred.
In some cases, nationally reviewed and approved courses must still undergo additional “pre-check” processes at the state level, even when they meet established national standards. This duplication adds cost and delay without clear benefit.
It raises an important question: If an independent accreditation process has already evaluated a course, what additional public protection is achieved by repeating the same review?
Financial Obstacles
The financial burden is also significant. Associations and educational providers routinely incur thousands of dollars in application fees for a single conference, followed by per-attendee processing charges. These costs are ultimately passed on to clinicians – raising registration fees and limiting access, particularly for early-career doctors and those in underserved areas.
Discouraging Research Engagement
Perhaps more concerning is how this system discourages engagement with scientific literature. In many healthcare professions, physicians and other providers can earn credit for structured journal review, guideline analysis and quality-improvement activities. These formats actively promote evidence-based practice.
In chiropractic, however, many jurisdictions do not recognize such activities for continuing-education credit. As a result, the system implicitly favors time spent in lecture halls over time spent critically evaluating research. This runs counter to modern healthcare standards and slows the profession’s integration into evidence-based practice models.
Contrast With Medical CE
The contrast with medical continuing education is instructive. While medical physicians also operate under regulatory oversight, their system relies on centralized accreditation, shared credit definitions and predictable approval processes. This does not eliminate variation, but it reduces unnecessary duplication and administrative burden. Educational providers can plan with confidence and clinicians can focus on learning rather than compliance.
Chiropractic has taken steps in this direction through programs such as PACE, which aim to standardize course approval. These efforts deserve recognition, but their impact is limited when states continue to impose parallel review systems and additional fees. Partial harmonization is not enough.
A More Modern Approach
None of this is an argument against regulation. High standards matter. Public trust matters. Accountability matters. But effective regulation should be transparent, consistent and proportional to the risk it addresses. When administrative complexity outpaces demonstrable benefit, the system deserves re-examination. A more modern approach is both achievable and necessary.
First, nationally approved courses should be broadly accepted without redundant state-level review. Second, boards should establish clear timelines and service standards for course approval. Third, credit should be expanded to include structured research engagement and quality-improvement activities. Fourth, reporting systems should prioritize interoperability rather than platform fragmentation.
These reforms would not weaken professional standards. They would strengthen them by redirecting time and resources toward learning that improves clinical care.
Chiropractors today practice in an increasingly complex healthcare environment. We collaborate with medical physicians, physical therapists, athletic trainers, and other professionals. We are expected to integrate emerging evidence, adopt new technologies and meet rising patient expectations. Our continuing-education infrastructure should support that reality, not impede it.
The goal of continuing education is not compliance. It is competence. If we want a profession that is adaptive, evidence-informed and trusted, we must ensure that our regulatory systems align with those values. Modernizing continuing education is not a threat to public protection. It is an essential investment in it.
