The Chiropractic Practice -- Now, and Then

"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)

 

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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.