Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher
While most doctors of chiropractic are all too familiar with the decrease in their gross practice incomes over the last 5-10 years, few have considered its impact on our chiropractic colleges and ultimately, our profession. Managed care, a tightening economy and heightened competition have all taken their toll.
The number of students enrolled in U.S. chiropractic colleges has also fallen sharply as a result. One report suggests that total U.S. chiropractic college enrollment fell from a high of 15,398 in 1996 to just over 10,000 in the fall term of 2002. This 5,000-plus drop represents a 35 percent decrease in student enrollment overall.
In general, fall 2003 enrollment numbers are encouraging. After three straight years of double-digit declines, U.S. chiropractic colleges enjoyed a modest increase of less than 1 percent.
Unfortunately, enrollment at several chiropractic colleges went in the other direction.
Given the events of the past year, it is easy to see why Life University dropped from a reported enrollment of 3,523 in 1996 to approximately 750 in 2003 (a 78 percent decline). The temporary loss of accreditation certainly took its toll.
But Life is not the only chiropractic college to see such staggering declines. Six other institutions experienced losses of one-third or greater over the same period of time. (One of those colleges lost almost 57 percent of its students.)
What this means for U.S. chiropractic colleges is obvious - but what does it mean to the profession? What will be the long-term negative effect of reduced growth at this juncture in the history of chiropractic? Do we need a period of slower growth to make up for the declining reimbursement rates most DCs have experienced for the past several years?
It seems almost criminal to see our growth slowing when so many people are incorporating various forms of "alternative care" into their health regimen. Looking around, you don't see any of the other so-called alternative care professions slowing their growth. Acupuncture and massage therapy are increasing the number of colleges/schools at a healthy rate. Naturopathy is beginning to gain licensure in a number of states, including California just a few months ago. The growth of physical therapists doesn't appear to be slowing, either.
So, why are fewer students enrolling in U.S. chiropractic colleges? I believe it may have to do with our attitude.
One of the primary reasons people enter chiropractic college is because they are encouraged to do so by their doctor of chiropractic. They visit their DC and become enthralled with chiropractic because of what it did for them or someone they know. They see chiropractic as an opportunity to care for people. They watch their doctor provide an adjustment and recognize the benefit that adjustment brings to the patient. When their doctor sees their interest, they recommend a chiropractic college.
But the era of managed care and declining reimbursement has taken away some of the joy of being a doctor of chiropractic (or a doctor of anything, for that matter). Filling out paperwork and asking permission (authorization) have negatively influenced most practices.
But chiropractic isn't about managed care or seeking authorization. The reward comes when that patient stands up straight, pain free, looks you in the eye and says "Thanks, Doc, I feel a whole lot better."
Take a look at your list of patients for today. They are people that greatly appreciate the gift of chiropractic you give them each time they come to see you. They may not come in as often as they should (some of us need reminding because we get too busy), but they know exactly who to turn to in order to stay healthy.
Take just a minute or two to think about all the people you cared for each day. Take a deep breath of satisfaction and know that you are deeply appreciated.
Be proud of who you are and what you do. Your patients are proud of you. That's why we come to you.
You shouldn't be surprised when some of your patients ask you about becoming a doctor of chiropractic. They appreciate the gift you have and want to share it.
Think about the young people you know who would also benefit from a life filled with caring for others. They have a desire to serve, and want the joy of seeing people healed through chiropractic.
Take the time to tell them about what you do. Let them spend some time with you, so that they understand all aspects of chiropractic practice. Don't sell them pie-in-the-sky or doom-and-gloom. Let them know the real story. Yes, it's hard work (like any other profession), but it has rewards that go beyond the income, right to your soul.
Once they've spent enough time with you, direct them to the Web site of the chiropractic college you would recommend. If the school isn't too far away, set up a time to tour the campus with them, or offer to call the college to make an appointment.
Being a doctor of chiropractic may be a bit harder than it used to be, but it is no less rewarding. Share the rewards with some future DCs, and let's see if we can get our profession growing at a strong, healthy rate again.
DMP Jr.
