Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher
Like watching your children grow, the changes taking place in our profession are often subtle and frequently subject to debate. At times, the arguments sound a lot like two relatives trying to decide if little Johnny looks more like his father or his uncle. The longer you spend watching something grow, the better you can tell where the changes will occur and how substantial they will be.
The first question many in the profession want an answer to is: How many practicing doctors of chiropractic are there now in the United States? The answers tend to vary widely. There are some publications that only mail to 30,000 DCs or less, insisting that this is the number of practicing doctors. There are others that quote numbers closer to 50,000. The actual number comes from the Federation of Chiropractic Licensing Boards (FCLB) and the federal government.
As part of an overall data upgrade project recently approved by the FCLB board of directors, the federation is working to extract the National Provider Identifier (NPI) from federal data that is updated twice a year and link it to licensure records. The NPI is the unique identification number for health care providers that is used by all health plans as of May 23, 2008, as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Preliminary analysis by the FCLB shows that there are about 68,000 DCs in active practice in the United States, with the only exclusions being DCs who have not secured an NPI.
Sixty-eight thousand U.S. DCs should not be a big surprise given that there are more than 2,000 DCs graduating every year from our chiropractic colleges. This has been happening for quite a while. And for those who insist that our numbers are decreasing because so many doctors are retiring, our most recent survey of the profession tends to refute that as well. As of June, 48 percent of U.S. DCs have been practicing for 20 years or more, according to our survey.
What is happening is that the chiropractic practice model is changing for an increasing percentage of our doctors. In the past, most DCs worked in single-practitioner practices. This number has steadily decreased to 68 percent. At the same time, multiple-chiropractor practices have risen steadily to 25 percent. This brings the total number of chiropractic offices down, but it's hard to tell what that number is without knowing how many doctors still serve various communities as single practitioners in different offices.
What may also be surprising is the number of DCs involved in multidisciplinary practices. This has grown considerably and is now up to 9 percent. Our next survey will ask questions to better understand which professions DCs are practicing with and under what types of arrangements.
So, as we approach the end of the first decade of the 21st century, we find our profession in the United States approaching 70,000 practicing doctors of chiropractic. We see the profession (like our country) graying, with almost half of our doctors in practice over 20 years. And we see fewer solo practices and a rising trend toward multidisciplinary clinics. We are a growing profession moving with the demands of our communities to progressively serve an increasing population of chiropractic patients.
