Both my father and grandfather were doctors of chiropractic. In those days here in California, their respective practices consisted of adjustments, nutrition and colon therapy as required. They could and did perform other primary care duties as needed, but not typically. They practiced just as they had been taught.
Today's chiropractors have several ways they can practice: alone, with other DCs or with other non-chiropractic providers. They can focus primarily on delivering chiropractic adjustments or add a long list of other services and products that can provide additional revenue streams.
We recently conducted a survey of doctors of chiropractic in an effort to better understand how our profession practices. While not definitive, these are the responses we received as to the working definitions DCs in the U.S. thought best described their practice:
Which of the Following Best Describes Your Practice?
On the surface, we see 70 percent of chiropractors still practice a more traditional form of chiropractic (either solo or with other DCs) with at least 80 percent of their revenue derived from adjustments, rehab, PT, etc. Of the remaining 30 percent, approximately half rely on other services and products for at least 30 percent of their revenue. The final 15 percent (approximately 10,000 doctors of chiropractic) have adopted a different style of practice that involves working with non-chiropractic providers (just over 9 percent) or offering other services and products that drive more than half their revenue.
Practitioner Experience and Practice Type / Style
As you might expect, there is a difference between the type of practice chosen by a doctor in their first five years of practice versus a doctor who has been practicing for 25 years or more:
What Percentage of Revenue Is Derived From Third-Party Payers?
The other survey question we found interesting in understanding how DCs have adapted to the changing health care environment had to do with reliance on third-party payers:
As you can see, only about a third of the profession relies on third-party payers for most of their revenue. A quarter of DCs are essentially cash practitioners. As is the case with the correlation between practice experience and practice type, revenue source is related to the number of years in practice:
Practice Experience and Reliance on Third-Party Payers
Data Analysis: What's Trending
In looking at the data, a number of trends become clear. Almost three-quarters of chiropractors who have been practicing for less than 10 years participate in either third-party-payer-dependent practices or cash practices, with few in between. But after 15 years in practice, the percentage of doctors relying solely on third-party payers drops to less than 10 percent and is consistent from then on. Likewise, after 15 years in practice, the percentage of DCs with traditional practices drops from 86 percent (for those in practice for 10-14 years) to 66 percent (for those in practice for 25 years or more).
Doctors just starting out in practice have more choices than ever. Many are choosing integrated, interdisciplinary or specialized practices as a way to better provide their services. While many new DCs are beginning as cash practitioners, a larger number are almost entirely dependent on third-party payers. But the longer a doctor of chiropractic is in practice, the less they depend on third-party payers, and the more they seek to earn additional revenue from other services and products.
These trends are not altogether surprising, as they reflect the efforts of DCs across the country to adapt to the changing health care environment. Adaptation and innovation will likely continue to be important for success in the near future.
Read more findings on my blog: http://blog.toyourhealth.com/wrblog/. You can also visit me on Facebook.
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
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Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
