New Opportunities for DCs

For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices. But recent trends are pointing to what could be a new era for chiropractic.

The MD Example

A report published by the AMA last year gives an interesting look at current trends in medical private practice. The results are based on a 2016 survey of MDs across the country that was compared to similar survey results in previous years. The report found the following:¹

• "2016 was the first year when less than half (47.1 percent) of patient care physicians had an ownership stake in their practice."
• "Younger physicians are less likely to have an ownership stake in their practice than older physicians."
• "There were signs of a gradual shift towards larger practices over the 2012 to 2016 period."
• "The 2016 data highlight that multi-specialty practices are larger than single specialty practices."
• "In 2016, 21.0% of physicians in hospital-owned practices said their practice had been acquired by a hospital in the past 5 years."

Some of the reasons for this shift away from private practice included the cost of required patient management technology, as well as the need to improve outcomes and follow patient reforms. It seems most MDs now prefer employment to the egregious requirements of the current health care system.

Trending in Health Care

The health care world was startled earlier this year when Amazon, Berkshire Hathaway and JPMorgan announced they were going to "form an independent health care company for their employees in the United States."² Frustrated by the current situation, the three companies are looking to create a higher-quality, lower-cost benefit for their more than 840,000 employees.

In a CNBC interview about a month later, Warren Buffett of Berkshire Hathaway noted: "Our goal is really, not just for the three companies, our goal is something other people can pick up on." The group has apparently received numerous inquiries from other companies wishing to join their effort.³

The next day, Apple announced it is opening its own clinics under a program called "AC Wellness." Apple will initially staff two of its own facilities as it addresses the health care of its 120,000 employees.⁴

Next Up: Chiropractic?

Over the past few years, I have had the chance to talk with DCs who are involved in the changing landscape of chiropractic practice. Some are employed by hospitals, large corporations or government entities; others are employed by prominent franchise companies. One is selling her practice to the local hospital and joining its staff.

What I can tell you in all these cases is that these docs are very happy with their employment situations. And while it's not the norm, it is the trend, especially for newer DCs.

The rising cost of operating a private practice will likely drive more DCs to enter multi-doctor or multi-discipline arrangements, if not employment relationships with hospitals and other facilities. There seems to be an admission by administrators that patients need and want chiropractic care, but the choice of which DC is the best fit may still be confounding some organizations.

The other point that should be obvious in the face of the above announcements is the growing role technology will play in health care. It is no coincidence that companies such as Apple and Amazon are leading the way in changing the approach to quality health care. They have extensive data that will allow them to develop highly targeted, high-quality care for their employees. In the end, technology may become the ultimate driver of health care reform.

How much of the health-care decision-making process will be governed by artificial intelligence remains to be seen – but data will drive decisions, with or without AI. Doctors who are comfortable with technology and its role in patient management will be better prepared to flourish in this new era. As a friend of mine always states at the end of his emails: "If you don't like change, you're going to like irrelevance even less."

You may be the best doctor of chiropractic in the world, with the most sensitive hands and the most effective technique. But your ability to care for patients will be eroded if you aren't familiar with and ready to embrace the technological and practice changes that are right around the corner. One thing's for certain: They are coming soon.

References

1. Kane CK. "Updated Data on Physician Practice Arrangements: Physician Ownership Drops Below 50 Percent." Policy Research Perspectives, American Medical Association, 2017.
2. Wingfield N, et al. "Amazon, Berkshire Hathaway and JPMorgan Team Up to Try to Disrupt Health Care." The New York Times, Jan. 30, 2018.
3. Isidore C. "Buffett Expects Health Care Effort With Amazon, JPMorgan to Open Up to Other Companies." CNN Money, Feb. 26, 2018.
4. "Apple Will Open its Own Medical Clinics for Employees." Engadget, Feb. 27, 2018.

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