In 2005, I recognized the opportunity performing commercial driver's license (CDL) exams represented to the chiropractic profession. I even thought I was overly optimistic by referring to it as the "greatest opportunity ever" for DCs; the "brass ring" within our reach.
My error was that I was not optimistic enough. I drastically undervalued the impact performing CDL physical exams would have. And that impact is more than just financial: As we speak, it is advancing acceptance of the chiropractic profession into other federal, state and private-sector programs.
In less than three years, DCs who are certified medical examiners in the National Registry (NRCME) have performed 3.6 million driver physicals representing payments totaling $300 million to the profession. During that time, DCs performed more than twice as many exams per provider than any of the four other major professions.
With 23.5 million total driver exams performed over the same time, we can estimate the average number of driver physicals being performed every year as more than a million exams, representing annual payouts of over $600 million.
There is only one bit of news that is puzzling. The chiropractic profession is measurably the smallest group of CMEs. There are only about 3,500 DC CMEs compared to the largest group (MDs), with more than 19,000 providers. However, although outnumbering DCs by more than a five-to-one margin, MD CMEs performed only just over twice as many total exams compared to DC CMEs.
The Financial Advantages
Chiropractors have insurmountable advantages in performing driver exams. They operate at a lower overhead cost, giving them a significant advantage in pricing. The average reimbursement for DCs is above $80, making it a better reimbursement than many chiropractic services. And there is no insurance involvement. Perform the exam and get paid. DCs also generally have more open appointments, giving drivers the opportunity to obtain same-day appointment.
The Veterans Administration now is required to provide or pay for driver physicals for veterans. That program is still being initiated, but an effort was thwarted to eliminate DCs from providing VA driver exams, even if certified medical examiners in the National Registry.
The Non-Financial Advantages
As you might imagine, drivers are generally not a healthy group. A medical condition can end their driving earlier than in other professions. Fortunately, the well-trained and concerned CME is a significant resource to drivers. Those CMEs who will go the extra mile to guide the driver through the medical requirements to allow the driver to "keep on truckin'" provide a rare and valuable service.
What's more, consider how DCs performing driver exams have affected other programs. DCs in up to 30 states are or will soon be allowed to perform FAA BasicMed medical exams on general aviation pilots.
When I graduated from chiropractic school, I bothered the FAA Surgeon so much that I had to back off, leaving me with the opinion that performing pilot physicals would not occur during my time as a DC. I was wrong about that, happily so.
Although there are not the number of FAA BasicMed exams being perform as compared to driver exams, the FAA medical program is generally considered the "gold standard" of medical programs by government agencies and the private sector alike. Some states have required that to perform the FAA BasicMed exam, you have to first be a CME in the National Registry.
But that's not all. Hopefully later this year, DCs will also be included in the U.S. Coast Guard Merchant Mariner medical exam program, plus an opened door for DCs to perform the medical exam for scuba divers. Others potential opportunities include medical evaluation for respirator use, respirator fit testing and more.
I have just touched on the tip of the iceberg with this article. I haven't even touched on the other services to the transportation industry that DCs can provide – far bigger than I ever imagined.
Well-Worth the Investment
I projected that DCs would the major presence in performing driver exams. The profession needs more certified medical examiners. It requires taking a FMCSA-accredited training program (most are less than 12 hours) and a few weeks of study to pass the NRCME certification test. (If you don't pass it the first time, you have to wait 30 days to take it again.)
Becoming certified in the National Registry is well-worth this small investment of your time. Isn't getting a piece of $600 million a year while contributing to a worthwhile effort to benefit drivers and help ensure safe roads enough?
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."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
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?
