On the 125th anniversary, industry leaders weigh in on what to expect over the next 125 years and the future of chiropractic
The U.S. and the world at large need chiropractic now more than ever. In the U.S. we enter 2021 battling the COVID-19 pandemic and an opioid epidemic that has been overshadowed but never went away. The future of chiropractic is now.
Infant mortality, long a baseline measurement for a country’s health, remains high in the U.S., which spends more on health care per citizen than any country, and nearly twice as much as the average developed country, according to commonwealthfund.org.
The statistics point to a full-on health care crisis in the U.S.
Even prior to the onset of COVID-19, of the 11 leading high-income countries in health data from the Organization for Economic Cooperation and Development (OECD), the U.S. has the lowest life expectancy and highest suicide rates. We have the highest chronic disease burden and an obesity rate twice that of the average OECD country.
Future of chiropractic: greater access to care
“We can start by strengthening access to care and primary care systems,” the 2020 OECD report states. “Our findings show that the U.S. has a relatively lower rate of physician visits compared to other nations. This is surprising given U.S. adults’ seemingly greater health needs. We do know from previous Commonwealth Fund surveys that adults in the U.S. experience greater affordability barriers to accessing physician visits, tests and treatments. Increasing access to affordable health care and strengthening primary care systems are two of the most important challenges for the U.S. health care system.”
Greater access to care will likely be a challenge, as experts have been predicting a decline in doctors of chiropractic regarding the future of chiropractic, and also MDs in the coming years. Older doctors are retiring, young doctors are not replacing them quickly enough, nor is the system keeping up with population growth, according to the report “Chiropractic 2025: Divergent Futures,” funded by the NCMIC Foundation and produced by the Institute for Alternative Futures.
Pedaling furiously to stay in place
How does chiropractic react to a decreased number of doctors and an increase in patient need and population?
Chiropractic Economics staff spoke with experts in the field who point to a need in the future of chiropractic for widespread promotion of national organization membership to new doctors, better specialty diplomate promotion and increased health promotion integration, increased insurance equity and achieving Medicare coverage for chiropractic patients.
Also high on experts’ lists are better branding for chiropractic and changing public perception, promoting chiropractic school enrollment and better business education, and over and over again — research, research and then more research.
Chiropractic is staring down a doctor shortage at a time the U.S. clearly needs even more doctors — especially DCs of color — to expand care to more areas and demographics to secure the future of chiropractic.
Here are a few of the industry experts who shared what the future could look like, and should look like to continue the industry’s current upward trend of acceptance and care:
Patrick Montgomery, DC, MS, FASA, FICC, professor of chiropractic history
“Young membership in the American Chiropractic Association (ACA) is crucial,” Montgomery says. “A couple of years ago, ACA recognized the need to push the importance of increasing membership among young doctors. Many members of the leadership realized that all the great advances that have been accomplished by the veterans may vanish unless younger DCs get involved to continue to improve, expand and grow the chiropractic profession.
Another area to build on is upgrading the status of diplomates of the various sub-specialties, promoting them to the public and integrating them with other health professions. During the times before the Wilk trial, the chiropractic profession had to create its own specialty organizations. These organizations established extra training programs and testing procedures, and promoted these new specialists as having extra skills to help those patients who needed that something extra that general practitioners could not provide. Currently, these specialists do not receive the proper recognition from other professions or from third-party payers. They sometimes receive recognition of their skills from personal-injury trial lawyers, as they can see the benefits of having those DCs on board for their clients.
Finally, it is important that we pass legislation to ensure Medicare and other insurance equality in payments. As long as DCs are limited in their allowed reimbursement, there will not be the demand for chiropractic care from beneficiaries enrolled in those programs.”
Karlos Boghosian, DC, president of the Federation of Chiropractic Licensing Boards
“The chiropractic profession bears the responsibility to maintain its identity as a drug- and surgery-free health care option, keeping alive the ancient wisdom that the body has the recuperative power to heal,” Boghosian says. “Through the teachings of our profession in the past 125 years, the world has become aware of the relationship between healthy body function and the nervous system. Moving forward into the next 125 years, we have an obligation to advance the profession through research, clinical studies, education, regulation and consistent introduction of emerging technologies.
We need to continue our efforts toward how the practice of chiropractic is regarded by the general public and the many health benefits it offers. We must commit to increase the enrollment in our chiropractic educational institutions and equip our graduates with good communication and business principles to ensure professional viability in addition to academic and clinical curricula.”
Wayne Wolfson, DC, president of NCMIC Group Inc.
The NCMIC Foundation sees research as the primary driver for the validity of chiropractic care and has funded more than $16 million to support chiropractic research and education since 2003. They have provided grants to more than 40 DCs who have or are currently pursuing postgraduate degrees that will enable them to conduct research to advance the profession.
“Additionally, funding has been provided to Dr. Heidi Haavik, a renowned chiropractor and neurophysiologist at the University of Auckland whose research focuses on understanding neuroplasticity and the effects of chiropractic adjustments of dysfunctional spinal segments — vertebral subluxations — on somatosensory processing, sensorimotor integration and motor cortical output,” Wolfson says. “Health care continues to evolve and there is no doubt that research will be key to chiropractic’s inclusion and its future role in the health care delivery system.
“Research is and will continue to be the key to advancing the chiropractic profession today and in the years to come.
It is essential for the profession to advance in the ever- changing health care delivery system that we have data which demonstrates the benefits, cost-effectiveness and high degree of patient satisfaction.”
Micheala Edwards, DC, president of the American Black Chiropractic Association
“In order to advance the profession further, we first must work together to diversify chiropractic in order to provide our services to the vastly changing and diverse populations of the United States,” Edwards says. “To do this, recruitment efforts for our schools must become the business of all of us; education of the masses about all that chiropractic has to offer has to improve; and we must continue to conduct sound research studies to further provide evidence of chiropractic’s effectiveness.
“These amongst other things would contribute to widespread use of chiropractic globally. Efforts to produce collective branding and marketing on a national level is another key component that will catapult the profession into a new era.
Without these things, we will continue to face the residual effects of the actions that led up to the Wilk decision. While the outcome of the case was positive, the debacle tarnished the profession and has caused a continuous battle for recognition and validation.
“The time for our leaders to unite in these efforts is now. Leaders from our educational institutions and professional organizations and associations must become the force to push for these important feats. I expect to see a change overall in the next decade where chiropractic will be the ‘gold standard’ in health care across the nation.”
RICK VACH is editor-in-chief of Chiropractic Economics.
