Despite its challenges, chiropractic remains a deeply rewarding career, and its future success depends on collaborative efforts from leadership, institutions and nonprofits to support young doctors and strengthen the profession.
Despite its challenges, chiropractic remains a deeply rewarding career, and its future success depends on collaborative efforts from leadership, institutions and nonprofits to support young doctors and strengthen the profession.Chiropractic has served patients for more than a century, helping millions improve their health and mobility without drugs or surgery. However, the profession is facing a period of uncertainty as a majority of current DCs enter the final stage of their careers. According to the National Board of Chiropractic Examiners, 58% of DCs are likely to retire in the next 20 years based on age alone, with another 22% ending that period in their 60s. Replacing these doctors will be critical to keeping the profession stable and thriving for years to come. This article will help DC’s attract more talent before they enter retirement.
To attract more talent and ensure chiropractic’s future success, the realities of being a DC must keep improving. As with every profession, there are systemic issues at play. Dedicated nonprofits are already working skillfully to strengthen the foundation of chiropractic through advocacy, advancing reimbursement, protecting scope of practice and improving public perception. The Foundation for Chiropractic Progress, the Chiropractic Future Strategic Plan and the Chiropractic Defense Council, among others, are all doing crucial work that deserves the full support of the profession.
However, alongside these big-picture efforts are other challenges receiving less attention from chiropractic leadership but weighing heavily on young doctors. In my work, I frequently speak with new doctors and those leaving the profession at a young age. Many are concerned with challenges that earlier generations did not face. A primary concern is the mismatch between debt and income. The 2025 Chiropractic Economics Salary and Expense Survey shows doctors in their 20s average $97,500 annually (showing significant growth over the last decade); however, lenders we work with report average student debt for young DCs could exceed $300,000. So even with strong starting salaries, young DCs have to either devote nearly half their income to achieve timely student loan repayment or rely on long-term government forgiveness programs, which are unpredictable. While this is a reality for many graduate-level careers, DCs are hit especially hard due to their lower average income than other professionals with similar debt.
Decreasing insurance reimbursement, rising practice overhead and a competitive business environment in many areas further compound the challenge.
For students exploring chiropractic, those within the profession know DCs love chiropractic and consistently report deep satisfaction with helping patients. However, to keep the chiropractic legacy strong, the profession must face these issues directly and advocate for solutions. The following strategies offer a path forward.
Improve access to business education
DCs are healers first, so most enter school to help patients (not run businesses). But the majority will practice independently as the only doctor or sole associate. At a minimum that makes patient acquisition, conversion and retention their direct responsibility. Many become independent contractors, essentially running a practice within another practice, or they eventually own their own practice outright. To survive, much less thrive, it is important for these doctors to have a solid foundation in business and financial management.
Unfortunately, DCs get little formal business education, resulting in too many graduates stepping into practice with a lack of business knowledge to run their practices. This lack of business training also contributes to other, profession-wide issues. Doctors who have difficulty managing their business often cannot pay associates a professional salary, or they overvalue their practices when selling because they lack retirement savings.
To help address this concern, schools could expand supplementary offerings to create more awareness of the need for outside training prior to graduation. Annual required soft-skill bootcamps and consultant fairs, modeled after job fairs, could offer repetitive exposure to key concepts, such as cash flow management and patient conversion and retention. Continuing education could also be broadened. In many states, CE excludes business content, perpetuating blind spots leading to board issues, practice closures or even exits from the profession. Including more practice management fundamentals in CE would strengthen outcomes for doctors and patients.
Improve access to higher incomes
While associate salaries have improved significantly in the last five years, they still do not support the debt loads graduates carry. One promising pathway is buying a thriving practice. When young doctors buy a practice that already generates a professional income, they can afford to repay their student loan debt in the prescribed 10-year period, avoiding the massive interest accumulation that comes from deferring payments. At the same time, they are also building equity and enjoying a lifestyle closer to what they probably expected when they decided to take on sizeable debt to invest in a professional career.
Unfortunately, very few retirement-age doctors understand the realities of selling in today’s market. Many underestimate the preparation required to successfully navigate a thorough sale process, which dramatically lowers the chances of a successful transition. Many DCs also practice into their late 60s or 70s, holding onto their clinics even as they reduce hours. As a result, practices often shrink as the doctors shift to part-time hours. For younger DCs carrying heavy student debt, stepping into a reduced clinic makes it far more difficult to cover both the purchase loan and cost of living, much less their student loan obligations.
Alumni departments, associations and private companies that support DCs have an important opportunity to strengthen this ecosystem by providing their doctors with education and resources on retirement planning and the keys to success in associate buyouts and practice transitions. With better guidance, you can approach these milestones with confidence, eliminating the challenges many don’t realize will be an obstacle until it is too late.
Improve public relations for the profession
Much important work is already underway to elevate and strengthen chiropractic’s foundation. However, a targeted effort to reach the next generation is missing. A campaign that highlights patient testimonials and shares the experiences of successful doctors could offer a more balanced view of what a chiropractic career can look like when managed well. Over time, such efforts could help shift online search results, counter outdated stereotypes and encourage more students to view chiropractic as a rewarding and sustainable career path.
Create mentorship opportunities
While differences in technique and philosophy will always exist, the chiropractic profession needs to embrace its next generation. Young doctors crave practical knowledge from those in the trenches about what works, such as how to bring in new patients or choose liability insurance. Chiropractic leadership, possibly associations, could take the lead by creating roundtables, boot camps or a chiropractic version of SCORE (the business mentorship program supported by the Small Business Administration). Experienced doctors could provide guidance on everything from patient communication to business management, while young doctors could gain confidence and avoid common early mistakes. By pairing mentorship with tangible benefits, such as recognition programs or vendor discounts, the profession could create a culture of support rather than competition.
Final thoughts
All professions have their challenges. Despite those outlined above, chiropractic continues to offer the next generation a deeply rewarding career path. Leadership, schools, associations, alumni networks and private companies can all help address these everyday issues that directly impact young doctors. At the same time, it is critical for DCs to stand behind the nonprofits already working to safeguard the profession. Through these combined efforts, we can ensure the next generation of DCs thrives and chiropractic’s future can be as meaningful and impactful as its past.
An exclusive interview with Crystal Misenheimer
Crystal Misenheimer, CBI, CM&AP, a leading expert in chiropractic practice sales, is the first and only chiropractic broker to earn the coveted Certified Business Intermediary (CBI) designation from the International Business Brokers Association (IBBA) and sets the gold standard in expertise, quality and service. A former clinic owner, she is uniquely qualified to provide comprehensive support on the complexities of clinic valuations and practice sales. Contact Misenheimer and her team at 888-508-9197, marketplace@progressivepracticesales.com or online at progressivepracticesales.com.
