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BREAKOUT OF RESPONDENTS-
CA/Office Mgr. 1.5%
Figures calculated by average or mean were achieved by dividing proportionately the total number of respondents per question.
Medians were determined by calculating the middle number or range. Percentages are based of the total number of respondents.
Welcome to Chiropractic Economics’ second annual salary and expense survey of the chiropractic profession. At your request, this all-encompassing survey has been expanded to include even more details than the first one. For example, we’ve added the median gross and net income ranges for the first five years in practice through the “peak” years (12-14) and the “golden” years (31+) that are truly financial gold mines. We also asked whether net and gross revenue are increasing or decreasing. Across the nation, the overwhelming response is net and gross are increasing for three out of four practices.
We’re again extremely pleased with the willingness of our loyal readers to share their private financial information and take the time to answer our inquiry. Chiropractic Economics’ second salary and expense survey was sent to recipients of the March and April 1999 editions of Chiropractic Economics magazine. Surveys received within the designated time period have been tabulated here.
Following is a summary of demographic dataplus practice stats, staff, income, expenses and personal data. The survey also includes information on the impact of managed care, group/multi-disciplines and retail products on the chiropractic practice. Information derived from this survey will be used in future articles and to help determine editorial topics of interest. Those who are interested in additional information about this survey may contact Chiropractic Economics’ Business and Editorial Office. Thank you to everyone who participated!
Gender, Age, Number of Years in Practice
Again, virtually all respondents, 98%, are Doctors of Chiropractic and two percent are students or office personnel. Twelve percent of survey respondents are female and 88% are male. Our respondent and gender percentages are the same as those found in many other surveys, including our 1998 reader surveys. The ages of respondents ranged from 25 to 75, with an average age of 41, which is similar to 1998’s range of 24 to 76, with an average age of 41. The breakout by age is 13% under age 30; 29% ages 31-38; 25% 39-45; 25% 46-55 and 8% are ages 56 and up. Average length of time spent practicing is 12.6 years, the same as 1998. Respondents again reported that 76% are married, with 7% married to a DC and 33% married to a staff member.
Number of Hours, Additional Activities
Almost all respondents practice full-time with 4% putting in more than 50 hours a week; 23% working 40-49 hours; a full 53% practice 30-39 hours; 15% 20-29 hours and only 5% put in less than 20 hours. These averages are similar to 1998’s figures. Respondents also engage in additional activities, including 4% who consult with business or industry, 2% lecture or give seminars, 56% retail products to patients and 4% teach at a college or school. Another 5% engage in other professional activities including conducting Independent Medical Examinations (IMEs), offering weight management classes, strength and conditioning courses, reading x-ray films and one respondent is team chiropractor for an NBA basketball team.
Principle Form of Employment
Solo, Group, Multi-Discipline
Eighty-two percent consider themselves solo practitioners compared to 1998’s eighty-six percent. One twist is 51% of Chiropractic Economics’ 1999 practitioners are truly solo while another 31% practice solo and have integrated other disciplines. These numbers have changed significantly compared to 1998’s respondents who indicated 64% were solo practitioners and 22% who integrated other disciplines. Fifteen percent of 1999’s respondents are part of a group or have partners and 3% reported being employed by a DC, compared to 12% and 2% respectively in 1998. Of the 31% with multi-disciplinary practices, 6% have an MD or DO (3% in 1998); 24% offer massage therapy (18% in 1998); 13% offer rehabilitation (5% in 1998) and 11% indicate a dietician/nutrition (5% in 1998). Other disciplines accounted for 6% of respondents who mentioned acupuncture, physical therapy, exercise instruction, hypnotherapy, Doctors of Naturopathy (ND), homeopathy, psychotherapy, treatment for chronic pain and the services of an electrologist.
Location and Competition
Population Density, Number of Competitors
Chiropractic Economics’ respondents estimate a mean of 13 clinics within a five mile radius of their clinic, an increase from estimates of 8 in 1998. A full 55% favor suburban locales, followed by 23% in rural areas and 22% in urban locations.
Patient Visit Average, Number of New Patients
An average of 106 patient visits (PVA) per week are the norm for individual respondents; lower than 1998’s average of 114 weekly patient visits. However, respondents estimated 135 patient visits on average for their clinics, up from 1998’s 120 PVA. The mean number of new patients per week is 5.44; very similar to 5.36 new patients in 1998.
Number of Doctors, Clinics, Staff
Chiropractic Economics’ practitioners own an average of 1.06 clinics and have an average of 1.10 doctors per office while group practices have an average of 3.04 doctors. The mean number of full-time employees in each office is 3.15. The average number of total employees in 1998 was slightly lower at 2.83.
Fees and Income
Sources of Revenue, Managed Care Participation
Ninety-two percent of all respondents accept the following sources of revenue, in descending order: cash, 99% (97% in 1998); auto insurance, 92% (same as 1998); private insurance, 92% (91% in 1998); Medicare, 81% (86% in 1998); workers’ compensation, 78% (83% in 1998); managed care plans, 60% (65% in 1998); Medicaid, 34% (36% in 1998) and 3% accept other forms of payment such as attorney’s liens and barter arrangements.
Of the 56% who receive income from retail products, the products offered are: nutritional products, 77%; pillows, 77%; orthotic supports, 71%; topical creams/ointments, 47%; weight management products, 20% and other products, 7%. Additional products mentioned include health books and videos, homeopathic remedies, ice packs, orthopedic supports, air purifiers, physical therapy items, botanicals, magnetic wraps, TENS units, rehab and exercise products. Respondents listed additional sources of professional income as renting office space, claims review and collecting deposition fees.
A full 64% of respondents participate in at least one HMO, PPO or IPAcomprising a majority of our survey practitioners. Statistics from the 1998 survey are comparable at a rate of 65%. While 64% of this year’s respondents say they are “in” at least one managed care plan, it is worth noting that only 60% reported that they consider managed care as a “source of revenue.”
Practice and Staff Expenses
Respondents reported spending an average of $92,548 on their practice’s expenses, up considerably from 1998’s total of $82,385. The expense categories in descending order are: office space, $20,024; miscellaneous expenses such as business loans, dues and insurance, $16,528; advertising/marketing, $8,998; student loan payments, $8,925; business supplies, $6,208; practice management consultants, $6,137; equipment leases, $5,769; utilities, $4,550; computers/software, $3,889; continuing education/professional travel, $3,648; other professionals such as CPAs, attorneys, etc., $2,793; malpractice insurance, $2,782; and medical equipment/repairs, $2,297.
Staff expenses include the following average gross amounts per annum for salaries, bonuses and retirement plans: Doctors of Chiropractic, $81,824; associates, $61,604; chiropractic assistants and staff, $40,179; and MDs, LMTs and PTs, $41,507.
Gross and Net Income
By Region, Age, Gender, Number of Years in Practice, Multi-Group Specialty, and Managed Care Participation
Income for this portion of the survey was compiled based on specified ranges, rather than individual figures. The median gross income reported by 1999 survey respondents was again in the range of $150,000 to $249,000; individual median net income was again reported to be in the $60,000 to $74,900 range.
In addition, 74% of overall respondents reported that their gross revenue is increasing and 72% overall reported their net revenue is increasing.
Gross and Net Income by Region
Respondents in the Midwestern region of the United States reported the highest net income in 1999 with a median range of $75,000 to $89,900. This is in contrast to 1998 when the Eastern region reported the highest net income. The 1999 median net income range for the East, West and South is $60,000 to $74,900.
Median gross income for all regions fell into the $150,000 to $249,000 range, the same as 1998 figures. The majority of participants in all regions of the country reported their gross revenue is increasing, including 83% in the West, 75% in the Midwest, 67% in the South and 66% in the East. The net revenue in all areas is increasing as well, with 82% in the West, 72% in the Midwest, 70% in the South and 64% in the East.
Gross and Net Income by Age
Age is a factor. Survey participants under 30 reported a median net income range of $45,000 to $59,900, although this is in a higher bracket than 1998’s respondents aged 30 and under who netted $30,000 to $44,900. The highest net income range remains at $75,000 to $89,900 for respondents aged 39-45. Groups netting a median of $60,000 to $74,900 include age ranges 31-38, 46-55 and 56 and up, the same as 1998 respondents. The median gross income was $150,000 to $249,000 for all age groups with the exception of those under 30 and those 56 and up, whose median gross was $100,000 to $149,000, similar to 1998 results with the addition of the under-30 group this year.
Gross and Net Income by Gender
Females still fall behind in 1999 when it comes to median net income, with $45,000 to $59,900, although this is a jump from last year’s net income of $30,000 to $44,900. Males still earn a median of $60,000 to $74,900. Gross median income remained the same in 1999 for both groups at $150,000 to $249,000.
Gross and Net Income by Number of Years in Practice
With the addition of this new category in 1999, 1998 numbers are not available for comparison. However, the median gross revenue results are in ascending order: year one, $50,000 to $99,000; years two, three, four, five, 6-8, 9-11, 18-20, 21-23, 24-30 and 31+, $150,000 to $249,000; and years 12-14 and 15-17 grossed $250,000 to $349,000. The ascending order of median net income is year one, $30,000 to $44,900; years two, three and 21-23, $45,000 to $59,900; years four, five, 6-8, 18-20, and 24-30, $60,000 to $74,900; years 9-11, $75,000 to $89,900; years 15-17 and 31+, $90,000 to $104,900 and years 12-14 netted $105,000 to $119,900.
Gross and Net Income by Specialty
One new surprise in this category; groups and partnerships leapt into the $350,00 to $499,000 median gross income range, up from 1998’s $250,000 to $349,000 range. Net income for groups/partnerships was also higher than 1998 with a median of $90,000 to $104,900 compared to $75,000 to $89,900 previously. All others, solo only and solo with multi-disciplines had a gross median of $150,000 to $249,000 and net median of $60,000 to $74,900.
Respondents reported an average gross income of $157,883 from associates; $53,100 from MDs and $79,785 from LMTs, PTs and others. This is an increase over 1998’s respondents who reported $131,226 average gross income from associates.
Gross and Net Income by Managed Care Participation
Despite the higher administrative costs, managed care still has not produced any more income in 1999 than for those who are not involved. Gross and net revenue for both groups remained in the median ranges of $150,000 to $249,000 and $60,000 to $74,900 respectively.