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Dynamic Chiropractic – May 31, 1999, Vol. 17, Issue 12
Dynamic Chiropractic
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Dynamic Chiropractic

The Chiropractic Practice -- Now, and Then

ACA Survey Reveals Dramatic Changes over Last 20 Years

By Editorial Staff

"All is flux, nothing stays still." -- Heraclitus (540-580 B.C.)

"The ever-whirling wheel of change on which all mortal things doth sway." -- Edmund Spenser (1590)

 



Veteran chiropractors talk about how practice used to be. The tendency to talk about bygone days is natural enough, but how exactly has the chiropractic practice changed over the last few decades?

The American Chiropractic Association (ACA) has been surveying its members on various aspects of chiropractic practice for decades. Some of the data goes back to the '60s, but the majority of it dates back about 20 years. And while the responses of the ACA members do not necessarily speak for the entire profession, they're indicative of some interesting trends.

   
Gender of U.S. Doctors of Chiropractic
     
  Female % Male %
     
1972 3.3 96.7
1997 16.3 83.7
     
% of DCs Using Computers
     
1981 8.1  
1994 81.9  
     
Principle Form of Practice
     
Solo Practice  
1972 79.5%  
1997 70.0%  
     
Group or Partnership Practice  
1972 15.6%  
1997 22.7%  
     
Employed by Another DC  
1972 1.3%  
1997 5.1%
Patient Flow Per Week
     
Average Number of Patient Visits Per Week / New Patient Visits
     
1979 103.9 8.7
1980 107.1 8.5
1981 113.2 8.5
1982 116.3 8.0
1983 108.8 7.6
1984 115.5 7.6
1985 109.2 6.2
1986 111.8 6.9
1987 111.8 6.4
1988 116.0 6.6
1989 124.1 6.9
1990 130.2 6.9
1991 127.9 6.8
1992 124.7 7.5
1993 129.4 6.9
1994 109.2 5.6
1995 120.7 5.6
1996 108.5 5.8

Chiropractic Patient Characteristics        
               
Gender of Patients          
               
  Female Male          
               
1980 56% 44%          
1997 58% 42%          
               
Age of Patients            
               
  Under 16 17-44 45-64 Over 65      
1977 8.0% 40.0% 34.0% 17.0%      
1997 10.0% 41.0% 33.0% 16.0%      
               
Conditions            
               
  NMS Viscerosomatic Vascular Other      
1972 74% 10.6% 1.5% 13.9%      
1994 88.6% 7.2% 2.7% 1.5%      
               
Sources of Income          
               
  Cash Private Insurance Work Comp Medicare Medicaid HMO/PPO Auto
               
1975 70.7% 13.2% 8.6% 1.6% 1.7%    
1995 27.7% 28.6% 10.8% 8.4% 1.2% 8.6% 14.5%
               
Average Income          
               
  Gross Net % (Net/Gross)    
               
1980 $83,572 $43,457 52%        
1989 $216,366 $101,423 46.8%        
1991 $234,192 $91,965 39.3%        
1997 $228,236 $86,519 37.9%        
               
Perceived Supply of DCs          
               
  Need More Right Number Too Many  
               
1975 41.0%   51.0%   8.0%    
1997 7.6%   60.4%   32.0%    
               
Student Loan Amounts at Graduation        
               
1979 $15,227            
1997 $82,731

The ACA data presents some interesting realities:

• The number of women in chiropractic is steadily increasing (currently almost 20%).

• Almost every chiropractic practice has a computer.

• Patient visits rose to a high of over 130 per week in 1990, but fell back to almost where they were in 1979. New patient visits have dropped by 1/3 over the same period.

• While U.S. chiropractors are caring for more neuromusculoskeletal complaints, the makeup of the average chiropractic patient hasn't changed appreciably.

• Cash now accounts for less than 28% of practice income, as opposed to over 70% 20 years ago.

• Net income for the chiropractic practice reached a high of over $101,000 in 1989 with gross income reaching its high in 1991 at over $234,000. Unfortunately, both figures have since fallen. But the real story lies in the percentage of net income derived out of gross. In 1980, DCs took home 52% of their gross income. In 1997, that percentage dropped to below 38%.

• Over 92% of the profession surveyed believes there are either enough DCs or too many in the U.S. Our chiropractic colleges need to carefully address the supply and demand equation for chiropractors and make the students aware and prepared for that competitive business environment.

• The average chiropractic student loan amount in 1997 was over five times greater than the student loans of 1979.

Editor's note: Our thanks to the American Chiropractic Association for supplying this information to be shared with the chiropractic profession. A copy of the full report is available from the ACA at (800) 368-3083. The member price is $49.95; the nonmember price is $149.95.

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