EPISODE 476: The Future of Chiropractic?

Hey, chiropractors. We're ready for another Modern Chiropractic Mastery Show with Dr. Kevin Christie, where we discuss the latest in marketing strategies, contact marketing, direct response marketing, and business development with some of the leading experts in the industry. 

Dr. Kevin Christie: [00:00:00] Welcome to another episode of Modern Chiropractic Mastery. If you're a chiropractor or a chiropractic student, what I'm about to share might be a little uncomfortable, but it's a conversation. Our profession. Definitely needs to have. Uh, I'm actually read a couple articles, um, Dr. Dennis Short and he, uh, it was in Dynamic Chiropractic.

He is the, uh, president of Campbellsville University, the chiropractic program there. And so he had wrote a two-part series on the future of chiropractic, a reality check. And so I wanted to give some of my thoughts on that. As well, and I will in today's episode. Before I do, I, I wanna make mention of our, one of our collaborators, Kyra Health, USA, I've mentioned before.

We use them in our practice to have compliant discount plans that allows us to offer discounted cash rates to patients compliantly. And it's really helped me sleep at night and also [00:01:00] a win-win for our patients and our practice. So check them out@cairohealthusa.com. All right, let's. Let's dive in. So as I mentioned, the title was The Future of Chiropractic.

It was in. Dynamic Chiropractic back January and February of 2026. It was part one and uh, two of that. And, um, you know, it's just one of those things where I think we, we do understand there's challenges in my, in our profession, and so we want to kind of chat about that. Right? Let's have a hot conversation around it because.

You know, chiropractic's, popularity is arguably at an all time high. You know, patients are seeking drug-free, hands-on care more, more than ever, right? Um, but as Dr. Short kind of mentions here, uh, the profession is facing kind of a perfect storm of converging pressures, right? Political hurdles, uh, within the profession, or, you know, let's, let's call it, [00:02:00] you know, even trying to fight Medicare and things like that.

There's financial pressures on practitioners as we know there's declining student enrollment, right? There's, uh, tightening up of the financial aid and, uh, some shifting of public perceptions around all that, right? And so it kind of poses a. Central tension, right? Like, how can demand be rising while the profession is contracting?

So, um, that's something that we need to, um, yeah, dive into, right? Um, two decades ago, 15,000 chiropractic students enrolled in the us. Today it's more about 10,000. And, you know, why, why are fewer students choosing chiropractic? Right. So I think there's a. A broader decline in higher education, enrollment in general, not just chiropractic, um, students researching online and finding the, the financial picture might be unappealing, right?

Fewer prospective students have ever received an [00:03:00] adjustment. Maybe they haven't had, had the experience. And so, um, you know, when you decide to become a chiropractor, what was your story like? Why did you become a, a chiropractor and maybe why are students not, uh, becoming chiropractors? And I know like some of you might be listening like, oh, it's probably good that there's less chiropractors, could be less competition.

But I, I, I think there's, um, a problem with that as well, for sure. Right. And let's first dive into the financial. Uh, equation that, uh, was discussed really. Right. And so, um, this was kind of the core of, of part one, but in the early tur in the early two thousands, I graduated in 2005, so I can attest to this.

The, the average debt, the average student debt, uh, was 140 K. Um, and the average income was 80 K. So the debt to income ratio of 1.75 and that, the other thing that mentioned there is, is [00:04:00] the. Is the interest rate, right? So like my student loan interest rate is like 2.75 from back, I think when I locked it in, in oh four.

I graduated in oh five. So yeah, that's, that's obviously a low interest rate and, and lower debt. So now today the debt is over 300 k. And the average income is 70 K. So you got a ratio of 4.29, so from 1.75 to 4.29, and that ratio needs to return to about 2.0, uh, or below, or for the profession to remain viable, right?

So he's, he's using this 2.0 number and it's a threshold we crossed around 2005. Ironically, again, that's when I, I did graduate, so I think I got out just in time, uh, for that. Um, and I think it's, it's challenging, right? Um. We're asking people to make a $300,000 bet on a career that pays less than it did 20 years ago.

And that's a hard [00:05:00] sell, there's no doubt about it. Now, I'm a, I'm an optimist. I like, I, I'm, I'm an optimist. But you gotta have the real conversations, right? Like, I, I love the profession. I'm glad I did it. In our mastermind, um, group, we were having a chat about. Would you recommend it? I just think I would be asking clarifying questions of, of a student before I would say yes, become a chiropractor.

I would say, um, you know, if you, if you, uh, are entrepreneurial, right? Um, are you wanting to be a business owner? Do you, do you have that desire? Do you know what it takes? Um, are you willing to really put in the work? Um, if you, if you're just looking for a job long term, the ROI might not, might not be there, but there is, if you, if you do a great job, you can find really good group practices and there's a lot more opportunities now than there was before.

Like, there's a lot of cool things and we will get to some more positives as we go forward here and 'cause, uh, he does provide kind of a, a path forward, right? So [00:06:00] obviously the first one is we gotta. You gotta fix the financial equation at the, at the school level, right? Chi Chiropractic schools must meaningfully reduce the cost of education.

'cause we're not, it's gonna be hard to, to get down to that 2.0 again, it's hard. It's gonna hard to do it by just the average income increasing enough. It's gonna have to be a combination of the two. So the chiropractic schools are gonna definitely have to do that. And, um. And he's got some key points in that.

I, I recommend reading as far as, uh, cost sharing with larger universities, more online courses, eliminating resource training programs, consolidating admin roles, scrutinizing executive compensation, right? Like it. As we can probably imagine, uh, the costs that have gotten outta control for these schools.

And so they feel compelled to charge what they have to, and, um, and he has a key point of nothing should be off the table and, and savings just has to be passed on to the, onto the students. Right? Uh, the other one is practicing DC should refer students towards schools with lower [00:07:00] tuition and stronger business training.

Um, and I think that's a key, right? Like these chiropractic schools have to have lower tuition, but they also have to be providing stronger business training. They're just not, which is frankly why MCMI think is thriving, like it is, is um, so many chiropractors new, um, been in practice 10 years, 20 years are seeking our help because we have a lot of resources and experience around it and other coaches and experts, and we can, we can, um, provide you with a continued business training that.

You're just not gonna get at school. It's, it's you, but they have to have more at school for sure. Another path forward is recruit students earlier. Right. Uh, can't rely solely on traditional college pipelines. Outreach needs to start in high schools. That's how I, that's how I found out. I was a high school, uh, baseball player, had a sports injury and was seeing a chiropractor in his work.

I had a, uh, English teacher where we [00:08:00] had to do a project on. It was like a WR investigative report. We had to do a written project, an oral presentation on what we wanted to be, and I was finally coming to the realization, uh, I wasn't gonna be a professional baseball player, so I didn't know what I wanted to do.

And, uh, my mom was like, oh, why don't you do that report on the chiropractor they you've been seeing? So I was like, all right, sure. I didn't necessarily do the. Project thinking I'd become a chiropractor, but as I did the project and did it, I decided I want to be a chiropractor at 17 and, and here we are, right?

So what can we do to reach people at high school, because that's when a lot of decisions are being made, for sure. And, uh, that's, I think a, a really good point there. Um, and now he also talked about increasing income through unity and participation, right? So obviously to, to get to that 2.0 number, we're gonna need to obviously increase the income and, uh.

Fewer than 10,000 [00:09:00] of 70,000 plus practicing chiropractors belong to either major national Association, a CA, or ICA. Um. If Dr. Short calls for either collaboration or a merger between the two, a un unified voice is essential, that, that might be challenging. Um, the big legislative prize, full inclusion in Medicare, that was kind of earlier mentioned, the political part here.

Um, it's more around this inclusion Medicare, this would be obviously huge. Right. Um, that would be awesome. So. I, I would love for that to have been waiting a long time. I know, I know a lot of great chiropractors are putting a lot of great effort into it, and so I, I, I am encouraged. Um, and hopefully that does happen.

That could be a, a big game changer for sure. Um, so I think there's a lot to it, right? Um, it's not easy. We need, one of the things that's, [00:10:00] I, I'm not sure if it was mentioned here, I read through it, but I, I forget, but, um. Frankly, we need owner chiropractors making a better living. Right. I'm gonna give you kind of my, one of my big, I think, root causes of this.

I, I fully agree. Like, man, we gotta get the student loan situation under control. Right? That part is just insane. Um. How do we, how do we increase the, uh, income opportunities, compensation structures for associates? How do we, um, get owners making more money? Right? Because the problem is, it's not just associates aren't making enough.

The owners of practices aren't making enough. Like, I can't even tell you how many. Chiropractors I speak to who made more as an associate than they do as an owner now, and I'm not talking about people that just opened up their practice. I have calls with [00:11:00] chiropractors that have owned their practice for eight years and they make less money now as the owner than they did as an associate or than other associates, right?

Like I, I know a lot of associates making 80, $90,000, a hundred thousand dollars, and I know a ton of owners that have been in this. Ownership role for a while, a bit now, and they're paying themselves $60,000. And it's, and I'm not saying that to denigrate anybody, but um. It's challenging. It's not just, oh, I'm not, I, I gotta get outta this associateship so I can be an owner so I can make more money.

Yeah. The ceiling is much higher as an owner. There's no doubt about it. And if you do things right, you will. But the, I think one of the fundamental problems we have is not enough owners are able to pay themselves enough money A, and then B, enough money to. You know, pay themselves enough money to pay, to pay themselves to, to survive, [00:12:00] and then be able to pay for an associate and pay an associate well, right?

The combination of an owner who probably as an owner wants to make, you know, 150,000 before starting to consider paying an associate 80,000, right? That's right there. Um, $230,000 worth of payroll right there. And so cost of living's gotten so high. So the owner needs to make a certain amount of money to then feel comfortable with paying another doctor a certain amount of money.

And if we can get more owner doctors being able to thrive and pay themselves a living wage and do well, then not only will they, uh, that number go up, right? So the average would go up because the owners are making more money, but now they're able to provide more jobs that are. You know, competitively compensated.

And, and that's where we need to get [00:13:00] to. And I think we need owner chiropractors. Um. Understanding that when you decide to own a business and start a business, the fail rate of small businesses in general across all types of small businesses is super high. It's definitely a lot better in our profession, but it doesn't mean it isn't hard.

It is so hard to grow and operate a business. That thrives and you have to take it seriously and you need help. You need training. You need business and marketing and communication and financial awareness. You have to be continuing that for yourself, just like you would clinical competency. And the more that the owner chiropractors take that on.

Not only will they make more money for themselves, they will be able to hire associate doctors and and, and be able to pay them competitively, which will also decrease your [00:14:00] turnover of those associates. I mean, owners are burning through associates left and right, and associates are burning through. Jobs left and right because compensation structures are faulty and it's, and it's challenging.

So I think, uh, the profession has, I agree with this article in a lot of ways that the, that the profession is facing some significant challenges, but I am very optimistic on it and I think attacking it from the owner standpoint. And getting them to understand business fundamentals. And we're having a kind of a crisis within the owners of chiropractic and, and trying to pigeonhole certain types of practice styles into business models that are not working.

I, I did podcast episode before where there's a product market. Mismatch, right? The, the product of what a lot of chiropractors are offering is a mismatch to what the consumers are looking for, and they're trying to [00:15:00] force feed that, and that ain't working, and they're not, you know, they're, they're, they're either.

Undercharging or they're spending way too much time with a patient that's not fully needed by just the dc and if they're spending too much time and not charging enough, uh, that's a, uh, you're gonna be spinning your wheels for a long time. Uh, or if you're spending a lot of time and you're trying to charge a boatload.

You haven't positioned yourself as an expert, like a real expert to be able to charge hundreds of dollars a visit. That's a product market mismatch. And you might feel good about yourself that you're getting paid what you're worth by that patient, but you're not getting enough patients and enough revenue and enough profit to then be able to pay yourself a six-figure income, let alone pay an associate close to a six-figure income.

And so there's a product market mismatch there. There's such a good sweet spot of being able to spend the appropriate amount of time [00:16:00] with the appropriate level of care, with the appropriate business systems in there. That is a product market match that then hyper speed your growth of your practice. And I've seen it.

We've got a lot of clients like that. I see in the mastermind group. There is that sweet spot and that's the one thing that we try to help our chiropractic clients with on that. And I think if we can get that. Fixed combined with all the awesome opportunities that are out there now, which I love. I think we can really help this out and hopefully we can get the reduction in student loan stuff going on with the schools and the cost and let's make it a little bit more reasonable there.

So that's my take on Dr. Dennis Schwartz's two part series in Dynamic Chiropractic titled The Future of Chiropractic, A Reality Check. I recommend going to check and read that out for yourself and what your thoughts are on it. Uh, but that's a little bit of my take.