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December, 2013

It's Time for Change - The New Norm in Chiropractic Practice

By Drew Stevens, PhD

We can all attest that health care has changed. With constant rhetoric from "Obamacare" to insurance co-payments, running a practice has become more challenging. No one in the universities could have taught you this or prepared you for the chronic environmental changes. After all, it appeared so easy: learn, study, engage in clinics, take the exam and voilà, instant practice success!

In addition to health care volatility, there are also changes in patient behavior. First, patients have access to more information now than 20 years ago. When you're ill, I'm hoping you consult a professional who has expertise in the problem. I don't go to the Internet and try to cure myself, but many try. Second, many seek the "magic pill" because they want it fast and want it now. But third, many do not know where to look and whom to trust. That is because the messages are all ubiquitous. There is so much you can and must offer patients.

time for change - Copyright – Stock Photo / Register Mark The problem is that many in chiropractic focus on just that – chiropractic. Patients today seek remedies for droves of issues; chiropractors can be a vital resource and need to think of themselves as such. Unfortunately, many in chiropractic are so focused on alignments, subluxations and the back, they forget that in certain aspects – not all – based on the relationship, they can be much like a primary care physician. Additionally, being so focused on chiropractic lessens your competitive differentiation. Patients simply view you as the other chiropractor down the street; just another person who cures back pain, nothing more.

The Business Model: Differentiating Yourself

Patients today seek doctors who offer the best value. What this means to you is finding the trends that impact your target market. For example, if you reside in a small town, you might offer general health services, somewhat akin to the family medical doctor. If you live in a larger community that offers multiple doctors, you need differentiation. Therefore, if you service very busy Generation X'ers or baby boomers, you might offer dietary and nutritional services for those who take little interest in their bodies or are obese.

The wonderful world of chiropractic allows doctors to help restore normal physiological function to help improve the overall health of the individual. Therefore, many chiropractors can and do utilize a myriad of aspects to help restore the body to normal state, while others simply focus on alignment. Therein lies the issue: just focusing on the back minimizes the potential opportunities with aging demographics, the pharmaceutical oligopolies and the myriads of app geeks seeking free advice after falling off a ladder. Remember, patients do not seek advice until a chronic disorder is evident. Yet doctors of chiropractic can alter their models so their patients are more preemptive, while illustrating their continual value to overall patient care.

There is another notion to consider: The world of positive health relates to having a healthy back, biochemistry and brain. There is increasing research and sometimes debate regarding the benefits of spinal manipulation on visceral function. Counseling patients on these issues will help build the doctor-patient relationship, since you are concerned about the whole person. This is directly how to transform your practice.

What Are Your Options? Ways to Expand Your Services

There are many doctors today who offer acupuncture and massage therapy. While these models have been used for years, there is little differentiation from one doctor to another. Patients today seek sage advice from those they trust, and doctors need to offer additional services that aid their patient demographics. Since chiropractors are concerned about the entire body, now is the time to offer advice that holistically heals the body.

Several new studies provide a clearer path for chiropractic success. First, "At its recent annual meeting, American Medical Association (AMA) delegates rejected the advice of their own Committee on Science and Public Health and voted to reclassify obesity as a disease rather than a condition or disease risk factor." (Feyter 2013) As we know, there is increased evidence of sedentary adults eating unhealthy foods. Chiropractors who only conduct alignment might want to consider nutritional counseling to augment issues of diabetes, obesity, lethargy and a myriad of other issues. Patients today are under undue stresses from work, economics, family, etc., which causes numerous body stresses. Chiropractors can assist in eradicating these issues with preemptive care, rather than only when patients are in despair.

Second, according to a recent CBS News interview, Dr. Norman Marcus, director of muscle pain research at New York University School of Medicine, states that 80 percent of Americans suffer from back pain at some point in their lives, and that a new study suggests many of them are not getting the correct treatments. Dr. Marcus asserts that many patients are overmedicated or not receiving the proper solutions to their problems.

As we know, many patients use a flight / fright approach to health care; however, many organizations are decreasing programs due to rising insurance costs. Yet while programs are diminished, no one has reviewed the negative impact to productivity due to unhealthy employees. This is where chiropractors can assist.

One method of chiropractic is counseling organizations on the myriad of health care issues that impact productivity, e.g., ergonomics, fitness, burnout and nutrition. To that end, many chiropractors can begin "walking clubs" or fitness seminars that illustrate methods of remaining fit while they sit. Doctors can also offer ergonomic tips due to high computer work, as well as numerous health care methods. There is minimal limitation when attempting to construct programs that increase employee productivity.

Finally, we are entering an era of aging demographics. Consumers and patients are so fearful of aging that plastic surgery is more than a $10 billion business in the United States. There are a myriad of infomercials suggesting magic potions, pills and positions. There is the fodder from "Shake Weights" to "Ab Rollers" to the "Belly Burner." When chiropractors treat and discuss health care issues with prospective patients, they become fitness consultants. Why join commercial gyms and engage in ludicrous exercises when the local chiropractor can develop a personal accountability program at half the cost and half the effort?

Chiropractic competition is rising to new heights and requiring new changes. In years prior, chiropractors might only focus in one practice area. However, multiple competitive forces, as well as environmental changes, force chiropractors into unchartered territory. There is discomfort, there is risk and there is the unknown. But without changing business models, chiropractors will flounder. Similar to the manner in which patients care for themselves, chiropractors can also develop the fright / flight approach. There is too much time and too much money to quit. The only way to preserve the practice is to make some changes, aid your patients and develop new enthusiasm. The choice is easy, remain unchanged and struggle, or go with new norms and new possibilities.


  1. "Back Pain: Are You Getting the Right Treatment for Your Backache?" "CBS This Morning." New York: CBS, July 29, 2013.
  2. Feyter N. "The AMA Says Obesity Is a Disease. Is That Healthy?", July 16, 2013.

Drew Stevens, PhD, is known as "The Revenue Doctor." He helps chiropractors develop strategies that exponentially grow revenue and returns personal time. He is the author of eight books including the widely acclaimed "Practice Acceleration" by Greenbranch publishing. He can be reached through his website at

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