I spoke to a colleague of mine over the phone last fall. He complained that his practice was at an all-time low. In my area, hearing about practices that are slow is not uncommon. However, this particular doctor had recently received a national award and was also added to a major university’s medical staff, the first time in the history of this well-known institution that a chiropractor has held this position.

Another friend of mine and I had chuckled at a trade publication that reported on the incomes of chiropractors. We did not know how or where they got the data, but if the data were true, we questioned why the following were so reduced: post-graduate certification courses, association memberships, and the number of students entering the profession. In fact, the reductions in chiropractic enrollment in our area is so significant that the local school in my area, Los Angeles College of Chiropractic, is now called Southern California University of Health Sciences. Among other things, it has added acupuncture and homeopathic programs. No longer can it survive on chiropractors alone.

In Dynamic Chiropractic there was a front-page story that the fourth hottest profession in the upcoming decade was a chiropractor. Again, I question where this research was done. Obviously, the high default rate, the high disability claims from practicing chiropractors, and plummeting insurance reimbursement to chiropractors were not looked at.

Healthcare crisis: Patients pay insurance companies more money for policies that have fewer benefits; patients have higher deductibles; patients have higher co-pays; and the reimbursement to healthcare professionals from insurance companies is significantly reduced. If the insurance companies sell policies with less coverage for more money and, in turn, pay smaller amounts on claims, why are healthcare prices out of control? (BECAUSE THE COST PER SERVICE/PROCEDURE HAS SKYROCKETED!)

In addition to chiropractic colleagues, friends who are medical doctors and dentists report similar stories; that is, they are paid less now than they were 5 years ago and much less than they were 10 years ago. In turn, it costs them more money to try to get the insurance companies to pay.

When I began practicing, I was the fifth chiropractor in my town. By the end of the century there were 35 chiropractors in Brea, California. That number, plus or minus an associate or 2, is now between 20 and 25.

I have noticed a difference in chiropractic students in the last few years, especially since the word is out regarding the decline in practitioner income. No longer do I see students whose major concerns are how much I bill and how much I collect; rather, those who are in the profession now seem more concerned with how to be good practitioners. They are very aware of the current practice realities. Those entering chiropractic are, in my opinion, doing so for the right reasons; that is, patients’ health as opposed to personal wealth.

Regarding the cause of the healthcare crisis, blaming the attorneys will no longer work. In this area, the total amount of personal injury lawsuits are reduced and the average settlement per incident is reduced. I believe the same is true for malpractice. There are fewer malpractice lawsuits and the settlements for these suits are lower.

I remember 10 years ago speaking to a prominent chiropractic attorney about seminars. We discussed that I would give a seminar with the goal of getting patients better with fewer visits. I remember him telling me that I would not get good attendance. I believe that with all the income and reimbursement changes, the type of person entering the profession today has a different attitude and there is a future for seminars that define success or better results as lower healthcare costs and fewer visits rather than the traditional chiropractic marketing seminars designed to extend and increase total visits.