Snap, Crackle and Pop

Chiropractors are seeing more patients than ever and that trend is expected to continue as Baby Boomers grow older. The popularity of alternative medicines and Americans newly-found caution towards pain killers only increase the demand. But the real question is can the industry get paid for it?

By 2016, the chiropractic industry is forecast to reach $14.8 billion in revenues. Those sales are divided among 142,000-143,000 chiropractors practicing in America today. That number is growing slowly even though the healthcare industry overall continues to grow far faster. The slower growth can be explained by a number of trends that have turned out to be a two-edged sword for the industry.

As I mentioned, the graying of America has been one trend that has filled the offices of many chiropractors around the nation. To be fair, my headline is misleading since the days of forcing someone’s body into contorted positions and inducing a snap, crackle or pop are long gone. I, for one, have been going to chiropractors for years ever since injuring my back during a rocket attack in Vietnam. Sharing the waiting rooms with me and my disc issues, have been an increasing array of patients suffering a diverse list of common ailments. Neck pain from whiplash injuries, scoliosis, hip and knee problems and carpal tunnel syndrome are only some of the aches and pains that afflicts all of us oldsters (and many youngsters as well).

Unfortunately, most of these conditions cannot be resolved by surgery nor will they disappear forever once treated. I have herniated discs and for me this is a chronic condition. Although that’s bad for me, it’s good for the chiropractic business, or could be if it weren’t for the limitations placed on chiropractic visits by most medical insurance companies.

Most plans limit chiropractic visits to 12 sessions a year. I can go through that many visits in one month if I throw out my back severely, which can happen once or twice a year. After that, I pay out of pocket. Most people can’t afford that.

Although chiropractic care is gaining acceptance among more and more health care providers, it wasn’t always that way. There was a time in the not too recent past when most medical professionals wrote chiropractors off as quacks or charlatans. The insurance companies, following that lead, made it extremely difficult for chiropractors to be reimbursed for their services.

The passage of the Patient Protection and Affordability Act in 2010 (Obama care) is expected to improve the position of chiropractors among health insurance providers. The act makes it illegal for insurance companies to discriminate against chiropractors and other providers’, relative to their participation and coverage in health plans.

That may be good news, but like other medical practitioners, chiropractors are faced with shrinking reimbursements, while at the same time their regulation and insurance costs are skyrocketing. Another hindrance to the growth of the profession is its position as an alternative medicine and not a primary form of healthcare.

Yet the well-documented shrinking in the numbers of general practitioners in America has also bolstered the demand for chiropractors as an alternative primary care physician.

“People often say they would rather come to us first before going to their doctor,” says Ron Piazza, owner of Berkshire Family Chiropractor in Pittsfield, MA, and a practicing chiropractor since 1985.

He has a point. In my experience, it usually requires one to two months before I can get a visit with my GP. If there is an emergency, my alternative is the hospital emergency room. But I can get in to see my chiropractor on the day I call, if it is an emergency or a day or two if it is not. I know that whatever ails me, he will have a lot more expertise in guiding me in the right direction.

“More and more, we are being considered the first line of defense by our patients,” Piazza explains, “simply because there is nowhere else to go except the emergency room.”

That makes a lot more sense when one realizes that the education required to become a chiropractor is not that much different than that required of a medical doctor. It is a four-year curriculum after college including residency whereas, in general, an MD requires six years, although two of those years are in residency.

From a personal point of view, I can expect to hurt myself at the gym or snow shoeing or cross country skiing or something else at least once or twice a year. The older I get, the less likely that my body can rebound on its own. I have a strong aversion to taking drugs and have found that a chiropractor performs for me the same function an auto mechanic provides for my car. In fact, I’m going for a tune-up tonight.

2 Comments

  1. Hi Bill,

    Just wanted to thank you for a clear and level-headed take on chiropractic. It’s uncommon to see something like this in the general media. Normally, either claims are made for the discipline that are unfounded, or it is dismissed out of hand entirely. In our view, used appropriately and administered properly, there is a place for spine-care specialists in the pantheon of medical practitioners.

    Indeed, for those who need such care, surgery should always be the final resort, as the medical outcomes of vertebral and disc surgery are extremely poor. A recent study determined that of patients who undergo lower-back surgery, about 80 percent require additional surgery and their initial presenting problem (pain) is not resolved.

    In contrast, patients who first seek conservative care, such as chiropractic, tend to have significantly better results. This is why, as you note, the PPACA should offer chiropractors a role to play in lowering healthcare costs. For the moment, Section 2706 of the Act appears to give DCs and NDs a seat at the table: http://aanp.membershipsoftware.org/files/One%20Pager%20about%20Sec%20%202706%20for%20May%205%202012%20AANP%20FLI.pdf

    However, the AMA’s lobbying arm is looking to remove that language from the Act, as part of their long-standing battle against chiropractic treatment. The Senate health committee is favorably disposed toward Section 2706 so, for the time being, we are not seeing a serious threat from that angle.

    Best regards,

    Daniel Sosnoski
    Editor-in-Chief | Chiropractic Economics
    904-567-1539
    http://www.ChiroEco.com

    Reply
  2. Dear Dan,

    Reply

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