Reinventing the ACA
How to fix the Managed Care Medicare Chiropractic Leadership MESS
Many in the chiropractic profession are struggling financially. Whether it is a new graduate, or a well established chiropractor, incomes are under significant pressure. Unfortunately, no one on the national level appears to be responding. The membership of the ACA is very low because the average chiropractor thinks it would be a waste of money to join; and, as of the moment, they are right.
What is the problem? The ACA says it could accomplish more if it only had more members. The 55,000+ chiropractors (active/alive-not historical total) who do not belong to the ACA have no interest in joining until they see some results. The chiropractic profession is at an impasse (def. a predicament affording no obvious escape. -Websters) but in the meantime, very real problems are confronting the profession and all the profession is getting is excuses.
Pg. 4, Educational Institutions
When it comes to maximized the long-term potential of chiropractic, the profession has a dilemma. If the chiropractic profession wants to be perceived by the public in the same manner as engineers, geologists, physicists, biochemists, or medical doctors, it must attract the same type of individual to the profession as they do to theirs.
Government agencies and high school guidance counselors provide information about a career in chiropractic. Students interested in becoming a chiropractor may now compare the potential of a career in chiropractic alongside alternative careers for high-achieving students. While the chiropractic profession has attracted some of the brightest and most gifted, the typical student entering chiropractic today has changed along with the business opportunity.
The ACA needs to be concerned with the type of students being admitted to chiropractic colleges/universities. When students are unprepared to deliver the quality of health care demanded by consumers, or to handle the competitive business challenges in an era dominated by managed care, the profession suffers greatly.
You can see indication of these problems in:
The deteriorating quality of advertising in which unsubstantiated claims of quality and/or superiority are made
An increasing proportion of chiropractors who use gimmicks such as free services or vastly reduce fees for the patients first visit in order to attract patients to their practices
Chiropractors who under treat patients because of intimidation or constraints imposed by managed care or insurers
Chiropractors who over treat patients workers compensation and/or personal injury (PI) patients to make up for the low reimbursement
The Money Shot
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The Wisconsin Chiropractic Association conducts an annual compensation survey in which more than 50% of the chiropractors in Wisconsin participate. In 2006, the mean income for male chiropractors with less than 3 years experience was $31,714. The mean income for female chiropractors with less than 3 years experience was $30,833. According to the National Association of Colleges and Employers, the average starting salary for a liberal arts graduate in 2006 was $30,958. A chiropractic graduate spends an additional $100,000 - $125,000 only to find out that their salaries are comparable to a 4-year liberal arts graduate, INSTEAD of the much higher paying careers in engineering, geology, physics, biochemistry, or the medical profession.
Those incomes are for those chiropractors who succeed. The chiropractic profession, unfortunately, has failures and a much higher percentage than other health care professions.
The U.S. Department of Health and Human Services maintains a website that details the number and amount of defaulted HEAL loans (see chart).
Defaulted HEAL loans as of May, 2007
Discipline, Total Defaulted, Amount Due
Allopathic Medicine
134
$19,000,205
Chiropractic
623
$66,951,919
Clinical psychology
32
$3,031,897
Dentistry
218
$36,059,040
Health Administration
2
$70,192
Optometry
22
$1,769,415
Osteopathy
27
$4,574,761
Pharmacy
14
$1,018,577
Podiatry
83
$16,253,083
Public Health
5
$591,638
Veterinary Medicine
1
$47,537
Total Defaulted, Total Amount Due
1,161
$149,368,264
As of May 2007, defaults by chiropractic represent 45% of all defaulted loans. That statistic, in itself, is an incredible blow to the credibility of the career prospects in chiropractic. However, when you consider that the number of students enrolled in chiropractic colleges/universities is a small percentage of the total number of students in ALL health professions, the default rate of the chiropractors is staggering.
The data in the chart strongly suggests that the market for chiropractic services is NOT large enough to sustain the number of graduating students and/or that these graduates are not trained to meet the challenges upon graduation.
