Chiropractic 2025:

Chiropractic 2025: Divergent Futures
Of course, not all news was bad and those who could afford the best care saw great breakthroughs. Remarkable
advances in science offered new treatments that could decisively address many illnesses. For example, advances in
quantum biology combined with an information infrastructure that supported increasingly personalized treatments.
Yet the high cost of these technologies kept markets small and allowed only those with means to receive the great
benefits of 21st century science.
One surprising breakthrough for chiropractic care was the MyMobilizor. A group of disgruntled, unemployed,
and disillusioned young chiropractors had teamed up with some bioengineering students in 2018 and developed
an exoskeleton device that promised to help elders maintain mobility late in life. The device could sense spinal
problems and provide appropriate adjustments. While this was not (yet) a cost-competitive alternative to the care of
a trained chiropractor, wealthy consumers bought these devices instead of having to go to the chiropractor’s office
each time they sought an adjustment. Chiropractors were divided over whether this chiropractic device was a threat
to DCs or a helpful advertisement for the importance of a healthy back.
Any positive press for chiropractic was welcomed in the early 2020s to counter public misconceptions and targeted
misinformation against chiropractors from competing providers. Outcomes studies that had been mandated by
the PPACA became a highly politicized game in the years leading to 2021. Chiropractors found themselves
disadvantaged in the game of “my study is better than your study.” After decades of research, by 2010 there had in
fact been some studies that supported the cost-effectiveness of chiropractic for back and neck pain, and even a few
other conditions. Chiropractors fought to include the new indications in chiropractic guidelines. However, providers
and insurers continued to ignore this evidence amidst the plethora of comparative effectiveness studies conducted
between 2010 and 2020 by well-funded competitors using years’ worth of data from electronic health records
(EHRs). An overwhelming number of these outcomes studies steered patients toward physicians and drugs. DCs
were no match for them as the chiropractic field had been losing the comparative effectiveness game for most of its
history. Only about half of practicing chiropractors adopted EHR systems. Furthermore, few of these systems were
interoperable or provided DCs with the capacity to generate outcomes measures and cost effectiveness data. Where
chiropractors did develop positive findings, the studies were often looked down upon as too small, foreign-based,
not objective enough, or not adequately scientific.
What drew most attention to the chiropractic field was the “civil war”—an impassioned and vitriolic feud between
broad-scope chiropractors wanting pharmaceutical prescribing rights and focused-scope chiropractors wanting
to protect the core chiropractic identity. The feud was decades-old but intensified in the 2010s. Caught in the
crossfire, middle-scope providers were unable to focus attention on the profession’s common agenda. Broad-scope
practitioners were working in 20 states to get expanded rights in the hope of growing their practices and income.
The focused-scope community, particularly the ICA and Life University, fought these efforts at every opportunity,
joining with state medical societies to stop the expansions. The acrimony was often the greatest—or in some states
the only—public visibility for the field. By 2025 chiropractic practice rights expanded in only three states, but the
damage to the profession’s public perception was felt in most of the states where battles had been fought. At the
national level, the American Chiropractic Association folded by 2018 as membership declined and the recessions
wiped out the Association’s reserves. The International Chiropractors Association struggled with a similar fate as it
continued to oppose broad-scope activism.
In the marketplace, chiropractors remained largely in solo or small group practices. Four to five% of the U.S.
population was still using chiropractic services in 2024, down from 7% in 2010. This small segment felt highly
satisfied with DCs and loyally supported them. However, beyond these patients, for most of the public a lack of trust
had become the defining view of people who had never even been to a chiropractor. Given years’ worth of intra-
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