Chiropractic 2025:

Chiropractic 2025: Divergent Futures
DCs and DPTs screened and triaged neuromusculosketal complaints, while NPs and PAs screened and triaged
internal disorders. They used the pathways to determine the treatment course for patients. When needed, they sent
patients with more complex conditions to the MDs and DOs on the team. In this role, chiropractors screened for
serious spine pathology such as cancer, infection, fracture, or inflammatory joint disease, and examined patients to
determine whether there was any neurological deficit and if the deficit was an emergency. Subsequently, the DC
typically used their delivery system’s pathways to develop a treatment plan based on evidence-based treatment
methods that included education, exercise, manual therapy, acupuncture, nonsteroidal anti-inflammatory drugs, and
any other treatment approach that had been shown to be of benefit. The DC or DPT as primary spine care clinician
also identified depression and referred patients to psychologists, psychiatrists, and social workers as needed.
DPTs and DCs thus gained more respect because of their effective diagnostic capabilities. Furthermore, given
the growing demand for care, DCs and DPTs no longer had to compete with one another for patients. In fact, the
American Physical Therapy Association and American Chiropractic Association started to work together to educate
the public about prevention of chronic pain and the important role that DPTs and DCs were playing in the new
system of health care. Nevertheless, most MDs continued to be more familiar with referring to physical therapists
for rehab and other conditions, and ACOs or hospitals in many cases owned physical therapy practices.
Patients became assertive in their research for self-care and for choosing providers. In the years leading to 2025,
what had started decades before on sites like PatientsLikeMe.com grew into a large-scale public engagement with
personalized medicine and health care. Low-cost personal biomonitoring tools built each patient’s health profile in
detail, linking that to their electronic health record. Patients played an increasingly assertive role in getting the care
they wanted and in using innovative, alternative, or conventional approaches according to their individual needs and
wants. A large segment of the population kept patient diaries, experimented with different treatment combinations,
and shared the results with other patients and with their health care provider systems so that all could benefit.
While chiropractic had historically been outside of mainstream science and health care, the field increased its
research efforts in the mid-2010s. By 2017, use of electronic health records (EHRs) among DCs in their office
practices had grown to 80%, and groups such as the Patient-Centered Outcomes Research Institute (PCORI), the
Cochrane Collaboration, and PatientsLikeMe provided new research approaches that chiropractors—regardless of
philosophical orientation or leaning—utilized to show the profession’s value proposition.
With zettabytes of data from personal health records, virtually all integrated care systems by 2020 were providing
their patients with personal avatars (digital health coaches) to recognize and leverage the extent to which their
health was shaped by social, psychological, and behavioral factors. Community health workers also used digital
health coaches to meet patients’ needs in their homes – effectively lowering per capita demand for in-office visits.
Chiropractors, like other health care providers, took advantage of health care technologies that were becoming
increasingly important to their new patients and the primary care teams. By 2020, chiropractors were personalizing
their treatments for patients based on the patient’s genetic data, while providing the still-appreciated human guidance
and care that people, particularly geriatric patients, sought as they were getting acclimated to personal biomonitoring
devices. And DCs and DPTs continued to be sought out for the value of their manual therapy. By 2025, nine% of
adults in the U.S. or 24 million people were seen by the 68,000 practicing DCs.
In the years leading to 2025, broad-scope chiropractors won expanded practice rights in 10 states despite heavy
opposition by the ICA and focused-scope chiropractors. In those states roughly 10% of DCs got the online or
in-person pharmacology training that was required for the expanding practice rights. By 2025, just over 3,000
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