Chiropractic 2025:

Chiropractic 2025: Divergent Futures
greater cost effectiveness than medical or surgical treatment. This helped stimulate business for DCs. However,
most chiropractors were subject to flat or declining fees for visits dictated by Medicaid, Medicare, and insurance
companies, slowing the growth of the profession by 2025.
Given the evidence for chiropractic and the recognition that spine issues were a major part of primary care, many
chiropractors successfully joined primary care teams, hospitals, and ACOs as primary care providers for spine health
over the decade leading to 2020. However, the increasing use of care pathways specifying optimal care, both within
integrated health care systems and for consumers spending out of pocket, kept the number of visits limited for
chiropractors and others. Some patients were willing to pay out of pocket for more chiropractic visits than protocols
recommended. Others used upscale services offered by their chiropractor such as simulations for predicting
musculoskeletal, spinal, or overall health. Other DCs also built successful practices as the go-to specialist for
sports injuries, obesity, nutrition, as well as back, neck, and extremity pain among children and teens. In rural and
underserved communities, broad-scope chiropractors tended to be the primary care provider of choice, particularly
in the 10 states where they had won expanded rights (both pharmaceutical prescribing, and injection or IV delivery
when relevant), under the condition that they get requisite clinical training in pharmacology. Their expanded
pharmacopeia for prescribing also included herbal, homeopathic, and oriental medicines. While this development
seemed to contradict the core values chiropractors had long held, many of these broad-scope DCs were in fact
using their new training to take their patients off prescription medicines in favor of diet, adjustments, and oriental
medicines to facilitate the body’s own capacity for healing, health, and wellness. By 2025 there were just over 3,000
DCs (including some doctors of chiropractic medicine, or DCMs) using the expanded practice rights in the 10 states.
While the changes in health care and chiropractic were important, researchers, patients, and community leaders
recognized that health care was a relatively small part of the health equation. To create and sustain health,
wellness, and quality of life, they needed to address all the domains of health, including the social, economic,
and environmental conditions in which children and adults would live, play, learn, work, and pray. Leaders began
to draw on “big data” applications that aggregated data from national, community, and individual health records
to target and design comprehensive and multifaceted policies, programs, and interventions. By 2025, many
chiropractors had joined the movement in one role or another. The most impressive ones were found working in
communities where the PCMH had evolved to the Community-Centered Health Home (CCHH). These leading
edge DCs coordinated care for the individual, analyzed community conditions and health patterns, and worked
with the communities to improve health and self-healing. They participated in or led initiatives such as the
development of local parks and community gardens, the promotion of walking groups and after-school programs
to address childhood obesity, or projects to prevent falls and accidents in the homes of seniors. As a result, in many
communities chiropractors are recognized for their work in promoting community health.
In 2025, many more people know what only a few knew before—that the human being is a profoundly resilient
organism with an innate drive for healthy growth. In fact, thanks to the support of effective providers, digital health
coaches, healthy communities, and a growing body of knowledge on prevention, health promotion, self-healing, and
self-care, approximately 30% of Americans, mostly on CDHP plans, have no long-term relationship with a primary
care provider. Many primary care providers are left to wonder if it might not have been smarter to choose a more
high-touch path like physical therapy or chiropractic.
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