Chiropractic 2025:

Chiropractic 2025: Divergent Futures
3. Continue to strive for high standards of practice.
In the years ahead, empowered consumers (especially if they are using their own money, paying-out-of-pocket)
and managed care networks will both demand better information on their health care providers. They will look
for providers who generate good outcomes for their patients and yield good value. The chiropractic profession
should define and ensure high standards of practice that will keep existing patients satisfied with their care while
attracting new patients to chiropractic. Higher standards will better position chiropractic as a profession, and will
produce individual chiropractors that are more likely to be successful, whether they seek to integrate or to maintain
independent practices.
Support local reporting of outcomes. The development of local and national reporting systems that indicate the
results of health care providers in their patient care will be important in the years leading to 2025. For patients,
these systems will ultimately comprise comparative reports on individual providers. The chiropractic profession
and its various associations and organizations should support the development of such reporting on chiropractors
and other health care professionals. Ultimately, this reporting will take into account patients’ disease and risk
sensitivities, along with other measures such as patient satisfaction, in rating the outcomes of health care providers.
Angie’s List, PatientsLikeMe, and other local or national groups will make these outcomes and costs transparent for
patients, often in relation to patients’ specific conditions. This reporting will allow patients, ACOs, PCMH teams,
and chiropractors to better identify the best providers in the community, as well as those chiropractors who oversell
services and technology.
Provide more effective policing of false and misleading advertising. The professional chiropractic organizations
and state licensing boards should have strict standards against false and misleading advertising, communications,
and marketing. Chiropractic state licensing boards and organizations should publicize those standards and enact
effective consequences for chiropractors who violate them.
Promote the use of best practices and agreed-upon guidelines. The profession needs to have guidelines that
define best practices, including treatment courses. The Council on Chiropractic Guidelines and Practice Parameters
(CCGPP) has been working on this and on related care pathways. More widely used guidelines (generally disliked
by chiropractors) are those developed and deployed by managed care networks. More than half of all chiropractors
belong to these networks in 2013. Rather than rely on non-chiropractors to entirely define the guidelines, the
chiropractic field should develop or co-develop guidelines that can be agreed upon and used by ACOs, PCMHs,
and managed care networks. These should rapidly incorporate research showing additional indications where
chiropractic care is effective.
Better police the profession: IAF believes that the marketplace, including local ratings of health care providers,
will play a more important role in punishing chiropractors that over-treat or provide ineffective care. But the
profession, particularly licensing boards and possibly state associations, must play a more active role in policing the
profession.
4. Anticipate and engage consumer-directed care plans and tools.
Engage with the development of self-care tools, particularly their decision-making rules. Consumer-directed
health plans are growing, as are the tools that will allow patients to more wisely spend their out-of-pocket health
care dollars. It is likely that people will become better informed and more scrutinizing in their choices. Chiropractors
have always been good at directly engaging consumers or patients, but will need to recognize that consumers and
patients will be using these self-care tools that tell them when to go to a chiropractor, what the best course of therapy
is, what the costs are in their communities, and who the best DCs are. Chiropractors should take part in developing
the criteria that will be used to define “best” in this context.
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