Chiropractic 2025:

Recommendations

Info

Chiropractic 2025: Divergent Futures Abbreviations 1 ACA American Chiropractic Association ACO Accountable Care Organization CAM Complementary and alternative medicine CCHH Community-Centered Health Home CHC Community health center DoD U.S. Department of Defense IAF Institute for Alternative Futures ICA International Chiropractors Association LBP Low back pain NIH National Institutes of Health PCMH Patient-Centered Medical Home PCORI Patient-Centered Outcomes Research Institute PPACA Patient Protection and Affordable Care Act VHA Veterans Health Administration, U.S. Department of Veterans Affairs WFC World Federation of Chiropractic
Introduction Chiropractic 2025: Divergent Futures Where will the chiropractic profession in the United States be 12 years from now? This Chiropractic 2025: Divergent Futures report by the Institute for Alternative Futures (IAF) presents scenarios that provide four different answers to that question. The 2025 scenarios reflect the opportunities and challenges for chiropractic in the U.S. given our assessment of developments within both the chiropractic field and the broader context of health, science, technology, and society. The scenarios invite deliberation about which futures are more likely and which are more preferred by chiropractors. Viewed from 2013, the future of chiropractic remains fascinating and uncertain. Chiropractic as a uniquely American invention has persisted and grown worldwide despite organized suppression. In fact, chiropractic has become a global force. More and more countries, including Denmark and Switzerland, are granting legal recognition for the practice of chiropractic, and accept the profession as a member of government-sponsored health care delivery programs. There are now more schools of chiropractic located outside the United States than within it. Chiropractic has also become a recognized and accepted health profession at the World Health Organization. International educational standards are being adopted across various accreditation agencies. Regulatory bodies are working to remove the impediments to practitioner mobility between jurisdictions. Chiropractic research is advancing as well in the U.S. and in countries around the world. The entrepreneurial spirit of chiropractors, fractures within the chiropractic community, and isolation from and oppression by organized medicine have all left chiropractors largely independent and separated from health care provider systems. As chiropractors were included in health insurance coverage in the 1980s, chiropractors enjoyed a brief period of relatively unrestricted, well-paid patient visits and many earned high incomes. However, a tightening of both reimbursement levels and allowable visits followed. With the rise of managed care in the 1990s—and later managed access to chiropractic services—chiropractors have seen their incomes, on average, fall further. Now, with the implementation of the Patient Protection and Affordable Care Act of 2010, “value” is being redefined and measured in new ways; primary care is shifting from largely solo and small group physician practices to multidisciplinary teams; and provider organizations are shifting from fee-for-service to bundled payments, risk sharing, or capitation. These are among the major changes in health care that chiropractic is facing. Differences among chiropractors are also important. There is great diversity of practice styles and philosophies within the chiropractic profession. For this report, we will use an awkward but serviceable division of chiropractic into three communities (defined more specifically in Appendix 2): focused-scope, middle-scope, and broad-scope chiropractors. While there are differences within each of these, critical parts of chiropractic’s future will be shaped by how each community evolves and interacts with the other two. About 10% of chiropractors (“broad-scope”) focus on primary care or specialties dealing with a range of conditions beyond the spine. Many in this latter group want to broaden their practice rights further to include prescribing rights. They have been trying for years to do so and in 2013, it appears they may win this battle in a few states. At the other end of the spectrum, 10-15% of chiropractors (“focused-scope”) correct subluxations in the spine to free the body’s self-healing capacity. Some argue that they do not “treat conditions” but only fix problems with the spine 2
Page 1 and 2: Chiropractic 2025: Divergent Future
Page 5: Table of Contents Abbreviations 1 I
Page 11 and 12: Chiropractic 2025 Scenarios Scenari
Page 13 and 14: Scenario 1: Marginal Gains, Margina
Page 17 and 18: Scenario 2: Hard Times & Civil War
Page 25 and 26: Scenario 4: Vitalism & Value Imagin
Page 29 and 30: Comparative Scenario Matrix Chiropr
Page 31 and 32: DCs practicing in integrated health
Page 33 and 34: IAF Recommendations Chiropractic 20
Page 35 and 36: 2. Accelerate research. Chiropracti
Page 39 and 40: Christine Goertz, DC, PhD Vice Chan
Page 43 and 44: Chiropractic Schools, Education, an
Page 45 and 46: The Figure below identifies various
Page 47 and 48: FIGURE 3 16,000 14,000 12,000 10,00
Page 49 and 50: Tuition and the ROI Story Chiroprac
Page 55 and 56: The 50 States of Chiropractic Chiro
Page 57 and 58:
FIGURE 4 Liver Disease Kidney Disea
Page 59 and 60:
Chiropractic 2025: Divergent Future
Page 61 and 62:
Page 63 and 64:
Percentage of Respondents in the Ch
Page 65 and 66:
Page 67 and 68:
RARELY SEEN (1-10/year) CONDITION A
Page 69 and 70:
Page 71 and 72:
Primary Care and Health Care Reform
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
88 Ibid. Chiropractic 2025: Diverge
Page 85 and 86:
Page 87 and 88:
Page 90:
Institute for Alternative Futures 1
show all

Chiropractic 2025:

Create successful ePaper yourself

Delete template?

Save as template?