Chiropractic 2025:

Chiropractic 2025: Divergent Futures
Community health centers (CHCs)–a type of FQHC–currently provide about 7% of primary care in the U.S., but
they are likely to provide a larger portion of primary care as health care reform is implemented. In our research
for this report, we found CHCs in Iowa, California, and Connecticut that utilized chiropractors. 201 Generally in
these CHCs the CHC leaders have had positive personal experiences with chiropractic care, or they knew local
chiropractors they trusted to provide care. In Connecticut and Iowa the CHC established a connection with
a chiropractic college and functions as a training site as well. CHCs can prove an important opportunity for
chiropractors. At least one interviewee suggested that the percentage of CHCs offering chiropractic care will
increase by 2025, as CHCs search for ways to provide low-cost effective care and DCs look to gain business,
exposure, and more experience. However, at least one other interviewee suggested that although CHCs may “offer”
more chiropractic care, what really determines use and implementation of chiropractic care is method of delivery
and payment.
Corporate clinics are another important opportunity for inclusion of chiropractors. Leading companies like Google,
Microsoft, Cerner, and Cisco are moving to onsite health care that includes chiropractic care. The clinics take a
variety of forms, some part of health insurance, some free care. But having chiropractors available at the clinic is
increasingly a desired option.
Chiropractors, Public Health, and Prevention
With increasing societal emphasis on prevention, the PPACA also provides opportunities for the chiropractic
profession to go beyond patient care to engage in public health. Section 4001 on The National Prevention, Health
Promotion, and Public Health Council has led to the development of the National Prevention Strategy, which was
released on June 16, 2011, and aims to guide the nation in the most effective and achievable means for improving
health and wellbeing. With the adoption of such national strategies for health and prevention (as well as others such
as Healthy People 2020), chiropractors and chiropractic educational institutions (as with all clinical professions and
health care systems) will need to clarify their roles in prevention and public health.
Collectively many organizations and individual DCs are involved in the “Straighten Up America” Campaign,
focusing on activity and posture to promote health. 202 DCs have the opportunity to continue to press patients in their
practice to live more healthy lifestyles. They can do more screening with their patients for hypertension, diabetes,
smoking, and obesity. DCs can get involved in their communities to encourage exercise activity, and can also
support worker safety. This prevention opportunity parallels the community service that many DCs do working
with the chamber of commerce or other local groups. Many DCs have pursued an MPH (Master’s in Public Health)
Degree and nearly 300 are members of the Chiropractic Section of the American Public Health Association (APHA).
This section focuses on public health issues (such as wellness) in the context of chiropractic practices and policies. 203
Looking ahead, some interviewees felt that the number of DCs earning an MPH, joining the APHA, and engaging in
public health activities and research will grow over the years to 2025.
The PPACA also offers new leadership opportunities for the chiropractic field. Section 4001 on The National
Prevention, Health Promotion, and Public Health Council, for example, requires that its Advisory Group include
“integrative health practitioners who have expertise in—(i) worksite health promotion; (ii) community services,
including community health centers; (iii) preventive medicine; (iv) health coaching; (v) public health education; (vi)
geriatrics; and (vii) rehabilitation medicine.” 204 The Board has been established, and although it does not currently
include a chiropractor, DCs are eligible to join it in the future as they demonstrate expertise and increase their
activities in these areas.
The PPACA also requires that the PCORI Board of Governors include a “state-licensed integrative health care
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