Chiropractic 2025:

Chiropractic 2025: Divergent Futures
and nervous system. They are more fundamentalist in their philosophical positions than members of the middlescope
or broad-scope communities. Focused-scope chiropractors actively oppose broad-scope chiropractors’ efforts
to expand their practice rights as violating chiropractic identity and principles.
The core of the profession (“middle-scope”), about 75-80% of chiropractors, provides patients a portal of entry
to care as spine and musculoskeletal health providers, though the practices of these chiropractors take many
forms. However, DCs in all three communities share an appreciation for the innate ability of the body to heal, a
commitment to conservative and less-invasive care, and the use of manual modalities (including spinal adjustments).
Why Scenarios?
Scenarios provide a powerful way to bound the uncertainty of the future, as well as identify likely, challenging,
and visionary pathways of how the chiropractic field may evolve under diverse conditions. Such scenarios
extend the time horizon beyond the conventional 5 year planning horizon, and include the examination of trends
and wild cards that are not usually considered in a strategic planning process. By exploring multiple scenarios,
organizations and individuals are better positioned to develop a sense of where current trends may take them. They
can then proactively respond to changes at the macro and micro levels, and find themselves better able to leverage
opportunities and mitigate threats that might otherwise surprise them. Furthermore, people and organizations that
work with scenarios that delve deeply into the future tend to develop more creative and useful options than those
who develop plans based only on the past and present.
This is the third set of chiropractic scenarios developed by IAF since 1998, funded initially by NCMIC Group,
Inc. and for this report by the NCMIC Foundation. Why do another round of chiropractic scenarios? We normally
recommend that individuals and organizations update their scenarios every four to eight years, and then “future test”
their strategies, plans, and actions against the different scenarios to assure robust initiatives, rather than prolong
current or previous efforts based on outdated assumptions. Now is an especially opportune time to update the
scenarios and account for the changes initiated by recent health care reforms.
Our previous two chiropractic scenario reports effectively anticipated much of what would occur, yet they missed a
few things, such as the downturn in chiropractic student enrollments after 2000. In this third round of futuring, we
integrate the current directions and dimensions of health care reform. We also look more closely at the spectrum
of chiropractic philosophies and how each community may evolve and interact with the others and with the
broader health care system. We also consider developments entirely outside the field such as the economy, political
landscape, and social and cultural environment. We hope that new readers, as well as those who are familiar with our
earlier reports, will find these 2025 scenarios useful and inspiring.
Developing the Chiropractic 2025 Scenarios
To construct the Chiropractic 2025 Scenarios, we began with a review of our previous scenarios on chiropractic,
The Future of Chiropractic: Optimizing Health Gains (1998) and The Future of Chiropractic Revisited: 2005 to
2015 (2005); recent IAF reports, Primary Care 2025 and Health and Health Care 2032 and relevant research on
chiropractic and related topics in peer-reviewed journals as well as less formal sources. Appendix 2 summarizes the
research and background information that shaped the scenarios.
Next, we developed preliminary forecasts for key topics within chiropractic and for external forces shaping the
field. We used these preliminary forecasts in interviews with chiropractic college deans and presidents, researchers,
association leaders, network leaders, and chiropractors with successful and innovative practices, as well as
chiropractors getting other health professional licenses. We also made special efforts to more thoroughly understand
the different camps or schools within the field—for lack of a better set of terms: broad-scope, middle-scope, and
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