418- The State of Chiropractic
11 Nov 2025 · 0 min
Podcast episode ("418 - The State of Chiropractic") hosted by Dr. Jeff Langmaid (recorded Dec 18, 2023). Main content summarizes a BMC Complementary Medicine and Therapies study (surveys sent ~2018–2020) that sampled ~9,000 U.S. chiropractors with ~3,500 responses (~40% response rate). The episode outlines the seven survey items about exam scope, clinical ideology (spectrum from subluxation-focused to broad wellness), role in healthcare, views on adjustments for cancer, attitudes on vaccination, belief in plain-film detection of subluxation, and X-ray use for new patients. Key reported findings: 78% value spinal analysis and differential diagnosis equally; 41% treat primarily musculoskeletal conditions, 29% a broad spectrum, 17% subluxation-focused; 57% see the profession's role as spine/neuromusculoskeletal care; cancer role split (43% pain/quality-of-life, 41% nervous/immune support, 11% innate intelligence interference); vaccination views split (39% agree vaccinations positive, 37% disagree); 53% agree X-rays help detect subluxation, ~29% neutral; X-ray usage for new patients clustered at 0–20% (39%) and 80–100% (next largest group). The episode also includes marketing pitches for Patient Pilot (The Smart Chiropractor), AlignASleep, and Stemwave.
Questions this episode answers
December 18, 2023
Between 2018 and 2020
About 9,000 surveys were sent; about 3,500 responses received (~40% response rate)
Welcome to the Evidence Based Chiropractor where each week we deliver the latest chiropractic research and marketing strategies all in the time it takes to get to your office. Now here's your host, Dr. Jeff Langmaid.
Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langme. This week we are back with research. It's an awesome new study that really starts to showcase the state of chiropractic. What do I mean by that? The title of the study was associations between demographics and clinical ideology, beliefs and practice patterns. This was a survey of randomly sampled United States chiropractors. They asked seven really high impact questions. I'm gonna outline what those seven questions were. It's awesome for you to think about them as we go through them and then we'll highlight what the respondents said. So this really took a look at hey, where'd you go to school, how long you've been in practice and how do you approach patient care? So if you'd love to know what other docs are doing or what the state of chiropractic is, this is the episode for you. Before I get started, I wanna say a few words about patient pilot by the smart chiropractor. If you have a patient list of more than 500 and you're not consistently communicating you, you're missing out on reactivation opportunities. We have our best offer of the year going on until 12:31 at midnight. So if you'd like to have more reactivations come into your practice, actions follow results. You have to have the automations to generate the consistency of messaging to generate the reactivations. Without that consistency you just can never get anywhere. So we make it super easy providing the content, the automations, everything you need. And the question often is what can I expect for a result? That depends on two things. One, the size of your list, more fish in the sea, more opportunities. So we recommend a list of at least 500 to work with us. That's how it's gonna get you good results. And two, how much your patients like you, how much what was their patient experience like and do they wanna come back in? And if you believe you have a list of more than 500 and most of those people would love to come back in and see you, we would love to put that list to work for you and make it super easy@thesmartchiropractor.com I'll drop that link down below thesmartchiropractor.com but as I said at the top we're talking research today. This came out in BMC Complimentary Medicine and Therapies in and it took a look at the state of chiropractic. Chiropractic is the largest complementary and integrative health profession out there. But there's been a lot of debate probably since the first adjustment was delivered in terms of professional identity and scope of practice. So those questions around this I view as a good thing because questions do clarify. However, there's been a lot of push and pull and some of as they highlight the barriers to full integration into the healthcare system is the fact there's a lot of variability and inconsistency with how each individual one of us might apply our craft. And I view this, the easiest example would be a comparison would be like attorneys. So if you need a personal injury attorney, that's a lot different than a maritime lawyer, that's a lot different than a contract law, that's a lot different than a personal injury. You know, these are different kinds of clear definitions. You don't just say, I need a lawyer. It's like, well, what kind of lawyer do you need? Because that's going to vary wildly in terms of who you hire. And us as chiropractors, we just say we're chiropractors. And there's so much that goes into that because we have some docs that are exclusively focused on sports, some docs that are exclusively focused on pediatrics, some that are more of a gp, like a general provider. There's so many different types. And this goes back to the messaging you put out on your website. This ties in, it always ties back to what are you putting out there in your community? Because obscurity is the biggest challenge, as we highlighted on a previous episode, it's one of the biggest challenges for anybody running a business. Obscurity. If everybody in the world knew who you were and what you did, you'd never have an issue having a full set of books, having every appointment full. So it's a really, really big deal. And often the irony is we don't want a niche down because we're afraid of turning away people when as we're doing that, we are turning away people. So an easy example for this would be if you are into golf, let's say you're TPI certified. Your website should be like golf crazy. You should have a golfer on the hero image. You should have blogs about golf, you should be putting out content about golf. And ironically, which is not ironic, you will actually not only attract golfers, but other people. But if you have a website that's like super generic and you hope to attract golfers, you, it's never gonna work. If it's just like one tab deep into your website, it's not gonna work. They don't know how to choose you. Cause think about it like a golfer. If you were a golfer looking for a chiropractor, you looked at two websites. One had all of these families, random stuff, the other one had golf stuff top to tail. You'd obviously the answer's super clear. But many of us kind of hedge and we get scared and we say, ah, I don't know if I really wanna niche down. I'm concerned. I'm telling you, don't be concerned. As I say, the riches are in the niches and there's no question about that. So this ties in in a broad way to what we're discussing within this study because it says, man, there's just a lot of different ways you can practice. I'm going to encourage you regardless of where you are on that spectrum, own it, take it to heart and make sure you get that message out there. Because it's important for people to be able to understand how to choose you. Now this study took place between 2018 and 2020 is when they gathered up all the surveys and they used a seven item survey. These seven questions are really, really good. So as I went through this, you go through these seven questions, you got a pretty darn good idea of how you approach clinical practice. So let's go through the seven questions, then we'll tie into what did other docs out there say? What is the state of the profession? So question number one was in the examination and assessment of a patient's condition, do you perform a spinal analysis? B differential diagnosis. And the answers that you could give were A, only B, only usually A, sometimes B, usually B, sometimes A or always A and B. Interesting. First question number two, which one of the following best describes your predominant view of the conditions you treat? And this ranged from basically subluxation only all the way across to the broadest spectrum of health concerns that may include lifestyle and wellness issues and everything in between. There's a few different responses, but it basically had you choose amongst a continuum. Question number three, what do you feel is the one best role for doctors of chiropractic in the greater healthcare system? The three choices were general primary care, subluxation, detection and removal or spine neuromusculoskeletal care. And I encourage you to think about your answers as we go through these number Four, when it comes to the treatment of a severe condition like cancer, which one option most closely matches your view? Chiropractic spinal adjustments could be used to help a patient with cancer by there's a couple choices. Removing interference to an intelligence, improving nervous system and immune system function, reducing pain and improving movement and quality life. Or there is no role for spinal adjustments for people with cancer. And then questions 5, 6 and 7 had a kind of multiple choice answers here as well. So question number five, in general, vaccinations have had a positive effect on global public health. Everything from strongly agree to strongly disagree. Six, plain film imaging is helpful in the detection of vertebral suffixations. Everything from strongly agree to strongly disagree. And then number seven, approximately what percentage of your new patients do you take or order X rays? And it was five different choices. 0 to 20%, 20 to 40, 40 to 60, 60 to 80 or 80 to 100%. So those were the seven questions. I think they're great and I think they give us a really good idea. If you thought about your answers to that, you probably have a. It should be a very good representation of how you practice. So how did other people answer? That is the ultimate question here. That's why I say this is about the state of chiropractic in many ways. Well, they, they send out surveys to about 9,000 docs and they received 3,500 responses. About a 40% response rate. That's really good. Within that it was skewed a bit. Male 75% of the respondents were male, 25% were female. A little surprising there, in my opinion. They also asked about where you graduated school. The Most popular school, 21% of who responded had went to Palmer in Iowa. Second most popular was 12% went to Life University. Third most popular is about 10% went to Logan. Those were the three most popular schools. And then they basically asked how long you been out? How long have you been practicing? 17% were 1 to 10 years and then it was 25%. For each of these, 25% of the respondents were been in practice 11 to 20 years. 25% 21 to 30 years. 23%, 31 to 40 years. So a pretty good sampling of experiences. So the scope of examination was the first question. Let's take a look and be interested to know if you think about what do you think people would answer? Did they differential diagnosis or spinal analysis? Well, 78% said they were of equal importance. So regarding the scope of examination, nearly 80% of the respondents said differential diagnosis and spinal analysis were of equal, equal importance. Now, regarding the view of conditions treated most people, 41% selected musculoskeletal and biomechanical conditions. The next largest response was a broad spectrum of health conditions at about 29%. And then the third most popular at 17% were vertebral subluxation as an encumbrance to health. Now interestingly, those that chose vertebral subluxation tended to come from Cleveland, Chiropractic Life, Life, West, Palmer, Davenport, Parker and Sherman. They were weighted against the other respondents. Now, in terms of the chiropractic profession's role in the greater healthcare system, a majority, 57% determined the best role for the profession was spine and neuromusculoskeletal focused. Let's keep trucking. Regarding the role of adjustments in treating people with cancer, most respondents were divided between reducing pain, improving movement and quality of life, 43% and improving nervous system and immune function at 41%. A minority, 11% selected removing interference to innate intelligence. Concerning vaccination, we had a great divide. It was kind of a reversed bell shaped curve here where 39% responded that they agree or strongly agree that vaccinations had are good for public health and 37% strongly disagreed or disagreed. So that was interesting to note. And for the detection of vertebral subluxation on X ray, the distribution was trimodal, as they say. A majority of respondents, 53% responded agree and strongly agree. A minority disagreed and responded disagree or strongly disagree. And about 28%, 29% were neutral regarding plain film. So really, really interesting. And then the use of X rays for new patients, really two camps here, which probably not surprising. And some of this probably plays into technique. They didn't get into technique here, but I can't help but believe that some of this plays into technique, which is 0 to 20% of new patients receiving X rays, 39% of respondents. And then the second most common was 21% which had 80 to 100% of people. So that's an interesting again reverse bell shaped curve there is like really you either do almost all the time or you rarely do, which was very interesting. So that was the study findings and that is the state of what's going on when you take a sampling of chiropractors around the country and say how are you approaching practice now? Several chiropractic degree programs consistently had proportions of respondents selecting answers corresponding with subluxation base care. They were Life, Life, West, Palmer, Davenport, Parker and Sherman. Interestingly, and compared to the respondents in the first decade of practice, respondents with two, three or four decades of experience had an increasingly greater proportion of respondents responses. Excuse me, consistent with subluxation based subgroup across all survey items. So a really, really interesting study. I again, I'd encourage you take a look at the study or you can obviously rewind this episode. It'd be interesting to know, I just think from a personal perspective as I was going through answering those seven questions, I'm like, oh, that's an interesting question. How do approach that things that you. I think we all do every day, but we might not think about every day. So interesting study, really, really great. And it gives us an opportunity now to jump forward with this. So I'm hopeful that they'll actually follow up this study with others and I'm sure they will because typically the goal of a great study is not only to answer a question but to stimulate 10 more questions. So I'm hopeful that they continue with the analysis of this data. But also I'll be very, very excited for further follow up studies because I think it's just really good to know what's really going on. We all have our inherent biases. You go to a school, you're surrounded within that school of the people you tend to, you know, hang out with, the people who have a similar viewpoint as you. As we go into the field, sometimes we can become siloed or we hang out again most of the time with people that have relatively similar views. But it's nice to know just like what, what's going on out there in the profession at large. And this study did a great job at beginning to answer that question. So as we wrap up, I'll say a few words about AlinaSleep. AlinaSleep.com is the. It is the pillow I use. It is a chiropractor's pillow. So if you have pillows in your practice, go to alignasleep.com, please check out what they have going on. You need to get that product inside of your practice. Or if you've never had a pillow but you've been asked and you're like, ah, I'm not sure what to do. Alignasleep.com, i cannot recommend it enough. I'm gonna drop the link down below allianasleep.com, and finally, as I've spoken about before, if you are using Softwave Shockwave technology in your practice, I can't recommend the brand Stemwave enough. This is the brand I use personally. It is what we use within the practice that I have go stemwave.com the evidencebasedchiropractor gostemwave.com the evidencebasedchiroPractor they will hook you up. So if you've been considering having a new modality, the end of the year, great time for a tax write off. Invest in your business, invest in your practice. Invest in a piece of technology that can not only really help you with revenue but also help a lot of people. So that's what I love. So go stemwave.com the evidence based Chiropractor I will drop that link down below. If you have not left a rating or review for this podcast, I would love it if you take a moment and do so. I really appreciate you tuning in and if you have any questions you can always reach out to me. Jeff the evidencebasedchiropractor.com thank you for being a chiropractor. Have an awesome week in practice and I will talk to you soon.
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