Why Are Group Practices – Chiropractic and Others — Growing?

group of 4 chiropractors of a group practiceIs a Chiropractic Group Practice for You?

In 2014, roughly three out of four chiropractors owned their practice solo.

By 2024, that’s down to about half.

And the flip side of that decline is real growth: the share of chiropractors working in a multi-doctor or multidisciplinary setting has roughly doubled in ten years — from about 22% to about 48%.

Doubled. In ten years!

We’ve seen this happening in the field. But with better research tools, I was able to confirm it. Two separate industry surveys, from the National Board of Chiropractic Examiners and Chiropractic Economics, both show the same trend, year after year.

Why is this occurring

  1. Administrative demands keep piling up. Prior authorizations, OSHA compliance, personnel management, documentation requirements — it’s a full second job that doesn’t shrink just because your practice is small.
  2. Marketing has gotten harder and more expensive. With more providers, more provider types, and more channels to compete on — social media, review sites, paid search — its more than any solo doctor can keep up with alone.
  3. Overhead keeps climbing. Equipment, staff, and competitive wages all cost more than they used to, and they cost the same whether you’re splitting them one way or four.
  4. Third-party pay keeps shrinking. Medicare’s actual chiropractic payment rate has fallen roughly a third since 2001, adjusted for inflation. Commercial insurance pays better, but it comes with its own squeeze — visit caps, prior-authorization requirements, and tighter claim scrutiny every year.
  5. Succession has changed. Aging solo owners need someone to hand the practice to — retirement, sale, or simply relief. An associate who eventually buys in solves that. Staying solo to the finish line often doesn’t.

This is one of the reasons corporate chains like The Joint are growing — from about 309 clinics in 2016 to nearly 1,000 today. That’s roughly tripling in under a decade.

A group practice has many advantages:

  • Shared overhead — rent, equipment, and staff, split instead of carried alone.
  • Focused management to smoothly take on the increased administrative and marketing demands, and better support the doctors and staff.
  • Local market strength — a three-doctor practice out-competes both the franchise down the street and the lone operator across town.
  • Real vacation coverage — your practice doesn’t close when you do.
  • Camaraderie — a colleague to talk through hard cases and hard days.

But you don’t have to sell your name to get that. An independent group practice gets you the same advantages, minus the franchise fee, the corporate playbook, and institutionalization.

And the timing works in your favor: chiropractic use is climbing nationally, not shrinking. The demand is there. The only question is whether your practice is built to catch it.

Here’s what group practice owners already know — most independents don’t: none of this works without dedicated management. The practices that thrive as groups are built on a management structure that has a purpose.

That Shift — from a personality-based, one-doctor practice to a business built on goals and led by a team — is exactly what I cover in my book from 2001, The Goal Driven Business.

Ready to make the Shift? And if you already are part of a group practice — is it time to upgrade your management?

Read (and apply) The Goal Driven Business.

And stay Goal Driven,

Ed

Let me know you bought the book (email an image!), and I will send you another at no charge.

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