Chiropractic + Naturopathic Doctor

On the trend: Results from our 5th annual Practice Trends Survey


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Although we can’t by any means extrapolate these survey results from the 211 responses we obtained to the entirety of the profession in Canada, survey results like these can help facilitate discussion, moving chiropractic forward. Please note: Although we invited our ND readership to participate in the survey, we didn’t garner enough entries from the survey to include the findings this year.

The majority of our respondents were from Ontario (43%), followed by B.C. (29%) and Alberta (14%). These numbers are in line with previous years of the survey.

Case management and earnings
This year, 36% of respondents have been in practice 20-29 years, and 21% of respondents have been in practice for over 30 years. Those who practised less than 10 years hovered at 22%.


Working in a multidisciplinary clinic with complementary health care providers (RMT, naturopath, etc) and no MDs, was once again the top choice for chiros in Canada, accounting for a whopping 64% of responses, while most of the remainder (18%) operate their businesses as a solo practice. Once again, males were more likely to work as solo practitioners – this year all female respondents selected multidisciplinary/interdisciplinary with, or without MDs. Despite the statistic nearly doubling last year, chiropractors working within clinics with other medical practitioners (MDs) has not grown, and stayed relatively stable from last year (8% in 2019, vs 10% in 2018).

The majority who have been practising for under five years report their net annual earnings in 2019 as “under $25,000” (40%). The majority of these practitioners practising for under 5 years spent 31-40 hours in clinical practice (60%), seeing 41-100 patients per week (60%). Chiropractors over the age of 45 (and have been in practice for more than 20 years) were the only cohort to work in a solo practice. The bulk of this age group reported net annual earnings between $51,000 to $150,000, spending between 21-40 hours per week in clinical practice, and seeing 41-100+ patients per week. Earning supplemental income from product sales was the most popular choice among all chiropractors (54%), but those older than 45 were more likely to have no other supplemental income than their younger colleagues.

Scope of practice, loss of income, biggest challenges
More chiropractors are warming up to the idea of expanding the scope of practice. This year, the question didn’t specify “prescription rights,” but instead offered the option of being “interested”or “open to the idea of expanding the scope of practice. 60% selected “Yes, depending on what evolves with research” and 25% selected “No, there’s no need to change anything to my scope of practice. 15% were “indifferent” to a change.

Despite the survey taking place in the latter half of 2020, the income statements/numbers we ask for are always from the previous tax year. Due to the COVID-19 pandemic, we asked our readership: “Do you expect to see/have you seen a marked decrease in income/earnings for 2020 due to the COVID-19 pandemic? (All answers are in NET earnings).”

Your answers: 18% expected their income to remain the same as 2019; 18% expect a loss of income of $10,000 or more compared to 2019; 25% expect a loss of income of around $20,000 or more; 32% expect a loss of income of around $30,000-$50,000; and 7% expect a loss of income of more than $50,000 compared to 2019. More than likely due to these figures, the majority of DCs (46%) are not expecting to splurge on any major purchases within the next 12 months, with the exception being that 32% of DCs are planning to purchase office furniture, computers or other administrative tech, and/or conduct renovations. Again, this could be due to the pandemic and major business/scheduling/administrative changes clinic and business owners are enacting.

Another interesting point the pandemic has brought us within this survey: “high cost of running my practice” has now been selected as one of the top challenges DCs are facing, which shares the number 1 spot with “lack of – or not enough inter-professional collaboration.” “Other,” rounds out our top 3, in which chiropractors specifiedchallenges related to COVID-19, and, as one chiro put it: “The damage done by ‘principled’ chiros, and the ignorance they represent.”

Lack of respect was also specifed by one particular individual: “Lack of respect for the diversity in the profession and a lack of inclusivity. Further, I find the focus on MSK, to the exclusion of NMSK and reducing the unique identity of the Chiropractic profession to be suicide for us. The PTs are gonna eat our lunch if we don’t own and focus on the nerve system.”

Close behind the top 3 challenges, 11% of respondents chose “patient retention” as well as “lack of support from provincial/national associations, or my regulatory college” as their biggest challenges. Finally, “low trust level from the public and/or medical community” and “bad PR/public image/perception” have been de-throned from being the biggest challenges facing chiropractors. Of course, this doens’t necessarily mean these two previous winners (or actually “losers”) are no longer issues – this major shift could be a response towards the more pressing issues facing chiropractors due to the pandemic.

Only time will tell what next year could bring us. Until then, let’s focus on where we need to go.

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