Indications that chiropractic colleges may be on the brink of bankruptcy
Guest Post By: Dr. Anthony J. Lombardi
I was motivated to write this article because as time passes most of us focus on the future as we move through the different stages of our careers.
Rarely do we reflect on the current state of the places we once were – for instance chiropractic college. Currently,
we are in a time where there is an oversaturation of chiropractors and a decreased supply of chiropractic students. This indirectly decreases demand for our services and the chiropractic education. Naturally, this impacts the financial health of American chiropractic institutions.
This was highlighted in a study published in March 2014 in the Journal of the Canadian Chiropractic Association concluded and reinforced that new graduates are unprepared for practice. “Chiropractic students enter the profession within a context of a competitive healthcare market, possibly saturated consumer demand for chiropractic services, and tightened salary prospects.”
According to data from the U.S. Integrated Post-Secondary Education Data System (IPEDS), from 1995 to 2013 chiropractic college enrollment peaked at 15,000 students in 1996, and then dropped continuously until 2002 to an average of 9,957 students – a 33 percent reduction. Enrollment has remained flat at an average of 9,980 from 2002 to 2013.
In Ontario, Canada’s province with the highest population of chiropractors, the College of Chiropractors of Ontario (CCO) reported that the number of chiropractors in the province rose dramatically by 23% from 2009 to 2015. The utilization rate and population of Ontario did not increase at all during this same period, which is a contributing factor to the oversaturation of chiropractors in the province.
Lastly, the U.S. Health Resources and Services Administration (HRSA), an organization which collecting data on defaulted student loans – noted that in October 1999, May 2010 and January 2012, more than 50 percent of the individuals on HRSA’s default list had attended chiropractic college. Inversely proportional to this, the average income of practicing chiropractors has been dropping steadily.
In the U.S.:
1989 – $101,000 (Source: American Chiropractic Association)
1997- $86,500 (Source: American Chiropractic Association)
2010 – $87,000 (Chiropractic Economics and U.S. Bureau of Labor Statistics)
2001: $144,254.50 (Source: JCCA, 2005, salary data for Ontario)
2015: $70,000 (Source: PayScale, salary data for Toronto
2015: $66,531 (Source: PayScale, salary data for Canada)
These statistics make sense since the number of chiropractors has been steadily increasing while utilization rate has generally stayed the same. This means more chiropractors are fishing from the same unchanging patient pool.
So, given that enrollment is down, salaries are decreasing, and that there is an oversupply of chiropractors in North America – why is tuition at chiropractic schools in the US increasing so rapidly?
•My last year at NYCC in 2002, I paid $5,700 per trimester and today the cost is $12,000 per trimester ($36,000 US/$46,800 CDN per year). That’s an increase of 110% or 7.85% per year.
•Logan Chiropractic College went from $6,500 in 2003 to $10,600 ($31,800 US/$42,300 CDN per year) today – 63% or an annual increase of 4.8%.
•While University of Bridgeport went from $8,500 in 2003 to $13,200 ($39,600 US/$51,880 CDN per year) per year today – marking an increase of 55% or 4.25% per annum.
What’s even more interesting is that during the same time period – CMCC, Canada’s only English speaking chiropractic school had tuition change from $15,000 in 2003 to $24,000 ($19,000 US) today. Only an increase of 60% – or 4.6% annually.
One would think that CMCC, who has literally no other competition, would be more inclined to increase their fees since there is high demand to enter their classes due to the low supply of available seats. Rather, though, and contrary to everyday economics, US chiropractic schools who have a large supply of open seats in their classrooms and a vast number of other chiropractic schools to compete with – dramatically increased their tuition fees.
While the annual tuition increases for the US schools examined were 7.5%, 4.8%, and 4.25% – the rise in inflation in the US over that time period was only 2.32% per year. In Canada, the rise was 2.08%. Interestingly, in Seneca Falls, NY, the location of NYCC – the rise of inflation was only 1.9%. These statistics are courtesy of the Consumer Price Index (CPI) which establish the elevation in cost of living from region to region.
The likelihood of the situation is that since there has been a 1/3 reduction in enrollment since 2002 the schools have been forced to increase revenue by driving up tuition rates. By doing this, they can keep up with the escalating cost of staff and operations – while still maintaining their profit margins.
To gain a balanced perspective on the subject, I emailed the director of admissions of all four chiropractic schools and I asked them the following:
•What can be attributed to the increase in tuition?
•Are the students taking more courses than in the past?
•Do they have access to different equipment or facilities they did not have in the past?
None of the schools responded to my requests.
I am hopeful that they reconsider and answer my questions once this article has been published.
But ultimately, university and college students are not stupid. They see that investing $150k into a chiropractic education will not yield a fruitful annual salary in an oversaturated profession. They will see the increasing number if chiropractors leaving the profession, the high loan default rates – and they will simply choose another career instead of chiropractic.
My suggestion makes sense because it would alleviate over-saturation and stimulate demand. Simply, for one year each chiropractic college has to cease to accept new students. Of the 15 or so chiropractic schools, one year 7 schools will not accept new students – but the other eight will. And the following year the schools reverse – 7 schools take students and eight don’t. So collectively there will be a year’s worth of graduates removed from circulation.
This will reverse my title of this article and reduce supply and restore demand.
Dr. Anthony Lombardi has presided over 103,000 patient visits in 14 years of practice at Hamilton Back Clinic.