chiropractor practice management justifications for business degree program in chiropractic curricul
DESCRIPTION
Abstract: A chiropractor is considered a Professional as well as a Businessperson. The history of chiropractic profession has been shaped with myriad of specific claims within healthcare environment which led to desire to ‘fit into the perceived exigencies and requirements of the health care system’. However, the strategy to organize ethics within a profession exemplifies the need to be compliant with professional requirements and to exhibit integrity within the context of that profession. This study investigates the relationship between successful chiropractic practice and attainment of a Master of Business Administration (MBA) degree. A survey was completed by 150 practicing chiropractors in three (4) states of Texas, Tennessee, Oklahoma, and New York combined using an online survey instrument. Questions about additional earned degree in Business, its impact on financial and physical growth of business practices and establishments were quantified in order to rank the individual chirTRANSCRIPT
Chiropractor Practice Management: Justifications for
Business Degree Program in Chiropractic Curriculum
by Richmond S. Adebiaye, & Charlene Conner
ABOUT THE AUTOHR(S)
Dr. Richmond S. Adebiaye is a Professor of Computer
Information Systems, Information Security expert,
Academic Administrator and Researcher. He has over
twelve (13) years’ experience teaching various Computer &
Information Systems, Network Management and Security
courses. He also consults in the field of Database Design,
Management and Security, Digital Forensics, Penetration,
Vulnerability Testing, CyberSecurity, Application Security
Analysis and Development. He is presently the Program
Director of Computer & Information Systems at Parker University, Dallas,
Texas USA. He was the former Program Chair, CS/IT, Denver Campuses for
Colorado Technical University and former Program Director at the University
of Maryland University College. Dr. Adebiaye earned his Doctorate in
Information Systems and Communications from the prestigious Robert Morris
University, Moon Township, PA, and his Master of Science in Information
Security from Lewis University, Romeoville, IL. He is a Certified Information
Systems Security Professional and Certified Information Security Manager. He
also holds few Cisco certifications which include CCIE. Dr. Adebiaye is the
author of four (4) best-selling textbooks – (1) Object-Oriented Methods, (2)
Information and Network Security Management: Strategic Concept
Application, (3) Network Systems and Security (Principles and Practices and (4)
Network Systems Management which could be found on www.amazon.com. His
main expertise and research interests involve Designing, Building, Managing
Enterprise Network and Information Security and Forensics programs.
Dr. Charlene Conner serves as Dean, College of
Business and Technology at Parker University. Research
interests include human resources, organization behavior
with emphasis in team dynamics, generational influences
within the workplace, as well as organizational
development and change. Prior to entering Academia, she
served in both US government and corporate entities.
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Chiropractor Practice Management: Justifications for Business Degree Program
in Chiropractic Curriculum
Volume 02, Issue03, Jul – Sep’ 2015 2
AB S TR A CT
chiropractor is considered a Professional as well as a
Businessperson. The history of chiropractic profession has
been shaped with myriad of specific claims within healthcare
environment which led to desire to ‘fit into the perceived exigencies
and requirements of the health care system’. However, the strategy to
organize ethics within a profession exemplifies the need to be
compliant with professional requirements and to exhibit integrity
within the context of that profession. This study investigates the
relationship between successful chiropractic practice and attainment
of a Master of Business Administration (MBA) degree. A survey was
completed by 150 practicing chiropractors in four (4) states of Texas,
Tennessee, Oklahoma, and New York combined using an online
survey instrument. Questions about additional earned degree in
Business, its impact on financial and physical growth of business
practices and establishments were quantified in order to rank the
individual chiropractors as highly successful, having strains on
practice (moderately successful), and no growth (least successful).
Each of the independent variable responses from the research
questions was analyzed for each success group of Chiropractors to
determine whether the success level was related to any of the
independent variables. Correlation analysis, coefficient of
determination, and chi-square tests of independence were performed
on the independent variables and on the demographic variables of
age of respondent, location of business, cost of practice, attainment of
an earned MBA degree, implication of the earned degree to progress
of the practice and length of time in practice. Significant statistical
findings were obtained and significant statistical correlation was
found between the success variables and most of the independent
variables. Relationships between attainment of an MBA using
certain demographic factors and success level were also significant.
The research provided answers to questions regarding attainment of
an additional MBA degree and success aspect of a chiropractic
business practice.
KEY W O R D
Practice Management, MBA Program, Chiropractor, Chiropractic
practice
A
Richmond S. Adebiaye, et al.,
3 © 2015, IJASRD, All Rights Reserved
I. INTRODUCTION
Chiropractic is the most identifiable Complementary and Alternative Medicine
(CAM) primary contact profession in the United States [1]. Primary contact care provider
represents all healthcare professions that can “examine, diagnose, and provide care directly to
a patient, without a referral from another health care provider” with essential role of meeting
the health care demands of the society [2]. Chiropractors have several years of “professional
medical training, resulting in a Doctor of Chiropractic (DC) degree. They study the structure
and function of the spine and how it effects health and disease” [3]. In one research study, the
functions were more definite with notation that “Chiropractors may incorporate along with
spinal adjustments, massage, an exercise program, nutritional supplements, acupuncture,
homeopathy and biofeedback to name a few alternative medical treatments”[4]. Other
researchers also explored the professional and business combination of these functions.
According to one researcher [5], economic determinism comes with comfort
tendencies of self-actualization with decisions to be independent and have a successful
practice. However, while researchers deny the possibility of businessmen having ethical
obligations, probably due to competition of the market-place, the culmination of social and
the inter-professional interests, with the need to be relevant in professional establishment,
changed this trajectory [6]. It is now evident that successful professional could also be
responsible businessman through the combinations of both professionalism, knowledge and
attainment of additional higher business degree and institutional ethics with the desire for
economic and financial independence. The Chiropractic professionals require significantly
greater business acumen and practice management skills, earned through formal and standard
education, albeit Master of Business Administration (MBA) degree to be financially
successful and compete in the healthcare Industry [7].
This important role of a Chiropractor which utilizes natural healing through a “core
competency of spinal manipulative therapy (SMT), as well as other adjunctive therapies and
strategies”, is perhaps the greatest complimentary assets to the allied Healthcare industry.
Chiropractors manipulate the spine with their hands to realign the vertebrae and relieve the
pressure on the nerves. In so doing, have successfully healed symptoms associated with pains
and general body health. To support these important roles, a group of researchers [8]
established that several factors influencing the practitioner/patient relationship can include
educational factors such as business, marketing, public health, healthy lifestyles, and
collaborating with other health care professionals (Pg. 56). Other researchers [9][10][11]
surmised that the chiropractic profession has traditionally used preventative and active health
care strategies and patient-centered care in the delivery of services (Pg. 11) with verifiable
results and successes. The conclusion showed that, in order to be successful as a chiropractor,
the ultimate aim should be to allow lifelong “health process entrenched in the practice” with
additional astute knowledge of business skills which involve “educating the public through
marketing and patient communications regarding the available options that the profession can
offer” [12].
Chiropractor Practice Management: Justifications for Business Degree Program
in Chiropractic Curriculum
Volume 02, Issue03, Jul – Sep’ 2015 4
Figure 1: Diagram showing Chiropractic noted area of prevention of spinal
subluxations [11]
As noted in the above diagram, “Chiropractors may incorporate along with spinal
adjustments, massage, an exercise program, nutritional supplements, acupuncture,
homeopathy and biofeedback to name a few alternative medical treatments” [13].
Additionally, the uniqueness of a chiropractic practice was justified by professional standards
exhibited by the practitioners. As one researcher [14] puts it, “Rather than continue to
emulate medicine, as chiropractic had done in the second period of history, chiropractic
instead pursued an entrepreneurial orientation, such as the reemergence of charismatic
leaders, new work arrangements and diverse educational curriculums that catered to
perceived opportunities in the contemporary health care market (courses in acupuncture,
homeopathy)[15]”. The researcher concluded that “What was old, was new again, and came
to be used as a resource in the trying, competitive times of the 1990s until present twenty-first
century. However, to have a successful Chiropractic practice that would include a change
from the “current health care paradigm to one that emphasizes prevention, lifelong wellness,
and the empowerment of patients” could only be attained through earning a business degree
albeit an MBA program [16]. This would very well be ascertained to be well within the scope
of the chiropractic profession. The existing gap, between needed business skills and existing
skills suggests that current training and education programs are not enough [17]. An earned
additional higher degree in Business will provide adequate knowledge and skills necessary
for integration into business, ideology and practice of the profession.
II. RELATED WORK
The Chiropractic profession is the largest Complementary and Alternative Medicine
(CAM) profession in the world and one of the largest licensed health care professions in the
United States (Bureau of Labor Statistics, U.S. Department of Labor, 2014) [18].
Chiropractic, an occupation could very well be described as devoted to ”restoring health by
analyzing, treating and maintaining alignment of the spinal vertebrae, is a case in which these
Richmond S. Adebiaye, et al.,
5 © 2015, IJASRD, All Rights Reserved
market elements have always been more prominent, legitimate and explicit” [19].
Chiropractic is of increasing interest because the profession has attempted to integrate
business ideals along with pursuing more professional ethical health care standards. One
researcher [20] provided insights into the timeline which showed how Chiropractic initially
pursued an “entrepreneurial orientation in period one (1895 - 1961) and repudiated anything
professional or medical [21]. The researcher found that with the culmination of social and
inter-professional pressures, chiropractic reversed its trajectory, and pursued a
professionalization process in the second period of history (1961 - 1992) (pg.37). But, as
quickly as professionalism was attained, the health care environment and chiropractic's role
within it was altered leading eventually to the re-emergence of entrepreneurialism (1992 -
present) [22]”. Each period of history involved ongoing attention to being an alternative or
allied health care provider.
III. SIGNIFICANCE OF THE STUDY
According to [23][24], the growth of complementary and alternative medicine
(CAM) utilization rates have resulted in an expansion of the chiropractic profession,
experiencing usage rates in the population for 2008 of 5.2% (Pg.89). Sometimes regarded as
a “fringe or vague science, chiropractic care has recently gained more legitimacy and greater
acceptance among medical physicians and insurance providers. Though, some doubt remains,
demographic trends and the healthcare reform bill will revitalize the industry in the next five
years” [25]. Researchers also discovered that the chiropractic profession fits into the
definition of CAM with core expertise within musculoskeletal (MSK) conditions [26]. Other
researchers like [27][28] also supported this view and indicated that “chiropractic usage rates
were 5.9% for persons 18-64 years old, 5.4% for patients over 65 with Medicare, and 3.1%
for persons 18-64 with only public insurance”. Another researcher [29] also correlated
different statistics and evaluated that eighty two percent (82%) of practicing chiropractors
recognize the need for business education, with 16% indicating that they possess these skills
(pg.77). The general business problem identified by the researchers [30][31][32][33] is that
current chiropractic training is not preparing chiropractors enough to compete in the 21st
century health care and managed care market due to lack of additional business degree or
curriculum which fits or incorporates comprehensive business courses. Researchers like [34]
[35][36][37] observed that some chiropractors are “experiencing a difficult time starting and
successfully maintaining a practice due to lack of this specific skill. It is also very important
to note that Chiropractors are also entrepreneurs, who take risks, organize and operate
businesses and achieve a level of profitability for the long term. Other researchers like
[38][39] summed up activities that are important for a business professional like a
chiropractor to include “the assumption of risk from uncertainty, supplying and managing
financial capital, being innovative, being a decision maker, organizing, coordinating and
allocating”[40]. These researchers concluded that the ultimate specific business problem is
that “some chiropractors do not know the relationship between needed business knowledge,
training and their current knowledge level”, hence the need for additional business degree
(pg. 71).
Chiropractor Practice Management: Justifications for Business Degree Program
in Chiropractic Curriculum
Volume 02, Issue03, Jul – Sep’ 2015 6
IV. CLINICAL SCIENCE HOURS CURRICULUM OUTLOOK COMPARISON
According to reference shown on [41] by American Journal of Clinical Chiropractic,
it became obvious that there is a level of confusion by the public and even the chiropractic
patients in appreciating the level of training and education of a Doctor of Chiropractic.
Research has shown that a Doctor of Chiropractic has more hours of training in Anatomy and
Pathology, and even more hours of training in Physiology and Biochemistry than their Doctor
of Medicine counterparts and a higher number in overall Clinical Science hours [42]
Invariably, a Chiropractor, equally, has several years of “pre-requisite undergraduate
courses which are required prior to the application process of the potential student pursuing a
Doctorate in Chiropractic”, similar to their Medical Doctor (M.D.) counterparts. In an article
published recently in a journal, ‘My-Health Magazine’ indicated that in the United States,
“approximately 20% of adults have tried chiropractic care. It is the largest alternative medical
profession in the U.S. and the third largest doctored profession - after medical doctors and
dentists” [43]. This indicates that satisfaction rates are usually higher for chiropractic
alternative medicine compared to traditional care by an M.D.
The table below shows a typical curriculum content and hours from accredited four-year
programs in Chiropractic and Medicine [40.]
Subject Chiropractic
Hours
Medicine
Hours
1. Anatomy 570 368
2. Biochemistry 150 120
3. Microbiology 120 120
4. Public Health 70 289
5. Physiology 305 142
6. Pathology 205 162
7. Total Basic Science 1,420 1,200
8. Total Clinical Science*
*Total Clinical Science hrs. Includes:
Chiropractic Science
Clerkships
3,406
1,975
1,405
3,467
0
3,467
9. Total contact Hours
(Basic + Clinical yrs.)
4,826 4,667
Table 1: Comparison of Clinical Science Hours training between a Doctor of Medicine and Doctor of Chiropractic
[18]
Other researchers[45][46][47] believe that “practice management and consulting
endeavors have become more prevalent in chiropractic due to changes in the larger context of
the system of professions; the restructuring of health care around a platform of multi-
corporate hospital chains, the heyday of reasonable and customary insurance reimbursement
and its retraction into cost-conscious managed care organizations, as well as the interest by
medical physicians, physical therapists and veterinarians in performing
manipulation/adjustments”. With attainment of an MBA degree, a versatile and more
enterprising Chiropractor could maximize enough area in which to carve an exclusive
Richmond S. Adebiaye, et al.,
7 © 2015, IJASRD, All Rights Reserved
jurisdictional niche and increase the need to defend and capitalize on available unclaimed
work, all the while concerning itself with economic survival and prosperity [48]. In another
prominent research article titled “Success in Chiropractic Practice” by [49][50][51] supported
the justifications on facts, that Chiropractic practitioners successful business practice would
be dependent on business skills and attainment of business programs skills.
V. METHODOLOGICAL SURVEY DATA ANALYSIS
5.1 Statistical Data Outlook:
In order to classify as successful in chiropractic business practice, a Chiropractor must
have been in practice at least three (3) or more years. Assumptions were based on students’
loans repayment, if any, and stability of entrepreneurship within the study period. Other
factors included verified evidence of financial growth, measured by increased sales and
positive cash flow analysis presentation [52]. This includes evidence of continuing practice
growth, measured by “increased patient base, increased employee base, physical expansion”
or a combination [53]. The surveys included demographic questions asked each respondent
to describe his/her age, sex, years in practice, and whether currently in practice. Education
relating to attainment of MBA degree contained questions designed to elicit information
about the degree of success in practice and attainment of an MBA degree in addition to a
Doctor of Chiropractic degree. The classifications were numerically valued for either success
with a value or non-successful with different value. In approximation of either assigning a
numeric coded value equivalent to each answer in each question; or weighted according to its
perceived importance by the researcher to successful practice. Responses to the five questions
were totaled and used to rank the respondents on a continuum of success. Using evaluation
indicative for all success factors were divided into three groups of approximately equal size,
according to level of success (low, moderate, and high) [54].
5.2 Statistical Data Results:
This research utilized a survey to describe higher education degree and social support
determinants of successful chiropractic practice and proposed that an educational degree
which included attainment of business qualification factors such as an earned MBA degree
through prior business training and experience would be “shown to contribute to success in
practice”[55]. Data from the mailed survey were analyzed using “descriptive statistics,
correlation analysis, coefficient of determination, and X2 test of independence”. Findings are
discussed in more detail as they relate to the variables used. This resultant analysis showed
relationship between demographic factors and success results. The statistical analysis
revealed no significant statistical relationship between gender and practice success, but a
higher than moderate significance was shown between attainment of an additional higher
business degree and success. Significantly, “aligned with an MBA degree are those in their
early 30s and 40s, evidencing a higher success rate than those in their 50’s and 60’s. This
same disparity in success levels was also seen in comparing years in practice, most likely for
the same reasons [56]. However, the result failed to show if this success could be matched
with specific demographic factors at a later point.
Chiropractor Practice Management: Justifications for Business Degree Program
in Chiropractic Curriculum
Volume 02, Issue03, Jul – Sep’ 2015 8
5.3 Findings:
Although 164 chiropractors were randomly invited to participate in this research
study, only 152 of them participated. There was no explanation provided by 12 chiropractors
regarding their non-participation. The distribution of participants who actually participated in
the research with respect to their gender is shown in the Figure 2. On average, they were
38.25 years old (sd=4.14), ranging from the age of 30 to 47. As noted in the Figure 3, most of
the participants were residents of Texas (28.94%), followed by residents of Oklahoma
(26.97%), Tennessee (24.34%) and New York (19.73%).
Figure 2. Distribution of participants with Figure 3. Distribution of participants with
respect to their gender respect to their gender
VI. RESULTS
6.1 Hypothesis (H1): There is a difference between chiropractors with and without MBA in
yearly profit earnings as estimate of their business successes.
As shown in Table
2, more participants were
compared regarding their
yearly profit (from
business) than with respect
to their estimation of
business success. This
occurred as a consequence
of the fact that 16 chiropractors included in the sample started working in a period of 6
months or less before the start of this research, so their estimate would be biased due to the
fact they are still new on the market. In order to test if the chiropractors with an MBA
diploma fare differently from ones without the diploma in terms of average profit per year
and estimated success of business, data was collected as ranks, as two Mann-Whitney U tests
were conducted. According to the results of the first test (U=1295.50, z=-2.907, p<0.01),
there is a significant difference between chiropractors who possess and those who do not
possess an MBA diploma in terms of their average salary per year. The chiropractors with an
MBA diploma (M=2.32) earned significantly more than those without a diploma (M=1.86)
per year. The results of the other Man-Whitney U test (U=933.00 z=-3.073, p<0.01) indicated
Table 2. Descriptive statistics of average profit per year and estimated
success of business with respect to possession of a MBA diploma
N M sd
Average profit per year MBA 31 2.32 0.83
no-MBA 121 1.86 0.77
Estimated success of business MBA 27 3.78 1.12
no-MBA 109 3.14 0.96
Richmond S. Adebiaye, et al.,
9 © 2015, IJASRD, All Rights Reserved
that the two groups of chiropractors fare significantly different in terms of estimated business
success, as well. Chiropractors with an MBA diploma (M=3.78) estimated their business was
more successful than those without MBA Diploma (M=3.14).
6.2 Hypothesis (H2): there is a difference between Male and Female chiropractors in yearly
profit and estimate of their business successes.
Another pair of Man-
Whitney U tests were used in
order to test if the gender of the
chiropractor affects their average
profit per year or estimate of the
success of their business.
According to the results of the
tests, gender of the chiropractor
is not related to differences in
their average profit per year (U=2588.50, z=-1.20, p>0.05) nor their estimate of success
(U=2287.00, z=-0.114, p>0.05).
Figure 4. Distribution of chiropractors with respect to estimate of their success in business
As shown in Figure 4 and Table 4, the
distribution of estimated success of the
chiropractors without a diploma was
symmetric (z=-0.09, p>0.05), while the
distribution of chiropractors with a diploma
was negatively skewed (z=2.10, p<0.05),
which is an additional justification that the
chiropractors with a diploma considered their
business to be more successful. It should be
noted that participants who stated they are
Table 3. Descriptive statistics of average profit per year and
estimated success of business with respect to gender of a
chiropractor
N M sd
Average profit per year male 74 2.04 0.85
female 78 1.87 0.75
Estimated success of business male 68 3.24 1.08
female 68 3.29 0.96
Table 4. Distribution of the participants with respect
to their estimate of business success and possession
of a MBA diploma
MBA no-MBA
much below average 2 4
below average 0 23
average 8 44
above average 9 30
much above average 8 8
Chiropractor Practice Management: Justifications for Business Degree Program
in Chiropractic Curriculum
Volume 02, Issue03, Jul – Sep’ 2015 10
new on the market were not included in this analysis.
6.3 Hypothesis (H3): Average yearly profit and estimate of success are related to age or
gender of the chiropractor
In order to test if the
average profit per year and
estimated success of business are
related to the age of the
chiropractor, with respect to the
ordinal scale on which data was
collected, Kendall tau-b
coefficients of correlation were
calculated, and their results are
shown in the Table 4. The most noticeable result is the strong positive relationship between
average profit per year and estimated success of the business (τ=0.717, p<0.01). However,
the age of chiropractor was weakly negatively related to average yearly profit (τ=-0.254,
p<0.01), but not related to his/her estimate of the success of his business (τ=-0.145, p>0.05).
This means that younger chiropractors usually earn more, while they on average equally
estimate their business success. This result could have appeared not only due to age
difference, but also due to possession and non-possession of a MBA diploma. To check if the
chiropractors with and those without the diploma differ in terms of age, a t-test was applied.
The results (t=-5.077, df=150, p<0.001) showed that the chiropractors with a MBA diploma
(M=35.13) are on average significantly younger than those without the diploma (M=39.05).
Therefore, it is not completely clear if the age is related to average yearly profit, or it is just
the effect of the earned MBA diploma.
6.4 Hypotheses (H4): Descriptive and Inferential statistics on those who had a MBA
regarding their attitudes, and attitudes of those without MBA diploma.
Further analysis was conducted on those chiropractors who had a MBA diploma
(N=31) in order to describe their attitudes towards usefulness of the diploma. Twenty-one of
them (or 67.7%; 95% CI [0.5031, 0.8517]) expressed that their MBA diploma had a
significant influence on the success of their business. However, twelve of them (or 38.7%;
95% CI [0.2055, 0.5687]) stated they had faced major obstacles in business regardless of
their diploma. Generally, obstacles were easier to overcome with an earned diploma and
knowledge gained in the process of getting it, stated twenty of chiropractors (or 64.5%; 95%
CI [0.4668, 0.8236]), while only six of them (or 19.4%; 95% CI [0.0462, 0.3409]) expressed
they would have performed better as both professional and business owner without the MBA
diploma. Twenty-three subjects (or 74.2%; 95% CI [0.5788, 0.9051]) answered they would
recommend their colleagues to earn a MBA diploma. As shown in the Figure 5, of those who
did not have a MBA diploma (N=121), 57 (or 47.1%; 95% CI [0.3809, 0.5613]) thought that
an earned MBA would have contributed immensely to their success in business, yet only 26
(or 45.6%; 95% CI [0.3228, 0.5895]) of them expressed their intention to earn the diploma in
Table 5. Results of Kendall tau-b correlations
estimated
business
success
age
average profit per year 0.717** -0.254**
estimated business success -0.145
* p<0.05
** p<0.01
Richmond S. Adebiaye, et al.,
11 © 2015, IJASRD, All Rights Reserved
the future. These 26 participants were not different from the remaining 31 in terms of age (t=-
0.812, df=55, p>0.05), average yearly profit (U=381.50, z=-0.381, p>0.05) or estimated
success of business (U=296.50, z=-0.509, p>0.05).
VII. LIMITATIONS , RELIABILITY , BIAS AND FURTHER RESEARCH
Further research is indicated, by this research, in various areas. Research into
Chiropractor’s practice may still lead to greater insight into the entrepreneurial success nature
in the growing healthcare system. Several limitations are prominently observed during this
research study and more in-depth study may lead to a more specific understanding of
Chiropractic practice’s successful integration into the healthcare systems. For example, the
element (attainment of an MBA degree) used to quantify this study could also be subjected to
further scrutiny, in order to ascertain the validity in measuring successful practice. It might be
possible to combine several other factors. For instance, variables such as increase in sales or
time to attain a positive cash flow may be a significant factor to consider and which was not a
focus in this study. According to [57] in a research concluded that “Focusing on time to attain
a positive cash flow, for example, might be useful in looking at the initial success of a
practice, before it becomes established and while it is growing”[58]. The researcher further
concluded that “despite the difficulty of obtaining a valid measure of ‘success’, which should
include new chiropractors, those in practice for less than 5 years”. The researcher indicated
that ‘If self-efficacy is related to initial success, the relationship of the self- efficacy factors of
modeling and mastery might show a more significant statistical relationship to success within
the first years of practice’[59]. Another limitation has to do with the Chiropractor’s
availability to patients. This was also not a construct in current research. Time availability for
a Chiropractor may also be an influencing but limiting factor for success, which was not
specifically measured in this research. The time availability for Chiropractors could be
linked to number of patients a chiropractor may be willing to treat, even if all things being
equal and all constructs were significantly higher. The notion construed that, if Chiropractors
have an ascertain position as entrepreneurs, then would inevitably have freedom of time in
which the determinant of freedom of time use will be dependent on the Chiropractor’s
willingness to succeed. The fact is that a Chiropractor selects who, and when, to be available
to patients and at what cost could represent a valid construct in generating new research.
Chiropractor Practice Management: Justifications for Business Degree Program
in Chiropractic Curriculum
Volume 02, Issue03, Jul – Sep’ 2015 12
VIII. CONCLUSION
The business acumen present in managing a Chiropractic practice within a cycle
involve a lot of continuous practice building strategies albeit contained contradictory
pressures for chiropractor [60]. Pushed by the need to “survive in the face of competition and
exclusion, chiropractors turned to practice management” [61]. In fact, one researcher [62]
confirms that, with this guidance has “led chiropractors to pursue two conflicting strategies
that resulted in financial survival but could not bring them a resolution to continual
competition and exclusion” (Pg. 97). In fact, the analysis showed that the very pursuit of this
entrepreneurialism jeopardized ability to gain acceptance, legitimacy, trust and recognition by
Chiropractic practitioners. And so, this process created new “social psychological dilemmas
not only for the profession at large, but also within each individual chiropractor” [63]. The
theme here is “Financial survival” in the face of stiff competition in a highly competitive
healthcare system. The resultant analysis showed that since the theme of a practitioner was to
provide more care, more services as well as generate increased revenue, [64] complete
integration of business programs or joint business degree earned would provide the necessary
skills, business acumen, knowledge and expertise to generate more revenues and high patient
volume which may lead to improved success rates. In one issue of a chiropractic journal
named, ‘Topics in Clinical Chiropractic’, one of the contributors, [65] expressed concern that
"chiropractors lack skills in practice management, capital development, and marketing to
compete in a more competitive marketplace" [66][67]. This supports this research
justifications since market completion provokes innovative ways to be competitive and
remain in business.
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