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Dynamic Chiropractic Canada – August 1, 2008, Vol. 01, Issue 01
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Snapshot of the Ontario Chiropractic Practice

How Does Your Practice Compare?

By Tina Beychok, Associate Editor

Researchers from the Canadian Memorial Chiropractic College (CMCC) and Ryerson University recently released findings from an interesting survey of Ontario chiropractors.

The survey, an analysis of which was published in the Journal of Manipulative and Physiological Therapeutics, provides insight into how income is affected by personal and practice characteristics including experience, patient visits, location and products/services offered.

Ontario chiropractors who used a specific billing program designed by the Ontario Chiropractic Association were asked to provide a copy of their year-end practice data for the fiscal year beginning April 1, 2000, and ending March 31, 2001. Approximately 30 percent (731) of the 2,400 Ontario chiropractors submitted data for the study. Researchers Silvano A. Mior, DC, from CMCC, and Judith Waalen, PhD, from Ryerson, analyzed the data, paying specific attention to the relationship between income and specific practice details.

Average Annual Income

 - Copyright – Stock Photo / Register Mark Adjustment The average gross annual income of Ontario area chiropractors in the study sample was $144,254.50. The median gross annual income was $131,086.80. Income from patients and the provincial health plan comprised approximately 65 percent and 35 percent of total dollars received, respectively.

Practice Type and Location

Comparing the average Ontario group versus solo practice, the researchers noted: "In our sample, 66 percent of chiropractors reported to be in solo practice typically earned slightly more than those in practices with multiple chiropractors."

Location also was an important variable in terms of income. "Those who reported they had not changed their practice location had higher average incomes than those who did change; $149,790 and $127,715, respectively." Gross earnings also were higher in areas farther away from the metro Toronto area. The researchers speculated this might have something to do with a shortage of other health care providers in rural areas. However, they also noted slower income growth in areas with a lower overall income.

Practice Experience

Number of years in practice also appeared to influence annual income. Chiropractors surveyed were 40 years of age, on average, with approximately 13 years in practice. According to the researchers, "Based upon results from our analysis, for every 10.17 years (1 SD) after graduation, income would increase by $16,814.90, if the effects of all other variables are held constant. It appears that approximately 7 years following graduation, the mean income levels do not significantly differ."

Patient Visits - Total / Per Patient

One of the most important variables was the number of patients seen in the practice. The average number of patient visits per year was 9.04, and the average patient copay per visit was $17.54. The researchers found if the average number of patient visits increased by 3.29 visits per patient, income increased by $29,385.26, with all other variables holding constant.

New patient visits played a key role. "The number of new patients made the greatest unique contribution, significantly explaining approximately 17 percent of the variance in income. The level of this financial influence can be described as follows: If the number of new patients seen increased by 1 SD (approximately 95 patients), then income increased by approximately $40,649, when controlling for all other variables."

Product Sales

According to the researchers, income derived from the sale of health-related products such as back supports, vitamins, orthotics and therapeutic pillows accounted for 7.6 percent of the variance in annual income. Average annual income derived from product sales was $2,441 or 1.7 percent of annual income.

In their conclusion, Drs. Mior and Waalen suggest the number of new patients seen during the year contributed the most to variances in annual practitioner income, but cautioned, "[I]ts inverse relationship to the average cost per visit suggests price sensitivity." They also emphasized, "The effects of location and years in practice are important considerations for income growth, especially for new graduates."

Resource

  1. Mior SA, Waalen J. Personal and practice predictors associated with the income of Ontario chiropractors. J Manipulative Physiol Ther, May 2008;31(4):277-84.

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