ACA News — December 2014
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ACA Your Partner in Practice
Craig R. Myers

Take Control of Your Financial Future

A MAJORITY OF DOCTORS OF CHIROPRACTIC IN THE UNITED STATES HAVE A PRIVATE PRACTICE. When planning for the future, all DCs must make sure they are protecting their wealth while saving, as it's the path for future success.

Prudent planning requires you to have a preordained allocation of funds that can be liquidated. I call this the rainy day fund.

Invest in You

A prime example is the real estate crisis of 2007 and 2008. It destroyed many prominent builders and suppliers. The biggest challenge those industries faced was debt. Orders decreased dramatically, and banks with which they had long, prosperous relationships were calling in their notes. These businesses didn’t plan on this catastrophe when they were taking out the loans. However, the unthinkable did occur.

By viewing your practice as a stock market bound to have highs and lows, as most businesses do, it’s ill-advised to withdraw funds from your controlled stock market and deposit them into a public stock market over which you have absolutely no control. When one relinquishes control in favor of a financial gain, speculation occurs.

In a recent interview on prudent financial planning, John Bogle, founder of the world's largest mutual fund family the Vanguard Group, said, "Speculation is a fool's game.” In addition, he stated, “mathematically speaking, one has perhaps a 0.1 of 1 percent chance of beating the public market over time.” I recommend to my professional clients that they reinvest into their business or practice.

A successful alternative is withdrawing money from a chiropractic practice and locking into one's own assets. This eliminates speculation and ultimately guarantees wealth accumulation, while simultaneously protecting it for a time when it is needed most, such as financial emergencies or retirement. This strategy affords the ability to save and grow substantially outside the practice.

I am referred to and called upon by many professionals after they made decisions that resulted in major financial losses. When building a practice, many succumb to the ideas of needing to buy an office building or keep up with the latest technology. It's often because their competitors are making the same investments. Many incorrectly reason, "I'm young: no risk, no reward." I vehemently disagree with this theory. It is ludicrous to think anyone can afford to lose money. When Warren Buffett was asked by a prominent financial correspondent the amount of money he could afford to lose, Mr. Buffett answered, "I have two rules at Berkshire Hathaway: rule one, never lose money; rule two, don't forget rule number one." In reality, the situation is quite simple. One must establish a base plan that will allocate funds for life's necessities and pleasures without compromising one's goal for a prosperous and long-lasting retirement.

Financial Strategies

I always recommend a financial strategy that offers liquidity for opportunities and emergencies while building for retirement. By liquidity, I am referring to plans that achieve all of the elements of fiduciary responsibility as described above. An example is a non-qualified deferred compensation plan funded by life insurance. If structured correctly, it affords significant tax advantages that the IRS code allows. After reviewing the portfolios of 500 of my firm’s highest net worth clients, the non-qualified deferred compensation plan is the strategy of choice over 95 percent of the time.

As young doctors start their practices, most have some early success and increase their incomes; deservedly so, as they've worked hard. My advice at that point is to take baby steps. Ask what their required income is for living expenses. Any amount left over can be invested into a resource account that can be utilized for the future. Each year, you must sit down with your financial professional and coordinate a way to gradually upgrade your lifestyle. Instant gratification is not your friend. Generally, it takes five to ten years of being in your practice or career before you can start truly enjoying the fruits of your labor.

Don’t Forget Tax Implications

You must consider taxes. Running a successful business as well as taking care of your patients generally will increase your income. It is presumed you are going to quadruple your income or more by the time you retire. Evaluate the taxes you are paying on your income today and what the tax will be on your income 25 years from now. Maximizing your tax bracket and planning on future taxation are important elements of your success.

Craig Myers, founder of CR Myers & Associates, is a seasoned veteran of many years as a financial consultant. Most fundamental to Craig’s wealth strategies is his strict adherence to fiduciary principles and the preservation of his client’s wealth. He is a member of the world’s most distinguished association for insurance and financial professionals, the Million Dollar Round Table, the Court of the Table and its most prestigious rung, Top of the Table.

ACA Councils

ACA Council Events


21–22, 2015

16th Annual ACA Rehab Council Educational Symposium Orlando, Fla.


23-26, 2015

The Council of Diagnosis and Internal Disorders and The Council on Nutrition Joint Symposium St. Petersburg, Fla.

Events are listed for informational purposes only and are not necessarily affiliated with ACA or its Specialty Councils.

Key Facts about the Chiropractic Profession

ACA invites doctors of chiropractic to use these key facts and statistics about the chiropractic profession in their various communications to the public, patients and the health care community. By sharing consistent information, we can dispel misinformation about chiropractic and educate audiences regarding chiropractic’s efficacy and cost-effectiveness, as well as the rigorous criteria the profession meets through professional regulation and education standards.

By the Numbers

There are 77,000 Doctors of Chiropractic (DCs) in the United States who are required to pass a series of four national board exams1 and be state licensed.2 Roughly another 3,000 DCs work in academic and management roles.

There are approximately 10,000 chiropractic students3 in 18 nationally accredited, chiropractic doctoral graduate education programs4 across the United States with 2,500 DCs entering the workforce every year.5

An estimated 40,000 chiropractic assistants (CAs)6 are in clinical7 and business management roles for chiropractic practices across the United States.

It is estimated that DCs treat over 27 million Americans (adults and children) annually.8

DCs are educated in nationally accredited, four-year doctoral graduate school programs9 through a curriculum that includes a minimum of 4,200 hours of classroom, laboratory and clinical internship,10 with the average DC program equivalent in classroom hours to allopathic (MD) and osteopathic (DO) medical schools.11

DCs are utilized by all 32 National Football League teams12 in optimizing the functionality, endurance and overall conditioning of professional football players in the treatment of neuromusculoskeletal strain injuries, including neck pain, low back pain, strains to hamstrings and quadriceps, and whiplash injuries.

Injured workers with similar injuries are 28 times less likely to have spinal surgery if the first point of contact is a DC rather than a surgeon (MD).13

A recent study showed that treatment for low back pain initiated by a DC costs up to 20 percent less than when started by an MD.14

Patient Satisfaction/Clinical Effectiveness

Doctors of Chiropractic (DCs) are designated as physician-level providers in the vast majority of states and federal Medicare program. The essential services provided by DCs are also available in federal health delivery systems, including those administered by Medicaid, the U.S. Departments of Veterans Affairs and Defense, Federal Employees Health Benefits Program, Federal Workers' Compensation, and all state workers' compensation programs.15

Chiropractic outperformed all other back pain treatments, including prescription medication, deep-tissue massage, yoga, pilates, and over-the-counter medication therapies.16

DCs are the highest rated healthcare practitioner for low-back pain treatments above physical therapists (PTs), specialist physician/MD (i.e., neurosurgeons, neurologists, orthopaedic surgeons), and primary care physician/MD (i.e., family or internal medicine).17

DCs provide a patient-centered, whole person approach to health care marked by greater interaction and better communication, resulting in consistently higher patient satisfaction ratings than medical doctors.18

With prescription pain drug abuse now classified as an epidemic19 in the United States and the number of spinal fusions soaring 500 percent over the last decade,20 the essential services provided by DCs represent a primary care approach for the prevention, diagnosis and conservative management of back pain and spinal disorders that can often enable patients to reduce or avoid the need for these riskier treatments.

Chiropractic care has an excellent safety record.21 This should be viewed in the context of other treatments for back pain such as steroids,22 pain medications23 and surgery. 24 As a result, DCs pay malpractice premiums at significantly lower rates than allopathic doctors (MDs).25

The DC collaborative, whole person-centered approach reflects the changing realities of health care delivery, and fits well into Accountable Care Organization (ACO) and patientcentered, medical home (PCMH) models bringing greater clinical efficiency, patient satisfaction and cost savings.26

A systematic review in 2010 found that most studies suggest spinal manipulation achieves equal or superior improvement in pain and function when compared with other commonly used interventions for short, intermediate, and long-term follow-up.27

The American College of Physicians and the American Pain Society jointly recommended in 2007 that clinicians consider spinal manipulation for patients who do not improve with self-care options.28


1 National Board of Chiropractic Examiners (NBCE) Accessed Dec 2013.

2 Federation of Chiropractic Licensing Boards (FCLB) Accessed Dec 2013.

3 Association of Chiropractic Colleges, Accessed Dec 2013.

4 Council on Chiropractic Education (CCE) is the agency certified by the U.S. Department of Education to accredit doctoral graduate school programs who offer Doctor of Chiropractic (D.C.) degree; Accessed Dec 2013.

5 Association of Chiropractic Colleges, Accessed Dec 2013.

6 American Chiropractic Association (ACA) and Federation of Chiropractic Licensing Boards (FCLB) 2013.

7 Certified Chiropractic Clinical Assistant (CCCA) program. Federation of Chiropractic Licensing Boards (FCLB), 2013.

8 Barnes, Bloom, Nahin. CDC National Health Statistics Report #12. Complementary and Alternative Medicine Use among Adults and Children: United States, 2007. Dec 10, 2008. Extrapolated to 2013 U.S. population from 2007 National Health Interview Survey (NHIS) finding that 8 percent of the adults and 3 percent of the children in the United States received chiropractic services annually.

9 Council on Chiropractic Education (CCE) 2013.

10 Meeker, DC, MPH; Scott Haldeman, DC, PhD, MD; Chiropractic: A Profession at the Crossroads of Mainstream and Alternative Medicine. 2002; 136(3): 216-227.

11 Coulter, Adams, Coggan, Wilkes, Gonyea. A Comparative Study of Chiropractic and Medical Education. Alternative Therapy Health Medicine. 1998; 4:64-75.

12 Professional Football Chiropractic Society (PFCS) 2010

13 Keeney BJ; Fulton-Kehoe D; Turner JA; Wickizer TM; Chan KC; Franklin GM; Early Predictors of Lumbar Spinal Surgery After Occupational Back Injury; Results from a Prospective Study of Workers in Washington State. Spine, May 2013; 38(11):953-64.

14 Richard L. Liliedahl, Michael D. Finch, David V. Axene, Christine M. Goertz. Cost of Care for Common Back Pain Conditions Initiated with Chiropractic Doctor vs. Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee- Based General Health Insurer. Journal of Manipulative and Physiological Therapeutics; Nov 2010; 33(9):640-643.

15 American Chiropractic Association (ACA), 2013. www.acatoday. org/pdf/physicianstatus.pdf.

16 Consumer Reports Health Ratings Center. Back-Pain Treatments.; July 2011.

17 Consumer Reports Health Ratings Center. Relief for your aching back: What worked for our readers. ConsumerReports. org; Mar 2013.

18 Gaumer G, PhD. Factors associated with patient satisfaction with chiropractic care: survey and review of the literature. JMPT 2006 July-Aug; 29(6):455.

19 Unintentional Drug Poisoning in the United States. Centers for Disease Control and Prevention, 2010. Prescription Drug Abuse. White House Office on National Drug Policy. Accessed Nov 2013.

20 Whoriskey, Keating. Boom in spinal fusions questioned. Washington Post. Page 1. October 28, 2013; Rise in spinal fusion surgeries driven partly by financial incentives. Washington Post. Nov 13, 2013.

21 Stevinson, MS & Ernst, MD, PhD (2002). Risks Associated With Spinal Manipulation. The American Journal of Medicine, 112(7), 566-571.

22 Dabbs, Lauretti. A Risk Assessment of Cervical Manipulation vs. NSAIDs for the Treatment of Neck Pain. Journal of Manipulative Physiology and Therapeutics. 1995 Oct; 18(8):530-6.

23 Bronfort, Evans, Anderson, Svendsen, Bracha, Grimm. Spinal Manipulation, Medication, or Home Exercise with Advice for Acute and Subacute Neck Pain – A Randomized Trial. Annals of Internal Medicine. Jan 2012; 156:1-10.

24 Dekutoski, MD, Norvell, PhD,, Dettori, PhD, Fehlings, MD, PhD, & Chapman, MD (2010). Surgeon Perceptions and Reported Complications in Spine Surgery. Spine, 35(9S).

25 NCMIC, 2013. Avoiding Risky Business. American Chiropractic Association. Accessed Dec 2013.

26 Accountable Care Organizations Optimize Outcomes, Cost Savings and Patient Satisfaction with Chiropractic Care. Foundation for Chiropractic Progress. May 2013.

27 Dagenais S, Gay RE, Tricco AC, Freeman MD, Mayer JM (2010). NASS Contemporary Concepts in Spine Care: Spinal manipulation therapy for acute low back pain. The Spine Journal 10 (10): 918–940.

28 Chou R, Qaseem A, Snow V et al. Recommendation 7. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine 147 (7): 478–91.


ACA is pleased to announce the launch of its recently enhanced “Find-a-Doc” online membership and patient referral database. ACA members can now list the various treatments and techniques their practice provides. Simply log on to your member profile at, and update your practice’s information in just a few steps. This important FREE member benefit is a great way for potential patients and referring doctors to quickly find detailed information on ACA members practicing in their area. If you experience any problems using the new feature or if you have any suggestions, please contact us at