[This post was originally published on 2nd September 2020. It has been updated on 19th December 2024.]

Today, chiropractic clinics are facing a dynamic landscape filled with new challenges. From shifting patient expectations and rising competition to adapting to technological advancements and regulatory changes, clinics must evolve to meet these demands. In this blog, we explore some of the most pressing chiropractic practice challenges and provide practical strategies for overcoming them.

1. Shifting Patient Expectations

Demand for More Personalized and Tech-Driven Care

One of the first trends in chiropractic care is changing patient demands. Patients today expect more than just effective chiropractic treatments—they seek seamless, personalized, and technology-enabled experiences. From online booking to instant access to health records, patients are accustomed to the convenience offered by tech-savvy businesses in other industries and expect the same in healthcare.

According to the 2022 Health Information National Trends Survey, about three in five people access their records online or through patient portals.

Challenges:

• High Expectations for Convenience and Accessibility:
  Patients expect the same level of convenience in healthcare as they do from businesses in other industries, including online booking, digital payments, and instant access to health records.
• Need for Personalized and Comprehensive Care:
  Patients expect customized care plans tailored to their individual needs, requiring clinics to gather and effectively use patient data to create personalized treatment strategies.
• Pressure to Manage Multiple Communication Channels:
  The demand for immediate communication across multiple channels (phone, email, text, patient portals) puts pressure on clinics to be responsive and accessible at all times.
• Impact of Negative Reviews on Patient Retention:
  If patients’ experiences do not meet their expectations, they are more likely to leave negative reviews or switch providers, impacting clinic reputation and patient retention.
• Increased Demand for Time-Efficient Services:
  Patients expect faster services, including reduced wait times for appointments and quicker responses to inquiries, which can strain clinic resources.
• Need for Greater Transparency in Care:
  Patients are seeking more transparency about their treatment options, costs, and the overall process, putting pressure on clinics to clearly communicate these details upfront.

Today, chiropractic clinics are facing a dynamic landscape filled with new challenges. From shifting patient expectations and rising competition to adapting to technological advancements and regulatory changes, clinics must evolve to meet these demands. In this blog, we explore some of the most pressing chiropractic practice challenges and provide practical strategies for overcoming them.

Solutions:

• Invest in integrated practice management software to streamline communication, scheduling, and patient management, ensuring easy access to online booking and digital payment options.
• Implement patient portals and mobile apps that provide convenient access to treatment history, appointment scheduling, and direct communication with healthcare providers.
• Leverage SOAP notes tool that tracks patient intake forms, treatment progress, and medical history to deliver personalized care plans.
• Utilize automated reminders and communication systems to ensure timely follow-ups and enhance patient engagement with minimal manual effort.
• Monitor and address online reviews through an online review automation system, ensuring prompt responses to negative feedback and fostering positive relationships with patients.

Enhance transparency by providing clear information on treatment options, costs, and expected outcomes through patient portals and direct communication.

2. Shifting Patient Expectations

Retaining Patients with Innovative Strategies

The chiropractic industry is seeing rapid growth, with new clinics and practices opening regularly. The U.S. chiropractic market is estimated to USD 2.87 billion by 2030. This heightened competition makes it harder for clinics to retain existing patients and attract new ones.

Challenges:

• Increased Patient Choices
  With the rise in the number of chiropractic clinics and alternative healthcare providers, patients have more options than ever before. This makes it crucial for clinics to stand out and differentiate themselves in a crowded market.
• Loyalty and Engagement Between Visits
  Retaining patients goes beyond the treatment room. Clinics must find innovative ways to keep patients engaged between visits to foster long-term loyalty. Without consistent engagement, patients may drift to competitors or lose interest in maintaining regular care. Proactively addressing chiropractic patient care challenges like patient engagement can significantly improve retention and satisfaction.
• Competition from Other Healthcare Providers
  The chiropractic industry faces growing competition not only from new chiropractic clinics but also from physical therapists, massage therapists, and other holistic care providers who offer overlapping services. This makes patient retention even more challenging.
• Pressure to Maintain High Standards of Care
  With more clinics opening, patients are increasingly discerning about the quality of care they receive. This creates pressure for chiropractic clinics to maintain high clinical standards, offer advanced treatments, and continually improve patient care to stay competitive.
• Managing Reputation and Online Reviews
  Online reviews play a crucial role in attracting and retaining patients. A single negative review can impact a clinic’s reputation, especially in the digital age when many potential patients rely on online feedback to make decisions.
• Staffing and Operational Challenges
  As clinics grow, there’s often a need for more staff, which can lead to operational complexities. From scheduling to billing and patient care, managing a larger clinic requires careful attention to detail and the right tools to streamline operations.

Solutions:

• Develop a Strong Online Presence
  Focus on building a solid online presence with an active social media strategy, engaging patient testimonials, and educational content that highlights the benefits of chiropractic care. This helps build trust and visibility while differentiating the clinic from competitors.
• Offer Membership Plans or Loyalty Programs
  Encourage long-term patient engagement with membership plans or loyalty programs. These initiatives can help create a consistent patient base, offering discounted services, exclusive perks, and personalized care.
• Leverage Email Campaigns and Targeted Outreach
  Use email marketing to reach out to inactive patients, offering special promotions, helpful resources, or updates on new services. Targeted email campaigns can encourage patients to re-engage and keep them informed about the clinic’s offerings.
• Utilize Patient Feedback Surveys
  Regularly collect feedback through surveys to understand patient needs, identify areas for improvement, and demonstrate a commitment to providing high-quality care. Addressing patient concerns proactively can improve retention and satisfaction.
• Embrace Technology to Enhance Patient Experience
  Implement tools like patient portals, online appointment booking, and automated reminders to enhance convenience and improve patient satisfaction. Providing a seamless and tech-enabled patient experience can make your clinic stand out and attract more patients.
• Invest in Employee Training and Development
  Ensure that your staff is well-trained in customer service, the latest chiropractic techniques, and best practices for patient engagement. Happy, well-informed staff will help build stronger patient relationships and improve overall care.

Monitor and Manage Your Online Reputation
Regularly monitor review platforms and respond promptly to patient feedback—both positive and negative. Encourage satisfied patients to leave reviews and address concerns openly, demonstrating your clinic’s commitment to patient care.

3. Outdated Systems

A Barrier to Efficiency and Growth

Many chiropractic clinics still rely on outdated systems or piecemeal solutions for managing operations, from manual appointment scheduling to fragmented billing processes.

According to reports, the utilization of outdated systems incurs an annual expense of $8.3 billion for US healthcare. Outdated technology also leads to communication delays of approximately 45 minutes. These inefficiencies hinder clinic growth and reduce the quality of patient care.

Challenges:

• Inconsistent Patient Data Across Systems: Clinics often use disparate systems for various functions (scheduling, billing, documentation), leading to fragmented patient records. This lack of integration can cause delays in care, errors, and missed opportunities for improved patient outcomes.
• Difficulty in Managing Patient Flow: Without an integrated scheduling and workflow management system, clinics may struggle with optimizing patient flow, leading to overbooked appointments, extended wait times, and reduced patient satisfaction.
• Poor Patient Communication: Without a centralized communication platform, patient interactions may become disjointed. This leads to missed messages, delayed responses, and a lack of personalized follow-up care, impacting patient retention.
• Regulatory Compliance Challenges: Clinics are increasingly facing complex requirements for documentation, billing codes, and patient privacy regulations like HIPAA. Many outdated systems are not built to handle these regulations efficiently, leaving clinics vulnerable to costly mistakes or compliance issues.
• Inadequate Data Analytics: Many clinics struggle to gather actionable insights from their patient data due to fragmented systems. Without effective data analytics tools, clinics may miss opportunities to improve patient care or optimize their practice operations.

Solutions:

• Unified Practice Management System: The first step to overcoming challenges in chiropractic care includes transitioning to a comprehensive software solution. An all-in-one practice software that integrates scheduling, billing, patient communication, and documentation will help you streamline operations and improve patient care.
• Cloud-Based Technology: Ensure all systems are cloud-based, enabling easy access for both staff and patients while supporting backup, disaster recovery, and compliance with security regulations.
• Analytics and Reporting Tools: Leverage advanced analytics to track patient outcomes, treatment effectiveness, and operational performance, allowing clinics to make data-driven decisions to improve patient care and business outcomes.
• Patient Portal and Mobile App: Provide a seamless patient experience by offering a mobile app or patient portal that allows access to health records, appointment scheduling, secure messaging, and payment processing all in one place.

Automated Communication Tools: Use automated messaging systems for appointment reminders, follow-ups, and patient education to improve communication, reduce no-shows, and enhance the overall patient experience.

4. Billing Challenges

A Major Obstacle to Financial Stability

Effective billing is the backbone of any successful chiropractic practice, yet many clinics face challenges such as claim rejections, coding errors, and delayed reimbursements. 

According to the American Medical Association (AMA), claim denial rates for major commercial payers ranged from 1.63% to 9.6% and up to 23% for Medicare. 

Payment delays are one of the common problems in chiropractic care. Insurance payment delays occur due to claim denials, as they are forced to allocate additional resources to the appeals process.

These issues not only affect cash flow but also add stress to administrative teams.

Challenges:

• Coding Errors and Claim Denials: Incorrect coding, particularly with ICD-10 and CPT codes, is one of the leading causes of claim denials in chiropractic practices. This issue can be exacerbated when codes are not updated regularly to reflect changes in regulations, leading to increased rejection rates.
• Manual Billing Processes: Relying on outdated, manual billing systems increases the likelihood of human errors, such as incorrect data entry or missed billing codes. These errors often result in delays and rejected claims, affecting the practice’s revenue.
• Complex Insurance Regulations: Chiropractic clinics often deal with multiple insurance providers, each with different billing rules, regulations, and reimbursement policies. Keeping up with these ever-changing rules is time-consuming and requires dedicated resources to ensure compliance and prevent costly mistakes.
• Delayed Reimbursements: Many chiropractic practices experience significant delays in reimbursement due to inefficient claim processing, inaccurate coding, or delays in follow-up with insurers. This disrupts cash flow and makes it difficult for clinics to maintain financial stability.
• Inconsistent Follow-ups on Claims: Inefficient follow-up procedures for unpaid or denied claims can lead to revenue loss. Without a streamlined process for tracking outstanding payments and following up with insurers or patients, clinics risk uncollected payments, further impacting financial health.
• Increased Administrative Burden: The complexities of billing and coding often create a heavy administrative workload. Staff must constantly update codes, track claims, and resolve disputes with insurers, leading to burnout and decreased efficiency.

Solutions:

• Automated Billing Software: Implementing automated billing software specifically designed for chiropractic practices can minimize errors, streamline claims submission, and reduce claim denials. This software can also track claim status in real-time, providing alerts when actions are required.
• Staff Training and Certification: Regularly train staff on updates to ICD-10 codes, CPT codes, and other billing best practices to ensure accurate coding and reduce the chances of rejected claims.
• Real-Time Claims Tracking: Use billing tools that allow for real-time tracking of claims, enabling the clinic to monitor payment status and respond quickly to denied or pending claims, improving cash flow and reducing delays.
• Integrated Payment Solutions: By integrating payment portals into the practice management system, clinics can enable patients to pay easily and quickly online. This also reduces the manual processing time for payments and ensures faster reimbursements from patients.
• Dedicated Billing Specialist or Team: Consider hiring or designating a billing specialist or team to handle complex billing tasks, claim follow-ups, and ensure compliance with insurance providers. This reduces the administrative burden on other staff members and improves billing accuracy.
• Regular Audits and Reviews: Conduct regular audits of billing processes and coding practices to identify areas for improvement. Consistently reviewing claims and payments will help clinics spot patterns in denials or delays, enabling them to address systemic issues.

[Read our complete guide to chiropractic billing and coding here]

5. Patient Engagement

Building Long-Term Relationships 

As chiropractic clinics face increasing competition, retaining patients and keeping them engaged over time has become more difficult. Patients want care that evolves with their needs, not just a one-time fix. To build trust and long-term relationships, clinics need to focus on connecting with patients beyond that first visit and tackling modern chiropractic issues head-on.

Challenges:

• Patient loyalty: With so many options for chiropractic care, patients are more likely to switch providers if they don’t feel a strong connection or see continuous value.
• Lack of engagement between visits: Many clinics struggle to keep patients engaged once their immediate pain or condition is addressed, leading to decreased return visits and lower retention rates.
• Managing expectations: Patients may expect quick results, and if their treatment plan takes longer than expected, they may lose patience or feel that their needs are not being met.
• Attracting new patients while retaining existing ones: Balancing marketing efforts to acquire new patients while ensuring the satisfaction of current ones can be challenging, especially in a competitive market.

Solutions:

• Personalized care plans: Use patient data to create customized treatment plans that address individual goals and track progress. This approach helps patients feel more involved in their care and committed to long-term treatment.
• Regular follow-ups and engagement: Implement automated reminders, check-ins, and follow-up emails to stay in touch with patients between visits. To keep your patients engaged in between appointments, offer health tips, educational content, and updates on new services or treatment options to keep patients engaged.
• Loyalty programs and incentives: Introduce membership programs, referral bonuses, or special discounts to reward repeat visits and encourage word-of-mouth referrals.
• Build relationships: Make efforts to connect personally with patients, ensuring they feel valued. Whether through personalized messages, remembering important details about their lives, or celebrating milestones, these gestures build trust and loyalty.

How zHealth’s All-in-One Chiropractic Software Can Help:

1. Automated Patient Recall & Appointment Reminders:
zHealth’s automated recall system ensures patients stay on track with their treatment plans. Regular reminders via email, text, or mobile notifications help reduce missed appointments and keep patients engaged with their care.

2. Integrated Email Marketing:
With zHealth’s built-in email marketing tools, clinics can send personalized follow-up emails, share educational content, and inform patients about special offers, reinforcing their commitment to patient well-being.

3. Online Reviews Management:
zHealth simplifies collecting and managing patient reviews. By sending automated review requests after each appointment, clinics can build a strong online presence with positive feedback, attracting new patients and strengthening existing relationships.

4. Mobile-Friendly Patient Engagement Tools:
zHealth offers mobile apps for providers and patients. The Patient App allows patients to book appointments, view their health records, and check-in easily. This accessibility improves patient satisfaction and encourages long-term loyalty.

5. Integrated Payment System:
The integrated payment solution enables seamless and flexible payment options for patients. This not only improves their experience but also ensures faster transactions and reduces payment delays for the clinic.

6. Advanced Billing and Reporting:
zHealth’s advanced billing system streamlines the entire revenue cycle. With tools for accurate coding, automated claims submission, and detailed financial reporting, practices can maintain financial stability while focusing on patient care.

Conclusion

Chiropractic clinics need to embrace innovation, streamline workflows, and enhance patient engagement to deal with the challenges. Solutions like comprehensive EHR and practice management software, automation, and targeted marketing strategies are key to staying competitive and meeting patient expectations.

zHealth offers an all-in-one platform that addresses administrative inefficiencies, simplifies billing, and enhances patient communication. By adopting modern tools and strategies, chiropractors can turn challenges into opportunities for growth and deliver exceptional care.

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Read more articles:

Ultimate Guide To Enhancing Patient Experience In 2025

Chiropractic Practice Growth Playbook