"Throughout his career, Dr. Spontak was known for his leadership, mentorship, and his unwavering commitment to advancing chiropractic care for all. His contributions to the WCA and the profession will not be forgotten."
~John Murray, WCA
Recognizing the Legacy of Chiropractic in Wisconsin
WCA Legacy Awards - 36
Legacy Forward: WCA Fall Convention 2025 - 18
Remembering Dr. Bill Spontak - 38
Building Legacy: Welcome New WCA Membes - 22
BOARD
Directors
MARTIN
JACOB
MICHAEL
Submitted by EuroMedica, a Trusted WCA Corporate Partner
Chances are good that your patients are already familiar with omega-3 fatty acids. But whether they are getting them consistently through diet or supplementation may be open to question.
Fortunately, there is an alternative to oils for omega-3s, one that is easily added to any daily regimen.
This supplemental form of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) is bound to beneficial phospholipids rather than oil, provides valuable peptides, and is sourced only from salmon. It may change the relationship your patients have with omega-3s.
There is an omega-3 that was pioneered by French researchers at the University of Nancy. Sourced only from North Atlantic salmon, it is created with a unique process that uses water and enzymes immediately following the
catch. It introduces no intensive heat or harsh solvents that damage or alter the structure of fatty acids and other beneficial compounds in the fish. This method also preserves the naturally occurring wealth of phospholipids and peptides inherent in salmon, providing additional benefits not found in oils.1
Because this form is so stable, its recommendation is only two tablets per day. This virtually guarantees patient compliance—a real bonus for patients who have struggled with taking fish oil because they don’t like fishy-tasting burps or who are hit-and-miss with supplementation oils because of their heavy dosage requirements.
The phospholipids that bind and carry the omega-3s in this unique form ensure better absorption than triglycerides from fish oils, and are valuable for your patients in other ways, too. For instance, DHA is typically associated with phosphatidylserine (PS) and EPA is associated with phosphatidylinositol (PI) in the brain—to name just two of the five valuable phospholipids in this supplement.2
As for the peptides found in this omega-3, a scientific study reported that it reduced occasional anxiety and
protected neurons from the risk of oxidative stress.*3 And aside from these actions, the bioactive peptides contribute to its enhanced efficacy overall.*
As important as these brain-related considerations are, cardiovascular support is probably the number one reason for your patients to want omega-3s in their regimens.*
Regarding cholesterol balance, an open clinical trial saw dramatic benefits. In this study, 40 healthy volunteers took the recommended dosage of two omega-3 tablets per day without any modifications to diet or exercise habits. After 60 days, participants saw support for triglyceride and total cholesterol balance, and their HDL levels increased by 13 percent.† That is an impressive change in very short order, and one that patients looking for cardiovascular support would appreciate.4 Additionally, they’ll be grateful for the way that omega-3s can support immune defense, maintain delicate blood vessels in the retina.*5-10
Whether part of a cognitive, cardiovascular, or daily health protocol, or because you have patients who have tried to keep a regular intake of omega-3s but found it a challenge, you can change their paradigm.* Recommending this omega-3 tablet provides your patients with the DHA, EPA, peptides, and phospholipids they may otherwise be missing and in a form that is safe, convenient and effective.
†Supports healthy levels already within normal range. *These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
References:
1. Analysis at the Nancy-Universite, INPL-ENSAIA; Laboratoire de Science et Genie Alimentaires, Vandoeuvre-les-Nancy, France.
2. Dyall SC. Long-chain omega-3 fatty acids and the brain: a review of the independent and shared effects of EPA, DPA and DHA. Front Aging Neurosci. 2015 Apr 21;7:52.
3. Belhaj N, Desor F, Gleizes C, et al. Anxiolytic-like effect of a salmon phospholipopeptidic complex composed of polyunsaturated fatty acids and bioactive peptides. Marine Drug 2013;11:4294-4317.
4. Arer and Duclaut. Phospholipid-bound omega-3s from salmon: open clinical trial. Unpublished study, 2006.
5. Fish Oils. In: Hendler SS, ed. PDR for Nutritional Supplements. 2nd ed. Montvale, NJ: Physician’s Desk Reference; 2008:208-214.
6. Kendall-Tackett K. Long-chain omega-3 fatty acids and women’s mental health in the perinatal period and beyond. J Midwifery Womens Health. 2010;55(6):561-7.
7. Rocha Araujo DM, Vilarim MM, Nardi AE. What is the effectiveness of the use of polyunsaturated fatty acid omega-3 in the treatment of depression? Expert Rev Neurother. 2010 Jul;10(7):1117-29.
8. Chang JP, Chen YT, Su KP. Omega-3 Polyunsaturated Fatty Acids (n-3 PUFAs) in Cardiovascular Diseases (CVDs) and Depression: The Missing Link? Cardiovasc Psychiatry Neurol. 2009;2009:725310. Epub 2009 Sep 27.
9. Parmentier M, Al Sayed Mahmoud C, Linder M, Fanni J, et al. Polar lipids: n-3 PUFA carriers for membranes and brain: nutritional interest and emerging processes. Oleagineux, Corps Gras, Lipides; Volume 14 (Issue 3): 2007; p.224-9.
10. Bourre JM. Roles of unsaturated fatty acids (especially omega-3 fatty acids) in the brain at various ages and during aging. J Nutr Health Aging. 2004; 8(3):163-74.
by John Murray, Wisconsin Chiropractic Association Executive Director and CEO
One of the additional privileges
I enjoy as Executive Director of the WCA is being the editor of The Wisconsin Chiropractor magazine. The
frequency and format of the magazine has changed a bit over the years but the intent
remains the same; delivering timely and engaging content to our readers.
In 2020, we changed the format of the magazine from a paper edition delivered to clinics to a digital format delivered via email (and available on the WCA website).
As we explained when we made this change, the decision to move to a digital magazine was done with careful consideration of the consequences. While cost was the primary factor, compatibility with digital channels was a very close second. The membership of the WCA currently tilts slightly to the older cohort but the younger doctors are catching up in terms of numbers and their preferences to consume content in digital form and through online channels is a factor we needed to consider as an association.
Now before all of you “boomers” get your knickers in a twist (I consider myself to be a boomer, at least in my habits and preferences); I still prefer to read actual hard cover books and like my newspapers in paper format. But running a cost effective state association requires making difficult choices, and moving to a digital magazine made sense.
We continue to find ways to make the magazine as easy to read as possible. Using the “flip book” format instead of PDF makes it easier open and read. The digital format
also allows us to include more content - both articles and ads - which makes content contributors and advertisers happy. We try not to hit you with too many ads but the ads we do feature are from quality companies who want to reach potential customers with their products or services. They also help support the profession by supporting the WCA through their advertising dollars. We hope that you consider supporting our advertisers when making decisions about the products and services you purchase for your clinics.
The June edition always feels like a transition similar to the seasons. We all shift out of spring/school year mode to summer/school vacation mode. School vacation mode is not the same as doctor/staff vacation mode but you get my drift.
As WCA lobbyist (yet another hat I enjoy wearing), my attention this month is on the Wisconsin Legislature and the 2025-2027 state budget. With any luck, the Legislature will complete its budget work that hopefully includes some pro chiropractic policy in it by the end of June and their members will go home for the summer until the fall session begins.
As editor, I of course, recommend you read all of the content in this edition but I would be remiss if I did not highlight a few items of note.
WCA staff are currently planning the 2025 Fall Convention, visiting chiropractic schools to meet with students, helping members with clinic questions and migrating our website and AMS/LMS systems to another more user-friendly platform.
continued on page 10
Editor's Note - Cont. from page 9
The American Medical Association and the rest of the medical-industrial complex (my term) continues to besmirch the chiropractic profession and your training and education in the context of federal Medicare legislation.
� See page 30 to read their latest ill-informed letter to members of Congress and the American Chiropractic Association’s on-point response
The WCA is working to get a provision included in the 2025-2027 state budget that increases access to chiropractic care within the state Medicaid program.
� See page 13 for more information on our efforts.
Finally, the WCA Fall Convention in September will be here before we all know it. What a great opportunity to get some of your required CE credits completed with some great speakers and programs to help you build your chiropractic legacy.
One of the highlights of the 2025 WCA Fall Convention will be the second year of the new WCA Legacy Awards event that honors long time WCA members for their contributions to the profession.
� Watch for the Fall Convention guide in July and take advantage of the generous early bird registration incentives.
“We’ve
“When my mother, Dr. Betty, began her practice decades ago, Chiropractic care was illegal in our state. We’ve made incredible strides since then. I remember her unwavering commitment to helping as many people as possible, and I embraced that responsibility. However, my efforts to be generous and my failure to clearly explain the reasoning behind my services and fees—including offering different fee schedules— unfortunately caught the attention of my state’s Attorney General.
This experience was the driving force behind the creation of ChiroHealthUSA.
• I was determined to create a tool that empowers Chiropractors and protects our practices.
• I wanted to safeguard our profession while helping patients overcome barriers to care.
I invite you to learn more about CHUSA, and thank you for making a difference in the lives of your patients”.
Dr. Ray Foxworth CEO/Founder ChiroHealthUSA
Dr. Ray Foxworth, DC, FICC | Founder and CEO of ChiroHealthUSA
At ChiroHealthUSA, we believe the success of your practice should never come at the expense of your integrity. That’s why we’re sharing a recent—and unfortunate—reminder of how serious the consequences can be when billing procedures aren’t followed.
Last week, the Department of Justice announced that a chiropractor in Louisiana was convicted of health care fraud and unemployment insurance fraud. According to court records, Dr. Benjamin Tekippe, owner of Metairie Chiropractic & Rehab, was found guilty of billing Blue Cross Blue Shield of Louisiana for chiropractic services that were never performed. In fact, some of the claims were submitted while he was out of town—or even behind bars. (DOJ, 2025)
In an effort to deceive auditors, he also instructed his staff to falsify patient records, even having them write in their own handwriting to make the notes look more authentic. If that wasn’t enough, he also fraudulently collected unemployment benefits while actively working and billing insurance. The total amount of false claims? Over $2.3 million. The consequences? Federal conviction, fines, and potential jail time.
It’s a cautionary tale that every member of your team— doctors, chiropractic assistants, and billing staff—should take to heart. There is no shortcut worth taking when it comes to proper billing, documentation, and compliance. Even honest mistakes can lead to audits and headaches, but intentional fraud can destroy careers and reputations. (David J. Goldberg, 2021)
At ChiroHealthUSA, we’ve seen how great chiropractic teams thrive when they invest in training and systems that ensure correct billing procedures. That means billing for services that are medically necessary and provided, documenting each visit accurately, and staying on top of payer guidelines. It also means fostering a culture where your team feels confident asking questions and double-check-
ing procedures because you’re all accountable for the same standard. Check out our webinar archive to learn from the experts on proper billing and coding procedures.
We’re here to help with that, too. One of the most powerful tools you can implement is a Profitable Discount Strategy through ChiroHealthUSA. With this simple, compliant solution, you can legally offer discounts to patients who pay out of pocket—without violating insurance contracts or reducing your clinic’s revenue. It's a win-win for your patients and your practice. There is ZERO-COST to you as a provider so click here to learn more!
Instead of giving away care or risking compliance issues, you can grow your patient base and improve profitability smartly—by staying ethical, compliant, and patient-focused.
Your success should be sustainable and rooted in integrity. The temptation to cut corners or “fudge” documentation may seem harmless in the moment, but it can have long-lasting and devastating effects. Take this recent case as a reminder: there’s a right way to build a profitable, thriving practice—and ChiroHealthUSA is here to help you do just that.
If you haven’t already, let’s talk about how a Profitable Discount Strategy can support your goals and keep your practice on the right track.
Dr. Ray Foxworth, DC, FICC, is the visionary behind ChiroHealthUSA, serving as its esteemed founder and CEO. With over 39 years of dedicated service in chiropractic care, Dr. Foxworth has navigated the complexities of billing, coding, documentation, and compliance firsthand. His rich experience includes roles as the former Staff Chiropractor at the G.V. Sonny Montgomery VA Medical Center and past chairman of the Chiropractic Summit and Mississippi Department of Health. Dr. Foxworth is deeply committed to advancing the chiropractic profession, which is evident through his leadership roles. He is an at-large board member of the Chiropractic Future Strategic Plan and holds an executive board position with the Foundation for Chiropractic Progress.
John Murray, WCA Executive Director and CEO
As of press time, efforts between Governor Evers and Republicans who control both houses of the Wisconsin Legislature to negotiate key components of the 20252027 state budget have stalled and the Joint Committee on Finance (the budget writing committee of the Legislature) is moving forward with their own tax cut package, funding for K-12 schools, the UW System and local units of government.
The state has a healthy budget surplus (one time money available for one time expenditures) and strong ongoing revenue growth (projected new revenue in each year of the two year budget). But ongoing cost increases (called cost to continue), uncertainty at the federal level affecting the Medicaid program which is funded by both state and federal dollars, and the impact of a Wisconsin Supreme Court decision on school funding levels (you may have heard about the 400 year school funding veto) have made budget negotiations challenging to say the least. On the bright side, Wisconsin state government does not shut down at the end of the state fiscal year (June 30th) if a new budget is not approved. Wisconsin state government continues to operate at current funding levels until a new budget is passed.
Over the past month, WCA President Dr. Chris Resch and WCA Executive Director John Murray have been busy meeting with members of the Legislature including Speaker Robin Vos (R - Rochester), Senator Dan Feyen (R - Fond du Lac) Rep. Clint Moses (R - Menomonie), Senator Rachel Cabral Guevara (R - Appleton). Rep. Todd Novak (R - Dodgeville) and members of the Joint Finance Committee to advocate for expanded access to chiropractic care within Medicaid and reimbursement increases. The WCA has had success working with some of the same legislators to achieve payment parity and increased reimbursement for chiropractic adjustment codes in the past two state budgets. Given the political and fiscal headwinds facing this budget, inclusion of expanded coverage of chiropractic and increased reimbursement within the Medicaid package might be a tall order. Be assured that the WCA team working for you at the State Capitol will fight to finish on this issue. Look for updates on this issue and other state budget developments over the next few weeks as the Legislature looks to complete its budget and send it to Governor Evers.
The business lobby in Wisconsin, led by Wisconsin Manufacturers and Commerce (WMC), is using the management seat on the Workers Compensation Advisory Council (WCAC) to once again push for changes that would eliminate patient choice for injured workers and to impose a fee schedule for medical services (including chiropractic) that would reimburse you at Medicaid levels.
While these provisions are nothing new, the business lobby has started pushing them much earlier in the WCAC process than last legislative session. WCA is one of the named health care liaisons to WCAC and works with the other affected health care providers to push back on these ill-advised changes to one of the best worker’s compensation systems in the country. Stay tuned for more updates on this important topic.
Despite the Governor’s efforts to include a number of policy provisions in the 2025-2027 state budget to reign in the abuses of health insurance companies when it comes to pre authorization of health care services, the Joint Committee on Finance (JFC) removed all of his pre auth proposals along with every other one of his provisions deemed “policy” by Republicans who control the committee. This move was expected as the Republican-controlled JFC has done this for every one of Governor Ever’s proposed budgets. It is highly unlikely that any of the pre authorization proposals will make it back in the budget.
The good news is that Senator Tomczyk (R - Mosinee) and Representative Wittke (R - Caledonia) have reintroduced pre authorization legislation this session that (among other things) prohibits insurance companies from requiring pre authorization of services for the first twelve visits and in chronic cases 90 days of care. This bill is almost identical to AB507/SB 475 which the WCA supported last session along with a coalition of other health care providers.
Look for further updates on this issue as they developformally introduced.
WHEN
● Same- and next-day appointments with evening and weekend hours
● Subspecialized and DACBR radiologists who interpret patient exams and are available for consult
● Customized protocols:
● Weight-bearing imaging
● Flexion/extension imaging of the spine for a detailed diagnosis
● MRI options:
● 3T
● High-field open
● High-field wide-bore
The WCA's continuing education schedule is full of opportunities to sharpen your skills, earn CE credits, and stay current with the latest in chiropractic care.
Whether you prefer the flexibility of live online webinars or the hands-on experience of in-person seminars, we’ve designed our offerings to fit your schedule and support your professional growth. Plan ahead and save 20% when you register 20 days in advance!
WCA members can access webinars to view on-demand right. Simply login to your account on the WCA website and access educational content from the convenience of home or the clinic.
Note: recordings do not count for continuing education credits.
Zach Kasun, Membership Director | zkasun@wichiro.org | 608-292-1805
n e w WCA mem be rs !
Jacob Acosta
Gabriel Austin
Haley Baker
Latonya Brinson
Josephine Buehler
Carlos Castillo
Courtney Chavez
Kathryn Connolly
Kaylynn Cooper
Holly Cronin
Ron Cullis
Hannah Derenne
Teresa Disney
Meghan Erickson
Nate Euler
Reagan Fazekas
Raquel Gassmann
Darius Green
Marie Greene
Calvin Grenda
Travis Haak
Eily Hall
Jazmynn Hardy
Evalyn Herzog
Tyler Houghton
Samara Howard
Meredith Janssen
Keianna Jasso
Kathleen King
Dominick Kollmann
Katie Larson
Jai Liester
Jake Little
Andrea Martin
Dare Matz-Scott
Kaitlyn McHugh
Grace Mewhirter
Taylor Miller
Kate Murack
Taylor Nelson
Mat Oca
Yetunde Oyenuga
Dylan Parshall
Reagan Peirce
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Annmarie Romano
Haley Rowe
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Cole Schneider
Keaton Schoenfeld
Kaithlyn Servin
Mychala Spang
Jenna Stein
Tyler Stepp
Talin Tawer
Jake Totzke
Brooklyn Udelhofer
Alecka Vang
Eva Wampfler
Kathryn Warner
Jacob Zeilinger
Discounts on continuing education (CE) courses and convention registration
Complimentary webinars for professional and staff development
Access to the WCA Help Desk for billing, coding, and compliance support
Member-only resources and tools for practice management
Networking opportunities with other small clinic members $ Now your whole team can access the full suite of WCA member benefits with a Small Clinic Group Membership!
Designed exclusively for small chiropractic clinics with 2-6 DCs on staff, this tailored membership offering will provide small clinics with cost-effective access to the full suite of WCA membership benefits, while ensuring their teams have the resources needed to succeed. This pilot program was created to explore how the WCA can better support Wisconsin clinics of varying sizes.
Includes up to three clinic Doctor of Chiropractic (DC) memberships.
Add on additional clinic DC memberships for just $250 each.
Each year, we work hard to ensure our communications are effective, informative, and easy for all WCA members and customers to access.
To maintain this high standard of service, it is essential that every WCA profile is associated with a unique email address. We understand that some clinics prefer to use a shared email for workflow efficiency, but for our system accuracy and user-specific updates, each individual profile must have its own unique email.
NOTE: Failure to comply will result in a deleted WCA profile. If you have already replied to a recent fax or email you are all set!
Update your WCA Profile Online:
• Login to your WCA profile: www.wichiro.org.
• Select “Manage Profile” then click “Edit Bio.”
• Please be sure to provide a valid, unique email address that is current & in use.
Questions? Email: membership@wichiro.org
by Dr. Cindy M. Howard DC, DABCI, DACBN, FIAMA, FICC
Several years ago, my practice community experienced a rise in overdose numbers, and physicians began referring patients to me before surgical procedures because they were seeking alternatives to heavy medication protocols.
The statistics paint a sobering picture:
• Between 2011 and 2021, opioid-related deaths increased from 7 to 24 people per 100,000.1
• As of 2018, one third of Americans had received an opioid prescription in the past two years.2
• Of the people who died in 2022 from overdoses, 76 percent were from opioid-related use. 3
The regulatory landscape is evolving. Some states now require naloxone in workplace first-aid kits, and pharmacy chains face legal consequences for inappropriately filling prescriptions. Policy initiatives increasingly emphasize limiting opioid prescriptions and encouraging alternatives.
Opioids bind to receptors throughout the central nervous system, blocking pain while triggering dopamine release. This neurotransmitter creates the feel-good sensation driving continued use.
Over time, the brain produces less natural dopamine, creating a dangerous cycle: as production decreases, the person requires more opioids to achieve the same effect. Extended use fundamentally alters brain chemistry, making recovery increasingly difficult.
Genetic factors play a significant role—approximately 30% of the population carries variations that heighten susceptibility. The Dopamine D2 receptor gene is particularly significant; individuals with the A1 variant receive less dopamine naturally, increasing addiction risk.
Stress represents a significant risk factor for both initial addiction and relapse. Chronic opioid use disrupts hormone regulation, affecting cortisol, DHEA, serotonin, and dopamine. As the brain adapts to artificial dopamine, natural stress-coping mechanisms deteriorate, creating a perfect storm for addiction.
Karen came to me seeking alternatives to opioids for pain management. She had a stress fracture in her foot, tendonitis in her ankle, and persistent fatigue. Her physician had prescribed oxycodone, but she wanted to avoid opioids and explore non-pharmaceutical options for pain relief and recovery.
To develop a targeted treatment plan, I conducted a comprehensive evaluation beyond standard lab work. I ran a micronutrient test to identify deficiencies that could hinder the healing process, an adrenal profile to assess stress hormone regulation, and a food sensitivity test to eliminate inflammatory triggers that could slow recovery.
continued on page 27
Dr. Cindy M. Howard DC, DABCI, DACBN, FIAMA, FICC is a celebrated chiropractor, functional medicine practitioner, and author of "Positively Altered." With multiple board certifications and a passion for holistic healing, she helps patients address root causes of pain and dysfunction rather than merely treating symptoms. For speaking engagements or consultation, contact her at hello@drcindyspeaks.com or 708-646-6561.
Karen's lab results revealed elevated cortisol levels throughout the day, contributing to systemic inflammation and impaired healing. To counteract this, I implemented a multi-faceted, functional medicine approach:
� Cortisol Regulation:
• Prescribed phosphatidylserine to lower her cortisol levels and reduce stress-related inflammation.
� Pain and Inflammation Modulation:
• Recommended Boswellia and curcumin to help lower inflammation naturally.
• Performed acupuncture sessions that provided pain relief and improved circulation.
• My chiropractic adjustments addressed structural imbalances contributing to strain.
• Utilized cold laser therapy and TECAR therapy to accelerate tissue healing.
� Nutritional and Supplement Support:
• Increased Vitamin D intake to optimize bone healing.
• Introduced Pyridoxal-5-Phosphate (P5P) to support nerve health and relieve mild neuropathy symptoms.
• Supplemented with Omega-3 fatty acids to further reduce inflammation and support joint health.
By integrating chiropractic care, acupuncture, targeted nutrition, and stress regulation, Karen avoided opioid use entirely while successfully managing her pain. The combination of therapies not only sped up her healing process but also improved her energy levels, sleep, and recovery time.
Evidence-Based Alternatives
A comprehensive approach should incorporate multiple modalities:
• Chiropractic care
• Acupuncture
• Therapeutic massage
• Meditation and mindfulness
• Targeted exercise
Nutritional interventions can naturally support dopamine and reduce pain, including magnesium-rich foods, green tea, turmeric, omega-3s, and antioxidant-rich foods. Several natural compounds show promise:
• Turmeric/Curcumin: Comparable to tramadol for neuropathic pain
• White Willow Bark: Natural anti-inflammatory
• Valerian Root: Helps with nerve pain
• Capsaicin: Disrupts pain signaling
Research shows patients visiting chiropractors for musculoskeletal pain are 49 percent less likely to receive opioid prescriptions. Integrative programs combining chiropractic care with other modalities address not just pain but underlying factors.
Addressing the opioid epidemic requires:
• Developing personalized pain management strategies
• Incorporating stress reduction techniques
• Identifying underlying causes of pain
• Integrating multiple therapeutic modalities
• Educating patients about alternatives
As healthcare providers, we must present alternatives before turning to opioids. For patients already dependent, gradual transition to multimodal approaches offers the best chance for sustainable recovery. Through education, advocacy, and evidence-based care, we can help stem the tide of addiction while providing better outcomes for our patients.
See Dr. Cindy Howard in person at the 2025 WCA Fall Convention on September 27. She is presenting "Ethical Practices and Communicating Effectively: Let’s talk about Sex," sponsored by WCA Corporate Partner Protocol 4 Life Balance.
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The Honorable Kevin Cramer
U.S. Senate
313 Hart Senate Office Building
Washington, DC 20510
The Honorable Greg Steube
United States House of Representatives 2457 Rayburn House Office Building Washington, DC 20515
The Honorable Richard Blumenthal
U.S. Senate
503 Hart Senate Office Building
Washington, DC 20510
The Honorable John Larson
United States House of Representatives 1501 Longworth House Office Building Washington, DC 20515
Dear Senators Cramer and Blumenthal and Representatives Steube and Larson:
The undersigned medical professional organizations write to you in strong opposition to S. 106/H.R. 539, the “Chiropractic Medicare Coverage Modernization Act of 2025,” which would amend the Social Security Act’s definition of physician to extend Medicare coverage for services furnished by chiropractors beyond the manual manipulation of the spine.
This legislation would authorize chiropractors to use the title “physician” under the Medicare Part B program and be paid the same rate as allopathic (MD) and osteopathic (DO) physicians for manual manipulation of the spine as well as for any other medical services chiropractors are licensed to perform. By removing the current “manual manipulation” limitation in the Social Security Act, this bill opens the door for other services, which chiropractors have not been specifically trained to provide, and which could potentially put patient safety at risk, to be covered by Medicare.
Our organizations strongly support the team approach to patient care, with each member of the team playing a clearly defined role as determined by his or her education and training. However, a recent survey found that 27 percent of patients incorrectly identified chiropractors as medical doctors. 1 This legislation would exacerbate such patient confusion and prompt further misconceptions and false expectations regarding the care they receive.
While we greatly value the contribution of chiropractors to the physician-led care team, their training is not equivalent to the four years of medical school, three-to-seven-years of residency training, 200 hours of osteopathic manipulative medicine education and clinical experience (for DOs), and 1 2,000-16,000 hours of clinical training that is required of all physicians. In order to be recognized as a physician with an unlimited medical license, medical students’ education must prepare them to enter any field of graduate medical education and include content and clinical experiences from which they develop their clinical judgment and medical decision making skills directly managing patients in all aspects of medicine 2 Conversely, chiropractic students must complete a minimum of 4,200 instructional hours of combined classroom, laboratory, and clinical patient care experience.3 According to the Federation of Chiropractic Licensing Boards, many state chiropractic licensing boards do not require a Bachelor’s degree.4
1 Baselice & Associates conducted an internet survey of 802 adults on behalf of the AMA Scope of Practice Partnership, July 12-19, 2018. The overall margin of error is +/ - 3.5 percent at the 95 percent confidence level.
2 https://www.ama-assn.org/system/files/scope-of-practice-physician-training.pdf
3 https://www.cce-usa.org/uploads/1/0/6/5/106500339/2021_cce_accreditation_standards__current_.pdf
4 https://fclb.org/files/publications/1639413264_bachelors -degree-requirements.pdf.
The Honorable Greg Steube
The Honorable Richard Blumenthal
The Honorable John Larson
April 28, 2025
Page 2
Moreover, while chiropractic students are required to complete supervised instruction in a patient care setting, they are not required to complete a residency training program and do not undergo the level of subsequent training that MD and DO medical students receive. As such, chiropractors are not physicians.
Given their relatively limited education and training, chiropractors’ scope of practice is appropriately restricted under Medicare to treatment by means of manual manipulation, i.e., by use of the hands. This limitation is aligned with chiropractic training and the treatments that chiropractors most often provide involving common musculoskeletal complaints such as back pain. However, as currently written, S. 106/H.R. 539 would authorize the Centers for Medicare & Medicaid Services (CMS) to cover any medical service a chiropractor could be licensed to perform. In a state with overly broad or permissive licensure regulations, S. 106/H.R. 539 would establish a pathway for coverage and payment for chiropractors providing medical services for which they may have very limited or no formal training.
Even the American Chiropractic Association (ACA) website states that, “At a minimum, if passed in its current form, the legislation would include evaluation and management (E&M) codes, therapy codes including but not limited to CMT [Chiropractic Manipulative Treatment], and certain diagnostic and Xray codes.” The ACA further claims that “chiropractors will be able to bill Medicare for the full scope of their services allowed by their state, provided they have completed documentation training in the form of a one-time webinar or similar process, as determined by CMS.”5 Our organizations are concerned that permitting chiropractors to bill Medicare for the full and likely expanded scope of their license in a given state will lead to an unnecessary redistribution of scarce Medicare resources away from physician practices to nonphysician practitioners for services that they lack sufficient training and expertise to perform. Such expansion could increase overall Medicare costs and jeopardize the health and safety of Medicare patients.
We appreciate your consideration of our concerns about S. 106/H.R. 539 and would be happy to answer any questions.
Sincerely,
American Medical Association
American Academy of Emergency Medicine
American Academy of Allergy, Asthma & Immunology
American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Family Physicians
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngic Allergy
American Academy of Otolaryngology - Head and Neck Surgery
American Academy of Physical Medicine and Rehabilitation
American Association of Hip and Knee Surgeons
American Association of Neurological Surgeons
American Association of Neuromuscular & Electrodiagnostic Medicine
American Association of Orthopaedic Surgeons
5 https://www.acatoday.org/advocacy/medicare/
May 14, 2025
The Honorable Kevin Cramer
313 Hart Senate Office Building
Washington, DC 20510
Dear Senator Cramer and Blumenthal:
The Honorable Richard Blumenthal
503 Hart Senate Office Building
Washington, DC 20510
The American Chiropractic Association (ACA) is aware that you recently received a letter from organized medicine in opposition to S. 106, the Chiropractic Medicare Coverage Modernization Act. I’d like to take this opportunity to address some of the charges we find inconsistent with the bill’s language or intent.
As congressional leaders with oversight over Medicare, you are well aware that Medicare is a program of “Health Insurance for the Aged and Disabled,” and is not a law which defines scope of professional practice of any provider, despite what the letter would have one believe. Further, the letter is misguided in its opposition to S. 106 in the interest of public health and safety as it fails to recognize that chiropractic is a safe form of health care, especially relative to usual care delivered by MDs, which has benefited patient health for generations.1
Patients are far more at risk when prescribed an opioid 2 or even a common medication for low back pain, like nonsteroidal anti-inflammatory drugs. 3 S. 106 would simply extend Medicare coverage to those services that have been covered by private health insurers for decades and allowable under a chiropractor’s state licensure. It would end the discrimination against Medicare beneficiaries who seek to enjoy the same level of coverage they enjoyed prior to entering Medicare. S. 106 also will create parity across all federal programs – as chiropractic care is already being provided to federal employees, active-duty military, and veterans.
Organized medicine’s assertion regarding educational standards is also flawed, in that chiropractic’s academic programs and accrediting agency are accepted by the US Department of Education (DOE). Candidates for a Doctor of Chiropractic degree undertake four years of first-degree professional education and training, with four national board exams required prior to licensure. The Council on Chiropractic Education (CCE), a DOE recognized accrediting body, has overseen the competencies taught at our programs - the same process that medical schools have for their education and training.
Additionally, the letter states that “…permitting chiropractors to bill Medicare for the full and likely expanded scope of their licensure in a given state will lead to an unnecessary redistribution of scarce Medicare resources away from physician practices to non-physician practices...” Two important points here; one, chiropractors
1 Bronfort G, Haas M, Evans R, et al. Effectiveness of manual therapies: The UK evidence report. Chiropr Osteopath. 2010;18:3.
2 Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2020. Available at http://wonder.cdc.gov.
3 Dabbs V, Lauretti WJ. A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. J Manipulative Physiol Ther . 1995;18:530-536.
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are currently defined under the Medicare statute as “physicians.” 4and two, by their opposition to S. 106, organized medicine disingenuously supports the current system which requires Medicare beneficiaries to pay out of their own pockets for needed diagnostic and therapeutic services provided by a chiropractor and which Medicare would pay if provided by a competing MD. Many studies 5 , 6 have found chiropractic services to be beneficial to senior patients, which is truly the important focus. Additionally, a more recent study has concluded that among Medicare beneficiaries who initiated longterm care for lower back pain with an opioid prescription, the adjusted rate for escalated care encounters was significantly higher as compared to those who initiated care with spinal manipulative therapy.7
In closing, ACA values your support on this issue and we appreciate the opportunity to clarify these misconceptions on S. 106. We look forward to continued engagement as we work towards our shared goal of providing high-quality and affordable care to Medicare beneficiaries.
Sincerely,
Marc Nynas, DC President
In 2024, the Wisconsin Chiropractic Association introduced a new tradition: the WCA Legacy Award. This award recognizes and honors WCA members who have demonstrated 25 years or more of dedication, service, and commitment to advancing the chiropractic profession in Wisconsin. It reflects the WCA’s deep appreciation for the contributions of our long-standing members and their continued support of the our mission: to advance the chiropractic profession and empower our members to better serve their patients, their communities, and each other. 2025 Legacy Award Recipients to be Recognized at the WCA Fall Convention in September Watch
William David Spontak was born January 30, 1953, at St. John’s Hospital on the North side of Pittsburgh, PA, the son of John and Anna (Gecy) Spontak. Bill is survived by his loving wife, Lois Kaminski-Spontak; his brothers, Robert J. Spontak and Edward C. Spontak; Robert’s sons, Michael (Anne) and Eddie; Edward’s sons, Brad (Rebecca) and Edward; and great-nephew, Ed (Kelly).
William attended grade school at Nativity and high school at Perry Traditional Academy. He attended Penn State University and graduated in 1975 with a degree in Psychology. In 1985, he received his master’s in public administration and international affairs from the University of Pittsburgh.
He worked in human services for a mental health and drug and alcohol rehabilitation facility. After a severe neck and spine injury, he was introduced to a Chiropractor who saved him from neck surgery. After this experience, he decided to switch careers and become a Chiropractor. He graduated from Palmer College of Chiropractic in 1990. He started a practice in 1990 in Monroe, WI, and served the community for 35 years.
He belonged to Monroe Kiwanis, Crime Stoppers, Boys and Girls Club, Bel Canto Choir, and Grace Church. He served on the Board of Directors for the Wisconsin Chiropractic Association and was a Palmer College Alumni Ambassador and Representative. Bill has enjoyed playing music publicly since 1979. He played in a few bands over his life (Pipe Dreams, Menagerie, and most recently Vigilant Soul). He also enjoyed golfing, bicycling, skiing, handball, racquetball, and sailing. He was working on a license to become a Pilot.
"Throughout his career, Dr. Spontak was known for his leadership, mentorship, and his unwavering commitment to advancing chiropractic care for all. His contributions to the WCA and the profession will not be forgotten."
~John Murray, WCA
by Robert Silverman, DC | Republished with permission from Chiropractic Economics, May 2025
GLP-1 receptor agonist drugs have become so popular that Super Bowl LIX featured an ad for them. Practitioners today are likely to have patients taking these drugs or strongly interested in starting. These drugs are very expensive, are needed for a lifetime to maintain their effects and have other significant drawbacks. Nondrug approaches that enhance the natural production of GLP-1 are preferred, including natural methods, such as stimulation supplements and probiotics, as well as dietary changes and regular exercise, that offer promising, sustainable drug alternatives with fewer risks and costs.
GLP-1 receptor agonists, such as semaglutide (Wegovy, Ozempic), are synthetic peptide drugs that mimic the hormone glucagon-like peptide-1 in the body. These drugs bind to GLP-1 receptors in the pancreas, brain, liver, kidneys and muscles. They trigger insulin release from the pancreas, delay gastric emptying and help with appetite reduction and increased satiety.
While GLP-1 drugs are highly effective in improving blood sugar and triggering rapid weight loss, they have some significant drawbacks. Most importantly, stopping the drug stops the benefits, and almost all patients regain most or all of the lost weight. For many, the drugs cause unpleasant side effects, including nausea, vomiting, diarrhea and severe appetite loss.
The most worrisome effect of GLP-1 drugs is approximately 40% of the rapid weight loss comes from lean muscle mass.1 Although the studies vary considerably in the amount lost, any significant muscle loss is concerning, particularly in older adults. For them, stopping the drug and regaining the lost weight could lead to sarcopenic obesity—a high body fat percentage combined with sarcopenia, defined as low skeletal muscle mass accompanied by low muscle function.2 Sarcopenic obesity is associated with functional impairment, physical disability and frailty in older adults. Retaining muscle mass is the currency of longevity.
In addition to shrinking skeletal muscles, GLP-1 drugs may be associated with shrinking the heart. In a recent study, obese and normal-weight mice treated with semaglutide showed decreases in overall heart mass and the individual size of their heart muscle cells. Human heart cells showed a similar response, suggesting long-term use of GLP-1 drugs could cause cardiac damage.3
Despite the salutary effects of the GLP-1 drugs, most patients don’t stay on them for a long duration of time— more than 53% of adults who are prescribed a GLP-1 drug discontinued use within six months. At the one-year juncture, 68% have stopped using the drug. Unpleasant side effects are the most common reason for stopping.4
Another significant drawback to these drugs is their price, which can run well over $1,400 a month—a cost often not covered by health insurance. The cost of GLP-1 drugs outside the US is significantly less: $155 in Canada, $59 in Germany and $92 in the UK. Novo Nordisk, the manufacturer of Wegovy, could distribute the drug for $40 a month and still earn a 10% profit.5
GLP-1 is a hormone produced in the intestinal tract, primarily in the ileum (the distal end of the small intestine) and the colon by enteroendocrine L cells.6 The L cells play a key role in regulating appetite and blood sugar levels by sensing nutrients in the gut. They signal to the brain that food is present. Smaller amounts of GLP-1 are produced in the brainstem and by alpha cells in the pancreas. While GLP-1 is released in response to these triggers, it stimulates insulin release only when blood glucose levels are elevated.7
Many factors trigger the release of GLP-1 by the L cells.
The primary trigger is the presence of nutrients from eating. The L cells respond to carbohydrates, lipids and amino acids in the gut. A high-protein, high-fiber meal with monounsaturated or omega-3 fatty acids is particularly effective in triggering GLP-1 release. The hormones insulin and leptin also trigger the L cells. Insulin resistance can impair GLP-1 release.
Other triggers for GLP-1 release include physical activity and vagal nerve stimulation.
In the gut, GLP-1 is released in two waves. The early first release happens 15 to 30 minutes after eating. Another wave is released 90 to 120 minutes after eating. This wave occurs when digested nutrients stimulate the L cells. GLP-1 in the bloodstream increases two to three times after eating. The peptide has a very short half-life of only about two minutes before enzymes degrade it.
In the colon, L cells release GLP-1 in response to microbial metabolites. Secondary bile acids, short-chain fatty acids and polysaccharides within the gut microbiota can trigger GLP-1 secretion.8 Some bacteria also produce metabolites, such as tryptophan and indole, that stimulate GLP-1 secretion.
The short-chain fatty acid (SCFA) butyric acid, produced when bacteria in the gut microbiome digest fiber and complex sugars, is particularly important for stimulating GLP-1 release. Butyric acid is essential for colon health in other ways: It helps maintain the integrity of the intestinal lining, reduces inflammation, provides about 70% of the energy for colon cells and regulates their growth. People with type 2 diabetes often have low amounts of butyric acid-producing bacteria in their gut.9
Current evidence suggests GLP-1 agonists may modulate the gut microbiome and vice versa.10 We know people
with obesity have less diversity in their gut microbiome than people of normal weight. They have lower populations of bacteroidetes and an increased population of firmicutes. Their population of Akkermansia muciniphila is also decreased, and metabolites from this bacterium are known to increase GLP-1 production. This pattern of microbiome changes is linked to not only obesity but also insulin resistance and diabetes. It also impacts intestinal barrier integrity. In other words, the altered microbiome population can reduce SCFA production and contribute to leaky gut syndrome.11 In some patients, gut dysbiosis may be why they don’t produce enough GLP-1 naturally. This could also explain why they have stopped responding to their natural production of GLP-1.
Improving the bacteroidetes to firmicutes ratio and increasing the population of A. muciniphila could increase the natural production of GLP-1 in the gut. In addition, a higher bacteroidetes to firmicutes ratio can improve fiber fermentation in the colon, which increases the amount of butyrate and other SCFAs available to the L cells.12 This increases their release of GLP-1 while also improving gut permeability. Improving the gut microbiome composition may also impact the gut’s internal environment by delaying gastric emptying and changing nutrient availability.
Probiotic supplements that are known to increase bacteroidetes and decrease firmicutes can improve secretion from the L cells by improving butyrate production. Supplements of A. muciniphila could directly stimulate greater secretion from the L cells. Increasing A. muciniphila may also improve leaky gut syndrome because these bacteria help maintain tight junctions in the gut barrier.13
Leaky gut syndrome directly affects the energy-producing mitochondria in cells through inflammation, increased oxidative stress and disruption of the bidirectional communication between the gut microbiome and mitochondria.
When mitochondrial function is impaired, one result is decreased sensitivity to the actions of GLP-1. Activating GLP-1 can positively affect mitochondrial function by enhancing oxygen consumption and increasing ATP production.14 GLP1 also reduces the production of ROS and oxidative stress, which helps maintain efficient ATP production.
GLP-1 has a beneficial effect on the mitochondria of the insulin-producing beta cells in the pancreas. It increases their mass, improves efficiency, reduces free radical production and prevents apoptosis.15 In the heart, GLP-1 protects cardiomyocytes by improving mitochondrial function and reducing oxidative stress. It can also help prevent ischemic injury following a cardiac event.16
continued on page 43
GLP-1 is essential in suppressing appetite and creating a feeling of fullness and satiety in the brain. The peptide probably activates receptors in the brain that are responsible for regulating hunger and reducing cravings.
Another likely reason GLP-1 affects satiety, appetite and cravings is its role along the gut-brain axis. This axis is disrupted in people with obesity, prediabetes and diabetes. While GLP-1 doesn’t seem to cross the blood-brain barrier significantly, it acts on brain regions outside the barrier and relays signals to areas responsible for appetite regulation.17 GLP-1 also acts on the vagus nerve. Vagal sensory neurons have GLP-1 receptors, which allows them to receive signals directly from intestinal L cells. The GLP-1 secreted in the gut increases the activity of vagal afferent nerves. This increases the transmission of signals from the gut to the brain, modulates food intake, improves satiety and slows gastric emptying. The vagus nerve is also involved in GLP-1 signaling to regulate blood sugar levels and insulin secretion. Interestingly, vagal neurons responsive to GLP-1 extend into the brainstem, particularly the nucleus tractus solitarius, an area of the brain important for regulating digestion.
GLP-1 is released in response to dietary and bacterial metabolite triggers, but its effects on insulin secretion are glucose-dependent. The hormone will only stimulate insulin release when blood glucose levels are elevated, as they are after a meal and most or all of the time in people with prediabetes and diabetes.
The natural production of GLP-1 can be increased in the gut through dietary changes and supplements.
A high-fiber, plant-forward diet will support GLP-1 production by stimulating release from the L cells in the colon. Specific foods that have been shown to support GLP-1 levels include eggs, tofu, nuts (almonds, pistachios, peanuts), high-fiber grains, avocados, olive oil, fruits (apples, berries, pomegranates) and vegetables (Brussels sprouts, broccoli, carrots).18 Dark chocolate, green tea and coffee (including decaf) may also support GLP-1 production. Foods high in resistant starch (complex carbohydrates that reach the colon largely undigested), such as beans and whole grains, are fermented in the colon and become a good source of SCFAs to stimulate GLP-1 release. Fiber supplements such as psyllium have a similar effect.
The impact on GLP-1 comes from the fiber in these foods and their high polyphenol content, which acts as a prebiotic. Interestingly, cinnamon, a standard treatment for diabetes in traditional Ayurvedic medicine, has been shown to increase GLP-1 production.19 Cinnamon is very high in polyphenols, including procyanidins, catechins, epicatechins and phenolic acids.
Probiotics containing strains of Akkermansia muciniphila, Clostridium butyricum and Bifidobacterium infantis can help alter the bacterial balance in the gut microbiome toward bacteria that stimulate GLP-1 production.
Supplements that support colon health and GLP-1 production include berberine, ginseng, green tea extract, magnesium, glutamine and fish oil.
Exercise is an excellent way to improve the production of GLP-1. Studies show roughly equal increased post-exercise concentrations after high-intensity interval training, sprint interval training and moderate-intensity continuous training. No matter which type of exercise, the increased level effect lasts about 90 minutes.20
While GLP-1 receptor agonist drugs offer benefits in managing blood sugar and promoting weight loss, their high cost, potential side effects and possibility of longterm dependency make them less than ideal for many individuals. Fortunately, there are natural methods to enhance GLP-1 production, such as stimulation supplements and probiotics, as well as dietary changes and regular exercise, that offer promising, sustainable drug alternatives with fewer risks and costs.
Robert G. Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR, is a doctor of chiropractic, clinical nutritionist, national/international speaker, author of Amazon’s best-sellers “Immune Reboot” and “Inside-Out Health” and founder and CEO of Westchester Integrative Health Center. He graduated magna cum laude from the University of Bridgeport College of Chiropractic and has a master’s degree in human nutrition. The American Chiropractic Association Sports Council named Silverman Sports Chiropractor of the Year in 2015, and he is on the advisory board for Functional Medicine University. A thought leader and seasoned health and wellness speaker, he is frequently published in peer-reviewed journals and other mainstream publications and was the principal investigator in two Level 1 FDA laser studies. For more information, visit drrobertsilverman.com. View article references >>
See Dr. Rob Silverman at the 2025 WCA Fall Convention on September 25 and 26. He will be teaching "The Chiropractic Edge in Healthy Aging: Preventing & Managing Neurodegenerative Disease" with Dr. Powell, sponsored by WCA Corporate Partners NutriDyn and NCMIC.
In this NEW 12-hour course, Dr. Murphy, will educate on structure and function revealed through a poly-therapeutic intervention that will improve clinical outcomes.
He will explain topics ranging from Chiropractic care, laser therapy, ATP, mitochondrial function, diet, exercise, brain health, low back pain and state-of-the art technologies that are tailor-made for expert chiropractic care by managing common clinical syndromes. The knowledge and skills you acquire during this action-packed 2-day course will change your life, your practice and your patient’s lives!
16-17, 2025
Sheraton Brookfield
Presented by Dr. Daniel Murphy
12 CE DC/CT/CRT, 4 Nutrition
Sponsored by Erchonia
Registration Fees
Register 20 days in advance for Early Bird Pricing (EB)
• WCA Members in the first three years of practice attend at the reduced rate of $25/day.
• Members EB $232.00 | Regular Rate $290.00
• Nonmembers EB $316.00 | Regular Rate $395.00
Note: Attend one day only: subtract $100 from"Regular" rate above.
Professor and research expert, Dan Murphy DC, offers only the highest-level learning courses validated through extensive scientific research and proven techniques he has perfected through not only running his own full-time practice, but how he lives his daily life.
He travels the world to share the expertise he has garnered over the last 40 years with physicians who desire to take their skills to the next level.
Dan Murphy is a contributing author to the books Motor Vehicle Collision Injuries, published by Aspen, 1996; Pediatric Chiropractic, published by Williams & Wilkins, 1998 and 2011; and Motor Vehicle Collision Injuries, 2nd edition, Jones and Bartlett, 2005. Dan Murphy wrote approximately 90 quarterly columns in the American Journal of Clinical Chiropractic.
June 28-29, 2025 | 8AM–6PM ET | Online + On-Demand
Chiropractic Future Virtual Summit is your front-row seat to the next era of chiropractic. Join us live or or catch every insight later with on- demand access all in support of advancing our profession.
You’ll learn from an extraordinary lineup of thought leaders in chiropractic research, practice management , AI and technology, and patient-centered care, including:
Dr. Tim Bertelsman
Dr. Miles Bodzin
Brandy Brimhall
Dr. Monika Buerger
James Chester
Dr. Kevin Christie
Dr. Jeffrey Cronk
Dr. Tony Ebel
Dr. Ronald Farabaugh
Dr. Ray Foxworth
Dr. Jay Greenstein
Dr. Evan Gwilliam
Dr. Heidi Haavik
Kristi Hudson
Dr. Martin Harvey
Dr. Bruce Lipton
Dr. Fab Mancini
Dr. Eric Plasker
Dr. Mark Sanna
Dr. Alan Sokoloff
Dr. Kristine
Tohtz
Kathy Weidner
Student Membership Outreach Update, Zach Kasun, WCA Membership Director
This spring, the Wisconsin Chiropractic Association was fortunate to spend time with students. Check out where we've been...
On May 19, WCA got the opportunity to spend some time with some students down in Lombard, IL at the National University of Health Sciences for a Lunch & Learn. Representing the WCA in attendance was Dr. Tom Edwards (WCA Treasurer), Dr. Gene Yellen-Shiring (Past President), and Zach Kasun (WCA Membership Director).
We held an open panel discussion with students, sharing different clinical perspectives, and challenging students to think about the kind of chiropractor they would like to become in the near future. We fully understand that students nearing graduation have a lot on their plate, but the WCA is well-poised to support them now and throughout their chiropractic careers in Wisconsin. With over 110 years of representing Wisconsin chiropractors, the WCA is eager to help jump start the chiropractic success of the future generation!
The WCA was invited to the inaugural Palmer “Chiropractic Association Road Trip” this May! This was an opportunity for students to get to know 10+ regional state associations and how they can assist in their chiropractic future. Representatives of the WCA included Dr. Brad Freitag (District 5 Rep) and Zach Kasun (WCA Membership Director).
It’s always a great opportunity to hear from students whether they’re in their 1st Tri just starting out or their last – nearing graduation. Many students would agree that in school they are learning to become quality adjusters, but as many WCA members understand, there is SO much more to chiropractic than that. While there is a lot to consider, the WCA has the resources and expertise to coach them through this period of their lives so that they can begin practicing chiropractic in Wisconsin with confidence.
The key to a better quality of life lies not just in the supplement, but in the soil. Due to our steadfast commitment to sustainable and regenerative farming practices and a balanced ecosystem, our soil is more nutrient-dense than conventional farmland. For you, that means supplements that deliver maximum potency and efficacy for a better quality of life for your patients.
May 25, 1935 - March 21, 2025
Ronald (Ron) Lee Semmann, 89, a dedicated family man and public servant, passed away on March 21, 2025. He was born on May 25, 1935, to Eugene and Marguerite Semmann (Tank), in Milwaukee, Wisconsin.
Ron married Miriam Goetsch on April 17, 1960, and built their life together for over 50 years. They moved to Sun Prairie in 1966 where they planted roots and raised a family. After Miriam’s passing, he found renewed love and joy through his marriage to Ann Kramer on November 3, 2012.
He was a graduate of the University of Wisconsin-Milwaukee with a degree in Political Science, held a Master’s Degree in Public Policy and Administration from the University of Wisconsin’s LaFollette School, and earned a Doctor of Chiropractic degree from the National College of Chiropractic.
Ron had a distinguished career, culminating in his role at Madison Gas and Electric Company following his retirement from the Wisconsin Department of Natural Resources (DNR) as Deputy Secretary.
September 3, 1955 - May 12, 2025
Joseph Jerome Teff traveled peacefully to Heaven on Sunday, May 11th, 2025, at the age of 69. Known to many as “Dr. Teff”, the innate healer who knew just where to adjust. Dr. Teff was referred to as “the chiropractor to the chiropractors,” a title that spoke volumes about his expertise and reputation in the field. He wasn’t just any chiropractor. If you listen to his patients, he saved lives, showing up at any hour or day to help. He loved his work and felt most fulfilled applying his God-given talents.
Joe graduated from UW-Platteville before earning his Doctorate of Chiropractic from Sherman College in 1980. Joe was united in marriage to Marguerite Kennedy in 1980, and that same year he founded one of the country’s most successful chiropractic and nutrition clinics, a testament to his work ethic, dedication, vision, and love for helping others.
Joe was an innovator, had an insatiable curiosity, and lived each day with purpose. He led by example, often telling his children, “If it’s not fun, don’t do it.” Unbeknownst to many, he started all the fun back in undergrad! Beyond his professional life, he found joy riding his motorcycle, carving carousel horses, pheasant hunting, and cheering on his kids at their sporting events.
by Dave Newell, PhD1 and Michelle M Holmes, PhD2 | Republished from National Library of Medicine
Abstract
Despite numerous studies that measure satisfaction in patients undergoing chiropractic care, these have not yet been systematically summarized. The aim of this study was to perform a systematic review of existing literature to identify factors that contribute to high levels of satisfaction in chiropractic care. A comprehensive search was conducted to identify quantitative, qualitative, or mixedmethods studies exploring patient experience with chiropractic care. Forty-three studies were included in the review. The findings showed that patient satisfaction was consistently high in comparison to other professions. The review identified key factors that contribute to patient experience, which were not limited to clinical outcomes, but also the clinical interaction and clinician attributes. The findings of this review provide a core insight into patient experience, identifying both positive and negative experiences not just within chiropractic care but in the wider healthcare sector. Further work should explore factors that impact patient satisfaction and how this understanding may further improve healthcare to enhance patient experience.
Introduction
Therapidly expanding health workforce encompasses a diverse array of professions beyond traditional medicine, to meet the multifactorial healthcare needs of national populations. Chiropractic is a statutorily regulated profession, with chiropractors qualified to deliver a package of care, including pain education, self-management advice, manipulation and manual therapy treatments, and tailored exercise recommendations.1 Chiropractors identify as spinal health experts, focusing on improving function in the neuromuscular system and overall health and wellbeing of patients, predominately seeing pa-
tients with musculoskeletal conditions.2,3 Contemporary metaanalyses support the use of spinal manipulative therapy, a key component of chiropractic care, for such conditions.4,5 However, there is a shift to measure the impact of healthcare provision in a more patient-centered manner, considering not only clinical outcomes, but also patient experience and satisfaction measures as key metrics in determining quality of care.
Previous reviews synthesizing existing research on patient satisfaction identified that patients tend to report high levels of satisfaction with chiropractic care.6 In addition, patients are often more satisfied with chiropractic care compared to encounters with other healthcare professionals. Despite the overwhelming support for chiropractic care, there is limited understanding of the drivers for these high levels of patient satisfaction. One explanation for the high levels of satisfaction, is around the pivotal role that effective communication plays in patient care,6 with clinicians communication to identify their patients’ main concerns and other information as key.7,8 However, while communication is recognized as a potential driver of patient satisfaction in chiropractic care, there is limited exploration of this factor.
Despite the presence of numerous studies that measure patient experience and satisfaction within chiropractic care, these valuable insights have not yet been systematically gathered and comprehensively explored. Understanding patient experiences is thus important in the context of a value-based healthcare paradigm as a measure of the value of an intervention over and above traditional clinical outcomes.9 The aim of this review was to identify, categorize, and summarize the published literature pertaining to the experiences and satisfaction levels of patients undergoing chiropractic care.
continued on page 51
This systematic review has been written up in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.10 Literature Search An initial scoping search was conducted in 2020 to refine the research question and construct a full review protocol, published on PROSPERO, ID: CRD42020203251. Terms included derivatives of chiropractic and patient experience and satisfaction, an example search string can be seen in Table 1. The search was restricted to research published after 2005, following a systematic review published on patient satisfaction.6 Several databases were searched yielding the following search results: PubMED (506), Cochrane (115), Excerpta Medical Database and Allied and Alternative Medicine (EMBASE) (355), CINAHL (517), Index to Chiropractic Literature (ICL) (1758), and Web of Science (158) by MH in 2021. A bibliography search was also conducted to check for relevant studies.
Articles that met the following criteria were eligible for inclusion in this review: (1) focused on patient satisfaction or patient experience within chiropractic care, (2) primary empirical studies: qualitative, quantitative, and mixed methods, and (3) published in English. Papers were excluded if they were: (1) focus on perceptions of chiropractic care, (2) co-delivered interventions, and (3) case studies, pilot studies, conference abstracts, and non-empirical and secondary studies. Titles and abstracts were examined by at least one reviewer, with full-texts examined by two reviewers (DN and MH). There was 100% agreement on the final inclusion between the two reviewers. The screening and selection of studies is documented in the PRISMA in Figure 1. Data Extraction and Analysis Data extraction included citation, country, aims, participants, setting, study design, measures of patient satisfaction and experience, other outcome measures, analysis, intervention groups (where appropriate), and relevant results. Quality assessment was carried out using Markoulakis and Kirsh rubric,11 with broadly defined score descriptions, allowing for assessment of the methodological implications of the paper despite heterogenous study designs. Narrative synthesis was used to collate and integrate the findings of the included studies with textual descriptions developed to combine results and analyze the relationships between the studies.12,13 Data extraction and synthesis was conducted by two reviewers (DN and MH), with 25% of articles checked. Results Study Characteristics and Overview Forty-three studies were eligible for inclusion (see Figure 1 and Table 2). The studies were conducted across the United Kingdom, Europe, North America, Australia, and
South Africa. Chiropractic care was delivered in a variety of settings: private practice, university clinics, specialized clinics (military medical centers, therapeutic community facility). The studies included participants seeking chiropractic care for a variety of conditions (spinal pain, low back pain, neck pain, leg pain, headaches, and musculoskeletal conditions) and treatment of specialized populations (pediatric patients, pregnant mothers, older adults, military personnel, and athletes).
Generally, chiropractic patients are very satisfied with their care with high proportions generating consistently high satisfaction scores.14,15 This includes patient groups receiving care in both the independent and public sector.16 Studies recruiting patients presenting with conditions commonly seen by chiropractors reported high to very high satisfaction/experience scores with care.17-20 This is also true of parental satisfaction with pediatric care where scores range from around 75% to 95% satisfaction.21-24
Results of the quality assessment identified that reporting quality was mixed. However, no studies were marked as very poor or poor. The main methodological weaknesses identified were limited details on patient recruitment and the setting of chiropractic care. Within the quantitative studies, the main limitations were potential for respondent bias, and no details or limited details on generalizability. Taking into consideration the implications of these methodological flaws, no findings were deemed inappropriate and all concepts from the studies were included in the synthesis.
Ten included studies were randomized-clinical trials (Table 3). Notwithstanding their heterogeneity, all compared chiropractic treatment or spinal manipulative therapy deliv-ered by chiropractors to a comparator group, including exer-cise, medication, light massage, or a variety of sham interventions. Five trials used a combined intervention with manipulation as an addition to standard medical care25,26 and a further 2 explored adding spinal manipulation to a form of home exercise27,28 or home exercise and advice.29
By Dan Ruitenbeek, DC
The popularity of shockwave therapy in chiropractic offices has absolutely erupted in the last few years, and for good reason. The ability to help patients with complex musculoskeletal issues, tendinopathies, neuropathies, post-surgical joint restrictions, etc., makes it a very useful tool in the chiropractor ’s toolbox. I tell my colleague chiropractors that if they only had one therapy tool to accompany their adjusting, shockwave is so versatile that it would eliminate the need for a room full of different modalities.
Okay, now you have decided that shockwave may be the next addition to your practice, but which one? How much should you spend? What is the difference between machines and brands in each category? Let this be a guide to help you make your decision or at least narrow it down to help you ask the right questions before purchasing.
You may be surprised to hear that there isn’t one answer or correct machine for every practice. As we know, very few chiropractic offices are the same. This is a wonderful thing most of the time, but it does pose some challenges when giving advice about which machine to recommend.
My practice is a cash-based family practice, and we implement shockwave in a different way than a lot of other practices using the same therapy. We have clients that are heavy-hitters in the personal injury (PI) world some are very focused on sports rehab, some integrate with pelvic floor therapists, and others use shockwave for aesthetics. The list goes on and on.
The conversation with a prospective DC looking for a machine absolutely must start with a deep dive into their practice model to find the right machine for them. I will give a brief run-down on the types of shockwave therapy devices on the market and provide examples of practices where they are (usually) best suited. Hopefully, this will offer some clarity to the very confusing landscape of shockwave devices for sale.
Shockwave therapy is broken down into two main categories radial shockwave and focused shockwave. Radial devices deliver energy in a dispersive manner, making them ideal for treating larger surface areas and superficial tissues. Focused devices, on the other hand, concentrate energy in precise, deep tissue regions, which can be beneficial for niche applications. Think of radial therapy as your shotgun and focused therapy as your sniper rifle both useful tools that thrive in different ways.
“My practice is a cashbased family practice, and we implement shockwave in a different way than a lot of other practices using the same therapy.”
After the division of radial and focused, we break therapies down into how the shockwave is produced. Every detail outside of that is basically just branding and marketing. Branding is important, don’t get me wrong. However, I am not here to tote one style or brand over another, just to help you find the type of shockwave machine that suits your practice.
So, in the radial category, you will find pneumatic and electromagnetic machines. Pneumatic machines are larger and more powerful, reaching an output
of about 8BAR (translates to about 7 cm of effective penetration depth). For focused machines, you will see electromagnetic, electrohydraulic, and piezoelectric options. They all have similar penetration depth abilities (around 12 cm) but will differ in how the shockwave is created. We will explore all three options here to help support the possibility of adding focused shockwave therapy to your practice.
Radial shockwave devices are most commonly chosen for chiropractors and physiotherapists for economics, maintenance, ease of use, ability for staff to operate the machine, and long history of efficacy Electromagnetic radial machines are smaller and less powerful; they usually stop at about 4 cm of effective penetration depth. Electromagnetic radial machines are common in aesthetics and pelvic floor therapy because of their power constraints, portability, and ease of use. These could also suit the traveling chiropractor who needs more portability than power
Pneumatic machines have an easier time treating deeper scar-tissue-laden areas compared to electromagnetic ones. Thanks to almost double the power output, you will be able to treat a huge variety of chronic MSK injuries with pneumatic machines without a big jump in price from electromagnetic. Pneumatic radial machines are also easy to use, maintenance is infrequent and less expensive, and staff can usually perform the therapy
Focused shockwave therapy is growing in popularity in the chiropractic profession thanks to more companies coming to market with focused therapy and the marketing efforts therein. There is definitely a place for focused shockwave devices, but it’s really important to make sure your office is prepared for it.
Because focused shockwave machines have an increased power output and depth of penetration, they are a more advanced risk classification (class 2 or 3) compared to radial. This can be an issue in some states regarding who is able to treat patients with the machine. Technicians, chiropractic assistants, massage therapists, and physical therapy assistants may not be legally able to perform focused shockwave. If the goal of your office is to hand off the therapy to staff, this may not suit you.
The economics of focused shockwave are also vastly different from radial. The initial investment is at least three to four times larger than a radial machine, maintenance is much more frequent, and it adds significant financial concerns for smaller practices. When you factor in these overhead costs, the amount you will have to charge patients also rises. Focused therapy prices seem to hover around $250 or more per session, while radial sessions are less than $100. For high-end sports therapy clinics, professional teams, orthopedic offices, and regenerative offices, focused therapy may be a good fit for that style of practice.
I would also recommend having a radial on hand to manage the 80 to 90% of issues that wouldn’t need the extra power/depth. That helps save the focused machine from needing as much maintenance and will extend the life of both machines. This is what shockwave clinics (offices that do nothing but shockwave therapy) are doing in the EU and Canada.
For example, if you use a Ferrari as your everyday home-to-office car, you will spend an additional fortune on maintenance by using it for something unnecessary. Instead, you could drive your Toyota Corolla for your commute and take the Ferrari out to the racetrack on weekends. If the finances allow it and your practice model suits it, by all means, consider a focused device.
In conclusion, the general breakdown of machines to their respective suitable clinic styles are as follows:
Electromagnetic radial Aesthetics, pelvic floor, traveling chiro
Pneumatic radial Medium-to-large chiropractic offices, PT clinics, animal chiro, osteopaths
Electromagnetic focused
Piezoelectric focused
Chiropractic offices already equipped with radial growing their shockwave offerings, advanced sports therapy clinics, orthopedics
Chiropractic offices already equipped with radial growing their shockwave offerings, advanced sports therapy clinics, orthopedics
Electrohydraulic focused
Specialty regenerative clinics, orthopedic offices, professional sports teams
Portability, gentle, affordable
Versatile, affordable, long history of research in MSK therapies
Least expensive focused therapy over the lifespan of the machine, fewer maintenance needs
Least expensive focused from an initial investment, will need more frequent maintenance than Electromagnetic
Most expensive, penetration depth, newest technology
“If the finances allow it and your practice model suits it, by all means, consider a focused device”
I cannot stress the last step in the process enough, which is due diligence. There are different companies that make each of the different styles of machines, and it is important that the chiropractor calls and asks the right questions about the type of machine that suits their practice. Make sure you know what happens after you purchase by asking the following important questions:
• How is training handled?
• What is the setup process?
• What happens if my machine stops working?
• Do they have a loaner program when machines need service?
• Do they offer marketing help/clinic setup advice?
• What is the warranty?
• Am I allowed to do shockwave therapy in my state?
• Can my CA or technicians perform the therapy for me?
• Are they FDA cleared?
• What does maintenance cost every year?
How many shockwaves until the handle needs replacing?
I believe there is a shockwave machine for every office, but it takes some time to find the best one to propel your practice forward and not just be an expensive dust collector I sincerely hope this was helpful for any chiropractor looking to add shockwave to the practice. As a fellow shockwave provider and educator, I look forward to welcoming you all to the shockwave family!
Dr. Dan Ruitenbeek is a practicing chiropractor based out of Marietta GA. Dr Dan is the co-owner of SWCA ( Shockwave Centers of America). With over 16 years of shockwave therapy experience, Dr Dan and the SWCA team have been supplying machines and educating practitioners in over 900 offices throughout the US & Canada. You can contact Dr Ruitenbeek at info@shockwavecenters.com or 561-300- 3444 Visit www.shockwavecenters.com/learnmore for more information.
The Wisconsin Chiropractic Association podcast “Back to Basics” brings you conversations with leaders in the chiropractic profession hosted by WCA President Dr. Chris Resch. Check out our podcast library on youtube!
In this episode, I’m joined by Dr. Brad Freitag, a chiropractor who practices in Belleville, Wisconsin, located in the south-central region of our state. Dr. Brad graduated from Palmer College of Chiropractic in Davenport, Iowa, in 2001 and now owns and operates Belleville Chiropractic and Wellness with his business partner, Dr. Jay Makovec.
Dr. Brad is a second-generation chiropractor — the son of Dr. Terry Freitag — and he currently serves as a member of the WCA Board of Directors, representing the South-Central District.
Dr. Brad shares what it was like learning from his father, and the steps he took to open his own independent practice right out of school.
I hope you enjoy my conversation with Dr. Brad Freitag.
Tammy McKeown, C.T. | Membership Services Director | wcahelp@wichiro.org
| 608-292-1804
In a landmark development, Blue Cross Blue Shield (BCBS) has reached a $2.8 billion settlement to resolve antitrust claims brought by health care providers, including chiropractors.
The lawsuit accused BCBS of dividing the nation into exclusive regions and limiting competition, which resulted in lower reimbursements for providers. Although BCBS denies any wrongdoing, the company agreed to the settlement to avoid lengthy litigation – and you can get a piece of the pie.
If you treated at least one BCBS-insured patient between July 24, 2008, and Oct. 4, 2024, you are likely an eligible class member. This includes most chiropractors who have provided services to BCBS members during this period. To receive a payment, you must submit a valid claim before the deadline. Claims can be submitted online. July 29, 2025 is the deadline to submit your claim.
The $2.8 billion BCBS settlement sets aside $224 million for professional providers, including chiropractors. Payments are based on a points system:
Allowed Amounts:
• Less than / equal to $250,000 = 1 pt
• More than $250,000, but less than or equal to $500,000 = 2 pts
• More than $500,000, but less than or equal to $750,000 = 3 pts
• More than $750,000, but less than or equal to $1 million = 4 pts
• More than $1 million = 5 pts
� BCBS reached a $2.8 billion settlement to resolve antitrust claims brought by health care providers, including chiropractors.
� If you treated at least one BCBS-insured patient between July 24, 2008 and Oct. 4, 2024, you are likely an eligible class member. You may have received provider correspondence or notification.
� To receive a payment, you must submit a valid claim before the deadline of July 29, 2025. Claims can be submitted online.
This means a provider who received $1 is awarded the same point as one who collected $250,000 – a major advantage for smaller practices. Additionally, hospitals and ambulatory surgery centers have a separate pool of funds, so their claims won’t reduce what chiropractors receive. Each provider’s final payout is adjusted by a regional harm coefficient, ensuring fair distribution. If you’ve seen at least one BCBS patient since 2008, you are likely eligible, so don’t miss out!
1. Review the Settlement Details: Visit the official settlement website www.bcbsprovidersettlement.com to understand the specifics of the settlement, determine your eligibility, and learn about the claims process.
2. Submit Your Claim: If you are eligible and wish to participate, submit your claim by the July 29, 2025 deadline. Detailed instructions and claim forms are available on the settlement website.
For questions about the settlement, contact the Blue Cross Blue Shield Provider Settlement Notice Administrator: (888) 452-3095; Administrator@BCBSProviderSettlement.com
The WCA Help Desk was alerted about a request that our members were receiving.
Yes, it is legitimate and you should respond.
WCA Help Desk Director, Tammy McKeown, reached out to Senior Government Relations Director, Wisconsin contact at Blue Cross/Elevance Health for confirmation and explanation of these requests.
Datavant is a vendor engaged by Anthem for the purpose of retrieving records and/or performing reviews of medical charts.
WCA members are receiving the request as part of Anthem’s ongoing obligation to CMS that requires MAOs to attest annually that, based on best knowledge, information, and belief, all risk-adjustment data sent to CMS is “accurate, complete, and truthful.”
It is common practice for providers to furnish requested records so the plan can validate diagnosis data submitted to CMS.
HIPAA expressly permits disclosure of protected health information for “health-care operations,” which include risk-adjustment activities; therefore, no separate patient consent is needed to release records to Anthem or its designees.
All records are transmitted via secure fax or encrypted email and handled under strict privacy and cybersecurity protocols consistent with HIPAA.
In case you missed it. The Minnesota Chiropratic Association recently posted the following message on social media:
"Governor Walz proposed to terminate chiropractic care for MN Care and MA adults oer 21 and it passed on 6/9/25. This will go in effect 1/1/2026."
Read the MCA President's Message >>
This is why belonging to a strong state chiropractic association is critical to protecting access to chiropractic care.
Appleton. Attractive home/office for sale in prime Fox Valley area. Doctor retiring and selling attractive 2,093 sq ft home with practice, including lower level & garage. Prime commercial with surrounding residential property. Financing available.
Wausau. Long established practice for sale. $126,626 gross in 3 days per week. Very low overhead. Payor mix 40% cash, in-network most insurance plans. 2 experienced part-time CA’s. Div, some Act.
Milwaukee. Practice for sale in high-demand Milwaukee location. Sale includes practice and attractive building with upstairs apartment. $338,000 gross. Low overhead. Doctor retiring and will provide assistance for smooth transition. Financing available.
Manitowoc/Two Rivers. 23 year established referral practice. Ideally located along scenic Lake Michigan in professional building with ample off-street parking. $243,000 gross. Low overhead. 1,500 sq ft rent only $1,406 per month. Div/FD also therapies. Financing available.
Wausau. Interested in learning Functional Medicine? Dr will provide training. Learn techniques to complement your adjusting skills. This is a cash practice with $176,000 net operating income.
Contact Loren Martin
Practice Opportunities, Inc.
Phone: (952) 322-1177
Email: martin@practiceop.com
www.practiceop.com
by Dan Davidson, DC
Our bodies are constantly adapting. Daily movements, exercise, and how we respond to stress are adaptive challenges to our nervous system and musculoskeletal system. We are always learning, adjusting, and striving for balance.
This ability to adapt is neuroplastic resilience - the combination of neuroplasticity and controlled, resilient stress that strengthens us over time.
Resilient stress embodies a balanced, science-backed approach to health through hormesis. By integrating short bursts of resistance and adaptation into daily life through physical, mental, and environmental challenges, we can create long-lasting resilience and longevity.
Chiropractic care is central to unlocking this potential, helping patients move beyond symptomatic relief and toward peak health by optimizing balance, movement, and structural alignment along with optimized neuroplasticity.
The nervous system thrives on challenge. Intentional controlled stress encourages adaptation and strength. Think about standing on one leg. At first, there’s a wobble, but over time, the body refines its ability to stabilize. This is neuroplastic resilience in action.
Chiropractic care enhances this adaptability with spinal alignment and joint mobility, ensuring effective nervous system response to these challenges. By incorporating purposeful balance training, such as standing on one leg or navigating uneven surfaces, we engage gravity as a training tool. This strengthens core muscles and refines neuromuscular control.
Movement is key. Activities that require dynamic balance and rapid adjustments such as playing pickleball, are powerful stimulators of neuroplasticity. The unpredictable nature of the game requires quick directional changes, and precise coordination needed to track and hit the ball. This challenges the nervous system in ways that enhance reaction time, proprioception, and fine motor control.
There’s a reason why people who play racket and net sports tend to live longer. Research has shown that these sports combine multiple health benefits, including cardiovascular fitness, high-intensity interval training, and neurological stimulation (Janke & Russell, 2019).
Every day, we battle gravity. The way we stand, move, and react to forces around us shapes how well our body functions. When we are misaligned, gravity amplifies our imbalances, leading to unnecessary gravity stress on joints, muscles, discs and nerves. When properly balanced, we use gravity as a natural tool for strength and stability.
Chiropractic adjustments help restore alignment, ensuring the spine and joints move freely. True balance starts from the ground up. The feet are our foundation - supporting every step, shift in weight, and movement. An unstable foundation creates kinetic chain compensations that ripple upward affecting the knees, hips, spine, and whole body posture. continued on
Custom orthotics play a crucial role in achieving dynamic functional balance. By supporting the feet, they help distribute weight evenly, absorb shock, and promote optimal alignment. When the foundation is stable, the body adapts to gravity more efficiently, reducing strain and improving overall function. Whether standing, walking, or engaging in sport, balance isn’t just about stability, it’s about adaptability.
Chiropractic adjustments are more than just structural realignments; they optimize nervous system function including autonomic regulation. The spine houses and protects the spinal cord, the central highway for brainbody communication. When vertebrae become misaligned, nerve function can be disrupted, leading to pain, stress overload and dysfunction.
The vagus nerve is the body’s communication superhighway, connecting the brain to the heart, lungs, digestive tract, and more. It regulates the parasympathetic nervous system - also known as the “rest and digest” system. It is the physiological bridge between the brain and our gut health. Our patients have become overwhelmed by modern stressors. Many have lost vagus nerve function and its regulation of our health. Research studies indicate that chiropractic adjustments can enhance vagus nerve function, potentially improving autonomic regulation. Correcting spinal misalignments through spinal manipulation restores neural communication, enhancing vagal tone and promoting a more balanced autonomic response (Alanazi et al., 2024).
Chiropractic care has been found to influence vagal tone, which directly impacts heart rate variability (HRV), a key marker of nervous system balance and adaptability. Higher HRV is associated with greater stress resilience, improved cardiovascular health, and enhanced recovery (Haas et al., 2024).
A study on chiropractic adjustments and HRV found that spinal manipulation led to significant improvements in HRV, indicating a shift toward parasympathetic dominance—the optimal state for recovery and stress resilience (Haavik et al., 2024).
By improving vagus nerve tone and HRV, chiropractic care can:
• Enhance stress resilience and recovery.
• Improve cardiovascular function and reduce heart disease risk.
• Support digestive health by optimizing gut-brain communication.
• Boost mental well-being, reducing anxiety and improving mood regulation.
Chiropractors can incorporate additional therapies to enhance patient outcomes:
• Myofascial massage – Releases tension and improves vagus nerve function.
• Neural balance training – Improves proprioception and reaction time.
• Corrective exercise – Strengthens weak muscles and stabilizes joints.
• Cold laser therapy – Reduces inflammation and accelerates nerve regeneration.
• Whole-body vibration therapy – Enhances neuroplastic adaptability, improving balance, strength, and coordination (Sener et al., 2021).
Patients benefit from at-home strategies that reinforce neuroplastic resilience and structural alignment:
• Balance training exercises – One-legged stands, wobble board exercises.
• Core muscle strengthening – Planks, bridges, controlled spinal mobility exercises.
• Mini trampoline rebounding – Safe neural plastic functional movement challenges.
• Home vibration plates – Supports proprioception, muscle coordination, and neuroplastic adaptation.
By aligning the spine, supporting the foundation with custom orthotics, and engaging in functional movement challenges, we enhance our ability to interact with gravity in a way that promotes strength, adaptability, and longevity.
Peak health is about optimization, adaptation, and resilience. Chiropractic care provides the structure and alignment needed for the nervous system to function at its best. Combined with strategic movement, balance training, and purposeful challenges, we can harness the power of neuroplasticity and resilient stress to thrive.
See Dr. Dan Davidson at the 2025 WCA Fall Convention on September 27. He will be presenting "Neuroplastic Chiropractic: Gravity Balance, Tech Neck, HRV, and Vagus Nerve Function for Peak Health," sponsored by WCA Corporate Partner Foot Levelers.
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Anthony J. Lisi, DC1,2 , Lori A. Bastian, MD, MPH1,2, Cynthia A. Brandt, MD, MPH1,2, Brian C. Coleman, DC, MHS1,2, Brenda Fenton, PhD, MSc1, Joseph T. King Jr, MD, MSCE1,2,3, and Joseph L. Goulet, PhD, MS1,2
1Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA; 2Yale School of Medicine, New Haven, CT, USA; 3Section of Neurosurgery, VA Connecticut Healthcare System, West Haven, CT, USA
BACKGROUND: Key nonpharmacologic therapies, including those routinely provided by chiropractors, are recommended first-line treatments for low back pain (LBP). Little is known on whether such care provided in the Veterans Health Administration (VA) has a downstream effect on the use of other healthcare services, including opioid prescriptions.
OBJECTIVE: To evaluate the impact of chiropractic care on receipt of opioid prescriptions within 365 days of an incident primary care provider (PCP) visit for LBP among opioid-naïve VA patients.
DESIGN: Cross-sectional analysis with longitudinal follow-up.
PARTICIPANTS: Patients had an LBP visit with a VA PCP between 10/1/2015 and 9/30/2020, without any VA LBP visit in the preceding 18 months, and then 2 subsequent VA LBP visits in the following 12 months.
MAIN MEASURES: VA electronic health record data including outpatient visits, prescriptions, and comorbid diagnoses.
KEY RESULTS: A total of 128,377 patients met study criteria. The hazard ratio for opioid prescription in a propensity-matched sample was 0.77 (95% CI 0.71–0.83), indicating a significantly lower risk for receipt of an opioid prescription among chiropractic care users in the 365-day follow-up adjusting for potential confounders. The cumulative incidence of opioid prescriptions was 13.0% for chiropractic care users and 16.8% for nonusers and the number needed to treat was 27.
CONCLUSIONS: The results of this study show that nonpharmacologic chiropractic care can be an important component of opioid sparing strategies for VHA patients with LBP.
KEY WORDS: Veterans health; chiropractic; analgesics, opioid; low back pain; primary healthcare
J Gen Intern Med
DOI: 10.1007/s11606-025-09556-w
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2025
Prior Presentations North American Spine Society Annual Meeting, October 18–21, 2023.
Received September 16, 2024
Accepted April 16, 2025
Since the start of its Opioid Safety Initiative (OSI) in October 20131, through its current Pain Management Opioid Safety and Prescription Drug Monitoring Program (PMOP),2 the Veterans Health Administration (VA) has been working to embrace a culture of effective pain treatment while reducing the risks associated with long-term opioid therapy.3 VA’s strategy includes provider and patient education, risk mitigation, addiction treatment, and expansion of pain care treatment options, including nonpharmacologic therapies. One key consideration has been attentiveness that chronic pain rarely occurs in isolation but rather co-occurs with other medical, mental health and substance use disorders in veterans.4 These comorbidity patterns are crucial to consider as they can complicate the clinical presentation, course, as well as treatment options and outcomes for veterans. With respect to treatment options, in 2016, a VA Health Services Research and Development State of the Art Conference issued expert recommendations that a group of evidencebased nonpharmacologic therapies for chronic musculoskeletal pain should be available across the VA healthcare system.5 Of the pain conditions for which nonpharmacologic treatments may be indicated, perhaps none is more common and burdensome than low back pain (LBP). In North America, the age-standardized prevalence estimate for LBP is 10.5%, and rate of Years Lived with Disability is 1160 per 100,000.6 LBP disproportionately affects Veterans compared to the non-Veteran population.7 In VA patients, “M54.5, Low Back Pain” was the most common musculoskeletal diagnosis code in the first 2 years of ICD-10 adoption (October 1, 2015–September 30, 2017) both by outpatient visits (18.3%) and by unique patients (43.1%).8 It has been estimated that over 80% of incident visits for LBP conditions in VA occur in primary care provider (PCP) clinics.9
LBP clinical practice guidelines recommend evidencebased nonpharmacologic treatment options as first-line therapies including exercise, superficial heat, spinal manipulation, massage, cognitive behavioral therapy, and others.10 In the USA, one of the most common approaches for LBP patients is chiropractic care. In an assessment of commercial insurance and Medicare Advantage claims data, the top two
entry points for new treatment episodes for LBP were PCPs (53.0%) and chiropractors (23.1%).11 VA began providing chiropractic care “on-station”—care delivered by VA providers in VA medical facilities—in 2004,12 and continues to expand access,13 yet its overall use remains very low compared to the US general population (4.1% in fiscal year 2023, compared to 11–14% in the US general population).14–16
Prior observational studies outside VA have shown that patients receiving chiropractic visits for LBP tend to subsequently use less of other healthcare services such as advanced imaging, therapeutic injections, and pharmacological therapies, including opioids.11,17–19 More attention has been given to the associations between chiropractic care receipt and medication use, including tramadol, gabapentin, and opioid use. A recent meta-analysis of six studies of adults with noncancer pain found chiropractic care users to have 64% lower odds of receipt of an opioid prescription than non-users (odds ratio = 0.36, 95% CI = (0.30, 0.43), p < 0.001; range of length of follow-up: 7 days to 1 year).20 Similarly, two recent Canadian studies21,22 found lower rates of opioid prescriptions in chiropractic care recipients where study participants were previously prescribed opioids. An earlier study in VA found the veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who had at least one visit to a VA chiropractic clinic had lower rates of receipt of an opioid prescription in the 90 days after first chiropractic visit compared to the 90 days before the visit.23 Opioid prescription was higher among those veterans with moderate-severe pain, diagnosis of PTSD or depression and current smoking. However, these studies all considered samples inclusive of patients with previous and active use of prescription opioids, leaving open the question of the effect of chiropractic care on prescription opioid use in an opioid-naïve population.
The purpose of this study is to examine the longitudinal relationship between receipt of chiropractic care and receipt of opioid prescriptions within 1 year of follow-up after an incident PCP visit for LBP among opioid-naive patients receiving VA care for LBP.
Sources
This study was a cross-sectional analysis with longitudinal follow-up of national VA Electronic Health Record (EHR) data from on-station VA care (provided on-site at VA medical facilities). Data were extracted from VA’s Corporate Data Warehouse consistent with previously established methods.23,24 We used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines to report this observational study. The study was approved by the VA Connecticut Healthcare System Research and
Development Committee ([1583217-25] Musculoskeletal Diagnoses Cohort: Examining Pain and Pain Care in the VA using Complementary and Integrative Health (CIH) Interventions (EXEMPT)).
This patient sample was a subset of veterans with LBP from the larger group with any type of musculoskeletal disorder(s) (see Fig. 1). Patients were included in the study sample if they had a visit for LBP in a VA PCP clinic between 10/1/2015 and 9/30/2020. Our inclusion criteria maximized the likelihood of this sample index visit reflecting new initiation of healthcare for LBP by requiring no VA care for LBP in the 18 months preceding the incident visit. PCP clinics were defined based on VA clinic identifier “stop codes,” with a primary or secondary code of 301 (General Internal Medicine), 322 (Women’s Health), or 323 (Primary Care Medicine) linked to the visit.
We excluded patients with less than two subsequent onstation VA healthcare visits for LBP in any clinics within 365 days following their study index visit to limit the sample to those who were actively receiving care for LBP. This was done to minimize the likelihood of including cases that were self-limited to a single PCP visit, and/or cases where the LBP ICD- 10 code at the index visit may reflect a historical problem, rather than one the patient was currently experiencing. Additionally, patients who received an opioid prescription within 180 days prior to their study index were excluded. Patients who died within the 365 days after their study index date were also excluded.
The primary exposure of interest was use of on-station VA chiropractic care for LBP. This was identified using the VA clinic stop code 436 (Chiropractic Care) linked to an outpatient visit. Only chiropractic care visits that included an LBP ICD- 10 diagnosis were included. “Chiropractic users” were defined as patients with a study index PCP visit and at least two subsequent LBP visits in a chiropractic clinic within 365 days. “Chiropractic non-users” were defined as patients with a study index PCP visit and at least two subsequent LBP visits in any clinics other than chiropractic within that timeframe.
The primary outcome of this study was whether opioid prescriptions were filled (Yes/No) within 365 days of study index visit date, and the number of days from index visit to the receipt of an opioid prescription were for rate estimation. Given study inclusion criteria required a washout period of 180 days without an opioid prescription prior to study index, this outcome represents a “new” opioid prescription (opioid
You have spent your entire career developing and growing your practice. Now is the time to look ahead. If you do not have an exit plan, LSM may be your solution. Consider joining this large, patient-centered practice and see how smooth your move to retirement can be. Please contact Sarah Pavlik at 608-316-6972 or spavlik@lsmchiro.org for more information.
Running a chiropractic practice is not easy. Consider joining with LSM to revitalize your career. With 18 clinics, support staff and the latest technology, LSM can help you flourish. All benefits including healthcare, dues, malpractice and 401K plan. Work as the Chiropractor you were meant to be. Please contact Sarah Pavlik at 608-316-6972 or spavlik@lsmchiro.org for more information.
Are you semi-retired, between positions or looking for extra income? Like the thought of being able to assist other chiropractors who need time away? Doc For A Day is a locum tenans company that assists clinics while the doctor needs time away. We are looking for coverage doctors to help us fill this growing need. We assist with not only vacation time, but maternity leave, surgery recovery, illness and semi-permanent coverage. Must have current chiropractic license & malpractice insurance. We have seasonal and year-round coverage needs all over the state of Wisconsin. Call or Text Maggie: 847-367-9641 or info@docforaday.com
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Average salary of $150k-$200k across multiple markets. We are one of the largest privately-owned, fastest growing, chiropractic companies in the country complete with experienced teams of specialists including: marketing, clinical operations, legal, revenue cycle, HR, IT, maintenance, and more!! This robust team allows our doctors to focus on great patient care. Contact: claudia.wright@ medullallc.com or Call: 708-595-5227
• Appleton. Attractive home/office for sale in prime Fox Valley area. Doctor retiring and selling attractive 2,093 sq ft home with practice, including lower level & garage. Prime commercial with surrounding residential property. Financing available.
• Wausau. Long established practice for sale. $126,626 gross in 3 days per week. Very low overhead. Payor mix 40% cash, in-network most insurance plans. 2 experienced part-time CA's. Div, some Act.
• Milwaukee. Practice for sale in high-demand Milwaukee location. Sale includes practice and attractive building with upstairs apartment. $338,000 gross. Low overhead. Doctor retiring and will provide assistance for smooth transition. Financing available.
• Manitowoc/Two Rivers. 23 year established referral practice. Ideally located along scenic Lake Michigan in professional building with ample off-street parking. $243,000 gross. Low overhead. 1,500 sq ft rent only $1,406 per month. Div/FD also therapies. Financing available.
• Wausau. Interested in learning Functional Medicine? Dr will provide training. Learn techniques to complement your adjusting skills. This is a cash practice with $176,000 net operating income.
Contact Loren Martin: Practice Opportunities, Inc.
P: 952.322.1177 | Email: martin@practiceop.com | www.practiceop.com. WCA Member/Licensed Broker
Our professional locum tenans doctors are ready to fill in for you while you are away. Vacation, surgery and recovery, maternity leave, and semi-permanent coverage. All of our Docs are licensed, insured, experienced and have had background checks. Contact us to schedule your time off today! Call or Text Maggie: 847-367-9641 or info@ docforaday.com
Back in Action Chiropractic in Baraboo, WI is seeking a passionate chiropractor to join our family-based, patient-centered practice. We offer a supportive team environment, strong patient base, competitive compensation, and mentorship opportunities. If you're licensed (or eligible) in Wisconsin, compassionate, and eager to grow both personally and professionally, we'd love to hear from you!
Join our mission to help families thrive!
Interested? Email: DrJason@BackInActionBaraboo. com . Apply by emailing your resume and cover letter with the subject line "Chiropractic Application - Back in Action Chiropractic"
Join a phenomenal team with over 40 years serving in a rural community located in the Johnson Creek area - we are expanding! Seeking a professional willing to learn techniques and contribute their own. Practice honestly. Compensation is a base salary with a percentage of collections. Provider for most insurances. Excellent opportunity to transition into ownership in a few years. I will do a lot to make this a great relationship.
We strive to give each patient their personal best, complete adjustment. Patients and team members are encouraged to thrive.
Please email resumes and inquiries to: southcentralwichiro@gmail.com
We are offering a unique situation for Southeast Wisconsin chiropractors with established practices who are looking to drastically reduce their overhead while still practicing and running your own practice. Associates in Spinal Relief has a 3000 square-foot space and freestanding building with unlimited high traffic marketing opportunities. This opportunity is for you to become an independent contractor and practice within our existing location, which is fully furnished for all your chiropractic needs. If reducing your overhead by $6,000 to $10,000 per month sounds good to you, give me a call or send me an email.
Dr. Ken Kerwin Phone: 414-331-6009 (Personal)
Email: kirokenk@gmail.com
WE’RE HIRING AN ASSOCIATE CHIROPRACTOR AT GROUNDED ROOTS CHIROPRACTIC!
Location: Sheboygan, Wisconsin
Start Date: looking to hire right away- but can be flexible on start date
*Clinic Details & Benefits Package*
We’re looking for a passionate, driven chiropractor ready to make a difference in our thriving, wellness-centered community. Our office is rooted in neurological-based chiropractic care with a special focus on prenatal, pediatric, and whole family wellness. We serve young families, growing mamas, and those committed to creating the healthiest versions of themselves.
What We’re Looking For:
• Someone coachable, committed, and confident
• A strong adjuster who educates and inspires patients
• Someone aligned with a holistic lifestyle and wellness mindset
• A heart to abundantly serve and a passion for community connection
• Certification (or willingness to become certified) in TRT, MC², Webster Technique, and PX-pediatric care
• An energy giver, team player, and someone eager to grow with us long-term
If you’re ready to step into a practice where your purpose meets your passion, we’d love to hear from you!
Email: drerika.groundedrootschiro@gmail.com
• Resume
• Cover letter
• Short video of why you would be a great addition to our Grounded Roots Tribe
Are you a passionate and driven chiropractor looking to make a real impact on patients' lives? We want YOU to join our dynamic, patient-centered practice! Groskopp Chiropractic is a well-established, thriving clinic committed to helping our community by delivering effective treatments while building lasting relationships.
• Earn above-average compensation with opportunities for bonuses and growth. IRA match, health insurance reimbursement, paid CE, malpractice, license renewal, etc.
• Enjoy flexible hours and a positive work environment.
• Work in a modern, fully equipped clinic with the latest technology.
• Be part of a practice with an established, loyal patient base, plus build your own clientele. 25+ new patients a month.
If interested, contact: davemeyerdc@gmail.com
Are you a passionate chiropractor ready to take your career to new heights? Join our well-established practice, located just 30-45 minutes north of Madison, WI, in the charming town of Portage. With 29 years of serving the community, we are dedicated to helping families feel their best through chiropractic care and advanced therapies such as Decompression, MLS Cold Laser, and Shockwave therapy.
Why You'll Love Working Here:
• A busy, upbeat, fun, and collaborative office environment with a supportive team where you can make a real impact.
• TRUE 6-figure earning potential with a solid base salary and attainable bonuses.
• Paid vacation and a health insurance stipend.
• Technique include Palmer Package and Family Practice.
• What We're Looking For:
• A motivated chiropractor eager to learn and grow in a vibrant, fast-paced setting.
• A team player committed to exceptional patient care ready to bring their A-game.
***If you’re looking to elevate your career, earn a great income, and enjoy a balanced lifestyle in a beautiful location, this is the opportunity for you.
Ready to join our team? Apply today and start your next chapter with us! Send Resume to info@chirosconnect.com
FREE 20 yr clinic when you rent building for 5 years. Large apartment upstairs available on separate lease. Outstanding opportunity for New Doctor wanting private practice. Doctor retiring.
Click here for clinic photos
If interested, please call 608-487-1959
Chiropractic Company is currently looking to purchase a clinic in the Greater Milwaukee area.
If you have interest in selling, a merger or are contemplating retirement and need an exit strategy:
Please contact Kent McLeod at 414-213-4808 or drmcleod@chiropracticco.com or visit chiropracticbuyers.com for additional information.
ASSOCIATE WANTED - GREATER MILWAUKEE AREA
Chiropractic Company is a rapidly expanding group of clinics in the greater Milwaukee area, and we are currently looking for associate doctors.
We are unique in the profession in that doctors have the opportunity to advance from associate to clinic director, to shareholder in the corporation all based on their personal performance.
In addition to a salary and bonus structure we also offer health insurance, short term and long-term disability insurance, and a matching 401k plan. Continuing education, chiropractic coaching, 50% off a gym membership, license, CPR training, and malpractice insurance are also covered benefits of working with the Chiropractic Company.
For more information go to: www.chiropracticco.com/ careers OR Email: drmcleod@chiropracticco.com
ASSOCIATE WANTED - STATEWIDE
Are you a self-motivated Chiropractor? We’re looking for someone like you to join our growing team at The Wellness Way! If you’re passionate about quality patient care and wellness, we want to hear from you. You’ll have the opportunity to manage a solid new patient base in a rapidly expanding practice, and we’ll provide training you need to run a successful practice.
We Offer:
• Benefits: Dental and vision, PTO, and life insurance.
• Training: Comprehensive training to help you thrive in our unique approach to wellness.
Responsibilities:
• Adjusting and managing patient care.
• Providing lifestyle improvement tips to patients.
• Tracking patient information and maintaining detailed records of conditions and care.
Sound like a good fit? Reach out to Ashley Zeutzius, email: azeutzius@thewellnessway.com Phone: 920569-6882 Ext 138
ASSOCIATE WANTED – HIGH-RETENTION, HIGH-SKILL CLINIC IN VANCOUVER, WA
Due to our increase in demand, we’re expanding our core team. We have a rare opening for an associate chiropractor with 1-2 years of experience (no recent grads). We have a state-of-the-art facility with full in-house billing, marketing and IT.
This position offers a unique training program to master advanced skills rarely taught elsewhere, plus the opportunity to build your own practice with a patient buyout option. Enjoy travel perks, flexible time off, and unique
performance-based bonuses, and. We’re making only one hire—don’t miss out. Must love working with families, pets, athletes and executives.
Learn more. Apply now: https://jobs.carachiro.com/ job-application/
Z6 BODY CONTOURING LASERFDA APPROVED
Erchonia's ZERONA Z6 is a non-invasive, low-level laser that is FDA approved and clinically proven to contour the waist, hips, and thighs. It targets areas of stubborn fat and is the first laser specifically designed for body contouring. It provides an alternative fat loss treatment without the adverse side effects associated with surgical and other weight-loss procedures like liposuction, cryolipolysis, and body wraps. Perfect for a health spa setting or wellness clinic.
Paid nearly $40,000. Willing to do lease-to-own with an appropriate down payment. Asking $15,000 OBO
Click here to view photos. Contact: 217kochchiropractic@gmail.com or 715 - 256 - 9616
We are seeking to add an additional skilled and compassionate Full-Time Chiropractor to join our growing dynamic team. As a chiropractor at Fox Crossing Chiropractic, you will work directly with patients to assess, diagnose, and treat musculoskeletal conditions, using both hands-on adjustments and other therapeutic techniques. You will work collaboratively with other chiropractors and therapy staff to help patients achieve their desired health goals.
Benefits:
• Competitive salary and performance-based incentives
• Paid time off (PTO) and holidays
• Continuing education opportunities and professional development support
• Retirement Plan
Click here to learn more. If interested, please contact: Mancl.Chiro@gmail.com, Phone: 920-215-0090
Newer Zerona Z6, Non-invasive, cold laser for fat loss. This is the only treatment FDA market cleared for overall body circumference reduction. Very lightly used. Bought to partner with staff member but their plans have changed. FREE DELIVERY anywhere in WI. Safe & effective with very easy set-up.
Asking $20,000. If Interested, Email: jazsky@aol.com Click here to learn more.
Schubbe Resch Chiropractic and Physical Therapy of Appleton is seeking a full-time associate doctor. We are celebrating over 40 years of service in the Fox Valley and are continuing to grow and expand. Our clinic has five doctors as well as in house physical therapy services. We provide a mixture of insurance and cash-based services.
We are looking for the right candidate who is interested in building long-term relationships in the Fox Valley and is motivated to build a strong patient centered practice. We offer 401k match, health insurance, continuing education reimbursement, CPR training, malpractice insurance, and license renewal.
Our doctors use Diversified, Gonstead, Thompson drop, Cox flexion/distraction, and Activator techniques as well as other soft tissue techniques. We also employ physiotherapies as needed to include IFC, ultrasound, and low-level laser therapy. Position is performance based with minimum monthly wage guarantees.
• Contact Dr. Laura Kemps if interested:
• Email: laura.kemps@schubbeappleton.com
• Phone: 920-738-0200
Click here to learn more.
Associate DC position(s) available in an award-winning practice based out of Northeast Wisconsin. Ability to potentially run your own practice someday if you are the right candidate. Starting pay range is $70,000$150,000, company paid malpractice insurance and continuing education after 2 years, $5000 Student Loan forgiveness every 5 years, IRA match, health insurance reimbursement, PTO, and paid maternity/paternity leave.
Job Type: Full-time
Pay: $70,000 - $150,000 per year
Benefits: Employee Discount, Health Insurance, PTO, Professional Development assistance, Retirement Plan, and Tuition reimbursement.
Current locations that are hiring:
• The Chiropractic Advantage
• Linzmeier Chiropractic
*** If you're someone motivated and willing to grow with a passion for chiropractic; please apply! ***
Email: drbuss@thechiroadvantage.com
