Chiropractic franchise opportunities and the move to ‘fast-casual’ health care
A trend following great success in other industries is now available in chiropractic franchise opportunities
In the early 1990s, a Denver-based startup1 disrupted the unwritten rules of the restaurant industry. Back then, if you wanted a good meal, it meant table service, tipping, and an hour or more out of your life. Along came Chipotle, which combined the quality of full-service dining with the speed and efficiency of fast food. This emergent “fast-casual” model resonated with an increasingly overextended American consumer, who craved access to desirable goods and services on their terms. By 2019,2 there were more than 25,000 fast-casual restaurants in the U.S. alone, and the one-time experiment is now mainstream. So, what does any of that have to do with chiropractic or chiropractic franchise opportunities?
Here’s the connection: This fast-casual movement, born in the restaurant industry, is now permeating all aspects of consumer behavior. Yes, our patients are ultimately consumers — and this consumerism3 is disrupting the unwritten rules of our profession as it has everywhere else.
Patients today are equipped with more information than ever before, thanks to “Dr. Google,” and they are using it to assert more control over the decision-making process and treatment experiences. What’s on their desired menu?
- Improved transparency into pricing and processes.
- Convenience and affordability within their care plans.
- A personalized relationship with their provider and office staff, who put patient needs at the center of the plate.
Health and wellness trends
In a white paper4 by the placement firm Staff Care, they noted a shift toward “convenient care” that has fueled a surge in retail clinics across the country, coupled with extended hours and walk-in appointments, reflecting a rising tendency by consumers to “punish complexity and reward simplicity.”
NRC Health’s 2019 Healthcare Consumer Trends Report5 reported that “convenience and access to care” were the most important factors in a patient’s decision-making, while nearly one-third said they had personally used a retail clinic for primary care. And in a January 2022 survey6 published by The Harris Poll, they documented the importance of technology among patients that empowers them to take ownership of their health care experience. After all, why should they compromise for their doctors when the rest of the world caters to their needs?
To no one’s surprise, the same trends are impacting chiropractic. Traditional factors such as insurance and referrals have given way to a type of “fast-casualization” in chiropractic franchise opportunities that we have seen in other professions — from dentistry to physical therapy to urgent care, where quality and convenience coexist within the same service offering.
Increasingly, patients seek consumer-focused experiences. They want accurate online information to conduct research and comparison-shop, and they look for validation from positive online reviews. They want convenient locations and extended hours of operation. They are attracted by good customer service, including short wait times, ease of booking appointments and flexible payment solutions. They crave a partner relationship instead of traditional, one-way dialog.
Chiropractic franchise opportunities: a paradigm shift
Back in 1999, fast-casual chiropractic franchise opportunities emerged with a consumer-centric model that combined quality care with convenience and affordability within a membership offering. Retail clinics were strategically located in shopping centers serving daily consumer needs, and now number over 800 in 40 states. The formula is resonating with the public, particularly young adults. The average patient age in 2021 was 36.4 years old for this fast-casual experience, and nearly six in 10 were millennials or Gen Z. Of more than 800,000 new patients in 2021, 36% were brand-new to chiropractic — a funnel of untapped growth for the entire profession, waiting to be accommodated and welcomed into chiropractic.
Other providers have since followed, and the trends show no signs of slowing. Rather, the movement represents a distinct growth service line that every DC should be taking seriously, either as a primary practice or as a method for diversification. Today, our best estimate is this fast-casual segment of chiropractic franchise opportunities represents about 4% of the $20.4 billion7 chiropractic profession. By contrast, in dentistry it exceeds a 12% share. That’s at least a $1.6 billion+ sales growth opportunity, should chiropractic follow the same trajectory.
The franchising model is a great space to begin exploring, where the fast-casual concept is an established model. When applied to chiropractic, it empowers DCs to deliver exceptional and affordable chiropractic care to their communities. By joining a chiropractic franchise, DCs are equipped to focus more attention on the delivery of quality care and relationship-building with patients. A franchise model provides a well-established path for solidifying new business launches and reinforcing sustainable growth.
Additionally, the scalable nature and reliable support it offers leads to a variety of opportunities for chiropractors — whether it be valuable adjusting experience or real-world business skills, to becoming a shareholder of a chiropractic professional corporation, franchise owner or investor for diversification.
The road forward for chiropractors
The Greek philosopher Heraclitus is credited with one of my favorite quotes: “Change is the only constant in life.”
Patients are just people, after all, and people are always evolving with their environment; to remain relevant, we must change with them or risk getting left behind. For some DCs, this could mean taking the plunge into a fast-casual delivery of chiropractic care, whether as a franchise or independently. For others, it could mean adopting certain aspects of fast-casual to their existing practices to better resonate with patients seeking more convenient and modern experience. Ignoring the movement entirely is a risky strategy for those invested in growing their business.
PETER D. HOLT has served as president and CEO of The Joint Chiropractic since 2016. He has more than 30 years of experience in the franchise community, including managing franchise systems in domestic and international markets and serving on the board of directors for the International Franchise Association, where he started his career on staff for the IFA.