For over a century, chiropractic was defined by independent, local practices, but it is now entering a period of corporate consolidation. This shift is being driven by private equity firms, management services organizations (MSOs), and insurer vertical integration. Factors contributing to this change include the administrative burden of modern practice and a new generation of graduates who prefer salaried stability over the risks of ownership. Currently, approximately 15%-20% of the U.S. market is corporately aligned.

While corporate models offer benefits like predictable income and reduced paperwork, they often come with tradeoffs such as productivity quotas and reduced clinical autonomy. The article points to Australia as a potential future model, where large health funds own clinics and use tiered benefits to steer patients toward their own providers. This raises significant policy questions regarding patient autonomy and provider independence. To thrive in this hybrid ecosystem, independent chiropractors must capitalize on their ability to offer personalized, relationship-centered care and unique treatment modalities that corporate entities struggle to commoditize.