With incorporation of better medical and PT approaches in recent years, some of the cost and effectiveness margins chiropractic has had in the past appear to be shrinking. It's a competitive marketplace out there. The challenge for us, of course, is not to simply discount our services to new lows to be attractive for managed care contracts. Unrealistic price-cutting has jeopardized survival for far too many doctors in recent years. Rather, we must be able to demonstrate the value and affordability of the service we provide.
High prices are just as risky.
Research and clinical priorities for our profession should include finding answers to questions that customers are asking. Objective, evidence-based answers to these sorts of questions will help to counter the often arbitrary payer practices currently used to contain costs. Disruptive products in the computer industry are guaranteed losers, according to Mr. Lewis. Although you and I would both argue vehemently that this represents exactly the wrong incentive for an effective health care system, changing Western society's fundamental health care paradigm is unlikely to be accomplished by doing battle with a few claims managers or medical directors at insurance companies. The challenge I see for chiropractic in gaining meaningful long-term market share and influence is to develop a seamless migration path from the current installed base to a better health care financing paradigm.