Chiropractic by Province

Chiropractic by Province - Statistics

CHIROPRACTOR : POPULATION RATIOS (1999)
1.	NS.	-	45 chiropractors / 939,800 people	=	1 : 20,885
2.	NF.	-	27 chiropractors / 541,000 people	=	1 : 20,037
3.	PEI.	-	8 chiropractors / 138,000 people	=	1 : 17,250
4.	NB.	-	44 chiropractors / 755,000 people	=	1 : 17,159
5.	NWT.	-	3 chiropractors / 41,600 people	=	1 : 13,866
6.	QC.	-	918 chiropractors / 7,345,400 people	=	1 : 8,002
7.	YK.	-	4 chiropractors / 30,600 people	=	1 : 7,650
8.	SK.	-	158 chiropractors / 1,027,800 people	=	1 : 6,505
9.	MB.	-	191 chiropractors / 1,143,500 people	=	1 : 5,987
10.	BC.	-	717 chiropractors / 4,023,100 people	=	1 : 5,611
11.	AB.	-	587 chiropractors / 2,964,700 people	=	1 : 5,050
12.	ON.	-	2417 chiropractors / 11,513,800 people	=	1 : 4,764

This is only one of the statistics we should be analyzing and should question why there are so few chiropractors practicing out east. We should also evaluate the provincial chiropractic utilization rates, provincial health coverage, cost of living and disposable incomes in each province.

UTILIZATION RATES BY PROVINCE (CCA)
1.	BC.	-	17%
2.	MB.	-	16%
3.	AB.	-	16%
4.	SK.	-	13%
5.	ON.	-	10%
6.	QB.	-	8%
7.	Atlantic.	-	3%

These figures are very important and start to give you an idea of why the DC/pop ratios are the way they are. To simplify things, the greater the utilization rate the lower the DC/pop ratio is, or the more competition among chiropractors in that province. Ontario may be an exception because of the location of CMCC and many graduates remaining in the area.

CHIROPRACTOR: POPULATION RATIOS : UTILIZATION RATE (1999)
1.	MB.	-	5,987	X	16%	=	958
2.	BC.	-	5,611	X	17%	=	954
3.	SK.	-	6,505	X	13%	=	846
4.	AB.	-	5,050	X	16%	=	808
5.	QB.	-	8,002	X	8%	=	640
6.	NS.	-	20,885	X	3%	=	627
7.	PEI.	-	20,037	X	3%	=	601
8.	NF.	-	17,250	X	3%	=	518
9.	NB.	-	17,159	X	3%	=	515
10.	ON.	-	4,764	X	10%	=	476

As you can see, we multiplied the DC/Pop ratio by the utilization rate to get a new adjusted ratio. This set of statistics gives you a much more accurate picture of what province may be a good location for you to work. Provincial economies, costs of living and disposable incomes must also be evaluated.

COST OF LIVING (1998 - Stats Canada)
1.	NWT.	-	$71,200	1.72
2.	ON.	-	$57,200	1.38
3.	AB.	-	$55,300	1.34
4.	YK.	-	$55,200	1.34
5.	BC.	-	$51,300	1.24
6.	MB.	-	$46,500	1.13
7.	SK.	-	$44,900	1.09
8.	QB.	-	$44,600	1.08
9.	NS.	-	$43,400	1.05
10.	PEI.	-	$41,800	1.01
11.	NF.	-	$41,800	1.01
12.	NB.	-	$41,300	1.00

It takes into account total personal expenditures including personal taxes and deductions. In the right hand column we created an index factor based on the least expensive place to live, New Brunswick. As an example it will cost 24 % more to live in B.C. vs. N.B. This compares provinces; you can go to http://www.statcan.ca/ for city comparisons.

DISPOSABLE INCOME (1998 - Stats Canada)
1.	NWT.	-	$10,000
2.	YK.	-	$7,500
3.	AB.	-	$6,600
4.	BC.	-	$6,000
5.	ON.	-	$5,800
6.	MB.	-	$5,300
7.	SK.	-	$5,200
8.	QB.	-	$4,700
9.	NS.	-	$4,700
10.	NF.	-	$4,600
11.	PEI.	-	$4,400
12.	NB.	-	$4,400

The disposable income above is the personal income left after taxes and basic living expenses to spend on goods and services such as recreation, tobacco, alcohol, gaming, reading materials and chiropractic treatment.

REVENUES OPTIONS

It is very important to analyze the various sources of revenue options available to you when deciding where to practice in Canada as well as when formulating the financial projections for your business plan.

Adjustments/Manipulation.
The vast majority of your revenue will come from this area; because this is what we mainly do and this is what the research shows is effective. Therefore, this is what the payors are willing to pay for and will cover a portion or all of.
History & Examination.
This is a small part of your revenue and is covered entirely or in part by most payors.
Modalities.
Very rarely paid for by insurance, if you want to charge extra for this service, then the patient must pay for at their own expense. Most chiropractors that perform these services will not charge extra for them.
X-ray.
Coverage varies, but on average is only covered for a small percentage of your patients (WCB, Auto, some third party), therefore a lot of patients must pay at their own expense.
Reports.
These are required for workers compensation and auto injury cases and can vary from $30 for a fill in one page report to $700 for an in depth medical - legal report.
Orthotics.
We have the knowledge and skill to provide this for our patients at approximately $100 profit per pair. Most patients that get orthotics, which can cost from $150 and up, have 70-90 % insurance coverage through a third party plan at work.
Pillows, supports, etc.
Some payors such as workers compensation and auto will cover these items, but most patients will have to pay at their own expense.
Nutritional products.
This area is becoming very competitive; Sears, Costco, all pharmacies, etc. are all selling these products today and you can no longer make a profit on these products. The only opportunity to make any profit of these products would be in a rural setting where the products are not as accessible and you are making it more convenient and worth while for your patients. Any type of multilevel marketing in this area is against most provincial professional guidelines.
Massage/Athletic therapist.
This can be an excellent source of income and referrals for your clinic, especially if the area is in need of a therapist. Typically you have either a percentage split with the therapist or they will pay you a flat fee per month. The income you receive from this arrangement far outweighs the extra overhead that you will encounter. It is very important to hire a therapist that it familiar with the benefits of chiropractic and wants to work together with you to build your clinic, not compete with you.

PAYMENT SYSTEMS
1.		Provincial Health funding.
2.		User Fees.
3.		Workers Compensation.
4.		Auto Insurance.
5.		Social Assistance.
6.		Veterans Affairs.
7.		RCMP.
8.		Private Insurance (eg. Blue Cross).
9.		Native Affairs.

It is very important to analyze the various types of payment systems available to you when deciding where to practice in Canada as well as when formulating the financial projections for your business plan. These vary substantially from province to province. Click on each province and go to payment systems to find specifics on each provincial payment system.

SCOPE OF PRACTICE

Most provinces are becoming quite similar and allow spinal, extremity adjusting, and use of modalities. There are variations, which should be checked in advance to ensure it suits your needs. Click on each province and go to the provincial chiropractic association web link to find specifics on each provincial scope of practice.

MARKETING GUIDELINES

Varies considerably from province to province, for example in Alberta, the Yellow page advertising is limited to a one line listing. In Manitoba, you can only advertise for limited time periods after beginning in practice. Marketing guidelines have been changing a lot lately and becoming more liberal as the profession tries to increase its utilization rate. Again, check in advance to ensure it suits your needs. Click on each province and go to the provincial chiropractic association web link to find specifics on each provincial marketing guideline.

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