Adding Functional Health to Your Chiropractic Practice: The Ultimate Survival Guide

The Survival Challenge for Today’s Chiropractors

Let’s face it – traditional chiropractic practices are getting squeezed from all directions. On one side, you’ve got franchises advertising $20 adjustments. On the other, social media is full of viral “crack” videos promising instant miracle cures. Meanwhile, your patients still see you primarily as a back pain specialist, not the holistic wellness provider you trained to be.

I’ve spent decades in this profession, and the harsh truth is that the old model just isn’t cutting it anymore. About 40% of chiropractors make less than $150,000 annually, with about 20% making under $100,000. When you factor in student loans, practice expenses, and the cost of raising a family, that’s a tough road.

But there’s a lifeline most chiropractors are missing: functional health services. I’m not talking about adding a few supplements to your retail shelf – I mean creating a truly integrated practice that addresses the biochemical and lifestyle factors affecting your patients alongside your structural adjustments.

In my own practice, adding functional health didn’t dilute my chiropractic identity – it amplified it. My patients stayed longer, referred more, and paid more because I was providing them comprehensive care they couldn’t get at those discount chains. Better yet, I was finally practicing the way I’d always wanted to, treating causes rather than symptoms.

This guide will show you exactly how to follow this path. I’ll share the hard-won insights from my own journey and from the many practitioners I’ve mentored. We’ll cover everything from choosing the right functional health training to marketing your expanded services to creating the practice model that finally gives you the freedom and income you deserve.

The choice is clear: evolve or get left behind. Let’s dig in.

The Current State of Chiropractic Care

Financial Challenges Facing Chiropractors

I’ve watched the financial reality for chiropractors deteriorate over the past decade. The numbers don’t lie – roughly 40% of chiropractors earn less than $150K annually, with about 20% making under $100K. Only about 30% break the $200K ceiling, and most of these higher earners are concentrated in just a handful of states.

Strip away these outliers, and what’s left? Most chiropractors in the country making $100K or less – barely enough to keep the lights on after you factor in six-figure student loans, rising practice costs, and trying to support a family. I know plenty of dedicated chiropractors working 50+ hours weekly who still struggle to make their mortgage payments.

This isn’t just a rough patch – it’s a fundamental market shift that won’t reverse without completely rethinking the traditional chiropractic business model.

The Franchise Problem

Seven. That’s how many chiropractic franchise chains are now aggressively expanding across the United States, and they’re completely rewriting the rules of the game. They’ve systematically eliminated everything patients used to hate about going to the chiropractor:

• Need an appointment? Nope, just walk in.
• Only open 9-5? They’re open evenings and weekends.
• Complicated insurance forms? They’ll take $25 cash.
• Thorough exam and history? They’ll crack your back in 5 minutes flat.

I recently visited one of these franchises in a strip mall, posing as a patient. The waiting room was packed, the front desk was checking people in like a fast-food joint, and they were absolutely printing money while delivering what I’d consider the bare minimum of care.

The projected 7% growth in chiropractic over the next seven years? These franchises will gobble up most of it, leaving traditional practices fighting over crumbs unless they differentiate themselves in meaningful ways.

The Social Media “Crack Video” Phenomenon

Ever searched “chiropractic” on Instagram or TikTok? You’ll find thousands of what the profession calls “crack videos” – dramatic adjustments with theatrical neck twists and loud popping sounds, accompanied by claims that would make most ethical practitioners cringe.

“ONE adjustment CURED her 20-year migraine INSTANTLY!”

These viral videos have created a nightmare for responsible practitioners by:

1. Setting up completely unrealistic expectations about immediate results
2. Trivializing complex health conditions that require comprehensive care
3. Making thorough treatment plans seem like unnecessary upsells

I had a new patient last year who showed me a viral video and asked, “Why can’t you just do that?” When I explained proper assessment and care planning, I could see his mental “BS detector” light up. He was comparing my recommendation for consistent care against the instant miracle cure he saw online and the walk-in special down the street.

These compounding pressures are why so many chiropractors are looking for new solutions – and why functional health may be the most viable path forward.

Bridging the Perception Gap: From Pain to Wellness Provider

The Disconnect Between Doctors and Patients

Here’s the fundamental problem I’ve watched play out thousands of times: chiropractors and their patients are having completely different conversations.

When I ask chiropractors what business they’re in, virtually all say “the health business” or “the wellness business.” They see themselves as holistic practitioners restoring proper function to the body.

But their patients? They’re firmly in “the pain business.” They show up when something hurts, and they leave when it stops hurting. Period.

Don’t believe me? Pull up Google search data. Hundreds of thousands of monthly searches for “chiropractor back pain,” “chiropractor neck pain,” and “chiropractor headache.” Zero meaningful search volume for “chiropractor wellness” or “chiropractor health optimization.”

I’ve consulted with practices across the country, and this same pattern plays out everywhere. After reviewing thousands of patient records, I found that over 80% discontinue care within two weeks of pain resolution, regardless of whether they completed their recommended treatment plan.

This misalignment isn’t just a minor communication issue – it’s killing practices financially.

Reframing Pain as a Functional Problem

There’s a way out of this trap, but it requires completely reshaping how patients understand their symptoms from day one. My most successful clients use a specific communication framework that transforms the entire patient relationship.

It works like this:

1. First, validate their pain concern: “I understand your back pain is making it difficult to play with your kids, and we’re going to address that.”
2. Then pivot immediately to function: “But what’s important to understand is that pain is just your body’s warning system telling you something isn’t functioning properly. People who are truly 100% functional rarely experience chronic pain.”
3. Connect their specific pain to functional deficits you find: “See these findings on your exam? They show reduced mobility here and muscle imbalance there. Those functional problems are what’s triggering your pain.”
4. Establish the true goal: “While we’ll work to relieve your pain quickly, our real objective is restoring optimal function so you don’t end up back here in three months with the same problem.”

I had a patient – let’s call him Mark – who came in for typical low back pain. In the old model, I would have adjusted him, given him some stretches, and watched him walk out the door forever once he felt better. Instead, I used this functional framework, showed him his specific deficits, and connected them to both his current pain and future health risks.

Mark not only completed his full care plan but transitioned to ongoing functional care focused on performance optimization for his weekend cycling passion. Six years later, he’s still a patient and has referred 14 friends and family members.

The beauty of this approach is that it:

• Addresses their immediate concern without dismissing it
• Creates a logical rationale for ongoing care
• Completely differentiates you from those quickie franchise visits
• Sets up the perfect transition to functional health services

Why Functional Health is the Perfect Complement to Chiropractic Care

The Synergy Between Structural and Functional Approaches

I didn’t just add functional health to my practice on a whim – I did it because the integration made perfect sense philosophically and clinically. Both approaches share the same North Star: finding and fixing the root causes of health problems rather than masking symptoms.

Look at how perfectly these approaches fit together:

Chiropractic Focus	Functional Health Focus	What This Means For Your Patients
Structural alignment	Biochemical balance	You’re finally addressing both halves of their health equation
Nervous system function	Metabolic function	You can explain why they still hurt despite being “in alignment”
Joint mobility	Cellular function	You deliver optimization at both macro and micro levels
Pain reduction	Root cause identification	You solve problems others haven’t
Manual therapy	Lifestyle modification	You give them both passive and active paths to healing

In my practice, I witnessed this synergy daily:

• That patient with stubborn back pain who didn’t respond to adjustments alone? Once we addressed her chronic inflammation through functional testing and dietary changes, her adjustments finally “held.”
• The guy with persistent headaches? His adjustments helped, but identifying and treating his severe magnesium deficiency and hidden food sensitivities eliminated them completely.
• The woman with fibromyalgia who bounced between medical doctors for years? Our combined approach addressing both structural issues and hidden gut infections gave her the first relief she’d experienced in a decade.

This isn’t theoretical – it’s exactly how the body actually works. Structural problems affect biochemistry, and biochemical imbalances affect structure. When you address both, you’re finally working with the body’s integrated design instead of against it.

Creating a Lifelong Health Journey

But the business impact might be even more significant than the clinical one. Think about the fundamental limitation of pain-based care: once the pain stops, the patient leaves.

Functional health completely rewrites this story by creating a continuous health journey without a clear endpoint. My patients now stay with me for years because:

1. They understand functional health as an ongoing process, not a one-and-done fix
2. They see measurable improvements in biomarkers beyond just how they feel
3. They experience benefits far beyond their initial pain complaint
4. They develop a relationship with me as their health guide, not just their “back cracker”

I had a patient named Sarah who initially came in for neck pain. In my old practice model, she would have received 8-10 adjustments and disappeared. With our integrated approach, after resolving her neck pain, we identified several functional health issues through testing, including gut dysbiosis and hormone imbalances.

Four years later, Sarah is still a regular patient who views our care as an essential part of her health maintenance, not an emergency service. She’s referred 9 family members and close friends.

This is the difference between a perpetual “revolving door” practice and building a stable community of patients who value what you offer beyond crisis intervention.

The Business Case for Adding Functional Health Services

Potential Revenue Growth

Let’s talk numbers – real numbers, not fantasy projections.

When I first added functional health to my own practice, I saw a 43% revenue increase in the first six months. By year two, my practice revenue had nearly doubled. This wasn’t a fluke. I’ve since helped dozens of chiropractors implement similar models, and the pattern is consistent:

• Most see a 30-50% revenue increase in the first year
• Practices typically add $100K-$200K in annual revenue by year two
• Many develop substantial passive revenue through supplements and programs

These aren’t hypothetical projections – they’re actual results from practitioners who’ve made this shift.

Take Dr. J, who I mentored through this transition three years ago. Her supplement dispensary alone now generates around $150K annually – that’s pure profit above her consultation fees, lab markups, and adjustment income. Last year she netted more from her functional health services than from her chiropractic adjustments.

“I was doing about 120 adjustments weekly and making barely $90K in take-home pay,” she told me recently. “Now I do 80 adjustments and 15 functional consultations weekly, and my take-home has more than doubled with less physical strain.”

Diversifying Revenue Streams

The magic isn’t just in the total revenue – it’s in creating multiple income streams that don’t all depend on your hands doing the work. Look at what becomes possible:

Revenue Stream	Real-World Example	What This Means For You
Functional health assessments & labs	$4,500-8,000 per package	Income separate from adjustment reimbursements
Supplement sales	30-100% margins on monthly protocols	Recurring revenue that builds over time
Group programs	$1,000-3,000 per participant	Leveraged income from multiple clients at once
Telemedicine services	Full fees without facility overhead	Location independence and flexibility

I’ve seen the financial stability this creates. One practice I consulted with lost their insurance coverage with a major carrier, which would have been devastating in a traditional chiropractic model. Because they had diversified with functional health, the impact was minimal – they actually increased profitability that year by focusing more on their functional services.

Breaking Free from Physical Limitations

Let’s be brutally honest about traditional chiropractic: your income is directly limited by how many hours you can physically adjust patients and how many years your body can handle the strain.

I still remember the panic I felt when I injured my wrist and couldn’t adjust for six weeks. My income dropped to near-zero. That experience was a wake-up call about the fragility of a practice dependent solely on my physical labor.

Functional health breaks these chains:

1. You can conduct functional consults even with physical limitations
2. Many aspects of functional care can be delegated to trained staff
3. Your systems and protocols become valuable practice assets
4. You can serve patients even when not physically present

Expanding Through Telemedicine

The January 2024 addition of telemedicine CPT codes was a game-changer that most chiropractors haven’t fully recognized. While you can’t perform spinal adjustments over Zoom, you absolutely can:

• Conduct thorough functional health assessments
• Review and interpret lab results
• Create and modify nutritional protocols
• Provide lifestyle and stress management guidance
• Monitor patient progress and compliance

A chiropractor I mentor in rural Iowa used this approach to completely transform his practice. 

Practical Implementation: Adding Functional Health to Your Practice

Choosing the Right Functional Health Program

When selecting a functional health training program, chiropractors should consider several factors to ensure the investment delivers appropriate returns:

1. Certification Recognition: Choose programs with credentials recognized within the functional health community
2. Clinical Focus: Ensure the program emphasizes practical clinical applications rather than merely theoretical knowledge
3. Lab Access: Verify that the program provides access to functional labs even for unlicensed practitioners
4. Implementation Support: Look for programs offering ongoing clinical mentorship after completion
5. Business Integration: Select training that includes practical business implementation strategies

While several programs exist in the marketplace, they vary significantly in depth, practical application, and post-graduation support. Popular options include:

• Functional Diagnostic Nutrition (FDN)
• Functional Medicine University
• Institute for Functional Medicine
• Functional Nutrition Alliance

Each program has different strengths and investment levels, with costs ranging from approximately $3,000 to $18,000. The right choice depends on your specific practice goals, learning preferences, and budget constraints.

Decision Factor: “The value of a program isn’t just in the information it provides, but in the implementation support, lab access, and business strategies it delivers. These elements often justify higher investment levels if they translate to faster, more effective practice integration.”

Staff Training and Delegation

One of the most significant advantages of functional health is the ability to delegate many aspects of care delivery to trained staff members. Unlike chiropractic adjustments, which require the doctor’s hands-on expertise, many functional health services can be delivered by certified team members.

Effective delegation opportunities include:

• Initial functional health assessments
• Education on supplement protocols
• Diet and lifestyle coaching
• Follow-up accountability sessions
• Lab kit distribution and collection

This delegation creates a multiplier effect, allowing the practice to serve more patients without increasing the doctor’s workload proportionally. It also creates career growth opportunities for staff members, potentially increasing retention and job satisfaction.

Marketing Your Expanded Services

Successfully marketing functional health services requires addressing the distinct audiences who might benefit from this approach:

1. Existing Pain Patients: Educating current patients about the functional roots of their pain and the benefits of addressing these underlying factors
2. Health-Focused Individuals: Attracting new patients specifically interested in optimization rather than pain relief
3. Complex Case Patients: Targeting individuals with chronic, multi-faceted health challenges that have not responded well to conventional approaches

Effective marketing channels for functional health services include:

• In-office education materials explaining the functional health model
• Condition-specific workshops addressing common functional health challenges
• Social media content focused on root-cause approaches to health
• Strategic partnerships with complementary health providers
• Patient success stories demonstrating comprehensive health transformations

By marketing to these distinct audiences, practices can create multiple “entry points” for new patients, reducing dependency on pain-based advertising that often leads to transactional rather than relationship-based care.

Converting Patients from Pain Management to Functional Health

The Critical First Visit Conversion

The most crucial point in transitioning patients from pain-focused care to functional health occurs during their initial visit. This conversion must happen immediately—before the patient has formed fixed expectations about the nature and duration of care.

The conversion process follows a specific sequence:

1. Acknowledge and validate the patient’s pain concern
2. Explain that pain is always a symptom of underlying functional problems
3. Demonstrate through examination findings the specific functional deficits present
4. Create a clear connection between these deficits and the patient’s symptoms
5. Present a care plan addressing both immediate symptoms and underlying functional issues

This approach respects the patient’s immediate concerns while simultaneously shifting their understanding toward a functional perspective. Without this deliberate conversion, patients will default to a pain-only framework, leading to premature discontinuation of care once symptoms resolve.

Building a Belief System That Creates Lifetime Patients

Converting one-time pain patients into lifetime wellness clients requires constructing a coherent belief system about health that patients can embrace. This belief system must be:

• Logical: Following clear cause-and-effect relationships
• Demonstrable: Supported by observable measures and outcomes
• Personal: Connected to the patient’s unique health challenges and goals
• Actionable: Offering clear steps the patient can take to improve
• Progressive: Presenting health as a continuum requiring ongoing attention

When patients adopt this functional health belief system, they transition from passive recipients of care during pain episodes to active participants in an ongoing health optimization process. This psychological shift is the foundation of long-term patient retention and practice sustainability.

Communication Key: “The most successful patient conversations don’t just explain what’s happening; they fundamentally change how patients think about their health. This belief system transformation is what turns one-time visitors into lifetime patients.”

Case Study: Successful Integration of Functional Health

To illustrate the potential of integrating functional health with chiropractic care, consider the experience of Dr. Julie who successfully implemented this model in her practice:

• She maintained her identity as a chiropractor while expanding into functional health
• Her supplement sales alone generated approximately $150,000 annually
• Her practice included comprehensive lab testing and interpretation
• She developed a solid reputation as a wellness provider, not just a pain specialist
• Her model created significantly greater lifetime patient value
• The practice became valuable enough to be successfully sold when she was ready to exit

This case demonstrates that functional health integration doesn’t require abandoning chiropractic identity—it enhances it while creating substantial additional value both clinically and financially.

Overcoming Implementation Challenges

Time and Knowledge Investment

The most significant barrier to implementing functional health services is often the time and knowledge investment required. Many chiropractors express concerns about:

• The learning curve for mastering functional health concepts
• The time required to implement new systems and protocols
• The challenge of explaining complex concepts to patients
• The investment required for quality training programs

These concerns are valid but can be addressed through strategic implementation approaches:

1. Staged Implementation: Begin with one functional health service or focus area rather than a complete overhaul
2. Leverage Existing Knowledge: Build on nutrition and lifestyle concepts you already understand
3. Start with Simple Interventions: Begin with basic functional supports like foundational supplements before advancing to complex protocols
4. Use Done-for-You Systems: Consider programs that provide turnkey implementation rather than building from scratch

While some practitioners prefer comprehensive education, others may benefit from simplified systems that don’t require mastering every aspect of functional health immediately.

Maintaining Your Chiropractic Identity

Some chiropractors express concern about diluting their professional identity when adding functional health services. However, those who have successfully integrated these approaches typically find that functional health enhances rather than diminishes their chiropractic identity.

The key is positioning functional health as a natural extension of chiropractic philosophy, not a separate or competing approach. Both focus on:

• Addressing root causes rather than suppressing symptoms
• Supporting the body’s innate healing capacity
• Taking a holistic view of health and function
• Empowering patients to take control of their wellbeing
• Providing non-pharmaceutical health solutions

When presented properly, patients view functional health services not as a departure from chiropractic care but as a natural and welcome expansion of its principles.

Future-Proofing Your Chiropractic Practice

The chiropractic profession faces significant challenges from discount franchises, unrealistic social media portrayals, and changing patient expectations. Simply continuing with traditional practice models leaves many chiropractors vulnerable to declining incomes and professional satisfaction.

Integrating functional health services offers a powerful solution to these challenges by:

1. Differentiating your practice from low-cost competitors
2. Creating multiple revenue streams beyond hands-on adjustments
3. Establishing a framework for long-term patient relationships
4. Addressing health challenges that cannot be resolved through structural care alone
5. Expanding your impact beyond the limitations of physical practice

The most successful chiropractors of the future will likely be those who embrace this integration, positioning themselves not merely as spinal specialists but as comprehensive health optimization experts. By combining the biomechanical expertise of chiropractic with the biochemical and lifestyle focus of functional health, practitioners can create truly holistic practices that deliver superior outcomes for patients while ensuring sustainable business success.

The choice is clear: evolve by expanding your service model or risk being left behind in an increasingly challenging marketplace. For chiropractors willing to make this evolution, the future holds tremendous opportunity for both clinical impact and practice prosperity.

FAQ: Adding Functional Health to Your Chiropractic Practice

Q: How much can I expect to invest in functional health training?

A: Functional health training programs typically range from $3,000 to $18,000, depending on the depth, recognition, and support provided. Programs like Functional Medicine University start around $2,800, while more comprehensive programs with extensive lab training and business implementation support may cost more. Consider this an investment that should deliver returns through increased patient volume, higher patient value, and new revenue streams.

Q: Do I need additional certifications or licenses to offer functional health services?

A: In most jurisdictions, chiropractors can offer nutritional counseling and lifestyle recommendations within their scope of practice. However, specific regulations vary by state or province. Some functional health programs provide certifications that enhance credibility and clarify your role as a functional health provider. Always verify your local regulations before implementing new services.

Q: How do I explain functional health to my existing patients?

A: Frame functional health as a natural extension of chiropractic care, explaining that both structural alignment and biochemical balance are essential for optimal function. Use simple analogies like comparing the body to a car that needs both proper alignment (chiropractic) and quality fuel (functional nutrition) to run optimally. Focus on how functional approaches enhance outcomes for issues they care about.

Q: Will adding functional health services detract from my chiropractic practice?

A: When implemented properly, functional health typically enhances rather than detracts from chiropractic services. Many practitioners find that patients become more committed to their chiropractic care when it’s part of a comprehensive health approach. The key is integrating the services seamlessly rather than treating them as separate offerings.

Q: How can I get started without becoming overwhelmed?

A: Begin with a focused approach rather than trying to implement everything at once. Consider starting with:

1. Basic nutritional assessments and recommendations
2. A small, curated supplement dispensary addressing common needs
3. One or two key functional lab tests that complement your chiropractic focus
4. Educational materials explaining the connection between functional health and structural care

This phased implementation allows you to grow your functional health services organically while managing the learning curve.

Q: How do I handle patients who just want pain relief and aren’t interested in functional health?

A: Always meet patients where they are. For those focused exclusively on pain relief, provide excellent chiropractic care while gently educating them about functional factors that may be contributing to their problem. Look for “openings” in conversations where functional health might address a concern they’ve mentioned. Remember that not every patient will embrace functional health immediately—some may need to see results from chiropractic care before expanding their health perspective.

Q: What should I look for when choosing functional lab companies to work with?

A: When selecting functional lab partners, consider:

• Access protocols (whether they work with non-MD practitioners)
• Quality control measures and laboratory certifications
• Comprehensiveness of test reports and clinical support
• Practitioner education and interpretation assistance
• Pricing structure and patient affordability
• Turn-around time and reliability

Look for labs that specifically support chiropractors and offer training on interpreting results and creating clinical protocols based on findings.