My Glaringly White Chiropractor
What will it take to make the office welcoming to Black patients?
Chiropractic care has a race problem. I am by no means the first person to say this, but my recent experience receiving care has pushed me to face this reality. I go to one of the better chiropractors in town. Not once have I seen an African American person in my chiropractor’s office. No Black staff. No Black patients.
I live in a part of town that is at least 50% African American. My chiropractor’s office is in a suburb nearby that is slightly whiter, but still fairly mixed. Despite this, their patients and staff are all White.
In chiropractic care, this is the norm. Studies have found that over 97% of chiropractic patients are White, despite 12.6% of the US population being Black. Chiropractic care tends to serve underserved patients: rural patients, uninsured patients, and female patients whose pain has been ignored by mainstream medicine. But while White women whose pain has been dismissed by general practitioners find relief in chiropractic care, Black women and men do not.
Healthcare disparities are a well-established fact of the US medical system, but the case of chiropractic care is even worse than that of general medicine. While 54% of mainstream Medical Doctors are White, 85% of Chiropractic Doctors are White. Only 0.9% of Chiropractic Doctors are Black. Current enrollment in chiropractic courses shows no signs of this changing.
Black People Embrace Other Holistic Medicine
It is easy for White practitioners to assume that Black people simply must not be interested. I doubt this is true. I know enough Black people to see that they often embrace holistic and natural medical solutions. They are well aware that conventional medical systems are not meeting their needs.
We are seeing an increasing number of Black doulas taking on disparities in maternal outcomes. A growing number of Black-owned yoga studios focus not only on fitness but also on body positivity, countering the skinny white woman narrative of other studios. Take a leisurely stroll through our regional farmers’ market and you will see stalls operated by Black women offering natural health and skincare solutions.
So why would Black people not be coming in to see the chiropractor? In one word, trust.
Black people, for good reason, prefer Black doctors. White doctors too often ignore their pain and diminish their symptoms. White doctors too often fail at listening to Black patients or understanding the Black experience. They rarely study health conditions that disproportionately bother Black patients. And, far too often, White doctors cause and exacerbate Black patient’s pain.
Going to a chiropractor requires a ton of trust. You have to be willing to let someone feel all over your body and then literally re-arrange your bones. There is no way you are going to do that with someone who is talking down to you, talking over you, or in any way demeaning you. If you go for a visit and feel like the chiropractor is uncomfortable with you, you won’t keep coming back for treatments. You want a chiropractor who intuitively understands your body and your life.
Walking through the doors of a White chiropractor’s office is a huge risk if you are a Black person. You might do it if you had a close friend recommend the office to you. Otherwise, you probably will find someone else to address your health needs.
All White Messaging for All White People
The smart thing to do for chiropractors seeking to grow their patient base would be to establish partnerships that encourage Black people to refer their friends. But in many cases, practices have (I hope unwittingly) done the opposite.
I first found out about my chiropractor from a mother-baby support group, one that met at 10 AM on Tuesdays. The group was led by two well-meaning, but obviously privileged, White women. They had set up partnerships with several wellness organizations around town. They gave me a welcome packet with coupons for more than half off at the chiropractor. My pelvis was out of place after birth, so I went seeking relief. It worked out wonderfully for me, a White woman.
Once I was established as a regular patient, the chiropractor gave me coupons for introductory visits to give my friends and family. Wonderful. But this kind of friend-to-friend marketing tends to perpetuate racial divides, simply because our social circles are rarely as diverse as they ought to be.
Friend-to-friend marketing tends to perpetuate racial divides, simply because our social circles are rarely as diverse as they ought to be.
If word of mouth marketing from your existing patient base won’t increase diversity, then you are reliant on your print and web-based marketing. And here, again, my chiropractor’s office fails miserably. All the pictures are of White people. The web pictures, the marketing copy, the pictures posted in the office. Every — single — one. There’s not a sign at the door saying “Whites Only”, but there might as well be because a Black person walking in would quickly see that they are not the intended care-recipients.
The How and Why of Fixing This
If chiropractic care remains limited to White patients, then healthcare disparities will be increasingly exaggerated. Black populations already report higher levels of back pain and related disability — the primary condition that chiropractic care is known to alleviate. Not only is chiropractic care effective for spinal injuries, but it is also often far cheaper than conventional medicine. Given the lower income of Black populations, it could offer much needed financial relief as well as pain relief.
A 2019 report by the International Chiropractors Association and the American Black Chiropractors Association called for increased recruitment of Black students to chiropractic training. Certainly, more Black Chiropractors are needed. But it will be hard to convince someone to study chiropractic medicine if they have never had any experience with it. People tend to go into medical professions because they or their family members benefited from that profession.
To increase diversity among doctors of chiropractic, you need to increase diversity in the patients. I don’t know all the answers on this, but the principles are much the same as increasing diversity in other areas.
Approach the problem with humility. Admit that the fault lies within the White institutions. Check your own hiring, marketing, and outreach strategies to see where you have perpetuated White exclusivity. Then start making tangible changes. Stop hiring receptionists and assistants you already know, and cast a wider net. Hire a marketing consultant who knows how to craft messages for Black communities.
Ask the Black community what they would like to see. Partner with Black leaders — in this case, the doulas, yoga teachers, and pediatricians that the Black community trusts — to learn, build trust, and develop referral networks. Be willing to take your practice to their office to work in a space where their patients are comfortable. Expect to be met with skepticism initially. Stick with the relationships and show that you are someone who can be trusted to listen to Black professionals and Black patients.
Chiropractic care ought to be not only accessible but welcoming to everyone who needs it, regardless of race. Right now, it is not. But with some humility and intentionality, it can be.