Investors and other buyers looking to purchase a chiropractic business often email us to ask "Can a non-chiropractor own a chiropractic practice?"
The quick answer is that in approximately half of the states, it is legal for a non-chiropractor to own a chiropractic practice. And of course, that means that the other half of the states do not permit non-DC ownership. So the best answer is: it depends.
Nationwide Trends in Non-Chiropractor Ownership Of Chiropractic Offices
When I originally wrote this post several years ago, it was to have a quick way to point sellers, buyers, investors and other interested parties to getting more information on whether or not a chiropractor could own a chiropractic practice. The concept of the “corporate practice of medicine” (CPOM) was a relatively quiet issue discussed infrequently in chiropractic.
Since that time, there are a few distinct trends that are happening nationwide:
- The number of non-chiropractors interested in purchasing chiropractic practices has significantly increased.
- Like other healthcare professions, franchises are growing in popularity in chiropractic.
- Corporately owned and managed chiropractic practices are also increasing in number.
- Non-clinician ownership/control is facing tighter scrutiny in state chiropractic boards.
- Increased enforcement against fee-splitting and sham MSO structures is occurring.
- More explicit regulation of chiropractic boards and disciplinary authority regarding non-chiropractor owned practices is increasing with a number of bills being introduced in multiple states.
Today’s Practice Reality of a Non-Chiropractor Owning a Chiropractic Business
In 2026, there are effectively three categories of states that now exist with respect to a non-chiropractor owning a chiropractic practice and rules governing the corporate practice of medicine (CPOM):
Category I: Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Strict CPOM States that require DCs to own-operate chiropractic businesses.
Category II: Â Â Â Â Â Â Â Â Â Â Â Â Â Â Moderate CPOM States that permit non-DC ownership through a compliant management structure
Category III: Â Â Â Â Â Â Â Â Â Â Â Â Â Flexible CPOM States that permit direct ownership by anyone with a few legal safeguards in place
How Chiropractic Franchises, Multi-Disciplinary Practices Get Around this Rule
The primary reason that the answer to this question is not a fixed one is the fact that each state can establish its own set of rules or requirements regarding if a non-chiropractor can own a chiropractic practice. But a quick survey of businesses in any given state will reveal that there are chiropractic franchises and multi-disciplinary practices being operated and owned by non-chiropractors. So how do they get around this rule?
The answer is fairly simple -- the legal structure of the business ownership. While I'm not an attorney and not privy to the exact details of how the legal structure workaround takes place, but a simplistic explanation is that a management entity corporation is created to own the chiropractic practice. That management company is "owned" by a chiropractor or chiropractic group. The actual business can then be owned and operated by whoever underneath that management company – often called a Management Service Organization (MSO).
In this way, MSOs are commonly used to navigate around the Corporate Practice of Medicine rules in that state, which include the practice of chiropractic. Legally, the MSO is a business separate entity that is owned by non-chiropractors and the MSO provides administrative and non-clinical services to a chiropractic practice. Typically, these services would include things billing, marketing, human resources, information technology support, facilities management, and equipment leasing – anything short of actual clinical decision making.
To be clear, the MSO does not practice chiropractic; the clinical practice remains owned and controlled by licensed chiropractors. This structure allows non-chiropractors to invest in the business side of healthcare while maintaining compliance with ownership regulations.
Depending on whether the management company is a franchise, an individual investor or some other variation on the theme, the business (owned by the non-DC) pays the management company a flat fee, salary structure or some other arrangement for their ownership and management of the chiropractic practice.
This is how chiropractic franchises such as The Joint Chiropractic® and similar businesses operates in every state and why non-DCs own those franchises, even though they may be located in a state that does not permit a non-DC's to own a chiropractic practice.
Which States Do NOT Permit a Non-Chiropractor to Own a Chiropractic Practice
In their franchise disclosure document, The Joint Chiropractic® points out which states would require setting up a separate entity to get around the issue of non-DC owners. (see link), According to their research, the following states forbid non-DC ownership and would generally fall into Category I or Category II:
- Arkansas
- California
- Colorado
- District of Columbia
- Florida
- Hawaii
- Illinois
- Kansas
- Kentucky
- Maryland
- Michigan
- Minnesota
- New Jersey
- New York
- North Carolina
- Oregon
- Pennsylvania
- Rhode Island
- South Dakota
- Tennessee
- Vermont
- Washington
- West Virginia
- Wyoming
Accordingly, in these states, you would have to set up a management entity to legally work around this issue.
Which States ALLOW a Non-Chiropractor to Own a Chiropractic Practice
These states fall on the other side of the fence and, at this time, do not have any rules expressly forbidding a non-chiropractor to own a chiropractic practice and would typically fall into Category III States:
- Alabama*
- Alaska
- Arizona
- Connecticut
- Delaware
- Georgia
- Idaho
- Indiana
- Iowa
- Louisiana
- Maine
- Massachusetts*
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Mexico
- North Dakota
- Ohio
- Oklahoma
- South Carolina
- Texas
- Utah
- Virginia
- Wisconsin
*Alabama and Massachusetts fall in between and permit a non-DC to own a practice, but require a special permit or registration.
Important Things To Note
Here are a few important reminders about the concept of whether a non-chiropractor can own a chiropractic practice:
- Even in “allowed” states, non-clinicians usually cannot control clinical decisions.
- Many states require a licensed chiropractor to serve as clinical director or own the professional entity.
- Franchise and private-equity models often use MSO (Management Services Organization) structures to comply with state law.
- Rules change frequently through board opinions, attorney general guidance, and legislation.
Do Your Due Diligence
The intent of this article is to help both chiropractors looking to sell their practice and buyers looking to purchase a chiropractic practice navigate the issue and answer the question "can a non-chiropractor own a chiropractic practice?"It is NOT intended to be legal advice and the information above can change within a moments notice, so it is upon you to verify its accuracy. In other words, to definitively answer this question, you should do your legal research to confirm this info with the state you wish to own a practice.
Additional Resources
Looking to buy a chiropractic practice? Check our current listings of chiropractic practices for sale or you can learn more through our FREE Videos for Buyers.
Thinking about Selling your practice? See the path to a successful practice sale or transition or if you’d like to dive deeper,  check out our FREE videos where we teach the strategies behind successfully selling (or slowing down) your practice, without making costly mistakes!
