When asked what challenge chiropractic practices are underestimating in 2026, Erik Kowalke, DC, Owner of Higher Health Chiropractic Michigan and Founder/CEO of SKED, didn’t hesitate. 

“The cost of labor,” he said. “Not just the cost of finding new qualified employees and team members, but the cost to keep the ones you have.”

He went on to note that, as inflation increases, practices can’t expect to keep wages stagnant without losing talented staff. 

“Everything costs more — buying a home, filling your fridge, getting gas,” Dr. Erik explained. “Employers are offsetting that by increasing benefits and pay. 


If chiropractors don’t follow suit, their team members will find a job somewhere else.”

Making matters worse, patients also expect more convenience than 
ever before. 

“You can get a toothbrush from Amazon delivered to your door within six to eight hours,” Dr. Erik said. “Costco deliveries come to your door. Target deliveries come to your door. You can even get your car filled up in your driveway.”

“But patients go to their chiropractor, and it’s massively inconvenient,” he added. “If they want to change their appointment, they have to call. They don’t have to call anybody else, but they have to call their chiropractor. A lot of them stop coming in because it’s causing so much friction in their lives, and their chiropractor has no idea why they lost that patient.”

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So, if it costs more to keep the same team, and patients expect more from you, how do you continue growing your practice without breaking the bank?
If your instinct is simply to work harder, Dr. Erik warns you’re headed for disappointment.
“If you just keep doing what you’ve always done — but just push more — 
I think you’ll see similar results,” he explained. “Just working harder is not going to help.”

The key to thriving despite these challenges is providing your team with the tools they need to get more done with less effort. 

“If you have better systems and better software, it takes less work to manage everything,” Dr. Erik said. 

If you’re skeptical of this solution, Dr. Erik understands your hesitation.

“A lot of the software chiropractors use to run their practice are just out of date,” he explained. “So, you have all these systems and workarounds to ensure you have accurate information, and that takes a lot of manpower and time to maintain.”

But software that uses modern technology, like AI, is helping businesses in every industry become more efficient — and the chiropractic space will be no exception.

“We’re going to see a shift from looking at software as a want to a need,” Dr. Erik said. “The value is going to be so high, you’ll have to have it to run a successful practice.”

“Instead of having software that helps somebody do a task, we’re going to start seeing software that does the task for you and makes decisions on your behalf,” he added. “That’s a big change.”

One of the biggest reasons chiropractors hesitate to adopt AI and other tools is their concern for how patients will react. 

“We often wonder if we can keep that family feel in our office if a patient calls in and, instead of Mary answering at the front desk, they speak with an AI representative,” Dr. Erik noted. “I think five years ago, maybe 20% of patients would have accepted that. In 2026, I think that’s going to be closer to 80%.”

As AI makes its way into many different areas of our lives — from social media platforms to search engines and more — patients will become increasingly comfortable with it.

“People are using AI and LLMs to look for information more and more,” Dr. Erik said. 
And in many cases, AI can provide a better patient experience than what patients are currently getting.

“The technology has improved a lot,” Dr. Erik explained. “And the customer service for most businesses in the U.S. is fair to poor. What we’re seeing now is the service with AI bots in some cases is better than speaking with a human, which has never been the case before now.”

Practice owners are likely to find the experience is better for them, as well. 

“This technology will adhere to the office’s policies more than most team members will,” Dr. Erik said. “We’ll have AI representatives that say exactly what you want them to say and say it how you want it said. That’s something we haven’t experienced as business owners.”

Dr. Erik doesn’t just tout the benefits of technology in theory. He uses it in his own practice every day.

“We’re focused on giving an extraordinary patient experience, which means making everything convenient from the moment they schedule,” he said. “Over 80% of our new patient appointments are scheduled online outside of our business hours. They can fill out and submit paperwork and insurance through their phones.”

“We’ve reduced a massive amount of friction that might keep them from coming into our office. We make it really easy and low stress,” he added. 

If you’re feeling overwhelmed, Dr. Erik has a simple, practical solution for identifying areas where you can make the most significant improvements in your patient experience. 

“Audit your current process,” he suggested. “Pretend you’re the patient looking for your office. Search for your practice on Google using incognito mode so it doesn’t know you’re the practice owner. Search the stuff a new patient would search for. How difficult is it to find your practice? Do you even show up?”

“Then, go through the whole process,” he added. “Schedule the appointment. Fill out the paperwork. Go all the way through coming into the office. Find out how difficult or simple that process is.”

“Most people think they have a good process, but there’s more friction than they expect,” Dr. Erik explained. “Just spend an hour going through the whole process, and you’ll find things you can improve. That will help you a lot 
this year.”