Stronger at the Wrong End
The NBCE-FCLB merger is a defensible move. It is also a revealing one.
The National Board of Chiropractic Examiners and the Federation of Chiropractic Licensing Boards voted recently to merge into a single institution. The new entity takes the NBCE name. The FCLB continues as a department within it. The stated rationale is efficiency, shared mission, cost savings, and better support for state licensing boards. None of those reasons is wrong. The merger may well deliver on all of them. But the timing of a governance move is rarely the most interesting thing about it. What a profession chooses to consolidate, and what it leaves alone, is where the real story lives.
The two organizations share more than a mission statement. They share a position in the pipeline. NBCE administers the examinations that determine whether a chiropractic student can move toward licensure. FCLB supports the state boards that issue and oversee those licenses. Together, they govern the back end of the process, the stretch between a completed degree and a practicing chiropractor. Merging them creates a more coherent, better-resourced institution at that end of the pipeline. That is not nothing. Coordination between testing and licensure has real value, and the inefficiencies of running two separate organizations with overlapping governance have real costs. On its own terms, the merger is a defensible move.
The problem is that it is a move at the wrong end.
Chiropractic’s credentialing pipeline runs from admissions through education through testing through licensure. The merger addresses the last two. It leaves the first two exactly as they were. Admissions decisions still rest with individual institutions whose financial health depends on enrollment volume. Curriculum standards are still set by an accrediting body in an ongoing relationship with the schools it accredits. The 70% completion threshold, meaning the accreditation standard that defines success as graduating at least 70% of students within six years of a four-year program, still stands as the profession’s official tolerance for delay and attrition. None of that changes because NBCE and FCLB are now one organization.
What the merger does is make the back end more legible. It creates a single point of contact for state boards, a unified governance structure for the examination and licensure tracking functions, and presumably a stronger institutional voice in conversations about portability and reciprocity. Those are real improvements to real problems. But they are improvements to a part of the pipeline that was already more aligned than the part that the profession is not addressing. The exit had infrastructure. It now has better infrastructure. The entrance has a conflict of interest that nobody has formally named, let alone resolved.
This is worth sitting with because it is not unique to chiropractic. Institutions in any field tend to consolidate where consolidation is politically feasible, where the parties involved share enough common interest to make a deal, and where the gains are visible enough to justify the effort. Merging two organizations with overlapping governance and shared mission is the kind of move that produces agreement because everyone can see what they are getting. Restructuring the admissions model of tuition-dependent schools is the kind of move that produces resistance because everyone can see what they are losing. The merger happened because it could. The admissions problem persists because addressing it costs something the profession has not yet decided to pay.
The NBCE and FCLB leadership described the merger as consistent with how other regulated professions handle the relationship between licensing boards and national examinations. That framing is accurate as far as it goes. Other professions do consolidate these functions. But the comparison worth making is not whether the back end looks like other professions. It is whether the front end does. Medicine, dentistry, and osteopathic medicine all have standardized admissions thresholds that exist upstream of any individual institution’s enrollment decision. They have entrance filters that operate before the school has a financial stake in the answer. Chiropractic does not. A merger at the exit does not close that gap. It makes the exit more efficient while the entrance remains what it has always been.
The more useful analysis of this merger probably cannot be written yet. What a newly consolidated institution does with its position, how it uses its expanded governance structure, whether it turns its attention upstream or remains focused on the exit, that will take time to become visible. This essay will return to that question when there is something real to assess. For now, the merger is approved, the back end is stronger, and the front of the pipeline is exactly where it was. That gap is the story worth watching.
Dr. Glenn Jaffe is a chiropractor, practice owner, and national advocate with more than 20 years of experience in the profession. A former president of the North Carolina Chiropractic Association and a current national and legislative leader, he writes about leadership, cultural relevance, and the long climb of chiropractic and the work required for chiropractic to mature. He is the founder of BoldAzure, a leadership platform for chiropractors focused on identity, culture, and responsibility, both within the profession and individual practices.
Learn more at boldazure.com