When Licensing Becomes a Cartel
Originally published: 2025-08-25
The Problem with Professional Licensure
Professional licensure is often justified on the grounds of protecting the public. But as an OECD/FTC/DOJ competition policy report makes clear, licensing regimes frequently go far beyond legitimate safety concerns. Instead of protecting patients, they protect market incumbents.
“Excess qualification limits … restrict entry, inflate prices, and enrich professionals without improving consumer outcomes.”
This observation rings true in chiropractic, where the Council on Chiropractic Education (CCE), the National Board of Chiropractic Examiners (NBCE), and the Federation of Chiropractic Licensing Boards (FCLB) have built an elaborate licensing machine that serves their own interests rather than the public.
Conflicts of Interest in Self-Regulation
The report also highlights the structural flaw of self-regulation. Licensing boards, often stacked with members of the very profession they oversee, become conflicted enforcers.
“Boards comprised largely of market participants are prone to conflicts of interest, undermining their claim to act in the public interest.”
Chiropractic’s regulatory framework is no exception. By outsourcing authority to the CCE, NBCE, and FCLB—private corporations run by insiders—state boards have effectively abandoned their responsibility to regulate in the public interest.
Lessons from the AMA Conspiracy
The report recounts the infamous AMA campaign against chiropractic. Through its “Committee on Quackery,” the AMA conspired to “eliminate the chiropractic profession,” ultimately found guilty of antitrust violations.
“Professional conspiracies against chiropractic were judged unlawful restraints of trade.”
History now repeats itself—but this time, the threat comes from within. Instead of medicine seeking to eliminate chiropractic, chiropractic’s own cartel seeks to eliminate competition, marginalize dissenting voices, and restrict the freedom to practice.
Why Antitrust Matters in Chiropractic Today
The FTC has already warned against professional boards that abuse their authority to restrict competition. Courts have stripped away state-action immunity in cases where boards acted more like trade associations than public servants.
Chiropractic’s cartelized licensing system—built around NBCE exams mandated by CCE accreditation and enforced by FCLB-aligned boards—looks no different. It is a closed loop that enriches insiders, blocks innovation, and raises costs for students and patients alike.
“The evidence shows licensing often harms consumers, restricting access and raising prices without measurable quality gains.”
A Path Forward
The competition policy report recommends more consumer representation on licensing boards, open recognition of alternative pathways, and critical review of laws granting exclusive control to a single profession.
In chiropractic, that means dismantling the stranglehold of the CCE, NBCE, and FCLB. It means allowing alternative accreditors, alternative exam pathways, and restoring state boards to their rightful role as independent public regulators—not handmaidens of private corporations.
Bottom line: Antitrust authorities have already identified the very problems we see in chiropractic today. Licensing has become a cartel. The solution is not to double down on failed structures, but to open the doors of competition, restore fairness, and put the public interest first.
