Ronald J. Farabaugh, DC, a champion of integration and research, was honored earlier this year with ACA’s Chiropractor of the Year Award, recognizing his exceptional service, achievement, and leadership within the chiropractic profession. Over the course of his career, Dr. Farabaugh has embraced different roles and new challenges and opportunities to contribute in meaningful ways to improving patient care. In this interview, the ACA Blog explores how his journey began and how his enduring quest for knowledge, paired with a passion for sharing it, has guided him and continues to shape his work today.
How did you initially become interested in chiropractic and decide to become a chiropractor?
I remember it like it was yesterday. I was in my second year at the University of Pittsburgh, working my way through a pre-medicine curriculum. My dream was to become a surgeon. Then, I received a tragic phone call that would change my life. My father suffered a stroke. I raced home to visit him in the hospital, thankfully to find that the stroke was mild, causing only minor damage. When I inquired as to the cause of his stroke, the doctors informed me the drugs took his blood pressure down too low, causing the stroke. So, the drugs were discontinued. I was confused along with the rest of my family. Why? I was led to believe that the medication kept him “alive” for the past 15 years. Did he need the drugs or not? To further my confusion, after a lengthy discussion, the doctors related the fact that there was no way to predict what would or could happen to the human body when simultaneously ingesting numerous drugs. One drug affected his kidneys, one his brain, one his heart. In essence, the drugs never got to the cause, and the side effects could not be predicted.
Along with the rest of America, I never thought about the issue of “relief” of symptoms versus “cause” of the problem before this incident. “Cause” at that time in the healthcare environment was not an issue. Research on lifestyle modifications, diet, stress management, and proper rest was at an infantile stage. I knew drugs and surgery were important but wondered if there were any other alternatives. I began a search and embarked on a quest for knowledge that eventually led me to chiropractic.
The logic behind the healing power of the human body and its relationship with the brain, nervous system and organs simply made sense. The nervous system controls and coordinates every function of the body. Healthcare…a natural way! Was it possible?
I have never regretted the decision to enter the chiropractic field. I have been able to help thousands regain their health, naturally. In addition to my practice, I have been able to find another avenue to help not just my patients, but millions of other patients suffering pain. How? I became involved in local, state, and national organizations. Over my 30-plus year career, I have been president of Central Ohio Chiropractic Association and Ohio State Chiropractic Association. Additionally, Gov. Ted Strickland appointed me to serve on the Chiropractic State Board, where I was elected president in 2012. I was also appointed to and became chairman of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP; now Clinical Compass) in 2009. CCGPP is a group dedicated to advancing evidence-based chiropractic, charged with reviewing and developing guidelines for the chiropractic profession. I have been published in peer-reviewed journals many times regarding chiropractic case management and guidelines and pediatric care. The latest, in 2026, addressed adverse events related to spinal manipulation.
You began in private practice and later became vice president and national physical medicine director for Advanced Medicine Integration Group. What was that transition like?
After 40 years of practicing chiropractic primarily using the Gonstead technique, I was simply beat up physically. After six joint replacements, I had to admit I could no longer function as a full-time traditional chiropractor. God had a plan! The CEO of AMI called in 2015 and offered me a job as the national physical medicine director, managing chiropractic networks and the AMI Integrated Chronic Pain Program. I was at first skeptical of moving in this direction, but I investigated and found that AMI was different. AMI’s entire program is based on education related to documentation, coding, guidelines, and care management. I work directly with network chiropractors, physical therapists, massage therapists, acupuncturists, nutritional councilors, and nurse case managers to improve patient care and outcomes. As a medical director, we do not cut codes, cut fees, limit visits, deny care, preauthorize, or use arbitrary limits. We educate…period. I have been with AMI for more than 10 years, but I also missed patient care, so I went back into practice part time in December 2025. I love it!
You have had a long association with the Clinical Compass. What do you want people to know about the resources available to assist them in practicing in a more evidence-based manner?
The Clinical Compass (CC) team of researchers and volunteer leaders, in addition to the CC Evidence Center, is the best kept secret in chiropractic. This resolute team does what the average chiropractic does not have time to do…read! They dig through the mountain of published literature and summarize those papers into primarily systematic reviews and clinical practice guidelines. We are in a war and evidence/research is our best weapon. But we need a cultural shift in our profession. To stay current, you need to first want to stay current. It takes effort. Translating that evidence into knowledge and clinical utility is vital to help improve the outcomes of the patients we serve. If a DC remains uninformed, they risk becoming outdated.
You were recognized as Chiropractor of the Year in part because of your important work on the systematic view, “Cost of chiropractic vs. medical management of adults with spine-related musculoskeletal pain.” For our readers who may not be familiar with it, can you explain the significance of that paper and what it revealed.
This is one paper every DC should have in their own personal library. We compared chiropractic to traditional medical care and reviewed more than 2,200 papers dating back to 1991. The data was clear, when patients visit chiropractors, especially from the onset of care, it results in a rather dramatic reduction in downstream services and their associated costs. Downstream services include:
- opioids
- surgeries
- hospitalizations
- injections
- specialist visits including surgeon referrals
- emergency department visits.
Cost reductions are dramatic when patients choose chiropractic. Who the patient visits first matters!
The body of evidence supporting not only clinical effectiveness, but now the cost-effectiveness, of chiropractic services—especially for spinal conditions—has expanded significantly in recent decades. From your perspective, what is resonating most in healthcare circles and changing minds about the value of having chiropractors on the healthcare team?
We have never been in a better position to dominate the market when it comes to the treatment of musculoskeletal conditions, especially related to low back pain (LBP), neck pain, headaches, and sports injuries. LBP is the No. 1 cause of disability not just in the U.S., but around the world. If we became branded just for LBP, we would all need 10 associates. However, we are also better positioned to lead the brand in “personalized care with a whole-being care approach.” Chiropractic is not just about pain. However, we must focus on solving society’s problems, especially related to costs. Our message must be provided to unions, employers, legislators, and governmental agencies. We need to show those who take financial risk just how much they could save by encouraging chiropractic, for both acute and chronic care, and without barriers to access. We need an army of volunteers!
At ACA, you serve as chair of the Research Advisory Board, which has been active in the past year reviewing guidelines from outside groups seeking feedback from stakeholders. In general, what holes are you finding in existing guidelines?
The No. 1 deficiency in nearly every guideline we have reviewed is related to chronic pain. Most guidelines limit chiropractic to acute care, and a few visits for chronic care, making it nearly impossible in payor systems for a DC to manage a moderate or severe chronic pain case. If we want society to consume less drugs, less opioids, and have access to less expensive care, guidelines need to remove artificial barriers for patients to visit chiropractors. Fortunately, we have conducted the necessary research, it has been summarized, and guideline developers are beginning to consider that literature and will hopefully update their guidelines soon. It is an uphill battle, but research is on our side.
In respect to research, what questions does chiropractic, as a profession, still need to ask?
Important gaps remain in current research, particularly regarding specific populations, conditions, and outcomes. Addressing these gaps is critical to advancing effective care management:
- Populations
- older adults
- Medicaid users, and
- pregnancy.
- Conditions
- high-impact chronic pain
- chronic neck pain
- lumbar radiculopathy.
- Outcomes
- function
- value-based models
- quality of life.
- Other
- cost effectiveness
- patient safety
- quality of care
- system- and societal-level outcomes of integrating within healthcare systems
- concordance with guideline-recommended care (i.e., Do chiropractors adhere to guideline recommendations through chart reviews; and for those chiropractors who do adhere to guideline recommendations, are their patient outcomes and patient satisfaction different from chiropractors who do not adhere to guidelines?).
The future is filled with opportunity. Life is change; growth is optional! We need to support research initiatives. And as new research emerges, we need to embrace that knowledge, even if it challenges existing practice habits and care management strategies.
For students or early-career chiropractors interested in research or integrative leadership, what experiences or skills should they prioritize?
Just remember that in five years you will be the product of the books you read and the people with whom you associate. So be careful of the friends you keep. I personally could never have accomplished much in chiropractic without following the leadership of those who came before me, and those willing to mentor me in areas with which I had little experience. If you want to accomplish anything big in life, surround yourself with people way smarter than you! In keeping with that philosophy, I brainstormed the answer to this question with a few exceptional leaders of the Clinical Compass. Allow me to offer a few suggestions:
- Apply for postgraduate VA or hospital residencies.
- Apply for research/policy fellowships.
- Identify mentors.
- Follow the CARE checklist and draft a case report for publication.
- Read lots of articles.
- Join and participate in organizations such as Student ACA and the American Public Health Association, and the North American Spine Society (NASS).
- Attend scientific meetings—NASS, Association of Chiropractic Colleges Research Agenda Conference (ACC-RAC), Academic Consortium for Integrative Medicine & Health, International Society for the Study of the Lumbar Spine (ISSL), World Federation of Chiropractic, American Public Health Association.
- Volunteer and follow through by delivering—bodes well for leadership experience.
It is important to find alignment between your own interests, your mentor’s expertise and experience, and the priorities of funding agencies. When these elements are aligned, motivation and support are stronger, increasing the likelihood that a project will be carried through to completion.
Lastly, do not make this about solving chiropractic. Seek mentorship broadly, across a variety of disciplines, and solve societal problems like runaway costs of spinal conditions. Be okay with uncertainty. Realize the work is never done!
