What Problem Does an Association Solve?

Editor’s note: This is part 1 of a three-part essay series, The Association Problem.

I don’t see the problem the same as some of my colleagues in leadership.

Associations are struggling; that much is hard to miss. Membership is harder to hold onto, dues revenue doesn’t stretch the way it used to, and even the basic rhythm of organizational life feels more strained. Conventions are now one option among many competing for time, volunteer leadership is harder to recruit, and groups that once naturally sat at the center of a profession now share attention with a growing field of other organizations, platforms, personalities, and loosely formed communities. The explanations come quickly: people are apathetic, younger generations don’t join things, everyone is busy, social media has scattered attention in a thousand directions, and nobody wants another meeting at the end of an already full day. There’s probably some truth in all of that, but it never quite feels like the full story.

Apathy, especially, feels like an easy answer because it turns a complicated shift in behavior into something almost moral: people stopped participating because they stopped caring. Maybe some did, but that explanation doesn’t hold up for long when the same people who are supposedly disengaged will spend a Saturday at their daughter’s soccer tournament, fly across the country for a concert, sit through three days of a technique seminar, join private online groups, listen to hours of podcasts every week, pay for coaching programs, or plan a golf trip months in advance. Their attention didn’t disappear; there are simply more things competing for it and far more places to spend it. An association meeting without continuing education attached isn’t competing with an empty calendar. It’s competing with family, rest, travel, work, hobbies, children, other professional events, and sometimes just the desire to not spend another day inside the same professional world that already fills the week.

That changes how decisions get made. Most people don’t carefully weigh the long-term health of institutions when deciding what to attend. They look at what is in front of them and make a fairly quick calculation about what they will get from it, who will be there, whether they need it, and whether it justifies stepping away from everything else. We’ve become very efficient at sorting information and opportunity, which is probably necessary given how much of both comes at us every day. The problem for an association is that something whose value takes longer to explain begins at a disadvantage. A convention featuring a speaker you want to hear gives you an immediate reason to go, just as a weekend with your family gives you an obvious reason not to. An organization asking for your time because its strength may matter to the profession five or ten years from now requires a different calculation, one whose benefit is much harder to see in the moment.

Even that doesn’t fully explain what’s happening. Competition for attention can explain why someone skips an event, but not why associations, civic groups, fraternal organizations, and other once-central institutions seem to be dealing with similar problems. A few generations ago, joining was one of the primary ways people entered a community. Churches, lodges, unions, professional societies, local clubs, and civic groups connected people to information, relationships, identity, status, opportunity, and belonging. They occupied that role partly because there simply weren’t many other places to find those things.

Professional associations grew inside that world. A chiropractor decades ago didn’t have a dozen different professional communities available at any moment. Information moved slowly, geography mattered, and seeing colleagues usually meant traveling to them or waiting until everyone gathered in the same place. Professional conversation happened in those rooms because that was where the profession could actually gather. Education required putting people together physically. Even a journal arriving in the mail carried weight because there was no constant stream of opinions, research, arguments, updates, and technique videos arriving throughout the day from people scattered across the country. The association didn’t have to persuade anyone that it was one of the places where professional life happened because there were relatively few alternatives.

That world changed gradually. Information moved online, education became portable, relationships became less dependent on geography, and professional conversation no longer had to wait for the next convention or district meeting. A speaker someone once waited a year to hear might now be available on a webinar next week. A question that once sat unresolved until doctors gathered can now be put in front of hundreds of colleagues and answered the same day. The people you used to see a few times a year may now be people you communicate with regularly without ever being in the same room. None of this required an association to fail. Other ways of doing many of the same things simply became easier, faster, and more convenient.

That makes the usual explanation feel incomplete because it assumes something changed within the association that caused people to move away from it. In many cases, the larger change may have been that people no longer needed the association to do as many things for them as they once did.

Every institution begins because something doesn’t work well enough when people try to handle it individually. A group encounters a problem that requires coordination, so some kind of structure forms around the response. That sequence becomes easy to forget once an organization has been around for several generations. We inherit the bylaws, committees, meetings, publications, and traditions, and those visible pieces gradually become confused with the reason the institution exists, even though most of them developed because they addressed particular needs at particular times.

A professional journal, for example, provided a reliable way to distribute information to doctors who otherwise had few efficient ways to receive it. A convention addressed several needs at once by concentrating education in one place, bringing colleagues together, exposing members to leadership and new ideas, and connecting doctors who might otherwise have little contact with one another. District meetings brought communication closer to home while creating opportunities for local leadership and giving newer doctors a way into an established professional community. Committees, leadership programs, continuing education, and publications developed for similar reasons. They were not arbitrary features of an association; each one answered a need that existed when it developed.

Over time, institutions accumulate these solutions. One responsibility leads to another, and the organization gradually becomes identified with everything it has learned to provide. An old house offers a useful comparison. Rooms are added over decades, a porch gets enclosed, a garage appears, another room gets built onto the back, and eventually someone looking at the finished structure may have no idea which part was there at the beginning. The additions are real and useful, but their familiarity can make them seem foundational even when they were not part of the original reason the house was built.

Professional associations followed a similar pattern. As they addressed more needs, more of professional life ran through them. Members received information and education there, built relationships there, found leadership opportunities there, and relied on the same organization for political representation. Membership made sense partly because so many different parts of professional life were tied to it.

Associations still publish, hold conventions, provide education, and create opportunities for members to connect, but none of those functions belongs primarily to the association anymore. Information appears online as events happen. Education comes from many providers in many formats. Professional conversations move through private groups, text threads, social media, podcasts, and other forums. Relationships can be maintained without waiting for the next meeting. The association can continue offering all of these things, but members no longer depend on one institution to provide them.

It also means a broad professional organization is competing with groups built around much narrower purposes. A seminar company can devote itself almost entirely to education, a practice consultant can concentrate on business problems, and an online community can focus on keeping people talking to one another. The association is still capable of providing education, business resources, community, and professional connection, but it now provides them alongside organizations designed to concentrate on one piece of what once existed under a common roof.

Some of what associations are experiencing is plainly decline. Membership and financial strain matter, and an organization that cannot recruit enough people to govern it has a real problem. But losing a former function to another provider does not necessarily mean the institution has lost its reason for existing. It may simply expose the difference between the activities an organization accumulated over time and the problem that required a collective in the first place.

That distinction leads to a more useful question: if all of these activities developed because they solved problems, which problems still require an association?

A chiropractor who needs education can choose among courses, seminars, webinars, and other sources. Someone looking for community can find groups inside and outside chiropractic. Mentorship can come through relationships that have no institutional connection, professional conversation already happens in many places, and even leadership experience can be developed through organizations other than the state association. None of those needs has disappeared, but an individual chiropractor now has several ways to address them without depending on one particular organization.

Representing an entire profession before a legislature is different. One doctor cannot maintain all of the legislative and regulatory relationships needed to represent thousands of chiropractors, just as one practice cannot reasonably track proposed rules, insurance changes, committee hearings, and legislation while also running a business and seeing patients. Individual doctors can and should participate in that work, but participation by individuals still requires coordination if the profession expects to have a consistent presence over time.

These are collective problems because the outcome applies across the profession regardless of which individual doctors participated in producing it. Scope, licensure, reimbursement policy, and regulatory language are not things one chiropractor can solve for himself and then carry home to his own practice. Whatever happens applies much more broadly, which is precisely why an organized response is necessary.

That is close to the problem chiropractic’s early organizations were trying to solve. Chiropractors were being prosecuted for practicing medicine without a license, which made legal defense, recognition, licensure, and political organization practical questions about whether and under what conditions the profession could operate. An individual doctor could defend an individual prosecution. Establishing a legal place for chiropractic required people to organize beyond the individual case.

A century later, the issues are different, but the category of problem remains. State associations work on reimbursement, scope, regulatory language, board decisions, administrative rules, and legislation that may affect practice throughout a state. Most doctors will never read the proposed rule or sit through the committee hearing where it is discussed, but they will still practice under whatever comes out of that process.

At the same time, many of the more visible reasons people once experienced an association now have alternatives. Doctors can obtain CE elsewhere, find community elsewhere, read professional commentary elsewhere, attend events run by other groups, and develop meaningful professional relationships without ever entering an association meeting. As those activities move into other settings, the attention around them moves as well, but the legislative and regulatory responsibility does not automatically move with it.

An online group may influence what thousands of chiropractors think without assuming any obligation to represent them before a legislature. A podcast can shape professional conversation without maintaining relationships with lawmakers, and a seminar company can care deeply about chiropractic without monitoring proposed regulatory language that may affect every licensee in a state. Those groups may have substantial influence within the profession, but influence and responsibility are not interchangeable. The fact that doctors increasingly look elsewhere for education, conversation, or community does not transfer the responsibility for collective representation to the places receiving that attention.

That may be why some of the usual arguments about association relevance miss the issue. Questions about whether the convention is good enough, whether the CE is engaging enough, or whether the networking is worth the time are reasonable when someone is deciding whether to attend or purchase those things. They become less useful when the question is why the institution itself remains necessary.

The more revealing question is which problems still require the profession to act collectively. Once the activities that can be obtained elsewhere are separated from the problems that cannot be handled individually, advocacy and protection of the profession begin to look less like another program offered by the association and more like the work for which the association remains difficult to replace.

That does not make the association problem easier. Many of the activities that once gave members regular, visible reasons to participate now compete with alternatives, while the legislative and regulatory work continues to require staff, relationships, organization, time, and money whether most members ever see it happening.

If this is the problem only the collective can solve, what keeps enough people inside the collective to keep solving it?

Dr. Glenn Jaffe is a practicing chiropractor with more than twenty years in the profession. He served as president of the North Carolina Chiropractic Association and has worked at the national and legislative level on the profession's governance priorities. He is the founder of BoldAzure, a leadership platform for chiropractors. He writes about where the profession is, how it got there, and what maturation actually requires.

Learn more at boldazure.com