Dr. Jeremy Brubaker

Where do I start? The all consuming, burning question of all fledgling Chiropractors. Our generation is hoping that apple may have an app for that coming out. After speaking and listening to you, the future of our profession, voice your fears about starting a chiropractic practice, it is horribly apparent that no one is addressing your concerns.

Just go, Google, and try to find good information on starting a chiropractic practice. Aside from a few student forums, several periodic articles and some sites by disgruntled MD’s and DC’s bashing our great profession, there doesn’t seem to be many content rich sites out there for us.

Now there are several companies that put out information such as dynamic chiropractic and Chiro-Economics which often have good content occasionally on this subject, but it’s truly a challenge to find trust worthy materials on a consistent basis.

In the past I’ve stated my love for this profession and how the future of it depends on you! While practicing chiropractic you get to see the true results and the impact the doctor of chiropractic makes to patients lives and their futures, (the exact reason you are in college). If we continue to graduate boat loads of Chiropractors and not equip them for the realities of small business management and productivity, we’ll will continue to see the 82 or so percent of practicing D.C.’s struggle to pay their bills. That my friends, is not making an impact on peoples’ lives or preserving our profession. Helping new doctors succeed what drives me to take the time to give you this blog. Let’s get to some meat and tators.

Here are some of the things I wish someone would have taken time and talk with me about in Chiropractic College. No one did it for me, so let me do it for you.

TOP 10 THINGS I WISH I’D KNOWN IN SCHOOL

10. Where I’m going to practice?
- Is it a good market, (what is a market?)
- Location in market

9. Business Plan
- How am I going to start?
- Plans & Goals for my practice
- How to write an effective business plan

8. Financing
- How to get a bank to loan money
- Why good credit matters
- How to fix my credit while still in school

7. What’s the best business structure?
- LLC, SUB – S, Sole Prop.
- Which is the most tax friendly

6. What do I need to look for actual building?
- Stand alone or strip mall
- Layout, patient flow
- Permits, leases, equipment
- Buy vs. lease

5. How is office going to run
- Office protocol
- Patient flow
- When, where
- Don’t shoot from hip

4. Staff – manage staff
- Need Staff – the most important part of practice
- Great Doctor, poor staff, poor practice
- Hire, fire, pay, motivate
- Referrals to office

3. Marketing – where are patients coming from
- Newspaper, screenings, yellow pages, TV, mailers
- What is effective, getting folks to your office for help

2. Insurance – Taboo, don’t talk a lot about in school
- Know the rules, how to play
- Every state is different
- How to teach someone else how to deal with them
- How to get paid if you want to stay in practice

I don’t want to overwhelm you, but when you get out of school, it’s flat out overwhelming.

…..and the No. 1 thing I wish I’d know when I was sitting in your shoes..

1. There are people out there who want to help you.
- Other docs, mentors, visit/observe them… Read their blogs!
- Professors @ Chiro School: Great resource when in practice as well
- Management groups
i. Good ones, Great ones, and ones to run from
ii. Who’s there to help and who’s there just to make money
(When I was in school I thought they were all out for $)

We are going to explore each of these over the next few posts! Believe it or not from just reading this list you will be further ahead of where I was while sitting in student clinic.

Question: What area are you in need of knowledge, and what do you plan to do about it?

Making your way through Chiropractic College, the furthest any of us typically see ahead of us is tomorrow. Our thoughts are constantly, what do I need to study, which tests are coming up and how am I going to stay awake during microbiology. Although there are always a few exceptions, most early quarter/tri chiropractic students are all thinking the same type things. I’m ashamed to say, I too was busy memorizing and regurgitating facts and physiological functions and not asking the right questions. During college there will always be guest speakers coming on campus, preaching this and selling that. There’s one or two that years later I still remember. Dr. Guy Riekeman, now the president of Life was talking about knowing what you know, knowing what you don’t know, and not even knowing that you don’t know. Love or hate Dr. Riekeman, the man makes you think and ask questions. Therein lies one of the greatest pieces of advice I was given as a chiropractic students…Ask questions.

Don’t act like you know it all when you don’t!

My favorite book often speaks about the power of humility and the knowledge that follows. That’s a tough sell for educated and motivated new Doctors. Not even knowing that you don’t know is what us as students should be most ashamed of. It’s typically not until after graduation and staring student loan repayments in the eye that the real questions start to fly:

* Is a strip mall next to chucky cheese a good location for a chiropractic practice?
* Why is a commercial lease so expensive?
* Can lottery winnings be used as start up cash?
* Where’s the express Medicare application?
* Is a NIP Number important?
* And the most important question, should I wear sneakers or sandals in the office?

Now if haven’t begun asking yourself these sort of things, well…It’s time to expand those concepts and jump out of your box of knowledge into another realm.

Oh, by the way…the answers.

* No, not a good idea next to Chucky
* EVERYTHING commercial is ridiculously expensive
* Yes, you can use lottery winnings as start up cash (But you’ll need to be struck by lightning 7times before that happens)
* There’s NOTHING express when dealing with Medicare
* Yes, it’s important and it’s a NPI number (not NIP, that’s something completely different)
* Neither, I find Bass Shoes the most comfortable and cost effective dress shoes (clearance rack of course).

Whew, glad we got that straight!

It would be great to say that chiropractic students looking to start a chiropractic practice are asking even silly questions like these early in Chiropractic College. Reality is that it’s fast and furious, by the seat of your pants toward and after graduation (At least it was for me). By the time that last quarter/tri rolls around most students are too ashamed to admit that the need help and to fearful to ask dumb questions. For me, I didn’t know who to trust.

The greatest thing about this blog is… who cares if it’s a dumb question; Lord knows I should have asked a heap of them prior to signing the lease for my chiropractic practice. If you agree to be honest with yourself and not kid yourself, I’ll agree to field your concerns, fears and questions with real life success. Now let’s have it.

Question: What are you scared or embarrassed ask?

“Your potential greatly exceeds your concepts of today” – Thomas A. Owen III

Let’s just get real and not kid ourselves here. All doctors especially myself, coming out of school tend to know more about everything than anyone who has ever been in this profession before. Personally, I’m the biggest do it yourselfer ever. There’s nothing I won’t try to do myself, and when I think I know something about it, no one can do it better. Although confidence is an essential part of being a leader, and all health care providers need to be one, there comes a time when confidence becomes ignorance and then you learn those valuable and often painful lessons (you wish you never had to learn). The most difficult part for me is then admitting that someone, particularly my parents, may have been right about something. Now I’ll never admit on record, and you can’t make me admit, that I was wrong and they potentially may have been correct. We’ve all been in that position at some point.

Now, there are several things that I absolutely love in life. Number one is the Lord and our Savior, number two is my family (my awesome wife, my best buddy (my 5 year old son) and of course Jake the dog). Number three is Chiropractic, every facet of chiropractic. The process of opening my office was a blast, sheet rock, paint, leases, equipment, marketing (did I mention I’m a do-it-yourselfer). Day to day patient care and the bodies healing ability is absolutely amazing to experience. The business end of the practice is also a favorite of mine, managing the nuts and bolts and actually earning a profit from serving others is incredible. There is no reason that every student coming out of school can’t achieve the success we’ve found in chiropractic.

The one thing that did hold me back and delay the opening of my chiropractic practice for a year was my absolute Ignorance of what awaited me after the stroll across the stage at graduation. Our office has always been open for other doctors (even the guy down the street) and we love students to come and observe ask the questions I should have asked before throwing my cap in the air. The problem with answering doctors and student question that way is that you would have to come to my office for the information, and Pennsylvania in the winter time…well some folks like it.

Have you tried to find answers and information about opening a successful chiropractic office, or any helpful information for a chiropractic student without someone trying to sell you something? I know I didn’t and haven’t found any up to date other than one or two articles from the ACA or a chiropractic periodical. With National health care staring us in the face, if we don’t come equipped out of school ready and willing to make our mark, we as professions are in trouble! No pressure… students! If any there was a time for the next generation to step up this is it baby.

It is my hope that this blog will be for you, what I was dying for as a student. I’ll never claim to be an all knowing resource; even I am not that Ignorant to think I know it all. One thing I’ve learned is to ask those who have gone before me and learn from their failures and triumphs so that I reach my goals as quickly as possible without the costly regrets and errors they have made. I read a quote one time from Dr. Jim Saeli that said “Success leaves a path…Follow it”. Every new grad does not need to and shouldn’t have reinvent the wheel. This blog is an opportunity for you to interact and ask questions of someone who has been there and has succeeded. I love this profession and do not want to see the next generation of chiropractors fail simply because they didn’t have an opportunity to ask questions and find the resources necessary for success. Asking even dumb questions, is better than the being the ignorant know it all chiropractor, using my original method of trial and error.

Question: What is the most important questions that chiropractic students never ask?

p.s. You only get one life to be happy and make a difference, don’t waste it!