Why Should You Start a Chiropractic Practice?

Recently, a brand new doctor of chiropractic said to me that coming out of school he didn’t feel qualified to start his own practice and that he should associate for a while before trying it on his own.  What do you think?  Could that be fair to say of the majority of new graduates?

Unfortunately this is not the first time I’ve heard this kind of statement.  Being around this profession long enough, I would have to agree with his fear and reservation coming out of college.  My question is, if this is a common scenario could there be a solution to overcome it?

We all know new chiropractors that come out of school and open their own chiropractic offices and have great success.   Are they special, gifted or privileged?  Or have they just by chance found the keys while in school and simply applied them after graduation with a predictable result?

How many of you have seriously looked into associate positions? If you have then you’ll agree that finding a associate ship with a fair salary with a doc willing mentor you to prepare you to leave their practice and open up your own practice really don’t exist.  Now there may be one or two exceptions where the lead doctor loves to mentor and develop the next generation of the profession.  God Bless them and there needs to be more of them.  But think about it, as a business owner are you going to pay someone with no experience and train and mentor them for a year or two, and just when they may start to bring a profit in for you they leave and open their own business.  No wonder there aren’t good associate positions out there.  They don’t make any sense for a businessman.

Where does that leave you, the insecure new doctor?  Honestly it leaves the responsible directly where it always should be, on you! Ooh did you expect that?  Don’t for a second kid yourself and think someone else is going to pull you up.  Has anyone taken an exam for you?

The sooner you realize if it’s going to be it’s up to me. Then you’ll be the one searching out the answers in first or second quarter and gathering the education you’re not going to get while at chiropractic school.  You’ll come out of Chiropractic College with confidence and a plan.

Question: Why would you spend 1-2 years working for peanuts, not being truly mentored or appreciated, only to start a practice and do everything you would have had to do 1-2 years ago?

p.s. I’m willing to share the keys to success, but you need to take the step and ask…I’m here for you.

Chiropractic Practice: What business are you getting into?

We are no longer in the age where the doctor knows best, is a family friend and never questioned. So the question is, what type of business are we in and how do we function in it.  Be honest, most of us are not naturally business minded, we are more mission minded and health conscience.  That’s why you’re in chiropractic school and why we become chiropractors.  As you are well aware, most chiropractic colleges cannot give us the business education we need, and honestly they shouldn’t.  They are not business colleges, they are chiropractic colleges.  It would be like going to your cardiologist for an atlas adjustment, it just doesn’t make sense.  First off, as chiropractic students and doctors we are inundated with management and consulting companies trying to give us business help.  What I’m going to say next may shock you, especially those of you who knew me in school.  I say thank goodness and thank God for some of them that help us become successful.  Now be careful who you deal with, just like anything in life, but don’t rule out all of the folks out there to help you based on a couple knuckle heads.

We’ve been blessed to have a great experience when it comes to getting help in practice and we were taught by one of my mentors the essence of the business we are in.

To quote Dr. Tom Owen, he told me “You’re in the People Business Buddy”.  That has always stuck with me and has kept me grounded even when the success came.  If you plan to be in the chiropractic business long term, you must realize that the management and structure of your practice are vital to success. But without remaining focused on why you are there, and who you are there for, you’ll struggle even if you’re bringing home a decent living.  That may sound counter intuitive, but there are way too many burnt out frustrated chiropractors out there that have profitable practices.  Knowing that as you begin your career may help you avoid that type of situation.  Even if you’re one of those frustrated docs, take some time today and look back at the enthusiasm you had as a fledgling doctor and get it back!

Question: What lights your chiropractic fire?  Protect that flame with your life.

What does it take to open a successful chiropractic practice?

As I was doing some yard work over the weekend it occurred to me what it takes to get a new practice off the ground, and in a hurry.  How does yard work relate to opening an office?  You may ask.

I had just cut some large dried dead grasses, the kind that gets six or seven feet tall.  With them in a large pile down by the creek, I lit one small match and tossed it into the grass without much thought.  Within 20 seconds the grasses were fully engulfed.  It was just then I noticed that the wind was blowing and the Bermuda grass under the pile was extremely dry with plenty of dry leaves and twigs nearby.  You do the math.  Needless to say all conditions were in line for a bunch of flames and neighborhood filling smoke.

Now it took everything to be just right for my small forest fire to spread, but nothing would have happened without the initial spark. That my friends is what it takes to open your successful office with  a bang.  All conditions must be just right to open and open big.  Everything including your clinical system, business system, marketing system and management system must be in place.  But the key to your success is whether or not you have the spark to ignite your fire.  Without it, all the conditions may be right, but you won’t see the growth and success you may expect and desire.

The spark I’m talking about is much more than just your excitement and enthusiasm.  Which by the way are two necessary things.  You must have a passion and love for what you are doing.  That passion comes from knowing what you are doing and why.  So many new graduates truly do not have a clear idea what chiropractic is and the power behind a proper adjustment.   If you take some time and look at some of the ultra successful chiropractors in our profession, that are doing it right, you’ll find a passion and love for chiropractic and for their patients.  They will be able to tell you exactly what they do and why they do it.

Question:  What about Chiropractic lights your fire? Is it strong enough to keep you focused for the next 20-30 years of practice?

Top Ten things I wish I knew as a Chiropractic Student: 6. Office Protocol

Would you like to perform at peak levels of efficiency and productivity with the highest clinical standard possible? If you answered anything but #@%% yes, you should seriously consider why you are putting all your efforts into opening your chiropractic office.

What if I told you that in your practice, you will use very little if any of the protocols and procedures you’ve studied and used in the student or outpatient clinics at your school. Somehow, I bet you’re not surprised at all.  So if you don’t use the protocols you’ve learned in school, what are you going to use?

Are you going to wing it? Shoot from the hip?  Then hope for the best?

With anywhere from one to two hundred thousand of student loans to repay, not to mention thirty to one hundred thousand or more in additional capital invested for start up, are you truly willing to risk all you have invested and your future, just winging it?

This week, take some time and ask yourself, do I currently have a system in place to achieve and exceed my goals for a long term self sustaining practice?

Question:  Are you’re office protocols time tested and proven to deliver outstanding results?

Chiropractic Practice: An Olympic Sport?

Have you been watching the winter Olympics this year?  I’m from the northeast and my wife is from Minnesota. We’re no strangers to the snow, and love the winter games. What a display of talent and execution!  As I’m watching the technical aspects of each event, I’m in awe how precise the athletes are in all aspects of their sport.  They are true professionals.

Just recently we were on a short ski trip with some friends.  Their two kids had never been on skis, while our son has been on skis every winter since he could stand.  Watching these six and seven year olds struggling to grasp this new concept then negotiate with their muscles to stop and turn on the snow was quite a scene. Our son was zipping around them trying to show them what to do, and it occurred to me how ineffective he was at helping them.

When my wife, a former downhill racer and ski instructor, started guiding them through the basic principles, the light bulbs began to come on.

Now what was the difference?  My wife and son both could ski, but only my wife owns, understands and can communicate the principles needed to ski properly.  As you can guess her approach, with expertise, was much more effective than my six year old saying,  hey watch me.

Why is it that when we come out of school with our chiropractic degree we automatically assuming we are Olympians? Experts in all aspects of opening and running a successful practice.  There’s no doubt that as clinicians we’re prepared to treat patients exiting school.  But come on, we haven’t been training intensely for years to market and manage a business, staff and office procedures?  No wonder the success rate of new Chiropractors is atrocious, and student loan defaults rank among the worst of any profession.  To be the Olympian in your new chiropractic office, you need to train in all aspects of the business.  Operating at peak performance in all aspects of your trade consistently.  That’s the definition of a true professional, and leads to ultra success!

As you start preparing for your new chiropractic practice, take a moment and ask yourself, where do I stand?   Am I seasoned professional, able to execute turns, moguls, jumps and ski through the trees?

More likely there are many aspects of your business that need studied and perfected before heading down the black diamond into your chiropractic practice.

Question:  What are your weak areas, and how do you plan to overcome them?

Top Ten things I wish I knew as a Chiropractic Student: 5. What type of office space is ideal?

Imagine with me for just a second, go ahead close your eyes. Well, close them after you read the next sentence. Visualize with me the perfect picture of your new chiropractic office space.  Is it large or small, stand alone or strip, on a busy street or peaceful road?  Every one of you is going to have a different picture in your mind and a myriad of different answers.

Now take a minute and put yourself in patient’s shoes and visualize what you expect, when visiting a doctor’s office for the first time.  Very likely, you will have two very different looking pictures. One important thing when planning your practice is to find a middle ground where you have your own unique space without disappointing a patient’s expectation of what a successful doctor’s office looks like.

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Top Ten things I wish I knew as a Chiropractic Student: 4. How to finance my practice.

There it is, the burning question that most chiropractic students and doctors wanting to open a practice are asking themselves. The answer my friend may surprise most of you.

In this economic climate, it is impossible to secure financing for your new practice.

That is completely true, if you choose to believe it.

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Chiropractic Students should Plagiarize: When starting a Chiropractic Practice

Have you’ve ever written anything?  If you’ve made it to Chiropractic School you have at some point, and you know how professors will hammer you for not sighting your sources. Plagiarizing can cost you your diploma or career if you publish someone else’s research as your own.

The great thing when starting your new chiropractic office is that copying a success is not only accepted it is one of the smartest moves you can make!  Don’t reinvent the wheel! Learn from the successes and failures of others, so you can avoid the pitfalls and errors others have experienced.

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Top Ten things I wish I knew as a Chiropractic Student: 3. Business Structure

What’s the best business structure for a new Chiropractic Practice?  That depends on the amount of taxes you want to pay.

**Disclaimer time, I’m no CPA or Attorney so blah, blah, blah do your own research**

I’m here to get you to think, not be your CPA.   So let’s keep this simple.

Here are your most common options for business structure:

  • Sole Proprietor – All income taxed @ highest rate & self employment tax (earned income)
  • LLC,LLP – Layer of personal liability, Flow through and taxed like sole proprietor (earned income)
  • C-corp. – Benefits larger companies, more write offs, fringe benefits,   Taxes more complex and dual tax
  • S-corp. – Flow through entity, friendly to use but requires organization, but much more tax friendly

I strongly suggest doing your home work.  Here’s a couple places to start:, My New Company, Incorporate Time & Legal Zoom. Now they’ll all try to sell you something, but they give good information and compares strengths and weakness for you.

You never want to evade taxes, that leads to jail.  What you do want to do is minimize your tax liability while using the tax codes the way they were designed, which actually contain many benefits the small business owner.

One of the biggest problems for the new doctors I work with is that they become so successful so fast that their CPAs rarely plan for their income the first year.   Then they get whacked with huge tax bills that they were not prepared for, and nearly go bankrupt while having a hugely successful practice.  I speak from experience, we got slapped with over a 30K tax bill my first year, all my accountant said was “oops, I didn’t expect you to do so well your first year” My intention is not to bash the accountants, we need them, but please be sure to find a wealthy one that utilizes and understands the chiropractic profession as well as corporate structures.  Had I been structured properly, my tax burden would have been 10-15K that first year.  There you go, I may have just saved you close to 20K with this post alone.

Question:  Who do you need on your “power team” to help you set up your business?  Go find them now!

If you need some help on this, I have some great suggestions for you!

Top Ten things I wish I knew as a Chiropractic Student: 2. Business Plan

I talk with chiropractic students and doctors from all over the country looking to open their offices. Without fail there are always a couple of questions they always asked about how to get their financing:

  • What kind of business plan do I need?
  • Where do I find financing?

Now, two or three years ago the economic climate was significantly different than today.  So, my recommendations on this subject have evolved and changed accordingly.

What kind of business plan do I need?

It’s simple, a great one. In years past, a good credit score and a logical plan was enough.  Today traditional lenders have changed the rules.  No longer does a good credit score account for much, even a better than average score doesn’t pull the weight it use to.  As a rule, chiropractic students coming out of school are over leveraged and undercapitalized which makes it challenging to get any kind traditional financing.  In order to have a shot with a lender today, you must take your business plan very seriously.  It’s going to take more than the mock one you put together in your stellar business class in Chiropractic College.  One surprising source for small businesses is actually the SBA, there are templates and some great information there for you.  Your business plan must be professional and presented that way, or lenders stop listening very quickly.

Where do I find financing?

The true answer is anywhere you can!  If you picked up the tone from the last question, it’s very difficult to secure traditional financing for a small business start up, let alone a chiropractic practice.  Now is the time to start thinking of other sources for your startup capital.  As students it means minimizing expense increasing savings, part time jobs, conserving those student loans, family contacts, building equity in homes, etc.  If you put together a proper business plan it then becomes much easier to go to non-traditional lenders.  With a thorough plan,  asking friends or family for financing becomes much easier.  Believe it or not, there is still plenty of dollars out there to get your chiropractic office open, it just takes more effort , determination and a don’t quit attitude.

Recently I heard the story of the publishing of Chicken Soup for the Soul.  Jack Canfield went to 35 or so publishers, who said no, but it only took one to say yes, and you know the rest of the story.

Don’t Ever Quit!

Question:  Are you a currently working on your plan to finance your dream?

“If you do what you ought to do when you ought to do it, there will come a time when you can do what you want to do when you want to do it” – Zig Ziggler