Starting From Scratch

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How do you create something from nothing?  Especially when starting a chiropractic office.

It’s a question all practicing doctors have asked themselves at some point.  It’s not the question that gives us the problem, it’s finding the answers.

Check that, it’s finding the correct answers.

With so many things to consider, think about, plan for, save for, organize, purchase, lease, hire, fire, build, learn, implement….etc.  It truly is very overwhelming when starting a business when you have no experience, or have struggled or failed in the past.

Working with and helping doctors, and students in chiropractic college, prepare to open their first business or 2nd chiropractic office, has taught me several things that may help you as you begin your career or start over.

1. Time is a valuable commodity (our only true limitation)

2.You’re not as busy as you think (if it’s a priority, you find the time)

3. You’re not as smart as you think (get help, and don’t act like you know everything)

4.It’s never as hard as others say, except when it is:) (have the right attitude, and ignore the negative skeptics)

5. Your concepts of today will typically not get you where you want to be (continue to seek and grow)

Question:  What does all that have to do with starting from scratch? 

You tell me, look forward to your comments and questions!


Top Ten things I wish I knew as a Chiropractic Student: 7. Staff

Are you a leader in the chiropractic profession, like these guys?

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How would you like to be the center of attention, have everyone looking to you for the answers, be depended on for inspiration, and make all the big decisions?

Sounds like a lot of pressure and work, huh?

It seems much easier to go about my business, stay under the radar, and do my own thing, Right???

But, would you ever follow someone that had no mission and no idea where they were going and did their own thing?  Think about that for a moment or two…

While you consider that, see if you can guess the answers to these questions relating to your chiropractic practice…

  • Do you know what one of the most important pieces of your chiropractic office will be?
  • Did you know this one aspect can literally make or break the success of your chiropractic practice?
  • Do you know who will be responsible for the majority of your chiropractic referrals in your practice?

Hopefully you’ve put the pieces together, congratulations, you now know more about staff than the average chiropractic student and new doctor.

Honestly, do you really think you will reach your maximum potential without the help of others?  If so you are aiming way to low.Screen Shot 2014-09-22 at 11.52.50 AM

Your Chiropractic Assistants (CAs) can be the key to your success, or the bane of your professional existence.

  • “Give me a great doctor and a poor staff and you’ll have a poor practice”
  • “Give me a mediocre doctor and a great staff and you’ll have a great practice”.  – Dr. Tom Owen

That comes from one of my mentors Dr. Owen, who has helped opened over 1000 offices and helped over 10,000 chiropractors succeed in practice over the past 50 years.

Ask any doc that has practiced for a couple of years and they will nod and agree about the importance of good staff.

I can’t remember the class on how to develop, train and lead a great staff as in Chiropractic College, do you?

We were always taught to master your technique and you’ll have a great practice .  Why then, aren’t the great doctors (clinically) the ones with the biggest practices?

And how on earth does the knuckle head in the back of our Chiropractic classes, that none of us would let touch our dog, now have a booming office.  More times than not, surrounding yourself with good people and developing them is one of the major keys to success.

Will you be shocked, when you open your chiropractic office and find, you are the center of attention,  everyone is looking to you for the answers, and you will make all the big decisions?

You ARE a leader in the Chiropractic Profession no matter if you are on a stage speaking to thousands, or in your office seeing patients.  Others are counting on you to be a light of hope and have the answers.

Question:  What can you do now to obtain the skills and knowledge will you need to lead, hire, fire, pay, motivate and develop a great staff?

The “Secret Ingredient” when starting your chiropractic practice!

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No matter what business you are in, to be successful you must always strive to improve your volume, sales and overall productivity.  The chiropractic business is no different.  Ray Kroc (founder of McDonalds) once asked, “Are you green and growing or ripe and rotten?”

What a great thing to ask yourself every morning when you get up and look in the mirror!

You’ll find that success is not a destination but more a constant moving progressive, sometimes elusive target.  As soon to be entrepreneurs, your continued growth is essential to long term sustainable success.

Often times in our journey towards success, we tend to search to find the magic bullet.  You know, the one thing that will push us over the edge.

Some may call it the “Secret Ingredient”.

Many chiropractors have gone very array in search of this “Secret Ingredient”, thinking the next gadget, laser, nutrition, decompression, rehab, massage, or diplomate will be their answer.  Many  have invested time energy and resources in the latest and greatest thing only to accrue more overhead, frustration and disappointment.  They end up, unfulfilled, burnt out, and no closer to where they hoped to be.

My son is 7, and for the moment really likes Kung Fu Panda. I’m finding that most of life’s principles and lesson can be found hanging out with seven year olds.

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Doc, if you haven’t realized it yet.  There is only one secret ingredient to your success… YOU!

Dr. Tom Owen always says your success will be found in your Attitude, Actions, Concepts and Procedures; and in that order.

I’m all about learning to be efficient, proficient, productive and profitable.  It so often starts by taking the hard look in the mirror and asking yourself the tough questions, realizing you are the secret, full of potential, knowledge and skill.

Question:  Are you Green and Growing or Ripe and Rotten?  Only you can answer it.  What can you do today to begin to be green and growing?

How I Lost Almost $300k Opening a Chiropractic Practice!

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Yes you heard me, actually it was more like 264k, either way it pains me to talk about it.

Students and new chiropractors need to know! What happened to me, can easily happen to you if you are not prepared.

Have you ever heard the term, time is money?

Say you graduate from college and want to open a Chiropractic office. You soon realize that although you are a board certified Doctor and ready to practice, no one ever showed you how to open a successful practice/business.

So you begin to put it together:

1. Financing (obtaining working capital and start-up)

2. Market (choosing a good market, whatever that means)

3. Location (office space, lease negotiations, build out, equipment, etc.)

4. Pre-opening marketing (what works, what doesn’t???)

5. Office management (hiring staff, paper work, insurance/medicare, billing, etc..)

6. Office procedures (proper consultations, exams, reports, referral tools, etc..)

7. Advertising (what, when, how?)

8. Collections (how, and what to collect.)


I could go on and on, but you get the point. There is a ton to do and know when opening your new practice.

Remember time is money. How long do you think it will take you to figure all that, and more out?

Maybe a better way to ask it is… How long do you think it will take you to figure all that and more out, and know it will work?

Here’s how I lost 264K+, and you could too.

It took my wife and I four months, after graduation, to admit we didn’t have a clue how to get our office open right, and another eight months to get help and finally get our doors open.

If I Calculate the revenue from our first year in practice ($264K) and compare it to the year we didn’t get open ($0.00),  (actually factoring in living expenses and student loan payments for that year, it is a very negative number)…

You can understand why it hurts to talk about.  Students and new doctors typically don’t  realize or acknowledge the time value of money, and that by not knowing or taking action they are losing, big time! Reality is much different, and more costly than you can imagine.

Questions:   1. What can YOU do now that will help you avoid losing out the way I did?

2. Who can help you do it right the first time, saving you both time and $$$$?

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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