I remember not long after enrolling in chiropractic school, and well before graduation, realizing that chiropractors don’t have a safety net. I have come to see now, after 14 years in practice and coaching and speaking to hundreds of chiropractors, that this lack of a back-up plan is one of our biggest challenges.
First of all, doctors have always been an entrepreneurial bunch. That includes MDs, DCs, DOs, and DPMs. Many years ago, you had to open your own practice and most doctors did. But, for most specialists—particularly the MDs—there is always a back-up plan. The most obvious being the relationship between medical doctors and the hospitals. Consider a recent reallife example:
I had a patient in the other day who said her sister, who was an internal medicine doctor with her own practice, had quit practicing. She had found that in dealing with the Affordable Care Act, and all the associated compliance regulations, she couldn’t run her practice anymore. So she quit and got a job at an urgent care center. My first thoughts were that must be terrible. In fact, she only works 10 days a month, is making more now than when she was in private practice and has more time off.
Keeping the above in mind, you can see what’s happened is that MDs and most specialists can focus on learning techniques for delivering better care. They don’t need to learn marketing, business systems, and so forth. They can focus on learning techniques if they want, and many do. And most DCs would like to focus on learning techniques, too.
Here is the problem: If you can’t keep your practice going, what is your safety net? We only have one choice; we have to learn marketing and business strategies.
First, DCs need to commit to having better opportunities for associates. It is nearly impossible to start a clinic right out of school. Most practice coaches don’t even recommend trying it as they have in the past, given the many new challenges and high levels of student debt.
We have to create good associate positions where young doctors can learn and make a good wage. If my associates perform well, they can make six figures without doing any spinal screenings, and we need more jobs like this. And second, you need to learn business, marketing, and systems. If you are going to make it today, you need to learn those things. Look for books, seminars, and coaching opportunities. You should be studying business and marketing 10 times more than technique if you are a practice owner. And if you don’t want to teach yourself, you can pay a coach or consultant who will teach you.
Let me make a bold prediction here: Within 10 years or so, you will see hospital systems and other corporations buying chiropractic clinics. Health care is turning into a control game; namely, who can control the patients—look at all the corporate mergers going on in the health care industry.
The medical docs have figured out that we control a lot of patients, and the hospitals will be next. It won’t be too long before we see hospitals buying chiropractic offices for a fair price and paying DCs a salary to be part of the system.
Not all of us will opt in, but you can see the likelihood of many opting for the safety net. In the meantime, work on finding (and later creating) good associate positions, and if you own a clinic, spend more time on business and marketing than you do on technique.
JAMES R. FEDICH, DC, has a successful practice in northern New Jersey. He is a speaker, consultant, a podcast host and the author of multiple books, including Secrets of a Million Dollar Clinic. He can be contacted at drfedich@ milliondollarclinic.com or through drjamesfedich.com.