Could ‘retirement in practice’ help chiros achieve work-life balance?

One of the greatest regrets people have is not taking enough time for themselves, particularly as they age. A closely-related question is deciding at what age to retire from practice.

But there’s an alternate solution called “retirement in practice.” I first heard of this concept while attending a Whitehall Management seminar in Arizona. The speaker was Greg Stanley, an accountant who has become extremely familiar with chiropractic and dental practices in the United States and Canada. His lectures and study courses were simple, but informative. His observation was that many (if not, most) chiropractors were not really great at retirement. At a time when they have the most knowledge and expertise, clinical acumen and reputation, many retire only to find out that they are bored and no longer feel excited about their lives.

Stanley said that chiropractors should retire when they physically cannot adjust any more. Until then, they could “retire in practice” which means they take more and more vacations and maintain their practice in a more compressed time frame. Retirement in practice is the concept of taking short to medium holidays on a regular basis. Most chiropractors will not find their practice growing if they take two or more weeks off. Extended periods of time away reduce the patient’s connection to the doctor and they instead find alternate providers. The solution of shorter trips and vacations is often a helpful way to restore the older doctor, breathe new enthusiasm into the practice, and help locate other doctors who might one day become the clinic owner.

I had the opportunity to meet an extreme example of  such a practitioner on a cruise a few years ago.  This orthodontist had 27 people working for him. He travelled one week each month and his systems and procedures were in place in such a way that most of the work was done by his staff while he was involved with the case planning. His practice was generating five million dollars each year and each month he wrote out 27k in incentives for his staff. What I appreciated was that he really made his staff the advertising and social media centerpiece for the practice. It was a practice about them and the patients and less about his expertise.

While I really enjoy my practice, what I think keeps me engaged is the travelling I do with my wife Jan, who works with me in her own naturopathic practice. We often talk about fine-tuning our retirement in practice evolution.

In our case, the past six months we have had three, seven-day trips to Paris, Jamaica and Calgary (convention and skiing). While over Christmas and New Year’s we visited New Zealand for two weeks. There is tremendous value in travelling and seeing the world, meeting new people, and having different experiences. As doctors treating our patient’s health issues, we know that our own health is not forever so we should not delay opportunities.

Tips for taking trips
First, try to arrange to take a course, attend a symposium, meet with other chiropractors, visit a college, or some other professionally-related activity while you’re away. It will allow you to write off at least the cost of your flight. Secondly, have a plan and bring your partner. While travelling alone will often compel you to meet people, relationships will grow and improve when you share new experiences with your partner.  Taking advantage of Airbnb and other online booking resources will often introduce you to places you might not have seen otherwise. Consider making a list of all the places you want to visit, remembering to do the more active things earlier in your life. Take advantage of long holidays like Christmas, Easter, and three-day weekends – they can minimize your time away from practice. You may pay more for a flight, but you will more than make up for that by returning to the office on a day when you can be there to provide care.

Scheduling mini vacations
In our office, we tend to work Saturdays – why is that? Saturdays are a great day to practice. Often we see new patients and the day is short, for example, starting at 8:30 and ending at noon or 1:00 p.m. The upside of that is we can grab a flight on Saturday night and fly back on a Wednesday. This allows me to see patients Thursday through Saturday, inconveniencing fewer patients.

In-house locums
It can be useful to have a chiropractor share your clinic so that the clinic continues to pay the overhead while you are away. If you want a hassle free associate, consider offering a semi-retired chiropractor an opportunity to work 12-20 hours per week in your office. They can increase their hours when you are away so that patient care is not compromised. Seasoned chiropractors can also keep you from making the same mistakes that they may have made decades ago.

The patients that don’t click with you will often click with an older chiropractor whose schedule is not as busy. Your associate chiropractor will often be willing to work the hours that you don’t want to have providing you with better coverage for new patients and walk-ins.

Practice amalgamation
If the idea of retirement in practice appeals to you, consider inviting your friendly neighbourhood chiropractic competitor to join you in practice. By combining your practices and selling each other off, you may find yourself in the enviable position of having a full practice (two practices) when you are not travelling. You may find that by splitting the overhead and sharing patients, your income will remain close to the same even though you are travelling more. Make sure you have similar techniques and practice philosophies though, or you may not be happy with the outcome.

Chiropractic, like medicine, is universally needed and the chiropractors I have met do very well. I will be interviewing chiropractors in subsequent columns to provide us with a different perspective on work-life balance. Stay tuned.

Dr. Dirk Keenan is a second-generation chiropractor practicing in Ottawa’s oldest clinic for the past 34 years.  Dr. Keenan pursues an active interest in multi-disciplinary clinics, inter-professional education, and chiropractic practices abroad. He is currently in the midst of establishing an international locum service. You can contact Dr. Keenan at dirk@thespinedoctor.com.