Business Talk – Anatomy of a start-up clinic

Anthony Lombardi
August 25, 2014
Written by
After 12 years in private practice, I decided to turn back the clock and open a satellite clinic to complement my flagship office. This start-up office provides a niche service to patients while expanding awareness of my brand.

My second location is a 500-square-foot space within a commercial building that houses a dance studio, karate school and a dental office. It is owned by the operator of the karate school, and the rent, which is very reasonable, includes utilities, a wireless network, running water and signage on the inside and outside of the building. It offers chiropractic care, physiotherapy and massage therapy, and the niche service is that appointments are only between 5:00 pm and 9:00 pm on weekdays.

In many ways, opening a satellite location is very much like starting a practice right out of school. By applying a few simple principles you can make a start-up office successful without draining your bank account.

Target property owners that are not large corporations
These rental opportunities will provide you with a better price because small businesses or “mom and pop” corporations will see you as an opportunity to turn unused square footage into cash. In these cases, the owners usually try to do anything they can to promote your business – because, after all, if you do well then they get paid over the long term.

Be a copycat
If the owner’s business is successful, then you will find that promoting your business alongside theirs will expose more potential patients to your whereabouts. Being part of a newsletter, joint mail-outs or mutually promoting each other’s business in social media are simple things you can do on a regular basis.

Keep expenses low
Keep expenses low by becoming interactive. In my satellite clinic, I do not use any support staff. The therapists rebook the patient’s next appointments using a laptop and collect payment using the Square device which attaches to their smartphone. The day before their scheduled appointment, all the patients receive reminder text messages to ensure they show up for their booking. I purchased two reinforced massage tables for $300 each, and the equipment and supplies needed to provide outstanding clinical care. In total it cost about $1,500 including promotion costs.

Grind it out
If you want to be successful, you need to be willing to work – and that means you need to be prepared to grind:
  • Take every patient visit as an opportunity to grow – focus on producing outstanding clinical results.
  • Remind patients you are accepting new patients and give them three to four business cards before they leave.
  • Return every email, text, message, direct message (on Twitter) and call, and be willing to adjust your schedule to secure the new or follow-up patient appointment.
  • Commit time/set time aside to brainstorm ideas to promote your brand and generate new patients.
You need a communications plan
For this section, I interviewed communications consultant Victoria Miecznikowski who helped me launch both of my clinics. According to her, it is of paramount importance to have a communications plan – and I second that. What follows is my conversation with Miecznikowski. If you have any other communications questions, you may contact her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it
  1. Why is a communications plan important? A communications plan will help you identify your needs and opportunities, determine communication goals and measurable objectives, develop your strategy and tactics, and help you craft your key messages.
  2. What is branding? Why is it important in a chiropractic practice? Originally, branding referred to a company’s trademark advertising, using visual designs, logos and slogans to create a brand identity. These days, your brand has become your value proposition. What can you offer your clients and prospects that your competitors don’t? What is your niche? How can you solve a problem that they don’t even know they have? You want to position yourself as an expert in your field. 
  3. When you design a communications plan, do you tailor it to the individual chiropractor?  The first thing I do when meeting with a new client is talk to them to find out their goals, both long-term and short-term, and to gain an understanding of their style of communicating.  Most importantly, your communications plan should also be tailored toward your intended audiences. Again, do some research to find out which methods your clients, and potential clients, prefer to use to communicate with you. What are other clinics doing? What can you do to enhance your customer service in a way that works best for you and your clients?
Bottom line
After all of this, the next question of course is: How is the new clinic doing? Is it viable? Do people know about it?

Because it is a niche clinic in use only 10 hours per week, it still generates over $1,500 per month after all expenses. The benefit of this niche set-up is that it keeps the day or hours open to rent to other health professionals. In the fall, a medical doctor will be running a chronic pain clinic out of that space during the day – helping more people and generating more capital, which will further reduce my expenses. 


Anthony Lombardi, DC, is consultant to athletes in the NFL, CFL and NHL, and founder of the Hamilton Back Clinic in Hamilton, Ont. He teaches his fundamental EXSTORE Assessment System and conducts practice-building workshops to health professionals. Visit www.exstore.ca for information.
More in this category:  |  Backing Up to Stay Ahead »

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