Business Talk: Mind your own business

What students are not learning from chiropractic schools
Anthony Lombardi
December 10, 2014
Written by
I have developed a burning passion to help others in our profession become successful. I now expect more from the academic institutions that house future chiropractors at a time in their careers when they are most fragile. I expect chiropractic schools to be leaders in the profession on all aspects of practice, and I refuse to accept anything less, because leaders not only expect to be successful, they demand 100 per cent from everyone around them.


Chiropractic education now costs about $150,000 and the expectation is that the schools will produce competent doctors that will, at the same time, keep the public safe.

When franchisees put forth their investment on a franchise like Time Hortons, McDonald’s or Subway, they are not just taught how to competently and safely prepare the food. These chains make sure franshisees learn how to run the business at a profit, otherwise they might feel ripped off. Moreover, if these restaurants started failing at business it would hurt their entire brand.

So how do we explain this responsibility related to the chiropractic school if you were to try to draw a parallel? I interviewed three authorities on the topic.

Phil Smith-Eivemark, author of Beyond The Bottom Line
“McDonald’s, Tims and all other franchisors make their money from their franchisees so it is in the companies’ best interests to make sure their franchisees know how to run their businesses. That, and only that, is why the big franchisors train their new franchisees in how to run their businesses before they let them open their shops. This is the major difference between a chiropractic school, which makes its money from your tuition and not from your business. The schools presently see their responsibility only to turn out well-trained chiropractors, not well-trained chiropractors who know how to run a business profitably. If the schools had a financial stake in your post-school success, you can bet your bottom dollar they would make sure you knew how to run your clinic profitably.”

Dr. Stephen Perle, faculty member at Bridgeport Chiropractic College
“I think the analogy is not valid, because the franchisee is buying a different product than the student who is ‘buying’ a first professional degree. They are buying a business opportunity, which isn’t what professional education is. How much training do MDs, DMDs, DPMs, DPTs, APRNs, etc. get in business? The biggest problem, I think, isn’t teaching them to be successful; it is the profession’s inability to define itself in a cogent way and create opportunities for new graduates.”  

Rami Reda, commercial real estate and business developer
“The programs created are not based on 100 per cent performance of all franchisees or want-to-be chiropractors; they are based on the overall and average outcome to gauge whether the program is a success. Just because I go to university doesn’t mean I will get a job offer. The theory, however, is that if we teach students the core skills and competencies, they will receive the tools they need to succeed. But, our education system needs a change-up, as it isn’t always the case. We have lots of underemployed and unemployed students with MBA, PhD and undergraduate degrees, but do we blame the university, the student, or is it something not within our control?”

As a field practitioner, I can empathize with other chiropractors grinding out their business practices. Our schools are geared to prepare us to be chiropractors, and we take an oath that focuses on the patient. But by not helping us with our business practice we are unable to focus on the patient. Naturally, chiropractic schools could spend more resources helping their students with business, but that would cost money, which would increase their tuition or decrease their profits – either way, that approach is not “beyond the bottom line.”

“I think the colleges have the moral duty to provide their students with the education that ought to prepare them to practice. That includes some knowledge of business practices and procedures,” says Perle of Bridgeport Chiropractic College. “So, often I listen to my peers – both graduated and in their final years of schooling – comment on how little business education they have received. Many of these individuals seek guidance externally from established DCs, while others who do not have this opportunity look elsewhere. The difficulty is discerning the ethical, responsible and quality-based programs from the others.”

About a year ago I penned an article called, Wake up call, which focused on helping schools realize they need more attention on the business side of things. Although that article clearly demonstrates the responsibility lies with the student, it may not matter if the attrition rate of chiropractic practices begins to influence enrolment into our profession.


DR. 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.


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