Keys to getting your startup practice on the right track

Lloyd Manning
February 29, 2016
Written by
Location and market conditions can dictate the likelihood of success as a solo practitioner.
Location and market conditions can dictate the likelihood of success as a solo practitioner. Photo: Fotolia
There comes a time in their career when every employee chiropractor would feel it is time to cut the ties and start his or her own practice. However, starting from the ground up is seldom as simple as renting a vacant space, moving in, hanging out one’s shingle and initially attracting a sufficient number of patients to make it pay.


To ensure success in going solo, it must be a well thought-out, well-planned and well-executed undertaking.

It’s a business
In my many years of running a commercial real estate and business appraisal service I frequently told my staff that it was mandatory they be professionals, but never forget that we are running a business, where making money is a prime objective. I now say the same to you. You can be the nation’s best and most qualified chiropractor, but when you cut all of that away, you realize you are running a business, a service business, one with all of the perks and downsides that are part of the package. There is a fine line between being a professional practitioner and being a business manager. At times, the line becomes blurred. You are not an amicus curiae (a legal term meaning, friend of the court) – for an amicus curiae does not get paid, which is not your intention.

Get organized
The starting point for venturing out on your own is an organized assessment of your particular situation, your experience, chiropractic education, specialties if any, and financial situation, including how long you can survive with a minimum income. A complete self introspection of why you want to do this is a must and, perhaps, more important. You must be positive about your objectives, the experience and talent you bring to the venture, what you expect and whether this expectation is realistic. Starting a new practice is tough. Taking a crash course in accounting and business management would be beneficial. Stick-to-itiveness is vitally important. The competition is not going to turn over their patients to you voluntarily.

What are the numbers?
As you will be starting from ground zero, a well thought-out marketing plan that fits in with the neighbourhood where you intend to establish your clinic is essential. Required is an accountant’s approach to calculating probable fixed clinic operating and staff costs, and a predictable estimate of the variable costs as a percentage of gross revenue at varying income levels. Calculate your break-even point at different levels, pessimistic, most probable and optimistic, not overlooking that you need to be paid as you develop your practice. Your level of success and staying ability will largely depend on the financial planning that you do at the get-go.

Location, location, location
The importance of your clinic’s location cannot be overstated. You will fall into one of two categories: a chiropractic practice looking for a market for its services, or a market needing a chiropractic practice to fill the void. When seeking a suitable location for your clinic, first determine where it is, and then try to establish your new practice in the second category. Establishing your practice where there is a clear demand – but less supply – will ensure that the competition will be far less.

Whichever category you fall into, it is also necessary to measure the level and competency, and if possible, the patient retention of your competitors. An underserviced marketplace will provide you with more opportunities to develop your practice in a shorter span of time. In a crowded marketplace – one with several chiropractors – you will probably be little other than more of the same. Your marketing cost will be considerably higher, your establishment time to where the practice pays will likely be substantially longer and your growth potential lower.

Look before you lease
When considering the type of neighbourhood in which to establish a chiropractic practice, some chiropractors prefer to be in or near a downtown location, where they can attract the executive crowd. Others prefer an area occupied largely by blue collar workers and middle class residents. All others are somewhere in between or a combination of the two. It is far beyond this writer to determine which is best. That is your decision. All cities and larger towns have industrial-commercial development departments and chambers of commerce. These organizations are anxious to assist anyone starting a new business in their community, particularly a needed professional service. They can provide you with more community, area and neighbourhood population, income statistics and data than you could ever use – usually for free.

Do not overlook industrial-warehouse districts as many industrial workers develop physical problems. Consider a rural community with a population of 3,500 or more. Many have large trading areas and negligible competition. Avoid areas or communities that are declining or struggling to hold their own, have a single industry with questionable future, have high vacancy rates, a surplus of empty or poor buildings, or where there is an overabundance of “for sale” and “for rent” signs. Ensure that the building you select is readily accessible, has ample parking on site or nearby, is physically attractive, in a good state of repair, in an improving neighborhood and is patient-friendly. Cheap rent is not cheap if it detracts your patients.

Sell your services
When you start out, a strong marketing campaign is a must. You want to move from being unknown to being well known in as short a time span as possible. Unless you go into a crowded market, it is seldom necessary to embark on a high-priced advertising campaign. Create a marketing strategy that is low key, yet professional. Spend your advertising dollar where you get the most bang for the buck. Satisfied patients and word-of-mouth are the most effective forms of advertising. Past patient referral is still better. If going into an area or community where you are not known, joining a few clubs such as Rotary, Kinsman, Masons or the Knights of Columbus can prove to be beneficial. Remember, you do not join a club to get business but to make friends. Friends patronize their friends. Focus your marketing strategy to attract, on a positive basis, as many patients as you can. It is important to avoid snake-oil type salesmanship, such as “chiropractic cures everything from hammer toes to cancer.” Effective advertising is that which conveys the message of what you do, yet is simple, to the point and professional. Always bear in mind that you have two elements to sell: chiropractic as a profession with its many benefits, and your personal chiropractic clinic and professional practice.

You can do it
Starting a new chiropractic practice, or any business, is frequently a tough go until it gets to where it is a paying proposition. Perseverance and patience are required. So much depends on you, the location you choose and the underserviced market for your services in that area. Growth is only possible where there is an unfilled demand for your professional chiropractic skills and knowledge. Still, every business and every chiropractor started with only an idea or a dream. You are not alone. The law of probability is on your side. You can do the same. 


Lloyd Manning is a semi-retired business appraiser and financial analyst who is now a freelance business article writer. He resides in Lloydminster, Alta. He can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


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