Tough love

What’s slowing down your business, in a nutshell
Anthony Lombardi
April 24, 2018
Written by
The longer I practice, the harder it is to give business practice advice because what works for one person doesn’t work for another.
Additionally, very few people will discard their old failing ways in exchange for what you recommend for improvement.

So, it is about time that I administer some tough love and tell you the truth about why chiropractors struggle in practice.

Let’s be frank – practices are businesses. And, chiropractic businesses that fail usually do so for one or all of these reasons:
  1. Their product is simply not good enough.
  2. Their business problems are reflections of their personal problems.
  3. The chiropractor lacks the right personality.
Some contend that if you complete chiropractic college, then you shouldn’t need to improve yourself because that’s what you pay chiropractic colleges to do. If you follow that logic then everyone would be a chiropractic business superstar – that is clearly not the case.

However, if you aspire to achieve better clinical results, be prepared to learn from those who are doing it better than you. Through mentoring you can learn to attain outstanding clinical results yourself. This will help solve problem No. 1.

Think about how you present your product. If you subscribe to the philosophy – visit one, assessment; visit two, report of findings; visit three, first treatment – then do not be surprised if your patients start a mass exodus from your practice. In an internet-based world, patients are extremely well informed and they will find a chiropractor who meets their needs and wows them on the first visit.

With respect to problem No. 2, if you have personal issues, family conflict, or any type of extraneous stressor, no practice building course will help you. You need to seek counseling to help solve your issues or accept the situation you’re in. If you don’t, your business will never reach its potential. Back in 2012, I interviewed the author of Book Yourself Solid, Michael Port. Port stressed the importance of recognizing that in most cases, a perceived business problem is a personal issue in disguise.

Problem No. 3 is the toughest to overcome. If you are an introvert, a boring conversationalist who has problems answering questions about your product, or if you struggle with self-promoting your practice, then your battleship is sunk. The older we get, our ability to change our personalities becomes more impossible due to the decrease in the neural plasticity in our brains.

There are four basic business personality types based on the Myers-Briggs Type Indicator: dominant, expressive, relational, introverted.

Based on this description of business personalities, a chiropractic business practice would be best suited for an expressive personality and least suited for an introvert. Why don’t chiropractic schools factor this information into the admissions process to reduce the number of candidates least likely to succeed in business practice?

Think this is crazy? It’s happening right now in medical schools.

In 2014, University of Guelph researcher Dr. Debora Powell identified a list of key personality traits that can predict a medical school student’s success during the clerkship year, where students directly interact with patients. These are: social confidence, achievement-focused, and tolerance.

The study demonstrated that grades and MCAT scores had weak relations to clinical performance.

Powell, also a psychology professor at the university, said the findings might mean medical schools should begin implementing personality testing for admissions. Powell reported that any kind of additional tools schools can use to improve selection of who’s going to help future patients should be considered.

Another study from the Journal of Applied Psychology in 2009 concluded that clinicians who were “open and extroverted” would be best doctors for their patients. Since chiropractors are clinicians and business people, would chiropractic schools think about doing this? Would they consider discouraging introverted personality candidates from entering their college? Or are they more concerned about their financial bottom-line and less concerned with the future success of their students?

My point is, the factors for business failure lie in your intrinsic genetic makeup, your personal lives, and your clinical outcomes. Chiropractic is a communication-based profession. This means in order to be successful we need to generate referrals from the patients we see on a regular basis. To do that we must be personable, clinically impressive, and adaptable to whatever life throws our way.

Dr. Anthony Lombardi 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 for information.


0 #4 A Lombardi 2018-04-25 13:22
I agree Peter I do not believe inteoverts should be overlooked but I floated the idea in the article based on the research and on what medical schools sre doing. It was included in the article to stimulate a reaction from the profession - amd it succeeded.
0 #3 Peter Emary 2018-04-24 13:25
Thanks for your reply, Anthony. I enjoy reading your columns, and you offer lots of good business advice. As an introvert myself, however, I felt I needed to comment on this article because introverts still play an important role in our profession and therefore should not be excluded from entrance into our schools. Thanks again, and keep the columns coming!
0 #2 A Lombardi 2018-04-24 13:08
Hi Peter, thanks for your well thought out comment. Naturally there are exceptions to every generalization, but the available research shows that in a competitive businesss arena, the indoviduals who can easily and effectively communicate their product are the ones that stand a better chance to secure the opportunity to show the patient that they are different from others in the field. Like all walks of life the most successful are usually the ones that do everything well - regardless of their personality type.
0 #1 Peter Emary 2018-04-13 21:11
I don’t think that introverts should be overlooked for entrance into chiropractic or medical schools. Many introverts end up becoming our best teachers and researchers. Our profession prides itself on its diversity and this should include all personality types. I for one am an introvert. I have a successful clinical practice, a wonderful family life, and will be starting my PhD this September. My research aims to help improve the credibility of our profession as well as to create opportunities for integrating chiropractors into the healthcare system.

We all have our own strengths and weaknesses. And like in any healthy group—whether it be a team, community, family, or profession—we all play a part in its success. Please do not count out the introverts in chiropractic. They play an integral role in the profession, too.

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