5 Reasons Your Chiropractic Practice Is Struggling (& How to Fix It)

Key Points:

Hint: A "bad location" isn't one of them 

• There are a few common reasons chiropractors struggle to run a successful, profitable practice, including having a personal injury (PI)-only practice, odd practice hours, and a lack of patient education around maintenance care.
• It might seem unimportant these days, but professionalism is essential to have a successful practice. When you take pride in your appearance and clinic space, your patients will notice.
• Your practice is only as good as the people working for you — good doctors and good staff are key to your patient experience as well as your everyday work environment.

As a fellow chiropractor and practice owner, I want nothing more than to see your practice thrive. But one or more of these five common mistakes may be holding you back from reaching your full potential as a business owner. 

Here are the five biggest reasons why your practice isn’t thriving and ways to get back on the right track.

Reason 1: You’re Running a PI-Only Practice

Taking only PI (personal injury) cases, regardless of the legalities of your particular state, is a significant gamble for your business. You’ll only be paid for personal injury cases after the legal battle is over, which may take anywhere from several months to years.

Of course, these will typically be higher payments, but in the meantime you’ll be wondering where your next paycheck is coming from — and that’s never a feeling you want to have. PI patients also have a very low rate of transitioning into maintenance care because they aren’t paying for their initial treatment themselves. So while you may get a larger payment from the initial treatment plan, that client is unlikely to ever return to your practice.

The reality is this: you need long-term maintenance patients to build a sustainable, reliable business with sustainable, reliable income. There’s no quick fix to attract these patients overnight. But when you emphasize maintenance care and slowly build up that value in your patient population, you can seriously change the long-term profitability of your practice (not to mention decrease your everyday stress).

Reason 2: You’re Only Open at Odd/Inconvenient Hours

As a practice owner, it’s tempting to only be open during hours that are the most convenient for you. Who doesn’t want to work for just a few hours a day and close for a long lunch break? But having odd or inconvenient hours for your patient population seriously affects who can come to your clinic and receive treatment. 

For example, at Simply Southern Chiropractic Center, we treat quite a lot of teachers, but teachers can’t come to the clinic during the school day. So we have to be open in the morning, before school starts, as well as in the evening at least some days of the week. Our original clinic hours were Tuesday through Saturday, Tuesdays & Thursdays 10:30 am - 7:30 pm, Wednesdays & Fridays 8:00 am - 5:00 pm, Saturdays 8:00 am - 2:00 pm. We were always slammed with patients during those evening hours, especially on Saturdays. It really made a difference.

Here’s the mindset shift: your clinic is not about you. It’s about the patient and when they can make time out of their busy day to see you. It’s part of your job to cater to their convenience and when they can find the time for an adjustment. This becomes even more critical when you encourage maintenance care as a core part of your practice.

If you’re currently open at odd hours and you want to make the shift to more convenient hours, don’t expect to see every slot fill up right away. But given a little time, they will begin to fill up, and your patients will appreciate the change.

Reason 3: You’re Not Discussing Maintenance Care During the Initial Treatment Plan

Most people come to see a chiropractor at first due to pain and discomfort. As chiropractors, we know that pain is the last thing to show up and the first thing to go once treatment begins. But then we need to work on the underlying root cause reasons behind that pain in the first place, and that can take much longer to correct. And then after that, we have to make sure the body continues to stay structurally healthy with regular adjustments. The idea of ongoing care can be a big mental hurdle for people to overcome if they’re unfamiliar with chiropractic therapy.  

That means we need to educate our patients on the importance of maintenance care from their very first visit, and continue to educate them often throughout the initial treatment phase. At SSCC, we talk about maintenance care on day one, halfway through their first month, and again in their second and third months. We have a very high conversion rate from initial treatment to maintenance care.

The tendency to skip the discussion about ongoing care may come from a place of not wanting to sound “salesy,” but it’s simply a matter of practice to not come across that way. Think of it like talking to a family member or close friend. You would recommend ongoing care to them because it’s the best thing for their health, regardless of your business. As the clinician, you can keep your focus on the importance of getting regular adjustments for your patients’ health, and let your front desk staff handle conversations about payment and scheduling.

Once you’ve educated the patient on the importance of ongoing care, a great practice to put in place is to schedule out their visits for an entire year. Explain to them that by scheduling out well in advance they can often get the most convenient appointment times for them, and then they don’t have to check their calendar every time they come back for an appointment. It’s already on the books. And you get the assurance of knowing they’re more likely to keep an appointment that’s already been scheduled in advance. It’s a win win.

Reason 4: You’re Not Showing Up Like a Professional

This is a hard truth for some people, but it’s absolutely essential: if you want to be treated like a medical professional, you need to dress and act like one. Wear professional clothes: nice slacks, button down shirts or blouses, and smart but comfortable shoes. Some offices choose to have a “uniform” like a polo shirt and dress pants, and that’s fine. At our office we simply require business casual attire, but more on the business than casual side. Scrubs are okay, but make sure you look clean and put together.

Having a clean space is also incredibly important. People will notice if you, your staff, or your space is unclean, and they won’t return because of it. Imagine if your doctors office was dirty and messy, with dust on the counters and trash lying around — would you go back? I wouldn’t!

See your appearance and your office presentation as part of the service people are paying you for. If you pay for a service from someone, you want them to show up professionally and well-groomed and clean, and the same applies to you as a care provider. I’m not saying you have to put on a full face of makeup and an updo to go to work every day, just look clean and presentable. It’s all part of the job.

Reason 5: You Don’t Employ Competent Staff

When you’re first starting out as a practice owner, it’s tempting to hire fast and fire fast, especially when you find yourself getting busier and growing quickly. But it pays to take the process slowly and make sure you hire smart, competent individuals who want to work for you and support your mission, not just people who are there to collect a paycheck.

I made all the hiring mistakes you can imagine early on in my practice, which is why I created the free hiring funnel guide to help you avoid my mistakes and hire the right people the first time.

You can learn all about that process in the guide and on the MILLION DOLLAR CHIRO: The Podcast for Chiropractic Practice Owners, but here are a couple of things to look out for when you hire staff for your practice.

1. They need to be on board with chiropractic care, understand why it’s important, and be able to communicate to your patients in a friendly and approachable way.
2. They have to be able to listen and be coachable. You can teach skills, but you can’t teach values like hard work, honesty, loyalty, friendliness, approachability, and being a team player.
3. They need to have common sense and be willing to ask questions when they don’t know the answer. You’d be surprised how many people don’t have these two qualities, but it’s another thing you can’t really teach. Or at least, teaching your employees common sense isn’t a good use of your time.

Take it from someone who’s been through it all, you want to invest in your staff up front and hire the right person the first time — it will save you so much time, energy, and money in the long run.

Bonus: Good Doctors Are the Cornerstone of Your Practice

If you’re reading this blog, you already know this, but here’s the bottom line. If you don’t have good doctors, none of the previous five reasons matter for the success of your practice. You must have top-notch chiropractors on your team who treat their patients well, keep up their skills, and continue to learn and grow as practitioners. The same goes for you as the clinic owner.

Do whatever you have to do to provide excellent, praise-worthy care, and make that the bedrock of your practice. It’s our responsibility as chiropractors to show up as the professional healthcare providers we are and improve the perception of chiropractic care one patient at a time.

Take Your Practice from Surviving to Thriving

When you begin to address these five reasons, you can take your practice from surviving to thriving in a matter of weeks to months. Still, it’s hard to go on this journey alone. If you want to learn from a successful chiropractor with two thriving clinic locations and a seven-figure business, see the ways we can work together below! I can’t wait to get to know you and your unique practice.

Want to get started? Here are two ways you can work with me:

• Six or twelve-month one-on-one coaching packages: If you’re a chiropractor looking to grow your business and aiming to reach seven-figure revenues or more, then consider applying for private one-on-one coaching with me.
• 'Owning A Chiropractic Practice: Things Chiropractic School & Management Groups Do Not Teach You' online course: Not quite ready for one-on-one support? Learn all about the business side of running and owning a chiropractic practice in my online course.