Blog

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06/Nov/2022

I’ve said this before and I will say this again, when I was in my first day of chiropractic school, Dr. Winterstein said: “Take care of your patients and your patients will take care of you.” If you go into any form of healthcare, you either go in it for the patient or you go into it for the money, most of the times it’s hard to do both and if you go in it solely for the money, boy do I have news for you.

With the current state of the world, I wanted to elaborate a little bit of the bind that healthcare providers have been put in. For most providers insurance companies set the fee schedules and you either agree to the network rates or you go out of network and become kind of a pain to the patient. We are in-network with just about every insurance company that is offered in the state of Nebraska and we don’t plan on changing that.

As you have probably noticed, the price of everything is surging at the moment and healthcare is no exception. The problem we run into, raising prices in the healthcare setting doesn’t really matter or help when you are running a healthcare business.  We are only allowed to charge the patient the allowed amount that is set by the insurance company. This most recent year, a fee cut was set across the board in all healthcare fields, a few companies kept prices steady but the bigger ones gave a fee schedule cut across most professions (chiropractic is not alone).

It doesn’t really matter if I charge a million dollars a visit, if I bill that to insurance I can only charge the patient a certain set and agreed upon amount.  Some insurance companies are easier to work with in regards to allowed amounts and some have limits that are very cumbersome, in regards to number of services that are allowed per treatment session.

This is where the hard part comes in, even if I wanted to raise prices, I can’t because insurance will only allow a certain amount per line charge and for the most part we are taking fee cuts not raises. (Think about it this way, nearly every insurance company is “for profit” and needs to show that they are making money, they are going to charge the patient more for coverage and reimburse the doctors less, it’s a novel concept that is simple to understand, but tough to break the cycle)

The crux within the profession at this time, in order to increase your bottom line which is ultimately necessary to keep up, so we can continue to stock the clinics correctly and pay help a wage that is deserving of what they do, the business needs to collect more money, not necessarily that your profit is larger but your expenses eat away at it a lot quicker.

  1. We could charge more money per visit for the care that is delivered, this sounds like a good idea but in reality, it’s not all that possible because insurance will only allow you to charge/collect so much and within your contract with the insurance company you can only give a certain percentage of a cash discount before you are breaking the contract.
  2. More patients could be seen on a daily basis. This is an obvious choice until you put it into practice, inferior care would delivered because you would not be able to spend time with patients plus you have to keep up with all of the background work (insurance & paperwork). We are always trying to build the clinics to see more people but there is an ultimate limit to this philosophy.

We don’t plan on drastically changing anything, but I just wanted to lay out the current dilemma that most providers are under at this stage. Charge more (not all that possible) or see more patients (lose the personal care that is desired). People pay a lot of money for insurance coverage and we, at our office, feel that you should be able to use it and reap the benefits of it. It’s not a fun time to run the office but we will continue to treat patients fair and honest and give the best possible care we can provide.


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13/Oct/2022

Building a business and a following within the profession can be a long, tedious process. When chiropractors graduate from school, you get a piece of paper and a license and think that you are going to go out a crush it. In your mind, you think that patients are going to be lining up to seek your care, well I’ve got news for all of the new graduate out there…it doesn’t typically work this way.

I’m ten years into practice, days have their ups and downs but overall things have been trending upwards.  When the office first opened, seeing 40 patients a WEEK was the goal, that is by far not the case that this point in the business.  Constant growth is always going to be the goal.

The thought process has come too light, am I doing this on my terms or am I working within a profession that sets it sights and goals based on public perception. I would like to think that over the course of the last couple years the practice has started to evolve into something that I am proud to work at and have comfort telling people what I do with no shame.

As a new generation graduates from chiropractic school and the older/baby boomer generation within the profession is starting to retire, the profession, I feel, is at a bit of a crossroad.  The younger generation is trending more towards the rehabilitation aspects of the profession and the older generation is geared more towards adjusting patients and using the adjustment as the main tool in their repertoire. This is just an observation, not necessarily a hard and fast rule.

The irony of the profession in the years to come is that a lot of older offices do not fit the mold of an office that a lot of new graduates are going to want to buy or take over. This is the perplexing argument within the profession.  There are arguments to be made on both sides and I feel that there is evidence to support the older and younger generation.

This is where I start the argument of building your following or tribe as I would call it. I would consider that I run a fairly hybrid type practice. We lean heavily on the adjustment and a few therapies.  If you are looking for specific post surgical care, stem cell injections, lots of hands on exercise programs or other specific neurological/spinal condition, there may be other providers that are better at handling certain types of case.

Building a trust within your patient base and allowing decisions/discussions to flow freely make for the best type of care.  Claiming to help everyone is not only irresponsible; it’s a flat out lie most of the time. Our goal within the practice is to continue to grow the practice while getting the best possible results for the patient whether that is at our office or at another.  I have people all the time stop in just to ask questions, it’s refreshing to know that people feel comfortable will come in ask a question and walk right back out without feeling that they were taken advantage of.

This may sound a little strange, but I check the obituaries fairly regularly and when I have a patient pass away, a small member of the tribe is now gone.  The tribe is ever growing and ebbs and flows, people will come and go, lures from other offices are tough to ignore, but I would like to think that we are always available when you are in a time of need.  Whether that is for a conversation or for treatment from our office, just know that you will never be taken advantage of and we lean back on the old school chiropractic technique.

Do we fall for the latest trends, I would like to think we don’t but we have tools and tricks of the older generation while trying to work within an ever changing healthcare field of the younger generation. We don’t hard sell and just know just because you go to a different office for a time or two, you will always be welcomed back into the tribe at Spracklin Chiropractic where we lean on the adjustment, a few therapies and DOT Physicals, that’s it, we make it simple.


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18/Sep/2022

As I age and get a few more years in practice, I’m finding that there a things that you just have to let go and there are certain things that you can genuinely have a pulse on and control.  Life can be this way in general, I’m learning to step back on certain aspects and go full bore ahead on the things you can get ahead on.

A patient showing up late or scheduling at weird times is one of those weird quirks that is hard to control in order to run an office. We try to be as accommodating as possible but with small kids and a family life, there are times that I need to get out of the office for any number of things.  Working early and getting out of the office early is normally preferred.  Sure, there are days that are more flexible than others but when daycare calls about a sick kid, you have to respond.

Sickness and health is another obstacle. We are coming out of a COVID pandemic and it still circulates throughout the communities. If a flu bug or COVID hits the office, you don’t really have a good option.  Either you close the office, if you are unable to work or if it’s someone else in the office that is sick, well it looks like I’m a one man show from time to time. It’s not necessarily impossible to do, but there are some tasks that get put on the back burner for the day. Family illness and colleague illness also happens. Adapting and working with patients that are looking for a fix while their normal chiropractor is out with illness does happen and we try to accommodate those situations the best we can. Kids or parents do need you from time to time and flexibility is the key to operating the office how I see fit.

If a piece of equipment is broken and a part is on back order for a few weeks, there really isn’t a whole lot we can do to expedite that process. Spare tables and equipment is used from time to time but patience is the key. I don’t own a shipping company so, if a shipment gets lost and we can’t get a product in for a month as opposed to a week, we’ll all have to just live with that.

Continuing education is another obstacle that many people don’t understand.  As a healthcare professional we are required to obtain certain types of hours.  Is this a fun thing to do, not normally. It’s just something you have to do in my position.  This coming two year cycle I’m actually going to change it up a little bit and get out of the office a little more to obtain different types of continuing education, things that interest me and the practice a little more professionally than just what I can get by going to Omaha twice a year. Will this cost me and the office a little more than normal, sure, but I feel that I will grow personally and professionally if I get out of my comfort zone every once in a while.

I’m writing this piece more as a reminder for myself.  There are times when frustration sets in and you just want to get out of the office.  The mind is on other things and the clock doesn’t seem to move fast enough, I need to get into the mental mindset that work until your done and move on.  The business has been awesome and it has been growing the past few years but everyone that owns their own business will tell you that being a business owner is an awesome blessing and a terrible curse, because while you may own the business it also owns you. If I’m not in the office, it doesn’t bring in revenue.  Having a work life balance is tough when you own the practice but stepping back and putting everything in perspective is nice sometimes because it shows you where you were and how far everything has come all while leading a life that I can be proud of.


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14/Aug/2022

If anyone ever says that running a small business, balancing a family life, making patients happy all while trying to turn a profit while living a comfortable life, boy do I have news for you. I wanted to kind of elaborate about what goes into the scheduling, getting the best results and finding a work-life balance.

For the past year and a half we have been closing early on Fridays. It has become apparent that this is not a new phenomenon but we still miss a lot of phone calls on Friday afternoon and have a hard time getting out of the office at a decent time.  I started doing this in order to get out of the physical office.  I get a lot of quips about how I need to get to the golf course, which is the case some of the time but a lot of times I end up having to come home and finish up paperwork from the week. Whether it is insurance paperwork or a daily note, all of this has to get done in order for the staff to take care of their daily tasks.

The end of the day is a lot like this as well. By the time 4 o’clock rolls around, we are pretty much wrapping things up for the day. We are not opposed to taking later appointments than that but calling after 4 to get in that same day is probably not going to happen.  Sticking around and waiting for a walk in appointment is crazy, most of the time I need to go pick up boys, finish up with some paperwork and get on with my day.  I have always told people that I am an early bird. I would much rather start early and leave the office early, than start early and leave late.

Now time is just one aspect of people pleasing in this office, another thing is trying to figure out exactly what patients need/want in order to get the best results. Finding a happy medium with people is tough.  Most people will come in with a specific complaint and will want it addressed, but most will have a pre-conceived notion as to how long it should take to fix.  Balancing that is the trick, the patient thinks one time and you should be good to go.  I’ve reached a point that I no longer feel guilty telling people to follow up with their care, if they need it, the patient gets to make the ultimate decision about scheduling, I get to make the recommendation.

The entire point of running a successful small business is to make people feel better and to make sure that if they have the same problem again that they return to your office. Being available and making sure that you provide value are the keys to making the business run efficiently. I’m huge of efficiency, we don’t like sitting around waiting on for the phone to ring at the end of the day and we are not big on making people come back for unnecessary/unwanted care, the philosophy of giving value to patients between care and price while limiting waiting time is a key for us. We feel that happy patients refer other patients and this is ultimately how you build a small chiropractic office in central Nebraska.

In ending, are we people pleasers in the office, absolutely we are.  There is a point to this as well. Taking time for my family and professional life is always a priority and I try to take the opportunities as often as I can because they don’t come about all that often. I’m not out of the office much for personal time so if I’m able to get out of the office 30 minutes early during the week, I’m going to take it. Come in or call early, we are available.

We genuinely appreciate all of our patients and look forward for the years to come.


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10/Jul/2022

I’m an early riser, most people in my life know this about me.  I feel that it’s the only legitimate time that I get to myself.  I workout, watch the television shows that I want to watch and drink coffee while the house is quite and everyone else is asleep.

A couple of days ago, I was working out in our basement.  Normally I will turn on some YouTube videos, sometimes I watch financial advice, motivation videos or sometimes just music videos.  This particular day, I wasn’t feeling anything in particular so I just turned on a mix video of classic rock.  One of the first songs that came on was “Thunderstruck” by AC/DC. Everyone knows this song but something hit me different this time.

Between the ages of 14-18 I played legion baseball back home and the CD that was played at the field before every game and between innings was AC/DC Live, basically their top hits blasted over a loud speaker.  I think I could recite the entire CD verbatim.

As I’m in my basement working out all of a sudden I have a tear running down my eye because I started to think about all of the good times and situations that I grew up with based around a CD that has not a lot of meaning to anyone. The primary position that I played/excelled at was pitcher, I was always instructed that as the pitcher you are essentially in control of the game.  The pace in particular, everything revolves around how fast or slow you want to work.

As you age, things start to get more complicated.  Adult responsibilities start to pile on (mortgage payments, running a business, kids and everything in between). I think the thought process that was going through my head with a tear running down my face was, life was so simple when you are in high school, you may not realize it but it really is. I woke up in the morning, maybe mowed a yard or two and then went to the baseball field and did this for years.  Nothing really complicated about that.

Practice can be the same way.  You can make it as simple or as complicated as you want it to be.  More, more, more in every sense is common place in the profession. More patients, more therapies, more services and always looking for the next best thing is normal within the profession.  I think we have found our happy place and plan on staying this way for many years to come but the pull and temptation is always there.

Simple is actually easier to operate and keep track of. We offer things in the office that I feel benefit a wide variety of patients without high pitch sales and pretty much explain themselves.  Living simply as a business owner can be a little more complicated, you have responsibilities and other people’s livelihoods depend on you showing up to work and providing quality care for patients.  It’s a little bit of pressure that can get to you at times.

I have heard “Thunderstruck” many times since I quit playing baseball but there was something about it on an early Thursday morning that caught me.  Life can be as simple or as complicated as you want it to be and there are unforeseen circumstances that arise but I’m finding out that just rolling with it is probably your best option.

Business ownership can be a lonely place, not a lot of people truly understand business ownership especially healthcare, but we will aim to keep it simple for everyone and makes everyone’s life a little easier along the way.


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05/Jun/2022

10 years into practice and we are FINALLY starting to hit our stride with the business, we have had our roller coaster of times but ultimately things have been wonderful.  One of the things that I have noticed over the years, we get asked all the times about techniques and how we perform certain things.  Other chiropractors perform different things and this is actually one of the weird things about the profession because a lot of times the right hand may not know what the left hand is doing between different offices.

In the state of Nebraska our scope of practice is fairly wide open and in general chiropractors have a good base of knowledge of health, whether they use it or not is another argument. Chiropractic schools do teach a broad base of knowledge across numerous fields, the vast majority just don’t use the knowledge on a daily basis.

If you bring in an MRI report, x-rays, lab results or any other main stream lab report, can we interpret them, sure we can but I just don’t do it every day, for most of these things you should stick with the person that does this specifically for a living.

Back to the initial rational behind this post, patients come in all the time and will say to me, well my previous chiropractor didn’t do it that way or do you perform such and such procedure. The way I run the business or purchase equipment is done on a very intentional level and with a specific purpose. I don’t look at purchasing equipment as a money making tool, obviously I need to have equipment, but I’ve intentionally told myself that I purchase equipment because it will benefit people not necessarily as a means to more income.

I don’t necessarily know what other chiropractors do and honestly I have reached a point that I don’t really care.  This might sound pompous but it’s genuinely not intended to.  Other chiropractors perform detoxification foot baths, applied kinesiology, upper cervical adjusting or even lab testing for specific conditions.  While I understand that this will attract a certain demographic and I have nothing against this but I don’t really understand these procedures and at this point in my practice and life I don’t really have a will to learn.

The therapies that we offer in the offices are proven over time, I’m comfortable with them, easy to explain to patients and are mainstream. I honestly don’t know the mechanism behind a lot of the therapies other doctors perform in their offices.  Stem cells, don’t know the mechanism on a detailed basis, detoxification foot baths, don’t know, shadow adjusting, yes it is a thing, don’t even ask.  Therapies that can be replicated over time are the ones that I am looking for in the offices.

We will continue to build an office around the thought process of taking care of people first and foremost, giving a value for the care that we perform, not dragging people on for the sake of getting more visits out of a patient and to perform quality care.

Staying in your lane can be a wonderful thing, we feel that we bring a value to musculoskeletal care and are fairly good at diagnosing specific conditions and know our limitations.  We are not trying to be everyone’s everything, but we do feel that we can provide quality care to a lot of people with specific back and joint pain.


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30/Apr/2022

May 1st of every year is a little bit of a reflection point for the business and household.  This year actually marks the 10 year mark for me being in practice and 9 years of running a practice by myself.  The course of a practice and the general mindset has shifted slightly over the years.  The first couple of years, you just worry about staying afloat.  I have had my wonderful wife by my side the entire time and while she may not understand exactly what goes on in the practice on a daily basis she supports the process that it has taken.

We have offices and Kearney and Minden, the Arnold office was functioning for roughly 6 years and when our first born arrived it was time that I needed to spend Saturday’s at home with the family.  I miss the people of Arnold and Custer county, I don’t miss the drive.  I get asked all the time about coming up every once in a while, and while I don’t plan on doing this, don’t ever say never.

Business mindsets are constantly shifting.  The first year in practice I was miserable, it was not the kind of practice that I wanted to run. So I started out on my own adventure.  I am comfortable with how I practice and feel that the offices give people what they need in care.  We attempt to offer patients a variety of therapies and treatment options that are utilized and supported by evidence.

Having multiple offices can have its own trials and tribulations.  When we bought the Minden office, I told myself that I wanted mirror offices. Whatever treatment you receive in Minden, the exact same option would be available in Kearney. With this come some financial implications, when you decide to buy one you have to buy two of whatever it is you invest in.  Costs aside, I like how the offices function and feel that we are starting to hit our stride and momentum over the past couple of years.

If someone that operates a business tells you that it is sunshine and rainbows every day, they’re either delusional or lying.  I would tend to lean towards the second option.  As opposed to staying open and afloat, the things that we worry about most now is cash-flow, keeping billing up to date, insurance problems and picturing the exact direction the practice is going.

Kristina & I feel that we have reached a point in the practice that we are really not all that interested in purchasing new and better things but to get to a point where we just build the practice to serve more people. Student loans are paid off (I would highly recommend this) and we can see the light at the end of the tunnel in regards to the business debt. We own both of the buildings that we work out of and the infrastructure is set up so no significant changes need to be made at this point.

Support staff has been absolutely wonderful and I wouldn’t know where the offices would be without Marty and Carol.  They essentially run my world in regards to the office.  They have become very good at talking me off the ledges that I approach or just listening to me vent. I inherited them when we bought the practice in Minden and they have been absolutely amazing.

We could not be in the current situation that we are in without the support of our families, close friends, superb classmates that serve as a sounding board, wonderful support staff, a pretty cool accountant, an understanding/flexible banker and all of the outstanding patients that come through the doors. While we may not be the biggest or most popular (according to Best of Kearney) office in the area, we feel that we have lots of room for growth in a couple wonderful facilities that offers practical chiropractic care for nearly everyone that comes in the door.


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16/Apr/2022

Frustration comes and goes in the life of a chiropractor/small business owner but this past week a few incidents struck a little different. I can almost guarantee that this story is fairly common within the healthcare field that the public does not hear much about but I’m going to tell it anyways just based on the pure scummy/frustrating nature of the story.

A little over a year ago a law firm reached out to me about taking on a patient that had been in an auto accident.  (I won’t name the law firm, but it is not local to me by any means) I took the case.  Being in the healthcare field, you understand that when you accept cases like this it may take years to get paid and a reduction in fees is normally going to take place. A couple of weeks later, the same law firm called about another person in a different case.  I took on that case as well.

Maybe I’m a sucker at this point, but I treated the patients and they were eventually released from care.  For every auto case there is normally a MedPay amount that auto insurance is required to cover, but as soon as lawyers get involved it can get messy in a hurry.  The cases normally have substantial amount due, because there are no upfront insurance write offs and the goal is to get the patient back to MMI (Maximum Medical Improvement) as soon as possible, so you treat aggressively from the start.

I felt that I took care of these patients very well.  They had been to physical therapy and received minimal benefit, so they wanted to try something else.  Great, send them our way and we will see what we can do. I think the treatment lasted for maybe 10 visits on the first patient and roughly 15 on the second, this is fairly lengthy for our office but they improved and in my professional opinion had reached MMI.

No additional treatment was going to be necessary on our end.  They avoided the medical system to keep them from having injections, surgeries, MRI, advanced imaging or any such things.  I honestly thought that I had done my job to the best of my ability.

This past week, we were trying to clean up some claims in the office and old auto cases always come up.  I periodically send out a few emails just to kind of check on the status of the claims, I understand that they may not be settled yet, but just from a curiosity perspective one want to know where they stand.

A couple days after I get a few emails back, the attorneys that had asked me to take the cases all of a sudden come in and indicate that they have “disengaged” from the case.  The frustration and “dumbfoundedness” hit me like a ton of bricks.  So a patient contacts a law firm, the law firm sets the patient up for additional care and then when it’s all said and done tell them that they will no longer represent the patient.  I’m assuming there was not enough money involved in the cases for the attorneys to profit, so they just drop the case, this is an assumption, but a good one.

All indications are that the lawyers have their butts covered and that I can send the bills to the patient.  I’m not exactly sure what I will do at this point because the patient did everything that they were supposed to do according to the attorney from the start and got left high and dry.

Morals and ethics are something I pride myself on but this situation just kind of struck me a little different. I’m not asking for a pity party but this just screams of a scummy lawyer with little to no ethics or morals.


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02/Apr/2022

I get these inquiries all the time when treating patients. While I don’t necessarily mind answering them, it does just seem to be a topic on conversation.  Just because you walk into the office and no one else is there does not mean that we are slow on that given day.  As with any other business, we go through ebbs and flows.  Spracklin Chiropractic has been around for going on 10 years to this point.  I used to ponder about how busy I am on a daily basis but at the end of the month and end of the year the numbers always seem to be just fine and most of the time grows slightly.

There is actually a thought process that you should cluster book patients on the schedule, there is a positive impact on when people come in and see other people in the office.  It gives the office credibility if there are other people seeking services from the office. I whole heartedly agree with this but when we allow for walk-ins in the offices, then there are going to be down times based on certain scheduling quirks that are planned for.

My wife and I are not paupers, of course you always want to see more patients and make a bigger impact in the communities I serve.  By making a bigger impact, normally money will follow.  Making a bigger impact does not necessarily mean taking advantage of people by making them come back for visits that are not necessary or by increasing your charges so that it makes up for the short fall on a given end.

The philosophy of the office is slow and steady, we have been growing consistently over the years but I always say that I’m able to sleep at night. There are days that we see more patients that we really want to in a given day and then the very next day we twiddle our thumbs waiting for the phone to ring…Welcome to Small Business Ownership.

I recently invested in decompression tables in the offices, I tell myself every time I purchase things in to the practice, I’m not doing this to add revenue to the office.  I think of specific patients when I buy things and purchase based on what value it can bring to the office.  A physical therapy office visit may cost you $150 just to walk in the door, if I can keep my costs at a reasonable level and provide the same basic services that other offices offer, but be able to charge $75 a visit, then it’s a win for myself, the office and the patient.

Caring about what your competition used to really work on me mentally but I’ve actually reached a point where working on my own practice and myself has become much more of a priority.  If by taking a day off bothers a few patients, I’m actually okay with that, because taking a day out of the office may actually benefit everyone involved in the practice.  Whether it be continuing education or rest and relaxation time, it will allow patients to benefit as I feel more refreshed or bringing new knowledge to the practice that could potentially benefit more people.

I like to have open conversations in the office, whether it be about the condition that is presented for the office, my life, your life or anything in between.  Don’t get me wrong, I will continue to answer the question about how busy the office is, but just know that you may come in one day and we usher you straight back and then you could return later that week or sometime later and you may wait for 10 minutes because we may be inundated on a given day.  We take the good with the bad but just know that we are happy with the pace of the office but will always strive to be busier.


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07/Feb/2022

I get comments from time to time saying that I don’t need to worry about money: “You see plenty of people, you must have a fancy car, mini mansion and take nice vacations a couple times a year.”

I want to kind of get back to the roots of this blog and talk to a younger demographic for a second about the finances that go into becoming a chiropractor, the numbers that come along with running a practice and how young chiropractors make a living.

I’ve said this before and I will continue to preach it, if you think you are going to become a chiropractor to become rich, I have some news for you.  The average American chiropractor makes between $70,000-90,000 a year.  Most have to take out student loans in order to finish the degree.  I graduated almost 10 years ago now and my loans were close to $180,000.  There are stories out there with people in the 250-300K range.  There are ways around making very minimal payments but the interest continues to accumulate and if you are looking for income based repayment, I hope you have done your research on the tax implications if you just make minimum payments for the next 20 years.

I’m a huge advocate for being as aggressive as you can, getting the loans paid off as fast as possible and from a bare minimum, you at least own your brain. Kristina and I made some very strategic moves in order to get the loans paid down, waited to start a family, worked relentlessly/obsessively to make extra payments and lived fairly minimal for the first couple years out of school to get them paid off.

Most chiropractors coming out of school end up working for someone for at least a little bit of time, while this is not the rule, some people do start practices right out of school.  Associate positions normally pay minimally and normally pad the pockets of the practice owner.  Starting a practice is expensive, more loans are probably necessary and the building period to making a profit can take a little while, if at all.  If you can keep your overhead to less than 50% you are doing well, but I caution when the bills start rolling in, your bank account never seems to get ahead.

If you think that you will make six figures, drive a luxury car and take a couple of weeks off a year your first couple years out of school, I want to know what you are smoking or what you are doing because I want what you got.

I’m going to preface this with, Nebraska, where I practice has a pretty good situation to practice in. The state association is very well organized and insurance reimbursements are reasonable for the area.  Chiropractic schools seem to be putting out more and more chiropractors with no sense of running a business, so unless you know the insurance game and have a little bit of business sense, it can be a rough go starting out.

Just some very simple numbers on a monthly basis: Rent ($1500), Utilities ($200), Software($200), Minimal Salary ($2000), Student Loans ($1000), Bank Loan for Practice ($1500), Advertising ($100), plus you will have random stuff that comes up.  Let’s say that you can keep your practice overhead to around $6000-7000 a month which includes paying yourself, at an average visit of $55 a visit, you will need to see roughly 35-50 patients per week to make a bare minimal lifestyle. These numbers will fluctuate greatly, you may hire help, you will pay payroll taxes and other practice related expenses are not included but you get the picture.  This doesn’t include saving for retirement, a building, a home or a car.

When someone says you must be rolling in cash because the practice is always busy, the thing that people don’t normally take into consideration ,is the pure cost of running an office, paying people and still having enough meat on the bone so that your own family can survive.

I’m not writing this for a sympathy vote, my wife and I live a fairly comfortable life with two young boys.  She works and probably always will, she worked hard for her degree as well and we feel that she should use it. The way the business is structured will actually benefit myself and Kristina in the years to come but it can get tight at times because the ebb and flow of patient visits on a given week or month.  We are ten years into practice so the ups and downs are expected but it does make you think a little bit when patients think that you are getting rich off of them.

I chose the chiropractic profession because I knew that I would be able to help people and I could ultimately be my own boss.  The sky is the limit, but right now I’m comfortable driving an eleven year old car that is paid off while trying to get ahead in life.  Like I said, this is not a sympathy blog but more of a put the numbers into perspective so people can wrap their minds around them.

If you are a young chiropractor with the world at your finger tips, there are a lot of different ways to make the numbers work and I have some good ideas that I keep to myself unless asked about but just know that knowing your numbers is a must, it will be a grind and that if you keep all this in mind, odds are you will be okay in life, not poor, not rich but okay.  People will always have more that you, so be comfortable with who you are and own it.

Questions are welcome and we will see everyone in the weeks to come.


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Providing effective natural chiropractic care to the Kearney Community.

Copyright by Spracklin Chiropractic 2019.