My normal working schedule is Monday thru Friday 7AM to 5 PM with a lunch break in the middle, I travel to Arnold every other Saturday morning to work for 4 more hours.  I hear from other doctors that I don’t need to work that hard and I hear from patient that I need to take some time for myself.

I absolutely love what I do and the people that I am able to help on a daily basis.  Whether you come in for a simple DOT Physical or can’t hardly walk into the office because you are in so much pain, I want to be there for you.  When I leave the office for the day and I miss a phone call from someone that is trying to get in, I genuinely feel bad.  If you call for a DOT physical, there are times that I will come in at 6:45 in the morning because I want to make things convenient for the patient.

Now there are limitations to this request as well, if you call at 4:30 on a Friday and think that I am going to stay late, you may be a little crazy because I do try to make it convenient for people but the patient also has to take my schedule into consideration as well.

As I said before I absolutely love what I do for work and for people but I actually may be addicted to work.  I always tell people that I don’t have a lot of vices in life, but I truly do love to work and to play golf.  So in the summer I do take some time off to play a little golf but I do feel like I am letting patients down by not being in the office.

My alarm goes off most mornings around 5:10AM and I am out the door most days by 6AM depending on which office I am at and am ready to see patients by 7AM.  I justify this schedule because Kristina and I are on a mission right now to get some debt paid down. 

On this mission to pay down debt, I have not only worked long hours in the offices and try to build a practice that I can be proud of but I also do insurance reviews in order to pick up a few extra bucks.  As the debt gets paid down, I will ease up on the work schedule but have no idea on the specifics of that.  I am just going to keep showing up and treating patients at this time.

Between writing a blog, working at the offices, doing insurance reviews and trying to have somewhat of a social life, I stay pretty busy.  This past weekend, I did not have any commitments, I didn’t have to go to Arnold, no reviews and it rained most of the weekend so I was able to just lay low.  I cherish these weekends but by Sunday afternoon, you wonder if it has been a productive weekend.  Let me tell you, it is, it gives you a chance to regroup and evaluate everything from life and practice.

So, why do I work so hard? I work endless hours in order to serve my patients in order to accommodate as best as I can but the trade-off for something like this is that it will eventually pay off dividends for Kristina and I in the future.

I know that this post is not much but it does put some perspective as to why the lights are on at the wee hours of the morning and when you call the office, someone will almost always pick up to get you scheduled at your convenience. 

As always, if you have any questions or comments I would love to hear from you.

Secondly, in my crusade for student loan refinancing a link has been given with Credible, who I think makes the process the easiest.  Check out previous blogs and be sure to check out Credible.

http://refer.credible.com/2C6pJM

Now, I’m going to preface this by saying this is my opinion on this topic and I understand that people are under different circumstances and that there are numerous, rationale reasons to use the IBR system but I am going to advocate for individuals that have six figure student loan debt to not use the program.

When you graduate professional school, whether you are a doctor or a lawyer most people don’t really think about how they are going to pay off their student loans, they just think that they are going to rule the world based on the education that they just received.  It is a real slap in the face when you finally start to face the fact that these loans are going to need to be paid.

As I stated in the previous post, most government backed loans are at 6.8% and I believe that the interest is the same no matter what you select for your repayment plan.  The problem with this is that with individuals with a six figure loan amount, you are never able to get ahead of the interest on these loans, at one point, I believe I was paying a little over $900 a month in interest.

With many young professionals, you are not making much money when you graduate, most of the time as a young professional your salary might be minimal enough to pay very little, if any on your income based repayment plan.  Numerous chiropractors don’t pay themselves hardly anything when they are fresh out of school as they pour almost all the money that they make back into the business.  Now that sounds well and good, but when you start to analyze what the interest is doing while you are paying little to nothing on your loans, it will make your heart sink.

Another problem with income based repayment is that whatever you have left on your loans after 20 years of paying, will roll onto your personal income tax.  So the thought process is, if I pay the minimum amount for 20 years, the rest will be forgiven, but the caveat is that the “forgiven” amount is that it does show up on your income tax as income for that given year.

Let me give you an example, this will be very general in nature.  Let’s say you are a new chiropractor and you have $200K in student loans when you graduate.  The first five years you don’t make enough money to qualify to pay anything on your student loans…your interest will continue to accrue.  After five years of doing nothing you are up to $260K.  Now, after five years you start making a little money and you can pay a little every month, but you still aren’t touching the interest because your $900 is now $1000 a month, you can kind of see the perpetual cycle with this.  Now after 20 years of payments, you would be close to 45-50 years old and you could potentially have between $300-400K in student loans left.  If you roll that amount into your personal income, so in addition to paying on your loans for 20 years, you will now owe an additional $100-150K in taxes on the amount that is forgive.  This is a very brief explanation but if you can piece personal finance and compounding interest together, it is easy to see the vicious cycle that you can fall into at this point.

With all of that being said, if you are young medical doctor or lawyer that is going to go work for a non-profit and can have your loans forgiven after 7-10 years, then by all means, go for it.  But in the world of chiropractic, this is just not an option for young chiropractors.

The reason I write about this, is because I am all about personal responsibility, now if there is a program that you can take advantage of to make your life easier to pay off student loans, go for it.  I took out the loans, ultimately I am going to have to pay them back, and this is why I am becoming such an advocate for student loan refinancing.

There are options that are 20 year repayment, that means when you are done with the repayment after 20 years you are done paying and don’t have to worry about the tax implications.  But you will have to face the fact that your payment will start immediately and not when you can afford it.

I have been established in practice for over 5 years now, I have told myself that I want to pay off my loans as fast as possible.  Don’t ask, but I started to listen to Dave Ramsey and while I agree with him on the premise of debt reduction some of the steps that he indicates to take are not realistic when starting a practice and growing operations.  This why I have refinanced my loans twice and look forward to being student loan free in 2-3 years.  By refinancing I was able to reduce the interest that I pay from $900 a month to roughly $300, so the majority of my payments go towards principle plus Kristina and I have been getting super aggressive making extra payments.

Income based repayment is not a bad program, but I feel that it is a terrible program for young professionals that have no shot of working for a non-profit and have six figures in debt as you will never be able to get ahead of the interest while making minimum payments.  The taxes when it is all said and done will make you cringe if you wrap your mind around the numbers. 

Unless you are one of those fantasy thinkers that thinks that the government is going to forgive all student loans (it probably won’t), go ahead and get aggressive with your loans and get that huge monkey off your back.  If you have any interest in refinancing, I highly recommend Credible, as you get numerous options in one place and the options run the gambit.  Click on the referral link below to check it out.

Again if you have any questions or comments on this topic I would love to hear from you.

http://refer.credible.com/2C6pJM

If you would have told me 10 years ago that I would take out a loan of over $150K for a piece of paper, I would say that you are crazy.  That’s exactly what I had to do to get the education that I wanted and I will be paying for it for the next couple of years and I do not regret it one bit.

You don’t realize when you are going to school how the loans actually work because the school just tells you that you will need to take out “said” amount in order to pay for school and living expenses.  When you sit down at exit counseling before graduation, you get a piece of paper indicating what you owe in school loans.  Now a six month grace period is granted to everyone with government backed loans, but you don’t think much about it because you feel that you are ready to go conquer the world and make the money back in no time.

The standard repayment plan is a 10 year plan but many people are suggesting that chiropractic student’s move towards income based repayment or pay as you earn plans, I will go into why this is such a bad idea in a little while.

Now maybe I graduated at just the wrong time, but I have talked to friends that have student loans with interest rates from 2-4%, but I graduated the rate was 6.8% and I believe that it is roughly the same since then.  The friends graduated from college roughly 5-10 years before I did.

I started on the standard repayment for the first year out of school, I was just trying to get my feet under me and grow a patient base.  When I decided to start my own practice, I switched to income based repayment because it would lower my payment in the short term and give me a little cash flow for the business, at the time this was great but in the long run this was a stupid decision as I did not really understand what the program all entailed.

About a year into practice by myself, two years out of school, I started to really look at the numbers and was wondering about the number that was my student loan.  It kept going up while I was on income based repayment, like I said I will get into this later, but we decided to get out of that program in order to really start attacking the loans as I did not want to be hampered with this loan forever.

Kristina and I really started to look at student loan refinancing.  I initially thought this was a bad idea for me but the more I looked into this it was a great idea for what I was trying to accomplish.  I would never qualify for forgiveness because I work for myself and I didn’t want to have student loans for the next 20-25 years. 

I started to search around Credible as it gave me the most options for refinancing my loans from numerous different lenders.  I investigated other options but the interest rates were by far the best with Credible.  Initially, the rate was at 3.14% but it was variable over ten years.  I stuck with this rate for about a year until the rates really started to creep up, as it is based on the Federal Reserve rate and if you haven’t noticed interest rates have started to increase.  Just recently I actually just refinanced again to a five year loan at roughly 3.75% but this time it is fixed.  We have been getting super aggressive with the loans recently and have a goal of paying them off significantly sooner than the term of the loan so the shorter term loan was okay in our minds.  It was tough to press the button initially but I think it will be good overall.

If you have any questions or advise on this topic I would appreciate the feedback.  If you ever consider refinancing your student loans feel free to use my name as a reference.  It really is worth looking into for people that have a stable income and a desire to pay your loans off sooner rather than later. 

Next week I would like to address why income based repayment and pay as you earn is such a terrible idea for professionals like chiropractors and how it will end up costing you more money in the long run.

When you really think about that, an entire generation is paying on student loans with interest rates that are nearly double the mortgage rates that you can take out at the same time.  I understand that this is an unsecured loan but the country is going to end up with a generation that is riddled with debt, with no real shot to pay them off in a timely manner while contributing to the economic growth of the country.

One final thought, I was once told by a friend that your student loans should be looked at as an opportunity cost, as you would not be able to make the kind of living without taking out the loans.  While I truly do believe this, it is really tough when you make the payment every month to think about it like this, but it will be worth it in the long run.

Use this link to explore your options with credible which is feel may be very much worth your time.  http://refer.credible.com/2C6pJM

I got to thinking about this topic as I have been updating offices and equipment, but as the business owner and chiropractor in the offices, what exactly do I expect out of myself and the offices on a day to day basis.

When Kristina and I purchased the Minden office, we knew walking into the situation that we would need to upgrade the office and the tables.  Not that the tables were bad, but I prefer to work with flexion-distraction tables, and the Minden office was equipped with Hylo tables.  This was going to be a process as financially it was not possible to do everything that I wanted at one time. 

If you can remember, I started practicing with a couple of used tables in the Kearney office and then eventually upgraded to a table that I prefer.  When the office was moved in Kearney, equipment was updated again to tables that would be conducive to a growing office and to things that I liked.  I worked on tables in Minden that I did not necessarily like but made do.  A month ago, that all changed, we upgraded all of the equipment in Minden and took a few “newer” tables to Arnold, so that all of the offices had the necessary things that would allow me to treat patients to best of my ability.  I’m 6’5”, I don’t need to be running to a chiropractor daily due to tables that do not rise up to my level and be bending over all day, this was the main point of getting new equipment.

All of the offices have quality, new to almost new equipment at this time.  The equipment is not only comfortable for the patient but it allows me to perform my duties as effectively as possible.  The offices run the gambit.  While the Kearney and Arnold offices are not ideal in my mind, they are fairly inviting, comfortable and serve the purpose.  They are open concept, so privacy can be limited but for the most part patients are good with it.  The Minden office is the most inviting office in my opinion, we have tried to make it the everyman office.  All walks of life come through the doors and the offices try to allow for an environment that is welcoming to everyone.

With that all said, after this purchase I started to really think about what I owe my patient when they walk in the door and the expectations that I place on myself.  Empathy, Optimism, Quality Equipment, comforting environment to walk into and lastly, the truth.

I feel that when a patient calls or walks into the office that you, the patient is putting enough trust in me to give them relief and if I can’t get them relief then at least guide them in the right direction.  Empathy is key to allowing me to determine what the patient is dealing with.  While I can honestly say that I have not experienced a lot of the conditions that present in the office, I try to put myself in the patient’s shoes and try to at least walk them through some of the symptoms that they are describing.

Humor can be a great thing when trying to give optimism to a case.  A patient may be in extreme pain when they come into the office and a little laughter can ease the mood and take the patient’s mind off of the situation.  After being in practice, you can kind of tell based on how the patient is able to respond to pain how long of a process it will be, my hope is to use that to my advantage to walk the patient through the pain and symptoms that they may be experiencing.  Giving the patient a logical path and length of time will give the patient a little optimism with recovery.

Lastly, I owe you the truth.  If I ever have the privilege to treat the readers of this post, I feel that I will attempt to guide you as far as I can through the pain that you are suffering from.  While it is not my favorite thing to do, I have to swallow my pride and tell patients that I am not able to help them and they need to seek alternative care beyond myself from time to time.  While I will attempt just about any case, there are some things that you cannot linger on and the patient may need to move on.

I write this in the hopes that it keeps me accountable to my patients and that it reminds me on a regular basis that I owe my patients the best.  Now, there will be days that get tough but I hope that patients will continue to hold me to these items.  Empathy, Optimism and the Truth are big factors in building a trusting patient base and I hope to continue to grow through these principles.  The buildings and equipment are beneficial in having a welcoming environment but the factors that hold the practice together are the principles that I hold myself too.

I am going to start to address the debacle that is chiropractic student loans in the coming post and it may either be a really long post or be broken into the numerous small posts.  This is a topic that I am becoming fairly obsessed with and am looking to guide a future generation.

Roughly a year ago, Kristina and I were perfectly content working in Kearney and traveling to Arnold one day a week.  Heck we had just moved offices in Kearney and were just settling in there. We were in the process of putting new floors in our house and we received a phone call from Roy Wakefield on a Sunday afternoon.

I had known Roy for about five years since I started practicing in Kearney and would always tell him that if he ever needed to get out of practice and retire, to let me know.  I would say this half-jokingly because I never in my wildest dream would have imagined that we would buy a practice.

I walked out into the driveway to tell Kristina that Roy had just called, we kind of chuckled and said…ah, hell lets run down to Minden real quick and talk to Roy as we did not have any floors or any television in the house at the time, so we had nothing better to do at the moment.  So we loaded up the dog and decided to take a little drive and this is where our lives change in a matter of about 20 minutes.

Now, I had known that Roy’s office had animal heads in the waiting room and trees outside, so I kind of knew what I was walking into but Kristina, I believe was a little in awe of the office.

So we walk into the office of Wakefield Chiropractic with an open mind and are interested in seeing what the details were, not that we were all that interested at the moment.  Wakefield Chiropractic was one of the most established and recognizable practices in Central Nebraska for some time so I knew that the office had a reputation of being well respected.

As I have stated in the past, I am very much a numbers person, we started to get into the numbers and then the wheels really started to turn in my mind.

I knew what the Kearney and Arnold offices was capable of but this was a whole different animal in our minds.  I had never had any type of employee, payroll, work comp. insurance and all of the other aspects that come along with operating a business on this level.  I had always just been a single person office that would answer my own phone and take the day as it comes. 

I don’t think we were even out of Minden, when Kristina and I looked at each other and said we have to do this and take advantage of it.  As many people know, I tend to overthink things, but this decision just felt right. Our main hang up was the schedule and how to make the money work until things got established enough.  Kristina and I had a few connections in Minden, a few phone calls were made to see if we were crazy or not. 

Probably 4 hours after leaving the Minden office for the first time, I called Roy and said that we were going to do this.  He kind of laughed and said “you may need to sleep on this and give it a week to let it sink in.”  Kristina and I were heading to Chicago for a friend’s wedding, we drove out there, so we had plenty of time to mull over this decision. 

After numerous conversations with friends and family, it only solidified our decision to take the plunge to Minden.  I started to meet with people and ironing out the details with Dr. Wakefield.  One last wrinkle, I would need to start working in roughly 2 weeks.  Details were coming at us fast and furious. 

Another issue, I was inheriting two secretaries that had been to the office for over 25 years a piece and had yet to meet them.  I headed to Minden on a Friday afternoon and started to get a mental grasp around what exactly I was taking over, the girls seemed to be open to everything that I was hoping to do with the practice. 

The first couple of weeks were a little strange for me as I was trying to figure out a daily routine that would work for everyone involved in the picture, me, Kristina and the girls, just to make sure everyone was comfortable with the situation.  I was working on tables that I was not accustomed to and providing services that the girls had never heard of.  We had a few bumps in the road but for the most part is was smooth sailing.

We are a little over a year into the Minden office and things are starting to click along nicely.  I told myself it was going to take a while to get everything in place and allow patients to be comfortable with my techniques and ways of operating.  In the past year, we have replaced the carpet, painted the entire interior of the building, brand new tables, added therapies and services and most recently the outside of the building was redone and painted.

The purchase of the Wakefield Chiropractic allowed the business to grow and prosper throughout the last year and we do not regret the decision for one minute.  We hope to continue to grow the Minden office through by introducing the community to services that I offer and through continued quality chiropractic care.  DOT Physicals and acupuncture have always been a niche part of my practice and I hope to continue to allow patients to experience the benefit of these services.

We cannot thank the community of Minden enough and look forward to continuing a prosperous business for many years to come.

I have been wanting to start writing down thoughts for the past four years, so here is the start of something that is beneficial to the readers and an outlet for me.  I have wanted tell my story for some time as I feel that people coming out of chiropractic school are ill prepared for what the working environment is really like and how much of a struggle starting your own practice or buying one can really be.  This blog will document: how I got to where I am, the struggles that come along with practice, struggling with student loans and some interesting tidbits in practice.

The first thing I would like to do is introduce myself, you could just go read the about me page on the website but I hope to delve a little deeper into where I come from, my background and how I got to where I am now.

I was born and raised in Valley, NE about 15 minutes outside of Omaha on Hwy 275.  I had a fairly normal upbringing in a middle class family.  My dad worked in Omaha ever since I can remember and my mother is a retired music teacher.  I was blessed with a very solid educational background at a public school, my teachers were very instrumental in my educational guidance, but sports were my real passion throughout school.  I played basketball and baseball throughout high school and eventually accepted a baseball scholarship to play at UNK, which is what ultimately brought me to Kearney, NE. 

While attending UNK, I met my wife, Kristina Rupp, from North Platte and we have basically be inseparable since we were 19 years old (it’s really strange writing that, I don’t feel that old).  I majored in Exercise Science and Chemistry from UNK.  Baseball was my life the first two years of school, at which point it was determined that my love for the game had diminished and that I was actually on pace to graduate close to a year early.  I ended up graduating in 3.5 years from UNK. 

While taking Pre-Med classes at UNK, I ended up doing some shadowing and felt that chiropractic would fit my desire to treat the public with their health concerns and the lifestyle that I would eventually like to lead.  While researching chiropractic schools, I knew that I wanted to stay in the Midwest but also wanted a quality evidence based education.  I ended up actually only applying to National University of Health Sciences in Lombard, IL as I felt that this would fit my personality and my desire to live in a larger city. 

Three weeks after I graduated from UNK, I moved to Lombard.  My parents and Kristina helped me move but Kristina ended up having to go back to Kearney to finish up another year and a half of nursing school.  I will never forget orientation day at National.  Roughly 50 people that have never met each other, sitting in a room all of us anticipating what is to come.(You end up getting over those nerves, as some of my best friends and colleagues are the people that I spent 3.5 years with in Lombard).

If I recall, there was a group of 7 people that started and finished together and I can honestly say that we keep up regularly, go to each other weddings, children are starting to trickle into the equation and I consider them to be colleagues and resources, besides being good friends.  We stressed, studied, bickered, complained, led and followed while in school. 

When I was in undergrad, I shadowed a doctor which ultimately led to a part time job in college and went off to chiropractic school with the understanding that I would ultimately go back and work in that clinic.  I never really had to look or think about future employment, which we will get to later, but ended up being a mistake in my case.  With roughly a year left in school, I ended up working the morning shift on the National campus, most people wanted the afternoon session, city clinic, Salvation Army clinic or hell some had the option of a Florida clinic.  Dr. Grant Iannelli was my clinician and I consider him one of few people that helped shape how I continue to practice to this day, not only is he a great human being and is one hell of a chiropractor.

My friends make fun of me, as I believe I moved back to Kearney one day after I graduated into a house that Kristina bought without me ever seeing (we still live in that house, so it was a really good choice).  In the future posts, I would like to dive into my first year of practice, starting my own practice, operating a satellite office and eventually purchasing a large practice. 

If there is anyone that has any questions please feel free to contact me.