Nearly every healthcare professional undergoes a white coat ceremony and during that ceremony, normally fairly early on the journey, an oath is taken:

Hippocratic Oath

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not”, nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

Chiropractic Oath:

I do hereby swear before God and these assembled witnesses, both corporeal and spiritual, that I will do my utmost to keep this, my sacred, trusted oath, as a graduate of the (National University of Health Sciences), that henceforth: I will esteem those who have taught me this Art, Science and Philosophy of Chiropractic and with this torch of knowledge, fashioned by Hippocrates, I will light the way to the understanding of those Natural Laws which preserve the human body as a fitting temple for the soul of man.

I will keep the physical, mental and spiritual needs of the sick as my foremost duty, ever searching for and correcting the cause of their disease to the best of my ability, insofar as my science is in the highest precepts of my Alma Mater and harmonious with the Vis Medicatrix Naturae.

I will at all times stand ready to serve my fellow man, without distinction of race, creed or colour, in my lifelong vocation of preventing and alleviating human suffering, wherever it may be found, by exemplifying in my own life a pattern of living in harmony with the Laws of Nature.

I will refrain from any act of wrongdoing and will regard the keeping of a patient’s confidence as a moral obligation, using any such information only in his or her best interests. May God so direct the skillful use of my hands that I may bring strength to the sick, relief to the suffering, peace of mind to the anxious and the inspiration to mankind to attain bountiful health

That we may live this life to the fullest expression of its innate endowments. I therefore, solemnly swear to uphold these principles and precepts to the best of my ability, so help me God.

Most individuals that go into a healthcare field indicate that they would like to help people.  While money is also a driving factor, the initial factor revolves around the ability to see people improve their lives.

We live in a strange era right now because in the United States there are so many different insurances that cover so many different things and there are nuances between companies.  Sometimes we perform the exact same procedures in the office and the reimbursement can range $40 from the low end to the high end and this is just the way the contract is written.

Are there certain policies that pay better than others, of course.  I would be lying to you if I said anything different. Some are easier to work with than others and coding can be different from plan to plan.  Is it a lot of background work, yes it is, but at the end of the day you need to come back to the reason you went into a healthcare field in general, to help people.

A general trend that you have been seeing recently is that offices are starting to drop certain insurances and adding back in cash services. While I completely understand the numbers behind doing this, I feel that ultimately the patient is the one being left behind. Insurance is offered through jobs, Federal marketplace and normally government services. The patient does not normally have a lot of say of the intrinsic details and coverage that the policy covers. Patients are paying for coverage and will normally go to a provider that is in-network. Why pay more for coverage you are already paying for.

The argument is that certain insurances just don’t pay enough to justify accepting the care.  While I would argue the office is not necessarily losing money, it’s just not making “enough.” So they let those long standing patients go somewhere else because their insurance (unless they want to be treated out-of-network or cash) which they probably didn’t get to choose, does not reimburse enough.

(I’m not going to get into the argument of insurance companies cutting reimbursement rates while operating expenses continue to go up, premiums go up & reimbursements go down, this is an entirely different argument)

The ultimate discussion is that people need care and while money is a huge driver in healthcare, it should not be the ultimate driver. Taking care of people of all walks of life is the oath that was taken and will continue to be followed.  We accept nearly every insurance plan offered, will take auto cases, work comp cases and cash patients. We charge a fair price for the services that we provide and are honest to a fault.

I would implore my colleagues and fellow healthcare professionals to think back to the day you took whatever oath you took and the excitement/joy that came with that day.  Bring that energy back to the office and help the people that are seeking your care, trust me the money will follow and you will lead a great life.

Recently, at the start of the year, I have been trying to sit down and re-evaluate the previous year and look forward to the year to come.  2022 was a good year on a professional level but the end of the year put a little bit of a hamper on the year on a personal level.

At the beginning of the year we added decompression tables to both offices.  I thought that this would bring a new aspect to the offices and allow for a different therapy to be offered.  Quite honestly, I absolutely love the technology and thought process behind the therapy but we have found that we just don’t use the tables like we thought we would.  Another doctor offered to purchase the tables from me and I took the deal, so beginning this week we will no longer be offering decompression therapy in the office but will still have flexion-distraction and the roller table which essentially accomplishes a lot of the same things.

We grew our DOT business year over year. I have been performing these exams for the past 10 years, the only reason that I know this is because I have to recertify my certificate by the end of 2023. The years are starting to add up and while I feel like I just graduated from school, it has actually been a few year at this stage.

Colleagues have gotten sick or go out of town, we try to fill a void when others are out of the office with patients that may actually come and go due to this but I just hope that if I need anything from colleagues on a professional level, I would like to think that it would be reciprocated.

The start of the new year is always a little reflective, as it’s my birthday as well, but it actually comes across at a good point to ponder what a year it has been.  I wanted to elaborate a little bit on my personal situation as well: my wife and kids are doing great, growing like weeds and basically starting to take over my life, as it normally does with children.

As many people that have come into the office these past couple of weeks, you may have heard that my dad (Craig) received a liver transplant a couple of days before Christmas.  A heart medication that he had been on for years was the culprit as to why his liver began to fail.  While we are grateful that he was given the chance to receive the transplant, it’s starting to look like a lengthy recovery is going to be a reality.  His liver, kidneys and heart all look to be doing well at this stage, things keep popping up during the recovery process. I will continue to think/worry about this daily but as I told my mom this past weekend, I’m able to escape it for a little while, she’s the one that is living the day-to-day aspects of it. We will continue to pray and hope for a speedy/quick recovery but a long road appears to be ahead.

In ending, 2022 was a great year for the practice and a strange year for me personally.  I have come to terms that I need to start having more fun at work, laughing more and getting out of the office a little more to enjoy my family and boys as they grow up. I will be taking a few days office January for a long weekend/vacation and a few days off in February to attend a conference that I have wanted to attend for some time. We will continue to strive to keep things simple and consistent at the office and cannot thank our patients enough for the level that we have grown the practices too and look to continue to build in the coming year.

A saying that almost everyone knows is that it takes a lifetime to build a reputation and a second to ruin it. When building and maintaining a practice for over ten years now, we have not strayed too far from our initial strategy.  Create a practice that provides practical/evidence based care at a fair price with little to no treatment plans. Thus far, the strategy has worked fairly well for us.

There are practices that will try to sell treatment plans that are accompanied with numerous therapies and treatments over several months, while I can’t argue that people get better with those types of plans, it’s just not the type of practice that I, myself, would want to go to.

Other practices run on a corporate model, where the care is extremely affordable.  I question how quality the care is, when every patient that walks in the door gets a two minute adjustment and is out the door before the car is even cool.

There are practice models for everything in between, from multidisciplinary models to functional medicine to shadow adjusting and foot baths. Chiropractors are a unique bunch to say the least. Conventions make for an interesting time because of the vast array of personalities.

I’m a relationship person, while I like adjusting people and feel that I can deliver a quality adjustment, I do feel that adding features to the treatment can be beneficial. Acupuncture, laser or any of the other therapies we offer in the practice do add to the benefit of the care. If the therapy is not warranted we don’t do it.  I appreciate the conversations I get to have with my patients and getting to know them. My wife thinks I’m weird based on the number of things I can remember about random people, but I like it, the conversations can get interesting.

I know more about farming and cattle then I thought I would ever know, but it’s interesting to me as it’s a business just like any other business that is run. I’m starting to see initial patients graduate from high school and college, getting into the real world and complaining about paying bills.  I’m actually trying to put a larger emphasis on just having more fun in the office, most people in the world would be envious of what I get to do every day but I feel that sometimes I take myself a little too serious at times so if we start laughing in the office, feel free to join in.

Plain and simple, we like simple in the office.  The longer I go, the more I appreciate simplicity.  We keep our billing straight forward, the treatments are geared to the specific patient and scheduling is almost too easy in the offices. Walk-ins are welcome and DOT physicals are scheduled same day (while I still recommend pushing the date closer to the expiration date).

While reputation isn’t on the time of my mind on an hourly or even daily basis, I do think about it periodically and we don’t plan on changing anything drastically about the office, other than we are letting people know that we are trying to keep things simple and if certain things aren’t getting used we will most likely be eliminating things that don’t bring value to the office.

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.

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.

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.

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.

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.

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.

May 1^st 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.