A s I travel across the United States and around the world, I often hear two questions from students and new doctors in the early stages of their careers. First. "How do I go about starting my own practice?" Second. "How will the new insurance programs (i.e.. the Affordable Care Act) affect the business of chiropractic?" The answer to the second question is still a developing story. Later in this article. I will share my insights based on experience. To answer the first question, let me take you back fifty years to when I was a new doctor, newly graduated from Logan University. Starting Out Even by today's standards, my life then was moving at a quick pace. After graduation. I served for a time in the US Navy, got married, and then returned to my home state of Minnesota full of energy and ready to practice in the field I loved. My list of riches was a short one: a "56 Ford convertible (not well suited for Minnesota winters): a pregnant wife expecting our first child: and a diploma. There is one dramatic difference between my situation and what students face today, and you can sum it up it a single word: debt. I had none. Students graduate now with debt that can easily reach six figures. Please, keep reading, though, because the lessons I learned then will serve you well when it comes time to get out of debt quickly now. I looked for office locations, but didn't have the money to lease a building, much less equip a practice. Good fortune led me to the DC who first recommended me to chiropractic school. He listened and took pity on me as I poured out my story, and then offered his extra adjusting room. He said if I cleaned it up and painted it. I could use it until I decided where to base my own permanent practice. I sold the convertible to pay for an apartment that would serve as a home for our new family. My grandmother, who lived nearby, generously let me use her car on the weekends. I did use it. too. to drive to any and every event I could find in my ongoing effort to rccniit new patients. It was a shoestring start, but it worked. After spending about 90 days in my one-room office, and attending nearly every event in the count}', my practice started to grow. That very humble beginning turned into a 25-ycar practice with 18 of those years spent in practice with my first doctor/mentor. In total, we occupied only about 1.200 square feet, but over the years, we worked up to treating 1.000 patients a week in those tiny offices. You don't need luxury to get started, or to succeed Modem marketers have convinced us that we must acquire every amenity and live on credit-card luxury to have any hope of success. In my experience, that simply isn"t tme. Many things have changed since I first began my practice, yet that basic principle of hard work and solid skill makes all the difference, even now. I recently met a young doctor at a seminar in Texas. She poured her heart out about how much she loved chiropractic, yet hated working for the clinic that hired her. After some encouragement, she began to try a different approach. She chose the town where she wanted to base her practice and began to investigate. She found an established doctor with a large clinic and talked him into renting a room to her. With nothing more than an Activator instrument and table, she began much as I did. Having trained in the Activator Method, she had a tremendous advantage because she had an established, step-by-step, effective procedure she could rely on to give her confidence. She worked hard, and in 30 days, her business showed a positive cash flow. After 90 days, she rented her own apartment and began paying off her student loans. After a year, she asked her lessor if she could rent two rooms to expand her practice (he was delighted to have someone who could share the expense). After two years, her lessor/doctor offered her the chance to buy the clinic. Interestingly, she turned him down because she had now learned a solid business lesson about the enormous value of low overhead. Because of this doctor and hundreds like her. I began to work with chiropractic industry leaders (Foot Lcvclcrs. Lloyd Tables. Multi Radiance, and. of course. Actuator) to create a package of equipment we now call the "New Grad Package." It supplies the new practitioner with all the basic equipment necessary to start a practice. Along with this package, we also offer an elegant leasing arrangement tliat allows the new doctor to finance the purchase with monthly payments as low as $ 136. What about the changes in insurance laws? How is that going to affect my new practice? During 50 years in chiropractic. I have survived recessions and the American Medical Association, as well as the pain we chiropractors often inflict on ourselves. And guess what? Chiropractic is still here today. I've also logged well over two million miles on travels that have taken me to mam countries around the world. My observation is that socialized medicine nearly always creates a two-tiered system: one system is funded by the government and the other is private pay. People must wait for care through a government system, and as a result, the private-pay system grows quite rapidly. It varies by country, but in my experience, the private-pay systems look very much like the American system of care with which we're all familiar. I also have observed that even when chiropractic is included in the original law that created the government healthcare system, it is among the first things cut when government budgets get tight. Based on my experience, my advice to new doctors here in the US is to operate a very low overhead clinic. Take payment in cash whenever you can. and be sure to accept Medicare (you can't opt out). Americans prefer convenience and I believe they are unlikely to stand in line and patiently wait for care. Also, always bear in mind that you are the practitioner of choice for spiral care. You can tmst your skills and constantly work to refine them, but know that no matter wliat practice path you choose, there will always be a need forgood chiropractors. Dr.. Irian Fuhr travels extensively to chiropractic seminars, conferences and events around the world. Ilewill he providing his insights and perspectives from these visits as a regular guest commentator for The American Chiropractor. You can reach him at 602-445-4230 or email awfuhr(q)jaclivator.com.
