Choosing a Prime Chiropractic Location

Part 4 in our series of Assessing the Salary of a Chiropractor

Where you’re located could make all the difference in the world

A chiropractor in California is going to have different issues to consider than a Florida chiropractor will, even though both are coastal states. That may not have much to do with salary as much as it does with what one does with their salary (such as living expenses).

blue chiropractor sign

Chiropractic has also been growing internationally and there are many more opportunities than there were 10 years ago. Remember one thing when you’re getting ready to open a chiropractic practice… Where there are people, there is potential for success. It may be nice to live in a town of 173 but unless the other nearby areas have a significantly greater number of people, you may be doing some struggling if looking to build a volume practice.

Where there are chiropractic schools, there tend to be greater numbers of chiropractors. The state of California has four chiropractic colleges, whereas the state of Florida only has one. As a result, California has more practicing chiropractors located in the state than any other location on the planet, including Florida.

If you were searching for spring break locations, “best spring break location for hot babes” or something like that, you’d likely end up with a Florida location, or maybe Cabo, Mexico. After you graduate college, you won’t be looking for any spring break locations, you’ll be seeking prime locations to set up chiropractic practices.

Interestingly, the chiropractic school in Florida (Palmer Florida in Port Orange) is not far from Daytona Beach, infamous for its spring breaks. We may see an increase in chiropractic offices around those areas is more students graduate from that school.

Living expenses could be an entire article of its own and I’ll likely get into that in a blog format, I brought up some basics below.

If you intend to party like a rockstar while attending chiropractic college you may find yourself being squeezed trying to keep your lifestyle afloat. There’s nothing worse than living like and multi-platinum rap artist while you’re in school, only to end up down and out on the streets, with a couple hundred grand in student loan debt, with no chance of paying it back, because you were too wasted in school to learn anything.

I’ve heard of it happening, all too many times. Those that don’t plan for financial success usually end up as financial failures. Well, you could always default on your student loans, encumbering the rest of the world with your burdens and debt, become a hate blogger, and live in your mommy’s basement.

Nearly everything above applies to student life and student living, including living styles for the first few years after you graduate. You can do plenty of partying, have a good time in school, get a great education, nail all of your national and state boards, and not be burdened with debt. You just better off making some plans before you get started.

I know quite a few chiropractors that own the most expensive houses in their neighborhoods, but they didn’t buy them the year after graduation. They made plans, they follow those plans, they revisited those plans on a regular basis, and they continue to work those plans today, now living a very attractive lifestyle. You could call it lifestyles of the chiropractic rich and not famous (at least not outside of their practice base).

What expenses are there when you open your office?

Some fixed chiropractor business expenses will include…
Administrative salaries (what you’re paying your staff)
Rent (unless you own your building or property)
Utilities (gas, electric, water)
Insurance (general liability insurance and practice insurance)
Taxes (city, state, local, municipal, federal)
Telephone (plan on four lines or more plus at least one mobile phone)
Auto expenses (Will there be a company car?)
Supplies (face paper, x-ray film for analog docs, file folders, coffee, printer toner)
Sales and marketing (internal marketing such as mailers, external marketing such as Adwords, Facebook Ads, and other online marketing)
Interest (anything you might have to pay on borrowed money)
Miscellaneous (What if you have equipment other than chiropractic equipment in your office?)

Others
Education Expenses (continuing education, licensing, seminars, DVDs and online courses)
Legal and Professional Fees (business attorneys, tax attorneys)
Business Entertaining (open houses, patient gatherings, healthcare talks)
Travel (seminars, more continuing education, practice management training)
New Equipment (x-ray tubes or digital x-ray, adjusting tables, film cassettes, computers, mobile phones)
Software (chiropractic software, Microsoft Office, Windows upgrades, billing software)
Charitable Contributions (many many many patients will ask you to support their cause)
Advertising and Promotion (internal and external marketing as well as online marketing)

Some other expenses include but are not limited to…

Educational products related to business skills (adjusting, report of findings, new patient lectures)
Business association dues (chamber of commerce, International Chiropractors Association, ACA, World Chiropractic Alliance, ICPA, Chiropractic state association)
Business-related magazines and books (Journal of vertebral subluxation research, JAMA, ICPA Pathways)
Coffee and beverage services (bottled water, tea)
Office supplies (paper, pens, toner, window cleaner, vacuum bags, trash bags, toilet paper, hand towels and many many others)
Seminars, trade shows & conferences (this could go under continuing education but you will likely attend conferences regularly that will have no continuing education credits)

What about practicing / living in different cities if you’re going to be in the U. S.?

Think about cost of living and renting vs. owning…
I friend of mine in Lantana, Florida recently bought a 5 bedroom home in a gated community for under $500,000.00

In the city I live in (Los Angeles) I don’t know if there is anything like that even available for purchase. You may pay $950,000.00 or more for a starter home in many California beach communities. By starter I mean one or two bedrooms plus 1 bath with very little property. What goes for the home often also goes for commercial rates. Can you afford to own the land your office is on or will you rent?

Something that happened in my area around 2004… A local chiropractor in Santa Monica had a great practice location. Plenty of parking, lots of space, great visual from the street, and massive pass by traffic. What had happened is the lease came up and hers was not renewed. The entire property was renovated and she was put out of her location as a result. As is the nature of business, another Santa Monica chiropractor experienced his business grow significantly.

Trying to find a new location with current rates what they are could be a difficult task. Again, I am only speaking of one area and a single example so do some work on your own demographics before you go on my input alone. You may pay $1000 per month rent for 1000 square feet in some areas. You may pay $4000 per month for the same square footage in others. If you’re going to be a single chiropractor office, four grand monthly payment just for rent could be a real mood drainer.

We are not selling widgets…
The number of patients coming into one chiropractic office vs. another vary greatly. Some chiropractic offices in the US (individual DCs) will see 60 visits per week. That can be 20 people coming in 3x per week. It can be 60 people coming in once a week. These numbers are never static, nothing is static in a chiropractic office. We should be able to assess averages though based on past performances. One week an office can be full of new patients and the next week there may be none. We want to average those numbers and income earned over both weeks to get more accurate data.

The Big Ones
There are some offices in the US that are seeing in excess of 1000 visits per week and a few above 2000 visits per week. Is anyone over 3000 visits per week as a solo doctor? If there is, I’ll get some data and post it here. If they are seeing 1000+ visits per week then how long are they there?

Doing the math on adjustment fees collected…
$20 x 100 = $2000 (this can be per day / per week / per month) Yes, some DCs see 100 per day and more. Some, in fact many, see less.
$50 x 100 = $5000 (this can be per day / per week / per month) Yes, some DCs see 100 per day and more. Some, in fact many, see less.

$2000 x 5 work days = $10,000 per week
$10,000 x 48 = $480,000 per year
That’s assuming a 48 week period (allowing time off for vacations). These are much higher numbers than what is being reported above but wouldn’t it be nice to get some of this info so we can see where the upper volume offices are functioning?

We have many other factors to get into…
How many hours does one work? Some current data says an average of 30 – 39 hours per week. For example, in my chiropractic office I have 25 adjusting hours per week. But it is not accurate to say I work 25 hours per week. There are morning preparation hours, marketing hours, report hours, weekends doing events, spinal screenings, etc…

To tell you the truth, I’ve pretty much organized my day so that I can go in and see patients (typically a four-hour shift) and allow my staff to handle everything else. As an aside, I’m blessed to work with some great people.

I will not begin adjusting patients on a Tuesday typically before 3:00 p.m. but I may be in that same office at 6 a.m. getting narrative reports or other office work completed. I will get plenty of time to exercise, rest, handle other tasks, and address other “work-related” issues.

You can’t put a price on the freedom you get from having your own chiropractic practice. If you read through all the pages of this article on salaries, you probably already made some comparisons to other fields. Make no mistake, there are those who have in chiropractic, and those who have not. For those that have gotten what is often referred to as “The Big Idea” chiropractic is an absolute joy. Work weeks that are under 40 hours and being able to set your schedule around your lifestyle are benefits that outweigh income for many chiropractors.

Ironically, nearly every chiropractor I know that works less office hours, often times sees more people and has better earnings, than those that work long days and don’t take regular vacations.

The variations of reimbursement insurance…
In theory all of the $50 on a per visit adjustment would be collected. But is that the case? We’ll find out and post some data here. One insurance company may only pay $25.00 per visit for 12 visits. One may pay $34.75 per visit for 20. One may pay the full fee. The person receiving care would be responsible for the balance but it would be great to get some data on how much gets left unpaid.

There are probably as many different ways to collect fees as there are chiropractors. Some do cash only. Some accept insurance. Some offices have care plans that provide affordable care for whole families. Some offices focus on work-related injuries. Some receive most of their income from settlements handled by attorneys. There’s any number of ways to combine the way chiropractors earn their incomes. I didn’t even get into those that work with sports teams, salaried chiropractors for movie sets and television shows. Traveling DC’s the provide care to mega-celebrities, big business tycoons, and models.

Yes, this is a mish mash of information but it gets a bit more cohesive each time I do some updates. I have received hundreds of emails asking for more info. You can probably tell that I’m rather excited about this stuff. For those of you in doubt, it may be helpful to know that I went into school with no savings and paid for my entire education with no family assistance. What I did have was some common bonds with fellow classmates which became an essential component in my being where I am today.

Read through all the pages if you haven’t done so already, think about the topics you want more details on, and email me. Please note that I may address your e-mails on the chiropractic salaries blog (without sharing your personal information), so that I don’t have the answer the same questions each time someone e-mails me. Gotta have my beach time!