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February, 2013

The Four Pillars of Success for a New (or "Old") Practice

By Perry Nickelston, DC, FMS, SFMA

It's the moment you have been working toward for years. The long hours of learning the art and science of chiropractic is about to pay off. You set a goal in life to help others by sharing your passion for chiropractic. Opening up your own practice is the culmination of hard work, determination, overcoming obstacles and mastering your craft. Optimism rules your thoughts and you are finally ready to take the next step on the journey of owning your own business. Open up the doors and the world will come in with open arms.

Not so fast. It's easy to get excited about your new venture while losing sight of minute details that can make or break your first year. Effective long-term practice systems have a foundation built upon four pillars of support: staff development, marketing, communication and adaptability.


You can be the most skillful doctor in town and yet still struggle if the wrong people are part of your team. Many doctors spend thousands of dollars on practice-management systems with little success because they are built upon a foundation of poorly developed staff. The most critical element of new-practice success is hiring the right people to interact with your patients and each other.

Personality counts above all else for your front-desk staff. Technical skills can be taught, but personality traits are hardwired. Changing a bad personality is nearly impossible and not worth the effort. Go for the gold in personality; the extrovert, the one who likes to smile and loves interacting with people. Hire front-end people based on communication abilities instead of experience.

For positions involving record-keeping, billing and insurance, introverted personalities may be your best choice. Choose someone who is detail-oriented, task-driven, accountable for their work and likes to follow a routine. Once you hire a cohesive team, do all you can to make them feel valued and appreciated. Develop a positive learning environment that fosters ongoing opportunities for continuing education. They should feel they are truly part of a team, not just an employee who shows up to punch a time clock for a paycheck.

Do they have input into practice policy? Can they approach you with new and innovative ideas to improve the practice? A productive, feel-good environment goes much further than you realize in building a successful practice. Rules of the road: Hire for attitude and train for skill; hire slow and fire fast.


Do you have a marketing calendar for every week of the year and a monthly summary sheet? If not, create one now. How can you hit a target you can't even see? Set goals for yourself and your staff for each week and hold everyone accountable, including yourself. Documenting and tracking a marketing calendar is essential in discovering what works best for your practice. You should know every detail about each campaign and its effectiveness-to-investment ratio. There are many online resources where you can download sample annual marketing plans. Simply follow the template and change according to your target niche of patients.

Never stop marketing. Marketing is not something you do when business is slow; it's something you do so business never gets slow.

Implement a strategy based on social media exposure to form more personalized relationships with current and prospective patients. Log into Facebook, Twitter, YouTube, LinkedIn and blogging sites. Connect with people. The best part about this model of advertising is that it's 100 percent free! In a first-year practice, you want to keep expenses to a minimum; what better way to do that than pay nothing? During the first year, it's natural to tighten up the belt and cut your marketing. Much of your effort should be from "internal marketing" and assurance of patient retention. It is more cost effective to keep an existing patient than to constantly search for new ones. Some of the best ways to do this include:

  • Word-of-mouth programs: ask your clients to help you out.
  • Referral strategies with incentives.
  • Newsletters and special promotions.
  • Educational workshops partnered with like- minded non-competitors.
  • And of course, outstanding customer service that keeps patients coming.

Involve your staff in discovering fun and creative ways to market internally. If these ideas sound a little crazy, I suggest to you that they are the ones you should implement. Remember, being remarkable is a good thing. Boring is bankrupt, particularly when it comes to your practice.

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