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Hopefully you have read
page 1, page 2 and page 3 so you know where we are coming from.
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).
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)
Taxes (city, state, local, municipal, federal)
Telephone (plan on four lines or more plus at least one cell
phone)
Auto expenses (Will there be a company car?)
Supplies (face paper, x-ray film, file folders, printer
toner)
Sales and marketing (internal marketing such as mailers |
external marketing such as Yellow Pages, Internet 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 CD-ROMs)
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, adjusting tables, film
cassettes, computers)
Software (chiropractic software, Microsoft Office, Windows
XP, Vista, 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 Internet marketing)
Some other expenses include but are not limited to...
CD-ROMs, videotapes & DVDs 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, your 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 $750,000.00 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 29 adjusting hours per week. But
it is not accurate to say I work 29 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...
mail@planetc1.com. 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!
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