You have been in the practice for many years. He has been successful in building and maintaining his practice. The career goals you set upon graduation have been far exceeded. Now you have ten, fifteen or twenty years before completing your degree. What are your options to grow personally and professionally?

Turning one practice into multiple practices would define the growth of many chiropractors in the middle of their career. To be able to serve more of the community and, in turn, increase your passive income, decrease physician/patient time, and increase equity in practice would further broaden the definition of your success.

As the co-owner of six chiropractic practices, my experiences may shed light on whether expanding multiple practices is a viable option for you to achieve greater professional satisfaction. If asked, most chiropractors would say they would love to have multiple practices and reap the rewards, but most chiropractors who try to expand fail.

A common business plan is to open a second office and work in it on your days off. Build a small patient base and then an associate can take over the existing patent base. What invariably happens is that the existing practice declines in profitability, a small practice is built on the satellite practice, overhead costs almost double, and the physician works an extra two days on top of the regular work week, with no financial ability to hire a staff member. associated. The doctor now finds himself bleeding until he hemorrhages. The reality is that every hour they spend in the satellite office they are losing money and enthusiasm.

This failed plan is reproduced over and over again. I have profited by buying many of my satellite practices from bleeding stage doctors. All the doctors felt that selling their practices at an undervalued price is better than continuing to lose money and energy. For them, it was selling or closing the office entirely.

The fundamental mistake that these doctors have made is that they have worked in their practice, not in their practice. This statement by Michael Gerber in E-Myth should be fully understood before attempting any expansion.

Doctors tell me all the time that they are working harder than ever, spending time traveling from office to office, training new staff, and seeing more people. They are not achieving their goal of multiple practices; they’re just doing more than they already are with a lot more overhead. They are working on their practice.

The chiropractor whose goal is multiple practices must work less as a chiropractor and more as a visionary, manager, and staff motivator. A transformation from the practice of chiropractic to the business of chiropractic must occur. A shift in thinking from “This is what I do, I’ll do it more myself” to “I must delegate responsibilities to grow” is a must for growth. Your interest will grow in other related areas, such as information technology for greater efficiency, human resources for quality recruitment and training, and improvements in basic business modus operandi. His responsibilities will include researching the best purchasing opportunity for printing, telephone, X-ray sales and service, commercial liability and malpractice insurance, and durable chiropractic supplies. The physician who puts his energy into implementing specific systems that can assess productivity and efficiency within his practice is working in his practice.

There are three interdependent traits that I have found to define success in any project, but definitely in multi-office sprawl; vision, motivation and implementation of the system. The vision you create will be the motivating force that develops quality systems that can be highly executed.

You, the Chiropractor, must be the visionary; the leader who has a burning desire to climb this mountain. His employees must understand, accept and follow this vision. Ideally, the chiropractor, staff, and patients should all be aligned on the practices mission.

This vision must encompass the satisfaction of all involved. Each person working with you must have a community and personal interest in reaching the goal. By serving the community, the practice, and oneself professionally and financially, you solidify the entire organization with the vision.

No one person can execute all the tasks necessary to build and maintain multiple practices; it is a true team effort. Acknowledging this statement exemplifies the need to motivate your team. Not all employees are motivated by the same compensation or the same management style. My experience has shown that evolving towards a well-defined corporate culture allows the leader to anticipate the needs of the team. High employee diversity leads to greater difficulty motivating and managing. Similar personalities are motivated by similar and predictable ethics, expectations, and rewards.

As the organization grows, the talent needed to manage and motivate must increase as well. My basic theory for successfully managing staff is to clearly define what is expected of the employee, get them to accept that level of competence, and then motivate and manage them to achieve that expected level.

“Success is in the system” and “the system is in the solution” are common phrases in my offices. We live by them and we grow by them. The most famous illustration of the concept is McDonald’s. With 300 percent staff turnover, they rely on systems to deliver a predictable standard of quality and service. Once the system was established, replicating the service to over 25,000 locations around the world was history.

In many multi-employee physician practices, the chiropractor has the least knowledge about the systems within his or her practice; the office manager runs “the show.” This doctor is binding that person to the point of being held hostage. The clinician who eliminates each major task within his practice and develops a system for completing that task for others will be able to become multiple practices. That doctor must first master the task, document the process or system, and then set it in stone for everyone to use. Every system should have a component that evaluates and monitors the effectiveness of that specific system for constant improvement. This allows the physician to delegate the ability to monitor. The result of this process is growth; growth by organization, not by individual.

The most difficult challenge is committing to multiple practices, financially and emotionally. Make a real commitment, don’t go into the plan saying, “I’ll open a second office and see how it goes.” Once engaged, you become the architect and design the business plan with your talents. Drawing on your past experiences, you will transition from concept to reality.

Personally, going from one practice to six has been one of my most challenging and fulfilling professional experiences. I can relate it to mastering a video game. In a video game, at first every move you make hits a land mine that brings you closer to death. As you begin to understand this new environment, you develop a plan or vision to win. It soon becomes apparent that a motivated workforce with a plan or system will win over its opponent. Additional repetition of necessary tasks increases your ability to perform at a level of excellence. With all these forces behind you to gain intellectual strength, political influence, and financial independence, you crush the opposition. Unfortunately, life doesn’t exactly imitate video games.