Chiropractic + Naturopathic Doctor

Business Talk: Do we really need you here?

Anthony Lombardi   

Features Leadership Profession

The question clinic owner DCs are asking their associates

Did you ever consider the number one reason companies hire someone is because they are in need of their services? Conversely, the number one reason people are laid off is because the company doesn’t need their services any longer.  

Even successful companies make changes if their employees are no longer needed. Tim Hortons, a universal success and a staple for many Canadians, laid off 350 top paying jobs from their head office earlier this year because they were no longer needed after fast food chain Burger King purchased the coffee giant.

This is happening in chiropractic offices across the continent as well. Clinic owners are asking their associates: “Do we really need you here?”


This is purely business and has nothing to do with clinical competence, being a nice person or chiropractic philosophy. It’s simply a business question answered by mathematics to determine the “need value.”

Associate doctors have to realize that if they are not committed to learning the system and aren’t focused on growing their patient base, their future will essentially be uncertain – especially if their numbers consistently fall short of expectations.

How does it add up?
Let’s say the clinic owner DC sees four patients an hour at $50 per visit, while the associate doctor sees two patients in an hour at $50 each. If the clinic receives 50 per cent of the associate’s fees, then the clinic makes $50 an hour with two patients. What happens if the clinic owner realizes they can make that $50 per hour by seeing one more patient per hour simply by improving their clinical assessment and treatment systems?

Associates need to demonstrate they are needed. This means they have to bring an element that the owner cannot reproduce without them.

From a business perspective, most clinic owners will make changes if they see an opportunity to make them. If they realize they can be as successful without you, they will make the change – just like Tim Hortons did.

In high school, I played quarterback and I started every game, but I also never missed a practice. I thought if the coaches saw someone else at my position it would give them other options if I wasn’t performing well during the game. You don’t think this happens?

Wally Pipp was the everyday starting first baseman for the New York Yankees in 1925, until one day he took a game off due to a headache. A young player named Lou Gehrig took his place and he played that day in Pipp’s place. Gehrig ended up playing the next 2,129 games in his place.

This is why it is so important not to miss work and to be as valuable as possible. You must do as much as you can to build your practice and this includes working as many hours as possible for as long as possible – until you make an unchangeable impression.

How to make an unchangeable impression
To make yourself indispensible in the eyes of the clinic owner DC, you need to be able to do something they cannot or will not do. This usually includes: working late hours; working weekends; seeing insurance, MVA and WSIB cases; willingness to pound the pavement to promote yourself; willingness to do talks and presentations to companies, organizations and schools; acquiring a niche skill others in the practice don’t have, i.e. acupuncture, massage therapy, active release technique.

I had to do this to build my practice into one that produces 600 new patients per year. There are no gimmicks, no tricks; it’s all hard work coupled with the implementation of a simple clinical and business practice system.

Find a place you can embrace
If you are willing to learn from the clinic owner and embrace their assessment and treatment approach – and if you pound the pavement and build a patient base over 12 to 18 months –you will have developed something the clinic owner cannot live without.

The key to being a good associate is to learn, but the bigger picture is to take it as an opportunity to build your own practice. We live in an economic time where the cost of chiropractic education is the highest it has ever been and the lending rates are the lowest they have ever been. Today is the cheapest time in history to purchase land, buy a building or borrow money to rent a place to build your own clinic. If you cannot afford it now then you are not likely to be able to afford it for a very long time.

If you make it a priority to make yourself needed and be a valuable part of wherever you are, then you will be able to build yourself a solid, prosperous future.

Dr. Anthony Lombardi, DC, is consultant to athletes in the NFL, CFL and NHL, and founder of the Hamilton Back Clinic in Hamilton, Ont. He teaches his fundamental EXSTORE Assessment System and conducts practice-building workshops to health professionals. Visit for information.

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