Chiropractic + Naturopathic Doctor

Business Talk: 5 keys to becoming a valuable associate

Anthony Lombardi   

Features Business Management

What associates need to hear

Photo: Adobe Stock

Associate doctors have to realize that if they are not committed to learning the system and are not focused on growing their patient base, their future will essentially be uncertain. When you are focused and committed to the job, you will be successful. But hard work and sacrifice are non-negotiable ingredients in the recipe for rewards.

Recently, I was reading an article by and I was surprised at the advice they were dispensing to new graduates:

“Chiropractic jobs that offer an associate position with no salary and pay a percentage split only are a ticking time bomb. To be blunt, this bomb is going to explode eventually. The real question is whether the owner or the “associate” will be impacted first. The chiropractor who agrees to work for no pay and who has no patients to start must hustle to create an income so that they can eat with little to no cushion to begin their adventure. This is remarkably like starting your own practice, except that you are going to give a percentage of your income to the owner and be subject to their rules, second-hand treatment by their staff and all the limitations of working for someone else (without the steady paycheck).”


Clearly, I disagree with this statement because if you are an associate, you should be treating the opportunity as if it was your own practice. If you are not, then you will not be an associate for long – anywhere. The key to being a good associate is to work hard and make yourself indispensable, while at the same time learn the ropes, develop your skills, and earn some money.

No sugar coating
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.

An associate cannot be missing work. If an associate misses work or cancels often, then the clinic owner discovers ways they can succeed without them. In 2001, an abdominal injury forced New England Patriots quarterback Drew Bledsoe to miss several games. He was replaced by an inexperienced young man. Well, Drew Bledsoe is long retired in part because the man who replaced him (Tom Brady) is still playing.

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.

5 keys to becoming a valuable associate

1. Do not miss work
Take it from Drew Bledsoe. He regrets missing time due to injury and in retrospect he probably would not have missed so much time if he knew his replacement would play so well. If you miss work often, you give the clinic owner an opportunity to discover how they can do things without you.

2. Go the extra mile
It is key to do things like work late, work weekends, see acute patients in need, help out with paperwork, and ask to shadow your mentor when you are not seeing patients. In order to maximize your experience you have to sacrifice. If you are just starting out, no one is really interested in helping you unless you demonstrate you are willing to sacrifice for them.

3. Take minimal vacation
See number one. You just finished three to four years of undergraduate work and then four years of chiropractic college. That was the easy part. Now please get to work – no clinic owner is interested in hearing you need a vacation.

4. Aim to improve your skills to match your lead chiropractor/clinic owner/mentor
Your skills need to continually grow and develop to match the time you are with the clinic as an associate. A good clinic owner will train you and set a timeline for your development. If you do not follow that timeline or lag in your development, they may become less interested in spending time to do this for you.

5. Learn every clerical procedure
You need to become indispensable. So, learn every aspect of the clerical procedures and offer to help when the clinic is stuck due to illness or bad weather. At times, you may be working late and need to cash out a patient and rebook them. Make sure you know how and as soon as possible.

I had to do all of the above to build my practice into one that produces hundreds of 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.

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. Many will read this and say I am “too hard” or my recommendations are “unrealistic.” However, we live in a time where expenses (housing, fuel prices, groceries etc) at are an all-time high. These expenses are just as elevated for clinic owners, and just because they are established does not mean they will be giving you any handouts. If you would like an opportunity at success, you need to demonstrate you are willing to work for it. By work I mean sacrifice and do the things that seem difficult.

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.

Anthony LOMBARDI, DC, is a private consultant to athletes in the NFL, CFL and NHL, and founder of the Hamilton Back Clinic, a multidisciplinary clinic. He teaches his fundamental EXSTORE Assessment System and practice building workshops to various health professionals. For more information, visit

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