Chiropractic + Naturopathic Doctor

Business Talk: What gets measured gets improved

Anthony Lombardi   

Features Business Management

Photo: Adobe Stock

Five young business students (John Collins, Nick DeLuca, Abigail McManus, Olivia Missios, and Yue Wu) from the McMaster University Business School approached me this past winter.

They requested that my practice be the topic of study for one of their group projects in their 3rd-year COMMERCE 3MC3 course. Their objective was to analyze my practice business model, study the market for my services, outline the strengths and weaknesses of my business and offer objective solutions for improvement. When we assess the direction of our business practice on our own, I feel we limit ourselves from seeing our strengths, or accepting the areas that need improvement. The group of five used interesting metrics to audit my business, allowing me to ponder how to improve my practice continually. In the end, they generated a 58-page report which I can refer to in the future.

For the project to be completed, I handed over three years of my business financials, submitted to a group interview, and agreed to be present during their final presentation.


Problem identification
The group identified three problems as paramount. First, because my practice operates on an “injury” model versus a “wellness” model, my practice requires a constant stream of new patients to sustain the business. They stated that Palmer (2015, and not our Palmer), wrote that most patients cease attending appointments once their primary complaint has abated. Only 31 per cent of people reported continuing seeing a chiropractor even if they were not experiencing pain. The business group found that this could create a conflict of interest for me because if patients get better, then they stop coming, which decreases revenue. However, if I provide the results the patients wanted, this could lead to positive patient referrals. The other problem they identified was that according to their research, many people, in general, are not as clear as to what chiropractors treat. In their survey, over 50 per cent of the participants had never been to a chiropractor. Also, my practice name (Hamilton Back Clinic) could suggest that I only see back problems even though I treat an array of musculoskeletal conditions. I also have five RMTs and physiotherapy services.

From a business point of view, the students commended the various streams of revenue I can generate by offering massage and physiotherapy services. They state that these elements mean that the focus is placed on developing specific strategies to target the awareness issues identified. They considered the community and online reputation I have grown as evidenced by almost 12 new patient referrals per week to be positive. The robust Google, Facebook and affiliated online review platforms are positive as well.

The substantial online presence is thanks in part to the YouTube videos I began producing and uploading back in 2008. I wrote about this in a Business Talk article in 2011, which outlined how online was the way of the marketing future:

“Today, that one person who had a fabulous experience with a chiropractor will now tell hundreds of their closest “friends” about what a great chiropractor they had. It’s not a matter of if you start a social media network – it’s about when.”

The group listed that my Hamilton Back Clinic Facebook page has 2,138 followers, 1,645 YouTube subscribers, 541 on Twitter and 1,185 on Instagram. They compared them to controls in the surrounding area and found my social media presence to be trending.

Having said all that, the group found my website to be ancient. I have not updated my website since 2006. They feel that my site could be a reflection of my services for someone who does not know me. My logic for not changing it is that I’m concerned that overhauling my website will shift the search engine algorithm. Whether this is valid or not, I do not want to tinker with something that works. The group also stated that another weakness is the lack of awareness that I offer RMT, physiotherapy services, and treat MVA and WSIB cases.

Market analysis
The group found 136 chiropractic offices in the Hamilton region and 5,559 in all of Canada, representing a 2.5 per cent Canadian market share. Hamilton only has a 1.5 per cent share of the Canadian population, which reveals a higher than average density of chiropractic offices in this area. They also determined that 70 per cent of Hamiltonians have chiropractic extended health insurance, but only 15 per cent of them use it. Lastly, in the report, they determined approximately 85,000 Hamiltonians go to chiropractors out of about 536,000 residents.

The future
Since the group was made up of five millennials, they focused on the future of their generation relating to chiropractic. I thought this was innovative since most reports always focus on the baby boomers. By 2025 the millennials will make up 75 per cent of the workforce. The average Canadian family works 65 hours per week, up from 58 in 1976. This figure continues to increase with the smartphones never leaving our pockets. They see chiropractic becoming something millennials embrace as a regular part of their lives or just another service to use if needed. They surmise that continuing to provide higher value to chiropractic services will well serve my business in the future.

Thank you to the McMaster University Business School and these exception young students for taking the time to include me in their studies.

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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