Too many chiropractors hire their associate doctors at the wrong time, without the proper milestones to measure progress in place and with no cohesive plan for how that associate will fit into the overall strategy for growth. As a result, the associateship either fails quickly or flails slowly and eventually, they call it quits and terminate.

Unfortunately, many associates enter into this relationship in a similarly poorly planned manner, with few tangible goals, no metrics to gauge success or a lack of an understanding of how the associateship will further them towards their overall plan. And, as you might imagine, the consequences are the same – failing or flailing until the day where they call it quits or are fired.

But it doesn’t have to be that way.

Great associates can be created and they are a business decision to be considered like many others choices entrepreneurs face. As such, the “blueprints” for their creation and cultivation need to be in place long before the associate ever arrives.  Without the proper plans in place, the associateship will assume the default success rate of any business venture – which means most will fail in a short time.

Buying Shoes or Building a Business?

Without the proper criteria in place, the hiring, the evaluation and the progress of an associate becomes mostly an emotional decision. The two doctors are feeling each other out to see if they are “a good fit” to work with each other. They see if patients like the new doc and if their treatment style is similar or complementary enough. And the associate tries to determine if they can get along well together with their new boss and staff.

While I will not deny that any associateship contains an emotional component, this should be less than 20% of the criteria to measure the success of the relationship. And the other 80% or more should be a business decision.

Planning a successful associateship (from either side of the equation) is a business decision that needs to be evaluated from the perspective of an investment rather than an emotional decision akin to purchasing some shoes or planning a vacation. And unfortunately, from the success rates of most associateships, it appears we are better at buying shoes or taking a trip.

But there are concrete criteria we can apply that will help us plan for a successful associateship, so let’s discuss those:

The Milestones & The Mistakes

Milestone #1 – Busy — I am a firm believer that there are marked milestones that represent the different phases of growth and success in chiropractic business and each milestone requires some strategic planning and proactive decision making to move the business up to the next level. Hiring an associate doctor is one of them.

In this way, the very first criteria must be that your business is busy enough that it actually needs an associate to continue growth and profitability.

Most docs are not foolish enough (and they don’t have enough money anyway) to consider hiring an associate when they first open their practice. The reason why is simple: they are not busy enough to need one.

So here’s the simple fact: if your schedule is not busy, you don’t need an associate. I define “busy” as having a schedule that is 75% or more booked, most of the time. Read that correctly. Just because you have been in practice for a while doesn’t mean you need an associate.

Mistake #1: Emotional Vs Business Decision

This is where the first mistake comes in. In many cases, practices have the potential to produce more with better systems in place, better business strategies, an accountable team and any number of improvements to their existing procedures. If a practice’s numbers indicate the chiropractor/owner can do additional care without adding an associate, then there is absolutely no reason to hire one.

Too many chiropractors make the EMOTIONAL mistake of wanting an associate because they are tired or because they mistakenly believe that adding more providers will automatically create more demand.

This is nonsense 98% of the time. Adding capacity to create more profits is a fine strategy, but you don’t necessarily need an associate to do that. There are better (and cheaper) ways to increase your bottom line without adding an associate to your payroll.

Another DC requires more patients, a bigger payroll, time to mentor the associate and solid systems to plug them into.  Without these things in place, the premature hiring of an asssociate simply causes you to “multiply your messes.”  That is, the extra provider will actually expose or emphasize the existing weak links in your systems and your procedures.

Simply put — a chiropractic practice will not grow on it’s own and if it’s not growing at your experienced hand, why do you think a young doc who has no business or chiropractic experience will grow it? And even if they do, why would they want to stay on board? They are now carrying you!

Milestone #2 – Secondary Streams

So once a chiropractor has passed Milestone # 1 of being busy enough with solid systems in place, the next milestone to meet is to maximize other secondary streams of income.

In other words, just because your schedule is busy, it’s not necessarily time to hire another chiropractor.  There are plenty of opportunities to maximize the income potential of the patients that you already are seeing. Here are some secondary streams to consider:

  • Could you add an ancillary service such as massage to your practice?
  • Are you performing rehab consistently (and getting paid for it)?
  • Do you have solid systems in place for recurring revenue?
  • Do you have procedures in place to insure the full range of your services are offered or delivered consistently?
  • Are your collections procedures solid and helping you get paid for what you do?
  • Is your Accounts Receivable appropriate for a practice your size or are you leaving money on the table through poor billing practices?
  • Are you coding properly for your services or are their better and more appropriate codes that could get you paid better?
  • Have you optimized your product sales, weight loss programs, nutritional supplements or other sources of cash income?

Mistake #2: Leaving $ To Spend $

Most practices that consider associates fail right here. They know they are busy and feel the pressure of a full schedule. They have enough systems in place that their business appears smooth running the show as they have always done it. They want to increase income, so an associate appears to be a good idea.

But the fact remains, that they have a ton of profit potential left on the table by not maximizing the above items. They are leaving income on the table that requires no extra expenses (in most cases).

Looking WITHIN the practice to increase profit potential is consistently a better and more surefire investment than going outside the practice (via hiring an associate) to chase additional income that definitely requires an additional expense (associate salary) and is a bit risky in terms of an investment (after all, you can’t actually prove that your associate will work out before they arrive).

You are literally trying to add potential when you already have a lot of untapped potential within your practice.  Put another way…you are leaving virtually guaranteed money to run off and spend some money by gambling with an associate. At this point, you don’t need an associate, you need to maximize the potential you already have without one.

Profits Ahead! When You Pass Milestones 1 & 2…

As I mentioned, most chiropractors who have failed associateships find (after the fact) that they have failed to consider these first two checkpoints.

So they hire the associate anyway and fail.

If this is you, do yourself a favor and continue to maximize your schedule and your opportunities for profits WITHIN your practice without adding an associate. If you need help in this regard, that’s a primary focus of my chiropractic coaching programs and we can help you get there faster.

And what if you pass the first two milestones? Congratulations!

Stay tuned for Part 2 of this article, where I will discuss additional milestones and mistakes to avoid on your path to creating an awesome associate!

[For more info on our private coaching programs, click the link here.]