EPISODE 460: The Current Landscape of Evidence-Based Practices with Curt Kippenberger DC

Hey, chiropractors. We're ready for another Modern Chiropractic Mastery Show with Dr. Kevin Christie, where we discuss the latest in marketing strategies, contact marketing, direct response marketing, and business development with some of the leading experts in the industry. 

Kevin Christie: [00:00:00] All right. Excited to have Curt on the, on the call today here in our podcast, one of our, actually our first associate coaches for MCM and really helped us, uh, go from a, a small mom and pop shop of me doing some one-on-ones to building out a team here at MCM helping out, uh, chiropractor. So, so welcome to the show.

Curt Kippenberger: Yeah,

thanks. Always a pleasure to come on and, uh, connect with our MCM community in a different way. Absolutely. And before we dive into it, uh, what was your positive out of 2025 as we record this? It's the early part of January. Might be late January, early February as it come out, comes out, but what was positive for you?

Yeah, I think we'll probably get into some of the topics that really helped me in, uh, in the Portage 2024 to 2025. But everybody has rough times in practice, rough times with family, rough times in their professional career, and 2024, I mean, it, it just flat out. It sucked, man. It was hard. . Lots of, lots of other [00:01:00] things going on personally in my life. Yeah. But, um, yeah, between my team internally here at Focus on Health, uh, my family, my MCM family, including the, the coaching clients that we serve and mm-hmm. The, uh, mastermind communities, I mean, all of those troops, rallying behind 2025 was a complete turnaround.

We went from, uh, a, a fairly decent loss to a fairly decent, uh, profitable. Uh, gain in 2025. And so obviously you can imagine financially that's huge for us, for the practice, for our family. Uh, and you know, I don't wanna say for your ego, but for your purpose, right? Like you, yeah. You spend a lot of time trying to refine your craft and be really good at it, and especially in the evidence-based world, and then you just get dinged up and you're like, well, is this even worth it?

Um, so yeah, I would say, uh, just an overall flood of my purpose and my passion. I was actually talking with one of our clients this morning and he said, I'm stepping into 2026 inspired. [00:02:00] And I was like, man, I'm right there with you. That's exactly how I feel. Mm-hmm. I've got as much fuel on my fire. For what we're doing here internally at Focus on Health, what we're doing with MCM and uh, yeah.

Um, as Brett Winchester would say, I'm more on fire today than I was yesterday.

Kevin Christie: Yeah. And you know, it's one of those things where I, I learned some years ago from, from Strategic Coach, they talked about it is, um, some years are stabilizing years and some years are accelerating years. And, uh, they're not all accelerating years, even the best ones.

And, uh, you know, it's, it's okay to recognize that, you know, probably for you, 2024 was a stabilizing year, and then you were able to stabilize that and accelerate in 25 and then. Probably compound that acceleration into 2026, and that's what we look for. You know, if I were to, if I were to do a cross section of a 10 years of a chiropractic practice and, and it, whether this was mine and or yours or others, is, I feel like in those 10 years, there's probably [00:03:00] two.

You hope that they're not back to back years, but there's probably two out of the 10 that are real stabilizing. Like, okay, we gotta right this ship. And then, uh, you know, then from there, the eight would fall into hopefully. Some sort of accelerating, but I think there's a, a, a spectrum of that. Some are just kind of like, yeah, we're, we're doing pretty good.

We're not great. But then we have maybe 4, 3, 4, 5 of 'em are like, oh, this is a really good accelerating year. And I think that is what one should expect when owning a business, uh, of any type. Right?

Curt Kippenberger: Yeah. You know, everybody talks about the seven year rich and so many different facets. Right. And I had this weird crossroads in my life, I think.

I think it was right before Krista and i's seven year anniversary, or maybe just after it, but it was before I was seven years in practice for sure. And I, I just reflected back. I was like, man, okay. I was a high level wrestler for seven years and then, and then it was done [00:04:00] and I raced my bicycle semi-professionally for seven years and then like that's behind me.

And I was like, okay, we made it to seven years in our marriage. Like we're in year eight or nine. Like, okay, cool. Then I was like, oh shit, I've got this chiropractic career. And I can remember when seven years came, I was like. Yeah, this wasn't so bad. And then, uh, of course, a couple years later at the 10 year mark, that's when COVID hit.

And so yeah, the, maybe, maybe there's different niches, but you're certainly right. Somebody at some point is gonna focus a, a tough time or something that really requires a high level of acuity to Portage. Within your first 10 years. Yeah. Then there's always that funny saying about it is, uh, sometimes in your business, you know, are you the, are you the firefighter or are you the arsonist?

Uh, sometimes I think we might get bored sometimes and we set fire to our own business maybe. Subconsciously, or we know some people that do it consciously. Um, you know, it's kind of, it, it kind of goes back also to, you know, whether you use the fire [00:05:00] analogy again. You gotta kind of burn some shrubs there.

Or, or, I always really enjoyed, uh, Dr. Henry Cloud had a book and he talked about. It was called Necessary Endings was the book. And he talked about pruning your, you know, your bush and, and you gotta prune that sometimes to allow for growth. So sometimes you do have to be a little bit of an arsonist. You don't wanna burn the whole thing down, but you gotta clear the, the brush and, and that way you don't let it really burn on fire.

Right. Um, and, and you have to be able to navigate that strategically, um, sometimes. And that, that can be the tricky part. Absolutely. And you know, the, the brush that you're speaking of could be. It could be human resources, it could be procedures or processes, it could be systems. And I think just constantly evaluating those needs is what takes to drive a business forward.

Yeah, no, absolutely. And one of the things I also wanted to mention from what you were saying was. You know, you are a coach to other [00:06:00] chiropractors. I'm a coach to other chiropractors. We have Ashley Jordan. We're onboarding, uh, another one we're growing. Um. And I've faced this and you probably did sometimes, you know, even us coaches, we have our own struggles in our practice.

Like it, it would be, it would be uh, really a farce if you thought even the chiropractors with good practice. 'cause you have a really good practice. I know I do and Ashley, like we have good practice. But even with that. It doesn't mean we're, we're immune to the struggle. Right. It's part of it and, but sometimes you as a coach, you're like, well shit, like my practice is having a bad month or a bad day or a bad year.

Uh, you kind of get a little bit frustrated with that 'cause you're coaching chiropractors to do that. And I've been in that. I mean, we've had some years where it's like, shit really bad. But it's being able to work through that is a skill set and, and having. Coaches or mentors or groups, accountability to help you through those times, [00:07:00] right?

Yeah. I can't tell you. I'm, I'm sure it's 100% if it's not, let's just call it 80% of my clients after our, as we're approaching the end of our call, I think I've thanked them for giving. They gave me more than I gave them that day. And I, I think that's the unique thing about mentorship is it's not a, it's not an I'm a leader.

Follow me. It's a we're learning together and we're, we're going through these processes together and hopefully we identify some things that you mm-hmm. Maybe haven't navigated that we can help you navigate. Maybe you see some things that we're about to have to navigate and that co-learning I think is something I really appreciate about the Mc M community and both in our coaching and in our mastermind.

There's not a lot of ego in the room and there's no gurus, and people are really just out to help make the profession better and make the person on the other end of the phone or the other end of the table better. Yeah, and sometimes when you're coaching, I, we talk about it when we have our, every other week coaches meeting is, you know, we have our, our trainings and lessons [00:08:00] and all that that we have for MCM to help chiropractors, better at marketing, business, communications, finances, all the things.

And we, we work. Clients through that stuff, but then we have to recognize sometimes, uh, it's a call where we're just putting out fires or there's an opportunity like, oh, you got a really good opportunity. So it's on the positive note. Sometimes we have to come in like it's bar rescue and, and and, and try to get it going.

And that's fun too, right? It's, uh, it's always interesting navigating the different scenarios that we do face that these, these practice owners do, you know, deal with. He just inspired me to wear a suit to every call and, uh, grow my hair back and slick it back a little John Popper style. That's awesome. I would, yeah, I mean, it would be fun to go and actually go in person and do chiropractic rescue missions at, at clinics in person.

Yeah. Well, I know you and I have talked about that idea of going and auditing a practice that we're, you know, engaged with in coaching and Yeah, sometimes spending an hour or two just as a fly on [00:09:00] the wall, you can really identify some. Some opportunities or really pat some people on the back and say, wow, man, like we've seen this.

200 other times and what you're doing is a well-oiled machine. And you know, I think that that's, that's a cool idea. It's, it's very logistically difficult, but I think, uh, I think on down the line, maybe that's something we should look forward to. Yeah, it probably comes with a price point that too many car partners and I might not want to pay.

Um. But I wanted to switch gears a little bit. You know, based on your clients you have that you're coaching or some of the members we have in a mastermind that you collaborate with and work with, what are some of the things you're seeing, some of the best, uh, practices do the right way to, to get where they are?

Yeah. You know, if we, if we look at that idea that you were talking about, the pruning, um, one of our mastermind members, Ben Fergus, he, he uses a phrase blowing stuff up. Um, yeah, yeah. And. Ben is probably one of the best in the world at just like really objectively evaluating [00:10:00] things and just like this isn't working, and he either flushes it or significantly changes it to pivot on a dime.

Yeah. And I think that that realization that nothing is concrete, everything is plastic, everything's moldable. Uh, that's. That's something we should strive for in private practice as clinicians, as business owners. Because if we're doing the same thing that we were doing two years, five years ago, like we're, we're stagnant.

We're not serving our community, our patients any better. And so, yeah, I think the constancy of evaluation. The adaptability, that's what we're seeing some of the top practices do. And. One of my, my wife's favorite quotes is, any system can be changed on your next new patient. And so you don't have to sit there and ho hum and, and give it 90 days to release this idea.

You just, mm-hmm. On a dime and start tomorrow or next hour. Yeah. Uh, definitely, and, and Ben, I feel, is a really good representative of what an MCM doctor is. You know, he's, he [00:11:00] is very clinically skilled and knowledgeable, but he also cares about running a good business and doing it ethically, and it's been cool to see him do that over the last handful of years.

Absolutely. So cool. Now let's, uh, go ahead. Sorry. I was gonna say, and I think the other is, you know, we, we evaluate the front end, so all of the, the systems and the stages, but I think something that the Mastermind is really. Empowered me to do is really looking at the financial backend of everything, and we talk about delivering ethical care.

Well, there's ethical ways to run your business too, and not just, not just trying to money launder and not just trying to, you know, bill for more what you do, but literally protecting a profit margin that protects your practice, that protects yourself, that encourages good, healthy growth. I, I think until we heard Ray Tuck.

Talk, you know, two or three years ago in Mastermind, uh, I had judged everything off of our top line revenue and not necessarily on purpose. It was just easier numbers to look at. Right? And it's like, [00:12:00] yeah, collect a million bucks and, you know, 995 went out, you're like, cool, we make, we made 500 or $5,000.

Yeah. Uh, but yeah, you know, long term, that's not very sustainable. And I think that. To have the ability to maintain grit, you have to have a healthy profit margin, and I think the cash confidence course that MCM released is a really great platform to understand your numbers. In depth and, and make sure that you're doing this not only two days from now, but two years, 20 years, 40 years down the line, and it's got some equity at the end to get rid of.

Yeah, no, absolutely. And, and that's one thing we try to do is, you know, I think there's a, I think there's a misconception that chiropractic practices aren't worth anything when you go to retire now. Yeah. I mean, the vast majority of chiropractic practices. Probably won't sell for your entire retirement nest egg.

There are some that will, if you can get into the two to 3 [00:13:00] million revenue range with good ebitda, you could probably get a good, very good chunk for something like that from private equity. Granted, a person that's got a practice doing that kind of revenues probably living a little high on the hog, and so.

You need more nest egg to maintain your lifestyle. It's all relative, right? Yeah. Um, you give someone $3 million and they would probably be doing jumping jacks and set for retirement and others is like, okay, that's one part of my retirement. I need more. But you get the point. You, you can sell it for a pretty good, you know, piece of your retirement, not everything.

And we wanna build it that way. We wanna build, build it that way from the beginning. And I think that's what we. Our aim is as coaches, so not even for the fact of selling it down the road, but if you do it the right way like that, now it becomes more profitable and becomes your kind of golden goose. And then you're able to do things like we've had, I had posted in our Facebook group, we've had I think nine I.

Uh, MCMs, whether they're coaching clients or mastermind over the last three or four years, buy their office real estate that [00:14:00] I know of, and that's, that's a big chunk of your retirement down the road. And so if the practice can spit off profits to be able to do something like that, then you're. You're on a whole other playing field with it.

It's not, I don't think everybody has to buy, I don't think it's the end all be all, but it's definitely nice in the scenarios that it makes sense to do that. But, uh, let's, uh, let's switch gears a little bit. You know, you've been coaching for a while, even before you're coaching with us, but, um, what are some of the kind of mistakes you see with, with some of the clients you work with and something they need to keep an eye on?

Yeah, I think. I think the majority of our profession probably looks at mentorship and coaching as a luxury or maybe on an as needed basis. And I really think that regardless of you surrounding yourself with like-minded peers and creating your own mastermind, whether you engage with a formal coaching service like Mc M or whether you join formal groups like.

Uh, the Mc m mastery for Mastermind or [00:15:00] Strategic Coach, those high level rooms, you have to have that. It's not a, it's not a luxury. It's a non-negotiable. Yeah. And I see a lot of people. Come in having a specific need, and then they might withdraw for a while to go work on that. Mm-hmm. Uh, but the problem is just like our patients when they self-release or when they withdraw their acuity, their audit to, you know, come back in, it's, it's not always there.

And then life gets busy and you have a kid or something else changes and it just gets pushed off. And so I think making mentorship, whatever that means to you and non-negotiable, and something that holds you accountable too. A monthly phone call, a quarterly would be, gosh, bare minimum. And I say the same thing to my patients.

I don't trust anybody's biomechanics past 90 days, so mm-hmm. Don't be flocking out in the world on your own. Like, let's at least put a Snelling chart to the damn thing and see if your mood can still see. Um, so, but I think the, the other phase of that is [00:16:00] when, uh, when things get hard mm-hmm. People tend.

To wanna pull back the reins and, and maybe leave their coaching or leave their consultant. And that could be financially hard. I get it. Sometimes you just gotta. Split hairs and, and do what you do financially. I, I understand that, but I, I do think there's a certain percentage of folks that are, they have difficulty compartmentalizing and prioritizing their practice needs or their professional or personal needs.

And so that's where mentorship can be really great because not only do we identify those things, when we say, Hey, you know what? Like, you've got these six big projects. Let's prioritize what's an A project? What's a B project? What's a C? Let's assign a date to the A projects. Let's put a, a barometer on the Bs.

C's are gonna be in the parking lot until we knock off some of these A's or B's. And I think that when you're stuck inside the pic, or when you're stuck inside the frame, it's hard to see the whole picture, right? Mm-hmm. So when you're, when you're in the trenches. You got two choices you can fight and you can be the buffalo [00:17:00] and go through the storm or you can withdraw.

And I see too many people withdraw at the wrong times. Yeah. And, and to your point with like affordability or you know, you're getting a little crunched, I often tell the story I haven't told in a while, so I'll, I'll tell it now. But you know, I. 20 15, 20 16 was really hard for me financially, both in, in the practice we were trying to navigate going outta network at a time.

I lost a doctor, I was going through a divorce. It was a lot. And I definitely had started to bury myself financially and it was hard. Couldn't, couldn't write the ship. And I remember, I, some people don't know, but I had a. A different podcast called the Modern Desk Jockey, which is the first podcast I started in 2016, before I started this podcast in 2017.

And I was, uh, I had a podcast, a different, a podcast producer back then, and he was a, uh, he had changed careers from a financial advisor to podcast production. He's done really well with that, which has been cool and really helped me get started. And he would listen to my episodes, obviously [00:18:00] producing 'em.

And he, he had emailed me, he's like, Hey, you know. I know your podcast is about health and wellness for the, the desk worker, but you know, financial peace of mind is, goes into that. Would you want to interview someone on that? And I was like, yeah. So he connected me with a guy and I interviewed him and I'm interviewing this guy about financial wellness and I'm like, man, he's hitting all the right buttons with me and I, and I, I need some help.

And so after I got done recording that interview, I reached out to them and I remember it was, you know. It was gonna cost $1,500 a month. And I mean, I was, I was losing two or three times that a month at the time. Right. And I, but I, I did it and I found a way to do it. And, um. It really, it really got me out of it and on a good pace and I, I just owe so much to that.

And it was a hard decision to spend money when you're losing money or even if things are tight, but having the, the trust that I needed someone to help me out of [00:19:00] this and, and I did. Um, and I, I'm much better off for it. So sometimes it feels tight to make it happen, but that's kind of when you need to do it a lot of times.

Yeah. And I think like there's a, there's a reason why it's tight, right? You may. Yeah, exactly. Yeah, you, the definition of insanity is continue to do the same things over and over and get the same result, and I think that we get caught in that hamster wheel effect, but you know, the opportunity cost of something like that, if you have a good group of people that you know, like, and trust, I mean, one of the favorite things about the Mastermind is our hot seats, right?

Mm-hmm. What obstacle or what opportunity do you have? And sometimes they are significant obstacles. I mean, we've had people up and relocate their practice thousands of miles away. Yes, that's right. We had a good, healthy thing going. Yeah. Um, we've had people like the real estate things. We've had lots of, lots of different great conversations.

And um, yeah, to be able to run that at the flagpole of known, liked, trusted colleagues is invaluable. And I, I [00:20:00] did a kind of, on the other side of it is on coaching is there are those that are doing very well and still have coaching. And I did a, I had kind of wr went through our coaching client list and also our mastermind list.

And um, and I don't say this number because you have to have this number to have a great practice. I, I am, I, I've never been a big fan of like. You gotta have the $1 million practice for it to be good practice. I, I don't believe that. I think it's awesome and amazing milestone. You get there, get there.

Like, I, I love it. But I accounted. We have 16 practices that I know of that are above that 1 million mark in revenue and some of them quite a bit more. And yet. They're getting our coaching or they're in the mastermind, some do both. Uh, you know, they're just trying to get even better, right? And I think that's cool is when you also have clients that are, have great practices, which we have many, but they know they need someone in their corner to get even better and, and have that [00:21:00] accountability.

Also, we have a good group feel both on our coaching and mastermind where you, if, if we don't have the answer, we have someone in our, uh, sphere that does. And so that's been been pretty cool to see as well. Yeah, I think what's really interesting, and I'm sure this is not just intraprofessional to chiropractic, but um, you know, I don't know how many NPI seminars I've taken, I don't know how many times I've taken the same seminar.

I've been to adjust Aon just about as many times as in years I've been in practice, at least 15 over the last 18 or 19 years of opportunity that could have been there. Guess what? I still learn something new every damn time. Even though they are allowing me to be a co-instructor, I still learn something new.

And the same things with mentorship. Like once you start to feel like you've got it all figured out, you either need to get a bigger room or you need to quit looking in the mirror for advice 'cause that person's telling you the wrong things. Yeah, no, absolutely. Um. What are you excited about in [00:22:00] 2026? Or just in, in, in some of the things that you're seeing practices do or the profession?

Yeah. Personally, we are really, even though I suspect that this will be, you know, another really great year, we, we did plant a lot of seeds in the soil as we came to the end of 2025. So, mm-hmm. I've done some tech upgrades. We're doing some 3D motion or, uh. 3D Markerless capture system through, and we're gonna integrate that into our functional movement evaluations.

Mm-hmm. Finally bit the bullet after years, uh, and got a shockwave unit, we're integrating that into, you know, the orthopedic side of our practice. We're doing some other things for our gym. So I'm just really excited about reinvesting some tech and some healing technology that's gonna help us take focus on health and movement lab to another level.

Uh, I think, you know, you, I was reading one of your emails this morning about, you know, cash versus, uh, insurance and what to do. I think what's really cool is you don't, it's not a binary decision anymore. [00:23:00] Like you don't have to just be cash. You don't have to just be insurance. I think this hybrid practice that you referenced is really.

I don't wanna say the next step, but you know, there's certain areas that it's just very advantageous to remain in network and it, it removes those initial barriers of access. And so long as you're doing some of these add-on services ethically and empathetically to your patient population and their needs, everybody wins, right?

Like we've talked, what's the phrase we use? Like if, if it improves your outcomes and improves your incomes, that's actually a good thing for both parties. Uh, so I'm excited to see a lot of. All of these big cool technological advances happening around the periphery of our profession and seeing how it's really elevating chiropractic as a whole.

Yeah. Uh, you know, a RT was such like a mind blowing breakthrough mm-hmm. When Mike Lahey dropped this soft tissue technique and it, it's helped so many practices. It's still to this day, standing the test of time. Uh, I'm looking at shockwave and high level laser and needles, all is the same way. And I [00:24:00] think that, uh, we're just gonna see better and better things from our evidence-based chiropractors.

Yeah, I, I had sent out that email 'cause you know, it obviously there's a big trend going cash and I get it. Um, I think there's a misconception that going all cash is the holy grail. Um, I think there's a misconception that being in network with insurances. Is, is evil and it's terrible. Uh, and this coming from someone that dropped all the insurances and gone cash, and I, and I'm personally glad I did, but the circumstances were, were there for me to, for, for me to do it.

Uh, but yeah, the reality of it is, is, is a lot of the big healthy practices that we see. Um, they are in network with insurances and have found a good way to, um, have cash packages, you know, easy, like ours is eight visits in our practice for cash patients or add-on services like dry needling, laser shockwave, and get good at that.

Because the interesting test case [00:25:00] on that is if you, if you're happen to listen to this and you're an in-network provider and you're thinking about going outta network. Why don't you test run, seeing if your practice can sell, add-on services, or to your cash patient patients now and get good at that.

And because if you can't, if you can't get good at that, good luck going cash. You're not, it's gonna really struggle. Now, if you can get really good at it, you may find that you don't need to do it. You might find that your office visit average is pretty healthy because a fair amount of your insurance patients.

Are paying for cash services to add onto the insurance. Yeah. Or you might get really good at it and you find, yeah, I do want to drop some of them, or all of them and that's fine, but let's work through that. And that's something I think a lot of, we, we've been working a lot with our clients on getting good at that in an elegant way.

You know, it's not the. Six month care plan. It's not the $6,000 care plan. It's not like the hard sales tactics that those things take. It's an, it's an elegant way of doing it [00:26:00] at a reasonable, um, offering. I think most providers make that decision on cash versus, you know, in network based off of emotional charges.

You are like, oh, it's hard. Oh, I gotta file all this paperwork. Like, no, you still gotta take notes. You still gotta do your diligence and take good care of people. Um, when you evaluated yours, I mean, I know the story like you were watching your reimbursements rates continue to plummet and you literally just did a cost benefit analysis of how long is this sustainable?

And we've had to do those same things and you just get creative. And if you are seeing that trend, I mean, I've been in practice 15 years, I'm sure everybody else that's listening, whether you're here 15 months. Or you know, twice as long as I have, none of us have probably seen a big increase in our reimbursement rates, and that's just the simple truth.

Um, but you can sit there and bitch and moan about it and you can continue to do what you're doing. You can define insanity. You can adapt yourself and become a hybrid, or you can just burn the boats and, and go all cash. But just make sure you're doing it objectively. You're not [00:27:00] just doing it because it's hard or it's easier or whatever.

It's, yeah. And we have plenty of clients that are cash based and, and doing well, and we work with 'em on that. Again, that's my practice. So I'm, I'm, I'm very attuned to it on how to make it work and it could be good. And, um. You know my concern with like the big. The big care plans like the, when you get into the three, four, $5,000 ones, is that, um, on, on the surface it seems like it makes sense because I'm all, I'm all for chiropractors escaping the commoditization trap.

I'm all for them charging what they're worth. I do think chiropractors are worth a, a, a lot. Um, so I'm all on board with it. But I think the problem is when you see a lot of people doing it is inherently there's a very small percentage that can. Do it, and you might see those. Testimonials are those people that have done it, but it's a small percentage, just like there's a small percentage of NFL quarterbacks that are worth $50 million, [00:28:00] like, and there's a lot of quarterbacks that are worth nothing.

Um, and so in any industry, there are gonna be the outliers or small percentage that can do something pretty unique. That, uh, being able to sell those large care plans and the long care plans, those takes a very, uh, certain type of person and a certain type of sales tactic, uh, to, to do it. And so that's tricky and something that you have to definitely navigate.

I do think there are plenty of. Cash. I, I shouldn't say think. I know there's plenty of cash-based practices and styles of cash-based practices or the things we teach where you don't have to do that and you can still do very well. And uh, that's some of the things we try to, to thread that needle. Yeah.

And one last thing to add to that, unfortunately too, it just takes time and experience. You know, when, when we were 15 days outta school versus 15 years, the acuity on your cases are so much different and you can make such. [00:29:00] Faster clinical decisions. And so school's great. It teaches you how to assess people, make sure you're not going to hurt them and qualify them for chiropractic care.

And it checks all the boxes that you are smart enough to pass all the boards. Beyond that, I mean, you're starting at patient zero when you get out and, and to try to sell somebody, you know, a package that's probably elegant, probably really good for them, right? Like, you know, if it's. Chiropractic and some, uh, exercise management and some diet and lifestyle how whatever, whatever arms that you're delivering, uh, that's great.

But yeah, to, to sell that up front is very, very challenging. You gotta get good at what you call the table stakes, like get good with your hands, get good with. Manipulation and soft tissue and get good results, and then let people start spreading the word and use your patients as your ground soldiers. I, one of my friends sent me, uh, uh, Instagram video, and it was a medical doctor evaluating something that Peter Atia had on his podcast.

Mm-hmm. He was like, everybody thinks that just because we have an [00:30:00] MD or a do behind our name, we know everything and, and we're impervious to air. He is like. We get zero nutrition, we get zero lifestyle, we get zero. This, like, Peter Atia spent a good chunk of his middle career learning how to be a lifestyle and health span expert.

He didn't get that at Hopkins or I, I can't remember where he went to school. I think it was Hopkins. And, uh, same thing here. Like we went to Logan. Both you and I, like, we did not get the experience that we have had over the 15 years, 20 in your case. Uh, to replace that. And so, yeah, unfortunately, I hate to say it, it just takes time to get good at it.

And those other skill sets are great, like being able to talk, being able to sell things. Those are very great traits, but you've gotta have that clinical experience behind what you sell to really be, um. I don't know. Ethical in the delivery of it. Yeah. And we do know Logan is akin to Hopkins, right? Yeah. I I think it's the Hopkins of the Midwest.

That's okay. Um, but to your point, yeah, like I, there's a good episode I've, it [00:31:00] was three or four years ago now with James Spencer. He's actually not too far from me here, and I've gotten know him. When he was a student all the way up, and that's a good episode where he was someone that he charges a lot, like $500 an hour.

Now it might be even more since that episode, but, uh, he spends an hour and, but he didn't start with that. He, he started regular, worked his way up, really built an expertise and a niche, and he's on the, you know, top 5% or 1% of demand. And he's in a, in a very affluent area, and he kept on just increasing his rates incrementally to get there.

And it worked out. I think what we're finding is too many the, the docs haven't been able to position themselves as an expert yet. 'cause it takes time and word of mouth and all that and they come outta the gates with the four or 500 an hour and then it, that becomes really challenging. And again, some can do it, some can do it, but I just don't know if enough can for it to make sense for a lot of people.

And I [00:32:00] think there's a lot of ways you can build a great practice without. Doing that early on. And then if you get to the point where you are now the expert, you can keep on increasing rates or you can drop the insurances. I mean, that's obviously what I did was I did have, you know, people forget, I've kind of led two lives in this profession and people think of me now with MCM and business and marketing.

But, um, I was the sports chiro and working with a lot of pro athletes and going to combine and, and all that. And, uh, I really built up. Luckily a level of expertise, you know, traveled on the PGA tour for a year, did a lot of cool things so that when I did go drop insurances, I had a level of expertise in the eyes of the holder.

At least. I'm not saying I was the best chiropractor, that's for sure, but enough people thought I was, um, that it worked out. It still still was hard. Yeah, and I think the other thing that's hard if like let's say you go with that high, high value model right outta the gates. If you get one or two patients to sign up for that, you're like, [00:33:00] man, that was a thousand bucks.

Like, yeah, that's good. Mm-hmm. But unfortunately, if you go 30 days in between that next one, I know that's where you start to starve a little bit. Yeah, so well look it, man. I'm, I'm excited. We're gonna see you here next week in Park City. Then we'll see each other in, uh, Tampa. We're gonna see each other in Sonoma, in Bar Harbor, Maine, in Dallas, and then probably at an MPI seminar.

Yeah, I think, uh. I think you and i's, travel schedules have gotten closer and closer to each other. If we go a couple weeks without seeing each other, I get withdraws. I don't know about you, but Exactly, exactly. So no, definitely looking forward to it. And um, thanks for your time today, man. This is great.

Absolutely. Yeah. Thanks for having me again, Kevin. Look forward to 2026. Absolutely.