EPISODE 473: Bridging the Associate-Owner Chiropractor Divide

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. 

Welcome to another episode of Modern Chiropractic Mastery. This is your host, Dr. Kevin Christie, and today I'm going to, uh, narrate or read a blog I wrote for Cairo up titled, bridging the Associate Owner Chiropractor Divide, uh, creating Mutually Beneficial Relationships, and we're gonna dive into that.

Got a lot of good feedback and actually got some questions on it that I will. Clarify at the end. Uh, ironically the morning I come in here to record a couple solo episodes, I get the email with some questions about this particular episode, so that's exciting. We'll, we'll, we'll dive into that. Uh, before we do, I do wanna make mention you still can.

Sign up for our London Patient Experience Masterclass. That's gonna be with Dr. Chris Chippendale and myself. It's a one day masterclass on the patient experience. The early bird is over, but we still have a very reasonable price for you to join us and it's exciting. You know, sometimes you don't know.

This is the first time I've done anything [00:01:00] internationally and you're not sure if people are gonna sign up and if it's gonna happen and, and, uh, you know, we had a. A little slower start to it, but then all of a sudden, boom, we had people signing up and we've got, uh, a nice crew there. We are capped at 25 people.

We do have some slots available, but we, we have an event coming in and, and we're gonna have people there and some really good docs, which has been pretty cool to see those, uh, who have signed up. And so that is going to be June 20th and in the morning session from nine to 12. Chris will talk about the doctor patient communication experience, and then we will have lunch.

Then we'll break break for lunch, and then from one to four I will be talking about service versus hospitality, and then also marketing essentials for the patient experience. And then from four to 5:00 PM we'll be heads down work building your new patient experience. You'll leave there with a new patient experience and you're gonna be right in London.

So check that out. You could. [00:02:00] Go to Bitly, BI t.ly/mcm uk 26. We'll put that in the show notes. We'd love to see you there. You can still sign up, and that is gonna be in, uh, June, on June 20th. So, all right, let's dive in. We've, uh, again, bridging the associate owner chiropractor divide Definitely a struggle out there.

There's no doubt about it, and we want to try to tackle it as best we can. Okay, so let's go. Um, the chiropractic profession faces a persistent challenge, a disconnect between associates seeking me meaningful opportunities. And practice owners struggling to find and retain quality doctors. Uh, this divide creates frustration on both sides and limits growth potential.

The good news, it doesn't have to be that way. Uh, understanding the disconnect. At its core, the associate owner divide comes down to misaligned expectations. Uh, owners often [00:03:00] hire associates expecting them to generate new patient volume and drive growth. While associates may assume their role is primarily to serve existing patients and focus on clinical care, when expectations aren't aligned, tensions appears almost immediately.

This divide is further compounded by. Preparation gaps. Many young chiropractors graduate with strong clinical skills, but limited business knowledge. They may not fully understand what it takes to build and sustain a profitable practice. Conversely, owners sometimes fail to clearly communicate expectations or provide the mentorship and systems needed for success.

The result, uh, great opportunities for young chiropractors can seem scarce. And owners struggle to find associates who can make meaningful con contributions. Bridging this gap requires honest communication, shared understanding, and intentional planning. [00:04:00] I. Financial realities and career positioning. A key factor in aligning expectations is an honest conversation about the return on investment for becoming a chiropractor.

Young chiropractors need realistic insight into income potential. Practice ownership costs and the timeline for building a successful career. Chiropractic school plays a crucial role in preparing graduates, not just clinically, but also for the business realities they'll face for associates. Success goes beyond clinical skill.

Thriving associates demonstrate an ownership mindset. They ask questions about. Patient adherence, marketing effectiveness and operational efficiency rather than simply showing up to treat patients. business literacy curiosity [00:05:00] about practice metrics and initiatives are critical.

Differentiators for owners hiring an associate is a financial and operational commitment. Before bringing on additional doctors, a practice needs a solid economic foundation. Um, certain things here I had written about before, monthly collections. A, a sustainable practice typically generates 30,000 or more per month or 360,000 annually.

Um, it's either that, you know, that and, and above, um, profitability model following approaches like Profit First. Owners should take home roughly 35% in compensation, allocate 10% to profit, and cover all operating expenses and team salaries with the remainder. That's where I had a question, so I'm gonna interject right now on, uh, the graph that was on here.

10% profit, 35% owner's compensation, 60 or 55% operating expenses and [00:06:00] staff salaries. Um, that's, that's like a one. Um, metric from Profit First. So that strategy is from Profit First. Mike Mitz, uh, or Dr. Holly Tucker, someone I always, uh, reference and refer to who can really bridge the gap between being certified in Profit First and as a chiropractor.

So it really works out great. Um, and, and there's different, uh, breakdowns based on revenue models. This is, uh, for, say that 300. And 60,000 or so, that's that. But you can reference, um, the target allocation percentages from Profit first, and that's where that comes from. And it's not a set in stone. That's why oftentimes working with an expert to know the nuances of your practice can be helpful as well.

But it's a really nice model that Profit First lays out. And, and I, I, I stand by it. I love it. Next one. It says, stable team. A core staff and operational systems should already be in [00:07:00] place when considering hiring an associate. Without these elements. Hiring an associate can strain the practice financially and operationally, and the divide persists because quality opportunities remain limited.

All right. What defines a great chiropractic job from the associate perspective of fulfilling chiropractic position includes competitive compensation, mentorship. From an experienced practitioner exposure to diverse patient cases, clinical autonomy and decision-making authority, a clear path for professional growth, associates value transparency, practices that openly share financial metrics and involve associates in strategic discussions.

Foster Trust and help doctors understand the business. Whether they [00:08:00] eventually plan to buy in or simply want to contribute meaningfully. That was where I got another question. As far as, um, sharing financial metrics, uh, we had the great game of business come speak.

To our mastermind group. A couple years prior to that, we had Dr. Ray Tuck. Um, he came and spoke about how he grew his businesses and a lot of it was around financial clarity. Now you don't share, like you would share potentially a, a payroll number, like the total amount, including payroll taxes and teach him all that stuff.

I think one of the key things is, is just teaching them financial metrics. Like, you know, an associate oftentimes doesn't realize. That you have employer taxes, right? So if you, if you write $10,000 in a month in payroll, you get taxed another like 10%. So it costs you a thousand dollars in taxes to pay people, which is always boggles my mind.

But, um, breaking that down so you could, you could show your overhead. And then the bucket of payroll and, and payroll taxes would just be a number, like [00:09:00] 20,000 a month. It wouldn't show what Bob's making or Mary's making, or Dr. Smith is making. Right? And so teaching them about practice finances is huge because frankly, they don't know it and they're gonna think you're, you're, you're making so much money, you're bearing it under your backyard and hiding under your mattress.

And when as an owner, we know that's not happening. Even if you have a thriving practice, like, um. It's, it's not, we don't have the margins like a plastic surgeon or so, so that's, uh, to answer that particular question. Alright, going back, uh, for owners, the focus is on hiring for success, not just filling a, a schedule gap.

A strategic approach involves defining roles, responsibilities, and measurable goals upfront. Establishing, sorry, lemme redo that one. Establishing, establishing, lemme do that again. Becky. Establishing. Clear compensation structures aligned with expectations. This one, I'm gonna just chime in on here. I think this is one of the huge issues that owners [00:10:00] do to associates.

They come up with these, and I, I was a victim of it when I was an not an associate. Um, I had clear when I was an associate, but I was in a partnership. And that partnership, I was like a minority partner. So I was more of like an associate, um. That it was just like a cockamamie, uh, compensation structure.

And I see too many owners do that. There's really no clear compensation structure, um, with expectations. Okay. Uh, next, providing training, marketing support, and operational autonomy, depending on the associate's role. Compensation deserves special attention, complicated or unrealistic bonus structures often lead to frustration, transparency, and simplicity build stronger, longer lasting relationships.

Alright, building mutually beneficial relationships. Successful associate owner partnerships share several [00:11:00] key characteristics, written agreements clearly outlining compensation roles, responsibilities, decision making authority. And any ownership or partnership opportunities update these agreements as the relationship evolves.

Two regular communication schedule, consistent check-ins to review practice performance, address concerns, and ensure alignment. Poor communication is the root of most conflicts. Number three, professional development. Invest in your associates growth through continuing education, clinical mentorship, and exposure to practice management decisions.

Associates who feel involved are more likely to invest fully in the practice. Owner transition. Many associates start with vague promises of future ownership. These promises often create tension when expectations don't match reality. To avoid issues, structure, ownership, op options explicitly define trial periods, purchase prices or valuation [00:12:00] methods and formal documentation involve advisors, practice brokers, attorneys, and accountants can help structure.

Transitions properly. Maintain patient and staff trust. Plan carefully for how the transition affects patient, staff and operations. If ownership isn't an option, be upfront. Many associates thrive in long-term positions, as long as expectations are clear and compensation is fair. Miscommunication is what typically leads to dissatisfaction.

The role of professional development, life events, seminars, sorry, lemme redo that. Becky. Uh, live events, seminars, and professional development opportunities are often overlooked, but play a major role in bridging the divide. They develop clinical and business skills, they create networking opportunities, and they expose both associates and owners to best practices from successful.

Practices. Investment in professional development [00:13:00] signals a commitment to both the associate and the broader profession. So moving forward, bridging the associate owner divide requires intentional effort from both parties. Associates must approach opportunities with an ownership mindset. Seeking to understand practice economics and contribute to growth.

Owners must provide clear expectations, proper support systems, and fair compensation structures that align incentives The chiropractic profession needs both great jobs for young doctors and great associates for established practices. By addressing the disconnect head on with honest communication, clear agreements, and mutual investment and success, we can create relationships that.

Benefit everyone, associates, owners, and most importantly, the patients we serve. The divide isn't insurmountable. With the right approach, o associate owner relationships become powerful partnerships that elevate the entire [00:14:00] profession. So that is the blog I wrote for Cairo Up. You can go to cairo up.com and they have a great website and they've got a resource section with a blog and you can find it.

Uh, right there. And you can read that there's, they put in a couple nice graphs on there as well, which was good. And I, um, believe I answered most of the questions on that. Um, let's see here. One of the questions was, um, autonomy in practice, right? I, I'd mentioned about, uh, reasonable associate autonomy. And the question they had had asked was, for instance, if an associate's first patient is booked at 8:45 AM but the clinic opens at 8:00 AM is it reasonable for them to arrive at eight 40?

Am these nuances seem important and may be worth unpacking further? No. You gotta set, I mean, you gotta set standards, right? I think you gotta have that, like in our clinic. Um, we have a pre-shift huddle before each shift, so it's expected to be, uh, if we [00:15:00] were to open up at, uh, 9:00 AM we are all, we're at our meeting at 8:45 AM even if my patient or associate patient isn't until eight 30 or, or sorry, nine 30.

Right. So yeah, you, you would, you would need to set that, uh, uh, with autonomy. It's, it's a framework, right? I kind of, even clinically, I often use the, the phrase or, or the idea of like. You want to have, uh, say an associate that is working within a congruent clinical framework that your practice offers, but giving them some artistic freedom, right?

Um, you're, you're not gonna be hovering over them and, and critiquing every clinical decision they ever make. You're gonna have a framework of what your clinic stands for and the standards of clinical care that you have. And maybe you want a, an associate that is, uh, you know, really good with manipulation and palpation.

You expect that you expect them to be, uh, a RT certified. You expect them to know how to use shockwave. Like you can have [00:16:00] those. Expectations of clinical care, but then, um, have some artistic freedom within that. And I think that's the same thing with just the general autonomy is you don't wanna be micromanaging them, but there's gonna be standards and expectations.

So, um, that was the only one I didn't answer as I was speaking in there. And, um, hopefully this is helpful for owner doctors and associates. I've mentioned it on podcasts before. I do think, um, I. There's a lot of owners doing a lot of good things. There's a lot of associates doing a lot of good things, but we also have too many owners that are, um, a, they're, they're, they need an associate, but they truly can't afford an associate.

And so they, they, they, they pigeonhole the situation and it leads to bad outcomes. And then there's owners that are deceptive or, um. Not up with the times on what reality of compensation should be or, um, growing an associates, sometimes it becomes, um, an eat what you kill [00:17:00] type or not eat what you kill.

Was it something eat their young type of situation. And an associate, you know, there's a lot of great young associates. I, I get to speak with 'em, I run into 'em, but man, there's a lot. And this, it's no different now than it, it was even when I was coming out. There's just a lot of. Young docs that come out that are just, just totally unprepared and not, not ready for what the realities of private practice are, and we need to fix that as well.

So hopefully we can help. Hope you enjoyed that. Have a great week in practice and we'll talk soon.