While we are all concerned about the quality of the care we offer, there is a mitigating factor involved in our practice decisions. It is called the bottom line! The truth of the matter is that we have to show a profit at the end of the day. This bottom line is more like an edge than a line as it involves service rendered, income generated and overhead expenses. Each of these factors need to be considered to develop the perfect practice.

The Service.

Actually, this is the easy one – in fact for Chiropractors, it is too easy. Why? Chiropractic adjustments get results! The vast majority of Chiropractors practice some level of a diversified technique as they have discovered that while all techniques work, one technique doesn’t fit every patient’s needs. This is a key issue regarding the service you render. The better you can fit your care to the patient’s needs, the better will be the results. While this may sound simplistic, the fact that chiropractic adjustments get such good results, most Chiropractors miss the need for the specific application of adjusting toward a specific patient need. The guidelines for care have focused on frequency and duration plans and missed a critical step called “Intensity of care”. A patient with an over-aroused nervous system and sympathetic responses in high gear does not need further over stimulation with a high level of sensory input such as frequent visits, multiple areas adjusted and high intensity input. What they need is less input, fewer visits but a longer duration of care. This plan has a dramatic effect on outcomes and patient visit average (PVA). Increased PVA means increased income and practice stability. My experience in practice with PVAs of 12 and then up to 180 as I changed my approach in practice, means that I can write with authority about the effects of making these types of changes in your practice. Yes, the practice was very busy with the 180 PVA foundation but it was what I thought Chiropractic practice was to be while at college. My bank account enjoyed it as well.

Income Generated

After over 50 years of being involved with Chiropractic, I’ve seen just about every practice management approach, gimmicks, additional sales attached to the practice, and the dilution of the value of the adjustment. I experienced the shift from straight Chiropractic, to posture analysis, to joint manipulation, to joint mechanics and pain relief in defining the profession. Today we see even more confusion in the mind of the public as to what the profession of Chiropractic has to offer. We see “Stop Smoking” and “Weight Loss” clinics calling themselves Chiropractic. While these generate income and are part of what I call a healthy Chiropractic lifestyle, they don’t reflect the real value of Chiropractic. They do however restrict the scope of practice of Chiropractic and this is another critical factor in income generation. If your practice only focuses on weight loss or pain reduction, once these goals are accomplished you will need to replace that patient. This is where those practice management groups are so willing to charge you a ton of money to attract new patients. Anyone in business soon learns that repeat business is the key to business success. That is the difference between practice with a PVA of 12 and one with 180, where the appointment book fills up 6 months out and you will start to see patients booking their time a year in advance.

Today there is great news for the Chiropractic profession! The research over the last 15 years now has established that the reason the Chiropractic Adjustment gets great results is as a result of its direct effect on the Brain and its function. No longer are we tied to the vertebral subluxation and the nerve root pressure relief theory to support Chiropractic results and with this research comes a shift in the intent of chiropractic care. This new knowledge moves Chiropractic out of the structure correction model and into the improved neurological function at the central nervous system model. This also means that we don’t address signs and symptoms as our basis for either care plans or results of care. The question now becomes, “How efficient do you want your nervous system to function?” When patients recognize this is the real value of Chiropractic, their level of participation soars. Income is now a result of you giving your patients something of greater value.


The art of running a business tends to be in short supply when it comes to many chiros. It seems to start with the huge amount of debt students generate with the education loans now available. Hindsight has little value in these cases. The problem is that the huge loan debt cripples many new graduates and we see them dropping out of the profession within a few short years. Many will start as associates and find that their loan payments absorb 90% of their income. The realization of being in their own practice becomes more of a dream than a reality. While many of the new graduates are in tune with the new neurological intent of care, the senior DC is not and they have to practice in the style of the associate office.

The expense of office rent, equipment, staff, electrical, water, marketing, and advertising are issues that require an office budget. DON’T forget the TAX man!!! Then you get to pay yourself! That is right – the Doctor needs to be put him/herself on salary as well! I do have a formula for staff and Doctor salaries. Most DCs tend to pass out when they see what their salary should be. There is another factor in expenses that most DCs miss completely! Every successful business has an expense column to cover reinvestment in the business. The standard is 10% of the gross. DCs tend to be very short-sighted about this concept.

The new approach of Neurologically Based Chiropractic has created a shift from straight spines, pain reduction, and spinal care. This means that much of the old analysis instruments in use are no longer of value to determine the care needed. The need for every Chiropractor to buy an expensive X-Ray machine is no longer in place. Most Radiography Clinics will take the films for DCs. This reduces the debt load for the business. New equipment such as the NeuroInfiniti now fits the new direction of the profession with its ability to show abnormal CNS patterns and responses. This step alone matches the new intent of Chiropractic care. The NeuroInfiniti also brings in a new income center in the form of bio and neurofeedback within the Chiropractic office to help reestablish better neurological patterns.

What we now have:

  1. By recognizing that income is generated not by the number of new patients, but by the quality of patients, and their higher participation in Chiropractic care.
  2. In shifting the intent of care from pain relief or weight loss etc. to improved brain function, we open the scope of practice. This means a broader patient base.
  3. By developing the good business practice of budgeting and reinvestment, you can continue to offer the highest quality of care for your community

Neurologically Based Chiropractic is a reality and the equipment and training are available for you to move your practice to a new level of income and excitement. You deserve to open this possibility! I recommend that at the very least, you call some of the DCs enjoying this experience. Just call DeDe at 1-877-391-9662 and ask for a referral to speak with about how their practices have changed for the better.

2 Responses

  1. Hi Team , how does a Chiropractor Asssistant provide towards the building and growing of the practice. Furthermore than what is already being taught ?

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    The Stress Response
    Evaluation & Report

    What “should” happen to your heart rate, your breathing rate and your muscles tension if the fire alarm in your office building went off right now?  Now what “should” happen to your heart rate, your breathing rate, your muscle tension if you were lying down in your bed getting ready to take a nap?

    We all know the answers to these questions. Your patients even know the answers which is whymaking it about the brain is so easy. The reason I say “should” in the earlier questions is because for most of our patients, their brain and nervous system gets stuck in either sympathetic engagement or parasympathetic engagement due to the patterns they have developed over the course of their life in dealing with stress. This is obviously a problem and according to research is the CAUSE of over 90% of all disease today.

    This is why it is so vital to measure the function of the brains of our patients. Not only to determine IF their brain and nervous system is adapting to stress and recovering properly but also to find out where it is stuck leading you to the best care plan possible for each patient based on their brain type.

    The Neuroinfiniti is the ONLY instrument on the market today that does this. The test is called the Stress Response Evaluation or SRE and this is what the report can do for your practice, your patients, and your confidence as a chiropractor.

    Please first note that the report is quite extensive. In fact so much so it is currently used for research purposes. Most chiropractors however will only need bits and pieces of this information.

    The report gives you the objective measurements of 7 different areas of brain and nervous system function both during stress and then also during recovery. These areas include brain wave pattens, an EEG, but also TRUE heart rate variability, heart rate, respiration rate, hand temperature, skin conductance, and sEMG of the trapezius muscles. This is shared in an easy to read chart system that any chiropractor can learn to read in just a matter of a few minutes. In addition a patient portion is available as well. This portion, should you choose to give it to the patient, shares the details of each specific measurement and then also shows them in an easy to read gauge format their Health Resiliency Index (HRI) score for each measurement plus theiroverall score. This allows the patient and the doctor to very easily see where they are as compared to where they should be. This simple gauge format motivates patients to not only accept care to move in the right direction but to continue care once symptoms are gone and to keep a high score once the high score has been reached. It also encourages patients to bring in loved ones to find out their scores.

    To learn more about how this amazing instrument and SRE is helping chiropractors all over the world explode their practices and save more lives schedule a FREE discovery call today so we can design a package to best suit you based on your goals and budget.

    DeDe Van Riper

    Speak directly to discuss our products and services

    Dr. Clint Steele

    Schedule Time With Dr. Clint For Clinical Questions

    What Is The NeuroInfiniti &
    Why Do You Need It?

    Are you tired about patients dropping out of care early? Tired of patients only accepting care based on what their insurance will pay? Tired of simply just seeing neck and low back pain patients when you know chiropractic is about so much more? Are you worried about where and when the next new patient will come from or how long they will stay? If so then let me take a couple of minutes to share with you how we are helping docs all over the world change their practices for the better.

    Introducing the NeuroInfiniti.

    The NeuroInfiniti is an absolute state of the art neurophysiological instrument that measures, at the highest level, the brain and nervous system’s ability to adapt to and recover from stress. The term is called Allostasis and it is ultimately the foundation of health.

    The reason this is important is because more and more research is leading to more and more experts concluding that over 90% of all disease is caused from chronic stress levels effecting the brain’s ability to adapt to and recover from stress. The public is seeing this everywhere they go. And it is going to become more and more prominent.

    With all that going on…wouldn’t it be a no brainer for a practitioner to be able to measure the effects of stress on the brain and nervous system. And wouldn’t it be a no brainer for the public to want to seek help from a practitioner who can not only objectively measure their brain function but then also know how to care for it properly?

    In a 12-minute non-invasive, pain free assessment, the specifically designed software program that comes with the NeuroInfiniti will walk your patient through a brain based assessment that will measure, both during stress and recovery, brain waves patterns at the cortex of the brain, an EEG as well as TRUE Heart Rate Variability, Heart Rate, Respiration Rate, Hand Temperature, Skin Conductance (GSR), and sEMG of the trapezius muscles all during stress and recovery.

    It will then give you a detailed report that you can use to not only build trust and confidence with your patient so they are more likely to accept care BUT also give YOU the confidence and knowledge to know exactly how to develop a specific detailed care plan for your patient ultimately leading to better patient outcomes. These outcomes, along with the added trust and confidence in you as their provider, then also leads to increased retention, increased referrals and increased case averages just to name a few benefits.

    This instrument can then be used to measure progress to keep your patients engaged and active in their care. It can even be involved in some of the care for your patients and add an additional revenue stream by assisting your chiropractic adjustments with amazingly effective biofeedback and neurofeedback sessions as you work towards restoring their brain’s ability to function properly.

    We even have packages that include all the training you will need to change the conversation from pain to brain, conduct a brain-based day 1, a brain-based ROF and brain-based education PLUS we teach you how to create care plans and financial packages that get accepted so patients not only follow through with care but are also willing to pay you, even if that means out of their own pockets. You can even use our patient finance partner with a 100% approval rate of up to $20,000 for care at your office, if your patient would like to use it.

    No more patients dropping out of care early.
    No more patients dropping out of care because their insurance no longer pays.
    No more wishing for more referrals.

    If you are ready to change your practice for the better contact us today to schedule a FREE introductory call to find out how the NeuroInfiniti can help explode your practice and help you save more lives. We will help design a package to best suit your goals and fit your budget.

    DeDe Van Riper

    Speak directly to discuss our products and services

    Dr. Clint Steele

    Schedule Time With Dr. Clint For Clinical Questions