Style

Mode of Practice

All Chiropractors are unique in their own way, which accounts for the fact that there are so many different models of practice within our profession. Too often we generalize that one practice will be exactly like the next. This is VERY far from the truth.

Besides the fact that many of us have graduated from different Chiropractic Colleges, and at different times in the evolution of those courses and programs, we all have different belief systems as to the very value of Chiropractic. At one end of the spectrum, we have people that focus on subluxation and full health potential, while on the other we have people that include various forms of physical therapy and rehabilitation. On top of this, some focus on acute case management only, while others address health care, and still others focus on wellness development care.

Take all these varying belief systems about Chiropractic, and then add the varying personality styles of the practitioners, and you can begin to see the complicated matrix of types and modes of practice!

For you, depending on your particular personal style and life situation, there will be several ways for you to get into practice.

• Individual Practitioner
• Purchase or starting from scratch
• Partnerships
• Professional Corporations
• Associate Positions
• Independent Contractors

Style Exercise

What practice format will you start with?

Are you entrepreneurial, and ready to start your own practice solo?

Or do you want a partner to share the work, the expenses, and the profits?

Would you prefer to rent space in an established office as an independent contractor, or do you feel you need more seasoning as an associate doctor, employed by another doctor to help in an established practice?

Or, would you be interested in becoming a coverage doctor for a while, to gain experience in a variety of different practice settings, to solidify your own thinking before you build your own practice?

All have their merits - you'll have to decide which configuration suits you best at this time.

Begin to determine the location of your target practice - do you want a city practice, a suburban practice, or a rural practice?

What climate?

What socioeconomics?

Expect to live within 30 minutes of your practice - where do you want to live? Define a thirty-minute radius around that location, to narrow down the landscape to decide on an area.

What type of building do you want?

Do you want a storefront clinic, a home office, a suite in a professional building, or an office condominium?

Free standing building or part of a larger structure?

What size?

What rooms will you need in your office flow - reception room, business area, adjusting rooms, examination and X-ray rooms, doctor's office, bathrooms, storage, educational areas, therapy or rehab or massage areas, for starters - you'll have to think about all of this to plan your office, unless you're planning on becoming an associate or an independent contractor, where the plant is already set.

Exercise: Visualize a series of potentially ideal practices for you. (If you are new to visualization, please click here.) Play with these ideas, and imagine a few different approaches that might feel good to you. In this early stage, be willing to cast off preconceived notions and try on new ideas - it's fun and productive!

For example, maybe you would enjoy a family practice, in a small town. Imagine what your office could look like, what your staff would be like, what kinds of patients would be coming in.

Now, for contrast, imagine a high volume personal injury practice in a big city, inter-referring with attorneys and other professionals. Gives you a different feeling, doesn't it?

Neither is right or wrong in and of itself, one just may be more right for you.

There are two important reasons you are doing this at this early date. First, by visualizing your possible future, you get feelings that tell you if you are moving yourself in the right direction. Second, there is ample evidence that this kind of visualization process enhances the likelihood of success. Whether this happens because you clarify your own actions and take them with more certainty, or if there is a quantum effect on the electromagnetic fields of life, is not important for this part of the discussion. Visualization is a very useful tool, and it will come back to reward you many times over when you master it.

Visualizing is as normal as any other kind of thinking. If you have not yet refined your visualization skills, not to worry - it's like any other skill, put some time into it and you'll improve. Silva Mind Control teaches visualization, (link to Laura Silva) or you can just start by challenging your belief about your own ability - for example, have you ever had a dream?

Well, was that stuff actually happening in the room at the time?

No, you were visualizing!

Nevertheless, willful visualization doesn't always appear as a movie or clear picture - it's a visual representation, so be prepared, especially in the beginning, for your visualizations to be less distinct. This in now way means that they are less powerful - you are assigning an internal representation, a picture, or other representation, to the thought you are choosing. It might be a smear of color, a streak or stripe of another color and that may be all you can muster in the beginning. No problem! You are the one who is assigning the meanings here. So start where you are and go from there. It will get better, either by having your ability to visualize clear pictures improve, or by your ability to interpret those visual representations that are not clear pictures so that you can get the very same value from it. Be patient, and stay at it, and you'll see how powerful this tool can be.

Scope

What do you hope to accomplish with your practice? Are you aiming at a general practice, where you take all comers and help whoever happens in your door? Or are you focused on a particular specialty, such as sports, personal injury, nutrition, pediatrics or a particular set of conditions you prefer addressing, such as musculoskeletal complaints, visceral disorders, or emergency care?

Your position on this significant matter will evolve over time, but you must make some decisions - not making them is indeed making a decision, that you will be a generalist who takes all comers. Choosing to focus at this early date may seem premature, but it will help you to put your attention in places it can do you the most good. Think of it not as a restriction, but rather a guideline, to help you make your learning process more efficient.

Types of Practice

Wellness Practice

Many practices are turning their attention toward wellness - expanding their services past pain relief toward a proactive approach to quality of life and longevity. Enough has been written about the Wellness Revolution to make it a viable practice model, typically including not only chiropractic care, but also additional wellness services like nutrition, exercise, meditation, and training in lifestyle design. Prominent chiropractic philosophers such as Patrick Gentempo and his Creating Wellness Alliance, and health researchers like James Chestnut have developed programs that integrate wellness techniques into chiropractic practice (http://www.creatingwellness.com).

Acute Care Practice

Many practitioners enjoy the thrill of emergency care. Dealing with acute patients requires clinical excellence as well as a stable and focused psychology. You may want to specialize in personal injury work, where you need to document your findings effectively to support the needs of your patient outside the adjusting room, or in sports chiropractic, where you take additional training to learn to manage these types of cases. Or, you may just practice general chiropractic, but focus on painful disorders and helping people achieve relief and stability in their spine and nerve system.

It is recommended that if you choose to take cases only to the point of relief, that you develop a relationship with a wellness chiropractor for inter-referral when you complete your program of care. That way, you stay focused on the type of practice you prefer, and your patients can still reap the rewards of ongoing chiropractic services.Rehabilitation PracticeSome chiropractors recognize that after the acute phases of care are complete, the patient would benefit from reconditioning of rehabilitating their structure and nerve system. There are many courses in rehabilitation; some geared more to exercise and physical therapy, some to more esoteric and alternative approaches.

Rehab, spinal decompression, exercise physiology, and alternative bodywork techniques all play a role in returning the patient to optimal condition. You may want to include elements of rehab in your course of ongoing care.
http://www.spinemedtherapy.com
http://www.certhealthsciences.com

Spousal Partnership

Like any relationship, spousal partnerships should be entered into with open communication and clear definition of roles. You would never hire anyone you can't fire, and likewise, you only want to practice with your significant other if there is clear discussion on the options if things don't work out. Personal relationships sometimes work in the professional setting, and sometimes they don't, so leave room for consideration if there is the need to reconfigure the professional partnership, to avoid the need to reconfigure the personal one.

Sometimes spousal partnerships work great, so don't be afraid to try it if it seems like a good idea to you - just be sure there is a businesslike atmosphere in the office, leaving all home issues home. Similarly, you may want to keep office talk at the office, so you have a life together outside of chiropractic.

Create certainty around each partner's roles, as you would in any business setting, and in case of extended absence, from childbearing, illness or unforeseen circumstances, have a back-up position as you would in any partnership, where work can be systematized and delegated as needed, to keep the office running in the absence of the partner.

Specialty Practice

You may elect to focus your attention on a particular specialty, like personal injury, sports, pediatrics, geriatrics, nutrition, family care, or some other delineation of practice.

There is finesse to orchestrating, marketing, and building specialty practices, and it will be in your best interest to model other practitioners who have been successful in these specialties. Do your due diligence, study your material thoroughly, and investigate the subtleties of conducting such a practice, from one who knows. It will help to save you wasted resources, and point you in the right direction most efficiently.

Scope Exercise

What kinds of patients do I enjoy taking care of most? Who do I enjoy the least? If I fill my day with a variety of people, does that work better for me, or do I prefer similar cases so I can establish a rhythm. Notice that there are no correct or incorrect positions, here, only the ones you try on to see how they fit. And don't be afraid to experiment in your thinking - that kind of brainstorming lead to quality thought processes that in turn lead you to appropriate critical thinking and decision-making.

Selecting Your Practice Mode: Types of Practitioners

Depending on your particular style and life situation, there are several ways for you to get into practice. Since 90% of all chiropractors choose to open their own individual practices, there must be a good reason... and there is. The individual proprietor generally fares far better financially than those involved in group practices or in partnerships.

Although opening your own office puts you under greater economic stress in the beginning, it also allows you to take full and total responsibility for your own career. You can practice the techniques of your preference ... use the procedures you like ... and answer to no one but yourself. A little scary perhaps, but also the best way to find your true potential.

As your practice grows, you can add staff, an associate doctor, or other professionals to help you. This allows you to maintain control and grow at your own pace, in accordance with your own goals.

It's often difficult to determine if your dreams of being a sole practitioner fit with your personality and style. Take this test to help answer more questions for yourself: Evaluate Your Entrepreneur Potential.

Online Resource: E-Myth Worldwide. For 30 years, E-Myth has been helping small business owners achieve success. http://www.e-myth.com/

Peter Lawrence, DC, CCSP is a senior coach with The Masters Circle. He is a 1987 graduate of New York Chiropractic College, and practiced for 17 years New York City. Anthony Pusateri, DC, is a senior coach with The Masters Circle.

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