Joseph Mannella, DC, moves forward by keeping his focus on improving chiropractic care.

In a mere decade and a half since becoming a chiropractor, Joseph Mannella, DC, has gained two or three lifetimes’ worth of experience at building and selling practices. To date, the Michigan doctor has launched seven offices and, of those, divested himself of five (at a price equal to their fair-market value, no less). In every instance, the sale and subsequent transition to new ownership went smoothly—and, in most of them, the buyers were one-time associates of his.

Joseph Mannella, DC, in front of his Richmond office.

“Two of the most difficult situations you can have in the business of chiropractic are, first, associateships and, second, the sale of your practice,” Mannella says, based in the city of Richmond. “I came out on the positive side of both situations because we—myself and each of my associates—put our focus on chiropractic care and doing what’s right for our patients above all else, and then worried about terms of sale and related business aspects after that.”

So committed were Mannella and his associates-turned-buyers to keeping those priorities straight that today, long after the fact, the doctors remain best of friends.

“We’ve stayed in close contact,” Mannella says. “During the time we worked together, we’d built up a lot of trust in one another. That trust carried us through the process of building up the practices and then handing them off. That trust instilled in us a great amount of loyalty, so that now it binds us like brothers.”

Mannella might have been satisfied creating just one hugely prosperous practice and letting it go at that, were it not for his intense desire to create opportunities for his colleagues to become independently successful.

“My approach,” he explains, “was to build a satellite office, bring in an associate to run it with an eye toward one day having him become its owner, help him in every way possible while he’s establishing himself, then, at the right time, usually 2 or 3 years later, sell it to him and open another satellite office in a different market elsewhere in the state, bring in an associate for that new one, and repeat the process all over again.”

Wished He’d Known
Mannella opened the first of his seven offices in 1989, the same year he graduated from Logan College of Chiropractic. He chose to set up shop in Grand Rapids, in the western part of Michigan (Mannella’s hometown was Harper Woods, a community outside Detroit, on the state’s east side).

But, 4 months into the launch of his 2,400-sq-ft office, Mannella worried that he had gotten in over his head. Justifiably so. “The complexities alone of dealing with insurance made me realize there was a lot more to a practice than having great intentions and a vision,” he says.

Joseph Mannella, DC, pictured with Scott Alcott, DC, (right), a former associate at an office Alcott bought from Mannella

Mannella instinctively knew the way out of his troubles began with education, so he hired a practice consultant and attended every business-oriented seminar he could. “The most important thing I learned from that education process was how to be fully responsible for all aspects of my practice, including those I wished I could somehow avoid having to deal with, such as insurance,” he says. “Because, the one area you don’t take responsibility for will end up adversely affecting all the other aspects of your practice to the point that you have unhappy patients and no growth.”

Mannella is pictured with Brian Woodbeck, DC (right), an associate at Mannella’s Sandusky, Mich office

While consultant-supplied insights were frequently helpful, an error Mannella made was placing too much confidence in those experts and too little in himself. “I wish someone had warned me about the amount of money and time you can waste on consultants and still never be equipped to implement the changes you need to implement,” he says.

Mannella is pictured with Eric Marshall, DC, (left), a former associate at an office Marshall bought from Mannella.

In 1990, Mannella’s chiropractor wife was pregnant with their first child (they now have a total of three; the youngest is 10). News of the pending blessed event prompted him and Elizabeth Mannella, DC, to pull up stakes and move to her hometown of St Clair, about 40 minutes north of Harper Woods, to be near her mother and father and thereby benefit from their long years of parenting experience.

Preceding that relocation, Mannella sold the Grand Rapids practice and used the proceeds to start a new one in St Clair in a 3,600-sq-ft freestanding building constructed to his specifications (Mannella’s practice occupied only half that space; the remainder was rented out).

The Mannella Envelope
Much to Mannella’s delight, the St Clair office was successful almost overnight. “All the lessons I’d learned in Grand Rapids, I was able to apply from day one in St Clair,” Mannella says. “I went in feeling totally confident, and that was crucial.”

Before long, Mannella opened a satellite office about 30 minutes north of there. “I expanded my practice out of a sense of duty, and I was beginning to recognize that I had to help as many people as possible,” he says, indicating this is how he came to fall into the rhythm of building and selling practices.

Indeed, just as he did in St Clair, Mannella bought land and put up a building to house the northern satellite. After he sold that office, he hung onto the building and collected rent from the buyer, Scott Alcott, DC, an associate who had been overseeing the place.

Around 1995, Mannella took on an associate, Eric Marshall, DC, in the St Clair office. The addition of that second doctor lightened Mannella’s clinical caseload enough that he was able to explore a sideline as a consultant—again, a step spurred by his desire to help others. For a time, Mannella toured the national seminar circuit, but soon gave that up after deciding the impersonal nature of speaking from behind a podium to a sea of anonymous faces wasn’t his cup of tea.

By then, however, Mannella had sold his St Clair office to the associate and left clinical practice. Realizing his foray into seminar-style consulting had been a mistake, Mannella built yet another office and donned once more his practitioner hat. This time, it was a 100% cash practice and located in the Detroit suburb of Warren—far enough removed from any of his previous offices to not represent a competitive threat.

Warren was a highly successful practice: Being cash-based loomed large as a reason for that, but so did the fact that Mannella opted to rent space in a pre-established but underutilized chiropractic office.

“It was sort of a turnkey operation for me: I literally showed up the first day and started seeing patients; everything I needed—equipment, support—was already in place,” he says.

A year later, Mannella sold the Warren office. “The drive from my home in St Clair to Warren was an hour one way. It got to be too much after a while.” So, he opened anew with an 1,800-sq-ft freestanding office in Richmond—a much nearer location. “When I started the Richmond office, I was very settled in my thinking and approaches to chiropractic,” he says. “As a result, it was the most stress-free opening I’d yet experienced.”

Nearly 4 years after Richmond went live, Mannella added a satellite office in a town about 45 minutes away. He sold it 18 months later. Then, in 2004, it was déja vu all over again when Mannella opened another office; this one 75 minutes distant in the city of Sandusky, Mich, which is still under Mannella’s ownership. The chiropractor on-site full-time is Brian Woodbeck, DC, in line to eventually become its owner.

Necked Truth
Mannella may or may not once more repeat the cycle by starting another office after the Sandusky site rolls over. He is not sure because he is currently steeped up to his clavicle in a couple of hot-and-heavy sidelines, one of which is a company he formed a while back to produce and distribute an immensely popular neck orthotic he invented for correction of forward head posture and loss of normal cervical curve. “I developed this device as an alternative to products that were difficult to use and that were expensive,” he shares. “I wanted a neck orthotic that would simulate the effect and feel of my traction table.”

Interestingly, when Mannella conceived the idea for his invention, he told no one and, for 2 years afterward, engaged in no development work on it. “I was excited about the invention, but I purposely waited to see if my idea would lose its appeal to me or if I would be more certain and excited to do it after the waiting period,” he explains. “I had in the past rushed into projects like this, only to have them end up costing me a lot of time and money. I never gave myself enough time to really think them through, to realistically assess what it would take to make a go of them, or even to see if the project aroused in me sufficient passion to keep me excited about it for longer than a few weeks or months.”

But this time was different; the excitement he felt in the beginning stayed with him, thanks to patients continually pleading for advice about what they could do at home to help correct their loss of cervical curve.

“I knew the neck orthotic would be the perfect solution for them,” he says. “Patients were asking for help so frequently that finally I knew I had to try making this device.”

Mannella calculated that the neck orthotic would cost him at least $50,000 in development expenses and again as much to bring to market and properly advertise. Nevertheless, he figured it was worth the gamble.

But before producing it in quantity, Mannella (with the aid of a high-heat hair dryer) molded a handful of prototypes from soft plastic and tested them on select patients. He experimented with different configurations until he was confident he had the design down pat. He also received guidance from professional designers, engineers, and fabricators.

In the course of all that, Mannella found it wise to ignore the advice of well-meaning, but doubting, friends and family. “I had people tell me this isn’t going to work, that it’s already been tried or done.” he says. “I’m glad I didn’t listen to them.”

Living for the Momentum
Having a hit product under his belt, Mannella now finds people wondering if next he will turn his attentions to inventing something for the lumbar curve.

“They ask me about that, and my answer is no,” he says. “The development process takes a huge amount of time. You have to deal with different vendors and lots of financial setup. It takes a lot of energy, and all parts of your life feel it.”

Besides, he is too busy with the second sideline, a consulting firm known as Momentum Implementation Agency, which he started only this year. Says Mannella, “What I’m most passionate about is being able to sit down with other chiropractors, one-on-one, and help those doctors become more of who they really are so they can flourish and have the practice of their dreams.”

Mannella corrects those who assume his consulting service is one that offers seminars. “I don’t do seminars; I do implementations,” he says. “Implementation creates serious, lasting momentum in a practice, which is what’s most necessary for achieving genuine success. Seminars, on the other hand, are usually little more than a pick-me-up for despairing chiropractors—and a short-lived pick-me-up at that.

“Plaguing our profession is the notion that you can learn and grow from sitting in a seminar, listening to a tape or CD, or reading a report or manual. The truth is that anything that requires action and skill needs to be implemented. You can’t implement the skills necessary to be able to ride a snowboard, for example, by reading Five Secrets to Successful Snowboard Mastery or some such thing. Same is true with chiropractic success. The skills a chiropractor needs to be successful have to be implemented.”

Momentum Implementation Agency—MIA, for short—provides an implementation program geared around a 3-day, in-office, one-on-one encounter with Mannella. During that visit, Mannella teaches (and the trainee practices) techniques for correct, efficient handling of paperwork, consultations, examinations, and payments. He also provides fully individualized instruction in the art and science of developing dynamic health-and-wellness profiles, reports of findings, patient-education tools, market-outreach programs, ultraeffective patient recall letters, and more.

“I lead the chiropractor through a personal, private, in-depth, self-discovery session to help with implementation so that momentum can be achieved and sustained,” he says. “Everything is implemented to suit the chiropractor’s unique personality, style, and practice preference.”

Between MIA and his invention, Mannella has plenty on his plate. The two ventures brim with upside potential and could, if they really were to take off, become all-consuming of his time. But, if that happened, Mannella would find a way to regain control of the clock, because the one thing he will not permit is other activities to force his permanent retirement from practice.

“Practicing chiropractic is my calling; not practicing isn’t an option,” he says. “It’s who I am. It’s what I am here for.” CP

Rich Smith is a contributing writer for Chiropractic Products.