Tom Schmidt, DC, quadrupled his practice space by creating a multidisciplinary wellness center

For Tom Schmidt, DC, dreaming is serious business. The Lakeville, Minn-based chiropractor’s dreams have become reality. He has gone from an 1,800-square-foot solo practice to a 7,200-square-foot state-of-the-art facility with four chiropractors, five massage therapists, and six personal trainers.

Tom Schmidt, DC, holds biweekly new-patient orientation classes at his facility. The classroom is also used for staff meetings and yoga classes.

And although it was founded on a dream, Schmidt’s practice is based on solid, easy-to-follow business principles—the primary of which was simply to share his vision with others.

Sharing the Dream
Schmidt’s dream had begun percolating in college when he saw the benefit of DCs working together in business partnerships. “In order for our profession to move to the next level, we need to be more concerned with the success of our profession rather than personal success,” he says.

But that was easier said than done. Like other DCs, Schmidt worked by himself after he graduated, and, though he enjoyed his work, he was “consumed by the practice.” This left little time to take the steps needed to put his dream in action.

To help him devise a plan of action, Schmidt hired a personal coach. One of the first assignments the coach gave him was to write a business plan, which was something Schmidt had experience doing from his school days. With the business plan in hand, Schmidt then moved on to the next step: finding a consultant who could help transform the dream—which was now in black and white—into three-dimensional reality.

In this, Schmidt was lucky. He found a consulting firm that specialized in setting up multidisciplinary practices. But even though the consulting group was essential in transforming the dream into reality, Schmidt says that having and sharing the vision in the first place was essential. “If I didn’t do that, I wouldn’t be here,” he says.

Once the company analyzed his business plan, it began to put the pieces in place to transform the solo operator into a group practice, breaking down each step into a chunk-sized goal. But even though these transformational goals were small, they required Schmidt to do business in a very different way.

Transforming the Dream
One of the biggest changes that the consultants suggested was moving from an all-cash business—the norm in Schmidt’s experience—to accepting insurance. “If I wanted to be multidisciplinary, I was going to have to entertain the thought of accepting insurance,” he says.

To make it a reasonable, easily attainable goal, the consultants suggested that Schmidt just be admitted onto one local provider’s rolls. “It was a huge change,” Schmidt says, but, he adds, it allowed him to begin collecting fees that reflected his actual treatments instead of generic, one-price-fits-all “adjustments.”

The payoff was that his revenue doubled between 2003 and 2004, and again between 2004 and 2005, which required him to hire a full-time insurance person.

The systems and procedures that the consultants put in place were done with scientific precision, allowing Schmidt to know exactly how many people he needed to hire based on the number of patients being seen in the practice.

But, even though Schmidt swears by the company he used, he also does not discount the almost supernatural intervention of his plan coming together. He notes that not a single member of the group was brought on board through any sort of solicitation. “The practice has kind of created itself,” he says.

A supernatural agency could be at work, but the practice opportunities afforded by having a staff of five assistants handling scheduling, billing, and other day-to-day tasks could be a motivator as well. Schmidt acknowledges this and points to one of his colleagues who only works part time. Because she can focus primarily on treating patients, her attenuated time is spent almost exclusively with them, rather than spending time running and managing the business.

Even with the consultants and their proven systems in place, there was one challenge that Schmidt had not counted on—the difficulty of finding a building to house his burgeoning practice.

If You Build It …
Originally, Schmidt had planned to rent a bigger office to house the growing practice, but the rental deal fell through at the last minute. But, as with everything else associated with Schmidt’s practice, things seemed to take care of themselves.

Near the original site, Schmidt found an office condominium that was for sale. The 7,200-square-foot, three-story condo was not what he originally had in mind, but, by becoming the owner of the building, it allowed Schmidt to create exactly the kind of facility he wanted.

Schmidt and his colleagues have been in the new facility since March 2005. Schmidt characterizes his new headquarters as a “warm and homey environment with no fluorescent lighting, and earth-tone colors.”

The facility includes eight adjustment tables, four physiotherapy tables, three intersegmental mobilization tables, an active care room, three private treatment/education rooms, and three massage rooms. In addition, the practice boasts a digital x-ray machine and a foot scanner. The state-of-the-art facility also has eight flat-screen monitors located around the building. These show educational videos to patients.

Schmidt has found advantages of having a multi-story facility. The main 3,300- square-foot space is given over completely to chiropractic and massage treatment. Offices are located on the upper loft area, which gives the providers a quiet area to attend to paperwork and other practice-management issues.

Erik Peacock, a certified personal trainer at the facility, assists a patient with a bridging exercise.

The 3,300-square-foot lower floor includes a 1,700-square-foot rehab gym and a classroom, which is used for patient orientation, provider and staff meetings, and yoga classes.

The large building has allowed Schmidt not only to fulfill his dreams of today, but prepare for the future. The space could accommodate up to seven or eight DCs and at least as many massage therapists, but Schmidt is cautious about the pace of the practice’s staff expansion and overall growth. “I’m sticking with slow growth, because I don’t want turnover,” he says.

Staffing is a question of patient volume, and is directly tied to practice growth and needs to be addressed before expansion in terms of services and practice load.

Schmidt tries to meet with key staff in one-on-one sessions at least once per quarter, and he encourages anonymous feedback about problems and ideas for improvement. “A lot of the answers to practice growth come from the staff,” he says.

And even if he is a bit cautious about growth, Schmidt is more than generous in nurturing his multidisciplinary practice. Though he does not know the exact percentage, he is constantly reinvesting back into the practice.

For those who want to follow in Schmidt’s footsteps, he recommends that you “evaluate your ‘big why.’ If you’re in it for yourself, then you have the wrong motivation. The focus of your practice has to be on the product—serving people with your unique talents.”

He also recommends his fellow DCs “think bigger” and abandon the lone-wolf competitiveness of the solo practitioner for a model that embraces and mentors other DCs.

Although Schmidt is a dreamer, he has seen the practical side of turning one’s dreams into reality. “If you have a dream, and accountability, what is guaranteed to show up is you,” he says.

Most important for success, says Schmidt, is that you must “be open to instruction and be willing to listen to sound advice.” CP

Empowering Patients In addition to traditional chiropractic care, Tom Schmidt, DC, offers his patients other complementary services as well. The addition of these services, which include one-on-one treatment in the facility’s rehab gym, came out of the recognition that along with imbalances of joints, there is corresponding imbalance in the soft tissues. But, for Schmidt, it is more than just doing standard chiropractic care, such as adjustments, massage, and e-stim. “If all you do is adjustments, that’s very short sighted,” he says. Instead, Schmidt has taken a page from physical medicine and aims to transform his customers into “wellness patients.” Stretching and strength training are now on the menu of services. The rehab staff—which includes five athletic trainers—works one-on-one with patients. The goal is to make the patient’s chiropractic needs routine, with the occasional adjustment the only chiropractic service they might require. This combination of stretching and, if needed, strength training is overseen by a DC and follows from adjustments and massage therapy. The specific time that Schmidt and his colleagues introduce these wellness exercises is tied to the patient’s health and fitness, but, typically, it is after the patient has received several treatments. Once the patient is ready, he is shown exercises and stretches designed to keep him well. When patients are given a stretch or exercise for home, they are also given an accountability assignment. At the beginning of the next treatment, the patients will be quizzed about their assignment, which will gauge whether or not they are ready to move on. The goal with this approach is to make the patients responsible for their treatment and long-term health. “This is active care, which means having the patient doing the work,” Schmidt says. “We’ve got to empower them for the treatment to be a success.”

C.A. Wolski is a contributing writer for Chiropractic Products.