Many chiropractors are enjoying thriving practices. What are the factors involved in their growth? Is there a common determinant for success that cuts across the board for all DCs? Is it advances in technology, dedication to their patients, or just hard work? Interviews with several chiropractors who have experienced practice growth shows that the reasons are as varied as the doctors themselves, and what works extremely well for one DC may be unknown, or even undesirable, to another.

Dennis Conway, DC, Galesburg, Ill, incorporated the Pro Adjuster computerized spinal analysis and adjustment system into his practice early in 2007 and has since doubled his patient load.

The Pro Adjuster system uses a percussive force instrument that the chiropractor applies to the patient's spinal column. The head of the instrument is made of stainless steel and aircraft aluminum, and connects to a piezoelectric sensor that transmits a waveform back to a computer for interpretation and analysis. The system is used both for computerized analysis and adjustment of subluxation, with the adjustment force delivered by a "hammer and anvil" percussion mechanism within the instrument.

Conway first learned about the Pro Adjuster while visiting a chiropractor friend in Chicago. "He showed me how it works," Conway says. "The chiropractic market is pretty crowded … I felt some new technology would help give my practice a boost."

As evidenced by his Web site, galesburgwellness.com, Conway is strongly committed to the Pro Adjuster system. The site provides abundant information about the technology, including several television news segments. Conway is currently the only chiropractor in the Galesburg area (population 30,000 with 17 chiropractors) using Pro Adjuster.

Melina Youngs, DC, Coral Gables, Fla, uses a more traditional approach but will also use the latest technology to advance her practice. She favors the old-fashioned manual adjustment technique, and enjoys the intuitive feeling that she says can only be gained through a hands-on approach. Any technology that will assist her in performing her own adjustments, such as the Saunders 3D ActiveTrac traction table, is fine with her. "With this table," she says, "you can create traction in many directions other than the customary axial (head to toe). You can bend, twist, or extend the bottom of the table. I have two of them now."

Tom Schmidt, DC, says billing software from Eclipse helped him deal efficiently with practice growth.

Youngs also uses the AquaMED dry hydrotherapy table, which provides patients with a whirlpool massage without getting wet. Youngs says that 30% to 40% of her patients use it as part of their regular treatment. "They request it and really enjoy it."

Other Contributors to Growth

Chiropractic software is an example of behind-the-scenes technology that also contributes to the growth that Youngs has been realizing yearly. Youngs has been doing well enough to add 600 square feet of office space with construction under way on a larger waiting room and front office and two additional massage rooms.

"I've been using Eclipse software since I started my practice 7 years ago," she says. "It helps immeasurably with running the entire office, patient ledgers, bills, insurance, and patient e-mail reminders."

She uses Life Systems' Chiropad software for daily notes on patients, reports, and x-rays. "It helps me to see more patients because I can do everything more quickly."

In a similar vein, Tom Schmidt, DC, Lakeville, Minn, used a consulting company to upgrade his practice and dramatically increase business. Breakthrough Coaching of Vernon, NJ, provided a model that included the revamping of his billing and collection procedures.

"When we first started, we were being reimbursed only for spinal adjustments," Schmidt says. "Now we're also getting reimbursed for our physical therapy modalities, including electrical stim, interferential, ultrasound, and laser. Prior to Breakthrough Coaching, our average collection was $25,000 to $30,000 a month. Now, after one year of their help, we're seeing $75,000 to $90,000 monthly."

The consulting company contributed in other ways toward the growth of Schmidt's practice. Schmidt had envisioned multiple providers in one space to enable better care for patients and a better quality of life for himself and his colleagues. Breakthrough Coaching helped create a multidisciplinary model that now includes three chiropractors, five message therapists, and one physical therapist (who works in conjunction with the massage therapists). "They also did a great job of getting my team together and providing staff training," Schmidt says. "Teamwork is a huge factor for growth and success."

Dennis Conway, DC, incorporated the Pro Adjuster computerized spinal analysis and adjustment system into his practice early in 2007 and has since doubled his patient load.

Schmidt adds that the new building with its larger space of 73,000 square feet has allowed for greater growth. "Look at your busiest hour in your present facility and see if you're utilizing all your available space," Schmidt says. "If you are, you need more space. Flow is vitally important." This forward-looking attitude is another benefit of Schmidt's alliance with Breakthrough Coaching. "Like a lot of chiropractors, I had vision—I knew what I wanted—but I lacked implementation. From that standpoint, being open to a coach is really important."

Schmidt also credits his office computer systems, particularly Eclipse and Addison's Writepad software, again at the suggestion of Breakthrough Coaching. "You're only going to be as busy as your systems allow you to be," Schmidt says. "As growth develops, efficiency becomes increasingly important. The Eclipse software is a great help with patient scheduling and billing, and the Writepad helps to keep notes about treatment. You won't get reimbursed if your notes don't justify the treatment, and the software is a big help with that."

Scott Rubin, DC, St Petersburg, Fla, has seen a dramatic four-fold increase in cash business, going from $3,000 to $4,000 per month to $12,000 to $15,000. The reason is a diagnostic program he instituted 2 years ago, a program he learned about from another chiropractor, Tim Maggs, DC, Vancouver, Ore. The program involves three basic elements: scanning with Foot Levelers Associate Platinum, the Winposture, and the Standard Process symptom survey nutritional analysis.

Scanning, Rubin says, "measures how arches of the feet affect complete skeletal structure. It helps in treating chronic muscle dyskinesis." The Winposture "measures center of gravity, both anterior to posterior and left to right." The symptom survey, a nutritional analysis designed by Standard Process, measures the patient's nutritional needs.

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"I had these resources, but I wasn't using them in the way they should be used, in the way Dr Maggs has organized them." Rubin decided to follow Maggs' formula, and as a result he has been able to establish robust sales of foot orthotics and nutritional products, significantly increasing his cash income.

"I now sell 20 to 25 pairs of foot orthotics monthly (at $250 to $350 per pair), and $2,000 to $3,000 in nutritional products per month in the Standard Process detox line, in particular the SP Cleanse, SP Gastrofiber, SP Omega 3, and SP Greenfoods.

Adding further to his selection of beneficial services, Rubin became a certified Pilates instructor. Along with two massage therapists, his modestly sized 1,800-square-foot office is doing a total of $45,000 to $50,000 in business per month. "We've had outstanding growth in the last eight months," he says.

We've looked at four chiropractors enjoying significant growth, each with a different explanation for that growth. If anything, this should attest to the creative choices available to any chiropractor with an eye on the future.

Alan Ruskin is a staff writer for Chiropractic Products. Contact him at .