113 - Why Most Practice Launches Feel Harder Than They Should with Dr. Chris Grier

[00:00:00] If you're an on purpose chiropractor, even if you're a student and you're an on purpose chiropractor, you have a big mission to serve, things to do to go out there and serve the population. And as we say, if there's no money, there's no mission. So if you're on purpose, you have to set up the business appropriately.

[00:00:23] Hello and welcome to Build Your Remarkable Practice podcast. This podcast is dedicated to chiropractors who are in the seasons of launching and building their practice. Join myself, Dr. Lona, and my co-host, Dr. Bobby, as we have conversations each week as it relates to building the practice of your dreams. And remember, you can have a remarkable practice as part of a remarkable life, not instead of one. We are here to lead you on the way.

[00:00:54] Welcome back to the Build Your Remarkable Practice podcast. And I am back here with Dr. Chris Grier, longtime guest. He keeps coming back, which I'm grateful for. And he's also my co-host in the launch season of practice. So if you've jumped on a strategy session, chances are you either talk to Dr. Chris or myself, if you're considering launching a practice in the near future and you may want some help.

[00:01:20] And both Chris and I were chatting offline that getting help in our early season of practice was crucial for our success. Right, Chris? Absolutely. Yeah. Well, thank you for having me back, as always, Dr. Lona. You know, it's an honor to be on the podcast. I think that, you know, the Remarkable Practice has the two best podcasts in the profession. So thank you for being the host on one of those.

[00:01:42] And you're right. Like when people launch, there's this whole spectrum, as we were just moments ago talking about, but there's this whole spectrum of how we launch. And so I'd love to dig into that more. And from listeners, you know, we realize that some people might already be in practice. Well, if you're already in practice, listen up, because there are things that you might glean from this that can help you in your current stage of practice. There are associates who might be listening who have this inkling of like, man, I'd really like to have my own thing.

[00:02:12] I feel like I have that personality and that mindset to have my own thing, but I don't know where to start. That's a great group. And then, of course, it might be hopefully their students listening. People who are going through school, you know, getting in the next year or two ready to launch, who might be a perfect fit for what we have to say. So let's dig right in because I think there's a lot of content here. And, you know, eventually you might open a second practice. That's always part of it, too.

[00:02:38] You know, Chris, it's funny. You just said, and it just reminded me where you said, and you don't know where to start. I wrote a book about 10 years ago called Just Tell Me Where to Start because at that time I thought, man, I had just gone through the first couple of years of practice, launched, I would say, pretty successfully to the point that I had paid down my student loans very rapidly. And I just remember reflecting, like, where were those stories in school?

[00:03:05] Right. Like, where are those stories of somebody who got out, launched a practice, did chiropractic for the record, not something else, and then was able to financially and business-wise successfully run that business? Because, you know, and it wasn't a success story necessarily 20 years later. It was like, no, pretty rapidly we're doing well.

[00:03:26] And I'll just frame this up, too, because I remember sitting in one of my experiences in peak or externships, and it was a great experience. I learned a lot there. But one thing that horrified me was this doctor telling me that 20-some years later she was still paying on her student loans, you know? And I just thought, man, you're teaching some of the business class here, and you've still got student loans. Like, that felt really heavy to me to hear that.

[00:03:55] And that was part of what lit a fire under my ass of, like, okay, I know I want to help people. I know chiropractic is good for people. Now I need to learn how to do this business thing. And if I'm going to launch a practice, I need to learn how to do it successfully and understand the financial piece of running a business, too. Yes, for sure. So many people have the heart for chiropractic. You know, they know that they can help people, and maybe they're in practice, and they've already been helping people.

[00:04:20] Or they, you know, have been doing great things in school and know they have that clinical certainty. But they completely lack any business acumen. And that's certainly where I was coming out of school. I didn't know where to start, so I was glad. In fact, that's one of my things. If we're talking about, like, what went well in our launches, one of the things that went well for me is I had guidance, you know, right off the bat. I made sure that I had guidance with that from a business side of it.

[00:04:49] I didn't really need the help clinically because I really felt like I had a good foundation to start with. But I knew I needed help on the business side of it. So having help is like check that box, I would say, if you're considering launching. Yeah, I agree. I did not have help right from the jump. Not at least not coaching in the chiropractic space. I had other types of help.

[00:05:10] But I think if I look back on that first couple years, the first year I had a lot of vision and I also had clarity that I loved adjusting and that that's what my foundation was going to be built on. And what I realized after getting about 11 months in, there were – I was saying this to you offline. There were people coming in like, you know, word of mouth was happening. I was out in the community. I remember someone saying to me, I see you everywhere.

[00:05:38] And I thought, yes, that's exactly what I want you to say because I felt like I was everywhere because it really – I tell young chiros that like you're going to be a politician on some level for this next period, right? You got to get out and meet everyone that you can and you do need to show up everywhere. And I had a house of cards. That's exactly what I would call it because it was the loner show and it was total personality. I had no business systems.

[00:06:08] I didn't understand what to do with the money on some level that was coming in or where my next investment in the practice should be until I got the right coaching that could help me start to put structure in place and actually run a business, not just the loner show. Yeah, absolutely. And I think it's worth pointing out that people with very big personalities, with that very attractive personality, they can do this successfully for a year or two or whatever.

[00:06:37] And then you're exactly right. It builds this house of cars. It's like, doesn't this look nice? Wow, I can't believe you've built this. And at the same time, it's like a moment from collapsing because there aren't the systems underneath it to glue it together. Yeah, that's exactly how I felt. I remember thinking, this isn't good. This isn't good. And also not sustainable. And there is a season.

[00:06:58] I think that's one thing I want to underline too is like there is a season that is going to require a sheer grit to like your desire to lift this practice. And that's what it is. It is a lift. Right, Chris? Absolutely. And I don't think sugarcoating that serves anyone because there's no real balance in that season. But if it's in harmony with your vision, it's going to feel good still.

[00:07:28] Yes, absolutely. I think two things there. The idea that there's an easy way to do this is a myth. That's mythology, right? Like, oh, here, just buy this package or, you know, hire this coach or whatever. And your launch is going to be a piece of cake. Like, you can pretty much just like sit around and plan your vacations. Like, that's never, that's not the thing. And the second thing is vision. So let's land on that for a bit because it is our very first step in our roadmap to launching is vision.

[00:07:58] And, you know, we go vision, then we go practice systems, then we go business systems, practice plan, business plan. And I think it'd be worth talking about all three of those things just to give the listeners a sense of what do we even mean by that. But the first thing is vision. And sometimes people have this big, massive vision. Some people don't even know that they should have a vision. They just want to do chiropractic, you know, in some way that they want to be a chiropractor. So let's dig into that.

[00:08:28] Like, as people are launching a practice, we obviously put it number one in our 21-step roadmap, you know, to being able to launch. I think it's the appropriate spot. I think that it needs to be revisited after at every single step along the way. Does this fit and serve your vision? So let's talk about the different ways to create a vision and the different visions that we've seen and the ones that we've seen be successful. Yeah, that's great. And that's not going to go away, right?

[00:08:57] Like, no matter whether you're in build or scale or whatever, it's like we're coming back to vision because if you're the leader of, you're the captain of that ship, it's going to be you setting that course of this is what we're trying to create here. This is what I see. This is how it creates the life I want to live as well because there is that business vision or the practice vision as well as how that marries the life vision that you have.

[00:09:23] And to recognize there is sometimes during that season, I think there has to be a rectifying, I don't know, where you recognize sometimes. I'm going to pour in hard here because I can see the fruitfulness of freedom that will come by me diving in right now.

[00:09:46] And I think sometimes people want the freedom or all the opportunities and optionality that comes with what the practice can give you, but it's not there yet. And so picking your head up and changing the vision is actually undercutting you at the knees too. And that I see more commonly than sometimes people being really focused. It's like, yes, I know there's a lot of things you can look at and there's a lot of opportunities out there. But what is the real practice vision? If we're launching this practice, this is where we must be focused right now. Sure.

[00:10:15] And the guidance, I think, as we mentioned before, guidance is what helps shorten the timeline between that freedom of our vision. Ah, this is what we're going for. And the time that we launch, right? Because it can be, it can really become protracted if it's like we're trying to figure it out on our own. We're trying to grind it out. We're trying to whatever. Just simply like listen to passive things instead of having active guidance with it.

[00:10:40] And so on that, on the vision side of it, I like the, I really, really love the concept in our modules of the puzzle box cover. You know, like we, we have, we want to launch a practice. And so we know there's a thousand pieces to launching a practice. But what does that really look like? Well, you get to decide and you get to create the puzzle box cover. Because if you don't have that puzzle box cover, you don't have any idea other than the edges. Like, okay, where, where do I start? What do I do?

[00:11:09] So the vision is going to need to serve the two things. I'm glad that you mentioned it. It needs to serve your practice vision, but we need to make sure that we're having it congruent with the vision for your life as well. And so, you know, our, our tagline is helping you create a remarkable practice as part of a remarkable life and not in place of one and not instead of one. So have your life vision. What do you want to create in life? You could have it all.

[00:11:37] One of my great mentors, Dr. Steve Hoffman says this, if you could have it all, what is it all? And talking about that from a life standpoint. And then once you've defined that, then you go create the business that serves that. And that's what the vision really needs to be. Is what's the vision for my practice that serves this remarkable life that I'm building. And we've seen it all over the map, right?

[00:12:00] Like we've seen the, the, I'm going to create this practice and launch it with every possible thing. Like this great, big, frankly, expensive version. And I'm not saying that's right or wrong, but we've seen that really big side of it. So the, the practice that opens in two or 3000 square feet, like right away and, and has all the bells and whistles.

[00:12:25] We've also seen the very opposite side of that, which is like, I'm going to start on a shoestring. I don't want to borrow any money. So I'm going to rent a 500 square foot room in the back of a gym. And that's how I'm going to launch. Well, I, I think, I think that both of those oftentimes get given to us. I think both of those visions oftentimes get given to us instead of come. Really good point. Yeah.

[00:12:54] And that's what I encourage the listener to think about. Like, okay, is my vision of, of my practice is how I want to launch my practice. Is that my vision or is that some other vision that's just landed on me? And it is absolutely worth taking the time to get this right. So let's chew on that for a second. Because if, and if you're one or the other right now, or maybe you're like, no, I'm somewhere in between if I'm listening and I'm trying to think about what my practice size looks like and budget

[00:13:23] looks like and how I envision the feeling when I step through the walls and how many spaces are available with like how many rooms and how many tables and all of that. Right. You know, if you're somebody who's on a shoestring and depending on where you're at in your process right now, like I think sometimes too, just asking yourself, where did I, where did that come from? Right. Like, is it already understanding?

[00:13:48] Like I sort of have a lack mentality around money and I'm really worried or I haven't done enough preparation to get myself in a position where I can launch strongly. So I'm doing this out of default or on the flip side, maybe you have a mentor that has the practice with all the bells and whistles and a big expensive build out. And this is like their third iteration, but you haven't seen the first and second iterations

[00:14:17] of what their practices look like. And so again, that doesn't make either end wrong because you could do it either way. There's just definitely different stressors on both sides of that coin. And if I, you know, we've opened three brick and mortar practices. So I had two partners in our second and third practice and both were very successful launch and build and then scale and then exits for me.

[00:14:41] And all three of our brick and mortars launched what I would consider in a scrappy way, meaning like I was cognizant that like the more money we take out or the more money we pour in, the longer it takes for us to pay that back and to get in the black potentially. And so I just really, that was part of me bringing what I brought to the table was like after I had done it once, I had experience of like, okay, let's do it again.

[00:15:11] And how will this look? And each time we learn more, right? But I never have thought it was a bad thing that we started in a thousand square feet, leveraged a couple of tables to start with and just kept it modest because again, chiropractic isn't expensive really. It's like, you need tables, you need a computer, you need your hands. You need, in our case, we use insight scans. Yep. But we could get open and not have to spend that much money.

[00:15:41] And that's the great news for the listener right now, right? We're not dentists. You know, it's like we need a million dollars worth of equipment, which I think is real in a dental office, right? So there's no way to start scrappy as a dentist, right? As a chiropractor, you can make a space look really nice and it can have growth potential and you could have one, I would encourage two tables to start with, you know, make sure

[00:16:08] that you have some ability to increase your volume quickly. We don't have to have the world to do it and we have to have something, you know, we have to have something. So it's finding that sweet spot that matches the vision, I think is the beauty of it. Now, as we then talk- And just know your numbers, right? Like, that's the other thing is like when you are considering like, do I get this table or this table? It's like, well, which table do you really love? And do I buy this used piece of equipment or, you know, whatever?

[00:16:38] It's like, well, just know your numbers. How long will it take you to pay that back based on what you're going to charge per visit? And just understand those things. Yeah. Yeah. Yeah. I mean, just as simple as when I ask a potential launch, like, okay, what do you anticipate your collection visit average is going to be? And they give me this look like, what's a collection visit average? It's like, okay, like we need some basic business here. For sure. Yes. And so you have to have that guidance, you have to have that business acumen to even

[00:17:05] figure out how what you take out or what you are going to put in right away is going to have a return on that. You also have to know the practice system that you're going to run in order for you to know what, how many spaces you're going to need to adjust, what kind of equipment you're going to need, how you're going to start as far as do you have employees to start with or not? All of that stuff. The practice system is really important. So let's, let's touch briefly on practice system and, and, and business system.

[00:17:34] If we have a second for that, but practice system just simply is how are you going to care for people? Once people walk in your door, this is beyond attraction. Once they walk in your door, what's your system with them? Are you going to run a day one and a two? Are you going to combine day one and two into one day? Are you, what, what sorts of assessments are you going to do with people? And then once you've figured out if you can help them and how you can help them, how is it that you're going to help them? Are you going to do care plans?

[00:18:02] Are you going to, you know, what's your retention system going to look like as far as educating people? We need to know how you're going to care for people for the life cycle of that patient in your office, which ideally, I think for most of the people listening, like the idea of a great big retention practice is attractive. So how are we going to do that? You have to launch with that vision. Right. And that vision keeps evolving as you get more clear about like, I'm going to have to educate more. I'm going to need to dial it.

[00:18:32] And that's what Chris is underlining is right now. If we, if we can start to put that on paper to actually have a plan from what you can see right now. And let's say you're like, it's murky. I don't actually know. That's why you have a coach or also that's why you go shadow and mentor and get mentors because you can learn a lot about what you don't want and do want by just seeing how others run their practices. Right. For sure. I was going to mention that too. Go see practices.

[00:18:59] If you don't know, if you haven't been in 15 practices, you don't know what you want. You don't even know what's available. I'm an hour from Palmer where, where I practice and I love having students come over and visit me on the business system side. Just so we kind of bring it full circle between vision practice system and business system business system is how are you going to pay? What's the financial entity that you are going to have behind your practice that serves you and your employees so that the business is successful.

[00:19:29] So this is a profitable thing that you're starting and not just some great place where people get excellent chiropractic care, which people need a great place to go that gets excellent chiropractic care. And the only way for that thing to survive is for it to have a successful business behind it. Mm-hmm. And a coach said to me, if you're all goofed up in your money and how money comes in, right? You could be given the best care ever and it's going to return to you, but it's going

[00:19:55] to return to you in banana bread and apples and pies and stuff because you haven't set up good systems in your front office to allow the exchange that needs to occur. Right. So if we're opening a practice, we need to get our mind right around the money, the numbers and how that's going to flow through and then how we reinvest that back into our business as well as pull some for our life. Right. Yes, absolutely. Because if you're an on-purpose chiropractor, even if you're a student and you're an on-purpose

[00:20:22] chiropractor, you have a big mission to serve, things to do to go out there and serve the population. And as we say, if there's no money, there's no mission. So if you're on-purpose, you have to set up the business appropriately. Yeah. And that's where when we project things out in your business plan, let's say you have a more conservative spark, you save some of that money so that there's six months of overhead sitting there as well as a marketing budget because we didn't put it all into a massive

[00:20:52] build-out or something like that. But then as we are making money, we can get that extra table. We can get more equipment. We can do more. Now, I'm not saying that if the money's not there to not do it in the beginning or it is there to do it in the beginning. However, again, you have to really play with those numbers side of things and think about like, okay, if our overhead is X, when do I cross the threshold of patient volume where I'm overcoming my expenses?

[00:21:21] That can be really fascinating to look at. And that's what Chris and I can do with people as we're helping them launch is helping them understand those numbers. Because I think that's one of the biggest gaps that we see is just people don't know how to extrapolate out what business will mean in a chiropractic practice because they've not been exposed to it before. Absolutely. There's so much to know and so much to learn. I think that most people launching are in that stage of they don't even know what they don't know. So that's where the guidance is.

[00:21:51] It's ignorance is brutal. Yeah. Until it isn't. Until it all comes crashing down. Yeah. Or it becomes a really painful, heavy thing for a period of time. And it's going to be a lift, as you said. But it can be done really, really successfully. I think under the show notes here, we'll put the launch roadmap. So anyone that is considering opening a practice in the next year to two years, download it, take a gander at all the different steps.

[00:22:18] That's what our launch program is designed to do, is to help you navigate through those steps more gracefully and successfully so that we can build a successful practice. Yes. Excellent. Thank you for coming on again this morning, Chris. And I probably will see you in about a month. All right. Sounds good. Thank you, Dr. Lona. Take care of all the listeners. Hey, everyone. Please listen in for this next bonus interview of one of our remarkable success partners.

[00:22:45] They all help us help more people find the benefits of chiropractic. So listen on. All right. I am here with an amazing success partner that we have who has been helping chiropractors and chiropractic offices, and therefore more people access chiropractic for quite some time, if I'm not mistaken. So welcome to our call here. Glenn, great to have you. Tell us a little bit about who you are. Thank you very much, Lona.

[00:23:11] And Dallin Associates, Dallin Design, has been around since the mid-80s serving chiropractic. It started out when my wife was a CA working in a 400-square-foot chiropractic clinic, and we came in to help her work more effectively. And that doctor that she worked for, sir, our work, and a bunch of their friends hired us. And here we are, 39 years later. We have over 7,000 chiropractors served.

[00:23:38] And we help chiropractors be able to do more in less time and in less space is what it comes to. That's amazing. I love that. And if I'm not mistaken, you have your own healing story in your family of chiropractic transforming your family's life. That's why we do what we do. Chiropractic actually saved my first son's life. He came down with an ailment that the allopathic model gave him six months to live. And my chiropractor jumped in and said, stop treating symptoms, start treating causes.

[00:24:09] They found it was a challenge. It was a brain tumor, C1 to C3, which is very similar to chiropractic. It was putting pressure on the nerve, which was impairing some of his elements. They did a quick little recession. And he's a little over 40 years old now. So yeah, that's why we do it. Yeah, that's beautiful. So I had the privilege of having you look at our office and give us some layout help. And it has made a difference for sure.

[00:24:39] And so why don't you tell us a little bit how you work with existing clinics as well as new clinics, looking at layout, maximizing space, being able to see more people? So first place, when people see Davlin Design, they look at us as a designer. It sounds like an aesthetic component of this, an art form, which when you hire a designer, it usually means you're going to make things look really pretty, but it's going to cost a lot of money. And we're pretty much exactly the opposite.

[00:25:08] We'll make it look good. But most importantly, this is kind of the science of design. How do you pack 21 pounds of chiropractic in a five-pound office? So dealing with so many chiropractors over the years, we've realized that 87% of the chiropractors I speak to severely underutilize their space. So we come in and can take a bird's eye view and look at a space and figure out how to best flow patients. How do we pack more volume and more services in there?

[00:25:37] Studying with, you know, the different, studying with Steve and TRP and all of the coaches and all of the colleges, we listen to what they're teaching and then we figure out the best way to fit more into your space. Yes. Yes. And I will vouch for some of the things we just had in our conversation where you're like, oh, you can tweak this or have a CA do this over here. You know, that was super helpful. You know, it's funny. Again, I'm a very numbers crunching person.

[00:26:05] It doesn't take very much to double a practice. Doubling a practice seems like, wow, geometric. But I did some statistical analysis. And if you take three of your stats, your patient visit average, your weekly patient visits and your fee per adjustment, and increase those statistics by only 1% per month, you've doubled your volume in 28 months. Works no matter where you are.

[00:26:30] 1% in PVA, 1% in new patients per month. So we keep them around longer. We attract more because when you have a better educated patient, they're going to refer more of their friends. And while you're not going to charge, you know, 1% more every month, when it comes time to increase your fee, let's say by five bucks, think about me. Save my son's life. What's chiropractic worth to me?

[00:26:57] Anything you want to charge me, just don't tell my chiropractor because I pay cash. So if we can tweak the improvement, the performance of your front desk CA by a little bit, she could do more. If we can help the doctor conserve time and motion, they can do more. And it's just very simple, you know, changes. Great case in point, the TRP clients nearby me owned his own 1,200 square foot facility. He wanted to add an associate.

[00:27:24] He wanted to double his weekly volume and he wanted to increase services. But he was in a 1,200 square foot brick building. He couldn't add on. So he was ready to move. That's what he called me back. Glenn, I'm going to move. What should I do? I looked at his space. I said, don't move. We were able to double his volume. We were able to go from one adjusting table and one exam room to three adjusting tables, one exam room. We were able to, he had two front doors, one facing one direction, one facing the parking

[00:27:54] lot. So it was even more of a challenge. We got him five modality bays instead of two and he was able to bring on an associate in 1,250 square feet. So that's what we're all about. That's awesome. All right. So you've got everybody thinking like, I thought my space was well laid out. And then you looked at it and you were like, oh, you're using half of your space well. You know? So if somebody wants you to look at their current space or maybe they're getting ready to potentially move or open a practice, like what can they do? How do they get a hold of you?

[00:28:24] How do they start this process? Okay. So first place, it's never too early to reach me. We will talk to you. We just launched something for TRP clients exclusively. And that is trpclinicefficiency.com. Basically, we're going to look at your space and let you know, we're going to actually give you a score. And this is where you want your score to be lower than higher. You don't want a score of 90% because that means I can't do very much more.

[00:28:52] So let's say a doctor has two or three years left on his lease. I look at it and can let him know that, well, you have a score of 65%. That means you can grow by 35% more. So if they at least know that, and we start talking about how that happens without him having to move, he can now implement everything TRP is teaching them and the marketing and the patient education and all of the growth strategies that TRP brings to the table.

[00:29:21] And then as he hits the next benchmark, we can implement phase one of change. It's the next benchmark phase two. And then hopefully we get him to the end of the lease. And yes, he might be in a pressure cooker, but ultimately it's got more cashflow, more revenue. And now we can either buy a building or move into the next facility and we'll let them know how much space they really need. Yeah. Oh, that's beautiful. Okay.

[00:29:47] And how to like, probably we'll link this under the show notes so people can connect with you and obviously they can find you online and reach out that way too. Yeah. Absolutely. Absolutely. So TRP site audit was one of them. Also TRP clinic efficiency.com. I like clinic efficiency instead of site audit. That sounds a little, I never want to be audited. Yeah. So it depends on the person we're talking to.

[00:30:13] Um, but yes, and, and that'll get us linked together and then we'll take it from there. We'll show you the whole process. It's very easy. Takes a little work on, on their end as far as getting me photographs, but I can usually look at a space and in 10 minutes, just give you an idea of, man, I could do so much with this space and it's, it's not going to cost you a lot. And you could do so while you're still in practice. I keep that in mind too. So. Yeah.

[00:30:40] I can't say enough good about like, just have a conversation with you and your knowledge of, you know, flow and really the demands on our offices, because I think that is a unique thing to understand the amount of people coming through an office and how disruptive certain little tweaks are. Um, you are a genius as it relates to helping us see more people. Thank you very much. It's my, my pleasure and my honor. Awesome. All right. And we'll see you at one of the next upcoming immersions I'm imagining too.

[00:31:10] Looking forward to it. Thank you so much. All right. Thanks Glenn. Have a great day. Thanks for listening to this episode of build your remarkable practice podcast. Remember what the world needs now is chiropractic and what chiropractic needs now is more successful chiropractors. If you like the podcast, please subscribe, share with your friends and leave us a review. And if you'd like to connect with us personally, please click the links in the show notes to schedule a call.