Dear Bill

I started my new practice less than six months ago. Since my patient volume is in it's infancy, I've been doing everything myself. Do you think that my new and current patients see my office in an inferior light because I'm also the receptionist, etc.?

Some do, some don't.

If every patient is a chiropractic virgin, having never been to a chiropractor before, they probably figure that how you're doing it is the way it's done. No problem.

Additionally, you probably have some patients who appreciate what they perceive as a real personal touch. Again, no problem.

However, the fact that this issue concerns you suggests that you may be sensing some limitations to your future growth from being a "one-man band." There's no shame in starting small. The key is not to linger there a moment longer than you need to.

Practice Launch Math: 1 + 0 = 1

When you're doing everything you tell yourself that when it gets busier you'll hire someone to help out at the front desk. The problem is you rarely get busy enough. From time to time it may get a little crazy, but not consistently enough to assume the risk of an employee.

So it's easy to get stuck there. And while it's somewhat hectic, you don't have to share your profits with anyone. Or have to explain anything. Or be accountable to anyone else. Many new practitioners get trapped when they rely on this type of practice math. Because it's only valid for your earliest start up days in practice.

But if you don’t play well with others, you may resign yourself to keep things simple.

Practice Stagnation Math: 1 + 1 = 2

You take the leap and hire someone for the front desk. Unfamiliar with good questions to ask or the resources to administer a personality test, you’re thankful that someone wants to help.

Before long you start having your doubts about your hiring choice. The low grade frustration isn’t enough to replace your employee and the thought of doing so is unappealing.

Adding the additional mouth to feed produces just enough additional income to justify the salary and takes the burden of certain tasks off your shoulder to justify inaction.

The real magic is when you add the right person.

Practice Growth Math: 1 + 1 = 3

When you add the right employee it increases your productivity so that a surplus seems to emerge out of thin air. Granted you need a person who is coachable, personable and trustworthy. But if you train the right person and have effective procedures, you can significantly increase your production and help more people.

Without getting help, instead of spending most of your time doing $100/hour tasks, you'll be distracted by having to perform $20/hour tasks. That's not a very good ROI based on the considerable expense of time and money you invested to become a chiropractor. It's not personal, it's economic.

This requires a leap of faith. Especially those who abhor the simple reality that what they have is a business that's simply called a practice. Adding an employee is a business decision you make without all the proof you'd prefer.

If you lack the necessary faith that you can fill the additional capacity that an assistant would create, consider cluster booking as many patients as possible in the afternoon and early evenings and hiring the sharpest high school or college student you can find. Pay them more than they could get waiting tables, even if that means temporarily reducing your own salary. This baby step toward adding a full time employee might be all that it takes to convince you.

This is about creating a potential and then filling it. It requires a leap of faith in yourself and the willingness to be responsible for not only for your own income, but for someone else's. Clearly, big boy pants time.

Congratulations on your new practice. Thousands have gone from struggling student to prosperous chiropractor. You can too.

Thanks for the question!

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