Blog List - Anterior Assist

How to Start Your Own Chiropractic Business

Starting your own chiropractic business is an awesome accomplishment, but it is also a very trying, stressful, and overwhelming task. Though as overwhelming as it may be at first, it is worth the stress and frustration. 

Where do I start when it comes to the ins and outs of starting a chiropractic office. Do you use a practice management company or software? Do I make an LLC, corporation, or sole proprietorship? How do I acquire loans? These are all questions you need to ask yourself while still in school in your last trimesters. The sooner you start, the better off you will be. 

The Starting Point for Your Future Chiropractic Business

The number one point you can do while being in school is paying attention in your business classes. In my experience at Palmer College, we had a class that was a designated crash course, business 101. We had to write a complete business plan and financial excel spreadsheet showing projected profits in this class. These documents are crucial for locking in adequate funding when you start your business. On this same note, you will need some sort of collateral to start your business. This collateral can be money you have been saving, a paid-off car or a co-sign with your parents. A bank or any other financial institution wants to see skin in the game. They will likely look for a 20% investment in the project from you. 

Finding Funding for Your Chiropractic Practice

Funding a project like a business can be complex, sometimes being right out of school. Banks are cautious of new graduates because you have no track record, minimal equity, and a ton of student loans! I would get creative with funding and look at every other financial avenue before approaching a bank or credit union. I say this because banks and credit unions are the least flexible with loans. They have stringent rules, require excessive collateral, and their interest rates are typically the highest. 

I would first look at local economic development corporations. These corporations have meager interest rates (as low as 1%) to promote growth to the community. Contacting your local economic development coop would then also have additional contacts regarding finding additional funding to finance your office space.

You can also get creative with credit cards. But please be smart. Remember, you have to pay your credit cards back, and you need an excellent credit score. A great example is I used a Citi credit card. I maxed the credit card out because I was allowed 12 months of interest-free money. I had to make sure that I paid the card off in full before the 12 months were up. 

What is the Best Entity for Operating a Chiropractic Practice?

When you start your chiropractic practice, you need a name. You also need to identify as an LLC, Sole proprietor, or corporation. My recommendation would be an LLC taxed as an S corporation. This structure is what I utilize personally for my practice. In short, the benefits of an LLC taxed as an S corporation are to allow you the simple protection of an LLC but the tax savings of an S corporation. With an LLC taxed as S-Corp, you need to pay yourself a wage and pay taxes on the earned income. However, the additional funds made by your clinic are not taxed at the same rate. This strategy can save you thousands of dollars a year when it comes to paying taxes. I will also add that you need to discuss this with your CPA and lawyer to find the best approach for your situation. I recommend a few books for you to read to get your mind thinking like a business owner. These books are “Millionaire Next Door” and “Rich Dad Poor Dad” If you are too busy to read books in your spare time, I highly encourage subscribing to Audible from Amazon.

Insurance and Back Office

Chiropractic school teaches us for over three years how to be great chiropractors. However, the amount of time given in the “real world” is minimal. There is very little classwork about insurance billing, claims, explanation of benefits (EOBs), checking patient coverage, and so much more. However, these things are a massive part of a successful practice that accepts insurance. Now, before you just write-off taking insurance and doing a cash practice. Think very hard as to how many patients you would lose if you do not accept insurance. I will be the first one to say I would LOVE to be a 100% cash practice. However, I see a significant number of Medicaid, Medicare, and commercial insurance patients. You have to look through the patient’s vantage point. If my insurance says, chiropractic visits are $15 per visit. That is what a patient walks in the door expecting. If you do not accept their $15 copay or 100% coverage by Medicare/Medicaid, expect a large number of your patients to turn around and go to the next chiropractor down the street. 

The first few months are rough when accepting insurance. Insurance claims have a significant learning curve. It all starts to make sense and is not a big deal at all! I recommend you run your whole back office by yourself for at least a year. This year of hands-on training makes you 100% proficient in every aspect of your back office. After you understand it all, you can hire a back-office staffer. I recommend this approach because if you hire a back-office staff from day one, that employee will find out very quickly you have no idea how to do their job, and they will slowly control you. That is not a position you want to be in ever. You want to train your staff how you want your clinic run, not have your employees train you!

You may be wondering why don’t I just utilize a practice management system to tell me what to do? This approach is an option, and there are many different companies out there to teach you their methods. But it is THEIR method of practice and NOT yours. You may be the clinic owner, but they will be telling you how they think you should manage the practice. But I’m personally too much of a free thinker to be told how to run my clinic. Also, it is costly to be a part of a practice management system. If you were smart enough to get through chiropractic school and pass your boards, you could figure out how to run a chiropractic clinic! 

Marketing Tips for Your Chiropractic Business

When it comes to starting a new small business, you need to be joining the 21 century and become active on social media platforms. Make fun and engaging contact that you feel your community will enjoy. No one knows you exist until you market what you are selling, and you have to market it well! Do not just post clip art pictures! Take pictures of yourself, of the progress of your building. People want to see accurate and authentic posts from you, not dull posts. 

What Equipment is Needed to Start A Chiropractic Clinic?

When it comes to your first equipment, buy used equipment and furnishings. For example, my reception chairs are over 40 years old! One reason is that they were cheap. I bought them from a retiring chiropractor, and they still look great. Why would I buy new! 

I also have a Bennett x-ray machine from 1984. It works just fine! I paid $3,000 for it, and three years after purchasing it, I converted it to digital for another $22,000. A total of $25,000 investment vs an $80,000 new x-ray system. 
By researching your options on different chiropractic equipment websites, you can save thousands of dollars buying used, refurbished equipment. After you grow and produce more income, you can reassess and see if purchasing additional equipment and chiropractic tools or trading up equipment is a viable option!

In short, when you are opening up your first clinic, you have to keep overhead as low as possible. If you buy all new everything, you have a higher likelihood of failure. You will have enough monthly bills from student loans, mortgages, utilities, payroll that making payments on an $80,000 x-rays machine will not be fun and will put your practice in a financially challenging position. 

Know Your Cost of Living

There are so many factors that are involved when it comes to opening a practice. One that is commonly overlooked is the cost of living. You have to remember that insurance reimbursement is the same across the board. You do not get paid more by insurance companies when you practice in a town or region that has a higher cost of living. I would heavily encourage you to dive deep into the top 5 communities you wish to practice in and investigate the cost of living in each of those communities. For example, I work and live in a small town and community in Lake City, IA. This town has 1800 people. You may think this is way too small for a community. But it isn’t at all! I am one of three different chiropractors in practice. Granted, the other two are close to retirement age, so I will likely be getting even busier. But that is besides the point. I am very successful in a small community with competition. We see many patients a week. I will be honest. I doubt I see as many as my friends in the metros. But, patient volume is only a small part of making money! My friends may see 25% more patients weekly, but I know my overhead and cost of living is less than 50% of their expenses. I own my property, allowing for significant tax advantages of depreciation while my friends are paying very high rent. Home prices are triple the cost of the same house in Lake City. My commute is 4 minutes while theirs is up to 30 minutes. Just remember when it comes to picking a location to really sift through every aspect of your decision. When you do this, you will always make the right decision!

Hire the Right Staff for Your Practice

Your staff will make or break your business. Your clinic staff is the heartbeat of your office. Your employees should not be overlooked. When I first opened up, I hired a few receptionists that were not a good fit. They came to work cranky with a new excuse every day as to their reasoning. They would be sick once a week. Their car wouldn’t start, snowed in, you name it! I highly recommend you vet your staff deeply, unlike myself when I first opened up. I had a significant problem. Can you imagine having the phone answered by someone who didn’t get any sleep and was cranky to my patients? The patients did not reschedule, or I started to notice that I was swamped on the days the crappy receptionist was off. My patients wanted chiropractic care but did not want to associate with one of my staff. When this kind of a problem arises, you HAVE TO document every single encounter that is not okay for your staff to act. It is tough just to fire an employee with no repercussions. The last thing you want to do is fire an employee and pay unemployment for that person. Suppose you document each encounter and have at least one intervention with the employee, including a written and signed document by yourself and the employee explaining your concerns. In that case, you should be pretty safe with any future issues. In short, it is of paramount importance to have the best team possible to work for you. If you have a great team, you will have no issues becoming successful. We have a great team today, and we will make sure to keep this team for a very long time.

I hope this was helpful for you and your endeavors in starting your own chiropractic office. This blog was only the tip of the iceberg regarding the ins and outs of opening your practice. But this is an excellent start out of the blocks in the right direction towards opening your successful practice. You can open a successful practice anywhere as long as you utilize the topics in this blog. Good luck!

Six Ways Chiropractors Can Stay Healthy for Their Patients

Chiropractors are called upon by their patient base for care frequently throughout the day. Each time we interact with a patient, we touch them multiple times on the neck, back, and of course, when we shake their hands. Therefore, our immune system has to be in top working order all year, not just during flu season, for us to stay healthy and keep our doors open. 

Chiropractors have to practice what we preach. We have to be proactive about neck pain, back pain, and overall health, including all the systems of our body.

2. Exercise and Flexibility.

It is not enough to work out a few days a week and call it good anymore. We not only have to feel good and just go about our day working a desk job, but we also need to heal our patients as well. Resistance training and cardiovascular exercises are critical. Chiropractors have to stress our muscles and joints with activities with much greater demands than our job requires. This approach ensures the microtrauma of repetitive movements, “providing chiropractic adjustments” daily never causes issues. If we continually stress the body at a higher demand in the fitness center’s controlled environment, then we have a minimal risk of injury in the workplace.

Flexibility is just as important as exercise. Flexibility and dynamic stretches/yoga are crucial daily as well. Dynamic flexibility and stretching is an unsung hero and necessity that is always overlooked as unimportant. However, when we perform chiropractic care daily, we put our body into some interesting positions to get the right line of drive or line of correction to make a significant adjustment for the patient. 

I overlooked regular stretching until I got a hip flexor tear while adjusting a patient. After having that intense pain linger for well over a year, I knew I had to make a lifestyle change to make sure that never happened again. So every morning, I set aside 30 minutes to make sure my joints are warmed up and ready for a full day of chiropractic adjusting.

3. Family time/Personal time

It is essential to define work and personal time and make time to be disconnected from our work. However, not fully disconnecting is incredibly exhausting on the body, physically and emotionally. Never shutting our Facebook off or forwarding calls to our cell phone keeps us engaged and geared up all hours of the day. This state of being constantly on is not a healthy situation long-term. We all know the power the central nervous system has over the whole body. We need to make sure that we take just as good care of our mental health as our physical health. They are both equally important.

4. Divide the work and focus on your patients

Running a chiropractic clinic is no simple task. First and foremost, you are treating patients all morning and afternoon. Your primary focus should be patient-centered care. We as providers need to be assessing each patient visit and figuring out what we need to do for that patient based on their complaints. We should not be concerned about minor daily issues that arise. Insurance-related problems need to be addressed by your billing staff. I do not have a full-time billing staff. My billing staff remote accesses a few hours a week and handles all my insurance-related inquiries. My reception staff is always trained to be busy, even when we are not seeing patients. During a quiet day, they clean or file paperwork. You need to be focused on healing patients and keep it simple!

chiropractic clinic anterior assist

5. Sleep and regular chiropractic care

How much sleep would you say you are getting every night? Chances are it is not a full eight hours. I am just as guilty as anyone else. When it is a beautiful summer evening, and the sun doesn’t set until 9:45, I have difficulty getting to bed by 9:30 to get my full eight hours of sleep. I can also say when I do not get my full eight hours of sleep. I am not as responsive and much more sluggish. Getting eight hours of sleep each night is just as important as regular exercise. Rest is when our body rebuilds damaged tissue and heals. If we do not allow our bodies to sleep, we do not heal. When we do not heal, we cannot serve our patients as well as we should be.

6. Use of chiropractic tools and instruments

Chiropractors say, “With hands only,” myself included. However, if we use this quote verbatim, we never excel in our career, and we never become progressive in the field. If farmers used the same saying, “with hands only,” we would be planting our seeds one at a time by hand. 

I agree that using our hands as chiropractors is essential, and the use of our hands only is adequate for many patients. However, we need tools and instruments to adjust the spines that don’t respond to traditional techniques. Anterior Assist is a great example. Anterior Assist helps chiropractors adjust a patient’s thoracic spines with ease. It offers a comfortable thoracic adjustment while offering 100% protection of the chiropractor’s hand as well. Anterior Assist was designed by chiropractors to aid chiropractors. This tool allows chiropractors to continue with long successful practices pain-free. The following link will enable you to learn more about Anterior Assist and what it has to offer. https://anteriorassist.com/how-to-use/

In addition to all of this, we need to practice what we preach and get regular adjustments. Seeing a chiropractor regularly for spinal adjustments allows our body to heal and allows our systems to work at optimal levels, including the immune system. Getting regular spinal manipulations regularly improves our likelihood of living a more healthy life offering a quality of life that is second to none.

What You Need To Know About Chiropractic Tools And Equipment

Chiropractic colleges typically have a great array of tools and equipment they allow students to try out while treating different patients. However, many times what schools offer is only a drop in the bucket of the potential tools on the market. Anymore, chiropractic schools do not accept donated tools/equipment from manufacturers. Because of this, students are not getting exposed to all of the possibilities out there.  I strongly encourage new chiropractors to scour the web and look for different tools outside of what is offered within the walls of chiropractic school. 

Here is a list of just a few common tools new chiropractors should seek out: 

Soft Tissue Tools:

What is Instrument Assisted Soft Tissue Mobilization (IASTM)? IASTM in short is a method of scraping the skin to break up scar tissue in the soft tissues of concern. This process increases blood flow and then re-aggravates the area to stimulate the healing process again. This method can be used for scar tissue, muscle contractures, contusions, herniated discs, tendonitis, ligament sprains, increased range of motion (ROM) and also, of course, help with improved function and pain relief. 

Graston owned the patent the soft tissue tools that were used to “scrape” the patients soft tissue. It’s a great product, but far overpriced for what it is. Now, a quick search shows many other brand names now that the Graston patent has expired. Examples are “Myofacial Releaser, FAKTR, Hawk Grips, Rocktape has its own line now, too. In short, they are a dime a dozen. I would recommend one tool that allows you to mobilize the majority of the body areas. Purchasing one tool instead of a kit keeps costs down and allows you time to really decide what other tools you may need in the future.


Vibrational/Percussive Soft Tissue Mobilization:

In the past few years a large number of different battery operated vibrational soft tissue tools hit the market. These tools look very similar to a jigsaw with a tennis ball instead of a blade. I joke about this and think I could have made one myself. However, on a serious note this has been a great addition to my personal chiropractic office. It is much faster and efficient to use a percussive instrument for 30-45 seconds on my chiropractic table before I perform a spinal alignment, rather than 15 minutes on electric stimulation. Efficiency is key in a busy practice. The following link is to the Theragun I personally use in my own practice. https://www.theragun.com/us/en-us/pro-us.html

Traction Devices:

There are a few options for traction of the lumbar spine, and I utilize both of them. One method, the decompression table as the picture shows, is great for the low back. It can be used for the cervical spine decompression as well, however, patients tend to get claustrophobic. They don’t like the tightness of the machine around their necks for 20 minutes. However, I use the decompression table on the low back a great deal. Many times, a long axis slow pull and relaxed motion works well on patients. I describe it like an accordion going back and forth. This motion opens the lumbar facets and offers great relief to the nervous system with a limited amount of force needed.


Anterior Assist Alpha:

Anterior Assist Alpha is the best chiropractic tool on the market for thoracic spinal adjustments and manipulation. I’m not just saying this because I designed the tool. I’m saying it because I felt a need to design the tool. There are other anterior thoracic manipulation tools on the market. The Guardian, Anteater, and Thoracic Manipulation Tool (TMT) for short. However, none of these tools fit the void I was having in my own practice. In school they teach students to use their own fist or hand as a fulcrum for an anterior thoracic adjustment. However, after only a few weeks of using my hand as a fulcrum , I noticed my hand was always aching. I knew immediately I did not want to use my hand as a fulcrum for the next 40 years!


I tried different tools. I started with Anteater. I saw that it protected my whole hand. However, It was very large, intimidating to all my patients, and very expensive. I then looked up the Guardian anterior adjusting tool. However, as their website shows, it doesn’t protect the hand from repetitive trauma of the adjustment. Thoracic manipulation tool is very similar to the Guardian in the way that the tool does not help protect the provider's hand.

After reviewing the other options on the market for thoracic spine manipulation equipment and tools I knew I had to design a superior product. A tool that is appealing to the patient. A tool that is effective in offering a smooth comfortable adjustment at the same time of offering adequate protection to the provider. In short, it is functional and affordable. If you are interested in purchasing a tool yourself, or if you want to learn more about Anterior Assist Alpha, check out our website at https://anteriorassist.com/.

Cheers,
Dr. Redenius

What Tools Do Chiropractors Use

No matter the technique a chiropractor utilizes, they all need chiropractic tables. There are a few chiropractic tools and techniques that do not require a table, however, when it comes to the scalability and performance of a provider. A table is crucial to have a successful practice treating subluxations and reducing patient pain during their chiropractic treatment.

There are over 200 chiropractic adjusting techniques in circulation. No one, single chiropractor can master them all. However, a great chiropractor will find their strengths and weaknesses and then choose a handful of techniques based on their own strengths to reduce pain to a patient's area of concern.

Chiropractic adjusting tables:

There are many different options for chiropractic tables. Some are just a bench roughly knee height. Others have more options. The more options you have (pneumatics, hydraulics, electronics), the more chiropractic techniques you can utilize and the more age groups of patients you can treat. You also have less wear and tear on your body with a table that can do more of the work for you. The following link is the site to the table I currently use, the Lloyd Galaxy Ultimate. https://www.lloydtable.com/index.php?p=210393

Electric Stimulation:

Electric stimulation is a great passive modality used by chiropractors and physical therapists on a daily basis. Electric stimulation allows a provider to relax the muscles around the area of concern to be able to effectively help the patient with their issues. 

Electric stimulation is a great addition to a practice because it is passive. I recommend a separate room for this treatment. This allows you to leave the patient unattended and treat another patient at the same time. Electric stimulation times run usually 15-20 minutes. It is crucial to have your adjusting room available to adjust during this time.

chiropractic adjusting tables anterior assist
cold laser anterior assist


Cold Laser:

Cold laser is another hand held device to add to your chiropractic clinic. It is quite expensive, but it is an effective treatment for sprains, soft tissue injuries, nerve pain, and any kind of pain relief. An effective cold laser treatment only lasts two minutes. I personally like cold lasers more than ultrasound because it takes less time to treat, and I do not have to keep the modality moving all the time,  as I would with ultrasound.

Activator Adjusting Tool, Activator Method:

Activator is a hand held device that allows a provider to treat patients with many complaints such as neck pain, thoracic pain, or low back pain. The picture beside is an example of the activator adjusting instrument. Activator technique is a handheld, spring loaded spinal adjustment tool to offer precise, minimal impact adjustments. This technique is a great benefit to all age groups, but primarily to the elderly population who are more arthritic and fragile seeking relief from chronic issues.

Anterior Assist Alpha

Anterior Assist Alpha is a great way to adjust the thoracic spine without hurting your own hands. This instrument assisted approach to adjusting the thoracic spine offers the protection chiropractors need on a day to day basis. 

anterior assist alpha

Anterior thoracic spinal adjustments are taught in school to use our fist under the patient’s body as a fulcrum. However, using this approach only causes damage to the chiropractors own body. 

A chiropractor should never hurt their own body caring for a patient. 

When you visit https://anteriorassist.com/ you will find more information pertaining to the use of this tool. I have found this tool to be very helpful for my patients that are very large, obese, overly stiff, or muscle bound.  

There you have it; a quick overview of a few must-have chiropractic tools in every chiropractors office. Each one of these tools has their own advantages. 

Using these tools throughout your day will make you a better clinician. You will be able to offer patients what they truly need based on ages, fragility, and musculoskeletal structure.

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