December 2008

To be or not to be an 'associate' -- that's the question

by Dr. Timothy J. Gay

When I graduated from chiropractic college, I felt we were all on the path to changing the world. My chiropractic brothers and sisters all had very different slants on how they were going to practice. Some were going into practice with family members who wanted them to work in the family practice. Others were going to "set up shop" wherever they could just to get by, opening the doors of a scantily outfitted office to prospective patients. Still others planned to go into shared space or independent contracting positions to maintain their practice autonomy.

Upon visiting clinics and seeing all aspects of how practices became successful and thriving, to practices that were on the brink of failure, I made the choice to be the underpaid associate willing to put in the time and sacrifice to learn how to build a practice and run a business. I had the good fortune to work with one of the best chiropractors ever to be (and who still is) in active practice -- and who remains to this day, my friend and mentor. He made me work hard and much of what he taught me I took to heart and have taken with me through out my career. The experience I gained as an associate, far out-measured any of the hard work I thought I was doing.

Over time, I've heard many stories about the mean clinic director and how hard the poor and lowly associate has to work. Listen up, nothing's beneath you. There is nothing that needs attention in the clinic that you should feel you're above doing (e.g. cleaning the toilet or straightening brochures)!

The following criteria can be used to gauge whether or not you should be an associate:

1. Are you fearful about opening your own practice? It's normal to be apprehensive when changing or doing something new, however, being too fearful means you may not have the self confidence or the positive determination it takes to overcome the fear of the unknown to start a new practice.

2. Are you inexperienced and don't want outside help? You may be school smart, but most DCs who fail in practice violated business principles, like staff hiring and training, inadequate finances, or promoting and marketing their practices. They may offer a thousand reasons for their problems but still not know why the boat sank. Most choose not to learn business skills or have successful business advisors to help guide them.

3. Can you raise money or get financing to create a new practice? Financing right out of school is difficult because of your lack of work experience or a viable track record of accomplishment in a previous practice. Banks like to see a work record of at least a year or two of continuous work to determine whether you're a good loan risk. New practices fail due to of lack of funding. The doctor may not have borrowed nor had enough money so funds ran out before the practice started making a profit. Do you have the skill sets and practice procedures? If not, maybe an associateship would be the best avenue at this time.

4. Are you willing to work 70 hours a week? If you're apprehensive about any part of the practice -- direct marketing, management, report of findings, collecting money, long term recommendations, or making any recommendations, etc. -- then plan on being an associate. You'll work for someone else 40 to 45 hours weekly without all of the headaches and risk involved in running a business. If you want to succeed you must be willing to work 60 to 70 hours a week for the first three years. The new practitioner needs to work 20 hours a week more than the doctor who already has an established practice in the same community.

5. Will your spouse and family be supportive? You'll be under more stress arranging construction loans, building out your office, equipment leases, and dealing with bankers and will need their support. Will they also be supportive of you working 40+ hours a week, plus spending 20+ hours as a member of various associations while working on other projects that will be directed toward the practice and building the business? If not, then become an associate.

6. Are you able to follow advice or are you arrogant? The chiropractor with the know-it-all attitude most likely will struggle with building a practice based upon arrogance and being stubborn. The DC who says "don't tell me what to do, I know what I'm doing" needs an attitude change. Doctors with no experience and very little practical knowledge of what succeeds and falls short in a practice, no matter which system is used, often fail due to their inability to listen. If you have any intention of using a coach or becoming an associate for knowledge and guidance, leave your ego outside and listen to someone who's already been there and done that.

7. Are you unmotivated? Are you avoiding doing those things that really need to be done, by inventing things to do and keeping yourself busy (constantly checking your e-mail, surfing the Internet for information that pertains to something other than practice, etc.)? If focus is an issue and staying focused on the elements of your business and your practice are a problem then becoming an associate might be the right choice for you. If self-motivation is a problem for you, then motivation may be provided by the doctor who offers you an associate position. Perhaps he or she will stimulate you to do more than you thought you were capable of on your own.

8. Are you a passive person? All DCs starting their own practices need enthusiasm and energy. The goals they set will determine whether they'll accomplish what's necessary to succeed without accepting anything less. They learn how to move ahead in the profession and continue to beat their competition. If you're passive by nature, become an associate and learn how to better confront the issues of running your own business through learning and working alongside someone else.

9. How is your ability to communicate to the public and your patients? The greatest communicators have the largest practices. Having the ability to say what you truly think and communicate to patients how you can help them, makes all the difference in their decision as to whether they'll begin or continue care with you.

If you've read this article and feel you're not ready or willing to face the outside world of business, then you may want to work for someone else and pick and choose what parts of their practice you would utilize and what parts you would not. Be sure that the person you select to associate with has a solid, successful practice and the expertise to help you along your way.

Whether you choose to start your own business or become an associate, the education, experience, and knowledge you have will lead you to the right decision. Before you make any decision, do your homework and find out what's right for you. And remember, there are no wrong decisions, only the ones that go unmade.

(Timothy J. Gay, DC, a 1977 Palmer College graduate, is the founder and director of Ultimate Practice [www.ultimatepractice.com] a chiropractic management and consulting company specializing in personalized chiropractic consulting. A highly respected and nationally recognized speaker, he is the author of several books, as well as numerous CD and video products for the chiropractic profession. Dr. Gay holds seminars around the country on a variety of topics and may be reached by calling 1-866-797-8366, or by e-mail at ultimatepractice@ultimatepractice.com.)