Q: Hello Doc. , I have taking over a 2700 sq foot chiropractic office and just dismantled its multidisciplinary operation. I always e mail you for help and have some more questions. I am concerned about my overhead. The rent is 4200 a month which I kknow is outrageous, but I only paid 42,000 for the office. I am seeing around 90 a week right now but want to triple that number. I have salary issues as well. You have mentioned that the overhead should not be more then 15%of you overhead. i dont understand that too well. 15% of what? Also can you tell me how I can legall y have lower fees for a cash patient? Is it even possible? Well I will start with this. I admire you for the effort you put out in order to benefit others. I feel your concern is genuine and that you deserve the best of things for your efforts to help others. Thank you as always A: As far as your question .. $4200 a month is not only high .. it is astronomical for a new practice or for a new DC. But .. you have a base of patients to grow from. As you know .. the $4200 is just the start .. there are utilities .. office expenses .. insurance .. etc .. and then there is staff .. 15% of your gross salary should be for staff. You may have inheritied too many if this practice was multidisciplined. Now .. there are no hard and fast rules .. you may wish to cross train a CA to help with marketing .. or have a 1/2 time person for that .. this may add to your staff overhead but it should pay for itself .. place a timeline for results and cut the cord if it isn't profitable. Since you feel good about purchasing the practice for $42,000 .. take some of the money that you would have paid and put it in the PR kitty .. you need to promote to get the numbers higher and feel comfortable and not kill yourself with costs to maintain the practice. You may consider hiring a P/T PR person .. or start a newsletter campaign in the community and put the money into printing and mailings. In order to feel comfortable and have less stress .. you have to feel as if you are doing something .. doesn't have to cost much .. just doing something to market yourself. You may wish to take the money you would have spent and sign on with a consultant and do exactly what they say .. many DC's do this and borrow to pay the fees .. not that I endorse that .. but if you claim success with a low fee to purchase the clinic ..you may wish to bleed a little to make it more successful. As far as cash patients. (Not sure where you practice) call PCP (Preferred Chiropractic Doctor) 1-800-239-3552 .. this is a clean way to offer a reduced fee and be paid an equitable fee. Have a Great Day Dr. M