Selecting Your Practice Mode ... by Larry Markson

found on webpage: http://www.chiro.org/newDCs

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Types Of Practitioners

A. INDIVIDUAL PRACTITIONERS

Since 90% of all chiropractors choose to open their own individual 
practices, there must be a good reason . . . and there is. The 
individual proprietor generally fares far better financially than those 
involved in group practices or in partnerships. 

Although opening your own office puts you under greater economic stress 
in the beginning, it also allows you to take full and total 
responsibility for your own career. You can practice the techniques of 
your preference . . . use the procedures you like . . . and answer to no 
one but yourself which is a little scary perhaps, but also the best way 
to find your true potential is. 

As your practice grows, you can add staff, an associate doctor, or even 
an extern to help you. This allows you to maintain control and grow at 
your own pace, in accordance with your own goals. 

B. PARTNERSHIPS

Most chiropractors enter partnership arrangements because they need to 
pool capital or they require emotional support. Unfortunately, 
experience indicates that most partnerships do not work FINANCIALLY, 
even if they do work PERSONALLY. Many new practitioners proceed anyway, 
based upon an erroneous impression that two can produce and earn twice 
as much as an individual practitioner. That is simply not the truth and 
rarely, if ever, happens. 

Partnerships are simply not the best way to start. However, we recognize 
that some of you will still choose to open a partnership practice. Prior 
to making that final decision, we recommend a thorough investigation of 
all pros and cons ... in an attempt to avoid common mistakes that can 
cause problems later on. 

All partnerships must be registered and protected by a legally executed 
written contract that contains a "Buy/Sell Agreement" secured by life 
insurance. ...our attorney can provide details. 

C. PROFESSIONAL CORPORATIONS

With the current tax laws, if you are an individual practitioner there 
is generally no real advantage to forming a professional corporation. So 
DON'T DO IT, and don't allow your accountant to talk you into it. In 
multi-doctor or partnership practices, a professional corporation does 
offer some protection and may need to be considered. 

Professional Corporations/Associations (P.C. in some states, P.A. in 
others) that employ two or more doctors, need the protection of a 
"Buy/Sell Agreement" and a life insurance policy to cover the buy-out in 
the event of an untimely death. 

Remember, a professional corporation does not shield you from a 
malpractice suit. 

D. ASSOCIATE POSITIONS

After graduation, some of you will select to become an associate doctor 
in an already established practice. The decision to become an associate 
is usually based on one of two reasons; either you feel the experience 
of being in an established practice will help you gain additional 
knowledge and confidence, or you lack the necessary capital to open your 
own office. 

Unfortunately, there are more applicants for associate positions than 
there are offices requiring the services of an associate doctor. 
However, if an opportunity does present itself, you should be aware that 
you may be required to sign a contract with the head doctor. That 
contract will have a "restrictive covenant" which will prohibit you from 
opening your own practice within a given mile radius of the office. 

As an associate, you want to practice on the same days as the head 
doctor and know in advance that he/she is willing to teach you every 
phase of running a practice. The entire object is for you to gain the 
necessary and valuable practice experience that creates a true 
professional. You must be allowed to do consultations and reports of 
findings on your own, and also to examine, x-ray and adjust enough 
patients to elevate your level of professional expertise and competence. 


Be careful with any contract that includes a provision to pay you as an 
independent contractor. Numerous law suits have found that most 
"independent contractors" are actually employees and should be 
compensated accordingly. 

Also, it is not recommended that your compensation be based upon any 
kind of percentage of services rendered or collections. This arrangement 
rarely works in the long run. Either the associate doesn't earn enough 
to stay with the practice, or the associate earns "too much too fast", 
and is terminated by the employer. Another reason is that in many 
states, percentage contracts have been found to be "FEE SPLITTING", 
which is a serious offense. Call us if you need any assistance in 
interpreting the financial proposals contained in any associate 
agreement. 

Lastly, someone seeking an associate position should know in advance 
that associates rarely earn enough money, after taxes and personal 
expenses, to accumulate the capital necessary to open their own 
practices. Therefore, an associateship is to be considered strictly as a 
"chiropractic residency" or "professional apprenticeship".