Scratch-Startup  by .. John T. Whitney, D.C. .. found on webpage: http://www.chiro.org/newDCs


In past articles I have disparaged starting a chiropractic practice from 
scratch. However, there are exceptions where starting from scratch is 
indicated, e.g.. no viable practices for sale in your chosen area, 
virgin territory, robust opportunity for a quick start due to dearth of 
chiropractors, or temporary insanity.
In whatever case, for the purpose of this article let us assume a 
scratch start is indicated; a totally new enterprise.
Remarks made in the past about need for a specific location still apply: 
high visibility, opportunity to use large area for signage, easy access 
to parking, ground floor if economic, proximity to other people 
activity, not an office building. favorable demographics (> 1/5000), not 
young startup families, reasonable monthly lease payments.
In a scratch-start situation the enthusiasm of, "doing-it-on-your-own", 
must be tempered with a sharp eye on what your monthly total costs and 
monthly overhead will be. There is a tendency at this time to overspend. 
You see, scratch-start is the most expensive method of all to get into 
practice and carries the highest risk of failure. The average, properly 
done start-up office costs $100,000. That does not include a marketing 
budget for the first year that could easily be another $10,000.
Build-out costs average $50. per square foot; a 1000 square foot office 
space will cost you $50,000 just for the walls, doors ceiling, carpet 
and paint. Of course you can do it for less, and we have all heard the 
shoestring startup tales where the doctor rockets to fame and fortune in 
a matter of months. These cases are rare indeed. In business you begin 
by counting on the most likely scenario and outcomes. Of course you pray 
that you will be the exception, and maintain high positive expectancy. 
But for now, rational thought should prevail. If you could find a place 
that is already built out or needs little renovation, that is a stroke 
of luck.
When building out a place you may want to consider, "portable walls" and 
doors. There are prefabricated office systems/designs that you might 
want to consider. The new ones are outrageously expensive but due to 
general downsizing in the business community there is a plethora of used 
equipment for sale at the moment. Look for all of your needs in this, 
used, market. 
Before you sketch your office layout, take a little time to visit other 
well done offices that practice much like what you have in mind. You 
will surely pick up some good ideas. Don't overlook the "open concept", 
it may sound foreign to you at first but it is a very efficient, 
inexpensive office design. Few people who work in an open concept would 
ever do it any other way.
Think twice before designing your office around your technique. Allow 
yourself some latitude in this area. It is a well known fact that 
chiropractors change their technique and approach to practice several 
times in the first few years, Don't get stuck with an expensive design 
that accommodates only one approach to practice. This could be a costly 
error.
It is important that the office design, look, feel, and conform to your 
patients needs and tastes, not yours. This is not going to be you home 
or your den, this is a place of business (as well as healing) and should 
conform to your target markets sense of what is acceptable and desirable 
This is probably a fitting location for Norman Rockwell rather than 
Pablo Picasso or Paul Klee. The decor should reflect the values of your 
market, not yourself. Your office is not about you, it is about them. We 
are striving to get in tune with and please those whom we serve. If a 
friend walks into your office, looks around, and says that this office 
is, "so YOU", you have probably made a mistake. 
"Study your market". No matter what your market you can be sure some 
smart people have studied that psychographic market and know the needs, 
wants, fears, desires, and expectations of your chosen market. A good 
place to start is the American Demographics book catalog ( 800- ). You 
are out of your element in this area, a little homework is indicated. 
Health-care office decor is a spec