Dr. Joel, When I graduated from Chiropractic school and entered the real world of private practice the paradigm I embraced (at the time) was MORE! MORE! MORE!. I thought by having more staff, equipment, room, etc...the more income I would have...silly me. I have since sold that practice and have enjoyed a short sabbatical of reflective travel and am now eager to jump back into the trenches...so to speak. In your opinion...can a Chiropractor or should a Chiropractor (in today¼s environment) build a new practice utilizing the paradigm LESS! LESS! LESS!? I am considering leasing a small BUT excellent location of space (250 sq/ft) and building a referral cash based practice with a low tech/high touch one employee (me) practice. My vision is for the most part clear in developing this type practice BUT what in"your eyes" should I consider before embarking on this new journey? Can a Chiropractor earn a reasonable living practicing this way in 1999 with just his hands, table and knowledge??? DC in Wisconsin Thanks for the e-mail. More is not always more and less at times can be more profitable. The key is to profit and accumulate your funds. There is no golden rule on how much you can make and should make. Therefore .. give what you wrote me some thought. Can you literally make a decent and expanding living and practice in 250 sq.feet .. no matter how cheap or how nice .. without sacrificing any potential growth even if the growth comes on its own. With small quarters .. you can get by .. but if there is a nice influx of new patients and they also refer people .. will you have room or will there be a capacity problem? You can also do it all yourself .. front desk and adjust. I bought my present building from a dear chiropractic friend who retired but always worked by herself. It can happen but you will be restricted. In fact after reading your e-mail last night .. I brought up your question to my class this morning. I used the analogy of the elephant. Supposedly .. elephant trainers use a chain around one foot and place a stake in the ground. The elephant learns quickly how much latitude they have before they are restrained and restricted. After awhile the trainer takes the chain away and the elephant never goes beyond their boundaries. Same with a small practice .. you will be confined and find that you limit your growth based on restraints because you can't expand right or left. You can have low overhead and be low tech as you want .. but give this some thought. This is still a business. Be careful .. if you were burnt with high overhead and looking for more before .. don't be trapped into doing the opposite this time Have a Great Day Dr. M