Q:

Hello Dr. Joel,

If I could impose on a few minutes of your time for some insight or ideas. 

I'm an 2001 graduate. After school I worked as an associate for about six months. After 
leaving that position, I returned to my prior occupation as an RN, to generate some badly 
needed cash. 

Several  months later I found a struggling practice for sale, and sought a bank loan for 
about $50k for it's purchase. Although I have impeccable credit, I was denied the loan for 
lack of enough money saved and a heavy student loan debt. From there I decided to make 
as much money as possible over the next year, doing the nursing, to try to pay down my 
loan and save. Over the last two years I made 89K and 112K, and have saved about 20K 
and paid down my loan by about 15K to $108K.

Right now I'm at a crossroads, trying to determine the best course to follow that will get 
me back on track and into Chiropractic again.

I've been looking at associateship positions to try to get some needed hands on experience 
from both a clinical and business stand point. Some of my concerns with a full time 
associate position though is getting compensated enough to save and meet my loan 
obligations, being locked out of my area of residence in the future by radius clauses, and 
prolonging the opening of my own business.

I'm not sure that an office buy out is the right way to go because of incurring more tens of 
thousands of dollars of debt, when for the most part it seems like one is mostly buying 
patient files when buying a practice. 

Lastly, I still am considering a bare bones, small start up. I could open an office say 3 days 
a week and do another job the other 3 days to make ends meet financially. Working part 
time in another doc's office, at the same time, may be an option to gain some experience.

My wife and I are considering relocating to the Atlanta area. She has extended family there 
and we perceive the area to be a good area to practice in. What do you think.

I was hoping you may have some insight or ideas that might help me shape a plan and 
direction to follow.

Thanks very much 

A:

Thanks for the e-mail and tough question. I apologize for the late reply. First of all you 
must consider priorities. The fact that you went through chiropractic college and acquired a 
huge student loan is indicative that there was and is a desire to be your own boss and a 
chiropractor. The majority of students find after graduation student loans hovering over 
their immediate future and they either plan how to pay for it or they decide it is too much 
and default. I recommend a plan and work it for a few years until you can manage and get 
debt free. The only way this can happen is for you to work and pay down on it as best you 
can. If it takes working as a DC or another year as a nurse or your wife can assume the 
financial burden it is up to you both to decide. 

If you intend being a chiropractor then the priorities are this. Determine what your 
immediate and long range plans are without considering the student loan hovering over 
you. Determine how you can finance either a start up or weather the financial storm six 
months at a time. Determine where you wish to plant your roots and stabilize your life. 
Determine the locations within these areas to offset any potential failure or slow start. 
Determine the options available whether as an associate or an IC or possibly starting on 
your own. Determine a game plan to make it happen both with practice management and 
marketing. Determine how you can repay loans and the cost of living for six months at a 
time. Okay lets look at each:

Determine what your immediate and long range plans are without considering the student 
loan hovering over you and determine how you can finance either a start up or weather the 
financial storm six months at a time:

If all you see is student loan debt you will never go past GO!. The majority of graduates 
have loans and they manage .. you will too. Just assume there is no student loan .. how 
would you proceed and how would you gather money to start on your own? The bank may 
give you credit since you have less debt but who knows. It will take you a minimum of 
$20-30,000 to open your own office and have some money left for purchase and 
marketing. This is very conservative but possible if you lease equipment and have a 
generous office lease proposal. I recommended graduates ask their family to take a $20,000 
home equity loan for them. They promise to pay the loan .. which is at low interest and all 
the interest is tax deductible. It is a win-win if you can be assured you will pay the loan off. 
A $20,000 loan over 3 years is like a car payment. But with leased equipment it can 
happen. It is a shoe string beginning but it can happen. As far as student loans this was 
posted last week within my weekly e-mail. Check it out:

Student Loan News: Message from Dr. Pete Fernandez, consultant

My job as a consultant is to increase your take-home income.  The following may greatly 
reduce your overhead --- thus increase your income dramatically. I am referring some of 
my clients to a student loan consolidation firm that dramatically lowers their monthly 
student loan payments.  The program is simple and free and may reduce your student loan 
payments by up to 53%.  A doctor with a $100,000 loan would have his/her student loan 
payments reduced from $1015 down to $485 which is a savings of $530 per month or 
$6360 per year. This is a federally regulated program.  In addition to lowering your 
monthly payments, you can lock in the interest rate at the lowest rates in the past 38 years.  
So it's simple, it cost you nothing to lower your loan payment and lock in the lowest rate in 
the past 38 years.  This firm handles all the paper work and there are no credit checks.
You can contact Dr. Magnano at 1-800-611-0098 for more information on this program.

Determine where you wish to plant your roots and stabilize your life and determine the 
locations within these areas to offset any potential failure or slow start:

As far as Atlanta it is saturated with chiropractors. This is where I practice. It is a popular 
city for the LUCC graduates .. as myself .. to stay. Every community has a chiropractor 
and the insurance is all managed care. Can you make it .. yes! It may be a little harder on 
your own but possible. Therefore choosing Atlanta is a fine idea but choose the areas 
wisely. Whether in Atlanta or not the same holds true. What areas are ripe for a new 
chiropractor .. will I make a living and will my move be cost effective in the long run. 

Determine the options available whether as an associate or an IC or possibly starting on 
your own:

Associateship are never money makers but they can hold you over for a few years while 
you pay off loans. An IC sounds great on the surface but the same work to build a practice 
within someone else's practice can be spent building your own. The advantage of either is 
the overhead is kept minimum. The cost of running a practice can be high even without a 
patient. Once you decide what you want to do then you can focus on where and with whom 
to do it. Each week there are a number of IC and associate postings within my e-mail. I 
recommend you e-mail or call these offices to see if they can pay you enough to uproot you 
and have a few extra bucks to eat. As far a being locked out of future areas due to clauses .. 
just be firm that it isn't written into any contract you sign. Also buying someone's practice 
is both good and bad. The good is it is a practice with patients and location ..the bad .. it is 
a practice with little patients and even less potential ones. Location is important and any 
practice worth selling will cost you unless the DC will finance you and help in the 
transition. A part time practice makes part time money. Your own practice three days a 
week and working for another DC the other days is foolish. Plant the proper seeds on your 
own and nurture your own growth and wealth. 

Determine a game plan to make it happen both with practice management and marketing:

Choose wisely for the next 6 months. If it is to open your own practice breakdown the 
needs and determine if you can spare a dime after each month. Find out what money you 
can get to sustain yourselves for a few month. If you choose a location be prepared to work 
it and create a PR farm so you can tap into the community. Check my webpage often and 
scroll down and Practice Tips and Cyberconsulting areas for tips and answers. You can 
purchase my book .. Smart Start (found on my webpage) which has helped so many 
gradutes get going with practice management and PR tips. Be prepared. If you really want 
some help and don't mind paying for a coach then I recommend Dr. Pete Fernandez. He 
calls you every week to determine if you are on the right track and tweaks it if not. You can 
attend one of his seminars in Atlanta by calling them at 1-800-882-4476 and be sure they 
know I referred you. The classes are dynamic.

Determine how you can repay loans and the cost of living for six months at a time:

Okay it boils down to eventually live a life without debt. Student loans are notorious for 
default but should not be an option. You can pay off all your loans in a timely fashion and 
once your practice takes off and you have a budget that you can follow.

Conclusion. If you want to work as a nurse to pay a little debt here and there you'll be like 
driving a car while you are still is in neutral. You won't go very far. But if you decide on 
the location and check the postings for the last year .. again found on my webpage under 
Previous Postings .. www.chirosmart.net you may be able to pin down some opportunities 
.. especially in Atlanta that will be worth the risk. I think the ultimate is ownership but that 
takes guts and a workable plan.

I hope this helps

Have a Great Day

Dr. M