Common Pitfalls in Your First Year of Practice

<strong>Common Pitfalls in Your First Year of Practice</strong>

A chiropractor’s first 12 months in practice can be a shaky time. “What do I do?” is the big question, but “What don’t I do?” is arguably more important. Review our preventative tips to avoid some rookie mistakes.

  1. Careless Compliance and Documentation

Even the most experienced chiropractors know how these can hurt a practice. Your first year in business must prioritize full compliance and precise documentation so you know – not assume – that you’re getting them right.


One way to stay current with the latest rules and regulations is working with a third party whose job it is to follow these things. This gives you greater peace of mind and liberates your time to fully focus on providing care and building your new practice. Don’t let anxiety or over-confidence lead to claims or billing errors which could cost thousands of dollars.

  1. Lacking a Disaster Recovery Plan

You’re probably excited and optimistic as a new practice, but remember: Murphy’s Law is the one legal force no chiropractor can placate. You can only prepare. You’re never more vulnerable than in your first year, so consider the following to protect your interests:

  • Create a government-compliant disaster recovery plan.
  • Review insurance policies like malpractice, business interruption, general liability, and workers’ compensation, all of which can help prevent financial disaster.
  • Invest in cybersecurity and train yourself and any employees in safe cyber practices.
  • Make it as easy as possible for staff to perform their duties remotely should the clinic be closed by unforeseen circumstances.
  1. Not Maximizing Marketing

This should receive the lion’s share of your time before your service begins. If you’ve already launched into your first year of practice, then now’s the time for vigorous promotion. Here’s a mini marketing masterclass:

  1. Overspending

Practices need many things as they start: premises, equipment, furniture, etc. It’s a delicate balance to separate what you really need from “ideals” you’d merely like. Functional, reliable purchases of essential items should be your focus in Year One; the more expensive items should wait until you’re established. Some start-ups opt to lease as many aspects of their practice as possible in their first 12 months – an approach that can significantly reduce outlay and overheads.

  1. Undervaluing Your Services

Resist the urge to set excessively low fees in your first year, even to ease patients’ financial burdens. Inflation annually increases the cost of everything you’ll need to operate. Determining fees is fluid when starting out, since you’re still discovering some essential factors:

  • Your monthly operating expenses.
  • Average monthly income.
  • Average income per visit.
  • Average cost of delivering care.

As these slowly become apparent, combine them with an awareness of the per-code market values for services in your area. This will provide a solid foundation for setting first-year fees you can comfortably survive on into your second year.* [See editor’s note below.]* Editor’s Note: These factors are to be used to determine fees for individual practices only.  Doctors are strongly cautioned against any prohibited antitrust activity, including collusion or price-fixing with professional competitors.

About Author

Ray Foxworth, DC, FICC, MCS-P

Dr. Ray Foxworth, DC, FICC, is the founder and CEO of ChiroHealthUSA. For over 35 years he worked "in the trenches" facing challenges with billing, coding, documentation and compliance in his practice. He is a former Medical Compliance Specialist and currently serves as chairman of The Chiropractic Summit, at-large board member of the Chiropractic Future Strategic Plan, board member of the Cleveland College Foundations, and excutive board member of the Foundation for Chiropractic Progress. He is the former Staff Chiropractor at the G.V. Sonny Montgomery VA Medical Center and past chairman of the Mississippi Department of Health.Go to to register today.

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