Perhaps the title of this article should have been “Please Don’t Do it that Way!” as I often find myself trying to contain that exact sentiment with many new clients. On the other hand, I am often hired after-the-fact, after the clinic owner has already made many, if not all, of the mistakes I will cover in this article.

Before I delve into the “mistakes” let me state an initial important axiom that I personally know and believe to be true:

“Any chiropractor can successfully implement a plan of bringing in an associate DC and profit greatly from the relationship

That being said, there are right ways and wrong way to do it – without question. Needless to say, the wrong way is all to often the default way. If that sounds like you, please don’t kick yourself too hard. I have done it the wrong way, and most chiropractors entering the associate arena have done the same. There is a learning process to implementing this correctly and just because you have a successful and busy practice, this in no way ensures that you will also, without the proper planning, tools and experience, be successful when hiring an associate or associates.

After 23 years in practice, having owned 16 clinics of my own, written 6 books on the business of chiropractic and having trained and personally consulted with hundreds of offices, I believe that ‘hiring an associate’ is the area of consulting I am strongest in. When it comes to finding, hiring, compensating, transitioning, motivating, training, and managing the chiropractic associate, I may be good at it but more importantly I am passionate about helping chiropractors do it the right way.

So, here then are the 5 biggest mistakes chiropractors make when hiring an associate (in no particular order):

  • Compensating your associate on a straight commission structure, or percentage of collections. Although in unique situations this sometimes is warranted, most of the time compensation through a percentage of collections is not the best option. Reason being, you don’t want your associate focused only on “money.” For one thing if they know exactly what they are bringing in they will naturally extrapolate from that how much of that income is going to you, how much of it is going to expenses (in their eyes) and how much you are then profiting from them. This is a quick road to them opening their own clinic, with your patients, across the street in competition with you. Instead what you do want them focusing on is the one number that all numbers lead to at the end of the month – Patient Visits (PV). New patients, patient visit average and missed appointments are vitally important, but they all lead to the main non-financial number of importance in a clinic’s success, and that is PV.
  • Expecting the associate to bring in all their own patients. Okay, obviously some arrangements are set up this way, but this is usually more of a partnership than a true associateship. But, let me back track on this point and say of course you want them to bring in new patients! The disconnect lies in the common scenario where the associate is essentially given a key and told “go build a practice.” Let’s face it, if they could do it on their own at this stage in their career they probably already would be. Instead you want to structure the relationship so you not only set up a patient flow, including new patient flow for them (where the become indebted to your business) but you then teach them, instruct and direct them how to get new patients. If you still plan on practicing full-time yourself and can’t envision having the time for this ongoing investment, then in one way or another you’ll have to outsource it, which can be done.
  • Assuming the associate will put at least nearly as much into the practice as you have or do. Sorry, this won’t happen. It is not their business and it is not their baby, and they are not on the hook for it. On the other hand, if you set up the compensation structure just right and motivate them in all the other relevant ways you can get them to perhaps perform at somewhat near an owner/operator’s potential – but it should never be assumed to be automatic.
  • Competing with your associate. This somewhat relates to the issue described in #2 because if you are struggling too and just want to bring in an associate to help cover part of your expenses then you won’t be in a place to start handing over your own patients and new patients. Given that situation you’ll end up in competition with your associate which is not a healthy place to be. If that is your need or situation then perhaps consider getting a partner, not an associate.
  • Not being upfront and transparent, not properly training, and not creating full-proof accountability systems. I know that covers a lot, but it does all tie together. If, from the start, you essentially both agree that “these are your goals, and this is the road map of how you are going to get there” then all that is left is to follow that up with the proper systems and air tight methods of accountability to ensure the greatest chance of follow through and eventual success.

If you have ever hired an associate in the past and done so either successfully or unsuccessfully I would venture to say that you would agree with this list. If you are going into the world of working with an associate for the first time I hope this sort list will be of some value to you. If you find yourself wanting to work with a chiropractor and coach who can help you avoid all these errors and set it up right, contact me and we can discuss your unique goals and situation to see if I can help you avoid mistakes and fast-track you towards more time off and increased patient volume and revenue. Find out more at, or contact me, Dr. Troy Counselman, directly at

Recent Posts

Start typing and press Enter to search