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Ray Foxworth, D.C., FICC, MCS-P

There are some definite pros and cons to solo practice. I spent the first 20 years in practice on my own. My dad joined the practice part-time, but I didn’t really consider taking on a full-time associate until after a conversation with my practice coach. We were discussing the growth of my practice. The reality was that I was one person, and I just could not see any more patients each week. Additionally, I still struggled with taking time off to go on vacation, the dentist, or even a sick day. Hiring an associate seemed like a daunting task, however, it meant the potential for adding flexibility to my schedule and for new business growth.

Before hiring an associate, there are many things to take into consideration. The first is office production. Is your office busy enough to sustain two doctors? Hiring an associate will drop your income in the beginning and create a disruption in your schedule as you begin training your new doctor. Is the number of new patients per month consistent and growing in your practice? At least 30-40 new patients per month is a great way to start your associate off on a successful foot. Unless you plan on slowing down and transferring a good bit of your own patient load to the new doctor, you need a strong marketing plan to keep new patients coming in the door.

Do you have written standard operating procedures for your practice? Are they updated and accurate? You need to have a strong system in place for how everything operates in your office, from how to perform consults, exams, and present treatment plans, to how appointments are scheduled, and who discusses patient financials. There needs to be a strong focus on training. My associates train with me for 12 weeks before seeing patients on their own. I know this because I had previously hired associates and didn’t pay as much attention to making sure we were creating a consistent experience for patients. There was always the challenge that when I was away, the patients weren’t as accepting of our associate doctor. Spending the time to make sure we were as close as possible to duplicating the patient experience really paid off.

What I’ll call my first real successful associateship involved a doctor who had been in practice for 7 years in another state. We had a long conversation about trying to create a consistent experience and put our egos aside to ensure that if he was out, or if I was out, patients wouldn’t hesitate to see the other doctor. It worked and worked well. We, for lack of a better term, considered it the Foxworth Way, not to serve an ego, but for the benefit of the patients. During that time, each associate attends every consult, exam, report of findings, etc. No matter how much experience a new associate has when coming to your practice, it is important that they learn and understand your style of practice.

Do you have enough office space? Each doctor should have two treatment rooms that are constantly in rotation. Before we began constructing a new office space, we expanded our office hours and set our doctors on a rotation. This allowed us to see even more patients than before. It was also more cost-effective than expanding our office in the beginning, as we continued to grow each associates’ patient load.

Hiring an associate can be exciting, and a little stressful, but it provides big payoffs in the long-term. It is important that your associates know the ins and outs of your practice, from how the practice works from the front desk, to billing and insurance, and compliance. If you are concerned about how to hire and train the right associate for your practice, get help! I did that when I hired my first associate eight years ago. I have since added three more. Hiring an associate provided me with some much-needed flexibility with my schedule. It gave me the opportunity to work on my business and not just for my business. Ultimately, it allowed me to have some balance between my personal and professional lives and, more importantly, our doctors don’t have to spend 20+ years in a solo practice and miss out on the important things in life, like attending their children’s programs or events, family vacations, and the worry about unexpected illnesses or “life” happening. The peace of mind that comes from knowing you have other colleagues that have your back, because you have theirs, has proven to be priceless.

To learn more about training staff, adding an associate, or expanding your practice marketing, check out our weekly webinar series at chirohealthusa.com/webinars.

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