The Trouble With Associates
Finding a good chiropractic associate is tougher than ever. Here's my plan to fix it.
Finding good clinic associates is getting tougher each year.
New chiropractors want different things than I did when I started: They value time off, steady paychecks, and no weekend work.
Who can blame them?
Becoming a chiropractor doesn’t hold the same social status or pay as it used to. Student debt is high, and chiropractic incomes are stagnant. Many new grads take on part-time jobs outside the profession to supplement their income. Considering the average chiropractor is no longer practicing 5 years post-graduation, it is safe to assume the “Mercedes 80s” are far behind us.
The median income for chiropractors is $76,530, or just over $43/hour. Ouch. Graduating with $150K+ in student loans and historically high living expenses can seem impossible for new grads.
The work culture has changed significantly over the past 20 years. Multiple career changes are now common. Work from home, tech booms, and work/life balance seekers are changing the style of work. Many will job hop for a small pay raise.
In chiropractic, we're seeing similar changes. Associates want steady salaries instead of percentages, health benefits, paid time off, and shorter work weeks. Many have little interest in building a clientele. They just want to be technicians for the highest-paying clinic.
When I was new to chiropractic, I worked long hours and built up my patient roster. But, times have changed. New chiropractors seek work-life balance from the start, while my generation only considered it after we had already been practicing for a few years of practice, usually due to burnout.
I recently interviewed a smart young grad. But, when we talked about the associate job, the conversation went like this:
“Are your salaries competitive with other clinics?
“No salaries. We pay a capped percentage with the option to buy in to the practice later,” I replied.
“What if I don’t want to be an owner?"
"Then, we won’t offer it to you.”
"I can’t work weekends. I need work/life balance.”
“But, you’ve just graduated," I said.
[Blank stare]
“How do you know what unbalanced feels like?” I asked, confused.
You get the idea.
I've had many talks like this. It seems like new chiropractors are looking for a safer job with more personal time. This isn't a bad thing.
What if they're right?
Should chiropractors rethink how they hire associates? The old-fashioned associate culture of “build your business within my business and I’ll take 50% in perpetuity until you get pissed off and leave to start your own clinic” was never a great model anyway.
On the other hand, simply providing a well-paying job for an associate without mentorship may not be the best. Maybe we need a hybrid system where an associate can enjoy a balanced lifestyle, learn the business, and be compensated fairly?
Here’s my plan to attract better associates:
Be clear about the job: Tell them about the flexible hours, earning potential, and learning to run their own practice. I want a partner, not an employee.
Offering training: Many young chiropractors want to keep learning. I've started providing more training in my clinic to help them improve and feel supported.
Associates are not profit centers: Offer a capped fair percentage.
Skin in the game: After a year, I plan to offer a small percentage of the business profits and ownership in the practice. If the associate prefers to branch out, I’ll partner with them and finance the satellite office.
Be more flexible with schedules: This doesn’t mean less work, but I’ll try to make their hours more flexible, which helps a lot.
With these guiding principles, I hope to attract and keep great new associates. If you're having trouble, let me know. Our job is to keep our profession strong and help our patients, while also assisting new chiropractors.