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How To Start A Chiropractic Business

How To Start A Chiropractic Business

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How To Start A Chiropractic Business

How To Start A Chiropractor Business

Being a chiropractor can be a gratifying job, but for many chiropractors, the ultimate dream is to open their own practice. Starting a chiropractic business allows you to be your own boss, set your own hours, and focus on patient care.

Starting a chiropractic business is an exciting opportunity, however, ensuring your practice’s success involves more than just having the right qualifications and skills. This guide provides an overview of the chiropractic industry, steps to starting your own practice, and answers to frequently asked questions. With the right preparation, you can turn your passion for chiropractic care into a thriving business.

Business Overview

A chiropractic business offers non-invasive treatments for patients suffering from musculoskeletal system issues, particularly spinal disorders. As a chiropractor, you’ll be diagnosing and treating health problems that affect the nerves, bones, muscles, ligaments, and tendons. Some of the main responsibilities include patient consultations, developing treatment plans, and performing adjustments or manipulations on patients.

Industry Summary

The chiropractic industry is expected to generate $19.5 billion in sales during 2023. A few facts about the industry include:

  • Approximately 68,000 chiropractic firms operating in the US
  • 95% of practices have less than 10 employees
  • No major national chiropractic chains exist
  • Half of patients with persistent back pain receive chiropractic care
  • Industry revenue has grown at an average rate of .4% over the last five years and is expected to grow at 2% annually through 2027

Demand for chiropractors is driven by the prevalence of back, neck, and joint pain, as well as sports injuries. While the industry struggled during the 2007-2009 recession as patients delayed discretionary services, future prospects remain positive. The aging baby boomer generation and their increased healthcare needs will support industry growth.

It’s important to keep an eye on the pulse of the industry. Telehealth, for example, is a growing trend, and some chiropractors are offering online consultations. Another trend is the focus on holistic wellness. Patients are not just seeking out chiropractic care for back pain; they’re interested in overall well-being. A growing emphasis on evidence-based practices is also changing the way services are offered and marketed. Integrating these services or collaborating with other healthcare providers, such as physiotherapists and massage therapists, to offer a broader range of services to their patients.

Steps To Start A Chiropractor Business

Step 1: Obtain Necessary Credentials

We won’t spend much time here, but there are a number of credentials that are required by each state before providing chiropractic services. This typically involves completing the required education, usually a Doctor of Chiropractic degree, and passing relevant exams to become licensed. It may also include additional certifications in specific chiropractic techniques or specialties. This step ensures you meet all legal and professional standards to practice chiropractic care, before starting a chirporactic practice.

Step 2: Market Research

Starting a chiropractic practice, or any business for that manner, requires careful planning, and a key component of that is market research. This step helps identify whether there is a viable market for your services. It gives you insights into who your potential patients are, what they need, and how best to reach them. This information is invaluable for making decisions that will affect your business in the long term.

The first task is to evaluate the population demographics in your intended area. If the area has a large population of older adults, that’s usually a good sign. Older folks often have issues that chiropractic care can help with, like back pain and joint issues. But demographics can offer even more nuanced information, such as the prevalence of sports or physically demanding jobs in the area, which could also indicate a need for your services. The Census Bureau and Bureau of Labor Statistics offers data to help with this research.

It’s also important to know how many chiropractic clinics already operate in your target area. A high number of clinics could make it challenging to differentiate your practice, while a low number may suggest limited demand or untapped potential.

Conduct surveys or interviews with local residents to find out their thoughts on chiropractic care. Maybe there’s a gap in services that you could fill, or perhaps there’s a negative perception of chiropractic care that you’ll need to overcome with targeted marketing.

Identifying potential referral sources such as hospitals, physical therapy clinics, and primary care offices can be an essential part of your market research. Establishing relationships with these facilities can help build your patient base. Additionally, look into any collaborative care or integrated care programs in the region where your practice could participate.

Step 3: Write a Business Plan

Once you’ve gathered insights from market research and are confident that there’s a need for your chiropractic services, the next step is crafting a business plan. Think of a business plan as your roadmap. You wouldn’t drive to an unfamiliar destination without some sort of guide, and the same holds true for venturing into the business world. A well-thought-out business plan sets the course for your practice, outlining the path from where you are now to where you want to be.

A business plan also serves as a reality check. While market research gives you an idea of the terrain you’ll be navigating, a business plan digs into the nitty-gritty details of the journey. How will you get patients through the door? What kinds of equipment will you need? What’s the timeframe for turning a profit? Writing a business plan forces you to confront these questions head-on. It makes you spell out all the operational and financial aspects of your practice, from marketing strategies to revenue projections, shining a light on the feasibility of your venture.

Related: How to write a business plan

Step 4: Source Funding

After completing market research and a business plan, you should have a good sense of the viability of your chiropractic practice. The next major hurdle to cover is funding. Finding the funding to start your chiropractic practice is no small task, but it’s essential for turning your business plan into reality.

With the money secured in this stage, you’re one step closer to launching your practice. Here are some common sources of funding to consider when starting a chiropractic business.

Personal Savings

The initial source of capital for most business owners is their personal savings. In some cases, the owner may have enough saved up enough to start, while others will need outside funding.

Small Business Loans from Banks

Traditional bank loans are often the first outside funding source that entrepreneurs consider. Banks offer relatively low interest rates, but their qualification criteria can be stringent. You’ll need a strong business plan, personal investment of at least 15%, good credit, and sometimes collateral.

If the bank considers the loan risky, an SBA (Small Business Administration) loan guarantee can offer an extra layer of protection to the lender, making them more likely to approve your application.

Equipment Leasing

Instead of purchasing equipment upfront, new practices can consider leasing. Equipment leasing allows you to rent necessary equipment, such as chiropractic tables or imaging machines, instead of buying them outright to free up their cash for other aspects of the business.

Loans from Friends and Family

Money borrowed from friends or family usually comes with fewer formalities and sometimes lower interest rates. However, mixing business and personal relationships carries its own set of risks and should be approached carefully.


These are smaller loans, often less than $50,000, that can be easier to obtain than traditional loans. Microloans are usually targeted at newer or smaller businesses and may be a good starting point if you only need a modest amount of capital.

Credit Cards

While convenient, using credit cards for business expenses is risky due to high interest rates. This option should be a last resort and for short-term needs only.

Related: Finding the money to start a business

Step 5: Register the Business

The next step is making sure your chiropractic business is legally sound. This is a multi-step process that includes choosing a business structure, registering your name, and obtaining the necessary licenses and permits.

Business structure: The first order of business is to decide on the structure that best suits your needs.

There are several types of business structures: Sole Proprietorship, General Partnership, Corporation, Limited Liability Company (LLC), Limited Partnership (LP), and Limited Liability Partnership (LLP). The choice depends on factors like the number of owners, the desired level of liability protection, tax implications, and the complexity and cost of formation.

  • Sole proprietorship: This is the simplest form of business structure, which involves minimal paperwork and lower startup costs. However, as a sole proprietor, you’re personally liable for the business’s debts and obligations.
  • General partnership: In a partnership, two or more people share ownership. Like a sole proprietorship, it’s relatively easy to establish but exposes partners to personal liability for business debts.
  • Corporation: A corporation is a separate legal entity owned by shareholders. This structure offers liability protection but is more complex and costly to set up. It’s common for professional services like chiropractors to set up as a Professional Corporation (PC) in states that allow it.
  • Limited Liability Company (LLC): An LLC combines the liability protection of a corporation with the simplicity and flexibility of a partnership or sole proprietorship. It’s a popular choice for small businesses because it offers protection without the complexity of a corporation.
  • Limited Partnership (LP): In an LP, there is at least one general partner with unlimited liability, and one or more limited partners with liability limited to their investment in the business.
  • Limited Liability Partnership (LLP): An LLP is similar to an LP, but it offers all partners protection from personal liability, except for their own professional malpractice or misconduct.

Each state has different rules regarding business structures, so it’s crucial to research your state’s specific requirements or seek legal advice.

Related: Comparison of business structures

Forming an LLC sounds complicated and expensive, but using an entity formation service guides you through the process so you know it was done right.

Some popular LLC formation services include:

IncFile - $0 plus state fees & free registered agent for 1 year!

ZenBusiness - Best for beginners. $0 plus state fees & free registered agent for 1 year!

Northwest - Best privacy protection. $39 plus state fees & free registered agent for 1 year!

Business name registration: After registering the business structure, you may need to register your business name. This process will vary depending on what business structure you pick. Sole proprietors and partnerships will often be required to register a “Doing Business As” (DBA), while corporations and LLCs register with the state during the formation process.

During this time, it’s also a good idea to check if the name you want is available as a web domain, even if you’re not ready to set up a website yet.

Related: Finding a domain name for your business

Obtain business licenses and permits: Chiropractic practitioners have several regulations to be aware of. From client privacy regulations under the Health Insurance Portability and Accountability Act (HIPAA) to state professional licensing and others, it’s important to research the required licenses and regulations before starting a chiropractic office.

In addition to chiropractic business-specific requirements, there are also general business requirements that may be required, such as a business license, sales tax permit, or Employer Identification Number (EIN).

Related: Common business licenses, permits, and registrations by state

Step 6: Acquire & Set Up the Office

You’ve scoured the market, your business plan and funding are set and the business is registered. Now comes the next step which is acquiring an office and setting up your chiropractic facility.

Choosing the right location for your chiropractic practice can significantly impact visibility and patient accessibility. Consider areas with high foot traffic, like busy retail districts or near gyms and medical offices, which can provide excellent visibility and potential patient referrals. The size of your practice will dictate the amount of space needed; however, approximately 700 square feet is typically sufficient for a solo practice.

Once you’ve secured a location, it’s time to map out an efficient office layout. A well-designed workflow can enhance productivity and patient experience. Your layout should include spaces for examination rooms, treatment areas, reception, and storage. Think about the path a patient will take from entry to exit and design your office to facilitate this journey smoothly.

Investing in the right chiropractic equipment is another consideration when setting up the practice. Key equipment includes adjustment tables, imaging technology, and physiotherapy machines. Research various brands and models to find equipment that suits your practice’s needs and budget.

Finally, establishing accurate and efficient billing processes is critical for maintaining a healthy cash flow. You have the option to handle billing in-house or outsource it to a professional billing service. Whichever you choose, make sure the process is designed to handle insurance claims accurately and promptly to avoid payment delays.

Step 7: Hire Staff

Hiring employees and becoming an employer is a significant step that comes with specific responsibilities and legal requirements. Common types of employees hired in a chiropractic practice include chiropractors, chiropractic assistants, receptionists, and office managers.

Before you start the hiring process, there are several legal requirements you’ll need to meet. First, you’ll need to obtain an Employer Identification Number (EIN) for tax reporting purposes. Make sure to verify the employment eligibility of your potential hires, typically through documents like a Social Security card or a passport. It’s also crucial to report new hires to your state, as each state has its own set of requirements. Worker’s compensation is a requirement in most states, ensuring that you have financial coverage for any employee injuries. Finally, be aware of labor laws concerning wages, benefits, and working conditions.

Related: State guides for hiring your first employee

Step 8: Create a Marketing Strategy

In the world of chiropractic care, where competition can be stiff, effective marketing is key to attracting and retaining patients. Start by identifying your target audience, whether that’s athletes, seniors, or office workers to tailor your services and messages specifically to them. Your brand identity plays a significant role here. Develop messaging that clearly communicates what your clinic specializes in and what sets you apart from others.

A website acts as your online storefront; it should be informative and user-friendly, allowing potential patients to understand your services and easily book appointments. Online, optimize your website and business listings for local search engine optimization (SEO) using location-specific keywords. Paid ads on platforms like Google and Facebook can also be focused on your local area to reach people actively searching for chiropractic care.

Physical signage, both exterior and interior, also plays a role in getting noticed. Exterior signs draw in walk-ins, while interior signs should create a welcoming environment.

To establish your clinic as a trusted local expert, consider community outreach efforts like free talks, screenings, or workshops. Building relationships with local businesses like gyms, health stores, and physical therapy clinics can expand your network and potentially offer avenues for patient referrals.

Related: Low-cost ideas to market a new business

Step 9: Prepare to Open!

As you prepare to launch your chiropractic business, several additional steps should be considered to ensure a smooth start and ongoing success of your practice. Every business will have different needs, but here are some common ones:

Business insurance: Protecting your business with the right insurance is critical. This could include general liability insurance, malpractice insurance, and property insurance to cover potential damages to your office space or equipment.

Setting up bookkeeping: A well-organized bookkeeping system is essential for tracking revenue, expenses, and profitability. Many businesses in this field hire an accountant or use software like QuickBooks for this purpose.

Opening a business bank account: Separate your business finances from your personal ones by opening a dedicated business bank account. This simplifies accounting and can also help protect your personal assets.

Purchasing management software: Consider practice management software like ChiroTouch or Genesis Chiropractic Software for scheduling, billing, and electronic health records.

Greg’s Tip: Unless you have someone on your team that has experience, hire an experienced biller or billing service since insurance billing can be complex.

Inaccurate billing can result in your practice to either not getting paid, or waiting long periods to receive the money it’s due.

Greg's Business Tip

Common Questions When Starting A Chiropractic Business

How much does it cost to start a chiropractor business?

Starting a chiropractic business requires significant upfront costs. You should expect to spend between $50,000 and $150,000 to cover expenses like equipment, licensing, insurance, marketing, and space.

The biggest expense is equipping your office with the necessary chiropractic tools and technology. This includes an adjustable table, imaging equipment (x-ray or MRI machine), and other tools for adjustments. Expect to spend $25,000 to $75,000 on initial equipment purchases.

Leasing an office space is the next major cost. You’ll need room for waiting areas, private exam rooms, and treatment areas. The first month’s rent and a security deposit could cost $5,000 or more upfront. Buying office furniture, decor, and supplies will cost around $5,000 as well.

Obtaining business licenses and permits typically run between $500 – $1,000 depending on the state.

Initial insurance costs, including liability and malpractice insurance, could be around $3,000 to $4,000.

Marketing is another area where you’ll need to invest upfront. This could involve costs for website design, logo creation, social media setup, and initial advertising campaigns. While the costs can vary widely depending on your specific strategies, a reasonable estimate might be around $2,000 to $5,000.

Other startup costs include legal fees, utilities, payroll until revenue kicks in and office technology. It’s wise to have an extra $10,000-$20,000 as a contingency fund too.

How profitable is a chiropractic practice?

A chiropractor’s net profit will depend heavily on the revenue generated by their practice and how well they manage expenses. Industry statistics provide some benchmarks.

If you charge an average of $70 per session and see about 20 patients per day, five days a week, that’s $70 x 20 x 5 = $7,000 per week or about $364,000 per year, assuming you take two weeks off.

Overhead costs like rent, utilities, equipment, marketing, and salaries (if you have staff) could eat up a large portion of your revenue. An estimate might be around $200,000 per year for a small, moderately-equipped practice.

To find the profit, subtract the expenses from the revenue, which would be $364,000 – $200,000 = $164,000 per year before taxes.

Of course, profitability ultimately depends on your patient volume, insurance mix, fee schedule, and expense management. But, these industry benchmarks provide a reasonable estimate to help project potential earnings for a new chiropractic practice.

What skills are helpful in running a chiropractic practice?

Here are some key skills that can be helpful in running a successful chiropractic practice:

Communication skills: Being able to clearly explain treatments and conditions to patients, listen to their concerns, and develop rapport is critical. Good communication also helps in marketing the practice and interacting with staff.

Empathy: Understanding patients’ situations and showing genuine care for their wellbeing leads to better doctor-patient relationships and retention.

Organization: Managing patient records, appointment schedules, billing and other administrative tasks requires organizational skills. Systematizing processes is key.

Business acumen: Having strong business skills helps with managing finances, marketing, operations, hiring, and long-term planning. Taking business courses can be beneficial.

Leadership: Effectively guiding and motivating staff, resolving conflicts, and making executive decisions requires leadership abilities.

Technology skills: Leveraging practice management software, social media, and other technology in a chiropractic practice necessitates having some technology proficiency.

Interpersonal skills: The ability to collaborate with staff, interact positively with patients, and develop professional relationships with other healthcare providers is vital for success.

Problem-solving: Identifying issues impeding the success of the practice and determining solutions to improve processes, increase efficiency, or boost growth takes analytical thinking.

Developing these “soft skills” and continuously improving processes through systemic planning helps chiropractors manage the business side of their practices while also delivering excellent patient care.

Should I purchase an existing practice or start new?

Buying an existing practice reduces startup risks and provides an immediate patient base and revenue, but costs more upfront.

What is the NAICS code for a chiropractor business?

The NAICS code for a chiropractor business is 621310, which is offices of chiropractors.

The NAICS code (North American Industry Classification System) is a federal system to classify different types of businesses for the collection and reporting of statistical data.

Related: What is a NAICS code and how to find yours


How To Start A Chiropractic Business

How To Start A Chiropractic Business

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