How to grow a chiropractic business as the industry shifts

A 2022 guide to how to grow a chiropractic business and expanding into the trauma care and personal injury sector

The business of chiropractic is changing rapidly, and at the same time, staying the same. The consistent part of how to grow a chiropractic business is the “life-blood” of every practice, which combines getting new patients and keeping the ones you have. What has changed drastically is how you get and keep those patients. Before you consider spending your money and time on new patients, you must first consider what you are trying to get.

Finding the ‘right’ cases

Too many doctors realize too late in the process that they successfully attracted the “wrong” type of cases. They end up with third-party administrators that “suck the profits” from the doctor, Medicaid, Medicare, or too many low-paying cash patients, and working too hard for those levels of reimbursements. Strategizing for 2022 means deciding if you want a strong cash practice or focusing on personal injury and everything else in between. No matter what you choose, you need to be prepared and find the best source for information on maximizing each sector of business.

Although there is tremendous benefit from every type of patient you help, I focus on personal injury because I am passionate about trauma care. There are also higher reimbursements for the same care. There are many states where the reimbursements for personal injury are $300-650 per visit, doing the same work I do for a cash patient for $60 or a third-party managed care for $40.

How to grow a chiropractic business: the changing industry

As much as too many “self-proclaimed experts” will tell you to “stay the course,” you don’t need to make changes; the entire industry has changed over the last few years when it comes to how to grow a chiropractic business.

You cannot overlook the effect COVID has had on our society regarding employment (or the lack of), readily available cash, the ability to maintain high-paying insurance coverages, uninsured motorists, the courts closing down, and the backlog of cases. The list is long, and you have to adapt based upon valid “intelligence” to thrive in this ever-changing marketplace.

I can only speak with utmost authority on personal injury, as that is my “everyday focus.”

Most doctors who have had sizeable personal injury practices realize “suddenly” that their PI volume has shrunk. Lawyers they have worked with cite the courts, lack new cases, are not getting referrals from you, or are not an orthopedist. Each of those has a level of plausibility and some truth; however, what they are saying is they do not want to work with you. What makes it worse is you believe it all. No lawyer will ever close the door to a relationship because they want your referral.

The problem with your referral is they are stuck with you and your subpar credentials and documentation. Too often, you will cost them their case, and they don’t care if you are a healer or buy them fancy gifts or dinners. That “game” has long passed. Should you refer to them, you will typically get an occasional referral back, but it may be a low-quality case that has little to no value and will be labor-intensive on your side.

Become their solution

In understanding how to “activate” the referral relationship, you must start to become the solution to their business and become the “easy button.” This begins with documentation and continues with “real credentials” beyond your doctor of chiropractic degree so that they may use you in court to prevail.

This is no different than a lawyer not wanting the general MD with no advanced credentials. They will have a hard time credentialing that MD as an expert, where most of our profession falls. There are so many avenues available to DCs in the marketplace, with quality academics rendering “real credentials” approved by our schools and licensure boards. It’s time to use your CE requirements strategically in how to grow a chiropractic business to support your practice goals. The real winners will be our patients, which is always our primary focus.

The final goal of academics is to teach your referral source, whether it’s lawyers or MDs. Once you become their teacher or source of information, they will now consider you an expert or peer. That immediately changes your reputation, and you will no longer be considered a technician, but an integral part of the treating team.

Start with credentials and documentation

The above strategy is one facet of personal injury success, as there is no one thing that will be the arbiter of success in the personal injury marketplace.

Fancy dinners, research articles, cross-referrals and specialized reports have a place. However, that place is not creating relationships or resurrecting old ones; those have to be earned, starting with documentation and credentials. As stated above, there are no one or two magic items for personal injury success, either with lawyers or MDs as referral sources. However, this is where you start.

MARK STUDIN, DC, is an adjunct associate professor of chiropractic at the University of Bridgeport, College of Chiropractic; adjunct professor at Cleveland University – Kansas City, College of Chiropractic; and adjunct professor of Clinical Sciences at Texas Chiropractic College. He is the president of the Academy of Chiropractic, teaching doctors of chiropractic and interfacing with the medical and legal communities ( He can be reached at [email protected] or at 631-786-4253.


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