By focusing on marketing, hiring, financial literacy and leadership, you can create the systems and culture needed to build a thriving practice, improve patient experiences and achieve sustainable growth.
By focusing on marketing, hiring, financial literacy and leadership, you can create the systems and culture needed to build a thriving practice, improve patient experiences and achieve sustainable growth.Across the US, DCs are filling a critical gap when it comes to spinal care. Yet, many private practices remain stuck at a plateau. The average clinic brings in approximately $295,000 a year and operates with a staff of only three. It’s not because DCs lack expertise in diagnosis, adjustment or healing. It’s because most of us were never taught how to run, let alone grow, a business. Chiropractic school did not teach us how to manage our payroll, market our services or lead our teams. Without this expertise, even the most skilled practitioners can find themselves trapped in survival mode, struggling to scale their impact.
My journey into chiropractic care
I know this all too well. From an early age, I knew I wanted to be a doctor. My mother was a physician, and her compassion, dedication and ability to change her patients’ lives made a lasting impression on me. I chose chiropractic care because I wanted to help people regain mobility, avoid surgery and live pain-free. But the day I opened my first clinic, I realized how unprepared I was for the business side of healthcare. I didn’t know how to recruit the right staff, build a marketing plan or even read a profit and loss statement. Every decision felt like a test I hadn’t studied for.
The first years were the most challenging. I spent late nights learning how to balance patient care with the demands of running a business. I made mistakes, many of them, but each one taught me something invaluable. Over time, I learned how to put systems in place, energize my team and create a work culture that truly made a difference. Those changes didn’t just make my life easier, but they made my practice stronger. Now, we have three thriving locations across California that each help our patients get their quality of life back.
How to move beyond the plateau into a thriving practice
Looking back now, there are four core business skills I believe every DC should master if they want to move the needle in their own practice:
1 Marketing
Being the best DC in your area won’t matter if no one knows you’re there. A strong online presence is non-negotiable. Your website should instantly communicate who you are, what you offer and why patients should trust you with their care. I like to encourage satisfied patients to leave reviews, since those testimonials can influence decisions more than any ad. And don’t forget about social media. For many potential patients, social media is the new Google search. Consider sharing short, easy-to-follow tips on posture, stretches or injury prevention on Instagram, TikTok or YouTube. Every opportunity to be seen is an opportunity to grow your practice.
2 Hiring
Your team is the backbone of your practice and can make or break it. Before you even post a job listing, define your values and the qualities you’re looking for. Skills can be taught, but shared values and cultural fit are much harder to train. Before you even post a job listing, get crystal clear on your mission, values and the qualities you’re looking for. Hire people who believe in your vision for patient care and are eager to grow with you. Then, invest in them through training, mentorship and regular feedback. When your team feels trusted and aligned with your purpose, they will take ownership of their roles, elevate the patient experience and help you build a thriving practice far beyond what you could achieve alone.
3 Financial literacy
Know your numbers as well as you know your patients. Understand your profit and loss statement line by line. Track what it costs to acquire each new patient and whether your marketing is delivering a real return. Build a budget that protects your day-to-day operations, while also fueling long-term growth. When you have a clear financial picture, you make smarter decisions, avoid costly missteps and identify opportunities for expansion that may not have otherwise been on your radar.
4 Leadership
As DCs, we are deeply invested in helping our patients succeed. That focus is part of what makes this profession so rewarding, but it can also come at a cost. In prioritizing the needs of others, it is easy to put our own leadership development on the back burner. The truth is your practice will only grow as much as you do. Make space to work on the skills that strengthen your ability to lead, from communication and decision-making to time management and strategic thinking. This is not about stepping away from patient care; it is about expanding your capacity to shape the future of your practice.
Putting the pieces together
When I finally brought these elements together in my own practice, everything changed. I had the freedom to step back from operational tasks and focus on what I do best: caring for my patients. Over time, I began talking about what worked with other DCs, and I quickly realized how many of them were struggling with the same challenges I had once faced.
Over time, I began to see patterns in what helped these practices move past their plateaus. The same elements came up again and again: clear operational systems, intentional marketing, solid financial tracking and a workplace culture that attracts and keeps great people.
Final thoughts on building a thriving practice
The truth is growth rarely happens by accident. It’s the result of intention, clarity and the decision to dream bigger for your thriving practice, your team and your future. If you’re ready to take that next step, start building the systems now that will support the business and the life you want.
Brigitte Rozenberg, DC, is the founder and clinical director behind one of the US’s most innovative models in nonsurgical spinal care. With more than 30 years’ experience, she has built Spinatomy Spine and Disc Centers into a multi-location thriving practice with three centers and a growing business license model. Her proprietary treatment protocol, Advanced Spinal Restoration Therapy™ (ASRT), has helped thousands of patients find lasting relief from chronic pain, without surgery, without drugs and without compromise. For more information, visit spinatomycenters.com.
