The roads more traveled

As you near graduation, you’ll likely grow increasingly concerned about taking your first steps in the real world outside school. To better assess your options, consider the responses given by new DCs to a recent survey by the American Chiropractic Association.

Almost 30 percent of new DCs open a solo practice with no staff members. Any experienced chiropractor will tell you without hesitation that you should never practice alone.

At the very least you should have a chiropractic assistant (CA).A staff member in the practice can help protect you against claims of wrongdoing and malpractice. In such a case, you’ll want someone else to be able to support your version of events. If you are a female DC, there are safety issues to consider, too. Just as importantly, working as a doctor is hard enough without having to do your own billing and scheduling on top of providing patient care.

About 20 percent of new graduates work as associates. While getting experience is wise, most associateships fail. You’ve heard of “associate jail”? Most of the reports are true. You can certainly benefit from being an associate to a good mentor doctor. But 90 percent of the doctors who start out in an associateship will tell you horror stories.

If you are thinking about becoming an associate, you need to know how to find a good position. One in which a mentor will guide and teach you. You can get this information from a new-practice coach.

Almost 20 percent of new DCs open a solo practice with a CA. This is a wise choice because these doctors have a CA to help and support them from the start.

Whenever you establish a solo practice, you should work with a new- practice coach or consultant. There are hundreds of things you need to know when starting a practice, otherwise you risk paying the “dumb tax,” i.e., the money you waste by doing things wrong.

Starting a new practice without a CA and expert advice virtually guarantees you’ll pay a hefty dumb tax.

Approximately 10 percent joined an existing practice with a more experienced doctor. Many times, this is a good option – but most of the time it isn’t. The doctors who join an experienced practitioner as an independent contractor (IC) have usually made a big mistake.

Be aware that IC arrangements have a tendency to blow up, with both doctors going their separate ways (and usually with a loss of friendship). Such arrangements need an agreement carefully laid out in advance for a successful outcome.

Some 10 percent join a multidisciplinary practice. This can lead to a good outcome. Working with other medical professionals is enlightening. You learn a lot, and your patients can be taken care of in a “one-stop shop.” Be careful, though, as many multidisciplinary practices are formed to bypass existing laws (e.g., to bill Medicare for non- Medicare reimbursable fees).

Takeaway lessons

Research practice consultants as you go through school and think for yourself; don’t follow the crowd. Often, when one student selects a consulting firm, his or her friends join the same one. Instead, investigate at least three to four. Look into online practice-starting firms, too. There’s no substitute for experience, and no excuse for paying the dumb tax.