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Creating Chiropractic Opportunity
Episode 3225th January 2024 • Align Your Practice • Dr. Joseph Esposito
00:00:00 00:23:53

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Dr. Brian Dahmer is a highly successful chiropractor with 6 clinics in Florida who joins the podcast to give his insights on associates, building a stellar team, and scaling one’s business. His attentive and generous leadership has been a major factor in never having a doctor leave his practices in almost 20 years. 

About the Guest:

Dr. Brian Dahmer, a dedicated Chiropractic Physician, has been relieving individuals from pain since November 2006. Graduating Cum Laude from Palmer College of Chiropractic in 2004, he was honored with the prestigious John Connelly Most Outstanding Graduate award, a distinction bestowed upon only one graduate among approximately 208 students.

Driven by a profound passion for chiropractic care, Dr. Brian extends his healing touch beyond borders. He participated in Palmer College's Clinic Abroad Program, providing chiropractic care in Bolivia, South America. As a second-generation Chiropractic Physician, he embodies a commitment to his craft and a legacy of healing.

With the motto "Save Lives One Spine at a Time," Dr. Brian brings a wealth of experience in treating patients of all ages. From infants only days old to individuals in their golden years, he continues to make a positive impact through his chiropractic expertise.

Notably, Dr. Brian is the proud owner of six Family Chiropractic for Wellness offices, strategically located in Spring Hill, Inverness, Homosassa, Land O' Lakes, Brooksville, and Hudson. These offices serve as beacons of health and wellness, reflecting Dr. Brian's commitment to extending quality chiropractic care across multiple communities.

About the Host:

Dr. Joseph Esposito, D.C., C.C.N. C.N.S., C.C.S.P., D.A.B.C.N., F.A.A.I.M. C.T.N., is the Founder and Chief Executive Officer of AlignLife. As such, he is responsible for the direction of AlignLife as it expands further across a dynamic and rapidly changing healthcare landscape. Dr. Esposito has more than 20 years of experience in a broad range of businesses, including chiropractic, nutrition, technology, and internet marketing.

Dr. Esposito has extensive post-graduate academic accomplishments, as well as 15 years of experience managing successful chiropractic clinics in multiple states. He also is the founder and CEO of Aceva LLC, a service-based nutritional company providing products and services to the AlignLife clinics. As the former CFO of an internet publishing company, Dr. Esposito understands the power of leveraging the internet to impact the lives of millions of Americans.

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Dr. Joseph Esposito: Welcome to another episode of align your practice. This is Dr. Joe Esposito. I'm excited today for our talk about treating chiropractic opportunity for those of you who just graduated or have been either in your own practice or employed in a, in a clinic. We're gonna break that down a little bit. I have a guest today, Dr. Brian Dahmer, who is a second generation chiropractor. And we had a conversation about six months ago. And it was just kindred spirits. I just loved the way he spoke about this awesome profession, what he's doing for our profession, and how he supported chiropractor. So Doc, thanks for coming off.


Hey, glad to be here, Joe.


Dr. Joseph Esposito: So let's start on letting the guest know, you know, a little bit of your background. And then we'll we'll break down a little about the chiropractic opportunities that we have in the profession.


Dr. Brian Dahmer: Sure, yeah. You know, my father's chiropractor graduated from Sherman College in 1981 had been around it, you know, all my life. And I went to polymer in Davenport, Iowa, and just always had a strong passion to help people. And, you know, I knew that I would be good. Just seeing all the miracles and things that happened in clinic in even in my own home, when my father used to bring people home on a Sunday afternoon, and I had to carry them in, and then they would walk out. But, you know, I just, I had a drive and wanted to help as many people and and as we grew, I knew that, you know, I actually bought one of my father's practices out of the town that I lived. And, you know, we turned it around, and all of a sudden, you know, from 30 people a week, or we're seeing over 300 a week, and I had the opportunity to hire my first associate right out upon our Florida, plumber, Florida wasn't even in existence when I graduated in oh four. And we started to build a team. And then I was like, Man, I want to go practice where I live, I go to church, where my kids go to school there. What would it be like to open a clinic, you know, where I live. And that's where it all started, you know, with our journey. Now, fast forward, we have six clinics, we have nine, you know, chiropractors. And from that moment, back in 2006, when Dr. Patel joined our group, I haven't had a single associate, leave our office. You know, we've let a few go, you know, two or three that just weren't a good fit, and didn't have that same drive to want to grow. But we just created an incredible team environment where Doc's can thrive, that are just true. Caregivers want to be the best doctor they can. And they're getting paid really well, you know, working four days a week, being able to spend time with their families, and just love to collaborate, and they see the growth in the future. You


Dr. Joseph Esposito: know, I love that. And that's what attracted me to bring you on to the podcast is you've never had an employed chiropractor, lead your organization. And that gives testament to what I'm seeing in the profession. 25 years ago, I think most people took a job as a stepping stone to open a clinic and 99% had an opening their clinic. Now what we're seeing is about 30 to 50% of the profession suffering because running a business, it's not the same as being a doc, we don't see a lot of surgeon saying Oh, I wish I opened this hospital. They want to be a surgeon, they want to serve people in their professional. So the expectation that every chiropractor has to run a business is destructive to this profession. because not everyone's wired for business. And we shouldn't expect that. So pardon me, Doc, because I want to edify the practitioner. I want to edify the people that are in the art of chiropractic that are delivering it serving and helping people live better life, because that's what this is all about. If you don't have the knack for business now in this, in this stage of chiropractic, there are amazing opportunities for you to be a caregiver, deliver amazing care. And Dr. O'Brien hats off to his organization and not having to ever have a doctor lead. So what do you attribute to a difference? And you know what I mean by the stereotype work, we they say hire practice aid, they're young, there was no salary you couldn't stay, even if you wanted to, because you couldn't feed your family. What do you think shifted? Now, these days, like your clinics, there are strong opportunities and align life we have opportunities for doctors coming in, they could either be employed, or they can buy a franchise and run their own business, whatever the risk and reward they want, and how they're wired is where we'll let them go. But what do you think the changes whether it be your business or this profession that's allowing caregivers to have a prosperous abundant life as a target? What are your thoughts? You know,


Dr. Brian Dahmer: I think that number one when you come out of school because I actually just hired two dogs out a plumber in Iowa they were actually in the same class. And I didn't mean for that to happen interviewed completely separate, I think I did 32 interviews before landing on both of them, and they just joined two months ago. And the collaboration in the friendly competition that they have is just so much fun. In their complete opposite personalities, you know what I mean? One is really in the sports, he just did 75 days hard, he's in the gym, he loves to taking care of athletes, you know, and he comes from a family of contractors and, and the other is just incredibly intelligent, more of a teacher, a great listener, you know, acupuncture Certified Used to be a massage therapist. So different backgrounds, and what happens when patients come in, you know, we'll have grand rounds, where we put clinical cases up, and everybody kind of comments on, you know, what's going on how they would be treated, the care plan, they would set up. And when you have several minds, and people in the same room collaborating, the patient wins, because they get just better care. It's elevated, new techniques and new equipment that we're constantly adding to the office. So it's never antiquated. It's always cutting edge, you know, we have digital X ray, and all our clinics, everything's paperless, if a patient comes in their information is overall six clinics. And so, you know, a lot of doctors when they're coming out of school, they don't want to stumble and try to figure out in 10 years, what they could learn in two years. And so we say, Listen, if you know you want to launch and you want to go somewhere and open up, that's perfect, but a lot of dogs when they get in it, it's not just about the resources that that are there is the group, but also they're having fun. And they can go on vacation. And we have other Doc's that they know, like, and trust covering their patients, so they don't have to come back to double the work. And oh my gosh, this person fell off their care plan, or I got, you know, my, my new patients are stacked on top of me, and I can't even enjoy coming back from my vacation because I have all this work. And so it's already taken care of, and we're helping each other that way. We pay well. And I think I always put myself in their shoes, because we know as chiropractors, it can be exhausting physically, mentally, emotionally, you know, you come in and, you know, the patient wants to know how long how much can you help me and maybe they're a little irritable, because they're in pain, and it's our job to you know, have the skin of a rhino and soul of an angel, right, and just kind of turn them around in once we get that first result. And they're feeling better than we know that they're going to, you know, stay pay refer and then move on to that that wellness that we all strive for. And, and that is our, our final valuable product for all our associate doctors is to be able to take someone as a new patient through a care plan, get them out of pain, and then get them to wellness, in renew on wellness to maintain their health. And that's the stat that I look for in any associate coming on.


Dr. Joseph Esposito: So you said a couple things. So one of the things that provides the environment is and I'm thinking of doctors that are listening, that are looking to hire their first doc, their first doctor, converting from just having a job to building a business by employing doctors. So there'll be people listening and trying to mind your conversation for what do I need to prepare for. So one of it is a fun atmosphere. That's pretty important. And you mentioned that, because I like that myself, I create an environment where people like, at the end of the day, they're more lit up than when they came in, they had so much fun. They they miss the team when they go on vacation. Like that's the energy you want to create for the doctors that you hire. The second thing you said is they don't have to deal with a lot of the minutia of a practice, they got coverage, so you're making the opportunity more seamless and less stressful. So they have fun, they don't have to do a lot of the detailed work. And they get to focus more on their, their their craft. Any other advice for the doctor that's about to hire their first employee in Cairo. Those are two good pieces, anything else that you would say, guys build this or set it up this way? Or,


Dr. Brian Dahmer: you know, I would just say have a strong benefits package, have a strong, you know, salary, don't be afraid of that and make sure you write down your plan. I mean, when you hire a dark, obviously, you know if you're doing things right, they should be in the blank 90 days. And so you need to have a plan for that. And, you know, what are you going to do that's going to bring value to the practice once this associate is taking on the patients, maybe you're seeing yourself or or maybe you're just trying to add I think that it's important to have regular meetings with your associate doc, even when they're, you know, you know trained and they're just no ons go, I meet with all the docs once a month, we have different clinical excellence goals, I pay for their continuing education, you know, pay for their malpractice, do retirement have a strong benefits package that way, I had one doc that I even did a life insurance policy with. And this is kind of a unique plan. And, you know, he wants to be an owner in the future, I saw just a great talent in him and knew he's going to be really good. So it's over 10 years, and I put $10,000 in this policy each year. If something happens to him, he chooses the beneficiary and has a half a million dollars to go to whoever he wants. If he leaves before the 10 years, it just comes back to our company. And we would start over but if he finishes, he gets $100,000 cash at the end to do whatever he wants with, you know, and of course, I'm hoping that he invest in the practice and buys it. If not, if he just stays on wants to be a part of the group, then he's got a great bonus that he can do whatever he wants with. And so, you know, he was really excited about that I saw, you know, something special on him at the very beginning. So that's just an example of creating a good win win relationship, you know, with an associate right off the beginning,


Dr. Joseph Esposito: I like that. And there's another model of earmarking a piece of your percentage of revenue that they are driving, you're marking it aside that sit in an escrow account the same vehicle where there's money down on a purchase one of your clinics or expand in your organization or go out on their own 10 years later. So it gives them a piece of a nest egg that they can use for something where 1% of 5% or whatever you do put aside and again, if they decide not to continue, then they lose that money down. If not, they have some kind of downpayment. So yeah, I like those vehicles were over, they could see a vision over three 510 years, helps build longevity in the office as well. The other thing I recommend is that we make sure that we know their core values of what how they how they're wired, and making sure that we help them honor their values through their business relationship with us. So what are they trying to accomplish professionally and personally, and not just train a doctor but develop a doctor. So doctor that is able to generate 30 grand a month in revenue is different than a doctor that can generate a million a year in revenue. So you got to level them up and they want to be continually developed. Don't think you just train them on the first two weeks and be like, Okay, why work? No, absolutely not. Right? They want to be developed. And then they enjoy that journey. As long as they're continuing to develop. I think you have a good win win relationship. And also, don't be afraid to open the door to conversation meaningful. Hi confront conversation about work, economics, the equity exchange and the relationship to make sure that everyone's feeling that there is a strong relationship. So I'm sure you have, over the years, you have some tough conversations sometimes or someone feels a certain way. And you you have an open conversation and build the relationship stronger. Right? I mean, that's just


Dr. Brian Dahmer: absolutely, absolutely. I mean, I had one doc that was looking to open a practice right down the street, signed the lease and was ready to leave and was afraid to tell me then, and, you know, my staff found out about it told me about it. I said, hey, we'll have lunch with you today. And you know, I pulled them in and I said, you know, what are you doing? I said, Have I paid you? Well, and he said yes. So they're giving you a good opportunity, great, you know, environment, you know, we always update to the newest equipment, anything you've asked, you know, I've tried to provide make your job as easy as possible. All I ask is if you if your PPF like you mentioned your personal professional financial goals, if they don't align, that's, that's fine. Just tell me about it. I mean, I will gladly give you recommendations and help you, you know, go open wherever you want to open. And so we had a long conversation. And you know, at the end of the day, he came back and said, You know what, I don't think I want to take on all that, you know, stress and I just want to stay here. And he's like, I think I just wanted to inquire because I know I can do it. And I'm like I know you could and you know it's just a matter of you know where you want to be 10 years from now. And so you have to have those regular meetings and you have to talk about those things you have to renegotiate sometimes contracts and and I did it wrong at the beginning you know I was basing it based on patient visits and in other you know quantity because I that's just where I came from high volume and now I do it more on quality and outcomes and just no more you know What hits the bank and is collected, so it doesn't matter the case type or if they sell a pillow or a vitamin, you know, they're they're getting a piece of everything and, and we create a win win, especially when you have multiple docks at the same office. So I think those are very important conversations to have along the way, and you will renegotiate from time to time. But as long as you have your percentages, and you know what your costs are, and your employee cost doesn't go over that percentage, then you have some room to get creative.


Dr. Joseph Esposito: And my advice to you if you have associates, first off, open the door for those conversations. Second off, don't make decisions during the conversation. If you unsure, you got to look at your business model, you got to make sure that the relationship can be maintained. But as Dr. Dahmer said, if their personal professional or financial goal is can't be met within the context of what you're able to provide, it's okay, work together, make a plan together, honor a separation if that's the best solution, but keep it where we have a brotherhood, or sisterhood in chiropractic that we we love this profession, I think I see too much negative relationship in that it just breaks my heart that I have every practically every associate ever had, has been mentored me, I mentor them after when they left to guide them and help them on their journey. And it's feels good to be able to keep relationships, even when there's not full alignment on some of the future things. So if you're in practice, just plan on that and plan on not only, like I said not only training but plan on developing that's a key component of making sure that there is good equity exchange in the relationship. They want experience. They want the scar tissue, they want it easier, better systematic way of delivering the care with all of the infrastructure of the clinic. Awesome. So get give me some thoughts on opening like doctors are looking at opening multiple clinics, he went from one to six was that over a short journey, a long journey? Because again, we have people that are in their second, and they're like, What is the future look like? Well, let me ask you this question. Which one was the hardest? The second?


Dr. Brian Dahmer: Definitely the second, definitely a second, you know, and you know, once you do the second, the third was a little bit easier. And then after that, it's like, okay, you know, let's, let's go for five and six came, you know, within a year and a half. And so, you know, you know how to scale, you know how to hire you, you're not afraid to take that risk? I think the biggest scariest thing is, you know, what, if I hire this associate doctor or open a second practice, I'm in between two offices, we build a volume that I can't possibly see myself and they leave. Right? And what are you going to do? And that's always a scary thing that the other scary thing is, what if I can't afford them? I bring them on and have this salary and extra overhead, I have to hire another ca and and then you know, how long am I going to have to float this doctor before it's profitable, and I pay back my investment. So those those are the parts that you really have to plan for. And just create backups. I would say the first thing is you get with your marketing team, and you do a waiting list practice and you figure out how to pre launch this associate doctor that you're bringing on. You know, the two that I just brought on before they even started. I mean realized credentialing takes a little while to if you're in you know with insurance, you got to talk to your credentialing team, how long is it going to take to get them on the plans that you're on. Because at the beginning, it'll just be cash and maybe personal injury, something like that. So you want to, you want to start at least three months ahead of time. And doing some interviews with this associate that you can put on your, you know, social media, you build up their profile on your website, you start to have them be an exam doc and do screenings in your community. And all of a sudden, you build up a waiting list of new patients that are ready for the opening day. And it will make it a lot easier to be profitable early in the first you know 3060 90 days and then sell from there. You know and then you just continue to you never stop interviewing. Because you'll get better at interviewing, you'll create backups you'll find Doc's that maybe won't be a good fit full time but they'd love to be a philan doc for you just in case you know something happens you have some backup there. And then eventually you replace yourself if that should go and become you know phase two and working on your business instead of in it eventually as you multiply it's it's very necessary. I stopped seeing patients about three years ago and then just became a clinic director and so my job is to you know, train and, you know, lead the group forward and keep bringing new services in Um, you know, things that I couldn't do when I was seeing, you know, 350 people a week.


Dr. Joseph Esposito: So what do you think, to make the next office? Do you have a parameter of saying like 30% margin or X dollars of free cash flow on the last clinic? In order to open? Do you have a marker that you would say, like someone's in their first clinic, they're eyeing the second they're doing, they're doing really well. And they're wondering, Am I ready for that? Second one? Do you have something in your mind that you would say, don't jump until x? Do you have a thought on that? Yeah, absolutely.


Dr. Brian Dahmer: I mean, I think that it's important, I mean, I have a goal to pay the clinic off in two years or less, you know, whatever, build out equipment that we've put into it. And as long as I have paid off 50% of my initial investment, then I will launch the next one. The other thing that's important for me is I've always wanted to be within a 15 minute radius, or we're in three counties, we have two offices in each county. And every time we open another office or overhead drops, because I get on the radio, and I talk about, you know, our clinics that goes across all six locations, so that $250 investment on the radio now is split six waves. We have a full time marketer that goes around and markets to attorneys and doctors and does events, health fairs, those type of things. And we'll have, she just did, the manatee festival is a two day event, she you know, signed up 20 new patients, they ended up being dispensed between three clinics. So my marketing cost goes down, my billing cost goes down. Because now my biller is are you know, taking over and splitting, and then the admin cost your regional manager goes down. So I think that you when you have a bigger footprint, also you'll have we're in north of Tampa, in Florida, and there's a lot of attorneys in Orlando, Tampa, even Miami, that are marketing all over the state of Florida, and they look and they see wow, there's this royal area, you know, they look us up and we're getting referrals that we never would have gotten before. So, you know, when I launch and I look 50%, you know, paid on the clinic that we open make sure that we have a certain amount of profit margins and then we launched the next one that I try to keep it in that area. Also for staffing reasons because sometimes we'll bring up a manager in the office and say, Listen, we're going to be launching How would you like the opportunity, you know, to be promoted and go be the point person in this launch? And it's worked out really well that way. That's


Dr. Joseph Esposito: awesome. That's awesome. Well, awesome, great conversation. I really appreciate your time I appreciate we do it's his profession. I love that you're a principal doc building big business a lot of people think when you're the principal doc you there's a stereotype that the business is separate the people I do business and the principal, but I I love meeting principal doctors that are doing amazing things and building abundant businesses because that's what this profession needs. So thanks for all you do for the profession, the way you treat your doctors and the business insights that you provide. And everyone thank you so much. Absolutely, Doc, for being here. Thank you




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