Radio Front Desk
Radio Front Desk is a podcast that talks to real people in real clinics about what it takes to build a health and wellness business.
Host Denzil Ford, Editor-in-Chief of Front Desk magazine, digs into the inspiring stories of folks building their practices from the ground up — including what works, what hasn’t, and everything in between.
Created by the team at Jane App, this podcast is your source for discovering fresh ideas and proven strategies for clinic life. Join us on this journey of building a practice you love.
Radio Front Desk
What does it really take to start a practice? | Joseph Ibe: Chiropractor, business owner, and investor
Joseph Ibe is a seasoned chiropractor, business owner, and investor - what some call a multi-hyphenate, and for good reason. He’s spent time building and flipping clinics, breathing new life into businesses that need it, and giving the next generation of practitioners a stake in the ground.
In this episode of Radio Front Desk, Denzil learns about what it actually takes to get started building a practice. Spoiler alert - according to Joseph, it’s not as scary as you might think.
To check out more stories like Joseph's, head to frontdesk.jane.app.
Dr. Joseph Ibe is a Blair Upper Cervical Chiropractor with 14 years of experience in private practice and a serial entrepreneur focused on health-related ventures. He thrives at the intersection of technology and patient care, always seeking innovative ways to improve outcomes. Driven by an unwavering commitment to the patient experience, Dr. Ibe believes exceptional care is the foundation of every healthcare provider’s mission. His vision of a healthier future is built on utilizing technology to advance well-being, stating, “I believe in a healthier world with healthier people utilizing technology to advance their wellbeing.”
In addition to growing his practice, Dr. Ibe has ventured into the startup scene, enterprise-level projects, and academia, gaining valuable insights from each sector. His work reflects a belief that the pursuit of serving others is endless and that healthcare professionals should continually evolve, learn, and apply their skills across various industries.
Dr. Ibe is passionate about creating solutions that blend technology and humanity, helping to shape the future of healthcare. His enduring mission is to inspire others to strive for excellence and to pursue service to their communities with relentless dedication.
This podcast is for informational purposes only and should not be considered as professional medical, legal, or financial advice. The views and opinions expressed in this podcast are those of the guests and do not necessarily reflect the official policy or position of Jane or Front Desk magazine. Listener discretion is advised. This episode contains mature content and language that may not be suitable for all audiences.
There is a new generation of chiropractors coming through schools that are heavily in debt, that lack the business know-how to open or maybe the confidence to opening up a clinic or going to private practice themselves. And that's not anybody's specific fault for new practitioners, but they may need a middleman or an earlier generation chiropractor like myself, the 10 to 15, maybe 15 to 20 year out that can help them along the way.
Speaker 2:Joseph Ivey is a seasoned chiropractor, business owner and investor what some would call a multi-hyphenate. Now, that's a big word, but I'm using it for good reason. Joseph has spent time building and flipping clinics, breathing new life into businesses that really need it and giving the next generation of practitioners a stake in the ground. In this episode of Radio Front Desk, we'll talk about what it actually takes to get started building a practice. Spoiler alert according to Joseph, it's not as scary as you might think. Welcome to Radio Front Desk, a show that surfaces what real people in real clinics are doing to open, run and grow successful health and wellness businesses. I'm your host, denzel Ford, editor-in-chief of Front Desk Magazine by JNAP. Here we have powerful conversations with health and wellness professionals on the business side of clinic life. We hear their stories and discover what works and how to do it, and we also talk about what doesn't work. If you want to check out more stories like this, head to frontdeskjaneapp.
Speaker 1:Let's start with a fun story with my first clinic. So the first clinic I opened was downtown San Mateo. It was a very interesting color, like avocado yellow-ish, green wall, low light place and, um, you know, immediately when I was signing the lease, I'm like, oh my God, am I really doing this? Because I was excited, and oh my God, am I really going to be seen in this office? Um, but, nonetheless I'm. I'm really fortunate for the opportunity.
Speaker 1:Uh, dr Anthony, who gave me that first opportunity, really gave me the latitude in his, you know, avocado colored office to say go, and I'm really appreciative of that day because I felt like that was going to make me more of a doctor. And after the first year I was fortunate enough to be able to grow out of the space, move right outside of downtown San Mateo, affectionately known as like doctor's row. It's where, like a lot of the private practitioners are. I spent my next 12 years in a brighter office white colored walls, nicer paint, nicer aesthetics and then, just last year, we actually relocated because the landlord had sold the building next block over, I guess today I would say, certainly a minimalist approach. I think if you're looking at your background, denzil, it's probably very similar aesthetics. Got some plants Doesn't have a white tiger with a scarf on it, but maybe one day.
Speaker 2:So just wondering if you could give some advice to people who might be in that same moment of their career journey, their entrepreneurship getting started, picking a space, and what are three things that you think are critical during that moment? And maybe like one thing that I don't know if you would avoid it, or one thing that you know that kind of a mistake, if there's anything you could think of and you feel comfortable sharing. People like to hear about what went wrong.
Speaker 1:So a lot of things went wrong. Let's start with the three things like just starting the practice One I would say for any provider that has the ability to go into private practice, like chiropractors, it's not as difficult as you think. More often than not, we kind of get into our heads and thinking like, oh, like there's a bazillion things I have to do, like this corporate entity that like Apple and Google and Jane, right Like it's, there's no way I can like develop that in. You know, a few months after, or even a few weeks after, you know, getting licensed, that's probably number one. Is it's not? It's not as scary or big as you know?
Speaker 1:Getting licensed, that's probably number one. Is it's not as scary or big as you think? Right, it is quite easy and logical to do. The question is what steps are you willing to take and what risk tolerance do you have to actually developing it? I started really small, right? I didn't have a ton of money, I had just graduated, and so it was very scary for me to consider opening up a private practice and so, ergo, a lot of my decisions were based around, like my budget at the time. Yeah, yeah.
Speaker 1:You don't have to open up a five-star. You know glass ceiling, you know floor-to-ceiling location right off the bat. Build, grow into it and then lean into it after that. I think the second thing I would recommend or maybe even speak to providers about after like getting over that initial fear is partner with someone or work with someone that's done it before so you're minimizing the mistakes thereafter. Now there are coaches out there. Chiropractic coaches are. There's a lot of them and I I wouldn't necessarily say for that, for those that are like starting up practice you need a coach, maybe a being semantic, maybe a consultant or someone that's just done it before that can lend you a helping hand to get you some to minimize those mistakes.
Speaker 1:The third piece once you open up shop, don't look back. I've I've gone through a bunch of Tony Robbins conferences and experiences, and one thing he talks about, at least the one thing that sticks in my mind, is burning the boats. Fully commit to that private practice, to growing that entity. I'm a parent, I'm a dad of two. My wife and I have raised, you know, boys. We have a 14 year old, which is a whole other story and similar to having kids, though you just got to pause whatever your life was before that and hit the start button on your life moving forward. Early mistakes for me I'll sum it up in one and that was having a consistent fear that I wouldn't make it, and that held me back from making quick decisions.
Speaker 1:Right, I'll give you an example. I probably spent like when I first got started this is before I even opened the clinic I probably spent like two weeks like deciding on a bank and a merchant service. And it was like dude, choose a bank, right, they're all relatively the same, you're not loaning any money out at the moment. And a merchant like dude, choose a bank, right, they're all relatively the same, you're not loaning any money out at the moment. And immersion service all they're doing essentially is like swiping a card and you're collecting money, like the interest rates are relatively the same, 2.75, 2.4. Like, does this really mean that money? And so that inhibition to pull the trigger, that fear factor, I think, was me. For me, it was a big mistake.
Speaker 2:That's an interesting one that you talk about payments, because a lot of people really do lean into worrying so much about those fractions of a percent and they do multiply out if you're processing a lot of money. But it's interesting that you're like just get started with something.
Speaker 1:That's really interesting to me, yeah, and so nowadays, when I think about like the decisions I make in life, kind of 14 years, 13 years forward, my decisions are far faster, they're well thought through, but I don't take weeks to consider what bank account I'm going to move.
Speaker 2:Yeah, interesting. So talk to me a little more about, on that note, operational efficiency for someone who's just getting started, really small. What could they focus on, like? Is it some sort of technology? Is it really focusing on getting people in the door, like what is like the best way to focus to keep your clinic running efficiently in those early days when you're small?
Speaker 1:Yeah. So I looked at my clinic as one like big project plan and the emphasis and time was focused on the things I did the most. So, for example, like adjusting as a chiropractor, your main, your main service is not actually adjusting, it's detecting in vertebral subluxation and then correcting it through the subluxation I'm sorry, through the adjustment as needed. So be really honed in on your professional skill first. If you're not there yet, I encourage you to not open up practice and hone that part in just yet. And I would say that for any healthcare professional right, you've got to know it almost automatically. Is that a word Automatically?
Speaker 2:I like it. I like it.
Speaker 1:We'll go with it. You've got to be automated in your services provided. And then the second piece for me was the clinical components of like soaps. So I took on an EHR I happily use Jane now and learned all the facets associated with the clinical aspect of soap.
Speaker 1:Charting, or charting notes. That was really heavy for me because it's like, well, if I can't adjust a patient, that's one piece. If I can't chart my notes timely and then bill out based on that and then receive money on return. Those are two or three most common things. And the third one was patient interaction, or what other businesses know as maybe like client or patient experience. So I spent a lot of time on that and understanding what the walkthrough was like when they walked in the door, the interactions that we had with either me At the early times I didn't have front desk and I would argue that a lot of young practitioners I've made a couple bucks to go forward somebody, and I know all the aspects of that particular job set. Then I can hire somebody applying systems, thinking to a clinic and making. It's not just about efficiency, though.
Speaker 2:It's also about when you're talking about the front desk there and how the clients walk in. You're really talking about the patient experience as well. I wonder if you could elaborate on that a little bit, how you think about a patient experience in their whole journey throughout your clinic.
Speaker 1:I model a lot of what I like I'm sorry, what I do in clinic to the things that I like in in my own personal life. Two companies I follow, certainly not exclusively but very deeply. One is Apple right and second is the Ritz-Carlton.
Speaker 2:And I will tell you, Ritz-Carlton is an excellent.
Speaker 1:Actually they're quite aligned, yeah, behind the scenes.
Speaker 1:So if you, if you take it even like a quick google search, you're like apple, um, ritz-carlton and then steps of service, right, you'll know that each company has um and they're on. They're both individual, but they have steps of service. That's like how to engage a client or a customer, right, and I would study that in-depthly, like okay, what does it mean to do this, what does it mean to do that and think about it on the consumer's end. And so earlier I have, like my wife and friends, like I would do something or I'd talk through it, I'd have them run like role play with me in the clinic just to see and feel like what their engagement was going to be like.
Speaker 1:Now, please understand, like, again, I didn't have bazillions of dollars to throw at a really fancy office and make it, but I was like what could I do, given the space, given my time, given my you know, my bank account, really to afford them the best Ritz-Carlton-like experience? One example Denzel is using first name when they enter the game. Denzel, nice to meet you. Hey, happy to see you 11, 15, you're right on time.
Speaker 1:A level of acceptance, some chit-chat inside the patient office or in the room to talk about how the tiger's doing or how the kids at home are doing and really getting to feel like a sense of belonging. And then one of Apple and Ritz Carlton's is like a fond farewell and an invitation to return Right. And so when Denzel leaves the office space and maybe they've in my office we don't bill on the spot, meaning Denzel can walk in with just her keys to her car, no wallet, no ID. I mean, obviously we know who she is, but she doesn't have the need or is forced to pay at the time of exit. She'll get an invoice and she pays that within three to five days. We've built that level of trust with our clients and patients. To say one we trust you, you're a family, we're going to be taking care of you and ergo we know that you'll pay within the allotted time.
Speaker 2:Oh, I love so much about what you're saying. I have a few clinics that I go to and that's how it works. Mostly, I think they have a credit card on file, but the act of not having to pay when I leave after I've received this care, that kind of puts me in a particular physical and emotional state. I just love that aspect of the patient experience personally. So thank you for bringing that up applying the hotel experience, the luxury hotel experience, to a clinic, because there's so many wonderful examples of luxury hotels where they put so much effort into the customer experience as part of the overall thing, and to the point where, if you stay at one of those hotels and then you go to a normal hotel, the way you interact with the staff is like wait what I can't interact with these people the same way I do at like the Ritz Carlton, so love that example, also very tactical, because you can kind of think about what's happening and then think of ways that you can implement that yourself.
Speaker 1:Yeah, the next time you go to any hotel and it doesn't have to be the Ritz Carlton, I just so happen to love the brand Right and obviously, like I, stay at other hotels as well. But my point is, when you get accustomed to high quality service, it doesn't necessarily mean high ticket cost. But when you get into high quality customer service, you start to understand that people are one, people love it, they're attracted to it, and two, they'll pay you just for that experience, right, totally. And we, my wife and I, own a fitness studio. One of the things that she's infatuated with and I'm like scratching my head over it, but I was like, yeah, it makes a ton of sense is the fragrance in which we walk in, so we have fragrances.
Speaker 1:It's a larger fitness studio and there are three different fragrances based on the the walk-in, the midsection and then the locker room area. And I'm like, abby, I don't understand that. And she's like, no, trust me, it works. And I'm like, yeah, okay, it works, right. The Bellagio is an example. We were just recently in Vegas and if you've ever been to the Bellagio, even to this casino ground, it's very difficult for you to smell like smoke or booze. You'll smell a very floral, vanilla-like scent all the way through and you're like, wow, this is a great experience.
Speaker 2:Yeah, there's. Actually. I have an academic background as well, I have many lives as a career person, but there's a whole sector of history, of philosophy, history of science, that talks about the environment, the role of objects in the course of history, but also they veer into the role of smell and the role of sound in the course of history. But also they veer into the role of smell and the role of sound in the environment, but also it's not just the environment, but it's it shapes how people interact with one another, like, quite literally, it's very fascinating stuff. Yeah, yeah, I love that you're bringing it up.
Speaker 1:For the small business owner. Look you, maybe you don't have control over the HVAC and can insert like vanilla notes into it, or maybe you don't even have an HVAC system at all. You just got an open window, but there are things that you can do that associate with your target market or your ideal client, whatever business phrase you want to insert there that would attract them subconsciously to you and ultimately add more engagement to their interactions with you, the provider, and them, the patient client.
Speaker 2:I have an example in my personal life. I see this massage therapist and he's a sports massage therapist, so it's very the lights are on, no music, it's very like nuts bolts, um, but he, he and I talk while he's doing the massage and I'll talk about movies that I'm watching with my kids and he. Next time I see him, he, he will have watched the movie and then we talk about that movie and it's it. It is quite literally one of the reasons I go back. I mean, he's also a very talented massage therapist, but just that experience of getting able to have, like a real relationship with this person, that is a, you know, periodic part of my life. It makes a difference. It really makes a difference.
Speaker 1:And it didn't cost him anything. I mean, assuming the movie was like online or on Netflix or what have you right, it did cost him a lot to say oh yeah, let me watch that movie and hope that Denzel has a better experience by talking through it.
Speaker 2:Yeah, yeah. So let's switch gears a little bit to entrepreneurship and how you've approached that. So you have a clinic ownership, but you've also done other kinds of entrepreneurship with the business side of clinics. Would you talk about that for a little bit? Sure.
Speaker 1:Yeah. So I own a practice in San Mateo Again, it's 14 years old, called True Health Centers, and over the last several years I've had an opportunity to move and diversify that. And what do I mean? I've had an opportunity to purchase clinics, slot associates into them, see how they grow, cause I'm fascinated with this idea of, like multi-clinic, but I don't want to be seven, 10, 20 places at a time. I want to see if I can replicate and this is for no one else, this is not for a specific dollar amount. I actually just want the challenge from my own personal knowledge to say, yes, I can do this. Yes, I can replicate myself.
Speaker 1:Yes, what I've been thinking all these years in my San Mateo office or in a fitness studio or in our plant shop, I can do in the clinic space. And so we've been fortunate enough to have multiple locations around the Bay Area. It's been a great experience. It's not all rainbows and sunshines. It's starting all over With a practice that I've purchased as an example, the most recent practice we purchased. You think that you're going to walk into the patient base and the accounts receivable you signed on the dotted line with, but the reality is, and it goes for any business. You know there is a level of attrition with patients because again they follow the doctor and they had the relationship with the doctor not necessarily the new person.
Speaker 1:You know, obviously sometimes, depending on the practice acquisition, you know, you might want to change some of the aesthetics and so one of the learning things I kind of like epiphanies was like, hey, like for the first, like six months, maybe even nine months, maybe a year, don't touch anything, keep it as you know, keep it as regular or normal, as the last owner had, in hopes to gain goodwill and ultimately engagement with the existing clients to say, hey look, I'm not a bad guy, I'm not turning away or I'm not doing anything bad to your experience, and then slowly adopt new things over time, that kind of match your needs and desires.
Speaker 2:Yeah, I think that's a like big goal story, just thinking of our listeners and how a lot of our goal here is to talk to people who are opening and running, grow and growing their clinics. But then the next level is like wow, how can your story is this like so inspiring? Because you can also think of this next level where you're kind of like becoming an investor in this industry.
Speaker 1:um, that's a really good point too. Denzel is like we're in a really unique generation, um, and what I mean by timing? Um, so I'm 10 to 15 years old. That's where I good point too. Denzel is like we're in a really unique generation, and what I mean by timing so I'm 10 to 15 years out. That's where I, like I kind of categorize myself.
Speaker 1:There is a new generation of chiropractors coming through schools that are heavily in debt, that lack the business know-how to open or maybe the confidence to opening up a clinic or going to private practice themselves.
Speaker 1:And that's not anybody's specific fault, it's. Chiropractic schools are focused on educating and graduating the best chiropractors that could be in the world right To taking care of others rightfully so and so it does require some postgraduate education. I don't think you need an MBA, but I'm not the judge of that. I think you need, maybe a consultant or a friend that says, hey, help me through this, and then walk through that with them, and I'd like to think that my generation is supporting this new generation by offering them opportunities Sometimes it's employment, sometimes it's equity stake or ownership opportunities to get them off off, off their off their feet, right, yeah. So that's, that's really unique and I'm, you know, and a lot of baby boomers are, you know, moving away from active private practice. Maybe they're trying to settle down, and so the world is offering a really huge opportunity for new practitioners. But they may need a middleman or an earlier generation chiropractor like myself, the 10 to 15, maybe 15 to 20 year out, that can help them along the way.
Speaker 2:Yeah, let's dive into that a little bit. So when I think of like mentioning a few buzzwords, when I think of coaching, I think of somebody sitting with another person and kind of drawing out what's already inside of them and helping them see themselves and their abilities in a different way. And then there's consulting, which is kind of like the person has like what it takes to execute something and you're helping someone else. So first do you agree with that and then maybe you could dive more a little bit into your involvement with the consulting side of helping this next generation.
Speaker 1:Yep.
Speaker 2:Yep.
Speaker 1:Without judgment. I think there's a bazillion coaches out there, and if you jump on Instagram or any major social media platform, you'll find one. People that are experts in whatever field that you're considering looking into, including parenting right.
Speaker 1:I mean, I get my parental notes or my guidebooks from social media influencers and a lot of them are offering coaching videos or universities to masterclasseses and all good. Please like, allow that to flow in abundance. But as a new grad, I don't know if you need a coach per se as so much as a teacher slash consultant. That again has gone through it. That is maybe an SME or like subject matter expert in that particular, like dissection of your, of your business career, opening a practice as the example and letting them support you through that piece alone. I think that's important. I've been able to consult with enterprises, startups. I have fun in both. I think I enjoy startup a little more because the fluidity of decision making is required, right and enterprise. You can hide a bit behind timelines and budgets and committees.
Speaker 1:Right, I enjoy that as well, Dividends are a bit higher, but my point is similar to education well, let me take this another way. Education well, let me, let me take this another way. These students that are graduating from chiropractic college likely have gone directly from like K to eight, eight to high school or so, like nine to 12. And then you know you need at least 90 units to go into chiropractic college. So let's, but let's, assume they did their bachelor's degree right. So they went how long in school and kindergarten to graduating through undergrad into grad school. They've their minds, have been trained, if you will, to have a teacher, give them a step by step before they start to like develop their own initiatives and take their own actions. And so I think, working with a consultant that's done that like right, maybe at the tail end of graduation, circa like nine months prior to graduation, six months prior to graduation, probably through your first year, maybe two years, of opening up a practice. So you're minimizing the mistakes, because some of them are costly.
Speaker 1:You look at a lease agreement. You know, you, that if you break the HVAC system, and that's ownership on you, not the landlord, that's a $30,000, $40,000, $50,000, $100,000 mistake. And you're like, oh gosh, I didn't know that and I thought I was just renting this space.
Speaker 2:Yeah, another one I could think of is hiring too early. Maybe you know you hire someone too early, you aren't quite ready, and then it doesn't work out, and that's a very expensive mistake as well, both in time and energy for sure. So what do you think? Oh, go ahead.
Speaker 1:Well, I was going to say when hiring, I think I would rather hire too late than too early.
Speaker 1:And here's what I mean by that and you mentioned it earlier in the podcast is that you don't want to know every aspect In this case. You know pun on the front desk situation. You want to know everything about the front desk how to receive a check or cash, how to deposit it, how to schedule out for the doctor or yourself. In that case, understanding like the exceptions to the rules, and well, someone can't pay today and or they're arguing about this or that, um, or complaining about this and that and how to like move the business forward or the interaction forward, um. You want to know all that before you start to hire that first person so that when you train them and assuming that you're the owner and you're hiring your first employee, let's say the front desk staff you're giving them real world experience and affording them again fewer mistakes as possible and ideally at that point you have the capital to hire them part-time, full-time, because now their sense of belonging and their bills are on you as the practitioner or the business owner.
Speaker 2:Yeah, I've not heard that yet. Make sure that you understand everything at the front desk before you hire someone. I think that's a really helpful little nugget, so thank you for sharing that. I'm wondering what else you think that this next generation of students could benefit from in terms of looking at the business side of what they're walking into in this career.
Speaker 1:Yeah, let's see what could the next generation yeah.
Speaker 2:Let's see what could the next generation Like. Maybe we could talk about like opening their practice, like what, what do they, what do they need to be doing, that they maybe just don't come out of school right out of the gate? Understanding?
Speaker 1:Yeah, that's a great question. I would say start selling a product service now, like while you're in school, I'm fortunate enough to be able to speak to some of the younger classes or guest lecturers, younger chiropractic students, and the most common advice I give them is start to sell a product service now. In fact, open up a business now, and that comes into many different fashions, and what I mean by that is, if you're comfortable and like want to go through the steps, either on your own or with some help, open up a company, open up a corporation, open up an LLC in the state in which you hope to do business, or just do it in the state that you're living in at the moment. It doesn't even have to be that. Open up a soul prop and learn the business side of things simultaneously to your studies. The reality check is you will never have like a solid eight hours or 10 hours of the day, especially if you have kids, right, You're going to have pockets of time to learn things, and so in those pockets of time rather than maybe on, you know, scrolling through social media or on Netflix take that pocket of time and like learn how to open up a sole proprietorship in the county in which you live. Open up that and learn how to sell and receive money.
Speaker 1:Maybe you make we have a family member that is really big into like um, I don't know how like crocheting and they build like these guides and they sell online, um, these, these little, I'll say these cute little masterpieces. And you know they did that step by step. So, as a chiropractic student, as an example, like start crocheting like hats or you know making fun t-shirts or not even that. Make like little you know bracelets that you know you can buy the stuff from I don't know Michael's or online and Amazon. See if you can sell it to build an audience, Right.
Speaker 1:And then secondly, like, learn from those opportunities. So let's say I sell you know a bracelet and make them for five bucks. I, you know it only costs me a dollar. Now you're learning about, like profit margins. Someone takes payment like hey, like I'll sell you or I'll Venmo you or I'll, you know I'll, I'll tap it on square. You know you're learning about payment processing. So by the time you graduate you can take that knowledge in those pockets of times. It's like selling bracelets as an example, um, and apply it to a larger scale, aka like a clinic wow, interesting.
Speaker 2:You're literally saying take like a, a much smaller I don't know commercial transaction and use that to learn.
Speaker 1:So interesting, yeah, that's exactly what I'm saying I and, if you think about it like, well, if I think about it, rather, I was doing that through my school and I'm just sharing what I did right when I wanted to. Um, I helped found I'm a co-founder of mission trip america, now known as service trip america, where we offer complimentary chiropractic care, pro bono care, to underserved in San Francisco. That all went on for a number of years and what I didn't know at the time was like that was a stepping stone to like building engagement. Building interaction, understanding the client experience that I had later adopted into like my first clinic, or you know, clinics, and it didn't cost me anything. I mean a lot of work involved in terms of like setting up the infrastructure, building the framework for the program, understanding the interactions between the program director at la rasa, central legal and in san francisco, and like what it meant for us as like students at the time.
Speaker 1:And and what's the downside? Somebody says no and the in the concept of like bracelet sales. Like somebody says, sorry, I'm not into it, or ah, that's too cheap. Like, okay, you learn how to take. You build that resilience.
Speaker 2:Yeah, interesting. I'm wondering if you think that the clinic is analogous to a startup.
Speaker 1:It very much is so yeah, you have a product or service that you're attempting to sell. Yeah, more often than not. Well, I don't want to say more often than not, but occasionally you are answering for venture capital. That could be mom and dad saying hey, can you help me get the down payment on the lease or the security deposit or the liability or whatever. And then from there you're either paying back venture capitalists aka mom and dad as an example or you're paying yourself back through the loans you've taken through grad school.
Speaker 2:Right yeah, do you read on startups at all? Or what kind of business books do you read?
Speaker 1:I read a lot. Recently I got into Headway, which is like summaries of books. Yeah, cool, yeah. What are my favorite books? Um, if that's the question, let's say I don't in no particular order. I would say art of the start, for sure I would say atomicomic Habits. What's Mark Hansen's first book? It's like how to not give a fuck or something to that. I read a lot of Tony Robbins. I experienced a lot of Tony Robbins material and then I look at other, just for like bouncing off of ideas. I watch and read a lot about like what is it? Shark Tank, warren Buffett I've watched almost everything on YouTube about Warren Buffett. I listened to Arrita's letters, his investor's letters, every year. I watch a lot of Grant Cardone. I'm not into like real estate as Grant Cardone, but it is interesting because when you find people that at a certain level of success that you deem important or relevant, there are similarities between that and then the step one that you're taking.
Speaker 2:Right yeah, so interesting. So what do you think about? Do you think about the competitive nature of where your clinic is located, in the sense of thinking like an entrepreneur, imagining the clinic as a startup Is a competitive environment in which you exist, something that also crosses your mind.
Speaker 1:It does to a degree, but it doesn't inhibit me from if I was to open up a clinic today or if I was to relocate my clinic tomorrow, and what I mean by that is I like to be around like my San Mateo clinic. There were some things I wanted when creating the business plan, like, for example, my target demographic of having between the age like a female between the ages of 35 to 45, with a gross income household income of $250,000 that was associated with one or more social groups. It could be like a church group, could be a knitting group, running club, that type of thing. So I found locations based on like that market and I said, okay, like what are the peripheries? Okay, like I'm by a Trader Joe's, I'm by a hospital system, by Whole Foods, I'm by like eateries downtown, and my market matches that.
Speaker 1:As far as other chiropractors being there, I don't think that's anything unique. I mean, there's probably a dozen chiropractors on the block next to me or around me, rather, and but that doesn't inhibit me. Like, the space I wanted was for the market I wanted, and therefore I'm just going to lean into it. Every chiropractor is going to offer something unique. I focus on head, neck and neurological disorders, right? So, denzel, you're, you're going to see a sports massage therapist. Let's assume, let's pretend it was a sports chiropractor and you had an elbow issue or knee issue. I'm happy to look at it as just a consultant on the case. But I wouldn't know what to do and I'd have to send you back to that sports chiropractor.
Speaker 2:And so there's a lot of actual referrals.
Speaker 1:I do by simply having a niche market in this cervical chiropractic.
Speaker 2:Right, so interesting. I've talked to several other people and they kind of see it very differently. They're very attuned to the competitive nature of the location in which they are. So I love your answer because I think it poses a kind of counter story to that. What about when you're flipping clinics? Is that like which one you choose to invest in? Is that part of your consideration, or is it more about the clinic itself and like the viability of the business there?
Speaker 1:Yeah, unfortunately, buying clinics at least in my experience and I'm sure there are other people to say otherwise, but in my experience it's not as easy as like buying a house. And what I mean by that is if you and I were like wanting to buy a house, we could go on like Redfin or Zillow and type in the address and we can get pretty standard results price per square foot size of a lot. Standard results, price per square foot size of a lot, you know, proximity and like a grading score of like schools around the area, and that would all play a role into, like the decision making of yes, we want it, no, we want. And then there's some hardcore numbers Like, for example, if you're renting like a multi-unit, like occupancy levels right and average average like a multi-unit like occupancy levels.
Speaker 1:Right and average. What was it? Average rental With clinic purchases. I think it really boils down to a gut feeling in a geography that you want. Now, naturally, there are some numbers associated with it. I look at things like gross profit over the last one, three, five, one year, three year, five years, excluding COVID. I look at the overhead associated with it. What's the percentage overhead to gross profit? I look at the tenure of the lease and or the provider. So if I'm buying something, if you're selling a clinic to me today like hey, by the way, I got to be at the end of the month, I'm going to say that's not worth anything because I'm going to boo.
Speaker 2:Yeah.
Speaker 1:Unless you have what's called a high PVA, patient patient visit, patient visit average, In which case I might consider okay, maybe right, Because the actual patient file and the patient, the revenue that the patients are driving is, is worth a potential loss of a lease. I would say that all of those fractures play a role too, but at the end of the day, it is a gut feeling.
Speaker 2:Do I like?
Speaker 1:this practice Do I like. The provider has built enough for me to say, yeah, let's take the risk on it.
Speaker 2:Yeah, Love that. Back to the lease. What's a standard lease term for a clinic space or what's a good lease term that somebody should be looking for? What's too short? What's maybe too long? What's a good number?
Speaker 1:You know if you are settled in to the area, if you know you're going to commit to the area, I would say at least three to five years.
Speaker 1:If you're noncommittal and what I mean by noncommittal is perhaps you're considering a move, maybe you're starting a family, like we did, or you have this innate feeling that this may not be your future then at the very least a one year. In my opinion. I think it takes at least a year to get a practice up and going and start to see at least 50, 75% of the types of cases that you may encounter in your future. I'm talking about the patient that doesn't want to pay because they got a crappy adjustment. I'm talking about the patient that needs a little bit of financial support because they were starting care and now they can't afford care. The edge cases of somebody missing some clinical abnormality I think you'd probably see that within your first year abnormality I think you'd probably see that within your first year and then three to five years just offers some level of stability, because the last thing you want is to be moving every six months to a year and concerned about like is my community going to follow?
Speaker 2:Yeah, yeah, that's a lot for for anything in life. I think that sounds like a lot, but definitely for trying to start a business for sure. So we talked about so many things that you have been up to um clinic ownership, like consulting, clinic, uh, investing and, you know, getting returns on those investments. I'm wondering about just the the idea of wearing many hats. How are you make decisions? How are you making decisions on that, like when to take on more, when to slow back? You mentioned you have a family, so how, how do you, as a human being, make decisions on when to push into all these opportunities and when to like step back and take care of yourself, make sure you're there for your family?
Speaker 1:Oh gosh, that's tough. How do I make decisions? On that One? My wife is my best sounding board. Her and I make decisions together.
Speaker 1:Nothing is exclusive in that sense. You know what? I'll tell you this, and this is like a really like, uh, like intimate thought, and that is I'm really scared of dying before um fulfilling my life's work, and I won't necessarily publicly hear, like, what my life's work is, but I've written it down a million times and I've refined it over the years and I'm deathly afraid of, you know, not being able to see that on. And so that fear, and perhaps a lot of anxiety, causes me to make decisions faster than I probably would if I was, like you know, 20 or younger, having kids. You know a teen and a soon to be teen. So is that a tween Knowing that I want to have a different lifestyle for them? That doesn't mean that I'm going to give them the world and that they'll never have to think about money, but it's like I want them to see, I want them to mirror an example that I'm providing for them as a dad and a business owner, in hopes that they will outpace me, right, yeah?
Speaker 1:So that's that's a lot of like. Why make decisions in state and with speed? And then the other piece is the why not Like what have I got to lose? Yes, I mean, there's financial security, obviously. I've been in startups and I've invested and I'm like, oh, that didn't work out well and I've lost a lot of money. And my wife is like what's going on? And I'm like I don't know. But at the end of the day it's like I't die, right, um, I learned a lot from it, so that probably won't happen again. Um, did it kids create some heartache and some headache for, you know, a few months or a few period of time? Yeah, a little bit. Um, so in that, in that same vein, it's like I might die, I'm gonna die. Gary v says it all the time and you know I've been taking that to heart. And, um, you know, if I don't die out of a product, okay, cool, I'm more resilient. And on to the next.
Speaker 2:Thank you so much for sharing that.
Speaker 2:My personal version of that is I'm not quite sure I go to like I don't want to die, but it's definitely more of like trying to become something that I believe I didn't start from, more of like trying to become something that I believe I didn't start from, and so almost like an escaping my upbringing, if you will, where I'm always trying to be something that I think is better than where I came from, and it definitely creates a momentum, and the people around me often feel that momentum and I don't know if I've ever disclosed that to them where it comes from, but that's totally where it comes from.
Speaker 2:It's from this sense of I started somewhere that I am not proud of, and so I need to escape out of that. So I think I'm doing something really similar to what you're doing as well making decisions about how to usually how to push in. I have to be super intentional about, you know, kind of like taking a load off and stepping back a little bit. I I also work very fast and I think a lot of people who are going to be listening to that are going to be very feeling, very relatable to what we're saying here as well. So what?
Speaker 1:a very thank you for sharing that. Yeah, thank you. That's uh. That means a lot to know like I'm not the only one, because oftentimes we get into these boats and you're like you wake up every day and you grind and you know seven days of work week is is very common for me and I'm not working like every hour again.
Speaker 1:I like to work within the pockets of time that I have, especially with the boys, and they're competitive soccer players and like yeah, it feels like every day and, and it's like I, I don't know how to like, I don't know where my off switch is, and so it requires someone else to like hey, by the way, it's, but it's especially my wife, it's actually it's only my wife to say like, hey, like, chill out you, you, we need to go somewhere or we need to do something yeah, that is different from yeah the off switch is very difficult for me too, it's I.
Speaker 2:I have to find tricks, because the brain also won't turn off so I can actually say, hey, okay, it's too much, I'm gonna like really not work, or I'm just gonna like do something calming, but what happens is that the brain is still going.
Speaker 1:So yeah, yeah, yeah, awesome.
Speaker 2:Okay, well, what is next for you? What's in the next? What's your plan for your next steps in your entrepreneurship journey?
Speaker 1:That's a great question. I think I'm going to lean into the existing projects I have now, and what I mean by that is I've got my hands full. I don't know how to juggle in real life, but I know how to juggle in my mind and so I think it is establishing, affirming, maturing what I've currently got going on before I jump into the next venture. I think that level of maturity at this stage is required. That was very cryptic, but yeah, I want to mature the things I currently got going on.
Speaker 2:Yeah, I love that. I love that so much. I think, whether it's cryptic or not, I think it's sort of a nice segue from what we were just talking about as well, like handle what you have in front of you and do it great and then think about what you want, maybe a politer way to say.
Speaker 1:I'd like to refine the projects I'm working on.
Speaker 2:Yeah, I love that. I love that so much. Well, thank you so much for being here today. It's been such a delight talking to you, and I think there's so many great tips that we've pulled out for people, um, all the listeners that are going to be hearing this. So, thank you so much.
Speaker 1:It was lovely meeting you and I hope we can keep in touch. Let's do this again. Thanks, denzel, appreciate it. You, you, you, you you.