The High Volume Myth and Chiropractic Marketing

groupThis week I’m in L.A. at a conference, but I wanted you to see one of the most popular blog posts I’ve ever written. It was also the most controversial. Tell me if you agree or not. Read it and leave your comments below.
Have you ever been told you needed to see a large number of visits per week to be successful in practice? While it’s not going to make some of the coaches who read my blog happy (yes I do look at my subscriber list), I’m going to let you in on a little secret…

You Don’t Need High Volume To Be Profitable In Practice

I’m not certain where this got started.

It was likely back in the early days of chiropractic, where chiropractors only did adjustments and everyone charged the same price. Under those conditions, it makes sense that the more visits you see the more you’ll collect each week.

But to believe that today is simply false.

Every doctor has different prices, different therapies, different equipment.

You see, most chiropractic coaches lead you to believe that high volume (or at least more visits) is the way to go. Some even make you feel bad about your practice if you’re not seeing what the top doctors in their coaching group are doing.

Here are some of the ways the high volume lie is used by coaches to make doctors feel guilty…

-when you do an event like a P.A.D. or dinner workshop and you don’t get 60 new patients from it

-when you’re not seeing 1000 visits per week many will say you aren’t “sacrificing enough” or “you don’t have a big enough mission yet”

– if you’re not getting “x” number of referrals per week like the big guns are, you’re not “on purpose”

Number of visits per week is only part of the practice success formula I teach. Dollars of income per patient visit is a much more telling number.

Here’s how you cut through the fluff and find out how these high volume doctors are really doing. Ask them for their average collected amount per visit. Not there “estimated care plan” numbers, but the real deal. I’m about to reveal to you the secret formula no high volume coach wants you to know….

$collected each month divided by your monthly patient visits= average $ per visit

Wow, eye-opening isn’t it. (But believe it or not, this stat is does not show up on any of the coaching group’s statistics forms I’ve been a part of in the past.) Turns out most high volume doctors are making less than $30 per visit, some even lower than that.

Funny story about coaching groups and high volume real quick…

One group I was a part of did put your monthly collections number on your name badge at the seminars. They did it as a mental boosting type of thing, where you were excited to show up and get your new badge when you hit a certain goal.

The thing I really like about it was this…

No one could come up and B.S. you about their practice. A guy could come up and talk all day about seeing 300 a week, but if his “badge number” was lower than mine, his advice went in one ear and out the other. Turns out high volume guys weren’t the mentors everyone looked up to in this group, it was the “high income” guys instead.

I’ve seen moderately high volume and I’ve seen what most would consider low volume. Guess which practice was more profitable, had lower stress, and allowed me to take time off?

When I was “higher volume”, I was was flat broke making $17 per visit because I was giving away care for free. At the lower volume, I was getting $90 per visit. Maybe I wasn’t making as huge an impact on the planet as the guys seeing 1000 a week, but you know what…I was making a huge impact on the patients I did see each week.

And I was making the biggest impact of all…being there as a father for my children!

What’s really going on here is that these coaches are imposing their values, their goals in life, they beliefs on you. If you really want to see 1000 visits per week, that’s great, go for it. But don’t believe the lie that you can’t be happy without seeing high volume, or that high volume equals high income.

It urns out the low volume practice fit my lifestyle better. I wanted to help people get well, make a good living, and spend time with my family. None of those things require high volume.

What about you? What do you want out of your practice? If you want a high volume practice, tell us why? Let us know in the comments below.

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  1. says

    Well said, again doc.

    I spoke with a friend of mine who was trained in the high volume model of practice. She was having numerous problems with her rotator cuff and shoulder from the “high volume” of patient care she provided and took about a year off from practice before getting started again. It takes a toll on the body.
    A “patient centric” practice is concerned with the number of people who get help, not just an number who get an adjustment. Striking the balance between volume, profit and overhead is why it is called practice.
    Sadly, the guilt and judgment are in every profession. However, I believe it is one of the key barriers holding this profession hostage. Way too much competition among docs. Where’s the race? What’s the goal? Make the most money? See the most people? It is very ego driven.

  2. Doug DeSalvo says

    I am in full agreement with this blog. The only issue with volume is if a doctor has a goal to hire an associate to handle the overflow. The lead doctor then needs to create volume he or she does not necessarily want to handle themselves until they can afford to hire the associate. The next problem is finding a competent associate who is a good fit for the practice.

  3. Dr. Behm says

    I have always felt the the average $ per visit was important. I agree with you completely. I believe in working smart and hard not just hard.

  4. says

    Love this post. Very accurate. Of course you do want to see as many as you can every day. But I teach to NOT do it by giving away the farm.

    Mike, we appreciate what you are doing to help chirorpactors grow!

  5. Sean says

    I whole-heatedly agree! Let me tell you first hand that I personally built my practice up to 500 patient visits per week at an average of $30 per visit. I was miserable! Yes, I was seeing lots of patients and on the “mission”, but I had no time to work ON my business it was all spent working IN my business. I was constantly marketing on my breaks, staying late to do ROF’s, marking xrays and really feeling as if I was missing things with my patients. So I decided I would change the way I practiced. The interesting thing was that I increased my prices, decreased the length of my care plans and really charged for what I did and my visits have decreased, but my collections have increased! The thing that I like the most is less overhead (less appointments made at the front desk, less phones ringing, less problems to deal with, less staff required etc..) but also less stress!

    I was with a management group that was all about “Saving Lives”, and if you aren’t seeing 1000 patients per week, then your not on purpose. My personal opinion is that if saving lives means that we lose ours in the process….what have we gained. Yeah we may see 1000 pts per week, but what about my little son growing up never getting to see his own father. I am more excited about practice now than ever. Keep preaching the good work brotha!