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Dynamic Chiropractic – April 22, 2012, Vol. 30, Issue 09
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dynamicchiropractic.com >> Practice Management

50 Years in Chiropractic: Advice for Each Decade

By Arlan Fuhr, DC

When I graduated from Logan College of Chiropractic in 1961, I had the same fears and apprehensions that today's graduates face. I needed a place to start practicing and I needed guidance, as I had little clinical experience.

I was fortunate to have one advantage – I was debt-free when I graduated, thanks to a scholarship and help from family. I was broke, but student loan bills weren't looming.

I looked into many opportunities in different parts of Minnesota and ended up living with my parents until I could find a place to practice. I had been encouraged to study chiropractic by Dr. W.C. Lee from Redwood Falls, Minn. I visited him after graduation and he made me a generous offer to use an extra room in his clinic until I could find a location. (That memory brings to mind a saying: "There is nothing as permanent as something temporary.")

I was from a family that had lived in Redwood Falls for four generations and was comfortable with my roots, so I took on the daunting challenge of starting a practice within a practice. The good news was that Dr. Lee was a generous man and allowed me to keep everything I made for the first six months. Then I started paying a percentage of my billables to him.

Advice for Decade 1

Find a solid mentor and absorb all the advice you can from a trusted source. That relationship with Dr. Lee lasted 20 years until he retired, and was instrumental to building my early career as a chiropractor. New practitioners are often tempted by outside forces, from practice management groups to equipment salesman; Dr. Lee helped me avoid traps and gimmicks and helped me stay focused on what was most important, the patient. He told me, "Take care of the patient and the money will follow." Following his steady advice and guidance helped me get my practice off the ground.

Building a practice was not a flash-in-the-pan success. It took me approximately 10 years to have a really stable clinic. No matter how good you are, I believe it takes at least four years to build an initial patient base, and during that time, you'll experience highs and lows. One week, your patient volume will be up, and the next week down, as people get well and are discharged from your care. However, as your base grows, the broader fluctuations start to level out and steady growth begins.

Advice for Decade 2

Build your practice for the future by following the advice in one of my favorite and most influential books, The Richest Man in Babylon: pay yourself 10 percent of what you make first. During my second decade in practice, two things happened: (1) I was seeing a large number of patients; and (2) I became really interested in finding better ways to take care of my patients. In that second decade, the instrument adjusting technique I was developing began to mature. Being the only practice in the country using this instrument to adjust attracted people from miles away looking to experience this new type of care. This period also forced me to look beyond patient care and envision the practice of the future, including a plan for investing in my own growth.

Advice for Decade 3

Learn more about business than you did in chiropractic college. During the third decade of my career, I learned what it was like to have more than one clinic, as I began hiring associates and expanding my practice to other communities. I managed practices in two Minnesota towns, both county seats and centers of agriculture. Learning how to manage a business in addition to honing my patient care skills served me well during this period. When I decided to relocate to Phoenix, the sale of both clinics together gave me the capital to make the move.

Advice for Decade 4

Determine what you really like to do and follow your heart. If you do, you will never work a day in your life. I made the move to Phoenix in my fourth decade because I became interested in clinical research and how it could influence chiropractic's position in the health care arena. I needed to have access to a major academic institution. In addition to the universities in Arizona, research institutions could also be found in the states bordering Arizona.

Moving a whole corporation was a major undertaking. My family packed all our belongings in two moving vans and headed to the Southwest. A friend leased me his building and I started a clinic with the same principles I'd utilized in those early years in Redwood Falls. This time, it took longer because developing a following in a large metropolitan area is more difficult and costly, but once you get established, the referral base is incredible.

I continued to practice while working to establish research at nearby Arizona State University. The engineering department had a biomechanical division, which was the perfect fit for researching my adjusting instrument. Though the lead academic contact told me our research was immature, he raised some great questions and was interested in working on the effort. I remember walking on air the day we met, as I had established a university relationship with someone who had real interest in chiropractic. I knew research could make a real difference to our profession and it was quickly becoming my passion to marry research with chiropractic.

Advice for Decade 5

In your mature years, never stop trying to make a difference. Leave a legacy upon which young practitioners can build. In the fifth decade, I maintained a clinic, but directed more and more of my attention to research. Our research began to bear some substantial fruit. We expanded our clinical trials and studies to other universities and researchers. I learned early that researchers only want to be involved with efforts in which they are truly interested, so we associated with teams around the world that were compelled by chiropractic and how an instrument might affect spinal manipulation. Last year, we compiled our research for the annual Research Agenda Conference, and realized we had amassed 100 peer-reviewed papers on the instrument and its associated technique.

People often ask me if I ever thought a small-town Minnesotan could have a tangible and international impact on health care. Honestly, the answer is no; never in my wildest dreams did I think it would go this far. But I always stayed true to the patient, who was the reason I got out of bed every day and worked long hours to develop a different approach to chiropractic.


Click here for more information about Arlan Fuhr, DC.

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