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#162: 5 Things You Must Know Before Starting Your Own Chiropractic Office - Overhead

Low Overhead Chiropractic Office

We are on week 3 of the 5 things you need to know before starting a practice podcast series. If you’re new to the podcast or haven’t listened in a while then you can catch up by listening to episode #158, week 1 of this series, we talked all about mindset, and why identifying your personal challenges now will help you as you transition into practice. Week 2, episode #160, we talked all about the business plan and why having a blueprint for your success is necessary. This week I am diving a bit deeper on something we talk about a lot on the podcast and that’s your practice overhead! If you haven’t already downloaded the ebook that goes along with this series, visit and download it today. In the ebook, there are action steps for each of the 5 things we’re talking about in this series, and it’s a great way to get started as you pursue your dream of opening your own chiropractic practice. And if you’re a nerd like me then it’s nice to have a workbook to print off and take notes on while you listen to the podcast.

What is Chiropractic Office Overhead?

We’re going to start today by talking about what overhead is, then I’m going to walk you through a few scenarios so you can really get a visual of how each of those scenarios would play out in real life over the long term. Today’s talk about overhead will give you a lot to think about, so put down whatever else you’re doing and pay attention! If you need to, listen to the podcast again. This is a really important topic.

Overhead is the sum total of all ongoing costs it takes to operate your practice regardless of how much or how little income you bring in. These expenses directly affect the profitability(net income) of your practice and you have complete and total control over how many of these things you make a part of your overhead or not. Overhead will or can include the following: office rent, EHR, phone, fax, wifi, utilities, website, office supplies, clinic supplies, malpractice insurance, liability insurance, employees, etc. We recommend keeping your overhead low, especially to start! 

We Recommend Low Overhead!

We recommend keeping overhead low because the more money you are paying out to others, the less profit you will have. That means you’ll have less money landing in your back pocket to take home or re-invest, and that’s not good. We want you to take home every penny you deserve and re-invest or invest everything else! This was one of our goals when we were starting. You will quickly see that by running a chiropractic practice, you are helping other businesses profit before you see your own profit, to name a few-your landlord, the cable company, the EHR company, your malpractice company, etc. So, the less money you are paying out to them, the less time you have to spend working and/or the more money you can keep for yourself. 

Office Overhead Examples

Let’s look at some examples, and talk some numbers so you can see the difference. 

  • If you are paying $2000 for your office space, and I’m only paying $1000, then I can work that much less than you, or take home $1000 more each month, that’s $12,000 a year. 
  • If you pay $250/month for your phone lines, fax, internet, etc, and I pay $50/month, then that’s another $2400 a year for me. 
  • If you pay $250/month for your EHR and I pay $75, that’s another $2100 for me.

It all starts adding up fast. In this scenario I saved myself $16,500/year. So I can work that much less, or I can take home enough to buy a nice used car. It’s a small amount each month, but it adds up to a huge difference over time!

Chiropractic Practice Management Group Overhead

Think you need to start like the large management groups tell you to do? Then you’ll need:

  • $3000/mo minimum for build out and lease
  • $3000/mo for a CA
  • $1000/mo for an xray lease
  • $1000/mo for other equipment lease
  • $250/month for your EHR
  • $250/month for phone and internet 

Adding up these numbers will take you close to $10,000/month in overhead. So, you’ll need to market to, bring in, and treat enough patients to build up $120,000 a year to cover that, before you can even start paying yourself. But, wait a minute...Know what you’ll need if you’re going to start making that kind of money? You’re going to need more staff! And so this cycle continues…you’ll need to treat more and more patients, to payout for all of your expenses, before taking home any of this money for yourself or your family. This isn’t to say this isn’t a viable option, but make sure that’s where you want to go before you head down that path. You can definitely succeed going that route, but it’s going to take time and energy to build, and the journey to success may not be what you’re looking for-it could include shady billing practices, sleezy sales scripts, high overhead, long days, nights, and weekends, and so many other things you don’t really want. If you’re intrigued by the large practice management groups then you need to ask them several questions before you signup. So, you know exactly what you’re signing up for.

How We Started

When we started our first practice we were very conscientious of overhead. What was the smallest amount we could spend monthly to bring in the income we needed to support our family, without wasting money on unnecessary gadgets or space. Rich and I kept our overhead low so that we could work less. We wanted to spend time with our kids. We wanted to be able to take vacations. And we didn’t want the stress that comes with carrying a high overhead. Instead, we’ve made additional income on investments, having multiple low overhead practices, and multiple streams of income. 

Other chiropractors that didn’t make it through the first years of practice, or barely scraped by had gotten themselves into too much debt or had taken on too much overhead to get open. Their operating costs were insurmountable when it came to bringing in the income to survive and thrive. Please don’t make this mistake! 

Chiropractor Low Overhead vs. High Overhead

Many of you will opt to become an Independent Contractors in order to start with the lowest overhead possible and we think that’s great! I spoke to someone starting her own practice this week and her monthly overhead will be less than $1000/mo. If she brings in $100,000 the first year, she could easily take home $80,000 or more, before taxes! That’s a great paycheck for your first year on your own! For comparison sake, let’s say someone she graduates with goes the high overhead route we talked about earlier. That chiropractor might bring in $200,000, 2X the revenue of her practice, but only take home the same income, which is not 2X the first chiropractor's income of $80,000. How much harder did the high overhead chiropractor need to work, how much more stress did that chiropractor take on to not make any more profit...too much in my book! In a couple years the high overhead chiropractor could bring in $300,000, take home $120,000 and the low overhead could bring in $150,000, and also take home $120,000 of that. So, the chiropractor with low overhead can work half as much and bring in a similar income, with the option of getting a larger space and growing the practice bigger, or taking other routes to creating additional income. There’s more flexibility with having lower overhead.

Overhead Action Plan

Here’s our action plan for this week! Decide whether low overhead is the right choice for you. If it is, then set your personal and professional budget for life and practice, so you can make it happen. Building up savings to work with and utilizing a budget for living and creating your practice will especially be useful when creating your business plan. When you set a budget, then you can accurately assess how much money you’re bringing in or need to bring in, so you can set goals, and you know how long your savings will support you through the startup process. Not sure where to start? We have a savings checklist and budgeting worksheet inside The Foundation. There’s a whole list of ways you can save money or bring money in, then a spreadsheet that allows you to figure it all out using your own numbers.

Saving Money in Chiropractic School

After seeing several of our peers struggle and close their practices, we realized how important budgeting and finances would be for succeeding. If you’re still a chiropractic student or not yet in chiropractic school then please listen to episode #142: Tips for Saving Money and Decreasing Student Loan Debt (Spotify | iTunes). In that episode, I give you the detailed step-by-step process I used to minimize my student loan debt and maximize my savings while in school.


Low Overhead is everything! Before you sign on the dotted line or swipe that credit card, please make sure you are purchasing a necessity and not a want. You can always add things to your practice, but you can’t always get back the money you paid, and it would be very rare for you to be able to reduce your lease amount! 


If you plan to use a practice management group, make sure you ask them how much a typical office’s overhead is, what the gross revenue of the typical practice is and what the typical net profit is. Make sure you understand the amount and kind of work it’s going to take to bring in the gross revenue. Make sure the journey to getting there is right for you. Is the extra work and stress of managing that size business, worth the extra gains? If you’re unsure of all of this then talk to your accountant or reach out to us. It’s really important you know what these numbers mean before you commit.  


I get so excited for you guys each week as we talk about these things that you must know before starting your practice. This is extremely valuable information you all need. It is going to put you in a better place as you start to transition from student or chiropractic associate to small business, chiropractic practice owner. Please go download the ebook that accompanies this series at You can also visit our profile on Instagram @lifestylepractice and follow our link there to download the ebook. Don’t waste your time, get started today! Have an awesome week!


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