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Success in Practice: What Does it Take?
Bob Simmonetti, DC

There are many ingredients needed to be successful in chiropractic practice. Some are related to character traits, others to business acumen and to a great degree your success in practice will be determined by how you view your role in our health care system.
After being in practice for nineteen years plus I am not naive enough to think that this article will be so extensive that it will cover all that “it takes” to build a thriving, fun and profitable practice. However, success leaves clues and there is definitely proven factors which must be present to build a prosperous practice. My desire is to break down these factors in a series of articles and help to insure your success in practice. So here we go!

Before you ever open your doors the most important single factor which will determine your success or failure is how do you view your role as a doctor of chiropractic. Do you see yourself as a pain relief specialist? Do you see yourself as a musculoskeletal rehabilitation specialist? Most chiropractors state that they do not treat symptoms and that they correct the cause of health problems. This is a good thing because society is fed up with the medical approach that specializes in treating symptoms and conditions. In fact our society is rapidly moving towards and will demand a health care system that emphasizes wellness and prevention.

It would behoove you, the upstart practitioner, to view yourself as a “health coach”. That is, you should be knowledgeable of all of the proper lifestyle choices to promote health and at the same time you should not hold yourself out as someone who treats conditions with any of these lifestyle choices or any other adjuncts. You see treating conditions or symptoms is a losing proposition for the doctor of chiropractic for several reasons, foremost because of the aforementioned trend in society. The other reason is because medicine does it quicker and better. Another often-overlooked reason is that treating symptoms or conditions is not chiropractic.

The doctor of chiropractic should imbue and teach healthy lifestyle choices. At the center of the lifestyle choices is having a nerve system free of interference. This must be the most important lifestyle choice emphasized by the doctor of chiropractic. It is not something to be considered only after symptoms or a condition exists. Would you consider eating good foods only after you were fifty pounds overweight and had stomach pains? Keeping my three children’s spines functioning free of subluxation is what I do before they have a “condition” develop. Keeping spines in my office free of subluxation is one critical factor that will determine my success in practice. If my emphasis is on treating symptoms or a condition, once it is gone so is the patient.

Does size REALLY matter?
By Dr. Andrew A. De Saro

This is a daunting question that has plagued men for ages. Often thought is the concept that the bigger something is, the better. Our society certainly makes us think this when the highest accolades are given to the construction of the tallest building, the design of the longest bridge, the richest person, or the practitioner with highest patient volume per week. Little value has been placed on a person’s character, it’s all about what they can do. All too frequently we become prey to the bigger is better mentality and neglect the beauty or richness life has to offer, despite the quantity. So, what becomes of us when we use this way of thinking? How do we begin to realize and see our interconnectedness with one another?

In our practices we have many kinds of patients. I would like to show the distinction between two categories. Many patients have amazing stories about their recovery after beginning care with us. This makes it very easy to see and instantly measure the impact we had on their life and vitality. You may have seen a patient who came into your office shuffling along unable to take a normal step without pain and then carefully maneuver onto your adjusting table ready to receive what only you can give. After such an encounter the patient rises and is able to move in ways they couldn’t, even before the pain brought them to your office, not to mention the pain is gone now. Truly Amazing! Now let us consider the patient who hasn’t experienced the “amazing” transformation that Chiropractic has to offer. Many of these patients come to the office, get adjusted and regularly repeat this some weekly, others monthly, but continue without the result experienced by the previously described patient.

I am willing to say, no, I am willing to guarantee that every patient, every time experiences the miracle of life right on your table in your office. As chiropractors it is inherent in the work we do that we will touch, move and inspire others through the process, but more importantly it is who we be. Whenever these thoughts cross my mind I always think back to a story told by a chiropractor at Palmer Lyceum a few years ago. The story goes, a woman came in to see this chiropractor because she had been having trouble moving without pain in her lower back, pretty common. As she began to develop a relationship and trust with the chiropractor she began to tell about her husband who had knee pain and that it must be getting worse. She went on to say that her husband has been abusive and the beatings had become more intense, he even took their three year old daughter’s favorite doll’s head off in front the girl. So the woman’s plea to the chiropractor was that if he could do something for her husband’s knee pain maybe things would get better. The chiropractor told her he would do what he could and so the husband began care. In a couple of weeks on a visit the woman rushed into the office while her husband was getting their daughter out of the car and told the doctor that there hasn’t been one abusive episode since care begun for the husband and that he hasn’t had a drink either which the doctor wasn’t aware there was a dinking problem. Best of all, the woman said with a tear going down her cheek that last night he put his daughter on his lap and read her a book, something he had never done. When you fail to see the impact you have made through your hands and your love, remember that you have impact beyond your reach and sight.

To answer the question “What impact do I have” I would like to share BJ Palmer’s “An After Thought” from 1944.

“A slip on the snowy sidewalk, in Winter, is a small thing. It happens to millions.

A fall from a ladder, in the Summer, is a small thing. That also happens to millions.

The slip or fall produces a subluxation. The subluxation is a small thing.

The subluxation produces a pressure on a nerve. That pressure is a small thing.

The pressure cuts off the flow of mental impulses. That decreased flowing is a small thing.

That decreased flowing produces a dis-eased body and brain. THAT is a BIG thing to THAT man.

Multiply THAT sick man by a thousand, you control the physical and mental welfare of a city.

Multiply THAT man by a million, and you shape the physical and mental destiny of a State.

Multiply THAT man by one hundred thirty million, and you forecast and can prophesy the physical and mental status of a nation.

So the slip or fall, the subluxation, pressure, flow of mental impulses, and dis-ease are BIG enough to control the thoughts and actions of a nation.

Now comes a man. Any one man is a SMALL thing.

This man gives an adjustment. The adjustment is a small thing.

The adjustment replaces the subluxation. That is a small thing.

The adjusted subluxation releases pressure upon nerves. That is a small thing.

The released pressure restores health to A man. That is a BIG thing to THAT man.

Multiply that well man by a thousand, and you step up the physical and mental welfare of a city.

Multiply that well man by a million; and you increase the efficiency of a State.

Multiply that well man by one hundred thirty million, and you have produced a healthy, wealthy, and better race for posterity.

So the adjustment of the subluxation, to release pressure upon nerves, to restore mental impulse flow, to restore health, IS BIG enough to rebuild the thoughts and actions of the world.

THE IDEA that knows the cause, that can correct the cause of dis-ease, IS ONE OF THE BIGGEST IDEAS KNOWN. Without it, nations fall; with it nations rise.

THE IDEA is the BIGGEST I know of.”

How small do you seem to be? Does the size of what you do only measured in the effects seen? I challenge the idea that what happens on the adjusting table is merely a musculoskeletal or neuromuscular manipulation and not a true life altering miracle Is there such a thing as a small miracle? What makes one miracle better than another one? Who ranks miracles? Any life-giving act expressed with love through touching another is a miracle that knows no limit to size or impact on the lives’ of the people involved. When you give that adjustment, in that moment you feel the entire body give way and relax while you relax and become present to the innate. The person turns and looks at you taking their first breath without the subluxation causing dis-ease in their body with sheer gratitude and says “ Wow, I needed that” or “Ahhh, I didn’t know it was that bad”. This is THE true miracle of life, giving life and fully expressing life.

So, in my world, the Chiropractic world, it’s not the size of the miracle that matters but the life you make with the your miracle. When all of us become the same family at NB and touch the thousands or the one hundred thirty millions of people that we touch, we create a new nation, a better race for posterity. Be apart of the NB family and join us as we create a new race, a new world forever.

ICPA and New Beginnings Extravaganza Just Days Away

Come join us at Now You Know April 29 thru May 2, 2004 and experience a practice-changing event in chiropractic philosophy, science, and art! Come share the excitement of both New Beginnings and the International Chiropractic Pediatric Association Extraviganza!

Philosophy: Experience Chiropractic Philosophy: Keynote Philosophy Speakers: Drs. Guy Riekeman, Bob Hoffman, C.J. Mertz, Pasquale Cerasoli, Bob Braile, Eric Plasker, Tony DeMarco, Jay Handt, Peter Kevorkianand the rest of the New Beginnings Philosophy Team.

Science: Enjoy the validation of Chiropractic Philosophy with our Keynote Science Speaker: Bruce Lipton, PhD. Make informed choices on Vaccines: "Immunity and Chiropractic" presented by: Stephen Marini, D.C., PhD. Hear the ICPA Research Update with Joel Alcantara, D.C, ICPA Research Director.

Art: Multiple I.C.P.A. Technique Workshops including Webster Technique Certification. Plus special ICPA Family Practice Panel. Drs. Claudia Anrig, Tony Carrino, Jeanne Ohm, Carol Phillips, Armand Rossi and Jim Thompson.

This years event will be held at the Ocean Place Conference Resort Long Branch, New Jersey. For more details visit their websites at and

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