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Multiplicity
By Maria M. Lameiras

Is a second practice a smart investment?

Do you ever feel as if you could get more out of your life, if you could make more of yourself? I’m not talking about cloning, but how about opening a second practice? It’s not a bad idea: A second practice could expose more patients to chiropractic, offer a more convenient location for some of your existing patient base and provide additional income. But, operating multiple practices is not for every chiropractor.

Some practitioners both own and practice in multiple locations, while others hire associates to run branch offices. Such expansion can spread the message of chiropractic and prove financially beneficial, but even successful multi-branch practitioners can burn out, if they are spread too thin.

Dr. John Hofmann ran multiple chiropractic offices in Michigan for many years, including four practices he ran with his colleague, Dr. James Gregg. Although he says running multiple offices can be done successfully, he feels strongly that chiropractors can run a better practice by focusing on excellence in one location.

“Most of the time, when doctors have to set up a second practice, they think it is going to be easier. They know how to work and they think it will expand their income, but I have found that a second or third or fourth practice never does as well as your first,” says Hofmann, who retired from practice eight years ago after suffering a stroke.

“That is the same in any business. You are not putting the same attention or effort or love into those subsequent practices as you did with the first one. Your chances of being taken advantage of in terms of employee theft or graft go up and, if whoever you’ve hired to run that practice quits, then you are running two places instead of one,” says Hofmann, adding that he saw more than 360 new patients in one month alone in one practice. “If I were to give advice, I would say to make one place work well. If you want to see more patients, hire more help in one office. If you want to open more than one practice, you can—if all you want to do is work. Two practices just double your worry and troubles.” Hofmann’s former partner James Gregg still operates four practices in Michigan and soon is opening a fifth.

“Some people think of opening multiple offices solely to increase their income. If that is your sole purpose, you are going to struggle. My reasons are simple. I thrive on reaching new communities and serving them with the benefits of chiropractic care,” he says. “All practices reach a level of success in both volume and income and, at that point, growth gives way to maintaining that level of success. Once a practice reaches that level and is stable, I like to expand. Every day I see places where I’d like to open a new practice, but I never expand until the newest practice is successful.”

The hardest transition for Gregg has been that from a practitioner to an administrator. “At a certain point, in order to expand, you have to give up more and more patient care, and that is something I don’t entirely want to do. I always wanted to stay in touch at the patient care level, but I can’t be locked in to a specific schedule,” he says. “I have to be able to move from office to office. It is important that your influence and presence always be felt in your other offices.”

Being committed to such a demanding work schedule takes a toll on your personal life, Gregg admits. “It definitely has an effect, but I still live a dream, and I am thankful for that. Taking time off is probably the one thing I should be a lot better at,” he adds. “However, I feel being successful is being able to come and go when you please, and I can pretty much do that. I choose not to do it a lot, but if I want to do something or go somewhere, I go.”

Gregg’s children share his passion for chiropractic. His daughter, Lisa, is staff manager of his offices and his oldest son, Jimmy, is a student at Life University in Marietta, Ga. His younger son, Michael, is planning to follow the same path.

In practice for more than 30 years, Gregg is occasionally asked when he plans to retire.

“To me, most people retire from something they don’t like. I do something that I love and truly enjoy it. Other people call it work, I call it a lifestyle,” he says. “I don’t do well with a lot of time on my hands. I like to push the envelope and move ahead and see how much I can do in this world before I leave it.”

Since 1987, Dr. Kevin Fogarty has built his practice, Fogarty Chiropractic, from one office in Orlando, Fla., to three—taking over a mentor’s practice in Rockledge, Fla., and opening a new office in Cocoa Beach.

“What made it more appealing was that I had the opportunity to buy the buildings the practices were located in, so I was not only buying the practices, but the real estate as well,” Fogarty says.

In 2004, Fogarty decided to begin scaling back for personal reasons. He sold the Cocoa Beach practice in early 2005, and by early 2007 he will have completed the sale of his original Orlando office. He will maintain his practice in Rockledge, which is closer to his home.

“My purpose was to bring more people to chiropractic and I believe I achieved that. Between the three offices we had more than 1,200 patient visits a week,” he says. “I’m a hands-on guy, so I’m involved in the aspects of management in all ways, from the doctors’ treatment style to the quality of care. That commitment of time takes a toll. I worked six days a week, plus I was drawn more into the management of the business and it took me away from what I enjoyed most, which was taking care of patients.”

Now that he and his wife of 27 years have two children—daughters ages 9 and 7—priorities have shifted.

“My wife has been an integral part of growing the practice; she has been in the whole thing from the get-go. She used to run the front desk, including all of the insurance and payroll. After the kids came along, we had everything set up at our house and she was able to do a tremendous amount of work from home, but I still sometimes did not get home until 7 or 8 p.m.,” he says. “It got to the point where I had to schedule time to be with my wife. If I didn’t schedule things in, I was losing out on time with her. That is a big sign of saying it is time to slow down a little.”

Although his practices have been successful, Fogarty says he has seen other chiropractors who haven’t had as much luck in balancing one practice, let alone multiple practices.

“Running multiple practices can be very lucrative as long as you go about it in the right way. I have seen a lot of doctors attempt to expand and fall flat because their level of commitment isn’t high enough,” he says. “They are not willing to put in the time and to do whatever it takes to work all the practices. Their focus is on the money, not on what is really important—providing patient service. If you provide the service first, the money will always come.”

Three Reasons to Operate a Single Office

1. You are not willing to sacrifice your personal life for your multiple practices.
2. Your current practice is in a survival stage and has not reached your preferred level of success for volume and income.
3. You want to focus your energy and talent on one office and making it the best in your area.

Three Reasons to Operate Multiple Offices

1. Your personal mission is to spread the chiropractic message to as many people as possible.
2. You are willing to step into a more managerial role and step back from caring for patients.
3. You are willing to work more days a week and longer hours.