Unlocking Your Practice's Potential: The Power of Niches in Chiropractic

Welcome to the Practice Builders Podcast hosted by Dr. Vince Leone and Dr. Kyle Pankinen, your source for building cash services. Let's dive in. Welcome everybody to the Practice Builders Podcast. My name is Dr. Vince Leone, joined by my co-host, Dr. Kyle Pankinen. How are you, sir?

Doing wonderful. So excited to be here with you today. And what a, what a, what a great thrill to do this.

Our first ever podcast. So, you know, Kyle and I decided to do this podcast because we wanted to help other doctors out there in our industry with what we've learned by both building seven-figure practices. And I have a consulting company called Specialized Practice, and that's what we specialize in is helping doctors grow high-value cash services. And Dr. Kyle is our clinical coach. And so this podcast is really geared towards really all chiropractors. If you have specialized equipment like decompression or laser or shockwave, and you're currently offering these services, and maybe, maybe you're not getting as much traction as you'd like in the market, and you want to go to the next level, or maybe you are doing really, really well, you know, you're at Whatever, $75,000, $100,000 a month, but you want to go to the next level, $150,000, $200,000 a month, that's awesome. Or maybe you're just starting out, you know, maybe you're thinking, hey, I want to protect my practice, and by not only relying on insurance and not relying only on adjustments, I want to use leverage and these high-value cash services to create an additional revenue stream for my practice. So all are welcome here. We, we could help all of these doctors, and with this podcast, that's, that's my goal. What do you think, Dr. Kyle?

Yeah, we not only want to help you to get to that next level of your business, to implement cash-based services, niches, and things, but we also want to use this podcast to try to elevate our profession clinically as well. So that's the marriage of both worlds. We want to be excellent clinicians, and we want to be high-end in our businesses and be rewarded for our expertise. In our hard work. And we see so many chiropractors out there that are struggling.

Mm-hmm.

And when you hear Dr. Vince's story and my story, you will hear the story of 2 doctors that were at one point in their careers struggling. And we, we wanna share with you how we were able to break through and get to that top 1 or 2% of the profession and share with you how you can potentially do that as well. So That's kind of what we're all about here at Specialized Practice. And we just wanna share and hopefully what we share with you will resonate and it'll help you move the ball forward in your practice as well. I love it. Yeah. Anything else you wanna add with that, Dr. Vince, before we introduce our— introduce your background?

No, not really. Other than, hey, Tony Robbins always has said success leaves clues. You know, so yeah, I think, hey, we just with this podcast series, we want to leave those clues for all of our listeners so that you can take this information and implement it ASAP, right? And start changing your life, start changing your practice, grow your practice, have more impact, have more money, have more freedom. You know, that that's what these niches do. What we we call these high ticket niches. That's what they allow us to do. So. It allowed me to do that. It's allowed you to do that. It's allowed all of our clients to do it. So yeah, let's dig in. I love this. I'm excited.

So we want to go on our first podcast here. We want to— I want to dig into Dr. Vince's, Dr. Leone's background here a little bit. And so I'm going to pretty much open up the floor to him to explain to you how he got into the world of niches, to go from what I would call a barely surviving chiropractor to a thriving million-dollar-plus practice that did it for year after year. And so I think you're going to find his story is quite intriguing and inspirational. And hopefully, if you're one of those docs out there that is struggling, it'll give you hope. So, Dr. Vince, Take us back to the beginning. Take us back to your early days in practice and where you were at and how life happened and how things moved forward for you.

Yeah, um, you know, graduated in 2007. I was an associate for 2 years for my father. And, uh, you know, as, as, you know, young men are, we're sometimes a little stubborn. We think we can do it best, even though my dad has had a successful practice for many, many years. So I went off on my own, and, um, but I didn't go very far. I just went downstairs in the business building, right? There's— it's a— it was a 2-level building. There was a little 1,000-square-foot office open, uh, that had happened to open up right, right beneath us. And so, uh, I took over that lease and basically just kind of struck out on my own, um, I had a coach at the time, and it was a challenge because, well, for a couple reasons. The main one, in my opinion, right or wrong at the time, was there was so much competition. Now, I don't really ascribe to that. There is some reality. In my situation, though, in our business park, there was, I think, 13 Other chiropractors, and they'd all been there at least like 15, 20 years, right? So we had Joel Verona, who had a massive practice with 4 or 5 other doctors underneath him. We had Dr. Simmons, who'd been there for 30 years, super successful, 2 docs underneath him. He did upper cervical. Joel did PI. My dad was doing kind of PI, regular chiro, and some decompression. And it was just like, man, where am I gonna get patients? You know, and I, you know, just like everybody else, where do you get new patients? And, and so that's why I hired the coach in the first place. Hey, how do I build my practice? But it was really struggling. I was not doing very well. Had a couple PI cases. And my coach, Dr. Eric Breitenmoser, at the time, you know, he's Austrian, I think. You know, so he has this heavy accent, and he was like, I had reached out to him, and because he was doing, he used to do these one-day seminars, which were great. In fact, I'm going to start doing these. But anyways, point being, he's doing a one-day seminar in Portland, and I emailed his assistant. I said, hey, could I take Dr. Eric out to lunch? Because I'm a little nervous about my current situation. So I had, you know, I was just very Fairly newly married, just had our first child, and wasn't making any money. So, so I drove down to Portland, which is about three hours from Seattle, took Dr. Eric to lunch. We both had the salmon. I don't know why I remember that, but I was like, what what the heck do I do? You know, I'm because I bought he had this kit, right? It was like five grand or six grand or something. It's like the you know the new patient kit or whatever, and it came in a big box with a bunch of. CDs and manuals, and I went through it all, and, and some of it worked and some of it didn't, and that's just marketing. But, um, I was like, you know, I— Dr. Eric, I'm a little nervous, um, because I'm not making any money. Um, what should I do? And he's like, Dr. Veens— yeah, because he has this heavy— Dr. Veens, you got to specialize. You're dying. And I'm like, you're right, I am dying. How do I specialize? What does that even mean? And he's like, call my friend Dr. Joe. So I went to— so Dr. Joe DiDuro was teaching. So this was 2009. He was teaching how to treat neuropathy patients. And so I called up Joe, put it on a credit card, $3,500, didn't— money I didn't have. And I just dove into neuropathy and I went to Half Price Books. I buy every book they had on the shelf for like 50 cents each. Taught myself marketing, direct response marketing, right? So there's 2 types of marketing. There's direct response and then there's brand, you know. So Coca-Cola on the billboard is brand. Direct response is I put a dollar in. In other words, I'm going to run a newspaper ad. I'm going to spend $1,000. I expect to get $10,000 back, something like that. So bought Dr. Manna. Remember Dr. Manna? Killer ads.

Oh yeah, I remember the— I remember the killer ads, not Dr.

Manos specifically, but yeah, bought killer ads, wrote an ad for neuropathy, put it in the paper, and the phone started to ring. And it rang and it rang, and I started signing up patients left and right and getting patients better with neuropathy, and the practice just took off from there. Now Timing in life is very important, and I was fortunate. And by the way, that's why I went into coaching in the first place. Dr. Bright Moser saved my career. I don't know what I would have done if I didn't go into neuropathy, because overnight I was like $20 grand, $30 grand, $40 grand a month. I was making like $7 grand a month. That's tough. That's not good. So that's why I always tell doctors, it's like, hey, there is so much opportunity with these services when you specialize in something, you get really good at it, and then you learn how to reach the people that need the service. And so I did that for a couple years. My dad was like, what in the world are you doing down there? There's no parking spots for our patients. Uh, now part of that is because when you come in for a neuropathy treatment, you're there for like an hour, right? So they're taking up valuable real estate. But the point with that is he was like, hey, can you help me with the marketing? And I said, sure. So I wrote him, uh, did this 15-page marketing plan for to grow his decompression because he was, you know, had the chiro and always did well with chiro. And he did phenomenally well with Cairo. I mean, he owned Joel Verana's— he sold Joel the building, the practice, all that type of stuff. I mean, he for decades ran the large, probably the largest practice in Washington, had 5 associates underneath them. It was the Mercedes '80s and it was hammer down. So, but, you know, it was different times. You know, now he's by himself. He had sold that practice. He was slowing down. But he loved decompression, and he's like, I want to build my decompression, you know, because as I get older, I still want to practice. I just don't want to do 100 adjustments a day. And so created that business plan and marketing plan for the decomp that started to grow, and then we ended up merging in— I think it was like late 2012, early 2013, something like that. Um, and so we had neuropathy and decompression. We had one table, one neuropathy. Started with radio, got on radio, and radio worked really well for us. And then our radio rep was like, hey, there's other guys. There's this guy, Dr. Kevin Poulsen in Bellevue, and Dr. Mark Shelley, and I think he's in Everett or Edmonds or something, North Seattle, doing the same stuff you, you guys are. You should kind of get together and maybe do some You know cooperative marketing. So we did founded Sound Pain Solutions, and then it was just all bets were off. We all were dumping a bunch of money into marketing, and we all just boom just blew the top off. And the and that little four you know cooperative still going on. My dad's still in practice. The docs all those other doctors are still in practice, still doing great. And so that's really my my story in a nutshell. You know, niches saved my practice. A coach saved my practice, and you know, really specializing in one particular niche first, then moved on to decompression. We ended up, you know, we grew to four DRX tables, four neuropathy stations, four lasers, and it was it was it was a fun ride. I'll tell you that.

For the chiropractor out there that's listening to this, that's maybe struggling, maybe they're around that five, seven, ten. Less than $20,000 a month. They're looking to add maybe a niche like you did to your practice. What kind of a timeframe are they looking at? How, how long would it take them to kind of get up to speed to maybe add that first niche and then to start to see that revenue creep up based upon your experience, what you've seen other clients, but also in your own practice? How quick can a doctor expect to start seeing at least some results?

That's a great question. I would say probably 90 days. You know, I get asked a lot, hey, what niche should I choose? And to me, it's, it's very clear, and we'll probably do a separate podcast on this particular topic. I think decompression is the best niche, best first niche for chiropractors. Right? It's, it's so perfectly aligned. We're already treating the spine. I have found, you know, you're gonna have between your new patient flow anywhere from 10 to 20% are gonna be disc patients.

Right?

So, you know, obviously decompression is not covered by insurances. So you have your chiro practice and say you're doing 10 grand a month. You can buy Super cheap decompression table for like ten grand or something, right? Now that's not the one I recommend, but you can find them, right? And you know, all you got to do is go to Google and say, you know, use decompression table, and there's tons of them out there. You know, as you know, we like we like the Hill. I still like the DRX. I know you know people make fun of the DRX, but hey man, we did we helped a lot of patients and made a lot of money with the DRX. So I'm still a fan. Um, but, you know, you, you get a table, you learn about DiSC. Now, I don't know about you, at Parker— I went to Parker— um, they didn't teach us a whole lot about the DiSC. Uh, and so I had to relearn. And, you know, Dr. Mark Stuten, he's got this PI program and he has all these online courses. Really, really good material. I really like Dr. Dr. Student, and he's, he's just like us, but for PI. He's like, hey, be top-notch clinically, be top-notch from a paperwork perspective, have attorneys want to work with you because you're so good, you know. So I really have a lot of respect for Dr. Student and what he's done over the years. But I bought his MRI courses. I was like, hey, I want to, I want to know what the heck I'm doing here. You know, I don't want to just use what I learned 5 years ago in school. So if in 90 days you can get a table, you can learn, get really good at disc, you can get your protocol together, your price point, all that type of stuff. Now, if you're just doing decomp for your protocol, then you know maybe your care plan is gonna be two or three grand. So in 90 days, three patients, you can add five to ten grand very, very easily per month. And if you're only making $10K, if you can double your practice in 90 days, I mean, that's pretty good, right? I don't know.

So, and that's the power of the niches. And what we'll get into in later podcasts is you're not looking necessarily to, with adding niches, adding tons more volume and taking on a ton more work. 2 or 3 or 4 of these patients a month For a practice that, like Dr. Lin said, $10,000 a month, it's pretty easy to add an extra $10,000 of revenue a month with minimal amount of extra work. And, you know, if you can get $2,000 or $3,000 or $4,000 or $5,000 per patient, and that's just basic, you know, internal marketing, talking to your existing patients. Now you start to, as you build that, add in the external marketing, and pretty soon it starts to snowball and to grow. And that's what we'll dig into a lot more upcoming episodes. But what we want to do is just give you an idea, listeners, that, hey, if you're struggling, if your revenue is not where you want it to be, think about adding niches. Dr. Leone did it and it radically changed his life, his practice. Going from, as he said, about $7,000 a month barely surviving to having a practice within a fairly short time going to collecting well over a million plus per year. And so maybe you don't have aspirations of being a million-dollar practice, but but you'd like to have more. Maybe you'd like to double your practice or to go from ten to twenty or twenty to forty. Whatever it is that would make you content and happy, it's very possible to do with these cash-based services and niches. Any other thoughts on that, Dr. Leone?

Well, I think that's a really good point. It's really up to the doctor how much they want to add and, and, you know, how much they want to grow. My dad told me this analogy or this story. I don't know when I was like a kid, and because he always talked about goals, right, with us. And, you know, he's like, well, when you set your goals, it's like you're going to the ocean and you can bring a thimble or you can bring a dump truck and it ain't going to make any difference to the ocean. So whatever you want, it's not the how that you focus on, it's the what, right? So start with the what, what do I want? And then the how will figure itself out. And I always thought that was really interesting. So sometimes when we're at $10K or $20K, doing $50K or $100K seems out of touch, out of reach, not even possible. And what I would tell you is anything is possible. But you know, you don't have to start— if you're at $10K, you don't have to say, hey, I want to do $100K a month. Maybe in 3 years I would 100% believe that's possible in 3 years, but maybe in, you know, in say the next 12 months, hey, I want to be consistently at $25,000 a month. So I think the goals should be a little scary but super rewarding. And what I can tell you is when you're used to doing say $10,000 or $20,000 a month and then you add an extra $10,000 or $20,000 in cash, man, that's life-changing. And then it kind of gets addicting. Because you're you're just playing the game at a higher level, right? So every patient is worth quote unquote worth your practice now three four five thousand dollars versus a thirty dollar adjustment. It's just a different way to play the quote unquote game of chiropractic, and it's to me it's a whole lot more fun.

Hundred percent, and the old model, and Dr. Vince and I talk about this, is the old model is. In chiropractic is more and more and more and more volume. But in today's world, especially if you're insurance-based practice, you can do tons of volume and have very little to show for it unless you're you know maybe specialized PI or something like that. And with the niches, it's more lower volume, less stress hopefully, and But higher case fee, all cash, all cash, and that is a game changer. And you can do you can still have your traditional chiropractic practice if you so choose, and if you love doing chiropractic, great, keep doing it. But add the niches, or as some doctors do, they just go full bore into the niches and develop around that and build a big practice around that. So it's really. How you want to proceed with your own practice and career, and what your goals are. But the bottom line is these niches open up a whole new world for you docs, and there's so many docs out there struggling that they need to consider this. They need to consider adding a niche or two to their practice and cash-based services, and it's not that difficult to do. You don't need to reinvent the wheel. There's other doctors out there that have done it successfully, and you can learn from them to avoid pitfalls and mistakes and add these niches to your practice. And, you know, as Dr. Vince said, 90 days, you can start to produce, see some fruit for the work and investment of time and labor that you're putting in. And that's when it starts to get fun.

Absolutely. Absolutely. I love that. Well, good. I think that's a good place to wrap this up. What do you think, Dr. Kyle?

I think it's a great place. We'll dig in much deeper into further topics coming up. We want to try to keep these for the listeners to about 20, 30 minutes.

Yep.

Because, you know, I know when I listen to podcasts, if it's an hour, I don't have time to listen an hour, but 15 or 20, 30 minutes.

You almost don't even want to start it if it's an hour because you're like, well, I'm not going to be able to finish it.

Yes, 100%. So, so 20 minutes, actually try to keep these short.

Yeah, exactly. So 20 minutes, like that's a commute or you're making dinner or, you know, you have a, you know, a few minutes at the end of the day before you go home, you know, paying some bills, turn on the podcast. Here's what I would, you know, look, obviously our, our time is super valuable. Um, uh, Dr. Kyle's, you know, running a million-dollar practice in, in a very small town with 4 niches and big team and all that type of stuff. And I have a successful consulting business. My point is we are taking time out of our schedules to do this podcast to help you. So the only thing I would ask, or that we would ask, is if you get value out of this, please share this with a colleague, because that's the only way this is going to be able to grow. And so we want to change lives with this valuable information. So if you got value out of this, if this is something that is interesting to you as a chiropractor, please Tell a friend, colleague, share the link wherever you found it, wherever you watch it. We're going to have this, uh, we'll have a YouTube, uh, playlist on my channel, but mainly this will be on the various, you know, podcast platforms, you know, obviously iTunes and all that type of stuff. So would love it if you could share it, write a review, leave a 5-star review if you got value out If you didn't, don't leave a review and don't give us a 1-star. I don't want a 1-star review. But anyways, help us out. Help us help other doctors if you could. We really appreciate that.

Awesome. Thanks for listening, docs. And, uh, we will be bringing plenty more of these podcasts in future episodes to you. So, uh, we plan to keep this going for the foreseeable future.

Absolutely. Have a blessed day. We'll see you on the next one.