Dr. Vince LeoneOwner, Consultant, Specialized Practice · Owner, Consultant at Specialized Practice

Young Doctors: How to Succeed in Chiropractic Practice

21 Jul 2025 · 3 min

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2:37

In this interview, Dr. Vince Leone and Speaker B discuss the challenges faced by newly graduated chiropractors, especially the heavy student‑loan debt and low early‑career earnings. They stress that mastering core adjusting techniques is essential, but that simply being a competent generalist won’t differentiate a practitioner. Within the first one to three years, a young chiropractor should deliberately develop a specialty that sets them apart—most commonly spinal decompression and disc‑focused care—because the public perceives chiropractors primarily as spine‑pain experts, not wellness providers. By becoming an expert in disc pathology and offering decompression, a practitioner can attract a specific patient subset, command higher‑value cash‑case fees, and improve cash flow while reducing reliance on insurance. The conversation warns against trying to be a “unicorn” (a broad‑scope wellness provider) and instead recommends aligning with public expectations, focusing on spine‑pain expertise, and using niche services to build a profitable, sustainable practice in the first five years.

Chapters

Here's the problem. I think if you were talking to a young doctor, right? Because here's who I'm concerned about. Well, I'm concerned about the guy that's been in practice for 20 years and he's still doing $20,000 a month. But I'm concerned about the young doctors in the, say, the first 5 years of school because, you know, you're saddled with this big debt typically. So I don't know, what would you say to a young doc that is thinking of getting into these niches? And I don't know, like, what would be your advice to a young doctor?
Yeah, if I had to do it, if I had to go back and tell myself my first year practice or second year, I would say, you know, build your clinical skills up, build your confidence up, get good. You got to be a good— you got to be good at adjusting. You got to be good at chiropractic because that's your bread and butter. But I would also at the same time say, within that first 1 to 3 years, you need to do something that's going to set you apart. Yeah. From your competition. Because only, I don't even think 10% of chiros out there are what we would say, they're generalists, they're not specialists.
Yep.
And so you need to do something earlier in your career to set yourself apart that's going to attract a certain subset of patients to you. And as we shared on our previous podcast, decompression is probably the starting point into the world of niches for most young docs because you can enter that at a reasonable price. That's gonna set you apart because dirty little secret in chiropractic is the public sees us as spine pain experts, but most chiropractors struggle with disc conditions. They struggle with spinal stenosis.
They— no one in the, in the, in the kind of general population thinks of chiropractors as wellness doctors, right? So we really need to just follow what the public thinks of us. We're pain docs, right? Here's the problem. He's a unicorn. And what I would tell my younger self or younger doctors is don't try to be a unicorn. Because that's like a point. Put yourself, give yourself the odds of success. You already are an expert in spine. Become an expert in disc. Add a niche like decompression so that you can, you know, charge a relatively high-value cash case fee because you deserve it.