#89 - Master’s Series: Sports Chiropractic with Dr. Tim Stark, Part 1

Hi guys, it's time for another episode of The Factor Podcast. I'm your host, Jessica Riddle. Welcome and thanks for listening. Today is part 1 of a 3-part master series With Dr. Tim Stark. In our Masters Series episodes, Dr. Todd Riddle will sit down with pioneers, innovators, and leaders who have left a lasting impact in their respective fields. In this special 3-part series, we explore what it truly means to achieve mastery, not just in a profession, but as a lifelong pursuit of excellence and influence. Mastery is more than just proficiency. It's about reaching a level of expertise where knowledge and experience merge with intuition. It's the relentless commitment to learning, evolving, and contributing something of enduring value. And those who attain mastery stand at the forefront of their fields, guiding others with the wisdom gained through years of dedication. In this series, we're proud to feature Dr. Tim Stark, a true pioneer and influential leader in healthcare academia. With decades of experience at the highest levels of academic leadership, Dr. Stark has not only mastered the clinical aspects of chiropractic care for athletes but has also been a visionary leader in integrating sports medicine into the chiropractic profession. His influence has spanned generations, and his work continues to impact athletes, coaches, and healthcare practitioners today. So join us as we dive into Dr. Stark's journey, exploring the path of a master, his pivotal contributions to sports chiropractic, And the legacy he's building for the future of the field.

Let's get started.

Dr. Tim Stark, we are live. I've been looking forward to this. Welcome to The Factor Podcast.

Thanks, Dr. Riddle. Likewise, I've been looking forward to this as well for months, it seems like.

We've really been Working hard to plan this one out. We've got a lot of stuff that I want to cover. It's going to be a very wide-ranging conversation. I'm sure we're going to talk about motorcycles and coffee and barbecue, and then try to work in some clinical stuff as well.

Speaking of which, I like your t-shirt.

I wore it just for you. I was trying to harness my inner Tim Stark here. Whenever I'm talking to people and really trying to get our audience to know who they are, I think it's a great place to start from the very beginning. You have a very wide-ranging career with tons of experience in there. And basically what I wanna ask you to do first is just kind of give an overview of who you are. And then what I wanna do is kind of pick out some of those clinical nuggets outta there so that we can try to bring as much value about what's going on around in, in your head.

Yeah. Well, that's a really good starting question and a broad question of who are you? I tend to ask that question a lot when I'm coaching jiu-jitsu and I've got somebody walking in and they want to start a class and I'll tell— I'll ask them, what's your story? And they're like, what do you mean, what's my story? So, it's being— that question's being thrown back at me. I don't know where to even start other than I'm just a North Dakota kid, probably not a kid anymore. You and I share a common feature now where our gray matter is starting to leak out onto our face. But I'm just a North Dakota boy, grew up in a The state, the entire state is small, the state of North Dakota. I grew up in a pretty humble home. Parents worked their tails off to make sure that myself and my sister could have what we wanted. Was encouraged all through school to go to a tech school. Thinking back, maybe that would've been a good choice back in the day, but I had a number of friends that were planning to go to college and I didn't really know what I wanted to do. In the early days, like a lot of us when we're in grade school, we probably want to be veterinarians or firemen, and those were true with me. I think as I got into high school, well, somewhere around middle school, we had a visitor visit us from the United States Air Force. And he was talking about the Air Force and I just was engaged. I wanted to be in the Air Force. I wanted to fly. And so all through high school, that's what I thought I was going to do. And when I was a senior in high school, I was— I graduated high school early. And I was 16 years of age when I started my senior year in high school. And somehow I snuck through the cracks on that. So I started my senior year as a 16-year-old and still knew that I wanted to be in the Air Force. I knew that the Air Force Guard was pretty— what, there was an Air Force Guard in the state of North Dakota that really appealed to me, knowing that I could start early and have some of my school paid for because I still wanted to go to college. Probably wasn't Considering the regulars, so I was going through my medical physical when I was 16, and one of the reasons why I have facial hair is maybe not so much anymore because I've got a fair number of wrinkles. But way back then, when I was 16, I looked like I was nine, and I'm walking around the Air Force clinic in Fargo, North Dakota, the Happy Hooligans Air Unit Air Guard unit there, and they kept asking me where are my parents. They thought I was just some kid running loose in the clinic, and I had a clipboard. I had all my files. I was supposed to be going to this room and that room. And get poked and prodded and evaluated. And I said, no, I'm here for an Air Force physical. And they're like, what? We're stealing kids from grade school now? And so as soon as I turned 17, I couldn't enlist until I turned 17. When I enlisted, when I turned 17, within 2 months, we drove back to Fargo, signed on the dotted line, and started in the Air National Guard when I was still in high school. Graduated, went off to basic training, learned how to become a mechanic on a C-130 Hercules. Loved it, loved it, loved it. Wanted to go regular Air Force, but I also was passionate about exercise physiology, I went to North Dakota. I was actually going to start flying at University of North Dakota. I was there for a year, started flying, and flying hated me. I would get sick every time I would go up in the air. And maybe it was my instructors purposely trying to stall the plane and put me in spins, making sure that I knew how to get out of them, which is an important skill, of course.

Right.

But I would, I would have to say, I can't fly back. I'm so upside down right now. I don't know which way is up. And so quickly realized that flying probably wasn't going to be in my future and exercise and fitness was. And then went to North Dakota State to study. It was called corporate fitness then. And I think that's maybe an upcoming question about college and exercise science or exercise physiology, but it was called corporate fitness then. And that quickly changed to exercise science, but really enjoyed that. And was considering, and then I met the love of my life in the co-ed dorms at college at North Dakota State, Michelle. And she took us to Minneapolis for a job opportunity that she had after she graduated. And I was still in the Air Guard at the time, but was considering maybe medical school because I was told by many people, don't go and get a master's degree in exercise physiology or kinesiology or biomechanics. There's just not a job market for it. So this was. Back in 1990. It's probably changed substantially now. So I was looking at medical school, and then my mom— my mom who passed in February— I credit my mom for sending me off to chiro school. She's the one that said, oh, you're looking at medical school? What about chiropractic? I said, I don't know much about chiropractic. And she said, my chiropractor, who is Dr. Dennis Saylor, who's now retired, said that there's a really good school in the Minneapolis area, which is where we were residing at the time. And the rest is probably still history.

That's pretty incredible. I mean, I think I find— found myself in kind of the same place you did, trying to figure out— I was so interested as a kid in so many different things. I did not have the same penchant for flying as you did, but I found myself trying to figure out what my next moves were. I would really— biology resonated with me and physiology resonated with me. And I'm going down this path for a reason, because I just had a meeting with a student, and I'm constantly talking to prospective students about career paths and what resonates with them. And obviously, I think it's important to have some sort of biology, exercise science background getting into chiropractic school. Not that I think it's a deal breaker if you don't have that. What resonated with you? What was it about exercise science and physiology that, that just kind of got it for you?

That's a really good question. And I, I don't know. I don't mean to throw my parents under the bus, but I grew up with smokers and I'm trying to think if I ever saw them even exercise when I was growing up. I dragged my dad to the weight room, I know, a couple of times when I was in high school, but they were always so busy working and I really don't know what resonated. I think it was probably, if I think back, was somewhere in grade school, some conversations around health and how important it is to take care of yourself. And then, I remember finding myself in the library in grade school, looking specifically for books about health or about smoking and why smoking is bad for you, and reading those and bringing them home and sharing them with my folks, to the point where I was even finding their ashtrays. Like I said, they both smoked. I would find their ashtrays and I would hide them. And I had so many ashtrays underneath my bed and my parents would get, Tim, where's the ashtrays? And I'm not going to tell you, you shouldn't be smoking. And so I'm not really sure. It must've been something in grade school. That's where I really started digging into the books, even as like a 4th, 5th, 6th grader, just realizing that health was important and we needed to keep it top of mind.

It's interesting. So how do you, cause I come across this quite a bit when you're trying to make a decision about postgraduate education or just graduate school, I think a lot A lot of people in our position found ourselves deciding between physical therapy school and med school, physical therapy school and chiropractic school, and so on. How do you think that that foundation and that love of physiology helped to make the decision to become a chiropractor as opposed to med school for you?

Yeah, that's awesome. As I said, I was looking at medical school. My mom said, look at chiro school. I then did visit with one of our admission advisors, name was Lynn. And I think I'm still connected with her on Facebook. And that was back in 1992, roughly. So thank goodness for Facebook and staying connected. Maybe not everybody is thankful to have Facebook.

I think it's great for that. You're right.

Yeah. So she was great. She showed me around the program at Northwestern, told me about— I said, quite honestly, I don't know really the difference between chiro and medical school. I know they're both doctors and how does this work? And I looked at— I looked at and I did some research on my own. I looked at the curriculum of some of the medical schools around the area. I looked at the curriculum of, of chiro, talked to medical doctors, talked to chiros, and just realized that with my interest in strength conditioning, my interest in sports and performance, health and fitness, that it's just at that time seemed like chiro was a better fit to complement those components of wellness, I guess, if you will. Versus the medical side, maybe not aligning quite as well.

I think with a love of exercise and having a background in strength and conditioning and just being physically active, I think you're right that chiropractic from our side of the story fits a lot better than the medical school route at this point. Although I think that's kind of changing a little bit. I see medicine coming around to being more preventative. And I'm kind of happy to see that. But how was chiropractic school for you? What was the thing that you loved about it? Were you able to incorporate your strength and conditioning and physical fitness early during chiropractic school, or did that come afterwards?

Todd, you're an awesome interviewer. These are, these are great questions that they make me think back. I think whenever you think back about some of the nostalgia of where you came from is always an interesting conversation. The first year of chiro school, I think like almost any program, it was really, really tough, more challenging than I thought it was going to be to the With the exception of I was told, don't think of— don't think about doing anything for Christmas or any of the holidays. You're going to be studying. You're going to be— you won't be doing anything. You won't see family for 3 years. And I remember telling Michelle, my bride, I said, I don't think I'm going to be seeing you for Christmas for like the next 3 years. This is going to be close to hell from what I hear. It wasn't that bad, but it was a tremendous amount of study. I think some of the things in regards to maybe transitioning to sports chiro as well and complementing strength conditioning background was around the second or third term. No, I think it was even the first term. I met the president of the Student Sports Council. His name was Sean, and sat down with Sean. We were talking about the Student Sports Council, and I said, well, what's, what's the sports council? What's sports chiropractic? I really didn't know too much about it at that time. And again, that was a really engaging conversation. I just— and one of those things that just clicked, like, okay, this is my path.

Yeah.

No question, this is my path. And I don't know, hopefully people have those types of clicking or triggering sensations of like, this is definitely the vector I need to go. I don't think I've had many of them in my life. That was one of them where I just realized I need to jump on board. So I said, how do I become a member of the Student Sports Council? How do I get involved? And so that was probably early on, as you queried. early on aligning some of my strength conditioning and human performance interests with the chiropractic program and getting involved in a student organization.

Yeah, I think it really does help to dial your focus. I remember when I was in chiropractic school, I didn't have the same capabilities that you did from a sports standpoint, even though I was still deeply involved in sports and sports performance. My school didn't offer a lot of the same opportunities. So I'm curious though, Being a faculty member at TCC and helping to moderate the sports program there, what do you think the big difference, or what do you see as the big difference between when you were a student in a sports chiropractic program versus today? Are there big contrasts? Has it changed a lot?

I think it's changed tremendously. I believe students now have more opportunities than we did 20, 30 years ago when we were first in chiro school. I think And I know we're going to be talking about maybe— we'll probably talk about the professional associations and organizations. But I think these professional organizations are recognizing students and student leadership more, or even young doctor participation. The ACA Sports Council has their Next Gen Award. They also recognize students for student leadership. FICC, the International Sports Chiropractic Federation, they're inviting students to attend games, international games. And these students, when they're attending, have an opportunity to work with some of the best sports chiropractors in the world. And when they're there, of course, they're not touching athletes. That's not their role. Their role is to collect data and support the doctors that are there. But those opportunities, I don't recall existed 25, 30 years ago.

You're right. I, 2 years ago, worked World Games in which we had several students in attendance and the value of having them there, obviously, aside from Having some helping hands to run some errands every now and then. They were integral in making it a good experience for all of us in that, like you said, the data collection. The proof is in the pudding for us, and we have to accumulate that data to show just how effective we are in that sports environment. So, I'm curious. So, after chiropractic school graduation, I believe you moved back home. And set up shop for 10 years?

I actually, I did stay and did a residency. Yeah. After I graduated, before I even graduated, I was doing an externship on my T10. There's 10 trimesters at Northwestern. My T10 was down in Iowa. So I left home. I left my bride for a few months because I just knew that I needed to spend time with one of these 2 individuals in Iowa. One of them was Dr. Brian Milk and the other one was Dr. Bill Moreau. And they were both in Iowa. They were very influential with, again, supporting student involvement At Northwestern, they would drive up to Northwestern like every other weekend and hold a seminar. And usually they were teaching within the CCSP course, which I think we'll probably talk about later. But they're also holding extra seminars for just the students to learn various different things about sports chiropractic. So that was very influential as well. But I knew I needed to work with one of these 2 individuals. I decided to work with Dr. Brian Nook as an extern. Mostly because he was in a small town and I felt like there was greater opportunity to be more of not just a sports chiro, but a GP chiro and see more complicated— not that big towns you don't see that, but being Dr. Brian Nook was the only doctor in town. There were no medical physicians. He had a couple of practices. One town, he was the only doc in town. We did see some really out-of-the-ordinary non-musculoskeletal cases present. In our clinic. And where was I going with this, Todd? Too much gray matter.

You were talking about your transition from chiropractic school to setting up your own practice.

Yeah, that's right. And so when I was working with Brian— thanks for getting me back on track— when I was working with Brian, we were talking about sports chiro and what we need to do to be influential and make an impact and change And maybe brand sports chiro in a stronger sense. And we were both talking about residencies, and I felt like Northwestern had one of the best radiology residencies across the country. Tim Mick was leading that program at the time. So impressed with his knowledge base. And I just thought, man, if a chiro could graduate and do a residency in sports and rehabilitation, and in 2 to 3 years have the knowledge that Like Tim Mick has around radiology, but it'd be about sports injuries and rehabilitation. That could really be a game changer. And so this was 1996. Now I'm finishing my externship, driving back and forth from Minneapolis to Iowa about every other week or every 3 weeks or so just to spend some time with my bride. And when I'd become— when I'd come back to Minneapolis, I'd spend some time with the president at Northwestern, Dr. John Allenberg. And I said, John, I've got a proposal for you. What do you think about a sports injuries and rehabilitation residency here at Northwestern? Cutting edge, first one in America, et cetera, et cetera. And long story short, we were able to make that happen. I graduated in 1996, walked across the stage and started my residency in sports injuries and rehabilitation. And I was in that position for 2 years. And then I eventually— well, I was offered a full-time teaching position at Northwestern. I just felt like— I really think I need to get out there and, and, and start a practice, see what that feels like and see patients on a regular basis. And then if I'm interested in teaching, then I'll come back to it.

So I think this is an interesting place to pause for a second and address the importance of mentorship. I mean, you, it sounds like, and I know we're, there are gonna be plenty of other names that we're gonna discuss. You, you had some titans in your corner and you were able to learn and, and take on their knowledge. I mean, What a wealth of experience you had access to. Any comments about it?

Dude, I don't know how to explain it. Luckiest guy on the planet to be on the path, on a particular path and at the right time to have— and we used to call it the Nook and Moreau Show. And so they were on campus so frequent and at the same time regularly. Nook and Moreau is coming, Nook and Moreau is coming. And then I would just— and I eventually became the president of the sports council on campus. So then I would just jazz up that whole brand really and getting the students engaged. And we'd have 100 students in the gymnasium, and Northwestern's program wasn't that big compared to some of the other institutions, but we would have a lot of engagement for students bringing their tables in the gymnasium. And either Dr. Brian or Dr. Bill were up on a little platform and, and doing what they're teaching. And speaking of Titans, I, I was surrounded by them in 1996. So Again, right path, right time. In 1996, I graduated in April, and I remember my last year of chiro school, my one professional goal was I just wanted to go to an Olympics before I retire. I wanted to work as a sports chiro, contribute, work with some of the best athletes in the world. I graduate in April 1996, I start my residency within weeks, and then—

Uh-huh.

As soon as I sit in my residency chair, I get a phone call and a letter from the International Sports Chiropractic Federation inviting me to the 1996 Atlanta Olympics, mostly not to be a provider because I was just— I had just graduated. I'm by no means a titan, but they wanted me to go down there and help manage the clinic, collect data, support the doctors. Again, these titans that were there. And the titans that were down there, Todd, amazing men and women to be able to work with. And I still call them. They're like, yeah. And if you're, if you've been on Facebook and have been seeing some of my stupid profile posts and thanking my uncle this, my uncle that, because they're, they're selfless individuals that most of them are, 99% of them. Are selfless and they want to— they just looked at me as this, as this young guy and asked or answered any questions that I asked. When we'd go out for supper, they knew I was a poor student, just graduated. So they'd always be buying supper or they would split my bill and just a great group of men and women.

I found that myself. And I think when you decide to go down the sports chiropractic route and you get into the right circles, you find out just how selfless they are, how much they want To help you even to some degree financially, like you said, picking up dinners, things of that nature. I've got so many questions now. The first one that kind of popped into my head was, obviously you were instilled in you very early on the thought process and the idea of hard work, and you were a go-getter from day one, it sounds like, in chiropractic school, kind of took the bull by the horns and tried to mold your own experience. How much of that do you think plays into the success of a student that is interested in sports chiropractic?

Well, I've— I'm gonna, I'm gonna reference back to a statement that I've told my fellows when I was building and running the Human Performance Center at Northwestern Health Sciences. Every— the first week that I would have a brand new fellow, I would tell— I would identify what are their interests and their goals. And I told every single one of them that you will get out of this program what you put into it. If you coast through this program, you're going to be an average sports chiro when you get out. If you, if you put your heart and soul into it, not to take anything away from family, not to take anything away from your own health, but really focus, ask good questions, do a deep dive on a lot of different topics. far and work harder than the next person, you're going to be exceptional. And I think in order to be extraordinary in anything, you've got to take extraordinary efforts.

I would agree. I use the term a lot that learning is an active process. It's not passive. Now, having taught at the collegiate level for, shoot, 15 years now, it's still one of my primary mantras is that you have to mold how you want this to go. We can only introduce so much information to you before you take it upon yourself. to sculpt it and figure out what you want it to become and then pick it up for yourself and keep moving it forward. My next question was, and I want to jump back into 1996, can you give us an idea about what the state of sports chiropractic was then at that time?

So that'd be the year that I graduated. The Atlanta Olympics were about, so there was a lot of energy in the country around sport. Where sport chiro fit in It was still a challenge in 1996. Again, I think there's a lot more opportunities now. For example, the USOPC, and you volunteer your time and contribute on a regular basis as well with national teams. Those opportunities were rare. They were there, but they were rare. And USOPC at that time wasn't hiring sports providers. They were inviting them to come in and do internships. They were inviting them to go to university games and Pan Am Games and the Olympics themselves. But to work within the sports medicine field itself with other providers, I don't think that existed yet. And now every, I believe every OTC, Olympic Training Center, has a sports chiropractor working with them. The other pro teams in America particularly, it's so cool that every NFL team, as I under— if I've heard correctly, has at least 2.

Wow.

Sports chiropractors working on every NFL team. Unheard— not virtually— that type of statement, unheard of in the early to mid-1990s. However, there were chiros certainly working with teams. There, there was— and if you know much about the history of sports chiro, I just know a very superficial layer of it. It goes back to when chiros were working with high-performance athletes before the term sports chiropractic was even—

Right.

Any consideration. So we, all of us stand on— I know it's cliché, but all of us stand on shoulders of those that have blazed that trail, and there's no question about that. Very thankful for it. But as you said, you can't just coast to be extraordinary in the field of sports, Cairo. You just can't coast and plan to travel with the Nigerian bobsled team. No. I think that's the team, one of the teams you travel with or have traveled with, right? Yeah. You just can't coast and go to an international sport game. You've got to, you have to have a bit of a pedigree and a, not necessarily a go-get-it-ness, but a go-giver-ness. You've got to be able to make some sacrifices in order to participate at this level as well. I remember some of my colleagues. who have said when I, when I would travel internationally for either lecturing, but mostly for these games, some of my colleagues will say, oh, are they paying your way? Because you have to close down your office and this and that. Like, yeah, it's one of those, one of those sacrifices. And my family was left behind as well. And you're gone for days or weeks on end and it is what it is. So you have to be, you have to be willing to have those types of sacrifices as well.

I think you're right about that. The service component is also a thing that I talk a lot about, that if you're not willing to be selfless and serve with abandon, then it's gonna be really hard to kind of cut your teeth in this because there is a lot of time and finances that have to be given up to, to get to those positions. Maybe someday it won't be that way, but there's still a lot of service that has to be done. I mean, I also think that because we stood on shoulders of giants or still do, that it is also our responsibility. And I'm fairly certain that's probably why you got into education was to move that forward, to pay that forward in a way that harnessed our own skills and our own capabilities, but to also maybe even leave our own mark on it as well. So, I'm looking forward to kind of delving into that a little bit, talking about your experience in education and your background in leadership and kind of how you've molded your own career to try to not only obviously better your career but better chiropractic. So, So, what came after '96? What was the transition?

Well, '96 to 1998, I was in that residency at Northwestern Health Sciences. Man, again, one of those turning points. Would never give that time back. It was very influential in my growth. As I said, I think it was because of that position why I was invited to the Atlanta Olympics in 1996, in which I met Some of the greatest men and women in sports chiro. And I remember maybe the second week, it was a 3-week stay down there. And there's a number of stories that go around that Atlanta stay. But one of the stories was we had a number of Australian doctors of chiropractic visiting the clinic that Fix had put together, the International Sports Chiropractic Federation. And these Australian doctors were thinking forward to 2000. So in 4 years, it was going to be in Sydney. And these Australian doctors were exploring how this clinic was put together and how they're reaching out to athletes and how these athletes are coming in, how they're being managed, etc., etc. And so I got a tremendous opportunity to meet these Australian chiros, befriend them, and then the horrifying question or demand comes up and they said, hey, Tim, why don't you— why don't we go in the back of the clinic here and have you treat Each of us. Young doc, maybe hundreds of patient encounters, nothing like thousands and thousands or tens of thousands, but literally dozens or hundreds of patient encounters. And I'm supposed to dazzle these Australian sport chiros. And they did qualify with no pressure, of course. They said, and if you do a good job, we'll invite you to Sydney in 2000.

So that's where your face goes numb and you forget everything.

Yeah.

Like, oh man, I either got to completely focused and knocked it out of the park anyway. They high-fived me at the end and said, well, we hope to see you in Sydney. So that was a nice way to end that particular encounter.

Yeah, sure. That's so great. So you eventually got a practice started on your own.

Yeah, so I— in '98, I did finish that residency again. I was offered a full-time teaching position And we knew we wanted to go back to North Dakota.

Yeah.

So we researched a number of towns, visited a couple of them, and I told Michelle, I said, it really depends on the high school athletic director. So we knew in North Dakota there wasn't any pro teams, or we had some college teams, but I wanted to be involved with the high school level. And I told Michelle, I said, whatever high school athletic director says, yes, we would love to have you work with our athletic teams, In any capacity, strength conditioning, sports chiro, whatever. And so we talked to a couple of high school institutions. The largest one in the state was very excited to have me participate in some capacity. We have emails to demonstrate that. And we were all in. So we were all in to move to this particular community in North Dakota. And then once we, once we made that commitment, the athletic director said, oh, by the way, maybe you should talk to our medical director just to make sure that he's aware that You've been invited and, and so on. So I did. I reached out to this medical group and got a 2.5, almost a 2-page letter back on letterhead from the USA, whatever. I'm not going to give too much information, but basically the 2-page letter said, thanks, but no thanks. We don't need you. We don't want you. And I'm paraphrasing, of course.

Yeah.

But that's how I enjoy your private practice, but you're not going to be Working with our athletes. Well, lo and behold, I did open up my practice eventually in 1998. And the very first phone call I get was from their athletic trainer who knew me. I had met them as I was walking around the school and trying to understand their athletics program. The head athletic trainer did call me and said, man, I've got this athlete with low back pain, not responding to anything I do. Can you help me out here? And I hadn't even officially opened. I was maybe a week away.

Right.

So that did snowball into some other opportunities.

This is the golden door when you get that kind of desperate phone call from sports medicine saying, hey, we really need your help on this. And usually that, like you said, it's that snowball effect that just kind of gets it rolling. And the rest, as they say, becomes history. How did you enjoy clinical practice in your, in your own office? How did that go for you? Because I think a lot of people have this idea that once you get open and going as a sports chiropractor, that everything is Olympic medals and big paychecks and all the trappings of saying you're a sports person. But I think those of us that have been in the trenches know a bit better. How was it for you?

Dude, I think it was one of the most confusing times I ever had in my entire life, at least my professional life. You leave chiro school and I don't know if there is a chiro school that teaches business really well. And maybe it was the era of being in the mid-1990s still, but ICD-9, ICD codes and CPT codes. My wife is an IT guru and she was helping me start some software for the clinic. And she said, okay, let's run a sample patient through it. It's asking me for an ICD, an ICD code. And I was like, I don't know what an ICD code is. And then she goes, okay, well, I can look one up. They're given an example. How about a CPT code? I don't know what a CPT code is. And I went all through my externship and not throwing Dr. Bryan under the bus because he even said, he said, Tim, you could work up front and learn how to do the front work, or you can be back here with me or a little bit of both. And I said, I don't want to know anything about running the front. I want to be the best diagnostician that I can be. So I'm going to be in your shadow the whole time. And so I chose that path, which was not the right path. I think anybody that is going to leave school, open up their own practice, golly, they better, they better pay attention in business class. Because even marketing, what I learned about marketing, I didn't learn anything in chiro school about it. It was all about actually my newspaper guy in the community that I practiced in who invited me to a number of marketing opportunities where I could learn about how to market my practice. And so, yeah, it was a, it was a very confusing time. Energizing to some degree because I like building stuff. I like starting from scratch, or I like taking an absolute mess and cleaning it up and finding some order in it. Well, this was an opportunity to start from scratch and build a practice and build it the way I wanted to see it built in my community, mostly with a sports focus. In regards to all the glamour around it, I didn't pay myself a single penny for the first 3 years.

Right.

So, I remember my first check that my bride cut for me. She goes, guess what this week is? And I go, I don't know. What's this week? She goes, it's payday. It's pay week. And I just wrinkled my forehead because I hadn't been paid for 3 years. I said, what does that mean? She goes, I think we've actually got enough now in the bank that I can cut you a check. That was a big deal. I remember buying my first stool because I had been kneeling for 3 years and wearing out the left knee. Left knee of my pants when I'm kneeling at the head of the table. And I was so happy to be able to buy a stool. And so I think there is those little wins that actually are massive wins when you're first opening up a practice. You got to be proud of yourself too when that happens.

It recalibrates everything. Something simple as having a stool to sit on. Yeah, I find that a lot of students coming out trying to figure out whether they're going to open or go work for someone. Whichever path they choose, I think there are some misconceptions for them about how it goes. If they're going to go out on their own, how much it's going to cost. And if they're going to go work for someone, how much they're going to make. And usually both are pretty inflated. So it's, it's kind of interesting. So how long were you in private practice for, at least in North Dakota?

Yeah, my practice in North Dakota, gosh, I practiced for about 8 years or so full-time. And at that time we had built, we had moved the practice from one part of the community to another. It was a really good move. We needed more space. We were expanding doctors. At one point in time, I think we had 5 providers in the office before I sold it and moved to Australia. I think it was 5. And I, and I think one of them was an OT and she was working independently, but she was under our roof and we would collaborate back and forth on some patients. We had a massage therapist and I think we had 3. 3 doctors of chiropractic, maybe 4 at one point in time. So we had some pretty good growth. I was able to sell the practice to the first associate that I had brought on. He was an intern of mine, Aaron Jones. I think I can share some names.

Sure.

Aaron Jones, he was one of my first interns when I was in my first location, and he was great. He was really interested in sports. Asked really, again, asked really good questions, was humble. He knew where his weaknesses were. He didn't admit any strengths really, and because he wanted, he wanted to just be weak, period, so that we could just feed him with information no matter whether he was already good at it or not. He could be— he turned out to be an awesome clinician. No question to have him take over when I was traveling, having him take over the practice, having him take over the sports teams we were working with. Really smart dude. And then I remember when he was an intern, he was finishing his internship and I said, all right, Aaron, what's next? And he goes, well, and he was kind of shy about it. He goes, I was kind of hoping that maybe I could come on as an associate at your practice. And I did call him an associate earlier and I misspoke there and I'll tell you the story here. But he said, I'm hoping that maybe stay here and I like the community. I like the practice. I'd love to come on as an associate. And I said, nope, not interested in hiring you as an associate. And I felt like I just crushed his spirits.

Yeah.

And then I said, hold on. I said, I would love to bring you on as a partner. And it was an early decision that I had made when I first opened up my practice that I really didn't want to have associates. I wanted to have partners. I wanted to have partners that had a stake in the game, that were really excited about the brand and were willing to grow the brand. And do the best they can because now they're working in their business. They're not working for somebody, but they're working for themselves. And I felt like they could manage and address their patients in a better way.

Brilliant business move. I, I share a very similar sentiment to that. So over the course of your time in private practice, talk a little bit about your distribution of patients. Lots of sports? Was it more GP? What, what did you, what did y'all see?

Yeah. I think when graduates leave and they want to be a sports chiro, they think that's what their practice is going to be like. And in other words, like 80%, 90% sports. And it's— it depends on how they set up their practice. If they set up their business model in a capacity where maybe they're in a fitness center or they're part of a fitness center, and I'm seeing that more and more, and I think it's a great business model.

Right.

Yes, they're going to see a patient base that's very active, probably leaning more towards being very athletic as well, where I did not do that. Thinking back, I would have, I would have done that times 10 for sure, but it just didn't occur to me. Later, years, years later in the practice, I did start a strength conditioning business and that, that did of course feed into my practice as a GP. But for the most part, it was a GP practice. I'd see moms and dads, aunts and uncles, et cetera. And of course they would have kids that were in sports. And of course, if you build a trust with those parents, they're bringing their kids in and vice versa. Kids are in some sort of athletics program. They hear about you through another parent or another fellow athlete. They hear about you. They come in, the kid comes in, and next thing you know, you're seeing the whole family. And so again, I started off with my very first patient was an athlete. But it real quickly tipped to being a GP practice. But I volunteered a lot. I did a lot of volunteering, probably 2 or 3 nights a week. I was out working with athletic teams. And it does not necessarily mean those athletes are gonna come see you. It's, again, it's one of those service-oriented things that you have to be able to swallow hard when an athlete is sitting in front of you and you drive across town and you work with this team. And the athlete sitting in front of you, they might be from a different part of town. And they're and they're like, oh yeah, I saw my chiro yesterday. And you know it wasn't you. I saw my chiro yesterday, and they said my SI was out, and they knew you were going to be seeing me. So could you take care of my SI? And I go, well, let me take a look at what what that even means. Yeah, that's another conversation. But that's that's just part of it. And again, you've you've got to realize why why am I volunteering time with these? these teams and these athletes and doing what I'm doing. It's not to get rich and pay for that third boat. I don't even have a first boat, but it's, it's a matter of contributing and helping people where they should be helped.

You said something there about the volunteer part, and again, I think that's going to be a theme that is intertwined throughout the whole thing. I also talk a lot with students and other practitioners that are kind of thinking about switching up, about building a practice, getting involved in the community. Being a pillar of your community in whatever way you decide to do it, whether that's join the Chamber of Commerce, get involved in the Rotary, join your church and volunteer at your church, whatever the case is, getting involved, I think, is one of the fastest and best ways to grow a practice because then everybody does become like family. Like anytime someone comes into the office, you're happy to see them because it's like a reunion.

Right. Yeah. What better way to brand yourself than actually to have them experience you as a person outside of your clinical environment, knowing that you're there for the community.

Right.

And that's exactly what I did. I threw myself into the community. As I said earlier, we're researching towns. I wanted to be part of the high school, but I also wanted to throw myself into the community. I did become a chamber member, but not just a chamber member, but I became part of 2 committees. One would go to business after business after business and do ribbon cuttings for them. And we'd introduce ourselves as, my name is Dr. Tim Stark. That's what I do.

Right.

And then I became, then I sat on the board of directors for the Chamber of Commerce. I was involved with a couple service clubs, the Lions and the Exchange Club, of which I became the president of the Exchange Club. And then later on the district president, which involved North Dakota and all of South Dakota, included about 12 different exchange clubs. So I was traveling between the different states. Again, it's service oriented. It wasn't really building my practice, but if anything, it was helping you maybe, maybe helping me build my brand. Not that I. That was my intention at all, right? But building relationships and trust within the community and showing people that I'm not just here to run a business and, and take your money, but I want to contribute back.

Yeah, it's that old cliché, they don't care about how much you know until they know how much you care. And that kind of embodies, I think, one of the best ways to grow a practice.

That's it for today's episode. Be sure to join us for part 2, where Dr. Starks talks more about the importance of mentorship, his pioneering work in sports chiropractic education, the strides he's making in teaching and mentoring future practitioners, and his experience at the 1996 Atlanta Olympics. You won't wanna miss it. Episode 89 drops in 2 weeks. As we enter the last quarter of 2024, we're also wrapping up our Factor Rehab live course schedule. Only 3 hands-on course dates are remaining for 2024. We'll be in Houston, Texas on October 5th and 6th, West Palm Beach, Florida on November 9th and 10th, and Greenville, South Carolina on November 16th and 17th. Click the link in our show notes for full details and to secure your seat, as these dates are expected to sell out quickly. And if you're interested in pursuing a new certification for the new year, be sure to check out our show notes for an exclusive discount offer from our sponsor, Southeast Professional Education Group. Click the link to receive a discount code for 10% off one of their online and hybrid course offerings and certifications. We'll see you next time.

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