In this 42‑minute mentorship video, investor‑mentor Alex (Speaker A) works with Raymond Kuhner, founder of ChiroFirst of Washington, to evaluate and scale his multi‑location chiropractic practice. Raymond outlines his current operation: six brick‑and‑mortar clinics, $5.2 M trailing‑12‑month revenue, $1.2 M EBITDA, 23 % net margin, and a 75 % insurance‑based payer mix. The conversation covers the company’s expansion strategy (historically buying locations, now considering organic growth), 3‑year goal of $5 M EBITDA and eventual institutional sale, and the core service offering (custom 60‑90‑day treatment plans with high‑ticket packages and spinal decompression). Alex probes the business model, pricing, lead generation, and sales metrics: ~35 leads per location per month, 80 % show rate, 71 % close rate, CAC ≈ $700 K, LTV ≈ $3.4 K (4.8:1 LTV:CAC), and ad spend of $1.5‑$2 K per location. They dissect marketing performance across Facebook and Google, noting ROAS ranging from 8‑to‑1 to 24‑to‑1, and discuss constraints such as inconsistent lead flow, complex insurance verification, and scaling people operations. Alex identifies opportunities to increase ad spend on high‑performing channels, refine sales infrastructure, and standardize operations across locations. The session ends with a walkthrough of the patient intake and sales process, setting the stage for a strategic plan to boost revenue, improve margins, and position the business for a future sale.
Chapters
If you doubled revenue across all of these, you'd already be at 5, and that's probably about 6 months of work.
Yeah, yeah.
So this is Raymond, he's a chiropractor, does $5 million a year. And this is Alex, I'm an investor and I make all the money that I have a golden chair with diamonds that I sit on at bed and I just count how much money I have. And the point of today is I'm going to try and help Raymond take his chain to the next level.
Hey Alex, uh, my name is Raymond Kuhner, I'm the founder of, uh, ChiroFirst of Washington. So just a little bit about my business, uh, we currently have 6 brick-and-mortar locations, trailing 12 months revenue $5.2 million, EBITDA of around roughly $1.2 million, and our net profit is about 23%.
Do you buy those or do you open up organic?
So far I've bought all of them.
Oh really? Okay. Yeah.
But I think moving forward we're going to change our strategy a little bit.
So overall the company is doing well. $5.2 million, 23% margin, healthy. I was curious whether he opened them organically or he bought them because there's basically two big expansion strategies. Either buy or you build. And so he chose a buy strategy. That initial kind of sorting told me, okay, these are the types of questions and problems points I need to look out for as he goes through the rest of the presentation. So what's the goal?
My 3-year goal is to try to get to $5 million EBITDA. I want to try to build a business that can run individually, but then I also want to entertain selling to an institutional buyer.
So this is very much up your alley, what we talk about. So when someone says they're trying to build it to sell it versus build it to keep it, I see both of those as basically the same path. It just shows how much they want to work like super long term. Either way, all paths lead to building a better business. So who do you help?
Specifically, our key demographic that we help is 35 to 65-year-old men and women that have some kind of condition that we can help with, whether it's pain, discomfort, or loss of movement.
Insurance or cash?
We're about 75% insurance.
Oh, interesting. Okay, how do you help them?
So the way we help them is when someone comes into our office, we'll design a custom treatment plan for them that might be over a period of 60 to 90 days. It might include chiropractic, rehab, and spinal decompression, right? So spinal decompression kind of differentiates us from a lot of our competitors because it's a niche service that we offer for people that have disc-related injuries.
Is that like stretching people out kind of thing?
Yeah.
Okay. Well, how do you make money?
Our offer. So basically on the front end, we offer a free consultation. So then when the patient comes in, our packages can range from $2,400 to $3,600 over a 60 to 90 day period. We're primarily a recurring revenue model.
Mm-hmm.
And roughly 1 out of every 7 of our patients, they come in for a larger case value. So like a car accident or a work injury might be worth up to $10,000.
Well, right off the bat, I think the reason that he's been able to expand is that he's making a decent amount of money. And so typical, you know, chiropractors who don't know business will sell one crack at the back at a time, whereas he's already selling high-ticket packages, which is the right direction to go for, you know, a premium service. And he obviously has a super premium with this whole kind of insurance $10,000 thing. And so it's like right off the bat, his price points are right. What's, what's What's advertising?
How do you find them for paid advertising? The number one is Facebook ads, though we spend about $1,000 per location on that. The second one is Google ads. So we're spending roughly $500 to $1,000 per month on, on each location.
Okay, got it. So what's sales velocity? How many do you sell per month?
On average, we're, we're getting about 35 leads per month. And out of the 35, we have 28 that show.
Okay, that's pretty good.
And so we have a show rate about 80%.
That's great.
And our closing rate is about 71%. So total sales probably roughly around 20.
Cool. Solid numbers. So right off the bat, Raymond's got really strong show rates, exceptionally strong close rates. And mind you, this is one location. So we'll see if that's system-wide, which then on some part of my mind, I'm like, okay, when you have super high close rates like that, we might need to bump prices. Like it just shows that the market is willing to spend more. And so for me, like I would say healthy close rate percentage is usually like 30 to 40%. That's kind of like usually where you find the sweet spot. Of price versus number of units sold. Not always, but that tends to be like a rule of thumb. But by and large, it shows that he knows how to get people to shop and he knows how to close. What's standing in the way?
What's the problem? If I were to prioritize my constraints, what I think they are, number one, I would say is probably lead flow. I think that we could do better in that department. It's not consistent. Okay. When I had one location, it was really easy to predict that and to, to change the outcome pretty quickly. But as we've scaled, I'm having a tougher and tougher time to, you know, scale the marketing.
What Raven's dealing with is super common when you go from one location to multiple, especially if it's purchased, let alone, you know, organically grown, because usually I call it founder magic or owner magic. It's like if you have one location, it's like your thumbprint's on it, like your heartbeat's on it. Everybody knows you. They kind of grew up with you. Everyone kind of knows your vibe. You have old customers who remember you. And so it's like always going to be special and different than everyone that you open after that because you're typically just not nearly as entrenched.
Second one would be like our sales infrastructure because we are 75% insurance-based. There's so many different plans out there, right? So we have to— when the patient comes in, we have to determine what kind of insurance they have by verifying it and then make a customized plan based off of that. So if there's a way to streamline that into one day, I think it'd be much more effective for us. When I personally practiced, I was able to do it in one day, but I'm having, I'm having a tough time training my doctors to be able to do that.
Okay. And then people operations.
People operations. So obviously when I had one location, it was really easy to control the standard. Right. But as we expand, it's harder and harder to have that same standard.
Hmm. Okay. So let's see the numbers.
So going over the numbers again. So top line revenue, $5.2 million last 12 months. Profit, $1.2 million. Net margin is about 23%. Our CAC is about $700,000. Our lifetime value is $3,400. So that's 4.8 to 1 LTV to CAC ratio. Marketing spend, we're spending about $1,500 to $2,000 per location right now. The show rate's 80%. Close rate 71%, and our annual ad spend on marketing is about $110,000.
So right off the bat, obviously the numbers are really strong. The amount that he's spending per location seems low given how much money he's making. So I think there's probably opportunity there, but I'm just very curious how it actually breaks down between locations because that'll probably give us more insight. Huh. Okay. Do you have anything broken out between channels, between Facebook and Google?
So this is our, our Facebook data. I was able to put together like our 12-month numbers for all the clinics for— and then for as far as the challenge that we have is because we're insurance-based, we don't get paid for like 30, 60, 90 days after. So I had to go back and I picked Q2 for 3 clinics.
Yeah.
Okay. So these are the numbers for, for those 3 clinics in quarter 2.
So looking at this whole sheet, I scanned it and then the bottom where you can see Q2 there, it's Capitol Hill, Everett and Kent. And so Kent, you see an 8 ROAS there. So that was really strong, the lowest CAC by a decent margin. And so I wanted to understand whether that was a performance thing, or like it just costs less because of a marketplace, cost per impression, CPMs are lower there. There might just be more people. I wanted to double-click into that to figure out why that one's doing so much better than the others. Okay, so why is Kent so much better? Is the doc there different than the other docs?
They're about the— no, he's, he's, he's good, but he's, he's about the same. I, I would say that culture of that team is, is really good. I think that's one thing that stands out.
Cuz, cuz CAC is half of Capitol Hill, right? You're getting more LTV and lower CAC at Kent.
Right.
Is it that the people that are coming because it's insurance? So is it that they're like feeling better? Like what? Like how could they get LTV to be so much higher? Give me other data that you've collected together.
Yeah. So this is from Google AdWords.
Well, these obviously do significantly better than your Facebook ads.
Yeah, for sure.
Interesting. So right off the bat, look all the way to the right. ROAS means return on ad spend. So you see 12 to 1, 24 to 1, 9 to 1. I'm seeing really strong ROAS here. And so I'm thinking, okay, so if I have a machine that I can put a dollar in and get $24 back out, I want to put as much money in that machine as humanly possible. And so that's why my next question. I'm asking how much more can we spend here? This is obviously a profitable channel. Are you maxed out on spend here?
I don't think I am. I work with a third-party company on this and I basically go off their recommendations.
Okay.
I personally would love to spend more obviously on this because the return is so high.
Yeah.
And these people are in, you know, immediate need of help.
Yeah.
So they're much easier. Our case acceptance goes up much higher with these patients.
High intent. Yeah. Really good. I mean, shoot, this is, this is the most promising part. So if you think about people's willingness to pay being proportional to their spending power and the pain that they're experiencing with it, now he literally has people in pain. And so when you have someone who's being interruption-based, that means like they're just scrolling around and they see an ad. They're probably not as in pain as somebody who's like, oh, I just did something to my back. They're on Google, they're searching for a solution immediately. So the intentions are completely different, or rather they're significantly stronger with people that are actually looking for the solution. And so I would wager that those people buy faster, they buy bigger tickets, and we'll see if that's true. Walk, walk me through the sales process.
So day one, patient comes in, we do a consultation, we take x-rays, we'll do an exam.
