Speaker 1: (00:00)
Welcome to episode number 32 of the simplified integration podcast. This is dr. Andrew Wells, our niches, the way to go Leonardo de Vinci once said that simplicity is the ultimate sophistication. And I agree you see the problem with the way that most consulting groups approach medical integration is anything but simple. In fact, it's the exact opposite. It's expensive, it's complicated. And quite frankly, it's exhausting enough is enough. There are far too many amazing integrated clinics that are struggling. I'm on a mission to change that when I've come to find from over five years, working with integrative practices is that simplicity really is the secret deal saying of less is more, is true through a streamlined approach. I was able to create multiple successful seven figure integrated clinics. And now I'm going to show you how you can do the same. Join me as I share with you the secrets to successful medical integration and practice growth. Join me on a journey to greater sophistication through innovation. I'm dr. Andrew Wells and welcome to the simplified integration podcast.
Speaker 1: (01:09)
Hey, what's going on doc. It's great to have you here on the simplified integration podcast. Thank you for joining today. So today we're gonna talk about niches and I've been in practice for about 10 years, and I've noticed a huge trend in chiropractic, and that is doctors are getting into what we call niches. And if you're not familiar with what niches are, niches are sort of sub health categories, um, and therapies and programs that doctors are offering such as, um, weight loss or neuropathy or functional medicine or, uh, regenerative medicine. Those are all considered niches. And I want to address the topic of why docs, why I think docs get into niches in the first place. And I want to ask you like one big question. If you look at the difference between like, what is the big difference between chiropractors and physical therapists? So if you, if you forget the set aside like philosophical differences for a moment, or whether whatever your opinion is about physical therapists, like set that aside for a second, but what's the big difference.
Speaker 1: (02:12)
Like we see the same types of patients. We see people who have chronic pain. Um, we see acute injuries. We take both take care of spinal related issues. So there's a lot of crossover between chiropractic and physical physical therapy. What's the, from a practice standpoint or a business standpoint, what do you think the main difference is? And I'll give you my opinion on this. Um, and just observations of our profession and physical therapy over the years. And I think the one major differences is that physical therapists tend to stick with physical therapy. They don't really branch outside of, of that, um, specific type of therapy and what they learned in school. Yes, you see some people that specialize in certain parts of physical therapy, or you have your doctors of physical therapy, but for the most part, most physical stick to physical therapy. Whereas when you look at chiropractors, if you go on most chiropractic websites, chiropractor, don't, don't, you do just practical.
Speaker 1: (03:08)
A lot of chiropractors specialize in two, three, five, 12 different types of services. And there's a reason for that. So if you look historically at, at, um, insurance reimbursement, that's the big driver between the two. Now, back in, you've heard of the Mercedes eighties back in the seventies, eighties, nineties, there were some pretty decent reimbursement for chiropractors. So if you had patients that came in, you could do an exam, go through a series of adjustments and get paid reasonably well for the services that we provide. However, in 2020, and even over the last five and 10 years, uh, insurance reimbursement for chiropractic has just been slashed or completely eliminated. A lot of offices have gone cash. Some offices do a, you know, majority cash, some insurance, and there are still some States that pay decently for chiropractic, uh, services and adjustments, but that's even going away.
Speaker 1: (04:00)
Um, comparatively you look at physical therapy, the coding and reimbursement for those codes have stayed relatively consistent. Now, yes, uh, insurance companies are starting to nickel and dime even physical therapists, actually all doctors across the board, but you can still make a decent living doing physical therapy if you're a physical therapist. So because in our profession, we don't have that stable reimbursement, and it's really tough to make the living that most doctors are expecting out of their doctor title or, you know, all the work that we put through and the amazing care that we give to patients, we have a certain level of income expectation, and because we're not getting that through traditional, uh, commercial insurance or Medicare, it's tough to make a living. So chiropractors have had to go outside of our, our standard profession to find supplemental income. And that's where niches come in.
Speaker 1: (04:51)
So if you look again like 15 years ago, there, there weren't a whole lot of niches in chiropractic. Maybe you're a chiropractor and maybe you did something like, um, nutrition, right? Like 15 or 20 years ago that might've been somewhat kind of like a niche. But now again, if you look at most chiropractic websites, you have doctors doing all kinds of different types of therapies. And so is it a good thing or is it a bad thing? And I will say that it's both, it's good because you know, chiropractors should be able to, to provide, uh, a wide array of services and help patients in a lot of different ways. Like, for example, if you, you know, you talked to a chiropractor who, who does weight loss, the argument could be made that well, weight loss is important to chiropractic because if you have extra weight, it puts stress and, uh, gravity pulls on your joints and it leads to injuries, bad joint, health, pain, subluxation, subluxation pressure on the nerve system. All those things are true. So it should be in a chiropractor's best interest to get weight off their patient. Um, and so, and you can, I guess you could argue for, you know, for the rationale to do all these different types of niches and therapies, but the problem
Speaker 2: (05:59)
Is that a new name
Speaker 1: (06:00)
Which will come out and I'll give you an example of this. And, and I think this is a good program, but there's a problem with it is if you look at like the neuropathy niche or neuropathy protocols that are out right now, fantastic protocols, great pro a great system to implement a neuropathy is definitely within the wheelhouse of a, of a chiropractic office. But the problem is, is that when it was first introduced, you know, there are doctors making a ton of money on it because it was new, but the problem is there's a really low barrier of entry. So once doctors figure out that there is a profitable system that they can implement in their practice with the, with, uh, not a whole lot of barrier of entry, then all these doctors jump on board and start doing neuropathy. So for example, where I live, there are like three or four doctors who have these big signs up saying we help with neuropathy patients, and they're all doing the exact same neuropathy program.
Speaker 1: (06:50)
So what happens is doc start running the same Facebook ads and the same newspaper ads. And they do the same seminars. They do the same programs. And all of a sudden everybody's fighting for this limited, uh, type of patient and your demographic and fighting for the same patients. And if you give that program two or three years or four years, eventually it gets watered down and it gets diluted. And so then what happens, a new niche comes out and then doctors realize, Oh, I can make a lot of money doing, um, doing, uh, a red light weight loss. And so doctors buy these, like these, uh, fat burning, like red light laser machines and put that in their office expecting to make $50,000 a month for the rest of their life. And then all the other doctors jump on board and start doing that program.
Speaker 2: (07:36)
And so what happens, the problem with niches is that,
Speaker 1: (07:39)
Especially if it's a low barrier of entry, it's really easy to get into when docs realize that it's profitable. Um, they all jump on board and then it ruins it for everybody.
Speaker 2: (07:49)
And that's like that. If you look at the
Speaker 1: (07:51)
Trends in niches, you'll see that doctors, look, if you ever hear testimony, videos from doctors who said, yeah, I tried this program and it was great. My first month I made $80,000 or my first month I made $60,000 ask them what their stats were two years down the road. I can guarantee you, it's not 80 or 70,000. It's not the same stats they were doing the first month. Because again, they have more competition they've eaten through their market. There's only a limited amount of patients that can, that can see those types of, uh, or that have that type of need and are looking for high ticket cash, uh, type of therapies. And so what happens is doctors end up every like two or three years cycling through a new niche and doing a new program and then another new program.
Speaker 2: (08:37)
And the problem is, is that it distracts,
Speaker 1: (08:39)
Tracks you from what your primary purpose is being a chiropractor. So all of your energy and your, and your marketing dollars and your efforts and your staff training go into learning these new systems, but then it takes away from chiropractic. And so doctors are really caught in this, like a, it's a double edged sword, right? You can make more money with niches, but you're taking away from your primary source. And then it also leaves you constantly searching for the next type of niche. That's the problem with niches. And so I'm not, um, and I'm not like I've been through. I know because I've done all these things. Like I've tried all these niches and every, every year or two years, I had to find a new niche. And so I'm not saying it's a bad thing, but the problem is, is you're always, flip-flopping from different, uh, different types of therapies, and you're never known in your community for being good.
Speaker 1: (09:25)
At one thing, you become the person who is always offering the newest gimmick or the newest, like flashy gizmo that you can offer in your practice. So you never become the, uh, like the hallmark place in your town for getting rid of, let's say back pain or, or helping people live healthy lives. Like it's, it's a, it's, it's a confusing message to deliver to your patient base and your community. And so you never become like that. Uh, um, that true, like center of excellence for getting people healthier, that true center of excellence for getting people out of pain. And so if you're looking at, and most of the doctors I talked to are looking for, um, ways to increase their income, they're looking for ways that they can do that without having to do all the legwork or all the physical work, to be able to automate certain processes or delegate certain tasks to their staff.
Speaker 1: (10:17)
But they also want to save for retirement or maybe create an office that they can sell down the road or pass down to an associate doctor, a cell. And if you're in the niche game, it makes it very hard to do those things because you're always flip-flopping from, from service to service. And so I want to wrap up this podcast with saying like, yeah, you know, if, if you're looking five years down the road, if you're looking 10 years down the road, you should have your eye on the services that aren't trendy, that aren't gimmicky are going to last the stand the test of time. And so, uh, you may know that I'm very much into regenerative medicine and I do medical integration. Even within that realm, there are niching things with integration that I really try to steer doctors away from, but we always angle toward services that offer a good benefit to patients are not niche-y.
Speaker 1: (11:07)
So you can still rely on them 10 years down the road, and you can also rely on them. So you can build an actually skill, a practice, and actually develop a true business. That's going to stand the test of time. So that's my thought on niches. I hope this provides some perspective on our profession and maybe compare comparing it to other professions and so ways that you can really build, um, on a, on a really solid and reliable platform to build and grow a business. So thanks for tuning in doc, uh, really happy that you joined. I hope you got some valuable information out of this podcast. Hope you have a great day and we'll see you on the next episode of the simplified integration podcast. See ya. Hey innovators, thanks for listening to the simplified integration podcast. The fact that you're listening tells me that you're like me, someone who loves simplicity and the truth is those who embrace simplicity are some of the greatest innovators. So hope you got a ton of value from what we covered on today's episode, be sure to subscribe and share with other docs that you feel could benefit from greater sophistication through simplification and innovation. If you've got specific questions that you'd like answered on this podcast, or you've got specific topics that you'd like me to discuss, just shoot me an email at firstname.lastname@example.org that's email@example.com.