Creating and Nurturing a Successful Chiropractic Assistant

Creating and Nurturing a
Successful Chiropractic Assistant

This section is compiled by Frank M. Painter, D.C.
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Thanks to Today's Chiropractic for permission to reproduce this article!

Joel E. Margolies, DC

You know you need a chiropractic assistant (CA), but how do you make that step and allow your office to make that transition? Will that position expand your practice or exasperate you? How do you train a successful CA and how do you keep them motivated once the novelty has worn off?

First and foremost, the most successful step in creating and sustaining a successful clinic is hiring the best staff. These professionals usually create the first impression of your office, which may be the most lasting or simply the last. Besides the need to welcome a new patient, your staff plays a huge role in linking every concept of practice management, including patient scheduling, payments, missed appointments, referral, internal marketing and public relations. It is crucial that you give thought to this and appreciate the importance of each member of your staff prior to hiring and training.

The road towards a successful chiropractic assistant is littered with failed attempts, throwing good money after bad, offering training material without proper training and then expecting both knowledge, caring and responsibility. This article will outline a few ideas to both stimulate your existing staff to develop their potential, as well as stimulate you to either re-train or re-hire new staff if necessary.

Prior to hiring a new employee, you must first outline your office purpose and mission statement. Adjustments aside, what does your practice say? Will it be a warm and family oriented clinic welcoming patients of all ages or will it be structurally biomechanical with rehabilitation and strong patient control? Will it be insurance driven or cash-based, requiring business sense and money management? Once you establish your “practice karma,” so to speak, you will create the right atmosphere in which to promote training and instill like ideas in staff. Too often people are hired on pure emotion and appearance, rather than their ability to be a strong team player and advocate of your purpose and professional goals.

I will start at the beginning for either a new practice or one that simply needs to hire a new CA. Assuming your advertising efforts have been successful, you now have a few potential candidates for consideration. The question is who to choose and what criteria are best to follow. Many doctors use skill or personality profiling tests, while others hire the first person breathing through the door.

Hiring techniques are an article in themselves, but it is sufficient to say that the most important part is the fit. Will this person click and be in step with you and the flow of your practice? Will they work in tandem with present staff members and be supportive of practice growth? With these questions answered, you now come to the most important component of a successful staff member and the most neglected—staff training.

Patient management starts and stops with education. A quality patient understands the value of the adjustment and the ramifications of spinal neglect. They should question you about proper body mechanics to sustain a healthy spine and maintain a correct posture. We are obligated to answer their questions and anticipate some blips on the radar screen when they feel neglected or wary of their care. Without proper staff training, including an intensive educational process, how do you expect your staff to be alert to the patient’s needs as well as be an advocate of chiropractic care? They must be attuned to the practice as if it were their own and appreciate the need for proper chiropractic care both for themselves, the patients and their extended family and friends. Although the intensive educational curve will not exceed a few days, the process will remain forever.

When hiring a staff member, especially for the front desk, let them know that they have been provisionally hired, which will last during a training period between four to six weeks. During this time, they or you may wish to discontinue the training process for any reason. It will soon be clear enough if they get the “big idea,” or will be a burden to practice growth and sustenance. During this training period it is your obligation to offer them the tools to become an extension of you and an excellent representative of your office and chiropractic. These tools may include books, video and audio tapes, but they never replace your personal attention with knee-to-knee discussions, script review and interactive scenarios they may encounter.

Careful attention must be given to their learning curve, personal attitude and quick response to given scenarios. Resistance to the training process or chronic partially-resolved issues will eventually prove detrimental to the end result. In other words, a less desirable candidate will soon prove obvious. It is at this point that many doctors fail in their effort to create the proverbial perfect CA. Rather than cutting their losses and looking for someone else, they actually become a hostage to their staff by accepting less rather than more, and allowing complacency to rule their practice. As hard as it is to look for and train someone else, it may be necessary for the sanity of the office, as well as the bottom line.

The initial introductory training cycle begins with the basic philosophy of chiropractic; the role of chiropractic within community health and wellness, the difference between allopathic medicine and chiropractic; and your professional choices for care. If the potential CA cannot appreciate your desire to transform the mindset of the patient concerning healthcare and appreciate the difficult but necessary task to offer the message of chiropractic to the community, than he will be useless to promote and maintain your office base. Why go further in training if they cannot get past first base?

Try as you might, the perfect CA might elude you if you feel that they will never be transformed as an advocate of chiropractic because they miss the simplistic but complex matrix that is chiropractic. To warmly and compassionately welcome new patients, prod those on the edge of compliance and reach out for new ones requires a person with intense understanding and the desire to fulfill the office goals and mission purpose. This may sound idealistic, yet it is within every doctor and staff member to desire more, and as a team it can be accomplished. The trick is getting through the initial knowledge phase of training by making it real, alive and fun.

Assuming the initial phase of training has passed muster and they have been awarded their position with honors, the task now is to maintain their freshness and purpose. If you consider how easily you get sidetracked with issues unrelated to patient care, you can appreciate the difficulty of running the front desk while managing the office’s inherent complex issues. Consider for a second what they must accomplish each day, including scheduling, answering phone calls, removing and returning files, handling money and financial concerns, dealing with insurance companies and managing the personalities of your patients. It is no wonder that the seedling you nurtured into a perfect flower can soon wither quickly on the vine.

The key to keeping staff excited and willing to add more to their task is continued education, philosophy discussions and attendance at chiropractic conventions and seminars. Chiropractic is an honored profession that must continually swim upstream to garner community respect and understanding. We need to support each other and share our wins and losses in order to collectively find the paths of least resistance. If it is necessary for you to rekindle the flame, it is doubly important for the staff. Keeping them excited and within close distance to other chiropractors and staff will result in staff longevity and productivity.

I recommend you review each staff member and determine if they need retraining or additional tools to make their job easier and more productive. Ask them if they feel comfortable with their level of knowledge and ability to answer questions posed by the patients. Determine if there are roadblocks to their performance such as massive paperwork, repetitive activity or workplace material. Maintain regular staff meetings with structured agendas that add to patient understanding and office interaction. Review each new patient and determine their level of education and where gaps of knowledge can be bridged.

Consider cross-training staff so that each staff person can appreciate the complexity and necessity of the other’s position. Create fun activities such as patient appreciation days and participate in holiday and community events. Take advantage of staff hobbies and allow those with creative skills to decorate the office and maintain a living breathing office that speaks of wellness and care. This will keep the practice active and allow the staff to interact with the patients and foster referrals. Create a financial or material bonus system as an incentive to achieve their goals and reward them with praise and appreciation often.

In conclusion, I recommend you question your desire to achieve your goals. If they are shared with your staff and you have created action steps towards achievement that can be reached, your initially intense CA training will pay dividends for years to come. Be wary of the complainer or reluctant CA who might sabotage your goals and literally suppress office growth, and never become hostage to a staff person who will compromise your goals and patient care as you appease their lack of enthusiasm or understanding. Keeping an eye out for these pitfalls during the training phase and maintaining a relentless pursuit of staff excitement and education will always be your ticket to success.

Dr. Margolies has maintained an active practice in Atlanta, Ga., since 1978. He was an adjunct instructor at Life University from 1995-1999 and has taught at the Karl Parker and Fernandez Seminars. He has also authored four books: Smart Start, Chiropractic Marketing and Public Relations, Workshop Workbook and the Personal Injury Workshop Workbook. He is also the author of a free weekly email newsletter concerning practice management, public relations and philosophy that is read widely. To receive his newsletter, visit his web site at

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