Danielle Angela, DC, never set out to become a chiropractor. What she wanted was to be a business owner. That makes her the perfect expert to offer business advice on how to start a new chiropractic practice. “I saw chiropractic as a pathway to running my own business. It’s the perfect blend of what I studied because it allowed me to combine my business and marketing skills with my desire to help people,” says Dr. Angela.
Dr. Angela started not just two very different models of chiropractic practices, learning valuable lessons the hard way. Today, she owns a practice that supports her patients, as well as the life she wants to live as a working mom.
Here’s what she wants you to know.
Why start a chiropractic practice?
Not every chiropractor begins their career with a dream of private practice. Dr. Angela started with that vision, but then spent years on faculty at the chiropractic school she attended. When she found herself working too long days and burning out, she remembered why she had become a chiropractor in the first place.
Dr. Angela left that job to open a new clinic in St. Louis with the hope of what many new chiropractic practice owners seek: flexibility, financial freedom and impact.
“Chiropractic was a way for me to combine my background in marketing and social work. I wanted to help people and own a business,” says Dr. Angela.
Whether your motivation is income potential or clinical autonomy, practice ownership can give you the freedom to build a business on your terms.
Step 1: Define Your Chiropractic Practice Vision
Before you rent a space or design a logo, you need to get clear on what kind of chiropractic practice you’re starting. Do you want a high-volume clinic with multiple associates? A boutique practice with limited hours? Something in between?
Dr. Angela learned the importance of planning your vision ahead of opening your chiropractic practice the hard way. “My first practice grew fast, but I worked 12–14 hours a day, including evenings and weekends. I was burned out and forgot why I started.”
Pro tip: Don’t just plan for opening day. Design your chiropractic business model with sustainability and your personal goals in mind.
Step 2: Start Lean: Small Space, Low Overhead, Faster Profitability
Dr. Angela made the mistake of committing to too large a space for her first practice. From the start, she felt the pressure of making enough money to cover rent. She also committed to small, recurring expenses that add up, like personalized floor mats with her logo and ads in community sports programs.
She eventually sold that practice and opened her second practice in a small town with a small office lease. She’s now open only 12 hours a week for patient appointments. “I had limited hours and filled my schedule in 90 days. It was the right fit for my life, and I was profitable sooner,” she says.
Tips to reduce startup costs:
- Avoid renting more space than you need
- Don’t splurge on unnecessary branding
- Say no to advertising that doesn’t offer measurable ROI
Step 3: Identify Your Ideal Chiropractic Patient
Dr. Angela is now able to build her practice with so few hours because she knew exactly who she was trying to target. Her ideal patients are moms, children and athletes. “I made my hours fit their schedules because I knew I wasn’t trying to serve everyone,” she says.
Knowing your ideal patient makes marketing easier and ensures your operations are aligned with your goals. It also keeps you from saying yes to everyone, which is a fast track to burnout.
Ask yourself:
- Who do I most enjoy helping?
- When are they available for appointments?
- What do they care about most in a provider?
Step 4: Choose Your Payor Model: Cash-Based vs Insurance Explained
As a busy mom of young kids, Dr. Angela knew she couldn’t handle the lengthy calls and paperwork required by any practice owner who accepts insurance. She made her second chiropractic practice cash-based, saving time she didn’t have. “I didn’t want to spend my time on the phone chasing claims. Most of my patients had high deductibles and were paying out of pocket either way,” she says.
Cash-based chiropractic practices are becoming more common, especially as insurance reimbursement shrinks and administrative burdens grow.
Pros of going cash-only:
- No need for billing staff
- Faster payments
- Simpler operations
- Better alignment with patient expectations in high-deductible plans
A cash-based model isn’t right for everyone, but if you’re starting small and want to maximize your time with patients, it’s worth considering.
Step 5: Build Partnerships with Local Providers to Attract Chiropractic Patients
Marketing a new chiropractic practice online is harder in 2025 than it used to be. Referrals from other providers remain a tried and true way to grow a new business. “Before I opened my second clinic, I spent time getting to know local providers. I wanted to know who to send my patients to and vice versa,” says Dr. Angela.
Local networking tips:
- Meet in person whenever possible
- Look for shared values and communication styles
- Follow up regularly when you have a shared patient and refer when appropriate
Dr. Angela has even built relationships with other chiropractors in her area. She recommends choosing collaboration over competition, especially when another provider is a better fit for a patient.
Step 6: Choose the Best Malpractice Insurance for Chiropractors
Malpractice insurance may feel like just another item on your startup to-do list when you’re starting a new chiropractic practice, but it’s essential to the long-term health of your business. “When I started, I assumed there was just one malpractice insurance company for chiropractors. I didn’t realize there were options, or what I should even be looking for,” says Dr. Angela.
Many new chiropractors make the mistake of defaulting to the first provider they hear about, but not all policies offer the same protection, support or responsiveness if you ever face a claim.
What to look for in chiropractic malpractice insurance:
- Claims-made vs. occurrence-based policies: Understand the difference, especially if you ever change jobs or retire.
- Coverage limits that match your risk exposure: Don’t assume one-size-fits-all. If you specialize in prenatal or pediatric care, for example, your risk profile may differ.
- Support from a risk management team: Some insurers, like CM&F Group, offer ongoing guidance, continuing education and even contract reviews.
Pro Tip:
Don’t wait until you’re in trouble to find out what your covers. Talk to multiple carriers to choose the one that aligns best with your practice model and patient population.
Starting a chiropractic practice is exciting, but it’s also full of ways to make you stressed and under pressure. Learn from Dr. Angela to stay lean, focus on your ideal patients and build with intention.
You don’t need to follow someone else’s blueprint. You just need one that fits you.
Frequently Asked Questions
- How do I start a successful chiropractic practice? Begin by defining your long-term vision, keeping overhead costs low, and identifying your ideal chiropractic patients. Focus on building a business model that aligns with your personal goals and offers sustainable growth.
- Is a cash-based chiropractic practice a good idea? Yes, especially if you want to minimize administrative work and maximize patient time. Cash-only chiropractic practices often have faster payments, simpler operations, and can be a great fit for patients with high-deductible insurance plans.
- What type of malpractice insurance should chiropractors have? Choose a policy that fits your risk profile and practice model. Compare claims-made and occurrence-based policies, ensure coverage limits meet your needs, and look for insurers that provide risk management support and continuing education.
CM&F Group’s digital insurance option for chiropractors allows you to spend less time managing insurance hassles and more time caring for your patients. Take advantage of easy, reliable and cost-effective malpractice insurance by effortlessly securing your practice’s protection online today. Click here to learn more.
