Running a chiropractic practice is equal parts service and business savvy. Whether you just opened your doors or you’re finally seeing consistent patient flow, there’s a lot that goes into managing a chiropractic practice without burning out or blowing your budget.
After decades in practice and growing up in a family full of chiropractors, Heather Dehn, DC, offers advice to new practice owners on managing their practices.
1. Don’t rush the tech, but don’t make practice management harder
Dr. Dehn jokes that she was the last chiropractor clinging to her paper appointment book. She had a foolproof system that worked for her and her staff, which included meticulously tracking patient appointments and following up when they missed one. “I was ready to live or die by my paper appointment book,” she says.
When she finally hired a tech-savvy employee who didn’t think like her, he convinced her to transition to electronic scheduling. But here’s the catch: Dr. Dehn asked him to learn her system first.
This wasn’t an annoying way to maintain control. Instead, Dr. Dehn wanted to ensure that anyone introducing new systems or technology into her chiropractic practice understood her workflow. “You can’t replace chaos with different chaos. Tech has to work with your system, not against it,” says Dr. Dehn.
Her office now has an appointment scheduling system that does everything her paper system did and more. Now, my patients get automated text reminders. My staff doesn’t waste time calling no-shows. Life is smoother. And yes, I wish I had done it sooner.
2. Get your SOAP notes right
If you ever get questioned, or sued your notes are your lifeline. Chiropractors all know this, but too often people go through the motions of creating a SOAP note without ensuring it’s useful. Many clinicians record a generic assessment every time without making a true assessment and treatment plan, says Dr. Dehn. “Notes are the bane of most chiropractors’ existence, and everybody finds their way to simplify them, but there’s a danger with EHR to make everything just look the same.”
Besides needing notes for compliance and legal reasons, Dr. Dehn regularly reviews patients’ notes when they mention a new issue to see how it compares to past visits and is grateful when they’re thorough. For example, when a patient insists a pain is the same as last time, Dr. Dehn can confirm or even remind them that the notes indicate the problem was on the other side.
Here are tips to keep your documentation legit:
- Subjective: Besides recording a patient’s experience, Dr. Dehn recommends always including a pain scale.
- Objective: Include range of motion, orthopedic tests and anything measurable.
- Assessment: This isn’t a copy-paste placeholder. Include your clinical take specific to today.
- Plan: This should be more than just “treat 2x/week for 6 weeks.” What’s working? What’s next? Are you considering imaging, exercises or referrals?
3. Don’t be afraid to refer out
Knowing when to refer a patient to another provider or for an imaging test separates professionals from egos. “The way to build your practice is to treat your patients correctly, and that sometimes means referring them out,” says Dr. Dehn.
If a patient isn’t improving after 3–4 weeks, stop and reassess:
- Do they need imaging?
- Is it outside your scope?
- Could someone else help them better?
You don’t lose business by referring out. You gain credibility and protect your license. Dr. Dehn has even referred patients to other chiropractors in her area when someone else’s technique might help them more.
4. Keep intake forms simple
If you’re still using the same intake form you found online in 2004, it’s time for a refresh. Too many chiropractic owners ask numerous questions in lengthy forms, only to repeat most of the same questions during the appointment. Patients get annoyed and tend to fill out forms hastily anyway. “Chances are they’re not going to tell you everything you need to know, so don’t make them write it all down,” says Dr. Dehn.
Instead, Dr. Dehn recommends the following:
- Don’t overwhelm patients with pages of irrelevant questions.
- Make sure your forms are inclusive.
- Don’t ask questions you’ll ask during the consult anyway.
5. Tips for keeping patients coming back
Marketing a new chiropractic practice in 2025 is no longer as simple as it was when Dr. Dehn started. Print ads are nearly obsolete, and building social media followings is harder now.
Keeping current patients returning and referring you to others is much simpler than attracting new ones. Dr. Dehn offers two simple ways to keep patients loyal. The first is to schedule a patient’s follow-up appointment before they leave the office.
The second is to send greeting cards or notes anytime you can. No one sends snail mail anymore, so it stands out in the best way when you do.
- Did a patient tell you they’re retiring? Send a congratulatory card.
- Got a new puppy? Send a new pet card.
- Someone brought you cookies? Send a thank you card.
You should send greeting cards because it’s thoughtful. As a bonus, it helps your marketing. Relationships build a practice.
Progress over perfection
Don’t try to build the perfect practice in your first year. Build systems that serve your patients and make your practice easier to manage.
Ask your staff for input. Track what’s working. And don’t be afraid to pivot. Being a great chiropractor is one thing. Being a great chiropractic practice owner is another.
Frequently Asked Questions
- What are the best ways to grow a chiropractic practice in 2025? Focus on patient retention and relationship-building. Schedule follow-up appointments before patients leave and send personalized greeting cards to mark life events. These small touches boost loyalty and lead to more referrals, which are more effective than modern ad strategies.
- What should a proper chiropractic SOAP note include? A solid SOAP note should go beyond templates. Include pain scales in the subjective section, measurable data in objective, a real-time clinical assessment (not copy-paste), and a plan that reflects progress, referrals, or imaging needs. Good notes protect you legally and guide care.
- When should chiropractors refer patients to another provider? If there’s no improvement after 3–4 weeks, reassess. Consider imaging or referral if the issue is beyond your scope. Referring out builds trust, protects your license, and can enhance your reputation as a clinician who prioritizes patient outcomes over ego.
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