How Much Do You Owe?

by William D. Esteb

Besides passing the National Boards, there is little that distracts chiropractic college students these days as much as the debt they’re running up for their education. Even getting enough patient visits at the student clinic pales in comparison to the concern many have over the $130,000 to $150,000 debt they’re amassing.

Too bad. It should be the least of your concerns.

If you have the extra energy to squander on such wasteful pursuits as worry, it would be better to focus on the communication skills necessary to explain, inspire and lead patients. After all, creating and cultivating meaningful and influential patient relationships will be the means by which you’ll be able to repay those who trust you to do so.

Instead, the few classes that are offered in chiropractic colleges that address these issues are practically sneered at. A waste of time. A distraction from what’s really important: technique and diagnosis.

No wonder. Apparently both the administration and students have this romantic notion that being a chiropractor is merely about adjusting people. Neglecting to see it as first a small business, creates a ticking time bomb. Problem is, the bomb doesn’t go off in a college lecture hall or the student center. It goes off hundreds, maybe thousands of miles off-campus. A parent’s nest egg evaporates. A new graduate’s credit rating destroyed. The dream of helping others, discarded to sell shoes or drive a cab. All because there was a greater emphasis placed on attracting tuition dollars from applicants with a dream, than in equipping them to successfully run a small business upon graduation. After all, this is a college, not a “trade school.”

Yup. It’s a business first. If you can’t charge (and collect!) more money than it costs you to deliver an adjustment, your toys will be taken away from you. It’s not personal. It’s not professional bias. It’s just business.

In the hopes of “unifying” the profession by drumming out the metaphysical and philosophical, chiropractic colleges are disgorging new graduates with the skill set more like medical doctors, that is, highly skilled technicians who lack vital people skills. Neglecting these “soft” skills in favor of the mechanistic and cookbook approach to administering the chiropractic intervention may have been a successful model a decade ago when generous third party reimbursement existed, but not today. Hobbled by poor communication skills and a reimbursement system with patient co-pays greater than the going rate for an adjustment, and deductibles larger than a typical case fee, loan default rates are going to go sky high.

The solution? Look now for every possible opportunity to bump up against your comfort zone. Acquire public speaking skills. Volunteer to do screenings. Learn “unapproved” techniques not taught on campus. Seek out the fringe, the unexplainable. Track down some old timers who practiced in the 1950s and 1960s. Ask questions. After graduation, go work for someone else and learn the business side of the equation. Sure, the wages will be puny, but what you can learn will serve you as “practice insurance.”

That said, the potential return on your investment from a chiropractic college education is enormous. The only reason you would allow your investment strategy to distract you is the fear (the result of doubt) of being unable to pay it back. Which begs the question. Why don’t you think you can pay it back? But perhaps more important, what are you doing now to insure that you can?