The Real Cost of Staying Small

Why Thinking Bigger Builds Sustainable Chiropractic Practices
Episode 24 – Seven Figure Chiro Podcast Hosted by Dr. Jeff Berard & Kristin Berard 

Many chiropractors dream of building a thriving, scalable practice, but too many get stuck in the trap of “staying small.” In this episode of the Seven Figure Chiro Podcast, Dr. Jeff and Kristin Berard break down the hidden costs of remaining a single-service clinic, and why scaling horizontally, not just vertically, is the key to long-term profitability, sustainability, and freedom.

What Does “Staying Small” Really Mean?

Staying small doesn’t just mean having a small space or a lean staff. It’s a mindset, one where you continue doing more of the same (chiropractic and maybe massage), simply by adding more providers rather than diversifying services or expanding your business model.

This approach leads to:

• Increasing overhead
•   Flat profit margins
• A ceiling on growth
• Burnout from overwork

As Jeff puts it: “Your revenue might go up, but your profit margin doesn’t. So, is the juice really worth the squeeze?”

The Vertical Growth Trap

Many chiropractors fall into the vertical growth model, adding more chiropractors, more massage therapists, but never actually scaling. While this may give the illusion of growth, it often results in:

• Competing providers under the same roof
• Diminishing returns on patient volume
• Volatile monthly revenue swings

Kristin offers a great analogy: “It’s like hiring another person to do the exact same thing you do, for the same audience. You're just stretching the same pie thinner.”

Scaling Horizontally: The Real Growth Opportunity

Instead of only adding more of the same, Jeff and Kristin encourage chiropractors to scale horizontally by introducing complementary services such as:

• Physical therapy
• Acupuncture
• Personal training
• Nutrition counseling
• Assisted stretching (e.g., Stretch Center)

By adding diverse services, you’re not just growing your patient base, you’re maximizing the value of your existing patients.

Space Matters: Think Ahead, Not Small

A common mistake among chiropractors is securing a small, tight office space to “start lean.” But without room to expand, growth becomes physically impossible.

Jeff shares their experience:

“When we moved to Michigan, we built a 6,000 sq ft building but only finished 3,000. Once we maxed out, we built out the rest, with PT, personal training, and our Stretch Center. Without that space, we wouldn’t have been able to scale.”

Why Staying Small Can Cost You Big

The biggest cost of staying small isn’t just money, it’s volatility, stress, and missed opportunity:

• Peaks and valleys in revenue create instability
• Inconsistent income leads to cautious decision-making
• Lack of service diversity limits patient retention

Chiropractors who stay small often hesitate to invest in innovation or new hires because they’re unsure what next month’s revenue will look like. Scaling gives you control and confidence.

It's Not Just About More Space, It’s About Smarter Planning

If you're already considering hiring another chiropractor, that likely means you have room. But do you really want to fill that room with more of the same? Or could you use it to introduce a new service line that expands your market?

Kristin explains:

“We didn’t add another chiro we added personal training tailored to our patients’ needs. That brought in a new audience and kept our current patients coming back longer.”

Think Like a Business Owner, Not Just a Provider

Every thriving business, whether a gas station or a medical clinic, relies on multiple offerings to serve multiple demographics. Chiropractors are no different. One service is not a sustainable model long-term.

If you truly want:

• Financial freedom
• Flexibility to work on your practice, not in it
• A future-proof model that doesn’t rely solely on your time

…then it’s time to think beyond the adjustment table.

Final Thoughts: It’s Time to Think Bigger

Whether you're early in your chiropractic career or feeling stuck in a stagnant model, the takeaway is simple:

-Growth is not the same as scale. -Scaling means creating more value without simply working more. -And scaling requires space, services, and strategic vision.

You don’t need to build a mega-clinic tomorrow, but you do need to plan with growth in mind.

Tune into Episode 24 of the Seven Figure Chiro Podcast to hear the full conversation and get inspired to break free from the small practice mindset.

Next Episode: We’ll explore the difference between growth and scale and how to apply both effectively in your practice.