What if the biggest opportunity for your chiropractic practice isn't opening another location, hiring more people, or spending more money on marketing?

What if it's simply maximizing what you already have?

In this episode of The Chiropractic Philanthropist Revival Series, Dr. Ed Osburn sits down with Dr. Josiah Fitzsimmons, chiropractor, entrepreneur, and practice-growth strategist, for a conversation about profitability, capacity, marketing, leadership, systems, and what it really takes to build a highly successful chiropractic practice.

Josiah opened his own practice just four months after graduating and had more than 400 prepaid appointments scheduled before his doors even opened. His first full year generated more than $1 million, the following year exceeded $2 million, and his practice eventually reached $5.5 million in one location. He says his practice is currently on track for $8.2 million. EP 444 Dr. Josiah Fitzsimmons

But Josiah's biggest lesson isn't about generating more revenue.

It's about understanding the numbers behind the business.

He believes one of the most overlooked metrics in chiropractic is percentage of schedule or capacity filled. Instead of immediately opening another location, adding more equipment, or increasing expenses, Josiah argues that doctors should first maximize the capacity they're already paying for. EP 444 Dr. Josiah Fitzsimmons

Ed and Josiah also break down a simple formula for determining the return on investment needed to make marketing profitable:

100 ÷ profit margin = break-even ROI.

For example, a practice with a 25% profit margin would need approximately a 4X ROI to break even. Understanding that number can dramatically change how a doctor thinks about advertising and patient acquisition. EP 444 Dr. Josiah Fitzsimmons

The conversation also goes back to Josiah's early days, when he used grassroots marketing, health talks, screenings, coffee-shop meetings, farmer's markets, and other low-cost strategies to build his initial patient base. Those efforts helped him generate more than 400 patients before opening his doors. EP 444 Dr. Josiah Fitzsimmons

In this episode:

• How Josiah built more than 400 prepaid appointments before opening his practice
• How he generated more than $1 million in his first full year
• Growing to $5.5 million from a single location
• Why Josiah has chosen to focus on maximizing one practice instead of immediately opening multiple locations
• Why capacity utilization may be one of the most important metrics in chiropractic
• How to determine whether your practice is actually operating at full capacity
• Why opening another location may not be the answer
• How to calculate your marketing break-even point
• The simple 100 ÷ profit margin formula
• How understanding your numbers changes your marketing decisions
• Why doctors should know their revenue, profit, marketing spend, new-patient numbers, staffing costs, and capacity
• How one doctor discovered he was generating an 18X return on his marketing
• Why some chiropractors turn off profitable advertising because they don't understand their numbers
• How to determine how much you can afford to spend to acquire a new patient
• Why lifetime value and profit margin matter when calculating acquisition costs
• Why tracking data gives you a "financial GPS"
• How Josiah used grassroots marketing when he had very little money
• Health talks, screenings, coffee-shop meetings, farmer's markets, and local events
• Why communication and certainty are critical to practice growth
• Why chiropractors can have an incredible healthcare message but still struggle financially
• How rejection and fear can hold doctors back
• Josiah's "ready, fire, aim" approach to business
• Why small, low-cost bets can help build confidence
• How Josiah borrowed confidence by learning from successful doctors while still a student
• Why continuing education isn't enough without action
• Why doctors need more implementation and accountability
• The importance of investing in your team
• Why team may be the biggest factor in a service-based healthcare business
• How training can improve communication, objections, and patient conversion
• Why Josiah closes his entire business for weekly team training
• How AI could change the future of chiropractic
• Why human connection may become even more valuable as technology advances
• Why knowing your numbers can help you make better decisions about marketing, hiring, and reinvestment
• How to maximize your existing practice before trying to scale horizontally
• Why scaling is simple once you understand the underlying numbers
• The importance of focus and thinking bigger
• Why chiropractors need to become better entrepreneurs and business owners

Josiah's core message is simple:

Know your numbers. Know your capacity. Maximize what you're already paying for before assuming you need something bigger.

CONNECT WITH DR. JOSIAH FITZSIMMONS

More Lucro

Dr. Josiah Fitzsimmons created More Lucro to help chiropractors better understand the financial side of their practices and make smarter business decisions using real industry data.

Inside More Lucro, chiropractors can access the Lucro Report, which provides industry benchmarks and data on areas such as practice revenue, profitability, marketing spend, staff compensation, pricing, and key performance indicators.

Josiah's goal is to help doctors understand where their practice stands compared with other chiropractic practices and, more importantly, identify where they can improve.

Create a free account and explore the data:
https://www.morelucro.ai/

More Nexus

Josiah also discusses More Nexus, which focuses on helping chiropractic practices with marketing and new-patient acquisition. Nexus can help practices generate and schedule new patients while layering different marketing strategies as the practice grows.

Learn more:
https://morenexus.io

RESOURCES MENTIONED

The Lucro Report

A free resource available through More Lucro that provides chiropractic industry data, including pricing, staffing, KPIs, revenue, profitability, marketing spend, and comparisons between average and higher-performing practices. EP 444 Dr. Josiah Fitzsimmons

https://morelucro.ai

The Bible

When asked what resource doctors should consume, Josiah's first answer was the Bible. He also emphasized that the profession doesn't necessarily need more education as much as it needs more action and implementation. EP 444 Dr. Josiah Fitzsimmons

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Apple Podcasts:
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https://open.spotify.com/show/164LfnNvQ3dlaL7nhlkfvr

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