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Big Chiropractor in a Small Village

chiropractic business managment Mar 01, 2023

Big Chiropractor in a Small Village

By Dr. Michael Perusich

You’ve heard the expression, “A big fish in a small pond.”  

I find this cliche interesting as it points to the fact that we often suffer from relativity, comparison, and circumstance in business.  In other words, we suffer by comparison unless the pool is small enough that we are the only relativity by which to compare. 

Many years ago, I was contemplating relocating my practice from a major city in the midwest to a very small town.  The practice was doing well, but it was a constant battle to gain a visible foothold in the market and create a niche that stood out.  

After evaluating the small town opportunity for many months, I committed myself and my family to move in the hopes that we could go from a small fish in a big pond, to a big fish in a small pond.  

Many people told me it would never work, that you just couldn’t make a living as a Chiropractor in a small town.  In fact, there’s a really good story there - ask me about it sometime when you see me at a speaking event!  

However, I felt like I had studied the market enough that I could strategize a way to do well and prove the naysayers wrong.  

The benefits I saw were many - lower costs for office space and housing, easier access to the employment market, and fewer people meant it was easier to meet a larger percentage of the market.  My projections indicated that I could be more successful in that environment.

Nonetheless, my calculations were wrong…but in a good way!   In the first six months, I blew right through my projections and within a couple of years our clinic became the go-to Chiropractic office in the area.  And, with some trial and error,  we created a million-dollar clinic and were more profitable than I ever dreamed, once we figured out the secret formula.

To paraphrase a 2018 Study by Stanford University, high-achieving students in big universities actually had less confidence than average-achieving students in small universities. 

In a smaller pond, we don’t succumb as much to comparison with other clinics.  In fact, if you become the big fish, then it's often your clinic that others will covet.  By comparison, in the big city, there’s always someone else with a bigger clinic, more locations, or advanced services.  Plus, in relative terms, in a small community, it's so much easier to stand out because the crowd is so much smaller, which brings you more confidence as noted in the Stanford study.

Being a big fish in a small pond certainly has its advantages.  You just need the secret formula to make it work.

I often hear young doctors getting advice from seasoned veterans in the profession to “find where you want to live and start your practice there.”  While that may be fine, there are so many untapped small-pond markets where you can be the big fish.  Maybe the advice should be “figure out where the pond is small enough that you are at the top of the food chain.” 

You see, if you figure out the secret formula to success, you become so profitable that you can visit any town or country, and always come home to your nice little pond.  You can be the big Chiropractor in a small village.

You may be wondering, what is the secret formula?  It’s strategy and pond size!  What’s your strategy for success and are you in the right pond where it can spawn?


Dr. Michael Perusich is a solutions-focused advisor with more than 25 years of success across the healthcare and consulting industries. His broad areas of expertise include coaching, training, content development, and motivational speaking.  Dr. Perusich is the CEO of Kats Consultants, LLC. where he and his team offer a unique platform of business knowledge and tools for today's Chiropractic entrepreneur.