Chiropractic Cash Only Practice

05/29/2026

𝐈'𝐦 𝐍𝐨𝐭 𝐀 𝐅𝐚𝐧 𝐎𝐟 𝐀𝐥𝐚𝐫𝐦𝐢𝐬𝐭𝐬, 𝐀𝐍𝐃... 𝐘𝐨𝐮 𝐍𝐞𝐞𝐝 𝐓𝐨 𝐑𝐞𝐚𝐝 𝐓𝐡𝐢𝐬.

I don’t believe in running around screaming that the sky is falling every time something strange happens in our profession. Fear clouds judgment. Panic leads to bad decisions. And overreaction usually causes more harm than good. But I do believe in paying attention. I believe in recognizing patterns. And I believe that Chiropractors need to understand the environment we are practicing in right now because things are changing rapidly.

Last week, 𝐈 𝐡𝐚𝐝 𝐚𝐧 𝐞𝐱𝐩𝐞𝐫𝐢𝐞𝐧𝐜𝐞 𝐢𝐧 𝐦𝐲 𝐨𝐟𝐟𝐢𝐜𝐞 𝐭𝐡𝐚𝐭 𝐞𝐯𝐞𝐫𝐲 𝐂𝐡𝐢𝐫𝐨𝐩𝐫𝐚𝐜𝐭𝐨𝐫 𝐬𝐡𝐨𝐮𝐥𝐝 𝐡𝐞𝐚𝐫 𝐚𝐛𝐨𝐮𝐭. A patient of mine had recently given birth and had experienced postpartum dizziness and headaches. Naturally, she went to the hospital to get checked out. During her ER visit, one of the very first questions they asked her was, “𝐇𝐚𝐯𝐞 𝐲𝐨𝐮 𝐛𝐞𝐞𝐧 𝐭𝐨 𝐚 𝐂𝐡𝐢𝐫𝐨𝐩𝐫𝐚𝐜𝐭𝐨𝐫 𝐫𝐞𝐜𝐞𝐧𝐭𝐥𝐲?” She answered honestly and said that she goes regularly for wellness care. The next question was even more telling. “𝐘𝐨𝐮 𝐝𝐨𝐧’𝐭 𝐥𝐞𝐭 𝐭𝐡𝐞𝐦 𝐜𝐫𝐚𝐜𝐤 𝐲𝐨𝐮𝐫 𝐧𝐞𝐜𝐤, 𝐝𝐨 𝐲𝐨𝐮?”

Now let me pause here for a moment. This particular patient does not receive manual cervical adjustments from me because she prefers instrument adjusting. So she explained that I use an adjusting instrument instead of twisting or manually adjusting her neck. 𝐓𝐡𝐞 𝐄𝐑 𝐝𝐨𝐜𝐭𝐨𝐫 𝐭𝐡𝐞𝐧 𝐚𝐥𝐥𝐞𝐠𝐞𝐝𝐥𝐲 𝐭𝐨𝐥𝐝 𝐡𝐞𝐫 𝐭𝐡𝐚𝐭 𝗲𝘃𝗲𝗻 𝗶𝗻𝘀𝘁𝗿𝘂𝗺𝗲𝗻𝘁 𝗮𝗱𝗷𝘂𝘀𝘁𝗶𝗻𝗴 𝗰𝗮𝗻 𝘁𝗲𝗮𝗿 𝗮𝗿𝘁𝗲𝗿𝗶𝗲𝘀 𝗮𝗻𝗱 𝗰𝗮𝘂𝘀𝗲 𝘀𝘁𝗿𝗼𝗸𝗲𝘀. Think about that for a second. Not only was Chiropractic immediately brought into the conversation, but the implication was clear from the beginning. They were looking for a cause to attach to her symptoms.

The hospital pressured her into undergoing a CAT scan to rule out injury supposedly caused by her Chiropractic care. When they didn't find what they suspected, they tried to pressure her into doing it again with a contrast but she refused because she is breast feeding. She and her husband were offended enough by the incident that they left and came directly to my office the next day to tell me what had happened.

Thankfully, the patient was doing well. By the time she presented to my office, the dizziness had resolved. Nonetheless, I performed vascular screening tests including George’s Test, Romberg’s Test, and Hautant’s Test. Everything was negative. I documented thoroughly, asked detailed follow-up questions, and confirmed again after the adjustment that she was symptom-free.

But what started as an upsetting conversation quickly evolved into something much larger. I contacted a friend associated with my malpractice company simply asking for advice on how to handle the situation diplomatically. I wasn’t calling to report malpractice. I wasn’t calling because the patient accused me of wrongdoing. In fact, the patient was upset with the ER doctor, not with me.

Yet suddenly, the entire matter became a formal incident report.

Why?

Because once an ER physician documents in a medical record that Chiropractic may have caused vascular symptoms, 𝗮 𝗹𝗲𝗴𝗮𝗹 𝗮𝗻𝗱 𝗽𝗿𝗼𝗳𝗲𝘀𝘀𝗶𝗼𝗻𝗮𝗹 𝗽𝗿𝗼𝗰𝗲𝘀𝘀 𝗰𝗮𝗻 𝗯𝗲𝗴𝗶𝗻 𝗶𝗺𝗺𝗲𝗱𝗶𝗮𝘁𝗲𝗹𝘆, regardless of whether there is evidence to support the claim. That’s the reality Chiropractors need to understand right now.

We are entering a period where medicine appears increasingly eager to redirect attention away from its own growing credibility crisis surrounding the COVID mRNA injections and their documented adverse events. Millions of people were injected and now countless patients are presenting with dizziness, headaches, myocarditis, vascular problems, strokes, neurological symptoms, and other unexplained issues that even the medical profession itself has acknowledged through the VAERS is related to the 'vaccine'. Instead of asking hard questions about the products and policies they aggressively promoted, some in medicine appear to be looking for alternate explanations and convenient scapegoats.

𝗔𝗻𝗱 𝗖𝗵𝗶𝗿𝗼𝗽𝗿𝗮𝗰𝘁𝗼𝗿𝘀 𝗮𝗿𝗲 𝗮𝗻 𝗲𝗮𝘀𝘆 𝘁𝗮𝗿𝗴𝗲𝘁.

If a patient walks into the ER with dizziness, headaches, vertigo, neck pain, or neurological symptoms, there is an increasing likelihood that Chiropractic care will immediately become part of the interrogation process. Not because there is clear evidence, but because narratives are powerful.

Now before someone twists my words, let me be crystal clear. This is not a call for paranoia. This is not an excuse to become defensive, combative, or reckless. And this is certainly not a reason to stop serving people. It is a warning to become extraordinarily diligent.

𝗗𝗼𝗰𝘂𝗺𝗲𝗻𝘁 𝘁𝗵𝗼𝗿𝗼𝘂𝗴𝗵𝗹𝘆. 𝗟𝗶𝘀𝘁𝗲𝗻 𝗰𝗮𝗿𝗲𝗳𝘂𝗹𝗹𝘆. 𝗧𝗮𝗸𝗲 𝗱𝗲𝘁𝗮𝗶𝗹𝗲𝗱 𝗵𝗶𝘀𝘁𝗼𝗿𝗶𝗲𝘀. 𝗣𝗲𝗿𝗳𝗼𝗿𝗺 𝗮𝗻𝗱 𝗱𝗼𝗰𝘂𝗺𝗲𝗻𝘁 𝗮𝗽𝗽𝗿𝗼𝗽𝗿𝗶𝗮𝘁𝗲 𝘀𝗰𝗿𝗲𝗲𝗻𝗶𝗻𝗴 𝗽𝗿𝗼𝗰𝗲𝗱𝘂𝗿𝗲𝘀. 𝗡𝗲𝘃𝗲𝗿 𝗰𝘂𝘁 𝗰𝗼𝗿𝗻𝗲𝗿𝘀.

Never become casual simply because you’ve adjusted thousands of people without incident. And most importantly, treat every patient the way you would treat your own family member, maybe even better.

Because these are strange times. The world feels upside down. The profession responsible for what some studies estimate to be the third leading cause of death through iatrogenic injury, harm caused by medical treatments, medications, and procedures, is increasingly positioning itself as the guardian of public safety while simultaneously casting suspicion on Chiropractic care.

Again, I’m not an alarmist. But I am observant. And I believe Chiropractors need to wake up to what is happening around them.

𝗕𝗲 𝗮𝘄𝗮𝗿𝗲. 𝗕𝗲 𝘃𝗶𝗴𝗶𝗹𝗮𝗻𝘁. 𝗕𝗲 𝗽𝗿𝗼𝗳𝗲𝘀𝘀𝗶𝗼𝗻𝗮𝗹. 𝗕𝗲 𝗰𝗼𝗺𝗽𝗮𝘀𝘀𝗶𝗼𝗻𝗮𝘁𝗲.

And above all else, never forget that the trust our patients place in us is sacred.

In Health and Faith,
Jay

05/25/2026

GREAT LISTEN!

IN8 THOTS — IntroductionWhy the Green Books Still MatterIn the Introductory episode of IN8 THOTS, Dr. Joe Sheppard explores why the Palmer Green Books continue to influence chiropractors more than a century after they were written.This episode div...

05/23/2026

𝐖𝐡𝐲 𝐖𝐞’𝐫𝐞 𝐅𝐮𝐥𝐥𝐲 𝐁𝐨𝐨𝐤𝐞𝐝 𝐖𝐡𝐢𝐥𝐞 𝐎𝐭𝐡𝐞𝐫𝐬 𝐀𝐫𝐞 𝐂𝐡𝐚𝐬𝐢𝐧𝐠 𝐍𝐞𝐰 𝐏𝐚𝐭𝐢𝐞𝐧𝐭𝐬

It’s interesting to observe that in the world of healthcare practices, particularly in Chiropractic, the dominant conversation seems to be scarcity. I scroll through online groups and all I see is anxious posts saying, “We need more new patients”, “Our Google results are slipping”, “I can’t figure out how to rank higher in AI searches” and “Our social media ads aren’t converting”. Converting? I didn’t know we were running a religion.

Hey, I get it, running and growing a practice matters and it can be stressful. But I’ll be honest: if I never saw another new patient again, I’d be perfectly content. At the end of every day, every spot in our schedule is filled. We’re generating strong, sustainable revenue. The practice feels abundant rather than anxious. And I don’t lose sleep over “marketing funnels” or “algorithm changes”. Seriously, I don’t even know what those are!

Instead, I trust God to fill my schedule. And, time after time, He does. On the rare days when He doesn’t, I trust that I needed a few open spots to rest or because I needed that time to spend with someone else.

This isn’t luck or magic. There’s a real, measurable difference between offices that constantly scramble for new patients and those, like ours, that rarely have to. Here are the most common reasons that I’ve observed after a few decades in practice.

1. 𝑶𝒃𝒔𝒆𝒔𝒔𝒊𝒐𝒏 𝑾𝒊𝒕𝒉 𝑹𝒆𝒕𝒆𝒏𝒕𝒊𝒐𝒏 𝑶𝒗𝒆𝒓 𝑨𝒄𝒒𝒖𝒊𝒔𝒊𝒕𝒊𝒐𝒏

Many offices treat existing patients as transactional and pour all their energy into attracting new ones.

𝗪𝗲 𝗱𝗼 𝘁𝗵𝗲 𝗼𝗽𝗽𝗼𝘀𝗶𝘁𝗲.

When you deliver exceptional care, build genuine relationships, and make patients feel genuinely valued, they stay. They refer friends and family without being asked. They show up on time, follow through on care plans, and become advocates for your practice. A full schedule built on loyal, long-term patients is far more stable than one constantly refilled with cold leads from Google Ads or ChatGPT searches.

New patients are great, they bring fresh energy and potential, but they’re not the lifeblood if your current base is healthy and growing organically.

2. 𝑺𝒚𝒔𝒕𝒆𝒎𝒔 𝒂𝒏𝒅 𝑪𝒖𝒍𝒕𝒖𝒓𝒆 𝑻𝒉𝒂𝒕 𝑹𝒆𝒅𝒖𝒄𝒆 𝑪𝒉𝒂𝒐𝒔

A lot of the “we need more patients” panic actually stems from operational leaks: high no-show rates, last-minute cancellations, inefficient scheduling, and team turnover.

When your calendar has large gaps and holes every day, it feels like you’re always starving for volume. We’ve built tight systems around punctuality, communication, and follow-up. Our team culture emphasizes ownership and excellence. Patients notice consistency. They trust the process. That trust translates into fewer gaps and more predictable flow.

When the machine runs smoothly, you don’t need to constantly throw new bodies at it to keep revenue steady.

𝟯. 𝗔 𝗗𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝘁 𝗥𝗲𝗹𝗮𝘁𝗶𝗼𝗻𝘀𝗵𝗶𝗽 𝘄𝗶𝘁𝗵 𝗦𝗰𝗮𝗿𝗰𝗶𝘁𝘆 𝗮𝗻𝗱 𝗙𝗮𝗶𝘁𝗵

This one might be unpopular in purely business circles, but it’s central for us so I can’t help but discuss it.

I’ve chosen to operate from a place of trust rather than fear. We do the work with excellence, clinically, relationally, and ethically, and then release the outcome. That mindset reduces desperate marketing decisions, price wars, or volume-chasing that can compromise care.
Plenty of practices run on anxiety: “If we don’t get 20 new patients this month, we’re in trouble.” That energy is felt by the team and sometimes even by patients. In contrast, a calm, confident practice radiates abundance. People are drawn to peace.

I’m not saying we’re passive. We maintain a strong reputation and make ourselves available in the community. But we don’t worship the metrics. We do our best and trust the rest.

𝟰. 𝗙𝗼𝗰𝘂𝘀 𝗼𝗻 𝗥𝗲𝗮𝗹 𝗩𝗮𝗹𝘂𝗲, 𝗡𝗼𝘁 𝗝𝘂𝘀𝘁 𝗩𝗶𝘀𝗶𝗯𝗶𝗹𝗶𝘁𝘆

Social media, SEO, and AI search are tools, not saviors. Too many offices chase visibility without asking whether what they’re visible for is actually exceptional.

Are you the practice that over-delivers on results and experience? Or the one posting daily for the sake of posting? Patients today are sophisticated. They can smell inauthenticity. The practices that win long-term are often quieter online but legendary by word of mouth.

We invest heavily in being uniquely different by being undeniably good at what we do. That creates its own gravity.

𝟱. 𝗞𝗻𝗼𝘄𝗶𝗻𝗴 𝗪𝗵𝗲𝗻 “𝗘𝗻𝗼𝘂𝗴𝗵” 𝗜𝘀 𝗘𝗻𝗼𝘂𝗴𝗵

Here’s the quiet truth many won’t admit: some Chiropractors are never satisfied. The schedule could be 95% full and they’d still feel behind. Growth becomes an idol. Bigger numbers. More locations. Flashier marketing.

Trust me, I’ve fallen into that trap in the past and it nearly broke me physically and financially.

But, now, I’ve chosen contentment with a thriving, well-run practice that serves our community without burning out the team or compromising quality. There’s incredible freedom in that. It allows us to focus on creating more Bright Lights in this world through patient focused care instead of expansion for expansion’s sake.

𝟲. 𝗧𝗵𝗲 𝗥𝗲𝗮𝗹 𝗗𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝗰𝗲

The gap between where your practice is and where you want it to be isn’t primarily marketing skill or luck. It’s philosophy, systems, culture, and priorities.
Offices that constantly need new patients are solving the wrong problem. They’re treating symptoms (empty slots) instead of root causes (retention, operational procedures, reputation, and mindset).

I’m not anti-growth. New patients are a blessing, and we welcome them warmly. But they arrive as a natural result of doing the other things right, not as the desperate fix.
If your practice is struggling with empty chairs, it might be worth asking some uncomfortable questions:

How is the experience for our current patients?
Are our systems creating gaps or filling them?
Are we operating from fear or from stewardship?
Have we confused “bigger” with “better”?

There’s more than one way to run a successful practice. Chasing volume through endless marketing is one path. Building something so solid that the schedule largely takes care of itself is another.

I know which one brings more peace at the end of the day.

In Health and Faith, Jay

05/18/2026

https://open.substack.com/pub/giveloveserve/p/has-your-ability-to-think-and-create?r=1uad6z&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true

I’d rather just see the prompt

05/16/2026

Did we learn our lesson or do some people need to repeat it? They're at it again with Hantavirus and separately but at the same time, ticks that release Alpha-gal into your system. Wake Up Humans.

05/14/2026

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05/14/2026

Do you remember the SNITCH HOTLINE to report those who were not 'vaccinated'? Don't Fall for it or Stand for it again! NEVER FORGET! This email sent to all providers in Rhode Island caused me to lose all I had worked for.

05/12/2026

𝐇𝐨𝐰 𝐈 𝐑𝐞𝐬𝐩𝐨𝐧𝐝𝐞𝐝 𝐓𝐨 𝐒𝐚𝐥𝐥𝐲 𝐒𝐜𝐢𝐚𝐭𝐢𝐜𝐚 𝐚𝐧𝐝 𝐓𝐞𝐝𝐝𝐲 𝐓𝐞𝐧𝐝𝐨𝐧𝐢𝐭𝐢𝐬

Before I get too far into this post, I want to tell you that you shouldn’t care about what I do in my office. You should only care about what you do in YOUR office. ←- Period, hard stop. And, having said that, respectfully, I don’t really care what you do in your office.

But, having said that, I’ve developed a wellness/maintenance practice in less than 4 years that sustains itself with or without any new patients and provides a great income.

I believe that has happened because I have a Mandatory New Patient Orientation that answers ALL the patient questions before they arrive and explains that I run a wellness/maintenance practice that doesn’t treat pain, symptoms or medical conditions. Patients who want quick fixes or only want treatment for pain or medical problems quickly realize that I’m not a good fit for that and screen themselves out. BUT, the ones that arrive tend to stay, happily pay cash for their care and refer their friends and family.

Today I got TWO emails from people that wanted to become new patients. I wanted to share their emails and my responses. Again, this is the way that I handled these situations and I’m not implying that you should handle them this way if it’s not congruent for you. I did start and adjust three other new patients today that ‘got the big idea’. And again, quite frankly, I don’t want or need anymore new patients though I do enjoy giving people their first Chiropractic Adjustment. I get a sense of satisfaction from that but I’m not willing to compromise to get them in the door…

𝗘𝗠𝗔𝗜𝗟 #𝟭:
Hello,
My name is ###XX and I was hoping to set up an appointment on 5/15 at 9 am. I was wondering how much and how long the appointment would be? I am having some rotator cuff tendinitis which is affecting my range of motion, which is the reason for my visit. I hope you can help!

Thank you, ###XX

𝗠𝗬 𝗥𝗘𝗣𝗟𝗬:
Hi,
Check out our new patient orientation videos at www.brightlightnh.com/first-visit to make sure that our office is a good fit for you. We run a wellness office and we don't treat pain, symptoms or medical conditions here. We do however, look for the cause of the problem during our examination and if it relates to the nervous system and spine, we will adjust you for subluxations and allow your nervous system the best chance of healing any related conditions. I promise that's explained much better in the videos. If you find that we're a Great fit, give our office a call and we will be glad to schedule you for your first visit. The office number is 603-434-3456.

In health and faith,
Dr. Jay

𝗘𝗠𝗔𝗜𝗟 #𝟮:
I have sciatica issues especially on my left side, it hurts climbing stairs. I’ve never been to one before so I’m a little nervous about it. Hoping you can help.
Thank you, ###XX

𝗠𝗬 𝗥𝗘𝗣𝗟𝗬:
Hi ###XX,

Although I do take care of a lot of patients with sciatic nerve pain, our office focuses on wellness care. There are two very informative videos on my website that explain how we take care of people in the office and I think it will also answer your question as to how chiropractic can help your sciatic problem. Check out the videos on our website on this page: www.brightlightnh.com/first-visit . If, after you watch the videos, you feel we're a good fit for you, give the office a call at 603-434-3456 and I'd love to help you.

In health and faith, Jay

𝗣𝗔𝗧𝗜𝗘𝗡𝗧 𝗥𝗘𝗣𝗟𝗬:
Thank you, I will do that.