The Employment Package: Research Is First Step

By Victoria Houghton, Communications Manager
There are many factors for new chiropractic graduates to consider when searching for an associate position. Salary comes to mind first, but as many first-timers with little to no experience to bargain with soon learn, it’s not the only piece of the employment package that offers value. Graduates should consider other factors, both professional and personal, when trying to identify the best opportunity available.   
Salary ‘Ball Park’
Students at chiropractic colleges often hear stories about the profession’s fantastic earning potential. While this may be the destiny for many down the road, it’s unrealistic to think that you will make the high end of the salary scale right out of college. “Students that are about to leave college tend to have unrealistic expectations as to what is really out there,” says Richard Vincent, DC, president of Integrative Health Care Practice Resources in Massachusetts, a professional service organization that serves DCs who have an interest in evidence-influenced, integrative practices. “Often times, I see them hit the wall of reality.”
The U.S. Department of Labor’s Bureau of Labor Statistics (BLS) estimates that in 2005 the national salary for chiropractors ranged from $32,900 (the lowest 10 percentile) to $102,920 (the upper 90 percentile). “It’spretty safe to say that these percentiles have a direct relationship with the amount of time a DC has been practicing, as well as the level of experience they have acquired,” notes Dr. Vincent, who is a past president of the Federation of Chiropractic Licensing Boards.
According to Pamela Garivay, director of Integrity Management’s QuickStart Consulting program, which focuses on new doctors, the average associate basesalary is around $3,000 per month. “The important aspect to watch for is what the contract says in regard to a bonus structure, hours, benefits and requirements for outside marketing,” she advises. (Editor’s note: For more on contract language, read “Scrutinize Language in Employment Agreements Before You Sign” in the September 2006 issues of ACA News, online at—click “ACA News Archive”.) Keep realistic figures in mind when interviewing, and be sure to take the following factors into account when negotiating an employment package.
Benefits are usually just the standard vacation and/or sick time,” Garivay points out. “Some clinics, will offer health insurance coverage, malpractice insurance and continuing education, however, that is not necessarily a standard.”
Then again, negotiating for these and other fringe benefits in lieu of a higher salary may save you more money than a few extra dollars in your paycheck. “In the past, the associate chiropractor has been treated a lot like an indentured servant,” says Dr. Vincent. “It’s time, however, to up the ante in terms of employment expectations.” Typically, he advises junior associates to request that senior doctors agree to cover additional expenses for malpractice insurance and a minimum of 12 continuing-education (CE) hours per year.
Cost of Living
It’s no surprise to anyone that the cost of living varies by location. Rent in a crowded city can easily cost three or four times as much as it does in a rural town. Additionally, utilities in a colder climate will cost more than in a mild climate. Once you decide on a place to work and live, do a comprehensive search on the financial implications that location may have on your budget. “How is the overall quality of life, how is the educational system, how are the demographics? How do rent, food, car insurance and other living expenses rate in terms of affordability?” asks Dr. Vincent.
Based on data compiled by the American Chamber of Commerce Researchers Association, has created several online calculators that can help determine important cost-of-living data. In particular, its cost-of-living comparison calculator compares the prices of specific items—groceries, housing, utilities, transportation, health care and miscellaneous goods and services—in all U.S. cities. Visit and click on the “Calculators” tab, then scroll down to the “cost-of-living comparison calculator.”
Logic tells you that with less competition, the odds of getting hired increase. And with fewer chiropractors in an area, the earning potential may be better because of greater patient volume per doctor.
The BLS has an online calculator that enables the job hunter to analyze the employment levels of a specific profession by state and county. Based on statistics collected by the Quarterly Census of Employment and Wages program in 2005, the calculator breaks down what percentage of the chiropractic industry is in a particular area and specifically how many chiropractic offices are located there. Visit and type in “Location Quotient Calculator” in the search function (on the calculator itself, look for NAICS #62131 to select chiropractic).
According to Dr. Vincent, however, the concentration of chiropractors in an area may or may not affect your employment prospects. “I think new doctors really need to develop themselves as shining stars and go right into the middle of the competition, because getting hired is really based on quality. If you are able to deliver that, you cannot miss.”
Bonus Structure
“Sometimes there will be a bonus structure set up in addition to the salary,” says Garivay. “Historically, these bonuses are based on the production the associate brings into the clinic.” However, according to Dr. Vincent, this type of commission schedule may not even come into play until further down the employment road. “When a new doctor comes into a practice,” he explains, “it’s [not uncommon] for them to be paid only a base salary for the first four to six months.”
If a senior doctor does offer the junior associate a commission up front, the new grad must, once again, bargain to secure a promising percentage. “You have to realistically convince the senior doctor that you can be an added benefit [and are worthy of a commission]. The senior doctor may want to downsize his time in the office, or he may just need an extra set of hands to handle an increased patient load,” says Dr. Vincent. Ask your professional mentors what they think an acceptable bonus compensation for providing such benefits to a doctor might be.

In the end, every doctor and every situation is different. Each person, as they embark on their career as an associate, must determine what combination of salary, benefits, and other factors will offer the most satisfaction today while paving the road toward bigger horizons tomorrow. “No one is going to do the work for you,” says Dr. Vincent. “There’s so much involved and it’s all on an individualized basis. Search the internet. Pick your mentors’ brains. Get experience.”
 Published in the May 2007 issue of ACA News.