Retention Beats Recruitment: The Real Chiropractic Growth Formula

Most chiropractors believe the path to a bigger practice is simple: more new patients. Dr. Kevin Day says that's exactly backwards — and it's burning docs out and draining their bank accounts in the process. In this episode, Nick sits down with Dr. Kevin Day of The Remarkable Practice to unpack how he scaled his own practice from 100–150 visits a week to over 600 (with 700 in sight) — not by chasing new patients, but by mastering retention, patient education, and team training. If you feel stuck on the new-patient hamster wheel, this conversation will change how you think about growth. What you'll learn: ✅ Why it's far cheaper to keep a patient than to buy a new one — and how that changes your entire growth strategy ✅ What PVA (Patient Visit Average) really tells you, why the industry average of 12 is a problem, and the simple rule that your PVA should be 10x your years in practice ✅ The dentistry lesson from the 1930s that explains why patient education is your most powerful retention tool ✅ Why "every role is clinical" and how your front desk and support staff quietly make or break retention ✅ The three stages of practice growth: doctor training (0–150), staff training (150–300), and patient training (300+) ✅ The litmus test that reveals whether your team actually believes in what you do ✅ The two biggest team-training mistakes that stall practices in the 80–150 visits/week range ✅ The 5 domains every practice runs on (attraction, conversion, retention, team, money) and the "4 R's" for building systems that don't depend on you ✅ How predictable revenue (EFTs & lifetime value) lets you bonus your staff, forecast growth, and finally step into the CEO seat ✅ Why the average chiropractor makes $500K worth of mistakes in their first 15–20 years — and how coaching shortcuts the curve A line worth the whole episode: "Teaching changes what you know, training changes how you do things, but coaching changes how you think." Chapters: 00:00 – Meet Dr. Kevin Day & The Remarkable Practice 00:40 – From 150 to 700 visits a week (the scaling story) 05:23 – What PVA is and why 12 visits isn't enough 07:30 – The dentistry lesson every chiropractor needs to hear 10:15 – The business case for retention: LTV, EFTs & predictable revenue 13:29 – Why every role in your practice is clinical 17:08 – The litmus test for a bought-in team 18:02 – The two biggest team-training mistakes 21:48 – Systematizing your practice: the 5 domains 24:00 – The 4 R's: right person, right seat, right work, right way 27:02 – How to connect with Dr. Kevin & TRP Connect with Dr. Kevin Day & The Remarkable Practice: Email: [email protected] Website: theremarkablepractice.com Dr. Kevin is hosting a 2-hour retention intensive in August — https://theremarkablepractice.com/upc...