How to See 450 Patients a Week Without Burning Out
Dr. Ryan Davis sees 450 patients a week at his Grand Rapids, Minnesota practice. He started as a solo doc at 140 visits and scaled to a multi-doc practice through CA-driven efficiency, AI-powered notes, and the $600/hour delegation rule his coach spent years drilling into him.
Episode Details
Most solo chiropractors hit a ceiling between 130 and 160 patients a week and stay there. Dr. Ryan Davis blew through it. His Grand Rapids, Minnesota practice now sees 450 patients a week across multiple doctors, his staff does half the work he used to, and he takes Tuesdays off to work on the business. The catch: scaling solo-to-multi-doc isn't about seeing more patients per hour. It's about delegating everything that isn't clinical care, even the stuff you're good at.
Ryan started his practice from scratch and spent years as a solo doc at 130-140 visits per week. He wanted to travel, he wanted freedom, and every time he took a two-week vacation he calculated that it was costing him $20,000 in lost patients, dropout rates, and missed momentum. His first associate, Dr. Joe, literally fell into his lap via a cold call. Ryan wasn't sure he could afford him, but hiring him was the catalyst that forced Ryan to level up his business and grow into the capacity.
In this episode, Ryan breaks down the CA-driven workflow that lets him see 90 patients a day without sacrificing care: his CA lays the patient down, pulls up subjective notes on a wall screen before Ryan enters the room, and adds sticky notes on the door flagging anything the patient brought up. New AI transcription software is starting to write the notes automatically. Ryan talks to ChatGPT on his drive to work every morning.
The conversation also hits the $600/hour delegation rule (from his coach of 15 years), the hiring filter he uses for associates (personality and confidence over skills), and why he keeps his practice open Friday afternoons and Saturdays when none of the other 20 chiropractors in his small town do. The availability gap is the cheapest marketing he has.
If you're a solo practitioner thinking about hiring your first associate, running a multi-doc practice wondering how to squeeze more efficiency out of your current footprint, or at the stage where you're asking whether you should add a second location or dig deeper into the one you have, this episode is a tactical playbook from someone who ran the experiment himself.
Key Takeaways
- The $600/Hour Rule: Ryan's coach spent years drilling this in. If you're worth $600 an hour adjusting, every task you could delegate for less is a waste. Most entrepreneurs delegate the tasks they don't like. The real leverage is delegating the tasks you're good at but shouldn't be doing.
- CA-Driven Efficiency: Before Ryan walks into a treatment room, his CA has laid the patient down, pulled up subjective notes on a wall screen, and added sticky notes on the door flagging anything the patient mentioned. Saves 2 to 3 minutes per visit. Across 90 patients a day, that's hours.
- Every Solo Vacation Costs $20,000: When you're the only doctor, a two-week trip doesn't just cost the flight. It costs the patients who dropped out while you were gone, the ones who didn't book, and the momentum you return to rebuild. Getting your first associate is the only way to take real time off.
- The Availability Advantage: Ryan's practice is open Friday afternoons and Saturdays. None of the other 20 chiropractors in his small town are. When competitors close, their patients hang up and call the next guy. Being available is the cheapest marketing there is.
- AI as a Consulting Partner: Ryan talks to ChatGPT on his drive to work every day. It knows his employees, strengths and weaknesses, marketing, and operations. He uses it to rehearse difficult conversations, pressure-test decisions, and get brutally honest feedback when he prompts for it.
- Hire for Personality, Not Skills: Skills can be taught. Personality, confidence, and a growth mindset cannot. Ryan's hiring filter is whether someone fits the clinic's sense of humor and whether they can have direct conversations with patients about money and care.
- Focus Beats Entrepreneurial Spread: Ryan owned a gym on the side for a few years. It drained his mental capacity. He sold it for a small profit and watched his chiropractic practice take off immediately after. Being best at one thing beats being mediocre at three.
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