Stop Seeing Patients 5 Days a Week

Most chiropractors grind five days a week, work 12-hour days, and wonder why they're stuck at the same revenue level they hit two years ago. Dr. Nikki Cottis was there. Then she got fired from her associate position when her boss came back from maternity leave and didn't need her anymore. Her husband told her she was opening her own practice. She didn't believe him. Ten years later, Chiropractic Connection in Gulf Shores, Alabama, is a 7-figure practice with three associates, and Nikki sees patients only two and a half days a week.

Nikki is also a coach at The Wealthy Practitioner, helping other chiropractors do the same thing. The systems she's built aren't theoretical. They're the ones who let her be home with her 7-year-old daughter, take vacations without closing the office, and run a coaching company on the side. Her core thesis: once you hit roughly $20,000 a month, seeing patients five days a week is the trap that keeps you stuck. The grind doesn't multiply. It plateaus.

In this episode, Nikki walks through the operational frameworks that make her schedule possible. The hourly rate framework: profit divided by hours worked equals your real hourly rate; delegate anything you do that's worth less than that and that you don't enjoy. The cost-to-deliver-an-adjustment metric: total monthly overhead divided by patient visits, gives you the floor every service must price above (hers is $31). The associate compensation model that doesn't pit team members against each other: pay base plus bonus on TOTAL office revenue, not personal collections.

The conversation gets specific on ClickUp. Nikki uses ClickUp to run almost every task in the practice. Every new patient creates a task with a subtask checklist. Every care plan discontinuation triggers a workflow for taking the card off file, updating the spreadsheet, and removing it from the email system. New leads from HubSpot auto-create ClickUp tasks for the front desk via Zapier. Patient journey gifts and cards are automated based on the first-visit date. She's the only chiropractor most operators have ever met who runs ClickUp like an agency runs ClickUp.

 If you're stuck at $50-60K a month, wondering why hiring more people hasn't changed anything, considering opening a second location but haven't fixed the first, or just exhausted from the 12-hour-day grind, this episode is the operations manual from someone who built the systems that got her her time back.