The Introvert's Guide to Scaling a 10 Clinic Chiropractic Business
Do you have to be an extrovert to build a massive chiropractic business? Dr. Tony DeRamus, an admitted introvert, explains how he scaled Sandstone Chiropractic to 10 locations. He shares why he treats his company like a "professional sports team" (not a "family") and the $1 million revenue rule you must hit before opening your second clinic.
Episode Details
In a field that demands constant communication, can a quiet, focused introvert succeed as a leader?
The answer is a resounding yes. In this episode, Dr. Tony DeRamus, founder of Sandstone Chiropractic, joins us to share his incredible journey of scaling his enterprise to 10 clinics. As an admitted introvert, Dr. Tony dismantles the myth that you need to be the loudest person in the room to build an empire. In fact, he argues that his introversion is a "superpower" that allows for the deep, focused work most entrepreneurs avoid .
Dr. Tony gets brutally honest about his early failures, including a disastrous first attempt at expansion that cost him $80,000. He learned the hard way that you must earn the right to scale.
So, when is the right time to open a second clinic?
Dr. Tony reveals his hard-earned playbook. Before you even think about a second location, your first clinic must be a "mothership" that has mastered its systems and is collecting $1 million per year. This milestone proves you have the culture, staff, and cash flow to support new growth without sinking the whole ship.
We also dive deep into his controversial (and highly effective) leadership philosophy: why you should run your practice like a professional sports team , not a "family" , and how this "A-player" mindset is the key to attracting and retaining top talent.
If you're a chiropractor with dreams of scaling, this is a masterclass in focused, sustainable growth.
Stop guessing what to track in your practice. Get the essential metrics you need to scale with our FREE High-Performance Marketing Metrics Dashboard.
Ready to build the marketing systems for your own multi-clinic enterprise? Book a call with the ChiroX team.
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Key Takeaways
- The $1 Million Rule: Before you expand, get your first clinic to $1 million in annual collections. This proves you have a full staff, a strong culture, and the systems needed to train new associates.
- You're a Team, Not a Family: Dr. Tony rejects the "we're a family" culture. He runs his company like a professional sports team, where the objective is to win, and A-players are brought in to perform. As he says, "winners want to be associated with winners."
- Introversion is a Superpower: Dr. Tony leverages his introversion to lock in, go deeper on problems, and work longer than most people can. You don't have to be an extrovert to be a successful CEO.
- The "Wow Factor": He follows Walt Disney's philosophy: "Do what you do so well that others can't resist telling others about you." Every part of your practice, from the first call, should create a "phenomenal wow experience."
- Honor Thyself: Before you scale, be honest and ask yourself if you really want the stress and sacrifice that comes with it. Don't let your ego write checks your life can't cash.
- You Can't Steer a Parked Car: Ideas are worthless without action. You have to be in motion and actively working toward your goal before you can navigate the path to success.
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Raise Your Prices, Scale Your Practice (How to Win)
"You're worth more, and you need to charge for it." Dr. Justin Rabinowitz shares the $200k insurance lessons that forced him to build a 7-figure cash practice. He explains why "my town is different" is a lie, how he doubled his prices and grew 34% during COVID, and the simple framework for getting patients to happily pay a premium.
Raise Your Prices, Scale Your Practice (How to Win)
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$7-Figure Chiro Practice: The System That Runs Itself
"If you have no money, you have no mission." Dr. Jesse Jacobs, founder of FreeForm Chiropractic, reveals how he built a $7-figure, 9-location practice by shifting from "healer" to "CEO." Discover why "skill doesn't scale" (but systems do) and how to pass the 90-day test that proves you own a business, not just a high-paying job.
$7-Figure Chiro Practice: The System That Runs Itself

The Future of Chiropractic is Integrated Care
The episode with Dr. Joe Denke reveals how a medically integrated model is the future of chiropractic, providing a blueprint for legally adding advanced medical services and staff (like NPs/MDs) to transform a traditional practice into a high-multiplier asset capable of generating substantial profit and securing the owner's early retirement.
The Future of Chiropractic is Integrated Care
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