UCM 289: 7 Mistakes Chiropractic Students Make When Transitioning into Their First Associate Job

The 7 Mistakes New Chiropractic Associates Make
Including rushing decisions, prioritizing pay over development, poor communication, ego-driven choices, and lacking a personal growth plan.

Choosing Development Over Salary
Why mentorship, systems, and long-term skill building matter more than starting compensation.

The Importance of Practice Models and Systems
Evaluating patient flow, case acceptance processes, documented systems, and measurable success metrics before accepting a position.

The Case for Specialization—Especially Upper Cervical Care
Why specialization accelerates growth, and how upper cervical chiropractic offers stability, cash-based models, lower failure rates, and repeatable systems.

Adopting the Right Associate Mindset
Humility, coachability, long-term thinking, clear expectations, and having an intentional personal development plan.

Well, hello, doctors and students. Welcome back to the UCM podcast. I am your host, Dr. Bill Davis with UCM Practice Growth Systems. Excited to be with you again today and really excited to present this information to you about seven mistakes chiropractic students make when transitioning into their first associate job. 

And this is such a crucial topic, especially if you’re a chiropractic student. Obviously, you’re a recent graduate, but even as, you know, when if you have a kid that wants to be a chiropractic, wants to follow in your footsteps, this would be a great thing to share with them. 

If you have a CA that is going this direction or a patient, encourage you to share this information with them. It’s really, really important information. It’s things that I wish I would have known when I was coming out of chiropractic school that would have really helped me in my transition into my first associate job. 

And so, you know, this is what most doctors have to learn the hard way. And I’m going to try to help you today to learn a lot easier rather than through the mistakes actually being made. And so why does this matter? 

Well, I mean, this is a critical window. When you’re making the decision about your first associate position coming out of school, it is a it’s a crucial time. You know, the decision that you make at this point, it can create patterns that impact your professional journey for years. 

This is a common problem that every new grad faces, these types of challenges, and it can lead to costly mistakes that can really derail growth and earnings. And it’s completely preventable with guidance that I’m going to provide you today, you can avoid them. 

And so let’s get into some of these things to help you better understand, you know, what is the real tension that’s happening here? You know, there’s this student tension. When you’re a chiropractic student, it’s always, you know, you’re moving towards the next thing. 

The next, you know, graduation is approaching. I got to get this board done, this, you know, complete this board exam. I have to complete this class, complete this requirement, whatever it is. It’s a constant rhythm of school. 

But as graduation is approaching, you get that finished line in sight, the pressure begins to finally build up. And it’s like, okay, I got to go to work. I got to start working for someone. I got to start doing this chiropractic that I’ve been training to do all these years. 

And your boards are nearly finished. You’ve invested years of study and sacrifice. And maybe you have some offers coming in. Maybe you have some different opportunities that are competing for your attention. 

And you may have some pressure to decide. You know, you may, you know, your fellow students or others that you know are asking, you know, where are you going to work? What are you going to do after school? 

Right. You have family members asking you that. And so this can create a combination of really an environment where you can make a hasty decision and you can make it feel like that’s necessary to make a hasty decision, but rushing rarely leads to the right choice. 

And so I encourage you, if you’re in this place where you’re getting close to graduation, to just take a minute and really think this through with me as we unpack some of these mistakes to help you make a good decision coming out of school. 

And so the big idea here is it’s not, this isn’t your final destination. Your first associate job isn’t where your career ends, it’s where it truly begins, right? And ultimately what you’re looking for is a training ground. 

You want to develop skills, your confidence, your understand systems that will define your practice journey for decades. How you enter it matters. The way you approach this transition determines whether you will thrive or struggle. 

And you want to really shift your perspective from getting a job to choosing your development environment, right? That’s huge. The right first position sets you up for long-term success. If you have that right mindset, it’s not just about, hey, where can I get a job? 

It’s where can I find a development opportunity that’s going to help me to grow as a chiropractor. So let’s get into these mistakes. Mistake number one is rushing the decision. I’ve already mentioned this a bit, but taking the very first offer you get, choosing speed over discernment, assuming any job is better. 

Remember, a few extra weeks of thoughtful consideration can bring years of regret. The right opportunity is worth waiting for. And so just take a little bit of time. Don’t let fear drive you. Don’t, you know, don’t get caught up in the urgency of the decision. 

Take a little bit of time to make the right decision. Mistake number two, and this is a really important one, and it’s one I’m going to spend some extra time on. Mistake number two is chasing pay over development. 

When you focus only on salary, you know, you’re comparing different opportunities that may be out there and you’re thinking, okay, well, this one pays more, so it must be better. That’s not the case at all.

When compensation becomes the primary decision factor, you miss opportunities to evaluate mentorship quality, huge, important, patient volume and system sophistication. Those are way more important than just how much you’re going to get paid. 

Of course, you want to have competitive salary and opportunities for advancement, opportunities to grow within the position, performance bonuses, these types of things should be built into a good position. 

But ignoring mentorship and systems is a huge mistake. The highest paying positions may lack the structure and guidance that you need to accelerate your growth and prepare you for future success. High pay can hide poor training, right? 

So just because someone is paying a lot doesn’t mean that they have the time or the system to develop you as a doctor. Practices that can’t offer development sometimes compensate with higher salaries, creating a trap that costs you in the long run. 

And so this is really important. Don’t chase pay over development. So the better question to ask is, who will I become working here? What kind of a skills and confidence and character are you going to develop in this environment? 

What skills will you gain in the time that you’re there? If you’re there for 18 months, 36 months, whatever it is or longer, you want to evaluate the position based on your growth trajectory and not just your starting compensation. 

The investment you make in your development during these formative years will compound throughout your entire career. So you want to choose growth over immediate gratification. And also you want to choose specialization over generalization. 

This is really important as well as it relates to development. Why does specialization matter? Well, specialists gain clarity, confidence, and competence faster. Depth early beats breadth early. So instead of just being a general chiropractor coming out of school, what we recommend is that you become a specialist, that you focus in on specialization. 

Focus accelerates skill development and decision making. Strong foundations create more options later, not fewer. Specialization brings clarity, but some specialties deliver more consistent outcomes and practice stability than others. 

So there’s a lot of different specialties out there within the chiropractic profession. You can specialize in different types of techniques. You can specialize in different types of conditions, different types of age groups, different types of types of practice. 

You know, there’s sports chiropractic and there’s functional neurology and there’s pediatrics and there’s, you know, there’s a technique focus, there’s scoliosis focus practices. There’s different types of specialization that you see within chiropractic. 

And we recommend that you pursue one of these areas because it’s going to make your career much more likely to be successful. But there is one specialty that stands out. Now, obviously, I’m a bit biased when it comes to this, but I’m trying to be as unbiased as I possibly can be. 

I started out as a general chiropractor coming out of school, realized two years in that, number one, the results I was getting were not as good as some specialists were getting. And that intrigued me. 

And then number two, I found a practice model, a specialty that really helped me to focus in on my skills and my skill development and really helped me to take my chiropractic career to a whole different level. 

And that was upper cervical chiropractic. And this specialty is unique. And I’m going to show you why it’s so unique for a variety of different reasons. And it’s when consistency, clarity, and stability matter. 

This specialty is unique and creates consistent outcomes and stability. When outcomes, patient understanding, and long-term practice stability are compared, this specialty consistently rises to the top. 

And part of it, too, is that there is very clear clinical logic as it relates to upper cervical chiropractic that creates highly repeatable results, structure and objective results as well. This isn’t about preference, about inherent structure and measurable outcomes. 

And so let me show you what I mean. If you have never explored upper cervical chiropractic, I encourage you to think about it starting today to keep in mind. It is about upper cervical care and what makes it different. 

The atlas and brainstem focus is really, really important. When you target the most influential region in the body with your practice, it makes a global impact, meaning minor misalignments, small misalignments in the upper neck can drive widespread compensation and symptoms. 

And you are able to help people that no one else can help because you’re getting to an underlying cause of a variety of different neurological issues. There’s a natural rebalancing that takes place as well. 

So precise corrections allow the body to unwind naturally, which makes the upper cervical chiropractic approach more long-lasting and more encouraging to practice members, patients as well, because patients can connect very quickly with upper cervical chiropractic because of its gentle approach. 

There’s no twisting, cracking, or aggressive adjustments, which patients can be very concerned about when it comes to general chiropractic. And you don’t have any of that in the upper cervical. It’s objective and visual. 

Clear measurements and visuals build trust fast. Upper cervical relies on advanced imaging. It relies on scanning technology, postural measurements, things that are easily seen and easily seen when they have been improved. 

They have great outcome measures within upper cervical. Also within upper cervical, there’s a basic philosophy that is crucial in upper cervical chiropractic, and it resonates so much with patients, and that is holding is healing. 

Focus shifts from frequency of adjustments to stability and results, meaning that it’s not about being adjusted thousands of times. It’s about getting the spine back into a normal, aligned position and keeping it that way as long as possible so the body can function at its highest level. 

So it’s about holding the adjustment rather than being adjusted, which again, resonates with people. They love that idea of I have a goal in mind to keep my alignment so that my body can be as healthy as possible. 

So why does upper cervical create strong careers? The biggest thing is that there’s lower risk and higher stability. And this is based on data that we’ve obtained over years and years of studying upper cervical chiropractic and understanding how it works and how it compares to general chiropractic practice. 

In upper cervical, cash practices are the norm. There is very few insurance-dependent practices within upper cervical. 95% of upper cervical practices operate as cash majority practices, as opposed to general chiropractic practice. 

It’s about only 44%. So a much higher percentage, over twice as high of percentage of cash practices within upper cervical. That leads to a more stable practice, a lower overhead practice, a practice that doesn’t require insurance dependence, doesn’t require insurance billing, and all the things that go along with insurance. 

The other thing is the actual fail rates itself. Within general chiropractic, the 10-year fail rate based on published research is about 25%. So about one in every four chiropractors will fail in chiropractic practice in a general chiropractic practice within 10 years coming out of school. 

Well, within upper cervical, those numbers are about 5% or less. And so a tremendous difference, about five times more likely to be successful in practice if you go into upper cervical care. The other thing is with upper cervical, you have predictive growth. 

You have very clear systems. You have strong retention and that leads to career confidence. You have very strong mentorship and repeatable systems that can lead to practice. 

So these are all the reasons why if you’re coming out of school, we highly recommend that you look into upper cervical chiropractic as a career direction, specialization for sure, and upper cervical as what we believe is the best specialty that is available for chiropractors. 

So let’s get into the next mistake. Mistake number three is not understanding the practice model. So when you go into any associate position, you want to understand how the practice works. You want to be able to ask questions that will lead you to clarity. 

No clarity over patient flow is a big mistake. And so you want to understand how patients move through the system from initial contact to retention, right? What is their processes? What is their systems? 

How do they do the different aspects of practice in order to move patients through the system? The other thing is not understanding case acceptance. What is the process for educating patients and presenting care plans? 

If that remains a mystery to you, then you may get into that practice and be like, whoa, this is, I don’t want to do this. I don’t want to say this. I don’t want to be involved in this kind of whatever, right? 

It just depends on your particular practice philosophy and what you are looking to do with your practice. But if you don’t understand that, if it’s all a mystery to you before you get into practice, that’s going to be a big problem.

And then another thing to look out for is, is success tied to a personality, right? There’s very, there are many practices within chiropractic that are personality driven, meaning that it’s all about the charisma of the lead doctor and not about a system that can be repeated. 

So if you take that doctor out of the equation, then the entire practice breaks down. So you want to find a practice, if you’re coming in as an associate, you want to find a practice where results doesn’t just depend on the doctor’s charisma. 

Instead, there’s repeatable systems that you can learn and you can master, right? That’s what you want to look for. So before accepting any position, ask detailed questions about how the practice operates. 

If they can’t clearly explain their systems, that’s a red flag. So what should you look for? If you’re a student or you’re a recent graduate, what should you look for when it comes to this type of thing? 

Great practices don’t rely on guesswork or individual talent alone. They build success on proven processes that can be taught, learned, and replicated consistently. When evaluating a potential associate position, you want to pay attention to whether the practice can articulate exactly how they achieve their results and more importantly, how they plan to train you to get results in their methods, right? 

And so what are some things that you should see in a good practice is documented systems. You want them to be able to show you written protocols for every aspect of patient care and practice operations. 

That’s a good practice to go into and be trained in. You also want to have clear expectations. We’ll talk more about this later, but they got to make sure they’ve defined this role that you’re stepping into. 

Repeatable outcomes. You want to see consistent results that prove the systems work regardless of who implements them, right? And if this is their first time hiring an associate, then you’ve got to be confident that what they have created makes sense for someone else to be able to step in and utilize it in order to continue to get results. 

Mistake number four is expecting perfection. Assuming the practice should meet every need. No practice is perfect, right? Looking for an ideal environment that checks every box will leave you disappointed and paralyzed, right? 

So it’s, you know, you can rush into decisions and that can be a mistake, but you can also get into a place of, you know, paralysis by analysis and never make a decision. So becoming critical instead of teachable, you don’t want to be that person. 

You don’t want to be a critic. You want to be someone who is willing to be taught. When you focus on flaws rather than learning opportunities, you can close yourself off from growth. And then the other thing is make, you know, remember, you want to remember that this is a growth season, right? 

Your association is about development, not a rival. Embrace the learning curve. And also, you can learn both positive and negative lessons from every opportunity you are in. And so, you know, even if you step into a practice where, you know, you, you like 70% of what they’re doing in this practice, okay, that’s pretty good, right? 

You can learn from that 30% too. If you have, you know, if you’re like, hey, okay, they do that in this practice, but in my practice, I don’t want to do that, right? Those are good lessons as well. So what is the right associate mindset? 

You want to be humble. You want to recognize that your degree is just the beginning. You literally know hardly anything when you’re coming out of chiropractic school. Real expertise comes from experience and a willingness to learn. 

You want to be curious, right? You want to ask questions constantly. Always be seeking to understand not just what to do, but why systems work the way they do. So why do you say it like that? What’s, you know, what’s so, so what was the thinking behind creating this system in this way? 

Right. These types of questions, understanding the why behind things is crucial to be able to really grasp the concepts and the principles behind systems. You want to be coachable. You want to receive feedback as a gift. 

The doctors who grow fastest are those who eagerly implement guidance, right? You want to learn things and you want to implement them, right? Information without implementation leads to frustration. You don’t want to be frustrated. 

And so take what you learn and implement it, right? Long-term focused. That’s the fourth thing here, the right associate mindset. Long-term focused. You want to make decisions based on where you want to be in five years, not just what feels good today, right? 

So keeping in mind this right associate mindset, you want to be humble. You want to be curious. You want to be coachable. You want to have that long-term focus mindset. Mistake number five, poor communication and expectations. 

I mentioned this just briefly earlier. Let’s get more into it now. Expectations are crucial. Everyone needs to know exactly what you’re supposed to be doing, right? As an associate, you want to make sure that your role is crystal clear. 

Unclear roles will lead to poor performance. If you start working without a clear understanding of what you’re responsible for and what falls inside or outside of your scope, then you’re going to be in trouble, right? 

The other thing is you want to see, you want them to have clear success metrics for you. If they don’t have success metrics, meaning KRAs, KPIs, key results areas, key performance indicators, these types of things that are measurable, that are consistently tracked, that you’re going to get feedback on consistently. 

Neither you nor the practice owner can divine what doing well actually looks like in measurable terms. You’re going to be in trouble, right? The other thing is you want a doctor, you want a clinic director, someone who’s going to have hard conversations with you. 

If you skip the uncomfortable questions up front, hoping things will work themselves out, they rarely do. So make sure you have those clear conversations in the front end during the interview process. 

Talk to them about, so how do I know if I’m successful in this role? What are the success metrics? How am I going to be kept accountable to these things? The most successful associate relationships are built on radical clarity from the start. 

Don’t let politeness prevent you from asking the questions that matter, right? Because you don’t want to be three months into this, six months into this, and then both of you are frustrated because you didn’t clearly communicate what winning looks like on the front end and you didn’t have that consistent cadence of feedback on whether or not you are winning. 

So what should be clear up front? Here’s some of the things that you want to make sure you are crystal clear on in an associate position up front. This is great. If you’re a doctor and you’re developing an associate position, make sure you define these things. 

Number one is schedule and responsibilities, right? You need to know the exact hours you’re expected to be in the practice, what kind of a patient volume they’re looking for you to build. What are your administrative duties? 

What’s your on-call requirements? You just want that daily clarity on what is expected. Compensation structure, right? You want to have detailed salary, bonus structures, benefits, performance-based incentives. 

You want to know all of that up front. You want to have a clear training timeline. What is their onboarding process for you? We recommend, you know, with our associate recruitment program, we have a 90-day onboarding plan that we give doctors to be able to implement with new associates. 

Do they have something like that for you? Do they have a clear onboarding plan? You know, you want to have that training timeline where there’s a clear timeline for training, mentorship, and the acquisition of new skills or responsibilities all built into the system. 

Do they have a growth path for you? Are they showing you, you know, what are the opportunities for advancement in this role, including compensation increases, expanded autonomy, and potential partnership tracks, if that’s something that is built into this role? 

And what are the exit terms? Clearly defined, you know, non-compete clauses, if that’s a thing. Notice periods, like how long before, if you’re planning on leaving, how much notice do you need to give them? 

Procedures for arrangement of termination. Just make sure everything is crystal, crystal clear. Document everything in writing. Verbal agreements are going to fade. People aren’t going to remember what they said. 

Writing it down, having everything clear, written clarity protects both parties, prevents misunderstandings down the road. Mistake number six, letting ego drive decisions. If you feel like you’re behind your peers in some way, right? 

Everybody else is open in their own practice. Why am I still an associate? Or believing ownership equals success. I won’t be a real doctor until I have my name on the door or rushing to prove something. 

I need to show everyone I made it fast. All of that stuff is just garbage, right? Don’t make a decision based on what somebody else is doing. Make a decision on what’s best for you and your situation. 

Some people will be able to move through an associate position very quickly. Some may not even do an associate position. It’s a rare, rare person, maybe 10% is able to come right out of school and go right into their own practice and be successful. 

Maybe less than 10%. But majority of doctors should do an associate position, should develop skills that they need to be successful in practice if they want to go on and on their own practice. And even if they don’t want to go on and on their own practice, that’s still, that can be a great life within chiropractic is being a long-term associate. 

There are doctors who, that fits perfectly. And in fact, there’s probably a lot more doctors who should be long-term associates than actually go into being a long-term associate. I’ve seen so many doctors struggle in practice who just either never develop the skills that they needed to be successful in practice on their own, or they’re just not made for it. 

They don’t have the right personality. They don’t have the right things that they need to be successful in their own practice. And they would be more successful being a long-term associate. So remember, there are different paths within chiropractic that can lead to success. 

And don’t get caught up in social media and comparison culture. Just amplifying these kind of feelings when you’re seeing maybe your classmates or friends or whatever, and they’re doing things that are different than you. 

Everybody’s path is different. The doctors who build sustainable, fulfilling careers don’t make decisions based on what looks impressive. They make decisions based on what builds competence and character and what is best for their situation. 

So a freeing truth here. Some doctors thrive as long-term associates, right? There’s no shame in finding the right practice and staying for years. Focus, clinical excellence, and quality of life matter more than titles. 

Some should wait before owning. Rushing into ownership before you’re ready creates stress, debt, and compromise patient care. Timing matters. It’s okay to wait longer and save more money before you take that leap. 

Faithfulness matters more than titles. Excellence in your current role, wherever that is, builds the foundation for future opportunities and lasting impact. Don’t get caught up in this thought of like, okay, well, I just got to get through this and then I’m going to move on and do the thing I really want to do. 

Be excellent, whatever you’re doing. If you’re an associate, you’re working for another doctor, give them everything you have. Be excellent in that role. Whether you’re going to be there for a year or you’re going to be there for 10 years or you’re going to be there for the rest of your career, treat every day as a gift and be able to really give your best to your patients and to that practice. 

Your career path doesn’t need to look like everyone’s else. Define success by the lives you change, the mastery you achieve, not by external validation. And the last mistake here to keep in mind, mistake number seven, having no personal development plan. 

The default path, without intentionality, most associates fall into a passive pattern that limits their growth potential. You don’t want to just be showing up, treating each day like a series of tasks to complete rather than opportunities to grow. 

You don’t want to have just, you know, no learning goals. Be very clear on what are you there for? What are you trying to learn? What do you want to learn in the first month, in the first three months, in the first year, in the first three years, whatever it is. 

Having clear learning goals, identifying specific skills, techniques, knowledge areas you want to grow in is really, really important. Like if you don’t have that on the front end, it’s going to be a lot harder to get everything you possibly can out of this experience of being an associate. 

And having no intentional growth, hoping that experience alone will make you better without deliberate practice and reflection, right? You want to be consistently thinking about, okay, what do I want to learn? 

How am I learning that? How can I apply that? Growth doesn’t just happen automatically. It requires vision and strategy and consistent effort. So this is what wise associates do. They track their learning. 

They keep a development journal. They document new techniques they’re learning, new principles they’re learning, difficult cases they’ve handled, skills they want to improve. They review it on a monthly basis to see how they’re progressing, right? 

Get a clear understanding of the things you want to learn and then learn them, right? That’s the goal. And request feedback. Get lots and lots of feedback. Hopefully your clinic director will have feedback mechanisms built in to your associate position. 

What we recommend with our doctors is a monthly job scorecard where you can review your key metrics and you can get coaching. You can get feedback on what’s going on. We hit this metric. We didn’t hit this metric. 

Why is that? Let’s talk through it. Let’s see how we can improve next month, right? That consistent feedback is so, so important. You want to get specific feedback on every aspect of being a chiropractor, right? 

Your adjustments, your patient communication, your clinical decisions. You don’t want to just wait for an annual review, if that’s what it is. You want to seek consistent coaching on a weekly basis and just in asking questions and getting responses. 

And then more of a structured at least, maybe once a month, where you’re getting that kind of feedback on a job scorecard type of environment. You also want to study leadership and systems, right? Don’t just rely on your clinic director and your experience within your associate position as your only path to learning, but read books, you know, listen to books. 

Learn as much as you can about practice management, about team leadership, about communication, about interacting with people, building relationships. All of these things are crucial skills in business and life that are going to greatly improve your clinical skills, but also your business acumen as well. 

So the common thread here, doctors and students, is it’s not about intelligence. You’re smart enough to succeed. That’s not in question, right? It’s a lack of guidance is the main issue, right? Chiropractic school teaches, you know, it teaches what it teaches. 

It doesn’t teach career navigation, no long game teaching, right? No one showed you how to think strategically about your career development until now. Hopefully today you’ve started to think differently and think, okay, what am I looking for in an associate position and really get some clear understanding of what is going to be your best next step? 

These mistakes aren’t character flaws. They’re gaps in education. The good news is once you understand what to look for, what to avoid, you can make dramatically better decisions about your future. You’re not behind. 

You’re right on time to get this right. And so the great thing is your career is not behind you. It’s ahead of you. And the next few months, if you’re getting close to that time of going into an associate position is you’re more prepared now after you’ve listened to this than you were before you listened, right? 

You now understand what most new graduates don’t. You know the mistakes to avoid and the right questions to ask. But we’ve got even more help for you. We love helping students. We love helping students make great decisions. 

And so we’ve created some great free resources for you. One is our career starter kit. It’s called From Student to Doctor, the Chiropractic Career Starter Kit. It’s a free resource. You can get it on our website at ucmgrow.com forward slash students. 

And you can actually access all these things that same link. You can also join our Associate Talent Network. This is a free talent network that we have where you put in your information, where you’re looking to practice, and we will connect you with upper cervical chiropractic offices that we have vetted and we have great opportunities in these practices. 

We also will do a free 20-minute career planning call with you. If you, you know, just aren’t sure what you want to do, do you want to start your own practice? Do you want to be a short-term associate? 

Do you want to be a long-term associate? You don’t know. You want, you know, you’re not sure about your preceptor position. Like all these types of questions. We want to talk to you. We want to help you. 

We want to help you make great decisions right out at the beginning so that you can have awesome career in chiropractic. So you can schedule a 20-minute career planning call with us and get personalized guidance. 

So you can do all these things, download the career starter kit, join the Associate Talent Network, and schedule your career planning call all at the same link. Go to ucmgrow.com forward slash students. 

Ucmgrow.com forward slash students. And you can do all these things and continue to move forward in your career. Wise decisions now change everything. Don’t navigate this transition alone. Get the support you need to start strong and build the career you’ve worked so hard to create. 

And as we always say around here, go team upper cervical.