Colorado or Texas to start a chiropractic practice? If so, what cities? (Denver: real estate, insurance)

[Chapinadancer]

My husband will be graduating from chiropractic school in Dallas,TX soon and we will be associating in New Zealand for two years after that. Once We are done in NZ it will be time to set up in the states. We have narrowed our options down to Texas or Colorado due to their economies and support for small businesses. We can move anywhere but prefer to live somewhere that has fun outdoor activities and where my husband and myself won't feel strange being of extremely diverse backgrounds. We also will be trying to start a family by then and would prefer living in a great location for families. So please give me all your advice and knowledge concerning your preferable location. Would you rather live/start a business in Colorado or Texas and if so, where? Thank you!

[StealthRabbit]

From a straight financial perspective...
Texas for sure, do the math on your business taxes / organization(LLC/LLP/Legal) / labor / office costs( Real Estate related)

Add in the Income Tax Free benefit of Texas

Subtract the Business Risk factor of CO politics / business issues / energy / infrastructure costs / risks.

Calculate the potential revenues / growth of your business (the ultimate resale value / or value over time to your income)

There are some pretty nice areas of Texas, (certainly better than DFW), Look to Boerne and Helotes area for business starts and potential growth. (Huge influx of new families and active retirees.)

Colorado has potentially a better Quality of life, but probably higher risk to that QoL. I would suggest CoS, and Loveland / Ft Collins for growth in your future client base, and decent access to Recreation (without fighting the Denver crowds to get there). Really nice if you can LIVE within your recreation space (Evaluate Glenwood Springs as a mtn destination, downside is quick access to international airport, upside is a nearby college and good growth of your potential client base / stable economy and MAYBE a chance to add niche clients from Aspen area or have a satelitte office there or in GJunction to sustain needed revenues.

Have your local SBDC or SCORE office help you run the numbers. (This is free, there are likely many retired Chiropractors as free business counselors in either organization). The national headqtrs of SBDC is in SA, TX. They are a wealth of information on market studies and finances for small business and practices. Seriously look at ways to service the US VA patients / revenue stream. Which state has the most robust medical / ACA / insurance board structure to assure your future revenues?

There are LOTS better states to consider this practice / recreational / quality of life. Do you have any student debt that needs 'forgiveness'? My Dr. did time on a NA reservation to get his debt forgiven, he said the Educational value of this stint was beyond expectation and made him a much better MD.

You mention need for 'cultural diversity / great family area'. Both TX and CO are not stellar at that virtue.

You might want to clarify.

[Chapinadancer]

Thank you for that wonderful advice! We appreciate your knowledge! We definitely feel like we would enjoy colorado more because of its natural beauty but feel it might be worth it to grind in Texas for a while to build up our finances. We definitely have NOT enjoyed our 3 yrs in Dallas though so we are researching other towns. And about my diversity comment, I am Guatemalan/Welsh born and raised on the coast of Maryland and my husband is Hawaiian/Filipino born and raised on Oahu. I guess you could say we are a tiny bit concerned for our future children and if they will feel a little out of place or treated differently because of their diversity.

[StealthRabbit]

Thx, I can see why you might be concerned.

I would head west (coast)

Areas near Vancouver BC ( but still in USA) are really nice for recreation and diversity.
Consider Bellingham and Fairhaven, WA.

CA and OR have some tax and school funding issues, so consider that. Race is generally a non-issue on most of the west coast, especially PNW.

Is HI an option? Both WA and HI offer free FT college instead of HS. That solves a lot of unnecessary social problems for your HS aged kids.

Colo can be less than pleasant for racial issues in schools, but certainly near high tech, metro / military is not as bad, and could actually be quite diverse. Keep CoS on your list.

[bluescreen73]

Honestly COL and cost of doing business are the only two pro-Texas arguments I can come up with. Houses are cheap and the state is really business friendly, but IMNSHO the Texas Triangle is a dreadful place to live due in large part to the awful climate and really bland geography.

Unless you REALLY like the water (and golf or tennis) the triangle region is an outdoor wasteland. If you like mountains, the closest Texas comes can be found in BFE, 8-10 hours drive west of DFW.

One thing to keep in mind about Colorado is the possibility of single payer healthcare becoming the law of the land after the election in November.

[Chaffeetrekker]

Chiropractors will not be as much in demand in Colo. now that Colorado has legal cannabis.....just sayin'

[Chapinadancer]

Originally Posted by StealthRabbit

From a straight financial perspective...
Texas for sure, do the math on your business taxes / organization(LLC/LLP/Legal) / labor / office costs( Real Estate related)

Add in the Income Tax Free benefit of Texas

Subtract the Business Risk factor of CO politics / business issues / energy / infrastructure costs / risks.

Calculate the potential revenues / growth of your business (the ultimate resale value / or value over time to your income)

There are some pretty nice areas of Texas, (certainly better than DFW), Look to Boerne and Helotes area for business starts and potential growth. (Huge influx of new families and active retirees.)

Colorado has potentially a better Quality of life, but probably higher risk to that QoL. I would suggest CoS, and Loveland / Ft Collins for growth in your future client base, and decent access to Recreation (without fighting the Denver crowds to get there). Really nice if you can LIVE within your recreation space (Evaluate Glenwood Springs as a mtn destination, downside is quick access to international airport, upside is a nearby college and good growth of your potential client base / stable economy and MAYBE a chance to add niche clients from Aspen area or have a satelitte office there or in GJunction to sustain needed revenues.

Have your local SBDC or SCORE office help you run the numbers. (This is free, there are likely many retired Chiropractors as free business counselors in either organization). The national headqtrs of SBDC is in SA, TX. They are a wealth of information on market studies and finances for small business and practices. Seriously look at ways to service the US VA patients / revenue stream. Which state has the most robust medical / ACA / insurance board structure to assure your future revenues?

There are LOTS better states to consider this practice / recreational / quality of life. Do you have any student debt that needs 'forgiveness'? My Dr. did time on a NA reservation to get his debt forgiven, he said the Educational value of this stint was beyond expectation and made him a much better MD.

You mention need for 'cultural diversity / great family area'. Both TX and CO are not stellar at that virtue.

You might want to clarify.

Oh and what other states would you recommend despite the diversity concern?

[sammy87]

Like everywhere else there is a Chiropractor on every corner in CO. Considering everyone and their mother wants to be here, Im willing to bet the market is pretty oversaturated.

I have a very close friend thats a Chiro and I feel bad for her.

Not sure if you know what the Joint is or not but its a Chiro chain. They are popping up everywhere. They charge a flat rate of $20/visit. My friend was offered a job there. The hours were like 10-7 6 days a week with no lunch break. Starting pay was $38k. According to her, its the death of the practice. Not sure how you can compete if you have your own and you charge insurance and the copay is the same. She had issues getting into a network with insurance. She was constantly told there were too many chiros already and couldn't get on board. Made opening her own practice difficult.

good luck.

[StealthRabbit]

Originally Posted by Chapinadancer

Oh and what other states would you recommend despite the diversity concern?

Colorado and Oregon forums are not too keen on recommendations to other states, from within THEIR forum.
I have lived with these folks for decades, it is best to let them remain thinking they have the BEST state in the whole world, it gives them warm fuzzies about their own choices.

You have a criteria list, Make a spreadsheet with weighted scale (scoring) add the numbers you need to determine the future success of your practice, Validate assumptions. Run the math, states will drop like flies and you will be left with only a couple viable choices (one might even be Colorado!). It is not unlikely, since it has growth, recreation, and a fairly equitable tax structure, and versitile economy.

Go and visit and do market research including LOTS of personal interviews with existing chiros, BEFORE you head to NZ. Do business analysis very thouroughly, stay wil local people when visiting (not hotels). Stay away from Economic Development people and Chamber of Commerce. You want a non-biased business study. There are tons of stats, especially at business school universities. You can find out very accurately what is being spent on chiro services, as well as the income figures for that NAICS sector. https://www.census.gov/eos/www/naics/

[Chapinadancer]

Originally Posted by sammy87

Like everywhere else there is a Chiropractor on every corner in CO. Considering everyone and their mother wants to be here, Im willing to bet the market is pretty oversaturated.

I have a very close friend thats a Chiro and I feel bad for her.

Not sure if you know what the Joint is or not but its a Chiro chain. They are popping up everywhere. They charge a flat rate of $20/visit. My friend was offered a job there. The hours were like 10-7 6 days a week with no lunch break. Starting pay was $38k. According to her, its the death of the practice. Not sure how you can compete if you have your own and you charge insurance and the copay is the same. She had issues getting into a network with insurance. She was constantly told there were too many chiros already and couldn't get on board. Made opening her own practice difficult.

good luck.

Thank you for your input, yes we have definitely heard of them. My husband was even asked to join by the head manager of the company but politely refused. They are not providing quality care and are kind of like the mcdonalds of the chiro business. You can get an adjustment there but that doesnt mean you are recieving the best treatment. My husband will be a specialized neuro chiropractor which there are only a handful of them in the u.s and he will be treating more severe cases. And yes over saturation can be an issue but if the population continues to grow as quickly as it is, so will the need for chiros.