Dr. Brian Bord from AlignLife Nexton returns to the Align Your Practice podcast to speak about his experience running a fully operational chiropractic and wellness center in under 400 square feet. Bringing in the most revenue per square foot that Dr. Joe Esposito has ever seen, it is clear that bigger isn’t always better. The doctors also discuss the pros and cons of existing inside facilities like Bold Fitness and Gold’s Gym. 

About the Guest:

Dr. Brian Bord got his BS in Physics from SUNY Geneseo and worked as an ICU tech for 2 years before attending Sherman College and getting his DC 24 years ago. Dr. Bord owned a practice in OH before settling in SC and has practiced and/or owned in a few different areas in South Carolina. He has been working at AlignLife Nexton in Summerville for 3 years now. 

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Transcript
Dr. Joseph Esposito:

We got Brian back right away Dr. Brian Bord again in the studio. And the topic today is bigger isn't always better. Brian, how are you?

Dr. Brian Bord:

I'm doing fantastic Joe. I'm just trying, I'm trying not to take it personally.

Dr. Joseph Esposito:

What we're talking about is bigger is always better in the clinic, the size of your clinic, the square foot. A lot of doctors want to come out of school with a 3000 or 4000 Mega clinic. I want the wellness clinic with everything inside of it. And I want to build this 5000 square foot Taj Mahal, but the reality is bigger isn't always better inside of the clinic. And we're going to break this down. Brian, you've been as we talked in a previous podcast, you've been in the medical integration. You've been in mobile Cairo, you've opened your own clinic, you've been in a wellness clinic. Now you're actually running in a line line clinic inside of a gym facility. And you've been doing that for a couple a number of years now. And that's what we're going to break down. So just to frame it out for people. What were your thoughts? Initially, like you've been in different types of clinics? What can you give us a feel when we first brought this opportunity to you? Well, it

Dr. Brian Bord:

was another opportunity, obviously, and throughout the course of my career, I have basically opened five clinics, and they'd been all different, all different sizes, all different facilities, all different offerings. But this one I saw as being just another challenge that I can get myself and the space. This is your space, this is your clinic, and okay, I will do everything that I can within it.

Dr. Joseph Esposito:

So when we look at this size, like I've been in the gym world with chiropractic for 25 years, I've opened in multiple gold's gyms, our gym facility, and our clinic was Gold's Gym of the year and 19. I'm sorry, no, it was 2000 I think four or five something around there. It's been a while. Gold's Gym with a year out of 660 locations. We were the most integrated facility with everything from Cairo, nutrition, PT, massage, you know, therapy, hydronic, rehab, and whatnot. It was pretty amazing. It was the beginning of the big box gym days back 1520 years ago. So I've been there. And I've always whenever I built a gym clinic, I always wanted to build a clinic where you could pick it up and drop it from the sky, and it would fall into the gym, and it'd be a full functioning clinic. I was always against what I saw Cairo's do is down the back hallway in the administrative offices. There's an extra room A by 10 square foot. And there's a chiropractor sits in there with one table, no staff, no equipment, no product, no X ray. And they just sit there and then they, they see three, four people a day, 10 people a day may be and they're in this little box in the corner. I've never done that I've always built full fledged, some of my two of mine had full fish tanks built into the wall. I've had boxes display boxes on food and nutrients along the hallway like custom designed educational displays like crazy stuff over the years. In this particular facility, Brian, we have like between three and 400 square foot, but it's still a fully functional clinic. It's got full digital X ray. It's got staff, it's got nutrients, right. And it's the most efficient space we've seen. We built in chiropractic inside of a gym facility. I will say we are working now more intensively with Gold's Gym. We just put an align life clinic in the one of the largest, I think it is the largest Gold's Gym in the nation. In New York, this thing should have its own zip code. It's so big, is probably one of the most beautiful facilities. When I went to see it, I was like, How can I work here, I want to work here. Like I just wanted to work there. I fought myself not to ask for a job at that clinic. But that's, that's a giant, a giant operation. In your facility, you're actually bringing in more dollars per square foot than any clinic that I've ever seen in my history or my career. So let's talk a little about that. You talked about a line life systems in the past and how valuable they are. When you're in three 400 square foot. There's no place for even a wrong step. You step backwards, you fall over. You can't. Your relation with your staff and your team and your flow. You don't have 300 square feet to mess up. Right. So talk us through that a little bit. Is it easier because you you have to use the space well it's like so refined. What are the struggles? What are the wins give us some insight?

Dr. Brian Bord:

Well, it's both restricting and freeing at the same time because we are forced to be efficient With our space, so unable to be in in order to be able to offer the, the the services that we need to offer, namely, like you're saying with the digital X ray, we also offer therapies, we do the two chiropractic tables, and I have a front desk and at that front desk, I have an absolute unicorn, she is so hard to find, but she is, she wears so many different hats in that clinic that it is crazy that she can tolerate me as well as she does, but it forces you to become very, very reliant on your staff to be able to manage the patient flow, because as you said, we're seeing we have 300 square feet, which means that our back room is a combination x ray therapy consultation area, we have the adjusting area, and then the front desk area. And that is what we have and to work within the systems means that the systems have to be flexible enough to allow for the limitations that we have with the space and with our, our availability in the scheduling and everything else that we're doing. But like you said, we are able to, to, to work within that because of the strength of the system to where it is a full functioning clinic. And not just an ancillary, they'll hold the wall kind of side thought where people can walk in to get cracked, if they happen to pull the wrong muscle when they're working out. So no, it's been it's been fantastic to see how it has been able to grow.

Dr. Joseph Esposito:

So if someone needed sprained their wrist, and again, those listening think 350 Or a little under 350 square feet, someone sprains a wrist in the gym, they could come in there and get an x ray, right? Yes, actually, someone has flat feet when they're running, you actually cast orthotics and support and adjust in that 350 square feet. If somebody are

Dr. Brian Bord:

extremely strong in orthotics, yes,

Dr. Joseph Esposito:

someone needs their their want to lose weight and their body fat. They want to know what the body fat is. You measure body fat with with objective testing, and you have nutrition in that same 350 I'm just getting what's inside this little you're providing a full fledge integrated health care experience inside of this facility, which is amazing. So inside of the gym world that you've been in, what are the positives? And what would you say the negatives for those that are looking we have students maybe listening to this podcast, and maybe wanting into the fitness world, and they may want to open it. Now they don't have to open the 350 square foot. So putting that aside for a minute, the values of being in a fitness facility, let's give the the positives and negatives, let's walk through that a little.

Dr. Brian Bord:

The obvious positives is is the fact that we have the gym members that are already there. They see us every time they're working out. So so long as we have visible messages, so long as we have the the service being very available to them. If they are curious at all, we are always open to conversation. And of course when they're looking for a chiropractor, oh, there's my chiropractor right there because I work out here. It's convenient. Plus talking to them on the first day, we already have a leg up because being in the gym as they are they're already health minded. So it's very, very easy to talk next level health with them.

Dr. Joseph Esposito:

The demographic, right, I'll just I'll just stop there. The demographic is right concerning health and people. And the lead generation is no brainer because there are people right in front of your office workout. So lead gen and demographic is dialed in. Any other I'm trying to think myself any other. Those are probably be I think the two biggest things demographic and yeah. What would be if there was a negative what would be the negative?

Dr. Brian Bord:

The negative. There's a couple that, for the most part can be overcome. First off would be there are some people that we've had that have come from outside lead generation that when they walk into the gym, and they see that we are a facility inside a gym, that automatically creates a little bit of a stigma, because they don't understand that it can be possible to offer a full service chiropractic care inside that gym space because they're already thinking, this is inside a gym. This is not what I'm expecting to see. So setting that as resetting the expectation can be done. But we have had patients that have walked in take him One looks at nope, no turned around walked out again. Luckily, it doesn't happen too often.

Unknown:

What was the other one?

Dr. Brian Bord:

The other thing is just in our specific location, the facility that we are in. And the fact that we are subletting space means that we are not allowed to have outside signage at all. So no sign on the side of the building, no a frames, no window clings nothing. So any kind of outside lead generation, we have to work a little bit extra hard to chase those down. And even with leads that we are able to generate digitally or through other sources, oftentimes, we have to give them very detailed instructions on where we are, because not the easiest place to find as well. So that is a little bit of a little bit of a hurdle that we've had to jump over the years.

Dr. Joseph Esposito:

So I agree with that if I was to open ideally, in a gym facility, I'd want my own entrance and entrance, two ways, one through the outside, and one through the gym. So it's easy for members. And it's also I can get access from the outside for those that don't want to partake in the facility itself. So I would agree with that. And also having outside signage would be beneficial. So in your case being inside, you must have a majority, what percentage of your new patients are gym members? Or are they referrals from gym members as well coming in? Do you have an idea on that?

Dr. Brian Bord:

gym members and referrals from gym members, I would say is probably a rough estimate about 50%.

Dr. Joseph Esposito:

So gym members, I'm saying if a gym member refers a family or friend, they won't necessarily be a gym member. So they will be outside of the gym membership. So I assume, right? You already have new people would be members there. But then as you build up value and understand and you take them to workshops, and they follow the Align life system, their family members may come that aren't your members. Is that? Is that fair? Is that right?

Dr. Brian Bord:

That's fair, especially at the beginning. We have been there for a good number of years now. So we have been able to make some good connections in the community. So our people's awareness of us being there is starting to increase as well. So right now I'd say that the gym members and referrals from gym members is probably about 50% of where our leads come from.

Dr. Joseph Esposito:

So yeah, 50% are not involved in that gym at all.

Dr. Brian Bord:

I'm rough estimating top of my head, but but we do get quite a few outside patients. Yes,

Dr. Joseph Esposito:

that's interesting, I would think it would be that high. But that's awesome. Well, so you build the value, you help patients that outcome and then they tell other people and then you get people from the outside. So it hasn't, based on your numbers, the gym itself hasn't hurt the opportunity, because the word is out that you are there and you're getting outcomes, and people will go anywhere to find people that can help them right. So that's exciting. So any other thoughts on the gym, because think of people going into a gym, I'll tell you that I've done I think I've done about five gym facilities. And my advice to you, if you're listening to this is number one, make sure that you have a good relationship with the owners, and you have pretty unified philosophy of what you're trying to accomplish at the facility. That's number one. Number two is I recommend that you have an opportunity in contract that you can educate the sales staff and the trainers so that there's no rub in you, helping level them up on their knowledge about wellness, about chiropractic, about spinal integrity about nervous system function. And if you can correlate those together and support those people, you literally have a sales staff on the floor in the facility that are brings massive value to you. So those would be some of my lessons learned. And and also make sure that the tour includes your facility, and that your marketing is able to be sent out with their email lists with their on their gym facilities so that you get more and more exposure with those about four things, I think, I think it's a very viable and strong opportunity to build a chiropractic clinic in the gym. And the number one thing for me is what you said is demographic. These people want to be healthy. They're spending the money, they're taking action, they're changing behaviors. And that's what we need to chiropractic. They got to show deployment, they got to do their exercises. They got to invest the time and the energy in Cairo versus conventional conventional health care. And the other words of wisdom on the journey at the facility from for attendees to the podcast.

Dr. Brian Bord:

Just understanding like you said that there are definitely some very powerful advantages and some disadvantages as well, most of the disadvantages can be overcome. And it's a matter of being able to have the structure in place, not just the physical structure, but the system structure as well to be able to allow for the smaller space, higher volume, and to be able to really maximize the the effectiveness of the message. So you don't have to water down the service in order to fit expectation for where you happen to be at the time.

Dr. Joseph Esposito:

That's a good point. What about the integration, the line life model where we look at body composition? Or we look at nutrition? Or we look at that model verse, just the straight Cairo Do you feel there's value in the gym with that discussion?

Dr. Brian Bord:

Oh, there's absolutely value in the gym. With that. You said they are very health minded already. So to be able to talk, nutrition with them is simply another aspect of health. And it's something that you present yourself as, as an expert on health and not just an expert on chiropractic, necessarily, then you will be able to talk to people, when they walk up, say, Listen, I heard that this is good for you during workouts, can you give me a little bit more insight on that? Or they're doing their body composition? And say, Well, you know what, I have this goal to reach my ideal percent body fat, how can I achieve this goal? Well, here's what you have to do. And just give them the framework given the list. And it's it's not any kind of large lift, because they're already there, mentally, you're just giving yourself you're putting yourself out there as the person that can help them achieve all of these health goals that they have. And not just the eliminate that little twinge in their shoulder, they get every time they do an overhead press.

Dr. Joseph Esposito:

Yeah, that's a great point. So you're, you're kind of like in the facility like the educator, you're like the support network, there's no hard sell, you're not like forcing patients to come. You just eventually, they want what you have, they get an evaluation, you build. It's very heavy, relational, relational situation, right, where you have to just constantly be there as an asset. If you were to go in there and use fear based, hard selling screening type techniques on the gym floor, you'll burn out the relationships, you'll lose your reputation, right, you could see if you do this wrong, and you're inside the facility, and that's your patient base, you could cause some damage, if you don't authentically provide opportunity without making like a hard sell concept. Right? You would agree with that.

Dr. Brian Bord:

Yeah. And that's, that's where you you just said the word hard sell. You don't want to set yourself up as a hard sell in the gym, because that will destroy whatever long term reputation you have. Because Jim members talk. And especially in the five o'clock hour, we see in the five o'clock hour, you see the same faces all the time, they all hang out together, they all talk. And if one of them thinks badly of you, they will all think badly of you.

Dr. Joseph Esposito:

So you see that the momentum is the opposite. If one talks good about you, you have you know, a bring them over. So I'm sure you have John brings over Mike, Mike brings over POB right that happens in your in your clinic, right? They're all absolutely yes. Yeah, yeah, constantly. So that's an interesting activity that you don't have outside.

Dr. Brian Bord:

But but at the same time, everybody knows that human nature dictates that it you might have one person say one nice thing about you. But yeah, if the one person says one bad thing about you, that's going to wind up spreading far, far more rapidly than than the good. So yeah, it's great to have people talking nice about you, you get one person talking nice about you, it can be a very, very powerful asset. But a bad word is going to carry a lot more quickly and a lot more, a lot further.

Dr. Joseph Esposito:

And that's why with the Align life system, that's why we consistently train on communication flow process outcome consistently, because we know creating consistently reproducible positive outcomes to reach people's goals is going to create a reputation that you built at this facility. And we plan to build in many more gym facilities is authentic outcome to create getting people what they want. So if you're interested in in a gym type practice, if you like the wellness mindset you like the fitness industry, you're welcome to reach out to us at a line life. Maybe have a conversation with Jack, Dr. Brian and his experience. We also have clinics and other gold's gyms that we'd love to have you take tours with. There's opportunities of growing inside i The Align life movement in regards to its synergy with some of the gold's gyms location. So we're definitely open open to that as well. So any final closing words, Brian, as we tie up today,

Dr. Brian Bord:

just never never believe that the success in your future ability to achieve your goals is dependent upon the size of the clinic that you have established. Because we've proven it before that it's possible to achieve immense success in a very small space. And that's, that's it's a common fallacy. And, yeah, it's absolutely not true, we have the physical proof of that. So never let that be a sticking point for you.

Dr. Joseph Esposito:

Yeah, and in closing thoughts, I like how you ended up because we started this with a lot of these kids out of school, or when I'm talking to them, some of we're looking at like 3000 square foot, the cost of build out is up literally, after COVID. It was like 60% increase, it's gone down, but it's at least 30 40% higher than it was a number of years ago. So the cost of a build out is astronomical. So we urge you to make sure that when you're building your clinic, you're making massively efficient utilization of every square foot. Now we look at the efficiency of Brian's clinic bringing over, over well over $100 per square foot, if you look at your numbers in your clinic, take your square footage at $100 100 times whatever square foot is, see if you're bringing that kind of revenue per square foot. That's efficiency, guys. So Ryan's massively efficient in his realization of space, but you want to just be cautious, you can always migrate to the next level clinic. But we urge you to be real purposeful on the way you build the clinic to make sure that you're not putting 50% of your gross revenue back just into paying for your your rent and overhead. So Thanks, Brian. Thanks for opening up your your time, your clinic, your energy for giving back to not only doctors but to students who recently spoke there. We'd love to hear you in the future as you continue to scale.