From Restaurant Systems To Multi-Clinic Chiropractic Success with Dr. Sam Wang

Chiropractic can change a person’s life in one visit, but can the profession deliver that kind of result reliably when a practice grows beyond one doctor? I sit down with Dr. Sam Wang to unpack the uncomfortable truth that scaling chiropractic clinics exposes: the variable is often not whether chiropractic works, but whether our systems make outcomes consistent and trainable.

We trace Dr. Wang’s path from a car accident and a first adjustment that erased severe pain to building a multi-location model, then connect the dots to an unexpected influence: restaurant operations. Corporate chains succeed because training is standardized, roles are clear, and processes run the same way every day. We explore how that mindset translates to chiropractic practice management, from front desk workflows and documentation to technique consistency across associates, plus why instrument adjusting appealed as a way to create reproducible force and predictable results.

The conversation also gets real about the modern landscape: consolidation in healthcare, heavier compliance demands, IT and cybersecurity concerns, and why “be a great clinician and a great entrepreneur” is often too much for one person. For students and new grads, we dig into the job market, the lack of standardized associate contracts, and the weight of student loan debt that can reach $250,000 to $400,000. Dr. Wang explains why structured groups and formalized postgraduate training can bridge the experience gap while protecting patient trust.

If you care about standardized chiropractic care, multi-doctor clinic consistency, and building a career that does not collapse under complexity, you will take a lot from this one. Subscribe, share it with a student or associate, and leave a review with your biggest takeaway.

Transcript

Welcome And Guest Introduction

SPEAKER_02 0:07

Hi, I'm Dr. Ellen Four, the chairman and founder of Activator Methods International. And uh I'm here to bring you Activate Your Practice, which is the podcast. And by the way, we just got our 2025 numbers in, and we had 2.4 million downloads in 2005. So we're gaining popularity not with only within the profession, but also with the people that are associated, like the patients. So uh this morning I'm really happy to introduce to you uh Dr. Sam Wang. And Sam has uh you're gonna find out a varied career here in chiropractic. And I'm going to let him start and just tell you a little bit about his chiropractic start and then what he got into. Good morning, Dr. Wang. Nice to have you with us. Well, good morning.

A Car Crash Sparks A Calling

SPEAKER_00 0:54

I want to first take the opportunity to thank you. I I'm so honored that you invited me to your show. And this is uh I don't do one uh off too often. And so this is one that when you invited me, I said, absolutely, we'll figure out a way to make this happen. So this is uh I'm just so grateful for being here. We're glad to have you. Yeah. So I started my carboctic journey uh making a long story short, uh traditionally through just getting involved in a motor vehicle accident. I was rear-ended uh about a week after the accident, woke up with traditional whiplash injuries and uh symptoms, and found the here the you know, the perfect storm of the commercial on TV was a chiropractor advertising whiplash, uh, to the state farm agent saying that they'll cover chiropractic as a benefit, to then living in Davenport, Iowa, going to high school there and going to Palmer Clinics to get my high school physical done, not understanding what chiropractic actually was, other than it was just a healthcare profession. Uh, and that's where the locals would go to get a cheap$5 sports physical uh for the state of Iowa for the public school system, and was able to uh go and experience my very first chiropractic adjustment, which was a Gonsted uh adjustment, cervical chair. And I came to that appointment. I remember distinctively having a very, very high uh pain uh complaint. It was nine out of ten, ridicular down my right shoulder. Anytime I turned my head or neck, and one adjustment just went from a nine to a zero. And I just remember thinking, this is what God has led me down the path of doing. This is what I want to do for people, uh, if if I can make that kind of impact. So that's what led me down the journey uh to become a chiropractor. And where did you go to chiropractic college? I ended up all the way down in the southeast in Sherman College. Uh back then, uh it was called Sherman College of Straight Chiropractic, and now just Sherman College of Chiropractic. Spartanburg, South Carolina. In Spartanburg, yes.

SPEAKER_02 3:10

And uh then tell us a little bit about you got out, started practice where?

Choosing Chiropractic School And Location

SPEAKER_00 3:15

Got out. Well, uh Midwest was always home for me, although I grew up in about eight different states, uh, from the Midwest down all the way down to South Louisiana and then southeast and then back around to the Midwest. And so, but Midwest was always home because my grandparents originally immigrated and settled in the Quad Cities. So I knew I wanted to come back and be near family. Uh so as I looked in the early 2000s, what state would be the easiest and the quickest to get licensed, Illinois was still on the list of not having to be requiring uh part four for licensure. And so I said, Well, I want to live near a major metropolitan, but not in one. So the suburbs of Chicago just looked very uh appealing, and that's where we started the first practice and then kind of blew up since then.

SPEAKER_02 4:03

So now you uh co-founded the Cairo One program. So tell us a little bit about the journey to get from a practitioner to an uh entrepreneur.

From Solo Doctor To Builder

SPEAKER_00 4:16

Yeah, so I think again, with the the confluence of events, I grew up with my grandfather owning several uh restaurants. Uh, and growing up in the restaurant business, just learned that there's a back of the house and the front of the house, and that everything that happens behind the scenes, essentially in the kitchen and the serving staff, to what happens, what you know the public and the customers see. Uh, that always stuck with me um growing up. And then so then in between um summers and and whenever I could afford the time, I would go work and serve tables at various restaurants from chain McDonald's all the way through a great experience for me was Applebee's, which was a corporately owned chain as well, um, down to you know, to my family restaurants uh and other restaurants that were just family owned, right? And operated.

SPEAKER_02 5:07

And so what you're saying is you took the management style from the restaurants across the board over to the chiropractic clinics and said some of this could probably work here.

Restaurant Training Becomes Clinic Systems

SPEAKER_00 5:17

Oh my gosh. I I had the realization when I was doing my preceptorship with Dr. Stuart Burnson up in Evanston, Illinois. The thought occurred to me was there are systems, whether we recognize the monotony clinical practice, there are systems that we follow. There are processes that we follow from just managing the front desk all the way through, you know, claims, insurance, billing, and and how we trained our staff. And very similar parallels in Applebee's, for example, when they hire a brand new table server, uh, you get training. It wasn't just here you go, here's an apron, and start speaking to our customers. You know, you had to learn the menu, you had to learn how people operated in their different roles and then and and what your role and responsibility was as part of the team. And then you actually had to learn customer service. You know, what does it actually look like to you know to perform appropriately? All the way down to there were systems on how you cleaned your station that you had an order, i.e., you would start with the light fixture, because as you're cleaning light fixture, it the dust would follow, you know, fall down to the table and then fall down to the ground. And so you would clean from top to bottom. Uh and the chiropractic practice, the business of the chiropractic practice was no different. There are clean, clear systems that you can follow to just make things very efficient.

SPEAKER_02 6:37

I think the word that keeps coming up is systems. Yes. And uh so one of the questions here was why is chiropractic being forced to think scale right now? And what do you mean by scale?

SPEAKER_00 6:48

Yeah, scale, I think, is at any I think growth of an industry once the the initial uh kind of benefits of the industry proving itself and surviving is then there's uh an understanding that there's grouping and consolidation that occurs. And if you look in a very uh close parallel in healthcare, i.e. dental or even physical therapy, they've consolidated, they've decided we're stronger in numbers than as independent practices. And so let's come together, not just uh with membership through our state associations or our national associations, but let's come together as industry so that we can guide and direct where the profession should go. And so when we see that healthcare in general has consolidated, um the finance, you know, the the the money out there has consolidated, you know, chiropractors have not. You know, we're still lagging there.

SPEAKER_02 7:54

Uh when when chiropractic scales, what does it reveal about itself?

Why Chiropractic Must Scale Now

SPEAKER_00 7:59

It really identifies if the systems or the processes, right, that we've developed over the years is more personality driven or it's actually process driven, right? Because unfortunately, you know, chiropractic absolutely works, right? There's no question, there's no doubt. So then it's the chiropractor that is the variable. And so if the chiropractor is practicing methods or techniques that aren't consistent, that aren't reproducible, that aren't reliable, and most importantly, that aren't trainable to the next chiropractor, that then we get inconsistency, right? And that inconsistency is where the distrust comes from. It's the unreliability of that method, right? Because unfortunately, our industry, if we currently identify who the most financially successful practices out there are nine out of ten times, they're personality driven. They're very big, charismatic chiropractors that are fantastic and and attractive, you know, and and and just you just love spending time with those human beings, but they're not necessarily the best clinically for patient care. Right. And so we need to, and what scale will show and and and point out is is this profession ready to grow with predictability and reliability versus are we really just a profession of strong personalities that succeed?

SPEAKER_02 9:44

You know, this is where back years ago I wanted Activator to be uh something consistent. In other words, you could get an adjustment like I gave in Redwood Falls, Minnesota when I first started in Los Angeles if we had trained you.

unknown 9:58

Yes.

SPEAKER_02 9:59

And I think that's what you're talking about is consistency. So you can go, it doesn't make any difference which doctor you see for the day because you're you're going to be uh doing the consistency.

SPEAKER_00 10:09

Yes. So when I was at Sherman, one uh thing that I just my logical brain just gravitated to was just instrument adjusting, right? So two reasons. One, as a student, I realized I could not compete against a 10, 20, 30-year veteran that has been practicing so many years and and had the skills in their hands. So I thought, well, how could I level the playing field? And instrumentation was one. But two, what I loved about instrumentation is that it's consistent so that your first adjustment and your last adjustment of the day, your body doesn't, you know, your instrument doesn't get tired. And it's the consistent, reproducible force that then again back to patient outcomes. That was really, I had such a blessing that my very first adjustment, I got to experience how my body could heal from the inside out and how my body was able to just by removing that interference, that consistency. And so that clinician was very, very strong. However, over the years, I've realized it's not a standard, right? And it's not a knock to the programs that are out there, it's just the inconsistency of how we treat our or train our providers, um, the programs that they graduate from, what they get introduced to. And then I think what we also are lagging behind as a profession is the certification programs or the residency programs, or you know, or the postgraduate training. Um, because I I've noticed now, depending on the institution, we have instructors that are teaching techniques, methods that they have very, very little experience in, right? But because of um financial you know constraints that they have to kind of consolidate and and teach a handful of different techniques, but and and they might be really strong in one or two methods, but not all of them. And so there's a dilution effect as opposed to what you even have, right, with your systems and how much information and education you've accumulated over the years. That that type of uh knowledge and and and experience to be able to go through that systematically and consistently and being tested all throughout the journey, uh, so that when you become certified and advanced certification, you can, as clinicians, understand there's consistency and reliability. But then I think most importantly, as patient, you really then can trust right that provider, that that chiropractor.

SPEAKER_02 12:44

Well, and I think you're saying what technique choices you know make, that's that's a big thing. Because if you have a multi-doctor, you know, clinic, you want them all doing basically the same thing. I mean, they're analyzing the patient maybe slightly differently to find out what the patient has for a problem, but then how they adjust them should be consistent.

Consistency Problems In Technique Training

SPEAKER_00 13:04

Yeah. The last thing I realized when we scaled with multiple locations uh and multiple associates was the care shouldn't be reliant upon what doctor is on the floor, right? The patient should not have any bias to say, oh, I like him better than her or or her better than him because they do XYZ differently, right? Or they're they just feel easier. And so for me, that standardization uh shouldn't be, I don't, I don't believe, chiropractor dependent or method dependent. However, the methods that you do use should be consistent in that practice throughout.

SPEAKER_02 13:45

Well, you know, that's where we got started in virtual training. And uh we found out that virtual training was actually better than a seminar because different people taught the seminars. And so when we put everything together in the correct manner and put it out only one way, the consistency went way up. I love it.

SPEAKER_00 14:07

I love it. You're preaching in the choir. That's exactly what I uh strive for is uh how are we actually even training our doctors the exact same way so that the product at the end of the training is consistently the same? And our, you know, and for for us, uh we like to test all throughout, right? Weekly, monthly, and then a final accumulative. And so we want to ensure the quality of the training is there. And if not, how do we continue to improve?

SPEAKER_02 14:35

Well, I think you'll agree when students come out of school, they have very little experience. Right. And so then they start, and what the model that you show them, that's what they're gonna follow.

SPEAKER_00 14:44

That's right. You know, our institutions have done a phenomenal job uh evolving through the years and have really clinically, didactically have trained these students, these new graduates, to become great providers, right? Of great doctors, clinicians. However, back to what you just said, they just lack this experience. They just lack the hours of actually doing the work. They understand the theoretical now, right? Uh, but they're just not hands-on enough. And that's where the consistency in that training.

SPEAKER_02 15:15

I remember as a young practitioner going in with my old partner, you know, had been in practice some 25 years, and he would show me things that I would like I'd drop my teeth because it was like so simple. Yes. But we didn't know what to do with it. And he'd say, Oh, this is how we do this, and da-da-da-da-da. And that's I think that consistency that you start getting. Um, what kind of chiropractors are multi-unit models shaping?

SPEAKER_00 15:42

You know, at the very worst, I'll be, I'll be uh balanced here at this one. At the very worst, we're we're we're bringing up a group of technicians, right? Because we're trying to remove as many obstacles and barriers to our clinicians so that they can be on the floor and provide care, right? I think the job of the chiropractor is to primarily is to educate and to adjust, right? Those should be the functions of the chiropractor. Then the chiropractor should have a really strong support team, chiropractic assistants or technicians that do all of the other things that we need support, no different than the medical model where you have a primary medical doctor on the floor and then a lot of supporting nurses in their trained areas of specialties to support that primary doc. And so I think if we can remove some of those distractions as much as we can, i.e. through the technology that comes out. Again, as all doctors, we I don't think any one of our us specialists, you know, have any enjoyment documenting the services that we perform. However, they're incredibly necessary. Uh, and so, you know, we leverage technology to help remove some of those burdens. But at the end of the day, you know, I think if you create a really strong system, at the very least, you end up creating um at least the argument would be that we create a bunch of technicians then and we're not creating, you know, independent free thinkers or, you know, because the systems, if they just follow the systems, they can do really, really well from a clinical outcomes as well as a financial outcome. Um, at the very best, though, I think we're teaching our clinicians listen, individuality is what your clinical assessment is, right? But once you then come and and start diversifying things without understanding the veritability, then you're you're you're practicing, right, unscientifically, and expecting uh on patients who are paying for care, right, uh, and expecting an outcome that might not be there. And so I think the systems help the clinician still maintain individuality, still maintain the artistry of chiropractic, because that's a huge uh component of what it is that we do, but have the reliability and the consistency so that we can still get the outcomes.

SPEAKER_02 18:17

Isn't that what a hospital does? I mean, when a student comes out and becomes an intern, they fall into the uh regiment of the you know systems in the hospital.

Multi-Unit Clinics And Doctor Development

SPEAKER_00 18:27

That's exactly right. It's it's just understanding, you know, there's too much on a traditional chiropractor's plate to have to be both a phenomenal clinician and to be an entrepreneur. You know, I think even 20 years ago, maybe 25 years ago, it's it was a lot simpler to do things, right? And today, with all the regulation, the compliance complexity, the IT infrastructure and cybersecurity that you have to be aware of, there are too many things involved that in order to just maintain baseline, you have to have, you know, 80, 100 hours a week committed to just balancing your, you know, your business along with treating patients. And so I think uh joining a system, right, a hospital system, a multigroup system, or even associating right with a with a senior clinician out there uh and following a system is the best path. I think it's the quickest path to just learning how to um be more effective and more efficient.

SPEAKER_02 19:33

But this is for the students. I remember doing a seminar one time in one of the colleges, and uh I was a bunch of seniors, and so I said to them, Where are you all going? How many of you have a contract or how many of you are, you know, got a place to go and about 80% of their hands went up? Yeah. And I said, How many of you have a signed contract? One hand. And it was it was a lady that you could tell this was not her first rodeo. Yes. You know, she had been out in the world before, and so she got a clinician to sign a contract for. So 99.9 percent, they really didn't have a place to go. And I think that's something that, you know, for the future for young doctors coming out, if they don't stay with a big group, fine. But I mean, to learn, it's uh quite an opportunity.

SPEAKER_00 20:20

Trevor Burrus, Jr. It's a fantastic opportunity. And I and I'll say, and I've you know, I think a lot of us leaders in the industry um identify this every year, uh, and including in 2026, there's no better time to be a chiropractor. There's so much opportunity, you know, today than what it was 20, 25 years ago. I the statistic I have internally is that for you know, 25 years ago, for every one chiropractor, uh there was, or sorry, for every five chiropractors, there was only one job 25 years ago. Today it's flipped. For every one chiropractor, there are five job opportunities, right? And so the challenge is though, I think because we're still a highly fragmented industry, uh, predominantly of mom and pops, uh, you know, individual independent chiropractors, um, that dealt that you know, we don't get the training for how to write up a really nice associate contract that covers both responsibilities. Um, and so that there's opportunity, but there's not a lot of professionalism yet and standardization yet. But I can say, you know, in the seat that I'm sitting in, it's just a phenomenal uh opportunity for these new students coming out of school today of having choice, uh, having the opportunity to join a larger group that has systems and training for them so that they kind of bridge that gap of graduating to then getting the hands on experience that they need, uh, to then be at choice of what to do afterwards when they can kind of reduce some significant student debt load, get The experience under their belt and then decide what's the next step.

SPEAKER_02 22:04

I never will forget you told me this, and I want to get it out here that there's a program with Cairo One, and if I'm not mistaken, that for if you work for seven years, is that correct? You get your student loans paid off.

Jobs Boom And Contract Reality

SPEAKER_00 22:15

Well, that has always been a concept that we've developed over the years to understand, listen, the financial obligations to become a chiropractor has, you know, tripled, right, over the last 20, 30 years. And uh not necessarily just through tuition, but really cost of living adjustments and things like that, right? So it's just more expensive to live uh into into uh become a chiropractor or any or for for that matter, for any healthcare provider. That burden, along with we needed to bridge a gap. We saw that there was a very huge need in the industry that when you graduated school, maybe a small one to three percent of the graduating chiropractors today really had the certainty and confidence predominantly through their prior lives, if there was a second career for them, um, that they felt the confidence to go out and open a practice from day one. Most of us was were just going, I don't even know where to file an application to get a state license, let alone open a whole business. And and then, you know, I didn't come from the means to be able to financially get a loan at a bank to be able to open my own practice. So what do I do? And so the rise of franchises and the rise of uh private, you know, clinic chain groups out there has really created this opportunity of not only um a job walking across the stage that you know you're secured with, but also uh a formalized postgraduate training program. And that's where then Cairo One recognized the need for this. And we said, how do we standardize everything from the front desk all the way to the back of the office administrative tasks and teach the chiropractor what he or she needed to know in order to be successful operating in a clinical model? Right. So that's what we did.

SPEAKER_02 24:09

Well, I I think that's fantastic because you know, kids don't understand money. I mean, uh I'm sorry to say, but you know, 200,000, that was a house. Oh my goodness. And uh then you got a clinic loan or you got a school loan on top of that, that's something that they just can't comprehend. So I think that this is something that students can take a look at and they can see how you have made a successful business run. And if they want to leave, fine. But if you can stay there for seven years and have your loans paid off, then you have no complaint. You can you there is a way to do it.

Student Debt Solutions And Closing

SPEAKER_00 24:42

Yes, and uh I'll give a sense of um um certainty if you're graduating, depending on the undergraduate institution you uh attended. Some of these students are graduating with now$250,000 to$400,000 of total student loan debt. Yes. Uh, but we have chiropractors in our organization that have over the years paid off all of that debt and have maintained a really great quality of life uh and finally are able to save money and actually then be at choice, whether they still decide to stay and work for the organization, because I have fantastic chiropractors that would that have now been with me over 20 plus years that have stayed on, or I've had really, really great chiropractors also that have really built uh paid off debt, built their wealth, and have now started their own chain uh of clinics. And so uh there's again, there's just no better time for chiropractors, you know, than today. And and the opportunity is just really abundant.

SPEAKER_02 25:40

Well, thank you for taking the time to spend with us to get it out to all the people that will learn. And I'm talking to the students now that are out there, just take a look at Cairo choice. That's that's one and Cairo one. Take a look at these for choices and finding something that you'll end up being trained and better off.

SPEAKER_00 25:58

Yeah, I think the best thing is understanding uh your personality, your characteristics, how you want to practice clinically, because there are different groups out there that have different kinds of approaches, and finding the best fit is probably the most important thing in ultimate success, not just financially, but ultimate success and satisfaction uh in in in making sure you find a home or a fit with an organization that matches your ideal values. And so, yeah, we absolutely appreciate the time uh and thank you for having me.

SPEAKER_02 26:29

Thank you, Dr. Wang, and look forward to helping all those students out there. Thanks for listening to Activate Your Practice Podcast. Remember, this is brought to you by SoftTech Table Company. You can find more information on this table at softechtables.com.

SPEAKER_01 26:49

Softtech manufactures specialized treatment tables designed to help chiropractors who utilize the activator method, maximize their time, and the success of their procedures. Upgrade to the only adjusting tables endorsed by Activator Methods at softechtables.com.