Empowering Women Chiropractic – Start-up Success – Dr. Janice Hughes

So today I have, I’m going to call it an expert in startup. I’m bringing to you a fairly brand new grad and I’m going to let Dr. Carolina introduce herself a little bit, but I really want to share with you success or keys in that startup process. And there’s nobody better than Dr. Carolina Tillotson, so welcome Carolina and please just take a second and introduce yourself a little bit.

Thank you, Dr. Janice. I’m Dr. Carolina Tillotson. My practice is called the Wellness Connection and I am based in Buckhead, Atlanta, Georgia. And like you said, I’m a very recent grad, so within the year and am currently practicing.

Right, right. And I’m going to tease a little bit, went to school in Atlanta and so many people start to tease about, “Oh, too many people don’t leave. They never leave Atlanta.” But knowing you and a bit of your history, talk about even why you stayed. How did you know basically where you wanted to practice and get into a little bit more about your model. How did you even know that that was where you want it to be?

Really great question. Because going through school I thought I couldn’t get out of Atlanta fast enough. And then as you progress through school you start to really think about what do I want my future to look like? What do I want practice to look like? And I think a lot of people through school, I thought I would associate and go off somewhere far away. Yeah, but for me, the deciding factor was choosing to practice where I wanted to live. And so deciding where I wanted to build my life and then building the practice in that location.

Right. And this happens a lot. I mean, I’m really fortunate to go into several schools and a couple of them I do business courses, others I just go and do some sort of off campus events for students because I think what’s really important with startup is a lot of times there’s that push pull, “Well do I do something that’s a little more safe and secure? I’ve got student loans looming over my head. Do I do something like associate,” which there’s some great opportunities. But how, as you made that decision, you were destined to own your own practice so then what other decisions went into that? Were you prepared or did you need to do some things to really get more clarity on what kind of model to even practice?

Absolutely. So to be a business owner, it will never fall into your lap. You have to be very intentional about not only the type of business you want to run, but within that business what you want it to look like, be like, who you want to serve, how you want to show up. And so I went outside of school to get extra help for that and I’ll shout out to Inspire Women and also the coach that I’ve worked the most with, Dr. Kim Carpenter. She’s been hugely instrumental in helping me actualize my vision and get clarity on that.

Yeah. And let’s talk about that a little bit because I would love to say that, again we had that all within us or that we even got that through school. But one of the things I find is that sometimes we enter chiropractic school almost clear on our vision or understanding our why or the picture even more than by the time we graduate. So really we’re talking about how you find mentors, coaches, models to really help in that process. And I’m just a really big advocate of that because let’s face it, athletic wise, it’s a given that people have coaches, so how even through that coaching process does that … It’s not about management. It’s not about saying, “Well, here’s the systems that you have to do.” Why are the questions so powerful. And how did that help you build your systems that are the model that you want?

Sure. So when I came to Inspire Women, you, Dr. Kim, I had gone through the process of reading the book Vivid Vision and had a really clear idea I thought at the time of what I wanted it to look like, smell like, tastes like, be like, what my personality of a practice. The gap though is that I’ve never been in practice. And so you have this dream, this vision, but how do you get there? And for me it was really important to find someone who had already done something that I wanted to do. Now the practice doesn’t look identical to my coach’s. It’s similar, but she’s built an incredible practice and she knows the way. And so coaches have coaches, healers have healers, doctors have doctors. To me it just made sense to find someone who knew the way.

Right. And so, I love the fact that you talked about the book. Vivid Vision is a fantastic book. There are other amazing resources. Share a little bit about your mindset and what else have you been doing in startup mode? What are you listening to? What are you attending? What are your, I’m going to say keys to focus and build your confidence and your mindset?

Mindset is huge. I don’t know if I could emphasize that enough. And yes, it’s just huge. So what you listen to, what you consume, that’s going to be your default thoughts when things aren’t going smoothly which, when you’re in startup mode, you kind of just have to buckle your seatbelt and just prepare to be on the ride, which is figuring it out along the way. And so the books I consume a lot through Audible and through Scribd, those are really good places to get audible books. What have I been listening to? At the beginning, I was listening to a lot of Grant Cardone. I was listing to, gosh …

I know. It’s when you get put on the spot.

I just finished Everything is Figureoutable, awesome book. So to me that is huge. So I might commute in or when I have time in the mornings I’ll listen to those books. And then I take time, especially before practice opened, I was taking time in the morning to meditate and to get really clear within myself so that as I had challenges throughout the day, I was starting from a really solid place.

Right and there’s some people, I was just at Life University last Saturday doing a business startup day and I described that what tends to happen is some people will call it your hour of power. Some people will focus on meditation. For me it’s a little less about the what you do. It’s more important that you create it so that you really think about working on your mindset, working on your state management.

You, like every sort of practitioner, you get hit with a lot of, I’m going to call it obstacles or challenges and we all do, actually. Any practitioner listening knows this. You can even think you’ve got it figured out in your riding on this even keel and a patient walks in and they’ve really sort of either plateaued and are frustrated or thinking chiropractic isn’t the right place for them or they’ve bottomed out. And so based on all of that, that’s where I think that it’s those success principles that are a little non-negotiable. Not that there’s one way to do it, but like you’re describing, sometimes you’ll have more time, particularly before you open your doors, but the power of it and staying connected to it is really important.

Absolutely. I would also say mantras or sayings, however you want to describe it, but having those power statements that are yours, that are in your own voice and doing that daily. Those several months before practice, I had my set of, I think seven and I said them seven times each, three times a day. That was the minimum. And so that really did help with mindset as well.

So let me talk and just ask you, because again, others are in this startup mode. What are a couple of key systems for you? I mean I know I was teasing before we got on live about the Jane app. Why do you use something like the Jane app versus some of the bigger EHR systems right now in startup mode?

Yes. So for me, Jane, and Jane is an EHR system, it’s cloud based and I first off, their customer service is fantastic, but it’s very easy to start with in terms of the system that they have in place and then learning to navigate it. It just is easy and at the beginning, and I’m guessing as I stay in practice longer, you want things that are going to cause you the least amount of headache as possible. And that, for me, has really been helpful to have that.

I also think a real key with now there are so many options, things like Jane app, tell me a little bit about how you’ve built in profit right from day one. So, for the audience, one of the things that I like to talk about is already with your vision begin with the end in mind. Again, is this profitable? Could you turn around and sell it even if in 18 months or two months you want it to relocate instead of thinking, “Oh it’s not this big entity.” If there’s profit built in from day one, profit first, then what starts to happen is you’ve built your asset right. So obviously Jane app is also really smart from a financial perspective, but share with the audience what else have you done in startup mode that’s allowing you to be profitable sooner?

So I’m a hundred percent cash practice. I don’t process insurance at all. I would say that has been something that’s helped me be profitable from month one. And does that answer the questions?

Yeah. So give some other tools, like what other things do you think about, is it just having the consciousness so that you know, like the Jane app, which is an EHR system to do all your scheduling, bookkeeping, things like that, that’s a smart choice compared to something almost that’s far more expensive. And so what are even some of the mindset about taking a look, for example, how did you set your fees?

Okay, so first and foremost, I chose a place that had low overhead and then I negotiated down. It was already low and then we went lower and so having that low overhead allows me to know that … I reached that goal a lot sooner, which feels great, especially when you’re first starting.

Yeah and the reason I’m asking Carolina kind of roundabout ways to get at the same thing is that you need some kind of a financial blueprint. So in startup … Now, I can talk to seasoned practitioners about the financial side and all too often overhead is way too high a percentage where we built these humongous entities and we’re not incredibly profitable. So one of the key things for any of you in startup mode is knowing, for example, your basic nut.

How much does it cost you to live per month? How much does it cost you to run that business per month? By when then can you already see that you would be profitable? What are the action steps to get there? So really clearly breaking that all down and knowing that because all too often just what starts to happen is overhead starts to grow or “Oh I need this,” or “I’m going to add this in”. And now your bottom line, your overhead and expenses, are going up higher or a much higher percentage than you ever intended them to be. So kind of that idea of in startup mode, you want to think about lean and mean. And how do you get the most impact from the things you’re using, the things you’re doing so that you really can have that profitability quickly.

Yeah, absolutely. So I’ve done, in terms of knowing your numbers, so I need to know my numbers for the business, but then know them for myself. And then taking into account student loans and all the other things that are important and affect the number.

Another thing with startup that Carolina is talking about, knowing your numbers, is the fact that in that very beginning, you have a lot of write-offs, but then you want to be grown. You want to become sort of a bigger practice and have more influence and more impact, but already part of your numbers is building in tax implications, starting to put money away for taxes. Unless you’re basically working for someone in a setting where they are taking tax off at source, being in your own practice, you need to start to consider that. Because all too many people you grow and suddenly you have a year, maybe that’s your two where you’re incredibly profitable and now you haven’t planned for the tax implications, so that can be another really important piece about just building those systems in, your financial systems, so your practice building systems as well as your financial systems and the clarity of all of that in startup.

And I would say that was one of the most beneficial parts to being able to coach with Dr. Kim was really learning to break down those numbers and knowing things like, set aside money for taxes because you think you’re just going to go out and make money and whatever you make is yours and it just isn’t the case.

Yeah, it’s almost a little shocking. It’s kind of like, “Oh, this is what I signed up for and I’ve never learned this before.”

Yes, yes. It’s a surprise.

Well, I’m going to put you on the spot a little bit and ask like if you could give other startup practitioners three keys or call them three tips, three key things that you want to leave them with, what would those be?

For startup?


Okay. I would say, find someone to mentor you and if you need to go and interview different people or search them out, get recommendations, but find someone who’s going to fit your personality and who’s done something that you want to do. So, find a really good mentor. Know your numbers. Speaking to early startup, sometimes in school numbers aren’t something that’s brought up at all, but they become hugely important as soon as you graduate.


If you can get a handle on that before you graduate, then that’s not going to be such a big shock and you’ll feel empowered versus disempowered. And the third one I would say mindset. Find something that works for you. Be a little creative about it, whether it’s meditation or mantras or taking time for intentional self care that allows you to get your mind right for you. It doesn’t have to be an hour, but it has to be some time dedicated for you.

Great. Those are fabulous. And you can see not only that you’ve been really working on this and thank you for sharing that. I think it’s important for startup practitioners to hear it from someone like yourself that’s really in the trenches, that’s doing it. Also for seasoned practitioners sometimes to go back to those things, I can only give the audience the example that there were times where I had grown or was beyond that startup and then all of a sudden, you start to flatten a little bit and it’s like, “Well wait a minute, I’m not doing those things that got me the startup success.”

So for anyone listening, please take Carolina’s ideas and tips to heart. So thank you so much Carolina, and we will make sure that again, others can reach out to you. We’ll put your contact information in. Other startup practitioners, I encourage talk to someone like Carolina that is in the trenches, is doing it, has that ability to share some of the same challenges and then also some of the incredible wins as well. So I really appreciate the fact that ChiroSecure is letting us talk about all facets of practice. We brought you, so far with this segment, different ideas about ten year exit strategies for seasoned doctors.

Talking to Dr. Carolina today about startup, we are all in that startup mode at some point. And often going into a new year, here it’s Happy Thanksgiving that I want to wish everybody and as we move into the holiday season, could you treat 2020 like you’re in startup? If we all brought that kind of energy at 2020, imagine what is possible. So just before we leave and end the show, I want to tell you that you’re in for a treat next week. The show is being hosted by attorney Mike Miscoe. So please stay tuned for that. And again, just taking this opportunity to say thank you to ChiroSecure for letting us really bring some of these pertinent issues to the audience. So Happy Thanksgiving and I look forward to seeing you on the next show.

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