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Josiah Fitzsimmons
Chiropractor and CEO of Lucro; founded Vero Health Center in West Des Moines, IA, scaling it to $5.5M revenue in 4 years with 36 staff
3
APPEARANCES
3
PODCASTS
012
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Jul 9, 2026
123 - The Four Types of Certainty Every Chiropractor Needs with Dr. Chris Grier
28:30

Stephen FransonCORRESPONDENT
How about number one? What's the thing that you said really just stuck out to you?
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28:36Josiah FitzsimmonsGUEST
For me, it was the actual profit margins of clinics across the country.
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28:40Josiah FitzsimmonsGUEST
Before I opened my practice, even since I've been open, before we had all this individual data, that's when most practices that I talked to were always claiming 40%, 50% profit margins.
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28:50Josiah FitzsimmonsGUEST
That's when most doctors... have said over the year and kind of as a benchmark profitability, even as a goal.
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28:56Josiah FitzsimmonsGUEST
And so even before we had a lot of this data, even our perfect P&L, I think was a little skewed with too high of a profit margin for clinics.
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29:04Josiah FitzsimmonsGUEST
And so what we found is that the average profit margin across the entire band is between 25 and 35%.
360 - What 500 Chiropractic Clinics Reveal About Growth and Profit
15:06
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9:44Josiah FitzsimmonsGUEST
I mean, the first thing that I always talk about when trying to maximize revenue is maximizing what you're already paying for.
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9:57Josiah FitzsimmonsGUEST
In our initial strategic planning session, we map out, you know, here's where you are, here's where you want to go, here's how you get there, here's all the financial opportunities or bottlenecks that are maybe preventing you from accomplishing that already.
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10:09Josiah FitzsimmonsGUEST
One of the top things that we, that we always talk about is, you know, whether you have 100% full schedule or a 50% full schedule, your rent doesn't change, your payroll doesn't change, you know, your electric bill doesn't change or, you know, utility bill.
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10:22Josiah FitzsimmonsGUEST
You know, most all of your expenses don't change, whether you're maximizing your expenses or not maximizing your expenses.

Pete CamioloHOST
Can you, uh, can you talk to a little bit about what you are seeing just as you're analyzing some of those, you know, those foundational building blocks, the ones we just talked about, and how docs can identify where the constraint is and where they have an opportunity to grow?
From Hustle to $7M: How Dr. Josiah Fitzsimmons Built a Chiropractic Empire Through Discipline, Systems, and Stewardship
2:43
Paul ReedHOST
I mean, honestly, right? Like 2:00 AM as a k- third, third grader, whatever, that's just nuts, yeah.
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2:49Josiah FitzsimmonsGUEST
So then, so then I got a full ride at college, and I'm like, okay, like, okay, I put my head down and I, and I can make it happen.
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2:56Josiah FitzsimmonsGUEST
Then I get into chiropractic college and, and I quickly learn that there's all these different techniques, and I'm like, "Well, which one's the best? How do I give the best care?" And then I'm like, oh, they don't teach us how to run a business.
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3:06Josiah FitzsimmonsGUEST
What do I gotta do? So I went to over 50 clinics while I was a student trying to learn how to run a, run the business properly.
5 MINS LATER