Can a single clinic really break past the limits most owners assume are fixed? Dr. Josiah Fitzsimmons proves it’s possible. He went from coffee-shop networking and craft-fair booths to building one of the highest-revenue clinics in the profession. In this conversation, he shares how simple actions turn into momentum that compounds year after year.
You’ll hear how structure, team, and data became his three breakthrough levers. From building an employee maturity model, to using financial reports as the first lens for every decision, to knowing the exact math behind CAC and payback periods, Dr. Josiah maps out the habits and numbers that drive scale. Whether you’re in launch, build, or scale season, his story shows what it takes to create a true business that grows with or without you.
Episode Highlights
00:51 – Hear why Dr. Bobby calls Josiah’s growth proof that a single clinic can push toward eight figures.
03:25 – Learn how an injury, curiosity, and visiting 50+ clinics shaped Josiah’s vision for launching.
06:47 – Discover why “don’t take notes, write action steps” became his guiding principle for execution.
09:26 – See how five to seven coffee shop meetings a day and $20 events fueled grassroots momentum.
10:47 – Find out how 400 prepaid appointments were booked before opening the clinic doors.
12:57 – Learn how two part-time hires, health talks, and sheer grit led to $1.2M in year one.
16:46 – Understand the big shift from great systems to true structure with KPIs and accountability.
18:50 – See how lifetime value grew by adding at-home protocols and supplements in a tight space.
24:30 – Hear how buying a larger building unlocked new capacity and pushed revenue toward $7M.
29:09 – Take in Josiah’s three biggest lessons: structure, team, and data as the drivers of scale.
44:44 – Learn why financial data is the first lens, even before EHR or marketing numbers.
50:00 – Apply the simple formula: 100 ÷ profit margin = your break-even ROI for marketing.
53:54 – Discover why you should set your marketing budget as a percentage of goal revenue, not current revenue.
55:43 – Get Josiah’s final flywheel: rhythms, team, and data creating compounding growth.
59:02 – Hear his reminder that chiropractors are often called “miracle workers” and why business must match that product.
1:01:07 – Wrap-up: $7M a year and climbing toward an eight-figure clinic with Lucro tools and vision.
Resources Mentioned
Join the TRP Remarkable Attraction Immersion – Oct 10 and 11 in Phoenix, AZ and Oct 24 & 25 in Adelaide, AUS – https://theremarkablepractice.com/upcoming-events/
To schedule a Strategy Session with Dr Lona: https://go.oncehub.com/DrLonaBuildPodcast
To schedule a Strategy Session with Dr Bobby: https://go.oncehub.com/DrBobbyBuildPodcast
Learn more about the Remarkable CEO Podcast: https://theremarkablepractice.com/podcast/