The Journey… The Making of a Chiropractic Rōnin….

In many ways I think the majority of the chiropractic profession comes to Chiropractic through their falling in love (whether we recognize the tingle of the butterfly’s or not) with the vitalistic  (Traditional Straight) model of Chiropractic.

My First experience with Chiropractic was when I was 16 years old.  “Dr. Andy” came to my High School in New York when I was a Sophomore (We are talking circa February 1993), as part of a short lived “Career day” series.

Dr. Andy started by explaining that he was into a wayward life before he discovered a chiropractor who had helped him with, not only a sports injury, but with some other, somatovisceral if you will, health issues.  This was enough to spring board his own entry into the profession. He showed us testimonials of his patients; a particular one I remember was of an 8-year-old girl who had been relieved of her digestive problems.  He explained that the brain and nervous system controlled everything and if you were able to have unobstructed communication between the brain and body then the body would heal itself.

This certainly made sense.

Dr. Andy asked if anyone had any questions.  Being 16 years old most of us weren’t even paying attention so there was only one person who asked a question:

“Are you a medical doctor?” I asked.

“No.”, Dr. Andy said, with a slight wince potentially signifying that he had lost my respect or interest.

“SOLD!” I thought as I now knew what I wanted to be when I grew up.  I informed a disappointed Mother that I didn’t want to be a journalist (she recognized my writing abilities) but a Chiropractor. My rationale was simple; anyone could write but not everyone could be a Chiropractor. Hell they even had to go to extra school for future employment.

It really was that simple. I wanted to be in Healthcare, but I didn’t see myself as a medical doctor.  I had two medical doctors growing up who were excellent, but I wasn’t the stodgy lab coat and stethoscope type guy.  This was not only a healthcare model that made sense but more fit my relaxed style.

Deciding to be a Chiropractor at such an early age set up an (almost) perfect fit.  My best friend in High School was the son of a Prominent Personal Injury (PI) lawyer, and he was sure to work in his father’s firm when he graduated law school.  We started talking about the natural symbiotic relationship that would continue from HS into our adult careers.

I said “almost” in the last paragraph because the contradictions in the two models, Straight Vs. Mixers, wasn’t apparent to me at that time.

(*Sidebar for the laymen reading this*:

It is nearly impossible to qualify and quantify the scope of Chiropractic Philosophy into a few sentences, and admittedly there are many far stronger than me on this topic but none the less I will try to define two types of Chiropractors (**Sidebar 2: There’s a lot more than two***) into as few words as possible:

STRAIGHT Chiropractors believe their scope of practice should be limited to the detection and correction of Vertebral Subluxation (***Sidebar 3: Don’t get me started on the scope of philosophy and research on Subluxation, please, but roughly speaking subluxation are vertebral misalignments which interferes with nervous system function and causes “Dis-ease” (poor health).***) via Chiropractic spinal adjustments while MIXER Chiropractors believe that Chiropractors can add elements of traditional medical diagnosis, use therapies as adjuncts to the adjustments, and work in conjunction with other medical professionals, both traditional and alternative.

****Sidebar 4: That’s doesn’t cover a scintilla of Chiropractic thought and is an EXTREMELY OVERSIMPLISTIC review yet I still managed to alienate many Colleagues in just a few short paragraphs**** Side bars off: )

When it came time to apply to Chiropractic college after undergrad, I applied to Three Chiropractic Universities: Life in Marietta Georgia, Palmer in Davenport Iowa and The Los Angeles College of Chiropractic (LACC).  The first two were considered More “Straight” (Vitalistic Model), the later more Mixer (Or Evidence based which is not the same but is used interchangeably).  Truth be told I had no idea, either way.

Also, truth be told, I already had my heart set on one of the Straight schools, but that attraction soured as they kept losing various forms I sent them (I won’t identify the school to protect the guilty.) As I was repetitively asked to send in paperwork that I had already sent in my mind started wandering towards the concept of Los Angeles.  New York to LA.  It’s like a Neil Diamond song.

I made a decision that would alter the course of my life: I was moving to Southern California.

To me it didn’t matter which school I went to as all I always planned on going back to New York too be part of their No-Fault Personal Injury insurance (Again not understanding the cognitive dissonance of a Straight {My governing philosophy} Vs. Mixer model {The de-facto model needed to pass muster with the 3rdparty insurances} and I just needed the diploma to do so.

LACC, as my classmates and I found out soon enough, was definitely in the Evidence Based and not vitalistic realm of Chiroworld (So open to other forms of health care that they became the Southern California University of Health Science (SCUHS ???) adding an acupuncture program early into my attendance).  While some decried LACC as belittling the Straights Philosophy of Subluxation my charitable remembrance was that LACC’s professors were utilizing research in hopes of proving the Straights correct, eventually (one day), as we hadn’t found the evidence yet to garner the respect of the medical community whose respect we craved.  But again, others would be more qualified to speak as I wasn’t paying attention much of the time.

I also didn’t understand what the problem was with my classmates’ desire for more of the Straight philosophy to be taught at LACC.  LACC wasn’t stopping us from learning philosophy they were just more geared towards helping us pass boards.  If I’m not mistaken, they were the best of all the Chiropractic Colleges at the time in churning out board passers, my primary concern.  After all, when this was all said and done, I was heading back to New York to practice PI.

Towards the tail end of my Chiropractic education (2002-2003) a series of events threw a monkey wrench into those plans: I moved to Newport Beach and fell in love with the place and I was also interning in a successful Workers Compensation (Work Comp or WC for short) clinic.  My Supervising Clinician and clinic owner was a brilliant man who had produced much peer researched papers and research in the field.  He also definitely fell on the Mixer side (The natural inclination of practitioners of WC and PI).

WC in those days were lucrative and I could see myself doing that style of practice as it was “easy” especially if you found a lawyer for referrals and an Orthopedic Surgeon you could work with. And despite having to diagnose and code to appease the 3rdparty insurances you are able to convince yourself that you are “really” adjusting subluxation and who cares if you bill a code or throw a hot pack on a low back.

In 2005 reality smacked many California Chiropractors in the Face, The Govenator, Arnold Schwarzenegger, initiated workers compensation reform which drastically cut the overall compensation and availability of WC patients.  Clinics heavily invested in WC were having yearly incomes diminish by 50% (and more) rapidly.  It was reminiscent of what I had heard happened in the late 80s- early 90s, as clinics sustaining themselves on easy medical insurance were not able to weather the cut backs in compensation that medical insurance was demanding. This point was really driven home when I relocated to Asia and I worked alongside Chiropractors in their 50s and 60s, many without a pot to piss in, talk about the glorious 80s.  Now they were happy to just to make a $2,500 guaranteed base salary to afford rent, food and the occasional negotiated affection of the indigenous women. Don’t worry, we will get to those stories eventually.

In early 2006 I, as an Independent Contractor, started a practice with another Chiropractor who was starting his second clinic.  Despite not having the Work Comp Rung to fall back on the practice quickly grew in two years due to having well-paying insurance patients, from the nearby federal buildings and the local longshoreman’s unions, and Personal Injury case.  Despite providing excellent care and having appreciative patients I was not subluxation based, or even evidence based. I just kind of pounded down the tight spots and the patients felt better, Very Scientific and Vitalistic.

I began to question what I was doing. The Money, while good, was diminishing as 3rdparty payers are always looking to cut payments, and I didn’t feel like this was the reason why I had gotten into Chiropractic in the first place.

At around this time (2012) I reestablished contact with my mentor from the WC clinic I interned at. He was now teaching within the newly formed Chiropractic program in Kuala Lumpur Malaysia.  He told me to apply and although it would be a drastic pay cut from private practice it would be a new adventure.  And while the school was undoubtably “evidence based” my mentor who had published much peer reviewed research had said that he was learning from Faculty members from Europe and Australia and New Zealand.

I applied to teach at the clinical sciences department and while interviewing favorably nothing moves fast enough in Asia. While I waited to her back from IMU I had to be honest with myself, I was already gone, I may have been gone for a while.  Physically present, but in a profession like Chiropractic I wasn’t mentally there.  I decided to see if there were Job advertisements for Chiropractors in Asia.

And that… well that starts a whole new Chapter…

Part Two: Answering the Call

The classifieds for Asia were interesting, to say the least.  Singapore offered “Subluxation Centered Practice/wellness” (with a healthy dose of decompression).  Indonesia the same.  Thailand offered what looked like pain relief practice. 

All promised “$100K” a year. Chiropractic First said their doctors where making “$150-$400K”.  One (1, Uno) of their doctors were making $400K USD+, a friend of mine who is an excellent Chiropractor and Communicator of Chiropractic and could see 500 patients a week on the dark side of the moon. That add is still up and I highly doubt anyone is making more than low 6 figures.

The advertisements seem to have almost a scientific approach towards attracting candidates with the following promises:

  • $100,000 USD per year was expected income
  • Marketing was taken care of
  • No Overhead
  • Cash practice/no insurance
  • Booming practices with appreciative paying patients that “got it” and “understood.”
  • Low Cost of living (Perhaps if you’re living in a Nipa hut, Singapore is Expensive)
  • Coaching and consulting provided, teaching you their “system” which “works”
  • “Pay off loans faster.”
  • “Just be the Doctor.”

Other than “Low Cost of living” this clearly targets recent graduates (Don’t worry it attracts a smattering of divorces and Mercedes 80’s refugees), almost at a repudiation of what you had just learned in the past 5 years Chiropractic College.  It’s as if the ads said:

“Listen we know you were told that “Now is the best time to be a Chiropractor”, but that was unrealistic, and they didn’t teach you about marketing and business.  Hell, your education failed to teach you this magic “system” that every other health discipline knows that they actually have patients in their offices.  They taught you how to press on backs and bill insurance.  Let us fill in the gaps.”

It worked on me. 😉

Again, I wasn’t in a bad place in Southern California, I was just wondering when the final chair would be pulled away on the musical insurance buoying my lifestyle.  Mid 30s and single knowing that It wasn’t going to be around forever learning a cash-based practice would be great to put into the arsenal.  Asia was exotic and the ads had a tinge of “The Asians get it, natural healthcare has been part of their culture for millennia.”

I checked the ads and narrowed it down to Chiropractic First (CF) in Singapore (which was hiring for clinics in Jakarta Indonesia), another chain clinic in Singapore that I would visit on the back end of the trip, I would swing through KL to at least touch base with the administration at IMU and there were two clinics in Jakarta that I was going to interview with.

Most of the interviews were done via email but I remember that CF was with skype.  My first interview was with a female Chiropractor who I could tell liked me as a candidate.  The best part of this skype interview was that I was doing it from a friend’s house while quite possibly legally drunk (my buddy thought it was a nice touch that I had a Jack & Coke during the interview itself), and it seemed to do the trick as she said she was going to recommend me for an interview with CF CEO Mat Kan.

The second interview, with Dr. Kan, was early in the morning before work so their was no drinking this time. What struck me about Kan was how intense he came off, he said that he had seen 500 patients a week before cutting back on his schedule.  His doctors that he trained were each seeing 300+ a week.

I could see him being honest about his numbers but there were signs of deception when I asked direct questions. He apparently had a “script” which he did not like to go off of.

But for the first time in my entire career I wondered something:  What is this “system” that only certain chiropractors know and why hasn’t anyone added it to the Chiropractic colleges core curriculum?

The other thing I left after the skype interview with Dr. Kan, was are these systems sustainable, and can they only be run by people who had a commanding aura like Kan?

Ie. Can Tony Robbins be the richest Chiropractor (not necessarily the most clinically competent)?

Well I would actually have to go to Asia to find out. What were the deals with all these chains and had they truly found the secret to breaking the shackle of the 3rdparty insurance rackets?

Part Three – The Interview Process

Itinerary in hand I headed to the LAX to catch a midafternoon flight on a Saturday.  Due to the Time difference I did not make it to Singapore until 3 AM Monday morning and was unable to sleep before my 10 AM interview with Kan at CF.

Kan was as he was on the Skype interview, calmly intense with a piercing focus.  He explained how his company had grown and how he used to see 500 patients a week until her personally slowed down to run the company. We went to a street hawker place for lunch and he probed further, suggesting that my alma mater, LACC, purged Subluxation based Chiropractors during my time that I was there (I would have credited the purge to a dumping of high salaries.  Some interesting inconsistencies came out in his speech as we discussed further.

I mentioned I was going to IMU the next day in KL.  He used this to suggest that I didn’t have the proper philosophy and mentioned how IMU did not teach true chiropractic philosophy (It being more Evidence based) and that he had already started blocking graduates by telling ministers in the Malaysian government to block Chiropractic graduates.

The only problem was at the date of this interview, July 2013, IMU did not have any graduates to block yet.  Its first graduating class would be 2015.  Its also interesting that many of CF’s recent expansion into Malaysia has been buttressed by these recent graduates who Kan claimed he would block.

I called Kan on this and he got deceptive again which was something that worried me as did something else.  Kan and I didn’t really hit it off, the interview could be seen as a failure except he mentioned that he still thought I could work for them.  Why if he had claimed that he had a ton of applicants and CF was very selective was he still considering me.

With this question lingering in my mind Kan was adamant that I go to a particular clinic to shadow a doc before heading to the airport.  This Chiropractor, the one I mentioned previously as being able to build a practice on the dark side of the moon, was warm and receptive when I went to his clinic. Young and energetic there was a sense of “Oh another Chiropractor shadowing me”, as I watched him work.  It became clear that this Chiropractor was very busy but the thought was again in my mind was all of CF’s clinics this busy or was it based on location and doctor quality and not “the system.”

I would soon have my answer as another Chiropractor (“Kaiden”) entered the office.  (This colleague would also become my friend). While engaging and polite, and quite competent as I would find out, he didn’t possess the same umph that Judge had.  And it was reflected in his numbers as he was seeing greater than half as many patients as Judge. I was able to quickly ascertain that Kan specifically send recruits here as a means of showing them the outstanding clinic while trying to make it seem like it is the norm.

I thanked Judge and Kaiden and headed to Changi airport before a departure to KL.  That night, on top of the sleep deprivation experienced over the previous two days I only slept two hours.

I went to IMU the next day and I was shown around by a Dr. Keith.  In his mid 50’s he had practiced in Southern California and said he planned on being at IMU for 5 more years before heading to his retirement home in Phuket Thailand.  Wow, some guy who actually handled the Mercedes 80s like you were supposed.

Keith was running out of things to show me so he recommended I head to Downtown KL to get a Drink at the Sky Bar in the traders Hotel.

After cocktails I headed to the Airport to catch another flight to Jakarta, Indonesia where I was staying with a friend, former patient and spiritual advisor, “Apollo” and his Indonesian Wife.  With two interviews the next day, I was looking forward to some sleep as I had slept 3 hours in the past few days, but Apollo and the X-Box had other ideas.

I did my first interview on only about 4 hours of sleep with a pleasant Canadian Chiropractor in the mall at Darmawangsa square.  I then headed to Wolter Mongonsidi street to another Chiropractor, (LC) the one I would eventually wind up signing with.

It was a Wednesday, one of his days off and he was explaining to me that he was seeing 220-260 a week in 4 days of work but wanted to bring in another Chiropractor to cut back his days to 3 patients while increasing it up to 400-500 patient visits a week.  Having two docs would also increase marketing opportunities.

Despite him being several years younger than me, he appeared to “get it” he had figured it out.  He also had a coach back home who he was going to have me utilize as well.

We went out for drinks where I met his girlfriend who had been a CA in big high-volume clinics back in the states.  Everything seemed to click and there were no red flags like I had picked up from CF and Kan (Speaking of which I was getting messages from CF that they knew I was in Jakarta and they wanted me to check out another clinic there.  I declined and they still kept hounding me.)

I had made my decision at that point that I was going to go to with LC but was still going to check out an office in Singapore after I swung through Bali on a quick vacation.

After Bali I swung into an office in Singapore (NH) and asked to speak to (The King Maker {KM}) the man I interviewed with and who had recruited me (I have become good friends with this man).  Apparently, he had been let go several weeks earlier but I met with several of the directors and they expressed an interest in me joining the company.  

Just as I was about to leave, I met a young Asian- American Chiropractor, JK, who was very friendly with me. We hit it off and she invited me for drinks later that night.  After around beer two she was telling me the horror stories; the company she worked for was like all the rest.  Only some of the docs make good money, the rest scrounge over the new patients.  The docs are shuffled in repeatedly.  CF has the highest turnover rate (She used to work at CF) and her company wasn’t far behind.  Basically, these companies will hire (and fire) anyone.

Hearing all that I said goodbye and told her I was definitely going to Jakarta, but I would visit as it was a quick 2-hour trip to Singapore.  The next day I boarded a flight to LAX knowing I would be back in the region in under two months.

Bagian Empat (Part 4) – Jakarta

August 2013 was a blur, or as we called it, ironically as you will see, “The Victory Tour”. All of my friends wanted to take me out for a drink or a meal, people coming out of the woodwork jockeying to take up valuable real estate on my schedule:

“I haven’t seen you in 6 months and you want the Friday night slot?” 

As the victory tour wound down and my weight crept up, I remember telling friends “I just can’t wait to get to Jakarta, so my life goes back to “Normal”. I’m going to spend two weeks doing Jumping jacks on the equator.”

“Jakarta” derives from the word Jayakarta ( जयकृत) which is ultimately derived from Sanskrit language; जय jaya (victorious)and कृत krta (accomplished, acquired),thus Jayakarta translates as “victorious deed”, “complete act” or “complete victory” which literally, Jakarta means the “victorious city”.

Me and my fat ass fresh from the Victory tour flew to Jakarta reading the manual to LC’s clinics, everything from staff procedures to scripts for the doctors to recite with patients depending on their day. This included not just the New Patient Examination and the Report of Findings but also sayings we were supposed to impart into the subconscious for the first 100 adjustments +.

LC met me at the Soekarno-Hatta airport in Jakarta, and I remember him telling me something that made my heart sink:  His practice had gone from the 220-260 range in July when I interviewed to 120 patient visits a week.  He quickly reassured me that this was due to the after effects of Ramadan when many Muslim Indonesians leave for their hometown, and even the Christian population might leave the country on Holiday.

I spent all of September training with LC.  The practice had a structure which incorporated Chiropractic Biophysics (CBP), Pettibone Systems, and CLEAR (Chiropractic Leadership, Educational Advancement, and Research) Institute exercise. 

Training with LC I was left with two impressions:

  1. He was an excellent clinical Chiropractor who passionately believed in the Vitalistic Subluxation based Philosophy of Chiropractic.
  2. His patients were mostly interested in their pain.

Pain was, after all, how most patients were attracted to his and other clinics in Jakarta. It seemed like there was a bit of a disconnect between why they were coming and what were the health goals. “When will the pain go away?” was a frequent question I heard. 

There were asymptomatic patients that came for regular maintenance mostly the wealthy Indonesians of Chinese Descent.  More so than they had the resources to afford consistent care I surmised that perhaps having built up generational wealth they were able to quickly make the connection between maintenance and long-term investments, only in health.

October Came around and I started to adjust some of the patients.  Many of LCs patients switched over to his scheduled days (understandably) and I started to see some of the “When will the pain go away?” patients.  A lot of them had signed up at a marketing event done in July and they were coming to the end of their 36 visit plans.  Counter measures were in place for what I would come to understand is the most feared day in these chiropractic offices calendar, Resign day.  The anxiety was built around whether the patients would buy another package, as they effectively were continuing their care, or whether they were leaving us for good. It was strange, as this was a psychology I didn’t experience in the multi-disciplinary clinic back in Long Beach, patients could fall off the face of the earth and then show up months later but with these practices a failed resign was the kiss of death to the doctor patient relationship.

On the Social front I quickly shed the Victory tour weight, a 10-day diarrhea bout less than half a week in no doubt helped and I joined Crossfit and Krav Maga.  I had trained Krav Maga back in the States and was adding Crossfit which I also came to love (despite accusations that I “cheat” at CrossFit, accusations that while I still vigorously deny them, have followed me through several cultures ;-).

Within a month of Joining Krav and Crossfit I signed up for the largest gym chain in Jakarta, Fitness First.  Within weeks I signed up with the second largest chain, Celebrity fitness.

Now maybe I went a little overboard with the exercise, but it is a familiar pattern for Ex-patriots in Asia. We arrive in a new culture; we don’t know the language, or the customs and we have no friends, so we fall back into the self and the desire to increase perceptions of health.

For me there was another aspect, the gym chains and Crossfit were located in Jakarta’s top malls, so it gave me an excuse to travel to different gyms, different malls, and gave me the opportunity to meet different women to fall in and out of love with in rapid non-life disruptive fashion :-).  Indonesia certainly had that in abundant supply as her women are truly graceful and beautiful.

As far as my living situation I moved into a room in the relocated Krav Studio and was now eligible to take all of their classes (MMA etc) as part of my rent.  Other than the prohibition against bringing lady friends home I really started to like my private life.

Unfortunately, work was starting to really suck.  LC admitted in early November that the 100+ patient exodus from July Interview and September Arrival were not coming back and that it personally cost him about $100K USD in anticipated revenue.  I remember feeling a visceral pain for him.

During this part I also was to experience another headache that would haunt all of us Chiropractors in Indonesia: Government Bureaucracy and the feared Immigration (Imigrassi)

Now a point of clarification: Indonesia’s rules for foreign workers is a shady vague morass of legalese designed to elicit confusion and hence dependence (Read: $$$) from both the foreign worker and employer upon Indonesian authorities.

Being under the relatively Benign Multiple Entry Business Visa (MEBV) I knew I didn’t have the (semi) full protection of the KITAS work visa and was pretty sure that I was in violation of multiple Imigrasi and department of man power statutes. In general, the MEBV is used for a foreign consultant to come into Indonesia and conduct business meetings, the KITAS allows him to live and work in Indonesia training a local to do his job (in theory)

On Sunday November 3rd, 2013, I was leaving Indonesia on the first of what would be many “Visa Runs”, knowing that I had to leave Indonesia after 60 days.

Of course it was day 61.

LC assured me that everything was going to be OK at Imigrasi. Truth be told he probably knew there would be a problem but didn’t want to cover the office on a Sunday while I flew to Singapore.

So I would be a Day late. 

“You are late by a day” – Imigrasi agent.

“Apa?” (what)

“You are late, come with me”

Two immigration officials bring me into a small room. They have me empty my pockets and they start going through my back pack.

They pick up my wallet and they search that as well.

Now if they find my Indonesian Business cards in my wallet, I’m toast. Remember the visa I presently had didn’t permit me to work in Indonesia but to conduct business. Working in an office and treating patients was strictly forbidden. By the letter of the law any discrepancy between business cards and work permits were eligible for 5 years in prison and fines in excess of tens of thousands of dollars.

As luck would have it they didn’t find my Indonesian business cards. Actually, (I’m bragging here) luck wasn’t involved, but genius. I threw my business cards in the trash before the immigration checkpoint and replaced them with my California business cards. Pay attention this comes in handy.

They are looking at my visa, which while a day late does list me as eligible to conduct business in Indonesia as a consultant and their pawing through my wallet turns up a Foreign business card and my California Chiropractic license. Everything looks (relatively) innocent, so far so good.

And here comes the bad.

In walks a man in his 50s with a big belly and ALL the Medals. Like ALL the Medals.

“What are you doing in Indonesia?” – Medals

“I have a business Visa.” – Me

“No. What are you doing in Indonesia?” – Medals

Well here goes nothing…

” Saya seorang konsultan medis di Indonesia bisnis visa.” (I am a medical consultant in Indonesia with a Business Visa)

(Side Bar: properly saying it would actually be “Saya seorang konsultan medis di Indonesia dengan visa bisnis.” 

“You speak Bahasa?!?” – A visibly astonished Medals

“Saya lebih suka itu” – (I prefer it)

(Side Bar. Yes I had my trademark shit eating grin on.)

Medals proceeds to speak to me in Bahasa. I have no idea what he is saying. If I were to paraphrase it would be:

“Bahasa, Bahasa, Charlie Browns teacher, Bahasa, Bahasa…”

This wipes my trademark shit eating right off my face.

When medals is done speaking the two monkeys that were pawing through my shit earlier are staring at me waiting for me to answer. Clearly Medals had just asked me a question expecting an answer.

Now as I still don’t understand what the Hell anyone is saying to me, I have no idea what Medals had just asked me. The questions could have ranged from “You’re not working here illegally?” to “you know anything about the dead coked up Hooker we found on the Tarmac?” And a simple “Iya” (yes) or “tidak” (no) could very well be the wrong answer.

The two monkeys are staring at me waiting to howl. I lean back in my chair and say:

“Adalah sesuatu yang lucu”

Laughter erupts in the room.

I literally just asked “Is something Funny” to the two howler monkeys.

Sidebar: (How did I know that line? 3 days earlier I was walking through the mall and a teenager was pointing and laughing at me. I Google translated on the spot the line “Is something funny” as a way of scaring the shit out of kids laughing at me  )

The howler monkeys are laughing. Medals starts laughing before speaking.

“Maaf, Bapak (Sorry Sir), there is a fine.”

‘Berapa” (How much)

“Duaratus ribu.” (200,000 IDR about $17.50 USD at this time)

” Tidak Apa Apa, Bapak” (That’s OK sir)

As I grab my wallet Medals starts rapidly stamping everything furiously.

I say my goodbyes and of course everyone wants to shake the hand of the white guy.

I clear immigration and I head to the gate happy that I will have a vacation and not a deportation. ;-).

A few days in Singapore where I saw my Asian- American friend JK from the Job interview and I headed back to Indonesia.

LC seemed indifferent to the Imigrassi story as I resumed work and we started gearing up for a marketing event that we would hope would attract new patients to refill the adjusting tables that were sparser from the departing of the majority of the July marketing event patients.

Midway through the week LC came to surprise me that we were meeting a mutual friend, Pak Deep, at a Business happy hour.  Long story short LC got very drunk late into the night and he wound up being culturally disrespectful to the Indonesians and started a fight inside Pak Deep’s apartment which required me to… naturally sedate him (I choked him out).  It was at this point that LC fired me only to have his Girlfriend rehire me in the early morning hours (beg me in the morning to cover the office as LC was in no shape to be adjusting patients).

I realized what had actually happened. LC was experiencing great frustration with the practice and was probably wondering why the hell he was paying me.  I mean I wasn’t actually needed although having me around to cover days and vacations and work marketing events were helpful. He told me after the blow up that he would understand if I wanted to leave and I told him that it was water under the bridge.

The marketing event was successful in increasing patient volume and we started to get a little busier. I settled into my own as the Holidays were occurring when LC and his girlfriend were returning to the states for a vacation.

I would be running the practice solo over the X-Mas Vacation and LC gave me a parting word of wisdom:

“Imigrassi usually goes looking for money around the holidays.  If they come to the office change into street clothes and pretend you’re a patient.”

Did I mention my picture was on my Business card at the front desk?

Over the Holidays I had a pretty good streak of signups 11 out of 11 with the streak buster being broken by our assistants’ friend who told me during the initial examination, two months earlier, that she was very busy and she would never be able to make it.

I teased my assistant that she never should have had her friend come to ruin my streak but in the end I had come to realize the futility of all the talk of “stats”.

Stats were how a Chiropractor measured himself.  New patient conversions %, patients retained %.  Patient Visits per week. Etc. You get the picture.  When I spoke bimonthly with our “coach” he spoke of Stats as the end all be all. 

This was the talk of salesmanship, like we were brokering mortgages or selling used cars.  It’s almost as if clinical outcomes took a back seat to monetary income.

Yes, businesses have to keep the doors open and the lights on but wouldn’t it be more fulfilling to market correctly to the demographic population you wish to attract? Yes, EVERYONE can utilize a Chiropractor but not everyone is right for YOUR version of Chiropractic. This is the big mistake we are making as we fight over the sliver of the population that utilizes us.

It was during this time that I realized, perhaps for the first time in my career, the disconnect between Chiropractors and the public.  It seems like we were utilizing a bait-and-switch, come for the pain, stay for the natural wellness.  Why didn’t we just sell wellness beforehand, attracting those people through the door to begin with?  It dawned on me that our marketing techniques, as a profession, might be askew. At the very least we were experiencing a massive breakdown of communication with the public.

LC’s return from America brought more “great news”, It turns out we were so busy (180 patients a week) I needed to come in an extra day per week.  And sit in a chair as he would adjust all the patients that day.

It became clear that It wasn’t that we were busy but that he was now actively trying to get me to quit. He asked me to fill out a self-evaluation, which I did, particularly remember me rating my adjusting as a 3 of 5.

LC rated me a 2 which is near decapitation levels of adjusting. I realized this was a hatchet job as he rated “Personal life getting in the way of work” as a 2 of 5 when there was nothing in my life that would indicate that.  My life was work and working out. 

I headed back to the states for a two-week Vacation and to attend continuing education seminar in California.  The best presentation was a particularly “dark” presentation on persuasion and marketing that started to click with me on what the profession had been doing so wrong all these years.

Upon my return two things happened: I finally got an Indonesian work visa, a KITAS, which listed me as a “Marketing Advisor”, keeping me firmly in legal jeopardy as business cards had to match work visas. LC was indifferent, again, saying that they were in a rush at Imigrasi. I figured was Imigrasi purposely gave me the wrong visa to keep the stay out of jail free cards flowing. At this time I was also introduced to a friend of LC’s, EB, who had previously worked at another of Chiropractic Firsts Jakarta clinics. LC was talking of starting a new clinic that EB would run. EB was the guy who Chiro First CEO Mat Kan wanted me to visit when I interviewed back in July 2013.  In other words EB had a busy clinic, and it was easy to understand why as he was an excellent Chiropractor and a Passionate communicator.

EB’s replacement… well not so much.  I met “Dandy”, the Chiropractor who replaced EB in CF’s large Jakarta clinic.  A few months earlier I walked into Dandy’s clinic and introduced myself, Dandy was wearing a large Batik, a traditional Indonesian Shirt, untucked to give his tummy some breathing room.  He said the clinic was doing “about 80” patient visits a week, seemingly dispassionate about the fact that the patient volume was 2-3Xs order of magnitude less than when EB was there. (I imagine Kan sitting in Singapore more upset by this fact.)

We had lunch in the mall’s food court, KFC being Dandy’s choice as it was the only food that had “taste”.  Yes, he was wearing a Batik, but his cultural awareness was lacking as Indonesian food is some of the tastiest in the world.

Now Dandy was a nice enough guy, decent adjustor, but there was a part of him that didn’t give a shit about the practice.  Go in, punch the clock and go home.

I wondered if this was what the “we have the system, make $100K in Beautiful Asia” advertisements were attracting. If Kan was reading me the riot act about only hiring the best I was curious what speech Dandy got before being hired.

Meeting Dandy also left me realizing another thing, no one had “The System”, Not CF, not Chiropractic d’Indonesia, the other large chain, not LC. LC had a 250+ patient a week practice pre-collapse because he was an excellent chiropractor and communicator. Same with EB at Chiropractic first Jakarta and Judge crushing it in CF Singapore.  Despite LC’s disenchantment with little old me even I was growing the practice, even if ultimately I wasn’t needed.

Making matters more burdensome my schedule was being packed with New patients attracted from a Group-On from a poorer section north of Jakarta known as Tangerang. The Patients were taking the bus several hours to come to the clinic for their discounted rate, not realizing my mission was to sign them up to packages. Even if they could scrounge up the money for care there was no way they could come more than once a week in traffic packed Jakarta, where even the shortest trip might take several hours.

Still LC had me come in 5 times a week. I would sit around doing nothing on Wednesday and even started coming in on my Thursday mornings to adjust.  The reasons were obvious to me:

My contract was structured so that I made a base salary of $3,500 USD.  As the Indonesian Rupiah lost value I was making a higher base salary a month in IDR.  However I would be placed on probation if I wasn’t seeing 150 patient visits a week (we were seeing about 180ish still, combined).  But I also had a “poison pill” where if my “adjusting value”, the cost per patients I was physically adjusting, dropped below $10K USD a month, I could start getting dinged salary wise.

And that didn’t come till May of 2014.  We had just finished a “road show” marketing event at a mall, where EB and I had a friendly competition seeing who could sign up the most new patients.  Together we had close to 40 sign up.

LC messaged me on my day off and asked me if I could come into the clinic that night.  I declined sighting a reason other than the truth, I was getting a massage at the moment.  The next day I remember putting on my favorite blue shirt and feeling miserable about going into work, something I was doing only to spite LC at this point.  When I get to the office LC says “we have to talk” as he closes the door to the doctors office.

“Uh oh”, I exclaim as LC struggles for words.  He looked particularly nervous as he informs me that they aren’t going to renew my contract (a little under 2 months away) and he came out and said that he couldn’t afford me anymore.

“That’s cool.  When is EB replacing me?”

LC was taken aback when I asked this and said as soon as EB returned from his wedding.  He went into how EB was the better option than me and I stopped him mid-sentence:

“LC, EB might be a better fit for this practice than me, but this practice is a 1 doctor, 4 day a week, 250 patient a week practice.  You shouldn’t have hired me.  You shouldn’t hire anyone.”

We end the conversation amicably and as I leave the office; I’m done officially as of that moment; I see the front desk girls upset as they just realized what happened.

Me? I feel as if a great weight came off my shoulder.  Why did I allow myself to be so miserable, I thought?  For spite?

I head to enjoy my day off and I shoot EB a message wishing him luck.  He messages me back and he was blind-sided that he was replacing me and not part of a growing team.  I tell him its all-right, careful not to talk shit as I know that it will just come off as being bitter.

LC and I didn’t speak much in the immediate after events but remained cordial, continuing to this day.

EB and I have gone on to become good friends speaking several times a week, also continuing to this day. The marketing event we had done together and another one after I left had brought the practice up to 288 visits a week.  During some good-natured shit talking EB was telling me that he envisioned the practice hitting 400-450 visits a week within a few months.  I had my reservations which I didn’t mind sharing at this point as it would not come off as bitter.  Enough time had passed that EB just thought I was crazy and not bitter with my low expectations.

The practice started to cool after that as did EB’s relationship with LC.

A year or so later EB was planning a relocation to Vietnam and he was stung by the way things were going and he inquired about how things ended with LC and I.  He asked me if I felt bitter and I told the truth:

All and all there were nothing to be bitter about.  Truth of the matter is this, even though LC and I had tension between us I’m lucky he paid me and kept me around for 9 months. Especially after I just left EVERYTHING behind in America.  I left my practice where I was an Independent contractor in a practice I had been in since its inception, I had been replaced already.  I had nothing to go back to I was starting over. Many clinics wouldn’t have even picked me up at the airport if their practice collapsed as LC’s had.

And the most important thing is this: I learned a lot.  There is always a lesson in the experience.

I said to EB “I look at it this way, I was the wrong guy for the job, but it was the right opportunity for me for a time being.  You were the better guy for the job, but it was entirely wrong for you.  And now balance has returned.”

Before EB had a chance to agree I added the Parthian shot “And I told you like I told LC, that fucking practice was a 1 Doc, 4 day, 250 a week practice.”  🙂

Part 5 – Job hunting when your Work Visa is Pulled.

The Euphoria experienced with not working is something I’ve felt several times in Asia.  Having only been fired once, this past time in Jakarta, I can tell you that whether Firing or resigning, good circumstances or bad, not having a Job is awesome.

Unfortunately, I needed a Job.

I’m looking at different jobs around Asia but I was particularly looking to stay in Jakarta but there were several other opportunities.  There was the Potential to start a New Chiropractic office within a Singapore owned ritzy established medical office in Plaza Indonesia, a mall frequented by Jakarta’s wealthy population.  The company looking to start this up was known as ACE Medical, and I was talking to a representative from their company, we will call him “Nelly”.

There was another advertisement for a few month’s old startup clinic in Surabaya, Indonesia’s second largest city.  The clinic had been doing so well in Surabaya that they were looking to bring in a second doctor.  The contact point for this was “Jason”, a western Chiropractor living in Singapore that had saved up enough to start the practice with a wealthy and connected Chinese-Indonesian, PR.  “Jason”, like most people in this story, I am giving a nickname to in order to protect their identity, but since Jason actually lied to me and said his name was Jason, his name will be Jason for the rest of his tale.  I will explain Jason’s subterfuge concerning his name soon enough.

There was also a Job in Bangkok, Thailand advertising as a locum or temporary position, that could manifest itself into a full-time job. 

I start out e-mailing with Nelly at ACE Medical for the not yet opened clinic in Jakarta.  This would have been my first choice, remaining in Jakarta in a wealthy central location, but I was taken aback at how clueless Nelly was.  Asking me dumb questions while forgetting what answer I gave in the previous email I was starting to sour on them.  I noticed that every now and then Nelly would ask some of his colleagues who had been copied into the email equally dumb questions and would get monosyllabic one sentence answers.  One such colleague of Nelly was “AI”, who always kept things close to the vest when discussing these matters.

Meanwhile I am talking with Jason about the Surabaya clinic and “Rusty”, one of the Chiropractors who I would be covering for in the Bangkok clinic.

Jason was laid back and open and I started talking to him on the phone and I found him very honest and trust worthy.  He laid out the situation for me.

The Surabaya Clinic was opened a few months earlier and had exploded with new patients.  Their Chiropractor, who was only signing up about 30% of the patients to small visit packages, was still seeing 175 patients a week.  Jason was honest in saying that he didn’t think their current Chiropractor, “Nature Boy” (I’ll get to that nickname later), was a very good Chiropractic communicator and they would love another Chiropractor to come in and relieve him of some of the new patient load.  

Talking to Jason was a relief after wasting time with Nelly and I was strongly considering his clinic in Surabaya.  He said he had other applicants, but I was his top choice and he would give me some time to decide.

Meanwhile I was talking with Rusty and the Bangkok opportunity.  It would only be a two-week commitment, and it could potentially lead to full time work. Rusty was a cool guy and I also found him honest and trust worthy but I could tell he was holding back some information, particularly that the Chiropractors were not making a lot of money.  

I thought to myself “what if I turned this into a working vacation, going for a few weeks and then maybe taking the Surabaya Job.”

I contacted Jason again and told him about my plans.  I told him the truth, I loved his opportunity but If I could put it on hold for a few weeks I would love to go to Bangkok and work.  I told him my word was my bond and that I wouldn’t back out if committed. Jason said I was more than welcome to do that as Ramadan was coming up anyway and the practice would slow to a crawl.  I committed and said I was on board to start in late June.

“I’m on board Jason, I can’t wait to get to Surabaya.”

“Marc that’s great, I’m happy to hear this but I have a slight confession.  My name isn’t Jason, its AI…” One of the Nelly’s colleagues copied onto ACE Medical’s emails concerning the Jakarta clinic, “…I’ve been reading all your emails to Nelly and I like how you’ve handled yourself.”

“Jason” continued the confession.  Basically, he had been a Chiropractor with Ace Medical in Singapore and was looking to move into more of a managerial or ownership role.  He answered an ad from PR and Nature Boy looking for help in Surabaya. PR had the resources and connections but no understanding of Chiropractic, Jason had the intelligence and savvy with Chiropractic and could bring financial backing into the fray and Nature Boy was useless  and brought nothing else to the table; no finances, no marketing experience nada except the ability to be a Chiropractor, and that ability was marginal at best.

I was chuckling as Jason (hey that’s his name from now on) told me all this and was now REALLY amazed at how crafty he was to pull this off.  Running a clinic in Surabaya undetected for several months, while working for Nelly in Singapore.

“Why aren’t you Nelly’s boss?  That guys a real idiot” I said.

“Nope.  He’s very smart.  He just wants you to think he’s dumb.  That’s the Singaporean-Chinese way.”

Excited about the emerging opportunity I get an email from Rusty in Bangkok saying that it will be cheaper for me to rent an apartment in BKK for 1 month instead of week by week for 2 weeks.  I say that’s OK figuring I can eat the extra two weeks, but Jason tells me that its cool that if I come in mid-July instead.

So, I committed to Surabaya and told Bangkok that I would come out for a few weeks but that I hadn’t made a decision, a lie as I was confirmed with Surabaya.

With that in mind I’m going to Live in Bangkok for a month on a working Vacation where half the time I won’t be working….

Cue Murray Head:

“One Month in Bangkok and the Worlds your oyster…”

ส่วนที่หก (Part 6) –  One Month in Bangkok and the Worlds your Oyster …

The origin of the name Bangkok (บางกอก) is unclear. Bang is a Thai word meaning ‘a village on a stream’. Officially, the town was known as Thonburi Si Mahasamut (ธนบุรีศรีมหาสมุทร, from Pali and Sanskrit literally ‘city of treasures gracing the ocean’)

The Full OFFICIAL name, The Longest in the world at 168 letters is:

กรุงเทพมหานคร อมรรัตนโกสินทร์ มหินทรายุธยา มหาดิลกภพ นพรัตนราชธานีบูรีรมย์ อุดมราชนิเวศน์มหาสถาน อมรพิมานอวตารสถิต สักกะทัตติยวิษณุกรรมประสิทธิ์

(Krungthepmahanakhon Amonrattanakosin Mahintharayutthaya Mahadilokphop Noppharatratchathaniburirom Udomratchaniwetmahasathan Amonphimanawatansathit Sakkathattiyawitsanukamprasit)

Which literally translates from the root Pali and Sanskrit words as:

City of angels, great city of immortals, magnificent city of the Nine Gems, seat of the king, city of royal palaces, home of gods incarnate, erected by Vishvakarman at Indra’s behest.

Sounds Lofty? Yet it has a reputation of Being “Cheap” if not, dare I say, ‘Seedy”. 

“How much should I bring with me, Rusty?”

“Well you’re going to pay about $400 the first night for 1 month of rent, and the deposit is $500.  So you at least need $900.  At the end of you 2nd week of work the company will pay you $200 and you’ll make about $400 dollars back from the deposit from the end of the month.  After the 2ndweek you’ll be paid around $1000 US for your work.  Bring about $1500, $600 to cover food and expenses for the first two weeks, before you get paid.”

Yeah Money goes fast in Bangkok, that’s all I can say.  I was broke most of the time as I fell in love with that city I first hated when I arrived Christmas Morning 2010.

Now one of the key points that these Chiropractic chains advertise is cheap cost of living.  Not really in the big cities.  Singapore is expensive no matter where you go, same with Hong Kong and Shanghai.  Bangkok, Manila, and Jakarta are going to cost you $600-$1,000 US for a studio/one bedroom in a newer condo in a central location. Jakarta you might have to pay 6 months to a year of rent UP FRONT. Yes, that’s not New York or San Francisco but it’s not “cheap”.

You can Live cheap.  There are ways.

Get an apartment out of the central areas and take the public transportation.  Singapore, Hong Kong, Beijing, and Shanghai have excellent public transportation.  Also expensive as Hell for housing.  Vietnam, Thailand and Indonesia the best public transportation might be the back of a motor bike or a motorized rickshaw.

Eat the street food.  Won’t kill you in Singapore or HK.  Might Cripple you in Jakarta and bury you in Manila.

Partying?  Manila can have cheap San Miguels.  BKK has hidden Happy Hour Gems. Muslim Indonesia?  Unless its Indonesian Bintang brewed in the country it will cost you an arm and a leg. Clubs?  Expensive everywhere.  1stworld China, HK, and Singapore are expensive while “2nd” world developing countries like Indonesia, Thailand and the Philippines have pockets of enormous wealth which has rich kids in those pockets spending daddy’s money.

Moral of the Story is this, if you desire a western lifestyle you will be paying western prices.

Another moral of the story is stop asking white guys how much things cost.  For the most part they might have rent and a stipend paid by foreign companies (and other perks like a maid and car and driver) for so after the gym phase kicks away the only have to spend on booze.  Which they think is cheap. You’re probably a Chiropractor. You won’t have happy Ex-pat money.

On the Work front Bangkok’s clinic was a lab coat wearing, shirt and tie, pain clinic.  I worked a marketing event and they basically were asking me to diagnose where the “Subluxation” was by palpation on a massage table in the middle of an exhibition center. They nudged me to have the “subluxation” detected while corresponding to the area of pain or symptoms they were having so they could go over to the big nerve chart and show the prospective patient.

I thought this was all hokie, and very unscientific but I was on a working vacation.  I drew the attention of the companies owner, “Rascal”, a Thai chiropractor educated in Life Chiropractic.  He liked me, and I liked him, although I could see the shiftiness that would be explained to me.

The next day, Sunday, I went to a clinic and saw around 24 patients.  Monday I went to another clinic and saw 3.  What happened?

Well the doctors were paid by the patient adjustment.  And Rascal would rotate through the 5 of the 8 busiest clinics every week, Monday through Friday.  The staff were instructed that all new patients were to have their 2ndvisit on Rascals day where he would pick and choose the rich, the important, the glamorous, and, from what I understand, the young attractive women. They were to come in on his days and there were talks that if they did they got discounts.

Not a bad gig if you can get it.

Working vacation, what do I care as I kept up the facade of sticking around as I just wanted to get paid and break even on the trip.  But I saw why the other doctors, rotating between good and bad clinics and locations could never get ahead.  Other than the allure of Bangkok there was no money to be made.

At the end of the two weeks they asked if I could do a few more days at the very beginning of July which I agreed to as it was just before my flight back to Indonesia.  I filled the two weeks in the beaches of Pattaya and the bars of Bangkok while indulging in Thai massages and even broke the bank on a Tattoo.

At the end of my stint, they wound up paying me what they owed me.  I had to leave the country on a visa run anyway so they had to pay me in hopes of getting me back.  I took the cash, headed for the airport and sent Rusty a message that it wasn’t going to happen. He understood and we kept in touch and remain friends to this day.

A few days later the Chiropractors I had temporarily replaced returned to Thailand from America.  They did not have proper work permits but were residing in Thailand on the much cheaper “Student Visas”.  Thai immigration pulled them into a room and asked the “students” who had been there for over a year a question in Thai.  They didn’t understand the question as the Immigration officers laughed.

They repeated the question to the older “Students” before them, this time in English:

“You’ve been in Thailand for over a year, can you write your name in Thai?”

Phew. I got out just in time.

Bagian Tujuh (Part 7) – Surabaya: The Fall of Chiropractic in Indonesia

I arrive back in Jakarta with about a week to spare before heading to Surabaya, Indonesia’s 2ndlargest city.

The etymology of the word, Surabaya, alludes to a prophecy of Jayabayaa 12th-century psychic king of Kediri Kingdom, foreseeing a fight between a giant white sharkand a giant white crocodile taking place in the area, which is sometimes interpreted as foretelling the Mongol invasion of Java, a major conflict between the forces of Kublai Khan, Mongol ruler of China, and those of Radan Wijaya Majapahit on 31 May 1293, which is now considered the date of the city’s founding. An alternate explanation suggest that it is from the Javanese sura ing baya, meaning “bravely facing danger”. (Thanks Wikipedia).

And danger was brewing:

Two of CF’s Chiropractors, seeing close to a thousand patients a week between them, had just been busted by Imigrasi.  

I call up Jason with a “what the fuck?” tone to my voice and Jason was more amused than anything.  I’m paraphrasing his words based on a conversation from half a decade ago, but it was something along the lines of:

“Wow kid you do have your ear to the ground.  Yeah, they just got popped.  Working on Tourist visas, Immigration got them, the police department was there, hell the Mayor’s office and the News crews were there for the raid.  They frog marched them to the airport and told Matt Kan if he was willing to pay $10K for each of them they can stay.  Kan told Immigration put them on the next flight back to Singapore.”

I was taking this all in and Jason continued: “Marc that isn’t going to happen to you OK.  PR (Jason’s Indonesian Partner) he’s… very well connected.  We have Immigration officers and Health department officials as patients.  The police come to get adjusted.  We are fine.  Besides those CF knuckleheads were on tourist visas.  We are in tight with Immigration you are going to get an official Chiropractic KITAS.”

As opposed to my Jakarta one which listed me as a “Marketing advisor” I assumed.  Jason explained that only the foreign Chiropractors who worked at “Citi Life Chiropractic” in Jakarta had the official ones.

I arrived in Surabaya and Jason picked me up at the airport.  He toured me around a little bit and we got a beer before heading to the clinic.  I met PR, a understated if not stylishly dressed man in his mid to late 30s with what appeared to be an expensive watch on his left wrist.  Jason had explained that PR was VERY wealthy, having major contracts from the Indonesian Government, that have been in the family for several generations.

I was also introduced to “Bumi” (Pronounced Boo-Me) an Indonesian woman in her early 40’s who wore a traditional Muslim headdress, the Hijab.  Bumi was with the Health department and asked to see my passport. She took it and explained in Bahasa to the staff that she would take my passport to immigration every month.

Point of clarity: Technically after I left LC’s clinic, I had my Marketing Advisor KITAS removed and was now on a tourist visa.  I wouldn’t even have the Multiple entry business visa that I entered the country with and permitted me to stay 60 days conducting business. Make no mistake until I received a tangible working Visa, I was working illegally in Indonesia on tourist visa.  On top of that I had to leave the country every 30 days which seemed like an immense hassle.

Bumi wasn’t worried about such things.  She was simply going to take my passport to Immigration every month and have them stamp it as if I had just left and bring it back to me.  Usually You get stamped when you enter a country, stamped when you leave, and stamped again when you enter another country.  My passport would look like I left the Republic of Indonesia, got on a plane which took off before doing a U-Turn and coming back to get stamped again.

Shit we were connected.

And then I also met the other Chiropractor, Nature Boy.  Nature Boy’s real name is Nick, but no one really liked him, so we don’t need to give him a pseudonym.  But we called him nature boy, a nickname he earned back at LACC.  Yes, I had met Nature boy a decade previously but didn’t recognize him at first.  Nature boy because he was a spacey dude and we caught him peeing on trees. “Nature man” NB would say, sounding like a true space cadet.  No shit, I think Nature Boy has Asperger’s, a diagnosis Jason said, “Holy shit you’re right.”

NB wasn’t too into Chiropractic, The Doctor of Chiropractic was more of an authoritative launch into his true passion, being a natural healer from Google University.  There wasn’t a colon cleanse or fast or cancer treatment that NB wouldn’t push. 

Seriously I could write a book about Nature boy.  Dude was weird.  But his chapter will be long, so I shouldn’t digress.

I few days later I start my first day of practice, and even as things were slowing down for Ramadan, I had 4 new patients on the schedule.  Day 2 I had 6.  Jason wasn’t kidding.

We had a payment structure that I truly hated and hate to this day, the Package.  A standard price that become discounted if you buy 12 visits, a greater discount if you buy 24, 36 etc. and we also had 50 and 90 visit packages that could be shared.  I understand the concept, but It was more “spa like” and didn’t seem to account for the tailored care that adds a personal touch.

Nature boy was chugging along at 30% package sales of the mostly 12 visit package.  I wanted to sell at least 36, something that the front desk girls thought was impossible, having worked with NB for so many months. In that time period we had actually lowered the price from prices above CF Surabaya’s price to lower than CF’s price.

Speaking of CF and (Nature Boy, incidentally) before the raid they had no problem seeing close to 1,000 a week between their two doctors.  They had built practices very fast by doing “Road Shows” a one-week long marketing event with a booth inside a mall doing posture screens or myovision or what have you.  They had signed up about 276 new patients in the Galaxy Mall where their first Surabaya clinic was, and their Doc was able to sign up over 50% of them to large packages.  At 3Xs a week visit schedules he started at 450 a week and grew from there to over 600.  His counterpart in Tunjungan Plazahad grown close to 400.   We knew all of this because Nature boy was with CF when they started in CF and they used him as a Road show monkey, canning him as soon as the marketing was over.  Never a week would go by with NB saying, “We need to do Road show, we need to do Road show, when I was with CF we got 276 New Patients.” Somehow implying that he was the one solely responsible for that.

No Road show for me, I had to do it the old fashion way, and I still built up pretty quick.  The “dark” techniques and system used I used, the Marketing and PRESuasion gleaned from the 2014 trip back home, are privileged information, and I will not be discussing them for that a reason and for another reason, I wasn’t able to implement everything 100% and don’t need you guessing what was utilized and what was created by me to fill in the patchwork.  Suffice it to say when utilized it worked when I filled in the gaps, it lagged. I’ll be happy to refer you to these methods, but I won’t discuss them further apart from the success they brought.

How much success?  Well in a few short months even LC was messaging me from Jakarta “So I heard you’re at 80 a day, what’s it like managing that load, I think we will get their soon.” 

October there was a Media blitz.  I was on live TV where I spoke in a controlled feminine voice which had my patients laughing at me.  I spoke on the radio where my base baritone returned (Face and Voice for radio?) and even made the 2ndlargest Newspaper in Indonesia.  

The media blitz was accompanied by a nervous Bumi instructing me what I HAD to say during each and every media appearance:

“I am here to transfer the knowledge to the local Indonesian Doctors.” – Bumi as stated through translators.

“I am here to teach the local Indonesian…”

“Tidak!” (No!) Bumi would say picking up my English.  I wasn’t “teaching” I was “consulting” and was thus “Transferring the knowledge” to the local Indonesian Chiropractors, who do exist.

This was the angle.  Technically foreigners aren’t allowed to work in Indonesia unless they are consulting with the local Indonesians on how to eventually replace the foreigners. Indonesia had home grown chiropractors, sort of.  A medical doctor, Tinah Tan, went to the Australian Chiropractic school came back to Jakarta and with her husband and set up a Chiropractic program and several clinics (The before mentioned Citi Life Chiropractic).  She had a reputation of being a “Bitch” sending Immigration after her foreign competitors, which I don’t know if that is true or not, as I did eventually meet her when her husband emailed me about replacing the foreign Chiropractor that was retiring.  I actually found her quite humble.

Speaking of immigration early November brought a little surprise.  I walked into the clinic and adjusted maybe 4 of the 92 (Yes 92) patients I had on my schedule when my general manager came into my office with Bumi.

“Dr. Marc you have to take the rest of the day off.  Immigration is coming to make sure that the clinic is up to regulation.”

Well I certainly wasn’t up to regulation working on a tourist Visa.  As Bumi shuffled me out of the office, the girls were rescheduling my patients telling them that I had a seminar to give in Jakarta. The last thing I witnessed as I left for the day was seeing the girls taking my diplomas off the wall and putting the diplomas of a local Indonesian Chiropractor on the wall.  The ones I had been “transferring the knowledge to” all this time.

November and December the Practice was reaching capacity as I was seeing triple digits a day and had to restrict NP slots down to 4 per day. I decided to book a 6-day vacation (BANGKOK!) as the practice would slow down for the Christmas and New Year’s times anyway.

I decided to get one more day of work in, December 22ndin which I was coming in on a Monday, normally a day off. Even as the practice slowed for the holidays, I still had 75 patients on the schedule and was struck at the end of the Day how many I had wished a Merry X-mas to, 70 of them.  Out of my 75 Patients in 88% Muslim Indonesia 93% of my patients on this particular day were Christians.

I went to Bangkok and met up with another Ex-Pat on X-Mas eve night, a former patient from Jakarta, a Jersey guy of all people, who I also happened to share the same Birthday with me, him being a decade older.  Another interesting connection was, being in the shipping industry, he was moving to Long Beach California to work with a shipping company who I used to see a lot of their patients.

Small world.

We sat in a middle eastern restaurant, near the famous Red-light district Nana Plaza, and he said to me:

“Marc, what are the odds that two guys, one from Queens and one from Jersey, would meet in Jakarta Indonesia and share beers in Bangkok Thailand.  Small world.”

Small world indeed.  Make a Hell of a story one day.  Or at least a blog ;-).

The rest of the Bangkok trip was a blur of friends, My old friend Carolina Mark made his maiden voyage to Bangkok from Newport beach and I also met, “K Guru” he was leaving the Bangkok office I locumed at to practice in South America, I met in person the King maker, a now good friend who interviewed me for a Singapore Job and was nowhere to be found when I went to the office where I met Asian American JK.  The King Maker was with the Bangkok clinic K guru was leaving that I locumed at.  I met J-Sizzle, a Chiropractor who was a friend of a friend, who was looking for a change in life. I met J-Sizzle at Suvarnabhumi Airport on December 26thand despite my advice inquired with Rusty about practicing with the Clinic.  He would later take the job in BKK.  I let J-Sizzle have my room for the last night at my 5-star hotel as I booked another room in Pattaya to go meet DR, a former patient of mine from Long Beach, another obnoxious former New Yorker.

Did you get all that? As Jersey might say, ‘What are the odds…”

There were ominous signs of the tumultuous 2015 about to unfurl.  On December 28th, 2014 as I was taking the bus to Pattaya to see DR, Indonesia AirAsia Flight 8501 from Surabaya to Singapore crashed killing over 150 passengers and crew.  I was frantically messaging my staff to see if our patients and their families were OK.

In January we opened a New Clinic in the South Western Portion of Surabaya.  The clinic was much larger than the cramped Mall space we had in the Grand City Mall.  PR spared no expense and even leaned on the concepts of “Feng Shui 風水” of his ancestral China in the clinic design. This included flying in ornate Koi fish from Kalimantan at a cost of several thousand dollars USD.  The Koi, intending to bring good luck to the clinic, died shortly after in the large aquarium that we weren’t able to solve the algae problems.  A few weeks later the just as expensive replacement was flown in from Kalimantan again. Days later the cleaning lady found that fish had jumped out of the tank and flopped towards the front door in an attempt to escape.

As I said, the ominous signs were there.

I was asked to work both clinics to handle some of the transfer of my patients to a closer clinic and also to handle the expected Golf Clientele, with my Certification in Golf Injury being handy.  But other than that; and my personal referrals the clinic would be handing off new patients to the two New doctors Jason just hired.

“The Warden” was the first Chiropractor to arrive.  Short of stature he possessed a bravado I figured was born from insecurity. He was coming from a large chain in South America with a mixed reputation. 

Jason set up a Road show for the Warden and despite having 186 New Patients signups I could see the Wardens personality conflicting with the Indonesian population. He was way too “chirpy” with the Indonesians, a joyful and laid-back people.  You can yell at them in private, my wonderful staff gave me the nickname “The Prince of Yelling”, but barking at them while pointing and twirling your finger in the air and shouting “let’s go” was a no-no.  During the Wardens public displays he managed to piss off my personal assistant that I hired, as she exclaimed that she “Hated Him”, which is an extremely strong statement coming from an Indonesian.

I pulled the Warden aside and in the midst of explaining to him that he will rub Indonesians the wrong way his ego caused a defense which I cut off prematurely – “listen to me, you won’t last here very long if you keep this attitude up.”

Over the next two weeks 155 of the Wardens 186 New Patients came in for examinations.  He signed up 24 (16%).  4 of the 24 Switched over to the French Chiropractor who came after the Warden. Frenchy will be referred to by his initials “FS” for the rest of the story, which stands for “Fuck Soufflé”.

*Side bar: We all thought FS was cool when he arrived.  And I would be the first to say that he was an excellent clinical Chiropractor, but he actually turned out to be a titanic asshole. Being an asshole myself on the rare occasions when I don’t like someone I see if other people like the person to make sure I’m not the problem.  Nope, not me, FS was the asshole.  Heard he just got fired in Vietnam.  That’s too bad.  Fuck Souffle. *

FS came in and being a good Chiro quickly grew, organically like I did in Grand City Mall.  The Warden continued to Struggle. An exasperated Jason frustrated with seeing the New Patients fly out the door told the front desk that if any of the Wardens new patients showed hesitation give them a free consult with FS.  This was the beginning of the end of the Warden in Surabaya, whose numbers were half of what Nature boys were.

We had to offer her free care after this.

Speaking of Nature Boy he wasn’t doing so hot either.  Frustrated that his numbers were lagging he decided to secretly record my consultation and copy me word for word.  Since part of my program required exercises based off initial X-Rays (which he didn’t know how to prescribe), and then Re X-Rays several months later (which he didn’t know when to redo) his results were less than spectacular.  

He was also complaining that his Indonesian wife (he got hooked in almost immediately off the boat in Surabaya) and his new baby cost too much Money. Her solution was to come into the office and steal my business cards in a vain attempt to drive patients towards her husband.  “I’ve made a terrible mistake” he would say explaining that his wife was sending his money to a “brother” of hers.  His final act of spite towards his wife was during Ramadan when, despite converting to Islam to appease his wife, he refused to fast.  The virtue signaling in the “conversion”, combined with the hectoring we got about his normal fasting regimen was no match for his passive aggressive desires to annoy his wife.  As I said, Strange Bird.

Early 2015 had FS and I on live TV where I gave excellent answer in my great radio announcers voice while I starred at the wrong camera the entire time. Literally after the show they asked me why I looked into the wrong camera the entire time something that could have been done during one of the several commercial breaks.  Indonesia’s newest media star was having his ups and downs.

My practice was still lucrative but slowly decreasing from the mid 300s a week as patients moved down in frequency. A considerable leak of people not re-upping packages was buoyed by changing some of the package rules to support retention (did I mention I hated packages) but with 10-15 patients dropping in frequency every week without New patients it was harder to grow.  New patients were also harder to come by as we now had 2 clinics, 4 docs and CF had figured out the magic formula to doing Business in Indonesia ($$$) and had two docs in their 3 better located Malls.

I was then rocked by News from Jakarta; Pak Deep tells me that LC just was hassled by Imigrassi and the “fines” amounted to over $20K USD.  He also told me that this wasn’t the first time that happened as Imigrassi had arrested him previously.  LC knew he was in a legal grey area, but he did know and pay the right people.  Until someone higher on the totem pole wanted a taste.

This would explain why CF was up and running again in Surabaya.  

May 2015 came around and the first real harbinger of doom for me came as I prepared to go to the Indonesian consulate in Singapore to actually pick up my Chiropractic KITAS 10 MONTHS!!! After Bumi told me I would have it shortly.

Beaming with pride that she had done her Job Bumi instructed me to go to the consulate in “cane you for graffiti” Singapore and slip the equivalent of $20 USD into my passport for the Immigration officer.  

Maybe I should have taken her advice.  My KITAS stated my job title as “Quality Control Advisor.”

After all these months Bumi looked at me and said don’t worry about the title it’s only a formality.  I complained to Jason who was very stressed about it as well.  He was equally stressed that other than FS everyone’s practice was lagging, my numbers were still in the mid to high 200’s a week but that was still a big decrease from my rapid growth between September-December.

Jason decided to create some changes, Out was The Warden and in Came “Skinny J” a CF refugee.  Nature Boy was caught trying to start his own clinic behind everyone’s back, the one thing that could have gotten him fired, and Jason was relieved he was sneaky enough to try it.  In came Big Ricky who was an immediate improvement.

I was chugging along in the summer of 2015 and decided, after rotating through a few incompetent Jack Daniels girls recommended to me, to hire a local Indonesian Chiropractor as a personal assistant, “Cece Jahat”.  In Indonesia women that are younger than you are referred to as “Mbak” (literally: “sister” pronounced like “baa” {I think}) and in Surabaya Mbaks of Chinese descent are referred to as the slang “Cece”. Jahat is the Indonesian word for Bad or evil.  I had taken to calling my dear friend “Bad Sister”.  I swear it’s a term of endearment.  

Hiring Cece, who CF had offered money to put her license on the wall, drew suspicion from Jason which was starting to strain our relationship.  Jason was a great guy, very bright, but I thought he was a little too hands off with problems and there were starting to be a lot of problems.

Another problem was when the company was switching payment schedules.  The company collected all the money up front from sales and dispersed it to the doctors based on when services rendered.  As an example: say in January I sell $30,000 worth of services but adjust few patients. On February 5ththey would pay me 40% of the total services (adjustments) for January.  If I don’t sell anything in February but all Januarys patients come in and exhaust their package’s, I make money and the company has to go scrounging through escrow accounts.  

In theory Chiropractors could increase their bonuses by telling patients they need to come in an excessive amount.  One Chiropractor working for Chiropractic First in Jakarta, nicknamed by his colleagues “Douche Bag”, was doubling his income with scare care methods involving seeing patients two and three times a day.

Skinny J and I discussed the policy change, we would now be paid on the 15thevery month, and what it signified.  Either they were worried we would bail and were holding our incomes till the middle of the month or they were giving themselves “breathing room” to make extra cash.  LC started doing this in my last few months in Jakarta.  

As a general hard and fast fixed rule ANYTIME a company changes how its employers are paid it is a sign that the finances are becoming fucked.

And then a massive problem emerged.  

A few times that I was adjusting Big Ricky’s patients who could only come in on my day I noticed that they were referred by my patient, which meant they should have gone to me as a New Patient.  I brought these instances to the front desk girls who always said, “Sorry Doc they didn’t tell us.” An excuse that was weak as it was written on their initial paperwork and they were supposed to ask on the phone.

Meanwhile I had a friend from the Indonesian city of Bogor, just south of Jakarta.  My friend, “Princess” ;-), has scoliosis and I referred her to EB at LC’s clinic in Jakarta. Having grown up in the Surabaya area Princess was coming to visit and said she would like to get adjusted by me. I told her to send me copies of her X-rays and that I would be in the office on Sunday.  I checked my schedule and had a new patient slot available at 6:00 PM which I told her to call the office and take.  

I was curious of what Princess’s impression of what our front desk capabilities were, comparable to LC’s clinic in Jakarta, and I asked her to make an appointment but to not mention that we were friends.  I found out why my referrals were going to Big Ricky.

Princess messaged me to say I must be quite busy not having any slots for the day, something I had just checked.  I walked to the front desk again and I checked the schedule which had clearly available slots for new patients.  I Messaged Princess and asked if she could ask for an evening appointment and to ask for the assistant’s name.  Princess called again, got the assistants name and was told flat out that there were no available appointments that day but there were several, the next day on Monday, Big Ricky’s day.

The prince of yelling instantly transformed into the Emperor of wrath as I messaged Jason.  Jason was pissed but he was also pissed at me for “running a sting operation”, and I was pissed that this accusation was not my intention and that HE should have run a sting operation. Still upset about my KITAS I dug the shiv in saying “Well I’m a fucking Quality Control Advisor.”

Cece Jahat tried in vain to get me to calm down as I screamed at my assistants. I had caught them red handed deliberately sending my referrals to the other doctor.  

Questions shot through my mind. How many had they sent over to Big Ricky?  What’s the ratio of walk-ins being sent to him when it should be evenly split? And most importantly how and why could they do this to me?

“Because Dr. Marc Mbak (GM) says we have to stand during consult and Dr. Big Ricky consult is shorter.”

Well we have an answer.  The girls don’t want to stand.

Now I don’t mean to pick on the girls too much, but this drove home another point about these practices.  When you have multiple doctors in the office it’s quite possible for allegiances to be formed; Fuck Souffles superior clinical ability had the front desk sending patients from the Warden to him.  That’s understandable.

Good work, Nature Boy

And while I didn’t mind a patient preferring a different style than mine, my big fear working with Nature Boy would be him “poaching” (Jason’s term for interdoctor patient switching) my patients after I had explained chiropractic in my long-winded, excessively detailed, standing too long consult.  NB couldn’t explain Chiropractic for shit, and he wasn’t nearly as good as an adjustor as I, but he did take his sweet ass time.  EVERY Patient got the “Flying nature boy”: three prone thoracic adjustments.  SI on the right…and the left.  Rotary cervical break on the right.  Rotary cervical break on the left.  3 Anterior thoracic adjustments.  Upon sitting up you then got the activator haphazardly done on random vertebrae.  And the coup de gras, arthrostim on every single vertebra for 3-5 seconds (I think this finishing touch was what had him REVERSING normal cervical curves as he drove the arthrostim into an un-extended neck.)

I’m sure this all felt good, but it was detrimental to patients, in many cases who with a limited understanding of Chiropractic and neurology, had no clue this was potentially detrimental to their health. But his 10-15 minute “sessions” sure beat my focused 5-minute sessions of analysis and adjustments for the time is money conscious.

Not to belabor the point but this is what you’re dealing with in Asian Chiropractic Chains, staffs that pick favorites, doctors who are hired to fill roles who in a pinch will resort to performing “extras” to mask clinical inefficiency.

After the Princess referral affair, I was hit with another death knell for my time in Surabaya, my work KITAS, which was expiring was not being renewed immediately. After half as many months with a KITAS as I had initially waited for my KITAS we would be returning to the Bumi takes my passport to Immigration system that she preferred ($$$) as we would wait until the new year to renew my KITAS.  My spidey-sence was tingling as this didn’t sound right, combined with LC getting popped.

Cece Jahat was leaving the glamourous job as my assistant to take an actual Chiropractic Job in Bali (She is a smart cookie) but connected me with Tinah Tan’s Citi Life Chiropractic in Jakarta.  I was figuring that if Anyone could make me 100% legal it was her office. Meanwhile the King maker in Bangkok passed along another opportunity, an American Chiropractor, “Roberto” had been hired by a wealthy Chinese woman who felt her life had literally been saved by Chiropractic. She was looking to start a Chain of offices throughout mainland China.  I wasn’t keen on leaving Indonesia which I had come to love, but the relaxed work schedule, rent paid, and tax free $100K a year (a target number for me as it allows me to stay under the US Taxing threshold) produced a seductive challenge.

Jason and I met for a Beer on Halloween 2015 where after he told me to “stop ripping the band-aid off slowly” I tendered my verbal resignation. I told him I could stay till mid-December but preferred earlier as, “Roberto” said the Beijing clinic in China would be operational in Mid to Late November.

After that I felt… relieved.  Again, I felt the same feeling of Joy when LC let me go.  Jason brought up a point, which I denied at the time, I let the good money I was still making, cloud my feelings.  He was right. 

Peace, Indonesia

The next month and a half my practice collapsed with no new patients except direct referals, and I didn’t care.  I lasted until December 13thwhen I walked out on a practice that was seeing 120-140 patients a week.  Not bad but certainly not the glory days.

I had to hold off on going to China, however.  They were up and running however I had an X-Mas/New Years vacation I booked months earlier and it made no sense to go to China just to take an immediate vacation.

I told Roberto that I would be arriving in Beijing the night of January 6.  In the mean time before taking my Vietnam, Bangkok, Kuala Lumpur Vacation I visit Cece Jahat one last time (Or so I thought) in Bali and take my holiday vacation before returning to Surabaya January 4th.

On the morning of January 6thas I was packing the last remains of my Indonesian life all hell Broke Loose…

Princess messaged me an article in Bahasa.

The details were sensationalistic but were as follows:  A 32-year-old woman, the daughter of a wealthy former Energy Minister, had died days after attending a Chiropractic First Clinic in Jakarta. The picture of the attractive Allya Siska Nadya was juxtaposed with a menacing picture of American Chiropractor Randall Cafferty who was portrayed as her assassin.

With the speed Princess sent it to me I sent it to my close confidants, Cece Jahat, Skinny J, and EB now safely in another country.  Cece Jahat had already seen it, as Indonesia for all its infrastructure concerns is a Tech savy viral society of 250,000,0000.  

Jason came over to collect some stuff I sold him.

“Yeah… you know, CF.  They will hire anyone.”

“Dude, this is big you need to be careful.”

The story had exploded in Indonesia no doubt fueled by the Indonesian Authorities in Jakarta “Shocked” that “Unlicensed” clinics had been operating in all the top malls by Chiropractors working on tourist visas.

Lost in all of this was the date the death had occurred, Mid-August, 5 months earlier.

Why was this story breaking now?

Well it certainly went a long way towards understanding why Imigrassi told us my KITAS couldn’t be renewed back in September.  They stopped renewing ALL foreign medical professional KITAS so that we were PURPOSELY not in compliance with the laws.  That also explains what took so long.  They were waiting for all of the foreign Chiropractors (really all foreign medical professionals) to be on Tourist Visa’s, contributing to the “Bumi Funds” all those months only to be shocked to “discover” that all these Chiropractors are working Illegally.

It was all a set up.  I’m only speculating here but here is my theory.  January 2016 was the start of the ASEAN (Association of South East Asian Nations) economic agreement that would allow the flow of professionals through SE Asian countries.  Indonesia, becoming more nationalistic in their previous elections, feared what may have been a deluge of medical professionals to the wealthy enclaves. It wasn’t uncommon for my patients, part of the wealthy 10% in poor Indonesia to come in with X-rays and MRI’s from Singapore or KL.  It wasn’t uncommon to seek dental care in those countries.  ASEAN might have scared the new ruling parties. Allya Siska Nadya Death was the spark that ignited when all the pieces were in place months later.

It didn’t help that the American Chiropractor, Randall Cafferty, had his license to practice in California suspended for Drunk Driving.  Indonesia stroked that fear that “all these” unlicensed Chiropractors were running around practicing unlicensed.  They even exhumed the Body, again 5 months later to do an autopsy at the gravesite “proving” that she died of a bleeding brought on by an adjustment.

Lost in the shuffle was that young Allya had sought care AFTER Cafferty wasn’t able to make her headaches go away.  She was prescribed blood thinners at the hospital undoubtedly contributing, if not causing her to bleed to death. Cafferty was no gem, but he didn’t kill Allya. It was no matter as the Political winds were blowing and witch hunters were looking for witches.

The entire Folly of this was that the Indonesian Authorities announced at press conferences where they were throwing chains on the doors of CF clinics that there was a Manhunt for Randall Cafferty, unaware that he cleared Immigration in November and was safety back in San Diego.  No matter the Indonesian police force had put in a request to the US Federal Bureau of Investigation to bring him back to Indonesia.  This request must have produced a chuckle.

My departure from Indonesia hit a snag.  My flight from Surabaya to Beijing had a layover in Bali. In the Surabaya Airport I show up with 100 KG (220 lbs.) worth of shit and they charge me the Equivalent of $100 to get the excess baggage to Bali and $3000 to fly it from Bali to Beijing (It cost $360 to fly it from LA to Jakarta in September 2013). I land in Bali and was met at the airport by Cece Jahat who has Garuda Indonesia pull all my shit off the Beijing flight.  I ship all my stuff to Beijing the next day for a third of the cost (Cece writing the address in Mandarin reminding me why I kept her around) and decide to stay poolside for an extra day or two (or three) while stressing out Roberto in Beijing concerning my most recent reason for delay.  The Chinese were worried that my arrival was not aligning with when the Dragon was lined with Aquarius but who knew when I will be in Bali Next.

The next few days involves the arrests of several chiropractors in Jakarta while other Chiropractors (all foreign medical practitioners, really) are fleeing the country.  Skinny J refuses to go back to work in Surabaya and the new Chiropractor for the recently opened Malang office high tails it out.  FS and Big Ricky’s names appear on a website reporting foreign Chiropractors.  CF’s Chiropractors bail while PR’s connections (Bumi) buys some time while the nationwide sweep makes its way to Surabaya. It eventually hit Bali as the American Chiropractor Cece Jahat works for gets arrested at the airport on a trip to Singapore.

A few months later it’s all done. The story of Chiropractic in Indonesia is finished.

Jason returned to Singapore to have an administrative role.  We remain friendly and worked on a business deal that fell through in China.

PR has returned to his several other business interests probably wondering why he got himself involved in this profession. PR was a great boss and owner, very supportive and it was never about money for him, but for the prestige in owning a clinic that helped others.  He didn’t deserve the taint that was left behind. We remain friendly and cordial and communicate every so often.

Mat Kan, from the press clippings in Indonesia had an arrest warrant out for him. Forced to pull out of Indonesia he opened up CF clinics in Kuala Lumpur Malaysia, staffed primarily by the IMU graduates he swore he was blocking from licensure for not having the proper philosophy. 

Randall Cafferty is adjusting patients in an Indian prison.  Thinking that his extradition claim was invalid he went looking for work in an Extradition country with Indonesia.  If he ever gets out he should write a book as well.  That’s a hell of a story.

The Warden wound up in another country practicing for a reputable chain.  With some proper ethical coaching he has been doing very well, from what I heard. Good for him he was never a bad guy, just coming from a bad place.  I am happy he has succeeded.

Nature Boy abandoned his wife and daughter (he has another abandoned Kid in Africa), and relocated to Hawaii running some fasting retreat.  He had for a short period of time a Video on Youtube entitled “Why Chiropractic is Bullshit” conflating his inability to grasps Chiropractic’s philosophy and his clinical inabilities with the profession being awful.

FS was married to an Indonesian woman that used to terrorize our mutual maid, Bu Sri, by showing her all the clothes that she bought with Souffles money. This delighted Ms. Soufflé cause the maid and her were from the same village.  They were made for each other.  As I said, last I heard FS got fired from Vietnam.  Fuck Soufflé. 

LC is married and running his own successful practice in an Asian country and doing well.  We remain cordial.

EB has remained with the original reputable chain he left Jakarta for.  We remain good friends and communicate frequently, mostly shit talking.

Skinny J and I remain close friends.  It’s not uncommon for us to send each other random unsolicited text messages to each other that say no more than “Fuck Souffle”.  If I really want to rile him up I leave an unsolicited voice message that says in a mock French Pepe Le Pew accent “Haw Haw Haw, I am zee best and you… you are zee worst.”. He has since practiced in the Gulf state of Oman and has returned to SE Asia.

Cece Jahat has returned to Jakarta and is in the medical profession.  A Medical doctor, an Indonesian Chiropractor, fluent in Indonesian, English and Mandarin, a human calculator, the worlds biggest fluffy dog lover and one of the truly smartest people I’ve ever met she is trying to gain enough work experience to relocate to Singapore to be close to her European Boyfriend.  I honestly thing of “Bad Sister” as the sister I never had. Funny story that she will kill me for telling: After all that she had done for me, including the last few days in Bali, I made the “mistake” of saying the words “I love you” to her as I left her to check in for my flight to Beijing.  I was way too early to check in, and I had to turn my ass around and messaged her asking if she wanted to get one last dinner in the Bali Airport. Dinner consisted of her smirking at me saying “I bet you never say those words to anyone”.  Yeah, yeah, yeah, I thought, but I truly meant it.  In the past 3 and a half years a corgi hasn’t passed me without me chasing it down and sending a picture to Cece Jahat.  If that isn’t love I don’t know what is.

And me, I got out of a bad situation just in the nick of time, again.  Almost unscathed. Almost.

A few months earlier our GM insisted that I do a photo shoot for a local magazine, showing me adjusting a “patient”, really a German model hired by the magazine for most of its photoshoots.  I was opposed to this because I think absence context a chiropractic adjustment can cause confusion.  My GM insisted, saying that it would be great publicity, so I relented and did the mock adjusting photoshoot.  The pictures never appeared in the magazine.

A few days after my arrival in China my Indonesian Patients were messaging me to show that I had once more graced Indonesian Media, this time with a menacing looking picture of me using an instrument known as an arthrostim. Beneath the Picture was the Headline “Memutar 45 Derajat Bisa Stroke hingga Meninggal.”

“Stroke and Death can happen at 45 Degrees.”

第八部分 (Part 8): China – Money Can’t buy Success.

When Communicating with Roberto about the China Opportunity I was told in no uncertain terms that no expense would be spared on this project.  The Owner of the Company, Ms. Bai*, had accumulated enormous wealth through her several businesses.  Even richer was her husband, the company’s Chairman, who was in negotiations to purchase a Taiwanese biomedical company for close to a Billion USD.

(*The Chinese probably aren’t reading this, their English names are selected and not direct translations, and I have nothing embarrassing to say about them so let’s just use the names I referred to them as.)

What made the story more intriguing was Ms. Bai’s passion for Chiropractic.  An extremely hard worker who would sometimes put in 18+ hours a day she was starting to become overrun by blinding headaches.  The headaches were preventing her from working, which was causing depression, and as she told it was making thoughts of suicide creep into her mind.  She went to an American colleague of Roberto who was able to help her overcome her headaches and the thoughts of bringing Chiropractic to mainland China quickly replaced thoughts of Suicide.

Roberto’s colleague was not too keen on being involved with such an ambitious project, so she tapped Roberto to be her director of clinics.  Roberto had previously worked in a high-volume clinic in Singapore and it’s model became the model for how “Chiro Care” would be run.

The model was ambitious marketing to get patients through the door, then x-rays and a tailored script memorized by all the doctors (and, perhaps most importantly, the staff) to try to sign patients up through a year of care.  

The model in Singapore wanted the Doctors signing up 65% of the patients to care plans, and then the patients would see whichever doctor they preferred, so the job was more of a sales position. The doctors would be paid around a flat $90K USD with 2-3 days off.  Without commissions the docs were relieved of the fears of poaching and just had to sign the patients up and adjust 80-100 patients per day they were in the clinic. I’m skeptical of this care in general but it appeared to work in Singapore.

Due to the Departure issues from Bali I didn’t arrive until early Saturday morning and was picked up by one of the general managers, Jacko.  He took me to my apartment, part of my contract was the company would pay rent, and I familiarized myself with Beijing and even walked to the office so that I wouldn’t get lost on the 30-minute walk on Monday in the cold Beijing January’s.

On Monday getting lost wasn’t an issue as Jacko arranged to pick me up at my apartment and walk me to the office in the Downtown Financial District with some of the staff, and one of the Doctors, ‘Grumples”.  

Grumples and I hit it off and talked the whole way into the office.  Just before entering the office I asked him how busy we were to which he replied, “Oh we don’t have any patients.”

This was certainly an ominous sign for an Office which had been open for almost 3 months. 

I walked in to the office and see how huge and well designed it was.  The staff I was about to be introduced to were in perfect charcoal grey uniforms.  I’m walking around and meet Roberto for the first time in person.  He explains that they have had few patients but are confident that with proper marketing they will get busy.  I ask about prices and packages and he says that the plan is to sell EVERYONE a 100-visit plan for about $15,000 USD, twice of what Singapore would cost and well above my expectations.  Roberto shows me the expensive Practice Management software and I look at the 6 $8,000 a piece omni chiropractic tables.  And this was just the Beijing Office.  The Shanghai office, which I was supposed to be transferred to after a few months, was even bigger and more equipped.  It was largely sitting empty, rent still being paid monthy, as Shanghai staff was flown up and given apartments for training purposes.

The staff that remained in Shanghai would have bouts of boredom broken when Ms. Bai would fly back from Taiwan and dump books she had purchased concerning Chiropractic with a request: “Translate this.”

As I came to see China believes that Money and Man power is the answer to everything.

I wander into Grumples office that was next to mine (Each Doctor had their own office) and within 2 hours of meeting me he is telling me how much he enjoys prostitutes in the Philippines.  Being an easy-going guy, I initially figured that he just reached a level of comfort with me, but as I saw soon enough Grumples talks like this with everyone.  

Grumples is your stereotypical 60-year-old American Mercedes 80’s refugee Chiro escaping to Asia from the West, after having practiced in Ohio and then the Shetland Islands before heading to Jakarta, Singapore and the Philippines. And had he found his dream Job.  I was still trying to process this all, escaping Indonesia and entering the most expensive non-functioning Chiropractic office on the planet which had no signs of being profitable and Grumples says, out loud in front of the general managers with the conviction of a county clerk during a Lunch Break “We don’t have any patients.  But it’s OK because we on Salary.”

Grumples came on board because Roberto was told to hire three more Chiropractors.  I had committed in October, Kamikaze* was a Parker Classmate of Roberto who was recruited, and he needed another “white Face”. *Kamikaze is half Japanese and half Mexican (We collectively and hilariously struggled for a Nickname that bridged both heritages and wasn’t too racist) and Roberto had to fight to get him hired because he wasn’t Caucasian (I think he looks white).  Roberto told me this after I attempted to get a friend who was fully Japanese hired.

Grumples shows up in an interview in Shanghai and he is pretty white. The staff would later tell me that they remember thinking that Roberto shouldn’t hire Grumples and were shocked when he did.  They took this as a sign that Chiropractors weren’t serious Doctors, as Grumples, showing up with a pendulous abdomen and a hyper kyphosis in the Thoracics, did not look the part of a serious medical professional. 

While the Chinese staff liked the hokey and jovial demeanor of Grumples, they had a saying for people like him, 为老不尊(wéi lǎo bù zhòng) which is a way of saying, in so many words “An Old Fool who hadn’t earned respect.”

Grumples seemed to work hard to earn this lack of respect through profound cultural ignorance.  The Chinese, a polite and reserved people, are diligent workers.

Grumples day consisted of arriving just before check in time in the morning, bragging about how he synchronized his leaving the apartment to get there just in time, playing on Facebook and hovering around the Timeclock at night with his coat on ready to go while complaining “I don’t know why they make us wait till 6 when there’s nothing to do.”

I would pull Grumples aside and remind him of certain cultural sensitivities.  He would say “Oh you’re right.” And a few minutes after return to autopilot. 

One particular moment that stood out was when our assistant, Limo, walked into Grumples office to put some paperwork on his desk.

“Limo, come here…. This girl wants to spend the week with me.”

I’m sitting in my office and while my jaw hits the floor part of me thinks this denseness is hysterical. Limo is a VERY reserved married mother of two, and I’m imagining Grumples pointing at the picture on the 24 inch monitors we had of some Filipino girl outside a Nipa Hut.

“Dr. (Grumples) why don’t you find a Chinese girlfriend who is a little more mature?” Limo asked her voice quivering with embarrassment.

“No, No, No…I like Filipino Girls. Besides I like them young, after 25 they’re too old.”

Limo managed to extract herself from this awkward conversation.  Grumples comes into my office and really nails home his denseness:

“Did you hear what Limo just said?  She said I should get a Chinese Girlfriend my age.”

I’m staring at him blankly cause that not really what she said.

“I don’t think that’s any of her business.”

“Dude, it was her business when you pulled her back into the room to show her some girl in a village a 6-hour bus ride away from Clarke (Clarke Airport outside of Angeles City, a predominate Prostitution town 2 hours north of Manila).  Come on man, tell me this shit on the weekend when we have Beers, don’t talk to the staff about this shit.”

“Oh”… he would say in his shocked voice. If only he walked around in perpetual fear of losing his dream job.

January went fairly quickly, and things wound down for Spring Festival, known colloquially as “Chinese New Year.” A one-week vacation looming decisions on Holiday destinations had to be made.

Grumples had selected the Philippines as his destination of Choice (again) as he had previously returned from a Visa run.  We were expected to go to Hong Kong for Visa Runs which were cheap and paid by the company but Grumples decided to take a red eye to Manila, jump on a bus for a few hours, sleep with a girl who he met on Facebook for $50, and come back as quick as he left upset that the company wasn’t paying for his entire trip which would be twice as expensive as a HK trip.  

“How come they paid for Kamikaze’s trip but not mine?”

“Trip? It’s a visa run, not a vacation, when you make it a Holiday, you pay yourself.”


I decided on Manila as well, having never been there before and having just gotten back from Bali, Vietnam, KL and Bangkok.  When the Taxi driver took me from the airport he told me how much prostitutes cost in the wealthy section of Makati where I was staying.  About $150.  I couldn’t fathom where Grumples was getting his girls from.

“$25.  $25!  I got her for $25 dollars!” Grumples said waving his phone in front of me in my office upon my return.  He excitedly showed me a skinny-fat Filipino girls Facebook profile loaded.  

“Yeah I’ve had hotter and freer.”  I wryly stated.

Grumples harrumphed as he went to the front desk and his mid-west draw carried through the office.

“This is my new girlfriend.  I got a new girlfriend in the Philippines.  I got bored of the last one so I got a new one.  By the way I need one of you girls to take me to the bank today cause I have to transfer some money to her.”

The rest of February was Grumples Western Unioning money to his “Girlfriend”, Kamikaze and I figuring out the swiftest process for converting and sending our money back to the states and generally sitting around doing nothing. The last week of February brought the prospect of being busier as we were going to do a marketing event.

My hopes were quickly dashed as the marketing event consisted of handing out flyers to secretaries who couldn’t afford us outside our office.  We did have 13 New Patients each, but it was a fool’s errand, as they were all free exams and treatments “won” at a lucky draw where everyone who entered won.

The normally reserved staff was getting more vocal with their impression of their Job.

One particular new patient I had made it clear from the start that she had no intention of going further than what was freely offered.  Regardless I gave a serious and impassioned call for her to continue care, which she denied.  Our assistant came up to me afterwards and he stated he felt bad for me because I had put my heart and soul into the consultation. In so many words he was saying “This business doesn’t work why are you trying so hard.”  I chuckled and said that wasn’t for the patients benefit but for his benefit and the benefit of the staff who were amazed that this was an actual business.  They accused me of exaggeration when I told them a few months earlier I was seeing hundreds a week, and that there were actual patients all over the world that utilized Chiropractic.

Two of our assistants said it best “I feel like we are all actors, and this is an expensive play.” This brought to mind Jaques words to Duke Senior in Shakespeare’s “As You Like It.”:

All the world’s a stage,
And all the men and women merely players;
They have their exits and their entrances,
And one man in his time plays many parts,

Early March brought tumult. Ms Bai stated that everyone, Doctors included, where going on a salary reduction in three months that would be recouped with performance bonuses. There was no way that these performance goals could be reached.  We confronted Roberto about this, it was clear by this point that he was in way over his head, but while he said that we were “On our own” he sheepishly stated that he didn’t think they would go through with this policy. (He was right, they never went through with the policy.)

A Few days later we are told that there will be an inspection in the office in an hour.  I was still on a tourist visa (again) and told Roberto, two months removed from the Indonesia fiasco, I was going home for the day. The Chinese staff told me it was OK to stay.  As soon as the authorities got there I was told to hide in a back office.  Another one of our GM’s, a lawyer whose family had Government connections, went out to talk to the police.  I was provided unencouraging updates:

“They saw you, they asked who Professor Marc Tafuro is?” (That’s what the giant poster with my picture said).

“They said they know you are back here.”

Magically the police went away, and I could come out of hiding.  I approached Roberto and told him if this happens again, I’m out.

Two days later on a Friday less than two hours from closing time we received “good news”. The next week were more Government inspections, no doubt triggered by my poster on the wall, so we had off.  Well, not off per se more to the point, don’t show up.  Not only were posters and diplomas coming off the wall but X-Ray view boxes as well.

“Can I go to the Philippines?” – Grumples asked Roberto.

Not possessing a US Credit Card Grumples scampered to the front desk for an assistant to buy him a ticket to Manila.  He would go to the ATM to pay the assistant in cash.

As for me Bangkok and Hua Hin were in my future.

We returned and there was a whole lot more nothing to do.  Kamikaze and I joked when we were going to have the Grand closing, complete with the taping up of the ribbon cutting from the Grand opening.

Ms. Bai was full steam ahead as she had a GM approach me and ask about furnishing for the Shanghai office.  Between tables and laser machines they were spending a fortune.

Grumples and I would be sent to Shanghai for the Grand opening (Despite the clinic having already been open) for a particular Holiday which was considered Lucky.

We were leaving our relatively nice apartments in Beijing and I was morbidly curious what accommodations the company would provide for us in Shanghai,

“I think they are gonna have nice apartments for us, Because Ms. Bai and Mr. Bai* wouldn’t want to disappoint us.” Said Grumples concerning our future accommodations.

*“Mr. Bai”, Ms. Bai’s husband, is obviously not Mr. Bai as the Chinese names are surname first followed by given name and the wife doesn’t take the Husbands surname at marriage. But Grumples referred to Mr. Jiang as “Mr. Bai” constantly.  We just thought Grumples was being Grumples but no, he ACTUALLY thought his Name was “Mr. Bai”. When we finally started to correct him, he referred to Mr. Jiang simply as “The Guy” and “Ms. Bai’s Husband” because he could pronounce “Mr. Jiang”.

“The apartments are Dumps” said Grumples upon first seeing our accommodations.

I was in a Porsche Cayenne being driven from Beijing to Shanghai when I got that message. Grumples was shocked, I wasn’t surprised, realizing that the gravy train wouldn’t last forever.

May through September were pretty much the same with one noticeable difference, Ms. Bai was gone. We were told she went to Australia to have a medical procedure done, yet her passport was in China.  Considering she had used a fake name to secure a lease on our now 2ndoffice in Shanghai I was wondering how many passports she had.

The end of September brought a Bombshell.  October 1 would be the national day Holiday and Grumples took a few extra days off to go to the Philippines (Duh) and Kamikaze was in Japan. Our former assistant in Beijing (Who hadn’t been with the company in months) messaged me to tell me that a meeting was going on at that moment in Beijing to discuss the dissolution of the company.

I’m messaging Kamikaze, who had already heard in Japan.  I messaged Grumples, who would not answer for two days (Nipa hut cell coverage and all). Kamikaze messaged me to tell me that He messaged Roberto who had no idea that there was a meeting down the hallway on the other side of the office announcing the dissolution of the company.  They didn’t invite the COO to the meeting.  That’s how little they respected Roberto.

Just before getting on a flight before going to America Grumples messages me indignant that he would be out of a job. Indignation turns to thoughts of petty revenge as he messages me on the tail end of my trip to say that he will be the clinic director of a new clinic system in Guangzhou and that he won’t be hiring me.  The new clinic system needs 10 Chiropractors, but I will not be one of the lucky docs because Dr. Big Shot wouldn’t hire me. We will return to this story line later.

I return from my trip and the Chairman informs me that he wants me to come up with an alternative business plan.  While I was gone Grumples had begged the Chairman to keep his job and said he would come up with a business plan and would work really hard.  The Chairman wanted to hear my ideas, despite having heard previously that “The American way does not work in China.”

I calmly pointed to the KFC across the street with a shit eating grin on my face.

“Looks like the colonel figured it out.”

Digging deeper I continued:

“I go to the mall and I see your fellow citizens fighting to get western goods.”

The people here are very stoic, and they rarely show emotion but as I continued, I perceptively noticed a grimace on his face as I prodded further.

“Your watch is Swiss, your shoes are Italian, your cars are German”… a frown started to emerge as I dug the shiv deeper.

“The only thing Chinese on you is your DNA.” 

And yet he still wanted my ideas.  I gave him some ideas and he put me in Grumples smaller now vacated office. Grumples was marooned in Manila.

I shit you not. After begging for his job to continue and saying he would come up with a business plan he was talking behind everyone’s back with a startup in Guangzhou. After shipping his shit to Guangzhou, he quits us with no notice. Doesn’t even collect a final paycheck. Heads to Manila to play big daddy clinic director when Guangzhou informs him that “The Investors backed out”, which is Chinese for “Thanks for letting us extract every bit of information needed to proceed in exchange for insincere flattery and promises we never intended on keeping.”

Grumples, shortly after informing me that he won’t hire me for his non-existent job calls me up begging me to go to his Bank in Shanghai to get his ATM card, which had just been declined in Manila, to be turned on. “Just pretend you’re me” he said expecting me to walk into a bank without the misfunctioning ATM card whose last attempted use in Manila under an hour ago and without showing ID.  Guess who had to pay for Grumples flight and hotel to shanghai just to get the card reactivated.

With Grumples returning to the Philippines I take over his office and manage to sign up three people in a short timespan before the lights go out. Literally.

They stopped paying the electric and phone bill. My assistant quit.  I literally would go to the office only when the lights can go on.  The landlord next door comes over and puts a for rent sign on our door.  I call up the Chairman and 10 minutes later the for-rent sign comes down.  No one seems to care as they are still paying me every month. The lights and phone never go back on.

Kamikaze is in Beijing, with at least one assistant and the lights on.  

The chairman comes over for a meeting and when the lights don’t go on, he says “Terrible”, as if he can’t believe that not paying the electric bill keeps the lights off.

This isn’t real.  This can’t be real.  This is a play. I’m only an actor. “All the world’s a stage…”

It was at this point I started talking with Mabuhay Chiropractic in the Philippines but meanwhile there were several Vacations to exploit. Chinese New Year was coming up again and it made sense to utilize vacation times for going back to work.

Just before Chinese New Year I’m watching an NFL playoff game early in a sports bar in Shanghai when Grumples walks through the door.  I ask him what he is doing back in Shanghai and he tells me he is broke and:

“I need to see if I can get my final paycheck from the Guy.”

“The Guy?”

“Yeah the guy, Ms. Bai’s Husband.”

“Mr. Jiang”

“Yeah the guy.”

Grumples had returned to Shanghai to see if he could collect his final $7000 that he walked out on when he thought he was going to be a clinic director in Guangzhou.  He called Mr. Jiang begging for the money and Jiang demanded a face to face meeting in Shanghai, prompting Grumples to return from the Philippines which would take place in the afternoon.

Meanwhile I asked Grumples what happened with the Guangzhou Clinic and I received a clinic on how the Chinese operate. 

They told him that they were going to start 10 clinics and they needed a smart man with his experience, as they had no idea what to do.  They had talked with other candidates, but he was the best one.  They were going to pay him $10K a month and get him an apartment with a car and driver.  

I’m listening to the story and thinking “Nelly”, the Singaporean-Chinese man that Jason corrected me when I doubted his intelligence.  So, this was what it looked like when you got taken in and rolled. They marked him, grabbed everything from him, Chirocare manuals and trainings, and unceremoniously dumped him. Must have been like taking candy from a baby.

I let him continue the story and asked him if this didn’t sound the least bit familiar over our past year experiences.  He said he told them to start small.  When I asked how they planned on paying him he said that they only needed 50 patients a week paying 500 RMB (Historically $75 USD a visit) and they would be happy. I did the math in my head and thought out loud:

“So they planned on your salary, before the apartment and car and driver, being 66% of overhead?”

This drew a blank stare. 

“Did they plan on playing office rent and staff salaries?”

“They said they were gonna give me the money.” Grumples said having never had alarm bells going off in his head.

“No wonder the investors didn’t go through with the plans.” I said with a chuckle before sipping my beer.

I doubt there were any nameless, faceless investors that pulled out.  They were just chumming the waters looking for fish to bite who they could extract info from.  

If Grumples didn’t learn a lesson with dealing with the Chinese in Guangzhou he received one a few hours later with Mr. Jiang.  After flying back to Shanghai Mr. Jiang was an hour late to the meeting, asked him why he deserved the money after walking out on the clinic, took a phone call for 30 minutes, then got off the phone to tell Grumples that he wasn’t going to pay him.

Grumples eventually said the Chairman paid him a few thousand.  Whether that was an ego protecting lie or an uncharacteristic mercy I doubt a lesson was learned.

But don’t fuck over the Chinese and not expect them to extract their pound of flesh.

I continue on as I had for months and I resigned in April when Mabuhay offered their new clinic in Cebu which was opening in July/August of 2017.  

Over two weeks after I resigned the chairman called me to tell me that we will have a meeting in our Minhang office and that he has “Good News”. The Minhang Office, my original office in Shanghai, has been empty since October and has a rent charge of $15,000 USD a month. 

They have spent over $100K USD maintaining an empty office for a little over half a year. Must be nice to have that kind of “FU money” burning in the pockets.

I attended the meeting, one, to find out why the hell the Minhang office is still open (and might I add their internet worked). Two to find out what the “good news” could possibly be for an organization that has bleed cash since its inception.

The good news was they wanted to continue. I let them speak for an hour before I excused myself as I had to go to the other office to adjust patients and said we could continue the discussion at night. 

The chairman said he would send me his driver to pick me up. I am driven to a residential district to a house that has to be worth several million dollars. They lead me into the dining room with a 14-person solid wood table imported from Brazil ($$$) where they serve me this tea from a 500-year-old tree. ($$$)

For perspective the tea leaves are Twice as old as America.

I resigned primarily to speed up the process of getting out of here. The Chinese have a concept of “saving face”, closing a business and firing an American Doctor, who you asked to come over here, is considered Bad Juju so I figured they would pay me into perpetuity if I didn’t resign.

I also figured that my resignation would be enthusiastically welcomed.

Wrong. Again.

They asked me to stay on and work on hiring other Chiropractors. They asked me how much I wanted to stay:

“You can afford me, but you can’t justify me. You’ve paid me more than enough.”

I saw the look in her eyes, she really wanted this to work and she really wants me to stay. This isn’t about money. It is about Chiropractic.

I already promised The Philippines I’ll be there by July, yet I told them I would help them in any way possible, which is not the answer they wanted but is the only answer I can give.

We concluded them meeting on friendly terms and I noticed that as I was getting ready to leave so were they, from this beautiful house.  I asked where they were going, and they said “Home.”

This Multi-Million dollar house, with the 500 year old tree tea and the big Brazilian wood table and the house staff was the house they used to entertain guests.  They lived in a large apartment in the more central part of the city.

As I said “FU Money.”

And not even Fuck You money can buy success in Chiropractic.

Siyam na Bahagi (Part Nine) – Mabuhay! the Filipino word for “Theranos”

Just kidding.  The Term “Mabuhay!” is the Tagalog (Filipino Language) greeting which is translated as “Long Life” or Health and is the title that Tetrault gave to his clinic when he arrived. The reference is to the company, Theranos, which was run by a controlling CEO and involved the massive turnover of employees thought unloyal. 

I started talking with Tetrault in October of 2016 when a friend who practiced temporarily (Not a lot of Mabuhay’s Chiropractors make a substantive amount of time, a problem with the chain chiropractic clinics) recommended I contact him and I decided, for the time being, to stay on in China, following an email that Tetrault wrote back telling me its “Decision Time”.  Tetrault was the one told me that Grumples had been fired in manila for groping a patient. He certainly didn’t mind gossiping about people in his midst. 

I always do due diligence when going to a different country/clinic system which has me vetting the person/group I will be working for and Tetrault was no different. Other than negative feelings about some actions in Vietnam (he has an underperforming clinic in Hanoi) it was mostly a lukw warm “he’s OK.”

There was sparse contact when Tetrault for a few months until he contacted me again in April of 2017 for the opening of a new Cebu clinic.  The idea had popped into my head of practicing in a beach location so this seemed fortuitous.  When I suggested that I might be interested he “asked permission” before volunteering that another friend of mine in one of his Manila clinics, who appeared earlier in these stories, had made $15,000 USD each of the previous two months, an exaggeration of a few thousand dollars.

A few days later I skyped with Tetrault and he talked about “a family style practice” and “serving the people” and “We say that The Lord is our CEO”.  He mentioned family life and even made an awkward joke about women who don’t get married “becoming lesbians” and I walked away from the conversation with my first real initial impression of him: This man is a doddering old Christian.

At this point I thought to myself that China was going nowhere fast and beach living sounded good and as long as I was in a clinic where I can do my thing and marketing and patient flow was good then everything would be OK, especially if this guy stayed out of my hair.

The first real sign of trouble happened when I asked him to reconfirm what the base salary was.  I had been told by two friends working with mabuhay that the base salary was around $3,000 USD.  Tetrault in an e-mail several months earlier quoted me at $4,000 which I thought was an honest mistake.  I asked him in an April 4, 2017 email: 

“The base you mentioned last October was $4,000 US which is “voided” when production is reached. I [sic] that correct?”

I already knew the answer, the base was $3,000 USD, and was anticipating a correction to what could have been an honest mistake of a simple typo but his answer was sneakily evasive:

“Regarding the base salary, the only thing that’s changed is the US dollar is stronger but the base is the same. Since you will be spending it in the Philippines it’s not changed, so same offer. And yes you were correct, although we guarantee a base, everybody makes above the base salary; the only thing that’s changed is the US dollar is stronger but it’s the same. You will be spending it in the Philippines so same offer. And yes you are correct, although we guarantee the base, everybody makes above the base.”

What was being said to me was that the Filipino Peso, normally at a historical norm of about 50 Peso to $1 USD had crashed 26% to around 37.5 in under 6 months, for the equivalent of $4,000 USD to become $3,000 USD. But don’t worry because you will be spending that in the Philippines (Actually I live sparsely in Asia and send most of my money home).

“Doddering old Christian”, I told myself when an honest appraisal would have had less benightment and more abortive guile. Shame on me.

I still had vacations in China so I moved some stuff to Manila while communicating with Tetrault.  He was excited about the opening of the Cebu clinic as it was in the “biggest mall in The Philippines” (7thbiggest) and that he anticipated its monthly income to be in the $50-60K USD range (2.5-3.0 Million Peso). I researched Cebu to see if there were expectations and I tempered my expectations thinking that $30K would be a decent collection for the area but NO! this was our largest clinic and they anticipated it being so busy that they will have two maybe three doctors in the office in the 6thto 9thmonth mark.

Having a large clinic doesn’t translate to being able to fill up the clinic, that will always be doctor/patient relationships, demographics in the area and proper marketing. I spoke with my friend who was doing well in one of Mabuhays Manila clinics and he mentioned another thing that concerned me, Tetrault’s expansion was reminiscent of other expansions in Asia which just lead to oversaturation.

At the end of June I arrived in Manila and Tetrault arrived at the airport to greet me.  Sort of. He didn’t even shake my hand I had to extend my hand for the greeting.  He drove me around Manila and told several stories: about how some of his doctors had married local filipino women and while they choose rich women he choose a “common girl.” (This was not true none of the doctors were married or in relationships with women from wealthy backgrounds or even what could be considered middle class).  He told me a story of how he was partial owner of a medical clinic as foreigners (Tetrault is from Winnipeg, Canada and spent his early professional career in the US) can’t own more than 40% of a company. He mentioned that he was fond of hiring his wife’s family but that her brother that he had hired had Tuberculosis and he was so angry that his brother in law was close to his daughter during his infection.

My impression of him was that this man just kind of rambles, if not babbles, intersparsed with information that he volunteers that he does everything “by the book”.  He mentioned that several times when he’s not mentioning that “that’s how things are in the Philippines”, in describing how grease needs to be applied to certain government machinations, if you understand.  Being in Asia for several years I understand that cash sometimes travels through unofficial channels (bribes, but you knew what I meant) but “By The Book” and “That’s the way things work” are two very different things.

I was a few weeks from having a viable work permit and the opening of the Cebu Office so I spent my time rotating through the various Manila clinics.  For the most part none of them seemed as busy as I had been in Indonesia, and at some where anywhere from 30-40 patients a day at the busiest.  Some of the less busy clinics were in the single digits and open less than 4-5 days a week.

The Doctors who were all good seemed at best resolved to their lot while some that looked downright despondent. (Head in hands despondent).  It was clear that some were earning in the $10-12K a month USD range and some were making the base. It was all hit or miss.

It all came down to what the Cebu clinic was like.  Manila had its wealthy pockets but Cebu was a wild card.

At the end of July I head to Cebu one week before the opening.  Walking around the mall, SM Cebu Seaside, on a week day it was nothing like the Malls in Manila and certainly not Jakarta.  SM Seaside was a literal Ghost town, with every third shop shuttered advertising that you could rent the space.  A few months later a patient would give me an ominous nickname for the mall “SM Suicide, where business go to die.”

Two Blue Dots on the bottom.

This isn’t an entirely fair criticism.  SM Suicide is built on a large anthropomorphic island in the south west of Cebu city known as SRP, the South Reclamation Project.  It has an ambitious plan. It’s just empty now and the surrounding areas that have been developed are generally poorer than other areas of Cebu, with horrendous traffic due to infrastructure concerns.  Opening in SM Suicide might not be a bad idea, 5-10 years from now I thought.  Why hadn’t they opened in another mall?

The questions didn’t end there. I go into the shell of the large office as the buildout was still ongoing and I’m immediately struck at the inefficiency of the floor plan, as it was completely lacking in flow.  Our trainer, who was to coach the doctors in how to sell “Big Packages”, I’ll call him TR, was pointing out in his excited manner the open bays and the Doctor’s offices and how 2-3 Chiropractors could occupy the office at the same time.

“Why is this doctor’s office in the middle with the door facing here?  The office should have been here with the door opening up here and two open bays next to each other divided by a curtain.”

“Well Tetrault didn’t design it the way I would design it.” – TR said with a “what can you do?” tone to his voice.

It would never matter as the office would never be busy enough to sustain two doctors let alone an open bay.

This isn’t to say the office was entirely horrible.  We hit $30K USD in collections our first month (what did I say) and averaged in the $28K range hitting as much as $35K+ a month or two in my duration there.  But my Cebu practice was probably never bigger than 120 patient visits a week almost a third of what it was in the heyday of Surabaya.  I never cared, I was over high volume but I came to realize that I would never have a relief doctor in my office.

With all the suspicions that I had building up it was a little bit over a month, Mid-September 2017, when I realized that my time would be short with Mabuhay.

In late July myself and my two Cebu assistants who had trained in several of the Manila clinics for June and July had pre-employment physicals in Cebu.  Unbeknownst to me one of my assistants had an inconclusive chest x-ray, hazy lung fields, a sign of Tuberculosis infection. She brought this up to Mabuhay’s Manila HR department, who told her it was probably because she was a smoker, and they told her that she had to retake the test the next day, at her own expense. The next day, late July 2017 her X-Ray was positive for tuberculosis.  She didn’t volunteer the information to HR.  And as she later stated in her defense they never asked.

When I walked into the office on the morning of September 11 2017 my two front desk who were hired after we had opened were frantic.

“FW is positive for tuberculosis! She has been working with Mabuhay for over two months.”

They explained to me what happened.  Since “FW” paid for the retest out of her own pocket the testing facility never contacted Mabuhay.  However, Mabuhay’s HR should have asked her for the examination results that they ordered her to retake.  Mabuhay claims they asked her several times for the info and that she never volunteered the results with Tetrault even bizarrely suggesting that she wasn’t fired for the positive TB test but for not reporting this earlier (she was fired immediately after we found out she was positive). Was I supposed to believe tht they were asking for confirmation of an inconclusive TB test while permitting her to work regardless?

Trading e-mails with Tetrault was maddening as he insisted that HR did nothing wrong.  Questions asked were answered with outlandish one sentence responses such as “Thank for your comments Marc…” and further elaboration requests were met with “I hear you.”

When I pressed further, he handed the entire matter over to TR, stating in so many words that he had other more important matters to deal with. Tuberculosis was important when around his daughter, but not his expendable workers.

When I told TR that I should have remained in China because the present company was inept Tetrault came back into the conversation, CCing a consultant in the States, LS, while talking about me in the third person saying that they will pull my work visa and that I would have to leave the country “immediately” (another lie as I could have gone to immigration and gone on a 1-6 month tourist visa was is freely available).  I sent an email directly to Tetrault and I detailed exactly how his HR head had left his company liable.  That gentled him up some as he gave a disingenuous apology for what I had been through.  But I could any concern he had was for his companies liability.

Since Tetrault didn’t have the balls to pull the work visa on a guy who displayed zero compunction about turning his company into a smoldering ash heap he suggested that I contact the consultant, LS, to discuss matters.  I had no idea who LS was so I decided to just send him an email completely detailing what had happened and why HR screwed up.  Truth be told I did this just to create a papertrail as I figured no one gave a shit.

LS certainly didn’t give a shit.  He was not at all concerned about my “Ignorant” (I believe that was the word) beliefs about TB, he was more concerned with “growth” and if I was the right “Doctor/Entrepreneur” for the office.

A couple of days later the HR emailed me to tell me that they are very upset that FW never volunteered the information and that everything should now be OK since no one tested positive for TB over a month earlier. Seriously.

It’s official these people were lunatics.

I decided that moment that I would stick around till at least the new year as if anyone had tested positive for TB it wouldn’t show up for several months.

I personally wasn’t too concerned for my safety, LS was correct, Tuberculosis doesn’t transmit easily, but the girls in the office were always eating in the cramped kitchen area, sometimes in the traditional Filipino way of sharing rice from a communal bowl with their hand. (The Indonesia’s use their non dominate fork hand to push rice into the spoon into their dominant hand while the Chinese use chopsticks for rice.  To each his own.). I was more concerned for their safety and I told them I would take care of any testing that might eventually come up.  

The little blow up with Tetrault had him leave me alone for the most part although I heard that he was offering several docs in Manila the Cebu job stating that I needed “supervision”.

My opinion of Tetrault was fully formed by mid-September 2017. I will leave official diagnosis to those who understand people who check all the boxes in the DSM-Vs personality disorder categories, but I could tell that he would bully and manipulate yet run away when challenged. He would have underlings deal with things deeming himself “too busy” to handle it. Some of the other docs would privately message me telling me similar stories of difficulty dealing with him and my advice to “push back” a little bit was generally not taken.

Around this time, I was also hearing more and more from Chiropractors in Singapore, Vietnam, Malaysia who had similar problems with Tetrault and how he had almost caused the downfall of chiropractic in Vietnam.  While some of his clinics in Manila did well, his Hanoi clinic is dwarfed by the Patient rates at ACC’s Hanoi clinics, which he has tried to emulate, failing spectacularly.

Another thing that struck me that, unlike Matt Kan in CF Singapore, Tetrault doesn’t have a central defining Chiropractic philosophy. While I have heard he is a competent clinician before his growth and expansion wet dreams in Manila he was a 10-visit package see you every couple of weeks guy. Very different from the man who told me to, in the absence of X-Rays to find “Other” indicators to prescribe 30-40 visits.  

 In America I had a friend who was recruited (head hunted) to work in a Federally Qualified Health Center (FQHC (I encourage you to click on the link and read more by Tetrault, working as an independent contractor in these FQHC’s.  FQHC’s are for disadvantaged, homeless and migrant people and come under very strict Medicare/Medicare guidelines and they pay big federal grant money (For a Chiropractic adjustment my friend was paid $24 of a total of $130-$140 of the total compensation). When he wasn’t a package guy in Manila, an 3rdparty insurance guy in California and a (Failed) Multidisciplinary clinic guy in Hanoi he was talking about starting scoliosis clinics in the Middle East.

Thanks, Mercedes 80’s Guy

Being in Cebu I luckily didn’t have much interaction with Tetrault apart from the occasional group email he would send when “Stats” were too low. “Stats”, ostensibly referring to patient visits and packages sold, are another way of saying “income” which was a persistent thought that was always on the mind of Tetrault. “Stats don’t lie” was stated often and were kept on whether the offices have sold big packages vs little packages. He even came to hand out “report cards” at Mandatory Doctors meetings, with recommendations from Tetrault on how to improve their “stats”, a seemingly constant concern. Any explanation, even a reasonable one like seasonal holidays or acts of God, like floods, to why your “stats” were low lead to being told that you were suffering from a “Poverty mindset”, irking the doctors even more.

These conversations were made more ridiculous by the fact that without a central defining chiropractic philosophy (apart from sell big packages), the Doctors success was extremely limited by which clinic they were in.

Kamikaze (I forgot that part, I dragged him from China) was languishing in the Eastwood clinic making base salary, while when he transferred to the Glorietta doubled and even tripled his monthly income.  Same Chiropractor, same clinical style, but even splitting revenue with another Chiropractor he was doing much better.

My “stats” were usually good, so I never received personal objections yet I feel that the staff was pressured to make “large packages” a priority, as bonuses were doled out based on clinic income, ie “Stats”. 

My personal belief I acted on was this: if you wanted me to sell big packages I would if the patients needed them.  I could do a modified CBP (Chiropractic Biophysics, designed to change the abhorrent curves of the spine), complete with arthrostim that I purchased and personalized exercise plan based off of X-rays. If I thought that patients weren’t right for this particular type of care or objected to requests like getting X-Rays I held no qualms of referring them to another chiropractor in Cebu, Tetrault’s friend, who was half the price and didn’t require X-Rays.

I returned from a brief visit to the US in Early November and on through March while my personal income would average enough to net me $100K a year I resigned from Mabuhay on March 15th, the Ides of March.  My staff was saddened and shocked even though I had told them the previous month I had planned on resigning multiple times I guess they just didn’t believe me.  They asked me to stay, just as HR and Tetrault himself asked me to reconsider my decision but my decision was final.  

The decision had been final for several months and I had even discussed this decision in late 2017 with a friend who was doing well in one of the busier Manila clinics.  He was disappointed with Tetrault as well, calling him a “sociopathic conman”, but was making enough money to ignore those feelings.  Several Doctors were making far less money, the previously discussed base salary, but it was enough for some people to stick around.  To be honest those feelings amongst my colleagues make my heart ache, as I can’t imagine they would have chosen that life when they started their journey into Chiropractic.

Despite the fact that I had the qualms with Mabuhay’s management I never felt the sheer dread going in to work like had occurred in Jakarta and in Surabaya. I liked being in Cebu and I loved my life inside and outside the clinic.  I was genuinely happy and didn’t even feel the weight off my chest feelings with my departure from the Indonesia clinics. But suffice it to say I have a keen eye for when trouble is brewing, and I recognized that Mabuhay’s model was doomed to eventual failure as it was making the same mistakes, at a faster pace, then other Chiropractic chains in Asia with a similar trajectory. 

The practice slowed down through April and May as New patients were harder to come by but retention was still there with existing patients.  In mid-May, with my staff still asking me to reconsider, and Mabuahay’s Operation manager and Regional CA Belle Abrasaldo asking me to stay on I was looking to leave as soon as possible as there were other opportunities of interest.  However, I had promised Mabuhay that I would say until June 30ththe latest.

And then on Saturday May 19thall hell broke loose.  I emailed Mabuhay’s operation manager asking to take off from the PITAHC general assembly in Manila and she forwarded the request to Tetrault. Tetrault denied the request and while trading e-mails back and forth displayed the effortless arrogance that angered the doctors who never spoke up.

I spoke up.

Again, Tetrault lost his voice and gave the task of answering me to his HR underling who, for a reason I will never understand, decided to copy all the doctors into the e-mail giving me an audience I would never had.  I used the opportunity to rip open a can of worms that could have remained safety shut.

With my re-resignation being bumped up a month to the following week, Thursday May 31st, a resignation gladly accepted by Mabuhay’s angered administration, I couldn’t help but have a sense of pride and satisfaction that I do when I unleash Ragnarök when required.

The last week was met with the girls expressing sadness that I was leaving and getting me a going away cake ( I yelled at them for the cake) and card saying that they will miss me ( I still keep the card), thanking me for the snacks and treats I always bought and even the incessant teasing that I exposed them to. My only regret was not saying goodbye to the patients, I knew that I was in for a war with Mabuhay and didn’t want there to be any accusation that I was trying to “sink” the practice, even in my last two days an existing patient and a referral new patient bought 36 visit+ packages, something that I felt guilty about.

In through the outdoor I exited Mabuhay and was planning on enjoying my week long vacation in Cebu before Heading to Manila for the PITAHC GA.  The girl’s lives got worse, Tetrault himself came down to run the practice, and the girls messaged me to say how much they hated working with him.  I teased them that if they had been nicer to me maybe I would have stayed and that this was their punishment.

The PITAHC GA was in Manila on June 7thand several Mabuhay Chiropractors, no doubt expecting fireworks between Tetrault and I, came up to me to thank me for “Saying what needed to be said.” There were no obvious fireworks between Tetrault and I, as he largely sat down and said nothing during the meeting. As one friend working for Mabuhay remarked he looked very uncomfortable and out of place, different from the image he tries to project as a leader and diplomat within the profession.  He was no doubt made more awkward when they came into the assembly room to announce that there was a car blocking a driveway that was prohibiting a doctor from leaving the site to respond to a medical situation.  After a few silent seconds Tetrault sheepishly rose from his chair as it was his car illegally blocking the doctors exit.  A few chuckles amongst the audience will never satiate the anger at myself for not uttering the words that came to me a few seconds too late: “Somebody tow the shitbox.”

We then had a presentation by a Filipino national that was Educated at Palmer College of Chiropractic West.  This individual serves on the Board of directors of PITAHC, the NCCC the Philippines National credentialing committee, and serves as president of the Association of Professional Chiropractors of the Philippines.  His presentation was a Bombshell.

He talked about Chiropractic in the region highlighting the Indonesia story and filling in some background details even I wasn’t familiar with.  He moved on to the problems that were faced in Vietnam (Guess who started those problems) and finished explaining the PITAHC laws.  What he said was nothing short of a bombshell:

Practicing Chiropractic in the Philippines without PITAHC registration, as per Republic act No. 8424, means you are not covered under The Traditional and Alternative Health Care Act Of 1997 (TAMA), but fall under R.A. 2382 the medical act of 1959.

Put simply if you are diagnosing and treating people (which is the practice of chiropractic per TAMA) in the Philippines WITHOUT PITAHC registration the health department can interpret that as PRACTICING MEDICINE WITHOUT A LICENSE. The APCP Website says that this is punishable by imprisonment. 

“OH Shit!” – Marc Tafuro, verbally, outside voice PITAHC General Assembly June 7th, 2019 Anno Domini

I shot dagger eyes over at Mabuhays CEO, slumped in his chair peck typing on his phone, looking uncomfortable as ever.

Tetraults position, found online, is more bold than his body language, claiming:

“In the Philippines, there are outdated laws that limit the practice by professionals to Filipino citizens. These same laws permit licensing by reciprocity and there are hundreds of Filipino citizens who are licensed and who practice in the United States. The Chiropractic profession currently is not regulated by the Professional Regulatory Commission (P.R.C.) so foreigners with appropriate residency status with rights to engage in employment and business, and who are qualified and experienced in Chiropractic, are operating their private practices under general civil laws meeting the same requirements of any commercial entity. In addition they undergo Certification by the NCCC to assure the public of their professional training.”

I’ll provide the translation:  As long as you have a work permit and have (or are getting) a residency visa, and seeing as the PRC doesn’t regulate you, you can practice. Besides Hundreds of Filipino citizens who are licensed practice in the United States.

This paragraph intentionally leaves out the most important entity, which is required for a Filipino to practice in the United States, the same as Americans in the Philippines, (and Americans in America), you need licensing from the DEPARTMENT OF HEALTH, in the Case of the Philippines DOH-PITAHC.

Can a Filipino walk into America, even with a medical degree from an accredited US based Medical school and start practicing without permission from the State department of Health?

Can I, a licensed Chiropractor in good standing in the State of California, walk into neighboring Oregon, Nevada or Arizona (Or Mexico to make the comparison more realistic) and start practicing Chiropractic?

Does the question need to be asked?

While Government and bureaucracy can be a contradictory morass of legalese open to interpretation the one thing you can never do is set up shop without getting permission.  In America you can’t even open up a lemonade stand, let alone practice a medical trade as a foreign national without proper credentialing. What level of tin pot dictatorship is the Philippines that you would assume you could practice Chiropractic with only a DOLE Card and an SWP/AEP?

I’ve described the process before and it remains the same.

Here is the only catch in all this: PITAHC, like the California state board, can never arrest me, they can only revoke my license. In California if I was losing my license for something illegal, that would be referred to the local or state authorities.  In the Case of the Philippines the DOH can make the arrest themselves.

Within the next year legislation supported by the majority is empowering PITAHC to investigate, prosecute and IMPRISON violators of its law.

At the GA we were told to self-police. I’ve chosen that path, remaining certified and in good standing, while communicating these truths to other Chiropractors.  Others have chosen to flout these laws, waiting till the last possible moment, while bragging that their lawyers have found non-existent loopholes.

Immediately after the GA I headed to Bangkok on a few days holiday in what would turn into a several month semi-retirement (I wish) in which I toured parts of Thailand, China, Malaysia, and the Philippines.  

On the Morning of August 18th, while sitting in The Sportsman Bar in Bangkok Thailand, I sent Mabuhay’s Doctors an e-mail documenting what had been discussed at the PITAHC GA.

“You’re Really Proud of yourself aren’t you.” Carolina Mark asked me as I hit send with a smile on my face.

The date wasn’t unintentional.  I sent the e-mail the morning of Mabuhays own general assembly where Tetrault can talk about the state of the company.  It was reported to me that the certified docs got a kick out of the emails while the uncertified were scared shitless.

Video’s and pictures were sent to me of Tetrault at the GA looking as awkward as we wondered “Did he know about the email?”. Some Mabuhay docs claim he was inadvertenly “defending” some of the charges in the e-mail by subconsciously using the e-mails terminology.

A couple of days later Tetrault addressed my email, exactly as predicted, referring to me as “disturbed” with a “perverted mind”, claiming I must have snapped after seeing all the happy people on social media at The GA (Apparently utilizing time travel technology).  Since ad hominem attacks against me didn’t make my unresolved questions go away, he handed off, again, the task of answering the docs questions about their legal status.

HR goes from ad hominin to slander which I’ve detailed before. But the damage was mostly done they can slander and scream and cry to the approaching hurricane.  Like all chains, which lose the personal touch which makes individual chiropractic offices a success, Mabuhay’s days will be numbered, either through Government sanction or the influx of competition. Usually that competition comes from within as chiropractors in these chains realize that they themselves, and a good location, are what are responsible for their success, not the brand itself.  

This isn’t Starbucks.

And while coffee can be commoditized, Chiropractic cannot.

Well that’s not true. It can be commoditized, and it is, which is to say that it is becoming indistinguishable amongst ourselves and other health care fields.  

As a post script there have been some changes since August 18th.  I have helped several of my former coworkers bring Department of Labor claims against Mabuhay.  I have written letters to the APCP, along with other former Mabuhay Chiropractors and Patients which have initiated investigations with the DOH-PITAHC. I can’t speak to anyone else but I know the documentary evidence I turned over can be used by various Government agencies who’s regulations may have been violated.  These things take time, but as Martin Luther King Jr. once said:

“Let us realize the arc of the moral universe is long, but it bends toward justice.”

I still communicate with several of the Doctors and former staff of Mabuhay, although the numbers dwindle as there is high turnover.  Gossip still flies to and fro as it tends to do in the Philippines, as do the memes depicting caricatures of Mabuhay admin.

SM Suicides clinic is sparsely populated, as several former patients and staff have told me.  In the one year after my resignation Tetrault and three other Chiropractors have failed to bring its numbers up. A Chiropractic collegue, who does rotational work through Cebu for a fraction of the cost, stated that he heard nothing but good things about me from my former patients.  Its always going to be value, demographics and the doctor patient relationship. Not the brand, not “the system” not the words of a guru.

As for me I never wanted to be an activist.  I left America almost 6 years ago for a simpler existence involving avoiding, amongst other things, legal taxes, car ownership and responsibility.  But Life has a funny way of hitting you.

The bouncing around between different countries and cultures made me realize how much one could give, even as a Chiropractor whose existence is usually chained to a particular office close to their home.  Seeing my colleagues at Mabuhay, even the ones in the “Good Clinics”, begrudgingly “content” with doing nothing except scouring the want ads for a “better job”, made me realize how I, myself am not one to talk. I had, if you will permit me to say, a “Poverty Mindset”, in deciding to high tail it to Asia, hoping to recreate on a more economic scale, my existence in California.

Some of my colleagues have left Mabuhay, many either seeking employment with established clinics or starting their own clinics. Some have remained, stating it isn’t “the right time” to leave.  I can only assume “the right time” can be described as “The last possible second.”

I didn’t leave at the right time, I left on my terms and that’s a freedom better than a salary.

Perhaps the Chiropractic colleges should make as a condition of acceptance the signing of a pledge that you will live your life with notions of independence, wonder and entrepreneurship as opposed to the constitution of a county clerk.  That would help with the profession, avoiding the fodder for these Chains.

I am currently consulting with a US based entity who is contracted with Team China’s sports medicine team for their National and Olympic teams. It has allowed me a greater freedom as I have traveled much this past few months communicating with different chiropractors in the region and deciding where to take the profession.  Hopefully it changes for the better.

Regardless this will be my most exciting chapter to “write” about because it is yet to be experienced…

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