10/22/2026
$300 Per Hour, Cash Payments, and a 7,000-Square-Foot Clinic in a Small Town!
One of the most important lessons I teach my students in business management is to build a practice where at least 50% of patients pay directly for their treatments rather than relying on insurance coverage.
Why? Because depending too heavily on insurance can limit your income and your patients' access to ongoing care. Many insurance plans provide only around $500 annually for osteopathic treatments, which may cover just three sessions. Patients with chronic pain, however, often require considerably more treatments.
I am proud to have many graduates who have built highly successful cash-based practices.
One excellent example is Fahad Sofi, a graduate of National Academy of Osteopathy (NAO), who practices in New Glasgow, Nova Scotia, a small town with a population of approximately 9,500 people!
Despite practicing in such a small community, Fahad operates an impressive 7,000-square-foot clinic and charges $300 per hour for his manual osteopathic treatments, entirely on a cash basis! He does not accept insurance for his own treatments, although other healthcare professionals working at his clinic do.
Fahad graduated from NAO in February 2026 and already completed our practical technique classes in Toronto, Canada. Yet he has returned to attend the same classes again this week at our beautiful waterfront campus in Bonita Springs, Florida. And I suspect one of his main reasons for returning is to see me! 😀
This is exactly why I love teaching business management alongside manual osteopathy!
I don't want our graduates to simply become excellent manual osteopaths. I want them to become successful entrepreneurs, build profitable clinics, achieve financial independence, and enjoy the freedom that comes with running a thriving practice.
Fahad's success demonstrates that you don't necessarily need to practice in a large city to build a successful clinic. With the right education, clinical skills, marketing, and business strategy, even a small town can offer tremendous opportunities!
We love seeing our students succeed! Their success is our success! ❤️
Dr. Shawn Pourgol, MBA, DC, DO, DN, PhD
Osteopath, Naprapath, Chiropractor & Founder of:
National Academy of Osteopathy (Canada, USA)
National University of Medical Sciences (USA, Spain, Panama)
Osteopathy Chronic Pain Clinics of Canada (380 clinics in 34 countries)
Florida Naprapathic Association
World Osteopathy Day