The Wheels Fall Off at Every Stage: Lessons From Scaling to 24 Practices Featuring Dr. Corey Malnikof, EP 283
What does it actually take to go from one practice to 24? In this episode of The Thriving Practice Podcast, Tracy Cherpeski talks with Corey Malnikof, founder of Palmer Care Group, about the real story behind growing a multi-location healthcare practice — including the month he nearly lost everything before finding the systems that changed his trajectory.
For practice owners considering a second location, Corey offers a refreshingly clear-eyed test: is your first practice profitable enough to cover an entire year of expenses for the next one? His answer pushes back on the common path many practice owners take — from one location to two to three to none — and gets at the heart of sustainable practice growth.
Whether you're weighing your first expansion or you're already managing multiple locations and feeling the strain, this conversation offers grounded, tested guidance on systems, delegation, and building a team you can trust to run things without you standing over their shoulder.
Key Takeaways
Test your first practice before you expand. Your first practice needs to be able to cover a second location's expenses for a full year before you open it.
Growth isn't linear. Corey describes distinct stages of growth where "the wheels fall off," each requiring new infrastructure before the next stage becomes possible.
Document everything, even imperfectly. A rough three-ring binder of procedures beats no documentation at all — you can refine it as you go.
Delegation is a skill you build in stages. Letting go of control — especially hiring — was the hardest part of scaling for Corey, but necessary to grow beyond what one person can do.
Coaching provides focus. Outside coaching and mentorship were constants throughout Corey's growth, helping him focus on the few priorities that actually move the business forward.
Q&A
How do I know if I'm ready to open a second practice location?
Corey's test is financial: your first practice needs to be strong enough to cover all of a second location's expenses for an entire year. If it can't, he doesn't recommend opening a second location yet, because too many things can go wrong in the early months — from staffing gaps to software hiccups — and a thin first practice can't absorb the hit.
Why do so many practice owners fail after opening additional locations?
Corey points out that the common path is one practice to two to three to none. Owners often expand while "free flowing" — riding early success without a strong financial cushion or documented systems — and end up pulling resources from the first practice to prop up the second, weakening both.
What should I document before I try to scale?
Every process in the practice, written down somewhere — even imperfectly. Corey suggests starting with a simple list of everything that needs a procedure, then writing rough notes for each one in a three-ring binder or with the help of an AI tool. The goal isn't polish at first; it's getting it out of your head and onto paper.
How do I know when to start letting go of control in my practice?
Corey watches for repetition: if he's doing the same task on a daily basis, that's his signal to replace himself in that role. He's clear that you should learn how to do everything in your practice first — but once you know it, holding on too tightly becomes the ceiling on growth, not the safeguard for it.
Episode Highlights
Corey's rough first 30 days in business and how he rebuilt from nearly nothing
Modeling his early systems after Nordstrom, Amazon, Ritz-Carlton, and Starbucks
The stages of growth where "the wheels fall off" and what changes at each one
Building a C-suite — hiring a COO, CFO, and HR support to scale past ten clinics
Why Palmer Care Group intentionally paused expansion at 24 locations
The hardest responsibility Corey has ever had to hand off as a founder
How Corey uses AI tools to support recruiting, training, and daily decisions
His advice for practice owners who feel maxed out but still want to grow
Memorable Quotes
"Your first practice has to be so good, so awesome that it could financially cover your second practice, all of its expenses, for an entire year." — Corey Malnikof
"We gotta subtract before we multiply." — Tracy Cherpeski
"When you decide to hand something off... watch the process. And when it doesn't go right — which it won't — you just correct it." — Corey Malnikof
"It's very hard to see from an outside in as yourself." — Corey Malnikof
"I truly believe my entire career has just been that I've been with the right coaches, consultants and people... They built me." — Corey Malnikof
Corey Malnikof's journey from nearly nothing in the bank to 24 practice locations shows what's possible when practice owners commit to systems, mentorship, and the discipline to pause before scaling further. If you're weighing whether you're ready for a second location — or a fifth — his test is worth sitting with: can your current practice carry the next one for a year? If this episode gave you something to think about, share it with a colleague who's considering growth, and explore thrivingpracticecommunity.com for more resources to help you build a practice that truly thrives.
Guest Bio:
Dr. Corey Malnikof is the CEO of Palmercare Group, a healthcare organization operating 24 chiropractic clinics across the United States. He is an entrepreneur, speaker, and leader known for building high- performing teams, scalable systems, and world-class patient experiences.
Corey’s work goes beyond chiropractic—he helps business owners and leaders understand that real growth comes from who you are, not just what you do. Through his leadership, speaking, and content, he teaches how identity, culture, and intentional systems drive sustainable success.
Corey is the author of “The 4 Dollar Sandwich” and has been featured on major stages and platforms, including appearances with Brian Tracy and speaking engagements for Parker University, Life University, the FBI, Keller Williams, and the American Chiropractic Association.
Find Corey:
Websites: CoreyMalnikof.com, PalmerCareGroup.com
Instagram: @coreymalnikof, @PalmerCareGroup
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