An American Success Story in Mexico
[Editor’s Note: The following post is by TDV legal correspondent, Jim Karger]
Forward: Puerto Vallarta, Mexico – This is an interview I completed December 2, 2012 with Jim Bourque Starr, chiropractor extraordinaire, whom I met several years ago when he was practicing in San Miguel de Allende, Mexico. I was experiencing severe dizziness that was affecting my quality of life. I had been to a myriad of medical doctors and had a plethora of tests, all to no avail. Jim suggested he might be able to help. And he did. Within a few weeks, all dizziness was gone. I owe him, and it was my pleasure to interview him in his new environs, Puerto Vallarta, Mexico. This is one of several interviews I will complete with successful expats in Mexico (although all future interviews will be solely in the TDV newsletter – click here to subscribe), with a view to empower those who are reticent to make the leap into a new world and learn how to make a living abroad from people who have done it.
Q: Jim, when did you first come to Mexico to live, and more importantly, why?
A: In 2004, I moved from San Jose, California, to Mexico City. I was in the States and met a woman from Mexico City. We married and moved to Mexico City. I started a chiropractic clinic there. It was surprisingly easy, because I didn’t have to jump through any hoops. I just set up shop.
Q: How did you communicate with the Mexicans who became your patients?
A: It helped that I was bilingual.
Q: Bilingual coming from the US?
A: In San Jose, California, many of my customers were migrant farm workers and over the years I became fluent in Spanish.
Q: Was it tough leaving your practice in the US?
A: Not at all. The State of California made it easier for me. I was not happy with the way migrant farm workers were being treated and often testified on their behalf in disability proceedings. The insurance companies and the medical lobby despised me. I had five clinics and they decided to come after me and did so by using the government of the State of California as their weapon.
They decided to make an example out of me and came in to my clinics with a warrant one day, seized everything I had, brought the media with them, and took out everything I had in five U-haul trucks. They held me and my 40 employees prisoner until they were done stripping my practice. The specious claim they concocted was that my x-rays were not of “diagnostic quality” and by sending them through the mail to insurance companies I was committing fraud. It was nonsense, but the State had unlimited assets with which to fight. I hired lawyers and fought it for six months. When they found they had no case, they came to me and said, “We can’t leave with nothing. We have spent too much money.” So they offered to settle for a fraction of what they originally wanted.
The X-rays were the legal excuse, but they could prove nothing there, so they settled by finding a technical infraction of the business code for failure to have a sign posted in my waiting room that said I was the owner of a medical rehabilitation center next to my chiropractic clinic. It was a joke but they had to find something. No fraud anywhere, none of the allegations that they thought they would find true ever came to the surface and were defeated. My lawyers said I could win it all, but I would have to spend everything I owned and more to do it. So, I settled in order to get on with my life, but my practice was ruined.
Q: How tough was it starting a new practice in Mexico?
A: For me, it was easy because I was so used to treating Mexican patients. This was really virgin territory. In the US there are about 150,000 chiropractors. In Mexico there are, at most, a few hundred, even today. It was a challenge because I not only had to sell myself but also the importance of chiropractic care. There have always been charlatans here who will crack your neck, but they are uneducated and many are, frankly, dangerous. I was able to educate people as a part of opening that first practice. Six weeks and I was up and running and successful. It is amazing what you can do without government standing on your chest.
Q: How long were you in Mexico City?
A: About a year, and then went back to the States to teach. It was during the months there that I decided I didn’t want to live in the US anymore. As soon as I finished my teaching obligation, I returned to Mexico City. I then opened two clinics in Mexico City. Unfortunately, I didn’t want to live in Mexico City. Too much traffic, smog, and crowding. That is when I moved to Acapulco, opened a clinic there right on the water. People came from the first day. I built a great practice there in a short period of time. Unfortunately, my wife didn’t like the heat and humidity in Acapulco, especially during the summer, and after a year-and-a-half we started looking for some place we both liked in Mexico and found San Miguel de Allende. I started my clinic there three days after I arrived and, as you know, Jim, I was fully utilized in a matter of months. From there I also opened a practice in Queretaro, a city of a million people just 45 minutes from San Miguel. Likewise, it was successful.
Q: But you are in Puerto Vallarta now, Why?
A: I was divorced last year and, unlike my ex-wife, I love the beach and decided to return. I love Puerto Vallarta – natural beauty, clean air, and there are a lot of people here who want to maintain a certain quality of life, of health. It is a popular place for Americans and Canadians to retire. (www.expatsinvallarta.com). My practice here is about 80% Mexican and 20% Americans and Canadians.
Q: How would you compare Puerto Vallarta to San Miguel de Allende?
A: San Miguel has more culture, but Vallarta has the beach. San Miguel is less expensive day-to-day, but Vallarta has its own airport close by. People are the same. I love both places. They are very different.
Q: What about government here? Any problems?
A: None, not in Vallarta, not anywhere I have practiced in Mexico. I had one jealous chiropractor in one location complain to the city government. They came out, took a look at our papers, and left. We never heard from them again. Here the people are so grateful to have this level of professional care, we have no problems at all. No one has ever threatened to sue me here. In the US, in the medical profession, that is a common occurrence and runs up the price of care. In the US right now, the average in California is $100 US a visit. Here I get $35 a visit and live better, a lot better. You can have a nice life, and you can do it without always worrying about the next shoe to drop.
Q: How do you like Puerto Vallarta?
A: I love it here. Puerto Vallarta has two natural rivers that flow from the mountains to the sea. There are jungles everywhere, natural habitats to an untold number of species. It is still very much a Mexican city, with rich and poor. A one acre lot in upscale Punta Mita, for example, costs $3 million US. On the other hand, you can find a nice studio apartment in a good section of town near the marina for $5500 pesos ($450 US dollars) a month. It is more expensive than San Miguel de Allende, but a fraction of the cost of living anywhere in the US.
I opened a clinic here (a place I hadn’t been in 25 years) and had about 200 patients in a matter of a few weeks. I recently teamed up here with the BioSpa and Chiropractic Center. We have an anesthesiologist, natural medicine doctors, and I am the chiropractor with an associate doctor. I have been implementing a patient management system and it has worked out well for both of us. Vallarta is becoming well known in the medical tourism arena and so we are seeing more Americans here having procedures that are either unavailable or extremely expensive north of the border.
Q: Would you ever go back to the US to practice?
A: Never. Not a snowball’s chance in hell. I learned up close and personal just how dangerous the government is there. They can and will take everything you own whenever they want to. You can assume the noble pose and say you will fight to the end, but that is exactly what you will do — you will fight until the end, until you are broke and broken. You are guilty until proven innocent.
[Author’s Note: That sad dynamic has not changed. See this article for more.]
I just went to a continuing medical education seminar in California and they talked no medicine, none. The entire seminar focused on compliance with the law, with regulations, on how to avoid having the State crush you. There are a lot of chiropractors there who are leaving practice not because they don’t like the practice but because they are scared. There are young chiropractors who won’t even adjust patients there because they are afraid.
Q: And how about you?
A: I am unafraid and I intend to stay that way. Mexico is still a place where you can do business without fearing the State. It is changing, especially in the immigration area, but compared to the United States this is still the Wild West. It is still fun here.
Q: Any regrets?
A: Perhaps that I didn’t make the move earlier, but I can’t really say that. All these experiences made me who I am today.
Q: Any advice to those who are thinking of coming to Mexico to start their own business?
A: Don’t let fear limit you. Follow your dream. If you stay in the States, there is going to be pain and pleasure. The pleasure is the convenience of knowing the way things work. The pain is the constant fear of government overreaching and mistreatment. Here in Mexico there will be pain and pleasure, too. The pain will be having to do things different ways, the need to learn a new language, a new culture. But the pleasure will be the freedom you can still enjoy here that was long ago eliminated in the States.
Q: Thank you, Jim.
A: Always a pleasure, Jim. Come back soon!
Jim Karger is TDV’s legal correspondent and the TDV Concierge and moderator for San Miguel de Allende, Mexico (TDV Subscriber can click here to go to his group), where he and his wife have lived for 11 years. If you are interested in knowing more or visiting San Miguel de Allende, recently rated as the #1 City in Mexico and the 8th Best City in the World by Conde Naste, contact Jim at firstname.lastname@example.org and join the San Miguel de Allende group available to TDV premium subscribers.
For more on Mexico and San Miguel de Allende, read this from The Economist.