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Welcome everyone to the chiropractic deep dive. Yeah. This is where we really break down strategies for practice growth, and this deep dive is part of The Successful Chio podcast. It’s brought to you by Five Star Management. That’s as a chiropractic consulting company, totally focused on well helping practices scale up.
So today our mission is pretty straightforward. We wanna give you a shortcut, really. We’re unpacking a fantastic session. Dr. Noel Lloyd led recently. He basically laid out a blueprint for sustainable growth and we’re zooming in on the key tool. He discussed the capacity quiz. 5.0, you’ll hear it called the CAP quiz.
Mm-hmm. Our goal is to pull out the, uh, the core problem that keeps so many practices feeling stuck, and crucially the solutions this quiz offers, which, you know, can be surprisingly simple sometimes they really can. So let’s jump right into that core problem because it’s, uh, it’s almost universal for chiros trying to grow.
It’s the practice set point. The practice set point. Okay. Define that for us. What is it really? It’s the big roadblock. It’s where practices just plateau. They get stuck below the level the doctor wants, and honestly, below what they often know is possible. Right. You see your colleague down the street maybe using the same techniques.
Exactly. And they’re seeing, say, 300 visits a week and you’re stuck grinding it out at 50 . You start asking why, what’s the difference and what does that feel like when you’re stuck at that set point? It’s not just slow growth, is it? Oh, no, it’s more than that. It’s often exhaustion. It’s that feeling where you push really hard.
Maybe you hit 160, maybe even 170 visits for a couple of weeks. You think, yes, we broke through and then bam. Something gives, the staff gets frazzled. You feel drained, appointments get missed, and the volume just slides right back down to where it was before. That’s the set point, pulling you back. It’s the maximum sustainable volume,
your current systems, your energy, your whole infrastructure can handle without breaking. We see it all the time in the data, right? A practice pushes past maybe 245. Yep. Classic example, pushes to 245, feels amazing for a hot second, then slides back down and settles around 220. And that 220 becomes this kind of magnetic ceiling.
It really does. It’s defined by these hidden capacity bottlenecks, things you often can’t even see when you’re in the thick of it. Which brings us to the CAP quiz. Mm-hmm. Because the whole point of it, the philosophy behind it. Is to find those hidden roadblocks, find them and remove them so your practice can just sail right through those old maximums, those old set points, and establish new higher baselines that are actually sustainable, not just a flash in the pan.
Okay. So the core idea is, yeah, your practice isn’t failing overall. No, never. It’s always hovering just below one, maybe two specific identifiable capacity problems like crucially. Solvable problem. That’s the key. They are solvable. You fix that specific bottleneck, and growth is almost the natural consequence.
Now, how does that play out? Because often doctors try to fix everything at once or they focus on the wrong thing, right? They might be trying to solve like problem Z when the real issue is problem A. The quiz helps clarify the sequence. Okay. Give us an example. Sure. Let’s say a practice takes the quiz and the biggest bottleneck identified is retention.
That’s issue number seven, I think. So patients are falling off the truck as they say, not finishing care plans. Exactly. They start care, feel a bit better, and then they’re gone before correction or strengthening. Practice growth is stunted. Okay, so the team focuses, implement strategies and solves that retention issue.
What happens next? Well, volume goes up immediately because patients are staying longer. But now because you’re actually seeing more people each shift, uh, a new problem emerges precisely. Maybe now, treatment time issue number three shows up as the next bottleneck because what worked fine at lower volume doesn’t scale.
Like inconsistent treatment times. Spot on. Maybe the doc took three minutes with one patient, 10 with the next. It wasn’t a big deal at 150 visits week, but add 50 more visits. Now it’s causing backups and stress, so you solve treatment time, maybe standardizing it, making it more efficient, and then maybe scheduling becomes the next hurdle.
The practice grows again. It’s this continuous cycle. Solve the issue, help more people have more fun, honestly, because things run smoother and yeah, make more money. It’s a positive feedback loop. Totally. And Dr. Lloyd and his team, they’ve boiled down decades of experience into these 12 core capacity areas on the quiz.
Okay. 12 areas. Instead of just listing them one by one, maybe we can group them, make it easier to grasp. Good idea. Yeah. You can really think of them falling into maybe three main buckets. What are they? Uh, clinical flow and infrastructure, then maybe doctor commitment and beliefs, and finally,
financials and patient acquisition. Okay, let’s start with clinical flow and infrastructure. The real nuts and bolts stuff, right? This is all about moving patients efficiently, so it includes staff productivity. Can your cas actually keep up with charting, patient flow, therapies? Yeah. What else? Clinic layout.
Is your physical space designed for smooth flow at your maximum desired volume, or is it a constant traffic jam? Makes sense. Layout matters hugely. Then treatment time, like we mentioned, needs to be short, repeatable, consistent. Not erratic. Got it. Scheduling. Can the front desk and the doctor easily control the appointment Book?
Think Block Scheduling. Efficient follow ups. Right? Proactive scheduling. And lastly, in this bucket, therapy and adjunctive services, are they easy to deliver or are they Time sucks causing backups in the flow. Okay, so if that clinical flow piece is clunky, your set point is gonna be low guaranteed. Bucket number two is doctor commitment and beliefs.
This is the internal stuff. The doctor’s own capacity in a way. Exactly, and it’s huge, often overlooked. It covers commitment, energy, like do you really have the physical stamina and just as importantly, the emotional fuel in the tank to handle more? Mm, the emotional tank. That’s big. It is. Then there’s Headspace beliefs.
Is your belief in yourself, in your chiropractic philosophy strong enough? Or do doubts creep in when things get busy? Doubts about deserving success or handling the volumes? All of that. And finally, management ability. Do you actually enjoy leading your team or are you secretly hoping they’ll just manage themselves, which never works long term.
You really can’t outgrow your own beliefs or energy levels. You nailed it. Okay, third bucket. Financial and acquisition capacity, right? Because you can have perfect flow and tons of energy, but if you don’t have patients coming in or staying, you’re stuck. So this covers new patients. Pretty obvious. Can you consistently generate the new patients you need?
The faucet needs to be on. Yep. Retention, which we talked about, keeping patients through all phases of care, ideally into wellness. Crucial for stability. Financial policies, can people actually afford your care? Are your prices fair? Does the system work smoothly for patients and the practice? No friction there.
And the last one, new patient processing. How smooth and stress-free is that initial experience? Can you get new patients processed quickly without bogging down the whole system? Okay. Those are the 12 areas grouped nicely. What’s interesting too is how sometimes people see the same problem differently, right?
Oh, totally. The example Dr. Lloyd gives is treatment time versus scheduling. The staff might point to treatment time being too long or inconsistent while the doctor complains about scheduling being a nightmare. Exactly. But they’re often two sides of the same coin. A bottleneck in patient flow. The quiz helps bring those different perspectives together, which leads perfectly into implementation.
Right, because this isn’t something the owner just does alone. Absolutely not. That’s like the biggest mistake you could make. We got some great insights on this from an office integrator that key person who runs the systems. Okay, so how do they do it? What’s the process? It’s a team effort. Done quarterly.
Usually the whole team, maybe 11, 15 people. Everyone gets involved, everyone front desk, cas, other docs? Everyone. The quiz gets handed out maybe at the weekly meeting. They get about a week to think about it and fill it out. And what’s the key instruction they’re given? Because it can’t just be a gripe session.
No way. The non-negotiable rule is never bring a problem without suggesting a solution. Ah, okay. So they list their top three capacity issues they see, and they have to propose concrete, actionable ideas for how to fix each one. That shifts the whole dynamic, doesn’t it? From complaining to contributing.
Fundamentally, they become stakeholders in the practice’s growth, not just critics. So why is getting that team input so vital? Doesn’t the owner usually know what the problems are? You’d think so, but honestly, the owner often has the biggest blind spots. They’re too close to it, especially new team members.
Right. They see things with fresh eyes. Exactly. They haven’t just accepted the way things are as normal yet. They aren’t conditioned to the current limitations. There was that great example. Yeah. Fantastic story. The doctor was absolutely adamant, like, we do not need to expand the clinic space.
Convinced the layout was fine, but the team, the team consistently quarter after quarter on their CAP quizzes kept saying, we need more space. The layout is the bottleneck. That’s why we can’t get past 300 visits. The leadership listened. They did. They trusted the process, trusted the integrator, compiling the feedback.
They added the extra room the team suggested, and the result within two months, the practice blew past its old set point and was soaring over 500 visits a week sustainably. Wow. That perfectly shows how the owner might not see the very limits they’ve perhaps unconsciously created. Right. The quiz helps externalize the problem and leverages the collective intelligence of the team.
But the integrator mentioned something critical for this to work long term culture. They called it diplomatic immunity. Yes. So important. You have to create a culture where team members feel genuinely safe to speak up. They need to know their honest feedback, even if it’s critical of current systems or leadership decisions won’t somehow come back to bite them.
Exactly. No negative repercussions and performance reviews, no passive aggressive comments later. Trust is everything and that trust gets shattered instantly. If leadership asks for feedback and then ignores it. Oh, absolutely. Follow up is non-negotiable. The integrator or whoever leads this needs to compile the results.
Figure out the top themes, triage the issue, right? And then present it back to the team. Here’s what you said. Here are the top three issues we’re gonna tackle this quarter. And what if the top issue is something huge, like needing clinic expansion? That can’t be fixed immediately. You still address it head on.
Leadership has to say, okay, we hear you on the clinic layout. That’s big project. Here’s why we can’t start construction tomorrow. But here’s the plan and the timeline for addressing it. You have to acknowledge it and explain the why behind any delay if you don’t. If you just ignore their biggest collective concern after asking for it, forget about it next quarter.
The effort they put into that quiz will be zero. You’ve completely killed engagement. Done. Finished. Why would they bother sharing insights if they think it goes into a black hole? Makes total sense. So moving to the big takeaways, what have the biggest realization people had from learning about this process?
Overwhelmingly it was that phrase. I don’t know what I don’t know. Ah. The quiz expands their whole concept of what capacity even means. Totally. It shifts their frame of reference. A doctor might genuinely believe they’re efficient thinking. My report of findings only takes 25 minutes. That’s pretty good.
Which might feel fast compared to an hour, maybe. But then the quiz data reflecting best practices from high capacity clinics shows that a truly efficient systematized ROF can be done effectively in say, eight to 10 minutes. Wow. That’s a huge difference. Massive. That extra 15 minutes per new patient, multiply by how many new patients you see a month.
That’s a colossal capacity roadblock you didn’t even realize was there. Okay, so the quiz reveals these hidden time sinks or system inefficiencies. Let’s talk practical solutions. Scheduling came up as a common one. Yeah. What was the actionable strategy discussed? Yeah. Scheduling is a frequent flyer on these quizzes.
The immediate, practical fix talked about was schedule sculpting. Schedule sculpting. Okay. What is that? It’s a perfect example of using team input to fix a flow problem. It means the front desk isn’t just passively taking appointments, they’re actively managing the schedule every day. Proactively shaping it.
Exactly. They review the schedule. Look for potential crunch times or friction points and they strategically move appointments around where possible. So instead of just letting the schedule happen to the practice, the practice takes control of the schedule. Mm-hmm. For example, they might see Mrs. Jones, who’s retired, always books her adjustment right in the middle of the crazy after school rush, right?
When things are most hectic. So the ca proactively calls Mrs. Jones and says, Hey. We notice you often come at our busiest time. Would a nine point am slot maybe work better for you? It’s much calmer then. Oh, interesting. Or maybe calling someone who consistently misses an 11:00 am appointment. Perfect example.
Smith, we see 11:40 AM Seems tricky for you. Often would 11:30 AM be a more reliable time? You’re gently training patients to fit the optimal flow, which smooths out those peaks and valleys that contribute to hitting that setpoint ceiling. Precisely. It alleviates those pressure points, and it comes from empowering the front desk based on the feedback to actively manage the flow.
So the real power here isn’t just the quiz itself, it’s the whole process. Absolutely. It’s recognizing your team holds valuable insights. It’s putting the whole team on the problem, not just the doc. And the result is: better engagement, less stress, and ultimately dramatically increased. And more importantly, sustainable practice volume, smashing through those old set points.
That really is the key takeaway. Using this capacity quiz process consistently, maybe quarterly, listening to your team acting on their solutions, that’s how you break free. It truly is the path to less stress and more success. So if this deep dive has hit home for you. If you’re feeling stuck at a certain level and you’re ready to figure out what specific bottleneck is holding you back, we really want you to take the next step.
Stop guessing, start diagnosing. Yeah. We strongly encourage you to book a free absolutely no obligation call with Dr. George Birnbach. He can personally help you start diagnosing where your practice’s set point really is and what first steps you can take. The link to book that free call
it’s right there in the show notes, easy to find. And hey, if you wanna really immerse yourself in these kinds of growth strategies live and in person, you should definitely join us in Orlando, Florida, November 15th and 16th. We’ve got a huge two day event happening actually. Two powerful events running side by side.
Yeah. First is New Patient Edge laser focused on how to get more quality new patients fast. And the second is our Win-Win Associates event. That’s all about implementing our proven system for associate doctors leading to more growth, more freedom for you, and way more success overall. Whether you need more patience or you’re thinking about leverage through associates.
We’ve got you covered in Orlando. All the details for both events plus the registration link for Orlando are also right there in the show notes. Check it out. It’s gonna be incredible. And finally, don’t miss out on future deep dives like this one packed with tips to save you time, money, and stress. Make sure you subscribe to the deep dive wherever you get your podcasts.
Thanks so much for tuning in. Thank you for listening.
