How to Build a Strong Chiropractic Practice Culture That Keeps Great Team Members

[00:00:00] Usually when we talk about a medical diagnosis, there’s this, um, clear expectation of precision, you know? Yeah, totally. It feels like engineering. Exactly. Like you take an X-ray and it clearly shows that jagged white line of a fracture. Yeah. And you can just point to the white box and say, “Well, there it is.

That’s the problem. Let’s fix it.” Right. It’s binary. The bone is broken or it’s not. The parameters are clean, the evidence is there, and the treatment plan just– it follows a logical sequence. Which is incredibly comforting. I mean, we like things to be neatly categorized, but the moment you step out of that treatment room and into the world of running a busy clinic, you know, managing a team- Oh, yeah.

Everything changes. Right. That X-ray machine becomes completely useless. Yeah. Suddenly, we’re looking at a diagnostic landscape that’s entirely invisible, yet it completely controls the health of your business. Which is terrifying for a lot of clinic owners. It really is. And that invisible landscape is practice culture, which is exactly what we’re unpacking today on the Chiropractic Deep Dive.

And we are [00:01:00] proudly a part of the Successful Chiro podcast. And, uh, since this deep dive is brought to you by Five Star Management, which is a premier chiropractic consulting company, we’re basically treating you like an extended part of the Five Star team today. We absolutely are. Our mission today is to figure out how to stop the hidden leaks that are quietly sinking your practice.

And we are doing that by extracting strategies from this truly powerful Zoom master class that was led by Dr. Noel Lloyd. Yeah, such a great session. It really was. The entire session focused intensely on this massive, invisible problem of practice culture. So we’re gonna break down how to create an environment where great people actually wanna stay.

You know, where they grow and thrive instead of just burning out and leaving. Right. So okay, let’s unpack this because when I visualize a clinic’s culture, I-I kind of see it as the practice’s internal immune system. Oh, I like that, the immune system. Yeah. Because when it’s strong, it fights off daily drama, minor [00:02:00] miscommunications, and like staff exhaustion effortlessly.

You don’t even notice it working. Right. It just hums along. But when it’s weak- Literally every little problem, a late patient, a jammed printer, a slightly grumpy front desk interaction, it becomes this massive infection that takes down the whole office for the day. That is so accurate. And what’s fascinating here is how Dr.

Noel Lloyd gave this abstract concept a very concrete definition on the Zoom call. Yeah. How did he define it? He defines culture as the collection of shared values, beliefs, attitudes, and behaviors. Basically, it’s the unwritten rules that dictate how things actually get done when the boss isn’t looking.

Oh, wow. When the boss isn’t looking, that’s the key right there. Exactly. It’s the living, breathing personality of your practice, and patients can literally feel the difference the second they walk through the door. They really can. But, um, before we can talk about building that thriving environment, we have to learn how to diagnose the symptoms of a weak immune system, right?

Yeah. We have to look at the disease [00:03:00] first. Right. So during the master class, Dr. Noel Lloyd and the participants laid out the exact mistakes that act as silent culture killers, and the symptoms are things we’ve all seen, like environments where absolutely no one goes the extra mile. Mm-hmm. High turnover Yeah, constantly high turnover.

There’s this constant hum of whispering in the break room, and staff performance is just– It’s entirely unpredictable. And the most destructive of those mistakes is what one participant actually called the bad apple effect. Oh, the bad apple effect. Right. Yeah. This happens when a clinic keeps a team member who simply does not belong.

And they keep them for far too long. I mean, the psychological toll of that on the rest of the team is massive. If you have, you know, a high-performing assistant who’s busting their back every day- And they’re watching this bad apple colleague show up late. Exactly. They roll their eyes at patients, face zero consequences.

That high performer’s just gonna stop trying. They realize the standard of excellence is a lie. The rot literally just spreads to the good staff. It [00:04:00] creates deep, deep resentment. And another participant highlighted how this toxicity often leaks out in the form of complaining during patient care hours.

Oh, that’s the worst. It is. Things go wrong in a clinic, right. The schedule gets backed up, the software crashes. But voicing those complaints out loud while patients are in the office, it completely fractures the professional atmosphere. Because the patient is there for healing and positivity. Mm. And instead, they’re forced to absorb the staff’s administrative stress.

Exactly. But, you know, why do clinic owners let that happen, though? Well, another participant pointed out that it almost always comes down to a fear of conflict. Ah. Yeah, that makes sense. We see a staff member snap at a patient, and instead of pulling them aside immediately, we turn a blind eye. We just hope it was a one-off bad day.

We hope it magically resolves itself. Mm-hmm. But spoiler alert, it never does. It mutates into this systemic issue where bad behavior just becomes the accepted norm. And we also have to factor in the human element here [00:05:00] too. I mean, you’re hiring individuals with vastly different life experiences. Some come from backgrounds where healthy communication simply was never modeled for them.

Right. The participant who brought up the drunk uncle analogy Yes. It– Th- that was perfectly described. They noted that a team member might come from a family where dealing with a negative, constantly complaining drunk uncle at the holidays was just the standard way people interacted. They literally do not know another way to communicate frustration.

Exactly. But- So as a clinic owner, you can’t just expect them to intrinsically know your professional standards. You have to actively educate them and firmly insist on specific behaviors under your roof. Okay, but let’s be realistic about this for a second. Here’s where it gets really interesting, but also a bit difficult.

Okay. Hit me. If I’m a busy clinic owner, and I have a waiting room overflowing with patients, I physically do not have the hours in my day to post a job listing, conduct a dozen interviews, and spend weeks training a replacement. Right. The [00:06:00] time crunch. Isn’t turning a blind eye to a bad attitude just a necessary survival tactic to keep the doors open?

I mean, it absolutely feels like survival in the moment. The prospect of operating short-staffed is terrifying. It is. But Dr. Noel Lloyd’s perspective on this is completely unambiguous. Keeping a toxic person because you are, quote, unquote, “too busy” is a fundamental failure of leadership. Wow. A failure of leadership.

Yeah. He emphasized that there are clinic owners out there who literally wake up and dread going into their own practice every single day. They hate the environment they created because they lack the courage to just rip the Band-Aid off and make a necessary change. So the short-term pain of operating short-staffed is nothing compared to the long-term agony of dreading your own business.

Exactly. Dreading the business you built with your own two hands. That is a heavy reality check. Yeah. So, okay, if tolerating bad apples and avoiding conflict destroys the immune system, what’s the antidote? How do we build an environment that naturally [00:07:00] repels that toxicity? Well, it starts by establishing a foundation that is actively inspiring and meticulously undeniably clear.

Dr. Noel Lloyd’s very first rule for culture is create a mission bigger than a paycheck. Right. Because if the only reason your staff shows up is to punch a clock, they’ll consistently give you the bare minimum required to not get fired. Exactly. You have to shift their perspective. Like taking a stack of boring insurance paperwork or, um, routine scheduling calls and linking those tedious tasks directly to a human life that was changed.

Precisely. The greatest practices don’t view themselves as just adjusting spines. They view themselves as transforming lives. And Dr. Noel Lloyd talked about the absolute necessity of sharing patient testimonies with your team regularly. That is so powerful. It is. When your front desk staff hears a first-hand story about a patient who can finally pick up their grandchild again without blinding pain, it fundamentally changes how they view their job.

They start wrapping their [00:08:00] daily routines around a much bigger calling. But, you know, inspiration is a phenomenal starting point, but without a rigid framework, that positive energy just sort of dissipates into chaos. Which brings us to Dr. Noel Lloyd’s third rule Make expectations crystal clear Yes.

Confusion creates frustration, and great cultures eliminate guessing Right. And in the master class, Dr. Noel Lloyd outlined five specific types of patient contacts that every single team member must understand on mechanical level. Okay, what are they? There’s the new patient in day one, the day two visit, the standard returning visit- Right

a re-exam, and finally, a new patient orientation class visit Let’s break down why defining those specific visits matter so much. I look at those five contacts like blocking in a Broadway play Oh, I love that analogy Right. Because if the actors on stage are just guessing where to stand based on how they feel that day, they’re gonna bump into each other.

Yeah They’ll talk over one another, and the audience is gonna feel that awkward [00:09:00] tension Yeah, it looks messy But if the choreography is locked in, it looks like magic to the audience. For a clinic, day one is all about making a scared, in-pain patient feel heard. Day two is often the report of findings where clinical and financial commitments happen, so the stakes are completely different The mechanics of those visits dictate the patient’s trust.

I mean, if the front desk treats a nervous day one patient with the same rushed, casual attitude as a returning patient who’s been coming for three years That new patient feels totally alienated Exactly. By giving your staff a crystal clear script and specific expectations for each of those five scenarios, you dramatically reduce the staff’s anxiety.

They aren’t guessing what to do Right If we connect this to the bigger picture, when the mission is inspiring and the daily steps to execute that mission are meticulously defined, accountability becomes organic rather than forced Okay. But moving from theory to, like, a random exhausting Tuesday afternoon reality- Yeah

having a [00:10:00] mission in an employee handbook doesn’t automatically fix a tired team Right. It takes work So how does a clinic owner actively enforce this positive culture on a daily basis? Let’s dive into the tactical hacks they discussed on the Zoom. This is where the rubber meets the road. Dr. Noel Lloyd’s fourth rule is incredibly practical, yet highly uncommon: catch people doing the right thing.

Which goes against every instinct in business. I mean, most management operates on a deficit model. We only pull someone aside when they mess up. And Dr. Noel Lloyd challenges leaders to completely reverse that model. The participants in the master class shared some brilliant, actionable tactics for this.

Like what? W- were they doing? Well, one clinic owner uses their daily morning meetings specifically to highlight staff members who were caught going the extra mile the previous day. Another clinic uses a physical team trophy. A trophy? Yeah. That’s fun. Yeah. It gets passed from person to person each month, paired with Starbucks gift cards to publicly recognize [00:11:00] outstanding positivity or productivity.

The creativity is fantastic. Yeah. But it doesn’t just have to be structured, formal awards either, right? No, not at all. A huge theme was the power of random, unexpected gifts of appreciation. One participant shared how they surprised their team after a particularly grueling high-volume week with flowers or coffee, beer, high-quality meat.

Wait, meat? Yeah. One doctor even cooked a massive batch of homemade shrimp salad and brought it in for the whole team to share for lunch. Handing someone a homemade shrimp salad is an undeniable way to reset a stressful week. I love that. It really is. And beyond the gifts, there was a profound emphasis on the fundamental basics of human connection, specifically the power of greeting everyone by name.

Oh, yeah. That’s huge. Dr. Noel Lloyd shared a personal story about visiting the Columbia Tower Club, which is this exclusive private establishment, and he noted that between walking out of the elevator and arriving at his private room for breakfast, five different staff members [00:12:00] stopped, made eye contact, smiled, and greeted him by his name.

Wow. That immediately signals that you are known, you’re valued, and you are in an environment of high-level care. Exactly. It establishes an overwhelming atmosphere of excellence, and participants echoed this strategy. One doctor enforces a strict rule that the team must greet every single patient by name on the way in and say goodbye to them by name on the way out.

And that builds such a tight-knit community that patients actually start learning each other’s names in the waiting room. Right. Another tactic that stood out to me was praising team members in front of the patients. Like, a doctor might walk into the adjusting room and say to the patient, “You are absolutely going to love our new associate doctor.

They have been getting incredible results with our patients.” It instantly builds clinical trust for the patient. Right, while making the associate feel incredibly valued. But wait. Let’s look at the authenticity of this for a second. Okay. If I’m a naturally reserved clinic owner who [00:13:00] rarely shows emotion, and I suddenly start showering my staff with extravagant praise in front of the patients, isn’t everyone going to immediately know I’m completely faking it?

Oh, they absolutely will, and Dr. Noel Lloyd offered a very strict warning about this exact trap. You absolutely cannot fake this culture. It has to be real. Yes. If you attempt to artificially compliment a poorly performing staff member just to boost their morale, they will know you’re lying, which just breeds cynicism.

And worse, the patient might have just had a deeply negative interaction with that same staff member at the billing desk. Exactly. The praise must be highly specific, and it has to be one hundred percent legitimate. You are acting as a detective looking for actual good behavior to highlight, not inventing it out of thin air.

Authenticity is the only currency that works here. So let’s say you’ve done the heavy lifting. You’ve established the mission, you’ve clarified the choreography for those five patient contacts, and you’re consistently catching people doing good work. You’ve built the culture. Right. You’ve [00:14:00] successfully built this positive, highly functioning culture.

Your next job is to defend it fiercely and empower the people within it to grow. Protection is paramount, and Dr. Noel Lloyd’s rule for this phase is hire for character, train for skill. Humble, positive, coachable. Exactly. You are searching for individuals who possess a naturally humble, positive baseline.

You can teach a positive person how to navigate complex scheduling software, but you cannot teach a miserable, cynical person how to have a bright personality. To protect the culture during that vulnerable hiring phase, Dr. Noel Lloyd shared what I think is a brilliant ninety-day culture hack. Oh, this was so smart.

When you bring on a new hire, you explicitly give them a ninety-day probationary period to learn the job, which culminates in a small raise if they succeed and integrate well. The mechanics of why this works are fascinating. It provides the employee with a defined, structured timeline to master their skills.[00:15:00]

But more importantly, it gives the clinic owner ninety days to see who this person truly is after the honeymoon phase of the new job wears off. Because it prevents the owner from firing someone too soon in a momentary flash of frustration. But it also creates a hard deadline that forces the owner to stop procrastinating if the person is clearly a bad apple.

Right. At day ninety, you evaluate the data and make a definitive call. And once they prove they belong on the team, you have to actively protect the physical and emotional environment they work in. I loved how Dr. Noel Lloyd likened clinic culture to a participant’s prized immaculately kept Corvette.

That was a great visual. You don’t just throw it in gear and speed blindly out of the driveway. You pull it out of the garage carefully so you don’t scrape the front bumper on the curb. Yeah. You treat it with reverence because it’s incredibly valuable and easily damaged. And to maintain that pristine Corvette, participants shared the tactical boundaries they enforce.

Like one participant encourages [00:16:00] their staff to take any negative personal emotions they are feeling before their shift. Like a fight with a spouse or bad traffic. Exactly, and mentally put those emotions in an envelope in your car before walking through the clinic doors. I instantly connect that envelope concept to checking a heavy, soaking wet winter coat at the door of a fine art museum.

Oh, that makes total sense. You don’t have to throw your coat away. Your feelings and struggles outside of work are entirely valid, but you cannot drag that heavy, wet coat through the exhibits, knocking over priceless artifacts and dripping on the floor. You leave it at the door. You execute your job in a beautiful, focused environment, and you can pick your coat back up when your shift is over.

And what happens if an employee simply cannot check that coat? Another participant noted that they are entirely willing to send an employee home for the day if they’re truly struggling and radiating negativity, rather than letting that mood infect the rest of the practice. It’s done with deep compassion though, right?

Yes, acknowledging they need a mental health break, but it [00:17:00] fiercely protects the immune system of the culture from being compromised. Executing that requires a leader who is paying incredibly close attention to the emotional temperature of the room. It requires the leader to act as the ultimate shock absorber for the clinic.

Yes. A great leader has what the masterclass described as broad shoulders. The mechanics of this mean that staff members absolutely can and should bring their problems or personal struggles to the leader in private, but the leader takes the hit. They absorb that shock. They process it privately and solve the root issue rather than reacting emotionally and letting that stress leak out to become a swirling whirlpool of drama for the entire team to navigate.

You absorb the chaos, so your team only feels the calm. And once you’ve absorbed that shock and created a stable environment, you suddenly have room for the most important phase: growth. You can’t just manage your team, you have to turn them into leaders. Which is Dr. Noel Lloyd’s fifth rule: build leaders.

[00:18:00] People stay in environments where they are challenged to grow. Retaining top-tier talent means giving them opportunities that stretch their capabilities. Dr. Noel Lloyd shared a perfect example of this. He had a staff member who had never hired anyone before, and rather than keeping that administrative power entirely to himself or just throwing her into the deep end to fail, he walked her through the entire process.

He had her screen the resumes, conduct the interviews, select the candidates- And ultimately make the final hire, all while he acted as her safety net. She was terrified initially, but by the end of the process, she had transformed from a manager into a true leader. When you invest in their actual human capital like that, you build a level of loyalty that a simple hourly paycheck can never buy.

We’ve covered a massive amount of ground today, from the psychological toll of bad apples to the 90-day review to checking our emotional winter coats at the door. We really did. And if we loop all the way back to where we started, to that X-ray machine metaphor, we realize that while you [00:19:00] can’t put culture on a light box, you absolutely have the diagnostic tools to treat your practice’s immune system.

You do, and it all comes back to that initial definition. Culture is the unwritten rules, which leaves us with a profound thought to mull over as you head into your clinic this week. What’s that? If culture is simply the unwritten rules of what happens when the clinic owner isn’t looking, what unwritten rules are your patients currently observing in your waiting room while you are busy adjusting someone in the back?

Oh, wow. Are they observing a team that supports each other and greets them by name? Or are they observing a team that sighs, rolls their eyes, and complains about the schedule? The honest answer to that question is the true diagnosis of your clinic’s health. That is so true, and if you aren’t thrilled with the diagnosis, the incredible news is that culture is a choice, and you could start rewriting those unwritten rules today.

Remember, as a listener of this deep dive, you are part of the Five-Star Management community, and you do not have to figure this out in isolation. Absolutely not. If you wanna fix your [00:20:00] practice culture, get your team completely aligned, and receive personalized expert help doing it, book a completely free call with Dr.

George Birnbach. You can find the link to book that call right now in the show notes. Having an experienced outside perspective evaluate your clinic’s systems can really be the catalyst for massive change. It truly is. Additionally, we wanna help you in person.

Come join us at our live two-day event in Dallas, Texas. It’s happening on November 14th and 15th. We actually have two incredible events running simultaneously that weekend. Such a great weekend. Right. The first is the New Patient Solution event, teaching you exactly how to get more new patients into your practice fast.

The second is the Win Win Associates event, focused entirely on our proven Win Win Associates system for generating more growth, more freedom, and more success in your practice. You can literally choose the track that perfectly fits your current needs. Exactly. The link to register for the Dallas event is also right there in the show notes.

Finally, don’t forget to subscribe to the podcast [00:21:00] so you never miss our weekly tips on building a wildly successful chiropractic practice. Until next time, keep an eye on those unwritten rules and keep building a practice where great people truly wanna stay.