Share this episode:
In this episode of The Chiropractic Deep Dive, we break down how front desk inefficiencies quietly limit growth in high-volume practices—and how Dr. Noel Lloyd’s One-Stop Shopping system fixes it.
You’ll learn:
👉 Book a Free Strategy Call
Get personalized help implementing these systems in your practice. Schedule your complimentary call with Dr. George Birnbach: https://myfivestar.com/work-with-us/
👉 Join Us Live: Practice Explosion (Chicago – March 21–22)
Learn how to implement growth systems that generate too many new patients—fast. Learn more & register here: https://myfivestar.com/in-person-seminar/
👉 Subscribe for More
Follow The Successful Chiro Podcast for weekly insights on chiropractic growth, systems, and leadership.
This episode was created using AI-generated voices and is based on real-world strategies from Dr. Noel Lloyd and Five Star Management.
Welcome to the Chiropractic Deep Dive. Yeah. This is a resource for practice management and it’s part of The Successful Chiro podcast. Mm-hmm. We are your consulting team here at Five Star Management and, uh, our mission today is really a rescue operation. We’re targeting the single biggest impediment to growth and.
Frankly, sanity in a high volume chiropractic practice. We are, we’re talking about the front desk. Exactly. The front desk. That’s right. We’re zeroing in on all that friction, the stress, and just the sheer volume of transactions that can turn a really successful practice into a, you know, a, a congested bottleneck.
Yeah. And this deep dive is based on some really actionable real world strategies from a recent presentation by Dr. Noel Lloyd, all focused on mastering what he calls one-stop shopping. Okay. One stop shopping. Let’s unpack the, uh, the core mechanics here. Our goal is to extract the absolute nuts and bolts strategy from the material.
Right. Specifically to streamline that front desk. Yeah. Reduce the stress on the staff, the cas, the doctor, and most importantly, just get rid of that patient annoyance. Yeah, that’s a big one. We’re talking about creating an efficient flow. Mm. That patients actually, you know. Appreciate, and we really have to start by defining the problem with the numbers that Dr.
Lloyd presented. I mean, think about it. In a traditional, non streamlined office, if you have 300 patient visits a week, that means you’re facilitating 600 front desk interactions. 600. Wow. 600. That’s maybe three minutes when the patient checks in, and then another three minutes when they check out, and three minutes sounds so trivial.
Those little delays, they just stack up into these massive, frustrating clogs, right? Mm-hmm. Especially during rush hour. Oh, absolutely. That four to 6:00 PM window. Yeah. When patients are trying to bolt out the door to pick up your kids or get home from work, it’s like, you know, standing in line at the grocery store when all you wanna do is just leave.
It creates unnecessary chaos. So the ultimate goal of one stop shopping is to template format, and, this is the crucial part. Train patients how to do all their clinic business in one single proactive stop. So you’re cutting that 600 transaction number way down drastically. Okay, so if we strip away the jargon, what is the simple definition of one stop shopping in, you know, in actual practice?
It’s actually elegantly simple. The vast majority of your returning patients, they take care of all clinic business, I mean scheduling payment, any forms, all on one stop at intake with the front desk ca, the chiropractic assistant, right? And then once the patient is done with their treatment, they just wave goodbye.
They’re trained to handle everything proactively. So the exit is just totally friction free. And we know this is a huge challenge. I mean, the survey data from that presentation, it showed front desk stress ratings going all the way up to a five outta 10. Mm-hmm. And that moderate stress level, that’s a massive red flag.
Mm-hmm. That’s the kind of thing that forces a practice to slow down volume. ’cause the front desk just can’t handle the flow and they might even turn away new patients, you know, just to maintain some kind of equilibrium. Exactly. So if we want to grow, we have to eliminate the bottlenecks first. That’s it.
Okay, let’s look at the pitfalls first. I mean, before we can implement the solution, we have to understand the structural failures. So what are the five common front desk traffic mistakes that the practice leaders identified? Right. So Dr. Lloyd’s group, they consistently pointed to these five habits and mistake number one, which we heard from a ca is not pre-scheduling multiple appointments.
Ah, that’s the big one. This is this single primary clog. And why does this mistake happen so often? Is it because the patient thinks they need to book their, like their entire 12 week plan while they’re standing there trying to leave? That’s exactly it. The patient is already mentally checked out and the CA ends up spending five 10.
I mean, we heard one story of 45 minutes trying to pick out dates from a calendar when the patient just wants to go home. Wow. So the solution isn’t booking every single visit on day one. The material suggests that if they’re on a wellness or active plan, you schedule the plan out proactively. They only have to confirm the next appointment at check-in.
That makes so much sense. It shifts the burden from the high stress exit point to the low stress check-in. So what’s mistake number two? Mistake two. Is not properly training patients on payments. Hmm. If patients don’t expect to pay upfront, the CAS have to constantly remind them and sometimes, you know, argue with them.
It causes delays. Awkwardness. Yep. The source material really emphasizes that patient compliance is actually incredibly high if the staff just consistently and confidently sets that expectation early on. So the friction isn’t really the patient’s refusal to pay, it’s the practice’s failure to train them on when and how to pay.
You got it. Which brings us to mistake number three, which is the danger of the chatty ca. The chatty ca. And this needs careful framing. It’s not about being unfriendly. This is about eliminating unnecessary conversation at the point of transaction, right? If finances and visits are already set up, you know, asking how’s the family or showing photos of grandkids.
It just clogs the desk. The relationships are important, but not at the expense of office flow. That is so critical. You have to save that great relationship building for the adjusting room or outside of peak hours. Okay, so moving on to payment. I imagine the fourth mistake is just a lack of systemization around money.
Mistake four is exactly that. It’s the failure to encourage prepaying or keeping a card on file. A contributor shared a fantastic solution here, but what was that? Require auto debits or a card on file, and you can incentivize it with a small discount. Then the CA just runs the card when the patient checks in for that day’s visit.
Simple. But doesn’t that create friction with some patients? I mean, what about people who prefer to use like an HSA card or cash? How do you handle that without creating a new backlog? Well, that’s where the training comes in. Again, patients are trained that their card will be run automatically. They’re also trained that they’re welcome to stop at the desk before their visit if they need to change the payment method.
Ah. So if they brought cash or a different card, that conversation happens before treatment, not at that high pressure exit moment. It totally eliminates that awkward financial talk when the patient is mentally out the door smart. Okay, finally, what’s the fifth systemic mistake? Mistake number five, is the lack of an automated seating process, right?
The strolling hostess. Exactly. Barb, the strolling hostess. Historically, front desk staff physically roomed every patient, and while seating a patient isn’t stressful, it’s a massive time sink. Yeah, I can see that. So transitioning to patient, self rooming and using automated systems to notify them of the next room, it saves so much administrative time.
The ca stays at the desk, managing the flow, not wandering the hall. That leads us perfectly into the payoff. So let’s shift from the problems to the returns beyond just reducing stress. What are the tangible benefits? Yeah, this is where the, you know, the financial motivation really comes in. The advantages affect every single part of the practice.
First, you get improved flow for everyone. Second, and this is the big one. Massive staff and payroll efficiency. Okay, let’s drill down on that payroll efficiency ’cause that’s the ROI. Wow. How does cutting 600 transactions down to 300 save the clinic actual money? It’s simple. Capacity management. If you have 300 patients a week and your checkout takes three minutes per person.
You might need two or three cas just to manage that queue during peak hours. Right. But if you implement one stop shopping, those cas are now only handling the check-in, which is faster. You can often handle the same volume, maybe even 20% more with two cas instead of three. So it either saves you a full-time salary or it converts a congestion manager into like a growth driver.
A growth driver, exactly. Yeah. That CA is now free to do insurance follow up or schedule recalls which directly contributes to growth. That makes perfect sense. Mm-hmm. Third, you get reduced stress. The cas feel less overwhelmed, which supports growth. And fourth, patient satisfaction, just soars and happy patients refer more people. For sure,
they’re seen on time, they get in and out, and that positive experience eliminates that terrible anecdote we heard. I drove by the office, saw 12 cars in the parking lot, and just kept driving. Oof. Yeah, you never want that. So achieving this flow, it requires rigorous training, not just of the staff, but of the patients themselves.
Where does this source material say. This critical patient training happens. Right, so this training typically happens on day three. Day three. They call it the office training day, or how to learn how to be a patient. Why day three specifically? I mean, why not day one when they’re new?
Day one is just too much information. Day two is typically the report of findings, the ROF, where the doctor lays out the care plan. By day three, the patient has committed to the plan and the cost, and they’re now ready to learn the operational rules of the clinic. So the staff does a walkthrough. Exactly.
Explaining the sign in, the upfront payment expectation and that wave goodbye exit. The scripting here seems absolutely paramount. Yeah, I mean, how do you pitch this to a patient so they feel privileged? Not, you know, inconvenienced. Practices use terms like express scheduling and express pay.
The pitch is all about speed and convenience because patients are busy, of course, and crucially, the doctor often introduces this concept during the ROF setting the expectation that because you’re on a defined care plan, we’re going to enroll you in our express system. And what are the incentives for the patient to actually participate in this express system?
The material highlights two main ones. First getting a discount for keeping a card on file or prepaying. Okay. Money talks. It does. And second, the really crucial one, securing the precise time slot they want, if they want that 4:15 Monday slot every week, express scheduling secures it for them. It links their compliance directly to their convenience.
That’s leverage. Okay. Let’s talk about advanced tools in tech that support this. We heard a great idea called the printout genius. Yes, instead of just relying on phone notifications. The practice provides a physical printout list of all future appointments, the whole care plan.
Mm. They ask the patient to take it home, compare it to their personal calendar, and then bring it back on their next visit with any changes circled. That’s brilliant. It proactively resolves conflicts. The patient doesn’t wait until week six to realize they have a conflict with a holiday or something.
Precisely. And technology simplifies the tech in dramatically. A lot of offices are now using systems like SCED, platinum Systems or Jane. They have a smartphone app or a kiosk for check-in. Right? The Bink moment. The Bink moment, yeah. With integrated card readers. So for our listeners who might not be familiar with those names, the key is the automated check-in.
Right? Why is that so transformative for the ca? It just offloads all that purely transactional work. Instead of the ca manually pulling a chart and swiping a card, the patient starts to process themselves. It’s just a huge efficiency gain and tying back to the automated seating, the systems can call patients to the next available room.
The patient scans in again to pull up their notes and X-rays that grab face, paper, and lay down. It makes a huge time difference. So we’ve covered the systemic changes. Now what about those extra slick ideas that take a well run office to the next level, the three high impact moves? Okay. Slick idea number one, and this was from tie in, is pretty radical.
It’s removing the phone lines from the front desk entirely. Wait, removing the physical phone, that sounds, that sounds counterintuitive. In a busy practice, how do you handle communication? The rationale is simple. Most routine communication, rescheduling confirmations, it’s now handled through text messaging or a patient portal.
True. When the phone does ring, those calls are often from, as the sources politely put it, needier people or have complex insurance questions, and they can tie up the ca for a long time while paying patients are waiting right there in front of them. Okay? So you redirect the function, you redirect it either to a back office staffer or even an offsite ca, but you ensure the front desk CA’s only focus is the face-to-face flow that shifts the CA’s role from interrupt driven dispatcher to
uh, to an active flow manager. That’s a huge perspective change. It is slick idea two is the power of directive dialogue. Getting rid of those open-ended questions that just invite hesitation. Can you give us an example? Bad script versus good script? Sure. The bad script is asking. So when do you think you wanna schedule next?
Right. The good script uses leadership. It’s, let’s get you scheduled. I have two great openings tomorrow, 10:30 AM or 4:15 PM Which one works best for you? So you offer two choices that work for the schedule instead of giving them an infinite option set. Exactly. It’s faster and it makes the CA’s job so much easier.
That is true leadership at the front desk. And finally, slick idea three, the focus on weekly product training. Yes. The importance of dedicating just 10 minutes of the weekly staff meeting to product training. So supplements, traction, wedges, shoe lifts. Anything patient facing? Why is that so critical for front desk flow?
I mean, that sounds more like sales, not flow management because it makes the patient facing team members instantly knowledgeable. If a patient asks the CA about a supplement, the CA doesn’t have to go interrupt the doctor. Ah, they can answer the common questions confidently, which eliminates those doctor interruptions and speeds up the whole transaction.
It follows that core compliance principle the factories and why coupling? Tell them why and they will comply. Exactly. Tell them why and they will comply. So let’s break that down with an example. If a patient questions the need for a traction device, how does that coupling work for the ca? Okay.
So the CA needs to be trained to deliver it in a specific sequence. The fact is. You need this traction wedge. The reason is your x-rays show a reverse curve in your neck, and this device is designed to reinforce the changes the doctor is making. And then the why is using this at home means your healing time will be significantly faster and you’ll maintain your relief longer.
When the ca can articulate that why the patient sees the value and they comply, no need to wait for the doctor. That makes perfect sense. Ultimately, this whole deep dive really shows that maximizing patient satisfaction and practice growth, it hinges almost entirely on training. I mean, you’re training the staff,
yes. But crucially, you’re training the patients on the express advantages of compliance. You’re demonstrating why following the system benefits them directly. Which brings us to a final provocative thought for you, the listener. We heard in the presentation how one successful practice stopped doing pay by the visit entirely to reduce friction.
Yeah, that was a big one. They accepted. They might lose a small percentage of patients who couldn’t or wouldn’t comply, but they significantly increased team morale, reduced front desk stress, and boosted overall profitability. So. If eliminating your most stressful payment method achieves that level of efficiency and team happiness, is that a trade off your practice should commit to something to think about?
For sure. Now, this Deep Dive was brought to you by us here at Five Star Management, and if you want to dive even deeper into streamlining your own clinics processes and really maximizing that efficiency, we encourage you to book a free call with Dr. George
Birnbach. The link to schedule that complimentary consultation is, um, it’s waiting for you right there in the show notes. Mm-hmm. And if you’re ready to take these efficiency gains and transform them into rapid practice expansion, join us at our live two day event in Chicago, Illinois, March 21st and 22nd.
It’s called Practice Explosion. It’s an amazing event. It is. This intensive training focuses on one thing. How to implement systems that ensure you get too many new patients too fast. The link to Register for Practice Explosion is also in the show notes. Hope. See you there. And finally, don’t miss our next deep dive into chiropractic management and growth strategies.
Be sure to subscribe to the Successful Chiro Podcast for more tips delivered weekly. Thanks for listening.
Current and cutting edge guidance to profit and joy in practice. Glad to have finally found them. I made an extra 75k this year and am moving out of my own personal “Groundhog Day” hell toward a joyous life.
I have been a client multiple times over the last 25 years. Excellent coaching, relevant and fresh content and have my best interest at heart.
Exceptional!! Definitely recommend. Game changer
I was a client years ago and just rejoined in Jan. 2018. Dr. Lloyd helped me learn how to attract and retain great patients years ago, and now with my new practice in Portland, OR. I'm super excited to be back with him and FSM. Thanks a lot Dr. Lloyd!
Best Organization ever. Very good and educated seminars. Dr Lloyd and Dr. Birnbach are the best.
Great program. Drs Noel and George provide powerful and highly relevant material that is current with changing times and tailored to our individual offices. I greatly appreciate the ability to grow while serving patients ethically and congruently.
So many ideas to promote my office. Like they say, if you can't find something you like on the menu, your not hungry!
I always look forward to going to the 5 star seminars to get recharged and callobrated for our office. In the previous 2 years we have grown personally and professionally in our practice with helping more people and having more fun! I am confident that we are able to train other Doctor’s and team members to be their very best. The steps are simple and Drs. Noel, George, and Leah are excellent and will help you with what you need! #bestdecision EVER!
Dr Lloyd is very precise and gives you the tools that can be valuable to not only uplift your practice but also improve the psyche to know that you can get to a target with his steps<br>Thank you for terrific weekend.<br>Dr Jignesh Bhakta. I would throw in a six star but they only allow 5.
Dr. Lloyd & Dr. Birnbach have been instrumental in providing us with the skills to make our practice grow. Thanks to their guidance we are on target to make our goals a reality. Thank you Five Star Management. You all are truly a class act operation.
Having great time at the new patient seminar. Dr. Loyd and Dr.<br>Birnbach dishing out great info.<br><br>Dr. Guyton
Fantastic work teaching chiropractors to expand their offices. Dr. Lloyd and Dr. Birnbach have been instrumental in helping us create the practice of our dreams and sharing chiropractic with our community!<br>Thanks<br>Dr. J
Five Star has changed my practice and my life. My stress is down, my success is up and my patients are happier than ever!
I love the seminars. Always great content to help a chiropractic or alternative medicine practice run smoothly. Thanks for your help!
Fantastic group! They helped me start a successful practice.
It is hard to imagine a better organization to coach and advise chiropractic businesses than Five Star Management. Every person at Five Star is available to whatever I need of them at the moment. I have valued my personal coaching relationship with Dr. Noel Lloyd. Everyone at my clinic knows that this year will be our best year ever in practice. Thanks to their guidance I have hired my first associate chiropractor and we are about to rip it up. No looking back!
Fivestar is a focused, step by step, approach to getting your practice in shape and then shooting for the stars.
Best year ever after best year ever, love this program. Thank you Dr. Lloyd!
Dr. Lloyd and Dr. Birnbach are fantastic! I learn something new every time I go to a seminar! They provide great feedback and offer resources to make your practice operate with ease! Thanks so much
I have been a member for 2 years. Since joining I have hired an associate, a community outreach assistant and had my first child with a 16 week maternity leave. I have had best ever numbers across the board and have helped more people than ever! Plus I have more time off to spend with my family. 5 star is hands down the best! Thanks Dr Llyod and the 5 star team because you guys rock!
Dr Noel Lloyd has been amazing to work with. He can help with any situation and can customize it for your office. Not the typical practice in a box only one way to do things. He's help make practicing fun again as well as increasing my profits.
Fivestar has helped me streamline my clinic procedures to provide excellent care to our patients in a low-stress atmosphere, with plenty of time for each patient. Thank you for helping me care for our patients better!"
My husband and I have been clients for two years. We have been thrilled with five star. The coaching is custom tailored to fit the needs of your practice and the vision that you have for your practice. Dr. Noel Lloyd, Dr.George Birnbach, Dr. Leah Meadows and their fantastic team do not have their own agenda. They listen to you and help you to reach your goals. The seminars are fantastic. I always come away with a very long to do list. The information is relevant to chiropractic practices today.We would highly recommend five star to any doctor looking to help more people, have more fun, make more money, or reduce their stress.
I've been a client for over 4 years now. Solid systems, solid support, great staff. I have tripled my my income in the last 4 years without working additional hours and the seminars help not only me, but help train and involve my staff. Dr. Lloyd, Dr. Birnbach, and Dr. Meadows are all truly committed to getting you to the next level and beyond. The clients in Five Star vary from the beginner to the seasoned multi practice owner with multiple associates making it relevant for just about anyone. Thanks for all your help!
My Name is Dr. Ricky Hanks. I have been in practice now fore 30 years.I am in my second year as a client in 5 Star Management. The whole team is amazing. The front line ladies of Amanda and Brittany are wonderful. The personalized coaching form of Dr. Lloyd is refreshing, caring, and based in chiropractic wisdom. Drs. George Birnbach and Leah Meadows add a special variety of marketing wisdom, business organization, and chiropractic office skills to the overall program. The 5 Star website is a virtual gold mine of wisdom and webinars that are taking me to the next level of excellence.<br><br>The whole 5 Star program has been an experience that has returned more than 10 times a ROI (Return on my Investment) in this program just in my first year.<br><br>Dr. Lloyd has been a compassionate, caring and understanding consultant/coach who has led me to be a better husband, father, grandfather,chiropractor,business owner, and person overall.<br>He has taught me to communicate better and more effectively with my team and my patients. His business/financial training has re-enforced that life is a fair and equitable exchange.<br><br>Have more Fun...Help more People...Be more Successful !!!<br><br>I highly recommend 5 Star to old veteran Chiropractors like me and especially young Chiropractors still in school or just fresh out of school. I only wish I had started with the Five Star Team 30 years ago!!!<br><br>Ricky L. Hanks DC