Staff Bonus Systems That Actually Work in Chiropractic (Without Giving Away the Farm)

 Welcome back to the Chiropractic Deep Dive. We are so glad you could join us today. Yeah, absolutely. This is, of course, a special segment of The Successful Chiro Podcast, and if you’ve been with us for a while, you know the drill. We take this massive stack of sources, trainings, private coaching calls, research notes, and we just strip away all the noise.

We get you the gold, and today we are opening up a file that, I mean, it honestly keeps a lot of chiropractors up at night. Oh yeah. The staff bonus file. It’s the eternal struggle of practice management. It is the dreaded B word. Hmm. You know, before we really dive into the mechanics and we have some very specific actionable stuff today, I have to mention that this deep dive is brought to you by Five Star Management.

That’s right. And looking through these notes, you can really tell why Five Star is the leader in chiropractic consulting. The whole philosophy we’re talking about today, it’s pure Five Star. It is. It’s practical. It’s safe. It’s designed to help you, the doctor win. And we’re speaking from that perspective today.

The goal isn’t just, you know, throwing money at your team and hoping for the best, right? The goal is to build a system where the doctor wins, the team wins, and most importantly, the patients win. So let’s set the stage. The source material today comes from a private Zoom training call. It was led by Dr.

Noel Lloyd, a legend in this space. Absolutely. And you have to picture this, it’s a mastermind setting. You’ve got Dr. Lloyd, you’ve got a group of clinic owners who are in the trenches just like you, and they’re all hashing out this one dilemma. And it really is a dilemma. I mean, think about the tension. On one hand, you wanna be generous.

You love your team, you want them to share in the success, of course. But on the other hand. Well, Dr. Lloyd lays out the problems pretty clearly right at the start of the call. Yeah. Let’s unpack that problem list because I think every single listener is gonna be nodding along so hard, their neck hurts. The first one is complexity. Oh, this is a huge one, right? If you need a degree in calculus to understand your bonus check, it’s just not gonna motivate you. Exactly. I’ve seen systems that look like they are designed by nasa. If the ca at your front desk can’t figure it out on the back of a napkin in 30 seconds, it’s useless.

It just creates confusion and suspicion. The second problem is even stickier entitlement, the classic Christmas bonus strap, you give a bonus three months in a row, and by the fourth month it’s not a reward, it’s just part of their expected salary. Hey, where’s my extra 200 bucks? Exactly. And that is a dangerous shift because now if you don’t pay it in their mind, you’ve actually cut their pay.

Right? Which leads to the big one. The fear that stops most doctors from even starting a bonus system in the first place. The fear of the upside down. The upside down. Yeah. Not the Stranger Things version, but. Maybe scarier. It might be scarier. This is the scenario where your team hits a target. Maybe it’s a volume target, so you have to write all the bonus checks, but your collections were low or your overhead was high and you actually lost money that month.

You paid your staff to lower your own profit. Dr. Lloyd calls that giving away the farm, and I think that fear just paralyzes so many owners, so they just say, forget it. No bonuses, just salary. You know, there’s a whole school of thought that supports that. On the call, they even brought up Daniel Pink, the author of Drive, great book, the Classic, and Pink argues that for complex creative tasks, those if then cash rewards can actually hurt performance.

Mm-hmm. He says people need autonomy mastery, and purpose. So you have the no bonus, just Vibes Camp on one side and the complex math equation camp on the other. But on this call, one of the participants, a really successful clinic owner, spoke up and he said, look, there has to be a middle ground, and that is what we’re drilling into today.

The middle ground, A system that’s simple, scalable, and most importantly, profitable. Let’s get into it. Okay. Solution number one. I was reading the transcript and I was just like, why doesn’t every business do this? We’ll call it the same month. Previous year model, the name isn’t flashy, but the logic is bulletproof.

The core concept is you are only competing against yourself. But not yourself from last month, yourself from last year. That’s the key, because chiropractic has seasonality, right? You can’t compare December to November. December has holidays. People are traveling. That’s always a weird month. Exactly. Maybe July is slow because everyone’s on vacation.

So this model says, let’s compare. July, 2023 to July, 2022. Apples to apples it’s apples to apples. It removes the excuse of, oh, it was just a slow month. Okay, so that’s the baseline. Now here’s the math, and for everyone listening, you might want to jot this down ’cause this is the secret sauce. It’s a two tier system, tier one growth.

If your clinic’s collections grow by 15% over the same month from last year. Yeah. Every eligible team member gets a bonus. And it’s not a percentage of the profit is it? No, and that’s the genius of it. It is a flat fee. Right? In the example from the call, if they hit 15% growth, everyone gets a hundred dollars.

Boom, done. Simple, a hundred dollars. That’s a nice dinner out. But then there’s tier two. Tier two is the stretch goal. If the clinic grows by 25% or more, that bonus jumps to $500. Whoa, okay. That’s a massive jump from a hundred to 500. That’s a five x multiplier. It’s significant. And psychologically that is huge.

I mean, if you were sitting at 20% growth on the 25th of the month, the whole team is gonna rally. Well they’re not letting that extra 5% go. No way. They’re gonna find a way to get people in, get payments collected and unlock that 500 bucks. I noticed a specific detail in the notes. It’s a flat fee no matter what.

So if you grow 32%, it’s still $500. Why is that so important? It protects the owner from that giving away the farm fear. You know, your maximum liability, if you have four staff, your max exposure is $2,000. But if you grew your practice by 30% to hit that number, that two grand is a drop in the bucket compared to the extra revenue.

Exactly. It’s scalable. You never pay out more than the growth can support. You only pay the bonus because the money is already in the bank. So a couple of rules to keep it tight. First eligibility, you don’t just get a bonus on day one. No, the rule they talked about was three months of employment. You have to earn your stripes, get integrated into the culture before you share in the harvest and the payout method.

This is a small detail, but I think it matters. Yes, they said don’t just bury it in the direct deposit. Yes, pay it as a separate line item, or even better, a separate check on the first payroll of the next month. You want them to see it, to feel it. This is the $500 I earned because we crushed it. I really wanted to talk about the culture shift this creates, because they talked about this tri-fold objective.

I love this. Help more people have more fun, make more money, and the order is so critical. You have to put help more people first. Right? And this bonus structure completely changes the team’s mindset about growth. Usually if the boss says, Hey, we’re hiring another doctor, the staff just groans, they think, great.

More work for me. Same pay. It’s a natural reaction, but. With this system, if the team knows they need to hit 25% growth for that $500 check, and the owner says, I’m hiring an associate, the team goes, yes, do it. When can they start? They become recruiters. They stop blocking growth and they start facilitating it.

They realize that new doctor isn’t a burden, they’re the vehicle to everyone’s bonus. There was this one story in the notes that just illustrates it perfectly, the story of the therapy ca and the patient with plantar fasciitis. This was such a great example. So you have a ca, she’s setting a patient up on a routine therapy and the patient mentions just offhand, man, my foot has been killing me forever.

Now, in a normal clinic, the CA might just say, oh, that’s too bad, and move on. Not her problem, right? But in this clinic, she’s motivated. She knows that helping more people equals hitting that growth goal. So she listens. She checks the chart, she realizes the doctor isn’t treating the foot, she flags the doctor down.

She says, Hey, doc, did you know Mrs. Jones has plantar fasciitis? The doctor Reevaluates prescribes a 10 visit shockwave package, and the ca helps close the financial plan boom. The patient gets better care. The clinic revenue goes up and the team gets closer to their goal. It connects the dots. It shows how listening to a patient helps everyone win.

That’s powerful. So that’s the year over year model. But Dr. Noel Lloyd also shared his personal favorite system. He calls it the small game. The Small game. This is for teams that love short term wins. It’s very high energy. It might be even simpler. It just tracks three numbers. Collections, new patients and visits the Holy Trinity of practice metrics.

If and the game is all about breaking records, not 15% growth, just best ever best ever. Okay. So he breaks it down into a weekly game and a monthly game, right? The weekly game, if the team meets or beats their best ever weekly numbers in all three of those areas, every team member gets $50, 50 bucks for a record breaking week.

Got it. And the monthly game. Same idea. If they break the all time monthly records in all three categories, everyone gets a hundred dollars. Now I can hear people thinking, wait, that sounds expensive. Isn’t he giving away the farm again? He addressed that directly. He did the math. Let’s say you have a superstar team.

They win the weekly game four times. That’s $200 per person, and they win the monthly game, so that’s another a hundred dollars. You’re paying out $300 per staff member. For a team of five, that’s a $1,500 payout. Exactly. But think about what had to happen for you to pay that. You just broke your all time collection record for the month.

He used an example of a clinic that collected $650,000. If you collect $650,000, you are not worried about writing checks for 1500 bucks. Not at all. You’re laughing. It’s the icing on the cake as he called it. You are paying pennies to make dollars. Okay, so we have two really solid models here. But before anyone runs off to implement them, we have to talk about the warning.

Dr. Lloyd dropped a pretty serious iceberg warning on the call. He did, and this is crucial. You have to be aware of the laws in your state about fee splitting the dreaded fee spliting. What does that mean here? Well, in many jurisdictions, it’s illegal to share a percentage of collected money with non-doctors.

You can’t tell your ca I’ll give you 5% of collections. Ah, which is why both of these models use flat fees. Exactly. A $500 bonus is a flat reward for a team goal. It is not a direct commission on medical services. It’s safer, it’s cleaner, and it keeps you compliant. That’s a huge distinction. Flat fees over percentages.

Hmm. Got it. And the other warning wasn’t legal, it was managerial. Mm-hmm. Dr. Lloyd said leadership training and management trump bonuses. This goes back to Daniel Pink. You cannot bonus your way out of a bad culture if your systems are broken. If you’re a pain to work for a hundred dollars, bill isn’t gonna fix that.

It’s a bandaid on a broken leg, right? He said the bonus is an excuse to coach. You use it as a reason to sit down with your team and say, Hey, I want you to hit that $500 tier. Let’s look at our phone scripts. How can I help you win? It changes the dynamic from do this because I said so to, let’s do this so we all get paid.

It aligns everyone. It turns you into a coach. And he also mentioned that not all bonuses have to be money. Yeah. Recognition, time off, lattes, a team dinner. Sometimes feeling appreciated is worth more than 50 bucks, but you need a system for that appreciation. So at the end of the day, the big takeaway is simplicity.

Simplicity and alignment. If your team understands the game, they’ll play to win. Now, I know there are people listening who are thinking, okay, I love the $500 tier idea. But my practice isn’t growing fast enough to hit 15% growth. Yeah. I don’t have the new patients, and that’s the bottleneck for so many, right?

You can have the best bonus structure in the world, but if the phone isn’t ringing, it doesn’t matter. This is where we as Five Star Management can really step in. If you’re listening and you need help installing this, or if you need to fix your marketing so you can use these bonuses we have you covered, you can book a free call with Dr.

George Birnbach. And he is just a master at this. He is. We’ve put the link for that free call right in the show notes if you wanna grow. It’s an absolute no-brainer. Just click it and book a time. Speaking of growth, if your biggest problem is just getting new people through the door, Five Star is hosting a live two day event in Chicago, Illinois.

It’s called too many new patients, which is a great problem to have. It really is, and the event is laser focused on getting a flood of new patients into your office fast. We teach you the systems, the marketing, the retention. If you wanna be paying out those tier two bonuses, you need the volume. This event teaches you how to get it.

Check the show notes for the link to the Chicago event. Seriously, it’s a game changer. And of course, if you enjoyed this, please subscribe to the Successful Chiro Podcast. We have so much more coming your way. Any final thoughts for everyone before we sign off? I’ll leave you with this. A bonus is just a transaction.

Yeah, I give you money, you give me work, but a team that is fighting for the practice, looking for ways to help patients and celebrating wins together, that’s a transformation. I love that. The money is just the scoreboard. The culture is the game. The culture is the game. Thanks for listening. Everyone. Go out there, help more people,

have more fun, and we will catch you on the next deep dive. See you next time.