You Don’t Get What You Expect… You Get What You Inspect | Chiropractic Team Training

[00:00:00] It is, um, it’s a really bizarre phenomenon when you spend hours or maybe even days writing out the absolute perfect recipe for your clinic. Oh yeah, we see it all the time. Right. You hand this beautiful, meticulously calibrated recipe to your team, who is basically your chef in this scenario, and you just assume, you know, you’re gonna get a Michelin star meal.

Because it’s all right there on the paper. Exactly. But then you finally walk out into the dining room, you take a bite of the food, and you realize they substituted salt for sugar and completely skipped the baking process. And it just leaves you standing there, right? Yeah. Staring at the plate, wondering how a documented standardized procedure turned into complete chaos the second you turned your back.

Yeah, it’s maddening. But welcome to the Chiropractic Deep Dive. This is a special part of the Successful Chiro podcast brought to you by Five Star Management. That’s right. We are a chiropractic consulting company, and today we are speaking directly to you, our fellow members of the Five Star Management community, because we share a mutual goal [00:01:00] here, right?

Clinic success. Pure and simple. Absolutely. And part of that success is figuring out why there is this, like, massive gap between what you teach your team in the morning huddle and what actually happens when a patient walks through your front door. Yeah, because you train your chiropractic team. You really do.

You run them through the scripts, you map out the systems, but you still somehow accidentally discover that the front desk is griping the ball. Or the adjusting areas are totally bottlenecked. Yes. So today’s deep dive is about closing that gap permanently. We are unpacking this really incredible Zoom call led by Dr.

Noel Lloyd. It’s a great one. He lays out a very specific three-step solution that shifts clinic culture from, you know, chaos to precision, and those steps are inspection, detection, and correction. Okay, let’s unpack this because the disconnect between expectation and reality in a clinic is… I mean, it’s staggering.

It really is. When a team member skips a step in a patient intake or totally mangles a [00:02:00] scheduling script, we have to look at why that breakdown actually happens, and the source material makes it super clear that this is rarely intentional sabotage. Right. It’s almost never malice. It really comes down to basic organizational entropy.

Like, without energy and observation from leadership, systems naturally degrade. They just fall apart. Yeah. And Dr. Noel Lloyd introduces a guiding philosophy, borrowing a concept from US Navy Admiral Hyman Rickover- Oh, the guy who developed the nuclear submarine program, right? Exactly.

And the quote is simple, but honestly it’s ruthless. He said, “You do not get what you expect. You only get what you inspect.” Man, you only get what you inspect. I mean, if we go back to that kitchen analogy for a second, doctors are essentially writing a menu, walking away, and just hoping for the best. Yeah, crossing their fingers.

And Dr. Lloyd points out that doctors have this deeply ingrained habit of presenting intricate procedures to their team and then, like, intentionally closing their eyes to the execution. Because when leadership closes their [00:03:00] eyes, human nature takes over. Right. Staff members, you know, they take shortcuts to save time.

Critical steps get omitted. Right. They’re busy. Exactly. And the real tragedy here is that the staff member often doesn’t even realize their performance has dropped. Oh, wow. I mean, they might be skipping three vital steps in a patient handoff procedure and honestly believe they’re crushing it simply because no one is watching to tell them otherwise.

That makes so much sense. But if inspecting the team is literally the only way to keep the system intact, what’s the psychological block here? Like, why are doctors so paralyzed by the idea of auditing their own staff? It comes down to identity, I think. Mm-hmm. Most chiropractors view themselves as healers, you know?

Mm-hmm. Caregivers, not drill sergeants or corporate enforcers. Right. They wanna be the good guy. Exactly. They associate the word inspection with painful adversarial conflict. They picture an audit as a gotcha moment. Hmm. Like they’re sneaking around trying to catch an employee doing something wrong just to punish them.

Oh, that sounds [00:04:00] awful. It does, and the anxiety of that confrontation is just so high that they avoid the inspection entirely. Which means if we are going to fix the clinic, we actually have to fix the leader’s mindset first. We have to completely change what an inspection even represents. And that is the core paradigm shift Dr.

Lloyd introduces. Since the fear of conflict is the roadblock, you neutralize it by changing the fundamental purpose of the audit. Okay, so how do we do that? Well, you’re no longer auditing your team to catch failures. You are auditing them to celebrate wins. Ah. He calls it positive inspection, right, and the psychology behind this is just brilliant.

It changes everything. The primary driving motivation for stepping out of your office and observing the front desk is literally to catch someone doing the right thing. You go out there hunting for an excuse to give an attaboy or an a atta girl- Yeah, he borrows this concept from The One Minute Manager, using those one-minute praisings to completely change the chemical makeup of the clinic environment.

Think [00:05:00] about the psychological safety that creates for your staff. When you flip the script, you transition from an adversary who’s waiting to drop the hammer to an advocate. Right. If your stated obvious goal is to catch your team being awesome, their nervous systems relax. They stop hiding their work and actually begin to crave your feedback.

Yes, and Dr. Lloyd uses a really great analogy for this. He says- Prepping a team member for a clinic audit should be exactly like prepping your kid for a math test. That’s such a good way to look at it. It is. You don’t hide the textbook and hope they fail so you can ground them. You give them all the study materials, you review it with them because your ultimate goal is for them to score 100% and feel an immense sense of pride.

But to follow that logic through- Yeah … you cannot possibly test someone on the material if they don’t have the textbook in the first place. Nope. You can’t praise an employee for doing a job right if you haven’t explicitly defined what right looks like. Which brings us to setting the baseline, right?

Setting [00:06:00] the standard through the job book. Yes, the job book is crucial. Dr. Lloyd talks about this hurry up offense for clinic onboarding. When someone is hired, there is no casual multi-year grace period where they just absorb the culture through osmosis. They get exactly 90 days to learn the job. 90 days, and they are handed a massive comprehensive manual.

And these job books are not like vague mission statements. One participant noted their front desk job book is a highly robust, entirely digital Google slide deck. Oh, wow. Entirely digital. Yeah. And it dictates the precise mechanics of the role, like exactly how to answer the phones, the specific routing of new patients, and concrete expectations for kept appointment percentages.

Every single variable is documented. And similar to, uh, an aviation student who has to prove to the instructor they can take off and land without crashing the plane, the clinic staff member actually has to be formally signed off on this job book. Yep, they have to prove they know it. But I do have to ask about the reality [00:07:00] of this because if I hand a new hire a 100-slide Google deck dictating every single word they say, aren’t I just turning my front desk into a row of corporate robots?

Like, I hired them for their warmth and their personality. That is a totally valid fear. But cognitive psychology actually proves the exact opposite happens. Structure creates freedom. Really? How so? Well, think about the mental bandwidth it takes for an employee to constantly guess what mood the doctor is in or, you know, try to figure out the unwritten rules of the clinic on the fly.

It is exhausting. Oh, for sure. When the baseline is thoroughly documented, there’s zero ambiguity. The employee doesn’t have to spend a single ounce of mental energy figuring out what to do. Which means they can dedicate a hundred percent of their energy to how they do it. Ah, like being warm, present, and deeply human with your patients.

Exactly. Oh, wow. The boundaries actually give them a safe playground. The resentment only builds when you reprimand someone for breaking a rule you never bothered to write down. That is so true. [00:08:00] Okay, so we’ve removed the adversarial fear of the audit, and we have a crystal clear baseline with the job book.

Now get to the mechanics. How is a clinic owner actually supposed to execute these inspections on a daily basis? Well, Dr. Lloyd breaks down five distinct types of audits, and each serves a very different psychological purpose. Yeah. The first is just random observation. Like just watching. Yeah. You are just a fly on the wall.

You walk a patient up to the front, and you actively listen to how your staff handles a live phone call in real time. You’re auditing the natural resting state of the clinic. Okay, got it. And the second is the scheduled ride-along. This one feels much more intentional. It is. You sit next to the front desk staff for a predetermined hour, or you join your associate doctor in the room while they do a patient history intake.

So you are physically in the passenger seat sharing the exact same context as the employee. Exactly. The third approach shifts the burden of proof to the employee through checklist drops. You require the team member to physically or [00:09:00] digitally drop a completed procedural checklist on your desk before they clock out.

Okay, so that forces them to self-audit their own key performance activities throughout the day. Yeah. Then the fourth is reviewing call logs and scheduling data. This pulls emotion completely out of the equation and just looks at the objective truth of the numbers. And the fifth is the ultimate test, having the team member actually teach the position to the rest of the staff, which we will explore the mechanics of that shortly because it really is the most powerful tool in the arsenal.

Oh, absolutely. Here’s where it gets really interesting, though. When running these audits, Dr. Lloyd relies heavily on what do you do drills. These are so fun. They are. These are intentionally chaotic stress test scenarios you throw at your staff to see how the system holds up under pressure. Because the clinic environment is rarely perfectly controlled, right?

If you only practice for perfect days, the staff will completely freeze when anomalies occur. Yeah, and the Three [00:10:00] Stooges scenario is a perfect example of this. You look at your front desk staff and say, “Okay, picture this. Three new patients are walking through the front door at the exact same moment. One is forty-five minutes early, one is exactly on time, and one is forty-five minutes late.

What do you do?” Or you give them the scenario where all three phone lines light up simultaneously- Ugh … while one patient is standing there trying to check in, and two others are waiting to check out and pay. Talk about a bottleneck. Yeah, but by role-playing these high-stress bottlenecks when the stakes are zero, you inoculate the staff against the adrenaline spike that happens when it occurs in real life.

It’s basically exposure therapy for the front desk. And speaking of practicing, one of the participants shared a tactic for phone audits that completely changes the dynamic of team training. Oh, the recorded call. Yes. They conduct weekly group reviews of recorded patient phone calls. This is essentially film study for your clinic.

Once a week, the owner and the staff sit together and listen to the audio of actual patient [00:11:00] interactions. But the framing is critical here, right? Huge. It is never used to point fingers or humiliate anyone. It is framed purely as a collective learning experience. They listen for the friction points, and as a group, they reconstruct how the script could have been delivered more effectively.

Normalizing the fact that mistakes happen is huge, but it brings us to a very, very delicate pivot point because no matter how positive your inspection culture is, audits will inevitably uncover real consequential errors. Yeah, someone is gonna drop the ball eventually. Exactly, and the absolute make or break moment for a clinic leader is how they handle the correction.

Humane leadership is the only way through this phase. Dr. Lloyd has a golden rule that cannot be violated. You never ever correct a staff member in front of patients, and you never correct them in front of their peers. Never. The correction must be private, and you must enter that private conversation armed with solutions, not just reprimands.

There’s a highly relatable story from the [00:12:00] master class about this. So Dr. Lloyd was quietly reviewing accounts receivable in his clinic, and from across the room he overhears one of his front desk staffers, someone he considered brilliant at her job, by the way, completely butcher a scheduling script. Oh, no.

She is on the phone with a patient and literally says, “We’ve got you scheduled today. Are you coming?” Oh, wow. From a clinical retention standpoint, that is a catastrophic script. Yeah. You are basically handing the patient an immediate frictionless exit ramp to cancel their care. It is the exact opposite of what she was trained to do.

But he didn’t bark at her from across the room. He absorbed the frustration, let her finish the call, and then pulled her aside into a private space. Which is key. Right. And when he brought it up, she was mortified. She immediately defended herself saying, “I never do it that way,” and he just gently replied, “Well, you just did.”

They were able to dissect the mistake safely because they were in private. And when you enter those private corrections, the employee is naturally going to [00:13:00] have their ego defense mechanisms triggered. They expect to be scolded. Sure. So Dr. Lloyd suggests a specific phrase to completely short-circuit that defensive response.

The leader should absorb the tension by saying, “I must not have been clear enough.” Wow. “I must not have been clear enough.” That is a masterful diffusion technique. It removes the accusation entirely. Exactly because If you say, “You did this wrong,” the employee’s amygdala fires up, and they have to fight back or shut down.

But if you say, “I must not have been clear enough,” you give them a graceful exit. You shift the dynamic from, like, a parent scolding a child to two aligned professionals trying to solve a system bug together. And once you’re in that collaborative space, the real magic happens. Yeah. Script upgrading. The participants on the Zoom call shared some phenomenal examples of upgrading standard responses.

Let’s look at cancellations. A patient calls and says they can’t make it. The default untrained reflex from a busy front desk is to just [00:14:00] say, “Okay, let’s get you rescheduled.” Right, which loses them. Yeah. But the upgraded script changes the entire trajectory of the patient’s care. Instead, the staff is trained to ask, “Are you sure you want to get off track?

You’re making really great progress.” If we connect this to the bigger picture of patient psychology, that subtle shift is incredibly strategic. “Are you sure you want to get off track?” invokes a sense of lost momentum. It anchors the patient back to their original clinical goals. Exactly. It frames the cancellation not as a simple calendar adjustment, but as a disruption to their healing process.

And the upgrades apply to everyday friction too. If a patient calls and says they are sick, the untrained desk says, “Feel better. Call us next week.” Right. But the upgraded script explicitly commends the opposite. “It is really good to get adjusted while your immune system is fighting something. Come on in anyway.”

That’s a huge shift. It is. Or if a patient calls and their specific doctor is out of the office, you never hit them with a dead end, “Dr. Smith [00:15:00] is out today.” You immediately offer a specific forward-moving alternative, like, “Dr. Smith is out, but his next available is Monday at 8:00 AM,” or, “Dr. Jones can see you today at 2:00 PM.”

By turning a correction session into a collaborative script-upgrading session, you empower the employee. Yeah. You aren’t just telling them what not to do, you’re actively equipping them with better tools. Which perfectly sets up the final stage of this entire process. We have gone from the leader inspecting the staff to the staff actively proving their absolute mastery of those tools to the entire clinic.

This is the fifth type of audit we touched on earlier. Having a team member stand up and teach their specific position to the rest of the clinic staff during an all-hands office meeting. It’s the ultimate crucible. I mean, if you can clearly teach the mechanics of a system to someone else, you have truly mastered it.

For sure. But Dr. Lloyd offers a major caution to leaders facilitating these training sessions. He uses the analogy of teaching a kid to ride a bike. When your [00:16:00] employee is up there presenting, you are supposed to hold the back of the seat and run behind them to keep them steady. You do not run alongside the bike, hitting them with a stick.

It’s a really funny visual but a crucial leadership lesson. Don’t sabotage your own team’s confidence by throwing obnoxious, impossible scenarios at them the second they open their mouth. Yeah, give them a chance. Right. You give them softball questions early on. You let them establish their rhythm and demonstrate their competence, and then you gradually dial up the complexity of the scenarios.

And when that team member finishes presenting their role, whether they just broke down the financial consultation process or the new patient phone routing, there is one magic question that every single other team member in the room must ask them. Oh, I love this part. The question is: what do you need from me in order to do your best work?

What do you need from me in order to do your best work? Consider how profoundly unifying that single question is. It completely destroys clinic silos. It really does. [00:17:00] The presenter answers the question, the rest of the team takes detailed notes, and then they literally parrot back to the presenter exactly what they’re going to do to support them.

It weaves a tight web of mutual accountability. The front desk suddenly understand the precise actions they can take to make the adjusting room run smoother, and the doctors learn exactly how to communicate so the front desk doesn’t get bottlenecked. So what does this all mean for you as you step back into your clinic tomorrow?

If you want to permanently close the gap between what you teach and what actually happens, passive expectation has to die. It has to go. It must be replaced by active, positive inspection. As clinic owners, we are obsessed with tracking KPIs, key performance indicators like patient visits, retention rates, and collections, but those are just lagging results.

Dr. Lloyd’s framework reveals that your KPIs will only ever improve if you actively audit the KPAs, the key performance activities that your team executes every single day to generate those [00:18:00] numbers. You have to bake the audit into the daily culture. Go out there hunting for wins. Catch your team doing things right.

Celebrate those moments, and when the inevitable mistakes happen, correct them humanely, privately, and collaboratively so your team feels supported rather than surveilled. Which brings us to a final thought I want you to really mull over as you analyze your own systems. What unspoken, unwritten habit in your clinic is currently overriding your carefully written procedures?

And what happens to your patients, your team’s morale, and your bottom line if you choose not to inspect it tomorrow? A sobering thought, but absolutely necessary because writing a beautiful recipe means nothing if you refuse to taste the food before it hits the dining room. So true. Now, if you are listening to this and realizing you need immediate help building these systems, Five Star Management is here for you.

We have three specific ways to help you take action right now. First, you need to book a free strategy call with our very own Dr. George Birnbach. He’s [00:19:00] amazing at this stuff. He really is. I’ll say that again, Dr. George Birnbach. He is a master at identifying the hidden gaps in your inspection process. The link to book that direct call is right there in the show notes.

It is the fastest way to get clarity on where your clinic’s specific breakdowns are occurring. Second, you need to step out of the daily grind of the clinic and come see us in person. We are hosting a live two-day event in Chicago, Illinois. It is called Streamline, Scale, Succeed, and it is taking place on July 25th and 26th.

You don’t wanna miss that. It is going to be incredibly hands-on, and the link to register for Chicago is also waiting for you in the show notes. The energy and the breakthroughs that happen when you get out of your own four walls are unmatched. Absolutely. And finally, if you wanna keep sharpening your edge, don’t forget to subscribe to the Successful Chiro podcast.

We are constantly delivering more actionable tips, deeper dives, and proven strategies to help you grow your practice and reclaim your peace of mind. Thank you so much for joining us on this deep dive, and we will catch you next [00:20:00] time