Tired of feeling like your schedule controls you instead of the other way around? In this week’s Chiropractic Deep Dive, we unpack the real systems that turn scheduling chaos into smooth, consistent patient flow. Dr. Noel Lloyd shares field-tested strategies from a recent training call — revealing how top clinics master scheduling efficiency, eliminate bottlenecks, and boost both patient experience and doctor satisfaction. Discover: ✅ The biggest scheduling mistakes that drain your volume ✅ How to empower your CAs to truly control the flow ✅ The “Air Traffic Control” system that keeps your clinic running on time ✅ Why Power Hours are the secret to higher profits and lower stress If you’re ready to stop running through “wet cement” every day and start operating like a high-volume, high-efficiency clinic, this episode is your roadmap.
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Welcome to the Chiropractic Deep Dive. This is part of The Successful Chiro Podcast where we cut right through the noise to give you systems that actually work in your practice. Yeah, and today's Deep Dive is brought to you by Five Star Management. We're a dedicated chiropractic consulting company, and it's fielded by some really critical insights from a Zoom call, Dr.
Noel Lloyd led focusing squarely on scheduling. And our mission today, it's pretty fundamental, isn't it? We're tackling that universal problem, clinical chaos. That's it. Helping you move from just, you know struggling to control patient appointments, to actually mastering them. That really is the whole game. The goal here isn't just getting through the day.
It's about controlling that schedule. Controlling patient flow, achieving what we call maximum clinical volume or MCV, right? And doing it with maximum efficiency. We're aiming for smooth, consistent flow, low wait times, and that's not just for patients. Critically. It's for the DC too. Yeah, absolutely.
Because if you're seeing those gaps or maybe clogs in your key time slots, what we call power hours, you're just leaving energy and money on the table. Dr. Lloyd had a great analogy for this shift. It's like moving from a really chaotic, messy dresser you can't find anything to a clean, organized, systematic approach that requires more than just new software.
Right? It's a cultural shift. Totally. A cultural shift. Okay, so let's start with the pain. When the system is breaking down, what are those, uh, visible signs? What tells the practice owner, tells the ca that things are really going off the rails? Well, the symptoms hit you right away, and honestly, they're exhausting.
It looks like poor flow. Way too much work for everyone and just deep frustration and that hits service delivery hard directly. The most obvious symptom though, it's the classic clogs and gaps. Okay. Walk us through what that actually feels like in the clinic. I mean, sometimes your reception areas absolutely jammed.
Patients are spilling out, you know, and then maybe 10 minutes later it's a ghost town. Your team's just standing around that whiplash effect. Exactly, and that huge inconsistency. It creates long patient wait times, which ramps up stress, anxiety, and it also leads to long DC wait times that causes massive frustration for the doc.
That sounds like a really draining way to practice. Oh it is. Dr. Lloyd used this phrase, described it as running through wet cement. Ah, I like that. Yeah, you're putting in massive effort, right? Working hard physically, but the system itself is forcing low volume and high stress. You just can't get into that rhythm, that zone of consistent care if your day is constantly lurching around.
So if you feel that heavy effort, but minimal return, that wet cement feeling. It's a huge sign. Your effort's probably fine, but the system is what's broken precisely. But fixing it means, you know, you gotta admit the mistakes you might be making first. Okay, so identifying where control is slipping away.
That's step one. What's the first big mistake you see? The first major one is what we call patient dictation, right? Someone on the zoom call use that phrase, uh, letting the inmates run the asylum. That stuck with me, huh? Yeah. It's true. It's when you let patients completely dictate the schedule flow, they demand that 4:30 slot just because they want it, even if it's, you know, blocked for efficiency or just not available.
And the clinic just ties itself into knots trying to accommodate them. Exactly. Twisted into a pretzel was the phrase used. You accommodate one person, but it tanks the experience for everyone else and crushes your team's efficiency. And I bet that leads right into the next headache. Booking errors. It sure does.
And we need to be clear here. There's a difference between being, say, overbooked, like squeezing someone in where there's a genuine spot. Okay. And then there's impossible booking where the ca agrees to something. The DC literally cannot do, like seeing 20 people in five minutes. Yeah. That's just setting everyone up for failure.
Why does that happen? Is it just being nice? Often, yeah, it's cas and sometimes dcs too, being people pleasers, they wanna say yes in the moment. But saying yes to the impossible guarantees the rest of the day fails and ruins the experience for every patient coming after. Wow, that's a tough truth. Okay, mistake number three, letting patients escape the plan.
Oh, this is a huge volume killer. Especially with your maintenance or wellness patients, they finish their adjustment, they head to the disc and say, oh, I'll just call you to schedule my next one. And you let them walk out and boom. The second they leave without that next appointment booked, they've basically dropped off the treatment plan.
But you don't wanna sound pushy. How do you handle that? The advice on the call was pretty smart. Yeah. It's a soft approach. You acknowledge their busy life. Say something like, totally understand schedules get crazy. So just to make sure you stay on track, let's book something tentatively as a placeholder, maybe two weeks out.
Ah, the tentative booking. Right. It ensures they still get the reminder. It keeps them connected to the plan gently. Mm. And stops them from just drifting away completely. It's like proactive defense. That makes sense. It connects to mistake four, which feels like a big culture piece. Only thinking short term, not booking the entire treatment plan right at the start.
Yes. Why wait? Think like, uh, think like an orthodontist. Okay. When you get your braces plan, they don't just schedule the next visit, they sit you down. They map out every single follow-up, maybe even the ROF. The report of findings or the DC reviews everything. Exactly. They book it all before you even leave the chair that first time.
So it sets the expectation right away. The policy shift is pretty simple. Then super simple. Just adopt the policy. Here at our clinic, we book out your entire treatment plan to ensure you get the best results. Let's get that started for you. Frame it as a benefit. They secure the best times they commit to their health.
Okay. And then there are the more sort of. Structural mistakes. Poor organization. Yeah. Things like not using advanced scheduling to offer patients that express checkout feel. Yeah. But the big one here is cluster booking. Cluster booking. This seems fundamental for efficiency. Why is it so bad to have scattered appointments like
one at 4:00, then nothing till 4:30. Then maybe one straggler at 5:30. That 5:30 patient that kill the flow. The DC has to trek across the office for just one adjustment. It drains momentum energy. Yeah. Clustering is about grouping adjustments together tightly. Especially in those power hours, maximize the DC's focus, minimize the fatigue of constantly starting and stopping.
Got it. Yeah. And one last specific clog, they mentioned specialty clogs. Yeah. This is scheduling maybe four or five quick adjustments at say, 8:50 AM right before you have a longer appointment, like a new patient or an ROF scheduled for 9:0 am sharp. Oh. Exactly. Huh? You're absolutely guaranteeing that 9:0 am specialty patient starts late and the whole morning kicks off
stressed. Mm-hmm. Those longer appointments need buffer room, not a pile up right before them. Okay. Let's shift to the team dynamics. Dr. Lloyd mentioned this part of the Zoom call, uh, really hit home for people. What does the ca, the person actually running this schedule, what do they desperately need from the DC to make it all work?
Honestly, it boils down to one word. Consistency. Consistency in what way? Consistent adjustment times. The CA needs to know reliably. Are you a seven minute adjuster on average, or a three minute adjuster or five, because if that number swings wildly, the CA's math just falls apart, right? If they schedule based on five minutes, but the DC takes 10 on a couple of patients, the whole block is shot.
The rest of the hour is ruined. And you know the classic culprit for inconsistency? Let me guess. The chatty patient. Well, yeah, but specifically what was called the room with a door. That space where a standard quick adjustment somehow morphs into a 20 minute consultation because the door's closed and the conversation just keeps going.
Ah, okay. That throws a whole clinic off schedule completely. Which leads to the next ca wish. Dcs need to be open to being timed. Ooh. I can see some doctors maybe bristling at that being timed monthly. Maybe even with observation or cameras, it feels a bit like micromanaging. It can feel that way initially, but the key is how you frame it.
It's not about punishment or judging competence. It's about gathering objective data for improvement. So it measures predictability, not speed, per se. Exactly. It gives the DC a clear target to shoot for. Like, okay, let's work on consistently hitting that four minute mark. It shifts the focus to being predictable.
Which is what the business needs for smooth flow. Makes sense. What else is on the ca wishlist? Planning and communication. Team powwows. Meaning? The DC needs to actually sit down with the CA regularly, maybe daily or weekly, and review the upcoming schedule. Proactively. Okay. Specifically looking for those misers patients who are starting to maybe skip appointments or fall off their recommended plan so the doctor knows, okay, I need to have a quick word with Sarah during her adjustment today to reinforce the plan and keep her engaged, preventing them from falling through the cracks entirely, right?
And maybe the most crucial structural need for the system to hold trust and authority. Mm. Explain that. Look, if you expect your cas to own the schedule, to enforce these policies, we've discussed like telling a patient, no, sorry, 4: 30 isn't available, which can be tough for them, it can be then the DC must back them up.
You absolutely cannot undermine them by making exceptions right there in front of the patient. Yeah, that line. Uh, don't worry about it, just shove them in. Ugh. Yeah. That one sentence. Just destroys the CA's authority and the integrity of the entire scheduling system. Instantly that breakdown is so damaging.
Okay, one last thing. CA's wished for. Proactive review by the DC looking at the schedule the day before to spot potential issues. Yeah. Identify patients who are known talkers. You know, the Sally Joe's who love to chat about their grandkids for 10 minutes. The DC should flag that for the ca. Maybe even proactively call Sally Joe to gently move her to a time slot outside the busy power hours where that extra chat time won't cause a bottleneck. Communication
again, it keeps coming back to that. It's critical. So the big message from the CAS is give us consistency, give us communication, and please give us the authority to enforce the rules you want us to enforce. All right, so let's flip the script. What do the dcs on that call wish for most from their cas? It was pretty straightforward actually.
The core message was, do your job. Control things. Kidding. Keep a sharp eye on the schedule. Really manage the flow proactively, and this is a big one. Make sure the charting gets done. Subjectives actions, all of it promptly. Ah, the notes. So the DC doesn't end up staying two hours late just catching up on paperwork.
Exactly. That's a major burnout factor for dcs. So cas owning that piece is huge. Okay, so beyond that basic request, what about best practices? What are the super high volume efficient practices doing right? Number one system that came up repeatedly was air traffic control. A TC air traffic control. So the cas are basically directing the DC like planes on a runway.
Pretty much. The CA team organizes the patient flow. They know which rooms are ready, how fast things are moving, and the key, the DC submits to the ATCs authority. How does that work physically? Doctors are trained. When you finish with a patient, you look to the front desk, you get a quick glance, maybe a hand signal, maybe a quiet verbal cue, room five, next, head to room four.
So the clinic design has to support that. Yeah. Things like using half walls or training doctors to just naturally turn toward the desk when they finish an adjustment, it allows the ca to give that instant direction, guide the DC out quickly and cue the next patient in. Minimize the dead time. Clever.
Okay. Best practice number two. Block scheduling. We touched on it, but it's worth repeating 'cause it's so vital. Grouping those adjustments. Yes. Grouping all the quick similar adjustments together into those focused power hours. It stops the DC from constantly running back and forth. Boost concentration and cuts down mental fatigue.
Makes sense for those really high volume practices. What else? Number three. Hot seats. This is really smart flow management, especially in semi-open adjusting areas. Hot seats. Yeah. You train patients that after they finish their warmup or therapy, they move immediately to a designated hot seat near the adjusting area.
They basically self load. They're ready and waiting right there for the DC. So the patient becomes part of the flow system. Exactly. This is essential if you're aiming for huge volume, like, you know, practices, seeing 150, 170 patients a day, the patient knows the drill. They help keep things moving seamlessly.
Wow. Okay. And the final best practice mentioned? Daily feedback. This creates that culture of continuous improvement. How does that work? It's simple. Implement a quick checkout sheet system. Could be digital, it could be clipboard on the door. At the end of every shift, each team member jots down: wins challenges and crucially, what can we do to improve it?
So you get immediate data. Immediate nonjudgmental data lets you make small tweaks daily stopping tiny issues from snowballing into major systemic problems. All these practices seem to build towards the main strategy. Dr. Lloyd emphasized the power hour strategy. Can you break that down again? Sure. Step one, you gotta know your numbers.
Determine your clinic's real maximum clinical volume. Your MCV. How many people can you actually see efficiently per hour, while maintaining quality? Okay, know your capacity. Step two, protect your primetime. Identify the three naturally busiest times in your week. Usually evenings, maybe lunchtime.
Designate those slots as mandatory power hours. Meaning, meaning, no specialty appointments allowed in those hours, adjustments only. And the DC must stay rigorously on time during these blocks. Non-negotiable. Got it. Step three. This is the big cultural piece the DC has to submit to the authority of the A TC.
The air traffic control. The ca running the show. Yes. If the doctor won't be guided, if they override the ca, the whole power hour system collapses. Okay, and step four, assuming it's working, scale it. Once those first three power hours are consistently full, running smoothly, maybe you've mastered seeing 12 people efficiently in that hour.
Then you add more power hour blocks, you gradually increase volume. Maybe working towards mastering a shift where you see 36 or more people efficiently, but it requires that doctor buy-in and sticking to the process. Absolutely. Commitment and process of mission are key. Okay, so to wrap all this up, to synthesize the steep dive, scheduling success really boils down to having a clear, solid system, right?
Yeah, system training your cas to run that system like clockwork. And this is crucial. Empowering them, giving them the resources and the authority to actually enforce the rules and the DC's role then becomes. Simpler in a way perform consistently within those established boundaries. Yeah, exactly. And seeing an idea like ATC or power hours actually become your standard operating procedure, your SOP, that feeling when it clicks in your clinic, that's pure gold.
That's what buys you freedom and fuels real growth. It really is about trading that day-to-day chaos for systematic control. So here's our final thought for you, the listener, to chew on. What's one single system, maybe something small that you could implement today to empower your team to actively enforce your clinic's culture instead of letting external pressures constantly dictate your success or failure.
And look, if scheduling is that bottleneck for you right now, if it's choking your volume, stressing out your team, holding back your growth, we genuinely want to help you fix it. That's what Five Star Management does. Absolutely. You can book a completely free, no obligation call with Dr. George Birnbach.
To talk about your practices specific challenges and needs. We've put the link right there in the show notes for you. Please take advantage of that and also we'd love to see you live. Don't miss our live two day event happening this weekend, November 15th and 16th down in Orlando, Florida.
Yeah, it's gonna be fantastic. We've actually got two powerful events running at the same time. You can join us for the new Patient Edge that's all about strategies to get more new patients fast. Or you can attend the Win-Win Associates event that focuses specifically on our proven system for achieving more growth, more freedom, and more success with your associate doctors.
It's a game changer. Both sound amazing. The link to register for either event or both is also right there in the show notes. Check it out before it's too late. It's this weekend. And finally, as always, make sure you subscribe to the Successful Chiro Podcast. We share actionable tips and deep dives like this one all the time.
Thanks so much for diving deep with us today. We'll catch you on the next one.