If your new patient flow feels like a rollercoaster—busy one month, quiet the next—you’re not alone. In this episode of The Chiropractic Deep Dive, powered by Five Star Management, we uncover the system that ends that chaos for good: the Community Outreach Assistant (COA) model. Dr. Noel Lloyd’s proven framework shows you how to train, manage, and scale with a COA who consistently drives 3–7 new patients per week—without you having to do all the marketing yourself. We’ll break down: - The #1 reason your external marketing isn’t consistent - The common COA mistakes that cost clinics thousands - The exact metrics and systems top-performing clinics use - Real-world results (like a COA who generated 342 new patients in one year!) If you’re serious about sustainable, predictable practice growth—this episode is your roadmap.
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🎙️ This episode was created using AI-generated voices to bring Dr. Noel Lloyd’s teachings and Five Star Management resources to life.
Welcome everyone to the chiropractic deep dive. This is where we really try to give you that shortcut to sustain success in practice. Yeah, we distill the best strategies, uh, directly from docs out there in the field, and today we're diving into maybe the single biggest headache for practice growth that, you know, new patient volume roller coaster.
Right? And we're gonna break down the system for managing a community outreach assistant, a COA. This deep dive is part of the Successful Chiro Podcast, and it's brought to you by Five Star Management. We're a chiropractic consulting company and we're really dedicated to helping you maximize your growth and honestly, your freedom too.
Mm-hmm. And the source material today, it's pulled directly from a, uh, a really potent zoom call. It was led by Dr. Noel Lloyd just recently. He really laid out exactly what it takes to well stop scrambling for new patients all the time and start building predictable systematized growth. Our mission today is pretty clear.
I think we wanna unpack that system. You need to stabilize your patient flow. Yeah. And we'll hit both sides. Yeah. The, uh, catastrophic mistakes clinic owners sometimes make. Oof. Yeah. And also the world class strategies that, well, they deliver exponential results when done right. Because, let's face it, if you're still the only one responsible for all the external marketing, uh, that practice growth journey, it's gonna feel super stressful.
Okay, so let's start with segment one. Defining the core problem, like why is this COA role an absolute necessity? Well, the central challenge we see again and again, especially in growing practices, it's uh, low new patient volume that combined with just no organized, consistent external marketing program.
And that leads right back to the stress you mentioned, right? The new patient volume rollercoaster. Mm-hmm. Everyone listening probably know it. Volume's down. You panic, you rush out, you market like crazy. They get busy, you get busy, you see results. Great. And then you stop marketing 'cause your schedule's packed and boom, the volume drops again.
Mm-hmm. Back to square one. Scrambling. It's just, it's a boom bust cycle that really eats away at your sanity as the owner. So the COA. This is the required systematic solution to get off that coaster for good. Exactly. And the goal isn't just, you know, filling a chair. The real goal is having a dedicated producing assistant.
Someone who generates, say an extra 3, 5, 7, maybe even more new patients through the door every single week consist consistently. That's the key word. It's kind of crazy when you stop and think about it though. We have assistance for everything else, right? Front desk billing, cas doing therapy. Yeah. All the internal stuff, but external marketing, which is arguably the most challenging,
um, emotionally taxing, definitely time consuming piece of growth. Yep. We often ask the clinic doctor. Who should be focused on patient care or maybe a brand new associate who's still finding their clinical feet to just shoulder that all alone. It just doesn't scale. It fundamentally doesn't scale. Yeah.
And uh, Dr. Lloyd really emphasized this on the call, the COA role. It's bigger than just like setting up screenings, right? They need to function as a true marketing manager, especially if you've got associates in the practice. So their job is actually helping the associates fill up their marketing calendars proactively and facilitating event logistics, making sure the whole outreach system keeps running, whether you the owner are physically in the office that day or not.
Okay, so how do we know if it's working, if we've actually solved the problem? The measurement piece? Yeah. The metrics have to be precise. The key metric isn't just a general count of new patients. It's gotta be the ratio. Ratio of what, like number of cold calls made to events booked from those calls to appointments scheduled at those events.
And then finally to actual new patient show ups in the clinic that result directly from that COAs activity. Yeah. You gotta track their specific KPIs. Exactly. If you can't measure that direct line, that lineage, you simply can't manage their performance effectively. Okay. Good point. And speaking of management, that kind of leads us right into the pitfalls, doesn't it?
Yeah. If the COA is the solution, why do so many clinics seem to struggle to make the position actually work? Let's dive into those common mistakes. All right. Segment two common mistakes. What did the participants on Dr. Lloyd's call highlight as number one? Number one, hands down was the training vacuum, just failure to train.
We heard that one anecdote. It was almost unbelievable. Clinic owner hires an external marketer. Mm-hmm. Provides literally zero training, gets zero new patients over two months. Okay, bad enough, but wait, there's more. But the real horror story part was the owner eventually realizes this person is still getting paid, but has actually been seen in the office for a month getting paid for ghosting.
I mean, that's beyond a system failure. That's like total operational meltdown. It really is. Failure to train is failure to launch, but like you said, failure to hold accountable while training, that's just financial negligence. Totally. Okay. Another big one. Clarity trap, meaning we often just assume people know what the job really entails, what success looks like, but without really clear quantitative goal.
Like numbers. Yeah, numbers like the number of cold calls they need to make per day or week, the minimum number of events they need to book per week. Without that, you get confusion. Drift and pretty much guaranteed under performance. You have to be precise. The COA needs a target that's not just vague, like go get new patients.
Right. But super specific, like book five screening events that result in at least 15 scheduled new patient appointments by Friday. Exactly. And that performance, it really starts with hiring the right person in the first place. Which brings us to the agony filter. The agony filter. What's that? It's simple, really during the hiring process of being on the phone, you know, connecting with strangers, handling rejection multiple times a day, if that sounds like pure agony to the applicant, there's a wrong person, absolutely the wrong person for this position.
This role demands a certain level of innate persistence, maybe even, uh, enthusiasm for the chase. Okay. That makes sense. And this ties right into the next big one, which might be the most common reason COAs fail. The split duties disaster. Ah, yes. Classic mistake. If you let the COA take on other admin tasks or, you know, split their time covering the front desk.
Mm-hmm. They will always gravitate away from the hard stuff, the necessary stuff, which is the outreach. It's like giving them two buttons, right? Yeah. The hard make, 50 cold calls button and the easy organize these files button. Which one do you think gets pushed? Every single time. Yeah. 'cause let's be honest, pretty much everything is more fun than cold calling for most people.
So the marketing just, dies on the vine. Deferred indefinitely. Yeah. And beyond just the job structure, clinics often suffer from a lack of practice. Meaning role-playing. Exactly. Failing to actually schedule time for the COA to role play scripts, practice handling objections, you know, with the doctor or manager.
So they're going out unprepared. Totally. You gotta practice the pitch, refine how to handle the no's, build their confidence together. That little bit of practice time. It fuels the whole week's success. Yeah. Okay. And the last mistake here. Inconsistent communication. Or maybe who's responsible for the communication.
Yeah. This insight from Dr. Lloyd's group was huge. It is absolutely the co a's responsibility to initiate the contact, the check-ins, the checkouts, to keep the busy clinic doctor in the loop. Right? It is not the doctor's job to chase down the COA and ask, Hey, what did you do today? The doctor needs to be available for that check-in, obviously, of course, but the, the COA has to own driving that accountability loop.
Mm. They need to feel empowered and responsible for reporting their progress. It sounds simple, that distinction, but making it work requires a culture shift where the COA is actually empowered to manage up and really take charge of their own performance metrics. Absolutely. Okay, so if segment two was the cautionary tale, what not to do, let's flip the script.
Let's dive into the specific actions that move you towards world-class success. Segment three, world-class COA, strategies and actions. Right? And this is where the numbers start to get really compelling, frankly. Yeah. We heard about this one, specific COA. High performer. Last year she produced 342 new patients for her clinic.
Wait, hold on. 300, and 42 new patients from one role. Yep. And when this call happened, she was already at 252 year to date. Okay. Let's just pause on that for a second. Right. 342 new patients. If your practice's, average case value is, let's say even just $2,000. Mm-hmm. Heather generated nearly $700,000 in revenue last year.
That's, that's not just an assistant role, that's a massive profit center. It completely reframes the value that kind of ROI makes having a dedicated, well-managed COA, pretty much non-negotiable for serious growth. So what's the secret sauce? How does someone achieve that? Well, the foundation, according to the discussion is the cold calling commitment.
Brutal consistency. Okay. What were the specific numbers? They were, uh, pretty startling, but clearly effective. Eight to 12 hours of high volume cold calls every single week, eight to 12 hours of week with a monthly goal of making 1200 calls, 1200 calls a month. Wow. Okay. That's, that's intense, right?
But it brings up that challenge again. Right. How do you find someone who can actually. Tolerate, let alone maybe even enjoy that level of intense, often difficult rejection filled work. You find someone with the right mindset, number one, and number two, you support them relentlessly. Okay. What's the mindset piece?
The essential mindset for handling rejection, and this needs to be drilled. During that role playing we talked about is that every single "No", just means not right now. Ah, okay. Not no forever. Exactly. People who turn you down flat one year, maybe because of budget issues or internal politics or just timing,
very often enthusiastically say yes to an event the following year. So persistence pays off because. Context change precisely. People change, companies change needs change. The COA just needs to be consistently present over time. Okay. And to maintain that kind of volume, that brutal consistency. The COA obviously needs strong support from the DC from the clinic director, absolutely critical.
The COA detailed the importance of daily check-ins and checkouts, but they're super brief, usually just 30 seconds to maybe a minute long, quick hits. What do they cover? Focused on just three things. Wins, challenges and excitements. WCE wins, challenges, excitements. Okay. That structure keeps the communication really focused, uh, mostly positive and holds them accountable without sucking up tons of the doctor's valuable time.
It's actually a highly efficient system for maintaining both mental health and performance focus. Smart. What about organization? You can't make 1200 calls without a system. No way. World-class COAs are ruthlessly organized. They use spreadsheets, often things like color coded Google Docs. Where do they get their call list often sourced from commercial data lists.
Something like Data Axle was mentioned. Yeah. Which is just, you know, a commercial database that helps you identify local business contacts and they use that to organize their efforts across specific sectors. Yeah, like dental offices, vet clinics, schools. Different types of local businesses, they don't just call randomly.
They define their ideal patient profile first. Exactly. And target industries may be known for high stress or repetitive strain injuries, places where chiropractic makes immediate sense and they plan ahead seasonally too. Super smart tactic. They actively look for those national awareness days or weeks like Vet Tech Week or Nurses Week, Teacher Appreciation Week.
Ah, so they can tailor their cold call pitch to be immediately relevant, right? It gives them an easy in, Hey, just call in because it's nurses week and we'd love to come pamper your team. It just cuts through the noise way better than a generic call. Makes sense. What else? Any other smart strategies? Yeah.
Another really clever tactic was creating a trusted backup list. They called it a F O R D list on the call. FORD, like the car uhhuh? It references that old sales concept of organizing contacts by categories, friends, occupation, recreation, dreams. But the point here is, it's a list of friendly places in the community, maybe local gyms
you have a relationship with, health food stores, places like that. Why have that list? Because inevitably, a big corporate screening event will cancel last minute it happens. This backup list lets the COA quickly pivot and book an easier, smaller event at one of these friendly locations. Ah, so their momentum doesn't stall.
Their metrics for the week don't totally tank because of one cancellation. Exactly. Keeps the engine running. Okay, so they book the event. What's crucial then, the number one rule for sustainability for getting repeat bookings is making the entire process super easy for the host. Usually an HR manager or maybe an office admin.
Right? Busy people. Yeah. So the COA has to be hyper organized. Communicate expectations really clearly provide all the necessary materials like the signup sheet well in advance, because if the host feels like they have to do any real work or heavy lifting, you're probably getting a no next time or maybe even not getting this event off the ground.
You certainly won't get a repeat booking easily. Yeah, minimize their effort, and the relationship doesn't just end when the screening is over. Right? No follow up is critical. A simple email afterward thanking them, maybe asking for quick feedback or even a brief testimony about how it went. That helps solidify the relationship, turns them into a potential repeat source, an advocate even.
Okay. Last piece here. How do you keep the COA motivated, connected to the why behind all those tough calls the doctor has to consciously involve them in the patient journey somehow. Like how share patient testimonials specifically from people who came in because of that COA screening event. Or even better facilitate real time interaction.
Like bring the COA in to meet the patient even just for a minute. Have a patient quickly tell the COA, Hey, thanks to you finding me at that health fair, I can finally play with my grandkids again. Something like that. Ah, so the COA sees the direct, positive end result of all their hard work out in the field.
Exactly. It closes the loop. Yeah. It fuels their motivation for the next thousand calls because they see the real impact they're having. Okay. So tying it all together, the source material from Dr. Lloyd's call, it seems crystal clear, the difference between that stressful rollercoaster. Mm-hmm. Consistent, even exponential growth.
Like the example. Yeah. That $700 K potential. It comes down to a formalized system. High accountability and finding training, and really supporting the right person in that highly leveraged COA role. It really is a system of consequence, consistency, and very clear KPIs. No guesswork. It's about eliminating the guesswork.
Yeah. Yeah. And maybe taking some of the emotion out of it. By relying on the system. Hmm. Which brings us to a final question for you listening, the clinic owner. Okay. We talked a lot about accountability and support, but let's talk consequences if COA just isn't meeting their goals, even after you've provided clear training and consistent support.
What is the consequence? Mm-hmm. You really have to consider that for the practice's health, the bottom line outcome of I can't do it and I won't do it. It's essentially the same negative result. Right? Zero new patients from that channel. Yeah. The end result is identical. So what action must you take to protect your system and your practice's growth?
Something to think about. And look, we know these can be challenging, structural and personnel issues to solve. We're here to help you build that world-class COA system. Yeah. If you need help building out those KPIs, the accountability structures, the training pieces, we really encourage you. Book a free call with Dr.
George Birnbach. It's a free, no obligation consultation. The link to schedule that call is right there waiting for you in the show notes. And speaking of systemizing growth and getting these things implemented, yeah, if you want a complete immersion, like really dive deep into these concepts and get them working fast, join us
in sunny Orlando, Florida. When is that? November 15th and 16th. Yeah. And we're actually running two powerful events simultaneously. Okay. What are they? First is the new patient edge that's laser focused on how to get more new patients. Fast, all the strategies. Got it. And the second one, the second is our Win-Win Associates event.
This one dives deep into our proven win-win associate system designed for maximizing your growth, your freedom, and your success through leverage. Awesome. So two great events, same time, same place, Orlando, November 15, 16. Mm-hmm. And the link to register for either the new patient Edge or the Win-Win Associates event.
Is also right there in the show notes for you. Perfect. And of course, make sure you subscribe to The Successful Chiro Podcast so you don't miss any more essential tips and these deep dives. Absolutely. Until next time, keep systemizing your success.