In this episode of The Successful Chiro, the Five Star Management team breaks down one of the biggest growth killers in high-volume practices: front desk congestion. Based on Dr. Noel Lloyd’s proven “One-Stop Shopping” system, this deep dive shows how excessive check-ins, payment friction, scheduling chaos, and inefficient staff workflows quietly cap your growth, burn out your team, and frustrate patients. You’ll learn how top-performing practices cut front desk transactions in half, increase capacity without adding payroll, improve patient experience, and reclaim sanity—using smarter scheduling, automated payments, patient training, and simple scripting strategies. If your practice feels busy but bottlenecked, this episode gives you the exact operational shifts to streamline flow and scale with less stress.
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:
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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.
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