Front desk chaos is one of the biggest hidden growth killers in chiropractic practices—and most doctors don’t even realize it’s happening. In this episode of The Chiropractic Deep Dive, we unpack powerful insights from a recent Zoom mastermind led by Dr. Noel Lloyd, focused on eliminating checkout bottlenecks and front desk stress using a streamlined system called One Stop Shopping (OSS). You’ll learn why a practice with 300 weekly visits is actually managing 600 friction points, how inefficient checkout ruins even the best patient experience, and how high-performing offices redesign patient flow so most transactions happen at one single stop—before the adjustment. This episode breaks down the most common traffic mistakes, the psychology behind patient compliance, and the exact training, scripting, and systems that allow practices to scale without overwhelming their staff. If your front desk feels chaotic, your CA is stressed, or your growth feels capped—this episode will show you exactly where the breakdown is and how to fix it.
What You'll Learn in This Episode:
The Payoff of One Stop Shopping:
Training & Systems That Make OSS Work:
Key Takeaway:
When your front desk is stressed, your growth is capped.
One Stop Shopping removes friction, restores flow, and creates the capacity your practice needs to scale, without chaos.
Next Steps:
📅 Book a free, no-obligation strategy call with Dr. George Birnbach and the Five Star Management team to implement One Stop Shopping in your practice: https://myfivestar.com/work-with-us/
🎧 Subscribe to The Successful Chiro Podcast for weekly systems, leadership, and growth insights
📌 Share this episode with your team and start fixing patient flow together
🎙 Note: This podcast episode was generated using AI voices and is based on the teachings, training calls, and systems of Dr. Noel Lloyd and Five Star Management.
Welcome to the Chiropractic Deep Dive. We're coming to you as part of the Successful Chiro Podcast, and this is all brought to you by Five Star Management, a chiropractic consulting company that's, I mean, it's completely dedicated to helping you transform your practice.
Our mission today, it's, uh, it's straight from the front lines of practice management. We're diving into the insights from a really, really productive recent Zoom mastermind session. It was led by Dr. Noel Lloyd. Okay. The entire thing focused on really one concept. Yeah. How to stop that stressful, you know, chaotic front desk experience.
Yeah. And replace it with a high compliance system, a system he calls. One stop shopping. Let's unpack that immediately, because if you're running a busy practice, you know that sound. Oh yeah. That sound of a bottleneck, that line forming that, uh, that stress sigh from your chiropractic assistant. The patient flow just gets stuck.
It could be intake, could be checkout. It's almost always checkout. It is the single biggest point of friction in a practice. And Dr. Lloyd's analysis, he gave us some pretty alarming math. Oh, I'm ready for it if you're running just a standard non streamlined office. Let's say 300 patient visits a week.
Okay. Pretty typical. You're not dealing with 300 transactions, you are managing 600 potential interactions or transactions right there at that front desk, 600. So intake and outtake. Exactly. And that volume. It just creates this cascading failure. You get stressed cas, which leads to stressed dcs, and ultimately you have patients who are annoyed, even if they just got the best adjustment of their entire life.
600 friction points that are actively sabotaging the patient experience that you worked so hard to create inside the adjusting room. That's it. So the whole goal of this mastermind was to solve that 600 point problem. So what's the target then? What's the goal? The goal is to streamline everything. You reduce the stress and the success metric is actually really simple.
Can you template format and teach your patients how to use this one stop shopping or, you know, OSS to just dramatically cut down on the number of stops they have to make. So give us the core definition. What exactly is one stop shopping In a chiropractic office? It's a total transformation of the patient flow.
Hmm. For most of your returning patients, they take care of all their clinic business, scheduling payment, any updates on one single stop at intake with the front desk ca. So when they first walk in. When they first walk in. Okay. And that's it. Once they're adjusted, they're free to go. When they leave your office, you know, ready to get on with their day, they just, they wave goodbye on their way out the wave
goodbye exit. I love that. It's such a powerful visual. It like instantly shows you the difference between a successful system and a failed one. Right. And you mentioned there was a really powerful analogy from the mastermind session that kind of anchors this pain point. Yeah. It's that classic checkout line frustration.
One of the participants brought up that feeling you get at a place like, say a Cracker Barrel years ago. Oh, I know exactly what you're talking about. You've had a great meal. You're satisfied. But then you're forced into this long, inefficient line just to pay, and it's completely separate from the dining experience.
You're standing there ready to buy a gift or something, but the line's not moving and you just. You put it down and walk out. I have done that a hundred times. You feel great. You're adjusted, you're healed, and then you're just trapped for five minutes to complete a ten second transaction. That friction at the very end, it can just override the entire positive feeling of the visit.
It's a practice killer. It absolutely is. And that exact stress point led the discussion right into identifying the five most common. Uh. Traffic mistakes that practices make that basically guarantee that exit friction. Okay. Let's, let's spend some time on these because I think understanding the pitfall is like half the battle.
So what's mistake number one? Poor pre-scheduling habits. This is a massive, massive time clock. One participant pointed this out, the, the resistance to scheduling patients for multiple appointments in advance. So instead of just quickly confirming three pre-book dates, you've got patients standing right there at the front desk staring at their phone, trying to figure out their calendar.
For 15, 20. I mean, one person reported sometimes up to 45 minutes. 45 minutes. No, that doesn't just jam up the line. It signals to every single person waiting that your office doesn't respect their time at all. Not at all. And the solution is so simple. You schedule out the whole plan upfront. Scheduling becomes a confirmation, not a uh, negotiation on the way out the door.
Right? Okay, so that leads right into mistake number two, which is about payment. This is all about patient training. One participant pointed out that if patients aren't trained to expect to pay at the beginning of the visit, you put your ca in this really awkward kind of adversarial position. They become a bill collector.
They do. They have to constantly remind the patient after the service, it reduces compliance. It's awkward and it causes huge delays while they're. You know, scrambling to find a card. Yeah. That's a terrible way to end a health visit. Oh, okay. So mistake number three. This one feels, very human. The chatty ca clog, it's so insidious because it really, it comes from a good place, right?
It's where the ca starts up this, you know, unnecessary social chat on the patient's way out. One of the doctors in the session really highlighted this trap. The ca thinks they have to be friendly, asking about the grandkids, the vacation, and they confuse being friendly with being efficient precisely.
Yeah, they end up in this time trap where either the ca is captured by the patient who wants to talk or they capture the patient. In this well-meaning, but totally non-business socializing. It destroys the goal of getting the patient out the door efficiently. It's a system failure, not a caring failure.
Which brings us to mistake number four, which is how you fix this. It's missing the day three walkthrough. This is so critical. This is about training, not just telling them the rules. Yeah. One of the chiros detailed that after the first two visits, his office dedicates day three to a structured patient training day.
So they literally learn how to be a patient in your office, exactly how to sign in, the expectation to pay up front, and then the exit process, which is simply wave goodbye, right? They physically walk them through the new process. You teach the new habit. Which makes total sense. Okay, finally, mistake number five.
This one seems like it eliminates the biggest source of friction of all it really does. It's not having a card on file or a clear prepayment policy. Oh, a participant noted that practice is offering auto debits get way better compliance and almost zero friction at the end. Her office requires a card on file for copays and they offer a discount for prepaid plans.
But here's the key rule. What's that? If the patient wants to use a different payment method that day. Like cash or another card, they have to handle that transaction before the visit begins, not after. So payment is always part of intake. Wow. Okay, so we've defined the pitfalls. Let's talk about the payoff.
When a practice actually does this, when they implement OSS, what are the measurable advantages they talked about in Dr. Lloyd's mastermind? The advantages are systemic and they're big. The first one is really tangible. Staff and payroll efficiency. Okay. Saving money, I like it. One of the participants noted that less stress for the front desk means you just, you need fewer people and fewer non-essential hours.
It's a direct cut in payroll because the team is focused on patient flow, not, you know, putting out fires and that focus probably reduces all that non-business chitchat too. They're just moving people through a system, not reacting to chaos. Absolutely. The second advantage is, I think, maybe the most important for practice owners.
You remove the block on growth. What do you mean by a block on growth? How does a stressed ca actively stop the practice from growing? It's, it's so counterintuitive, but it's real. One of the doctors explained that if the front desk is chronically stressed at your current volume, they will actively or maybe passively hold back growth.
Wow. Think about it. The phone rings at 4:00 PM it's a new patient. Your CA is already dealing with a line of five people waiting to pay. Yeah. She's overwhelmed. Subconsciously, she might just tell that new patient, the office is closed or, and this actually happens that they've called the wrong number. That is alarming.
So the staff is subconsciously throttling growth because the system is so chaotic. They fear the stress of more volume, more than they want success. And OSS removes that fear. It creates capacity and confidence, which leads to the third advantage. Patient satisfaction and retention. Right. Happy patients.
One of the doctors summed it up perfectly. She just said, everyone is happy. The flow is efficient. Patients get seen and they're out the door on time. And that leads to the best kind of internal marketing they tell other people. Yeah, and that connects to that external signal, right? An efficient flow keeps the number of cars in the parking lot low and moving.
If a potential new patient drives by and sees a frantic backed up office, a lot of times they just keep on driving efficiency signals, professionalism. It's the ultimate nonverbal communication about the quality of care inside. Okay. Let's shift to the training blueprint. This is where the rubber meets the road.
How do these successful practices actually train patients? To move from chaos to compliance, you have to master the psychology first. The practices that had success, they rebranded OSS to align with what the patient actually wants. So you sell the benefit, not the rule. You got it. Yeah. One doctor's office uses the terms express scheduling and express pay.
Why? Because your patients are busy. They want speed, they want convenience. So you're tapping into that compliance principle. Tell them why and they will comply. Exactly. You're using that fact reason pattern. The why isn't just for the office's benefit, it's for them. It creates predictability. The patient knows exactly what they're doing and when they're leaving.
So what are some of the specific tools that make this training stick? So the most valuable low tech tool they mentioned was the plan printout. One, doctor detailed how they give the patient a specific list of all their dates and times their whole care plan for them to take home. Ah, I love that. Yeah. And the instruction is compare this to your personal calendar and come back with any changes.
That's brilliant. It shifts the cognitive load of complex scheduling from the stressed ca back to the patient, but in a really structured, supported way. They solve their own calendar problems at home. That's the whole point. You eliminate the clogs before they can even start. But you know, technology is also playing a huge role here, right?
Like check-in apps for sure. Many of the advanced practices talked about using check-in apps where a patient just binks in with their phone and the system automatically tells them which room to go to. So that eliminates the need for a staff member to physically stroll and room every single patient.
Exactly. One participant called it a huge time difference because that staff time isn't being eaten up by escort duty anymore. It lets the ca focus on the next person's intake, which is the business critical task. One doctor mentioned his office is almost at what you could call zero stop shopping. Yeah.
Because 95% of his patients are prepaid or on a monthly auto debit. They use the cell check in, the card swipe, and they self room completely. The CA is basically just a facilitator, which must free them up to be more of a resource, which brings us back to empowering the CA one Doctor's. Big takeaway was this.
She implemented a 10 minute weekly product training session for her cas. On supplements, traction wedges, things like that. Oh, that's smart. That changes the dynamic. It does. It lets the ca answer common questions on the spot. It cuts down on the doctor's time, and it massively increases the patient's trust in that front facing team.
The ca has become, you know, knowledgeable resources, not just traffic cops. So that combination of training, tech and scripting is the blueprint. So to wrap this all up, what were the final sort of slickest process improvements they shared that really cut down on front desk stress? Two really strategic ideas stood out.
The first one was pretty radical. It was taking the phones entirely off the front desk. Whoa. Okay. That sounds risky. How do you manage patient communication if the front desk isn't answering calls? Well, they recognize that most routine stuff is text now, but the actual phone calls are usually from, as one person put it, a needier person.
A complex new patient case. Mm-hmm. Or an urgent question. So it's a different type of communication. Exactly. So they dedicated a remote person to handle all calls and texts. This freed up the CAS at the front desk to focus purely on the flow of patients who are physically in the clinic. The CA is no longer getting yanked away by a ringing phone when there's a line of people right in front of them.
That makes profound sense. You segment the communication channels, don't let the external traffic jam up the internal traffic. Okay. What was the second slick idea? It was all about using directive language during scheduling. Okay. What does that sound like? So instead of asking that open-ended question, when do you wanna schedule next?
Which just invites the patient to pick some random time that never works. Right? They switched to directive language. Let's get you scheduled. Yeah. Then the ca gives the patient two viable options that fit the practices block schedule. Would 2:00 PM Tuesday or 10:00 AM Wednesday work better for you? That is practice leadership in action.
It is the patient complies because you've given them two good choices, not an infinite sea of bad ones. It stops the slowdown before it starts. This has been an incredibly deep dive. All from one mastermind session with Dr. Lloyd, and the ultimate takeaway seems so clear. It really is implementing this one stop shopping, backing it up with deliberate patient training, especially explaining the why, the benefits of express pay and express scheduling.
It is the proven, scalable path to cutting stress, boosting efficiency, and removing those subconscious blocks to your own growth. And we are here to help you get that exact same efficiency. This Deep Dive was brought to you by Five Star Management and we're dedicated to optimizing your practice systems.
If you're ready to remove those 600 points of friction and really scale your business, we want to encourage you to take the next step. What's that book a Free call with Dr. George Birnbach link is right there for you in the show notes. Don't miss out on turning these insights into your new reality.
And make sure you subscribe to the successful Chiro Podcast. We'll have more tips and actionable insights designed to support your practice's success. Thank you for joining us for the deep dive. We'll see you next time.