Hiring an associate is only the beginning. The real challenge is launching them successfully. In this Chiropractic Deep Dive, we break down Dr. Noel Lloyd’s blueprint for taking a new chiropractic associate from an empty schedule to a productive, profitable part of the practice. You’ll learn how to choose the right candidate, create momentum before day one, use the “100 in 100” goal, build an effective marketing launch plan, and mentor your associate without micromanaging them. If you want your next associate to create growth instead of becoming another expense, this episode gives you a practical system for building a true Win-Win Associate relationship.
Hiring the wrong associate can be expensive. But even the right associate can struggle if they are never given a proper launch.
In this episode of the Chiropractic Deep Dive, we unpack Dr. Noel Lloyd’s approach to successfully launching a chiropractic associate and building profitability from the beginning.
In This Episode You'll Learn:
The goal isn’t simply to hire another doctor.
The goal is to create enough momentum, training, accountability, and patient volume that your associate becomes a profitable and confident part of the practice.
A strong associate program should create a win for the owner, a win for the associate, and ultimately a better experience for the patients you serve.
Ready to Build a Stronger Practice?
Book a Free Strategy Call with Dr. George Birnbach
Want help applying these systems inside your own clinic? Schedule a complimentary strategy call with Dr. George Birnbach and discover your next steps toward greater growth, profitability, and freedom: https://myfivestar.com/book-consultation/
Join Us Live in Dallas | November 14–15
Join Five Star Management for two powerful events happening in Dallas, Texas:
Win Win Associates — Learn the systems behind building productive, profitable, long-term associate relationships.
New Patient Edge — Discover proven strategies for generating more new patients and creating consistent practice growth.
Reserve your seat today: https://myfivestar.com/events/win-win-associates-new-patient-generation/
Subscribe to The Successful Chiro Podcast
Subscribe so you never miss another Chiropractic Deep Dive, strategy, or actionable idea designed to help you build a more successful chiropractic practice.
[00:00:00] You know, usually when we talk about a medical diagnosis, um, there's this expectation of absolute precision. Like, it feels almost like engineering. No, totally. It's wonderfully binary. Right. You break your arm, the X-ray shows that jagged white line, and the doctor just points at the film and says, "There it is.
That's the problem." Yeah. It's clean, it's visible, and just neatly categorized. But then, you know, you step into the business side of running a chiropractic clinic, and suddenly, uh, that X-ray machine is just completely shattered. It really is. We find ourselves looking at a diagnostic landscape that is incredibly murky, especially, well, especially when we're talking about hiring.
Yeah. Hiring is tough. And this leads to a gut-wrenching scenario that was detailed in our source material today. I mean, imagine this. A clinic owner is pouring their heart into their practice, and they get a phone call from their spouse who, uh, also happens to be the office manager and the bookkeeper.
Man, that is never a call you wanna get in the middle [00:01:00] of a busy shift. It's really not. And the spouse just flat out tells the clinic owner, "Look, we have to let this new associate doctor go." Oh, wow. Yeah. They say, "You need to go back to working longer hours and grinding harder yourself because this new hire just isn't making any money."
Just brutal. Think about the anxiety there, right? The frustration. Nobody's excited about the future anymore. You are essentially, uh, working harder just to subsidize the salary of another doctor who is standing around an empty clinic. Exactly. The expenses just mount up. The atmosphere gets incredibly tense, and the clinic owner's left feeling like they failed, but, um, they can't quite diagnose why.
It is the dreaded failure to launch syndrome. Yeah. Failure to launch. Well, welcome to the Chiropractic Deep Dive, everyone. This is a special part of the Successful Chiro podcast, and it's brought to you by Five Star Management. That's right. And as members of the Five Star management team, our entire mission today, and honestly every single day, is to help [00:02:00] your clinic not just survive, but absolutely thrive.
Yep. So today we are fixing that murky x-ray machine. We are gonna tackle that exact failure to launch problem and, uh, extract the cure. And we are pulling this cure directly from an exclusive masterclass Zoom call led by the incredible Dr. Noel Lloyd. Oh, such a good one. It really is. He laid out a very specific blueprint for launching an associate into instant profitable success.
We're gonna walk you through how to transform that stressful financial drain into, like, an exciting win-win scenario where the associate actually makes more money than they cost right out of the gate. Okay, let's unpack this because, you know, we cannot talk about launching an associate successfully if we load the wrong ammunition into the cannon in the first place.
Nope. You definitely can't. Right. The foundation of a successful launch actually happens long before the employment contract is ever signed or, you know, the first patient is even seen. Exactly. Dr. Noel Lloyd [00:03:00] emphasizes that the entire pre-launch phase really hinges on selecting a candidate who actually fits a launchable profile.
Right. And the very first filter they must pass is what he refers to as technique congruency. Technique congruency. Yeah. So the associate needs to look at your clinic Look at your specific patient interactions, your adjusting style, your philosophy, and basically say, "Yes, this is how I want to practice. I want to emulate your success."
So it's really about finding an apprentice, not just like an independent contractor sharing your roof. 100%. I always think about this like an organ transplant. Like if the underlying blood types, the core philosophies of patient care, you know, if they don't match, the clinic's ecosystem is going to aggressively reject the new doctor.
Oh, completely. No matter how technically skilled they are. But wait, isn't it tempting to, uh, to hire an associate specifically to capture a new demographic? Like what? Say you run a wellness-based family practice, and an [00:04:00] associate comes along offering a highly specialized sports rehab technique that you don't do.
Why is that so dangerous for this specific launch model? Well, what's fascinating here is that true mentorship requires absolute alignment. You know, you cannot effectively mentor someone who doesn't actually want to practice the way you do. Yeah, that makes sense. Or who is playing a completely different sport under your roof.
I- if they are constantly trying to like reinvent the wheel or subtly pushing back against your established clinical protocols because their technique demands a different flow- Right, 'cause they wanna do it their way. Exactly, then you aren't mentoring them. You are just arguing with them. And all that friction naturally causes a slow grinding launch.
You spend all your energy debating care plans instead of actually seeing patients. Which just bleeds the clinic's resources dry. Right. Now, beyond that baseline technique congruency, Dr. Noel Lloyd deeply analyzes the psychological makeup of a highly launchable associate using the LEAD [00:05:00] profile metrics.
Yeah, the LEAD profile. It's an assessment tool that really breaks down personality traits. I found this part of the masterclass so revealing, but before we dive into the most critical parts of that, let's establish what LEAD actually stands for. It's an acronym, right? It is, yeah. The letters stand for leader, enthusiastic or extroverted, analytical, and driver or decisive.
Okay. Got it. And while all four elements paint a picture of the candidate, the masterclass hyper-focused on the interplay between the L and the A as the primary predictors of a successful rapid launch. Interesting. So the most crucial metric you are looking for is a strong L score, ideally sitting right in the 55 to 60 range.
But why that specific 55 to 60 range for the leader trait? Like what does that look like when the doctor is actually in the room with a patient? Well, think about the reality of chiropractic care. It frequently requires course-correcting patients who want to, you know, veer off their prescribed care plans.
Oh, all the time. Right. So [00:06:00] imagine a patient who is scheduled for three visits a week to correct a structural issue. After two weeks, the pain subsides. They come to the front desk and say, "You know what? I feel fine. I'm gonna cancel the rest of my appointments and just come in twice a year." Uh, yeah. And an associate with a very low L score, so someone who is highly agreeable or maybe afraid of interpersonal conflict, they’re gonna look at their shoes, nod, and say, "Oh, okay, sounds good.
Call us if it hurts again." Exactly. And just like that, the patient drops off care, and their underlying issue just remains unresolved. They basically fail to lead. But an associate with a strong L score of 55 to 60 will naturally step up to that moment. Right. They won’t be aggressive, but they will be authoritative.
They’ll say, “Wait a minute, John. We agreed on three times a week to accomplish a very specific structural goal, not just to patch up the pain.” Wow. Yeah, that’s a completely different approach. It is. They’ll say, “Let’s step back into the exam room and look at your X-ray again so I can show you why stopping now will undo all the progress we’ve made.”
They [00:07:00] confidently guide the patient back on track. Because patients need that. Yeah. Without that inherent leadership trait, building a sustainable practice is incredibly difficult because patients ultimately need a confident guide to follow. So it’s not just about being a competent adjuster; it’s about commanding the patient’s health journey.
Perfectly said. And on the flip side of that assessment, the master class warned heavily against hiring a candidate with a very high A score, the analytical trait. Why does a highly analytical doctor struggle to launch? It basically boils down to paralysis by overanalysis. Ah. A high A personality requires a tremendous amount of certainty, data, and external validation before they are comfortable taking action.
Gotcha. If you tell them to go do a community screening, they want to analyze the demographics of the neighborhood, review three different types of screening software, and read a manual on the exact script before they even pack their car. They are essentially stopping at every single exit on the highway to unfold a giant map and check [00:08:00] the route instead of just putting the car in drive and heading toward the destination.
That is a perfect visual. And for the clinic owner, that requires constant exhausting overexplaining. Which slows everything down. Exactly. If the goal is a rapid momentum-driven launch, someone who stops to question the underlying mechanism of every tiny operational detail will naturally create a bottleneck.
You really want an associate who's hungry, humble, and just ready to run with the systems you've already proven. So you've run the lead profile. You've found someone with that strong fifty-five to sixty leadership score and a manageable analytical score. They align with your technique, and the energy is just great.
The dream scenario. Right. The contract is signed, but you know, if you just toss them the keys to the clinic, point to an empty treatment room and say good luck, all of that leadership potential turns into immediate frustration. Oh yeah, they'll flounder. They need a vehicle to drive, which brings us to the actual launch mechanics.
Dr. [00:09:00] Noel Lloyd's blueprint relies on a very specific, highly aggressive target right out of the gate. Yes. The 100 in 100 metric. The target is to push the new associate to 100 patient visits and potentially 100K in collections within their very first 100 days of practice. 100 visits in 100 days. I mean, for a doctor fresh out of school, that sounds like climbing Everest in shorts.
It does sound intimidating, I admit. But one of the masterclass participants offered a really vital clarification. What was that? This isn't a rigid punitive pass or fail rule. You don't fire the associate on day 101 if they're only sitting at 85 visits, you know? Okay. Phew. Yeah. The 100 in 100 is a pacing metric.
It's designed to create enough urgency and immediate operational speed to escape the gravitational pull of a slow launch. Because a slow launch is a psychological killer. It is absolutely toxic for the clinic's culture. A slow launch makes the owner resentful, [00:10:00] it makes the staff anxious about the business, and it basically destroys the associate's confidence.
Right. The goal of sprinting to 100 visits is to build a critical mass of active patients rapidly because once an associate hits that threshold, the practice dynamics just shift. They finally have enough people walking through the door to start generating internal referrals. Exactly. They have enough people on the table to practice their communication and actually transition acute patients into lifetime wellness care.
Yes. But they cannot generate internal referrals if the waiting room is a ghost town. Like they can't practice table talk on empty adjustment tables. No, they can't. So how do they get to that critical mass? Because as the master class pointed out, associate doctors are trained in anatomy and neurology.
They do not come out of chiropractic school with an external marketing background. Right. And this is where the pre-launch sprint becomes the clinic owner's primary responsibility. Okay. The owner must actively preload the associate's schedule before the associate even has their state license in hand.
Wow. [00:11:00] On the Zoom call, one clinic owner shared a brilliant strategy. They had hired a new associate who had a background as a Pilates instructor. Oh, nice. Yeah. And weeks before her official start date, the owner sat down and mapped out what they called a six-pack of marketing. The six-pack of marketing. I love that.
What does that actually look like in practice though? It is a customized variety of external marketing events designed to discover what venue works best for that specific doctor's personality. Okay. The clinic owner didn't just hand the associate a list of local businesses and say, "Hey, go introduce yourself."
The owner and their staff did the heavy lifting. Oh, so they set it all up. Yes. Okay. They called local Pilates studios to set up introductory talks. Uh, they booked 6:30 AM screening booths at local gyms. They scheduled noon massage and stress evaluation events at local corporate offices. That is amazing.
Right. They put all of this permanently on the calendar so that on day one, the associate wasn't wondering what to do. They were out in the community shaking hands, screening spines, and [00:12:00] booking actual appointments. And this brings up an internal dynamic that I think is the secret weapon of this entire blueprint.
Which one? The COA teaming strategy. Yes. For our listeners, a COA is a chiropractic office assistant, essentially the clinic's internal marketing assistant. How does the clinic owner utilize the COA here without breeding resentment? Because usually asking existing staff to help a new doctor build their practice just feels like asking them to babysit.
Yeah, it really does, and it requires a masterclass in communication and aligning incentives. How so? The clinic owner sits down with the COA and frames the situation transparently. They say, "Look, our established doctors are running at full capacity. They are too busy to go out into the community to do health talks and screenings anymore."
Okay, laying out the reality. Right, and they continue, "We are bringing on this new associate specifically so that your marketing role remains fully funded and active." Your job security and your bonus structure rely directly on teaming up with this new doctor, getting out to these events [00:13:00] together, and making them incredibly busy.
Oh, that completely flips the script. It totally does. Because instead of the COA feeling burdened by a rookie, they realize their own success is directly intertwined with the associate's success. Yes. It transforms them from, like, a reluctant chaperone into an invested sports agent trying to get their client fully booked.
Exactly. And the beauty of the system is that the owner has the exact same conversation with the new associate. Right, managing both sides. Yeah. The owner sits the doctor down and says, "I am employing a dedicated staff member strictly to help build your schedule. Your job is to make their job easier by feeding them leads, showing up to these events with high energy, and performing well."
It immediately manufactures this symbiotic win-win dynamic. Here's where it gets really interesting, though, and where honestly I have to push back a little on Dr. Lloyd's model. Oh. Yeah. We are talking about doing one or two external events a day, a six thirty AM gym screening where you're hauling a spine model on a table, followed by a full [00:14:00] shift in the clinic, followed by a noon corporate massage event.
Doing that during their very first weeks on the job, well, isn't that going to completely burn out a brand-new doctor right out of the gate? It is an absolute grind. I won't lie. And honestly, some associates do push back against the sheer volume of work. I would think so. But this is where the clinic owner must explain the biological reality of clinic momentum.
Setting expectations is paramount. Right. The owner must explain that this heavy external marketing phase is not the permanent reality of their career. It is the temporary priming of a water pump. Oh, I like that analogy. You have to aggressively and just exhaustingly pump the handle up and down at the start just to create the vacuum.
Exactly. You are putting in intense heavy labor upfront to draw the water up the pipe, but once the water starts flowing- Once you hit that critical mass- Right, once you hit that one hundred visits, the pump practically works itself. You transition to relying on internal referrals, and the [00:15:00] exhausting external marketing drops dramatically.
Wow. So it's a trade-off. Yeah. You are trading a few weeks of intense hustle for years of stability rather than, you know, suffering through three years of a slow, agonizing bleed with an empty schedule. You are stopping the hamster wheel before it even starts. Precisely. Okay, so we've hired the right LEAD profile.
We've primed the water pump with the six-pack of marketing, and the associate is running fast out in the community. Yep, momentum is building. Now the entire job of the clinic owner shifts. You have this incredible momentum, and you have to guide it without suffocating the new doctor, which brings us to the crucial difference between mentoring and micromanaging.
Yes. This is the phase where Dr. Noel Lloyd's system truly shines, and it starts with a preventative tactic that is just incredibly emotionally intelligent. I love this part. Before the associate even sees their very first patient, the clinic owner sits them down and asks a highly specific [00:16:00] question. They ask, "How have you been best coached in the past?"
Just asking them to reflect on their favorite teachers or, uh, their favorite sports coaches. Right. How did they treat you? And more importantly, when you inevitably make a mistake in this clinic, how do you prefer to be called out? It's so smart because it acknowledges that everyone receives critical feedback differently.
Right. Not everyone can take tough love. Exactly. Some people want it blunt and direct immediately after the mistake. Others need a day to process and prefer a gentle private conversation. Yeah. If you know how they prefer to be corrected in advance, then when they miss a finding on an X-ray or maybe stumble over a care plan presentation, you can sit down and say, "Hey, remember when we talked about how you like to receive feedback?
Well, we need to course-correct something." Oh, that entirely removes the ego, the defensiveness, and just the sting of criticism. It really does. It builds a bridge before you ever need to cross it. And to maintain that open line of communication, the masterclass highlighted the absolute necessity of [00:17:00] micro meetings.
Yes. Micro meetings are key. We are not talking about sitting in a stuffy conference room for an hour every Friday afternoon feeling miserable and reviewing spreadsheets, right? Far from it. The recommendation is a series of one to five-minute daily huddles. One participant detailed their specific routine starting every single day at 7:30 AM sharp with a five-minute huddle.
But why 7:30 AM specifically? Well, because it happens before the chaos of the clinic floor begins. Ah, yeah, that makes sense. Right. The phones aren't ringing yet. Patients aren't walking in. In that five minutes, the owner and the associate just review the schedule together. They actively anticipate tight spots.
Like what? For example, the owner might point to the schedule and say, "Look, you have three re-exams stacked at 10:00 AM. That is gonna create a bottleneck at the front desk. Here is exactly how we are going to navigate that flow." They also mentioned doing a quick wisdom dump during this time. What does a wisdom dump actually sound like?
It's highly practical, proactive advice. [00:18:00] The owner might see a specific patient's name on the schedule and say, "Mrs. Smith is coming in at 11. She's always very anxious about getting her cervical spine adjusted." Oh, so prepping them for the personality. Exactly. Mm-hmm. They'll say, "When you walk in, sit down, lower your voice, and explain the mechanism of the adjustment before you do it."
That's brilliant. It is consistent, upbeat, and entirely focused on setting the associate up for a win before the door is even open. And a massive part of setting them up for a win involves the ROF or the report of findings. Oh, this is huge. This is the make or break moment in any chiropractic clinic where a patient decides to commit to a financial and physical care plan.
Yep. The masterclass outlined a 12-month ROF sliding scale that is honestly a masterclass in delegation. Walk us through how a clinic owner preps an associate for this critical moment. Okay, so this system requires serious dedication. Every single day before the associate goes into a report of findings with a new patient, they must sit down with a clinic owner for [00:19:00] a five to 10-minute knee-to-knee prep session.
Okay. They literally open the physical file together. For the first one to three months, the clinic owner does 90% of the talking. The owner looks at the X-rays and verbally walks through their exact thought process. So the owner is pointing at the film saying, "Look at this degeneration at C5. Notice the patient's occupation as a desk worker.
Here's exactly how I would explain this phase of spinal decay to them." Yes, exactly. Okay. And, and they also dictate what not to say. Oh, interesting. Yeah. The owner might advise, "Hey, don't use the word arthritis with this specific patient. They indicated on their intake form they were terrified of it. Use the phrase wear and tear."
Wow. The, the owner is verbally scripting the interaction based on the unique nuances of the patient right before the associate walks into the room. And then I assume as the associate gains experience between months three and six, it shifts. Yeah. It becomes a 50/50 dialogue. They discuss the X-rays and the care plan collaboratively.
Okay. And finally, [00:20:00] in months nine to twelve, the associate does 90% of the talking. They sit down, open the file, and tell the owner exactly how they are gonna present the findings. And the owner just listens? Mostly. The owner just offers, like, 10% fine-tuning tweaks. The owner might just add, "Your clinical analysis is perfect, but make sure you bring up how this is affecting their golf swing," because they mentioned that on day one.
So what does this all mean? It is exactly the mechanism of teaching a teenager how to drive a car. Yes. Perfect analogy. Right. In month one, you are in the passenger seat, your hand is hovering right over the steering wheel, your foot is phantom braking against the floorboard. You are completely controlling the environment to prevent a crash.
Oh, yeah. By month six, you are relaxed a bit, giving verbal directions. "Take the next left." And by month twelve, you are just leaning back in the passenger seat, enjoying the ride, casually saying, "Hey, don't forget your blinker." That analogy perfectly illustrates the difference between micromanaging and mentoring.
Because a lot of clinic owners hear [00:21:00] about a daily 7:30 AM meeting and prepping every single ROF file for an entire year, and they think, "Wow, that sounds exhausting. That is the definition of micromanaging." Right. It sounds like too much control, but consider the alternative. Micromanaging is inherently reactive.
Yeah. It is looking for negatives and hunting for losses. Micromanaging is waiting for the associate to fail in the ROF, lose the patient, and then swooping into their office afterward to dissect everything they did wrong. Which helps no one. Exactly. Mentoring is actively removing barriers and giving them the answers to the test before they walk into the exam room.
Mentoring is a proactive, positive transfer of wisdom, and this brings us to the philosophical bedrock of Dr. Noel Lloyd's entire system, extreme ownership. Extreme ownership. The belief that if the associate fails to launch, it ultimately falls back on the clinic owner. Man, that is a tough pill to swallow for a lot of owners.
It is, but look at the chain of custody here. The owner chose the candidate. Right. The [00:22:00] owner was responsible for the lead profile assessment. The owner was responsible for priming the water pump during the pre-launch phase. The owner was responsible for the daily 7:30 AM coaching and the ROF prep. Right.
They set up the whole environment. Yeah. So if the associate fails after all of that, it's not necessarily their fault. They might just be better suited for a completely different style of clinic, but the operational failure to launch rests entirely on the clinic owner's shoulders. Wow. Extreme ownership indeed.
But, you know, that is exactly why having a proven blueprint is so profoundly empowering. Exactly. When you synthesize this entire journey we've been talking about, it really is a masterpiece of clinic management. You start by fiercely protecting your clinic's culture by picking a launchable candidate who aligns with your technique and has that crucial 55 to 60 leader profile.
Then you manufacture the momentum. Y- you do not wait for patients to magically appear. You preload the schedule with a customized six-pack of marketing [00:23:00] events, heavily supported by an internally aligned COA. Yep. You aim for that 100 visits in 100 days sprint to achieve escape velocity. And finally, you sustain all of that hard-earned momentum through daily positive proactive mentoring.
You prep them for success in the ROF rather than punishing them for failure after the fact. It's just an incredible system. It is. And to give you, our listeners, some perspective on the value of this, one of the participants on the masterclass mentioned that it took them 14 years of trial, agonizing error, and financial frustration to perfect this exact system.
14 years? 14 years. And Dr. Noel Lloyd is handing the blueprint out right here. It is a massive shortcut to success. It stops the financial leaks in the bucket so that everything becomes a genuine profitable win-win. Which brings me to a provocative thought I want to leave you to ponder today as you look around your clinic.
We have spent this entire deep dive talking about applying this rigorous [00:24:00] momentum building 100-day sprint mentality exclusively to our associate doctors. Right. But what if we engineered this exact same level of pre-launch momentum and precise positive coaching for every single role we hire for? Oh, wow.
Right? What if your front desk staff, your billing department, your rehab techs all had a customized 100-day launch plan? Imagine the unstoppable clinic culture if everyone experienced a launch sequence like this. That is a powerful paradigm shift that could completely transform a practice. And if you want to explore how to apply these specific win-win systems and operational strategies to your unique clinic, we have an incredible opportunity for you.
Yes, we do. You can book a completely free strategy call with Dr. George Birnbach. The link to book that one-on-one call is directly in the show notes. Absolutely. Do not miss out on chatting with him. And, you know, if you are ready to immerse yourself completely in these systems alongside the absolute best in the [00:25:00] chiropractic profession, we enthusiastically invite you to join us at Five Star Management's live two-day event in Dallas, Texas.
Oh, it's gonna be so good. It is happening on November 14th and 15th. And the most exciting part is there are actually two incredible events running simultaneously at the venue. Right. First is the New Patient Edge event, which is entirely focused on the mechanics of exactly how to get more new patients fast.
Always needed. Always. Second is the Win Win Associates event, which dives deep into the Win Win system we discussed today, providing the hands-on tools for more growth, freedom, and success with your associate doctors. You definitely wanna be in the room for this. The link for the Dallas, Texas, event on November 14th and 15th is also right there in the show notes, so go click it, get your tickets, and bring your team.
Bring the whole team. Absolutely. And while you are clicking around down there, make sure you hit subscribe on the Successful Chiro podcast so you never miss one of these deep dives or the actionable tips we share to help you thrive. We want you to [00:26:00] be fully equipped for whatever diagnostic challenges your business faces.
Because remember how we started this deep dive, talking about that murky, shattered X-ray machine of business diagnostics? Well, you don't have to guess in the dark anymore. No, you don't. You have the blueprint, the jagged line is clear, and the path to healing the failure to launch is right in front of you.
You just have to follow it. Thanks for joining us on this chiropractic deep dive, and we will catch you on the next one