Calculating How Much Front Desk You Need with Dee Bills

Thumb is that for every hundred patients that you see, you hire like one, like admin or one front desk, you know, is that a good rule of thumb like a hundred to that?

If they're doing verifications and authorizations as part of their job, then it's probably closer to 100 to 120. Not if you have a billing company or a billing department that's doing offs and verifications. You can get it somewhere between 150 and 175 visits per patient, care coordinator or piece.

How to get smarter in business and in life. This is the question, and I'm on a journey to get you that answer. I'm going to interview the world's top entrepreneurs and deconstruct their winning secrets. Going to talk about everything from marketing, money and living a bucket list life. I'm Rick Lau, healthcare entrepreneur. I grew and exited my 127 locations in my 30s. Welcome to the Clinic Boss Show. So, everyone, welcome to the Clinic Boss Show. So we got D bills, a front office guru, the Fog, who's trained over 1500 front desk teams. Welcome back to the show. Dee. Right.

Hey, Rick. Thanks so much for having me here. I'm. I'm excited as always, just to chat with you and see how we can help others.

It was, it was so awesome. Hang out in Florida. Hey, you know, like, we actually got to meet each other for the first time.

Yeah. And actual physically meet, you know, ever since online and. Yeah, it's always cool. Cool. Meeting people in person, getting real hugs, saying hello.

Yeah. Yeah. So I'm just curious, the. When you met me for the first time, like, in person. Although I've known you for years, was I what you thought I would be, like, in real person? Did my online profile and zoom do a good job to resemble, like, who I am in real life?

Yeah. Yes. But also, like, I realized, like, how just how, like, focused you are.

Okay.

Even more than I. I mean, I always, I was like this, He's a great businessman. But I was like, I just saw how you ran that conference and how you focused on people and just how focused you were on helping people. And I just really impressed me. I was excited.

So you're watching my every move at the Clint Boss Summit to see how I was interacting. Right? Yeah.

There you go.

And it's interesting. Like, yeah, so this is probably my, what is it, fourth or fifth event, you know, and I actually love this stuff, you know, Like, I love, I love in the moment, in the zone, you know, I love the energy. I love kind of like Running in an unconventional, like, business summit, you know, and if you went to the Florida event, it was very unconventional, right?

Yeah, I was actually took a video as it started, started like a short one, sent it to my husband and said, oh, my God, this is so not like anything I've been to in forever. And it's amazing. And. And he responded back. Really? And I was like, really? So, yeah, it was. It was. It was very unconventional, but in a. To me, it was very empowering. Even as a fly on the wall getting to participate, I. I just saw everybody kind of just shift over that. Those three days, like, just everything shifted. Yeah.

So I'm just curious, for people who has never been to one of my events, how would you. How would you describe it? You know.

Empowering? Very. I know you were playing some music when I hopped on today. Just very motivating. Very empowering. Very. Just, you know, I'm. I'm really big on you. I want people, when they're listening to me, to look and. And listen and think. Not. You know, I don't want them to sit there and take a million notes. I want them to, like, come away with, like, learn something, but also thinking differently. And I felt. That's one of the things I felt at the clinic boss conference. Whereas you people started to really think differently and look at things differently, and they didn't just stay in that common, you know, clinical rut. It was, let's think differently as a practice. Let's. Let's apply these things, but think differently as we do it. So I really enjoyed that part too.

And the games and the vulnerability. Like, people like, you know, it was having fun, wasn't it? Like, you know, like we're playing childhood games of rock, paper, scissors between like 300 people right on us. Or like. Or remember that game where we just dropped a piece of paper?

Yeah.

It was like such a simple game. It was like everyone, like, want to complicate it, Right.

They were so intense. Like, it wasn't even like people were playing. Was like, they were more intense than kids get in some of like the rock, paper, scissors. Just watching people and then dropping the paper and then just all of it. It. They got intense, like, in a good way, almost like, come on, bring it. I want to play this game, you know?

Yeah, yeah. No, no, it's good. We've done a lot of these events and like, you know, your typical PPS or your typical, like, physiotherapy conference or chiropractic conferences, like slide heavy. No inter person on stage is like just reading the PowerPoint presentation because they have a little, you know, like, like what, what do they call it? Like a, like a comfort monitor in front. So they're just reading it, you know, and there's no interaction. Like, you know, so it's. Yeah, we thought we'll mix it up a little bit.

Yeah, I learned a lot that day. I was telling Daryl recently, I, I want to get better at that, you know, because it's been traditional conferences I've talked at and worked with. Very more traditional. It's like, how do we, how do we get. How do I go there? Like that really? And so that's one of my goals for the conferences I'm doing in April is we, it's going to be so different than anything we're done and we're gonna have so much fun.

Cool.

Cool.

And hopefully, hopefully, hopefully, hopefully we'll be all speaking at PPS this year.

Yeah.

And we, we could do that too.

Have a lot of fun there. Yeah. Yeah. Cool. Maybe I get to come visit Canada over the summer and come up there and present a little bit some of your keeps and.

Yeah, yeah, I think we're gonna, we're gonna plan that. We're gonna have a little more like a clinic owner meetups where we just focus on one topic and you know, and what, What's a better topic than looking at your, you know, front desk revenue leaks.

Right.

You know, so before, before we dive into that stuff, like, I'm just curious like the. Because I get this question a lot in the community or people like, you know, just been following for years, is that how do you determine and, or calculate how much front desk do you need for your practice? Like do you have some type of formula or. It's like you just wing it. Like, you know, like, what's, how do you, like, like. Yeah, I just want to hear from you on that.

Yeah. You know, it there recently. I was just at a conference this weekend and somebody was talking and they were saying that your admin to your clinical is like one to one. And. But I also don't, I don't think that's realistic in today's world where it can be one to one all the time, you know, because that's, that becomes very costly on the admin side of things. Now I guess if you're looking at all the support staff, it could be you have to look at finances, you have to look at your average reimbursements, what can you afford, how much of your, you know, your overall income is going back out to pay for your.

So like a percent, you know, like, like 10% of revenue or 12% of revenue.

10 to 12% is probably realistic, but it could be for some it could be more. I think it depends on how many responsibilities you've given to your team. Your front office team too. If you have them doing multiple. What would constitute multiple jobs? You might be, you know. Yeah, you need to divide it in a way.

I remember you telling me in the past and maybe I think it was used that like, you know, like a good rule of thumb is that for every hundred patients that you see, you hire like one, like a min or one front desk, you know, Is that a good rule of thumb? Like 100 to 1?

Not a hundred. It's about a hundred. It depends. There's two. There's one caveat to that. If they're doing verifications and authorizations as part of their job, then it's probably closer to 100 to 125 because you're, you are going to pull them offline to do something that takes extra time. It's not patient facing if you aren't doing that. If you have a billing company or a billing department that's doing awesome verifications, you can get it somewhere between 150 and 175 visits per patient care coordinator or pec.

So just what I'm hearing is that if you, you're not doing like patient insurance verification on the phone, you know.

Yeah.

Then it's so 112. Sorry, 125 patients to like what? Right. You know.

Well, 150 to 170 is probably realistic per per patient care coordinator if they're not also doing those actions.

Okay. And actually, and then, and that's another good question. Is that like, you know, like what about part timers versus full timers? Right. You know, I had this conversation with Manju like last week on its episode and she was like, you know, if I, if you're to do it all over again to, you know, your multimillion dollar practice, you know, would your first hire be a part time front desk or full time? She was like 100% full time. You know, I just want to hear, I hear what your thoughts are.

So we don't hire part time people in our practice anymore. We did way back. We, in fact all of Mike's staff when he first started out were part time. I agree 100%. And the reason for that is there is something called part time mentality or part time think where, you know, I'm Only here for part time. So I'm going to get what I can get done and they go home. Is that all part time stuff? No, there's also full time staff who you could say that about too, but there's also that it, when everybody's there together full time, there, there is a something about a team, like there's something to be said about it. You can generate a team. They're all, they're all seeing and hearing and things the same. It also gives you more consistency of coverage and staffing. So 100. It would be full time. Yeah.

And then here was a conversation we had. You know, it was a bit of my justification is that like, you know, it takes you like months to train somebody, right?

Yeah.

And they get really good at the job and they get to know your patients and if they're part time, you know, because you can't afford them. Right. And like they want full time, they're, they have another part time job. So you're actually competing with another employer on that job. And so like, and then to me like, it's hard to find really good people, number one. Number two, it's, it's hard to train them, you know, you know, because there's this, this, this upfront cost to train them to do things your way, you know and because a job is so complex so that like, you know, like I would hate to lose someone, you know, after three months of all this training to like to them accepting full time from another person.

Right. Yeah. It fits in also with like, you know, you look at it and you say it's harder for a part time person to develop those relationships with patients because they're only going to see, you know, X number of patients. But now we've got this many that are coming in. It keeps that they almost feel like they're a little bit stepped back away from the group because they're not, they're not fully into that group. And you know a great. If you're hiring somebody right now and you really can only afford a part timer. One of my biggest pieces of advice I will ever give a practice is when you're interviewing these individuals, if your goal, your goal should always be to expand them to a full time position. So it's like, hey, I can afford you this many hours right now, but I'm looking for somebody that's going to grow with me. Are you that person that's going to grow with me? Yeah, I'm totally in. I'm okay. Good. So my goal is that we're going to get from here to here in this month and then from here to full time by three months or six months and you get that agreement in place. Now you've got somebody who wants to grow with you. You lay out what it's going to take for them to grow with you and get there and you can start where you need to as a owner or manager and build that team and build that team member up so that three months of training. The goal at the end of that three months is I've got more patience, okay. I've got more patience now I can have you more.

And how many months would you expect, you know, the owner to be able to like, you know, get them to a full time basis? Right.

Well, I would want it to be as fast as possible. In fact, I, when I'm sitting down with somebody, when, and I've done that in the past, I would, I would say you can do this as fast as possible.

You can reach one month, two months, three months, a quarter.

Three months would be. Three months is when is predominantly here anyway in the states is predominantly like your probationary period. A lot of practices use 90 days is like you got to be up and trained and all this and reading all these requirements. So three months would be my, you know, I really want to get you there in three months. And again I have. But I also have to look at my practice. Like, what is my prediction as a practice to grow? What is it going to take? Do I need another therapist, whatever. But I'm building them into that so that I can give them that. Remember that's, that's going to increase their fulfillment. If they're happy and they want to be there and you're helping them learn now, they can get there. So yeah, it's fun to play that game actually. It's.

So that's interesting.

So.

What about like, if you could only afford, if you can only afford part time, you know.

Right.

Actually, before we talk about that, I actually, like I had a conversation with Manju last week was saying that like, I think part of like being an entrepreneur and an owner is taking on risk. Right. So part of like this mentality of taking on risk is that like, you know, I will commit to hiring a full time like front desk because I'm going to generate an ROI with them within the three months or six months. Right?

Yeah.

And if I cannot do that, then I shouldn't even hire a front desk at all. Right. You know, and then secondly is that like, if you want to be like, I just want to part Time this and I just want five hours like you know, like then I'm gonna really challenge you on what type of like owner do you want to be, right? Like, are you, are you looking to build a multi million dollar practice or are you just like looking to build this like solopreneur practice? It's building 150k and like I don't want to have a lot of staff and like I just want someone to plug the holes here and there. Like if you did that, like fine. But if your goal, like if your goal was like I want to like build like a million dollar practice, like this is why I got to entrepreneurship, this is why I decided to be a clinic owner. And you're not one to take the risk to hire a full time receptionist who will give you like an roi, then I have an issue with that.

Yeah, I agree. I, you know, when I'm talking to people about hiring front office staff or just in general with your practice, you have to put policy. If you really want to be a large practice, if you really want to be like, you know, if that's your goal, then you have to think big. You have to think like a corporation. You might start out as, I don't care if it's a single clinic or 10 clinics that you want to be in. But if you want to expand and grow and be a multi million dollar practice, you have to think, think big and always continue to think bigger. You can't say like you were saying, oh, this is what I want. You have to say, so part of risk is saying I'm going to do whatever it takes to get that person there too. I mean obviously I'm going to hire great, train amazingly and then just do it. So yeah, I mean it's part, it's the hiring and part of it's that thinking big with it and thinking, yeah.

You'Re taking a chance like on a risk. But here's the thing is that like whether you spend money or whether like you got existing side working for you, your job as like an owner, right, as an entrepreneur is, is be able to get an ROI on your capital and how you're like how you people spend their time, right? And if you're not getting it, then yes, hire someone part time because you're losing money. But if I put $1 in, I want to make sure I get three know or two right. You know, and so that's a function of what they do now, right. You know, and let's be honest, like if you look at a typical sopreneur or a, a typical, like what would we call like the overwhelmed owner? You know, they, they, they, they bill less than $400,000 a year. They are like doing all these like $15 hour tasks when they can make more money just seeing a, like seeing a patient, you know, that is not a good use of your time. It actually makes more sense for you to see patients and pay someone 15 bucks an hour or 20 bucks an hour to do that stuff. Because even from a ROI standpoint that makes sense actually.

So it's very real. And talking to a lot of owners in the last couple of weeks and quite a few of them that I've been talking to shifted to a model. I don't know where it came from, but they shifted to a model where their clinicians were scheduling their own patients and they're finding that it's a complete and total nightmare because your clinicians are there to treat the patient, to get the result right. So if asking them to divide their attention and fill their schedule right, there's. Now they're not really focused on the result. They're supposed to be getting their work. They have to fill their schedule or they get so busy treating patients that they aren't filling their schedule right. And so that's a perfect example of it is not valuable to have that clinician doing their own schedule because there's no gatekeeper, there's nobody managing it, it's not happening in real time.

And yeah, what type of just, just in those scenarios, if you did it before and after, like what type of like drop in bookings are you seeing or revenue when you have a clinician do it versus like a front desk.

You know, just talking to them, their, their arrival rate is probably, their arrival rate dropped somewhere between on average probably 10 and 15%. So you've got an arrival rate issue. But then also, you know, their, their schedule utilization is probably Dr. 60, 70% because again patients might be calling to cancel, but they're not. The provider doesn't have time to get back to, you know, then we play or we give them. Well, I can get you in at 4 o' clock today and then Let.

Me call you back, let me call you back.

That stupid back and forth thing. Whereas if you have somebody at your front desk and they are very clearly laid out, require like responsibilities and they know how to do it, then your providers, you know, can do their thing without distraction.

But D Bill's online scheduling solves all that, doesn't it?

Oh dude, me and technology. Look, I, I'm not gonna, I'm not.

Gonna does it or doesn't. I'm careful. I'm your somebody. Because everyone's like, well, you know. Yeah, like.

I'm not going to argue that with you. Technology is a great thing to a point. But we are, we work in a profession that requires, requires communication. The I, I, I mean, I definitely think the technology can help us do things better. But the communication, when it comes to that patient, to ensuring that they arrive and schedule and are paying what's due there, ha. There's still that human being has to be there somewhere, whether they're remote or in the office. That's its own thing that we'll come to see over time how that works. But they, there's still that, that community. A point of communication is necessary in some fashion because it's easy. No offense. It's easy to ignore a piece. It's easy to ignore Test text. I can ghost you when you're texting me, but if you're consistently calling me and there's that human touch in there, what we found is it gets a much better result with people. Regardless of Gen Z vs Gen X vs Boomer vs whatever. It still gets a result.

Why are you making fun of us Boomers? D. Why are you making fun of us Boomers?

You're not a Boomer. Maybe, maybe Gen X, maybe Gen X, you and I, or maybe Gen X, we'll go with that. We'll admit to that.

Hey, how about this? Like, so when it comes to new patients, you know. Right.

Yeah.

Which one is going to get you better results? Them calling the clinic or them booking online? Right. For that first initial consultation booking.

I mean, calling, calling the clinic or the clinic, calling them, that it's there. That's my, my belief or my experience from it. Well, and you have to look at the result you're looking for. They might book online with ease, but is there a relationship there to get them to actually show up? Right. It's really easy for me to go online and book an appointment. And by the way, I, the medical field is not the only field. I have this conversation. I get my nails done, I get my hair done. We have this conversation. They get just as pissed off as everybody else when patients don't show up. What I have found is it's not the result of that phone call. There's one part get them to schedule, but there's another part where there's a relationship. And when you're booking online, there's no relationship with that patient. It's much easier for them to be like, well, I don't have a relationship with them yet. I'm just not going to show up. And so online is a great tool, but there's, there's no, there's no relationship there. So how do I know they're going to show up? How do we. They don't even feel a connection to us yet. It's this, you know, all right, I love that.

And I'm gonna put my marketing brand on. So, you know, like, on a typical website, you know, we heard from Neil, a typical website converts at 3%.

Okay.

So if you're relying on online, you're relying on all these people going to your website, you're assuming that your website is doing a really good job to actually get people to click on this button. And then once they click on this button, there's all these other buttons that they have to fill out, like, to actually finally do it. And there's just a lot of friction. And. And if a typical website converts between 2 to 5%, then yes, it's easier. But how many opportunities are you missing, like, because of that? Right. If you enjoy my content, I read a clinic owner newsletter. I share with you what's trending right now in marketing, selling your business, recruitment operations, front desk and more. Become a better clinic owner. Join over 22,000 clinic owners who get this free newsletter each week. Go to clinic owner.com to sign up today. Now I want. Now I'm going to compare the. I'm going to compare the other side, you know, for like, if. If. Let's just say most websites are pretty terrible, right? You know, and so if you're. If. If all you had on your marketing was like, to call the clinic, Right. Even, like, the shitty clinics are converting at half. Okay. And like, the really good ones may be converting at 80. And. And if you compare just those numbers compared to online, like, website, it's 90 days, like 10x, you know, so, so back to like, you know, like back to like, just to summarize, what we talk about is like, yes, it's easier online. But like my hunch. And looking at the numbers at the conversion rates, you know, the conversion rates are clearly higher on the phone, you know.

Yeah.

And plus relationships. Yeah. Because they're way more committed. They have their relationship, you know, like, and that on the phone they're going to talk about how amazing that physiotherapist that you call the right place. And so they're actually going to arrive and show and pay.

Yeah, yeah. And you have to think About, Think about, think about healthcare right now in general. It's very much that very quick phone call of, you know, good afternoon. And the person's like, I need an appointment. Are you a current patient or a new patient? And I'm not saying they're that cold sounding, but it is like, that's standard healthcare. We as providers in a pt, chiropractic, you know, occupational speech practices, and anything surrounding that. That's not us. We. You're. You become family as a patient for our practices. And so they need to feel that family. And, and not by like us being super, just super sweet, but we have to lead that patient. Look, people are not committed right now. They're. They're taking a step back from their health care. They're. They're hearing all these bad things online. And so part of our job as a patient care coordinator or pec is to get them, really get them feeling like there's this connection, there's relationship, and we get them. And then. Because the real result of that phone call and the real conversion does not happen until your patient steps foot in that door. I don't care if they've been to you before or they're coming to you for the first time, the real conversion can't even happen until they walk through the door and they step back with your provider. Yeah, but think of how many get lost if they can schedule and cancel online. Yeah, that's huge.

Actually, on that note, would you, Would you not allow canceling and scheduling like, through like online or text messaging or they just have to call the clinic? Is that like a golden rule of yours or.

No, it is one that I very strongly hold by and. Because, like, if you allow a patient to cancel online, then there's. You've lost a control point. You've lost that ability to control the outcome of that. Because again, somebody shouldn't be canceling. At the very least, they should be rescheduling.

Yeah. Because at least, at least it forces them to call the clinic.

Yes.

You know, and then they can reschedule. Whereas it's so easy just praying, cast. I do this with my massage appointments. Right. I'm just like, oh, this is easy. I'm just, I'm gonna cast for the entire, like, you know, like, I'm, I'm. I'm gonna entire month b. You know. Right. And then like, life gets busy.

Lost.

Yes. Yeah.

Cool. Keep going. Because you're right. Life gets busy. And when does that patient come back? And because they cancel them all online, believe it or not, that actually Affects your staff, Their willingness to reach out. Because it's like, then that mindset kicks in of, well, they'll call when they're ready or, you know, no, no, no. You know, and they don't just like, you, you. Yeah.

You're like, I'm lazy. And let's be honest, it's a lot of work to, like, commit to, like, something on your calendar, right?

Yeah.

So it's like, it's a physical bear. Like, I gotta look at it. I'm trying to squeeze it in. I'm thinking my. Like, I'm thinking about, like, what happens with my work. I gotta, like, drive my kid. I gotta do all this other stuff, and I'm trying to squeeze this in. Like, no. Like, it's. So then, like, the mental effort is a lot of work. Right? You know, so that.

But here's a fun fact in reverse. When it's on somebody's calendar, they're more likely to show up for it because they've booked it into their life and it's there. It's sitting there. That hair appointment that's booked out two weeks or three weeks from now. I'll show up to it. You know, More likely.

Yeah.

Less. Less loss of control.

Let's talk about front desk teams being overwhelmed. Okay. It's something that I hear a lot. And we all know that, like, running a clinic, they could be super overwhelmed. So let me ask you, like, what from a. How can a clinic owner help the front desk with, like, without overwhelming them? Like, how do they help them not be overwhelmed in their jobs? Because it is a very overwhelming job. Right.

We have a lot. There are a lot of points of contact, a lot of points of action going on at the front desk at all times. And it can be. So there are really key things you can do to help your staff. First, you want to make sure that you are properly staffed. Right. If you have one person and you're doing 200 or more visits per week now, they have a lot more points that they have to man. Like, they're managing your whole list. So that's one. Another one is making sure they're really well trained up to handle people. Handling people and managing people brings its own. Its own challenges. And because, again, you get personal staff.

Are you talking about, like, complaints? You know, like saints?

Just somebody calls you up and they. They're the one that wants to be in control of the conversation. Right? And what really. If we really want to help our patients, our front. Our front office teams need to be the ones that are in control of that conversation. And they're the guide that leads that patient right into your. Right on in your door, right? And if. Because if they're not the one doing it, the patient's the one doing it, then that leads into, you know, more resistance along the way. And so we should be quality. Our front desk should be trained to qualify patients and lead them into our practice so that they're already prepared to show up for that visit, that first visit. And then they're the ones managing them to keep them coming in. So they. They have to be trained how to manage people and how to interact with patients in a way that's not. I'm not super sweet Sally, where all I do is let you have free rein as a patient, but I'm also not the witch behind the window that pushes everybody away. Right? There has to be that happy balance and then be the guide to lead them. So training is super key. It's not something that everybody gets on the out in the outside world. They're not coming to us with these skills and this knowledge. And this is what we do. We. We work to help them to be able to do that. Tracking their metrics is another really key thing that you do because you want your staff. We were just talking about this in a community live today. You want your staff to understand that the metrics tell the story. They tell the story of what we're doing really, really well so we can keep doing it really, really well. Or they tell the story of maybe what's not working the way we want it to so that we as owners and managers can support our staff and give them the right training and support so they can make it go well. That doesn't mean, as an owner, I'm stepping in. That means I'm giving my staff the tools they need so that they can take things to the next level and see themselves winning. All of that, believe it or not, increases somebody's fulfillment in their job. Right? When I can see myself winning now, I'm fulfilled. But if I feel like it's just one big cluster all day long and everything's just swirling around me like a tornado, that's a problem. So there's one other point in that, is if you have more than one team member, they need to know the exact expectations of their. Each of their roles and what responsibilities each of them should be handling every day. So there's actual order and it's not. Well, I'm hoping that Sally's going to do it. And then Sally thought that I was going to do it. And now we're not. We're not getting along like, we're frustrated with each other. The owner's frustrated, manager's frustrated. Everybody should have a set responsibilities depending on what where we are facing in that clinic. To give example, check ins, checkouts. You see that a lot in dentist office. But then there's the verifier, then there's the new patient coordinator, you know, and again, you have to make that fit for the size of your practice. But when you have all of those things in place now, the team's going to feel less frustrated because it's kind of like, we know what we're supposed to be doing in the day. You've trained us how to do it, now we go and do it. We track the metrics, we high five the wins. We work on times when we're not fully winning so that we can win and get that result. Okay, that's what I would do. Wow.

So that, that works in theory. But what, what do you do when your front desk is already overwhelmed right now? And like, you know, and like that list that you gave us, like, let's just say, you know, like, none of that one or none of that's being.

Like, done, you know, like, yeah, start somewhere. Yeah, right. You can't, you can't just be like, hey, get it together. You can't keep replacing staff because it's costly and time consuming and stressful. So you've got to help the team that you have to really start somewhere. Now, one great place to start is just sitting down and creating responsibilities based on the. Like I said, check in, checkout, patient coordinator, whatever. Give them a list of responsibilities. Help them to see that they do help each other out, but that we each have responsibilities that have to be accomplished in a day. And that way we're not each doing the same job or the same action for the same patient. It's. It's split. Right. And then it gives them more certainty on what they're supposed to be doing. That would be where I would start. And if you don't have that.

Yeah.

If you're not talking. Oh, go ahead.

And then I'll just think on that point. And the second thing is that, like, you know, I think a lot of the source of the issue too is that, like, you haven't hired enough so this person's overwhelmed. Right. And you're getting a tell. Because if your front desk is rotating every, like, two, three months, like, you know, yes, it could be a training thing, but it could just be like, you didn't have enough people. Right.

That's true. So. Yeah, yeah.

So one thing I would. One thing I would like, recommend, and I see a lot of owners do, is that like, you may want to maybe outsource, like, even some of the phone calls. Right. You know, so that get to a certain point where like, you could get someone else to answer the phone. Then in the meantime, like, do the stuff that they talked about, focusing on roles and responsibilities. Like, you got to remove stuff off their plate so they could get really good with this before you add it back on or like, figure out like, hiring, hire somebody, but, like, you know, like, there's only so much like you could do if, like, they're totally overwhelmed, you know. Right.

Yeah. Yeah. And the key to that, though, is outsource the things. They don't outsource the points. If, if it were me, I would outsource the points, the lower points of control on the ladder. So things that, that aren't necessarily patient facing. So that now if they're really tr. If this outsource is really trained and the person and they get results, cool. But if. Don't just outsource to pull phones off the lines if they're not trained. Right. And again, that's where there are specific, like, great companies out there that can handle that. And then there are others that are mediocre and you're paying a lot of money. So. But what about outsourcing some of the, as you call it, the 15 jobs. What about outsourcing off of your front desks staff, all the, the $5, $10 jobs, the things that they really didn't have to be doing in the first place or, you know, getting, getting all that extra stuff. I'll give you a good example of something. Some practices I worked with in the past also have their front desk do laundry or clean rooms or clean tables. So anytime you do that and you give them these actions that are not, you're giving them another job. Right. But that's actually pulling them off patient care. And your front office staff are the, like, their number one responsibility is getting that schedule filled and getting the patients to show up. So anything else that's not related to getting patients scheduled and showing up for their full plan of care week after week? That's the kind of stuff you pull. Maybe you bring in a partnering.

Cleaning is probably one of the easiest things to outsource. Right. You know? Right.

Yeah. Well, to somebody, get somebody that's not your. Your main front des who's in charge.

Of scheduling the physiotherapist to clean, you know, and do the laundry.

We are therapists. Our therapists have done the laundry. That's that it's in their department. But yeah, it's just something to consider is don't. I'm not saying don't outsource like higher level actions, but make sure that there's training in that company. So it's good. You get a great result. Not just okay, because then you're losing money there and you won't be able to replace your front desk staff. And you know, that affects things.

All right, we got five minutes left. And I just, I want to get into the most juiciest question because I know, I know inside our community we've been talking about this D. What would you say are the biggest, like front desk revenue leaks, you know? Right. Right now.

Yeah. So obviously cancellation, same day cancels and no shows because number one, it stresses out the owners and managers and your staff. Number two, it's a lot harder to fill a same day schedule. Like, it's much easier to fill the schedule out. So arrival rate or same day cancels and no shows is a big hole. Not scheduling out the full plan of care, where or. Or struggling to get patients to schedule a full plan of care. Remember I said if I'm on your schedule, I'm more likely to show up. New patient conversions. Getting that person, not just a. Getting them on the phone. Right. I got 20 referrals that came in. Getting those people on the phone or calling you back, getting them to schedule an eval and then getting those eval to show up. Those are the things I'm seeing. And then obviously your typical MIAs or dropouts. But believe it or not, all the things I mentioned before, I said MIAs and dropouts actually increase your rate of missing in action patients and dropout patients. Because if they're not managed. Well, from that first phone call. Yeah. Through the eval, through scheduling out the plan of care, preventing cancels and no shows. That's the number one cause of dropouts.

Yeah, I love it. You know what I was hearing was that like, you know, like, you know, like for the clinics that have a lot of like, like referrals from docs or different agencies. Like, you know, like, let's, like, you know, like let's get those. Like that's. Those are big opportunities. The speed of scheduling those, you know, and calling those patients back. Right. You know, and then on the other side, you got inbound phone calls, you know, from direct to consumer. So answering those phones and like, converting those, like converting those conversations into, like, you know, into the first appointments so they actually show up, you know, and arrive, right?

Yeah. It's not just about, oh, I got them on the schedule. They got to show up for us to actually evaluate them and get them converted to a patient. So we have a process that they need to follow so that this is happening consistently. Yeah.

And, and do you remember we did this exercise at, at the clinic in Florida at the clinic Boss Summit, where everyone calculated how much money they were losing because of these front desk revenue leaks. And like, do you remember seeing like, the annual numbers, like, on the, on the, on the, on the poll there? Like.

Yeah, they're very real. To me, those are very real numbers. I mean, we're talking, we were talking. I mean, you had the low end of like 70,000. And then you had the people that really took it to the next level and looked at their numbers and when it was like some of them were over a million dollars a year.

Yeah, it was like million 200, 000. Half a million, 100,000, like 70,000. And these are people like, you know, yeah, we had a front, we had a front desk, like a calculator. People are like putting some of these key metrics and they didn't have it. We had default numbers and it was spitting out these numbers. And like, it's interesting is that like, you know, when you compare your front desk revenue leaks and you compare it to the marketing, right? Like, those numbers are much bigger than marketing. And, and what's nice about the front desk ones, it's stuff that you could control, right? Some of the marketing stuff. And like, let's be honest, that stuff is like, kind of like voodoo out there. And like, you're, you're, you're putting your faith in hands of some snake oil. Like, you know, snake oil selling, like marketing agencies. That may or may not work.

It's true, though. And, but yeah, I mean, for us, that was the first place we started in our practice and we cleaned up all those holes and we went from probably being a, you know, way back when, a $750,000 a year practice. Within a couple of years, we were $2 million practice. And it's just, you know, the more you keep that, that, that is just cleaning up holes. That's not adding more staff. That's not shifting anything. It's just cleaning up the holes and getting people in. Now, we were expanding, but we were expanding the right way. We weren't expanding by just hiring people and hoping to fill their schedule. We could use our marketing to drive more people in and grow. But you can't do that if you're, you know, you can, like, yeah, because.

Your front desk is your sales team. And, like, if you're driving a bunch of leads and your front desk can't convert and get them to arrive, pay, and stay, you know, then you got. There's no point of spending money in marketing. Right? So.

Right. That's right. It's literally like throwing it at the wall to see if it sticks.

Okay. Amazing. D bills. Thank you for attending this week's, you know, a clinic boss show. And hopefully we'll get you back at the. At the next episode or, you know, maybe later this year and we could, like, geek out on more, like, front desk office stuff. Right.

So we're such geeks. I love it. Thanks, my friend. I had a great time.

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