Dr. Noel Lloyd has been serving the chiropractic profession for over 44 years. As a clinic director, associate developer, consultant and coach he has seen enormous success for both his own chiropractic clinics and also practices around the world.
In this interview we discussed getting his first upper cervical adjustment at 4 years old, how to have associate programs in your practice that are actually mutually beneficial for everyone involved, new patient marketing programs that work and much more. Dr. Lloyd shared some incredible wisdom in this interview. Whether you are a doctor or a student you will love it!
Dr. Bill: Alright. I’m looking forward to speaking with you we've known each other for many years now. You helped me in my practice and helped out many other doctors that I know. So I know that this is going to be a great time to talk with you today about marketing and about chiropractic and upper cervical.
I would like to start with, how you got started in chiropractic? What made you become a chiropractor?
Dr. Noel: Well, that goes way back. I was four or five years old and I had a real bad fall off the monkey bars, went straight down of the top bar right on top of my head. Knocked me silly, knocked me out.
My dad ran to me, didn't know if I was alive or dead because of the fall and I started to scream. Anyway, they took me to the hospital because I was acting stranger and stranger. They found out that I had a concussion and the doctor said, “You need to watch this but he should be okay.”
What happened was that I wasn't okay. I got sick and I stayed some kind of sick. It was just the worst year of my life for illness. What happened was that a lady in a grocery store begged my mother to take me to a chiropractor. And this was back when chiropractic was I think barely legal in Washington State. This was in the 1950's.
I actually remember walking upstairs just as a little kid, grandma on one side Mom on the other. And we walked up into a Palmer specific upper cervical practice Dr. Arthur Thompson and Charlie Hanes on Hewitt Avenue in Everett, Washington.
My grandmother who didn't know about chiropractic neither did my mom, but my grandmother saw the bone and she said to my mom, "Corinne, this is voodoo." And she looked around at this packed reception area and she said, "But if it helps Noel, we'll stay." And I got my first adjustment.
Now, I don't know if it's – I remember my parents telling this tale and I visualized in my mind what I thought I heard or if I really remembered it but they do remember having x-rays taken. I remember the cork in my mouth so they could see when taking the x-ray. I remember getting adjusted because that was like a mule kick to the neck.
But I got a Palmer style upper cervical adjustment and literally that night my dad said to my mother he knew that they had “their son back”. And they just noticed the change and then I started to get healthy and well. And I remained under chiropractic care until I was eleven years old.
One night, when we were driving home from the chiropractor and my dad was looking out the windshield of the car and I was sitting there next to him and he said, "You're not too young to think about what you should, what you want to do for a career." And I remember thinking, “I am too. I'm eleven.”
And my dad said, "You can be a chiropractor and you could help people like Dr. Hanes and Dr. Thompson. There you could be your own boss. You could make a good living." And so, my dad never gave advice and so I always followed it. And so I said, “Okay.”
When I started telling people about how I was going to be a chiropractor people used to say crazy things like, “Well, you should just take this all the way and become a physical therapist. The chiropractor thing is a good start.” And I remember how angry I got. So then, I drove off to Palmer College when I was 18 years old, started practicing in Washington State when I was 22.
Dr. Bill: So as young as you possibly could be you were practicing chiropractic.
Dr. Noel: I was the youngest chiropractor in the state at that time.
Dr. Bill: So you came out of school and you were practicing in Washington and were able to build a successful practice there and build several clinics, had multiple clinics and associates and so forth. Tell us about that and what the process was to go from one clinic to multiple clinics and so forth.
Dr. Noel: Well, I remember, I started as an associate for a short period of time then I went to practice by myself. I was doing about 60 visits a week. I didn't know what to do and I went to a technique seminar and I talked to this guy and he told me what he was doing and I said, “Wow that's great.”
He said, “You need to go to a practice management seminar and you need to have somebody help figure out how many people you want to help and how much fun you want to have and how successful you want to be.” And I thought, “That sounds like a good idea.”
So, by this time my practice was about a hundred visits a week and then, boom, blink of an eye, 200 visits a week. Another blink of the eye another year 300 visits a week. And so I started by hiring a couple of associates who were working with me. But when we moved into the “big practice” all of a sudden, my individual practice was about 500 visits a week.
I was happier at about 430 patient visits a week. That's why I just was super comfortable. But I had a young man who's working with me and I knew for a fact that he was going to go out on his own. And so I said, “Why don't we do a clinic together?”
So, we put together a 511 square foot clinic in Downtown Seattle. That was literally with my business knowledge that I have gained and with my practice development skills that I had gained, the practice was profitable and this is no joke, with all of the overhead and everything and salaries and everything, it was profitable in 60 days. Making more money than it cost me in 60 days. And so that was a great practice and a great associate who worked with me.
But soon after that, I went to this career ending injury. I had a terrible fall skiing. I blew out a disc in my neck. Neurosurgeon said I needed a bi-level fusion and I just, I couldn't believe it. I just absolutely couldn’t believe. I couldn't practice.
So I decided that I wasn't going to get the surgery. I decided that I was just going to work on the practices. And so I started to work on three things, developing associates, developing the business and developing systems.
Practices are businesses that deliver health care. Chiropractic practice is a chiropractic business that delivers good chiropractic care. And you can be a wonderful chiropractor and a terrible practice management person or a bad chiropractic business person. And so, I worked on the business model and then I worked on marketing and amazing things happened.
You know, I have young guys coming to work with me: young girls come to work with me and just take off like rockets. From failure experiences to being able to see 200, 300 couple guys up to 500 visits a week in low stressed systems.
A whole another group to 390 plus patient visits a week. It was kind of interesting. It was an interesting stuff. We had a group there and then lots of people at 250. And so we kept opening up clinics. I never like owning more than five at that time but I love owning five. I liked having the clinics close enough so I could drive to them in less than an hour.
So in Western Washington we did these clinics. And then, I remember one week, this is a crazy thing. Within nine days three people came to me and said, “I want to buy a clinic from you. I want to buy the practice I’m in.” And I loved these kids. When I say these kids they weren't much younger than me at that time. But I love these guys and we had worked together shoulder to shoulder. And I thought, “You know what? I'll sell the practice to you.”
And so what I started to do is from the start, I would recruit people and say, “Hey, if you want to build a practice with me I'll teach you how to, I will develop you.” This is what I started to study first hand when I got my injury was developing associates, developing the business model and developing the marketing.
And so I would recruit people and say, “Come on, work with me and we'll grow you into a practice and a practice into you. We'll teach all these skills. And then, if you want to, but only if you want to, you can own this at a reasonable rate.” And I did 10 of those and some of the clinics were so crazy and so wild. We'd open up a clinic with a 161 new patients in the first month.
I mean, that was like a South American Soccer stampede. I mean, it was just, it was wild and it was crazy and it was fun. And a lot of those guys, in fact like most of those guys are still my friends to this day.
Dr. Bill: I believe a lot of people would know you from your associate programs and how successful they are. I’ve personally been to your associate win-win programs and they are fantastic. And I coached with you before and consulted with you; you have just some brilliant insights into developing associates in all different ways that you can have win-win relationships with associates.
Let’s talk more about that, as far as your associate development programs that you have put in place and different options that you have found to be successful when it comes to associates.
Dr. Noel: Okay. So, first of all, clinic director needs to start thinking about an associate when he or she gets busy because there's so many clinic directors that need a lot of help.
Number two, there's so many clinic directors that are absolutely chained to the practice. You know, you know what I'm talking about.
Dr. Bill: Absolutely.
Dr. Noel: The doctor becomes the absolute master of the three and four day vacation. And if this doctor dares to take a week of it can cost him $20,000 or $30,000. And if you're going to take two weeks off – I talked to guys that take $60,000 hits and just think, “Well that's what I have to do right?” And so they are overworked. They are afraid to slow down, to take a breath. They need to have some freedom.
And number three, they like to have some extra income. I mean, will that make sense that two doctors practicing in the same office and one of the things that you would get in exchange for your mentorship is that you get some extra income?
So, the clinic director needs health, freedom and extra money.
Well, what does the associate need? The associate needs a career opportunity. I mean, and I'm so passionate on this and so committed to this process because I've seen it worked well in my own system and I've talked to doctors who have just absolutely blown this thing up the wrong way not understanding these things.
But the associate needs a career opportunity. The associates need success training. By the way, success in chiropractic is not an automatic. It's not a given. I meet guys all the time that have struggled for years, struggled terribly for years. And then the third thing that they need to do is that they want to make good money as well.
And so if you had a Venn Diagram, two circles intersecting. Right there in that intersection I've got smart chiropractors or clinic directors, many of them who have paid literally hundreds of thousands of dollars for all their success training and their training on their technique. And when they've got these great clinics and they've got so much to teach, now what we need to do is connect the associates who needs that career opportunity not just a job but also need success training.
And I remember working with you and a couple of interns in your office and I remember saying to you, “Bill, they need to learn upper cervical. Nobody learns NUCCA without some real mentoring. It's a difficult technique. It requires a lot from the doctors so you can mentor them there. They need to learn how to do patient or practice management, how to keep a patient in a really, really good chiropractic care program from start to finish so that they get the best the chiropractic has to offer. And they need to learn how to share the chiropractic message outside the clinic.”
So, let me give you an example. So there's this absolutely great guy I work with Dr. Stan and he works in Michigan and he's in the Center of Michigan. And he brings on an associate who's Dr. Paul and Dr. Paul builds his practice and then, they bring on Dr. Rachel. And Dr. Rachel she goes from zero to 90 patient visits a week in literally less than two months. And these are her visits, her patients.
And so what happens is that Dr. Stan, he can get away with his wife and beautiful little girl and another one on the way; he could get quality family time where his associates give him that freedom.
His senior associate Dr. Paul, he likes to deer hunt. Well you know what? Dr. Stan and Rachel they cover for Paul when he goes deer hunting. So he gets the chance to help people, have fun and make good money as well.
So, there's this synergy that can happen but 85% of all associate programs end on a sour note and it's just tragic.
I just signed up a new guy and he's in my program and he is developing his associate program now. And he's going through our material and he said, “Noel, I've done everything wrong.” And he said, “Now that I see it laid out I understand why it's wrong and know how to do it right. I've got these interviews that I'm so excited about.”
And he says, “I believe that,” and I believe of this guy as well. He is going to be developing, mentoring, discipling, apprenticing associate chiropractors for the rest of his time on the planet and he's going to love that game and he'll make great money doing it. He'll have a lot of fun doing it and the associates will be grateful as well. That's why we call it win-win associate development.
Dr. Bill: Yeah, and that's awesome. Because you know I was an associate when I first started out in practice. And it is the relationship that can go bitter quickly. It's one that can turn in the wrong direction quickly for both individuals involved.
The associate starts getting disenfranchised and starts feeling like they're not appreciated and that they're doing all this work and they're not making any money. And the doctor feels that he's not getting enough out of the associate. Neither of them have a good relationship or a good experience. How much of having a good experience with your associates comes from setting expectations?
Dr. Noel: Only a hundred percent.
Dr. Bill: Yeah. Exactly.
Dr. Noel: So, here's the deal. We are the people, we are the clinic directors and we offer the job. And what you have to do, I believe this and I teach guys how to do this, is that you have a super clear picture of what win means for you and what win means for them and the intersection of the two and then have a plan.
And the plan is so critical. There's some recipes that you can't mess up. Like tuna sandwich – mayo, tuna, bread. That's pretty easy. Associates, it's really, really different. You actually can't follow everything up if the expectations from the start are not clearly defined. You need to understand doctor, clinic director, owner, what you're offering and then what you're inviting somebody to.
Well, let me give you an example. I'm going to promise that I'm going to train an associate in every area of success required in order for them to be a success in chiropractic. Whether with me for two years, and that’s the shortest program that I offer, or they're with me as a clinic director where I'm still the owner for a long, long, long time and it could be 10, 12, 20 years. And I need to outline the plan and it's always on me, always on me to focus on a mutually attractive future.
It's never something that you can take your eye off for months or weeks or even half of the year at the time if you have really good stability and you trained inside the system and it's not something that I'm worried about. But I frequently have conversations with my business associates now and I say, “Hey how are we doing?” “We're doing fine, we're doing great.”
Do we see what the future looks like? Now I've framed it carefully going in but I have to continue to keep framing it.
Dr. Bill: Right.
Dr. Noel: The expectation is hundred percent.
Dr. Bill: Yeah. And those expectations like you said have to continue to be revisited.
Dr. Noel: Well, yeah.
Dr. Bill: Not just a one-time thing but it's something that you continue to remind your associates about and remind yourself about. What was to be expected and what's a win-win for everyone involved?
Dr. Noel: Right. Plus I listened carefully to what my associates want. I'd say, “Tell me, what does it mean for you to help people, have fun, make money?” It's my goal that my associates make a $100,000 a year as quickly as possible. Now they do that in a business relationship with me where I do just fine. In other words, I'm not giving them a $100,000 in exchange for no work.
Dr. Bill: Right.
Dr. Noel: And it's not a base salary. It's a performance based collection. But, I'm on their side as their coach. I'm not only the team owner because I am the team owner, right? But I'm on their side as their coach and their cheerleader and I take a list of the things that are super important to them and those become the things that are super important to me.
So I've defined the playing field. I can tell you where in bounds is and out of bounds is. I explained the rules of the game before we go to the playing field and then I become your biggest advocate, your biggest fan. I'm always looking for how you can succeed. Because when you succeed in a business relationship with me, then I succeed as well.
I really think that people they know. Intuitively they know if Noel Lloyd's on their side. And I think that my associates would say, “Dr. Lloyd really, really cares about how I…” they would say I'm a smart businessman but they also know that I really care about how they do.
Dr. Bill: So, Noel, you formed Five Star Management many years ago and you've developed so many of your systems and you have taught them to doctors, not just associate programs but all aspects of managing a practice and I know you've worked with many upper cervical doctors and continue to. And so, tell me about some of the programs that are available through Five Star now that the doctors may be interested in.
Dr. Noel: There are two companies now. Five Star Management's been around for almost 30 years. 19 out of 20 times somebody gets in touch with Five Star it was because they need new patients.
Now we discovered when we got them all their new patients that there were other problems like, “Gee, I guess I don't have an efficient system that can handle the patient volume like I thought I could.” And so we would work on what I called a clinic operating system.
Computer has an operating system so does a clinic. A clinic has hardware so does a computer. So the operating system, so you could see all the people your heart desires and your technique allows in a low stress environment. And so Five Star did that full service – new patients, clinic systems, staff, retention and associates.
Then, we started another company which is a branch off of Five Star Management which is called theNew Patient Academy. And I love the New Patient Academy and I love Five Star. They are like my twin kids here.
And by the way, those companies they have put us in record numbers of client more than we've ever had. And there are almost tied, I think the New Patient Academy has a couple more clients than Five Star right now. But the New Patient Academy is all about training a part time marketing assistant to take your message into the community and bring back new patients into your office and I was very successful with that and try to teach people to do that.
And finally, my doctors at Five Star said, “Well, Noel, would you just do it for me? Would you just meet with my marketing personnel? Would you go to the selection process? Would you do that?” And I thought, “You know what? I will. And that’s what the New Patient Academy is.”
And the New Patient Academy is so cool for a couple of reasons. We have a selection process where we can find somebody who is temperamentally predisposed to being an excellent chiropractic sales person.
In fact, I believe that our selection process finds somebody who is actually genetically predisposed to do that job well. Then, we train them in what I call a ‘slam dunk absolutely marvellous new patient getting procedure’ that they can do. And then, we continue to encourage and manage and coach and follow them around for the doctor.
Plus and this is the fourth piece, we teach the doctor how to be the guy or how to be the girl who has the marketing assistant because that's the hardest position in all of chiropractic to manage.
It's easy to manage front desk CA. It's easy to manage a billing CA. It's easy to manage a therapy tech or massage therapist in your office. Associates are harder because they have your same degree. And by the way, if you learn how to do that, you'll have a ton more fun in practice. You'll make a ton more money and you'll help a lot more people.
But this marketing position since they spend so much time out of the office, it's a hard position to manage. So we set up the job correctly. We set up the management criteria correctly.
Our doctors who are in New Patient Academy, their community outreach assistant reports to the New Patient Academy every single day on an 18 point profile. I mean, it literally, when something goes wrong or askew we know about it frequently before the clinic director does. In fact, that's one of the features that we provide is we'll call the clinic director and say, “Hey, we got a problem here. We need to make some correction, we need to do this; we need to do that.”
Because keeping that person focused is that's what we do here. And when we do that, the vast majority of our clients are experiencing absolutely wild increases. In fact, some of them are so wild that they can scarcely keeping up. It is like taking a drink out of a new patient firehose.
So Five Star, focusing now mainly on helping doctors with their clinic systems and being able to handle the volumes and handling associates. New Patient Academy, specifically new patients.
Dr. Bill: And New Patient Academy is a separate entity from Five Star.
Dr. Noel: It's a separate LLC, they're both limited liability companies.
Dr. Bill: So you can be with the New Patient Academy and not be a Five Star client?
Dr. Noel: Yes. Now, lots of people come to Five Star and they meet people at seminars and the guy at the seminars says, “Yeah we have 600 new patients from the New Patient Academy last year and I didn't even go out of the office once.” And they go, “What the heck?” So they only want to find out more. So there's a lot of people that do both. There's an intersection of both.
And then somebody will come to New Patient Academy and say, “What am I going to do with all these new patients? I seem to tap out, I've got systems problems. The place is running so ragged and that we're busier. And I thought my problems were new patients but now I know that it's systems. Can I speak to Dr. Lloyd about that?” So, one feeds the other and the other feeds the one happily for us.
Dr. Bill: Got you.
Dr. Noel: And happily for them too.
Dr. Bill: So if someone was interested in learning more about Five Star, about the New Patient Academy what would be their first step?
Dr. Noel: Well, their first step would be to go to myfivestar.com. And I've got a couple of different courses that you can take there that are free. I've got this wonderful associate course four 17-minute videos. If you become a client that's your first assignment, if you want to do associates.
And so as a non-client just kind of shopping us you can go there. Take a look at my video blogs. I do a weekly video blog four out of five times it's going to be me. One out of five times it's going to be one of my clients and their experiences and see if I'm the type of guy you want to work with.
Now, I don't work with everybody. I don't. I'm 66 years old. I love my work. And one of the reasons I love my work is that I don't let people into my program who I can't support their goals.
If you're just about the money, if you don't care about the patient, if you don't care about the associate, if you don't, I don't want to work with you. And I don't want to be a snob and I don't want to be a turkey about it but each chiropractor has responsibility to build a practice that he or she loves.
And I have a responsibility if I sit at this desk and I still call this desk the best desk in all the chiropractic and I have to be on the phone with you. I have to coach you and I have to care about you and I have to watch your stats; I need to be able to take a look at you and say, “I like this guy. I like the way he thinks about his people. I like the way he treats his associates. I like his ethics. I like his heart.” And so that's the guy I recruit.
Dr. Bill: And then for the New Patient Academy if they're interested.
Dr. Noel: For New Patient Academy go to mynpa.com.
We do a free marketing analyser. And it's really, really good and the young women who work here, Britney and Amanda. Amanda used to be my COA, Community Outreach Assistant at Sound Chiropractic Center. Just a great coach. She's got really, really good experience. She works with her doctors, works with her COAs. She’ll be up on the phone with you answering all your questions, help you understand what the program's working like.
By the way, we don't suggest the NPA for all people who ask us. And again, we have to think that I'm not looking for somebody who's just in it for the money. I want somebody who truly wants to help people first, have fun second, and be successful third.
Dr. Bill: Perfect. Alright well, doc I appreciate your time today. This is great. Like I said that I highly recommend your programs. I've seen this success within my own practice and with a couple of friends of mine and clients of mine now.
Dr. Noel Lloyd I appreciate your time today. Anything else you'd like to share with our audience today? We've got students and doctors of all different types out there and anything you'd like to share before we finish out today.
Dr. Noel: Yeah. I would like to give a special encouragement to the upper cervical chiropractor. I love all the techniques but some techniques I love more. I remember going and being not long ago in a basic starting foundational new NUCCA class at a NUCCA seminar up in Vancouver, Canada. And I truly believe that a picture of what chiropractic philosophy is like is so beautifully and wonderfully illustrated by upper cervical chiropractic.
And I loved NUCCA. I coached a lot of NUCCA people. I think I met you Bill as a result of those some of the other NUCCA doctors that I was coaching. And every time I would speak to you on the phone when you're in practice, one of the things that you would start off with is just, what I recall the NUCCA miracles.
I look so forward to our coaching calls because you would – I remember one about a young man in the military who had this terrible debilitating pain in his hands and he'd been through all kinds of different treatment and it might have been hands and feet but, do you remember this guy?
Dr. Bill: Yes hands and feet.
Dr. Noel: And you had taken care of him and the pain had gone away. There's only one beautiful cure, wonderful expression of chiropractic philosophy in terms of technique that I think is the clearest and that's NUCCA.
Now, I love CBP, I love activator. I love all the other techniques but I have a special place in my heart because I started with Palmer Upper Cervical Specific Adjustment which gave me my life back.
And then, also you can love chiropractic for a lifetime. I'm 66. I've been doing this for 44 years. I still love it and passionate about it today.
And if you need some help, go to my website; see if I'm the type of guy you want to work with. And if I am, great. Get in touch in some way and we'll do a little short chat. And I’ll tell you if I think you’re qualified. And if you do, we'll have a ton of fun.