Today’s post is a quick reminder of something we too often sweep under the rug.  No one likes to deal with staff struggles and all of us like to point the finger when things are not going well in practice.

While the front desk does not deserve all the blame for poor performance of your practice, I have definitely observed a correlation in the success of your office and the quality of your front desk staff.  It’s very simple: the busiest, healthiest, most vibrant practices have, for the most part, outstanding staff.

Certainly, this generalization is hard to quantify, so let’s get very specific so you can begin to analyze potential areas you may need to improve – regardless of whether your practice is booming, stagnating or headed for the toilet.  EVERY practice can always do better in this department and MANY practices NEED to do better in order to thrive.

Each year, I visit more offices than my car tires want to count.  And it amazes me how many offices neglect the ultimate basics when staffing their front desk.  This is far from rocket science and very close to what most people would call common sense.  Unfortunately, it’s also rare enough that we really can’t accurately say it’s all that common in chiropractic offices.  So, let’s assume we are starting with a blank slate. Here are the basic requirements for a great front desk staff member.

Missing any of these? Train or liberate them (aka: “You’re fired.”)!

The Front Desk “Basics”

  • People Person:  If your staff member’s idea of a great day includes sitting in an office, locked away from any human contact, they don’t belong at the front desk.  They may make perfect billing staff but at the front desk they will be constantly annoyed by the (hopefully) constant presence of people.  Yep. Gotta love dealing with people to make the front desk work.  The downside is this position tends to attract social butterflies who can’t get a single thing done other than chat with patients.  But that’s another problem (see below).


  • Not Organizationally Challenged:  Some staff love people so much that they either cannot or will not find the time to handle a single piece of paper, collect a co-pay, schedule future appointments or manage any administrative task that comes their way.  If Chatty Cathy won’t stop talking long enough to serve your other patients or perform some of her other job duties, you’ve got to reign her in and spell out some basic requirements or let her know that Olive Garden is hiring hostesses.  You will not survive someone so disorganized that they leave all tasks for the rest of the staff while they “focus” on making patients happy.  While that is an admirable goal, it can’t be achieved at the expense of all others.  Trust me, the rest of your staff will hate you if you allow one person the title of “Social Queen” and force everyone else to work like drones.


  • Pleasant Phone Presence:    Since most new patient and many returning patient encounters still initially happen over the phone, a big basic staff requirement is someone who has a pleasant phone manner.  Pleasant may be defined as a voice that is pleasing to the ear (i.e. doesn’t sound like a 30 year smoker), polite (uses appropriate manners, says “ please and thank you”), professional (uses appropriate language, respectfully and avoids slang or obscenities) and easy to hear (does not speak too quickly, accent not too strong, and doesn’t talk as if there are marbles in their mouth).  Oh and one final note: they should not talk with food in their mouth.


  • Well Scripted Phone Procedures:  Your staff member should memorize the appropriate scripting for your procedures and policies for your office.  These should be scripted and not “off the cuff.”  There should be few surprise questions.  If your front desk gets stumped too often, then either you don’t have procedures or they have not committed them to memory. Both are bad.  One is your fault, one is theirs (and in turn, your fault for not enforcing it).

Sound basic?  They are!  But there’s not a week that goes by that I find front desk staff saying things that would make their doctor’s blood pressure boil.

The #1 “Secret” to Front Desk Success

Believe it or not, all of the above can be in place and you can STILL fail.  Why? Marketing and consulting experts from all professions, retail and service industries have pointed out a key factor in many successful ventures that needs to be present in your staff.  Even the political pundits agree that successful candidates need this and most Presidents possess it (to one degree or another).

What is this “secret” to success?

It is simply this: your front desk must be “likable.”

This can be defined in many differerent ways, but for repeat service businesses like chiropractic, most patients do not want to do business with people they do not like.  And on the flip side, they will forgive minor imperfections in your (or your staff’s) customer service…if they genuinely like you.

More specifically, if they genuinely like you AND your front desk staff.

It’s hard to believe that patient’s would stick with a doctor they don’t like, but they do.  And many tolerate even mediocre doctors or one’s who lack personality because their front desk staff more than makes up for this factor.

What is not tolerated is a less than positive experience with the doctor combined with a less than likeable front desk staff.  This will drive patients away despite your good results, affordable fees, convenient location and many other things that you do well.

Likeability From Another Angle

Many experts believe that a slew of failed politicians all suffered from a lack of charisma or likeability. Interestingly enough, even ones that were proven ineffective, shady or otherwise not a great candidate were given much grace because they were personally likeable.

Similarly, companies can achieve the same thing.  Apple thrived, not so much because Steve Jobs was so incredibly likeable, but because he told stories that inspired his staff and salespeople to manage relationships in such a way that they created Mac fanatics.

Every successful dentist I have seen has wonderful front desk staff. I think it’s mandatory for them.  Why? Well, no one likes going to the dentist.  They don’t care if the dentist is good; it’s just not fun.  So, most folks aren’t going to tolerate the icky dental procedures AND an equally icky staff.  But when Marsha knows you by name and asks how your kids are and cracks jokes the whole time she is busy getting you ready for a root canal, somehow it’s much more tolerated.

We can do the same in chiropractic.  Here’s a few ways to increase the “likeability” of the front desk:

  • Get to Know Patients:  It’s actually fun to watch the best front desk CA’s.  They seemingly know every patient and greet them with a smile when they come in.  Sometimes, hugs are exchanged. Stories are told. And you get the feeling of a reunion rather than a business appointment. This only happens when staff make a tiny effort to get to know a patient by interacting with them. This can be simply asking where they live, what they do or it can be accomplished by talking to their children, their dogs or even paying them a compliment on their shoes, purse or the wonderfully rare fedora they are wearing.


  • Recognize What Patients Do For YOU:  In the most basic sense, your staff should always be saying “thank you” and making the patient very aware that you appreciate them.  Thank the patient who offers to pay their co-pay or settle a bill. Thank them when they ask how you are doing.  Thank them when they refer (or even try to refer) a new patient.  Thank them for coming today and for making their next appointment. Thank them for being them – a great patient. Everyone likes to be appreciated and amazingly, they like the person who appreciates them!!


  • Become a Resource for Them Beyond Chiropractic:  When Betty complains that her tooth is killing her, offer a recommendation for a dentist.  When you hear that Joe is late for his appointment, let him know that I-5 is not a good choice right now because of traffic.  Let them  know that they should try McStuffy’s if they enjoy a good bacon ice cream sundae.  This shows you care about them as people and it makes them feel the same way toward you – increasing your likeability factor some more…


  • Cut Through the Confusion:  Help patients with paperwork.  Offer to email them something they need.  Explain the doctor’s procedures or policies very simpluy. Do anything to help makes things more simple and streamlined and let them know you are doing it…People like simple and convenient and predictable.  Don’t believe it? It’s the principle that every fast food franchise thrives on.


  • Go the Extra Mile: Personally, I love the fact that the front desk lady at my CPA’s office offers me water every time I visit their office.    I like when I visit a DC in the city and they have reserved parking just for their patients so they don’t have to feed the meter.  I like the option to get a reminder call, text or email – when it’s an option.  I like the fact that every time I spend some money at the printer’s office, I get an gift card to some restaurant and a thank you for my business. I like that my dentist gives me headphones to listen to music or watch a movie while having my procedure done. (In fact, I like this way better than attempting to talk to him while his tools and fingers are stuck in my mouth). These are nice extra touches that are all totally 100% unnecessary and that’s probably why I likethem.  How can your staff go the extra mile?  It probably doesn’t matter as much the format the extra mile takes place; any way you slice it, patient’s will appreciate and like you MORE for it – so do it!



So what if your front desk staff are milk toast, harmlessly vanilla and just sort of there?  Don’t be fooled.  You are losing out on some great potential to build relationships, to build your likeability and to build your practice.  They may not be driving people away, but they are not causing them to stay either. Do your best to try and turn them up a notch and see if you can get them to shine a little more.

And to address the elephant in the room – what if your front desk staff are just not that friendly, that well-spoken or well-liked?  Seriously consider that they are doing damage (however subtle or obvious) to your business.  It’s really tough to recover from a bad first impression, but it’s perhaps even harder to thrive when you continually expose your patients to a repeating bad or mediocre interaction with a less than stellar front desk staff member.  Do yourself a favor – relocate them to another job in your office that doesn’t require so much interaction or a position in someone else’s business.

Finally, when you replace them, put your best foot forward and get someone who can master all of the above.  I can just about guarantee that your business will grow with that kind of competence at the helm.