July 2, 2025 • 26 mins
What happens when your right-hand team member quits two weeks after you return from maternity leave? For chiropractor and business coach Dr. Manju Asdhir, it was the wake-up call that transformed her clinic — and her leadership.
In this episode, Dr. Manju shares with Denzil how she rebuilt her practice from the inside out. They explore what happens when you stop being the glue holding everything together, and start building systems that let others step up.
What You’ll Learn
- How to build a simple organizational structure that reduces daily chaos and helps your team step up
- The onboarding rituals and training systems that set new hires up for success
- Why clinic culture isn’t just about vibes — and how to build it intentionally, even with a small team
- The scoreboard system Dr. Manju used to track performance without micromanaging
Guest Bio
Dr. Manju Asdhir is a chiropractor, entrepreneur, and Solopreneur Coach with Clinic Accelerator. After becoming one of the first female chiropractors in Lindsay, Ontario, she grew her practice into three thriving clinics with a team of 25+ practitioners and over 10,000 patients served. Her flagship clinic earned multiple awards and 600+ five-star reviews. Today, she helps other healthcare professionals launch and scale successful, patient-centered practices — with strong systems and sustainable growth.
Resources mentioned
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
That rush of emotion.
I don't even think I felt thaton my wedding day Like.
Speaker 2 (00:04):
I am not kidding.
Speaker 1 (00:07):
I think I tried to keep my emotions in, but it was
a complete meltdown.
In front of her, she hadcarried the clinic while I was
on the mat leave.
It really unraveled a lot aboutmy leadership style and lack of
leadership style and it made merethink.
Rethink.
This is not a business.
This is just me running theshow.
Speaker 3 (00:33):
Welcome to Radio Front Desk by JNAP.
I'm your host, denzel Ford.
What would you do if yourright-hand person, your most
trusted team member, walked intoyour office and gave their
notice just two weeks afteryou'd returned from maternity
leave?
That was the moment everythingchanged for today's guest, dr
(00:53):
Manju Astier.
Dr Manju is a chiropractor,mentor and business coach who
built and sold not one, butthree thriving clinics.
In this episode, we talk aboutthe standard operating
procedures every clinic actuallyneeds to keep their team
aligned, including implementinga successful onboarding plan.
(01:14):
We also touch on the mindsetshift required to build a
business that runs with you.
Not because of you, let's getinto it.
Because of you, let's get intoit.
Dr Manju, welcome to RadioFront Desk.
How are you today?
I'm good.
(01:34):
I'm really excited to be hereand, yeah, thank you for the
welcome.
I want to start with what youcalled your career defining
moment, the day your front deskstaff gave notice?
Absolutely.
Can you take us back to thatmoment and talk a little bit
about what it felt like and what?
Speaker 1 (01:45):
happened.
It almost brings back a littlePTSD.
I will have to say that I hadbeen running my practice for a
couple of years at that pointand I had some part-time staff,
but we hadn't really built asolid relationship.
I think it was three years in.
I said, yes, I can finallyafford full-time, like, let's do
this, I'm ready to take someburden off my shoulders, I'm
(02:08):
ready to grow the team and Ineed some assistance, and I
decided to hire a clinic manager.
And so this person ended upbeing such a good friend of mine
, loyal relationship.
She would be sort of mysounding board for personal
things as well as professional.
And about six to nine months inI found out I was pregnant.
(02:32):
I went for a three-month matleave and came back with a
newborn at home and I remembervery distinctly two weeks after
I had come back she pulled meinto my office and said I'm very
sorry, but I have to leave thepractice.
And that rush of emotion.
(02:57):
I don't even think I felt thaton my wedding day like I am not
kidding.
I think I tried to keep myemotions in, but it was a
complete meltdown that I had,unfortunately and fortunately,
in front of her, because she hadcarried the clinic while I was
on the mat leave.
She was really good with people, so I didn't have to worry
about the HR part of it.
I thought, oh, everyone's goingto stick together, we're going
(03:18):
to grow together and that notice.
It really unraveled a lot aboutmy leadership style and lack of
leadership style and it alsomade me rethink like this is not
a business.
This is just me running theshow.
Two different things, wow.
(03:40):
So it was pretty impactful.
Speaker 3 (03:43):
I mean also just the self-reflection that you're
describing right now.
I don't think that's an easything to do.
You know.
It's much easier as humanbeings to turn it on the other
person, but to notice thatwhatever was happening with that
person was probably areflection of how you were
showing up.
Speaker 1 (04:03):
Absolutely, and she was a giver right.
So it was sort of, yes, I cansay yes to everything.
You know, that person thatalmost becomes like your family.
Yeah, and I think I cautionlike it was a pivotal point for
me too, because I said to myselflike, yeah, your work
colleagues, you know, we alwayssay like they're like your
family, they're like your family, but you have to really be
cautious with that statement.
(04:24):
And they're not your family andthere should be boundaries.
And if you don't set thoseboundaries, they're going to say
yes, yes, yes, Until theirboundary is we're leaving.
This is too much.
Speaker 3 (04:35):
Yeah.
Speaker 1 (04:36):
And that was huge for me.
Yeah, and I realized it wasmore of a one-sided relationship
where I felt like she was mysounding board, but when I
reflected, how much did I reallyknow about her?
Yeah, and so again that broughtup a lot about my own
leadership style and saying to,like I really need to break it
down to make it beautiful again.
(04:56):
How did you rebuild from there?
I had a kid at home, fourmonths old, three months old,
really tiny.
I had a part-time Cairo thatwas saying to me I'm going to be
leaving to open my own practiceeventually, and I had a massage
therapist that was with me fulltime and I was building towards
my future.
So I said to myself I have achoice of rehiring and doing the
(05:23):
same thing, but now I haveother priorities that need to be
balanced right.
Like the business is my firstbaby hands down?
I still say that to my daughter, that was my first baby.
But I can't be there all thetime, I can't have 60 hours a
week and say, oh, I'm going toput up the daily fires and I'm
going to be able to be presentfor this time.
I can't have 60 hours a weekand say, oh, I'm going to put
(05:44):
out the daily fires and I'mgoing to be able to be present
for this and I'm going to beable to treat patients.
It's like now I have half thetime I have to treat patients,
but I have to use that timereally wisely and reprioritize.
And how do I make this anentity so that in 10 years or 15
years, when I want to sell,it's not dependent on me anymore
?
So I had to go back and createsystems so that when I wanted to
(06:09):
open my second practice and thethird practice and the fourth
and the fifth or whatever Iwanted to do, I could take that
formula and replicate it.
Speaker 3 (06:17):
Yeah, I'm a huge fan of systems.
I think I could talk to you forthree hours about them.
What was the first system thatyou built from there could talk
to you for three hours aboutthem.
Speaker 1 (06:25):
What was the first system that you built from there
.
The first system I built was ascoreboard, and I have to thank
the company that I now work for.
Speaker 3 (06:36):
Clinic Accelerator, because they actually mentored
me, can you?
Speaker 1 (06:38):
just say a minute what Clinic Accelerator is.
So Clinic Accelerator is acompany that I work for now.
They help me scale my practices, identify those revenue leaks
and the gaps, and they're reallyfocused on the rehab world so
physios and chiros specificallyand we use resources that we've
had for like 10 years and it's acheat code for every single
(06:58):
part of your practice fromrecruitment, from finance, p&l,
like who to hire, when to hire,your scoreboard, how to conduct
a meeting, even something assimple as that, what to say in a
meeting so all those steps thatyou need to grow your practice.
Because I'll be honest, from mypoint of view, I had no idea,
like I was going on YouTube andspending countless hours and
(07:20):
then extracting nothing.
So I started my practice.
I was awful as a leader thefirst three years, awful at
systems, and then I actuallyjoined them to be coached and
from that point I was able toscale and the first thing that I
implemented with their help wasa scoreboard.
(07:43):
So I know a lot of people saythis and a lot of people I coach
now say this is like I don'tknow anything about numbers.
I actually don't know how I didlast week.
I think I did pretty good and Ithink I hit a target.
But I don't even know what mytarget is or should be, or how
many patients I've had, or whatmy answer rate is, what my
booking to prescribe rate is.
I had no idea of any numbers.
So if you asked me how manypatients came in last week, what
(08:05):
was your revenue?
Did you make any money?
Did you profit?
No idea.
Speaker 3 (08:10):
That was the first system I put in and just for
everyone listening what is ascoreboard?
Speaker 1 (08:16):
So scoreboard is basically a really fancy Google
sheet that will show you youranswer rate, your booking rate,
your booking to prescriptionratio, your win back rate.
It shows you all the statisticsso that you know every week how
you are doing what's yourrevenue, what's your ar.
(08:38):
How do you create that?
It is a template that'spre-made.
Ah.
However, the stats we pullthrough jane got you and it's
actually quite easy to pullthrough jane.
Yeah, yeah, I mean it's.
It's a matter of like twobuttons.
You can click yeah, um, andthen can ask your team like, how
did we do last week, withoutalways being the first person or
(09:02):
taking on that extra burden,right, right?
Speaker 2 (09:06):
Hey there, Christina, here Just a quick moment to
share that this episode isbrought to you by Jane.
We know how much heart you putinto building a practice you're
proud of, and that's why we'rehere to make things like
scheduling, charting andpayments run a little smoother.
If you'd like to take a peekhead to janeapp forward, slash
pricing, Because we love a goodbonus.
Don't forget to use the coderadiofrontdesk for a one-month
(09:27):
grace period.
Okay, I'll keep it short andsweet.
Back to the episode.
Speaker 3 (09:32):
So let's talk about something else.
I would call a system theorganizational structure.
I don't know if you'd considerthat a system, but I would I
know that you mentioned hiring avariety of different roles.
So the ones I have here areclinic director, clinic lead,
front desk.
I'm just wondering if you couldtell us more about those
different types of roles and theresponsibilities within each
(09:53):
one.
Speaker 1 (09:53):
Sure, I had a clinic director that was managing the
clinicians, treatment plans,even just like how are they
doing day to day?
We did coffee check-ins everyweek.
That were 15 minutes.
Hey, how are you doing?
That's how we would start off,so nothing about work
necessarily.
Then we had a clinician lead,so that was under the clinic
director and they would help theclinic director with marketing
(10:17):
duties.
Or let's say, we're doing somedoctor referrals, or if we're
doing some relationship buildingwith people in our community,
which was huge for us since wewere a rural practice and so
when you create thatorganizational structure and you
have those clinicians and yououtsource bookkeeping, you
outsource your social and do allthose things, all of a sudden,
as an owner I almost took myselfout of the job.
(10:40):
I was sort of like, oh, I couldtake a vacation for two weeks
for the first time in my life,and this is very odd.
Speaker 3 (10:49):
Right, can we drill into that a little more?
Just paint a picture for meSure A versus B.
Speaker 1 (10:55):
So usually when you start off, you're kind of like
the jack of all trades right,and that's fair, because it is
an expense to bring in a lot, alot of other sort of front desk
or you know.
However, you're sort ofpicturing your practice to be
and so you're treating, thenyou're going home and maybe
you're doing some note taking,then you're doing some of the
bookkeeping and you're trying topost on social to let people
(11:16):
know, like your brand andclinician recruitment, and then
you're doing interviews so youcan hire the next physio, build
a certain infrastructure, andyou're just sort of like doing,
I would say, 20% at each ofthose roles, because it's just
not possible to be 100% right.
You're putting on too many hats.
At the end of the day, burnoutis a real thing and we know that
(11:42):
.
And I think when you switchover to an org structure, you
finally realize that what's mostimportant are really only two
things marketing and recruitment.
So systems and those, and thenoperational systems, so your
front desk team, and now youstop being like a firefighter
(12:02):
and putting out daily fires.
You actually start looking atyour business on a whole and
growing it.
Speaker 3 (12:10):
I know you're very upfront with their staff about
career growth.
Yes, and I wonder if you couldtalk about your approach to that
when I interviewed people.
Speaker 1 (12:18):
What I would really show them is two things.
Number one if they're a newgrad, I would show them a
mentorship calendar, so athree-month calendar where they
would get mentorship everysingle week and it was scheduled
in, it was into their Janeprofile.
Oh, wow, okay.
Speaker 2 (12:34):
Yeah.
Speaker 1 (12:34):
So it was in there 30 minutes every single week.
I would grab the tea or coffee,bring it for them and then we
would sit down and go throughthe different cases.
Sometimes it would be hands-onas well, right, because, like,
as a new grad, you're not reallyas confident in your skills
right away.
And then, if it's someone who'sseasoned, they're looking for
different types of professionaldevelopment.
(12:56):
So things like how do I do mybookkeeping?
Or like, if I do want to marketon social, how do I actually do
that?
You know, almost like the breadand butter that we don't think
is relevant, but they're reallythinking about and they really
want to know.
The mentorship was one.
The other types of professionaldevelopment was for seasoned
people, but again, the wholeidea of retention.
(13:18):
So what we would do is here is aslide deck.
You're starting off as apatient experience coordinator.
That's great.
These are some of your rolesand responsibilities that you're
going to oversee with your team.
When these get fulfilled andyou are sort of like moving on
to the next and you're doingreally great at this we're going
(13:39):
to give you some professionaldevelopment.
Maybe it's bookkeeping and seeif you like it.
Or maybe it's a project, a30-day project in bookkeeping or
in social or in marketing, andthen maybe the next step would
be a patient experience manageror a clinician lead, right, so
we actually show them right awaywhat that career path is,
(14:01):
because that means we're provingto them that there is one that
exists it's not just like we'remaking it up fascinating.
Speaker 3 (14:08):
And how important is this?
Is it to start having thoseconversations early on, when
they start right away, like in?
Speaker 1 (14:14):
the interview oh wow yeah, I would say right away,
like in the interview.
Oh, wow, yeah, I would sayright away, because, let's be
honest, it's a very competitivemarket.
I think it's like less than 1%unemployment rate right now.
So what are you doing?
That's different, right.
Speaker 3 (14:27):
I love that.
So on another podcast you saidsomething that really stuck with
me when you grow, you need todevelop culture, meaning, when
you grow your clinic, you needto develop culture because you
want loyalty from your staff.
I mean, you've touched on thata little bit, but I wonder if
you could expand morespecifically into intentional
ways that you have seensuccessfully building culture.
Speaker 1 (14:48):
Yeah.
So the mistake I made early onwas I had zero culture
integrated into the clinic.
I was just trying to get to thenext step, right, trying to
hire the next clinician, and noone would really bite.
So I thought, like what's goingon?
There's a piece of the puzzlemissing.
And what that really was wasculture, because at the end of
the day, when you go to work,you want to have fun.
(15:10):
Yeah, and fun is such a simplething and it doesn't mean that
you don't have tough times as ateam, but you go home and you're
like, yeah, I had a tough day,but it was actually fun, yeah.
So you know how we talk aboutlove languages.
Yeah, there's work, lovelanguages too yeah so we did a
little anonymous survey,compiled all the results of this
(15:33):
love language quiz, and then Iasked my clinic manager to
create a once a month dosomething fun and it's not these
extravagant like dinners andall that, right, it's sort of
like let's do a Sunday, an icecream Sunday day.
And everybody brings theirfavorite topping, or like a blue
jeans day Cause we were scrubsall day, right and we're like.
(15:55):
And then one of the best thingswas it's fun for other people to
do it, because you're seeing itfrom your point of view and
often people are not as personalwith you because you might be
the owner or the boss orwhatever it is, but when it's
handed off to someone else, itmakes their job more fun too,
because they're getting feedbackfrom everyone.
And then it was just thisbeautiful 12 month thing, and
one of the best things that shehad done at that point was
(16:18):
birthday buddy system.
So everybody had a birthdaybuddy and so and you didn't know
who it was, so it wascompletely anonymous and you had
a certain budget to spend, andthen you would either decorate
it, get them a gift, bring acake in, and you would just be
surprised because everyone had adifferent relationship with
that person, or developed adifferent relationship with that
person, right, yeah?
(16:39):
So those are the small things.
I love the 12-month calendar.
I think that makes it reallynice, and I think breaking it
down to different team membersalso is a really good idea.
Speaker 3 (16:48):
Yeah, Personally I'll say I'm not really talented at
that sort of thing Fair enough,but when we've done a few things
like that and someone elseplans it and they you know they
really take ownership of it.
It creates such magic Like itdoes, and even I feel the magic.
I also know that you, you dosomething special in onboarding.
(17:09):
Tell me about that, love it,love it.
Speaker 1 (17:11):
That's my favorite thing.
And I tell all the people whoare starting we call them
solopreneurs like they'restarting their clinics and you
know they're, they're, they'reon their own at the beginning.
And I say, what is youronboarding process?
Like, it's the best thing forme.
And they're like what are youtalking about?
Like, yeah, I sent them acontract.
I'm like, no, like, no textmessages, you know none of that.
(17:32):
No emails.
Like you have you have to meetthe person.
Get them a coffee, go to likeyour go to their favorite coffee
place that's in town.
Give them a contract and belike I'm so excited for you to
come work for me and and with me, I should say not for me.
And then when they come in, um,you know, like you'll do the
whole social and you'll get allthe patients excited Like we
(17:54):
have this new person coming onand it's all this great stuff.
And you'll get all the patientsexcited Like we have this new
person coming on and it's allthis great stuff.
And the first day that theyenter, I always like doing like
welcome balloons, like coffeeTimbits or whatever they really
like, cake or whatever it is,and then a little bio in the
staff room about them.
It's something that's reallyunique and kind of says to them
like we really are excited tobring you on.
Speaker 3 (18:16):
Yeah, I mean, I'm learning from you.
Truly like I, this stuff is noton my radar and I hadn't really
thought about it in onboardingeither, but I love the idea of
balloons and I don't know how wewould do that.
We're, you know, a remote firstcompany right, I'm not really
sure, but I I'm literally likeeveryone needs to get balloons
tomorrow.
I love balloons balloons arethe best, so tell me how you
(18:37):
roll from onboarding to training.
Speaker 1 (18:40):
Two weeks before someone is brought on, we
onboard them with a really nicesort of like five point email
Congratulations and welcome.
The first thing we do isactually get them onboarded with
Jane.
So we actually ask them toreach out to customer service
and go through the process,because we know that when they
come into the clinic they'regoing to be a little bit nervous
(19:02):
.
Maybe they're the type ofperson that doesn't want to see
this for the first time.
They want to be prepared.
Yeah, If it's a clinician we'rebringing on board.
We also do treatment planningprotocols as well, just to give
them an idea of how the teamworks.
Usually we also do a staffmeeting and we ask them to come
in even before they start so theteam can welcome them.
(19:23):
And then, when they actuallyget in, the first 30 days is all
about shadowing.
I like to put them through ourfront desk training program.
It's a 12-week program atAccelerator and the reason I
like to do that is becausethey're going to be very
vulnerable and they're going tobe really nervous to ask
questions and, let's be honest,like I would be probably a
(19:47):
horrible front desk person.
So who am I to train somebodyelse?
So that's the first sort of 30days getting into the training,
you know, getting warm with theidea of what they're supposed to
be doing.
And the top three to fiveresponsibilities to focus on is
how to answer a phone call.
What do our clinicians actuallydo, Like, what does a chiro do
(20:08):
versus a physio?
A lot of people don't know.
Get treatment by those, by eachof the clinicians in the in the
actual facility, Right, andthen also just learning about,
like, how to book a patient in.
What is a treatment planinvolved.
So it's very basic, basicthings and we only work on those
five Short list.
(20:30):
Let them focus.
The next 30 days is reallyfocused on the metrics, Like I
said before, like the answerrate, the booking rate, the
prescribed ratio.
The booking rate, theprescribed ratio, the win backs.
How are they really doing withthat?
And then they understand andthey they know, like what some
certain targets are and how theymeasure.
Interesting and then the last30 days is culture.
(20:50):
So I always say plan an event,do something fun and just go
with it.
So it kind of comes full circlein those 90 days.
But the whole idea is like youwant them to be comfortable
enough to take charge.
Right, Take the lead.
Speaker 3 (21:07):
I worked the front desk in a clinic.
It was a naturopath and amassage business.
Okay, and this is not at allhow I learned to do that job.
Speaker 1 (21:18):
Well, we don't train our people Like we don't train
them right and then we expectthem Like.
I'll tell you honestly, I talkto a lot of people who are like,
oh, they're not.
I don't think my front desk issuited or cut for the job.
I said, well, did you give themproper duties and
responsibilities?
Speaker 3 (21:38):
Because if you don't, you're going to micromanage.
Okay, so let's talk aboutmicromanaging and then the flip
side of that, which is learningto delegate.
How do you do that?
What's your experience with?
Speaker 1 (21:44):
that I will say I was the worst micromanager.
I will say that, like I willclaim that.
I will definitely say that andthat's probably you're very hard
on yourself in your earlyleadership you know what I was
and and I do blame that for therotation of front desk it was me
right.
And again, that's why Ioutsource and we use those front
(22:05):
desk systems at Accelerator,because we're not supposed to
train our front desk.
We've never done that job.
We're great at treatingpatients.
We're not really great atanswering phones, let's be
honest, right?
So how do you stopmicromanaging?
Is you actually give themduties and responsibilities and
say this is sort of the job thatyou have at hand?
(22:25):
Are you okay with it?
Yeah, this is what you'resigning up for.
I'm here to help you andsupport you, but I'm not good at
this.
What did that feel like to you?
It felt like a breath of freshair.
Speaker 3 (22:36):
Oh, they're good, you can trust them.
Yeah, and they want to do good,right.
Speaker 1 (22:46):
Most people want to do good.
You want to.
You have to learn how to stepback.
For me, it was my my mat leave.
I wanted to have a mat leavethat was longer than three
months when I had my seconddaughter, and I was able to take
eight months, which I think isa record as like as a owner, and
the only reason I was able todo that was because when you
step back, people step up, right, yeah, and I realized like I
(23:10):
don't need to do the check-insweekly.
I need to have one meetingremote go through our scoreboard
, ask them how our staff isdoing.
What can we do more for thatperson themselves, like the
clinic manager themselves.
And it feels so good to knowthat you actually have an entity
and it's not just reliant onyou, like you have a true
(23:30):
business then yeah, and it wasso refreshing and they were able
to take it like up a notchwhere I'm not even there, I'm
not treating and we're makingmore.
Yeah with me, almost in a waychecking out.
Yeah, and it's a very beautifulfeeling.
I remember when I exited twoyears ago, my clinic manager
(23:52):
said to me when you hired me, Iwas completely lost and at the
end you pulled the leader out ofme.
It's such a nice thing to hear.
Speaker 3 (24:00):
Yeah, so you did end up selling your business.
Speaker 1 (24:04):
Tell us about that Bittersweet moment.
My first baby like I saidbefore I had grown it with
systems, with operations, and Iwasn't practicing for the last
four years before exiting.
Speaker 3 (24:16):
So with that in mind, I had what do you mean?
You weren't practicing?
Speaker 1 (24:22):
What were you doing?
I was managing, I was growingthe business, so it grew from
the one to three.
Speaker 3 (24:28):
So you didn't just sell on a random day.
You actually stopped practicingand were really working on
driving the business and you gotit to a point where you sold it
.
Speaker 1 (24:37):
Exactly Because that was always the end goal.
But when I was treating, I hadspent so much time with patients
that you don't have the time toactually grow your business
right.
That's the difference, Likewhen you're an owner really,
that is what you want to befocused on is growing.
Speaker 3 (24:53):
Right, but where's the time?
What was the state of yourbusiness when you could start to
get purchasers interested?
Speaker 1 (25:01):
I would say the key things that people are looking
for are they can swoop in andthey don't necessarily have to
be treating 20 to 30 hours aweek.
So less than 30% is what youwant to be treating Like.
You're that much of aminimalist in your business.
You want to have strong culture.
(25:21):
You want to have a really goodvibe so that that new person
coming in isn't coming intosomething toxic or really heavy
that they're going to have touplift.
And the last thing is you wantpeople to see the potential in
your business, right, so you'vegrown it a certain amount and
that there's so much more thatthey can do with it with their
(25:43):
own twist.
Speaker 3 (25:44):
And so it was another chiropractor that bought your
business.
Is that right?
Yes, Fascinating.
Speaker 1 (25:48):
Yeah.
Speaker 3 (25:49):
And so that was their choice and career, rather than
starting something from theground up.
Or maybe they had done thatbefore.
We don't know.
I'm not.
I'm not sure every singleperson out there realizes, and
maybe I'm just naive, I don'tknow.
But that's actually an optiontoo.
Speaker 1 (26:02):
Absolutely.
The trend right now is, andwhat we're seeing is, if you're
starting yourself, it's justhard because you have to build
the patient case yourself, whichis not easy.
There's a lot of competitionand there's a lot of people who
are ready to retire or maybetake on, like myself, a
different role, and so in thatcase you take on a business
(26:24):
that's existing and a caseloadthat's existing and it's far
better financially as well.
Speaker 3 (26:32):
Thanks for listening to this episode of Radio Front
Desk.
If you found it helpful, DrManju has put together a
playbook covering all thesystems you need to build a
strong clinic team, fromonboarding and training to
creating a culture that makesyour team want to stick around.
You can find the link in ourshow notes.
Thanks for listening.
That rush of emotion.
I don't even think I felt thaton my wedding day Like.
Speaker 2 (00:04):
I am not kidding.
Speaker 1 (00:07):
I think I tried to keep my emotions in, but it was
a complete meltdown.
In front of her, she hadcarried the clinic while I was
on the mat leave.
It really unraveled a lot aboutmy leadership style and lack of
leadership style and it made merethink.
Rethink.
This is not a business.
This is just me running theshow.
Speaker 3 (00:33):
Welcome to Radio Front Desk by JNAP.
I'm your host, denzel Ford.
What would you do if yourright-hand person, your most
trusted team member, walked intoyour office and gave their
notice just two weeks afteryou'd returned from maternity
leave?
That was the moment everythingchanged for today's guest, dr
(00:53):
Manju Astier.
Dr Manju is a chiropractor,mentor and business coach who
built and sold not one, butthree thriving clinics.
In this episode, we talk aboutthe standard operating
procedures every clinic actuallyneeds to keep their team
aligned, including implementinga successful onboarding plan.
(01:14):
We also touch on the mindsetshift required to build a
business that runs with you.
Not because of you, let's getinto it.
Because of you, let's get intoit.
Dr Manju, welcome to RadioFront Desk.
How are you today?
I'm good.
(01:34):
I'm really excited to be hereand, yeah, thank you for the
welcome.
I want to start with what youcalled your career defining
moment, the day your front deskstaff gave notice?
Absolutely.
Can you take us back to thatmoment and talk a little bit
about what it felt like and what?
Speaker 1 (01:45):
happened.
It almost brings back a littlePTSD.
I will have to say that I hadbeen running my practice for a
couple of years at that pointand I had some part-time staff,
but we hadn't really built asolid relationship.
I think it was three years in.
I said, yes, I can finallyafford full-time, like, let's do
this, I'm ready to take someburden off my shoulders, I'm
(02:08):
ready to grow the team and Ineed some assistance, and I
decided to hire a clinic manager.
And so this person ended upbeing such a good friend of mine
, loyal relationship.
She would be sort of mysounding board for personal
things as well as professional.
And about six to nine months inI found out I was pregnant.
(02:32):
I went for a three-month matleave and came back with a
newborn at home and I remembervery distinctly two weeks after
I had come back she pulled meinto my office and said I'm very
sorry, but I have to leave thepractice.
And that rush of emotion.
(02:57):
I don't even think I felt thaton my wedding day like I am not
kidding.
I think I tried to keep myemotions in, but it was a
complete meltdown that I had,unfortunately and fortunately,
in front of her, because she hadcarried the clinic while I was
on the mat leave.
She was really good with people, so I didn't have to worry
about the HR part of it.
I thought, oh, everyone's goingto stick together, we're going
(03:18):
to grow together and that notice.
It really unraveled a lot aboutmy leadership style and lack of
leadership style and it alsomade me rethink like this is not
a business.
This is just me running theshow.
Two different things, wow.
(03:40):
So it was pretty impactful.
Speaker 3 (03:43):
I mean also just the self-reflection that you're
describing right now.
I don't think that's an easything to do.
You know.
It's much easier as humanbeings to turn it on the other
person, but to notice thatwhatever was happening with that
person was probably areflection of how you were
showing up.
Speaker 1 (04:03):
Absolutely, and she was a giver right.
So it was sort of, yes, I cansay yes to everything.
You know, that person thatalmost becomes like your family.
Yeah, and I think I cautionlike it was a pivotal point for
me too, because I said to myselflike, yeah, your work
colleagues, you know, we alwayssay like they're like your
family, they're like your family, but you have to really be
cautious with that statement.
(04:24):
And they're not your family andthere should be boundaries.
And if you don't set thoseboundaries, they're going to say
yes, yes, yes, Until theirboundary is we're leaving.
This is too much.
Speaker 3 (04:35):
Yeah.
Speaker 1 (04:36):
And that was huge for me.
Yeah, and I realized it wasmore of a one-sided relationship
where I felt like she was mysounding board, but when I
reflected, how much did I reallyknow about her?
Yeah, and so again that broughtup a lot about my own
leadership style and saying to,like I really need to break it
down to make it beautiful again.
(04:56):
How did you rebuild from there?
I had a kid at home, fourmonths old, three months old,
really tiny.
I had a part-time Cairo thatwas saying to me I'm going to be
leaving to open my own practiceeventually, and I had a massage
therapist that was with me fulltime and I was building towards
my future.
So I said to myself I have achoice of rehiring and doing the
(05:23):
same thing, but now I haveother priorities that need to be
balanced right.
Like the business is my firstbaby hands down?
I still say that to my daughter, that was my first baby.
But I can't be there all thetime, I can't have 60 hours a
week and say, oh, I'm going toput up the daily fires and I'm
going to be able to be presentfor this time.
I can't have 60 hours a weekand say, oh, I'm going to put
(05:44):
out the daily fires and I'mgoing to be able to be present
for this and I'm going to beable to treat patients.
It's like now I have half thetime I have to treat patients,
but I have to use that timereally wisely and reprioritize.
And how do I make this anentity so that in 10 years or 15
years, when I want to sell,it's not dependent on me anymore
?
So I had to go back and createsystems so that when I wanted to
(06:09):
open my second practice and thethird practice and the fourth
and the fifth or whatever Iwanted to do, I could take that
formula and replicate it.
Speaker 3 (06:17):
Yeah, I'm a huge fan of systems.
I think I could talk to you forthree hours about them.
What was the first system thatyou built from there could talk
to you for three hours aboutthem.
Speaker 1 (06:25):
What was the first system that you built from there
.
The first system I built was ascoreboard, and I have to thank
the company that I now work for.
Speaker 3 (06:36):
Clinic Accelerator, because they actually mentored
me, can you?
Speaker 1 (06:38):
just say a minute what Clinic Accelerator is.
So Clinic Accelerator is acompany that I work for now.
They help me scale my practices, identify those revenue leaks
and the gaps, and they're reallyfocused on the rehab world so
physios and chiros specificallyand we use resources that we've
had for like 10 years and it's acheat code for every single
(06:58):
part of your practice fromrecruitment, from finance, p&l,
like who to hire, when to hire,your scoreboard, how to conduct
a meeting, even something assimple as that, what to say in a
meeting so all those steps thatyou need to grow your practice.
Because I'll be honest, from mypoint of view, I had no idea,
like I was going on YouTube andspending countless hours and
(07:20):
then extracting nothing.
So I started my practice.
I was awful as a leader thefirst three years, awful at
systems, and then I actuallyjoined them to be coached and
from that point I was able toscale and the first thing that I
implemented with their help wasa scoreboard.
(07:43):
So I know a lot of people saythis and a lot of people I coach
now say this is like I don'tknow anything about numbers.
I actually don't know how I didlast week.
I think I did pretty good and Ithink I hit a target.
But I don't even know what mytarget is or should be, or how
many patients I've had, or whatmy answer rate is, what my
booking to prescribe rate is.
I had no idea of any numbers.
So if you asked me how manypatients came in last week, what
(08:05):
was your revenue?
Did you make any money?
Did you profit?
No idea.
Speaker 3 (08:10):
That was the first system I put in and just for
everyone listening what is ascoreboard?
Speaker 1 (08:16):
So scoreboard is basically a really fancy Google
sheet that will show you youranswer rate, your booking rate,
your booking to prescriptionratio, your win back rate.
It shows you all the statisticsso that you know every week how
you are doing what's yourrevenue, what's your ar.
(08:38):
How do you create that?
It is a template that'spre-made.
Ah.
However, the stats we pullthrough jane got you and it's
actually quite easy to pullthrough jane.
Yeah, yeah, I mean it's.
It's a matter of like twobuttons.
You can click yeah, um, andthen can ask your team like, how
did we do last week, withoutalways being the first person or
(09:02):
taking on that extra burden,right, right?
Speaker 2 (09:06):
Hey there, Christina, here Just a quick moment to
share that this episode isbrought to you by Jane.
We know how much heart you putinto building a practice you're
proud of, and that's why we'rehere to make things like
scheduling, charting andpayments run a little smoother.
If you'd like to take a peekhead to janeapp forward, slash
pricing, Because we love a goodbonus.
Don't forget to use the coderadiofrontdesk for a one-month
(09:27):
grace period.
Okay, I'll keep it short andsweet.
Back to the episode.
Speaker 3 (09:32):
So let's talk about something else.
I would call a system theorganizational structure.
I don't know if you'd considerthat a system, but I would I
know that you mentioned hiring avariety of different roles.
So the ones I have here areclinic director, clinic lead,
front desk.
I'm just wondering if you couldtell us more about those
different types of roles and theresponsibilities within each
(09:53):
one.
Speaker 1 (09:53):
Sure, I had a clinic director that was managing the
clinicians, treatment plans,even just like how are they
doing day to day?
We did coffee check-ins everyweek.
That were 15 minutes.
Hey, how are you doing?
That's how we would start off,so nothing about work
necessarily.
Then we had a clinician lead,so that was under the clinic
director and they would help theclinic director with marketing
(10:17):
duties.
Or let's say, we're doing somedoctor referrals, or if we're
doing some relationship buildingwith people in our community,
which was huge for us since wewere a rural practice and so
when you create thatorganizational structure and you
have those clinicians and yououtsource bookkeeping, you
outsource your social and do allthose things, all of a sudden,
as an owner I almost took myselfout of the job.
(10:40):
I was sort of like, oh, I couldtake a vacation for two weeks
for the first time in my life,and this is very odd.
Speaker 3 (10:49):
Right, can we drill into that a little more?
Just paint a picture for meSure A versus B.
Speaker 1 (10:55):
So usually when you start off, you're kind of like
the jack of all trades right,and that's fair, because it is
an expense to bring in a lot, alot of other sort of front desk
or you know.
However, you're sort ofpicturing your practice to be
and so you're treating, thenyou're going home and maybe
you're doing some note taking,then you're doing some of the
bookkeeping and you're trying topost on social to let people
(11:16):
know, like your brand andclinician recruitment, and then
you're doing interviews so youcan hire the next physio, build
a certain infrastructure, andyou're just sort of like doing,
I would say, 20% at each ofthose roles, because it's just
not possible to be 100% right.
You're putting on too many hats.
At the end of the day, burnoutis a real thing and we know that
(11:42):
.
And I think when you switchover to an org structure, you
finally realize that what's mostimportant are really only two
things marketing and recruitment.
So systems and those, and thenoperational systems, so your
front desk team, and now youstop being like a firefighter
(12:02):
and putting out daily fires.
You actually start looking atyour business on a whole and
growing it.
Speaker 3 (12:10):
I know you're very upfront with their staff about
career growth.
Yes, and I wonder if you couldtalk about your approach to that
when I interviewed people.
Speaker 1 (12:18):
What I would really show them is two things.
Number one if they're a newgrad, I would show them a
mentorship calendar, so athree-month calendar where they
would get mentorship everysingle week and it was scheduled
in, it was into their Janeprofile.
Oh, wow, okay.
Speaker 2 (12:34):
Yeah.
Speaker 1 (12:34):
So it was in there 30 minutes every single week.
I would grab the tea or coffee,bring it for them and then we
would sit down and go throughthe different cases.
Sometimes it would be hands-onas well, right, because, like,
as a new grad, you're not reallyas confident in your skills
right away.
And then, if it's someone who'sseasoned, they're looking for
different types of professionaldevelopment.
(12:56):
So things like how do I do mybookkeeping?
Or like, if I do want to marketon social, how do I actually do
that?
You know, almost like the breadand butter that we don't think
is relevant, but they're reallythinking about and they really
want to know.
The mentorship was one.
The other types of professionaldevelopment was for seasoned
people, but again, the wholeidea of retention.
(13:18):
So what we would do is here is aslide deck.
You're starting off as apatient experience coordinator.
That's great.
These are some of your rolesand responsibilities that you're
going to oversee with your team.
When these get fulfilled andyou are sort of like moving on
to the next and you're doingreally great at this we're going
(13:39):
to give you some professionaldevelopment.
Maybe it's bookkeeping and seeif you like it.
Or maybe it's a project, a30-day project in bookkeeping or
in social or in marketing, andthen maybe the next step would
be a patient experience manageror a clinician lead, right, so
we actually show them right awaywhat that career path is,
(14:01):
because that means we're provingto them that there is one that
exists it's not just like we'remaking it up fascinating.
Speaker 3 (14:08):
And how important is this?
Is it to start having thoseconversations early on, when
they start right away, like in?
Speaker 1 (14:14):
the interview oh wow yeah, I would say right away,
like in the interview.
Oh, wow, yeah, I would sayright away, because, let's be
honest, it's a very competitivemarket.
I think it's like less than 1%unemployment rate right now.
So what are you doing?
That's different, right.
Speaker 3 (14:27):
I love that.
So on another podcast you saidsomething that really stuck with
me when you grow, you need todevelop culture, meaning, when
you grow your clinic, you needto develop culture because you
want loyalty from your staff.
I mean, you've touched on thata little bit, but I wonder if
you could expand morespecifically into intentional
ways that you have seensuccessfully building culture.
Speaker 1 (14:48):
Yeah.
So the mistake I made early onwas I had zero culture
integrated into the clinic.
I was just trying to get to thenext step, right, trying to
hire the next clinician, and noone would really bite.
So I thought, like what's goingon?
There's a piece of the puzzlemissing.
And what that really was wasculture, because at the end of
the day, when you go to work,you want to have fun.
(15:10):
Yeah, and fun is such a simplething and it doesn't mean that
you don't have tough times as ateam, but you go home and you're
like, yeah, I had a tough day,but it was actually fun, yeah.
So you know how we talk aboutlove languages.
Yeah, there's work, lovelanguages too yeah so we did a
little anonymous survey,compiled all the results of this
(15:33):
love language quiz, and then Iasked my clinic manager to
create a once a month dosomething fun and it's not these
extravagant like dinners andall that, right, it's sort of
like let's do a Sunday, an icecream Sunday day.
And everybody brings theirfavorite topping, or like a blue
jeans day Cause we were scrubsall day, right and we're like.
(15:55):
And then one of the best thingswas it's fun for other people to
do it, because you're seeing itfrom your point of view and
often people are not as personalwith you because you might be
the owner or the boss orwhatever it is, but when it's
handed off to someone else, itmakes their job more fun too,
because they're getting feedbackfrom everyone.
And then it was just thisbeautiful 12 month thing, and
one of the best things that shehad done at that point was
(16:18):
birthday buddy system.
So everybody had a birthdaybuddy and so and you didn't know
who it was, so it wascompletely anonymous and you had
a certain budget to spend, andthen you would either decorate
it, get them a gift, bring acake in, and you would just be
surprised because everyone had adifferent relationship with
that person, or developed adifferent relationship with that
person, right, yeah?
(16:39):
So those are the small things.
I love the 12-month calendar.
I think that makes it reallynice, and I think breaking it
down to different team membersalso is a really good idea.
Speaker 3 (16:48):
Yeah, Personally I'll say I'm not really talented at
that sort of thing Fair enough,but when we've done a few things
like that and someone elseplans it and they you know they
really take ownership of it.
It creates such magic Like itdoes, and even I feel the magic.
I also know that you, you dosomething special in onboarding.
(17:09):
Tell me about that, love it,love it.
Speaker 1 (17:11):
That's my favorite thing.
And I tell all the people whoare starting we call them
solopreneurs like they'restarting their clinics and you
know they're, they're, they'reon their own at the beginning.
And I say, what is youronboarding process?
Like, it's the best thing forme.
And they're like what are youtalking about?
Like, yeah, I sent them acontract.
I'm like, no, like, no textmessages, you know none of that.
(17:32):
No emails.
Like you have you have to meetthe person.
Get them a coffee, go to likeyour go to their favorite coffee
place that's in town.
Give them a contract and belike I'm so excited for you to
come work for me and and with me, I should say not for me.
And then when they come in, um,you know, like you'll do the
whole social and you'll get allthe patients excited Like we
(17:54):
have this new person coming onand it's all this great stuff.
And you'll get all the patientsexcited Like we have this new
person coming on and it's allthis great stuff.
And the first day that theyenter, I always like doing like
welcome balloons, like coffeeTimbits or whatever they really
like, cake or whatever it is,and then a little bio in the
staff room about them.
It's something that's reallyunique and kind of says to them
like we really are excited tobring you on.
Speaker 3 (18:16):
Yeah, I mean, I'm learning from you.
Truly like I, this stuff is noton my radar and I hadn't really
thought about it in onboardingeither, but I love the idea of
balloons and I don't know how wewould do that.
We're, you know, a remote firstcompany right, I'm not really
sure, but I I'm literally likeeveryone needs to get balloons
tomorrow.
I love balloons balloons arethe best, so tell me how you
(18:37):
roll from onboarding to training.
Speaker 1 (18:40):
Two weeks before someone is brought on, we
onboard them with a really nicesort of like five point email
Congratulations and welcome.
The first thing we do isactually get them onboarded with
Jane.
So we actually ask them toreach out to customer service
and go through the process,because we know that when they
come into the clinic they'regoing to be a little bit nervous
(19:02):
.
Maybe they're the type ofperson that doesn't want to see
this for the first time.
They want to be prepared.
Yeah, If it's a clinician we'rebringing on board.
We also do treatment planningprotocols as well, just to give
them an idea of how the teamworks.
Usually we also do a staffmeeting and we ask them to come
in even before they start so theteam can welcome them.
(19:23):
And then, when they actuallyget in, the first 30 days is all
about shadowing.
I like to put them through ourfront desk training program.
It's a 12-week program atAccelerator and the reason I
like to do that is becausethey're going to be very
vulnerable and they're going tobe really nervous to ask
questions and, let's be honest,like I would be probably a
(19:47):
horrible front desk person.
So who am I to train somebodyelse?
So that's the first sort of 30days getting into the training,
you know, getting warm with theidea of what they're supposed to
be doing.
And the top three to fiveresponsibilities to focus on is
how to answer a phone call.
What do our clinicians actuallydo, Like, what does a chiro do
(20:08):
versus a physio?
A lot of people don't know.
Get treatment by those, by eachof the clinicians in the in the
actual facility, Right, andthen also just learning about,
like, how to book a patient in.
What is a treatment planinvolved.
So it's very basic, basicthings and we only work on those
five Short list.
(20:30):
Let them focus.
The next 30 days is reallyfocused on the metrics, Like I
said before, like the answerrate, the booking rate, the
prescribed ratio.
The booking rate, theprescribed ratio, the win backs.
How are they really doing withthat?
And then they understand andthey they know, like what some
certain targets are and how theymeasure.
Interesting and then the last30 days is culture.
(20:50):
So I always say plan an event,do something fun and just go
with it.
So it kind of comes full circlein those 90 days.
But the whole idea is like youwant them to be comfortable
enough to take charge.
Right, Take the lead.
Speaker 3 (21:07):
I worked the front desk in a clinic.
It was a naturopath and amassage business.
Okay, and this is not at allhow I learned to do that job.
Speaker 1 (21:18):
Well, we don't train our people Like we don't train
them right and then we expectthem Like.
I'll tell you honestly, I talkto a lot of people who are like,
oh, they're not.
I don't think my front desk issuited or cut for the job.
I said, well, did you give themproper duties and
responsibilities?
Speaker 3 (21:38):
Because if you don't, you're going to micromanage.
Okay, so let's talk aboutmicromanaging and then the flip
side of that, which is learningto delegate.
How do you do that?
What's your experience with?
Speaker 1 (21:44):
that I will say I was the worst micromanager.
I will say that, like I willclaim that.
I will definitely say that andthat's probably you're very hard
on yourself in your earlyleadership you know what I was
and and I do blame that for therotation of front desk it was me
right.
And again, that's why Ioutsource and we use those front
(22:05):
desk systems at Accelerator,because we're not supposed to
train our front desk.
We've never done that job.
We're great at treatingpatients.
We're not really great atanswering phones, let's be
honest, right?
So how do you stopmicromanaging?
Is you actually give themduties and responsibilities and
say this is sort of the job thatyou have at hand?
(22:25):
Are you okay with it?
Yeah, this is what you'resigning up for.
I'm here to help you andsupport you, but I'm not good at
this.
What did that feel like to you?
It felt like a breath of freshair.
Speaker 3 (22:36):
Oh, they're good, you can trust them.
Yeah, and they want to do good,right.
Speaker 1 (22:46):
Most people want to do good.
You want to.
You have to learn how to stepback.
For me, it was my my mat leave.
I wanted to have a mat leavethat was longer than three
months when I had my seconddaughter, and I was able to take
eight months, which I think isa record as like as a owner, and
the only reason I was able todo that was because when you
step back, people step up, right, yeah, and I realized like I
(23:10):
don't need to do the check-insweekly.
I need to have one meetingremote go through our scoreboard
, ask them how our staff isdoing.
What can we do more for thatperson themselves, like the
clinic manager themselves.
And it feels so good to knowthat you actually have an entity
and it's not just reliant onyou, like you have a true
(23:30):
business then yeah, and it wasso refreshing and they were able
to take it like up a notchwhere I'm not even there, I'm
not treating and we're makingmore.
Yeah with me, almost in a waychecking out.
Yeah, and it's a very beautifulfeeling.
I remember when I exited twoyears ago, my clinic manager
(23:52):
said to me when you hired me, Iwas completely lost and at the
end you pulled the leader out ofme.
It's such a nice thing to hear.
Speaker 3 (24:00):
Yeah, so you did end up selling your business.
Speaker 1 (24:04):
Tell us about that Bittersweet moment.
My first baby like I saidbefore I had grown it with
systems, with operations, and Iwasn't practicing for the last
four years before exiting.
Speaker 3 (24:16):
So with that in mind, I had what do you mean?
You weren't practicing?
Speaker 1 (24:22):
What were you doing?
I was managing, I was growingthe business, so it grew from
the one to three.
Speaker 3 (24:28):
So you didn't just sell on a random day.
You actually stopped practicingand were really working on
driving the business and you gotit to a point where you sold it
.
Speaker 1 (24:37):
Exactly Because that was always the end goal.
But when I was treating, I hadspent so much time with patients
that you don't have the time toactually grow your business
right.
That's the difference, Likewhen you're an owner really,
that is what you want to befocused on is growing.
Speaker 3 (24:53):
Right, but where's the time?
What was the state of yourbusiness when you could start to
get purchasers interested?
Speaker 1 (25:01):
I would say the key things that people are looking
for are they can swoop in andthey don't necessarily have to
be treating 20 to 30 hours aweek.
So less than 30% is what youwant to be treating Like.
You're that much of aminimalist in your business.
You want to have strong culture.
(25:21):
You want to have a really goodvibe so that that new person
coming in isn't coming intosomething toxic or really heavy
that they're going to have touplift.
And the last thing is you wantpeople to see the potential in
your business, right, so you'vegrown it a certain amount and
that there's so much more thatthey can do with it with their
(25:43):
own twist.
Speaker 3 (25:44):
And so it was another chiropractor that bought your
business.
Is that right?
Yes, Fascinating.
Speaker 1 (25:48):
Yeah.
Speaker 3 (25:49):
And so that was their choice and career, rather than
starting something from theground up.
Or maybe they had done thatbefore.
We don't know.
I'm not.
I'm not sure every singleperson out there realizes, and
maybe I'm just naive, I don'tknow.
But that's actually an optiontoo.
Speaker 1 (26:02):
Absolutely.
The trend right now is, andwhat we're seeing is, if you're
starting yourself, it's justhard because you have to build
the patient case yourself, whichis not easy.
There's a lot of competitionand there's a lot of people who
are ready to retire or maybetake on, like myself, a
different role, and so in thatcase you take on a business
(26:24):
that's existing and a caseloadthat's existing and it's far
better financially as well.
Speaker 3 (26:32):
Thanks for listening to this episode of Radio Front
Desk.
If you found it helpful, DrManju has put together a
playbook covering all thesystems you need to build a
strong clinic team, fromonboarding and training to
creating a culture that makesyour team want to stick around.
You can find the link in ourshow notes.
Thanks for listening.
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