Radio Front Desk

How to Build Clinic Systems That Scale — Without Facing Burnout

• Jane.app • Episode 16

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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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The views and opinions expressed in this podcast are those of the guests and do not necessarily reflect the official policy or position of the podcast host or its affiliates.



Speaker 1:

That rush of emotion. I don't even think I felt that on my wedding day Like.

Speaker 2:

I am not kidding.

Speaker 1:

I think I tried to keep my emotions in, but it was a complete meltdown. In front of her, she had carried the clinic while I was on the mat leave. It really unraveled a lot about my leadership style and lack of leadership style and it made me rethink. Rethink. This is not a business. This is just me running the show.

Speaker 3:

Welcome to Radio Front Desk by JNAP. I'm your host, denzel Ford. What would you do if your right-hand person, your most trusted team member, walked into your office and gave their notice just two weeks after you'd returned from maternity leave? That was the moment everything changed for today's guest, dr Manju Astier. Dr Manju is a chiropractor, mentor and business coach who built and sold not one, but three thriving clinics. In this episode, we talk about the standard operating procedures every clinic actually needs to keep their team aligned, including implementing a successful onboarding plan. We also touch on the mindset shift required to build a business that runs with you. Not because of you, let's get into it. Because of you, let's get into it. Dr Manju, welcome to Radio Front Desk. How are you today? I'm good. I'm really excited to be here and, yeah, thank you for the welcome. I want to start with what you called your career defining moment, the day your front desk staff gave notice? Absolutely. Can you take us back to that moment and talk a little bit about what it felt like and what?

Speaker 1:

happened. It almost brings back a little PTSD. I will have to say that I had been running my practice for a couple of years at that point and I had some part-time staff, but we hadn't really built a solid relationship. I think it was three years in. I said, yes, I can finally afford full-time, like, let's do this, I'm ready to take some burden off my shoulders, I'm ready to grow the team and I need some assistance, and I decided to hire a clinic manager. And so this person ended up being such a good friend of mine, loyal relationship. She would be sort of my sounding board for personal things as well as professional. And about six to nine months in I found out I was pregnant. I went for a three-month mat leave and came back with a newborn at home and I remember very distinctly two weeks after I had come back she pulled me into my office and said I'm very sorry, but I have to leave the practice. And that rush of emotion. I don't even think I felt that on my wedding day like I am not kidding.

Speaker 1:

I think I tried to keep my emotions in, but it was a complete meltdown that I had, unfortunately and fortunately, in front of her, because she had carried 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 going to stick together, we're going to grow together and that notice. It really unraveled a lot about my leadership style and lack of leadership style and it also made me rethink like this is not a business. This is just me running the show. Two different things, wow. So it was pretty impactful.

Speaker 3:

I mean also just the self-reflection that you're describing right now. I don't think that's an easy thing to do. You know. It's much easier as human beings to turn it on the other person, but to notice that whatever was happening with that person was probably a reflection of how you were showing up.

Speaker 1:

Absolutely, and she was a giver right. So it was sort of, yes, I can say yes to everything. You know, that person that almost becomes like your family. Yeah, and I think I caution like it was a pivotal point for me too, because I said to myself like, yeah, your work colleagues, you know, we always say like they're like your family, they're like your family, but you have to really be cautious with that statement. And they're not your family and there should be boundaries. And if you don't set those boundaries, they're going to say yes, yes, yes, Until their boundary is we're leaving. This is too much.

Speaker 3:

Yeah.

Speaker 1:

And that was huge for me. Yeah, and I realized it was more of a one-sided relationship where I felt like she was my sounding board, but when I reflected, how much did I really know about her? Yeah, and so again that brought up a lot about my own leadership style and saying to, like I really need to break it down to make it beautiful again. How did you rebuild from there? I had a kid at home, four months old, three months old, really tiny. I had a part-time Cairo that was saying to me I'm going to be leaving to open my own practice eventually, and I had a massage therapist that was with me full time and I was building towards my future. So I said to myself I have a choice of rehiring and doing the same thing, but now I have other priorities that need to be balanced right. Like the business is my first baby hands down? I still say that to my daughter, that was my first baby.

Speaker 1:

But I can't be there all the time, I can't have 60 hours a week and say, oh, I'm going to put up the daily fires and I'm going to be able to be present for this time. I can't have 60 hours a week and say, oh, I'm going to put out the daily fires and I'm going to be able to be present for this and I'm going to be able to treat patients. It's like now I have half the time I have to treat patients, but I have to use that time really wisely and reprioritize. And how do I make this an entity 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 create systems so that when I wanted to open my second practice and the third practice and the fourth and the fifth or whatever I wanted to do, I could take that formula and replicate it.

Speaker 3:

Yeah, I'm a huge fan of systems. I think I could talk to you for three hours about them. What was the first system that you built from there could talk to you for three hours about them.

Speaker 1:

What was the first system that you built from there. The first system I built was a scoreboard, and I have to thank the company that I now work for.

Speaker 3:

Clinic Accelerator, because they actually mentored me, can you?

Speaker 1:

just say a minute what Clinic Accelerator is. So Clinic Accelerator is a company that I work for now. They help me scale my practices, identify those revenue leaks and the gaps, and they're really focused on the rehab world so physios and chiros specifically and we use resources that we've had for like 10 years and it's a cheat code for every single part of your practice from recruitment, from finance, p&l, like who to hire, when to hire, your scoreboard, how to conduct a meeting, even something as simple as that, what to say in a meeting so all those steps that you need to grow your practice. Because I'll be honest, from my point of view, I had no idea, like I was going on YouTube and spending countless hours and then extracting nothing. So I started my practice. I was awful as a leader the first three years, awful at systems, and then I actually joined them to be coached and from that point I was able to scale and the first thing that I implemented with their help was a scoreboard.

Speaker 1:

So I know a lot of people say this and a lot of people I coach now say this is like I don't know anything about numbers. I actually don't know how I did last week. I think I did pretty good and I think I hit a target. But I don't even know what my target is or should be, or how many patients I've had, or what my answer rate is, what my booking to prescribe rate is. I had no idea of any numbers. So if you asked me how many patients came in last week, what was your revenue? Did you make any money? Did you profit? No idea.

Speaker 3:

That was the first system I put in and just for everyone listening what is a scoreboard?

Speaker 1:

So scoreboard is basically a really fancy Google sheet that will show you your answer rate, your booking rate, your booking to prescription ratio, your win back rate. It shows you all the statistics so that you know every week how you are doing what's your revenue, what's your ar. How do you create that? It is a template that's pre-made. Ah. However, the stats we pull through jane got you and it's actually quite easy to pull through jane. Yeah, yeah, I mean it's. It's a matter of like two buttons. You can click yeah, um, and then can ask your team like, how did we do last week, without always being the first person or taking on that extra burden, right, right?

Speaker 2:

Hey there, Christina, here Just a quick moment to share that this episode is brought to you by Jane. We know how much heart you put into building a practice you're proud of, and that's why we're here to make things like scheduling, charting and payments run a little smoother. If you'd like to take a peek head to janeapp forward, slash pricing, Because we love a good bonus. Don't forget to use the code radiofrontdesk for a one-month grace period. Okay, I'll keep it short and sweet. Back to the episode.

Speaker 3:

So let's talk about something else. I would call a system the organizational structure. I don't know if you'd consider that a system, but I would I know that you mentioned hiring a variety of different roles. So the ones I have here are clinic director, clinic lead, front desk. I'm just wondering if you could tell us more about those different types of roles and the responsibilities within each one.

Speaker 1:

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 every week. 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 the clinic director with marketing duties. Or let's say, we're doing some doctor referrals, or if we're doing some relationship building with people in our community, which was huge for us since we were a rural practice and so when you create that organizational structure and you have those clinicians and you outsource bookkeeping, you outsource your social and do all those things, all of a sudden, as an owner I almost took myself out of the job. I was sort of like, oh, I could take a vacation for two weeks for the first time in my life, and this is very odd.

Speaker 3:

Right, can we drill into that a little more? Just paint a picture for me Sure A versus B.

Speaker 1:

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, a lot of other sort of front desk or you know.

Speaker 1:

However, you're sort of picturing your practice to be and so you're treating, then you're going home and maybe you're doing some note taking, then you're doing some of the bookkeeping and you're trying to post on social to let people know, like your brand and clinician recruitment, and then you're doing interviews so you can hire the next physio, build a certain infrastructure, and you're just sort of like doing, I would say, 20% at each of those roles, because it's just not possible to be 100% right. You're putting on too many hats. At the end of the day, burnout is a real thing and we know that. And I think when you switch over to an org structure, you finally realize that what's most important are really only two things marketing and recruitment. So systems and those, and then operational systems, so your front desk team, and now you stop being like a firefighter and putting out daily fires. You actually start looking at your business on a whole and growing it.

Speaker 3:

I know you're very upfront with their staff about career growth. Yes, and I wonder if you could talk about your approach to that when I interviewed people.

Speaker 1:

What I would really show them is two things. Number one if they're a new grad, I would show them a mentorship calendar, so a three-month calendar where they would get mentorship every single week and it was scheduled in, it was into their Jane profile. Oh, wow, okay.

Speaker 2:

Yeah.

Speaker 1:

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 through the different cases. Sometimes it would be hands-on as well, right, because, like, as a new grad, you're not really as confident in your skills right away. And then, if it's someone who's seasoned, they're looking for different types of professional development. So things like how do I do my bookkeeping? Or like, if I do want to market on social, how do I actually do that? You know, almost like the bread and butter that we don't think is relevant, but they're really thinking about and they really want to know. The mentorship was one. The other types of professional development was for seasoned people, but again, the whole idea of retention.

Speaker 1:

So what we would do is here is a slide deck. You're starting off as a patient experience coordinator. That's great. These are some of your roles and responsibilities that you're going to oversee with your team. When these get fulfilled and you are sort of like moving on to the next and you're doing really great at this we're going to give you some professional development. Maybe it's bookkeeping and see if you like it. Or maybe it's a project, a 30-day project in bookkeeping or in social or in marketing, and then maybe the next step would be a patient experience manager or a clinician lead, right, so we actually show them right away what that career path is, because that means we're proving to them that there is one that exists it's not just like we're making it up fascinating.

Speaker 3:

And how important is this? Is it to start having those conversations early on, when they start right away, like in?

Speaker 1:

the interview oh wow yeah, I would say right away, like in the interview. Oh, wow, yeah, I would say right away, because, let's be honest, it's a very competitive market. I think it's like less than 1% unemployment rate right now. So what are you doing? That's different, right.

Speaker 3:

I love that. So on another podcast you said something that really stuck with me when you grow, you need to develop culture, meaning, when you grow your clinic, you need to develop culture because you want loyalty from your staff. I mean, you've touched on that a little bit, but I wonder if you could expand more specifically into intentional ways that you have seen successfully building culture.

Speaker 1:

Yeah. So the mistake I made early on was I had zero culture integrated into the clinic. I was just trying to get to the next step, right, trying to hire the next clinician, and no one would really bite. So I thought, like what's going on? There's a piece of the puzzle missing. And what that really was was culture, because at the end of the day, when you go to work, you want to have fun. Yeah, and fun is such a simple thing and it doesn't mean that you don't have tough times as a team, 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 about love languages.

Speaker 1:

Yeah, there's work, love languages too yeah so we did a little anonymous survey, compiled all the results of this love language quiz, and then I asked my clinic manager to create a once a month do something fun and it's not these extravagant like dinners and all that, right, it's sort of like let's do a Sunday, an ice cream Sunday day.

Speaker 1:

And everybody brings their favorite topping, or like a blue jeans day Cause we were scrubs all day, right and we're like.

Speaker 1:

And then one of the best things was it's fun for other people to do it, because you're seeing it from your point of view and often people are not as personal with you because you might be the owner or the boss or whatever it is, but when it's handed off to someone else, it makes their job more fun too, because they're getting feedback from everyone. And then it was just this beautiful 12 month thing, and one of the best things that she had done at that point was birthday buddy system. So everybody had a birthday buddy and so and you didn't know who it was, so it was completely anonymous and you had a certain budget to spend, and then you would either decorate it, get them a gift, bring a cake in, and you would just be surprised because everyone had a different relationship with that person, or developed a different relationship with that person, right, yeah? So those are the small things. I love the 12-month calendar. I think that makes it really nice, and I think breaking it down to different team members also is a really good idea.

Speaker 3:

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 else plans it and they you know they really take ownership of it. It creates such magic Like it does, and even I feel the magic. I also know that you, you do something special in onboarding. Tell me about that, love it, love it.

Speaker 1:

That's my favorite thing. And I tell all the people who are starting we call them solopreneurs like they're starting their clinics and you know they're, they're, they're on their own at the beginning. And I say, what is your onboarding process? Like, it's the best thing for me. And they're like what are you talking about? Like, yeah, I sent them a contract. I'm like, no, like, no text messages, you know none of that. No emails.

Speaker 1:

Like you have you have to meet the person. Get them a coffee, go to like your go to their favorite coffee place that's in town. Give them a contract and be like 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 all the patients excited Like we have this new person coming on and it's all this great stuff. And you'll get all the patients excited Like we have this new person coming on and it's all this great stuff. And the first day that they enter, I always like doing like welcome balloons, like coffee Timbits 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 really unique and kind of says to them like we really are excited to bring you on.

Speaker 3:

Yeah, I mean, I'm learning from you. Truly like I, this stuff is not on my radar and I hadn't really thought about it in onboarding either, but I love the idea of balloons and I don't know how we would do that. We're, you know, a remote first company right, I'm not really sure, but I I'm literally like everyone needs to get balloons tomorrow. I love balloons balloons are the best, so tell me how you roll from onboarding to training.

Speaker 1:

Two weeks before someone is brought on, we onboard them with a really nice sort of like five point email Congratulations and welcome. The first thing we do is actually get them onboarded with Jane. So we actually ask them to reach out to customer service and go through the process, because we know that when they come into the clinic they're going to be a little bit nervous. Maybe they're the type of person that doesn't want to see this for the first time. They want to be prepared. Yeah, If it's a clinician we're bringing on board. We also do treatment planning protocols as well, just to give them an idea of how the team works. Usually we also do a staff meeting and we ask them to come in even before they start so the team can welcome them. And then, when they actually get in, the first 30 days is all about shadowing. I like to put them through our front desk training program. It's a 12-week program at Accelerator and the reason I like to do that is because they're going to be very vulnerable and they're going to be really nervous to ask questions and, let's be honest, like I would be probably a horrible front desk person. So who am I to train somebody else? So that's the first sort of 30 days getting into the training, you know, getting warm with the idea of what they're supposed to be doing. And the top three to five responsibilities to focus on is how to answer a phone call. What do our clinicians actually do, Like, what does a chiro do versus a physio? A lot of people don't know. Get treatment by those, by each of the clinicians in the in the actual facility, Right, and then also just learning about, like, how to book a patient in. What is a treatment plan involved. So it's very basic, basic things and we only work on those five Short list. Let them focus.

Speaker 1:

The next 30 days is really focused on the metrics, Like I said before, like the answer rate, the booking rate, the prescribed ratio. The booking rate, the prescribed ratio, the win backs. How are they really doing with that? And then they understand and they they know, like what some certain targets are and how they measure. Interesting and then the last 30 days is culture. So I always say plan an event, do something fun and just go with it. So it kind of comes full circle in those 90 days. But the whole idea is like you want them to be comfortable enough to take charge. Right, Take the lead.

Speaker 3:

I worked the front desk in a clinic. It was a naturopath and a massage business. Okay, and this is not at all how I learned to do that job.

Speaker 1:

Well, we don't train our people Like we don't train them right and then we expect them Like. I'll tell you honestly, I talk to a lot of people who are like, oh, they're not. I don't think my front desk is suited or cut for the job. I said, well, did you give them proper duties and responsibilities?

Speaker 3:

Because if you don't, you're going to micromanage. Okay, so let's talk about micromanaging and then the flip side of that, which is learning to delegate. How do you do that? What's your experience with?

Speaker 1:

that I will say I was the worst micromanager. I will say that, like I will claim that.

Speaker 1:

I will definitely say that and that's probably you're very hard on yourself in your early leadership you know what I was and and I do blame that for the rotation of front desk it was me right. And again, that's why I outsource and we use those front desk systems at Accelerator, because we're not supposed to train our front desk. We've never done that job. We're great at treating patients. We're not really great at answering phones, let's be honest, right? So how do you stop micromanaging? Is you actually give them duties and responsibilities and say this is sort of the job that you have at hand? Are you okay with it? Yeah, this is what you're signing up for. I'm here to help you and support you, but I'm not good at this. What did that feel like to you? It felt like a breath of fresh air.

Speaker 3:

Oh, they're good, you can trust them. Yeah, and they want to do good, right.

Speaker 1:

Most people want to do good. You want to. You have to learn how to step back. For me, it was my my mat leave. I wanted to have a mat leave that was longer than three months when I had my second daughter, and I was able to take eight months, which I think is a record as like as a owner, and the only reason I was able to do that was because when you step back, people step up, right, yeah, and I realized like I don't need to do the check-ins weekly.

Speaker 1:

I need to have one meeting remote go through our scoreboard, ask them how our staff is doing. What can we do more for that person themselves, like the clinic manager themselves. And it feels so good to know that you actually have an entity and it's not just reliant on you, like you have a true business then yeah, and it was so refreshing and they were able to take it like up a notch where I'm not even there, I'm not treating and we're making more.

Speaker 1:

Yeah with me, almost in a way checking out. Yeah, and it's a very beautiful feeling. I remember when I exited two years ago, my clinic manager said to me when you hired me, I was completely lost and at the end you pulled the leader out of me. It's such a nice thing to hear.

Speaker 3:

Yeah, so you did end up selling your business.

Speaker 1:

Tell us about that Bittersweet moment. My first baby like I said before I had grown it with systems, with operations, and I wasn't practicing for the last four years before exiting.

Speaker 3:

So with that in mind, I had what do you mean? You weren't practicing?

Speaker 1:

What were you doing? I was managing, I was growing the business, so it grew from the one to three.

Speaker 3:

So you didn't just sell on a random day. You actually stopped practicing and were really working on driving the business and you got it to a point where you sold it.

Speaker 1:

Exactly Because that was always the end goal. But when I was treating, I had spent so much time with patients that you don't have the time to actually grow your business right. That's the difference, Like when you're an owner really, that is what you want to be focused on is growing.

Speaker 3:

Right, but where's the time? What was the state of your business when you could start to get purchasers interested?

Speaker 1:

I would say the key things that people are looking for are they can swoop in and they don't necessarily have to be treating 20 to 30 hours a week. So less than 30% is what you want to be treating Like. You're that much of a minimalist in your business. You want to have strong culture. You want to have a really good vibe so that that new person coming in isn't coming into something toxic or really heavy that they're going to have to uplift. And the last thing is you want people to see the potential in your business, right, so you've grown it a certain amount and that there's so much more that they can do with it with their own twist.

Speaker 3:

And so it was another chiropractor that bought your business. Is that right? Yes, Fascinating.

Speaker 1:

Yeah.

Speaker 3:

And so that was their choice and career, rather than starting something from the ground up. Or maybe they had done that before. We don't know. I'm not. I'm not sure every single person out there realizes, and maybe I'm just naive, I don't know. But that's actually an option too.

Speaker 1:

Absolutely. The trend right now is, and what we're seeing is, if you're starting yourself, it's just hard because you have to build the patient case yourself, which is not easy. There's a lot of competition and there's a lot of people who are ready to retire or maybe take on, like myself, a different role, and so in that case you take on a business that's existing and a caseload that's existing and it's far better financially as well.

Speaker 3:

Thanks for listening to this episode of Radio Front Desk. If you found it helpful, Dr Manju has put together a playbook covering all the systems you need to build a strong clinic team, from onboarding and training to creating a culture that makes your team want to stick around. You can find the link in our show notes. Thanks for listening.