It Was Never a Staffing Problem.
It Was a Systems Problem
Wearing a Staffing Costume

schedule ~36 min local_hospital Practice Operations person PT · Physical Therapy

Jeff Thomas and his wife Natalie co-founded InMotion OC twenty-three years ago. Today he runs four clinics, two fitness centers, and a massage therapy practice with zero in-person front desk staff. Hear how self check-in kiosks plus Snapscale remote receptionists replaced six front desk hires without a single layoff.

JT
Jeff Thomas
·  Co-Founder & Owner, InMotion OC
·  4 PT clinics · 2 fitness centers · aquatic & massage therapy
Jeff Thomas — Four Clinics, Zero Front Desk Staff

Case Study

How Four PT Clinics Went to Zero In-Person Front Desk Staff

The Starting Point
Twenty-three years of front desk churn
By 2023, Jeff had watched the same cycle repeat for two decades. Finding, hiring, and retaining good front desk staff had gotten harder every year, and in California the candidates coming in at a reasonable rate weren't hireable at all. In twenty-three years, the longest front desk employee the practice ever had lasted three years. Not a morale problem, he says. Just the nature of the position.
The Vision
What if patients checked themselves in?
Instead of writing another job ad, Jeff started picturing a different front desk entirely. That vision drove his EMR decision. While interviewing platforms he asked each one about self check-in, and the one that told him it was partnering with a kiosk company won the deal. That EMR was Prompt, and Prompt introduced him to HiBridge for the kiosks.
The Introduction
HiBridge introduced Snapscale
The kiosk team told Jeff about Snapscale, and the combination clicked. Kiosks handled self check-in. Snapscale's team in the Philippines handled everything a person still needed to handle, appearing live on the screen. HiBridge customized the interface so it looks exactly the way InMotion OC wants it to look. Jeff's words: the combination worked perfectly.
The Rollout
Add first, subtract later
Jeff didn't fire or lay off a single person. He kept his front desk staff and added the kiosk alongside them, so patients used it during lunch breaks and after the receptionist went home. It worked both times. That proved the model at zero risk and turned the eventual transition into a small step instead of a leap.
The Migration
Attrition did the work
Every time a front desk person quit, which they always did, Jeff simply didn't replace them. The new small clinic opened with no front desk person at all and had no issues. The medium clinics ran fine, with therapy staff a few steps away to help anyone who needed it. Six front desk employees across four clinics became zero, without one difficult conversation.
The Result
A remodeled lobby and five to six remote receptionists
In the 10,000+ square foot flagship, Jeff remodeled the lobby and removed the front desk built for him back in 2008. In its place: kiosks with big screens and Snapscale receptionists greeting patients on them. Patients choose self check-in or call the receptionist. When a new patient walks in the door, the remote team member can pop up on screen with a smiling face before the patient has figured out what's what.
Before snapscale
Design, place and sponsor a job ad every time
Sort applications, run first and second interviews
A California candidate pool with nobody hireable in it
Three-year tenure at best, usually six months to two years
Gossip, entitlement and in-office drama to manage
Six front desk salaries across four clinics
After snapscale
Three vetted candidates with recorded interviews, next day
Hiring handled by Snapscale in about a day
Productive and helping within a week of the need
One departure in over two and a half years
Coverage at lunch, after hours and every hour between
Roughly half the cost of a U.S. front desk hire
6 → 0
In-person front desk staff across four clinics
~50%
Roughly half the cost of a U.S. front desk hire
1
Snapscale team member lost in over 2.5 years
40%
Of insurance verifications now handled by AI

"Now we have five or six front desk people through Snapscale remotely that are all in the Philippines, and we have no in-person front desk people. People can choose self check-in or call receptionist, and it's working great."

— Jeff Thomas, Owner · InMotion OC

"If we do need to add somebody or replace somebody, we just tell Snapscale. And then the next day we have three good candidates that we can choose from and watch their interviews."

— Jeff Thomas, Owner · InMotion OC

Key Takeaways

What Every Practice Owner Can Learn From This Episode

01
Stop Hiring for a Seat You Should Redesign
Jeff spent twenty years treating front desk churn as a hiring problem. It wasn't. Once he asked what the front desk actually needs to do rather than who should sit there, the answer stopped being a person and started being a system.
02
Add Before You Subtract
Keep your front desk staff and add the kiosk and remote receptionist alongside them. Let patients use it at lunch and after hours. That proves the model with no risk, and it's the single piece of advice Jeff gives every owner who asks.
03
Let Attrition Do the Migration
No layoffs, no firings, no difficult conversations. Front desk staff leave on their own within six months to three years anyway. Just don't replace them. The transition happens on a timeline the practice can absorb.
04
Do the Math on the Thirds
A third of patients prefer the technology, a third prefer an in-person friend, a third don't care. Of the middle third, about ten percent are genuinely bothered, and about ten percent of those leave. When you run the numbers, Jeff says, it's a no brainer.
05
The Savings Work at Any Size
Nervous about a large clinic? Keep one in-person person and let the kiosk and remote team cover the rest. Going from six to one is still a huge saving, and small and medium clinics generally don't need anyone at the desk at all.
06
Work On the Business, Not In It
Jeff isn't a licensed therapist, so for twenty-three years his whole job has been working on the business. He calls it his biggest advantage, and the goal he'd set for any owner-operator: treat less, build more.

Straight From the Conversation

Moments Worth Revisiting

On the Real Diagnosis

"Most private practice owners think to themselves, I got a staffing problem. My guest today thought that too. But what he eventually discovered was that it wasn't a staffing problem at all. It was a systems problem wearing a staffing costume."

Nathan Bush, Host
On the Hiring Pool

"These days, honestly, the candidates that we're getting at a reasonable rate are not good. At least in California they're not good at all, and nobody that we found were hireable."

Jeff Thomas
On the Turning Point

"When one of our front desk people would quit, inevitably, like they were always doing after a while, we just wouldn't replace them with someone else. We would just allow the kiosk and remote receptionist to take over that."

Jeff Thomas
On How Patients Reacted

"A third of the people loved the technology and preferred it. A third of the people preferred to have a friend at the front desk, an in-person friend. And then a third of the people were ambivalent."

Jeff Thomas
On Managing a Remote Team

"So here you have gossip, you have negativity to deal with, you have entitlement is a big one to deal with. I haven't seen one instance of any of those characteristics with our Snapscale team in the Philippines."

Jeff Thomas
On Where to Start

"What do you have to lose? Just try it without making any other changes and see how that goes. Don't remove front desk staff until after it's all working well."

Jeff Thomas

Free Resource

Get the Front Desk Transition Playbook From This Episode

We've packaged the exact rollout Jeff used, add the kiosk first, let attrition do the migration, and run the numbers before you commit, into templates you can put in front of your team this week.

  • Add-Before-You-Subtract Rollout Checklist
  • Front Desk Cost Comparison Worksheet (U.S. vs. remote)
  • Kiosk & Remote Receptionist Patient Script Pack
  • New episode alerts + 1 key takeaway per show