Hello, Don here. Welcome to Potential Practice
Mastery. We're we're trying to help you
get to the $1,000,000 mark and beyond in your private practice
production. I'm going to go over this is a
recording of a Friday. So my Fridays they tend to run
routine in the morning. So that's the the half day that
I do routine along with my nail tech.
My nail tech was on vacation, so it was just me.
So basically nail care every 10 minutes for the whole morning
and then we don't really do anything else the rest of the
week. So it's a kind of an efficient
way if you're not doing something like that.
It works really well. I know in the beginning you're
like, hey, what day do I do it? Or what happens if patients
can't make it? Well, if you just kind of make
it that way, they don't really have an option.
And if they can't see you in those times, it's a way to
decrease the amount of routine care.
And I've never really heard of any podiatrist that doesn't mind
doing less routine care. OK, so first patient was a
shockwave #5 out of 6 for plantar fasciitis.
He's starting to feel better. The nice thing about doing 6
sessions of Shockwave is that usually about fifth or sixth
session patients start to feel a little bit better.
So he is going to do one more in a week.
Next patient was a 73 year old female that was here for a
matrix follow up. So just a reminder, I do one
matrix follow up. I used to do 2 but I find that
one at 3 weeks is sufficient. I've tried to go to none and
sometimes that kind of gives me a hard time because of the the
drainage and the redness and the concerns that the patients have.
I think ideally if I had a like a nurse practitioner, it would
be nice to put all those paranic you follow or I'm sorry, matrix
follow-ups with that patient with that other physician or
treating provider. Next patient was this was
orthotic #1 patient that she came in for a an aroma wasn't
really having concerns right now.
Her main issue was, was frankly first rate elevatis and hallux
limitis. And that's what I, I noted on
the X-ray. So I spent a lot of times
talking about how X limit is kind of talking about how to
unlock that joint, bringing down the first ray.
And I find the X-rays really help me with that.
And then she had previously had orthotics.
We made her a new pair of orthotics with the first ray cut
out and just kind of explaining the importance of those
orthotics. And she'll be back in, it's
usually in two months. So what I usually do is patients
come in about 3 weeks to pick up the orthotics and then I see
them six weeks after. So that tends to be about a
little over two months for the follow up.
Next patient was Q tenza #6 so this gentleman, he's kind of a
challenging 1 because he has both diabetic neuropathy, but
he's also doing dealing with some chemotherapy induced
neuropathy for his cancer treatment.
He finds that the Q Tenza lasts about two months and then the,
the, the, the last month, the third month, he starts to have
more symptoms. And I said, well, that's really
ideal. So that's what he has.
So we are applying the, the Cutenza just for anyone that
doesn't do Cutenza. I, I find it pretty beneficial
for patients you're going to know after about 33 sessions and
if they don't find really much benefit after the third one, I'm
going to be, I stop it. So I'm only doing it for
patients that actually have relief.
I'm not going to do it forever on someone that has no relief.
The other thing that you you might want to consider if you're
doing this is I, I put it on, but then I have my staff take it
off. So it saves you some time.
It just really occupies a room for that, for that time.
You have to have it on for 30 minutes and it kind of makes a
little bit of a mess, but the reimbursement seems to be, seems
to be worth it. Next patient was a 58 year old
female. She had bilateral carry flex.
She's one that came from our newspaper.
She had kind of a really bad kind of onycholytic nail with
like that was WAVY and she had previously been treated by
another doctor said there was really no option.
She was a really good candidate for the the the carry flex.
I think it's going to look good for her.
She actually came in from one of our newspaper newspaper ads
because we had it like a before and after for a bad toenail.
Next was also another carry flex bilateral.
It's the tis the season for carry flex just so you know, and
so she did that as well. Bilateral carry flex.
Next patient was 75 year old that she was seeing me a few
years ago. She had bunions and they were
painful. I've talked to her a lot about
shoe gear. I spend a lot of my time talking
about shoe gear. My favorite shoes to recommend
are ultras and topos and also we sell in our office LEMS as an
option. But she has bilateral bunions
with pain. I did bilateral cortisone
injections and then she'll be coming back as needed.
Next patient was a 66 year old man who came in.
He had been treated in Brazil for ingrown toenails, kind of
came back. He had the medial hallux
bilaterally that were affected and I did matrixectomies and I'm
going to see him back in three weeks.
Next patient was a 77 year old man.
He came in, he had some balance issues and he was concerned
about some falls he had. He was scanned for orthotics, so
this is orthotic #2 And then I prescribed him some physical
therapy for him as well. And then the, the final patient
was some reason she got in my schedule.
She was a routine patient that maybe should have been not
placed in that, in that schedule.
So that was the afternoon, the morning I didn't put in there
because it was basically basically nail care.
My, my goal tends to be for each day to do 2 orthotics.
And so I was able to reach that goal today.
And I guess the, the MVP most valuable patient would be some
of these orthotics. There wasn't really any new
Shockwave patients that I could set up today.
OK, once again, if you guys find this beneficial, love to hear
back from you, Don at Podiatry Practice mastery.com.
Also, there's other things you're struggling with.
Let me know. One thing I'm kind of working on
is I have a pretty good system for my oral Lamisil.
I don't have a great system for my topical.
And I've talked to some other people.
They really, really believe in this entosolin or like Formula 7
and they can do that just as much as I do the the trabinifen.
I would love to know, I guess if it, if it works, I just don't
really believe in much of the topical and what you do kind of
it doesn't work. I I've talked to some other
people, they say, oh, you just do the same thing you do with
the oral, like not all oral works.
And you're right. And so I'm trying to figure out
a way of offering more of the, the one I have is the formula 7,
right? And so I would just use that
since I have it. And so all the patients maybe
that don't want the Tribenfin do the Formula 7.
And the other question is laser for like lunula, I have that.
I have lunula, I have kutera. I just feel once again, it it
doesn't work or maybe the patient selection is to be so
selective to have it work. So I'd love to know if someone
really has a great system of how they maybe combine the two,
combine the lunula with the formula seven.
I don't really think, I don't feel ethically I could do the
lunula with the oral medication because I think the oral works
by itself. So I don't think the lunula was
was needed. So I'd love to know other people
to how how you guys do that. Shoot me an e-mail,
don@podiatrypracticemaster.com. Let me know what works for you.
I'd love to do that. And if you do share, I will
share it with everyone else. OK, have a great day.