Hey guys, done here. Welcome to Podiatry Practice
mastery. I'm calling this this new series
the $1,000,000 new practitioner series.
This is a series that I have of articles that I wanted to write.
So my goal is to with these write 1000 word articles that
can be then published and then maybe even afterwards if put
them into like a book or PDF fashion for for new
practitioners. So the goal with this is how to
get to a practitioner, new practitioner to the $1,000,000
mark. And this first one I want to
talk about is how to increase productivity.
So this is a series to help new practitioners produce $1,000,000
in personal production in the office.
This can be a daunting task, but it is possible.
The first aspect that needs to be addressed is why do you want
to focus on production? Today, many podiatrists that are
finishing residency are opting to be employed versus being
owners. And usually if you're an
employee, you're less worried about your production than you
are if you're an owner. However, the, the higher your
production, most likely the more valuable you are to your
company. And, and most of the time our,
our salary is directly tied to how much you're earning or how
much you're producing for the, for your practice.
So the more you're going to earn in your bonus structure, that's
usually how it works. So for example, in our office,
we do straight 30%. So whatever the doctor produces,
they're going to get 30%. So if they produce 600,000,
they're going to get 180,000, right?
If they produce 800,000, they're going to get 240.
And if they get to 1,000,000, they're going to get 300,000.
So the more you can produce, the, the more your revenue would
be. So as a, as an associate that
that's an attractive offer. There's different like methods
of like changing it or scaling it, but I find that the 30 to
35% structure depending on your overhead tends to be the easiest
thing for doctors coming out. So the first aspect we need to
determine is how do you go about getting to $1,000,000 in
production? It might be daunting.
The first thing you need to know is how much you're producing
currently, how much you're producing each month.
And I, and I like to kind of make this simple for everyone,
and I've talked about this before, but how do you get to
$1,000,000 in production? Well, you divide it up.
So let's say there are 50 weeks in a year and you're working.
So you're going to take two weeks off.
Maybe you're going to have more weeks off.
That's fine. You can just do the math.
But this is going to keep it simple.
So yeah, 50 weeks in a year and you'd like to produce 1,000,000.
So you need to produce $20,000 per week.
OK, real simple, $20,000 per week times 50 is 1,000,000.
And so say you work five days a week, right, That would make
sense. Then you would need to produce
$4000 a day, OK. And if you see about 20 patients
a day, keeping it simple, you would have to produce about $200
per patient, OK? That's why it's important to try
to do things that produce more revenue and do less things that
produce less revenue. And we've and there's a lot of
different ways you can do that. Producing things that produce
more revenue would be a lot of self pay options, Shockwave,
doing Swift, doing small surgical procedures, all those
things can produce more than that 200 mark.
And it's obvious that this 200 mark is a kind of a baseline or
a equivalent of all the procedures that you're doing are
all the treatments all the patients that you're seeing,
right? The the median is, is $200.00.
So there be some you're going to produce 6 or $800, those are
going to produce less than that. The, the, the easiest way is to
produce do more patients that produce more and less patients
that produce less. OK?
So in terms of nail care, we found that it works best to
double and double book nail care and using assistant to help with
that and only doing it 1/2 day a week.
So that way that's where you're reducing the number of low visit
patients you're doing and you're kind of merging them together to
do a lot more volume of them to make it more profitable.
OK. And, and a lot of these other,
other and then different add on things as all we've talked
about. So ways, if you could do X-rays
on patients, that'll increase the revenue.
If you're doing an ultrasound on patient, it'll increase the
revenue. If you're, you know, if you're
going to have them, if you sell certain things in the office and
you do in office dispensing, that's going to increase the
amount of revenue for these patients.
So the, the, the first challenge for new practitioners, in my
opinion, is the quantity of patients that you're seeing
because it's, it's, it's a lot harder if you have, let's say
only 10 patients a day to get to that $1,000,000 mark because you
just can't produce enough with each patient.
So you need the volume 1st. And ideally, if you can do a
volume of, of high, high revenue producing patients that you want
to increase your per visit value, but you can't just
increase per visit if you don't have any patients to see.
So there is a, there's an easy equation that I've learned from
a couple of my business people that I follow.
One guy is Alex Harmozzi and the other one, there's a, there's
another, it'll come to me in a little bit who's this other guy
is, But they talk about there's only three ways.
And see, if you think about your Podiatry practice, there's only
three ways that you can increase revenue.
One is to increase the number of patients right until you hit
that cap of whatever, 20 to 25 that you can see.
The next is to increase the frequency of their purchases,
meaning have patients come back frequently.
So in my practice, they come back frequently.
Let's say I set up four sessions of Swift or I set up six
sessions of Shockwave or you know, you're, you're always
seeing patients, all new patients get seen back at least
one. So increasing the number of
visits, increasing the number of patients and then increasing the
per visit value. So the value of the patients you
want them to go up and then the the lower value patients either
you don't want to see back or you could have someone else see
back. Unfortunately, when you're a new
Doctor, a lot of times the ones that the more established page
doctors don't want to see, they're going to be sending them
to you. So you need to make those either
some way make them more profitable or see them less
frequently. So kind of one example to this
is if you're what I used to do, I used to do matrixectomies when
I didn't have enough patients, I would have them come back at two
weeks and four weeks. But now that I'm at the full
schedule, I'll only see them back in three weeks.
Or sometimes I don't even need to see them back by because that
that three-week visit is less valuable, less profitable, and I
can give them other patient education information that'll
kind of prepare them to what they're going to expect.
I go over a little bit more in detail.
I send them resources about that to redo that.
Same thing with Paranicias. I used to always see Paranicias
back in two weeks when I didn't have a full schedule.
But then as my schedule get got full, I would reduce the number
of of paranoia follow up appointments after I did an Ind
for those patients. So you have to figure out kind
of how you're going to do that. So each of these has a different
leverage points. So increasing the number of
patients. I feel initially when you're
starting is has the most leverage because you just need
patients and then after that developing procedures that have
more frequency of, of, of seeing them back.
And that would be like I talked about these regenerative
treatments. And then per visit value, once
you're full, then you can really optimize and increase the per
visits of these things. So once you Max out your
patients or have a full schedule, then all the leverage
comes from increasing the per visit value.
So either increasing the per visit value or reducing those
things that are low visit or making them kind of combining
them together or getting another person that can help see
patients. So for a new practitioner,
usually you're not full from day one unless you work for a really
big system that feeds you. Not the problem with being fed
by a really big system and being overly busy, let's say 25 to 30
patients. A lot of times you're interested
in the treadmill of seeing patients.
In all you're making all your revenue from volume.
So volume would be X-rays and then office visits, X-rays,
office visits, maybe cortisone injections, maybe small little
procedures. So you're doing tons of
patients, tons of volume, but your per visit value really
isn't there. And a lot of times the the
comprehensiveness of your treatment isn't there because
you're not thinking about a lot of DME like walking boots or
ankle braces or Afos or, or things like that or doing wound
care products in the office. So things like that that can
really boost your productivity, you're not thinking about
because you're such, you're just on this treadmill.
But that's the way some of these bigger, bigger groups, bigger
groups do things. OK, So one final point is, is
what about the RVU system? So some doctors work in these
big systems for that to use Rvu's.
If you use RVU system, you're going to be paid based on your
RVU number. So you need to figure out what
are the highest paying RVU things.
And then also the challenge with some of these bigger systems
that use Rvu's, you don't have these additional modalities that
are revenue producing like Swift or Ultrasound or Shockwave or
amnio injections or PRP or things like that.
And also you might not get anything based on X-rays.
So you don't have your own X-rays.
You're like doing X-rays through the system that you're that
you're doing. So you have to kind of figure
out that. OK, so the next article I'm
going to talk about here in the series is how to increase the
number of patients. So since patients is the biggest
bottleneck initially, when you're starting out, you're,
you're seeing 5 or 10 patients. We're going to talk about that
next.