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Hey guys, done here. 
Welcome to Podiatry Practice 

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mastery. 
I'm calling this this new series

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the $1,000,000 new practitioner 
series. 

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This is a series that I have of 
articles that I wanted to write.

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So my goal is to with these 
write 1000 word articles that 

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can be then published and then 
maybe even afterwards if put 

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them into like a book or PDF 
fashion for for new 

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practitioners. 
So the goal with this is how to 

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get to a practitioner, new 
practitioner to the $1,000,000 

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mark. 
And this first one I want to 

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talk about is how to increase 
productivity. 

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So this is a series to help new 
practitioners produce $1,000,000

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in personal production in the 
office. 

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This can be a daunting task, but
it is possible. 

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The first aspect that needs to 
be addressed is why do you want 

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to focus on production? 
Today, many podiatrists that are

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finishing residency are opting 
to be employed versus being 

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owners. 
And usually if you're an 

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employee, you're less worried 
about your production than you 

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are if you're an owner. 
However, the, the higher your 

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production, most likely the more
valuable you are to your 

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company. 
And, and most of the time our, 

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our salary is directly tied to 
how much you're earning or how 

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much you're producing for the, 
for your practice. 

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So the more you're going to earn
in your bonus structure, that's 

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usually how it works. 
So for example, in our office, 

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we do straight 30%. 
So whatever the doctor produces,

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they're going to get 30%. 
So if they produce 600,000, 

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they're going to get 180,000, 
right? 

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If they produce 800,000, they're
going to get 240. 

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And if they get to 1,000,000, 
they're going to get 300,000. 

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So the more you can produce, 
the, the more your revenue would

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be. 
So as a, as an associate that 

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that's an attractive offer. 
There's different like methods 

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of like changing it or scaling 
it, but I find that the 30 to 

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35% structure depending on your 
overhead tends to be the easiest

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thing for doctors coming out. 
So the first aspect we need to 

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determine is how do you go about
getting to $1,000,000 in 

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production? 
It might be daunting. 

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The first thing you need to know
is how much you're producing 

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currently, how much you're 
producing each month. 

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And I, and I like to kind of 
make this simple for everyone, 

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and I've talked about this 
before, but how do you get to 

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$1,000,000 in production? 
Well, you divide it up. 

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So let's say there are 50 weeks 
in a year and you're working. 

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So you're going to take two 
weeks off. 

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Maybe you're going to have more 
weeks off. 

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That's fine. 
You can just do the math. 

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But this is going to keep it 
simple. 

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So yeah, 50 weeks in a year and 
you'd like to produce 1,000,000.

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So you need to produce $20,000 
per week. 

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OK, real simple, $20,000 per 
week times 50 is 1,000,000. 

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And so say you work five days a 
week, right, That would make 

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sense. 
Then you would need to produce 

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$4000 a day, OK. 
And if you see about 20 patients

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a day, keeping it simple, you 
would have to produce about $200

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per patient, OK? 
That's why it's important to try

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to do things that produce more 
revenue and do less things that 

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produce less revenue. 
And we've and there's a lot of 

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different ways you can do that. 
Producing things that produce 

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more revenue would be a lot of 
self pay options, Shockwave, 

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doing Swift, doing small 
surgical procedures, all those 

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things can produce more than 
that 200 mark. 

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And it's obvious that this 200 
mark is a kind of a baseline or 

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a equivalent of all the 
procedures that you're doing are

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all the treatments all the 
patients that you're seeing, 

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right? 
The the median is, is $200.00. 

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So there be some you're going to
produce 6 or $800, those are 

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going to produce less than that.
The, the, the easiest way is to 

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produce do more patients that 
produce more and less patients 

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that produce less. 
OK? 

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So in terms of nail care, we 
found that it works best to 

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double and double book nail care
and using assistant to help with

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that and only doing it 1/2 day a
week. 

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So that way that's where you're 
reducing the number of low visit

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patients you're doing and you're
kind of merging them together to

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do a lot more volume of them to 
make it more profitable. 

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OK. 
And, and a lot of these other, 

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other and then different add on 
things as all we've talked 

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about. 
So ways, if you could do X-rays 

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on patients, that'll increase 
the revenue. 

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If you're doing an ultrasound on
patient, it'll increase the 

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revenue. 
If you're, you know, if you're 

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going to have them, if you sell 
certain things in the office and

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you do in office dispensing, 
that's going to increase the 

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amount of revenue for these 
patients. 

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So the, the, the first challenge
for new practitioners, in my 

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opinion, is the quantity of 
patients that you're seeing 

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because it's, it's, it's a lot 
harder if you have, let's say 

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only 10 patients a day to get to
that $1,000,000 mark because you

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just can't produce enough with 
each patient. 

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So you need the volume 1st. 
And ideally, if you can do a 

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volume of, of high, high revenue
producing patients that you want

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to increase your per visit 
value, but you can't just 

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increase per visit if you don't 
have any patients to see. 

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So there is a, there's an easy 
equation that I've learned from 

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a couple of my business people 
that I follow. 

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One guy is Alex Harmozzi and the
other one, there's a, there's 

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another, it'll come to me in a 
little bit who's this other guy 

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is, But they talk about there's 
only three ways. 

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And see, if you think about your
Podiatry practice, there's only 

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three ways that you can increase
revenue. 

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One is to increase the number of
patients right until you hit 

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that cap of whatever, 20 to 25 
that you can see. 

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The next is to increase the 
frequency of their purchases, 

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meaning have patients come back 
frequently. 

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So in my practice, they come 
back frequently. 

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Let's say I set up four sessions
of Swift or I set up six 

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sessions of Shockwave or you 
know, you're, you're always 

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seeing patients, all new 
patients get seen back at least 

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one. 
So increasing the number of 

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visits, increasing the number of
patients and then increasing the

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per visit value. 
So the value of the patients you

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want them to go up and then the 
the lower value patients either 

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you don't want to see back or 
you could have someone else see 

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back. 
Unfortunately, when you're a new

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Doctor, a lot of times the ones 
that the more established page 

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doctors don't want to see, 
they're going to be sending them

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to you. 
So you need to make those either

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some way make them more 
profitable or see them less 

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frequently. 
So kind of one example to this 

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is if you're what I used to do, 
I used to do matrixectomies when

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I didn't have enough patients, I
would have them come back at two

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weeks and four weeks. 
But now that I'm at the full 

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schedule, I'll only see them 
back in three weeks. 

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Or sometimes I don't even need 
to see them back by because that

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that three-week visit is less 
valuable, less profitable, and I

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can give them other patient 
education information that'll 

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kind of prepare them to what 
they're going to expect. 

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I go over a little bit more in 
detail. 

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I send them resources about that
to redo that. 

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Same thing with Paranicias. 
I used to always see Paranicias 

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back in two weeks when I didn't 
have a full schedule. 

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But then as my schedule get got 
full, I would reduce the number 

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of of paranoia follow up 
appointments after I did an Ind 

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for those patients. 
So you have to figure out kind 

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of how you're going to do that. 
So each of these has a different

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leverage points. 
So increasing the number of 

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patients. 
I feel initially when you're 

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starting is has the most 
leverage because you just need 

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patients and then after that 
developing procedures that have 

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more frequency of, of, of seeing
them back. 

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And that would be like I talked 
about these regenerative 

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treatments. 
And then per visit value, once 

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you're full, then you can really
optimize and increase the per 

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visits of these things. 
So once you Max out your 

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patients or have a full 
schedule, then all the leverage 

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comes from increasing the per 
visit value. 

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So either increasing the per 
visit value or reducing those 

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things that are low visit or 
making them kind of combining 

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them together or getting another
person that can help see 

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patients. 
So for a new practitioner, 

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usually you're not full from day
one unless you work for a really

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big system that feeds you. 
Not the problem with being fed 

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by a really big system and being
overly busy, let's say 25 to 30 

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patients. 
A lot of times you're interested

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in the treadmill of seeing 
patients. 

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In all you're making all your 
revenue from volume. 

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So volume would be X-rays and 
then office visits, X-rays, 

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office visits, maybe cortisone 
injections, maybe small little 

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procedures. 
So you're doing tons of 

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patients, tons of volume, but 
your per visit value really 

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isn't there. 
And a lot of times the the 

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comprehensiveness of your 
treatment isn't there because 

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you're not thinking about a lot 
of DME like walking boots or 

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ankle braces or Afos or, or 
things like that or doing wound 

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care products in the office. 
So things like that that can 

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really boost your productivity, 
you're not thinking about 

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because you're such, you're just
on this treadmill. 

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But that's the way some of these
bigger, bigger groups, bigger 

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groups do things. 
OK, So one final point is, is 

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what about the RVU system? 
So some doctors work in these 

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big systems for that to use 
Rvu's. 

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If you use RVU system, you're 
going to be paid based on your 

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RVU number. 
So you need to figure out what 

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are the highest paying RVU 
things. 

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And then also the challenge with
some of these bigger systems 

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that use Rvu's, you don't have 
these additional modalities that

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are revenue producing like Swift
or Ultrasound or Shockwave or 

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amnio injections or PRP or 
things like that. 

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And also you might not get 
anything based on X-rays. 

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So you don't have your own 
X-rays. 

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You're like doing X-rays through
the system that you're that 

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you're doing. 
So you have to kind of figure 

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out that. 
OK, so the next article I'm 

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going to talk about here in the 
series is how to increase the 

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number of patients. 
So since patients is the biggest

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bottleneck initially, when 
you're starting out, you're, 

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you're seeing 5 or 10 patients. 
We're going to talk about that 

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next.