Welcome to Podiatry Practice Mastery, where we're trying to
get you to the $1,000,000 mark and beyond in your personal
production in your Podiatry clinic.
Want to talk today about how a recent patient found me?
I had two patients today that came in because they found me
with my YouTube videos and I had one patient that Googled my name
and all she what she said was funny.
She said put she put in like a podiatrist with the best or the
most reviews. And when she did that, my name
came up probably because I was in her vicinity.
So one thing I want to share kind of our little secret for
getting online reviews. So our practice has about 1000
or a little over 1000 and everyone else has maybe a couple
100 reviews. So the first thing I'm going to
share about that. And then the second thing, I'm
going to share my my little log algorithm for doing YouTube
videos. And, and yeah, so first thing,
how we get reviews. We've tried a couple of things,
but what works best for us is we have an automated system that we
used to use called Swell. And so swell after every patient
comes in, it integrates with your medical record and it sends
them a review request about 5 or 6 in the evening and they give a
review. It's a really easy one step
process. Hey, did you have a good visit
and then would you give us a review?
That's pretty much it. The newer system we have right
now is a little more cumbersome with Mod Med.
It is with Clara and it asks first it sends something that
says you have a message, so you have to put in your date of
birth and things like that, which makes it that's one
difficult step. Then when you read the message,
it says did you have a good experience?
And depending if you say yes or no, either one, it'll ask for a
review. So I think that two step adds a
little bit more of complexity into the system and that's why I
don't think it's working as well.
So we are considering switching back to swell because the
current one, even though it's less expensive, who cares how
expensive it is if it doesn't work as well.
So that's the first thing. The second thing is how how does
content work for me? So I am not a influencer on
YouTube by any means, but I like to create content to make my
life easier and I'd like to make use the best use of my time in
terms of efficiency. So the the YouTube videos that
have the most traction, I know this is obvious, are the oldest
ones. OK, so the oldest ones, the
longer they've been up there, the more traction they pull and
the more revenue they bring in. I used to do kind of ugly
ingrown toenail videos. I got a little bored after doing
like 15 or 20 of those. So they do produce some revenue,
but I don't really enjoy doing them.
The full length version videos, which are basically recordings
of my patient presentations. So if you're not familiar with
what a patient presentation is, you can go to
patientpresentations.com. You can kind of learn about how
I make patient presentations. So basically they're
PowerPoints, and I would share these PowerPoints on a screen
with my little head talking. Those are the ones that have the
most traction because they're really, really comprehensive and
it explains exactly how I treat those conditions.
So those are the ones that have the most traction.
What do I do today? Well, today basically the issue
is I don't have is I don't, I don't have like a schedule for
recording these longer videos. So I do YouTube shorts and I do
that in between or during patient visits.
So I have a cell phone on me. I have two phones.
So one phone is with my scribe. That's that's listening to me.
And the other one I use something called Sub Magic
SUBMAGIC and that automatically puts subtitles, but not by me.
So what I do is on there you can upload a video or record a
video. I record a video on the device,
it automatically uploads it to the cloud and then my virtual
assistant goes in there and puts subtitles and puts the and it
automatically gets some really good type of titles and
descriptions and things like that.
And then they post one per day. And this is how many patients
are coming in now for my YouTube videos, because I'm consistently
posting YouTube shorts once a day.
I think patients their their attention span is lower and then
the then I re can re utilize those videos.
Then for the best videos for your your ads for like your
Google ads, your Facebook ads, you can re utilize them by
putting a call to action at the end.
So that is not my idea. I did steal it from Alex
Harmozzi. So it's a it's a good idea.
And that's kind of what's working right now.
And that's how I make videos in the office.
I don't want to always just go over the good things.
I want to go over some bad things today with with the
office. So the bad thing is I came back
from a little like 12 days of vacation.
And one of the challenges with Mod Med is the paperwork.
So the, the signing of paperwork in fax, this is kind of a pain.
It's laborious. It's not there's not really a
lot of efficiency in it. And you have to kind of like use
like a, which one of those pens, right?
You can, it only works on the iPads.
You have to have a separate iPads because I don't do all my
work on iPads, separate iPad. I, I log in and it always logs
me out because although otherwise you do everything else
on the desktop, but you can't sign documents on the desktop.
So I have to sign them in and some documents I have to sign,
other documents I have to review and send to my staff.
So it's just a cumbersome process.
It's not the best feature in my opinion.
In modved. I always like to be clear of
like what are the good and the bad?
And So what I ended up doing today is I just the ones that
were kind of a pain, I just printed out.
I printed out, gave it to my staff and had them sign.
I know some other doctors, they have them print everything
because the amount of time and frustration that it took me was
not worth it. Same thing with refill requests.
Refill requests for like medication sometimes can be a
pain because they're sending me these ones to actually fill out.
So I usually just delete those and I put in a new prescription
for the patient. So that is something that's a
challenge. Another challenge today was a
patient asked for a refund for six sessions of Shockwave.
And I don't usually have this that much.
I had AI called them. I didn't get a chance to talk to
them, but their thought was they saw three other specialists for
their sesmoid pain and I don't know if it got better.
That's what I want to ask them and they're there.
They said, well, you shouldn't use shockwave or shockwave
doesn't work on sesmoiditis. Now I find it does work on
sesmoiditis. Maybe in her case it didn't.
And you know, I'd like to know what you guys would do.
I, I, I may just because I don't like headaches, I may just
refund it. I may refund a part of it, I may
not refund anything really. I just want to see if she got
better and and kind of see what was going on and I'd like to see
who said that shockwave doesn't work for sesamoiditis.
That's what I'd like to know. Most likely would be someone
that does not do shockwave therapy.
That's another bad thing for the day.
Another bad thing. A patient came in and asked for
a refund of her orthotics. So she had shockwave for her
foot pain, for her Achilles pain.
She is totally better but she still has pain.
Now to her actually she's not paying.
She just can't wear her orthotics.
And So what I did with her is I actually sent them back to the
lab to have them redo because I think the arch was just in the
wrong spot for this patient and this is something I may refund
her. So I tend to refund if they ask
minus the lab fee for orthotics. I don't have a ton of refunds,
maybe one or two a year. So really I'm OK with refunding
it because she got better and she also did 6 sessions of
Shockwave. That was another kind of a
negative thing. Another last negative thing was
AI had a lot of my first day back, I had many routine
patients. I'm like what the heck is going
on with all these routine patients?
I didn't understand why because it's not my routine day.
We ended up looking into it and we have a new virtual assistant
making appointments for us. So they are just answering
questions and then just fitting them in.
But I guess they didn't know or they didn't get the memo or they
forgot. For routine appointments,
they're not supposed to do them otherwise at any time except a
Friday morning. So this is kind of a challenge,
frustrating thing. But I didn't know the answer to
that. And so I asked my staff to look
it up and they said, oh, it was the virtual virtual Podiatry
assistant and they put them in the wrong place.
OK, so that was the kind of the good, the bad and the ugly for
the for the day. OK, in terms of patients, once
again, because of the routine, it didn't make the day too
great. So let me go into this.
So first deation was a least LVPLVP, least valuable patient
was a routine patient. Next patient was a 52 year old
man with Kanthordin. I did a wart.
Now this was a a couple of things I wanted to talk about
our add-ons for office visits. So when you change the the
course of treatment, you can add an an office visit.
So this one since I added a Mikkelmod, he had done 4
sessions of Kanthridin was not seeing much progress.
We added a Mikkelmod to that I I think that condones for an
office visit. But I also talked to him once
again about Swift. So I think in his case he
already did 4 treatments like once every 3 or 4 weeks and so
he may have been better off if he did swift because it may be
gone by now. So I did remind him of that but
he didn't he wasn't ready to go to that yet.
Next was a 76 year old male who had this was a newer patient so
we did a diabetic foot exam and we did nail care for him.
So this wasn't because of the the Podiatry assistant
scheduling. Next was a patient with a 64
year old female with bilateral IPJ hallux ulcers.
Debrided those going to see her back in about 6 weeks.
She these are chronic ulcers that just really almost never
heal. I think she really needs some
work on the 1st MPJ to help the the bunion slash hallux lumitus
in that area that she has. Next was a 40 year old man with
a follow up for peroneal tendonitis.
This is a good patient. He's a young man, he was in a
Cam boot, took some meloxicam foam rolling.
He's 100% better so not so much LVP I call LVP is basically
level 2 visits which very rare. So he was like a just a follow
up next was a 79 year old female had a poor keratoma or IPK on
the 3rd digit hammer toe with a treated with a Crest Crest pad
and new peroneal tendon pain. So she did.
I gave her a physical therapy prescription so she had the
office visit that lesion destruction for that and I'll be
seeing her back in in after the PT if her foot pain doesn't go
away. Next was a 31 year old for an
orthotic follow up. She's doing much better.
She had some Achilles tendonitis that's feeling better for she is
APA and so I think she might need a little bit more shockwave
but she can't afford it right now.
She may do that in the future. The next patient was a fifth
toe. She has pain in the lateral 5th
digit and we ended up doing a actually the medial 5th digit
and we'd end up doing a matrixectomy on the 5th toe.
I don't do many 5th toe matrixes but I I I originally thought it
was due to her tighter shoes. She said she's tried wider
shoes. I somewhat wonder because
there's very few reasons we do these but we did a matrix for
her. Unless you're back in three
weeks. Next was a nail care patient.
Next was a 85 year old female. This is the one I've been
seeing. She's on 6 of 6 of shockwave for
the mid. Really big mid foot arthritis.
Now last visit I did a sinus tarsi injection and it made most
of her foot pain go away. So I wonder if the midfoot pain
really isn't the isn't the culprit and it's more the sinus
tarsi or the subtalar joint pain.
And I don't mind doing cortisone in a different place in my doing
shockwave. I think it that's fine.
But then again, I'm just she's not a good surgical candidate.
She's got this huge dorsal spur on the midfoot that I I thought
it was like bone marrow oedema from that.
But really if the cortisone helped her, I just going to
she's 8080 some. So I just see her back as needed
for cortisone. Next was a fungus follow up
where I did a booster dose. So those are always easy
follow-ups. Next was a 42 year old female
for an orthotic. This was that redo that I had to
do. Next was a 64 year old female
for right Achilles follow up. She wasn't really able to do
anything that I recommended and these ones are kind of
frustrating. So what I, what I tend to do now
is since she didn't do what I recommended, I told her again to
do it. I gave her meloxicam, I gave her
foam rolling. She already has a night splint,
talked about the morning stretch, talked about shoes that
UFOs, which she didn't get. And I'd said, well, why don't
you just give me a call if you want either physical therapy or
if you want to do shockwave. Though I think really shockwave
would be the best thing for her. But I find patients that don't
want to do anything, I, I tend not to see them back.
I tend not to make follow-ups for them because they're not
really wanting what what I think would help them to get better.
So this one I just kind of left it open-ended for her versus
like what seeing them back at a certain time and then kind of
trying to talk them or you know, educate them into doing what
would help them get better. Next was a 55 year old man.
He had bilateral tineopedis, bilateral fungus.
So he did the fungus kit and LFTS and he also had a mild
haglunds on the right, which wasn't painful for him and I'm
going to see him back in three months after that.
Next was a 78 year old man with an ulcer of the IPJ hallux, kind
of a a fissure that he has going on there due to a a previous
first MPGA fusion. So he has a fissure at the
distal tip because of the the way it was fused and it's just
not healing. He's been using collagen using a
lot of things I recommended like a carbon fiber inlay.
I recommended a rocker bottom shoe.
I've recommended an ortho wedge, orthoed shoe.
So and I recommended him go to the wound center, but but this
guy didn't want to go to the to the wound center.
There was another ulcer as well of another patient with an IPJ
and he did go to the wound center.
I try to send as many wounds just because I don't do a lot of
wounds as you if you're listening to this anytime you
realize. And so I try to have them go to
the wound center. I just think they'll get better
faster there. And so that one I sent to the
wound center. I did add an office visit even
though I've been riding the ulcer for a while because I
think it's appropriate considering that because of the
medical decision making. The next patient was a 76 year
old for right hallux. Limitis recommended the fiber,
carbon fiber insert anatomic shoe and possible fusion.
And then the next was a 65 year old man within that ulcer,
another ulcer. Next was a 75 year old female
for a fracture. Follow up for the hallux, it's
much better. Got X-rays.
That's the least valuable patient because all I got was
the X-ray. I did not even do an office
visit because it was a fracture. Follow up next was a 55 year old
for left Achilles. So this is number 2 out of 6.
And then next was a 50 year old man with Lex left hallux Limitis
only had pain when he was like kind of down on like kind of
doing like a forward lunge and putting his weight on there.
But I explained it was more for functional hallux Limitis.
So I talked to him about that. So that was the day once again,
if you guys have any other thoughts, shoot me an e-mail.
I would like to hear from people kind of what's working for your
practice. I'll be happy to share it here.
Any other things that are working?
OK Don at Podiatry practice mastery.com.
OK, thanks.