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Hey guys down here, welcome to 
Podiatry Practice Mastery. 

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We go over how to bring your 
practice to the $1,000,000 mark 

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and beyond. 
So this is a recording of a, of 

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a Friday. 
And just so you know, Murali is 

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getting the hang of things, but 
it it can be quite challenging 

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because we usually see about 20 
to 25 patients in the morning. 

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Everyone is double booked 
basically patients every 10 

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minutes. 
And so he has to put in a lot of

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information there. 
I want to go over. 

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I'm not going to go over all the
routine. 

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Marjorie was helping me with the
nails. 

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There are a few patients of note
that had office visits, so I'll 

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talk about those. 
One was a possible charcoal 

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foot, like midfoot swelling. 
Got X-rays on her Level 3 office

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visit was not charcoal though. 
Another patient that complained 

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of bunion pain, so I got X-rays.
So Level 3 visit because of that

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and then another pain, another 
person that had pain to the 

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left, 4th MPJ region and I did a
cortisone injection, not into 

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the joint but just dorsal to it 
where he was having some kind of

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some nerve pain. 
That was an office visit. 

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Next was a patient that we did 
an office visit for a possible 

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doing a new AFO. 
She had previously had one about

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3 years ago but due to being on 
Ozempic she lost about 40 lbs. 

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And I find when when patients 
lose a lot of weight they the 

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the there was pistoning in her 
AFO and because of that she 

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would qualify for a new AFO. 
Even though the last one she 

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paid out of pocket for this one,
I think her insurance changed so

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she would be able to get it. 
So this one specifically, her 

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son is very involved in her 
healthcare and she had mass 

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health and Medicare and, or, or 
something similar to that. 

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But it ended up being that they 
had to pay for the, the, the 

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last AFO. 
So they paid fully for it. 

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I guess that's something that 
happens occasionally, doesn't 

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happen a ton of times though. 
Next patient was a patient that 

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had some calluses and we did 
this kind of a young, a younger 

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person. 
So it was a level 2 visit 

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because we kind of talked more 
about the callous counseling and

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stuff. 
So those were the office visits 

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for the morning, for the 
afternoon. 

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First patient was a 59 year old,
got #2 out of 6 for insertional 

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Achilles tendonitis. 
So there'll be a few more set 

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up. 
Next was a 55 year old female, 

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had X-rays, had an ultrasound, 
had a ultrasound, ultrasound. 

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I did a cortisone injection. 
She had a bursal SAC, kind of 

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the fifth Met area. 
Put her on Celebrex, and I also 

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got a uric acid to see if 
potentially it could have been 

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caused by gout. 
That was a level 4 visit. 

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Next was AQ tenza #1 I need to 
figure out how to put the code 

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into my EMRI know there is a 
place for Q Tenza, but there was

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both the billing for the Q Tenza
itself and there is the 

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application fee bilaterally. 
So it tends to be different 

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based on the patient. 
Sometimes it's buying bill and 

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sometimes it is. 
We buy it and bill it and then 

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sometimes they get it from the 
pharmacy. 

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So it really depends on their 
insurance. 

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Next patient was a 20 year 20 
year old guy that had pain to 

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his ankle. 
We got an X-ray. 

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We did a cortisone into his 
ankle region to see if it'll 

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calm it down if it doesn't get 
better. 

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I talked to him about getting an
MRI for a possible OCD. 

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Next was a 78 year old female. 
This is a female. 

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This is kind of a weird one. 
She had a complicated 

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dislocation of the 2nd and 4th 
digit. 

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She is totally neuropathic and I
don't know if she kicked 

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something, but her digits were 
kind of like swollen indurated 

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the skin, little bit of brown 
discoloration mostly from just 

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the swelling and and I tried to 
relocate them. 

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I was unsuccessful in doing 
that. 

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But she is 78 totally 
neuropathic. 

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They don't hurt her, they just 
look ugly. 

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So for her I'm I'm treating it 
with fracture care and not not 

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fracture care. 
And I did talk to her about like

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pinning them and putting them in
location actually maybe even be 

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easier to either do that or or 
just do an arthroplasty of them 

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because they are kind of 
dislocated on the on. 

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So the the middle phalanx is on 
the top of the proximal failings

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kind of like a hammer toe. 
So you could either relocate 

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them and pin them, but I don't 
exactly know what caused it, nor

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does she. 
So this kind of a curious case 

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here for this patient. 
Next patient was a 59 year old 

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that had calcaneal fibular 
ligament issues and cave his 

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foot so I scanned him for 
orthotics. 

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Next was a 73 year old that had 
chronic and groans. 

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We did a left matrixectomy on an
edge. 

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Next was a 71 year old female. 
Number one out of 6 for plantar 

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fascial pain for I'm sorry one 
out of six shockwave right? 

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Next was a person that has a 
bilateral third kind of met MC 

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joint pain and I did a cortisone
injection bilaterally. 

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This is like the second time I 
didn't build an office visit 

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because specifically he came in 
for this. 

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So I think when patients come in
specifically for something, I 

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don't do an office visit because
I don't really have to think of 

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anything new and he's going to 
come back as needed. 

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And then there was another new 
patient that came in for 

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Achilles tendon pain, did 
Celebrex night Sprint, more foam

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rolling, morning stretch and 
things like that. 

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And I'm going to see him back in
three weeks. 

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So that was the day a question 
that came out was once again 

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about circulatory studies. 
There are a lot of different 

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companies. 
What one we use is we use Padnet

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mostly because it's paid for and
we don't, we didn't ever buy 

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that, whatever that thing is 
called, the maintenance program 

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kind of like you get with your 
car. 

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So it's all paid for. 
Very few things break on it. 

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It takes a little bit longer. 
I think like it takes, I have a 

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staff that they, they book them 
every every 30 minutes. 

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And so we just put them all kind
of on days when there's less 

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doctors in the office. 
But the thing I like about 

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Modmed is that when you order 
it, it actually has the, the 

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reasons that we would do it. 
So for example, if they're 

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diabetic over the age of 50 or 
non diabetic over the age of 70,

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those are some of the main 
reasons that we're doing the the

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Abis for them in the office. 
There are a couple of other 

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companies out there. 
I think they're they're good. 

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I've heard some issues with the 
smart ABI with the cuffs and the

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and the like breaking and giving
technical difficulty that way. 

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You really want something if 
you're going to do a lot of it, 

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you want it that's going to work
every time and really not going 

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to have to guess if it's going 
to work or not. 

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I think that's the same with 
shockwave. 

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So as long as the shock waves 
are always working because 

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we're, we're using them so much,
if, if there's an issue where 

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they break or something happens 
and you can't use it, you are 

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like out of Commission. 
And so the same thing with the 

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ABI, think it needs to be an 
easy device to use. 

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And really sometimes the more 
technology and more advanced 

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tickets with like Bluetooth and 
Wi-Fi and all these other things

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that can make it a little bit 
more challenging. 

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But then the benefit though of 
like I think the smart ABI or 

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some of these other ones is if I
recognize patients could benefit

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from it, I could do it that same
day. 

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Whereas I tend to schedule them 
with the staff on a different 

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day because they take a little 
bit longer to do. 

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I think these other ones, you 
just strap them on there. 

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You can do them in probably 5 or
10 minutes. 

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So that is my thought. 
I, I once again, I do not get 

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paid by any of those companies. 
Just someone when people ask me 

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questions, I'd like to share 
them here with everyone else. 

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But we are going on week 5 here 
of Mod Med. 

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It is getting better. 
My scribe is getting used to it.

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And eventually I'd like to start
to record some videos because I 

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didn't really find many great 
ones on YouTube about how to do 

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the things that we do. 
Like I could do it on Q 10s or 

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on X-rays or how we set things 
up or, or things like that. 

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I think that would be something 
that would be beneficial, kind 

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of the same thing I did with 
Athena when we used to use 

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Athena. 
But I hope everything is going 

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well. 
If you guys found this 

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beneficial like this, share this
with someone else. 

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And if you have other tips that 
are working to help your office 

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to get to the $1,000,000 mark, 
please let me know. 

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OK, thanks.