Hey guys, Don here. Welcome to Podiatry Practice
Mastery. We're trying to do the best I
can to help you get past the $1,000,000 mark and beyond in
your private practice. This is always something that I
wish existed when I was starting out just to kind of give some
some guidance and how to how to kind of get there.
So I'm going to go over a couple of days here.
I have, I haven't recorded in a few days.
I'm going to go over some of that kind of the high points
here. Patient 31 year old female with
bilateral care reflex. So she came in, her nails were
injured from a previous matrixectomy.
So this is 1 where she had a matrixectomy by another
provider. And I find sometimes that the
the either sodium hydroxide or whatever is used can injure the
nail. So all she had was like the
distal half or maybe even the distal quarter attached.
The proximal part kind of fell off and it's summertime here, so
she wanted it to look good. So we kind of took off the bad
nail, ground it down and it had something to attach to.
And so we did bilateral carry flex for her.
Next patient was a 75 year old. She's one that she had a
previous first MPJ fusion and by another doctor she had a second
MPJ fusion. I've, I've never seen a second
MPJ fusion before. That doesn't really happen that
often and she had an AVN of the second Med head which I could
see on the X-ray so the hardware was taken out.
I tried to do some shockwave for her, she was doing OK with that,
but then it just really affected her quality of life so she's
going to have to have a partial Med head resection for that.
Next patient was a 71 year old that had AI and D on the 4th toe
and so he came in for an ingrown toenail.
He also had done 4 sessions of swift for a really a chronic
wart on his heel and that wart did go away so it was nice to
see the follow up of the swift. I do find it working on
patients. There's a few recalcitrant
cases. I find that people just have a
ton of ton of warts. Another bad incident I want to
share was a patient of mine recently I treated with a wart
as well. I did Kanthordan on it and he
actually got an infection. So he, he had it on his IPG of
his hallux, just a huge wart. And I Kanthordan did it up, but
it was a big, big piece and I, I think it just got infected based
on that. So he, he sent me a picture over
the weekend. I just sent him to the Ed.
I've never had someone get a really bad infection from
Kanthordan. Usually it's, it's really,
really inflamed, but this one looked pretty bad for this this
gentleman. Next patient was a 21 year old
that had a fifth, a fracture of the fifth met.
She came in and put her into a tall Cam boot.
And then she'll kind of get better over time.
I'm going to do a four week follow up for her.
Next was a patient for nail fungus, came in, reviewed the
nail sample results and gave her a prescription.
Next was swift #4 out of four for this female, 37 year old
female, 4 out of four. And then they usually do a three
month follow Up next was an ingrown toenail.
This was kind of a kind of a challenge that she had an
ingrown toenail, but she also had like a lot of that tissue
coming out from underneath the, the under, like underneath the
toenail. And those were always kind of a
challenge. And when you, when you clip it,
it bleeds. And she wanted to have some type
of a treat. And I said, I told her
unfortunately there wasn't really any treatment for that.
Next patient was a 74 year old that had an exostosis to the 5th
digit. And I, I, I talked to her about
doing an exostectomy in the office.
She also had an ulcer between two of her toes that I debrided.
And, and I think the reason for this ulcer between the toes is
because this one also had a fracture.
She had a, a fracture of her foot, a stress fracture caused
the toe to swell and then the toes pushed together and create
a little bit of an ulceration between the two toes.
Next was #3 out of four shockwave for fibular fracture.
And she's starting to feel a little bit better.
Next was a swift. Now I count the number of
Swifts, just so you know. So this was #6 actually, sorry,
this is E pad. Sorry that I can't read my
handwriting. E pad #6 out of 6 for this
patient and then they're going to do a six week follow up for,
for me in the office. Next was a 18 year old.
It got a Lamisil booster so she's starting to feel better or
her toes are looking better after the first round of
gibenophin. Next was a diabetic foot exam
and this patient also had a poro keratoma or IPK and we did a
lesion destruction on that. Next was a post op status post
amputation, a couple of toes, but now she's having some
overload to the 4th and 5th toast so she is missing portions
of her first, second, third, and I'm I'm afraid that she's going
to lose a portion of her 4th and 5th as well.
Next was a 63 year old female for number a male for two out of
6 for shockwave. Next was a 56 year old status
post 5th digit arthroplasty bilateral.
That's one of the post OPS. She's doing well.
Next was E pad #5 out of 6 for her peroneal tendon.
She's really feeling better. She like me she is she has goats
so she brought me goat cheese. So if you want to know, we made
a goat cheese and caramelized onion little flat lead this
weekend with the with the goat cheese that this patient
brought. Next patient was the first MPJ,
had gout, did a cortisone injection, put them on some gout
medication. Next was a 54 year old that had
bilateral posterior tibial tendon dysfunction and on the
right it looked like there was a partial tear of the posterior
tibial tendon. So I'm talking to this patient
about doing bilateral AF OS. So I'm checking on insurance for
this. Actually I probably have to send
this patient out because it's Blue Cross Blue Shield and I
can't do AF OS for this patient. Next patient was a bunion and a
Taylor's bunion and I had done the right foot.
We're looking at doing the left foot, but it's not really as
bad. So I opted not to to do that.
Next was a follow up for toenail pain and she is doing actually
this is sorry, peroneal peroneal tendon pain.
She's doing, she's doing better. I had a Rep that stopped by the
other day talked about something.
It's a new kind of a type of Leniva for painful Ipks.
So this is called Liposana. It's kind of a fat injectable
that can go underneath areas of painful pressure.
So I don't know if you've heard of this one.
There's a couple of different ones that you can use.
I'd like to know if people are doing these a lot.
I, I know there was a recent conversation about that on one
of these other, one of these other groups on Facebook.
So OK, I'm, I'm going to combine a couple of these because I
haven't done this for a few days.
I think the, the number 5 out of 6 for shockwave fracture of a
metatarsal #5 out of 6 shockwave as well.
Another patient that got an Achilles MRI follow up matrix
cortisone to 1st MPJ bilateral second Med head pain did
shockwave bilaterally for that patient. 4th met fracture.
This is the fracture code that I was talking about it the
fracture code. And then this was actually this
one that had the ulcer. Another patient that had a
cockapallox that's hurting in the shoe side.
I recommended Niboso or like correct toes and I put these on
in a way where I cut them so there was only only holding down
the the first only covering the first three toes.
So to bring them down. I don't do a ton of those, but
occasionally I do for patients. Next patient was arthritis.
So we talked about orthotics. They had midfoot arthritis, just
a lot of a lot of a lot of the same.
Another fifth net fracture doing better posterior tibial tendon.
They came in for that. They wanted PT first for not
going to get better than if they don't get better, then we'll do
shockwave. Another one was two out of four,
two out of six Shockwave for plantar fasciitis matrix follow
up, 5th met fracture and then another X-ray for a fracture
follow up. So there's a lot of a lot of
patients kind of repetitive here.
I'm not even going to go over my Friday.
I didn't record for Friday either, but that was kind of a a
busy day, busy day with routine first half of the day and then
patients, regular patients the rest of the rest of the day.
Still getting the hang of mod bed.
Murali is getting the hang of it.
We're I'm still struggling to find where certain things are
like simple things like sending out referrals to doctors.
I said, I think you have to have like the doctor's name in there.
It has to be all like kind of documented the right way.
I'm not quite sure how to do that.
I figured out how to do Cutenza in there now and I know how to
do like the both the buy and bill ones, meaning we buy them
and bill for the actual Cutenza or just the application fee,
which is what we normally do. Most procedures are a little bit
easier, a little bit easier to schedule surgeries.
So I'm still kind of figuring it out.
It's getting a little bit less bad and I feel like in the end
it'll capture more of the revenue.
Now I'm going to I'm still uncertain how the reporting will
be because that's kind of the next step is kind of seeing how
this how this reporting will be for for mod Med so we can get
our reports, but that's about it.
Once again, if you guys find this beneficial, let me know.
I am working on a kind of a mastermind type of a idea, so
you might be getting an e-mail shortly if you're listening to
this or if you're registered for anything.
Also, if you want, I have $1,000,000 blueprint.
If you want kind of all this written down in kind of a video
format, you can certainly go ahead.
And, and I've tried to put it all together to make it a little
bit easier for you to scale to the $1,000,000 mark and beyond.
Hope that's beneficial. OK, you can just go to paddock
practice mastery com to get that.
It's called the $1,000,000 blueprint.
OK hope this is beneficial. Have a great day.