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Hey guys, Don here. 
Welcome to Podiatry Practice 

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Mastery. 
We're trying to do the best I 

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can to help you get past the 
$1,000,000 mark and beyond in 

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your private practice. 
This is always something that I 

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wish existed when I was starting
out just to kind of give some 

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some guidance and how to how to 
kind of get there. 

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So I'm going to go over a couple
of days here. 

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I have, I haven't recorded in a 
few days. 

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I'm going to go over some of 
that kind of the high points 

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here. 
Patient 31 year old female with 

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bilateral care reflex. 
So she came in, her nails were 

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injured from a previous 
matrixectomy. 

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So this is 1 where she had a 
matrixectomy by another 

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provider. 
And I find sometimes that the 

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the either sodium hydroxide or 
whatever is used can injure the 

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nail. 
So all she had was like the 

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distal half or maybe even the 
distal quarter attached. 

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The proximal part kind of fell 
off and it's summertime here, so

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she wanted it to look good. 
So we kind of took off the bad 

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nail, ground it down and it had 
something to attach to. 

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And so we did bilateral carry 
flex for her. 

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Next patient was a 75 year old. 
She's one that she had a 

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previous first MPJ fusion and by
another doctor she had a second 

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MPJ fusion. 
I've, I've never seen a second 

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MPJ fusion before. 
That doesn't really happen that 

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often and she had an AVN of the 
second Med head which I could 

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see on the X-ray so the hardware
was taken out. 

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I tried to do some shockwave for
her, she was doing OK with that,

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but then it just really affected
her quality of life so she's 

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going to have to have a partial 
Med head resection for that. 

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Next patient was a 71 year old 
that had AI and D on the 4th toe

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and so he came in for an ingrown
toenail. 

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He also had done 4 sessions of 
swift for a really a chronic 

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wart on his heel and that wart 
did go away so it was nice to 

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see the follow up of the swift. 
I do find it working on 

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patients. 
There's a few recalcitrant 

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cases. 
I find that people just have a 

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ton of ton of warts. 
Another bad incident I want to 

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share was a patient of mine 
recently I treated with a wart 

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as well. 
I did Kanthordan on it and he 

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actually got an infection. 
So he, he had it on his IPG of 

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his hallux, just a huge wart. 
And I Kanthordan did it up, but 

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it was a big, big piece and I, I
think it just got infected based

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on that. 
So he, he sent me a picture over

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the weekend. 
I just sent him to the Ed. 

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I've never had someone get a 
really bad infection from 

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Kanthordan. 
Usually it's, it's really, 

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really inflamed, but this one 
looked pretty bad for this this 

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gentleman. 
Next patient was a 21 year old 

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that had a fifth, a fracture of 
the fifth met. 

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She came in and put her into a 
tall Cam boot. 

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And then she'll kind of get 
better over time. 

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I'm going to do a four week 
follow up for her. 

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Next was a patient for nail 
fungus, came in, reviewed the 

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nail sample results and gave her
a prescription. 

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Next was swift #4 out of four 
for this female, 37 year old 

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female, 4 out of four. 
And then they usually do a three

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month follow Up next was an 
ingrown toenail. 

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This was kind of a kind of a 
challenge that she had an 

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ingrown toenail, but she also 
had like a lot of that tissue 

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coming out from underneath the, 
the under, like underneath the 

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toenail. 
And those were always kind of a 

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challenge. 
And when you, when you clip it, 

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it bleeds. 
And she wanted to have some type

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of a treat. 
And I said, I told her 

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unfortunately there wasn't 
really any treatment for that. 

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Next patient was a 74 year old 
that had an exostosis to the 5th

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digit. 
And I, I, I talked to her about 

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doing an exostectomy in the 
office. 

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She also had an ulcer between 
two of her toes that I debrided.

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And, and I think the reason for 
this ulcer between the toes is 

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because this one also had a 
fracture. 

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She had a, a fracture of her 
foot, a stress fracture caused 

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the toe to swell and then the 
toes pushed together and create 

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a little bit of an ulceration 
between the two toes. 

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Next was #3 out of four 
shockwave for fibular fracture. 

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And she's starting to feel a 
little bit better. 

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Next was a swift. 
Now I count the number of 

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Swifts, just so you know. 
So this was #6 actually, sorry, 

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this is E pad. 
Sorry that I can't read my 

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handwriting. 
E pad #6 out of 6 for this 

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patient and then they're going 
to do a six week follow up for, 

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for me in the office. 
Next was a 18 year old. 

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It got a Lamisil booster so 
she's starting to feel better or

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her toes are looking better 
after the first round of 

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gibenophin. 
Next was a diabetic foot exam 

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and this patient also had a poro
keratoma or IPK and we did a 

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lesion destruction on that. 
Next was a post op status post 

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amputation, a couple of toes, 
but now she's having some 

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overload to the 4th and 5th 
toast so she is missing portions

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of her first, second, third, and
I'm I'm afraid that she's going 

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to lose a portion of her 4th and
5th as well. 

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Next was a 63 year old female 
for number a male for two out of

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6 for shockwave. 
Next was a 56 year old status 

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post 5th digit arthroplasty 
bilateral. 

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That's one of the post OPS. 
She's doing well. 

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Next was E pad #5 out of 6 for 
her peroneal tendon. 

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She's really feeling better. 
She like me she is she has goats

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so she brought me goat cheese. 
So if you want to know, we made 

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a goat cheese and caramelized 
onion little flat lead this 

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weekend with the with the goat 
cheese that this patient 

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brought. 
Next patient was the first MPJ, 

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had gout, did a cortisone 
injection, put them on some gout

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medication. 
Next was a 54 year old that had 

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bilateral posterior tibial 
tendon dysfunction and on the 

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right it looked like there was a
partial tear of the posterior 

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tibial tendon. 
So I'm talking to this patient 

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about doing bilateral AF OS. 
So I'm checking on insurance for

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this. 
Actually I probably have to send

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this patient out because it's 
Blue Cross Blue Shield and I 

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can't do AF OS for this patient.
Next patient was a bunion and a 

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Taylor's bunion and I had done 
the right foot. 

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We're looking at doing the left 
foot, but it's not really as 

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bad. 
So I opted not to to do that. 

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Next was a follow up for toenail
pain and she is doing actually 

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this is sorry, peroneal peroneal
tendon pain. 

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She's doing, she's doing better.
I had a Rep that stopped by the 

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other day talked about 
something. 

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It's a new kind of a type of 
Leniva for painful Ipks. 

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So this is called Liposana. 
It's kind of a fat injectable 

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that can go underneath areas of 
painful pressure. 

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So I don't know if you've heard 
of this one. 

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There's a couple of different 
ones that you can use. 

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I'd like to know if people are 
doing these a lot. 

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I, I know there was a recent 
conversation about that on one 

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of these other, one of these 
other groups on Facebook. 

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So OK, I'm, I'm going to combine
a couple of these because I 

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haven't done this for a few 
days. 

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I think the, the number 5 out of
6 for shockwave fracture of a 

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metatarsal #5 out of 6 shockwave
as well. 

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Another patient that got an 
Achilles MRI follow up matrix 

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cortisone to 1st MPJ bilateral 
second Med head pain did 

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shockwave bilaterally for that 
patient. 4th met fracture. 

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This is the fracture code that I
was talking about it the 

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fracture code. 
And then this was actually this 

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one that had the ulcer. 
Another patient that had a 

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cockapallox that's hurting in 
the shoe side. 

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I recommended Niboso or like 
correct toes and I put these on 

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in a way where I cut them so 
there was only only holding down

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the the first only covering the 
first three toes. 

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So to bring them down. 
I don't do a ton of those, but 

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occasionally I do for patients. 
Next patient was arthritis. 

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So we talked about orthotics. 
They had midfoot arthritis, just

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a lot of a lot of a lot of the 
same. 

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Another fifth net fracture doing
better posterior tibial tendon. 

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They came in for that. 
They wanted PT first for not 

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going to get better than if they
don't get better, then we'll do 

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shockwave. 
Another one was two out of four,

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two out of six Shockwave for 
plantar fasciitis matrix follow 

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up, 5th met fracture and then 
another X-ray for a fracture 

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follow up. 
So there's a lot of a lot of 

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patients kind of repetitive 
here. 

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I'm not even going to go over my
Friday. 

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I didn't record for Friday 
either, but that was kind of a a

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busy day, busy day with routine 
first half of the day and then 

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patients, regular patients the 
rest of the rest of the day. 

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Still getting the hang of mod 
bed. 

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Murali is getting the hang of 
it. 

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We're I'm still struggling to 
find where certain things are 

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like simple things like sending 
out referrals to doctors. 

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I said, I think you have to have
like the doctor's name in there.

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It has to be all like kind of 
documented the right way. 

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I'm not quite sure how to do 
that. 

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I figured out how to do Cutenza 
in there now and I know how to 

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do like the both the buy and 
bill ones, meaning we buy them 

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and bill for the actual Cutenza 
or just the application fee, 

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which is what we normally do. 
Most procedures are a little bit

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easier, a little bit easier to 
schedule surgeries. 

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So I'm still kind of figuring it
out. 

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It's getting a little bit less 
bad and I feel like in the end 

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it'll capture more of the 
revenue. 

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Now I'm going to I'm still 
uncertain how the reporting will

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be because that's kind of the 
next step is kind of seeing how 

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this how this reporting will be 
for for mod Med so we can get 

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our reports, but that's about 
it. 

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Once again, if you guys find 
this beneficial, let me know. 

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I am working on a kind of a 
mastermind type of a idea, so 

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you might be getting an e-mail 
shortly if you're listening to 

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this or if you're registered for
anything. 

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Also, if you want, I have 
$1,000,000 blueprint. 

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If you want kind of all this 
written down in kind of a video 

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format, you can certainly go 
ahead. 

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And, and I've tried to put it 
all together to make it a little

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bit easier for you to scale to 
the $1,000,000 mark and beyond. 

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Hope that's beneficial. 
OK, you can just go to paddock 

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practice mastery com to get 
that. 

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It's called the $1,000,000 
blueprint. 

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OK hope this is beneficial. 
Have a great day.