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Hey guys, Don here, welcome to 
Podiatry Practice Mastery. 

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We're helping you get to the 
$1,000,000 mark and beyond. 

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So I am on day number I'm 
counting down here day #16 of my

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EMR transition. 
I think by day 30 it's going to 

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be pretty great getting better. 
I am still kind of figuring out 

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how to document and I'm I'm 
leaving earlier. 

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So basically I'm finding there's
a little bit more time for my 

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staff to to do the notes. 
So I'm I'm trying to do my notes

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the following day. 
In the past, I used to always 

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finish from the same day, but 
just cuz I have some extra time 

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during the day, I don't want to 
stay late. 

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So I'm trying to get out at an 
earlier time. 

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So that's, that's one thing that
I'm kind of doing. 

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I've, I've learned today in the 
EMR, I learned how to schedule 

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surgery. 
So within the EMR, there's like 

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the surgery scheduling thing for
my scheduler. 

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And basically, though I think 
I've mentioned this before, but 

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what I do is all, all the 
surgeries that I do, I have them

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all written in a Google doc with
kind of what's needed, the 

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equipment, the time, everything 
that's needed. 

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And, and I, and I give them to 
my scribe. 

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And then when he schedules the 
surgery, he just copies and 

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pastes that in there and just 
adds and what like, which we're 

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doing for like arthroplasty or 
arthrodesis or a bunionectomy or

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something like that. 
And more importantly, the things

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that aren't on that list, I 
refer out to someone else. 

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And I and I, this took a while. 
I haven't talked about this for 

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a while, but there are certain 
surgeries I just don't feel 

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comfortable doing and I don't do
a lot of them. 

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So I send them out. 
So if they're not on my list, 

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then I'll then I'll send them 
out. 

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And that, that's been a good 
reminder for me of not trying to

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go beyond my kind of my ability 
levels of things that I feel 

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comfortable, comfortable doing. 
I also learned about what else 

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was this? 
I, I learned how to get messages

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from patients in the portal. 
I've learned how to kind of like

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sign documents using an iPad. 
So that's the only reason I use 

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an iPad right now. 
And I'm, I'm still, we also 

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learned a lot of things come in 
electronically through faxes or 

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through these like connections 
that are made. 

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And then I've learned how to 
like process those documents and

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have them go and then write 
results on them. 

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So it's basically when like 
pathology results comes or LFTS 

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or things like that. 
I've been learning how to do 

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that. 
So for the day, I'm going to go 

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over these, these kind of I'm 
going to go over 12 patients. 

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I had more, but the other ones 
I'll go over the following day 

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just because I didn't finish 
their notes. 

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First was a 75 year old female. 
She had a bunion. 

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I did X-rays. 
She had some hammer toes that 

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are painful to the tips as well.
So I did the office visit and 

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and the calluses, she needed 
them trimmed. 

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I did them. 
I gave her Crest pads, 

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recommended anatomic shoes and 
if it doesn't get better, kind 

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of come back for the for the 
next. 

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She has a very large bunion. 
She would benefit from a lapidus

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and and hammer toe repair, but 
they wanted to try some some non

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surgical treatment. 
So that's kind of what I 

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recommended for her. 
Next was a 53 year old man. 

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He was for an orthotic follow up
after six weeks doing good. 

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So no need for a follow up for 
him. 

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Next was a 54 year old female. 
She failed Lamisil and she 

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almost, I don't know if she 
failed Diflucan, but she has 

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this like 1/4 toenail that's 
kind of still thick and it's a 

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little bit curved. 
So I think it could be more from

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the curvature of the nail and 
hitting on the shoe more so than

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fungus. 
So after failing Trabenafen and 

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Diflucan, I don't really feel 
like that could offer her 

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pulling it off or just kind of 
living with it and she's opted 

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to just kind of try to live with
it. 

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Next was a 65 year old female. 
She had a fifth met fracture. 

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I've been seeing her. 
I saw her initially 3 times. 

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I think we did 3 or 4 focused 
only shock waves. 

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This is a really bad fracture. 
It was like there's a big gap 

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where it was it it could very 
easily been been fixed. 

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She opted for non surgical 
treatment at at three months now

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she's finally getting out of the
Cam boot and she's doing better.

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There's still a little gapping 
in there and so I'm going to see

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her back in another two months. 
And next was a a patient that 

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had carry flex. 
So I've been having a lot of 

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carry flexes come in this days. 
She's a 57 year old female to 

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brided 2 nails that were 
thickened and I put on carry 

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flex. 
Next was a 62 year old female. 

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This was that competitive skier.
So she's she Oh, I'm sorry, this

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is a sorry, this is a different 
one. 

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I did the see the competitive 
skier that fifth met osteotomy 

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she's #5 out of 6 she's a 
competitive skier like water 

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skier. 
She's doing much better feeling 

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better. 
Next was a sorry it was just 

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kissing corns between the 4th 
and 5th toes recommended lamb's 

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wool. 
I have a page specifically on 

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kissing corns on on our website 
like a web page and this can do 

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a castellani paint and lamb's 
wool and ginger Violet, all that

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stuff to dry it up. 
But really I explained to her 

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and I showed her on the X-ray 
she has the 2 bones that are 

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hitting again. 
So I recommend an arthroplasty 

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of the 5th toe to take care of 
that. 

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So she's going to let me know if
she wants that. 

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Next was a 55 year old female 
for a fungus and recommended the

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kit trabenafin and LFTS. 
Next was a 20 year old male for 

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left fifth met fracture, kind of
an avulsion fracture. 

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Gave him a tall Cam boot to 
reduce the pole from the 

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peroneals. 
Next was a 55 year old up. 

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Sorry, 24 year old orthotic 
follow up doing well. 65 year 

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old orthotic follow up doing 
well. 

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And then an 80 year old 
arthritic ankle #2 out of 6 with

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shockwave. 
That's not to help with the 

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arthritis, it's to help with the
bone marrow edema around it. 

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So that was the day. 
There were more, I just didn't 

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finish those notes, but it was, 
it was a good day. 

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I'm getting better at shock 
waves, getting better at the 

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notes. 
Murali is doing a great job. 

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It just, it seems like it, it, 
it, it kind of like your wait, 

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wait, wait and then hurry up. 
That's what it's been like 

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because it's the staff are kind 
of learning. 

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We're also going through a lot 
of staff training. 

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We have many new staff that are 
kind of coming in trying to 

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train them, trying to get them 
up to up to par with with 

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treating things. 
So, but things are things are 

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going well. 
I'm going to keep writing on my 

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positive focus until I get to 
day 30 here. 

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So some of the positive things I
learned to do the surgical 

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orders, ingrown notes are a 
little bit easier. 

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There's some protocols for that.
The portal is working well and 

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we have this new online 
scheduling we've never had 

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before for new and and 
established patients. 

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So on our website I put a link 
that says like schedule online 

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and we're finding that patients 
are using that. 

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And we are, I'm working on a 
with my SEO people. 

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They're going to make a web page
for an urgent care, urgent care 

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foot and ankle kind of web page 
slash custom blog articles to 

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push to it. 
And the thought would be is to 

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use this and then the scheduler,
you can schedule by whoever like

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the first available appointment.
And I'm going to make another 

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scheduler that it won't be they 
can't pick the doctor. 

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It'll just have like the first 
available so they can pick an 

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appointment and come in right 
away. 

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And this would be in on this. 
I kind of put in the I'm putting

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in the things that we're already
getting from the urgent cares 

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that they see them and then they
come to see us. 

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So like the fractures, the 
gouts, the ingrown toenails, the

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ankle sprains, things like that.
So I'm trying to compete with 

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the urgent care with this, with 
this web page. 

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This is something that it's not 
quite up and done yet. 

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But if you want to go to our 
website and see this new, we 

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have online schedule, you can 
see how that works. 

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And also there's a chat bot in 
there that works pretty well. 

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It's called Clara. 
It's part of Mod Med. 

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It's it's kind of a neat patient
communication tool. 

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And we, it sounds like we have 
the deluxe meaning we're paying 

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for online reviews after 
patients come in. 

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We're, we're paying for online 
booking, we're paying for all 

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these other things because I 
think it'll reduce some of the 

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staff load because right now the
staff are answering tons of 

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calls and tons of communications
via that, that chat bot. 

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But it seems like the 
communication portions working, 

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working well. 
They have a pretty good system 

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there. 
Certainly everything has a cost 

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to it, but I think in the end 
it's going to make it a little 

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bit easier for making 
appointments. 

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We never had anything online. 
We kind of struggled because a 

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lot of times patients don't know
how to make their own 

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appointments and sometimes you 
don't take their insurances. 

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So we've had a couple of 
questions in there prior to kind

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of filter them out. 
We kind of said what insurances 

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we don't take on there and we 
just are like, yes and no 

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questions. 
That'll help a little bit with 

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the flow. 
OK. 

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So that's what's going on, 
getting a little bit better. 

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Everything else is good and 
we'll talk to you guys later.