Hey guys, Don here, welcome to Podiatry Practice Mastery.
We're helping you get to the $1,000,000 mark and beyond.
So I am on day number I'm counting down here day #16 of my
EMR transition. I think by day 30 it's going to
be pretty great getting better. I am still kind of figuring out
how to document and I'm I'm leaving earlier.
So basically I'm finding there's a little bit more time for my
staff to to do the notes. So I'm I'm trying to do my notes
the following day. In the past, I used to always
finish from the same day, but just cuz I have some extra time
during the day, I don't want to stay late.
So I'm trying to get out at an earlier time.
So that's, that's one thing that I'm kind of doing.
I've, I've learned today in the EMR, I learned how to schedule
surgery. So within the EMR, there's like
the surgery scheduling thing for my scheduler.
And basically, though I think I've mentioned this before, but
what I do is all, all the surgeries that I do, I have them
all written in a Google doc with kind of what's needed, the
equipment, the time, everything that's needed.
And, and I, and I give them to my scribe.
And then when he schedules the surgery, he just copies and
pastes that in there and just adds and what like, which we're
doing for like arthroplasty or arthrodesis or a bunionectomy or
something like that. And more importantly, the things
that aren't on that list, I refer out to someone else.
And I and I, this took a while. I haven't talked about this for
a while, but there are certain surgeries I just don't feel
comfortable doing and I don't do a lot of them.
So I send them out. So if they're not on my list,
then I'll then I'll send them out.
And that, that's been a good reminder for me of not trying to
go beyond my kind of my ability levels of things that I feel
comfortable, comfortable doing. I also learned about what else
was this? I, I learned how to get messages
from patients in the portal. I've learned how to kind of like
sign documents using an iPad. So that's the only reason I use
an iPad right now. And I'm, I'm still, we also
learned a lot of things come in electronically through faxes or
through these like connections that are made.
And then I've learned how to like process those documents and
have them go and then write results on them.
So it's basically when like pathology results comes or LFTS
or things like that. I've been learning how to do
that. So for the day, I'm going to go
over these, these kind of I'm going to go over 12 patients.
I had more, but the other ones I'll go over the following day
just because I didn't finish their notes.
First was a 75 year old female. She had a bunion.
I did X-rays. She had some hammer toes that
are painful to the tips as well. So I did the office visit and
and the calluses, she needed them trimmed.
I did them. I gave her Crest pads,
recommended anatomic shoes and if it doesn't get better, kind
of come back for the for the next.
She has a very large bunion. She would benefit from a lapidus
and and hammer toe repair, but they wanted to try some some non
surgical treatment. So that's kind of what I
recommended for her. Next was a 53 year old man.
He was for an orthotic follow up after six weeks doing good.
So no need for a follow up for him.
Next was a 54 year old female. She failed Lamisil and she
almost, I don't know if she failed Diflucan, but she has
this like 1/4 toenail that's kind of still thick and it's a
little bit curved. So I think it could be more from
the curvature of the nail and hitting on the shoe more so than
fungus. So after failing Trabenafen and
Diflucan, I don't really feel like that could offer her
pulling it off or just kind of living with it and she's opted
to just kind of try to live with it.
Next was a 65 year old female. She had a fifth met fracture.
I've been seeing her. I saw her initially 3 times.
I think we did 3 or 4 focused only shock waves.
This is a really bad fracture. It was like there's a big gap
where it was it it could very easily been been fixed.
She opted for non surgical treatment at at three months now
she's finally getting out of the Cam boot and she's doing better.
There's still a little gapping in there and so I'm going to see
her back in another two months. And next was a a patient that
had carry flex. So I've been having a lot of
carry flexes come in this days. She's a 57 year old female to
brided 2 nails that were thickened and I put on carry
flex. Next was a 62 year old female.
This was that competitive skier. So she's she Oh, I'm sorry, this
is a sorry, this is a different one.
I did the see the competitive skier that fifth met osteotomy
she's #5 out of 6 she's a competitive skier like water
skier. She's doing much better feeling
better. Next was a sorry it was just
kissing corns between the 4th and 5th toes recommended lamb's
wool. I have a page specifically on
kissing corns on on our website like a web page and this can do
a castellani paint and lamb's wool and ginger Violet, all that
stuff to dry it up. But really I explained to her
and I showed her on the X-ray she has the 2 bones that are
hitting again. So I recommend an arthroplasty
of the 5th toe to take care of that.
So she's going to let me know if she wants that.
Next was a 55 year old female for a fungus and recommended the
kit trabenafin and LFTS. Next was a 20 year old male for
left fifth met fracture, kind of an avulsion fracture.
Gave him a tall Cam boot to reduce the pole from the
peroneals. Next was a 55 year old up.
Sorry, 24 year old orthotic follow up doing well. 65 year
old orthotic follow up doing well.
And then an 80 year old arthritic ankle #2 out of 6 with
shockwave. That's not to help with the
arthritis, it's to help with the bone marrow edema around it.
So that was the day. There were more, I just didn't
finish those notes, but it was, it was a good day.
I'm getting better at shock waves, getting better at the
notes. Murali is doing a great job.
It just, it seems like it, it, it, it kind of like your wait,
wait, wait and then hurry up. That's what it's been like
because it's the staff are kind of learning.
We're also going through a lot of staff training.
We have many new staff that are kind of coming in trying to
train them, trying to get them up to up to par with with
treating things. So, but things are things are
going well. I'm going to keep writing on my
positive focus until I get to day 30 here.
So some of the positive things I learned to do the surgical
orders, ingrown notes are a little bit easier.
There's some protocols for that. The portal is working well and
we have this new online scheduling we've never had
before for new and and established patients.
So on our website I put a link that says like schedule online
and we're finding that patients are using that.
And we are, I'm working on a with my SEO people.
They're going to make a web page for an urgent care, urgent care
foot and ankle kind of web page slash custom blog articles to
push to it. And the thought would be is to
use this and then the scheduler, you can schedule by whoever like
the first available appointment. And I'm going to make another
scheduler that it won't be they can't pick the doctor.
It'll just have like the first available so they can pick an
appointment and come in right away.
And this would be in on this. I kind of put in the I'm putting
in the things that we're already getting from the urgent cares
that they see them and then they come to see us.
So like the fractures, the gouts, the ingrown toenails, the
ankle sprains, things like that. So I'm trying to compete with
the urgent care with this, with this web page.
This is something that it's not quite up and done yet.
But if you want to go to our website and see this new, we
have online schedule, you can see how that works.
And also there's a chat bot in there that works pretty well.
It's called Clara. It's part of Mod Med.
It's it's kind of a neat patient communication tool.
And we, it sounds like we have the deluxe meaning we're paying
for online reviews after patients come in.
We're, we're paying for online booking, we're paying for all
these other things because I think it'll reduce some of the
staff load because right now the staff are answering tons of
calls and tons of communications via that, that chat bot.
But it seems like the communication portions working,
working well. They have a pretty good system
there. Certainly everything has a cost
to it, but I think in the end it's going to make it a little
bit easier for making appointments.
We never had anything online. We kind of struggled because a
lot of times patients don't know how to make their own
appointments and sometimes you don't take their insurances.
So we've had a couple of questions in there prior to kind
of filter them out. We kind of said what insurances
we don't take on there and we just are like, yes and no
questions. That'll help a little bit with
the flow. OK.
So that's what's going on, getting a little bit better.
Everything else is good and we'll talk to you guys later.