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Hey guys down here. 
Welcome to Podiatry Practice 

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Mastery. 
I'm going to go over the 

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$1,000,000 minute, the things 
that helped me get to the 

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practice to the $1,000,000 mark 
and beyond. 

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So we are starting week four of 
our medical record, trans, 

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trans, translocation, moving 
from Athena to mod Med. 

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A couple of the snafus are which
I think are going to be good in 

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the end like billing for Q 
Tenza. 

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So there's a is something in 
there, but there's not the code 

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for the actual doctor doing it 
code. 

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There's the code for the the buy
and bill, but sometimes they're 

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doing it through a third party 
like Walgreens or something like

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that. 
Also things that are kind of 

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messing me up a little bit are 
like in office dispensing. 

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It's not a great way of doing in
office dispensing and 

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communicating to the staff or 
something like in house 

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purchases. 
So we have to make those up for 

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what things patients buy. 
The Shockwave is going well and 

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it puts in the cash pay as well.
Swift is going well, but we're 

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still kind of working on it. 
I really do like Clara, though. 

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Clara is the way of 
communicating with patients, but

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as well communicating with 
patients before their 

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appointments and after their 
appointments and asking for 

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online reviews and also for 
scheduling the appointments. 

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So it's kind of making it much 
more available. 

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So we're excited about that. 
I was talking to my, my virtual 

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assistant that's working on a 
new web page, like a urgent care

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web page she's working on. 
And on there we're going to have

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this link so patients can see 
who's available that day. 

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And then making a make an 
appointment. 

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We're not going to have like an 
actual walk in. 

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That's not really going to be 
feasible for us because 

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otherwise they'd just be waiting
a long time. 

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I don't think that's going to be
possible. 

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But I, I think the, the making 
the same day appointments is 

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going to work well. 
OK so today I'm recording this 

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is for Thursday and first 
patient was a 61 year old 

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female. 
She had a nail sample. 

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She had failed Lamisil and 
Diflucan and I did a nail sample

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for her but these were like a 
lot of years ago that she did 

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that. 
So I took a new nail sample. 

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Next was a 71 year old male with
an orthotic follow up. 

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Doing much better with the 
orthotics. 

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No follow up for him. 68 year 
old female had lesion 

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destruction nails debrided and I
did a nail sample. 

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So they're going to come back in
three weeks to go over that nail

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sample. 
Next was a 71 year old male with

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an orthotic follow up doing 
well, the goods and the bads of 

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doing orthotics. 
There's a lot of orthotic follow

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up appointments. 
Usually they're pretty normal, 

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but they're tend to be lower 
level visits. 

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I've always, I've almost thought
of doing my orthotics kind of 

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like my paranoia follow-ups, 
doing them in a 10 minute slot 

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and then double booking them 
with other ones because they're 

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kind of quick. 
Next is a 55 year old #2 out of 

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6 for a sesmoid fracture. 
He's not really seen much 

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improvement yet. 
I usually tell patients they 

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tend to start seeing 
improvements about week 5 or 6. 

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Next was a 47 year old male for 
right bunion. 

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He wanted to schedule surgery so
that was scheduled for him. 

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Next was a 34 year old male for 
swift #2 out of four seeing a 

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little bit of improvement. 
Next was a 55 year old female 

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for a lamb missile booster. 
Next was a 68 year old female 

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that had mid foot injection. 
She had a second met cuneiform 

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joint pain and we also scanned 
her for orthotics. 

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Next was a 55 year old female 
that had bilateral Aquinas. 

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Did a injection foam rolling for
this patient and they're going 

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to come back as needed if the 
pain comes back, most likely 

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doing shockwave. 
Next was a 88 year old female, 

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had callus care and nail care. 
Just as somehow they got it on 

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my schedule for nail care but I 
think it was a new patient. 

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New new patients can kind of 
find their way in. 

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Next was the 66 year old female 
that had a right medial 5th 

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digit toe exostectomy. 
So I did that in the office. 

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That's one of my favorite little
procedures to do where I take a 

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little blade and then I take a 
rasp and rasp it down in the 

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office. 
Next was a 67 year old female 

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that had arthritis on the on the
2nd digit and I'm not sure what 

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I did. 
I can't really I can't read my 

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handwriting. 
I'm I'm not used to this new 

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tracking system here. 
My other one had when I printed 

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it out my daily sheet I could 
see what they were here for but 

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this new one I can't do that. 
So I figured out a different way

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and I can't read my handwriting.
Next was a 31 year old female 

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with an Ind for bilateral big 
toenails. 

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Next was a 68 year old male for 
nail care, 37 year old patient 

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that was on Sporanox and it was 
getting better. 

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So etraconazole getting better 
and so I'm going to keep him on 

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it for a little bit longer. 
Next was a 18 year old bilateral

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matrixectomy. 
Then there's a one of my last 

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patients was a 77 year old had a
dislocated 5th toe. 

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I don't really see this but I 
guess he dropped like a file cap

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and he said on his fifth toe and
it dislocated. 

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So I used a toe fracture code, 
this fracture dislocation. 

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And so I got that and then I 
just had them tape it together, 

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but I didn't really want to pin 
it in place because it didn't 

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look all that bad. 
It was just swollen. 

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And then the next was a second 
met fracture and this one I did 

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AI couldn't really tell. 
Actually, no, this was the one 

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that was a bad 1 and I actually 
thought he needed surgery, but 

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he was like a one of these hard 
working men. 

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He dropped something on his 
foot. 

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It was a fracture. 
I told, if you're listening, I 

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told it a while ago, but it was 
almost like dorsally dislocated 

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and it kind of peaked dorsally 
and there's almost like sticking

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up in the skin. 
But it did, it formed a huge 

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callus formation around it and 
it's starting to heal. 

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So it's just amazing. 
No matter how bad these 

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fractures are, most of them heal
pretty well. 

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So this is a lot of callus 
formation around. 

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It's doing well. 
And so that was kind of the day.

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So it was a busy day. 
I was able to get out of the 

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office by 5:00. 
So that is a big win. 

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And then today was that I'm 
recording, this is on a Friday. 

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So I had a morning without 
Marjorie. 

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Marjorie had her birthday with 
my nail tech. 

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And so I had a couple of 
patients. 

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I did a nail sample callous 
care. 

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She had a rash on her foot, so I
did a clobetasol. 

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Another patient did AB is I'm 
starting to reorder the AB is 

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I'm not quite there yet. 
What I what I usually do is if 

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they haven't done in a year, I 
can put it in the, the medical 

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record to do an ABI and a, a 
diabetic foot exam with the ABI.

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The nice thing about a mod Med 
is it has this, this designation

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of why they need it and it has 
it like over the age of 50 with 

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diabetes or over the age of 65. 
And that's usually what I'm 

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doing it for yearly. 
And so it's in there. 

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I also did a swift today woman 
with bilateral ulcers in her 

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toes and then a patient that 
wanted Lunula, but I kind of 

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talked her into doing Trabefen 
because that's just kind of what

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I do. 
I think Lunula gets them in the 

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office because they search for 
us online. 

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But then I don't do that much of
it because I don't think it 

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works that great in, in my 
experience. 

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So that was the, the day things 
are, are going well. 

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I'm, I feel more confident with 
Mod Med Murali, my scribe is 

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getting the hang of it. 
So it's giving me a little bit 

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more time to work on work on 
other things and kind of focus 

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on perfecting the notes. 
And within mod Med, there's a 

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lot of these stickies, they call
it. 

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So these are written verbiage 
that you can change and save. 

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So we have we're trying to kind 
of fix those Morali my scribe 

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can't do that. 
I have to fix them, but then he 

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can he can use them in the 
future. 

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So that's what it is. 
So I hope you guys have a good 

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rest of the week and thanks for 
listening. 

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Have a good one.