Hi Don here welcome to Podiatry practice mastery we're helping
you bring your practice to the $1,000,000 mark and beyond.
I want to make kind of an uneasy confession.
I made my first Facebook ad today.
And what I, what I mean about uneasy is because it wasn't an
easy process. I, I've, I've had someone doing
them for me. They were basically we're doing
one for warts. I had this wart page and I was
doing Facebook ads. I was spending, I think it was
ending up they spent like $10 a day on these things, but they
really didn't bring many patients in.
Like I didn't see tons of patients get in.
So I turned it off and I have been my my my favorite guy to
listen to lately is is Alex Harmozzi, just my favorite
podcast. I shouldn't say guy, but he
talks about trying to make take the best YouTube short and then
tack an ad on the on the back end of it.
And so that that's what I did. I took my, my, my, my best
YouTube short and I put an ad on a put this.
It was kind of a painful process to to figure that out.
Now, mind you, I did it after surgery.
So I had surgery in the morning, I had a neuroma removal and I
had some time and I was thinking, well, what's the best
thing in like the biggest pain that I, I can work on that I
don't want to work on, but I probably have to learn how to
do. So I did this started out easy
at $5 a day and we'll kind of see what it brings in.
It's going to be going to my urgent care page.
So my main focus is here is filling up this new Doctor.
So there are slots every day for this new Doctor.
So trying to fill up this urgent care page.
So this is what I've done and it's not a comfortable process.
Like you have to edit the video, you have to do like another 3
seconds on the end. So I just switch to move it over
to cap cut and then put a little end screen on it.
It kind of looks horrible. If you want to see it, shoot me
an e-mail. Happy to send you the links.
You can see it dot at Podiatry practice master.com.
I'll share kind of as I'm going through the struggle.
OK. But then the the afternoon in my
office was a good afternoon. I'll kind of go over this once
again. One doctor, he asked for my
treatment tracking sheet. I'd be happy to send that over
if you just shoot me, shoot me an e-mail.
OK, so first patient in the afternoon was a 74 year old
female, had right haloxlimatus. So I spent a lot of time talking
about the sperm on the top, you know, hers wasn't that painful.
She's really interested in going on this, I don't know, 200 mile
hike in Spain and she got orthotics and I'm going to see
her back in eight weeks. So normally orthotics, they come
back in about two to three weeks to pick them up and then I see
them about six weeks later. So usually they make a 2 month
follow up for them. Next was a 99 year old little
boy. He was here with his dad.
He had bilateral sievers and and he got.
So this is funny, this is the benefit of my scribe.
So as I was explaining this, I, I, I have a little treatment
sheet. So once again, if you want my
treatment sheets, just shoot me an e-mail.
I have a little treatment sheet that I go through a little
patient presentation, a little PowerPoint that I go through.
And so he is going to do, you know, the morning stretch,
pretty much the same morning stretch foam rolling.
Then you got a night splint and he's going to do the 2 Lee heel
cushions and we, and he's going to start that.
I'm going to see him back in about four weeks.
And if it's not better, we'll either do shockwave or we're
going to do orthotics. So I, I didn't tend to do those
the first visit. We're going to do those the next
visit based on his, his, his improvement.
And the, The funny thing is, as I was leaving, Murali said to
me, he said, Don, do you want to do, you know, 1 sided night
split or bilateral? And I was just thinking about
doing 1 and when I asked the, the patient or actually his
father, do you want to do one of these or two of these?
And the kid said, well, I just want, I want to do 2.
So you can do bilateral night splints.
And I just find that a lot of times my scribe is, is more
confident than I am. He's like, he just wants to
clarify for his documentation. And, and, but it, but it adds a
lot of other things to me because that then I just asked
the patient, Hey, do you want to do one of these or two of these?
In this case, since he had bilateral severs, he did
bilateral night splints. So I'm going to see him back and
then we'll kind of go to the next step if needed.
The next patient was a 72 year old female.
She had bilateral bunions. We did X-rays and we did shoe
recommendations. So it was the husband and wife.
So we did shoe recommendations for her and she actually came
from an ad in a local newspaper. So we do this weekly ad in the
newspaper and then once a year they do like a spotlight of the
doctor. So they did a spotlight of me
and then she saw the ad and she wanted to come in and she had
previously seen another podiatrist.
She was there with her husband who was about 10 years younger
than her and he was a 62 year old man.
He had a left peroneal pernais brevis tendonitis, had the
insertion. We did X-ray, we did ultrasound
and we did a cortisone in there. He can't came in expecting to do
a cortisone and I said, well, we'll do 1 cortisone.
I'm going to see you back in four weeks.
If it's not better, then we're going to do shockwave.
And I kind of explained what shockwave was in, in the
benefit. I think that would have been
more more beneficial for him, but he wanted to do the the
cortisone. He kind of came in with that
expectation on his mind. He was already in a Cam boot for
two weeks before. Next was a 45 year old female.
She had E pad #1 out of 6 for plantar fasciitis.
Next was a 38 year old female did a left hallux avulsion and
she has been on two different types of antifungals. 1 was
trybenafin and now she is on Diflucan and she is having some
swelling and pain at the nail base and it wasn't getting
better and I think it was due to that kind of that the nail that
was there. So we did an avulsion today for
her. She also is dealing with some
chronic plantar fasciitis. And I find that certain
patients, certain demographics are don't want to pay for
treatment. They especially don't want to
pay full price. So in these patients, what I
tend to do is I just, I don't push them.
I just have them make that decision.
And if they just kind of live in or sit in their pain, eventually
they'll come through and want to do the shockwave.
That's what she really needs and she's going to set up those
shock waves. But I, I find it's not worth it
for me to say you need this, you need this, you need this.
They really have to come to the point where their pain isn't
going away and they want the shockwave.
And she's already failed at 2 cortisone injections.
And so I just said this is this is the next thing that you need.
So and I and I leave it at that. In the past, I used to try to
convince them, but I don't, I don't convince anymore.
I just say, OK, who's next? You'll be back when you need it.
Next patient was a 58 year old female with a left fifth met.
I can't read my AH. So she has two things.
She has a nerve in like almost like a neuroma on the fifth met
head. The way her foot is, she's
walking on the nerve on the outside of that lateral side of
the 5th metatarsal head. She's already had a couple of
nerves removed on her second toe of both sides and she kind of
lands on the bone slash nerve and I can feel it click back and
forth with my hand. So I've injected it twice.
She has a wedding coming up for one of her sons.
So I'm going to do the cortisone today, but we're going to come
back. And I've done this one other
time where I thought it was a soft tissue mass actually.
And I, and I removed it. So I removed it right in the
office and make a, just a, just a lengthwise incision where that
nerve is. And I just removed that just cut
out that nerve in the in the office.
The next was a, this was kind of my favorite, my MVP patient of
the day. She had a 57 year old female.
She was seen by an orthopedist for a, an Achilles rupture.
And he did a, an FDL transfer with this and he did a bone
anchor and the heel. And she is seven months out.
She's gone to PT and she never even saw the surgeon for the
post op, just saw the P as in this big hospital system we have
here. And she came in, I know her from
like my, my kids sports and, and I've been seeing her limp
around. So she came in and, and she has
just a lot of thickness in her Achilles tendon, certainly after
the rupture, a lot of a fusion in there, some bone, bone pieces
and things like that. And she's going to be a prime
candidate for Shockwave. So we did shockwave #1 out of 6
for her and she just wants to get back to a little bit more
normalcy in her life and she's still kind of limping around.
I told her she's still going to have tightness back there and
she's been doing the grass and technique and physical therapy,
but I, I think the shockwave is really going to help her.
We did X-rays. We also did ultrasound for her
as well. Next was a patient with
bilateral fit. OK, this is kind of a, a lot of
things this patient had. So these are these ones that
they just add up and up and up in terms of the office visit.
So first of all, she had the office visit.
New patient, 77 year old female, bilateral fifth met IPKS.
So I treat those they possibly could be warts and so I treat
those with lesion destruction. And in my documentation I put in
wart and I put in, you know IPIPK.
She also had nails that she wanted done and she wants to
come back for to see Marjorie, my nail tech.
And then she also has right plantar fasciitis.
So we did the X-rays. We and we did the the Pelto
special, which is the night splint, the foam rolling in the
morning stretch along with the icing and the anti inflammator.
I'm going to see her back in three weeks and see how she's
doing. And then finally we had a
patient that a 37 year old for a right hallux Ind.
So we did that. That was the day.
So it's kind of a busy afternoon after my surgery, but my kind of
my big accomplishment was making that Facebook ad, which was
very, very uncomfortable. I would love to know if anyone
is really great at ads and how they're working for you.
I know there are certain people that have courses and things
like that. I, I really just tried to muscle
through it my first time. I just kind of have to figure
out, I know I could pay others and I have paid others to do
them in the past, but I kind of want to figure it out.
So I, I, and then maybe at once, I understand a little bit.
I don't mind paying someone to do it, but right now I just want
to kind of figure it out. OK, well, I'll talk to you guys
tomorrow.