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Hi Don here welcome to Podiatry 
practice mastery we're helping 

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you bring your practice to the 
$1,000,000 mark and beyond. 

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I want to make kind of an uneasy
confession. 

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I made my first Facebook ad 
today. 

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And what I, what I mean about 
uneasy is because it wasn't an 

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easy process. 
I, I've, I've had someone doing 

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them for me. 
They were basically we're doing 

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one for warts. 
I had this wart page and I was 

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doing Facebook ads. 
I was spending, I think it was 

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ending up they spent like $10 a 
day on these things, but they 

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really didn't bring many 
patients in. 

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Like I didn't see tons of 
patients get in. 

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So I turned it off and I have 
been my my my favorite guy to 

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listen to lately is is Alex 
Harmozzi, just my favorite 

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podcast. 
I shouldn't say guy, but he 

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talks about trying to make take 
the best YouTube short and then 

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tack an ad on the on the back 
end of it. 

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And so that that's what I did. 
I took my, my, my, my best 

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YouTube short and I put an ad on
a put this. 

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It was kind of a painful process
to to figure that out. 

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Now, mind you, I did it after 
surgery. 

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So I had surgery in the morning,
I had a neuroma removal and I 

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had some time and I was 
thinking, well, what's the best 

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thing in like the biggest pain 
that I, I can work on that I 

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don't want to work on, but I 
probably have to learn how to 

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do. 
So I did this started out easy 

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at $5 a day and we'll kind of 
see what it brings in. 

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It's going to be going to my 
urgent care page. 

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So my main focus is here is 
filling up this new Doctor. 

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So there are slots every day for
this new Doctor. 

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So trying to fill up this urgent
care page. 

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So this is what I've done and 
it's not a comfortable process. 

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Like you have to edit the video,
you have to do like another 3 

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seconds on the end. 
So I just switch to move it over

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to cap cut and then put a little
end screen on it. 

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It kind of looks horrible. 
If you want to see it, shoot me 

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an e-mail. 
Happy to send you the links. 

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You can see it dot at Podiatry 
practice master.com. 

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I'll share kind of as I'm going 
through the struggle. 

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OK. 
But then the the afternoon in my

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office was a good afternoon. 
I'll kind of go over this once 

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again. 
One doctor, he asked for my 

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treatment tracking sheet. 
I'd be happy to send that over 

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if you just shoot me, shoot me 
an e-mail. 

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OK, so first patient in the 
afternoon was a 74 year old 

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female, had right haloxlimatus. 
So I spent a lot of time talking

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about the sperm on the top, you 
know, hers wasn't that painful. 

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She's really interested in going
on this, I don't know, 200 mile 

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hike in Spain and she got 
orthotics and I'm going to see 

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her back in eight weeks. 
So normally orthotics, they come

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back in about two to three weeks
to pick them up and then I see 

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them about six weeks later. 
So usually they make a 2 month 

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follow up for them. 
Next was a 99 year old little 

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boy. 
He was here with his dad. 

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He had bilateral sievers and and
he got. 

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So this is funny, this is the 
benefit of my scribe. 

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So as I was explaining this, I, 
I, I have a little treatment 

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sheet. 
So once again, if you want my 

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treatment sheets, just shoot me 
an e-mail. 

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I have a little treatment sheet 
that I go through a little 

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patient presentation, a little 
PowerPoint that I go through. 

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And so he is going to do, you 
know, the morning stretch, 

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pretty much the same morning 
stretch foam rolling. 

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Then you got a night splint and 
he's going to do the 2 Lee heel 

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cushions and we, and he's going 
to start that. 

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I'm going to see him back in 
about four weeks. 

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And if it's not better, we'll 
either do shockwave or we're 

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going to do orthotics. 
So I, I didn't tend to do those 

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the first visit. 
We're going to do those the next

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visit based on his, his, his 
improvement. 

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And the, The funny thing is, as 
I was leaving, Murali said to 

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me, he said, Don, do you want to
do, you know, 1 sided night 

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split or bilateral? 
And I was just thinking about 

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doing 1 and when I asked the, 
the patient or actually his 

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father, do you want to do one of
these or two of these? 

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And the kid said, well, I just 
want, I want to do 2. 

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So you can do bilateral night 
splints. 

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And I just find that a lot of 
times my scribe is, is more 

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confident than I am. 
He's like, he just wants to 

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clarify for his documentation. 
And, and, but it, but it adds a 

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lot of other things to me 
because that then I just asked 

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the patient, Hey, do you want to
do one of these or two of these?

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In this case, since he had 
bilateral severs, he did 

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bilateral night splints. 
So I'm going to see him back and

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then we'll kind of go to the 
next step if needed. 

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The next patient was a 72 year 
old female. 

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She had bilateral bunions. 
We did X-rays and we did shoe 

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recommendations. 
So it was the husband and wife. 

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So we did shoe recommendations 
for her and she actually came 

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from an ad in a local newspaper.
So we do this weekly ad in the 

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newspaper and then once a year 
they do like a spotlight of the 

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doctor. 
So they did a spotlight of me 

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and then she saw the ad and she 
wanted to come in and she had 

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previously seen another 
podiatrist. 

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She was there with her husband 
who was about 10 years younger 

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than her and he was a 62 year 
old man. 

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He had a left peroneal pernais 
brevis tendonitis, had the 

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insertion. 
We did X-ray, we did ultrasound 

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and we did a cortisone in there.
He can't came in expecting to do

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a cortisone and I said, well, 
we'll do 1 cortisone. 

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I'm going to see you back in 
four weeks. 

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If it's not better, then we're 
going to do shockwave. 

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And I kind of explained what 
shockwave was in, in the 

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benefit. 
I think that would have been 

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more more beneficial for him, 
but he wanted to do the the 

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cortisone. 
He kind of came in with that 

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expectation on his mind. 
He was already in a Cam boot for

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two weeks before. 
Next was a 45 year old female. 

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She had E pad #1 out of 6 for 
plantar fasciitis. 

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Next was a 38 year old female 
did a left hallux avulsion and 

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she has been on two different 
types of antifungals. 1 was 

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trybenafin and now she is on 
Diflucan and she is having some 

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swelling and pain at the nail 
base and it wasn't getting 

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better and I think it was due to
that kind of that the nail that 

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was there. 
So we did an avulsion today for 

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her. 
She also is dealing with some 

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chronic plantar fasciitis. 
And I find that certain 

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patients, certain demographics 
are don't want to pay for 

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treatment. 
They especially don't want to 

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pay full price. 
So in these patients, what I 

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tend to do is I just, I don't 
push them. 

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I just have them make that 
decision. 

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And if they just kind of live in
or sit in their pain, eventually

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they'll come through and want to
do the shockwave. 

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That's what she really needs and
she's going to set up those 

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shock waves. 
But I, I find it's not worth it 

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for me to say you need this, you
need this, you need this. 

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They really have to come to the 
point where their pain isn't 

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going away and they want the 
shockwave. 

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And she's already failed at 2 
cortisone injections. 

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And so I just said this is this 
is the next thing that you need.

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So and I and I leave it at that.
In the past, I used to try to 

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convince them, but I don't, I 
don't convince anymore. 

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I just say, OK, who's next? 
You'll be back when you need it.

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Next patient was a 58 year old 
female with a left fifth met. 

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I can't read my AH. 
So she has two things. 

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She has a nerve in like almost 
like a neuroma on the fifth met 

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head. 
The way her foot is, she's 

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walking on the nerve on the 
outside of that lateral side of 

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the 5th metatarsal head. 
She's already had a couple of 

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nerves removed on her second toe
of both sides and she kind of 

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lands on the bone slash nerve 
and I can feel it click back and

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forth with my hand. 
So I've injected it twice. 

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She has a wedding coming up for 
one of her sons. 

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So I'm going to do the cortisone
today, but we're going to come 

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back. 
And I've done this one other 

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time where I thought it was a 
soft tissue mass actually. 

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And I, and I removed it. 
So I removed it right in the 

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office and make a, just a, just 
a lengthwise incision where that

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nerve is. 
And I just removed that just cut

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out that nerve in the in the 
office. 

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The next was a, this was kind of
my favorite, my MVP patient of 

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the day. 
She had a 57 year old female. 

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She was seen by an orthopedist 
for a, an Achilles rupture. 

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And he did a, an FDL transfer 
with this and he did a bone 

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anchor and the heel. 
And she is seven months out. 

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She's gone to PT and she never 
even saw the surgeon for the 

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post op, just saw the P as in 
this big hospital system we have

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here. 
And she came in, I know her from

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like my, my kids sports and, and
I've been seeing her limp 

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around. 
So she came in and, and she has 

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just a lot of thickness in her 
Achilles tendon, certainly after

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the rupture, a lot of a fusion 
in there, some bone, bone pieces

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and things like that. 
And she's going to be a prime 

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candidate for Shockwave. 
So we did shockwave #1 out of 6 

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for her and she just wants to 
get back to a little bit more 

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normalcy in her life and she's 
still kind of limping around. 

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I told her she's still going to 
have tightness back there and 

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she's been doing the grass and 
technique and physical therapy, 

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but I, I think the shockwave is 
really going to help her. 

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We did X-rays. 
We also did ultrasound for her 

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as well. 
Next was a patient with 

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bilateral fit. 
OK, this is kind of a, a lot of 

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things this patient had. 
So these are these ones that 

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they just add up and up and up 
in terms of the office visit. 

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So first of all, she had the 
office visit. 

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New patient, 77 year old female,
bilateral fifth met IPKS. 

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So I treat those they possibly 
could be warts and so I treat 

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those with lesion destruction. 
And in my documentation I put in

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wart and I put in, you know 
IPIPK. 

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She also had nails that she 
wanted done and she wants to 

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come back for to see Marjorie, 
my nail tech. 

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And then she also has right 
plantar fasciitis. 

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So we did the X-rays. 
We and we did the the Pelto 

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special, which is the night 
splint, the foam rolling in the 

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morning stretch along with the 
icing and the anti inflammator. 

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I'm going to see her back in 
three weeks and see how she's 

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doing. 
And then finally we had a 

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patient that a 37 year old for a
right hallux Ind. 

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So we did that. 
That was the day. 

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So it's kind of a busy afternoon
after my surgery, but my kind of

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my big accomplishment was making
that Facebook ad, which was 

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very, very uncomfortable. 
I would love to know if anyone 

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is really great at ads and how 
they're working for you. 

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I know there are certain people 
that have courses and things 

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like that. 
I, I really just tried to muscle

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through it my first time. 
I just kind of have to figure 

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out, I know I could pay others 
and I have paid others to do 

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them in the past, but I kind of 
want to figure it out. 

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So I, I, and then maybe at once,
I understand a little bit. 

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I don't mind paying someone to 
do it, but right now I just want

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to kind of figure it out. 
OK, well, I'll talk to you guys 

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tomorrow.