Managing Complex Podiatry Cases and Scaling Your Practice

Hi Don here. Welcome to Podiatry Practice Mastery where we're helping you bring your practice to the $1,000,000 mark and beyond in your individual production. This is a recording of a Thursday here in the office. OK, so first patient was a matrix follow up.

They also had some peroneal tendon pain. That's why I did this follow up. So usually it's a three-week follow up. I'm starting to use these in 10 minute slots versus the 20 minute slot. But this is a quick follow up. She's doing fine. Her proneal tendons are doing fine. Next patient came in, she had a painful neuroma and we did staff did an X-ray, we did a ultrasound, and we did a neuroma injection for this patient. She'll follow up as needed if

needed for that. Next patient was a 42 year old. She had Achilles tendonitis. She's going to do the initial treatments, foam rolling, morning stretch, shoe changes, things like that. If it's not better in three weeks that I discussed with her about doing an ultrasound and doing shockwave. She did not jump directly to

shockwave because she really hasn't had pain that long. It's only been about 3 weeks. Next patient was a 14 year old, came in, brother and sister. They both got matrixectomies, left toes, both edges, both of them. So I did both of them. Next was a 68 year old female

plantar fasciitis. They did a foam roller morning stretch and she'll be coming back in three weeks to see how she's doing with that anti inflammatories.

Next patient was a 34 year old guy. He came in for a wart that's been there for years. He did #3 out of 3 for swift, it's totally gone. So I'm not doing the 4th one that I usually do a Swift. I'm going to do a three a three month follow up in a 10 minute slot. Next patient was a three-week matrixectomy follow up. She's doing fine.

Next patient was a patient with some FHL kind of pain, tendonitis, 71 year old kind of pain, a little bit distal to the kind of the heel kind of arch region, and in that I did was proximal to the first Med head region, kind of weird type of a

pain. So I did an ultrasound guided cortisone in that area to see if it'll kind of calm it down for him. So I'm going to see it back as needed. Next patient is 69 year old E pad follow up. Her heel is doing much better. She did have a neuroma on the right third and I did an ultrasound guided cortisone for her.

She's going to follow up as needed. Next was a 62 year old. She had a lateral heel pain which is not all that common, but there was really no medial heel pain. So we did the Pelto special night. Spent foam rolling, morning stretch, cortisone injection laterally with ultrasound.

There was some thickness and that. And also she was a patient that I saw her a while back and she did bilateral ANI fixes and it's been about nine months since I seen her and her nails look really, really good. So she did it more because they were ingrown and a little onycholytic and they're looking good now. So I took off those ANI fixes. So they usually don't last that

long, but hers did. I don't do a ton of ANI fix. I'd love to know if someone else does a lot more than I do. I do it occasionally for patients, but I'm tending to still do the the procedures versus the the little pieces of plastic thing I put on the toes. Next patient was a 64 year old Achilles tendonitis Aquinas shoe recommendations Pelto special, which is night splint, morning stretch foam rolling anti-inflammatory shoes. She'll be back in about 3 weeks,

if not better. We'll go ultrasound and then shockwave. Next patient was this is a patient. This is kind of the stressful one of the day. She tried to call multiple times in the morning, didn't get through, went to voicemail, right. And then it transcribes and their staff never got back to it for a couple of hours.

And so did she did come and I have Holst her toenail. She's going to go on vacation tomorrow. She needed to be seen. And unfortunately, this is the challenge we're having. And actually the real challenge is that I think I told you, my staff are turning down the phones so they don't want to answer the phone. So they're turning them down. It's not a good solution, but they it bugs them too much, they say when they're with other patients, but we're like, how do you how do you do this?

So one of the solutions is we might not have enough staff answering the phones in busy times. So we're going to have a virtual assistant, we're training them right now. They're going to be answering the phones, but they're also going to be answering all these like virtual messages as well. Next patient was a 29 year old.

She had, she's a rock climber and she had a fall and kind of impact pain. And so she has pain around a subtalar joint. Nothing really showed up on X-ray, but I'm going to get an MRI to see if there's any bone marrow oedema in that region. Next patient was a Lamisil follow up. She's doing fine in her toenails. No need for follow up for her. Next was a patient that I did Kantharadin on and she wanted to know something else you could do.

So for her I gave her a Nyquil mod as a prescription as well so I added that on. Just give another office visit. With that. I tend to do combination, so something topically like Kantharadin along with something topically. Just let the patients feel like they want to do something. So I did that. Next patient was a 52 year old that had a tineopedis. I did ketoconazole and I'll follow up with them as needed. Next patient was a gout follow up. I did a cortisone injection about 3 weeks ago.

He's feeling much better, really happy. Next patient there are a couple of other patients. So there's one patient that interesting he had before an exhaust ectomy, exhaustosis between the 4th and 5th toes before he had a callus. This time he didn't but when I fell between the head like an in duration of skin. So I explained again, the anatomy, the need to potentially take out that bone, the 5th, the proximal failings of the 5th digit. He didn't want to do that.

He's been doing anatomic shoes and kind of lamb's wool. He's been doing better with that. But he is now he is, he's, he's feeling better for that. So that was kind of the, the day I'm still kind of working on and I mentioned before kind of utilizing my time in the office to make YouTube short videos. So, so short videos, one minute

videos are like 1 to 2-3 minutes for YouTube shorts. And then I'm they're, they're working well. My staff is, or my virtual assistants are putting them up on YouTube, but I'd like to repurpose them to like Facebook, Instagram, other places like that. I'm not doing that currently. I would love to know if anyone else is doing that. If you're getting success and getting patience in that way, that's something I'd like to do.

So I'd love to know and if also if someone is really good at doing ads and stuff like that, I'd like to learn a little bit more about that. I'm, I'm kind of following this

Alex Hermosian. I feel like to fill up the, the, the, the new Doctor, I'd like to do more ads to get patients in. My struggle right now is if, if they're not answering the phones and I'm going to be paying for ads, then I'll be just be ads. I'm paying for that they're not answering the phone. So I feel like I have to fix this phone thing first. OK, you guys have a great day. Shoot me an e-mail don@podiatrypracticemastery.com if you have any great ideas, tips. OK, till next time.