¶ Recording a busy Thursday: highlights and key takeaways
Hi, Don here, welcome to Padaya True Practice Mastery, where I'm trying to help bring your practice to the $1,000,000 mark and beyond in, in your, in your personal production in your, in your clinic. So I'm going to go over the day, this is a recording of a, of a Thursday and kind of some good and good and bad things here. OK, so first patient was a 37
¶ Arthroplasty post-op review and patient recovery progress
year old guy. I did arthroplasty 5th digits, I did it 1 foot and then like six months later I did the other foot. He's feeling much better with these and he so just kind of quick post op now. Luckily he I think he travelled afterwards. So he's actually at 92 days post op so I could actually do an office visit now. So usually post op windows are not quite that perfect, but this one was. Next patient was a 68 year old patient that had was it put on
¶ Managing Lamisil prescriptions and lesion destruction for IPKs
Lamisil? I put them on a prescription of Lamisil. They also had IPK. I did lesion destruction on that today and I did an office visit because I haven't seen them for a while. Next was a 42 year old. Same thing. Actually theirs was a wart. Sorry, there's a wart.
¶ Treating warts, tailor's bunions, and reviewing shoe options
This other one was a poro IPK. On the fifth met head, I did an X-ray and they also had a tailor's bunion and I kind of reviewed the kind of the cause of that.
¶ Improving staff efficiency with X-ray protocols
Anatomic shoes come back as needed. Now, one of the mistakes I've been finding, we have some new staff and a lot of times they're not doing X-rays. And So what happens if they get X-rays? It makes it much more efficient if they come in and ask hey should I get X-rays? Well no, I will see the patient first if I'm not doing anything and then you can get X-rays
after. But I try to have them always get X-rays before and I prefer them to err on getting them when they shouldn't versus not getting them at all. Next patient was AI removed pins from some hammer toes. He would have bunionectomy and hammer toes.
¶ Pin removal post bunionectomy and hammer toe surgery
So this is a post op one. We did X-rays for him. This was next one was a 69 year old. She is 4 out of four for non radial only shockwave for a fibula fracture. She's feeling great at 4 weeks and I'm actually in have her in a boot one more week and then transition her out of the boot. So I think that doing focused
¶ Using shockwave therapy for fracture recovery and faster activity resumption
shot or non radial shockwave because because we have both softwave and focus shockwaves we just call them non radial. I did softwave specifically for this one and she's feeling so much better at 4 weeks, reduce swelling, ready to go ride her horse again like she wants to. And I think it's speed up the recovery for this patient. So that's the reason for doing shockwave for fractures. Not that it, it might heal the fracture a little bit faster, but the return to activity is
quicker. She's super happy. She actually did a a video. So just so you know, I'm starting to do more videos these days. I use Submagic, so good testimonials on things that I want to put on my website, like we're doing a new web page on urgent care on our website. And so I'm getting videos
¶ Capturing patient video testimonials to enhance marketing
talking about, hey, I should have came to see you versus going just to the urgent care where it was a waste of my time. So she was really happy. So I'm going to put her this thing on the shockwave portion of our website. Next patient was a Q 10S, a number one for a diabetic patient. Next was a 71 year old female
¶ Starting Qutenza treatments for diabetic neuropathy
plantar FAS. She had a #3 out of 3 for shockwave. For some reason I only did 3 for her. I don't quite remember the initial conversation but I did plantar fashion Achilles. She also was scanned for orthotics today and I'm going to see her back at the orthotic follow up.
¶ Combining shockwave therapy with orthotics for plantar fasciitis
Next was a 12 year old little boy, flat feet rotted by his mom. Talked about custom orthotics for him and we did scan him for orthotics. So that was orthotic #2. Once again, my goal every day is to do 2 pairs of orthotics. At least that's why that was my second one. Next patient was another IPK and
¶ Custom orthotics for children with flat feet
I did lesion destruction on that. They're going to come back as needed. Next was a ankle sprain patient, 73 year old. We did an ultrasound. It showed some tendonitis to the dorsal foot region. So we're going to do PT for her and I talked about shockwave if it doesn't get better, but she's not in that much pain. Next was a 46 year old female.
¶ Managing ankle sprains with ultrasound and physical therapy
We did cortisone with an ultrasound she did not want. She went kind of like the least expensive types of treatments. She was seen like 6 months ago and just was kind of dealing with her plantar fascial pain. So we did cortisone for her and I'll see her back as needed. Next patient was a 71 year old.
¶ Affordable cortisone options for plantar fascia pain
He had pain to the second metatarsal head and I did a so this was a kind of a interesting one. I, I did cortisone. He kind of wanted cortisone plantarly to like the the I didn't go into the joint but
¶ Treating metatarsal head pain with plantar cortisone injections
plantarly. I did a cortisone for this one and I'm going to see him back in about 3 or 4 weeks. Next was a 69 year old with a infection that was sent over to the office for evaluation. He's already getting better.
¶ Handling paronychia infections and quick recovery tips
He had a paronychia to the base of the second base of the hallux and it popped on its own. The pus came out and he's feeling much better. Next was 1/5 digit medial aspect exostectomy. I did that in the office with a bone rasp that was probably the MVP patient. Like these things, flexortonotomies and these exostectomies and matrixectomies and all these things are really the most valuable patients for these little procedures in the office. They're really efficient and
they they do well. Next patient was a a 43 year old. They had a Lamisil booster. Next patient was a 27 year old that had bilateral plantar fasciitis. She got the foam rollers, bilateral ultrasound, bilateral X-rays, and I'm going to see her back in four weeks Now. Her fascia was not all that thick. So I think just the, the Aquinas was the dominant force for that. Next patient was a 64 year old female. This is one that I've been treating number six out of 6 for Shockwave for her peroneal
tendons. She also has some subtalar joint arthritis and I did a video for this one as well showing like the subtalar joint arthritis. The other doctor wanted to defuse it, but all all was hurting her was her subtalar, her peroneals. And so we did 6 sessions of shockwave. She's much better. She actually gave me goat cheese last time and so we made caramelized don't even goat cheese if you wanted to know what we did with that. And I thanked her for that.
And then next patient was a #3 out of 6 shockwave and then the last one was a this is one of my favorite patients. He is a type 2 diabetic that I amputated part of his hallux. But then he actually listened to me and did intermittent fasting and ketogenic diet. I used to preach that a lot to my patients and but he's been still doing OMD, which is 1 meal a day for his fasting and his A1C is like like around six
doing much better. And he's, he's a motivation now inspiration to me because he's doing so well. So that was the day I think those in office procedures were really the, the most beneficial ones and been doing well for the practice. So once again, if you guys have some great cases, send them, send them my way. I'll, I'll be happy to present them. If there's other things that you are doing that produce a lot of revenue and help you to get to the $1,000,000 mark, I'd love to
know what you're doing. OK, Shoot me an e-mail down at Podiatry practice master com or if you have any questions about things that we talked about it. Thanks.