Vestibular, ocular, autonomic and dizziness issues, exam findings and rehab with Carlo Rinaudo DC PhD (cand). Managing spinal and MSK conditions with chiropractic and how vestibular rehab affects the nervous system, plus we talk about neuroConnect. I didn’t know this but in Australia the term Dr is reserved for medical doctors and all others, even...

Mouth breathing can lead to orthodontics, malformed palettes and sleep apnea. Discover what myofunctional therapy is and how proper tongue placement and breathing can counteract it. Sarah Hornsby discusses business and myomentor to help others succeed. As a dental hygienist she realized she could not do this for 30 years and while exploring myofunctional Therapy...

Cash practice marketing has unique challenges, continuity programs, considerations to purchasing a clinic or starting fresh, leadership hurdles and Dr. Joseph Simon physical therapist explains why you need a coach and perhaps his 9 step program. Dr Joseph Simon of Private Practice Business Academy teaching Doctor of Physical Therapists and alternative health care doctors about...

Dr. Joseph Simon, DPT talks to Dr. Justin Trosclair DC on A Doctor's Perspective Podcast

Cash practice marketing has unique challenges, continuity

programs, considerations to purchasing a clinic or starting fresh, leadership

hurdles and Dr. Joseph Simon physical therapist explains why you need a coach

and perhaps his 9 step program.

Dr Joseph Simon of Private Practice Business Academy teaching

Doctor of Physical Therapists and alternative health care doctors about

automation, systems and marketing.  He

starts the podcast with a bit of background and practice and home tragedy via a

hurricane on top of spending too much money on bad advertising that left him

over $150,000 in debt in 3 months. How did a text message flip the switch to

taking consulting more serious during this troubling time?

At the same time of hiring a $6000 a month marketing agency he

hired a $15 hour person doing what Dr. Simon already was previously doing…

which had better results after three months?

Can a physical therapist make it as a cash practice or should

they stay in their lane and just get referrals from primary care and orthopedic

doctors?

His system relies on a 9 Step Process (especially cash

practices) and he talks about parts of that on the interview.

For those PT’s who don’t have direct access to patients, he

gives a little details on how to still market the same way but to have your own

medical doctor you refer to to get that necessary referral.

Can you take a HMO clinic and switch to Cash only? You need

Income Statement, Balance Sheet, and Cash Flow Statement. Can the current staff

handle the transition?

What are his thoughts on having the original clinic owner

stay on for a period of time for a more smooth transition? Spoiler, it was a

surprising answer for me.  What are his

tips to retain a patient base during a buy out?

Would you rather pay for goodwill, an email list, an actively

engaged email list or well trained staff and systems?

Considerations to starting your own practice from scratch

instead of the complexity of buying an established clinic.

What has Dr. Joseph found to be a reliable continuity program for doctors especially a cash practice? How does a concierge practice work or a gym within a gym or a workout bootcamp?  Is the point of these for profit or constant contact?

We need to market: facebook, youtube, google, internal

referrals… what does he recommend?

#1 IDEA for Internal Marketing: What gifts should can you/

should you give to the patient? Should be it be full of your logo or customized

with their name?

What’s a potential value amount to spend on custom gifts?   

How much should you budget for marketing per year?

Top 2 issues clients struggle

with:  Leadership and Systems of a

Practice

 Why are most issues

that come up in the office really your fault and how do you start accepting

that as reality instead of blaming others?

Kids have coaches and parents to teach and help you, why don’t

we hire coaches to help in business as doctors?

How to tell when you have out grown or outpaced the coach you

hired and you need to upgrade?

Dr. Joesph has a 9

Step Formula for doctors who are “making it,” in practice 4-5 years and looking

to expand.

Becoming a cashPT clinic has hurdles. Dr. Aaron LeBauer DPT discusses creating a fair fee, why not take insurance, onboarding and  training staff, answering the phone, discounting services, handling objections and his favorite seminars. His backstory involves learning the limitations of his massage therapy offerings and realizing very early on in clinical rotations that he...

Dr. Erson "Dr E" Religioso III DPT talks to Dr. Justin Trosclair DC on A Doctor's Perspective Podcast

Becoming a cashPT clinic has hurdles. Dr. Aaron LeBauer DPT discusses creating a fair fee, why not take insurance, onboarding and  training staff, answering the phone, discounting services, handling objections and his favorite seminars.

His backstory involves learning the limitations of his massage therapy offerings and realizing very early on in clinical rotations that he did not want to see 43 patients per day. That was his big revelation that he can do physical therapy treatment on his terms, give the patient the best of his time and efforts, not play the insurance game and just accept high end cash  rates. After being in the trenches and learning and having coaches of his own, he packaged what he has learned and now offers CashPT © coaching for others looking to break free from insurance and practice exactly the way you want to.

When you get paid $43 from insurance regardless of how long you  treat the patient or what actual treatment

you give to satisfy the code, on top of being used to making $85 for an hour 1

on1 as a massage therapist… Dr. LeBauer decision to go cashPT was practically a

given.

How do you handle the caller that asks "do you take my

insurance?"   What are the 2 reasons why a potential patient

would ask about insurance to begin with?

Do you discuss fees on the phone if they ask? How do you build value on the

phone so they come in for a consultation and exam -  knowing that they will pay cash?

Acknowledge the objections and redirect with questions to determine the

deeper why they want physical therapy, the motivation to seek treatment now

instead of earlier and what is actually wrong with you.

Why are patients referred by a medical doctor some of the hardest patients

to pay cash for services?

What questions can another physician ask a physical therapist to see what

kind of treatment they will provide your patients? Joint restriction, soft

tissue restriction or motor control problem with treatment like manual therapy,

exercises and patient empowerment.

PICKING A FEE

How do you pick a cash fee? Do you pull a number out of the sky, is there a

formula, does the size of the town and median income play a part, can you over

price yourself or is it just undervaluing your service?

If you charge a high fee per hour, what happens when the patient only needed

38 minutes that day? What ethical dilemmas can surface from that type of

payment model?

Should you charge a case fee: for example, headaches cost XYZ? Can the same

condition be a different fee from person to person or does it need to be

uniformed?

How do you charge for Results?

What about a unique cashPT fee amount for each individual person for their

unique condition? This fee could be $2500 and you might recommend it will take

7 visits to get better… so what happens if they aren’t better by 7 visits? Or

maybe they got better in 4 visits.. What do you do then?

Can you believe that with only 9 patients a week you could earn $100,000?    What are some of his go to formulas to help

doctors establish a fee schedule?

Does the doctor or a dedicated person “close the deal?” Is it better to have

a patient pay per visit or commit to 8 visits and spread the payments out?

Can you discount too much for a prepay?

Cash practice PT physical therapy: learn about fees, location, marketing etc. Dr. Erson Religioso III talks about his EDGE mobility IASTM tool, BFR cuffs, using G suite as EMR and new trends and topics about modern manual therapy and mobility. We start with some pet peeves with chiropractic and physical therapy but mostly dispelling some...

Dr. Erson "Dr E" Religioso III DPT talks to Dr. Justin Trosclair DC on A Doctor's Perspective Podcast

Cash practice PT physical therapy: learn about fees, location, marketing etc. Dr. Erson Religioso III talks about his EDGE mobility IASTM tool, BFR cuffs, using G suite as EMR and new trends and topics about modern manual therapy and mobility.

We start with some pet peeves with chiropractic and physical therapy but mostly dispelling some of the negative stereotypes that we each have heard about the other. Then we dive deep into cash practice as a physical therapist.

He was 12 years as a insurance provider but for the past 8

years he has been cash pay.

As a cash practice PT Do you drive around the city, work at a gym, rent space in someone's office? What tends to work best to not only keep overhead low but provide an excellent service for your patient? Do you need 1500 sq ft and 5 staff? Instead of driving around all day, can you do telemedicine with skype or facetime?

Part of the reason he is on the podcast today is to talk about the products he created and the seminars of manual therapy that he teaches and it’s because of these ancillary services he was able to drop HMO plans and go cash without stressing about finances.

How do you handle all the scheduling, billing, website and marketing as a one doctor show?

Part of the allure of cash practice is to charge what you want and spend as much time as you want with patients. When you charge $125-300per hour, what happens when after 37 minutes the patient has made all the progress they could that day? Listen to Dr E’s novel approach to avoid this potential ethical dilemma. Also he touches on canceled appointment, which really matter when you only do 1 on 1 sessions not 4 people per hour.

Great pointers on time blocking to be more efficient and with six kids, he has tested his theories regularly.

How do you answer the question: do you take my insurance?  His answers leads into, why do direct marketing versus relying on medical doctor referrals.

Goal of manual therapy is to make nervous system to accept load and move threat free.

We discuss his theory on keeping the therapeutic benefits window open longer by doing better home programs as well as why he has changed his tune from IASTM needing to bruise you to a Light Touch accomplishing the same goals. Another concept, home exercises done longer than we would normally expect at one time. It challenges the body but not to the point over doing it.

Manual therapy that is safe and nearly Pain Free – what a novel concept. IASTM tools you are not deforming the fascia so no need to put more pressure that a dog licking you.

Most manual therapy works in the short term, but what works for the long term because we know it’s not really mechanical but is it more neurological?

Why is placebo so strong and how can that simple stimulus still get people to feel better?

Why is it that Trigger Points seem to feel bigger with our fingers than they actually are?

 EDGE SuspensionTrainer: Allows you to do different angels and change the intensity of different exercises by having one extremity suspended in air.

EDGE Mobility

Tool: his myofascial IASTM tool

 EDGE Restriction System BFR (blood flow restriction) Cuffs: a research b...

Tongue tie surgery, frenuloplasty,what is it, how can it cause headaches, forward head posture and poor sleep. Wetalk airway obstruction -how a dentist can help, why use mercury free fillings, root canal danger and DTR. Dr Allen Sprinkle DDS What is TruDenta and why does he prefer the DTR (disclusion time reduction therapy) instead for...

Dr. Allen Sprinkle, DDS talks to Dr. Justin Trosclair DC on A Doctor's Perspective Podcast.

Tongue tie surgery, frenuloplasty,what is it, how can it cause headaches, forward head posture and poor sleep. Wetalk airway obstruction -how a dentist can help, why use mercury free fillings, root canal danger and DTR. Dr Allen Sprinkle DDS

What is TruDenta and why does

he prefer the DTR (disclusion time reduction therapy) instead for bite

disturbances?  Two techniques to help

determine how you are biting, where is the pressure, how is the pressure

transferred between each teeth  and then

you can make dental recommendations based on the results.

DTR has true implications for

TMD TMJ problems but yet only 2% of the dentist have this technology, why is

that?

Can improper crown fittings

create bite disturbances?

Posterior teeth have peripheral

nerves and if they have too much friction when chewing it can create a

hyperactive impulse that goes straight to the trigeminal nucleus instead of

going to the spine first so you get even more tension and grinding.

Dr. Spinkle discusses in detail

about the important of a baby sucking their thumb in helping shape the arch of

the palate. Then he goes into how malformations of the palate arch can turn

into breathing and airway obstructions.  V shaped palates, narrow nasal passages, mouth

breathing, Eustachian tube blockages, ear infections, headaches and possible

even personality changes.

If you have a tongue tie (frenulum)

where you can’t lift your tongue very high or stick your tongue out past your

front teeth, it can lead to even more issues. Our body adapts to not having

clear air passage by giving shots of adrenaline and the body recognizes it

needs more air so one of the side effects is forward head posture.

Dr. Spinkle specializes in

releasing the tongue tie (frenotomy) via surgery. After a tongue tie release he

sees patients have improved posture and patients report headaches and tension

in their neck and pressure in their head almost immediately improve as well as

one patient whose stuttering ceased.  He

tells a few patient success stories with the tongue tie release procedure.

Tells several powerful stories

that might even seem to good to be true about the results of a tongue tie

release.

Reasons why chain smoking and

nail biting might be an indication of a chronic partially obstructed airway.

Mouth breathing can lead to

cavities, gum disease, clinching and grinding. This also leads to poor

breathing habits.

Tongue tie surgery can be called:

functional ankyloglossia, lingual frenuloplasty, frenotomy

Before you do the surgery, it

is a good idea to do myofunctional therapist for tongue exercises from an

expert, think special trained physical therapist.

Does he have to redo any

surgeries, does scar tissue play a factor in long term results?  Headaches and muscle tension relief are two

common results from the frenuloplasty (tongue tie surgery).

* Listen

about 32 minutes in and you can find out what to Look for in an exam to if a

patient might have a tongue tie. Step by step exam as well as questions to ask.

Why did he decide to become a

Mercury Free dentist? Mercury is the second most neuro toxic chemical to a

human so why is it allowed in our teeth and does it leak out and cause d...