Managing VAs, Patient Recall, and Treatment Acceptance

Description

Are your virtual assistants actually producing value—or just filling hours?

Many practice owners turn to virtual assistants for marketing and administrative help, but managing them effectively can be a challenge. When work is billed by the hour, tasks can expand to fill the available time, making it difficult to control costs or ensure meaningful results.

In this episode, Don shares lessons from managing virtual assistants by shifting from hourly expectations to task-based assignments. He also discusses practical patient recall strategies, the role of automation in reactivating past patients, and a communication framework that improves patient acceptance for higher-value treatment plans like shockwave therapy.

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Timestamps

[00:00] The Problem With Hour-Based Virtual Assistants

Why VAs often expand work to fill the number of hours allocated.

[00:50] Moving to Task-Based Management

Assigning specific deliverables with defined time limits to prevent time bloat.

[01:50] Examples of Task Allocation for Marketing VAs

Weekly newsletters, SEO page updates, ad monitoring, and call tracking.

[03:05] Using Automation to Recall Patients

How ModMed’s Clara helps follow up with patients who miss appointments.

[04:05] Combining Clara With Additional Recall Systems

Using automation tools to continue follow-up once the EMR recall system stops.

[04:50] Identifying High-Value vs. Low-Value Appointment Slots

Structuring the schedule to prioritize higher-value visits.

[05:40] Creating 10-Minute “Buffer Slots”

Using shorter appointment slots for quick visits or patients likely to cancel.

[06:20] Using Newsletters to Reactivate Patients

How regular email communication occasionally brings former patients back.

[06:55] Why Manual Recall Systems Are Labor-Intensive

Staff-driven recall processes require significant time and organization.

[07:30] Exploring Automated Recall Platforms

How tools like Banzai can automatically identify and contact inactive patients.

[08:05] Improving Patient Acceptance With Better Communication

Using future pacing and good–better–best treatment frameworks.

[09:00] Presenting High-Value Treatment Plans

How to introduce comprehensive treatment packages like shockwave, injections, and orthotics.

[09:40] Avoiding Discounts While Adjusting Treatment Plans

Instead of discounting, remove components from the treatment package.

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Key Takeaway

Managing systems—not just people—is critical in practice growth. Whether working with virtual assistants, scheduling patients, or presenting treatment plans, clear structure and automation help reduce wasted time while increasing practice revenue.

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Conclusion

What systems are you using to manage virtual assistants or reactivate patients in your practice?

If you’ve implemented automation or structured workflows that improved efficiency, share your experience. Conversations like these help practice owners refine the systems that drive growth.

Unlocking Revenue Hidden in Your Patient List

Description

Are you sitting on thousands of past patients who could come back—but never do?

Most practices focus heavily on attracting new patients, yet the biggest opportunity often lives inside your existing patient database. The challenge is figuring out how to reactivate those patients without overwhelming your staff with manual phone calls and recall lists.

In this episode, Don breaks down the systems he has tried to bring past patients back into the practice—from email newsletters and manual recall lists to a new AI-powered platform that automates patient reactivation. He explains how the system identifies inactive patients, launches targeted outreach campaigns, and automatically drives them back to online booking—turning your EMR into a powerful revenue engine.

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Timestamps

[00:00] The Challenge of Reactivating Old Patients

Why most practices struggle to generate revenue from their existing patient database.

[00:45] Email Newsletters That Bring Patients Back

How a weekly email newsletter keeps patients engaged and occasionally drives appointments.

[01:35] Tracking Calls From Email Campaigns

Using dynamic phone numbers to track which patients return from email marketing.

[02:05] The Traditional Manual Recall Method

Pulling lists from the EMR and having staff call patients for follow-ups like diabetic care or DME.

[03:00] Why Manual Recall Systems Often Fail

The operational challenges of organizing lists and assigning staff to make recall calls.

[03:40] Discovering an Automated Reactivation Platform

Introduction to the company Banzai and how it integrates with EMRs like ModMed.

[04:30] The Background Behind the Platform

Built by the creators of PatientPop, which previously focused on generating new patient reviews and leads.

[05:25] How Automated Patient Reactivation Works

Using AI to analyze your database and launch automated campaigns to bring patients back.

[06:15] Examples of Reactivation Campaigns

Shockwave follow-ups, orthotics recalls, or patients who haven’t been seen in over a year.

[07:00] Automated Messaging Cadence

How the system sends a sequence of texts and emails over several weeks to encourage booking.

[07:35] Rebooking No-Shows and Cancelled Patients

Automatically reaching out to patients who missed appointments if staff cannot reach them.

[08:00] Understanding the Revenue Opportunity

How the dashboard estimates potential revenue from inactive patients in your database.

[08:20] Pricing and Return on Investment

Typical pricing structure and why many practices recover the cost quickly.

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Key Takeaway

Your patient database is one of the most valuable assets in your practice—automated reactivation systems can turn inactive patients into a consistent source of revenue without adding staff workload.

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Conclusion

Have you implemented any systems to reactivate patients from your database?

If you’ve found a strategy that works—or if you’re exploring automation tools like this—share your experience. Conversations like these help practices uncover new ways to grow using the patients they already have.

Simplifying Shockwave Pricing in Your Practice

Description

How should you price shockwave therapy if your practice already offers laser treatments?

Many podiatrists successfully implement laser therapy packages but run into confusion when adding shockwave therapy. Should the treatments be offered separately? Should the pricing change? And how do you keep it simple for patients and staff while still reflecting the value of the treatment?

In this episode, Don walks through a practical approach to transitioning from laser-only packages to regenerative treatment bundles that include shockwave. He explains how he structures visits, when he charges for office visits versus procedures, and how ultrasound imaging helps patients understand why shockwave therapy is recommended.

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Timestamps

[00:00] A Question About Transitioning to Shockwave

A podiatrist asks how to introduce radial shockwave therapy when she already offers a six-treatment laser package.

[00:50] Combining Laser and Shockwave Into One Package

Why bundling treatments into a single regenerative package can simplify patient decision-making.

[01:40] Example Pricing Structure

Charging $250 per session and building a six-session regenerative package around that model.

[02:30] Avoiding Confusing Pricing Options

Why offering laser and shockwave separately can create unnecessary complexity for patients.

[03:10] Should Shockwave Be Discounted With an Office Visit?

Some doctors bundle procedures into office visits, but Don explains why he prefers keeping them separate.

[04:05] Structuring the Shockwave Treatment Plan

Initial evaluation, follow-up imaging, weekly treatments, and the final visit that reviews the next steps.

[05:00] Weekly vs. Every-Two-Week Shockwave Protocols

A discussion of alternative treatment schedules used by some physicians internationally.

[05:40] Delegating Shockwave and Laser to Staff

How training staff to perform treatments can improve efficiency in the practice.

[06:10] Using Ultrasound to Guide Treatment Decisions

Why ultrasound imaging helps reveal tendon pathology that patients cannot see externally.

[06:50] Ultrasound Billing Strategy

Charging per foot once for ultrasound and using it primarily as a diagnostic and educational tool.

[07:10] Typical Patient Workflow

First visit X-ray, second visit ultrasound, then deciding whether shockwave therapy is the appropriate treatment.

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Key Takeaway

When introducing shockwave therapy into a practice that already offers laser, simplify the decision for patients by bundling regenerative treatments into one clear package and using ultrasound imaging to guide and justify the treatment plan.

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Conclusion

How are you pricing regenerative treatments like laser or shockwave in your practice?

If you have a system that’s working well—or if you’re trying to figure out how to implement one—share your experience or reach out to continue the discussion.

Most Valuable vs. Least Valuable Patients

Why are some pods stuck below $1M despite working nonstop?

In this episode, Don reviews a recent run of patients and categorizes them into “most valuable” and “least valuable.” The difference isn’t about patient importance—it’s about revenue structure, service mix, and scheduling strategy. Certain visits generate only an X-ray follow-up. Others represent 5–15x the revenue of a standard office visit.

If you want to understand why some practices accelerate toward $1M–$2M while others stall, this breakdown makes it concrete: fracture follow-ups, routine rechecks, and low-yield visits must be scheduled differently than shockwave packages, orthotics, DME, and injectables.

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Timestamps (Total: 6:44)

[00:00] Why Patient Mix Matters

Not all visits generate equal revenue—understanding the difference is key to scaling.

[00:40] Least Valuable Example: Fracture Follow-Up

Initial fracture care pays well, but 4-week follow-ups often produce only an X-ray. Solution: limit visits and double-book into 10-minute slots.

[01:25] MVP: Lipazana Injection

$1,500 fat pad replacement—high-value, easier to explain than some biologics, strong candidate selection.

[02:05] MVP: Bilateral Lunula Laser + Fungal Kit

$1,500 laser plus $200 dispensing kit—bundling increases case value.

[02:40] MVP: Bilateral Plantar Fasciitis with Equinus

Two night splints, foam roller, structured dispensing—maximize bilateral opportunities.

[03:15] Shockwave Strategy Shift (3 → 6 Treatments)

Six sessions improve compliance, keep care in-house, and prevent PT from “getting the credit.”

[04:00] MVP: Shockwave + Orthotics Combo

Midfoot arthritis and plantar fasciitis cases combining packages for stronger outcomes and revenue.

[04:45] Lipazana #2 and Advanced Cases

Repeat high-value procedures for heel fat pad atrophy and post-surgical patients.

[05:20] Least Valuable: Post-Op and Stress Fracture Rechecks

Often limited to imaging reimbursement—schedule efficiently.

[05:50] MVP: DME and Balance Braces

Repeat DME (every 5 years) significantly boosts revenue and long-term patient value.

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Key Takeaway

Scaling your practice isn’t about seeing more patients—it’s about structuring your schedule so high-value services (DME, packages, injectables, shockwave) drive revenue while low-value follow-ups are compressed efficiently.

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Conclusion

Audit one week of patients and classify them: MVP or low-yield. Then restructure your template—double-book follow-ups, protect 20-minute revenue-generating slots, and build packages around high-impact treatments.

Your path to $1M–$2M isn’t volume alone—it’s intentional case mix management.

Late-Career Moves That Actually Increase Profit

You’ve got 5–10 good years left—how do you grow without wasting money or energy?

In this episode, Don answers a series of tactical questions from established podiatrists who want stronger profitability, better positioning, and more control over their schedule. From restructuring routine care to improving Google reviews, raising orthotic prices, and evaluating marketing vendors, the theme is clear: systems—not hustle—drive the next level.

If you’re in the back half of your career and want to work less while earning the same (or more), this episode lays out practical first moves that don’t require massive reinvention—just disciplined restructuring.

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Timestamps (Total: 10:13)

[00:00] Back Half of Career: First Three Moves

Block low-value visits into one day, consider hiring a scribe, and double down on services you enjoy and that produce revenue.

[01:25] Closing the Google Review Gap

High-review competitors win because of process. Use QR cards or automated systems (e.g., Swell) to consistently request reviews.

[03:00] Why Reviews Matter for Referrals

Patients and referring providers check reviews—volume signals credibility.

[03:40] Competing with Retail Insert Stores

Study their presentation model. Use dynamic demonstrations (gait review, imaging, education) and confidently prescribe orthotics.

[05:10] Pricing and Belief in Orthotics

If you’re charging $350, reconsider your pricing and your confidence. Strong presentation + belief reduces returns and increases acceptance.

[06:40] Evaluating a $400/Month Marketing Company

At that price point, expectations must be realistic. Ensure basics are done first: Google Business Profile, SEO, email list, tracking numbers—before running paid ads.

[08:00] Transitioning Away from High-Volume, Low-Pay Work

Block routine care, reduce low-value follow-ups, increase per-visit value with procedures, DME, and packaged services.

[09:05] Working Less While Making the Same

Opt out of low-paying insurance plans, tighten scheduling, protect 20-minute high-value slots, and intentionally take time off.

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Key Takeaway

If you want your final 5–10 years to count, don’t overhaul everything—tighten your schedule, increase per-visit value, systematize reviews and marketing, and eliminate low-margin distractions.

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Conclusion

If you’re aiming to work less but earn more over the next five years, start with one structural shift: block low-value care, upgrade your review process, or reassess your payer mix.

Small operational discipline compounds fast—and in the back half of your career, that leverage matters most.

Niche Down Without Losing Revenue

Everyone says “niche down”—but what if 80% of your schedule is routine care?

In this episode, Don answers a practical question many podiatrists face: how do you transition from a generalist, routine-care-heavy practice into a more profitable niche without blowing up your schedule?

He outlines two paths. First, make routine care more profitable by expanding services around those patients. Second, strategically reduce routine care through block scheduling and focused marketing. The key isn’t abrupt change—it’s structured transition.

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Timestamps (Total: 4:37)

[00:00] The Niche Dilemma

When most of your schedule is basic foot care, how does specialization realistically happen?

[00:40] Option 1: Make Routine Care More Profitable

Expand beyond nails: compression garments for edema, ABIs, annual diabetic foot exams, Onyfix, KeryFlex, matrixectomies, orthotics, and fat pad injections.

[01:45] Gradual Integration Strategy

Introduce higher-value services slowly within your existing routine-care base.

[02:15] Option 2: Reduce Routine Care Strategically

Block routine visits into one dedicated day or half-day (“Toenail Tuesday” model).

[02:50] Control Your Marketing Message

Advertise only what you want to see—plantar fasciitis, Achilles tendinitis, shockwave, orthotics—on your website, blog, and in-office materials.

[03:25] Make Low-Value Visits Less Convenient

Reduce unnecessary follow-ups (paronychia, matrixectomy, fracture care) and tighten post-op scheduling.

[04:00] Use Freed Time Intentionally

Spend more time on higher-value conditions, increase DME dispensing, and build systems around services you enjoy and that grow revenue.

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Key Takeaway

You don’t niche down overnight—you control scheduling, tighten follow-ups, expand services strategically, and market only what you want to see.

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Conclusion

If you’re stuck in a routine-care-heavy model, choose one lever this month: block scheduling, service expansion, or marketing repositioning. Small structural changes compound over time.

If you want the full framework for transitioning toward a $1M practice, review the Million Dollar Practice Formula and start implementing step by step.

Adding Fat Pad Injections to Your Practice

Do you have patients with painful fat pad atrophy who aren’t improving with pads and orthotics?

In this episode, Don shares his first experience using Leneva (fat pad replacement injectable) for a patient with severe forefoot fat pad atrophy. After hearing about it at a recent conference, he implemented the treatment in-office—complete with consent workflow, storage protocol, injection technique, post-op plan, pricing strategy, and marketing rollout.

This is a practical breakdown of how to evaluate, introduce, and operationalize a new regenerative-style offering—from patient selection to filming a YouTube explainer. If you’re considering adding higher-value procedures to better serve chronic pain patients, this gives you a real-world starting point.

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Timestamps (Total: 5:48)

[00:00] Why Consider Fat Pad Replacement?

Managing painful calluses and fat pad atrophy when orthotics and pads fail.

[00:45] Discovering Leneva at Conference

Initial exposure, hesitation with similar products, and deciding to trial it.

[01:30] Office Setup and Financial Workflow

$500 deposit, ordering and freezing protocol, consent forms, and tissue documentation.

[02:10] Injection Technique Step-by-Step

V-block anesthesia, thawing and drawing with 18-gauge needle (noting 20-gauge may offer better control), retrograde injection technique, and even distribution under the metatarsal head.

[03:40] Post-Procedure Protocol

Sterile strip closure, offloading padding, surgical shoe, 3 days heel weight bearing, 2 weeks protected weight bearing, gradual transition back to shoes.

[04:30] Pricing and Case Selection

$1,500 per 1.5cc syringe; typically one per metatarsal head depending on severity.

[05:05] Marketing the Procedure

Recording a YouTube video using CapCut, uploading via Google Drive, adding subtitles, and educating patients through email outreach.

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Key Takeaway

If conservative care isn’t enough for fat pad atrophy, adding a structured, well-priced in-office injectable option—supported by proper workflow and marketing—can improve outcomes and elevate revenue per case.

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Conclusion

If you’re evaluating whether to introduce regenerative or specialty injectables, start with one diagnosis, build your consent and pricing structure carefully, and document the process.

Have you added fat pad replacement or similar procedures to your practice? Share your experience—what worked, what didn’t, and how patients responded.

Full Schedule, Flat Revenue? Fix Your Case Mix

Is your schedule packed with routine nail care—yet your revenue doesn’t match your effort?

In this episode, Don answers a question shared by Jim McDonald from Podiatry Growth: how do you shift toward higher-margin care without losing the steady income from routine visits? It’s a common challenge, especially for doctors inheriting established routine-care-heavy practices.

Don outlines a practical strategy: consolidate routine care into structured block time, then intentionally use the freed-up schedule for higher-value services, marketing, or new technology. He also explains how to ethically increase revenue per routine visit through appropriate exams, diagnostics, and in-office services—without abandoning that patient base.

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Timestamps (Total: 3:30)

[00:00] The Core Problem: Busy but Underpaid

A full schedule dominated by routine nail care that doesn’t translate into strong revenue.

[00:40] Strategy #1: Block Routine Care Into One Day

Designate one full day (e.g., Fridays) strictly for routine care to protect the rest of the week.

[01:30] Upgrade the Model: Add a Nail Tech

Transition from a full day to a half-day of routine care by leveraging support staff.

[02:00] Protect the Other Days for Higher-Value Care

Use open time for plantar fasciitis, advanced treatments, marketing outreach, or learning new technologies.

[02:30] Increase Revenue Per Routine Patient

Add appropriate services such as DME for wound care, ABIs for diabetic patients over 50, and annual foot exams to elevate reimbursement ethically.

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Key Takeaway

Don’t eliminate routine care—control it. Block it into dedicated time and intentionally build higher-value services into the rest of your week.

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Conclusion

If your schedule is full but margins are thin, restructure before you work harder. Choose one step this month—block scheduling, staffing support, or adding appropriate in-office diagnostics—and measure the difference.

If you’ve successfully shifted your case mix, share what worked.

Busy but Broke? Fix the Real Bottlenecks

Are you seeing 25–30 patients a day—and still not building wealth?

In this episode, Don shares a listener win from Australia using “Good–Better–Best” treatment sheets, then dives into a bigger issue: why some podiatrists producing $300K–$500K still feel financially stuck. The problem isn’t always volume—it’s structure, service mix, and scheduling strategy.

He outlines three practical levers: packaging treatment options to reduce decision fatigue, consolidating low-revenue routine care into dedicated blocks, and increasing in-house, revenue-generating services. He also shares a marketing update on urgent care referral postcards—and the importance of tracking every campaign with dedicated numbers.

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Timestamps (Total: 13:54)

[00:00] Listener Win: $1,600 from One Treatment Sheet

Jackson implements a Good–Better–Best format and closes a comprehensive $1,600 care plan.

[01:30] Three Treatment Sheet Models

Checklist prescribing, Phase 1/Phase 2 (insurance → non-covered), and Good–Better–Best packaging.

[03:30] Why Packages Reduce Decision Fatigue

Bundling services simplifies patient decisions and increases case acceptance.

[05:00] Busy but Broke: The $300K–$500K Trap

High daily volume doesn’t equal profitability—especially if everything is insurance-dependent.

[06:30] Strategy #1: Block Your “Low-Value” Visits

Consolidate routine nail care into a half or full dedicated day (e.g., “Toenail Fridays”) to protect higher-value clinic time.

[08:30] Strategy #2: Increase Revenue per Patient Ethically

Incorporate shockwave, orthotics, AFOs, regenerative options, in-house imaging, and other services instead of sending them out.

[10:40] Strategy #3: Tighten Follow-Ups and Use 10-Minute Slots

Reduce unnecessary follow-ups and book simple cases efficiently to free 20-minute slots for higher-value visits.

[12:00] Urgent Care Marketing Update

Distributing urgent care postcards to shoe stores—and the key lesson: always use tracking phone numbers to measure ROI.

[13:10] Final Encouragement and Sharing Wins

Invite listeners to share successful systems and marketing ideas.

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Key Takeaway

If you’re busy but not profitable, fix structure—not effort: package treatments, consolidate low-revenue visits, increase in-house services, and track every marketing initiative.

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Conclusion

What’s one bottleneck in your practice right now—case acceptance, scheduling, service mix, or tracking? Identify it, adjust one system this month, and measure the result.

If you’ve implemented something that worked, share it. Your win could help another podiatrist move closer to the million-dollar mark and beyond.

What $1M Providers Do Differently

How are some podiatrists producing $750K–$1M per provider—without working twice as hard?

In this episode, Don breaks down the practical differences between busy practices and high-producing ones. It’s not magic—it’s math, structure, and service mix. From daily visit targets to packaging protocols and opting out of low-paying insurance, he outlines the operational shifts that drive real per-provider growth.

He also answers a second key question: how do you evaluate whether adding cash services like shockwave will actually pay off? Don shares how to think through break-even math, leverage demos, and structure packages so new technology funds itself.

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Timestamps (Total: 8:10)

[00:00] The $1M Question

What are $750K–$1M providers doing differently day to day?

[00:45] Start With the Math

20–25 patients per day at ~$200 per visit = ~$4,000 per day → ~$1M annually.

[01:45] Separate Profitable vs. Non-Profitable Visits

Block routine care into a half day, double book strategically, and protect 20-minute higher-value slots.

[02:40] Add and Automate Services

Imaging (X-ray, ultrasound), in-office procedures, orthotics, DME, and dispensing should be systematized—not optional.

[03:40] Package Everything

Fungal kits, equinus kits, shockwave bundles, laser packages—reduce friction and increase case acceptance.

[04:45] Track Daily Production

Use a daily tracking sheet to monitor imaging, DME, procedures, dispensing, packages, and follow-ups.

[05:20] The Elephant in the Room: Insurance Mix

Opt out of low-paying plans that prevent sustainable margins.

[05:50] Adding Cash Services Without Fear

Use break-even spreadsheets, demo equipment (“puppy dog close”), and shadow experienced doctors.

[07:10] Simple Break-Even Thinking

Often one package per month covers the equipment payment—the rest is upside.

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Key Takeaway

High-producing practices don’t rely on volume alone—they optimize per-visit value, package services, automate imaging and DME, track metrics daily, and make disciplined payer decisions.

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Conclusion

If you’re stuck below your target revenue, don’t work harder—tighten your math. Audit your daily visit value, block low-margin care, package your services, and run the break-even numbers on one new technology this quarter.

If you want the framework Don references, download the $1M Practice Formula and start implementing step by step.