Post 1 – Expanding Shockwave Beyond Heel Pain

When I first started with shockwave therapy, I only used it for plantar fasciitis, Achilles tendinitis, and a few forefoot conditions.

Over time, I expanded:

• Fractures – especially stubborn metatarsal stress fractures

• Nerve pain – like neuromas and dorsal cutaneous nerve entrapments

Key adjustments for nerve applications:

• Low energy settings (around 0.05 mJ/mm²)

• Focused head for targeted treatment

• Usually 3 sessions to start

This evolution came from years of treating the “usual suspects” and then realizing the same technology could help more complex problems.

Sometimes the best innovation in practice isn’t buying a new device — it’s learning new ways to use the one you already have.

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Post 2 – Why I Moved from 3 to 6 Shockwave Sessions

Early in my shockwave career, my standard was 3 sessions, then a follow-up.

The problem?

• Most patients improved around week 5… when they were in physical therapy getting the credit!

Now, I run 6 sessions for most soft tissue cases.

• Improvement starts around session 5

• I’m still the one monitoring and guiding the progress

• Patients see me as the one who helped them turn the corner

Lesson: Sometimes small protocol changes can make a big impact — not just on results, but on patient trust and retention.

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Post 3 – My “Sock Liner Test” for Nail & Toe Pain

Many toenail problems aren’t caused by fungus or trauma — they’re caused by shoes that are too small.

Here’s my quick in-office test:

1️⃣ Remove the sock liner from the patient’s shoe.

2️⃣ Place their foot on it.

3️⃣ If the toes go to the very edge, the shoe is too small.

This visual is powerful — patients see how cramped their shoes are.

It’s simple, memorable, and doesn’t require any special equipment.

Sometimes the most effective patient education tool is already inside their shoe.

In this episode of Podiatry Practice Mastery, I share my most recent Pocket Coach session — a behind-the-scenes look at how I’m structuring my time using Free Days, Focus Days, and Buffer Days based on my time in Strategic Coach.

You’ll hear:

• Why Free Days (bike rides, family weekends, screen-free time) are critical for renewal

• How Focus Days help me maximize revenue with high-value treatments

• The role of Buffer Days in cleaning up the past and building new capabilities

• My current quarterly, annual, and 3-year goals for practice, family, and personal health

If you’ve ever felt like your time is scattered, this framework will help you focus, recharge, and grow.

In this episode of Podiatry Practice Mastery, Dr. Don Pelto shares a behind-the-scenes look at his clinic day. From trying out Alleviate, a self-Graston-style tool for plantar fasciitis, to discussing shockwave therapy, OnyFix, and Charcot foot management, you’ll hear practical strategies, workflow pearls, and candid reflections on patient care.

Topics covered include:

• ​ Using Alleviate as a home-care option for plantar fasciitis patients
• ​ When shockwave delivers more value than softwave
• ​ Thoughts on doing in-house CROW boots for Charcot foot patients
• ​ Maximizing efficiency and profitability in post-op and fracture follow-ups
• ​ Clinical pearls for neuroma pain, nail avulsions, and regional pain syndrome

Whether you’re a podiatrist, resident, or healthcare professional, this episode gives real-world insights into treatment decisions, practice workflows, and the constant balance between clinical outcomes and business realities.

In this episode of Podiatry Practice Mastery, I break down my workflow for in-office skin and nail biopsies. Most doctors avoid them because they seem time-consuming, but with the right system they can be quick, efficient, and stress-free.

You’ll learn:

• How I stock every room for instant readiness

• The simple staff cue that makes the process seamless

• Why I numb first, then get consent

• How most biopsies take under 2 minutes start to finish

• When I schedule nail matrix biopsies separately

If biopsies feel overwhelming in your practice, this episode will show you how a small system shift can make them easy—and ensure you don’t miss critical diagnoses.

Today’s clinic day had a theme: lessons learned from cantharidin, shockwave, and the unexpected. After switching to a fresh batch of cantharidin, I was reminded that even small changes in potency can turn into weekend phone calls and hospital admits. It pushed me to rethink aftercare instructions. On the other end, shockwave patients reminded me how important it is to pair short-term pain relief with long-term biomechanical correction through orthotics. And of course, there were a few unique cases—a patient injured by aquasocks at an amusement park, a long-distance traveler seeking Onyfix, and even a pioneer of pickleball.

The through-line? Every product, protocol, and conversation shapes not only outcomes but also the flow of practice.

3 Takeaways for Colleagues:

• Be cautious when switching vendors or batches of treatment products (like cantharidin)—potency varies.

• Pair shockwave with orthotics to improve outcomes and reduce reinjury.

• Even routine cases (orthotic scans, fissure care, Onyfix follow-ups) are opportunities to streamline workflow and free up your schedule.

  
  

SEO keywords: cantharidin complications, plantar fasciitis shockwave, orthotics for heel pain, Onyfix podiatry, fissure treatment, podiatry workflow efficiency

Timestamps:

• 00:45 — Cantharidin complications and infections

• 04:10 — Shockwave + orthotics: combining pain relief with prevention

• 09:35 — The aquasock injury and lessons on footwear

• 14:20 — Ingrown toenail & Onyfix case from New Hampshire

• 20:05 — Neuropathy consult and Qutenza coverage struggles

• 27:40 — Shockwave for fracture nonunion

• 31:25 — Pickleball pioneer with tight Achilles

In this episode of Podiatry Practice Mastery, I share how adding a nail technician to my clinic has transformed patient care, boosted efficiency, and even improved patient satisfaction, all while giving me more time to focus on higher-value treatments.

If you’ve ever felt overwhelmed by routine care appointments or struggled to balance patient volume with quality care, this episode is packed with actionable insights to help you optimize your podiatry practice.

What You’ll Learn in This Episode

How hiring a nail tech improves clinic efficiency.

Why delegating routine care frees up my schedule.

How I manage patient expectations and preferences.

My workflow tips for smoother patient tracking.

Why You Should Listen

By strategically delegating tasks and building efficient systems, you can buy back your time, improve patient experiences, and scale your practice faster, without burning out.

Key Topics Covered

[00:01] Why my nail tech “makes me look bad”, a tongue-in-cheek intro

[00:19] Training challenges and finding the right team member

[01:08] Using scribes, techs, and systems for better efficiency

[01:56] Why patients prefer my nail tech, and how I handle it

[02:34] Legal considerations and scope of practice for nail techs

[03:26] Patient perceptions and scheduling preferences

[04:01] Sticky notes, flags, and systems to improve patient flow

[05:34] Afternoon cases: plantar fasciitis, night splints, and care kits

[06:25] Leveraging your nail tech for routine care and efficiency

[07:19] Managing Achilles pain and when to recommend shockwave therapy

[08:07] Qutenza applications and billing considerations

[09:06] Bilateral forefoot pain, treatment challenges, and FMLA discussions

[10:11] Upcoming six-month Podiatry Practice Mastery challenge

👉 Tune in now to discover how outsourcing, workflow tweaks, and smart delegation can make your practice more profitable, efficient, and patient-focused!

In this episode of Podiatry Practice Mastery, I answer a common question I get from other doctors: “How do you hit the million-dollar mark in your practice?” I break down the systems, strategies, and optimizations that have helped me consistently grow beyond $1M in collections, without working more hours or burning out.

From demand management to profit optimization, I share the exact steps I’ve used to structure my schedule, increase revenue per visit, and make the most out of every patient interaction while maintaining balance in both work and life.

What You’ll Learn in This Episode

How I optimized my patient schedule for higher profitability

Why demand must come before revenue optimization.

My approach to maximizing DME and procedures.

How I streamline workflows for efficiency and growth.

Why You Should Listen

Hitting the million-dollar mark isn’t just about seeing more patients, it’s about working smarter, optimizing your practice flow, and focusing on high-value care. I’ll walk you through how I balance profitability, patient satisfaction, and personal time, so you can grow without sacrificing quality of life.

Key Topics Covered

[00:00] How I scaled from $70k to $120k monthly

[01:04] Structuring patient scheduling for efficiency

[02:02] Why demand drives growth before optimization

[03:13] Managing supply vs. demand in your practice

[04:32] Increasing visit frequency before hitting capacity

[06:05] Handling low-reimbursement patients strategically

[07:33] Creating dedicated half-days for routine care

[09:19] Using treatment blocks to improve speed and profitability

[10:29] How optimizing DME drives extra revenue

[13:17] Leveraging imaging and procedures for higher margins

[16:43] Why Shockwave and Swift are high-value services

[18:31] Using treatment sheets to educate patients

[19:45] Building simple protocols for products and add-ons

[20:53] Why I avoid excessive surgery to stay productive

[21:41] The role of efficiency and using a medical scribe

[22:17] My $1,000,000 blueprint and growth challenge

[23:21] Balancing business success with a healthy personal life

👉 Tune in now to learn my proven strategies for scaling your podiatry practice, optimizing patient flow, and unlocking your next level of growth.

In this episode of Podiatry Practice Mastery, I share insights from a recent coaching call with a doctor who already has a profitable seven-figure clinic but wants to fill open appointment slots and attract more new patients.

I break down the three strategies I recommended to help him optimize his marketing, maximize patient flow, and strengthen his online presence, and actionable tips you can apply to your own practice today.

What You’ll Learn in This Episode

How I use A/B split testing to improve ads.

Why an urgent care landing page converts better than a homepage.

How boosting Google reviews drives more new patients.

Why You Should Listen

Even highly profitable clinics can struggle with filling schedules and attracting new patients. In this episode, I walk you through simple yet effective strategies to optimize your marketing spend, leverage urgency-driven pages, and build social proof that sets your practice apart from the competition.

Key Topics Covered

[00:00] Coaching a doctor with a $1.5M clinic

[01:17] Why A/B split testing ads improves ROI

[02:07] Using urgent care pages to boost new patient visits

[02:39] Why you should avoid sending traffic to your homepage

[03:12] Turning ad companies into teaching partners

[04:09] Driving all marketing channels toward one booking goal

[04:30] How 10x Google reviews build instant trust

[05:01] Why Swell is a great system for automating reviews

[05:19] Inviting doctors to book strategy calls

[05:35+] Patient cases: plantar fasciitis, warts, nail fungus, and Achilles pain

👉 Tune in now to learn how these three strategies can help you bring in more patients, boost efficiency, and grow your podiatry practice faster.

Ever had a patient ask for a refund after a treatment didn’t work? It finally happened to me, my first-ever shockwave refund in years of practice. In this episode, I unpack the full story, from the patient’s experience to the decision-making process, and share how I handled it without damaging trust or goodwill.

Along the way, I dive into real patient cases, from plantar fasciitis and neuromas to Achilles injuries, and the clinical lessons I’ve learned about balancing patient satisfaction with practice profitability.

What You’ll Learn in This Episode

How I handled my first $750 shockwave refund.

Why goodwill can outweigh short-term revenue.

Key lessons from challenging patient cases.

Why You Should Listen

Refund requests are rare but inevitable. I’ll show you how to turn a potentially negative experience into a trust-building opportunity while keeping your clinic’s reputation intact. You’ll also pick up actionable tips on patient communication, case management, and treatment optimization.

Key Topics Covered

[00:00] Coaching call breakdown, growing a million-dollar practice

[01:17] Why AB split-testing ads improves ROI

[02:07] Using urgent care landing pages to capture new patients

[02:54] Turning ad agencies into consultants for long-term growth

[04:09] Filling daily patient slots using targeted campaigns

[04:30] Setting up review systems with Swell to dominate Google

[05:19] How to book a strategy call for your clinic

[05:35] Patient cases: Swift follow-up success and plantar fasciitis treatments

[07:27] Swift marketing hack, free tips for social media videos

[08:23] Matrix follow-up, nail fungus testing, and results workflow

[09:12] Cost-saving strategies for non-fungal thick nails

[09:33] Shockwave therapy: when and why I choose it

[10:59] Identifying intermittent claudication masquerading as heel pain

[12:40] Diagnosing hallux impingement and surgical considerations

[13:15] The 6-month mastermind challenge to scale your practice

👉 Tune in now to hear how I navigated this tricky situation, and the practical lessons you can apply in your own practice.

Ever wondered how patients actually find you online? In this episode, I share how YouTube videos, Google reviews, and a simple content system bring patients into my clinic every single week, without me spending hours on marketing.

I break down the exact strategies I use, from automating online reviews to creating YouTube shorts and reusing those same videos for ads that convert. Plus, I talk about what’s working right now, what isn’t, and a few behind-the-scenes challenges I’ve been tackling in the clinic.

What You’ll Learn in This Episode

How I attract patients with YouTube and Google reviews.

My simple system for creating daily video content.

Why I’m considering switching back to Swell for reviews.

Why You Should Listen

If you’re struggling to bring in new patients from the internet or want a proven content strategy that works even while you’re busy seeing patients, this episode is packed with practical insights. I’ll show you exactly how I repurpose content, leverage automation, and build online credibility without wasting time.

Key Topics Covered

[00:00] How patients find me through YouTube and Google reviews

[00:44] My automated process for collecting 1,000+ reviews

[01:44] Comparing Swell vs. ModMed’s Clara for review requests

[02:06] Why my older YouTube videos outperform newer ones

[02:43] Leveraging patient presentations for high-performing videos

[03:35] How I create YouTube shorts and automate posting daily

[04:09] Repurposing video content for ads with CTAs

[04:47] Challenges with ModMed: paperwork, signatures, and efficiency

[05:58] Handling patient refunds for shockwave and orthotics

[07:27] Managing virtual assistant scheduling errors

[08:43] Office visit add-ons and treatment adjustments

[09:39] Chronic ulcer management and wound care referrals

[11:31] Differentiating sinus tarsi pain from midfoot arthritis

[12:23] Managing non-compliant patients effectively

[13:16] Difficult wounds, fissures, and referrals to wound centers

[14:29] Managing hallux limitus, fractures, and Achilles follow-ups

👉 Tune in now to discover how I consistently turn online visibility into real patient appointments, and how you can do the same.