Don Pelto, DPM - Podiatry Practice Mastery

Eliminating Open Slots to Increase Practice Revenue

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Episode Description

What’s the least valuable patient in your practice? It’s probably not who you think. In this episode, I break down why the most costly problem in a podiatry schedule isn’t low-reimbursement visits—it’s empty appointment slots that go unfilled.

I walk through real daily tracking sheets, contrasting least valuable patients with most valuable ones, and explain how tightening scheduling, stacking services appropriately, and identifying missed opportunities can significantly raise personal production. This is a practical, behind-the-scenes look at how small operational decisions compound into million-dollar outcomes.

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Timestamps

• [00:00] Why open schedule slots are the true least valuable “patients”

• [01:30] Reframing daily capacity and tracking missed potential

• [03:10] High-value visit example: plantar fasciitis workup to shockwave and orthotics

• [05:10] Least valuable visits: orthotic adjustments and post-op globals

• [06:50] Managing busy patients who “don’t have time” (and still need definitive care)

• [09:10] Staged procedures, bundling services, and visit efficiency

• [11:40] Identifying MVPs: laser, collagen kits, shockwave, and orthotic strategies

• [14:10] Systems thinking: staff training, automatic imaging, and upsell awareness

• [16:00] Why reducing low-value visits increases high-value capacity

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Key Takeaway

Your fastest path to higher production isn’t seeing more patients—it’s reducing empty slots and intentionally converting visits into higher-value, outcome-driven care plans.

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Conclusion

If you’re not tracking open capacity, you’re likely underestimating your true revenue leak. Start looking at your schedule through the lens of opportunity cost, not just visit counts. If this episode helped reframe how you look at your day, share it with your team or join the Podiatry Practice Mastery email list for weekly insights focused on real-world practice growth.

Using Rollovers to Convert Hesitant Patients

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Episode Description

How do you move patients forward when they feel like they’ve already “wasted money” on treatments that didn’t work? One simple pricing and communication strategy can lower resistance without discounting your value.

In this episode, I explain how to use rollovers—crediting prior patient spending toward higher-value treatments—to increase acceptance of orthotics, laser, and advanced care. I then walk through a fast-paced clinical day, highlighting where rollovers, judgment calls, and selective follow-ups fit into real-world podiatry practice.

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Timestamps

• ​ [00:00] What a “rollover” is and when to use it
• ​ [01:05] Rollover examples: prefabs, orthotics, and failed fungus treatments
• ​ [02:30] Why rollovers work psychologically without devaluing care
• ​ [03:15] Clinical day highlights: ingrowns, fractures, shockwave, and post-ops
• ​ [05:00] Managing uncertainty: infections, MRI follow-ups, and cautious monitoring
• ​ [06:20] Bundling visits and identifying future treatment opportunities

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Key Takeaway

Strategic rollovers help patients move forward by reframing past spending as progress—not loss—while keeping your care plan intact.

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Conclusion

If patients hesitate because they feel burned by prior treatments, consider using rollovers selectively for higher-cost, higher-impact care. It’s not about discounting—it’s about momentum. If this episode was helpful, share it with a colleague or reach out with feedback.

Turning Urgent Care Misses Into Referrals

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Episode Description

What if the biggest referral opportunity in your market is hiding in plain sight at urgent care? Many podiatry practices routinely see patients sent over late—after missed diagnoses, incomplete treatment, or delayed referrals. The question is: how do you turn that reality into a system that consistently drives new patients?

In this episode, I walk through a practical strategy for educating urgent care centers on the most commonly missed foot and ankle diagnoses—and how that education can position you as their go-to specialist. I also share a real-world clinic day breakdown, highlighting how clinical decision-making, follow-ups, and workflow systems intersect with long-term practice growth.

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Timestamps

• ​ [00:00] Why urgent care is a hidden referral opportunity
• ​ [00:45] Commonly missed urgent care diagnoses (Lisfranc, Achilles, Charcot, and more)
• ​ [02:00] Building an educational presentation to attract referral sources
• ​ [02:55] Using a “Dream 100” style outreach strategy with urgent care centers
• ​ [03:40] Clinical day recap: routine care, procedures, infections, and shockwave therapy
• ​ [05:05] Orthotics, phased treatment plans, and patient clarity
• ​ [05:45] Podcast workflow, follow-ups, and tackling no-shows

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Key Takeaway

Educating referral sources—especially urgent care centers—on what they commonly miss is one of the most effective, non-salesy ways to position your practice as essential rather than optional.

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Conclusion

If you’re seeing late referrals or poorly managed cases from urgent care, consider flipping the script by proactively teaching instead of reacting. If this episode sparked an idea or made you rethink your referral strategy, share it with your team or reach out—feedback and real-world discussion are always welcome.

What an Eye Doctor Visit Taught Me About Patient Experience

Episode Description

Have you ever walked out of a medical appointment knowing the care was good—but the experience could have been better? In this episode of Podiatry Practice Mastery, Don reflects on a recent visit to the ophthalmologist with his father and unpacks what podiatrists and practice owners can learn from it.

From smart delegation to staff utilization, to the importance of clear communication and slowing the pace of care, this short episode highlights practical ways to improve patient experience without sacrificing efficiency. Don also discusses why simple habits—like a “running commentary” during exams and better follow-up systems—can dramatically change how patients perceive your practice.

Timestamps

• ​ [00:00] Welcome to Podiatry Practice Mastery and resource reminder
• ​ [00:32] Context: Visiting the ophthalmologist with a family member
• ​ [01:00] What worked well: Efficient intake and advanced staff utilization
• ​ [01:48] Delegation lessons for podiatry practices
• ​ [02:22] The value of routine annual follow-ups
• ​ [02:58] What didn’t work: Medical jargon and lack of explanation
• ​ [03:32] The power of a “running commentary” during exams
• ​ [04:05] Rushing, documentation burden, and the case for scribes

Key Takeaway

Improving patient experience doesn’t require more time—just better communication, smarter delegation, and systems that keep patients informed and coming back consistently.

Conclusion

If this episode sparked ideas for improving your own patient experience, I’d love to hear your thoughts. Visit podiatrypracticemastery.com to download (or re-download) the $1,000,000 Practice Formula and share your feedback. Your input helps shape future conversations—thanks for listening.

How to Use Treatment Sheets to Guide Care and Increase Clarity

Episode Description

How do you simplify complex treatment plans without overwhelming patients—or your staff? In this episode of Podiatry Practice Mastery, Don answers listener questions from two practicing podiatrists focused on growth, systems, and execution inside a busy practice.

The first half of the episode addresses questions around scaling toward the $1M mark, including urgent-care style scheduling, website and marketing vendors, and practical insights on EHR and billing workflows. Don shares what he personally uses, what he avoids, and why simplicity and cost control matter at this stage of growth.

The second half is a deep, tactical breakdown of how Don uses treatment sheets in real patient visits. He walks through exactly how they’re stored, presented, customized, and integrated into visits for common conditions like plantar fasciitis and nail fungus—showing how clear structure improves patient understanding, compliance, and efficiency without feeling scripted.

Timestamps

• ​[00:00] Listener questions and episode overview
• ​[00:55] Scaling from $600K to $1M with an urgent-care mindset
• ​[02:05] Website and marketing vendors Don recommends
• ​[03:15] EHR, billing workflows, and ModMed insights
• ​[04:30] Insurance and DME expectations in real-world practice
• ​[05:30] Introduction to treatment sheets and where to access them
• ​[07:10] How treatment sheets are stored, printed, and updated
• ​[09:05] When and how to present treatment sheets during visits
• ​[10:30] Nail fungus treatment sheet: structure and patient flow
• ​[12:45] Plantar fasciitis and Achilles tendinitis treatment sheets
• ​[14:40] Guiding patients by checking what they don’t need
• ​[15:45] Why treatment sheets outperform slide presentations

Key Takeaway

Treatment sheets create clarity, consistency, and confidence—helping patients understand what’s happening now, what comes next, and why, while saving physician time and reducing confusion.

Conclusion

If this episode gave you ideas you want to implement, let me know what resonated. You can email me directly or visit podiatrypracticemastery.com to download the free $1,000,000 Practice Formula. If you want to see the actual treatment sheets discussed, reach out—I’m happy to share what I use every day in practice.

Surgical Wow Factors That Patients Actually Remember

Episode Description

What do patients remember most about surgery—the procedure itself, or how you made them feel before and after? In this episode of Podiatry Practice Mastery, Don breaks down the specific pre-procedure, intra-procedure, and post-procedure systems he uses to create consistent “wow” experiences for surgical patients.

Rather than focusing on monetization, Don explains how thoughtful preparation, proactive communication, and simple personal touches reduce anxiety, improve trust, and protect the physician. From structured pre-surgical visits to automated follow-ups and small post-op gestures, this episode shows how intentional systems—not extra time—drive better patient experiences.

Timestamps

• [00:00] Introduction and the importance of consistency in patient experience

• [00:45] Why systems—not effort—create reliable “wow” factors

• [01:20] Pre-surgical visits, consent, and structured discussions

• [02:40] Lessons learned from past complications and legal exposure

• [03:40] Day-before and day-of surgery communication habits

• [04:30] Intra-operative wow factors and involving families

• [05:30] Post-op contact, texting, and giving patients direct access

• [06:40] Using EMR tasks and automation for office procedures

• [07:35] Post-surgical kits and personal touches that stand out

Key Takeaway

Patients don’t experience “great care” by accident—clear processes before, during, and after procedures create reassurance, trust, and memorable experiences without adding chaos to your day.

Conclusion

If this episode gave you ideas to refine your own surgical or procedural workflows, I’d love to hear what you’re implementing. Reach out to me directly or visit podiatrypracticemastery.com for resources and to continue the conversation.

How to Talk About Cash-Pay Treatments Without Selling

Episode Description

How do you introduce high-ticket, cash-pay treatments without sounding salesy or uncomfortable? In this episode of Podiatry Practice Mastery, Don answers a listener question on how to communicate value and pricing for services like shockwave therapy, biologics, and other self-pay procedures.

Don breaks down the mindset shift most podiatrists were never taught in training—how belief, conviction, and structure directly impact patient decisions. He explains where cash-pay options should live in your treatment flow, how treatment sheets and imaging support the conversation, and when staff should (and shouldn’t) be involved. The episode offers a practical framework for offering advanced treatments confidently, ethically, and consistently.

Timestamps

• ​ [00:00] Introduction and listener question overview
• ​ [01:05] Why cash-pay conversations feel uncomfortable for doctors
• ​ [02:10] The importance of believing in what you offer
• ​ [03:40] How to build conviction before charging patients
• ​ [05:05] Where cash-pay treatments belong in the care pathway
• ​ [06:25] Using treatment sheets to guide phase-one vs phase-two care
• ​ [08:05] Provider vs staff: who should discuss pricing and why
• ​ [09:35] Imaging and ultrasound as value-building tools
• ​ [11:10] Language, phrasing, and setting patient expectations
• ​ [12:30] Advanced follow-up strategies when patients decline care

Key Takeaway

Cash-pay treatments work best when they’re presented with conviction, structure, and timing—patients respond to clarity and confidence, not pressure.

Conclusion

If this episode helped you rethink how you present advanced treatments, I’d love to hear your thoughts. Visit podiatrypracticemastery.com for free resources or reach out directly with questions you’d like covered in a future episode.

One-Sheet Protocols That Increase Revenue Per Visit

Episode DescriptionWhat if your biggest growth bottleneck isn’t marketing or reimbursement—but the way you present treatment? Many podiatry practices struggle to break past revenue plateaus despite being busy every day. The issue often isn’t volume alone, but how care is structured, communicated, and delivered.

In this episode, Don Pelto joins Giselle to unpack the systems that helped his practice cross the seven-figure mark. From consolidating routine care to designing one-page treatment sheets that integrate DME, in-office dispensing, imaging, and cash-pay services, Dr. Pelto explains how clear protocols drive both efficiency and patient buy-in.

This conversation is especially relevant for practice owners who feel overbooked but underpaid, are hesitant to add associates, or want a practical way to increase revenue per visit without burning out.

• [00:00] Introduction and context of the interview

• [01:38] The elusive $1M practice goal and common misconceptions

• [03:25] Knowing your numbers: 20 patients × $200 visits

• [04:47] Two real problems: demand vs. value per visit

• [06:11] Why routine foot care caps growth and causes burnout

• [07:12] Consolidating routine care into a half-day model

• [09:45] Creating space for higher-value patient visits

• [10:40] Building demand through focused marketing and referrals

• [10:58] Lessons from Alex Hormozi on leads and offers

• [12:52] Using video and condition-specific content to attract ideal patients

• [13:55] Positioning a podiatry “urgent care” for same-day access

• [15:56] Capturing patients lost to urgent care centers

• [17:28] DME and AFOs as part of standard treatment protocols

• [17:48] The treatment sheet: one-page protocols that sell ethically

• [19:24] Anchoring, pre-selling, and setting patient expectations

• [21:10] Integrating imaging, shockwave, and follow-up care

• [23:07] Why written protocols matter for associates and staff

• [25:07] Adding new services with a simple checkbox system

• [27:02] Saving time, reducing confusion, and increasing consistency

• [28:53] Coaching doctors through implementation and accountability

• [31:21] Final takeaway: all protocols on one piece of paper

Key Takeaway

If you want to grow without burnout, stop relying on mental protocols—put your full treatment process (DME, dispensing, imaging, and cash-pay options) on a single, patient-facing sheet and make it the standard of care.

Conclusion

What protocols are still living only in your head—and costing you time or revenue? Share this episode with a colleague, and let us know which systems you’re already using or struggling to implement. Subscribe for more practical discussions on building a more efficient, profitable podiatry practice.

Finding Revenue in the Details

Episode Description

Are you already busy—but still leaving revenue on the table? Many podiatrists hit a ceiling not because of patient volume, but because of underutilized treatments, incomplete systems, or discomfort presenting higher-value care.

In this episode, Don walks through two real clinic days, patient by patient, highlighting how everyday visits translate into growth opportunities. From shockwave therapy and orthotics to nail fungus protocols and bracing, he explains how small adjustments in confidence, systems, and tracking can compound toward the $2M practice goal.

Along the way, Don shares practical insights on price anchoring, EMR efficiencies, referrals, and why buying back your time may be the most important investment you make.

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Episode Breakdown & Timestamps

[00:00] – Practice Revenue Reality Check

Reflecting on last year’s numbers and identifying three key levers for growth: filling open slots, nail fungus laser protocols, and bundled treatment packages.

[01:35] – Using Price Anchors to Position Orthotics

How referencing outside retail pricing (e.g., Good Feet) reframes value and improves acceptance.

[02:25] – Day One Case Mix Overview

Joint injections, imaging, shockwave therapy, fracture diagnosis, neuropathy workups, and bracing decisions.

[04:40] – MVP Visits & Coding Awareness

Capturing added value through appropriate imaging, fracture codes, and comprehensive evaluations.

[05:45] – Nail Fungus, Ulcers, and Ancillary Services

Fungus kits, antifungals, ulcer debridement, crest pads, and follow-up cadence decisions.

[07:00] – EMR & Referral Friction

Why preset referrals inside your EMR matter—and how small inefficiencies slow down busy clinics.

[08:05] – Day Two: Orthotics, Fractures, and Sports Injuries

Orthotic scans, Achilles rupture workup, stress injury evaluation, and offloading strategies.

[09:30] – Treating the Right Achilles Injection

Nuanced cortisone placement at medial/lateral insertions—not the tendon substance.

[10:20] – Systems That Buy Back Your Time

Why scribes, asset organization, and reducing low-value visits are foundational for scaling.

[11:20] – Final Thoughts on Growth Strategy

Shifting from volume-based busyness to intentional, high-value care.

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Key Takeaway

Reaching the next revenue tier isn’t about working harder—it’s about tightening systems, confidently offering high-value treatments, and buying back time so you can focus on the care and decisions that actually move the needle.

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Conclusion

If this episode sparked questions or ideas, Don would love to hear from you. Email feedback or clinical questions to [email protected]—your input often shapes future episodes.

Be sure to review the Practice Audit and Million Dollar Practice Blueprint to identify missed opportunities in your own clinic. Sometimes the fastest growth comes from refining what you’re already doing.

Tracking Treatments to Break $2M Production

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Episode Description

Are you busy all day but still unsure which treatments are actually driving your production? Many podiatrists work harder each year without clear visibility into what services move the needle — and which ones quietly drain time and margin.

In this episode of Podiatry Practice Mastery, the focus is on real-world clinic flow, daily treatment tracking, and how intentional systems improve both patient care and revenue. Through multiple full clinic days, this episode breaks down shockwave therapy, orthotics, procedures, DME, follow-ups, and how small operational tweaks compound toward $2M+ individual production.

The episode also dives into under-discussed practice improvements: using admin email systems to capture leads, delegating orthotic follow-ups appropriately, increasing confidence with laser treatments, and adopting a “running commentary” exam style to improve patient understanding and trust.

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Timestamps

[00:00] – Why tracking daily treatments matters for $2M+ production

[01:15] – Daily treatment tracker: visit level, checkboxes, and visibility

[03:05] – Shockwave therapy patterns and follow-up decision-making

[05:20] – Orthotics vs braces: when to transition and why it matters

[07:10] – Pre-op visits, bone healing tools, and leveraging DME appropriately

[09:00] – Managing orthotic follow-ups without clogging the schedule

[10:35] – Nail fungus strategies: laser, oral meds, kits, and confidence gaps

[12:40] – Admin email systems, virtual assistants, and capturing inbound leads

[14:35] – Using medical-grade supplements for shockwave and anticoagulated patients

[16:05] – High-value in-office procedures (tonotomies, fractures, ulcers)

[18:10] – MVP vs LVP patients: recognizing time drains without resentment

[19:35] – Running commentary exams: improving patient clarity and trust

[21:05] – Final thoughts on systems, communication, and incremental growth

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Key Takeaway

Tracking treatments daily — not just revenue — reveals where production truly comes from and highlights which patients, services, and systems deserve more focus (or boundaries).

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Conclusion

If this episode sparked ideas for tightening your systems, improving patient communication, or increasing confidence in higher-value treatments, let us know. Share what changes you’re testing in your own practice, and explore more free resources at PodiatryPracticeMastery.com to keep building toward smarter, more sustainable growth.