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.

⸻

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.

⸻

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.

⸻

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.