Episode Description

How do you consistently move toward a million-dollar practice without adding chaos to your schedule? In this episode, Don records another full clinical day using his Million Dollar Minute framework—this time focusing on orthotics volume, case mix, and decision-making.

Starting with a 21-year-old bunion patient, Don walks through how he structures conversations around shoes, orthotics, and expectations, with a clear daily goal of two orthotic scans to reach 40 per month. He then breaks down a full schedule of shockwave therapy, warts, nail care, neuropathy, equinus, posterior tibial tendon dysfunction, and follow-ups—highlighting where systems, delegation, and product selection matter most.

The episode closes with practical insights on using over-the-counter orthotics strategically, adapting devices chairside, and a simple phrase that reframes cost conversations while improving patient trust and compliance.

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Timestamps

• ​ [00:00] Introduction & MVP of the day

Bilateral bunions, shoe education, orthotics, and setting a daily orthotic target.

• ​ [01:10] Wart care, Swift, and shockwave outcomes

Long-term wart management, Achilles shockwave success, and PT transitions.

• ​ [02:20] Qutenza strategy & specialty pharmacy insight

Why fulfillment method matters for production numbers and margins.

• ​ [03:10] Acute toe pain & OTC orthotics

Differentiating stress injuries, hematomas, and when OTC devices make sense.

• ​ [04:10] Orthotic follow-ups & compliance strategy

Why a second pair often improves outcomes more than adjustments.

• ​ [05:05] Routine care: warts, ingrowns, imaging, shockwave

Efficient flow through common but essential visits.

• ​ [06:10] Insurance-covered shockwave & edge cases

When coverage works—and why expectations still matter.

• ​ [07:05] Complex tendon and arthritis cases

Knowing when to escalate to MRI and reassess the diagnosis.

• ​ [08:00] Tracking “no’s” and declined orthotics

Why refusals are just as important to monitor as conversions.

• ​ [08:40] Afternoon follow-ups & pediatric cases

Shockwave completions, pronation, equinus, and long-term planning.

• ​ [09:35] Least-expensive-effective-solution philosophy

Modifying OTC orthotics, posting, and test-driving relief before customs.

• ​ [10:05] Closing thoughts

Applying systems thinking to daily care decisions.

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Key Takeaway

Consistent orthotic volume comes from structured conversations, smart use of OTC devices, and tracking both conversions and declines—not from pressure or over-selling.

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Conclusion

If you’re experimenting with orthotic workflows or balancing OTC versus custom devices, reflect on what’s improving compliance in your practice and keep refining what works.