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.