Podiatry Unfiltered

Podiatrist Michele McGowan reflects on how private practices across specialties are facing the same pressures—lower reimbursement, higher overhead, rising payroll and supply costs, growing administrative burden, private equity acquisitions, and hospital systems absorbing independent medicine—despite independent practices being profitable and valuable. She explains how she and her husband transformed their practice over the last four years by stepping away from low-paying insurance models, dropping certain insurances, implementing transparent cash pricing, and adding services not dependent on insurance approval, resulting in more time with patients, better outcomes, and less chaos. McGowan argues high-volume medicine harms care and shares that patients want present, unburned-out doctors who build long-term relationships. She introduces the Independent Doctors Network as a cross-specialty community to share strategies on cash services, AI/technology, sustainable operations, and practice-building resources via a webpage and Facebook group.

Why I Quit Podiatric Surgery After 20 Years (And My Practice Got Better)

Michele McGowan of Podiatry Unfiltered reflects on Muhammad Ali’s late-career fights to introduce the uncomfortable idea that quitting can be a win, then explains why she stopped doing surgery after 20 years in private practice. Trained in a strong surgical residency at West Penn Hospital, she built her own Florida practice and became board certified, with surgery once central to her identity. Over time, the realities of OR delays, lost time, and two decades of hospital call—weekend emergencies and missed family time—left her unfulfilled, and she wishes she’d changed sooner. Four years ago she stopped surgery entirely, found malpractice costs dropped, and discovered her practice and patient care improved. She now focuses on regenerative and conservative treatments (PRP, SoftWave, laser, orthotics) while referring surgical cases, emphasizing that doctors are allowed to change what no longer serves them.

00:00 Ali and Quitting

01:03 Why I Left Surgery

03:17 Training and Identity

04:42 Private Practice OR Reality

06:09 Call Burnout Turning Point

07:23 Stopping Cold Turkey

08:00 New Conservative Focus

09:23 Practice Got Better

10:41 Permission to Change

11:48 Closing Thoughts

Podiatry Unfiltered: Ethical “Selling” That Builds Trust (Shockwave, Laser & Real Treatment Plans) Dr. Michele McGowan and Dr. Tim Henne discuss how podiatrists can confidently and ethically present non-surgical treatments by building trust, focusing on patient “discovery,” and recommending plans with conviction rather than apologizing for costs or options. Using a chronic plantar fasciitis case, they explain reframing treatments like Softwave shockwave and Class IV laser around what patients want back in their lives, handling objections such as “I’ll think about it” and “that’s expensive,” and avoiding common mistakes like talking too much, leading with price, and weak handoffs to untrained staff. They contrast conservative care with regenerative options between conservative and surgery, emphasize patient selection and tracking progress (VAS), share their shift from high-volume visits to longer appointments, and note they personally use the technologies they recommend.

How to Implement Extracorporeal Shockwave (SoftWave TRT) in a Podiatry Practice | Webinar Replay (April 2026) Michelle McGowan (Podiatry Unfiltered/Independent Podiatrist Network) shares an April 2026 webinar on implementing extracorporeal shockwave therapy—especially SoftWave TRT—in a podiatry office, joined by Dr. Tim Henny and SoftWave specialist Liz Keener. She explains the three commonly discussed modalities in podiatry (radial pressure wave, focused shockwave, and broad-focused shockwave), why her practice chose broad-focused SoftWave (larger treatment zone), and the regenerative concept of mechanotransduction. McGowan outlines real-world workflow and clinical protocols (typical shocks, energy targets, pain-guided technique, VAS tracking, and when to add laser), discusses packaging and pricing (including pay-per-visit vs upfront plans), and covers patient expectation-setting and consent/ABN considerations. She also reviews marketing tactics (in-office videos, testimonials, email outreach), financing tools (Cherry), and answers audience questions on depth, insurance, costs, and combining shockwave with orthobiologics. 00:00 Webinar Intro and Invite 01:26 Friendly Network Banter 04:39 Webinar Kickoff and Agenda 08:00 Shockwave Basics Explained 08:47 Three Shockwave Types 11:55 Cellular Healing Effects 13:03 SoftWave Physics Demo 13:35 Treatment Technique Walkthrough 14:35 Depth Question and Use Cases 15:40 Protocols and Settings 18:04 Why We Chose SoftWave 20:38 Pricing and Patient Expectations 23:00 Treatment Packages and Plans 24:54 Marketing That Works 26:51 In-Office Video and Testimonials 28:00 Patient Testimonial Playbook 28:18 Shockwave Case Breakdown 29:02 Share Outcomes and Consents 29:27 Email Marketing That Converts 30:24 Patient Financing Options 31:30 Workflow and Documentation Setup 33:22 Athletes and Expectations 34:45 Old School Shockwave Evolution 35:41 Live Q&A Marketing Vendors 36:40 ABNs and Insurance Pushback 39:50 Pricing and ROI Reality 45:08 Shockwave vs Stem Cells 51:51 Wrap Up and Next Steps

In episode 12 of Podiatry Unfiltered, Dr. Michele McGowan shares how the book “10X Is Easier Than 2X” reshaped her mindset and improved her hybrid podiatry practice by shifting from chasing volume to delivering higher-value care.

She argues that “2x” thinking leads doctors to add more low-reimbursement visits, longer days, and more staff while increasing burnout without doubling profit, calling this the insurance-driven “volume trap.”

McGowan explains that “10x” means doing things differently: fewer patients, more time per visit, better outcomes, and higher-value treatment plans built around services like custom orthotics, laser therapy, SoftWave, and regenerative medicine protocols. She recommends identifying highest-value services, packaging care into programs (heel pain, neuropathy, nail fungus), educating patients, and stopping low-value visits that block higher-value care.

00:00 Welcome Back Intro

00:27 Why This Book Matters

01:21 Hybrid Practice Reality

02:21 The Two X Trap

03:58 Add Value Before Cutting

05:23 Doing It Different

06:20 Escape The Volume Model

09:04 What Ten X Looks Like

10:25 Stop Selling Visits

11:51 Make It Actionable

13:14 Patient Education Mindset

15:08 Final Takeaways Outro

Podiatry Unfiltered: Real Talk. Real Practice. No Filters.

Skip the sugarcoating and get the honest truth about what it takes to survive and thrive as an independent podiatrist. Hosted by Dr. Michele McGowan, a practice owner with 25+ years of experience, this podcast tackles the real challenges of building and running your own podiatry practice—from the business side nobody teaches you in school to finding autonomy in a profession increasingly dominated by corporate medicine.

Whether you're a podiatry student, resident, or seasoned practitioner feeling trapped in someone else's system, Podiatry Unfiltered delivers candid conversations about entrepreneurship, new technologies, practice management, and creating a career on your own terms. If you're wired to build something and refuse to have every decision made for you, this is your podcast.

Dr. Michele McGowan shares a case of a patient with plantar fasciitis and peroneal tendonitis who couldn’t take steroids or anti-inflammatories, leading to a discussion of conservative care and a continuum of options including SoftWave (shockwave) therapy, possible laser, and custom orthotics, with surgery as a last resort. After a brief orthopedic visit where surgery was recommended and regenerative options were dismissed as “cash pay,” McGowan reflects that she once viewed regenerative medicine as “snake oil” but changed her perspective after three years of study and positive outcomes. She emphasizes doctors must keep learning, present all options with risks and recovery, and notes the patient chose to proceed with her office’s regenerative package. She announces a free live webinar on April 8 at 8:00 PM with Dr. Henne covering shockwave types, protocols, pros/cons, and revenue.

We all know insurance companies are the evil ones constantly trying to destroy the doctor patient relationship. This last podcast was an attempted walk and talk that turned into clips in my backyard.(walking and filming is hard if you are a one man show ) more clips to come but if you are a student or podiatry resident private practice is not dead. You need to practice intentionally and provide better services that keep your patients active and doing what they love. I still love being a podiatrist 24 years into private practice. #privatepractice #podiatry #podiatrist #podiatryresident

Mentioned in this episode:

Welcome to Podiatry Unfiltered—the podcast where we skip the sugar-coating and talk honestly about what it takes to survive and thrive as an independent podiatrist today.

A quick preview of what's coming on Podiatry Unfiltered.

Remember that conference booth you avoided because the technology seemed too expensive? That might be costing you more than you think.

In this episode, I share the story of how I almost missed one of the best investments I ever made for my practice—all because I was too skeptical to even make eye contact with the vendor at a regenerative medicine conference.

I talk about my journey from walking past the Soft Wave booth to making it a cornerstone of my practice, and why so many podiatrists are looking outside their practices for opportunities when the biggest one is sitting right in front of them.

In this episode, Dr. Michele McGowan gets real about the state of modern podiatry and shares why independent practitioners have a massive advantage right now.

Michele breaks down:

1. Why regenerative medicine certifications (like ACPPS) are essential for staying competitive
2. The harsh reality of reimbursement changes since the "golden era" of podiatry
3. How 3D printing custom orthotics transformed her practice (and paid for itself in just 4 pairs)
4. The complete workflow for implementing 3D printing in your office for under $2,000
5. Why "being a good doctor" isn't enough anymore—you need to build smarter, not grind harder
6. Real patient stories showing how offering advanced services attracts better patients
7. Work-life balance truths: your kids won't remember your RVUs, they'll remember if you were there

If you're a resident, recent grad, or established podiatrist feeling stuck in the insurance grind, this episode is your wake-up call. Michele shares her journey from opening her own practice (while everyone thought she was crazy) to building a thriving independent practice that prioritizes both patient value and quality of life.

Join the communities mentioned:

1. 3D Custom Orthotics: Revolutionize Your Podiatry Practice (Facebook)
2. Independent Podiatrist Network (Facebook)

Resources discussed:

1. ACPPS Regenerative Medicine Summits
2. 3D printing with OLT (not sponsored)
3. Remi Laser, SoftWave therapy
4. Peptides, PPMX, Liposana

This is an early morning, pajamas-on, unfiltered conversation about the business of podiatry that nobody talks about in residency.