Podiatry Unfiltered

Get Comfortable Being “Cringe”: AI Videos, Direct Primary Care, and Talking Cash Prices in PodiatryMichele McGowan discusses why “cringe” often signals an uncomfortable but necessary skill, linking her experience using AI avatars and posting high-volume content across platforms with the need for physicians to talk openly about pricing and cash-pay options. She shares why she chose a direct primary care doctor despite paying $2,900/month for family insurance, valuing an hour-long visit, access, and participatory decision-making. After her brother questioned her AI videos, she realized visibility creates opportunities, including LinkedIn outreach from companies and potential podcast sponsors. McGowan argues patients pay for time, expertise, and choices, and that presenting appropriate options early is preparation, not sales. She describes seeing fewer patients while making more income by discussing value-based treatments ethically and consistently, emphasizing education, transparency, and patient choice.00:00 Getting Comfortable With Cringe00:33 Less Volume More Income02:10 Why Pay Direct Primary Care03:42 Time Access And Value05:23 AI Avatars And Posting More07:12 Cross Posting Past The Fear08:37 Visibility Creates Opportunities12:34 Purpose Behind The Content13:50 Talking Money Without Selling14:28 Present Options Early17:33 Real Practice Revenue Example20:35 Cringe Is Where Growth Happens21:22 Ethics And Final Challenge22:26 Closing And Share This

The Trick Nobody Tells You About Practice Value: Better Outcomes = Higher Profit (PRP, Shockwave, Laser) Michele McGowan argues that in regenerative and energy-based medicine (PRP, allograft, shockwave, Class 4 laser), improving patient outcomes and increasing practice value are not competing goals but the same compounding track: proficiency leads to better results, reputation, and demand. She contrasts this with insurance-driven, high-volume models where revenue depends on speed and routine services like nail care don’t compound into differentiation or meaningful practice value. She advises choosing additions based on what you’re willing to get genuinely good at, since that benefits both patients and the bottom line. She also discusses building profitability to avoid selling to private equity, including streamlining operations by firing a billing company, reducing software costs by switching from AdvancedMD to Jane App with Claim.MD, and gradually leaving insurance contracts that create authorization and denial issues. 00:00 Practice Value Myth 01:03 Why Volume Warps Care 01:35 Proficiency Builds Value 02:42 Compounding Demand Loop 04:10 Routine Care Trap 04:52 One Question Filter 06:26 Selling And Profitability 07:20 Firing The Billing Company 09:09 Streamlining Tech Stack 10:18 Avoiding Private Equity Exit 12:04 Modernize Your Practice 12:56 Closing And Contact

The Dark Side of Implementation: Change Your Podiatry Practice Without Permission Michele McGowan explains why getting excited about new ideas, buying technology, or attending conferences is easy, but implementing change in a podiatry practice is hard because of fear, money conversations, and worry about peer judgment. She emphasizes doing homework on evidence and indications, communicating ethically without promising miracles, and getting comfortable discussing cash-pay options as informed decision-making. McGowan argues that true implementation requires elimination—removing low-value or undesired services and creating schedule space—because “implementation without elimination is just accumulation.” She shares how adding services like Shockwave, laser, PRP, and a MediPedi spa worked through trial and error, packaging, and staff workflows, ultimately transforming the practice one uncomfortable decision at a time. 00:00 Dark Side of Implementation 00:52 Fear After Buying In 01:59 Peer Judgment and Permission 02:49 Evidence Without Hype 04:09 Talking Money Confidently 05:53 Fail Upward to Improve 07:02 Eliminate to Implement 09:16 What Actually Pays 11:47 MediPedi Spa Case Study 15:20 Systems and Staying in Lane 19:17 Profit Ethics and Patient Demand 21:50 Practice Transformation Over Time 24:47 One Thing Add One Remove 26:23 Final Encouragement and Wrap

Stop Apologizing for Your Fees: How to Confidently Talk Cash-Pay Pricing in Podiatry Michele McGowan explains why many private practice podiatrists struggle to say the price for cash-pay and regenerative services, urging doctors to stop apologizing and confidently communicate value. She argues patients already spend money on outcomes (LASIK, Invisalign, Botox, concierge medicine) and want clear options, not doctors deciding their financial priorities. Using examples like plantar fasciitis, ingrown toenails, and an insertional Achilles tendinitis patient, she emphasizes presenting conservative, regenerative (laser, shockwave/Softwave, PRP), and surgical choices upfront, focusing on outcomes rather than the technology. McGowan shares her evolution with transparent website pricing, staff scripts, and packages (including $300/session or $1577 for six shockwave sessions), and challenges listeners to notice whether hesitation is about protecting patients or avoiding hearing “no.” 00:00 Stop Apologizing For Fees 01:13 Why Money Feels Awkward 01:54 Patients Already Pay Cash 04:49 Offer Options First Visit 08:42 Achilles Case And Pricing 12:43 Quit Counting Their Money 13:39 Sell Outcomes Not Devices 17:21 Confidence And Value Talk 19:29 Transparent Website Pricing 23:36 Scripts Staff And Mindset 28:38 Practice Growth And Ethics 33:34 Final Challenge And Wrap

Implement or Die: How I Pivoted My Podiatry Practice (Regenerative Care + MediPedi Spa) Michele McGowan argues independent podiatrists must keep implementing new services instead of staying comfortable in an insurance-dependent model where reimbursement declines and payment isn’t guaranteed. She shares how she pivoted after 20 years of surgery into regenerative, non-surgical care (Softwave TRT, class IV laser, custom orthotics, allografts), then launched an in-practice medical spa service line in two weeks. She describes building a luxury, waterless MediPedi room for about $1,200–$1,500, hiring a licensed nail tech paid hourly plus commission, creating tiered pedicure offerings, and integrating KeryFlex and laser nail fungus services with new bundles like a $1,577 six-visit package. McGowan explains pricing challenges, consent/compliance, training staff with scripts, promoting via social content and ads, and why podiatrists should capture aesthetic foot-care demand with strong processes and experience. 00:00 Introduction: Implement or Die 00:39 About Podiatry Unfiltered 02:54 From Surgery to Regenerative Medicine 05:11 Building the Spa: The Idea 15:51 Creating the Laser + Spa Bundle 18:38 Compliance & Legal Considerations 24:08 Where to Start: Actionable Framework