Don Pelto, DPM - Podiatry Practice Mastery

In today’s episode of Podiatry Practice Mastery, I answer a question from a colleague working in a large orthopedic group who asked: “How can I build my own reputation when the system limits me?”Whether you’re in orthopedics, a podiatry supergroup, or working as an associate, the reality is the same—patients often get funneled by the system, not by your name. But there are ways to stand out without breaking the rules.We cover: • How to set up your own Google Business listing (even inside a group) and collect reviews. • Why QR-code review cards or Linktree pages can quietly build your digital reputation. • Leveraging community talks and lunch-and-learns to raise your profile. • The importance of being “the doctor who teaches” in your community. • Why execution (via VAs or systems) beats long idea lists you never get to.I also walk through Wednesday’s clinic highlights: Shockwave for neuromas, Anifix nail applications, offloading ulcers, and why video content from routine visits can fuel your online presence.Keywords: podiatry marketing, orthopedic group podiatry, Google reviews podiatry, associate podiatrist growth, shockwave neuroma, onifix nails, podiatry social media content⸻⏱️ Episode Timestamps (approximate for ~28–30 min episode) • 00:00 – Intro: Question from an ortho-group podiatrist • 01:20 – The group practice challenge: Being “fed” vs. building demand • 03:00 – Google Business hack: Why you need your own listing and reviews • 05:10 – QR codes, Linktree & Fiverr cards: Simple tools to drive patient feedback • 07:00 – Community outreach: Lunch-and-learns & becoming known outside the office • **09:00 – Why groups resist “big names” & how to navigate it • 11:00 – Clinic recap begins: Shockwave for neuroma case + YouTube Short recording • **13:30 – Bipartite sesamoid / fibular sesamoid fracture review and management • **15:10 – Nail detachments & Anifix resin applications • **17:00 – Callus care + idea execution via VAs (“Who, not how”) • **19:15 – Achilles tendinitis shockwave updates • **20:30 – Diabetic ulcer offloading with peg-assist cam boot • **22:10 – Onifix nail use for detachment + pricing strategy • **23:30 – Nail fungus case: why Diflucan (fluconazole) sometimes beats terbinafine • **25:00 – AFO referrals & orthotics • 26:10 – Other highlights: plantar fasciitis, ingrown toenails, cyst aspiration, pediatric wart case, non-union toe fracture, and end-of-day diabetic nail care referral • 28:30 – Wrap-up: Using patient care to fuel effortless content creation

In today’s episode of Podiatry Practice Mastery, I reflect on how small refinements in the way we treat, talk, and price procedures can change both the patient experience and the bottom line.We start with a practical question: How can we truly make ingrown toenail procedures pain-free? From ultra-slow toe blocks to comfort guarantees, I share ideas that could double as a marketing hook.I also discuss the difference between speed offers (urgent care in 24–48 hours) vs. comfort offers (pain-free toenail care) and why each attracts different types of patients.You’ll also hear how I: • Anchor pricing with biologics like amnio, even when I rarely use them. • Use ultrasound findings to guide Shockwave vs. regenerative decisions. • Frame Shockwave as “expensive, but predictable.” • Think through why practice management content doesn’t always gain traction with young docs—and how to package it better.Finally, we walk through Friday’s patient mix, from bilateral Achilles Shockwave MVPs to onychoplasty procedures, and why visiting other doctors’ offices might be the most underrated residency hack of all.Keywords: podiatry practice management, pain-free ingrown toenail, toe block injection tips, Shockwave therapy podiatry, ultrasound plantar fasciitis, amnio injection podiatry, urgent care podiatry offer, podiatry residency tips⸻⏱️ Episode Timestamps • 00:00 – Intro: Slow injections & the idea of “pain-free” ingrown toenails • 03:20 – Marketing hooks: Speed vs. comfort as competing offers • 05:15 – Podcast crossover: My interview with Podiatry Marketing + traction struggles • 08:00 – Why young docs skip practice management: Culture of surgery vs. entrepreneurship • 10:00 – Shockwave framework: How I anchor with amnio pricing & when I actually use it • 13:30 – Ultrasound’s role in selling care plans • 15:10 – Patient of the day: Bilateral Achilles Shockwave case ($3K+ revenue path) • 18:05 – Slow toe block in action: Matrixectomy & injection pearls • 20:20 – High-value in-office procedure: Dorsal hallux exostectomy with rasp • 22:00 – Fractures & globals: Why the 90-day window matters • 24:00 – Orthotics timing with Shockwave: Scan at visit 3, deliver at visit 6 • 26:15 – Other cases: Onifix nails, cortisone for plantar fascia before travel, cyst biopsy plan • 29:30 – Wrap-up: Why visiting other doctors’ offices may beat conferences for practice growth

In this Friday recap, I break down the systems behind a smoother, more profitable clinic day. You’ll hear how we batch routine care into a single half day per provider, which treatment sheets actually get used (and why they boost case acceptance), and what’s working in Facebook ads right now (plus the exact creator I learned from). I also share two recent second/third-opinion wins—why patients chose us (focused vs. radial shockwave, clear communication, simple immobilization) and how to keep them happy. We wrap with a practical “money model” for podiatry: a fast attraction offer, a three-tier package menu for plantar fasciitis, smart downsells, and a light-touch continuity idea that respects your schedule.Keywords: podiatry practice management, batching routine care, plantar fasciitis packages, shockwave focused vs radial, Facebook ads podiatry, treatment sheets, urgent care podiatry offer, Alex Hormozi money model, scribe workflow, second opinion podiatry⸻Show notesWhat you’ll learn • How to batch routine care into a single half day per provider without hurting patient satisfaction. • The 4 treatment sheets that actually move the needle (Plantar Fasciitis, Achilles, Warts, Nail Fungus) and how to deploy them. • A simple Facebook ads approach (learned from Ben Heath) and using ChatGPT to punch up ad creative. • Why second-opinion patients chose us (focused shockwave access, clear expectations, and—yes—a CAM boot when no one else tried it). • A practical money model for podiatry: • Attraction offer: 48-hour guaranteed appointment (speed beats “free”). • Packages: Basic → Advanced (Shockwave) → VIP Regenerative. • Downsells: short trials, phased sessions, orthotic-first. • Continuity/VIP: priority access + small perks without breaking your template.Tools & ideas mentioned • Treatment sheets (Plantar Fasciitis, Achilles, Warts, Nail Fungus) • Focused vs. radial shockwave for deeper/bony vs. tendinous issues • CAM boot for “never immobilized” over-use cases • Facebook ads notes from Ben Heath; use ChatGPT to generate hooks/copy • “Money model” framing inspired by Alex Hormozi (offer → packages → downsells → continuity)Calls to action • Want my treatment sheets? Email Don@PodiatryPracticeMastery.com • Interested in the 6-month challenge/mastermind to hit $1M+ personal production? Visit the site or email me.⸻Chapter timestamps (approximate) • 00:00 – Intro & Friday format: Why we batch routine care into a single half day • 01:10 – The 4 treatment sheets that matter: PF, Achilles, Warts, Nail Fungus • 03:10 – Batching playbook: Patients adapt to your limits if you set them clearly • 04:20 – Facebook ads in plain English: Ben Heath’s framework + ChatGPT for creative • 06:40 – Scribe leverage: Freeing up brainspace between patients to work on the business • 07:35 – Second/third-opinion wins: Why patients came (focused shockwave access) • 10:15 – Case nuance: Navicular bump, orthotic rub, and the power of proactive comms • 12:05 – Simple immobilization: When a CAM boot beats another round of theory • 13:20 – Money model overview: Offer → packages → downsells → continuity • 14:15 – Attraction offer: 48-hour guaranteed appointment vs “free” promos • 16:05 – Package menu: Basic (conservative care) → Advanced (6 Shockwave) → VIP (regen + priority) • 19:10 – Add-ons & downsells: Ultrasound, orthotics, phased Shockwave, CareCredit • 21:10 – Light continuity: Priority access without breaking templates • 22:30 – Wrap-up & next steps: What to implement this week

When I look back at some of the biggest “profit levers” in my practice, they usually weren’t flashy new surgeries — they were decisions around EMR billing, device investments, and how we packaged everyday care.In this episode, I answer questions from colleagues about EMRs (ModMed vs. Athena), shockwave machines, and a creative way to package ingrown toenail procedures for cash-pay patients. Each of these has the power to either leak revenue or multiply it depending on how you set things up.Here’s what you’ll learn in this episode: • Why EMR percentages matter more than software features for practice owners • How to choose the right shockwave device depending on your budget and goals • A smart way to package ingrown toenail care for cash-pay patients that patients loveSEO keywords: podiatry EMR comparison, ModMed vs Athena podiatry, podiatry shockwave device, ingrown toenail cash pay package, podiatry practice management tips⸻🕑 Timestamps • 00:00 – Intro – Why these small business decisions move the needle • 01:15 – ModMed vs. Athena – How EMR billing percentages impact profitability • 05:32 – Watch out for buy-and-bill traps – Qutenza, grafts, and hidden EMR fees • 08:44 – Shockwave strategy – Radial vs. focused, and which device I’d buy first starting out • 12:55 – The education factor – Why conferences matter as much as the machine • 15:22 – Google Ads idea from a colleague – Targeting ingrown toenails with less competition • 18:05 – Packaging ingrown toenail care – Consult, procedure, follow-up, and products bundled • 21:40 – Why patients love packages – Clarity, no surprises, professional positioning • 23:10 – Wrap-up & challenge – Share what’s working in your practice

Some treatments in podiatry look profitable on paper but carry hidden challenges. In this episode, I break down real-world lessons on KeryFlex nail restoration, Qutenza for neuropathy, and Swift therapy for warts—including costs, coding, patient communication, and clinical pearls.We’ll also dive into my current strategy for Google Business dominance using Swell to multiply reviews across multiple practice and provider listings.If you’ve ever wondered: • Is KeryFlex worth the time and learning curve? • How do I source Qutenza and bill it correctly? • What’s the best protocol for Swift (blocks, energy settings, and follow-ups)? • How can Google reviews become a practice-growth engine?👉 This episode delivers candid answers from the trenches to help you hit the million-dollar mark with clarity and confidence.Keywords: podiatry practice growth, KeryFlex podiatry, Qutenza podiatry billing, Swift wart therapy podiatry, podiatry Google reviews • 00:00 Intro, shoutout, scribe update • 00:50 KeryFlex: indications, pricing (kit + per-nail), FAQs & expectations • 05:00 Qutenza: sourcing, buy-and-bill vs specialty pharmacy, billing/application flow • 08:30 Swift protocol: energy settings, visit cadence, when to pair with cantharidin • 12:00 Google review “dominance” with Swell: office vs provider listings, staggered ask • 14:30 Rapid clinical pearls + wrap / challenge invite

Could a $4,000/month virtual assistant team from the Philippines outperform a $30,000 U.S. hire? And how do you track ROI when scaling ads and online marketing in podiatry?In this episode of Podiatry Practice Mastery, Dr. Don Pelto shares: • How he uses a virtual assistant (VA) to run websites, blogs, YouTube, email, SEO, and referral tracking inside ModMed • Why he’s investing in ads + proactive patient follow-up (phone calls from VAs to book appointments directly) • Insights from Alex Hormozi’s $100M Leads on patient acquisition cost (CAC) vs lifetime value (LTV) • Clinical pearls from the day: matrixectomies, ulcers, nail procedures, shockwave, Swift wart therapy, orthotics, and more • Why it pays to invest in better products and systems (orthotics, cam boots, treatment sheets) to reduce headaches and increase patient satisfaction👉 If you’re a podiatrist serious about scaling with smart marketing + operational leverage, this episode shows what’s possible.Keywords: podiatry virtual assistant, podiatry marketing ROI, podiatry SEO, podiatry practice growth, podiatry patient acquisition cost⸻📝 Show Notes with Timestamps (~18 min episode) • [00:00] Intro – Why I’m testing a bigger marketing spend with my VA team • [02:15] How our VA supports: SEO, urgent care page, blogs, patient emails • [04:00] New strategy: ads + proactive patient calls to book appointments • [06:10] Offshore vs U.S. pricing – $4K vs $30K for the same support • [07:20] Applying Hormozi’s CAC vs LTV framework to podiatry • [09:00] The “courage factor” in increasing ad spend and filling doctor schedules • [11:00] Clinical day highlights – lamisil booster, IPK, orthotics, nail samples • [12:30] Multiple matrixectomies + ulcer management in elderly patients • [14:30] Why I give treatment sheets (and now planning one for KeryFlex FAQs) • [15:50] Orthotics talk: Forward Motion vs Northwest, and why Aircast boots win • [17:10] Wrapping up: Swift case, wart care, and invitation to the 6-month challenge

Should you be billing non-operative fracture management — or just sticking with office visits + X-rays? And what’s the real story when switching EMRs like Athena to ModMed?In this episode of Podiatry Practice Mastery, Dr. Don Pelto shares:​ Why his practice delayed using the non-operative fracture management code (and the pros/cons once they adopted it)​ Practical insights on handling the 90-day global period, patient complaints, and profitability​ Tips for surviving an EMR transition (Athena → ModMed) — including training, templates, and billing features​ Clinical pearls from real patients: pediatric ankle pain, plantar fasciitis, Achilles tendonitis, ingrown toenails, warts, fractures, and wound care​ Practice growth strategies: how to identify your most valuable patient (MVP), capture hidden revenue with devices, and track lifetime value (LTV) + cost of acquisition (CAC)👉 For podiatrists serious about scaling to the million-dollar mark in personal production, this episode blends billing, operations, and clinical wisdom.Keywords: podiatry fracture management, podiatry EMR switch, ModMed podiatry tips, podiatry practice growth, podiatry billing codes⸻📝 Show Notes with Timestamps (~18 min episode)​ [00:00] Intro – Questions from colleagues on billing and EMR transitions​ [01:15] Non-operative fracture management: why we delayed using it​ [03:10] Pros + cons of fracture management (profitability vs 90-day global)​ [05:30] How ModMed helps with global tracking vs Athena​ [07:10] EMR switch tips: training, templates, and billing support​ [09:30] Most valuable patient case: 15-year-old swimmer with chronic ankle pain​ [11:40] Shockwave, plantar fascia, bunion + hammertoe pearls​ [13:20] Using DME + cam boots to capture hidden revenue​ [14:40] Wart treatment sheets and why I pre-book multiple visits​ [16:00] Tracking LTV + CAC: new spreadsheet tools for practice growth​ [17:30] Closing thoughts + invitation to the 6-month challenge

When patients start shockwave, they often expect to be pain-free in six weeks — but that’s not reality. In this episode of Podiatry Practice Mastery, Dr. Don Pelto shares how he sets patient expectations, handles difficult cases, and uses treatment sheets to keep patients engaged and compliant.You’ll also hear: • How to manage insertional tendinopathies with shockwave • Why clear treatment sheets simplify wart and nail care decisions • The hidden revenue in devices like cam boots (and why they’re often overlooked) • How to track lifetime value (LTV) and customer acquisition cost (CAC) to measure marketing ROI👉 Practical pearls for podiatrists looking to improve both patient care and practice profitability.• [00:00] Intro – Friday workflow: routine + regular patients • [01:10] Shockwave case 1: Achilles tightness after 6 sessions • [02:30] Shockwave case 2: plantar fasciitis flare after biking • [04:00] Shockwave case 3: insertional Achilles tendonitis & expectations • [07:10] Why setting expectations matters (shockwave follow-up timing) • [08:40] Using a “last visit shockwave sheet” for patient clarity • [09:30] Pyogenic granuloma case and biopsy workflow • [11:00] Cam boots as overlooked postop revenue • [12:20] Wart care: why I pre-book follow-ups + treatment sheet approach • [13:30] Quick pearls: routine care, nail cases, Swift vs laser priorities • [15:00] Practice growth metric focus: LTV + CAC tracking • [16:00] Closing + 6-month challenge invite

How can podiatrists make urgent care work in their practice — and is a virtual scribe really worth it? In this episode, Dr. Don Pelto shares practical strategies for filling schedules, streamlining documentation, and growing toward the million-dollar mark in personal production.⸻📝 Show Notes with Timestamps • [00:00] Intro – Why podiatry urgent care and virtual scribes are on podiatrists’ minds • [02:20] Insurance coverage in urgent care – how we screen plans, cash pay amounts, and lessons learned • [07:15] Why urgent care patients are often simpler (and how it fills newer doctors’ schedules) • [11:40] Speed as a unique selling proposition – why “seen within 24–48 hours” matters • [15:00] Virtual scribe setup – exact tech, cost, and workflow with Teams + Samsung phone • [20:45] Training a remote scribe on EMR documentation (and introducing them to patients) • [26:30] Is AI ready to replace scribes? My honest take • [30:50] Case pearls – plantar fasciitis, shockwave, Qutenza, nail and lesion care • [42:10] Biopsies made simple – my streamlined 2-minute workflow • [47:30] Scaling podcast SEO with Fiverr + ChatGPT – repurposing transcripts for visibility • [51:30] Closing thoughts – invitation to join the 6-month practice growth challenge

Ever wonder if a podiatry-specific urgent care can really work? In this episode of Podiatry Practice Mastery, Dr. Don Pelto breaks down how he set up an urgent care system inside his practice — and the marketing strategies that are helping fill schedules, especially for newer doctors.You’ll hear: • Why podiatry urgent care works differently than general urgent care clinics • How to structure online booking so urgent patients don’t disrupt office flow • The #1 marketing advantage of urgent care: speed of service • Simple, low-cost ways to promote urgent care with Facebook ads, postcards, and educational PDFs • How to partner with urgent care centers and PCPs to capture more direct referrals • Behind-the-scenes patient cases (plantar fasciitis, fungal nails, melanoma biopsy, and more) that highlight real practice revenue opportunitiesIf you’ve thought about urgent care as a way to grow your podiatry practice, this episode gives you the playbook — from scheduling logistics to direct response marketing tactics.👉 Join the upcoming 6-month practice growth challenge at PodiatryPracticeMastery.comKey Topics Covered • [00:00] Introduction – Shockwave resources, Notion, and Q&A format • [03:20] Is podiatry urgent care really urgent care? (What makes it different) • [07:15] How online booking slots simplify urgent visits • [11:00] Using urgent care to grow a new doctor’s schedule • [15:45] Marketing strategies: Facebook ads, postcards, and lead magnets • [22:30] Workshop idea: teaching urgent care centers how to triage foot issues • [29:40] Patient cases: plantar fasciitis, fungal nails, shockwave therapy • [42:10] Catching melanoma: why podiatrists should biopsy more often • [48:00] Scaling podcast SEO with Fiverr + ChatGPT help • [52:00] Closing thoughts + upcoming 6-month challengeResources Mentioned • Shockwave Resources – videos, protocols, and marketing ideas • Urgent Care Page Example – live marketing example • Podiatry Practice Mastery Challenge

The funny thing about practice is how our kids often see it differently than we do. My son recently told my wife he thinks I’m a YouTuber—because all he hears about are the videos and shorts I create. Truth is, I still love the clinic, but the videos bring variety and joy.Beyond family humor, today’s episode dives into a practical question from a colleague: Which shockwave machine should you buy? I break down radial, focused, and SoftWave devices—not just their costs, but their strengths, limitations, and the finesse required to use them well. It’s not just about the machine; it’s about setting patient expectations and growing confidence with the technology.Key Takeaways​ Radial shockwave covers 80% of podiatry needs and is budget-friendly for startups.​ Focused shockwave is the “workhorse” for bone, insertional tendinopathies, and nonunions.​ Patient outcomes often depend more on how we set expectations than on which device we use.SEO Keywords: podiatry shockwave therapy, radial vs focused shockwave, SoftWave podiatry, practice startup equipment, podiatry business pearlsEpisode Timestamps​ 00:00 — Why my kids think I’m a YouTuber​ 04:22 — A colleague’s question: which shockwave device to buy?​ 07:50 — Radial devices: cost, uses, and patient expectations​ 12:10 — Focused shockwave: why I call it the “workhorse”​ 17:20 — SoftWave pros and cons for podiatry practice​ 23:05 — Patient case: navicular pain resolved with focused shockwave​ 28:40 — Lessons on setting patient expectations and timing outcomes​ 34:15 — Daily practice pearls: pre-surgical discussions, x-rays, and shoe talks​ 45:20 — Review systems: why I switched from Clara back to Swell

In this episode of Podiatry Practice Mastery, I share how I balance old-school scribes with new-school AI tools like ChatGPT. You’ll hear how I:​ Use ChatGPT to optimize Google Business profiles and ads​ Leverage urgent care as a unique selling proposition​ Build systems around speed — because patients value quick access as much as quality careIf you’ve ever wondered how to practically use AI in your podiatry practice — without losing the human touch — this episode will give you actionable ideas you can apply right away.

This episode of Podiatry Practice Mastery explores the role of a medical scribe in my clinic, the fears AI is creating in the workplace, and why I see scribes as one of the best investments in efficiency and patient care.You’ll learn: • Why a scribe is more than just a note-taker. • How buying back your time can transform your practice and life. • The hidden risks of replacing people with AI too quickly. • A behind-the-scenes look at what a 50-patient Friday actually looks like in practice.👉 Tune in to see how outsourcing and smart delegation can help you grow your practice while giving you more time for what matters most.

Post 1 – Expanding Shockwave Beyond Heel PainWhen I first started with shockwave therapy, I only used it for plantar fasciitis, Achilles tendinitis, and a few forefoot conditions.Over time, I expanded: • Fractures – especially stubborn metatarsal stress fractures • Nerve pain – like neuromas and dorsal cutaneous nerve entrapmentsKey adjustments for nerve applications: • Low energy settings (around 0.05 mJ/mm²) • Focused head for targeted treatment • Usually 3 sessions to startThis evolution came from years of treating the “usual suspects” and then realizing the same technology could help more complex problems.Sometimes the best innovation in practice isn’t buying a new device — it’s learning new ways to use the one you already have.⸻Post 2 – Why I Moved from 3 to 6 Shockwave SessionsEarly in my shockwave career, my standard was 3 sessions, then a follow-up.The problem? • Most patients improved around week 5… when they were in physical therapy getting the credit!Now, I run 6 sessions for most soft tissue cases. • Improvement starts around session 5 • I’m still the one monitoring and guiding the progress • Patients see me as the one who helped them turn the cornerLesson: Sometimes small protocol changes can make a big impact — not just on results, but on patient trust and retention.⸻Post 3 – My “Sock Liner Test” for Nail & Toe PainMany toenail problems aren’t caused by fungus or trauma — they’re caused by shoes that are too small.Here’s my quick in-office test:1️⃣ Remove the sock liner from the patient’s shoe.2️⃣ Place their foot on it.3️⃣ If the toes go to the very edge, the shoe is too small.This visual is powerful — patients see how cramped their shoes are.It’s simple, memorable, and doesn’t require any special equipment.Sometimes the most effective patient education tool is already inside their shoe.

In this episode of Podiatry Practice Mastery, I share my most recent Pocket Coach session — a behind-the-scenes look at how I’m structuring my time using Free Days, Focus Days, and Buffer Days based on my time in Strategic Coach. You’ll hear: • Why Free Days (bike rides, family weekends, screen-free time) are critical for renewal • How Focus Days help me maximize revenue with high-value treatments • The role of Buffer Days in cleaning up the past and building new capabilities • My current quarterly, annual, and 3-year goals for practice, family, and personal healthIf you’ve ever felt like your time is scattered, this framework will help you focus, recharge, and grow.