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 love

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🕑 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