Why Good Ideas Don’t Turn Into Practice Changes

How can teaching urgent care clinicians help you build referral relationships? Dr. Don Pelto opens this episode with the practice-growth context behind his lecture series for ConvenientMD: an urgent care page on the practice website and direct relationships with local clinicians.The recording then moves into the second of three live lectures, with an audience made up mostly of physician assistants. Don discusses foot and ankle presentations that can look similar but require different evaluation, protection and referral decisions.Topics include midfoot and ankle injuries, tendon concerns, fractures, the hot swollen neuropathic foot, diabetic wounds, foreign bodies and ingrown toenails. Audience questions explore the practical handoff between urgent care and specialist care.This is audio from an in-person lecture. Slides and procedure videos referenced in the session are not included in this audio episode.Chapters:00:00 Recorded introduction: the urgent care referral approach01:25 Live lecture: welcome and session context03:26 Walking boots, surgical shoes and initial protection05:25 Midfoot injuries and diagnostic look-alikes09:04 Achilles presentations and differential diagnosis11:27 High ankle sprains13:51 Fifth metatarsal injuries17:36 Stress fracture discussion19:45 Persistent ankle pain and osteochondral lesions21:08 Calcaneal injuries22:09 Great-toe and sesamoid presentations26:30 The hot, swollen neuropathic foot29:22 Diabetic wounds32:03 Puncture wounds and foreign bodies37:02 Ingrown toenails and procedure discussion46:47 Vascular and infection red flags47:51 Pediatric heel pain50:50 Specialist selection and audience questionsFor licensed healthcare professionals. This recording shares the speaker's clinical experience and views. It does not replace clinical judgment, current guidelines, local protocols or supervised procedural training. The podcast is not being offered for CME credit.

A lower EMR fee is only part of the decision. In this episode, Dr. Don Pelto shares what his practice learned while changing EMRs, including the time required to rebuild templates, train doctors and staff, move patient information and get everyday workflows working again.He explains why becoming a confident user matters even when you have a human or AI scribe, what helped during the transition, and why talking to a doctor who already uses the system can be more useful than a demonstration alone.Topics include:• Comparing subscription or percentage-based fees with the work of switching• Saving templates, explanations and macros before the move• Learning to document without depending entirely on a scribe• Preparing staff, patient information, billing workflows and reports• Getting practical help during and after the transition• Evaluating patient recall, review, communication and scheduling integrationsDon discusses his estimate of approximately $70,000 in annual savings for his four-doctor practice and his own experience with automated patient recall. Financial figures and vendor opinions reflect his practice experience, not independently verified results or guarantees. Costs, features and integrations vary by contract and practice.

How do you explain Swift to a patient without making the conversation overwhelming? In this episode, Dr. Don Pelto shares how he introduces Swift alongside other wart treatment options in his own practice.He discusses setting expectations about visits, cost and discomfort, explaining alternatives, and keeping the treatment conversation simple. He also describes how he adjusts the conversation when a patient needs a different approach.In this episode:00:00 Introducing Swift and setting expectations00:36 Keeping the first-visit conversation simple01:24 Discussing the treatment course and cost01:37 Explaining another treatment option02:06 Discussing additional alternatives02:48 Addressing discomfort and patient expectations03:27 Where home treatments enter the conversationFor clinician education. The discussion reflects Don’s personal practice experience. Outcomes and coverage vary. Treatment selection, device settings and use in children require appropriate clinical judgment and current manufacturer guidance.

How can diagnostic ultrasound fit into a busy podiatry practice? In this episode, Dr. Don Pelto shares his approach to using ultrasound at follow-up visits for plantar fascia, Achilles tendon and other soft-tissue concerns.He explains how he prepares patients for a possible ultrasound, coordinates the next visit with his team, compares both sides and documents the examination. He also discusses the practical trade-offs between two ultrasound systems and why showing patients their images can help them understand the treatment discussion.Topics covered:• Preparing patients for the next step at the initial visit• Follow-up workflow and staff preparation• Coverage and payment considerations from Don’s own practice• Bilateral comparison and consistent documentation• Using images to explain findings and discuss treatment optionsChapters:00:00 How ultrasound fits into Don’s workflow01:24 Payment considerations and bilateral comparison02:00 Documentation and equipment choices02:36 Other soft-tissue uses03:14 Helping patients understand their findingsFor clinicians and practice owners. This episode describes Don’s personal practice experience, not a universal diagnostic or billing protocol. Clinical decisions and coverage requirements depend on the patient and payer.

Have you ever left a conference with a page full of ideas, then returned to the office and implemented almost none of them?An email from an experienced podiatrist got me thinking about why this happens. Most of us want to improve our practices, but patient care, notes, staff questions and everyday responsibilities leave very little time to make changes.In this episode, I share the processes that help me follow through: a weekly meeting with my virtual marketing team, a Google Doc for ideas to discuss at our doctors’ meeting, and a content workflow that starts with one podcast recording.I also discuss the work involved in adopting new technology, how delegation helps create room for improvement, and why starting with one manageable change is often more useful than trying to implement everything you learned at a course.In this episode:- Why good ideas often go nowhere after a seminar- How I use a weekly marketing meeting to plan and delegate- Why I save ideas for our doctors’ meeting instead of bringing them all to staff immediately- How one podcast recording becomes the starting point for other content- Why AI can create another bottleneck if no one owns the next step- How small, consistent changes can help a practice make progressWhat helps you turn an idea into something you actually do? Email me at [email protected]:00 Why good ideas don’t lead to change01:31 A weekly meeting for follow-through02:09 Collect ideas before bringing them to staff02:41 One podcast as the starting point for content04:05 Learning without implementing05:38 Making room for changes in the practice07:11 Start with one small, consistent change09:08 Keep trying and improve as you go

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What can you learn from a highly productive podiatrist who prioritizes listening, patient education, and personalized care? In part two of his podiatrist annual self-evaluation series, Dr. Don Pelto reviews his partner's answers and explores how asking better questions, explaining treatment options, and giving patients a clear plan can contribute to patient satisfaction and practice production.Don also discusses the challenges of running behind schedule, managing difficult patient encounters, improving staff communication, and creating longer appointment blocks for complex cases. Discover how experienced podiatrists can use self-evaluations to identify opportunities for improvement, mentor younger doctors, and transition toward a more sustainable clinical schedule without losing sight of practice profitability.Keywords: podiatrist self-evaluation, podiatry patient communication, associate podiatrist mentoring, podiatry practice productivity, podiatry practice management

What do you do when a patient has severe foot pain, but the examination doesn't reveal a clear explanation? In this episode of Podiatry Practice Mastery, Dr. Don Pelto shares the case of a 25-year-old woman who had already seen several doctors, tried different shoes and orthotics, and continued to experience significant foot pain. Drawing on ideas from The Body Keeps the Score and Dr. Sarno's work, Don explores the relationship between pain, the nervous system, stress, and past emotional experiences.Discover why persistent foot pain sometimes requires looking beyond traditional biomechanical explanations, how to approach sensitive conversations with patients, and why collaboration with primary care and mental health professionals may be valuable. This episode encourages podiatrists to consider a broader approach to unexplained pain while recognizing that pain is real even when its underlying cause isn't immediately apparent.Keywords: chronic foot pain, mind-body connection and pain, unexplained foot pain, trauma-informed podiatry, nervous system and chronic pain

How do you evaluate an associate podiatrist's performance and identify opportunities for improvement without making the review process uncomfortable or overly focused on production? In this episode of Podiatry Practice Mastery, Dr. Don Pelto walks through the annual podiatrist self-evaluation form he created with ChatGPT and shares his own answers. He examines clinical confidence, treatment planning, scheduling, productivity, patient retention, practice growth, and team communication.Discover how a structured self-evaluation can help you identify strengths, recognize areas where coaching could make a difference, and establish meaningful goals for the next 90 days. Don also shares practical examples from his own practice, including improving orthotic recommendations, delegating treatments, refining patient scheduling, and using outside coaching to develop clinical confidence. Whether you're reviewing an associate or evaluating your own performance, this episode offers a framework for more productive conversations and continuous improvement.Keywords: podiatrist self-evaluation, associate podiatrist performance review, podiatry practice productivity, podiatrist professional development, podiatry practice management

Could an AI medical scribe help you capture revenue you're currently missing in your podiatry practice? In this episode of Podiatry Practice Mastery, Dr. Don Pelto shares how using an AI scribe during routine nail care appointments has helped him document additional evaluation and management services that he previously overlooked during busy clinic sessions.Through five real patient examples involving hematomas, exostosis, neuropathy, and fall risk, Don explains how AI-assisted documentation helps him capture the clinical work he's already performing. Discover how an AI scribe can improve documentation efficiency, support appropriate medical billing, and help you evaluate whether switching from a traditional scribe makes financial sense for your practice.Keywords: AI medical scribe for podiatrists, podiatry billing and coding, E/M billing during nail care, AI scribe ROI, podiatry practice profitability