The Decompression Confidence Code: Cracking the Code to Success
In this episode of the Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankinen break down the three essential pillars for building clinical confidence in spinal decompression—and how those pillars translate to any high‑ticket, cash‑based niche for chiropractors and independent physicians. They begin by emphasizing that confidence in a clinician’s skill set and protocol is contagious; patients sense authenticity and are willing to invest when they see a practitioner who truly believes in the treatment. The first pillar is a "world‑class" examination: a thorough, hands‑on assessment that aligns imaging with physical findings, creates a "wow" experience, and differentiates the clinician as an expert. The second pillar is systematic outcome tracking: they describe their own Excel‑based method of logging baseline pain, disability scores, protocol details, and percent improvement, noting consistent success rates of 82‑94 % over multiple years. The third pillar is a robust, proven treatment protocol that integrates decompression tables with adjunct therapies; they stress that the table alone does not make an expert, and that a multi‑component program, validated by national data (e.g., 91 % success in a Hill‑DT protocol), is the “secret sauce.” Throughout, they weave in anecdotes about building 7‑figure practices, the pitfalls of relying on equipment without expertise, and the necessity of complementary systems (patient flow, marketing, team building) to scale. The episode closes with a call to action for clinicians to adopt these three keys, avoid “easy‑button” marketing promises, and consider Specialized Practice’s coaching and certification programs.
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Welcome to the Practice Builders Podcast, hosted by Dr. Vince Leone and Dr. Kyle Pankinen, your source for building cash services. Let's dive in. Welcome back, everybody, to the Practice Builders Podcast. My name is Dr. Vince Leone.
And I'm Dr. Kyle Pankinen.
And today we are going to talk about the 3 keys to achieving clinical confidence in spinal decompression. And frankly, you could probably, Dr. Kyle, apply this to any high-ticket niche, right?
Absolutely. If you're gonna get into the world of niches, you know that when you get into something new, you know, you have to build confidence that it's going to be good for you as a doctor to offer this to your patients, but that it's also gonna be something that's gonna change many of your patients' life. And that's a process to build that. And there are, you know, at least 3 essential factors that, that we see that are necessary to build that confidence over, you know, a course of weeks to sometimes some months. And but if you build that confidence, it is one of the most essential things to being successful At any of these niches. So that's kind of what we want to dig into today. Any other thoughts as we dig into that, Dr. Vince?
Well, I think, you know, a couple things. One, I just, for all the listeners out there, you know, we don't say this to brag, only to say that, hey, at least you're listening to a couple guys that have done it. Not only, so, you know, I've built a 7-figure practice. Dr. Pinkerton has built a 7-figure practice, and now I coach 7-figure practitioners. So this is not Some, you know, pie in the sky or something we kind of try to think of, you know, make up along the way. This was something that we found through the trenches of what it takes to build a 7-figure practice, what it takes to enroll patients into care. Because what I found, Doc, and I don't know about you, but the confidence in your skill sets, in your protocols, in really the The confidence and belief that you can help the patient. I felt that that was— it just, it came across subconsciously to the patients, and that's what they really latched onto. That's why they grow, are, were willing to invest, right, hard-earned money to go through the protocol because they felt my confidence. Did you have a similar experience? Or do you have a similar experience? Because I know you're still in active practice.
Absolutely in active practice. That is, I think, one of the most essential things. Patients can, in most instances, detect a phony. They can detect somebody that's just trying to sell them something, but they, they, they can tell when you're not— this guy isn't really an expert. This guy doesn't seem to be any different than the doc down the street that I've been to. He's just trying to sell me more care, and they can see through that versus somebody who practices at, in a sense, a higher level that has confidence that can look a patient directly in the eye and give them— tell them what they need. with honesty and with a degree of ethics and standards. And they can— patients are not stupid. They can sense when somebody's just offering them something that'll line the doctor's pocket. And they can tell also when somebody's coming from a point of expertise and a point of caring and empathy, and that genuinely has the best patient interests in mind. So I think along that lines, let's dive into what we think are the top 3 essentials. I think, I think the first one is to conduct a world-class examination. That's what we teach the doctors that we consult with first and foremost. One of the things is you have to conduct an exam that inspires some degree of confidence In your patient never ceases to amaze me when I do consults with doctors that they don't even do an exam. I mean, I'm not talking anything other than a cursory palpatory exam and and maybe review their imaging studies, but never never conducted an examination on a patient, and that to me doesn't instill a lot of confidence. in the patient if you don't do a high-end exam. I don't know what your thoughts are on that, Doc, but I just think that that is a key component that patients need to see you do, an exam that sets you apart as a specialist.
Oh, I agree 100%. And one of our clients, Dr. James Bergtold, This is what he feels has allowed him to have the rapid growth that he has had in his practice, because he has patients now telling him, I've never had an exam like that. And so it immediately sets yourself apart, right? Because you're demonstrating, you're not telling them that you're an expert, you're demonstrating that you're an expert, right? And so they start to get a sense of Okay, I found the right place. At least we're going to figure out what is wrong. Because, Doc, I don't know about you, but a lot of times patients would come in and they were never really given a true diagnosis. They never really knew for sure why that they did not get the results, whether it's another chiropractor or a PT or anyone else. It doesn't really matter. But a lot of times, you know, we get patients after they've been to 3, 4, 5, 6 practitioners. And like I said, sometimes they, they never even know what the heck is going on with their body.
Yeah. So that's, that's where I even, docs, if you even, I totally agree with Dr. Vince. Sometimes they don't know, but then conversely, there are some people that know what's wrong with them and they come in, but then the doctor just simply relies on the imaging studies and still skips over the exam.
Yeah.
And I still don't think that's a good idea. You're imaging, you wanna make sure that your imaging studies that they have match as close as possible their exam findings so that you can tell that patient, well, yeah, your imaging says you have an L4-5 disc. Let's see if some of your exam findings also confirm that this is indeed a disc. And you run through that. And if there's a match, it increases one, your level of clinical confidence, but it increases The patient's confidence that, yeah, this doctor agrees with this diagnosis, but they still took those steps necessary to confirm what the findings are. And so I just can't emphasize that enough, that even though, yeah, does it take a little time to do a high-end exam? It does. But if you get really good at it and develop a good flow, 5, 10 minutes, you can master Have a great exam that gives you all the information you need and gives that patient what I like to call the wow experience, the wow factor. Like you said, nobody has ever given me an examination like that before. And really, five ten minutes—it's all takes.
Yeah, and you know, Dr. Kyle is really the expert in this. That's why he teaches this to our clients and also, you know, is teaching this at the decompression. Summit certification. And last year, you know, for those doctors that attended, they were raving about Dr. Kyle's session because he literally taught doctors how to do a world-class exam in 10 minutes. And it's— I just don't think there's any substitute for clinical excellence with these niches. If someone has a serious condition, they want to go to an expert. They want and they're willing to invest in an expert, but you have to be that expert. I always have the analogy, you know, like I was in last weekend in Atlanta at Dr. Matthew Loop's Social Media Revenue Summit. I was one of the sponsors, but we got to go drive the race cars at the Porsche Experience Center. And, you know, if I bought one of those race cars, that does not make me an expert, right? It actually makes me dangerous because I'm not an expert race car driver and my instructor would attest to that. But here's the thing. Doctors buy a decompression table or a laser or a shockwave, and they assume in some cases that that makes them an expert in that niche or that you know condition, etc. But there's two investments in my opinion. There's the first investment is in the equipment. The second investment needs to be in yourself so that you can raise that clinical expertise. Okay, let's go to number two. Key number two in achieving. Clinical confidence. Dr. Kyle, tracking stats.
Tracking your results. So the first year that I started decompression, it was one of those things when I added to my practice, I was like, well, okay, I have the table, we developed this protocol, but you know, you don't know. You, you know, you hear of other doctors around the country that are doing well, but I needed to know for myself. So what I did my first year of doing decompression is I literally kept an Excel spreadsheet, put their name on it, put their start pain, their start low back disability index, the protocol that I use maybe on their laser, whatever. And I, and I tracked all their percent improvement. So I did their beginning pain, their outcome assessment. Mm-hmm. And percent improvement, and then that when I got to the end, then I would do their ending pain, their ending index, and overall percent improvement. And I did that for every decompression case I had in my first year. And I figured I did it the first year. I might as well just keep on doing it. So I've done it every year since then. And what we have consistently found. I think the lowest year I ever had was 82% success rate, and the highest year I ever had was a 94% success rate. But it's always in that range somewhere. So that built my confidence up so I can look a patient in the eye after having a year of research and now many more of tracking my own stats. I can tell patient, Mrs. Jones, You have an 85 or an 88, whatever percent chance of achieving success with this program. This is what we've been seeing over the last several years. So last year I had an 85% success rate. So this year, what am I telling my patients in their report of findings? You have an 85% chance to achieve an excellent clinical outcome. With your condition, you want to build confidence. Track your results for that first year or two. And what I always tell doctors when I'm coaching them is you want your protocol to at least help 80% of your cases by at least 50% or more improvement. If you have a protocol that can do that, you have a pretty good protocol, and you can confidently recommending that. If you can't help at least 80% of your patients. Then you need to shore up your protocol a little bit more. Anything else with that, Dr. Vince?
I don't think so, other than because it's going to lead into our number 3. But there is, when we talk about, you know, achieving clinical confidence and confidence in being able to grow your decompression practice, or frankly, any niche that you're growing, when you go above and beyond and you're doing what other doctors are not doing, that's when you know you're on the right track. 'Cause if you had to guess how many doctors are tracking all their stats with their patients, and I'd have to say it's probably less than 5%. So if you're doing what other doctors are not, you are putting yourself into that elite category. It's gonna give you confidence just in doing it, just the process of doing it. Then if you have a great protocol, which we'll talk about in a second, then you're delivering the proper results that it, it just, it's like a flywheel effect, right? So you're, You're have a world-class exam. You're tracking your stats. You're delivering the results, and then it flows back into the next one. And so all that continues to create confidence for you in practice, which patients will—it's going to be palpable for them. So that is goes into number three: having a robust and proven protocol to deliver results.
Yeah, and that's, that's what we teach about decompression. Some people think, well, I have a table, therefore I'm a decompression doc. And decompression, a decompression table is a tool that helps you with these more complex cases, but you need to view decompression not as a table but as a program. And What we're gonna teach doctors at the, the summit coming up here in a few weeks is that you have your decompression table, but you have all these, uh, adjacent or adjunct treatments or therapies that support your decompression table. And so I always like to say, with treating especially chronic cases, there's no such thing as a magic bullet.
Mm-hmm.
In other words, you, it's rarely one element or one particular treatment that is the, the magic bullet or the cure-all. It, it's a program with parts that all work synergistically together to produce the best possible outcome. And so the protocol is, should be one that, one, you've tracked your results on, but two, that other doctors around the country are also doing. The same or very similar protocol, so that it you can tell patients this protocol has a proven track record. So if you're in your very first year of doing this, and maybe you don't have your own stats, but you can rely on the fact that there are hundreds of other doctors around the country that are doing a similar protocol that to what you're doing. And so that can give you the clinical confidence to recommend this protocol even if you're relatively new to it.
Yeah, that's an excellent point because, you know, when you first buy a table, you may not have that, that confidence, and that's okay. But if you can lean on a protocol that already has helped thousands of patients with this condition, then you're all of a sudden, you're not a newbie, right? You're, you're using a proven protocol and, and just I mean, we're not gonna go over our protocol because that's for, you know, what we teach our clients. So it's proprietary. But our protocol alone, there's 5 components to it, right? So I always, you know, think about this, like, if a spinal surgeon was like, you know, leaned into a buddy and was like, hey, how do you do that discectomy again? Or, or, or what do you do at the, at the midway point of that discectomy? It's like, what? No way. But it's the same thing as spinal decompression guys going, hey, how many visits are you doing? And you're practicing on people's lives. It's crazy to me. It borders on malpractice. And they say, well, that's what the decompression table company told me. Guys, these guys aren't practicing. And none of them are doctors for the most part. The vast majority are not. There's no doctor involved. Now, Dr. Burkhardt actually is involved at Hill, which is why we like Hill a lot. But these guys aren't in the trenches, right? So if you're going to, you know, call yourself an expert and, and, and, and offer and take, you know, high-value cash plans for these services, you really want to use a robust protocol so that you can give the patients the absolute best chance at succeeding. And decompression is a fantastic therapy, but just like Dr. Kyle said, It's not the only therapy that we use, and it's a lot of time the synergistic effects of all the adjunct therapies that go together to create the end result that is giving us such great clinical outcomes.
Absolutely agree. You know, I'll share just a little tiny bit of research as we wrap up here today. They have done— I've read almost every study they've done on decompression. A lot of them They use it as a monotherapy. In other words, it's a standalone therapy. And some of those early studies on that, they showed 60, 70% patients improve. But if you have that, you build that as your base, and then you add in these other component parts of a successful program, that's where you get to the 85 or 91 or like the Hill DT that I use in clinical practice, they've done study on the program that is recommended for that. And Dr. Burkhardt will be teaching in a couple weeks with us in his office. They showed a 91% success rate with that protocol, not just the table, the protocol.
Hmm.
And so that's, that's, that's, that's the secret sauce in a sense. Is having that robust protocol.
Yeah. So here's the good news. If, if you're a doctor that, you know, has a table, but maybe you haven't gotten the results, whether it's clinically or you've been able to build your practice, like, just know that, hey, the, the model is out there to make it highly successful. And so, but it's, it's, you know, I just, there's no reason for you to go Make it up or figure it out on your own. We've already figured it out, and that's what we teach our doctors at Specialized Practice. It's like, hey, we have— and what I found, we have the systems, the clinical, and the protocol, or, and the marketing. And so if you have those 3 things, and it all starts with the clinical stuff, you need to have the clinical skill sets, which we're talking about today, and the clinical protocols, and that is your foundation. Then you add in the systems. be able to process patients efficiently and enroll patients into care in the report of findings, and then the marketing to drive in new prospective patients into the machine, then that is what is going to give you the tools to grow really honestly as high as you want. But, you know, we have doctors that, um, are having significant growth in a very short period of time. Um, before the, before the podcast, I was just talking with Dr. Thinking about one of our clients, Dr. Morales. I mean, she's been in the program since I think is June, and she just bought a Mercedes G-Wagon. So go figure. It's— so it can happen fast. I mean, if you, if you, if you have a table and you have some of the equipment, you know, we can, we ramp doctors up fast. But even if you don't, you know, even if you're like, hey, I have a successful chiropractic practice, I want to work less, I'd like to make a little bit more and have some more free time. Man, adding one of these niches, especially decompression, is, in my opinion, it's like the cheat code to practice.
Couldn't agree more. It's so exciting to see some of these docs take their practice to the next level, even significantly above what we would call even the next level, and where they're doubling their practice. We've seen some doctors triple their practice and When you see that and you see the smiles on their faces and the new vehicles and the vacations and the extra time they have off, it's, it's worth it. It's rewarding to teach it and it's rewarding to practice that way.
100%. Okay, so those are our 3 keys to achieving high levels of clinical confidence: world-class exam, tracking your stats, and utilizing a robust protocol. Any, uh, parting words there, Dr. Kyle?
Put that together. And, uh, you can't ever erase the fact that no matter anybody that's successful in life or anything, you still got to put the work in. Anybody that's ever done anything well in their life or that's been successful, 98% of them will say, I didn't have it handed to me, I worked my butt off. And you still got to be willing to put in the work. But if you do that and you have these, these things that we just talked about today in the mix, you're going to have a high chance of success.
Yeah, 100%. I, and I totally agree with that. And I feel like, you know, unfortunately, from a marketing perspective, a lot of doctors or a lot of marketers, right, that could be marketing agencies, they could be consulting companies. They kind of dangle this like this easy button. Hey, all you got to do is, you know, Buy our thing and, you know, your practice will automatically go to 7 figures. And I just haven't seen that in reality, not only in chiropractic, honestly, Doc, but like in life. I don't know any millionaire that— unless they've inherited it— I don't know any millionaire that has not worked hard to get where they're at. And it doesn't mean you have to work hard forever, right? So, You can, but if you put in the work in the beginning, then, right, you have the systems, the clinical marketing to scale, and you can build out your team underneath you. Now you can, can kind of take your foot off the gas personally while your team does all the work. But, you know, it starts with the doctor. You are the owner. And so, yeah, you're gonna have to put in some work. I don't, you know, we don't want to try to sell you something that's not the reality. There needs to be the work put in by the doctor. But gosh, man, we ain't digging ditches here, Doc. I mean, we're— all we're trying to do is expand our scope of practice, be excellent at what we do, help patients live better lives. I mean, that's, that's the good life, in my opinion.
Yeah. And it's, it's a good life and it's rewarding if you do it the right way. And like I like to say often, you can put your head on the pillow at night, fall asleep pretty doggone quick because you worked hard and you're tired. But you can sleep peacefully because you know that you're doing an honest, ethical service and you're delivering the goods.
100%. So that's going to wrap up this episode. Hope this was helpful for all of you doctors out there. And please, if you would, if you're getting value out of this, share this with a colleague because, you know, last I checked, there's a lot of chiropractors and other type of independent physicians not doing that great in practice. And there's a lot of factors for that, but a lot of it's insurance. They're making it more and more difficult for all of us to be paid even commensurate with our skill levels. So, the answer again for us is high-ticket niches because it's all cash and it's going directly to the consumer. So, if you have a colleague that you think would benefit from this, please share this. With them. If you could like and subscribe and even write a review, that would be super helpful as well. And then finally, if this is of interest to you, go visit us at specializedpractice.com and there'll be a way to learn more. And to, if you want to set up a call to discuss, there's options there too. So until next time, Dr. Kyle, thank you so much. And, uh, we'll look forward to seeing you all on the next episode. Take care.
