Why Most Doctors Fail with Spinal Decompression

Okay, hello and welcome to our webinar, Why Most Doctors Fail with Spinal Decompression Even with the Right Table: How to Turn Decompression into a Consistent, High-Value Profit Center. My name is Dr. Vince Leone. I want to thank you all so much for attending. I realize that you are all busy, and so I appreciate you taking the time to join us today. Okay, so Rick says it's fine. Okay, good. So it must have just been that particular doctor. So we'll go ahead and dive in here. Um, again, thanks so much for joining, and I hope you get a lot of value out of today. Obviously, you know, we can't— I can't download what I've learned since, you know, 2012 on growing spinal decompression to multiple 7 figures in 35 to 45 minutes. My goal is for, uh, for you guys to be able to get a good sense of Why you may be not achieving you know the goals that you want in spinal decompression, and what those and why, right? Because if we can, the first job is just awareness. Like why are we not achieving our goals with spinal decompression? Because I honestly believe, I mean spinal decompression, especially right now with what we're seeing in our membership. is it has so many use cases beyond just bulging and herniated discs. So, this niche is only going to grow and grow. And this is the absolute best time to be focused on this particular niche. It's the one niche, you know, because you can do weight loss, you can do knee, you can do neuropathy, plantar fasciitis. I mean, there's lots of niches, functional medicine, blah, blah, blah. But spinal decompression is the one niche. that most closely aligns with our scope of practice. And so, we're already experts in the spine, and adding and growing this is just such a natural next step to increase cash revenue, position yourself as an expert, make your practice more valuable to sell. So, the list of benefits just goes on and on. And so, my goal is to help as many doctors In our industry, add and grow spinal decompression in their practice, and then through them, help patients suffering from chronic neck and back pain get the relief that they need and deserve, and get off drugs, avoid unnecessary surgery. I always told my doctors and, you know, anyone I speak with about spinal decompression, I never speak poorly about physical therapists or spinal surgeons. Everyone's just trying to help patients. And spinal surgeons in particular, I mean, these are highly educated individuals, and they they do the best job that they can. And there's lots of cases where there is surgery needed, but there are lots of cases where it is not needed. And that's where we really need to position ourselves to provide that non-surgical solution for doctors. Now, if you stay till the end, I have a free gift for you. And I wrote this in the fourth quarter of 2025. It's called the State of Spinal Decompression. Benchmarks, Insights, and Predictions for Growth-Minded Chiropractors. This is a PDF. It's extremely well-researched. It's about 63 pages, so it's not a, you know, it's not the encyclopedia of spinal decompression, but it is going to give you a very high-level look at, you know, where we're at, where we are at right now in the spinal decompression evolution, predictions, and trends. Wonderful research articles that support what we do. This normally sells for $49. If you, if you stay to the end, I'll give you a way to go ahead and get this for free. And we'll just give you a simple email address. You just shoot me an email, say, hey, I attended your webinar, and I will return that with the PDF. But it's a— put a lot of time, effort, energy into it, and I think that it will give you more confidence as you move forward in your spinal decompression journey. So quickly, Who am I? Now, I couldn't figure out the video for whatever reason, so that's why you don't see me. But my name is Dr. Vince Leone, founder of Specialized Practice. We've helped well over 100 clinics implement spinal decompression systems and scale those up. Had my own multiple 7-figure decompression clinic as well. So this is not theory. It's all based on what has worked in the trenches. And really on all aspects, right, from the clinical aspect to systems and staff to, of course, marketing. And so everything we're going to talk about today and hopefully that you will learn is all based on successfully scaling spinal decompression. So moving on. So you bought the table. Now what? This is always the most frustrating part, right? Doctors kind of think, well, shoot, I made the investment in the table, and that could be a $10,000 investment, it could be a $100,000 investment, just depends on, you know, which table you bought. By the way, if you are in the process of trying to choose a table, I just wrote a very simple PDF that goes through, I I think about 5 or 6 of the primary tables. I think it was 5. But if you want that PDF, you can shoot an email, support@drvince— no, support@specializedpractice.com, and I will get that over to you. Just a really good high-level look at what the different tables are, price points, pros and cons. But probably most of you doctors, you already have a table at this point. And so you have the table. And, you know, patients aren't lining up. They aren't clamoring to get on the table. They're not begging you to sell them a care plan. So, that's kind of the first frustrating touchpoint. The marketing may feel inconsistent, right? Sometimes you get patients in, sometimes you don't. Sometimes leads are good, sometimes they're bad. Sometimes they don't even pick up the phone. Sometimes When you call them, they said, I didn't register for this. That's the joys of online marketing. It's just kind of part of the game. But the point being is your marketing feels inconsistent. One month you get zero new patients for decompression, the next month you get maybe 2 or 3, but it's just up and down. And what we want to create is a very consistent flow of high-quality patients that we can Evaluate properly, determine if they're a good candidate for care, and enroll into high-value cash care plans, and then finally deliver predictable, outstanding clinical outcomes. And that's the next thing— results are unpredictable. So, you may have a patient, you may, you know, be offering spinal decompression, you are getting them under care, but you're not getting the results. You may not be following a proven protocol. You may be doing the old, which I don't like at all. Hey, let's try it for 6 visits, see what happens, you know, see if you progress. Well, that is a terrible, terrible way to do spinal decompression, and I'll tell you why. I, you know, in our practice, we, you know, we had 4 tables, again, multiple 7 figures, hundreds and hundreds, if not thousands of patients through. Lots of patients respond after, say, 12 visits, 16 visits, 20 visits. Like, you know, we don't have a crystal ball. What we do know that the research supports minimum viable dose of 20 visits, right? That is what the research supports. So, if you're not even getting patients to 20 visits, you're not even getting them, giving them a fair shot. And it's not your job to You know, guarantee them results. Your job is to have extraordinary clinical skill sets around DiSC, be able to determine if they're a good candidate for care, enroll them into care, and then let the protocol do the work. So, when we do this properly, results do become predictable, right? But when we have, you know, patients that aren't lining up and the marketing feels inconsistent, results are unpredictable, staff doesn't know what the heck's going on, you're doing all Well, this leads to a lack of confidence, right? And a lack of confidence, A, doesn't make practice very fun. B, doesn't really inspire you to work harder to grow the niche because it just feels like they're, you know, it's just unpredictable, right? And so that confidence or lack thereof is then translated to the patient. And no patient is going to sign up for care or continue with care if the doctor doesn't have the confidence that he can or she can deliver the results. So, what I would tell you is this is not your fault. Okay, because you were never taught how to build a decompression system correctly. It's not taught in schools for sure. The manufacturer certainly isn't going to teach you how to predictably layer in a comprehensive spinal decompression system and scale it because their job is to sell you equipment, not systems, not training. Now, they may have some videos or something and they'll, you know, AirDrop them to you or, you know, give you a sign-in. But that is a poor excuse for training. And again, I'm not blaming the table manufacturers. That's not their job. Their job is to make a great table, right? And some do and some don't. But the point being is their job is to make the table. Their job is not to train you. I always say there's 2 investments. If you want to grow spinal decompression successfully, you have to make 2 investments. The first one is in the table. The second one is in yourself. You've got to become an expert in disc and spinal decompression if you want to scale this niche. When patients have chronic neck and back pain, and they've been suffering from chronic neck and back pain for months or years, and I know this because I went through this myself, but if they've been suffering for months and years, and they've tried chiros and PTs, and they've had surgical consults, and they've tried pills, potions, and lotions off Amazon, they are frustrated. They are skeptical, and if they come to you and they don't sense that you know exactly what you're doing and have that rock-solid confidence, they will move on because they don't trust you. Okay, but again, no one probably ever talked to you about this, right? That's why specialized practice exists. This is what we do. This is this is what we are an expert at, right? This is based on seven-figure experience, based on hundreds of doctors going through the program getting excellent results. So. It's not your fault that you didn't know this up until this point. It will be your fault if you decide to ignore it and just, you know, kind of move on as you have done in the past. And, you know, the past is a very good predictor of the future. So, if you keep doing what you've always been doing, you'll probably get the results that you always got. So, you got to change things up. Because decompression does not fail, right? Systems fail. So the tables work, but if you don't have the systems to evaluate a patient properly, enroll them into care, deliver great results, have a robust protocol, right, that delivers the results, team that handles the bulk of patient care, marketing that drives in good quality patients, that's what fails. Now, so why do most doctors struggle? No defined patient journey, no education, and no systems. Okay, if you think patients are unclear on what chiropractic does, try spinal decompression. I mean, they have no idea. They don't know that it hydrates the disc. They don't know that it creates a pumping motion. They don't know that it creates negative pressure in the middle of the disc. They don't know that at the Disc will then absorb water from the body, increase disc height, pull in bulges, et cetera, et cetera, et cetera. They don't know any of that. Again, they're coming to you. You're supposed to know all that. And then you then educate the patient about that, just like you have educated the patients about chiropractic, you know, the value of chiropractic and what it does and how it works and how it improves their overall life quality. Well, we need to do the same thing With our spinal decompression patients because this is new to them, even though it's been around 20-plus years, if not longer, it is still new to them. And so we need to have a really clearly defined patient journey. In other words, what happens on day 1? What happens on day 2? How are they educated? Are they getting webinars? Are they getting reports? Are they getting pre-consultation videos? How is the staff trained up? On how to process these patients, track these patients? Are they taking notes on every, on every visit? What happens if things, you know, are going sideways? What do they do then? All of these kind of components of the patient journey while under your care is critical. So most doctors don't have it. They don't have those things thought out. They haven't addressed that side of clinical care. Weak exams. Oh man, this is huge, right? If you don't have a world-class exam, I, I always say the close starts in the consult, and I don't even love the word close, frankly. I like, hey, we're going to enroll patients into care. But just very simply, the close starts in the consult. If you are kind of looking for some type of silver bullet in the report of findings to kind of hard sell or You know, force someone into care or anything of that nature, it's going to fail. I mean, are there sales and persuasion techniques? Yeah, 100%. But first, we need to earn their trust by doing a really world-class— what we call a world-class exam. A poor case presentation. If you— like, I remember, like, one of my early coaches was Dr. Eric Brighton-Moser, and he was kind of famous for the 5-minute ROF. And frankly, you know, for chiro, that worked, worked just fine. Really, you know, I've had 4 or 5 coaches, you know, in the chiropractic industry, have learned tremendous amount of information from all of them. And I enjoyed having— I love having coaches. You know, Dr. Eric, really, I credit him for saving my career because he is the one that shifted me into niches back in 2009. Yeah. But the 5-minute ROF doesn't fly with spinal decompression, right? We have got to be more thorough. You know, I remember, you know, I had to have a surgery. Well, my surgeon pulled out his pad of paper that I know he's done this a million times, but he drew exactly what was going to happen. You know, so it clarified everything. So clarity equals confidence. So you have to have a really structured Report of findings to create clarity for the patient, right? So if they don't understand what they're investing in, they're not gonna invest in it. It's like if I said, "Hey, I got this amazing real estate deal. You know, got six units in Scottsdale, and you know the rent's this and da da da da da." And but you don't understand the deal. You don't understand real estate. Well, you're not going to drop you know the money to invest in that, right? Because you don't understand it. You're not going to risk. your hard-earned money for something that you don't understand. And it's the exact same. It's a little smaller scale, right? It's the same thing, you know, when you're, you know, asking a patient to invest $5,000 with you or $3,000 or $7,000, whatever the case plan is. But you're asking them to invest their hard-earned money, right? They could spend that in lots of different ways, right? They could take a trip. They could buy a TV. They could, you know, buy a purse if they really want to splurge. You know, they could do some remodeling on their house. There's lots of ways spend $5,000, you know, are they going to spend it with you? Is the value there? So it's not a matter of cost, it's a matter of value. So poor case presentation will not account for that. Treating too early. There's another one, and we'll talk about this in just a second. And then no positioning. So if you're not seen as an expert and you're kind of just seen as, you know, just like every other chiro in your city, It's— in other words, if they, if they, if their experience with you feels like the experience with every other chiropractor, they're going to expect to do what they've done with every other chiropractor or PT, use their insurance. But if things are different, if they gain clarity and trust, then that's when things change. And that's what positioning is, right? Positioning you as the go-to expert for spinal decompression. So, let's go through the key mistakes. So, mistake number 1, buying a table without a system. So, equipment does not equal outcomes. Again, the table can do amazing things. But in my experience, well, obviously, one, we have to qualify the patient properly, make sure that they're a candidate for care. The systems to deliver the care is obviously crucial, but we have also, you know, added to our decompression protocol with other adjunct therapies. You know, things that can help accelerate the healing process, help eliminate potential complications in the healing journey, right? So just the equipment does not equal the outcomes. And, you know, immediately hiring— this is the big mistake that, you know, I feel like a lot of doctors do. They buy a table and they run out and hire an agency, right? And then they complain that the agency sucks. And maybe they do and maybe they don't. I don't know. But the point being is before you try to flood your office with all these people seeking care. Again, you have to have the system in place to qualify, enroll, etc. Now, mistake number 2. So, what I want you to be thinking as we go through these kind of key mistakes, and there are 6 of them, which one do you fall into? Right. Which mistake are you making? And look, Again, it's all about awareness. Progress starts with the truth. So there's no, no one's shaming, no one's shaming anybody. I'm not trying to talk down to you. I am a colleague of yours. I'm, I've just, I've been there and done that, right? So I'm trying to share with you to shortcut your path to success, right? I don't want you to continue to struggle. I want you to succeed. I want you to do very well. You know, I was just on our Client Q&A this morning, and our doctors are, you know, their, their lives are being changed. It's not just the money either. They're loving the results. They're, uh, loving, you know, the, um, the quality of the, uh, patient journey. They're loving that the, the increase in revenue— that's always nice. They're loving the confidence. Um, that's what's really fun for me. It's not fun to see a doctor struggle. when I know how hard you've worked to get where you're at, right? You've invested all the time in earning your degree and building a practice and hiring staff. And, you know, a lot of stuff falls on our shoulders as independent business owners. And so, I want to see you succeed because life is way more fun that way. So, mistake number 2 is not having world-class clinical skill sets and exams specific to DiSC. Okay, so, you know, in our program at Specialized Practice, what we call the Decompression Accelerator, we have what we call our world-class exam training. And so why is this so important? Well, the first thing is we have to figure out what the primary pain generator is, right? We have to have the confidence that we know, hey, this is a, this is, this is a great candidate for spinal decompression. I've feel very strongly that they're going to get excellent clinical outcomes? Well, that all comes back to the, the exam, the world-class exam, or whether it's not a world-class exam. So if you're just doing a couple orthopedic tests and range of motion, I would tell you that that's just not enough. It's just not enough. It's not enough for you to get enough information to have the confidence to recommend care. Right. And it certainly isn't enough for the patient to get a sense that they are in the presence of an expert, right? And confidence is earned. You got to put in the work, right? You know, my dad would always say, you know, everyone wants fire, but no one wants to put in the wood. Well, what is the wood? The wood is the time, the energy, the financials to build yourself up to expert status. So when we don't have world-class clinical skills and a world-class exam specific to spinal decompression and disc It does not create the confidence that we need. The confidence is weak. So the patient senses they're not working with an expert, and then you hear, let me think about it, right? How many times have you said, let, you know, patient, let me think about it, let me talk to my spouse, let me go home to look at my finances, like all these same lines time and time again. And you know what the easiest thing to do? At that point, blame it on the money. Oh, they didn't have any money. Oh, these leads are poor. Da da da da da. Guys, I'm telling you, that ain't the case. If they have a cell phone, if they have a job, and if they drove to your office, they can afford your care. Okay? And you should assume that. Now, if someone's taking the bus to your office, that should actually be—they they could be—they should be DQ'd on the phone. By a good front desk person. Okay, everyone has a cell phone. Now, if they don't have a job, again, red flag, right? And so, but I'm telling you, if they have a cell phone and they have a job and they have a car, 9 times out of 10, they can afford your care. It's just a matter of, do they value your care? If they do not value your care, if they do not respect you as an expert, And they don't believe that you can help them transform their life, they're going to tell you, let me think about it, let me talk to my spouse, let me look at my finances. Okay, so that's what— that's mistake number 2. And that's, that's why our whole ethos, that's our very first principle of spinal— our specialized practice is clinical excellence, right? We make experts. So mistake number 3. Moving along, treating on day 1. This is a big no-no. Right now, even if you're running some type of new patient special where it's a consult and exam and imaging, either taking imaging or imaging review and trial treatment and report of findings, even if you're running that special and, you know, some— in some markets that still works and some markets it doesn't, right? But the point being is, if you're doing that, That's okay. Uh, if it's getting in, you know, good quality people. But my— what I'm telling you is don't treat on day 1. And the reason why is because it kills your authority. Why? Because it skips the diagnosis. You haven't even determined, right, if they're a candidate for care. In other words, if you do your consult, exam, trial treatment, You haven't taken the time to correlate the, the 3 key things to determine if they're a candidate for care or not. So we need subjective complaints that line up with the disc. We need objective findings that line up with the disc, and then we need imaging that line up with the disc. Now, the caveat to this is if you— So, well, Dr. Vince, I do everything on, on one, in one day. Okay. No worries there. But in other words, like, so if you do your consult, your exam, your imaging, and then you say, okay, Mrs. Jones, so I'm going to take a little bit of time. You can go across the street, grab a cup of coffee, or we— or you can just hang out here. We'll get you water, but just make yourself comfortable. I just need about 20, 30 minutes. I'm going to review everything, and then we'll go over your review of findings, and if it's safe and necessary, we'll do your trial treatment. Well, I'm gonna—I want a treatment whether I—you know. Wait, do you want to make things worse? Well, no. But I paid for this. I paid for this trial treatment. No problem. Hey, if you're not a candidate, we'll just refund the forty nine dollars. No problem whatsoever. But I don't want to put you on the table and make things worse. Does that make sense? Yes. Okay, great. So are you okay hanging out? Yep, I can do that. Perfect. Then you do. Essentially what we call an all-in day 1. Okay, so then you're, um, uh, you do all the things I just talked about, then you actually do go back to your office and review everything. You get those 3 things, make sure they line up, and if they are a candidate and there's no contraindications, boom, then you go on your report of findings, you do your trial treatment, and you start care. That's when you can treat on day 1. But the mistake most doctors make is they run these specials They do the consult, the exam, the trial treatment, and then they bring them back for day 2 for the ROF. It's totally ass backwards. I'm just— it just makes no sense. So anyways, stop doing that. That is a big mistake. It's going to lower your conversion. It's like, you know, you go into your surgeon and you say, okay, I need this surgery. Okay, great. So we're going to get started today. And then on your next appointment, I'm going to go over the report of findings and what I recommend. And you're, you're like thinking, well, that sounds silly. Same darn thing with spinal decompression. Okay, so now you may say, well, but they, they're in pain. I get it. They've been in pain for a long time. It's chronic, right? It's not, it's not your job to save them on day 1. Your job on day 1 is to evaluate them, determine if they're a candidate for care. Right now, you can manage Pain, right? You can— hey, no problem. Let me get you an ice pack. We'll calm it down a little bit, or heat pack will calm it down. If you have laser, you could say, hey, you know what? I'm just gonna throw in a little laser treatment today. I don't see any contraindications on laser for you. We'll just do a 10-minute laser treatment. That should calm things down a little bit. You could do that. Typically, all we would do is ice. Hey, no problem, but we're not treating today, right? But here's an ice pack. I want you to sit, rest. We'll do a little ice. Let me go back and look. Or if they're coming back for day 2 on the next day, hey, take the ice pack home. You know, what have you been doing for pain management up to this point? Well, I've been doing this, that, and the other. Okay, well, I just want you to add in the ice. You know, I can't recommend drugs, but you know, if it was me, you know, and I was in a lot of back pain, which I've been, I would take an extra strength Tylenol. That's what I did. Not telling you to do it. I'm just saying that that worked for me. So you may consider that. Point being, don't treat on day 1 because we got to figure out what's the problem and can you help. Okay, mistake number 4, a weak report of findings. So now, by the way, your report of findings don't need to be like an hour long. Like, you can get through our report in 20 to 30 minutes if you're efficient. And so, but a weak report of findings, if it's too clinical, Like, the clinical's for you. Do you know what I'm saying? Like, do we want to go through their primary orthopedic tests? Yes. That were positive? Yes. Do we want to show their imaging and where the problem is? Yes. Do we want to dive into the nuances of all things spine-related? No. So, when I say sell the trip, think about it like you're going on vacation, right? And you go into a travel agent who don't— they don't exist anymore. So, just go with me here. It's just for the analogy. So, you go to a travel agent and say, I want to go to Tahiti. And they're like, okay, great. Let's get you set up. Now, let me tell you about this plane ride. And you're like, the plane ride? Oh, yeah, yeah, yeah. These seats, they're really comfortable and they're going to serve you this food. And this is the large man going to be next to you and he doesn't smell so good. But that's okay. Don't worry about him. And you're like, no, no, no, tell me about the beach, the margaritas, the palm trees. Like, tell me about Tahiti. That's what you kind of want to quote unquote sell. You want to, you know, hey, what happens when we're done with this? Like, what does life look like? You know, what are you going to get back to doing? And that kind of goes into the emotional trigger. So in your consultation, we want to get what is this condition taking away from them. Can't play with their grandkids or kids, can't work, can't sleep, can't have sex, can't golf, can't play tennis, can't exercise. Whatever that thing is that the condition is taking away, that's the trigger, right? So you want to figure out, well, what is the most important one? And that's what we're going to focus on. That is the trip. Hey, we're here. They don't care about visits and, you know, Decompression tables and lasers and all that type of stuff. What they care about is what their transformation will be if they invest in this journey with you, right? So we do want to tie into the emotional side of things because that's actually what's fun about practice is giving people their life back, right? So we talked about this already: no certainty, right? So if you don't have certainty that they're gonna You know, get the results, or they have an excellent chance at getting results. No close, no structure. If you're going into every report of findings for spinal decompression and they're worth $5,000 and you don't have a structured report, it's just going to create chaos, right? You know what we teach is obviously we have a very structured report of findings, and we use certain tools and at a certain point along the way, and we ask certain questions to overcome common objections and all this type of stuff. But if you're just kind of winging it, and you know, again, it's it's not just the money, right? I mean, five thousand dollars would be great to put into the bank account, but it's also a missed opportunity for this person to change their life, right? You never know what's going to happen if you know, you know they don't understand decompression. They don't you know trust you. They don't realize that they can get the transformation in your office, and then they. go somewhere else, or maybe they go to surgery, or maybe they just get hooked on drugs for the rest of their life, and that happens too. So no one talks about the opioid crisis. I don't know why, but it's still raging. People are still taking all that crap on a regular basis because they can't deal with the pain. They have to do something. Ask me how I know. I went through this, okay? Not the opioid side, but just chronic pain specific to a disc issue. So, So you need a really, you know, need to have structure so that when you go into each of your report of findings, you know exactly what you're going to do first, second, third, fourth. And you should know how much time that's going to take roughly, right? Then you're going to get— because we have, we have the front half, we have the transition, and we have the back half. So, and you should know, hey, I'm, you know, it's 10 minutes in, I should be roughly at this point in the report. And, and so that you can have a schedule that runs on time. All of the systems, all of this, you know, kind of melds into a well or strongly functioning decompression system. With no structure, you just get chaos. And if there's no education, right, if you don't teach them, you know, what does spinal decompression do that nothing else does? Right? And you, and you can, and by the way, you can do this in 2 minutes, but how it hydrates the disc and how it's the non-surgical, only non-surgical solution that does that. You don't get that aha because when you do teach that and patients have never heard it and they've been to chiro, they've been to PT, they've had a surgical consult, then what you typically will hear when you teach them this, they're like, why didn't anyone ever tell me this? Why is this information not readily available and out there? That's the aha. That's when, you know, you start to really gain their trust and they want to work with you because you taught them something no one else did, right? So that's mistake number 4. Mistake number 5 is poor patient selection. So, you know, we don't want to just obviously put everybody on the table, right? So that goes back to the qualification and the evaluation process. This is a huge one, not setting expectations. So, um, in our system, our goal is to get 80% of our patients 50% or better. Okay, 80% of our patients 50% or better. That's our bare minimum for success. Okay, so if you have a patient that's 75 years old, the pain is 7 out of 10, They've lived with this for years, and they go on the table and they get to like a 3, you know, out of 10, and they're able to sleep and, you know, do some of their normal activities of daily living. If we don't set the proper expectations and they're thinking they're going to go to 0, and you don't get them there, but you get them to a 3, which is amazing. Right? Like, you can live your life on, uh, 2 out of 3, right? But 7 out of 10 can't. But if you can get someone, you know, again, 50%, and usually it's much greater than that, right? It's just that's the bare minimum. So, but if you don't set the proper expectations with the patient in the ROF of what success looks like, well, then you are both— you're not on the same page. Like, in other words, they're thinking, whether they tell you or not, hey, I'm going to get out of pain, period, and I can kind of do whatever I want to do. A lot of times patients have unrealistic expectations. Well, we need to set the expectations because we are the doctor and we have the experience. Their experience is, hey, you said you could help me, so I'm just assuming I'm going to zero on the pain scale. So, but if you properly set the expectations in the report of findings. Hey, this is what I anticipate for you. Okay, so I think you're going to get great results, but this is what those results look like. If I can get you from a 7 out of 10, right, and you're not able to go on walks with your spouse, etc., but if I can get you to say like a 3 out of 10, maybe better, but like if I can get you to a 3 out of 10 on the pain scale and you probably will do walks with your spouse again, would that look like success? To you? Because if they say no, no, no, I want to be completely pain-free. I'm 75 years old. It's like, dude, there's a little too much tread on the tire to be expecting to feel like you're 25 years old again. And I always say that. I say, hey, I don't make the rules here. God made your body and you've been around for a long time. We're not going to feel 20 years old again. Do you understand that? Yeah, I get it. Okay. I just want to make sure because at the end of our protocol, this is what I anticipate for you to get to. It may be better. It probably will be. But this is what I consider success. Are you okay with that? Because it doesn't make sense for you to move forward unless you are. Do you see the difference? Do you see how that would actually gain trust? Because you're not, you know, simping for them to sign up. You're setting the expectations, you're determining what success looks like, and they have to choose if they're gonna play in your game, right? So, um, what happens if you don't do this is it leads to failed, quote unquote, failed cases. Like, they They walk out of there if the expectations are not set properly and they're like, that decompression didn't work. Then they tell their friends, well, screw that. That's not fair. We, we got them to our parameters, but it was our fault if we didn't set the proper expectations. Okay, so that's mistake number 5. Mistake number 6. No real marketing systems, guys. If you want to seriously grow spinal decompression, you're going to need to reach out to your community and educate people who are suffering from this condition. So if you're just going to throw out random ads and you know, oh, well, the agency probably knows what to do. I mean, they know how to run ads. Do they know how to talk to patients? I don't. Think so. I'm sorry, they haven't sat knee-to-knee with patients that have been through these conditions. So, you know, if you've never experienced it or you've never talked to people with the condition, it's kind of hard to write ads that would resonate with people. So, if they're just throwing up random ads with like a red back, like a red spine, And we're expecting that to convert to a good quality patient. That's just not going to work, honestly, most, in most instances. No funnel. Ideally, what you want to do is if you're running paid ads, Google, Facebook, etc., you're driving to a funnel that's going to educate them, allow them to schedule online, show them some videos that you've created so that they start to develop kind of trust and rapport with you. What to do next, what happens on your next visit, who to call if they have questions, you know, all that stuff. That's, that's what, you know, a good funnel should do. If you don't have that and someone's just running ads and they're, you know, all you do is get a lead in your inbox, that's not typically going to work. No follow-up. Fortune's in the follow-up. Sorry. If you're doing online ads, the fortune is in the follow-up. People are busy. Right. We have one of our newer clients, Dr. Ippolito, and his significant other Denise. She's just a rock star on the phone. She's, you know, calls 3, 4 times, and a lot of times they schedule on the 4th. And you know what they tell her? Thank you. Thank you for continuing to follow up with me. I've been meaning to do this. I'm just, I'm just busy. You know, this happened, work happened, whatever, life happened, something happened. I wasn't able to schedule the appointment. So, Fortune's in the follow-up. No multichannel strategy. What I mean by this and the no internal is what we really want to do is have 4 to 6. Like, if you want 5 to 10 new patients a month for decompression, you're going to need 4 to 6 total marketing strategies. So, 2 to 3 internal, 2 to 3 external. Okay? So, in other words, internal is, you know, email marketing, referral programs, physician referrals, open houses, whatever. Um, all these, you know, kind of tried and true internal marketing strategies to, um, have our internal patients either refer or come in themselves if they weren't aware that we offered the service. And then external strategies— Facebook, Facebook still works, Google, uh, TV, radio, newspaper, whatever. Pick 2 or 3, and you want all of those working together so that you have a comprehensive, uh, approach to generate good quality patients. So, those are all the mistakes. I've talked about some of the things that actually do work. So, let's kind of dive into what that looks like. And it's not always just getting more patients. Okay? It's really about building systems that converts them and gets outstanding clinical outcomes. So, we talk, you know, what we call this is a decompression conversion process, and we need 3 things. Okay? We need the clinical side of things addressed. So, that's the skill set. And the protocols. We need the systems in place so that we have the patient journey mapped out. They are educated properly. They have the ROF done properly, and they are enrolled into care. And then we have the marketing that drives in good quality patients. Hold on 1 second. Okay, so that is the conversion process. And what I can tell you, let's go a little deeper on what that looks like. So the clinical side of things, world-class exams. I'm not going to keep beating this drum anymore. I think you get it. World-class exams are needed. Imaging clarity. And X-ray is good, right? X-ray is good. MRI is better. If you don't have an MRI, does it matter? I mean, it depends. A lot of doctors ask, well, do I, do I have to have an MRI? I don't think you have to have an MRI. It's, it's wonderful if you do. We need 3 things, and we talked about this: subjective, objective, and then imaging. So, I need, we need to have one or the other. X-ray, MRI. On x-ray, we obviously want to see decreased disc height at the affected level, and we want to show that to the patient. If we have MRI, even better, because then we can actually see the disc. That's, you know, again, seeing is believing for patients. They can see that— I think I can see that decrease in disc height. We can definitely see the herniation, right? And I would recommend You know, don't just use the report, like get the films, right? Learn to read films. Like we just had Dr. Cliff Tao, who, you know, has a film reading service. You may have seen him on Facebook where he like throws up a film and say, hey, what's wrong? Anyways, he's just a phenomenal DACVAR. So he created a 90-minute training on how to read MRI for our members. But ideally, you're going to— if you do have an MRI, don't just rely on the report. Right. Get the imaging as well so that you can show that to the patient. Identifying the pain, the primary pain generator, and then using research-backed protocols, not guessing, not asking your buddy. Like, again, the research is out there. It's telling us how many visits that we need. Minimum effective dose, 20 visits. So that's the bare minimum, guys and gals. But the clinical side of things, that's, that's what we call pillar 1. Pillar 2 is systems. So day 1, consult, exam, and imaging. Day 2, ROF trial and enrollment. A structured care plan. Again, that's— this is your protocol. It's the research-backed protocol. The goal here obviously is to build certainty before talking about price. We want to create clarity, we want to create certainty, and we want to create confidence. So just remember, the 3 C's is what you want to build on your day 1 and day 2. So you want to build clarity about, you know, what's wrong with my body and, and how are you going to fix it? How does that work? Certainty— you are the doctor that can deliver this transformation, because that's what people buy. They buy transformations. They don't buy visits. And then confidence, confidence that I can trust you with my money and more importantly, my health. Okay, so certainty, clarity, confidence. Obviously, a clear diagnosis. I mean, this kind of goes without saying. And then future pacing, you know, hey, what is the life— what does life look like when we're done here? What do we need to do afterwards to maintain You know, the success that we get. You can start talking about maintenance care, right? Because they're all wondering, you know, those are the 3 big questions: is it safe? Does it hurt? And does it last a long time? Well, the research shows— again, this research is out there— the research shows results will last up to 4 years. Now, that's without maintenance. Okay, so, I, you know, I think Anything that is degrading in nature should have maintenance. We maintain our vehicles. Why wouldn't we maintain our cars? If we're going to invest $5,000 into healing a disc, why wouldn't we want to maintain that investment? So you want to talk about maintenance along the way. But the big thing on the future pacing really is, what does life look like on the other side? Right? And talking about that and getting excited about that. And then finally, when you get there, celebrating that. Right. And then again, structured report of findings. Next, marketing. By the way, is this helpful for you guys? Are there any questions at this point? Oh, actually, sorry, I saw some. Fine, I hear you fine. Sounds great. But the chat box won't work. Oh, sorry. Any tips for in-person lunch and learns or talks at required communities or any presentation about decompression? I mean, I don't have any tips for how to get the lunch and learns other than just, you know, outreach. But the point being is, yeah, you want to have a presentation. Certainly we offer that. But you want to have a clear presentation, no more than 20 minutes, that's going to walk through, you know, chronic neck and back pain, what it is, what the symptoms are, causes, typical treatments, what you do, how is it different, etc. So hopefully that answers your question. By the way, retirement communities are phenomenal. So in the Northwest, we have SHAG, which is 50 years and older, and they're always looking for entertainment. Like, they typically have an entertainment director, right? Or, you know, some type of manager that All they do is try to set up either offsite events for their people to do or bringing people in. So, if— and I think these are popping up all over the place, if they're not already there, these 55 and older communities, these are great, phenomenal, highly recommend. We tapped into those, you know, in our— here in the Northwest. But if you can, you know, reach out, get in touch with, you know, you just call the front desk, hey, who handles your kind of Events for your for your members, and they'll say, "Oh, that's Cindy. She's our marketing manager or whatever," and then just have a conversation. Explain who you are, what you do, who you help, how you do it. Da da da da. Would you like me to come in and share? You know what we do in the office, how we help patients with these conditions. A lot of your members are suffering from this. If we can help them be in better health and and you know. Get out of pain, they're going to be able to enjoy their community much better and do more of these events with you guys. So it's really a win-win. So that would be my answer there. Okay, good stuff there. Moving on, on the marketing, we want to target— in other words, we obviously, we don't want to target, you know, ages 20 to 80. We want to, you know, right around 40 to 65 or 70, 65 plus. That's our targeted We— now, you may say, well, can we target people that only make more than $100,000 a year? You can, but these days, because the algorithm is so good, if you teach it right, the algorithm is phenomenal, but you need to teach it. In other words, like, when— like, if you're using, say, GoHighLevel, you need to set it up so that the information from GoHighLevel, when people close or they enroll into care, that goes back to Meta. And tells it, hey, we want more like this. And then when they go into one column that may say, like, you know, poor quality, whatever, that also goes back to Meta that says, don't give us more of this crap. So that's the targeted messaging. So you want to, you really want to just open up wide the algorithm and just say, hey, this is the age range. We want it in this, you know, this radius around the office. And then after that, it's, you let the algorithm do its work. You have the messaging, in other words, the video, the images, images, the ad copy, all that really speaking to the type of person that you're trying to reach, right? And how you help them. Then again, after that, algorithm will take it from there. So, we want our marketing to be education-based. Okay, so we want to make sure that we start the relationship immediately educating patients. It doesn't have to be a 5-minute video. No one's going to watch that, but you can do a lot of in 30 seconds. You know, you really can. And so, we always get our doctors in front of camera. We give them the scripts, we tell them how to do it, and then we do all the editing and make it look pretty. But, you know, that is really crucial for, you know, good quality patients from online marketing. Again, we talked about simple funnels that schedule and convert, consistent follow-up. So, within the funnels, you can always build out, you know, email and text campaigns that follow up with the patients. But again, nothing substitutes for A live voice that cares. And again, multichannel strategy for consistency. So those are the 3 pillars. Okay? Those are the 3 pillars. Clinical, systems, marketing. It doesn't get too complicated if you just cover those bases. And you really don't need, you know, 20 patients a month. I get— there is this one doctor, I swear, every year I get an email from, hey, do you have the systems to generate, you know, 15 to 20 new decompression patients a month? Um, yeah, do you have the budget to even afford that? Um, do you even have a table yet? Doesn't even have a table. I'm like, look, why don't you start with getting a table? Then you start with training yourself. It's just doctors, they, they think they need to do these huge numbers because think about that. I mean, that's $100,000. Just in decompression patients. That doesn't include any other niches, doesn't include chiropractic, etc. Um, you know, it's just like, let's start— let's get the basics down first, okay? You don't need 20 decompression patients a month. If you had 5 at $5,000 and you generated an extra $25,000 a month, I promise you, you will be very happy. Very happy. And if you work that up to 10, and now you have $50,000 a month in extra cash revenue, you will be extra very happy. You won't know what to do with all the money. Okay, so let's start at the basics, because at 20, you need 4 tables. Okay, why do I know that? Because we— that's what we did. Okay, but what I can also tell you is that's a, that's a big practice. 4 tables. You know, 20 minimum. We were doing more like 20 to 30 a month. We had 12 staff. It's like herding cats. Not saying don't do it. I'm just saying that start, start in, start at the 5 to 10, get consistent there, start stacking money, get better clinically. And, and then, then you'll have the money to reinvest because to get to 20, you're going to need to dump a ton of money into advertising. To get to 5 to 10, not so much. So let's go through some case studies here. So Dr. Ross Reynolds, new client, just started in December. Great guy. You know, he was doing like 1 to 2 starts a month, and then just this month in March did 12 starts so far. I keep getting Facebook messages from him that says, sign up another, sign up another, sign up another. I'm like, Oh my gosh. Anyways, so, um, and then, so he started December 1st, he did $51,000. We weren't even running ads in December. Okay, so from in December and January alone, typically tough months because there's so much marketing out there, got Christmas and all that type of stuff, you're competing with all these things. Um, he did $51,000 in decompression alone. He was doing like $20,000 a month total before he started with us. Tell me or ask me if he is happy. He is very Very happy. He's talking about doing all kinds of things now. And I said, okay, how are you going to celebrate this? You should reward yourself. You're working. He's like, we're going on it, taking my whole family on a week-long cruise in June. And he's like, you know, last year we only did like a couple days or something like that. We did a 3-day cruise, and this year we're going to do the full week. Like, good, good for you. That's awesome. Dr. Michael Schaefer, Love Dr. Mike. Talk about a true expert. He really didn't need a lot of clinical training. This guy's a stud. He's in Naples, Florida. And kind of same thing, you know, that kind of $20,000 to $30,000 a month. You know, he started with— he started out just coaching, coached with us for a year. He had no decompression, right? So, we added about $10,000, $15,000 a month in decompression just from the coaching side of things, just tapping into his existing patient base. Um, and then, um, you know, he finally decided to start on the marketing side, uh, because of course we do both. And, um, you know, it literally just in the last 3 weeks in March did $20,000 just in decompression revenue. Um, guy's on fire. Um, he was like, oh, I don't know if I should do marketing, you know. And because his wife Kay is phenomenal, she's the office manager, um, and they're doing marketing, but it's mostly organic stuff, you know, posting And, you know, they'll do a— what is it, an article in a local magazine. So, and all that's, you know, it's done okay. But yeah, once we got him on camera and got him on Meta and Instagram, it's just, it's really, really popping for him now. Rachel, Dr. Masterson, another awesome doctor, had a table gathering dust. You know, didn't know how to use it, didn't know how many visits to do, didn't know how to do an exam. And but by the way, very successful doctor, you know, million-dollar clinic. So really no starts when she joined with me about 6 weeks ago. And literally since then, she's had 6 starts in the full protocol and absolutely crushing it. So, so those are our case studies. And I get— guys, these are just the ones in the last few months, right? So I just want to bring up recent ones. Because sometimes, like doctors, like oh well you're cherry picking and da da da because you've been doing this for many many years. It's like no okay well I won't cherry pick. How about I just pick some of the most recent ones? And so that's what I did. But at some point, you really have two options, right? You can keep trying to figure it out on your own, or you can choose to follow a proven system. So that's why we're here today. The whole goal here is to one. teach you about these kind of common issues that are holding you back. And 2, I want to tell you about what we do, right? Because I know in 9 out of 10 cases, I can help doctors add significant amounts of revenue. And when I say significant, I would probably say minimum $15,000 a month and up. Okay. So, our program is called the Decompression Accelerator. What it is, or what is it? Uh, it's a 90— what we call a 90-day sprint. Okay, so a 90-day sprint, um, and it includes everything you need: clinical, systems, marketing. Okay, so this is all based on everything we've talked about, um, all my experience in a 7-figure practice, all my experience coaching doctors to 7 figures, adding quarter million a year. That's, that's pretty much our average, about $20,000 a month. So So, you know, adding a quarter million dollars a year, not nothing. And tons of support. Okay, so how it works is when doctors come on board, we do what we call a fast start consultation. Based on that, I create your custom game plan, and then we— that's what we work on, that custom game plan over the 90 days. And it's going to cover clinical systems marketing. You have tons of support. Every single week we have live Q&As with the entire group. Not everyone joins, right? There's usually Anywhere from 7 to 15 doctors that will jump on at once, but you can always get your question answered. There's tremendous value being in a group of doctors that are all motivated and successful, and what's working and what's not, and what we're tweaking, and da da da da. There's tremendous value there. Even if you didn't even ask a question, you just listened, you will learn. So, those weekly Q&As are huge. Dr. Pankinen, he's our dedicated clinical director. Million-dollar practice in a town of 850 people. He's phenomenal, one of the best clinicians I've ever met. He's been a client since 2020, took him from $500,000 a year to $1 million plus a year. Now he does $1.25 million, and he's been a client ever since. But he's also our clinical director. He runs clinical Q&As on Tuesday. In other words, you bring your questions, your case studies, and then he's going to talk about all the latest research and, you know, what he's seen in practice and what he's recommending, you know. all that stuff. Like, doctors sometimes join just for him, which is fine. I'm a little sad on that. But anyways, he's a rock star and, you know, just one of the most humble people you'll ever meet. And then Thursday, I do clinical Q&A— I'm sorry, business Q&A on Thursdays. That's where we talk about systems and staff and marketing and just really kind of everything in terms of growing Decompression in your practice. You get monthly one-on-ones with me, lucky you, where we're going to track, you know, so we do the fast start consultation, we deliver your game plan, we do a quick follow-up call, make sure that you're clear on what the next steps are. Then we do a call every 30 days throughout that 90 days. Every Friday, so we have actually 3 coaches total. We got Dr. Pankin, myself, and Dr. Vinnie Cornejo. Another longtime client of ours, has done excellent. And he's really, really good in the ROF. So every single Friday you have the ability to schedule one-on-one with Dr. Pankinen for clinical, Dr. Vinnie for ROF, or me for any of the above. So excellent high-level group of successful doctors and a massive learning platform that has literally over 100 hours of content. It's my life's work, everything you would ever want to know about learning. Spinal decompression and growing it. So what you get in the program, obviously world-class exam training. We've hammered this. So this is there in spades. Research-backed protocols, ROF training, patient processing systems, staff training, mindset training, internal and external marketing systems. It's honestly, guys, this is everything you need to grow spinal decompression. And then after that. After that 90-day sprint, it goes month to month. Okay, so no long-term contracts. Now you may say, well, how many doctors stay around? A lot. Most do because they're getting a tremendous value, because they're getting a tremendous return on their— a tremendous return on their investment. Okay, so who's this for? So you got to be doing at least $30,000 a month. You know, we're even kind of pushing up a little higher, but bare minimum $30,000 a month. Rarely will we make kind of exceptions here. The reason why, obviously, you need the financial wherewithal to invest in the program. It's not cheap. But you also, you know, at least at $30,000 a month, you've kind of figured things out a little bit, you know, in practice. So, you know, we're not going to fix your practice like this. We're not a traditional, like, practice management company. I'm not going to teach you how to do care plans for chiro and all that type of stuff. We are helping you grow a spinal decompression niche, a new lane of service, or, you know, or building your existing lane of service that, again, is all cash. So we like to have our doctors at least knowing and having the basics down. So $30,000 a month, obviously you want to grow spinal decompression. You're committed to growth. You're a growth-minded individual. You're serious about scaling your business. And you're willing to commit to it. You know, I mean, I always tell doctors, hey, if there was an easy button, I would have found it. So, there is no easy button to adding $500,000, $250,000 to your practice. Okay? It requires work. It requires time, effort, energy, money. It just does. I'm sorry. You know, I remember I was talking to my buddy, he has a $100 million construction company. And, you know, we went through all this stuff, how he built it. He's like, you know what? Just took a lot of hard work. A lot of people looking for shortcuts. Okay? I wasn't looking for a shortcut. I wanted the— I wanted to know what was the most reliable way for me to get to where I wanted to go. He had a mentor that showed him, and then he just did the work. Okay? So it's going to take work to get there, but I promise you it is worth it on the other side. So, if you don't— this is our guarantee— if you don't make your investment back in the 90 days, we work with you until you do for free. So, this kind of is a non-risk investment opportunity to grow your practice. There are limited spots. We only do 5 per month, and we have 1, maybe 2 spots left this month. And this is how you get on the calendar: drvincecalendar.com. That will take you to a Calendly booking link. And you can find a time on my calendar, and we'll talk about your practice, where you're at now, where you want to be in 90 days, 6 months, and 12 months, because we always, you know, want to project out in the future. And I'll let you know if we're a good fit. Like I said, on that call, I do recommend if you're going to set that up, you know, bring your stats for at least the last 3 months, you know, obviously monthly revenue, you know, weekly visits, how many new patients you get, how many decompression patients you get per month now, what's your close rate, what's your care plan value, what does your protocol look like. Like, have those numbers ready so that we can have a nice, professional, efficient conversation. At the end of that call, I will let you know whether I feel like I can help you or not. I'll let you know whether I feel like we're a good fit, and if so, we'll talk about what the investment looks like and what It looks like to get started. And I always say, hey, you don't need a better table, you need a better system. Now, if you're here, still here, first of all, thank you. Thank you for hanging out, and I hope you got a lot of value out of this. I want to give you your free gift, and I think if you're into spinal decompression, I really believe that you will find a lot of value in this alone. And so it's the State of Spinal Decompression. Report 2025-2026. And all you got to do, send an email to me at support@specializedpractice.com, and I will return that with you with thanks for showing up to the webinar. And we'll just send it back to you in a PDF, and I think that you'll really enjoy that. So that wraps up our webinar. We went a little longer I'm not surprised. I talk too much sometimes. But anyways, point being, I hope you got a lot of value out of this. I hope you had a little bit of fun along the way. And I hope if you feel like, you know, if you feel like we'd be a good fit, I highly encourage you go to DrVinceCalendar.com, sign up for a call today. And other than that, you know, Godspeed. I hope that you, if you, even if you don't sign up for a call, I hope you are able to take some of this information And at least identify some bottlenecks in the practice, like what you need to focus on. You may say, well, shoot, my exam sucks, or I don't do an exam. Trust me, I've heard that too. So, whatever it is, or I need to do more structured report of findings, or I need to do more robust marketing, or whatever it is, even if we don't work together, I hope maybe sometime in the future we will. But in the meantime, I hope you can use this information. Find the bottlenecks in your practice. Just address one thing at a time, and so you can put your focus on that, fix it, and then move on to the next. And I think that you'll see some growth from there. So, with that being said, thank you again. My name is Dr. Vince Leone at Specialized Practice. God bless.