Why Most Doctors Struggle Growing Decompression

Hey there and welcome back. I'm Dr. Vince Leone, executive producer and co-host of the Practice Builders Podcast. With my partner in crime, Dr. Kyle Pankinen, we deliver proven strategies to help you grow fast, specialize with confidence, and build profitable staff-run practices. Let's go ahead and dive into today's episode now.

Hello and welcome to the Practice Builders Podcast. My name is Dr. Vince Leone.

And I am Dr. Kyle Pankinen, and we have a, I think, a wonderful episode for you today. I don't know what number we're on, Dr. Leone, but we're— we've done a lot of these podcasts. And, uh, I continually talk to doctors just about, you know, a couple times a month that say, hey, I listened to your podcast. And I had one doctor that just talked that he listened to our podcast. He was like every day he was going to listen to one of them. And so it's wonderful to hear feedback like that. So I think we got a great episode for you docs today, and Dr. Leone will introduce that for us.

Yeah, I do think we have a great topic today. And by the way, if you hear my voice being a little gravelly like Dr. Pankin, just going through a little bit of a head cold. So, but hey, we're gonna fight our way through, Dr. Pankin, and we got the dream team back together today, so I'm excited. Today's topic is, Why most doctors struggle with growing spinal decompression, and you know, I think this is a really important topic because it's it's what I hope doctors get out of this is that they can identify where their bottlenecks are.

Right?

What is the primary bottleneck, secondary, tertiary? So that because you can't work on everything at once. But, um, uh, these are the lessons we've learned over, you know, since, well, you know, however long Dr. Pankin's been in practice, 30 years, 20 years, something of that nature. I've been in practice since 2012, um, and then, you know, started coaching doctors in 2018, um, when we launched Specialized Practice. So, um, so these are the lessons we've learned, and we want to pass them on to you so that you can figure out which ones that may be affecting you so you can address it and then move on and hopefully grow your decompression practice.

Yeah, you don't have to reinvent the wheels here, Doc. These, these what we're going to go over today are— if you're stuck, it's most likely going to be in one of these key areas, and it might be a combination of them, but there's probably one or two that you'll come across like, yep, that's where my My weak spot is at. And then you just, you gotta take action steps, obviously, to try to improve upon those areas. And this learning, mastering decompression, and, and not just the clinical aspect of it, but the presentation of it to patients and patient selection, there's an art to it, just like anything. And it takes, it takes time to master the skills and the art of this, but When you get good at it, it gets really fun. And, uh, so we're gonna go over that with you today. So we'll dive into why most doctors struggle.

Yeah, 100%. And this is primarily geared towards doctors who have bought the table, right? Because that's why they're struggling with decompression, because they actually have a table. So, um, what I would tell you though is if you're listening to this and you are considering decompression, this will be great information for you. So, um, I, the first thing is you bought the table, now what? And I always say, you need to make 2 investments, right? The first investment is in the table. The second investment is in yourself. So a lot of doctors, they buy a table and they kind of assume, you know, people are just gonna be clamoring to get on the table and, you know, money's gonna be, you know, sprouting from pillows on the table. It's not typically the reality, right? So patients aren't lining up. These are some of the things that doctors complain of. Patients aren't lining up to learn more about decompression or get on the table. The marketing feels inconsistent. The results are unpredictable. And what happens is this leads to a lack of confidence, Doc. Um, and in my experience, confidence is the cornerstone to successfully growing spinal decompression.

That is one of the major themes that we teach all of our doctors at Specialized Practice is You got to have confidence in your clinical skills, but then you also have to have confidence in the actual decompression protocol and process itself of what you're going to take the patient through and what you're going to present to the patient. Because you're— we're taking— To go from general chiropractic to then elevating to Presenting decompression plans and protocols to patients—that's a step up. And that step up for doctors—if you don't have the confidence in your skills or the program or the protocol you have, patients will see through that, and they'll they'll sense that this doctor is pretty green, or this doctor is is doesn't have that confidence. And they're not as likely to then buy in. They're not as likely to follow your treatment recommendations. And so we have many ways that we teach doctors in order to build their confidence, but that is a huge, huge red flag to patients is that their doctor lacks confidence. And you know what, if you're a doctor that lacks confidence, I mean, you You feel that inside.

Can't recommend something that you're not confident in, you know?

Yes.

And so, uh, and what I would encourage doctors to think about is, uh, remember who you are competing against. So if you're gonna wade into the chronic neck and back pain world, these patients, they are seeing surgeons, who have been to school for probably 3 times, what is it, 14, 16 years to actually become a spinal surgeon. So these guys are alpha males. Gosh, I mean, these guys are intense. I've met them. They're very good at what they do. I never really like, I don't like to throw shade on different healthcare practices. Like they do a good job. They're trying to do the best for their patients. But that's who you're competing against. You're also competing against Apathy, one. So people just, you know, they're just gonna essentially drug their way through it or just not do anything. You're also competing against physical therapists, other chiropractors, which aren't as much competition. But then also all the stuff they're being sold online, because the algorithms pick up that you have these conditions and you're going to start seeing it in your Facebook feed, your your Instagram feed, Google, whatever. And so now you're competing against these big companies that are really, really good at selling something, right? It could be some type of medication, it could be a supplement, it could be a device. So you want to really keep in mind, you have to become a true expert, right? Because this is who you're competing against. And so if they come into your office and they're like, hmm, you know, uh, this doesn't really seem like a true expert. They may— they're not going to tell you that, but that's what they're internally thinking. Um, and maybe not even consciously, it could be subconsciously thinking that. Um, but, uh, so just keep in mind who you're competing against, and that's why you need to raise the bar, um, in terms of your own skill sets and systems and, uh, marketing, etc. And what I will say is it's not your fault. Um, you know, uh, most doctors were never taught how to build a decompression system Correctly, right? It's not taught in our schools. There's very few consulting companies that are doing it at all, let alone doing it right. I mean, I feel like Specialized Practice is the best in our industry in terms of creating true specialists in spinal decompression. I know who all the other players are. Some are good, some are not so good. You know, I'm just gonna be honest there. But the point being is you can't blame, say, the table company Because their goal and job is to make and sell tables, not to train doctors to be experts. So you really need to take it upon yourself to, um, to invest in your own skill sets, uh, your own training, your own acumen to become that true expert clinically, layer in the proper systems. And then, you know, thirdly, yeah, you got to drive in new patients via marketing.

Yeah, and the expertise— let's say so, when you come out of chiropractic college, you know the basics of the spine. You can handle some of the more generic or garden variety back and spine cases and neck cases and so forth, but the true disc cases with radicular components, spinal stenosis, degenerative spondylolisthesis When you get in the world of decompression, you're gonna attract those types of patients, the more complex stuff. And that's where the training or the lack of training is going to show up quite quickly. And so I know many of my colleagues who really, they don't treat disc cases. They actually pass the buck on them because they just don't feel comfortable or confident with their adjusting techniques and the skills they have. And so you need to build that level of expertise and confidence if you're going to go into the world of decompression and be really successful at it. And like Dr. Vince said, you can't rely on the table manufacturer to do this for you. You got to put in some effort on your own and get under the right system or coaching or training that's going to get you where you want to get.

100%. Um, so let's go through. We have 6 primary mistakes that we're going to go through here. Dr. Pankinen, are you ready to go through these 6 mistakes?

I am so ready, I'm just busting at the seams.

Love it. Okay, so make, uh, make— this is, this is the head cold, uh, by the way. I'm running on fumes in terms of sleep. My daughter has had pneumonia. She's, she's Doing much better now, but, um, consequently, Dad has not had a whole lot of sleep. So, um, uh, just bear with me on that. So mistake number 1, buying a table without a system. Okay, so again, equipment does not equal outcomes. And, you know, a lot of doctors, they'll buy a table and then they'll hire a marketing agency to try to drive in new patients. Big mistake, right? Gotta layer in the system Before, um, uh, before you start the marketing, right? That's, that's going the cart before the horse type of thing.

You have to have the right staff in place. You have to have the staff trained before you start really processing quite a few of these patients. You have to have a very specific time-tested protocol that you build around the table Because decompression is not just a table, it's a program.

Mm-hmm.

It's a, it's a protocol, and each part of the protocol works synergistically together to produce the best possible outcome or result for that patient. So you just, you just don't buy a table and say, oh, I'm just gonna start haphazardly having a few people do some You know, 3 or 4 decompression visits. That's, that's a recipe for failure. It's just, it's just not going to work that way. And so you have to have that protocol built in and understand the ins and outs of it, and then be able to effectively communicate what that is to the patient. And when you have that in place and you have a time-tested and proven protocol, The results will come, and then so will the, the fruit of that, the, the finances and things like that that you're looking for.

Yeah, well said. And there, there is one group, and I'm obviously I'm not going to name them, but it really frustrates me. It's one of, one of my irks is they do this, well, just try 6 visits and see how it goes. And then, you know, you kind of go 6 more and 6 more. It's like, that's terrible. I'm just going to say it. The research is clear, right? I mean, if you just do a little bit of digging, the research is out there. 20 visits is the minimum effective dose to get a patient to MMI. So why in the world would you be recommending you starting a patient at 6 visits? Because the vast majority of them are not going to get better in 6 visits. They may have a little bit of change. But if you're expecting to get significant change in 6 visits, you're mistaken. Dr. Kyle has already shown the research where most significant changes happen between week 3 and 7. So, you know, that's where I don't like— it's some, you know, in our industry, it's a little loosey-goosey, right? It's like, hey, you know, you ask your buddy, well, what are you doing? And, you know, it's like, that's no way to run high-level healthcare, right? It needs to be run based on research and proven outcomes, protocols that work. And so anyways, that's one of my little pet peeves is people that are in the industry and they're propagating stuff that they really have no— they have no business spreading that message because you are doing a disservice to the doctors and most importantly, you're doing a disservice to the patients. So let's go. I'll get off my soapbox. So, um, I, I have stepped off. Okay, so mistake number 2, um, not having world-class clinical skills and exams specific to disc and spinal decompression. Dr. Pankinen.

Yeah, this is—

The confidence, this is where the confidence comes in again, right? Because I always say the close starts in the consult. It doesn't happen in the ROF. It's pretty much, you just don't screw things up in the ROF. But if you have a world-class, and Dr. Pankin has created a tremendous training for our doctors, our members, the world-class exam training for neck and back. And I will venture to say this is probably the most thorough exam specific to disc in the industry. And so when you do this, what happens is you have patients that literally say, I have never had an exam like that. And so what's happening is you are earning their trust, you're developing rapport, and they don't want to go to anybody else because no one else has ever done that before. And so you're going to find that primary pain generator, and that's what's going to give you the confidence, or at least start to give you the confidence, hey, I can help this patient.

I've had several doctors over the last few years that have told me Doc, I, I listened to and watched your exam videos. I built it into my EHR, and I'm just doing it exactly as you laid out. And they will say things like, my conversion has gone from 20% to 70% or to 80%. And they— a lot of times they'll say, this is the only thing I'm really radically doing different is I'm just doing a, a much higher-end exam than I've ever done before. And patients will see when you do that exam that they really are in the office of an expert. It makes them feel that way. And that's the reason why the conversion goes up, because when they feel that now I'm finally in the right spot, this doctor is an expert. When you give the recommendation to Mrs. Jones and say, hey, you are an excellent decompression candidate. I'm going to tell you about our protocol, and this is what I'm recommending for you. The odds that they're going to say yes to that is much higher versus somebody who does a poor or cursory exam or only relies on imaging findings.

Or no exam.

Or no exam at all. I have many doctors that literally do no exam.

No exam. And I'm like, wow, you're pretty brave for at least admitting it. Um, but gosh, I mean, talk about a low bar.

Yeah, so I mean, if you have a, you know, somebody that comes in with just a, you know, a garden variety spine condition and that, you know, it's maybe a little bit acute or not a, not a major condition, yeah, can you rely on your palpation skills and your adjusting skills for a lot of those? Sure. But if you have somebody that's coming in with a significant disc issue and they have motor weakness and they have altered reflexes and they have sensory changes and they've been to other providers before, you're not going to win the day with that patient unless you're showing them that you are really invested in helping these disc patients and doing a high-end exam. And then that confidence comes in you, and then they're— then they're— you're going to be their guy, you're going to be their gal, you're going to be their doctor because Hey, you've demonstrated to them what you can do already with that exam.

And here's the thing. If you don't do this, what you will hear in the ROF are things like, let me think about it. The dreaded let me think about it, right? Or let me talk to my spouse or let me look at my finances. That's a soft no, right? That's basically them saying, I don't trust you with my health, with my money, and I'm not going to move forward. So that's why you never hear from them again. That's why they don't pick up your call if you call them again. Um, and so it all— the close starts in the consult and specifically the exam. So that's mistake number 2. Let's go to mistake number 3, treating on day 1. Dr. Pankin, why in the world would you do this?

Yeah, so treating on day 1 is something that's going to— if it's a true case where this is a potential decompression candidate, let's face it, most of these people when they're coming in They've already had this pain for weeks, months, sometimes years.

Mm-hmm.

You don't have to be in a big hurry to start treatment on day 1. Day 1 should look like we are gathering as much information about this case as possible through a detailed history, detailed exam, reviewing imaging if they're available, or getting imaging if there hasn't been done. And then setting up a separate day two. In other words, you've got to lay out and figure out what is causing the pain. In other words, what's the diagnosis here? And then you build from that in your day two. But day one is all about setting the groundwork and that laying the groundwork and the foundation and establishing that authority as the expert. And then when you get to day 2, your odds of acceptance are going to be much higher. Really, it's just a matter of finalizing some things with finances and things of that nature. But day 1, if you jump to treatment too soon and you haven't established that authority, that expert-level insight in their eyes, you're shooting yourself in the foot.

I mean, 100%. I mean, I always— we talk about need 3 things, right? You need subjective complaints that line up with the disc, you need objective testing that line up with the disc, you need imaging. So, uh, you're going to get that in the consult, the exam, and the imaging on day 1. Now, the caveat is if you want to do an all— what we call an all-in day 1, in other words, you get those 3 things and then you take time and say, hey, okay, Mrs. Jones, so, you know, Do you have time? Do you want to go across the street, grab a coffee at Starbucks or whatever? I'll sit down and review this, and then we can go right into the report of findings and see if you're a candidate. Now, that's okay, right? Because you're taking the time to actually determine whether they're a good candidate for care. We had a lot of people that would travel an hour, 2 hours, etc., to see us. So they didn't want to, if they didn't have to, drive on back and then come on back the next day. And so they were more than happy to hang out for 20 minutes, 30 minutes, go get lunch, come back after lunch. It just depends on your schedule. But the point here is we don't want to put them on the table until we've figured out if they're a candidate for care. And most importantly, if there's any contraindications. I mean, a lot of doctors don't even know, hey, when can I, cannot do treatment on a spondy? So that's just one example. So there are contraindications to spinal decompression. All those need to be ruled out before Before, you know, before you're, you know, put them on the table. Um, it's, to me, it's common sense. But anyways, that's a big mistake. Um, again, they're not going to tell you that this seems odd. They may ask for it. Now, if they do say, well, you know, I'm in a lot of pain, totally understand that. Um, let's— here's an ice pack. Let's, you know, if it's— if you're going to push them to the next day for, for day 2, which most doctors do, here's an ice pack. I want you to do, you know, just, um, you You can do, you know, heat or ice, whatever they seem, uh, tend to do best with. I want you to do this 3 cycles, 20 minutes on, 20 minutes off. I want to do 3 cycles of that tonight. That's going to manage the pain. We're not going to fix anything, but it's going to help you sleep a little better. Come back tomorrow, and then we'll talk about and go over your, um, your report. So, um, so anyways, that's mistake number 3, treating on day 1. I— you got to be firm with the patient, right? If you let them push you around, Well, then now you're setting up, uh, a poor relationship with the patient because now they're the leader, you're the, you're the follower, and that's not good. So, um, let's go into mistake number 4: weak report of findings, right? So, uh, a lot of— so I— one of my, uh, first coaches was Dr. Eric Breitenmoser, and, um, I always really liked, uh, Dr. Eric. He taught me a ton. I always say he saved my career because he's the one that got me into niches back in 2009. So I have a lot of love for Dr. Eric. Um, and I, you know, he has this really heavy Austrian accent. Dr. Viens, you're, you're dying on the vine. I'm like, yeah, Dr. Eric, I know that. What the heck do I do? You're my coach. He's like, you got to try neuropathy. No one's doing it. You know, it was awesome. So, and that's when I got into neuropathy. It changed my career. So, um, uh, but Dr. Eric was famous for the 5-minute ROF. Right. And that was for chiropractic, right? So if you're trying to do a 5-minute ROF, um, or you're kind of doing your, your kind of quick and, quick and dirty chiro ROF, uh, most likely that is not going to work with spinal decompression patients. You need to have a more structured approach so that you create 3 things, 3 C's: clarity, certainty, and confidence. For the patient, most importantly— well, they're all important, right? But they have to understand what they're investing in. You know, if they don't understand what decompression is and why it's going to solve their problem and create that transformation for them, they're just not going to invest.

Hey there, it's Dr. Vince, and if you're getting value from this episode, please make sure to hit that subscribe button so you never miss an episode. And if you know another doc who's ready to grow their practice, share with them. It might be exactly what they need right now. Thank you in advance, and now back to the show.

Yeah, they have to— you have to be able to connect the diagnosis that you established on day 1 and the disc or the stenosis, whatever, and how that, that is the root that is connecting to whatever the problem is in their life that is most affecting. In other words, It's it's doc. I know I have this, but I can't lift my grandkids. I I can't work. I can't sleep. My love life is no good anymore. I have men tell me that because of the pain that they're having. And so if you can connect with them of how changing this disc ball, changing this herniation, is going to alleviate pressure and is going to allow you then to. have whatever it is they're missing in their life back. And you have to have— you also, you have to have a certain degree of certainty. I always tell docs, in other words, you have to know what you're— you have to give the patient some odds of success.

Hmm.

So for instance, last year— I keep track of my decompression stats every year— and last year we had an 88% Meaning 88% of our cases saw a minimum of 50% or greater improvement. Well, what do you think I'm telling every patient in their report of findings this year?

Yep.

What are, what are your odds of success in getting help with this condition? Well, it's about 88%, you know, and that's, that builds confidence in the patient. Again, going back to that word, because they're like, okay, that's That's pretty good. And if they can get 50% or greater improvement, that's life-changing.

Mm-hmm.

For most patients, especially these that have been living with pain for weeks, months, or years, in most cases. And so it's gotta be a structured report of findings, going through that diagnosis, relating some of your exam findings, how that pointed to their problem or to a disc. How it relates to their imaging findings, going over your success rates and things like that. And you do those things, patients are going to more likely say yes in the report of findings.

Yep, 100%. Um, the only thing I'll add to that is the reason why it's— we like to get it really structured is one, for efficiency, so that you can get, uh, you know, get through it in, you know, 20, 30 minutes, something like that, so that you can kind of block out your schedule appropriately. But also, you know, every one of these patients is going to be, you know, quote unquote worth, you know, $4,000, $5,000, $6,000, whatever your care plan is. I mean, you want to take this very seriously, right? I mean, uh, it's going to be significant revenue for your practice. Um, it, it can be an inflection point in that patient's life. Um, you know, if they don't trust you and they don't move forward, who knows what's going to happen with them? You know, they may be hooked on drugs for the rest of their life. So, um, uh, but I think most importantly, when you don't have a really structured report of findings that you know that I'm going to do this, this, this, okay? Because we divide into the front half, the transition, the back half. So I'm going to do this, this, and this. I'm going to ask these specific questions, and then I'm going to go into the trial, and then I'm going to go into insurance and finances, et cetera. With no structure, there's chaos, right? And as much as possible in a healthcare practice, we want to create order, right? We don't— we want things to be predictable as much as possible. And you have control over this. You don't have control over over how your front desk showed up that morning. You know, maybe she didn't get her coffee or her, you know, super duper latte or whatever. You can't control how patients, you know, uh, react or don't react and, and how they may present in the, in the office. What you can control is your internal systems, right? Hey, this is how I do an ROF. This is how I do a day one. This is how things run in my office. I don't treat on day one. Like, that's what you have control over. And then that's what can create predictability. So that's mistake number 4. Mistake number 5 is poor patient selection, Dr. Paikin, and trying to treat everyone, not setting expectations. I think that's a huge one.

A couple things I see with poor patient selection are you have 2 extremes. You have, you have some, you have some doctors that are recommending decompression to, and a big package of decompression, to every single patient that walks through the door. One, And sometimes that's overkill and it's scaring some away. But then you also have some doctors that are treating, in a sense, they're taking on some cases that probably have very little hope of getting better. Multiple fusion levels, multiple levels of severe spinal stenosis where they're coming in And you know, the patient thinks you're my last hope, and you're trying to give them hope, probably maybe when there isn't a whole lot of hope. So there's there's extremes on both ends there. Then the expectations is this: If a patient goes into a spinal surgeon and they're they're a surgical case, according to research, they they expect that if a patient gets 50% better from the surgery. That was a successful case. Well, what we teach our docs is if somebody's coming into you for spinal decompression and they have a bad disc herniation, big bulge putting pressure on a nerve, some of those cases— or a bad case of stenosis— some of those cases, if you can get them 50% better, that is an excellent clinical outcome. So we set realistic expectations right up front where we tell patients the goal of treatment is we're gonna try to get you a minimum of 50% or more relief. You know what happens with that is then if they get 70% better or 80% or 90% better, which many of them do, they think you're a rock star.

Hmm.

But if you— they only get— if they only get to 50% better, they say, well, you, you You got me what we had hoped we would get, doc.

Yep.

And then you get those small percentage of cases that don't get that, but that's— it's not going to be a big percent, 10 to 15 at the very most, that will not get 50%. But she got— you can't tell a patient, oh yeah, we're going— never— we're going to fix this, or we're gonna, we're gonna get this 100% better, because you may not be able to deliver on that result.

Yeah, great point. And, um, and I think if you, if you don't set expectations, in other words, you don't clarify what success looks like, success for them is probably going to be different than success for you. Because if you're internally thinking, hey, we got 80% of our patients 50% or better, um, in their mind they may be thinking, success to me looks like I'm going to be pain-free, right? And so with, you know, a lot of these patients are older, they're 60, they're 70, whatever. There's a lot of tread, you know, there's a lot of miles on the car. Okay, I'll use that analogy. There's a lot of mileage on the vehicle. And I'd always tell patients, hey, no offense, but I just wanna let you know, you're not gonna feel 20 years old again, okay? You are gonna feel better. We're expecting, you know, this, like if you're at an 8 out of 10, I expect to get down to around a 4 out of 10. Does that look like success to you? Because if it doesn't, it probably doesn't make sense to move forward. If you're thinking you're going to get to zero, that doesn't— it's possible, but it's not realistic. It's not most likely. I think what is most likely is we get about 50% reduction in pain, probably a little bit more. But what, from your perspective, does a successful outcome look like? So what's interesting about this is when you do set these expectations, And have this conversation with the patient, it reduces refunds, it reduces unhappy patients, reduces, you know, a patient saying, oh, spinal decompression didn't work. Because—

Yep.

And here's what's really frustrating is like, you take someone from an 8 to a 4, that is life-changing, but they may walk out of there and say, well, it didn't really work for me. Hmm, well, it worked, you know, as long as you, you know, clarified What success looks like. It did work. Did it make it perfect? No. It's unrealistic, especially for how chronic these conditions are, how old the patients typically are, to get to perfect status. I think when you have that conversation with patients, they'll respect you more. They won't be thinking like, oh, you're trying to sell a miracle cure. And it's just— I think it's just good healthcare practices.

Yeah.

Um, so mistake number 6, this is our last mistake, Dr. Kyle. Uh, no real marketing systems, right? So, um, if you want to, you know, get to say 5 to 10 new starts a month, um, you're going to need to have multiple avenues of new patients. Um, so the data tells us there's about 100 million people in the U.S. that suffer from just general Neck and back pain, right? So 8 to 10% of those are due to chronic in nature disc, you know, DJD, etc. So that's what we can treat with spinal decompression. So if you think about that, let's just call it 10% for easy math. I mean, I don't you know math was never my super strong suit, so I don't want to like hurt my brain right now. But if you think about if you get 30 new patients a month just with referrals, right? You're doing 50 grand a month, 30 new patients a month. Well. If you are able to properly install systems in the office and internal market through email, flyers, signage, um, you know, workshops, etc., you're going to get 3 to 4 starts just from your new patient flow, right? Because about 10% of your garden variety neck and back pain have a disc, right? So what we want to do is build in internal marketing strategies so all your past patients, your existing patients under care know that you offer this treatment and know to ask you about it if they're experiencing the symptoms. And then you want to layer in your external marketing avenues, maybe 2 or 3 paid avenues. It could be SEO, it could be Facebook, it could be Google, it could be newspaper, etc. So we want a multi-channel strategy so that we get consistency in our new patient flow. Dr. Penkin is one of the masters at this, um, and having a— you know, he's doing— well, I'll let you kind of explain what you're doing, but, uh, you know, podcasts and, you know, radio and newspaper and Facebook and all that stuff.

Yeah, I always look at each one as a different bucket. Yeah, so newspaper is a bucket, Facebook is a bucket, radio is a bucket, podcast is a bucket, email campaign is a bucket, and each bucket you're trying to Get a little bit from each bucket every month, and I don't have. I've said this for years. I don't have one marketing thing that is just fantastic, where that's like I don't even need any of these other things because this one's so. I get all patients I need from this. No, I get little drops from each bucket every month, and and over a course of a month, though, that's. Enough drops from each bucket that it adds up to pretty good by the end of the month where I've had several leads, several startups. And so it's, it's a comprehensive strategy and I'm not putting all my eggs into one basket. It's diversified, I guess.

Mm-hmm.

And that would— that's what I have found has served quite well. I get— I talk to some doctors, well, do you think I should try a newspaper? Do you think I should try Facebook? Or my answer is, well, don't rely on one thing. Try them all. And, and then you might have to modify that as you go because maybe you, in your particular area, you find one that works better. Okay, well then divert more money to that ad campaign or whatever that is. And maybe put less in another thing as you sort through that, but Doctors are always looking for what I call the magic bullet, and there are some instances where there's a magic ad or a— but most of the time it's just consistently doing the right things month after month, multiple channels. At the end, that wins the day.

Couldn't have said it better. 100% right. And, um, you know, Dr. Pankin is a great example of that because he— his practice continues to grow. year over year, right? Um, consistency wins. Uh, and, and, you know, the diversity, right? Stability through diversity is what, um, you know, is going to get you that consistent flow of good quality patients. And then also using— we like to use education-based marketing with our clients where we are right on the ad trying to educate patients. We use webinars, we use pre-consultation videos, we use patient reports. Um, all of this to, uh, you know, different kind of touch points of the patient journey so that, um, well, one, it kind of does a lot of the heavy lifting in terms of educating the patients. Um, but 2, you know, a, a pre-educated patient just turns into a better patient. They, you know, they're, they're seeing you as the authority because you're teaching them something that no one else is teaching them. And, um, uh, that's really what I found cuts through the noise of the marketing, uh, kind of world right now. There's so much noise, there's so many people marketing. Um, I think what people really are drawn to is authenticity, um, and, and value. If they get value out of the information that you give them, they tend to respect you more. Um, and I don't think it's any more complicated than that. So, um, so that is our— I think we'll wrap it up there, Dr. Kyle, because, um, Uh, I think that covered that, the, the 6 mistakes and why a lot of doctors or most doctors struggle with spinal decompression. Um, so what I would encourage, and I kind of want to hear your parting thoughts, but what I would encourage doctors to do is kind of think back which of those mistakes and, and rate them. It doesn't— and I'm not saying you're— all of them, you're making all those mistakes, but I would just say, hey, what are 1 or 2 or 3? Like, which ones are— The mistakes that I am making, um, and then put together a plan to start shoring that up. And so that you can again start to get traction with spinal decompression, help more patients, and grow your practice.

Yeah, it's all about building. It's all about becoming better day by day, week by week, little by little. And so you might be listening to this like, oh boy, I'm overwhelmed, I have so many areas I need to work on. Pick the worst.

Pick the worst. Eat the frog, like what Brian Tracy says, eat the frog. I'm a huge fan of Brian Tracy. He's been around forever. The guy's a rock star. But he always talked about that, eat the frog, do the biggest one, just like Dr. Pinkett said, eat the worst one first. And then go from there.

Yeah, I love that. And that's right. I mean, that's how I, in my planner each day, when I go through the day, if I have a list of things I wanna get done that day, I've also learned to do the hardest thing first so that you just get that done. Because if you leave it to the end of the day, you're tired, it don't get done.

So right, my friend. So right. Okay, so we'll wrap it up there. I hope this episode gave you value, right? I hope you, you know, this was worth your time. If it was, please share it with a friend or colleague. Give us a like and a review. That would be awesome. as well. Um, and, uh, uh, I think, I think that's about it. Any, any last parting words, Dr. Kyle?

No, I think that we covered it well, and, uh, it was a fun episode. And, uh, I just hope you get something out of it. We get a lot of good feedback from the docs. I do, and Dr. Bledt. They're getting something out of it. So if they weren't, they wouldn't be listening day after day after day. So Keep listening, folks. We'll keep bringing them.

And we appreciate you for, uh, for being with us on this podcast. And so that'll wrap it up for Dr. Pankinen. I'm Dr., uh, Vince Leone, and we will see you next time on the Practice Builders Podcast. Until then, take care. Hey, it's Dr.

Vince again, and hope you enjoyed that episode. And if you're ready to grow your practice fast with high-value decompression patients then the Decompression Accelerator could be a phenomenal option for you. This is our 90-day sprint to help you scale with proven systems, staff-driven protocols, and full marketing support, and it's all guaranteed. Spots are limited. Head to www.decompressionaccelerator.com to learn more.