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New Patient School

A LIVE Role Play Of The Perfect Report of Findings

By December 18, 2020February 24th, 2021No Comments

What’s up everybody, Sam Carlson here with Patient Stream. Welcome to New Patient School. Today I’m like super excited. You know, I get excited for these trainings every week. But I’m not gonna lie, I got the slides for this training. I was like crap, I gotta put together a quick email, shoot it out and see if we can get some more people on because this thing is gonna be so much fun. And Andrew and I last week, it was not funny but funny, I guess. We did a training and the video, the file got corrupted. So I’m going to actually, this week, I’m gonna record audio and video. Anything can happen. So I just wanted you guys to… I wanted to give everybody a chance to show up. And I know Fridays are not the best days. But we’re working with what we can here folks and if we need to adapt the timeframes that we’re doing these, we will. But welcome to Patient Stream. My name is Sam Carlson. My co-trainer today is Dr. Andrew Wells. We’re super excited to have you here live I’m gonna go ahead and record., Boom, there we go. Got the audio going too. We’re super excited to have you here live. And today we’re going to be doing a live role play on basically a day to an enrollment process, report of finding process. And this is a continuation of previous trainings. We’ve been doing between getting leads to turn into shows, to turn into to educated patients, to turn into closed and enrolled patients. We’ve been doing these trainings now for, I think almost five, six, seven weeks, something in that realm. And I feel like this one right here is gonna be one of the most engaging and tactic like the, as far as tactics, this one’s gonna be loaded, loaded, loaded with tactics. So thanks for coming and we’re excited to get you guys started. I wanted to let you know what you’re here to do today. While I do, I own a company called Patient Stream. That’s not today’s goal. Today’s goal is to show you how to get new patients, okay? Our goal is to help docs grow their practices by providing obviously our amazing software that allows you to run your own ads. It’s a DIY Facebook marketing software and that’s really exciting. It’s great for us. We wanna give you the best training, okay? This training is free. This is not, you’re not paying for this training. This is something that we wanna do because we know that in the longterm, in the long run, if we help you get more patients, that just helps, what is it? A rising tide lifts all boats. So that’s kind of the school of thought we adhere to. And we also, our goal is to create a community of docs with drive and passion to get new patients. In fact, we’ve got docs on this call, Dr. Del Rio, he’s on this call. I and Michelle Sims, I’ve recently done, sorry. I’ve recently done trainings in interviews with them where they are transparent about the things they’re doing to have this success. And I’m hoping that with Patient Stream we can just share tons of transparency, show you guys what works, what we’re doing to have success and you know, again, a rising tide lifts all boats and we wanna make this easy, okay? That’s a dodo bird, if you didn’t know and Dodo birds are dumb. And so if we can make it so easy that even this dumb Dodo bird can do it then and that’s why he’s our mascot for New Patient School, okay? I’m gonna jump right into this. A lot of times I’ll fill these, you know, I’ll just give announcements about Patient Stream, what we’re doing right now. Obviously we have a ton of new niche offers that we’re uploading it’s crazy. January is gonna be crazy to say the least. But I wanna get into today’s training because I don’t know, maybe I’m more excited than you guys. I don’t know. But I’m really excited to get started. So I wanna introduce, if this is your first time, I wanna introduce you to our trainer. He’s a good friend of mine. His name is Dr. Andrew Wells. He’s an awesome guy. He’s the owner of a company called Simplified Integration which basically, if you wanna integrate your practice and you wanna do it seamlessly for way lower price, reach out to Andrew, he can help you do that, okay? He’s also I got a Simplified Integration podcast. He’s a lot like me in that we feel like when we share and we teach and we kind of hold nothing back, at the end of the day, that will, you know, that good karma will pay off in the long run. And again, the most important thing, I’ve said this before, I know him, I know myself, our most important job is as a father and husband to our families. And so I know he is that way obviously he’s got his lovely wife and two boys here and I know he’s an awesome guy. So Dr. Wells, gonna go ahead and have you unmute, how you doing buddy?

– [Dr. Wells] Great, man. How are you? Can you hear me?

– Yes, I am doing good. And I should also, I didn’t mention this last week but I should mention it because I think it is noteworthy. Thank you for doing this. I know that right now is not the most keen time for the Wells family. You have, you know, you’ve got that stinky Rona thing and I think your wife just got it and that’s no fun. So thanks for doing this and for following through we really appreciate it.

– [Dr. Wells] Yeah man, thank you for that note. I appreciate it. You know, I really don’t like to miss these meetings ’cause I know they’re valuable for people and I really appreciate the people who are on here. You know, I was diagnosed with the Corona virus and then, you know, I had two positive tests and I felt kind of crummy and lost my sense of smell and all that. So that created a whole set of issues and then my wife got it which created a whole another set of issue so my wife owns and runs a small business as do we and our kids are not in school so we’re trying to juggle this really wacky time right now. But the good thing for me is I get to be out of my house for like a minute and this is actually a good break for me so thanks for having me.

– No, we love you buddy. So I’ll go ahead, we’ll turn it over to you. I’ve got the slides. I looked at the slides and so I’m ready to do the role-play, I’m excited for this, but as far as, I don’t know that I’ll be able to anticipate some of the slides so just give me a, you know, clicker something for your next transition.

– [Dr. Wells] Yeah, so for you guys docs just know that like Sam and I have not role-played the role-play and really, you know, I’m thinking about this before I got on, I really at the end of this, just to kind of set this up a little bit, my hope is that at the end of it you guys are gonna be like, Oh, that’s actually, that’s all it is? Like, that wasn’t very special. And I really honestly hope that you think like, yeah, oh, that was really simple. I could do that. What you’re not gonna find at the end of this is like there’s some sort of magic line or like magic delivery or special sauce that will give you a higher conversion in your report of finding, it’s totally not that. And I’ve said this over and over again. If you guys have done a good job with your intake and your day one process and your followup this day two processes, this report of findings should go really smoothly in just reporting what your findings were from day one. And so I think this will be somewhat anticlimactic but I want you to know that in this scenario, less complicated, less fancy, less tricky. The simpler this process is, the report of findings, the easier it’s gonna be for you and the better your conversion rate will be. And I hope you understand that. And so this is, this dawned on me this morning. If you click to the next slide, if you would, Sam. I created this this morning and this is something that’s been rattling around in my noggin for a while and I was finally able to articulate it. And this is where we find the docs that convert at 80% or higher, or aren’t converting very well at all. We can sort of, we can pin you somewhere on this matrix. Now there are two components to a quality report of findings as the doctor or as the case manager, there’s a competence component and there’s a confidence component. And what I mean by competent is that a competent doctor is a person who has good clinical skills, they can articulate the what in terms of the diagnosis and the therapy and their sort of that’s like the clinical side of it. So you know what you’re talking about and you’re strong from a clinical standpoint. The other end of it is the confidence part. And what I mean by confidence is how well are you at articulating what’s in your head and what you know, to actually, to relaying that to the patient and getting the patient to understand it? And that has everything to do with how you walk in the room, how you respond to questions and concerns. You know, your verbal communication, and also your non-verbal skills, these are the things that patients are picking up on and they’re noticing. And so you could have, the best scenario would be someone who’s competent and confident. On the other end of the spectrum, the diagonal part in the red part on the bottom right you have an incompetent unconfident doctor who, this is a person who just doesn’t know what they’re talking about and it comes off as unconfident. And that’s pretty rare but what happens is, let’s say you have, let’s say you’ve just done like, launched a new therapy or you’re a doc fresh out of school and you haven’t really practiced your skills so much. You walk into the report of findings and you stumble over your answers, maybe there’s a lot of ums, there’s a lot of like just hemming and hawing and the patient will detect that instantly. And then you have more often than not, in the upper right hand corner you have docs who really know what they’re talking about but they don’t come off as confident. And this is a hard one to pick up on, in fact, a lot of doctors don’t know that they’re in this box. So they really know their skills but from the patient’s point of view they don’t seem like they have their stuff together. And I would say a lot of docs fall under that category and then finally you have in the lower left-hand corner, you have doctors who are incompetent, meaning they don’t know what they’re talking about but they come off as, yeah, they have the ego problem, like they really, they come off as like, yeah I can, no matter what the problem is, I can help you and they’re gonna kind of ram the patient through the report of findings process. So what we wanna do is get a situation where you’re competent and confident. And the only way I know to do this, so you can teach the competent part, right? You can teach protocols, you can teach therapies. That’s a very formulaic system, but oftentimes you find that it’s tougher to teach the confidence part. And the only way I know to teach the confidence part is just by role-playing and training and repetition, repetition, repetition. And this is where a lot of, I get this sort of this kickback sometimes where doctors say, hey, you know, Dr. Wells, I used your script. I said your script verbatim, I followed it to a T but the patient didn’t commit or they didn’t show up for their appointment. And what they’re missing here is it’s not what you’re saying so much as how you’re saying it. And that’s what I really wanna get across today is that how you come across to the patient has much more to do with what you’re actually saying. So yes, scripts are important and we use scripts and we’re advocates for scripts but so often doctors take that in a very literal sense meaning that if I just follow the script, I’ll be okay. That’s not it that’s part of it. And the reason I talk a lot about training and role-playing with your staff is because unless you do it, and to be honest I got competent and confident when I was about maybe 1500 report of findings in. So the first 200 were a train wreck. When I got to about 500 I was like, mediocre. I have a note pad, a little sticky pad in front of me. On the sticky pad it says, “Average sucks.” And that was, when I started out I was very, very average but the more I did it, the more I trained on it the better I got. And the takeaway from this slide, what I want you guys to do is that when you’re training and start to train on your day one process and especially your report of findings process, what we would do is in our office is we would train on it, we would role play just like Sam and I are about to do and at the end of the role-play I gave my staff orders, directions and a hundred percent confidence that if anything that I said during that process was awkward or didn’t sound congruent, or my head wasn’t in it. They had to call me out on it. And it’s funny man, we had a lot of fun with it but they got really picky on what they were noticing. Like, hey, Dr. Wells, you know your hands were in your pockets the whole time? You didn’t look very confident or you seem to be like over-exaggerating the benefits of what you’re talking about. Are you using hyperbole? Or you’re like, you’re inflating the results. You know, if they ever sensed that I was being inauthentic, they would just stop me and I would have to fix that part of the report of findings. And there was a lot of nuance there but give your staff the authority to do it because it’s very hard to self-regulate that, a lot of doctors saying, Oh, that was great. I’m doing such a good job and I’m so well-practiced and I’m the bee’s knees when it comes to report of findings but you really need to have an outside perspective on that process if you really wanna get good at it. And so that’s the takeaway is that you’ll role play, train on this process. And here’s my, I haven’t done a report of findings in like three or four years. So what you’re gonna see here is you’re gonna see me go through this process as a competent person. But what you’re gonna notice is that because I haven’t practiced it over and I haven’t done it in a long time you’re gonna notice that my confidence levels are not where they should be. So I am by no means report of findings ready if I had to do one today, but I just want you guys to understand as are going through it, like, you’ll see in this actual training that men like Dr. Wells just kind of stumbling a little bit there, for a good reason ’cause I just haven’t trained on it in years. You know, I can help people train but I really have not been in the trenches doing this for a long, long time. So you’re gonna see a little bit of that lack of confidence in me when I do this and…

– [Sam] Especially after I like trip you up.

– [Dr. Wells] Say it again bud.

– [Sam] I said, especially after I intentionally trip you up.

– [Dr. Wells] Yeah, yeah, yeah. Yeah, no, no, I really hope that you do. And I gave my, you know, for our staff, I told them, I want you guys to give me difficult objections. Sometimes they’re like way out of left field, sometimes they’re the typical objections like, wow, I don’t think I can afford this or that’s way more money than I thought or why doesn’t my insurance pay for this? Like, you know, you should have your staff ask you these tough questions because until you, you know, until you learn how to hit those curve balls, you’re gonna stumble in the real situation with patients. And so, you know, it’s my hope that you can trip me up. That’s the whole goal of role-playing. And as we’re going through this docs, use the chat box. So at the end, what I want you to do is you can spoon feed Sam some objections. So if there’s an objection doc that you’re getting on a regular basis and you wanna see how I would handle that, just type that in the chat box and then Sam will tee that objection up so you can see how I would likely handle that in an office setting.

– [Sam] Perfect. All right. So should we set up a… Next slide or do you wanna set it up first?

– [Dr. Wells] Yeah, yeah, let’s set up. So we’re gonna be, Sam you’re gonna be suffering with left knee pain and you’ve had it for five years. You’ve done cortisone injections. You’ve done physical therapy. You’ve done hyaluronic acid injections in the past. And the diagnosis is you have osteoarthritis, the therapies you did before offered some pain relief but it seems like it’s getting worse over the years. And now you’re at a, you recently had a consultation with an orthopedic surgeon and the orthopedic surgeon told you you’re too young to have surgery. And the goal here is just for you would be pain management. And to, at some point you’re gonna have to have your knee replaced but probably not for like another 15 years. So that’s kind of the scenario.

– [Sam] Okay, I’m ready for it. And what’s kind of eerie about this is other than the age part of this, this is my dad’s situation right now to a T.

– [Dr. Wells] Oh, okay, perfect. This is, you know, this is actually a really, really common situation. And what’s your wife’s name Sam?

– [Sam] Morgan.

– [Dr. Wells] Morgan, that’s right. All right, so we’re gonna role play this. I’m gonna try to not jump out of character as much as possible but I may at some point just to explain a couple of things and Sam if you have any questions that you think need explaining just interrupt me and let me know.

– [Sam] Perfect.

– [Dr. Wells] Hey Sam, welcome back to the office. It’s great to have you here today. This must be your wife, Morgan.

– [Sam] Yeah.

– [Dr. Wells] Hey Morgan, nice to meet you. Really glad to have you here today. And Morgan, first of all, I just wanna say, you know, thanks for being here, you may wonder why we wanted you to come here today and what we’ve found over the years and we’ve helped thousands of patients with knee pain is that spouses almost always have questions. And we wanna do here today to number one understand happening with Sam’s knee so that, you know and also we’re gonna go over some recommendations on what we can do to fix this problem. We’re gonna cover your insurance coverage, any out of pocket costs and what we found is that when spouses know, when you know what’s going on with Sam’s knee, not only will you be informed, but you’re in a better position to support him in the care that he needs to get better. And number one, this saves you guys a lot of time. It’s really hard for Sam to go home and explain all the details and the nuance of what we’re talking about today. So we just wanna thank you, I wanna thank you for being here today to support Sam and to understand the therapy and how we’re gonna help your husband get better. So thank you for that.

– [Sam] She’s excited to be here. I’ll just say she’s nodding, she’s got a big smile. She’s very pretty, so she’s excited to be here.

– [Dr. Wells] I’ve seen pictures, yeah, she is very pretty and thank you. Yeah, thank you Morgan, we appreciate you being here. Sam, before we get started, do you have any questions like anything that you wanna get off your chest or major questions that you have before we get rolling?

– [Sam] No, I think we’re well, are we gonna talk about money today? As far as costs and what my insurance and all that kind of stuff cover?

– [Dr. Wells] You got it, yeah, so the way today works, what we’re gonna do is I’m gonna start off by showing you what a healthy knee looks like and then I’m gonna show you what your x-ray looks like and then I’m gonna have you actually show me what’s good and what’s bad on your x-rays and the reason we do that is I really want you and Morgan to understand and get a really firm grasp on the issue that’s causing your knee pain so that you understand it. And then from there, what we’re gonna do is I’m gonna explain what therapies we have in place that will help you with your particular problem. And we’ll talk about what therapies we’re recommending, how long it’ll take for your knee to recover and then at the end we’ll talk about what your insurance cover is, we’ll talk about any out-of-pocket costs that are involved and we’ll answer any questions you have about care, specifically your care, what it costs and what’s involved.

– [Sam] Okay.

– [Dr. Wells] And at the end, if you have any questions we’ll be happy to answer any questions that you have. And it’s pretty straightforward. And I do want you to know Sam, so there are, a lot of the therapies that we’re gonna talk about today are covered by your insurance. There’s one therapy in particular that’s not covered by insurance, but I wanna present this as an option to you so that if you decide that, so at the end of this, you can say, “Hey Dr. Wells, I just wanna do what my insurance covers.” That’s totally cool, or you can say, “I really wanna do whatever it takes to fix my knee.” And I’ll present that option to you and you can decide at the end, what you wanna do and what makes the most sense for you guys. Does that make sense?

– [Sam] Okay, cool. Yeah, that’s cool.

– [Dr. Wells] So the first thing I wanna do is let me give you some context for what a normal knee looks like and so this is where, so if you look at this poster here on the wall, there are four grades of osteoarthritis and I’m gonna show you your knee in just a minute. But the reason I wanna show you this is there is what’s considered mild arthritis and there’s, there’s what’s considered severe arthritis. So on the left, what you’re looking at is grade one degeneration and this when the two bones in your knees start to, the space in between the bone starts to become smaller. Now, the funny thing about grade one is a lot of people have this and they have no idea that they even have arthritis at all because they don’t, there’s no pain, there’s no loss of motion. They just, they don’t feel it. Then you’re going to grade two. Now grade two is, if you look on the right part of that knee in grade two, do you see how that little space there is a little bit smaller than the one on the left? It’s starting to decrease.

– [Sam] On the right side of it?

– [Dr. Wells] Yeah, on the right side of that second knee.

– [Sam] Yeah. I can see that

– [Dr. Wells] Pretty small, right? It’s even hard to notice at that point. Grade two, you know, some people notice it, some people have a lot of pain with grade two and then some people don’t notice it at all. They’re asymptomatic, but this is, when you get to grade two this is a patient who’s had that problem for years. And they either, you know, symptoms can come and go, again, like I said, some people have no symptoms, some people are in a lot of pain in grade two. Then you go into the third knee, which is grade three. Now this is where most people can say, yeah, I can totally see the loss of space in between the bones. Do you see that right there on the right…

– [Sam] Absolutely, yeah, that one’s really easy to see.

– [Dr. Wells] Yeah, easy to pick up. That’s a problem that’s been there for a long time. Almost everybody in grade three knows they have a problem because it hurts. It’s stiff in the morning, it’s more painful when you do more activity and that the problem is very, very obvious at that point. And then finally you get into grade four, which is the knee all the way on the right. And this is when most doctors would label this as bone on bone degeneration.

– [Sam] Yeah.

– [Dr. Wells] When you’re in this grade, most people have a really tough time just using that joint. So we typically see people in wheelchairs, walkers, they’ve had tons of cortisone injections. They’re usually like right on the border of having to have surgery or, you know, or they’ve already had surgery scheduled. That’s grade four. That problem has been there for a long, long time, it didn’t happen overnight. It’s just progressed over time. And so do these phases make sense to you, these grades?

– [Sam] Yeah.

– [Dr. Wells] Okay, Morgan does this make sense to you?

– [Sam] Yeah. She’s happy about it.

– [Dr. Wells] Okay, great. Now what I’m gonna do is show you your knee. So this, Sam, on the left is a picture of your left knee. Now, what do you notice is happening in your knee?

– [Sam] Well the left side of it is really narrow and then I didn’t know I had, I mean, none of those other ones had that like sharp thing on the side, you’ve obviously got an arrow going to it so that looks uncomfortable.

– [Dr. Wells] Yeah, you’re right. You’re absolutely right. So you picked up the two major issues. On the left side of your knee you have a loss of joint space so that the gap is smaller. If you look on the right side of your knee, that’s what normal spacing looks like. That’s what the other side of your knee should look like. And then you pointed out that little spike that’s what we call a bone spur.

– [Sam] Yeah.

– [Dr. Wells] That’s a sign that this problem has been there for quite some time, that takes typically years to develop.

– [Sam] Okay. So one side of my knee is like healthy and then the other is not good?

– [Dr. Wells] That’s right.

– [Sam] Okay.

– [Dr. Wells] That’s exactly right. So do you see how this would cause your knee pain?

– [Sam] Yeah, I mean, and it’s funny because it’s the outside of that knee, so, you know, I definitely can pinpoint where the pain is coming from. So yeah, that makes sense. I don’t really, you know, on the other side I just don’t feel much over there. So that’s surprising that there’s that spur there. Yeah, and I don’t want you to get too caught up in where the spurs are and where the loss of space is in the bones because some people have pain in different areas in their knees so I don’t wanna get too caught up in where the pain is but the fact is you do have pain and you do have limitations and you can see really clearly on the x-ray that the problem, you know, it’s been there for a while and this is absolutely causing your pain. Now you’ve done what most patients typically do in the past is that, you know, you have cortisone injections and pain medication and physical therapy, which works your muscles and tendons and ligaments. And a lot of those therapies are really designed just to reduce inflammation and cover up the pain for a period of time. And that’s why, you know, you’ve done those therapies and you said they’ve helped a little bit but they haven’t actually fixed the problem.

– [Sam] Yeah.

– [Dr. Wells] Because clearly the problem with this x-ray you can see the problem is still there. So the question I have for you is if you do nothing about this what do you think is gonna happen to your knee a year down the road?

– [Sam] Well, I’m guessing we’ll probably, as far as a year, I mean, I don’t know how long it takes but I’m guessing we’re going toward that bone on bone stuff.

– [Dr. Wells] You’re you’re absolutely right. Yeah. So osteoarthritis is what’s considered a progressive condition. Progressive meaning that it just gets worse with time. So it’s not a matter of if it’s gonna get worse, it’s just a matter of how bad and how long it’s gonna take to get to that point.

– [Sam] I see, okay.

– [Dr. Wells] Does that make sense?

– Yeah.

– Okay. Now, so the big question I have for you, is this something that you want help in correcting?

– [Sam] Yeah. I mean, yeah. I wanna see, you know, as long as it works you know, that’s the thing is, you know, just we’re here to see what options are available, how much it costs and whether or not it would work.

– [Dr. Wells] Yeah, yeah, so, great question. So I’m gonna go through the therapies in a minute and the therapies that we use here, we’ve used for a long time with really good success. And we wouldn’t have you come back here, Sam if we didn’t think that we can help you and I’m really confident we can help you.

– [Sam] Okay.

– [Dr. Wells] And the one thing, you know, that I want you understand as well is that this is a, I totally just lost my train of thought. I had a really good one too.

– [Sam] I was just, I was touching on certainty of treatment like, I’m interested, but I’m lacking maybe I just don’t know why this, you know, I don’t wanna pay a bunch of money for something and then have it be just another band-aid like I’ve been doing.

– [Dr. Wells] Yeah. Yeah. And that’s a good question. And I, and so what I want, what I want you to understand too is that we would, number one, we wouldn’t have you here if we didn’t think we can help you. And the services that we provide are not designed to mask symptoms. And so we wanna help correct the problem so that you know, five years down the road and 10 years down the road, that you, number one, you feel better but also that your knee is functioning a lot better than it is today. So, oh, what I was gonna say is and I totally forgot to ask you this question Sam is based on your x-ray. What grade degeneration do you think you’re in?

– [Sam] I kind of look like that number three but with the bone spur.

– [Dr. Wells] Yeah, I agree. I think you’re like late grade two, maybe early grade three. And the good news about that is that you’re at a point where you can do something about it. This is what I was gonna say, is that when you get to grade four that’s a situation where really the only options you have left are surgery but because you’re in between grade two and grade three, you have the opportunity to do something about it instead of just waiting until it gets worse. And then just having surgery as your you’re only in final option. So that’s the good news and the therapies I’m gonna share with you are designed for patients just like you where you’re in this period where you have a problem but you don’t wanna do surgery at this point. So you have options at this point.

– [Sam] Okay.

– [Dr. Wells] So let’s go over those options for you, if you wanna skip to the next page. So say on the first option that I wanna talk about is hyaluronic acid injections. Now you mentioned you had these years ago and you said they, you know, you had some good results but then kind of the pain relief faded after a period of time.

– [Sam] Yeah, yeah, it felt good when I did it but you know, it faded after a couple months.

– [Dr. Wells] Yeah. And that’s by design. So hyaluronic acid, just so you know, I don’t know if anyone ever explained this to you but it’s a natural substance that your joints produce on their own. And what happens is over time, as we get older, as we damage our joints your body can stop producing proper amounts of hyaluronic acid and you can lose some of that cushioning and fluid that you have in your knee when you’re younger. So what we do with hyaluronic acid injections is it’s a natural injection so this actually comes from the coxcombs of roosters. So it’s not a steroid, so it’s not gonna, as you know, with steroid injections the more steroid injections you have, the more damage it does to your bones and the soft tissue in your joint. The nice thing about hyaluronic acid is it doesn’t have those side effects. It’s not gonna damage your joint. In fact what it does is it provides lubrication and cushioning. And what you’ll notice like you did before is that you’re gonna notice that your joint feels better. You’ll have less pressure on the bones and the cartilage in your joint. Your joints will move a lot better but you’re also gonna have a lot less inflammation. So it’s almost like WD 40 in your joints without any side effects. The only downside to hyaluronic acid injections is they typically wear out. So after about six months you’ll notice that the effects will start to fade. What we do with a lot of our patients is after that period we’ll do a second round. And the nice thing about your insurance is they’ll cover multiple rounds of hyaluronic acid injections, but you have to, they’re not, it’s a temporary fix, so to speak. So it’s not doing anything to really correct the problem. However, it will provide you with what your goals are. Less pain, the ability to do more activity with less pain and less side effects at the end of the night.

– [Sam] Yeah, okay.

– [Dr. Wells] So we do these injections in a series of five. So Sam will have you come once a week and each week we’ll do one injection, so it’s a five week protocol. And then after five weeks we’ll do an assessment to see how your knees are functioning after those injections.

– [Sam] Okay.

– [Dr. Wells] And then if you wanna skip to the next slide. So the second therapy that we offer is knee bracing. Now this is one that patients sometimes they’re a little hesitant about because I understand that not everyone wants to walk around every day with a knee brace on but let me explain what this does to actually help your knee. So this is not like a knee brace that you find at Walgreens like a little sleeve that you pull over your knee. If you notice in this picture there’s a little hinge on that knee brace. This is called an unloader brace. And the design of that hinge, what it does is it actually supports that space on the inside of your knee. So you have that little loss of joint space there.

– [Sam] Yeah.

– [Dr. Wells] What the brace is gonna do is it’s gonna help support your joint on the inside of your knee to help open up that space. So it’s gonna take physical pressure off of your knee. It’s gonna help support your joints and ligaments so that when you’re playing with your kids and when you’re coaching basketball it’s gonna not only make your knee feel better and support your knee, but you’re gonna have less pain after doing those activities. Now you don’t have to wear this knee brace all the time but if there are periods where you know you’re gonna be on your knees and stressing your joints and certain activities that you know are gonna cause knee pain, slap this little brace on and it’s gonna provide you with a lot of support during those activities.

– [Sam] Okay.

– [Dr. Wells] Also when we combine the brace with hyaluronic acid and with the other injection I’m gonna talk about in just a minute it just helps your knee function better and heal faster. So it’s gonna give you some relief and it’s gonna help you improve and get better faster.

– [Sam] Okay.

– [Dr. Wells] So that last hyaluronic acid is covered by your insurance, your knee brace is covered by insurance. And if you click on the next slide, so the last therapy I wanna talk about that’s covered by your insurance is regenerative medicine. Now, this is a really amazing, amazing therapy. And the nice thing is it’s covered by your insurance and we weren’t able to say that even six months ago but this therapy has been around for about 30 years. And it’s finally being covered by your insurance which is really good news. So regenerative medicine is using human cells to help your body repair itself. An amniotic tissue, so some patients have questions like what is amniotic tissue? Well, it’s cells that come from the birth process. Now this has nothing to do with abortions. Some people have that concern, but the cells come from mothers who voluntarily donate their placenta and amniotic tissue after having a scheduled C-section. So mom goes home with their baby. We use the cells for people with joint pain, just like you. So the cells are processed in a lab to make sure that they’re safe. There are no known side effects of amniotic tissue injections because it’s not a drug, it’s not synthetic, it’s just human cells and growth factors that we use to help speed up the recovery process. So the cool thing about this injection is it’s a one-time injection. You should notice pain relief within the first three days. And what the injection does is it actually works to help repair the tissue in your knee. Now, this is the first type of injection of its kind that we’ve had access to in the history of orthopedics, like you’ve experienced, cortisone injections, hyaluronic acid injections while they can help with pain, they don’t do anything to help repair the actual joint. This type of injection is the opposite. Because it’s regenerative medicine, regenerative meaning that it can actually help your body repair itself. So this is the only thing that we know of that can actually stop and actually in some cases reverse the signs of aging in your knee. So remember we talked about phase one, phase two, phase three, phase four degeneration. This actually has the potential to stop that process from getting worse. How cool is that?

– [Sam] Yeah, that’s cool. Yeah.

– [Dr. Wells] So this is what you see like a lot of professional athletes getting and celebrities have gotten these things for years, well, we have access to this exact same technology that we can use for your knee pain. And this is a one-time injection. So we actually start with this injection first, followed by that series of hyaluronic acid injections. So this injection we could do, we can actually do this injection today.

– [Sam] Oh. Geez, okay.

– [Dr. Wells] And the last slide, if you skip to the last one, the last thing here and Sam, remember how I mentioned some of these therapies are covered by insurance and some not?

– This is the one that’s not covered by your insurance but I wanna talk about it because I wanna let you know that this is an option for you and you can decide whether or not you wanna do it. The reason I’m talking about it is we get really really good results when we use knee decompression in conjunction with hyaluronic acid and knee braces and regenerative medicine. So this is that little device we had you sit on the last time you were in our office. and what it does is it gently stretches the two bones in your leg, and it opens up that space where you have degeneration. So it provides pain relief but it also allows your body to heal itself faster as we’re putting hyaluronic acid and regenerative medicine into your knee, it just opens up that space to allow for better blood flow, less pressure and increase healing. So this is a, I don’t wanna say a permanent fix, cause it’s not, it’s a temporary fix, but it aligns, it just helps our patients get better faster. And you’ll notice like you did, when you came in for your first visit that it just feels good. And so this is gonna get you back on the road to recovery and feeling better faster than not doing it. Does that make sense?

– [Sam] Yeah, that makes sense.

– [Dr. Wells] Okay. So before we go any further, are there any questions about the four therapies that we talked about? Sam either you or Morgan?

– [Sam] No, and you guys checked our insurance and so we do know that this stuff is covered and all that. I mean, the, I guess you said that just the one thing the knee, did you call it decompression, that wasn’t covered?

– [Dr. Wells] That’s that’s right. Yep.

– [Sam] But everything else is.

– [Dr. Wells] Yeah, so actually we’re gonna talk about your insurance coverage and out-of-pocket cost right now actually, if that’s okay.

– [Sam] Yeah. That’s great.

– [Dr. Wells] Yeah. I just wanna make sure you don’t have any questions about the injections or the knee brace or decompression.

– [Sam] So I do have one question real quick about the regenerative medicine. So you said it stops the pain. I mean, I’ve read about like people, you know, not getting knee surgery or things along those lines. So does it like, does it reverse? Like, I mean, what is it, does it just stop where I’m at? I’m at a level two between three and I’m stopped there and I just can stay there longer or what is actually happening?

– [Dr. Wells] It’s a really good question. And that’s a question we get really often and the question I get as well, does this mean if I have this injection that I’ll never have to have knee surgery? And that’s definitely not the case. Now we’ve helped patients avoid surgery. We’ve helped patients that were scheduled for knee surgery and they had this injection and they still years later have not had surgery. And so the idea with this injection is we wanna give your body as many chances as we can for your knee problem to heal without it getting worse. And this is an injection that has the potential to do that. So yes, it will help with pain, but it also has regenerative or healing components to it that will actually help your body stop and reverse those signs of aging. So, you know, you’re 40 years old now, Sam and you know, I don’t have a crystal ball so I can’t tell you that, you know what, you’ll never have to have a surgery ever in your life. Do I know if it’s gonna last for three years, five years, 10 years? I don’t know. But what I can tell you is that most patients get several good years of function in their knee without having to have another injection. Now because you’re young and because you’re in stage two, stage three degeneration, my guess is that you’ll have to do this protocol, this therapy over time. So I don’t want you to think that this is like a one-time injection and this is gonna solve all your problems with one injection is definitely not that. But I think that this offers a, this solution offers you or this therapy offers you a solution that you can really help stop and reverse the speed at which your knee gets worse.

– [Sam] Okay.

– [Dr. Wells] I know that’s a long worded answer to your question, but…

– [Sam] No, no, it’s fine. That gives me the answer that I was looking for.

– [Dr. Wells] And what I’ll tell you too and we’ll help you with this in our practice is that there are a lot of things that you can do to help your knee stay better which is maintaining a healthy weight. That has a lot to do with knee function. Staying away from heavy drinking and smoking. Like for example, we have patients that have done this injection and they’re smokers and they don’t get great results because they’re constantly putting bad stuff in their body. Exercise is important. So if you, you know, with your knee problem if you just sit and become really sedentary and don’t move your knee a whole lot and your muscles get weak this problem is gonna get worse faster. And so the goal here is to get you back to normal activity where you can use your knee in a healthy way and not damage it more but we wanna keep your knee as strong and as mobile and as active as you can for as long as we can. And the more you can do to put your body in a good environment where it can stay healthy the better off you’ll be in the long term.

– [Sam] Okay. That’s good. No, that all sounds really, really positive. Really good, I’m liking it.

– [Dr. Wells] Awesome. So let’s go over the cost. So if you skip to the next slide, now normally guys so just a little side note. This is, so this care plan I would go over. I wouldn’t just show this to the patient upfront. You wanna go through it line by line. So what I would do is take a piece of paper and cover up the bottom portion of it. So the way I would do it is you start right at the top. So Sam, you have a, your plan you have a $3,000 deductible. You’ve met a thousand dollars of that so far this year. So you have a remaining deductible of $2,000. So what that means is you owe that portion on your insurance plan before your insurance benefits start to kick in.

– [Sam] Okay. Yeah.

– [Dr. Wells] Okay. So the first line in here, we talked about hyaluronic acid and other, knee viscosupplementation is another word for that. You have a $20 copay per injection and we’re gonna do a series of five injections. So five times 20 bucks is a hundred bucks. So that is your out of pocket costs for the hyaluronic acid injections. Any questions on that at all?

– [Sam] No.

– [Dr. Wells] Okay. Moving one line down, durable medical equipment. So that’s the knee brace, you have a $50 copay for the knee brace and that’s just for your left knee. So that’s $50 out of pocket. And then we have, the next line down is knee decompression. So remember this is the one that’s not covered by your insurance. There’s no insurance plan I’m aware of that covers it. Our rate is $50 per therapy session and we’re recommending 12 sessions which is a total of $600. And then finally at the bottom we have the regenerative medicine injection. That’s a one-time injection and your insurance covers that. So there’s no there’s no copay or out of pocket cost for that injection.

– [Sam] Okay.

– [Sam] So grand total for your therapy and this would be all four of the therapies we talked about is $2,750. And we can do that in cash, credit card, check, however you wanna cover that. What makes the most sense for you?

– [Sam] Well, Morgan usually answers these questions.

– [Dr. Wells] Okay.

– [Sam] Sounds like she has a health savings account. So I think she just wants to use that.

– [Dr. Wells] Okay, yeah, we can do that. Do you know how much you have in your health savings account?

– [Sam] It’s maxed out, isn’t it, honey? Yeah. She says it’s max out. So in Idaho, that’s I think $5,000. I think, I don’t actually do this in real life. She does it, that’s actually for real she would actually make the decision.

– [Dr. Wells] Yeah, well, no, that’s why, Morgan that’s why you’re here. So again, thank you for being here. Yeah. We can use your health savings account for this. So what we can do is go to the front, I have a couple of documents for you guys to sign and we’ll take care of the payment and then we’ll go over instructions on today’s injections. So we’ll do the regenerative medicine injection today.

– [Sam] Oh, today? Okay, cool.

– [Dr. Wells] Yeah. So you’re gonna walk out of here feeling a lot better. We have a few documents for you to sign and then we’ll get a schedule set up for you to do the hyaluronic acid injections. The first one will be next week and we’ll go to the front desk and get those scheduled out.

– [Sam] Okay. Cool. Sounds good.

– [Dr. Wells] Yeah, I’m really excited for you and we’re really looking forward to helping you with your knee.

– [Sam] Yeah, I’m excited too. So I wanna back up just a little bit. I took a couple of notes as we were going but I wanna also say, I tried to like, feel like I was an actual patient. And so I’ll tell you what I felt as I went through because honestly it was like, that was like the easiest close in history of mankind. And I was trying to think I’m like, is there a place in his report of findings where I would have thrown up a doubt that would have kept me from, you know, doing something and I didn’t feel resistance and I authentically did not feel resistant. So I wasn’t trying to lob you a softball. I just didn’t, I mean without being, you know, weird and fake, I couldn’t think of anything. Again, I was putting myself in my dad’s position. I was just talking to him recently about, you know, this whole thing. And anyway, so that was one thing. One thing I noticed you were doing and we covered this maybe last week or the week before when you were going over each one of those therapies the reason I really liked it is because you would go over a feature, you would attach the benefit and then you would make it like, you would like say this is why you need it. So you would like relate that to me. And I noticed that, I think I didn’t notice that on the first one ’cause I wasn’t looking for that. But the second time, the second therapy was a hyaluronic. The brace, you were talking about the brace and you were saying how it like unloads the knee, right? And I was like, oh, he’s explaining the benefit. Wait, hold on. what did he just, so I started taking note of that cycle and I’m guessing, did you do that every time?

– [Dr. Wells] No, no, I did it. I don’t know if you noticed on the last training I did it like very deliberately in like the same way every time. But this time I didn’t, when you have four therapies that you’re talking about if you make the pattern way too obvious then it can come off as I’m . So I threw up a couple, like, you know examples of your particular lifestyle. Like I just happened to throw in, like, this is gonna help you after your coaching basketball games so that you can, the patient can actually now put themselves in a, you know, in a real scenario in their life like, Oh yeah, they can start to imagine themselves feeling better after coaching a basketball game which kind of future success. So it was a little more subtle this time. But I also wanted to make it really like, I don’t know, kind of boring in a way, you know?

– [Sam] So like you had a cautious certainty and meaning you were certain about the treatments but when questioned about, you know, regenerative medicines specifically, you gave a response that reflected both cautiousness and certainty. And I wonder if part of that comes from like and we’re getting questions about stuff that is not really about report of findings. It’s more about regenerative medicine which a hundred percent we’ll get to here in just a second. I promise. But I wonder if does that come from like the pressure’s kind of taken off because insurance is covering that thing in particular? Would you have done the exact same thing? If, ’cause this is news to me as far as them being covered by insurance. and I think most of the doctors that watch this, are watching this now or even on replay, it’ll be news to them. And again, I don’t wanna get into that just yet but I want you to put yourself in the position of if this was a cash service and I asked you the question that I asked you which was basically does this thing actually work? That was the underlying tone. ‘Cause that’s what most people wanna know. Would your response have changed?

– [Dr. Wells] No. No, what I noticed was when I first started doing regenerative medicine, this was like six years ago and we charged 5,000 bucks an injection. My natural instinct when questioned about its effectiveness was to overplay the benefits. You’d be be like, “Oh, this is like the greatest therapy ever.” And like,” Yeah, I really think this is gonna help you avoid surgery and you’re gonna be able to do all the things you wanna do.” And like in many cases sounded too good to be true. And a lot of it to be completely honest is I wanted to close $5,000 cash care plans, it’s great for the clinic. And what I noticed over time, as I matured through the process was the more that I didn’t do that the more that I was just completely, here are my cards, here’s what I expect will happen. here’s what could happen, here’s what might not happen, then more people would be like, “Oh yeah, okay, that makes sense.” And when you’re brutally honest like that without any apparent motivation.

– [Sam] Yeah.

– [Dr. Wells] Patients will, they connect with that and they’re looking for that, they want it, they wanna see if you’re gonna like try to oversell or undersell it. And what I found was if you’re just honest and it, that took a lot of training for me to do that, to be honest. But yeah, the more honest I was in terms of expectations, the better the outcome was.

– [Sam] Well, and also, this kind of, as you’re talking I’m thinking back to the previous trainings we’ve done and even trainings I’ve done for people on the sales process, whenever the delivery of the information is not internal, meaning you don’t own the information. You’re just like, oh, I’m regurgitating it. Then your subconscious does not match the reality of what’s coming out of your mouth. So meaning I say words one way when I really believe them. And I say the exact same words verbatim, phrases, differently if I’m not, like you said confident about them. So…

– [Dr. Wells] That’s a really astute observation. That took me a long time Sam but, you know, I think we should repeat that. That took me a long time to learn. Because the person that I learned regenerative medicine from was a very like hard pushing salesperson and would probably say anything to get a sale. And some of that I took with me as I learned it and I just picked up some bad habits, which is not, that’s not how I am normally like I’m not a pushy sales person, but I sort of adopted those sales tactics. And when I, the more I did it, the more I kind of found my own voice in what was authentic to me, it just, man I did so much better from a business standpoint that way in just using honesty and just being ethical.

– [Sam] Yeah, no, I like that. I do have one, I don’t know if it’s a criticism and I don’t know, honestly because I’m not a doctor, I just know like if I was selling something else this is probably what I would do, right? One of the things I really love about this approach is you’re not just saying, okay here’s a regenerative medicine shot, you’re gonna be good to go. All right? And I know there’s people that do that and I’m not a doctor so I can’t say whether or not that’s all you need but I can tell you from the lay person that seems like, hey man, you just charged me a boatload of money to, like for one minute’s worth of work. I don’t feel an equitable amount of exchange here. When I look at the knee viscosupplementation, the DME, the decompression, regenerative medicine or physical therapy. When I see this, I think, hey, I don’t know why but this feels better, right? And I think the opportunity missed is one of the things that I would have probably done is I would probably would have pre-framed something, I call it when we do our ads for knee stuff we actually call it a knee or a joint restore program, right? And so I frame out something that we created that’s nuanced to us. And the reason I would say today we’re gonna go over your customer results and we’re gonna show you how we frame them inside of something we call our knee restore program. We call it a knee restore program because our goal is to not just use one therapy or one surgery to fix the problem, it’s to add lubrication to it, to add more space to it, it’s to add new cell growth. So we’re going to show you an entire restoration, almost like you’d restore a car. We don’t just slap a new coat coat of paint on it, right? We’re gonna show you a knee restore program. So by the end, our goal can be focusing on how to resolve this problem for a long-term again not guaranteeing that you won’t eventually have to have something more invasive or interventional but for the time being, we can give you a restorative approach, something like that. You know what I mean?

– [Dr. Wells] I just realized this and this is how rusty I am at actually doing report of findings. I totally forgot to mention right before, you know, when I introduced myself to your wife, Morgan?

– [Sam] Yeah.

– [Dr. Wells] I didn’t preface this, is that you guys have just watched a 14 minute report of findings video that talks about exactly, that’s what we call it. They call it the knee restore program. I don’t know if you’d go back to the slide, there was like one of the slides, the first one had a play button on it. And so what I was supposed to say at the beginning of this training was, hey, Sam and Morgan, that’s it, yeah. So thank you for watching that video and that video describes the four pillars or the four aspects of our knee restore program which is lubrication, physical therapy and rehab, regenerative medicine, and stability. Those are the four pillars of it. And so before you guys even talked to me and before I go over all the components of it they already know, okay, this is a…

– [Sam] Yeah, ’cause you asked me if I had any questions. You were probably asking me if I had any questions about that.

– [Dr. Wells] Yes, probably, again, like, I am very rusty. This is the first time I’ve done it in years, but yeah.

– It was great.

– [Dr. Wells] I botched that and we talked about this on the training before the last couple of weeks is that you wanna have some kind of pre-education process. So what we do for our offices and our clients is we give them a, it’s a 14 minute video. It talks about, you know how all these components fit together so that it’s an actual program not a one hit wonder therapy. You know, if go to your orthopedic surgeon and they slap some cortisone in the joint and then, all right, come back when it hurts. Like that’s not our approach. There is an actual structured program that we take people through and I think patients like programs. They like to know that there’s a system and that the system that we’re using is a different system than what they’re used to, that hasn’t worked already. And you can do this in a video form. We do that because it just saves a lot of time in the offices. We used to do this in a group report. So for example, when we did regenerative medicine on a cash basis, we would get 20, 25 people in a room. And I would do a one hour lecture on regenerative medicine. And the one hour lecture was designed to qualify or disqualify that person for care. So we’d have half the group would be like, oh, this is great, I wanna see if I’m a candidate or the other half would be like, nope, not interested. So we’re kind of like weeding them in and out. But my point in saying this is you should absolutely have, before you go into the recommendations you should have some sort of patient education process that pre-frames and that sets up the conversation that you’re about to have. And in that video, we have this really cool testimony of a patient who was facing knee surgery and went through the program and he’s like, I was skeptical about it, but you know what, I’m so much better now. And he, you know, he was tearful in his testimony and that’s how we end that video. So there’s an emotional component to it. And it’s a real life person who said they went through the program and it helped them. And that’s, I think it’s a really…

– [Sam] And there’s another component missing too. I mean, in this explanation, this is all important. Education is important, but the other thing is like anything, there are services that will transition from a nuanced high ticket service into a commoditized, cheaper service, right? And so one of the, one of the problems that you’re gonna have in actually closing these care plans, these cases has nothing to do with the doubt in that person’s mind of whether or not they wanna do it. It’s more like, hey, can I get it cheaper over there? There’s other people doing this. Okay, so when you present a program that is nuanced and created by you, okay? Then it basically decommoditizes that service and a decommoditized service then has no price tag, okay? ‘Cause if they can’t, they’re not gonna get this exact same program when they go down the street, okay? They’re not gonna get the ABC integrated medicine knee restore program. They’re not gonna get that. And so if you have sold them on the fact that they need all of these things and why they need each component to combat your particular case, then I will tell you 100% my wife Morgan, right here, she will leave this clinic and she’ll be like, let’s see if we can get it cheaper somewhere else. That’s how she rolls. In fact, I hate shopping for Christmas presents for her because she’s like, you know you could have got that for like 20 bucks cheaper over here. I’m like, oh, geez, just have some money. Go buy it yourself. The point is, if you, I wrote this down setting up your own niche program and presenting it in that way is going to allow you to de-commoditize your service and that’s really important in closing and creating interest and desire. Authenticity, certainty, that was awesome. Great. I mean, overall, it was awesome. I’m gonna ask if anybody has questions. I definitely know, do you wanna, while people are coming up with questions, Dr. Wells, we’ve got questions coming in about the amniotic tissue injection. What some more details on that. I mean, just whatever you wanna share on that.

– [Dr. Wells] Yeah. Yeah. So amniotic tissue, there are codes now for amniotic tissue, regenerative medicine. So it’s, this is the same, by the way, this is what doctors call, I’m doing my air quotes, STEM cell therapy. So there is, this has nothing to do, most doctors are not doing STEM cell therapy, where that’s where you’re taking it from the patient’s bone marrow or from their . Most patients are outside of the US. So amniotic tissue is a part of the umbrella term regenerative medicine. And this is what doctors are typically charging four to $6,000 for. Most commercial payers now have codes that they’ll reimburse. Not only would they reimburse it, the law sheet pre-authorized the injection, so that you know that you’re gonna get paid on it before you do the injection. So instead of having to do these like these group lectures and seminars, and the really big like dog and pony show, you can now bill it through most private insurance. Medicare pays on it as well but I just wanna caution you that Medicare does not have the same pre-authorization process as commercial payers. Some doctors are billing this to Medicare. I think that’s a mistake and I think that’s a potential for an audit but the private payers, commercial payers like your Blue Cross Blue Shields, Uniteds will tell you in advance whether or not they’ll pay for it, they’ll approve it. So that’s what we’re, you know, we’re using now. We have a pre-approval process. We have an actual product that has a code that you could use for patients which we didn’t have before, which is really exciting. The biggest question I got with regenerative medicine for years was, does my insurance cover this? Or when will insurance cover it? And we just never had a good answer for that but now that therapy has been proven. It’s been around for quite some time. And it’s cool that insurance is starting to cover it.

– [Sam] Cool. And maybe we can do a training just dedicated to that in the future you guys, if you wanna see that. Jim says, “What do you tell people that don’t wanna prepay or pay each visit?” I’m guessing he’s saying versus pay per visit.

– [Dr. Wells] Yeah. So what we tell patients is that and that’s a, I would always address so that it looks like, hey, that’s a really good question, Jim. So the reason we don’t do that is if we had patients pay every time they come into the clinic as a busy clinic, we would have to hire one or two people just to take payments over the front counter when they come in. So instead what we do and the way we keep some of our costs down in our clinic is we just have patients pay for it upfront. Now that may, the question I always get is, well what happens if I can’t continue my care? Or what happens if I decide I just don’t wanna fall through with care? Well, the good news is is that if you let’s say you’ve paid for everything upfront and you decide halfway through, you know what? I just, I don’t wanna do it anymore. We will refund you anything that you’ve paid in advance or any service that you haven’t received up until that point. So just know that you’re not, you know there’s no contracts here. You’re only paying for what you receive but that’s how we help keep our costs down. And that’s how we keep our costs down for you as the patient. And that’s why we do that.

– [Sam] You know it’s interesting too. I would say Jim and to anybody else asking, if you, and this is going to change per location, by the way, if you have a objection that comes up frequently. First of all, you need to analyze, like, why is this coming up? What am I saying that is bringing this to the forefront? Okay. That’s like number one. And then number two is you can always tackle. I mean, this is something as a copywriter, when I write sales letters or things like that or scripts, I’m waiting to find the objections the doubts, the whatever. And then before I even give them a chance to talk about it or to ask questions about it, I answer it. So I might say something like in my pre-framing Jim I might say something like, so I’m gonna share our plan on how we’re going to, our knee restore program. We’ll go through each line individually. At the bottom we have a total, okay? We have some payment options for you to handle that. We’ll square that away generally in one lump sum payment or we have other options. And that’s how we do it here at our clinic. I mean, obviously that’s not rehearsed at all but I would just say from the beginning if that’s something that’s coming up frequently I would say, this is what we do. And this is how we do it. And not even why, I don’t know that I would put it in a why. Anytime, you gotta be careful about throwing in your why’s because they start to, sometimes they can come off as a defensive. So whenever somebody explains themselves too much that can be perceived as defensive. This is more of a treatment question. Let’s see here, where to go. Is amniotic injections similar to hyaluronic injections at all like they can be repeated every six months or anything like that.

– [Dr. Wells] Yeah. Yeah. So it all depends on medical necessity, but yeah if you can, you know, if you can prove medical necessity. So for example, hyaluronic acid, Medicare will pay that every six months. There is a way to document that. So you have to prove medical necessity which is pretty easy to do. And the same thing is true with amniotic injections. And the key there is you wanna get a pre off before you do the injection.

– [Sam] Yeah. That’s the same thing with like you know, x-rays, you know, if you wanna get another set of x-rays, as long as there’s an existence of pain, isn’t that the threshold for like, as long as there’s pain, then you can do that.

– [Dr. Wells] No, not so much pain. Pain is not a good reason to do these types of injections. An x-ray is typically your, there is a medical protocol to prove medical necessity but it’s, yes, you have to have pain but there are other components to it. One thing I just wanna say is that there are right now, disclaimer, there are a lot of groups who have jumped on this bandwagon of Q codes and amniotic tissue covered by insurance. A good chunk of them, I know from experience are not doing this legally and they’re not, they’re trying to sell a product. So I’ve been really cautious and patient with this process. And I’ve seen this coming over the last two years and I’ve talked to quite a few attorneys on the right way to do it. And also there’s a way to do it that’s gonna get you audited for sure. So what I would say is if you’re gonna do this or considering putting it in your clinic, please, please, please, please hire, it doesn’t take a lot of money, hire a compliance attorney, let them know what you’re gonna be doing or what you anticipate doing and let them give you some guidance on how to do it properly. If you’re relying on me or any other vendor or consultant to tell you what is legal and compliant you’re gonna end up in trouble. I’m telling you that not cause I’m being like unethical in what I’m doing but there are a lot of players out there that are giving out some very, very dangerous information. So I would caution you if you’re gonna do this don’t do it unless you contact a compliance attorney first and I can’t stress that enough. There’s gonna be a lot of docs who are doing this. I know for a fact they’re doing it wrong and they’re gonna pay for it later.

– [Sam] Well, it’s funny because you and I even talked about this exact same thing. I mean, since I do marketing for so many clinics I get people coming to me and asking me, hey, do you know people that are doing this and that and the other? And you know, I do, I know people, in fact we were working with a guy like two years ago that was doing that one thing where you put the, you do like an injection or insertion behind the ear. Do you know about this?

– [Dr. Wells] Yeah. That’s a great example of like this piece-in device or this selling it hard like Medicare is paying $8,000 per case.

– [Sam] Oh, this guy was making like 10,000 bucks. And so while I know about that, there’s a couple of people that I go to, I’ll go to you and I’ll go to Sonny and I’ll be like, hey, I heard this. What’s the truth? And I know it’s really funny that, and by the way, we didn’t rehearse today’s role-play at all. We talked a little bit and I said, hey, what if we set up this scenario? But other than that I wanted it to be as authentic as possible. And you and I have talked previously about, you know Q codes and things like that for regenerative medicine. And you had always been like, nope, not yet. Nope, not yet and so this is a new, and I know you have a compliance attorney that you reach out to and they just had been giving you, you know, they had not been clearing you for takeoff. And now it sounds like that’s now changed.

– [Dr. Wells] Yeah, you know, you and I get hit up with all these like new concepts and new ideas and the first thing I do when I hear something new is I just contact the attorney and the attorney can look up how to, you know, how to properly apply these therapies and codes. It’s all written and if it’s not written, then you know, you’re gonna get yourself in trouble. So that’s the first thing I do is consult an attorney, healthcare attorney and that, so I’m saying this to say, hey, don’t go out without doing your research and talking to an attorney on whether or not you should do it, but also then how to do it. But so many chiropractors get in trouble because they don’t know that they should talk to an attorney first and it doesn’t cost a lot of money for… My attorney charges me about 500 bucks to research a new therapy and he gives me some pretty, I have a couple that I use. And it gives me just really straight advice from an attorney who knows the game, not from a vendor. Vendors are trying to sell stuff and they want you to use their product. And that doesn’t mean that they’re giving you the proper information. I don’t know how this turned into a compliance call but it did.

– [Dr. Wells] I mean, you know, that’s the beauty of what we’re doing. I mean, this is authentic stuff. I mean, New Patient School again is about getting new patients. Patient Stream is an awesome software that allows us to run Facebook ads without a person effectively. And if we’ve got new conditions and niches we’re all about the niches. If you’ve heard anything I’ve talked about, I don’t believe that there’s such a thing as quality patients. I think there’s qualified patients and there’s a distinction there. And so, you know, this is new information. I assume that this means that we will have some new niches and offers coming soon in Patient Stream with this new information because you know, I mean, geez, I both you and I know that if we can help any clinic grow, make more revenue, thus getting, you know having the ability to help more people, man, we’re doing our job. We’re over our time limit. And so here’s what I’ll say. If you have any questions about any of, well, first of all, I’ll have the replay. It’ll be in the Facebook group. If you’re not in the Facebook group you should it’s Patient Stream Users Group. I’ll also have it on my YouTube channel. But if you have any questions about that feel free to tag Dr. Wells in the Facebook group. If you’re looking for help on any of the compliance stuff or any of the, you know, the things mentioned just reach out to him directly. What is your, what’s an email that they could reach out to? It’s [email protected] is that right?

– [Dr. Wells] Yeah, I’ll tell you what, I’ll type it in the chat box here.

– [Sam] Is that right? [email protected]?

– [Dr. Wells] That’s it. Yep.

– [Sam] Okay. So if you have any questions or wanna reach out to Andrew about whether integrating your practice, this protocol, this is a real protocol by the way, or anything else then just go ahead and reach out to Andrew Wells. So thanks guys, appreciate it. See on the next one. Thanks, Andrew.

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