Episode 03: What the Foot Do You Know Dr Dennis Timko DPM Podiatrist

Snow Mountain 17000ft Dr Dennis Timko Podiatrist Ep 03 A Doctors PerspectiveEpisode 03: What the Foot Do You Know

Dr Dennis Timko DPM Podiatrist

 

Dr. Dennis Timko Podiatrist takes a more conservative approach to his treatment and has a passion for diabetic injuries, neuropathy foot pains, pediatric feet issues, and will soon be double board certified.  He has three years of surgical training and has special certification in wound care.  He is currently learning more about herbal medicines and vitamin therapies and would like to offer a more complete approach to his patient’s needs.   Dr. Timko’s story for becoming a podiatrist is the kind that makes doctors special.  He was a runner and witnessed plenty of ankle and foot injuries and shadowed podiatrists for a few summers and that is when he realized, this should be my career.  I didn’t know this but the school he went to was an Osteopathic school in Iowa. First two years they all shared the same classes and then they switched to their specialties in year three.

Dr. Timko has a podiatrist podcast called WTF – What the Foot, is an aspiring Videographer, wordpress enthusiast, father, baseball addict and another surprise half way through the episode. He gives advice on tips and options to start up a new podiatry office, location, social media marketing and he says to just “ask the patient” for a referral. He also explains MACRA for Medicare reimbursement and the outlook of his profession in the next 5 years.

Key to his success, I don’t want my patient to leave the office until they can explain back to me what the problem is

Learn how to run your own clinic wordpress site.

Visit www.adoctorsperspective.net/03 to find links to things mentioned, the Travel Tip and the interview transcription.

Things Mentioned in the episode:

Electronic records:  Dr Chrono integrates with speech to text for electronic notes and it works on Apple devices www.drchrono.com

Leo Laporte     The Tech Guy

Prospect 361 on facebook baseball group facebook.com/groups/prospect361  

Tim McCloud  Rick Wilson podcast: baseball chatter  

Meet the master Podiatric Success podcast    

Spotify app

Gymaholic App: Punch in chest and shoulder exercises, length of work out and it generates random exercises on your phone

Score app:  Sport scores and notifies you when your player is up to bat  www.thescore.com

Lynda.com marketing, seo, videography, some software and building a website tutorials

Travel Tip
Don't forget google translate
Full Transcript of the Interview (probably has some grammatical errors). Just Click to expand

Justin Trosclair 0:03
Episode Three, what the foot? Do you know?

Unknown 0:06
I'm your host, Dr. Justin trolls clear.

Justin Trosclair 0:08
And today you're hearing Dr. Dennis Timko perspective

for doctors who want a thriving practice and abundant home life.

Unknown 0:18
Listen as your host Dr. Justin trolls Claire

Justin Trosclair 0:21
goes behind the curtain and interviews doctors and guess about real world triumph struggles,

Unknown 0:26
practical tips and entertainment on this episode of

Unknown 0:29
a doctor's perspective.

Justin Trosclair 0:32
Today's guest is a Board Certified doctor of podiatry from St. Louis. He's a baseball fan. He's a fellow podcaster and he offers some great advertising advice in the middle of the episode, any forecast the future of podiatry, and we have some striking similarities. I'll let you be surprised about what those are. When you listen, remember to stay tuned after the episode for the travel tip. Fair warning. His audio is different than my past guests. He had his own setup. It's a little loud and scratchy. But after a couple of minutes you kind of get used to it and it doesn't doesn't really bother you. So just want to give you a heads up the quality is a little different than what we're used to. Let's go hashtag behind the curtain with Dr. Dennis Timko. Help me. Welcome to the show. Dr. Dennis Timko doctor of podiatry.

Unknown 1:22
Yes, thanks.

Justin Trosclair 1:24
Thanks for having me today. Absolutely. Well, let's let's jump straight into this interview. What made you decide to do podiatry over any other specialty?

Unknown 1:32
This is a common question amongst a lot of my patients. So it's very easy to answer. Basically, when I was in college, I was a writer did a lot of running on the side and collegiate Lee.

Unknown 1:48
I was a Division Two cross country Runner Runner and saw a lot of foot injuries and dealt with them myself, as well as with my teammates. And and as I was thinking about what career I wanted to do, being a physician was the way I wanted to go, but I didn't know exactly what physician I want to be. So one summer, I had met another podiatrist who are now really close friends with and shadowed him a couple of summers before I graduated and really enjoyed the type of practice he had.

Unknown 2:27
So there's no major call. There's no like, you know, emergency life threatening issues when it comes to the foot. You don't see much cancer, people dying. So that that was definitely a plus. But basically that's how it all started.

Justin Trosclair 2:46
Well that's a lot of people's stories. they've experienced that firsthand and then investigating it and I know I shadowed a lot of doctors before I chose mine and that really helped concrete you know, what's a daily what's a day to day look like? You know, right,

Unknown 2:59
exactly.

Justin Trosclair 3:00
Now, what would someone common conditions you might treat? Why would someone go to you versus like an orthopedic or just a general medical doctor

Unknown 3:09
podiatry. We are trained basically in podiatry school. We don't go to medical school but we go to podiatry score know if you remember the, the episode and Seinfeld where Elaine would say, I'm dating this, you know, doctor, and Jerry says, Well, he's not a doctor. He's not a real doctor. He's a podiatrist. He went to school. Well, yes, I went to podiatry school. But we did learn a lot about podiatry and foot and ankle stuff. And so to answer your question, the difference between a podiatrist and an orthopedic that does foot and ankle, we specialize right away. We don't waste money much time in looking at shoulders and knees and, and hips. And we basically go two years in podiatry school, learning about everything, we dissect the whole body. And then in our third year, we kind of separate and kind of focused mostly on the foot and ankle. I did go to the iOS School, which is a do school. And we did study with the osteopaths. So the first two years I was in the same classes, as an osteopathic doctor learned exactly what they learned. But then our third and fourth year, we would go and focus on the foot and ankle. And then after graduation, we go into our residency, which can back in 2000, when I graduated, there was more residences that were two year programs. One or two year programs, now they become pretty much standard three year to four year programs, fellowships. So the young while here, the younger guys that are coming out from podiatry school, or I wouldn't say much more trained, but they're more focused on surgery than we were back 20 years ago. But uh, but yeah, I think if you go to a podiatrist, I think you're going to know that feel confident that they're going to know exactly what you got going on in the foot. And they're going to know the up to date things that are happening in foot and ankle surgery.

Justin Trosclair 5:31
Okay, okay. So if you got a foot problem or an ankle problem, best bet is to see a doctor podiatry before for anywhere else because you guys have specialized it in just like we've specialized in the spine or an eye doctor optometrists with Don, I

Unknown 5:44
think you'll find a lot more podiatrist being a little more conservative than an orthopedic. And I Oh, that's good. We'll get to that later in the interview here, because that's one of the things I feel that I'm a little bit ahead of the game where I think we will see a lot more physicians more into performing procedures, and less into more conservative measures. And I think I kind of stand out in that way. And I think a lot of patients really liked that about me.

Justin Trosclair 6:20
I definitely would agree with that. Because you can't undo surgery.

Unknown 6:23
No, you can't.

Justin Trosclair 6:26
Now, okay, I was gonna say kind of lead into the same question. So what is your specialty? Or what kind of specialties do they have in podiatry? I guess? And then what would you say sitter is yours,

Unknown 6:37
there really isn't a specialty I think podiatrists will have a niche into something that they enjoy doing. Some of the things that a podiatrist might have a niche in is like wound care, and diabetic foot care, where you'll see a lot of diabetes. Patients that high very high, very high blood sugar levels, and tend to cause damage to their nerves. When the nerves get permanently damaged, then you start having problems with neuropathy, and it can lead to pain. It can lead to alterations, things that can cause infections, amputate and lead to amputations. And so we're kind of the preventative measures, has podiatrist to try to catch those potential problems before they happen. And to save money to the insurance companies by avoiding, you know, losing limbs and causing problems in the future.

Justin Trosclair 7:47
Very good. Do you have you niche down in more diabetes or I do

Unknown 7:51
a lot of diabetes, I do a lot of neuropathy pain. I've kind of come in the last few years, a niche for pediatrics, kids fee and flat feet. There are some easy, simple ways to correct kids before they fully develop in the years of like four years old till about 12. And if you can catch it in an early age, you can do some simple things to correct it so that they don't have problems later on in life.

Justin Trosclair 8:27
Wow. So like if their foot is flaring out, or if they have flat feet already, you can do some inserts or whatever

Unknown 8:35
act correct you We always start out with, you know, simple conservative things. And I basically talked to the family and you know, they usually come and find us.

Unknown 8:48
Here's a story that could tell you that recently happened was a girl about 1011 years old, the father came and saw me and the way he found me was through my website. But what happened was he had been through about four different doctors,

Unknown 9:08
one DPM and about three orthopedic surgeons that didn't know what to do for his daughter. And his daughter hours in severe pain, she actually was taken out of school, because she had issues with activities and couldn't keep up with her classmates and had problems with balance issues. And it was basically all related to her foot problem. She had severely flat feet and both feet. And she went to a podiatrist here in town that basically didn't want to do anything for paid then looked up some information and found a poor diet, an orthopedic surgeon in Maryland. So we're talking Maryland, from St. Louis, Missouri, to Baltimore, Maryland, which is good to our flight.

Unknown 10:04
A lot of cost to him. And so he had to videotape his daughter, send it to the surgeon in Baltimore, who's a pretty well known surgeon has several books that I've read read. And this files doctor basically said, Oh, yeah, I can help you. But before I help you, I'll send you to a guy local, and have him try first was he went to the local guy here in St. Louis, and other orthopedic, didn't want to do anything, just physical therapy, nothing helped. And so she was kind of stuck, was planning on going to Baltimore to have the surgery done. And then come back for post op care, and then go back and forth. And I'm thinking that's crazy. So he ended up in the last minute googling, you know, foot flat foot in kids and happen to find one of my blogs about flat feet and kids and that I do a procedure job that can help them. And he found me and luckily called and came in. And I've already done her one foot Now we already did the second foot and they're completely happy. So it's one of those things that if you just know what you should do, and you have experience in it, then you can do it. It's really simple.

Justin Trosclair 11:23
That's amazing. And what a headache for this family. Just down the street. That's all I had to do. But that I'm glad your blog and you have a podcast. Yeah, that's got to help your SEO as well to get your name out there.

Unknown 11:35
Yeah, I enjoy just like my goodness.

Justin Trosclair 11:39
Yeah, I listened to a couple of your episodes, and one that stuck out to me was trimming toenails versus doing surgeries. And you could talk about if you will, but the summary was, I can see more patients less liability and make the same amount of money the same amount of time. Let me just clip some titles.

Unknown 12:00
nails in those infected poem, Nikki as we call them, but they're infection toenails that come in. And it's like our bread and butter. And I always make fun of people were like when they come in, I said I could do this with my eyes closed, and they'll go, No, please don't do that. Dr. Michael, I've done so many of them. And it's just one of those things, you just, you just do all the time. And I become really good at it and you make good money. And it takes you 1015 minutes. It's like why wouldn't you do it. And you know, it's going to work versus like a surgery that might take you an hour and a half. And you're like, Wow, it might help you 50% that might not. And you're getting like your pains getting cut and cut and cut every year. And you have this global period with with the surgery. So like after you do the surgery, you get this, you know, say $500 for the surgery, but that includes three months of postdoc management. So every time the patient comes in for dressing change, for physical therapy, whatever, it's included in that surgical payment.

Unknown 13:11
So right, your hourly rate isn't dropping

Unknown 13:13
our weight. It's dropping. Yeah, exactly.

Justin Trosclair 13:17
One more question about this. I'm curious. If someone breaks their ankle or no tears off some of the ligaments from a sprain? Do we go to you to fix that? Or is that more of an orthopedic surgeon so we

Unknown 13:28
are foot and ankle. We do have board certifications in both foot and ankle. That's another explanation for that. But But yeah, I see a lot of ankle sprains. I have done some fracture treatment and open reduction surgeries on fibula fractures and things like that. But it's not real common, especially in bigger cities, because you have a lot of orthopedics, and they can usually control the emergency room. And so those usually come in the ers and unless you are well known in the area and been there for so long, you're probably not going to get those referrals. That make sense, but the few that I've gotten with from friends, like an Achilles tendon rupture, a buddy of mine was his friend who was doing some karate and he must have kick something a little too hard and ruptured his Achilles tendon. And so my friend says a bad day. Yeah, yeah. fireman a lot of firemen and and he was just doing his activity doing karate and decided he wanted to rupture his Achilles tendon. So luckily, you know, my friend just said, Hey, I got a buddy. And he came and saw me, but that doesn't happen, you know, too often. But

Justin Trosclair 14:46
when there's easier ways to take an extended time from work then rupturing your Achilles. I mean,

Unknown 14:52
yeah, that's, that's a six month timeframe to hear something like that.

Justin Trosclair 14:58
That's all. Oh, wait, had a patient who was a volleyball player, and he never really restored his his full motion from, you know, whatever procedure he had, or however bad it was. But he was disappointed in it, because it kind of ended his volleyball career. But it's no joke.

Unknown 15:14
Yeah, yeah. It's not.

Justin Trosclair 15:17
So what are kind of double question or here? What are some common misconceptions about your profession? And do you guys have a lot of turf wars?

Unknown 15:28
Yeah, that's a good question. Similar misconceptions, I believe, is, you know, a lot of people, especially the geriatric world, they're used to the crop it is the show up at this, we called back in the early days, where we were just the toenail clippers, you know, you would come in and just trim the toenails, the nursing homes and things like that. So things have really changed and progressed in our profession. And we're more search surgeons than just you know, doing the toenails. Although, if you consider an insurance company, and you and you see somebody that has diabetes with the trim their toenails, or we call them to build their toenails, and that's a surgical code. So when you build that, that's technically surgery. So I'll get some people complaining about their bill saying that doctor perform surgery, and he didn't do any surgery. He just turned my nails. On the insurance piano form, they'll say, surgery, and uh huh. So you have to explain that to people. Sometimes they don't understand. Right, but, but you don't report

Unknown 16:45
me to the insurance board just just first.

Unknown 16:49
Right, right. But yeah, I mean, we're not just nail treating doctors. I mean, like we just talked about, I mean, we do surgery, we, we take care of empathy, and fractures and care and infections and cancer. skin cancers. I mean, I see people with little black.on their foot or underneath their toenail that might stand out. And I'll say, Hmm, we met a biopsy this because this looks a little suspicious. Once in a while, you might see one that's a, you know, precancerous lesion. And you might have saved that person's life. Absolutely. So yeah.

Justin Trosclair 17:35
I don't want to keep bringing it back to me. But I remember this one patient because it was he had it right here on his right by his ear. And it just looks shiny. And I was like, Huh, that doesn't look right. And sure enough, there was some kind of cancer, you got it removed within a couple of weeks. And it felt really good, because you don't get to do it very often. So when you do it's like, all right, school was good. Still remember?

Unknown 17:55
Yeah, exactly. As far as the turf wars, I mean, the, you know, the orthopedics and, and some of the vascular doctors will send patients will refer them out for for vascular insufficiency or peripheral vascular disease. And, you know, they might have a bad toe that looks like it's almost gangrene. And you want to get that patient some more circulation to their way to their foot, and you'll send it out to this vascular surgeon. And sometimes those vascular surgeons, you'll never see the patient back again. And, you know, sometimes there's a little, you know, turf war going on with that, but not that often. Well, that's good,

Justin Trosclair 18:39
that's good. Well, do you have any unique abilities or strategies or mindsets that set you apart from the other podiatrists out there?

Unknown 18:51
I think I'm kind of well rounded. I consider myself a conservative doctor. And I have also been trained very well, with a three year surgical training. But being on my own, I've developed a lot of skills and billing,

Unknown 19:10
teaching residents and I think my ability to communicate with patients, I I don't let a patient leave my office until they know for sure that they can explain it back to me what their problem is. I see a lot of people go to doctors, and they come back. And I think your pharmacist kind of mentioned this where they didn't even know what kind of medicine that was prescribed to them and what it was. And and I make sure that if I give them a medicine, or if I tell them what their diagnosis is, I want to make sure they understand it in layman's terms. So I think that's one of my positive things about me that's

Justin Trosclair 19:49
different than most doctors. That's a huge skill to be able to communicate because half the time they leave and like you said they don't know what to tell their spouse. Yeah.

Unknown 20:01
I guess some of the other things is, I'm pretty ahead of the game when it comes to electronic records. Technology, as you know, we're doing a podcast and and i don't know any other my pediatric colleagues that are doing podcasts in my area,

Unknown 20:20
YouTube videos and things like that social media, I'm pretty ahead of the game when it comes to technology.

Unknown 20:28
Smart

Unknown 20:30
men maybe like one other thing is my conservative measures. I'm kind of expanding my knowledge about like herbal medicines and vitamin therapies. And so to add to my conservative treatments, I've started this cell wellness program, where I actually have an RN, what a wonderful lady that works for me, that can draw some blood for me. And so we started doing some wellness program to to find out some more information about the patients more than just, you know, your CBC and, and blood levels and stuff. We're looking at thyroid levels and

Unknown 21:12
vitamin D levels and, and how that might, vitamin B might affect the nerves and with especially with diabetics,

Justin Trosclair 21:22
that can be

huge, hugely beneficial for your patience.

Unknown 21:26
Yes, yes, it is. And it's all like a one stop shop. So they're there, we could do it right at the office. So it's makes it convenient for the patient.

Justin Trosclair 21:35
And it seems like a lot of times you just have to offer a service. If they're already here for one thing, you offer it, and they're like, Oh, I didn't know you did that you like I do. So take advantage of.

Unknown 21:44
Right, exactly, exactly.

Justin Trosclair 21:46
Alright, so we're going to switch gears just a little bit here. Tom, like other doctors and students, if a doctor struggling or just starting out what are like some practical steps to get where you are today and your business?

Unknown 22:02
Well, just like we spoke before, invest in a good electronic record system. Whether it's a free one, or one that you have to pay, make sure you do your homework and start out with a good system. That simple that gets the job done, and doesn't take too much of your time.

Justin Trosclair 22:22
Real quick on that? Yeah, which one do you use?

Unknown 22:26
The one I use is called Dr. Crowe know, the reason why I like it is I'm more of a Mac kind of guy, and it utilizes your iPhone and iPad. very conveniently, effectively. It has a wonderful connection with a speech to text option of light from my phone. So I really, unfortunately have my phone almost all the time, my wife actually gets really upset at me because I'm always carrying my phone around. But I always tell her, it's for work it really for work. I'm not playing on Facebook or anything.

Unknown 23:04
I'm actually working,

Unknown 23:07
which is probably its own issue too.

Unknown 23:12
But uh, but the other thing is for a younger person coming out, learn social media and learn how to get yourself out there. As far as getting people to know who you are, that would be another thing, build a good website, and and learn like WordPress, very simple. It's not hard to do. don't hire somebody for $2,000, you could save a lot of money. And do it yourself very simply. And the last thing I would say is location, location, location, do your homework and find a good place where you can set up a little office and and look into some of the hospitals, maybe for smaller hospitals and make sure there's no doctor that in your practice that actually is an employed by that hospital at there's not look at possibly renting space, subleasing from a hospital, because you'll get some good referrals that way.

Justin Trosclair 24:12
What kind of square footage does a podiatrist need?

Unknown 24:17
I'd say, right now I have only about 600 700

Unknown 24:22
square foot, which is That's it? Wow, I downgraded. I had about 1500, I had two or three rooms. And I felt like I just had a lot too much space. So now I kind of like to spend more time with my patients. And I just do one at a time. So I have one room, I have an extra room. I have a room from my from for me just to do my notes and, and dictate and everything. And then I have a room for my office staff. So really simple. Really, that's all you need to see an x ray, a treatment room, rate room and room for yourself. And and that's really all you need.

Justin Trosclair 25:04
Okay, now when you mentioned location,

what kind of what's maybe top two things that you're looking for? As a podiatrist, when you're looking at location? Can you be in a six story building? Or do you want like,

what they call the storefronts in a shopping center? Or? You know,

Unknown 25:20
that's a good question. If you're in a big town, a bigger city, having that front with with a sign where people are coming by, excuse me, is not a bad idea. But it costs a lot more money. Yes.

Unknown 25:38
I honestly think the best doctors are the ones that don't spend a lot for advertising. They're kind of hidden. But the reason why they're so good is because people know about them. And they get a lot of referrals just from word of mouth.

Unknown 25:59
The doctor that trained me, I mean, he's been in business for over 30 years, but he doesn't advertise doesn't even have a website, or mine. And he is doing very well for himself. So but you know, when you're young and just starting, you can't do that.

Justin Trosclair 26:15
Right? What, what would be a couple of good referral strategies? Do you have those in your office like, dedicated, this is what we do to try to encourage referrals from people.

Unknown 26:27
I just, you know, basically tell them when I'm done with that, that patient is, you know, you just kind of have to tell your patient, you know, send send me a friend, you know, you know, I'm here if you need, you know, you know, ask a patient, Do you know anybody that has a foot problem? And, you know, a lot of times, so I didn't realize, you know, yeah, my one friend that did mentioned something about it at all? I don't know. I mean, that's probably one thing I try to remember is try to get your own patients to tell other people. So well, I really don't have any specific way to get patients in.

Unknown 27:07
Okay, that's fair,

Unknown 27:08
that's fair.

Justin Trosclair 27:10
How do you hire good staff? What makes them good?

Unknown 27:14
Have a wife that's in the HR department world.

Unknown 27:24
Luckily, my wife works in HR department in her company. And whenever I need somebody, she kind of helps me with the interview.

Unknown 27:35
If you

Unknown 27:35
train your staff,

Unknown 27:36
I do I train my own staff. I was, you know, again, I had the luxury of finding a wonderful lady just recently for the last couple years. And, and she's an RN. And she's been been great. So sometimes, you know, I've been through about, you know, probably three or four other people, but for her, but you know, sometimes you just have to try and trying to get

Justin Trosclair 28:00
it right. Are you guys allowed to have PhDs or in peace work underneath you? Or is that just for medical doctors?

Unknown 28:09
We have enemies, it makes sense. But I don't know very many podiatrist that have like a PA, or nurse practitioner,

Unknown 28:20
working for them. pretty expensive, I would think to have that.

Unknown 28:26
But an MA is definitely a necessary part of of a practice if you want to really get busy.

Justin Trosclair 28:33
Yeah. Okay. What what type of five or 10 year goals do you have? And how do you know if they're worthy of your pursuit?

Unknown 28:42
Okay, that's a good question. I thought about that really a lot. And actually, it helped me thinking about that question.

Unknown 28:50
Five years. I'm currently board certified foot and ankle, but it's kind of an offshoot company. And I'm actually in the process of getting double board certified with a newer company. So in within this year, I'll be double certified in surgery, I also looked into wound care, and getting certified as a wound care physician.

Unknown 29:21
Probably hire an MA, like we just talked about, move to a bigger office and get a nicer office that I really like.

Unknown 29:32
And then get more involved in this plant based nutrition and herbal supplements. I just kind of started that. And I'm just starting in that learning process of learning more about it. Right. My wife and I are currently mostly vegetarian, sweet, a little fish, but we're trying to be a little bit healthier with juicing and making smoothies and things like that. So I'm kind of like trying to help my own patients in kind of world to help them with their problems. And Alas, Funny thing is probably within the next five years is to drive a Tesla. Oh, you know,

Unknown 30:15
what is your favorite?

Unknown 30:18
Probably the ex model, but it's probably a little out of my price range. But it's a very cool car if you've ever driven one that I did have the luxury of test driving one last month and I think I I can like any other car now.

Justin Trosclair 30:36
I was driving on that drive. And I was riding in a car in China. And they mean you see Masada is and Ferraris and things. I saw a testament it's like some I was like, that's a Tesla. And she didn't even know and I was like, it's an awesome car. Just trust me. I can't believe they're driving one here. I don't know where they plug it in.

Unknown 30:55
It's incredible idea. My next house is probably going to have solar panels on it and and I'll buy one of their big test the batteries and and I'll never have to pay for energy again.

Justin Trosclair 31:10
My parents put that on a one of their patios, when they were given all this money away from the with the federal government. I think they cut their bill to I mean, 50 bucks. There's only like 300 to 350. So it obviously works.

Unknown 31:22
Yeah, this is a feature, I truly believe in it. So that's my five year model. You asked me what my 10 year model was,

Unknown 31:32
probably to unplug myself from all this dairy, phone and computers and stuff and kind of like simplify my life, I guess. I think we have a little bit of a problem in the world today with all this technology. And I think some of it needs to be kinda ease back a little bit. Especially with, you know, kids these days with attention deficit disorder and things like that. So my my thing is, I think in 10 years, I'm trying to kind of cut back a little bit. You know, I have a three year old, almost four, and I want to teach him some baseball, I'm a big baseball fan.

Unknown 32:15
Safer retirement, teach maybe possible look into teaching. And read, read more books.

Unknown 32:25
My,

Justin Trosclair 32:26
my thing for 10 years. Very good. Some Admiral goals there.

Where do you see your health your profession going in the next five years?

You kind of touched on it earlier because these kids are coming out with a three or four year residency and she only had to do to maybe?

Unknown 32:45
Yeah. You know,

Unknown 32:47
that's a good question. Because I think things are changing a lot in the world of medicine.

Unknown 32:55
There is a thing now with Medicare and the government. They're kind of enforcing this.

Unknown 33:03
Where we have to now go from a procedure based income to more of a preventative kind of thing. And the government is trying to, in incentive in give us incentives, or penalize us if we don't follow those rules, right. So

Unknown 33:24
they're starting Actually, this year, January 1, it's called maca,

Unknown 33:30
maca, ma CRA, is their way of trying to penalize or give us money for following their rules. And so they want to spend as much money. So it's more quality care than quantity.

Unknown 33:46
And so I think in the future, this could be a problem with

Unknown 33:51
doctors that do a lot of procedures, we're going to make less money, the more procedures you do. And you do more preventative stuff and you do quality care, you'll you'll make more money. So that's kind of what scares me. And the other thing is, you know, in my profession, associates, if you look at the numbers, it's been about an 8% drop in the pay for an associate over the last two years, just a lot financially, things have kind of dropped over the last few years. So I think with solo practice, there's going to be a lot more super groups, and hospital groups

Unknown 34:35
forming, and I think our future is more, you're not going to be a solo practice guy, you're going to be in a big group, because you're gonna have to share the overhead. It's too expensive now, do you

Justin Trosclair 34:49
like that or not?

Unknown 34:52
I don't know if I like it, but I think it's what's going to happen.

Unknown 34:58
But we're trying to I've been in practice 13 years, and I can't see myself actually working for somebody without actually having some kind of say, in the business or at least helping grow the business somehow. Not just being an employee and just, you know, coming and getting a paycheck every week, every couple weeks. I have a lot to offer. And I feel that that's what I would do. But yeah, it's gonna be a rough next five to 10 years, but we'll see.

Justin Trosclair 35:28
Okay, I'd encourage you listen to the dermatology episode, because he he discusses sometimes of the how the hospital's pay employees versus the kind of like a productivity versus the salary.

Yeah, the RV us. So the busier you are the more money you make. And you know, the world's your oyster, I guess.

Unknown 35:51
Yeah, yeah.

Justin Trosclair 35:53
Okay. Anything else on that?

Unknown 35:59
No, I think people think we hit it all pretty much.

Justin Trosclair 36:01
Okay. Then we're going to switch gears a little more personal.

Unknown 36:06
Okay.

Justin Trosclair 36:07
All right. So Dr. Kim, CO. You're a solo doctor. How much vacation do you take? And there's there a way to take more?

Unknown 36:18
We just talked about that. And my wife and I are recently and actually in 2016? I think we took a total of five days off. Oh, no. Yeah, last year was was it was a busy year for us. And things financially, we're a lot better. But we didn't take much time off. I think we went to Chicago on a trip for about three days. It was a business

Unknown 36:48
trip. We stayed at Trump hotel, which we won't tell anybody. But he did stay at the hotel. He made some

Unknown 36:57
nice hotels.

Unknown 37:00
But we won't stay there. Again, we don't want to get shot or anything.

Unknown 37:07
But But no, I think it's important to take some time off. We are planning some trips in the near future here shortly. But But, but it is tough. Being solo practice doctor to take time off. Because if you're by yourself, and you don't have anybody covering for you, you're not making money. You have a staff that's there that you're paying them, you know, for their time. Even though you're gone, you're still paying rent, you're still paying your malpractice, you're still paying, you know everything else. But you're not working so you're not making money. So,

Justin Trosclair 37:46
yeah, you gotta spend double for the vacation. Yeah. Do you guys have covered docs? Know, you know,

Unknown 37:54
I've helped out a couple doctors here in town because they need me I did my residency here and have a lot of well known colleagues that know me, and trust me. So sometimes I've covered for them.

Unknown 38:10
But my practice is kind of in a row town. So there's only two podiatrists in in that town. So it's it's not too hard to to leave. My wife is actually from Europe. So we've gone to her country in Bosnia a couple of times, and I've taken about 10 days off couple years ago, and, and it's okay. I mean, it doesn't suffer too bad.

Justin Trosclair 38:37
Yeah, 10 in a row. That's pretty difficult. Because typically, you'll have that month lag when you come back to build it

Unknown 38:43
back up. Yeah, yeah, but you gotta take some time off. That's another thing, or younger person coming out. You could you gotta have a vacation. You gotta recharge your batteries and, and otherwise you'll burn out.

Justin Trosclair 38:56
Do you work for day, weeks, five days a week, six days, weeks.

Unknown 39:01
I used to work Saturdays, but not anymore. Now it's pretty much a five day week. I work part time for another doctor on the side. And so I work a couple days for them. And then I work you know, two, three days for myself and, you know, trying to find time for surgeries and fit those in. You kind of have to have a block, like one day, every couple of weeks to find time to put your surgeries in. Okay.

Unknown 39:32
I don't do a lot of hospital work. So I don't get a lot of calls, like out of the blue. So I pretty much have a standard routine.

Justin Trosclair 39:43
Very good.

What uh, what preoccupies your mind besides your profession? Kids any hobbies? volunteering? Baseball, baseball, which team

Unknown 39:55
from the east coast, so I'm a big Yankees fan. But But anything baseball related? Big into like that fantasy sports? And stats? Yeah, I like numbers. So I'll sit there and study all kinds of crazy stats you probably never even heard of. And to try to I guess it's kind of like the stocks, you know, players go up and down, up and down. And you gotta catch them when they're down by him wonder cheap and sell them on their high kind of thing. So kind of have to know what's going on with it when you do that. But it's kind of my hobby. I think another hobby is is a video doing some video. videography. Okay. I have my office manager got married a year ago. And I offered I said, hey, what? I'll do your wedding. She's like, Oh, yeah, yeah, yeah, do it. So I did it in there. Pretty decent job. I thought and everybody seems to think that I should do that on the side. Because I enjoy it so much.

Unknown 41:06
So that's another hobby. I think I've done a few videos of us going to Bosnia and, and Mike, my kid growing up and kind of make a little fun little intro and stuff like that with music in the background. That's also

Justin Trosclair 41:21
when there's ways to monetize that as well.

Unknown 41:24
Yeah, yeah. I actually had a video of me doing an ingrown toenail. A patient, young kid, I think he was in the military came in and said, Do you mind if I video that? And I said, Yeah, no problem. I said you could video it, but you need to sign this form. Let me use it on on YouTube or something. Oh, no problem. No problem. So he signed the release and and so I did this little blog and and and video on YouTube. And I call it five simple steps on how to remove an ingrown toenail. And so I'm like, so I pull it up on there a couple years ago, and it got so many hits. Really, it was in the thought I it was my most popular video. And I was thinking myself, hmm, it's probably not a good idea. Because now all my competition, all those primary care doctors that normally would send me patients to do that procedure or probably doing it, watching my video. And now they know how to do it. So I took it down. Thanks, Dennis.

Unknown 42:27
Hey.

Justin Trosclair 42:32
Oh, my goodness. Well, there's people love to watch like, pimples getting popped in, like abscesses being drained. And it's really gross. But there's such a market for it.

So you have a wife, you have a three or four year old? How How do you keep a home and work life balance? And I know you already mentioned your wife says put the phone down. So what do you do? What are some practical steps to

to realize this balance?

Unknown 43:05
Yeah, that's, that's an ongoing issue here at the Timko home.

Unknown 43:12
Be on my own and now 13 years in practice.

Unknown 43:17
It's tough. I'm not gonna lie to you. But the thing is, is that you just have to realize that work is just work. You know, your true the people at home with people that truly love you and, and are meant to be with you. And, you know, even if work didn't do well, and I lost all my money, my wife and my kids would still be there. So you have to find ways to balance the home life. And,

Unknown 43:47
but it is a constant battle. I'm kind of a workaholic. I like doing the videos, I like doing the podcasting. And and it's kind of like the wife's like, Hey, aren't you you know, going to are going to have a day date or do something and, and we don't have any family here in town. All my family's on the East Coast all her family's back in Europe. So we kind of struggle with you know, babysitters, and people to watch our kid now. And so we have to really, you know, find ways to adjust to that. arcade goes to daycare, and so we'll do a day day instead of a night date. So that works. Yeah.

Justin Trosclair 44:31
Okay. So I have a question for that, then. Do you guys set up time to discuss how to, you know, for the month or for the week? how we're going to spend time together? What are we going to do to develop our relationship and spend time with the kids? You'll have any kind of concrete plans like that?

Unknown 44:51
Don't we're working on it? Okay, it's in process.

Justin Trosclair 44:57
All right. And like I mentioned, when I invited you, you, part of the podcast is to develop the personal side of life, not just the business. So I appreciate your honesty and your openness during these questions.

Unknown 45:12
my in laws are such a beautiful people. They don't speak English. But they will, you know, we'll fly them in for six months at a time. And they'll come and help us out there actually here now helping us until March. So it's kind of I feel kind of relaxed. Now. I don't have to always put my kids to bed or you know, do something, I can kind of focus on the job and work and then my wife and I can go do things together. So that's kind of a nice thing. We've, you know, till they get too old. They can't do that. But they're kind of been helping us for the last couple of years. That's amazing. Do you speak Boston?

Unknown 45:57
I know a few words. Okay. Yeah, stoma, that's what's up, you know?

Unknown 46:04
And then the answer and you just look at your wife like what she's saying.

Unknown 46:07
Yeah, so I, you know, I can kind of get by, and I'm getting better and better, actually, my son's three and a half, and he's actually communicating, speaking Bosnian now. So he is doing very well. So see, I

Justin Trosclair 46:21
didn't know that, you know, my wife is Chinese. And I don't speak much Chinese, but they'll come hang out with us for a couple of months and then leave. And so how are in that kind of bridges to the next question. You've got this international relationship?

How do you keep the love alive and feel connected? Are there certain cultural things that you've had to learn that she appreciates more than, say, an American woman?

Unknown 46:49
I think they're more loyal.

Unknown 46:51
I guess, to get a little personal. I have been married before to an American woman

Unknown 47:00
have any children. But the divorce was really simple. So it wasn't a bad thing. But I could see the differences between the cultures Americanized and, and, and Europeans and they tend to be more family.

Unknown 47:17
And loyal people very more closer. Next people and they live a simple life lifestyles. I've now been to Bosnia, two times now and

Unknown 47:31
actually three times. And it's it, I almost want to retire there. Actually, we've talked about retiring there. And the money is much cheaper, you know, so I cannot sit at the coffee shop all day, I always joke to my wife, I could sit at the coffee shop all day for 50 cents of coffee, going to Starbucks for four bucks at coffee. Hello. And

Unknown 47:54
you can sit there in separate coffee all day. And that's what they do. They you know, they relax and more, you know, more of an easygoing atmosphere and beauty, I mean, just the beauty of the environment and the mountains and rivers, and it's just a wonderful area,

Justin Trosclair 48:10
could you work there

Unknown 48:13
I'd have to learn the language and be more fluent. But I could go to Croatia, which is just a little north of Bosnia and Croatia is a little more Americanized. And, and most of the younger crowd speak things English. So, so I could possibly work there. But it's a little more expensive to live there.

Justin Trosclair 48:34
Okay. You know, here, the company pays for a translator, for me, which is kind of one of those the way they pay us even if they didn't, we could afford to do it on our own, because of the wage difference between what we make versus what they make. So yeah, it's really convenient.

Unknown 48:53
Yeah, it seems,

Justin Trosclair 48:54
seems me, I'm trying to convince my wife, let's get somebody to clean our house. We can, we can, and then we can spend more time together and not worry about having to clean our own toilets. And in the floors and everything, just

Unknown 49:05
yeah, let's outsource that. I've mentioned that to my wife many, many times, because she she wants to always constantly clean. And I said, you know, what, if it just helps our relationship and, and being at home, we can spend less time cleaning and get somebody to clean for us. Yeah,

Justin Trosclair 49:22
yeah. Alright, so we got a couple more questions that will wrap up. Okay. All right. Do you have a morning or lunch routine that grounds you or excite you for the rest of the day? You know,

Unknown 49:35
I have, you know, several two offices, and one office is about 40 minute drive each way. I do a lot of, you know, listening to podcasts on my route to work. So, you know, listening to certain podcasts is I guess my way and driving is my relaxation. So I don't really have like, an actual routine. But that's pretty much what I do.

Unknown 50:07
On a daily basis.

Unknown 50:08
Okay. Well, that's good. Because the next question is, do you have any podcast books or blogs that you secretly like, and stuff that you would recommend for everybody? A matter of fact, I do.

Unknown 50:21
The being in technology, I don't know if you've heard of that will report. The tech guy. Ask Leo listen to him. Ask Leo. Yeah,

Justin Trosclair 50:30
he looks like he's stuck in the 70s with his beard or something. Kinda. I think I got an email list.

Unknown 50:36
Yeah, he, he has really good podcast. And the first like, five minutes of the podcast is what I mainly listen to the rest is kind of like people calling in asking questions and some simple questions. And you could actually go to his website and, you know, skip through and see which questions you might have wanted to listen to.

Unknown 51:00
What's the first five minutes

Unknown 51:01
the first five minutes is kind of him talking about what currently is going on in the world of technology, and will kind of give you the politics about it and, and financials about it, and the different things that could happen? Like when like an Apple product comes out, or something like that, or potentially, you know, a company that's doing something different and, you know, fear into stocks and buying things, sometimes it's important information that he knows ahead of time.

Unknown 51:32
Some of the other things that I I listened to, you know, because I told you I was into baseball, there's a group of guys a private group on Facebook called prospect 361 and, and it's like, probably 1000 guys, I think I'm allowed the numbers up to but I could just type in a question about a baseball player and it could be anybody and all of a sudden I'll get like, people responding and they have a podcast in there guys, to really famous guys that talk.

Unknown 52:04
Tim McLeod and rituals and and they both sit there and and just bs about baseball and, and different things. And it's every Sunday, I believe, Sunday night, they do it. So like Monday morning, I'm always like going on my podcast and listening to them, getting some good tip tip tips on the season and which players are going to be the better player to pick up on and stuff.

Justin Trosclair 52:29
That's got to be good for your fantasy, too.

Unknown 52:32
Yeah, yeah, yeah. I know that our last one is the it's called meet the masters. So this is more for medical stuff, and a podiatrist. He's a guy in Florida. His name's Brett Lebowski. And he basically interviews kind of like what you're doing. He interviews, guys in our profession, and some other ones that are related to our profession. And kind of teaches, you know, what's going on in the world of podiatry and try to help people grow their practice and learn new things. So he's a good one to listen to.

Justin Trosclair 53:09
Very nice. You know, that's how I found you. I was on my overcast and searched podiatry and you came up in the blog and the podcast listeners like okay, I mean, we can't take this guy he'll be should be a really good guest.

Unknown 53:22
Did you like did you like the name?

Unknown 53:27
wtf.

Unknown 53:29
Like, all right, this guy's bold.

Unknown 53:33
Yeah.

Justin Trosclair 53:36
There was another question. I have it. I can't remember what it was. I should have wrote it down immediately. Your favorite apps? Yes. Your favorite apps? Do you have any favorite apps on your phone can be business our pleasure.

Unknown 53:48
I do. probably the number one is probably Spotify, okay, for the music and the instant music that you can listen to on a daily basis. So I use that at work and home.

Unknown 54:04
And another one is called Gemma Holic, I do work out on my free time. In gym a Holic is also on my Apple Watch. So I'll go to the gym. on my phone, I'll punch in, say I want to do chest and arms that day, and I have 45 minutes to do it in. So I'll punch in chest and arms and put 45 minutes and they'll give me a random gym to workout regimen. Oh, and I'll just and I'll look at my watch. And they'll say okay, your next is bench press. You do 10 at this much weight. And then you hit the button when you're done. And it tells you how much was to do when it vibrates to tell you. It's your turn to do the next set. And it calculates your calories and everything and keeps track.

Unknown 54:58
Are there a lot of exercise sizes. Like a lot of varieties.

Unknown 55:02
Yeah, yeah. It's really, really cool app. pay that.

Unknown 55:07
I think it's like three, four bucks. Maybe?

Justin Trosclair 55:09
Yeah, that sounds amazing. Because I get so bored sometimes like what else can I do?

Unknown 55:13
Yeah, yeah, there's some some exercise that kind of crazy. I'm like, I can't do that. I'll just skip it. I'll do something else on my own and just kind of skip it come back to it. But there's too many people to gym in there on that, that machine or something. I can't do it. So another one is called the score. Is this one, I guess? Well, it's actually for any sport. So if you're into football or baseball, what's so cool about it is you can put in your players on your team or your favorite player, right? And when that player is turned up to bat, it will actually, you know, give you a notification. Oh, wow. Right away. Hey, you know, Derek Jeter is coming up to bat what they're cheaters retired. So he wouldn't be but this to say he was playing, it will tell you it's up to bat so I can pull up my TV screen, put the game on us. And enjoy, you know, watching my player play. So that would be another one. And then the last one would be lynda.com. Have you heard of lynda.com? I don't think so. Oh, if you want to learn anything about marketing, okay, co

Unknown 56:28
learning how to do videography photography, certain software programs like Final Cut Pro, I movie, you know, anything. You want to learn how to build a website.

Unknown 56:43
It's an excellent kind of a tutorial. Saffery pay about 25 bucks a month,

Unknown 56:51
okay?

Unknown 56:52
So it's not a free one, but it has everything.

Unknown 56:57
And I've used it and then you know, you use it for few months, and then you just come out of it being right, if you set yourself to doing it, and you do the webinars on there and you learn. It's definitely worth it. It's really helped me, you know, build my website, learn how to do the videos and things like that. So

Justin Trosclair 57:18
yeah, you got all these gurus, charging you 199 and 297 to learn something. So 25 bucks is is a bargain if you actually implement it.

Unknown 57:28
Yeah, you gotta push yourself to it and sit at your computer and put your headphones on it and get all our distractions away.

Justin Trosclair 57:37
Well, that completely reminded me the question I had, when you're talking about use mentioned students doing their own WordPress site. Do you have a special theme that you like? And do you have any podcasts that are? How to do WordPress how to do find the plugins? Do you have anything like that for our audience?

Unknown 57:58
No, I just kind of go on to win. I mean, I've changed my website twice. Since I've been in practice. It's always good to to refresh your your site every few years. My brother actually is into that world of computers. And he actually hosts my website. So it's kind of nice that I have a brother. That's kind enough to do that for me. Yeah. So I've never had to pay directly to somebody. I mean, I helped my brother out as much as I can. So,

Unknown 58:31
but as far as, as far as the website design, I just kind of look around and see which ones I like and change it up. Yeah, it's probably due for a rebuild soon here. Okay. Well, I

Justin Trosclair 58:49
saw your logo that was pretty slick. I like that.

Unknown 58:51
Yeah,

Justin Trosclair 58:52
thanks. Yeah. Good job. Well, anything any closing remarks?

Unknown 58:57
No, I mean, I'm glad you had me today. And I enjoyed it really helped me think about my practice a little bit more.

Justin Trosclair 59:05
Fantastic, but

Unknown 59:07
Glad to meet you.

Justin Trosclair 59:08
Same has been really good. So many, many blessings for the for this next year in practice, too.

Unknown 59:15
Yeah, thanks a lot. Yeah, I think things are going to be positive going forward in 2017. For sure. Absolutely.

Justin Trosclair 59:25
Show Notes for this episode, are at a doctor's perspective, net slash 03. Thank you so much for being on the show. Dr. Timko, I think people can critically think about what you had to say and apply it to their practices, whether that's WordPress sites, challenging you to find ways to spend more time unplugged with your family, and the how and why you would refer to podiatrist. I appreciate you listening. Stay tuned for the travel tip. I almost forgot I am putting the final touches on a free ebook that I want to give to you guys. And guys, please go to a doctor's perspective. net, top side, the bottom, there's all kinds of places where you can sign up, put your email and your name for updates. Once the book is complete, I will send you a email and then you can download it. It is going to be my secret hacks about health, weight loss, strengthening the spine, different things like that. It's very actionable implementable is not only can you use it, but also your patients. So go on over to a doctor's perspective. NET sign up, and you'll be the first to know when that ebook is ready for downloads.

I am quite active on social media. And the easiest way to connect is the head over to a doctor's perspective net. Look at the top right, and you will see all the social media icons just pick your flavor and friend me. I found out in practice that people can hardly pronounce trolls Claire, much less spell it because of that. And username lack of availability. I have a mix of my name and Cajun Cairo. I'm from South Louisiana, aka Cajun country. I am a Cajun, I am a chiropractor, Cajun Cairo, you will find travel photos, updates, fun comments, etc. Connect comment, and I'll respond back

going to another country, and English is not the standard language. Do yourself a favor, download the Google Translate app, find the language that they speak and download that as well to your phone. That way, if you don't have internet, you'll still be able to use it. Remember, these translation apps are not perfect. You need to write small sentences. Like the chair is brown. Where is the bathroom? Don't ask these loan, you know 10th grade level questions. Keep it simple, like you're talking to a two year old and you may just get a decent enough translation to be understood. Now, what will they say back to you. I mean that's that. But some people will be nice enough. If you hand them your phone. They might actually type it was a little confused but they could type in then, you know give you a really good answer. So that is your tip for today.

We just went hashtag behind the curtain and this episode has come to an end. I hope you got the right dose for your optimal life. Please spread the word about this podcast by telling to friends, share it on social media and visit the show notes on a doctor's perspective. net to see all the references from today's guests. A sincere thank you in advance. You've been listening to Dr. Justin shows Claire giving you a doctor's perspective.

Transcribed by https://otter.ai

About the Author
Dr. Justin Trosclair, D.C., an expert in Chiropractic Care, has been focusing on back and neck pain relief for over 12 years and has delivered treatment to more than 6000 patients. With advanced training in treating disc derangement conditions, you can count on him to keep up to date with the latest research in physical medicine for spinal pain. He has 5 years of hospital experience in China, is currently working in Germany, and had a private practice in Colorado for 6 years. Dr. Trosclair hosts a doctor to doctor interview podcast called ‘A Doctor’s Perspective‘ with over 220 episodes. During his free time he wrote 3 books. Today’s Choices Tomorrow’s Health (rebooting health in 4 categories), a Do-It- Yourself acupressure book for 40 common conditions called Needle-less Acupuncture, and a step by step guide to look like a local for Chinese dinner culture called Chinese Business Dinner Culture. If you have kids, you may be interested in his 6 series tri-lingual animal coloring book series (english, spanish and chinese).