Your MVP Patients vs. Your Least Valuable Patients

Estimated read time: 4 minutes

If you’re stuck at $500K–$700K and wondering why you’re not breaking through, this might be the clearest explanation:

Different types of visits require different amounts of time and generate different revenue.

Some treatment plans can generate the revenue of 10–15 routine office visits. Other appointments may be a brief X-ray check.

Understanding that difference can help you structure your schedule without losing sight of the care each patient needs.

Let me walk you through a real few days in my clinic.

Least Valuable Patients: LVPs

Hallux Fracture — 4-Week Follow-Up

I recently saw a 57-year-old female for a hallux fracture.

Her initial visit was good value. It included:

• Fracture care
• CAM boot
• Imaging

But what about the follow-up?

It was essentially just an X-ray.

That’s a low-value visit.

So what do I do?

I double-book it into a 10-minute slot.

I want to keep my prime 20-minute appointments available for patients who may need more comprehensive care.

The same principle applies to visits such as:

• Stress fracture follow-ups
• Post-op fusion X-ray checks
• Other routine follow-ups

I try to limit the number of these visits and schedule them appropriately.

Most Valuable Patients: MVPs

Now let’s look at the other side.

1. Liposana Injection

One patient was a 91-year-old female with pain under the first metatarsal head and essentially no fat pad.

She received a $1,500 Liposana procedure.

That’s worth roughly 10 routine visits.

And honestly, I find this easier to explain than a $1,500 amniotic injection.

2. Bilateral Lunula Laser + Fungal Kit

Another patient was a 52-year-old male.

His treatment included:

• Bilateral Lunula laser: approximately $1,500
• Fungal kit with UV shoe sanitizer and spray: $200

That’s a $1,700 visit.

3. Bilateral Plantar Fasciitis + Equinus

For another patient, the first visit included:

• Bilateral night splints
• Foam roller
• Stretching protocol

One thing I think is important here:

Bilateral matters.

If the patient has bilateral symptoms, treat bilaterally when appropriate.

4. Shockwave: My 6-Session Model

I used to perform three shockwave treatments and then send patients to physical therapy.

The problem?

They improved during PT.

PT got the credit.

Now my model is:

• 6 shockwave treatments
• Orthotic scan at visit #3

By week five, patients are improving—with me.

That can mean better compliance, better outcomes, and better revenue.

Sometimes I’ll even do a bonus seventh treatment at no charge if they’re about 75% better and just need another push.

That builds loyalty.

5. Midfoot Arthritis: Shockwave + Orthotics

For a patient with midfoot arthritis:

• 6 shockwave treatments
• Orthotic at visit #3

Again, this is package thinking rather than looking at every appointment as an isolated office visit.

6. Another Liposana Patient

Another patient had a previous midfoot fusion and severe heel fat pad atrophy.

The treatment was a Liposana injection.

This is the kind of patient that can change your revenue mix quickly.

7. Balance Braces and DME

I recently had a patient with steppage gait who needed another pair of balance braces after five years.

In this case, reassessing the patient’s bracing needs after five years identified an appropriate treatment opportunity.

If you’re asking how to go from $500K to $1 million, DME can be a huge part of that answer.

The Pattern: LVP vs. MVP Patients

Look at the difference.

LVP patients tend to involve:

• X-ray only
• Quick fracture follow-up
• Routine rechecks

MVP patients may involve:

• Liposana
• Shockwave packages
• Laser packages
• Orthotics
• Bilateral DME
• Office dispensing

You cannot scale on office visits alone.

The Million-Dollar Insight

Let’s use some simple numbers from my practice:

• Office visit average: $100
• Liposana: $1,500
• Shockwave package: $1,200–$1,500
• Orthotics: $600–$700
• Bilateral braces: strong DME revenue

One MVP patient can equal the revenue of 10–15 routine visits.

So the question isn’t:

“How do I see more patients?”

The better question is:

“How do I structure my week to see more MVP patients?”

That is a very different way of looking at practice growth.

Practical Changes You Can Make

Here are several things to consider in your practice:

1. Put fracture and post-op follow-ups into 10-minute slots when appropriate.
2. Consolidate routine care into one half day.
3. Package shockwave.
4. Treat bilaterally when clinically appropriate.
5. Lean into DME.
6. Offer fat pad replacement when indicated.

You don’t necessarily need 40 patients a day.

You need the right mix.

Key Takeaways

Some patients can represent the revenue of 10–15 office visits, so your schedule should reflect that difference.

Limit low-value follow-ups and consider double-booking appropriate short visits.

Package shockwave and orthotics.

Don’t ignore appropriate bilateral treatment opportunities.

DME and procedures can be major revenue drivers.

Most importantly, stop thinking only about how many patients you see.

Start thinking about the value and type of care you provide during the patients you already see.

Want help reviewing your appointment mix? Contact me about your practice.