The Practice Builders

Dr. Vince Leone and Dr. Kyle Pankonin

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Welcome to the Practice Builders podcast, the show where innovation meets strategy for growing thriving chiropractic clinics presented by Specialized Practice and hosted by Dr. Vince Leone and Dr. Kyle Pankonin. They're here to share proven tactics to help you build cash-based revenue streams, maximize staff driven services, and reduce reliance on insurance.

21 hrs ago

54. Red Flags That Tell You a Patient Is Not a Good Candidate for Spinal Decompression

🎙 Episode 54 – Red Flags That Tell You a Patient Is Not a Good Candidate for Spinal Decompression In this episode of The Practice Builders Podcast, Dr. Pankonin breaks down six major red flags doctors should watch for when selecting spinal decompression patients. Successful decompression starts with proper patient selection. An MRI may show disc degeneration, bulges, or stenosis, but that does not automatically mean the patient is a good candidate. The MRI must match the patient’s symptoms, history, and exam findings. He also discuss why doctors need to set realistic expectations, screen for psychological and compliance barriers, and look at the bigger picture when patients have significant comorbidities like obesity, smoking, poor conditioning, or lifestyle factors that may limit results. Key topics include: Why the MRI must clinically correlate with the patient’s symptomsWhen severe multi-level central stenosis may limit decompression outcomesHow fear-avoidance, disability mindset, anxiety, or depression can affect resultsWhy “miracle seekers” often become disappointed patientsHow poor compliance can sabotage a 24-visit decompression planWhy comorbidities and lifestyle factors must be addressed before or during careThe big takeaway: not every patient with a bad MRI is a decompression candidate. The goal is to identify the right patients, set clear expectations, and create the best possible chance for a successful outcome. Doctors should define success around meaningful improvement, such as at least 50% pain reduction and better function, rather than promising to “fix” or “cure” the condition. 🎧 Listen now on your favorite platform!

26 min
Jun 15

53. How To Explain Disc Injuries So Patients Actually Understand

🎙 Episode 53 – How To Explain Disc Injuries So Patients Actually Understand In this episode of The Practice Builders Podcast, Dr. Kyle Pankonin tackles the real reason patients walk away from disc treatment — and it's not cost or fear. It's confusion. When you bury a diagnosis under terms like "annular tear" and "foraminal stenosis," patients can't say yes to something they don't understand. This episode hands you a plain-English analogy toolkit that turns complex disc injuries into something any patient can grasp in seconds. You'll learn: Why technical jargon — not price or fear — is the hidden conversion killer in your report of findings, and how to dismantle itThe four questions every patient is silently asking, and how to answer all of them before they ever have to askThe full analogy toolkit — Jelly Donut, Sponge, Ice Cream Sandwich, Tire, and Garden Hose — and exactly what each one explains, from annular tears to nerve impingementHow to draw a straight line from each analogy to decompression, so the treatment becomes the obvious solution instead of an upsellThe three differentiators that make patients say "no doctor's ever done that before" — and why clear communication sits at the center of themHow dialing in your explanation can lift conversion from a typical 40–50% all the way to 70–80%, helping more people avoid surgeryThis is a must-listen for any decompression doc whose great clinical work isn't translating into accepted care — because the gap usually isn't your skill. It's the moment between the diagnosis and the patient's understanding of it. 🎧 Tune in and learn how to make every disc injury make sense to your patients — because confident patients say yes, and confused patients say "let me think about it."

23 min
Jun 1

52. How to Choose Patients for Decompression

🎙 Episode 52 – How to Choose Patients for Decompression In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin break down how to identify the spine pain patients most likely to accept care, comply with treatment, and get the best outcomes — so you stop offering the wrong plan to the wrong patient. You'll learn: Why offering full decompression programs to every back or neck pain patient tanks your conversion rate — and what to do insteadHow to spot the clinical hallmarks of a true full-program candidate, including chronic disc, radiculopathy, and positional pain patternsWhy not every good clinical candidate is a good practice candidate — and how poor selection affects your team and your entire patient baseHow the "singles and doubles" framework fills your decompression schedule with mild-to-moderate cases and keeps your table running full timeThe red flags, contraindications, and behavioral warning signs that should disqualify a patient before you ever make a recommendationWhy categorizing every new spine patient into the right "bucket" from day one increases acceptance, improves compliance, and eliminates plan mismatchesThis is a must-listen for any decompression doc frustrated with low conversions — because the fix usually isn't your marketing. It's your selection process. 🎧 Tune in and learn how to match the right patient to the right plan every time — because when your selection is dialed in, your decompression program grows faster and runs smoother.

25 min
May 29

51. The Decompression Flywheel

🎙 Episode 51 – The Decompression Flywheel In this episode of The Practice Builders Podcast, Dr. Vince Leone breaks down the Decompression Flywheel — an 8-stage framework that helps chiropractors stop guessing, find the real bottleneck in their decompression growth, and fix it fast. You'll learn: Why most doctors assume they have a lead problem — and why the real bottleneck is almost always somewhere else in the patient journeyHow to track the 6 core numbers that reveal exactly where your growth is stalling every single monthWhy 90 days of data is all you need to accurately diagnose your biggest constraint and stop wasting time fixing the wrong thingHow building a staff-driven, team-equipped practice reduces your dependence on you — and makes decompression actually scalableWhy your existing patients, new patient flow, and past patient base are your three most powerful (and most underused) growth assetsHow clarity and confidence in the consultation and ROF convert more patients than any script ever willWhy capturing patient proof on camera fuels both your marketing and your team's moraleThe one rule that separates sustainable growth from burnout: scale the system only once the system is stableThis is a must-listen for any chiropractor actively offering decompression who feels like growth has stalled — and wants a clear, honest look at what's really holding them back. 🎧 Tune in and walk through each stage of the flywheel — because once you find your bottleneck and fix it, the whole system starts spinning in your favor.

25 min
May 18

50. Million Dollar Practice Habits

🎙 Episode 50 – Million Dollar Practice Habits In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin break down the 7 non-negotiable habits that separate million dollar chiropractic practices from the rest — and how any doctor can start building them today. You'll learn: Why thinking like a CEO — knowing your numbers, planning strategically, and dreaming bigger — is the foundation of every million dollar practiceHow to create a wow patient experience that drives referrals, increases case acceptance, and justifies premium care plan pricingWhy selling outcomes instead of visits is the single biggest shift you can make in your patient conversationsHow protecting your time and energy as the practice owner directly impacts your ability to growWhy building and inspiring a team around you is non-negotiable — and how to get staff to see their work as a calling, not just a jobHow to market consistently and emotionally detached through the peaks and valleys — and why most doctors quit too soonWhy the doctors hitting $1M+ never stop learning, and how coaching, seminars, and masterminds shortcut your path to successThis is a must-listen for any chiropractor ready to stop coasting and start installing the habits that compound into a thriving, staff-run, million dollar practice. 🎧 Tune in and discover which habit to start with this quarter — and how small, consistent improvements snowball into the practice you've always envisioned.

34 min
May 11

49. Why Decompression Patients Buy Outcomes, Not Visits

🎙 Episode 49 – Why Decompression Patients Buy Outcomes, Not Visits In this solo episode of The Practice Builders Podcast, Dr. Kyle Pankonin reveals one of the most powerful shifts a decompression practice can make — moving from selling visits to selling life-changing outcomes. You'll learn: Why patients don't buy decompression visits — they buy the possibility of getting their life backHow emotional drivers like fear of surgery and loss of identity outweigh clinical findings in patient decision-makingHow to reframe your messaging from pain relief to functional restoration and quality-of-life outcomesWhy positioning decompression as a non-surgical alternative changes how patients receive your recommendationHow to use the 50% Rule to set realistic expectations that lead to higher patient satisfactionWhat to focus on during your Report of Findings — and why possibility matters more than diagnosisThis is a must-listen for any decompression doctor who wants stronger conversions, deeper patient relationships, and a communication framework that truly resonates. 🎧 Tune in and learn how to stop selling treatments — and start selling the life your patients are desperate to get back.

27 min
May 4

48. Analysis of a $30,000 Day with Spinal Decompression

What does it actually take to go from a $30K/month, insurance-heavy practice… to $112K in a single month? In this episode of The Practice Builders Podcast, Dr. Vince sits down with Dr. Vini Cornejo to break down the real story behind his growth. Two years ago, Dr. Vini was stuck. He had a decompression table, some outside guidance, and the same problem most doctors face… no real traction. Fast forward to today: He just hit $112,000 in a single month… including a $30,000 day. Inside this conversation, we unpack what actually changed: The shift from generalist to specialist How his clinical confidence completely transformed his conversions What it really takes to handle 9 new patients in a single day Why implementation—not information—is the difference-maker This isn’t theory. It’s what it looks like when the right systems, skills, and mindset come together. If you're a chiropractor looking to grow a serious decompression practice, this episode will give you a clear picture of what’s possible—and what it actually takes to get there. Learn more about the Decompression Accelerator here: 👉 https://www.decompressionaccelerator.com

22 min
Apr 27

47. Why Insurance-Only Practices are Dying (and what to do about it)

🎙 Episode 47 – Why Insurance-Only Chiropractic Practices Are Dying In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin tackled one of the most urgent threats facing chiropractors today: the slow death of the insurance-only practice model. Drawing from over 26 years of clinical experience and real coaching results, they break down why flat reimbursements, rising overhead, insurance red tape, and volume burnout are quietly crushing practices — and what doctors can do right now to protect their income, their health, and their future. You'll learn: Why insurance reimbursements have barely moved in over two decades while overhead keeps risingHow chasing volume creates a negative flywheel that burns out doctors and delivers worse patient experiencesWhy relying solely on insurance gives you almost no control over your own revenueThe power of adding cash-based services — specifically spinal decompression — as your first nicheHow a hybrid model (not going all-cash overnight) is the smartest and safest transition strategyReal results: how Dr. Kyle went from $48–50K/month heavily insurance-dependent to pushing $120K/month, mostly cash-basedWhy patients absolutely will pay out of pocket — when you're selling an outcome, not just a serviceStep-by-step action items for doctors who are heavy insurance and want a way outDr. Leone and Dr. Pankonin also share honest advice on how to audit your insurance plans, drop the worst offenders, and gradually build a cash-based niche without losing your patient base overnight. If you're feeling stuck, burnt out, or like you're working harder every year for the same paycheck, this episode will show you there is a better model — and exactly how to start moving toward it.

36 min

Welcome to the Practice Builders podcast, the show where innovation meets strategy for growing thriving chiropractic clinics presented by Specialized Practice and hosted by Dr. Vince Leone and Dr. Kyle Pankonin. They're here to share proven tactics to help you build cash-based revenue streams, maximize staff driven services, and reduce reliance on insurance.

Creator

Dr. Vince Leone and Dr. Kyle Pankonin
Years Active

2025 - 2026
Episodes

54
Rating

Clean
Copyright

© Dr. Vince Leone and Dr. Kyle Pankonin
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