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.

18h ago

65. Practice From Abundance

🎙 Episode 65 – Practice From Abundance In this episode of The Practice Builders Podcast, Dr. Vince Leone gives listeners a behind-the-scenes look at a private Specialized Practice micro-training called Practice From Abundance, focused on recognizing when scarcity thinking begins influencing the way you run your practice. He breaks down how seemingly practical thoughts like “Will patients pay for this?”, “Are there enough decompression patients in my market?”, or “Can I afford to grow?” can quietly affect pricing, marketing, hiring, care recommendations, and investment decisions. Key topics include: How to recognize scarcity thinking before it starts driving business decisionsWhy you shouldn’t project your own financial beliefs onto patientsMaking the best clinical recommendation and allowing the patient to decide what they valueWhy you probably need fewer new decompression patients than you think to meaningfully growHow stronger marketing, communication, systems, and leadership can expand your impactWhy abundance isn’t reckless optimism, but a belief that opportunity can be createdA simple exercise for identifying where scarcity may be showing up in your practice The big takeaway: scarcity protects, abundance creates. Before changing anything, start by noticing where fear or limitation may be influencing your decisions and ask: What might I do differently if I believed there was more opportunity available to me? 🎧 Listen now on your favorite platform!
Sep 29

64. Clinical Pearls That Will Make You a Better Decompression Doctor

🎙 Episode 64 – Clinical Pearls That Will Make You a Better Decompression Doctor In this episode of The Practice Builders Podcast, Dr. Kyle Pankonin breaks down several clinical pearls that can help decompression doctors improve case selection, interpret MRI findings more accurately, and set better patient expectations. He covers why Modic Type 1 changes matter, how discogenic pain can exist even without obvious nerve compression, and why larger herniations like extrusions and sequestrations may actually have a better chance of reabsorption than smaller bulges. Key topics include: Why Modic Type 1 changes should change your treatment approachHow discogenic pain can exist without nerve compressionWhat rim enhancement may reveal about disc reabsorptionWhy larger herniations may respond better than expectedHow annular fissures can cause chemical radiculitis and may require inflammation control before decompressionThe big takeaway: don’t make clinical decisions based on one MRI finding alone. Understanding inflammation, herniation type, and the true pain generator helps you choose better cases and manage them more effectively. 🎧 Listen now on your favorite platform!
Sep 16

63. Why Every Decompression Doctor Needs to Know the Research

🎙 Episode 63 – Why Every Decompression Doctor Needs to Know the Research In this episode of The Practice Builders Podcast, Dr. Kyle Pankonin makes the case for why decompression doctors need to master the research behind their treatment, not just the marketing claims that surround it. Marketing lines like "decompression puts the disc back in" often outpace what the evidence actually shows, and today's patients are educated enough to ask for proof. Dr. Pankonin walks through three recent decompression studies, what each one actually demonstrates and where its limits are, and shows how to pair that evidence with your own clinic's outcomes data to build patient confidence and improve case acceptance. Key topics include: Why "does decompression work?" is the wrong question, and what to ask insteadCombining your clinic's own outcomes data (e.g., 85–93% improvement) with published research to build trustA 2025 USF chart review of 267 patients: 90.5% reported pain reduction, with gains in reflex, myotome, and dermatome testingA 2026 Korean RCT with blinded MRI evidence of reduced disc protrusion in the decompression groupA pre-registered case study showing complete resolution of a chronic C6-7 disc extrusion after a 6-month combined programFraming disc reabsorption as a possibility supported by emerging evidence, not a guaranteeSetting realistic expectations, including the 50%+ pain relief benchmarkUsing AI tools like ChatGPT to automate weekly research summariesThe big takeaway: doctors who master the research, not just the marketing, build real credibility with patients, colleagues, and referral sources. 🎧 Listen now on your favorite platform!
Aug 31

62. 10 Common Decompression Mistakes

🎙 Episode 62 – 10 Common Decompression Mistakes In this episode of The Practice Builders Podcast, Dr. Kyle Pankonin breaks down 10 common decompression mistakes that can hurt patient selection, clinical outcomes, and case acceptance. From relying too heavily on MRI findings to pulling with more force than necessary, many of these issues come down to the same thing: matching the recommendation to the actual patient in front of you. History, exam findings, imaging, neurological status, inflammation, and severity all need to work together. Dr. Pankonin walks through the clinical and communication adjustments that can help doctors select better candidates, set realistic expectations, and use decompression more effectively across a wider range of spine conditions. Key topics include: Why imaging alone should never determine whether someone is a decompression candidateHow realistic expectations, including the 50% improvement benchmark, can improve patient satisfactionWhen an MRI is truly necessary and when history, exam, and X-rays may provide enough informationWhy identifying the actual pain generator matters before recommending a decompression programWhy large disc herniations shouldn’t automatically intimidate youThe importance of addressing inflammation aggressively in stubborn casesWhy more pulling force doesn’t necessarily produce better resultsHow to match the number of visits to the severity of the patient’s condition instead of automatically recommending 24 visitsWhy decompression can apply beyond traditional disc cases, including facet problems, stenosis, and some spondylolisthesis presentationsHow better case selection and dosing can improve both the patient experience and clinical results The big takeaway: decompression works best when the protocol fits the patient, not when every patient gets the same protocol. Take the history, exam, imaging, severity, and goals together, then make the recommendation the individual case actually calls for. 🎧 Listen now on your favorite platform!
Aug 24

61. Stop Selling Technology, Start Selling a Future

🎙 Episode 61 – Stop Selling Technology, Start Selling a Future In this episode of The Practice Builders Podcast, Dr. Kyle Pankonin breaks down why patients don’t really buy decompression, laser, shockwave, or any other technology. They buy the future those tools can help them get back to. Most doctors naturally want to explain the science, the equipment, and the procedure. But patients are usually thinking about something much more personal: getting back on the golf course, traveling with their spouse, playing with their grandkids, or simply living without pain controlling their day. Dr. Pankonin explains how to uncover the patient’s “why”, connect your technology to that outcome, and shift your communication from selling treatments to selling transformation. Key topics include: Why selling technology and procedures often misses the patient’s real motivationThe question that helps uncover what pain has taken away from the patientHow to connect decompression, laser, and shockwave to the patient’s desired futureWhy the strongest recommendation focuses on outcomes, not visits or machinesHow to package services into condition-specific programs instead of selling them a la carteWhy your staff, marketing, and testimonials should all focus on transformationHow to set both a clinical goal and a functional goal for every patient The big takeaway: patients don’t want to buy a machine. They want their life back. Find out what matters most to them, then show them how your care becomes the bridge from where they are now to where they want to be. 🎧 Listen now on your favorite platform!
Aug 18

60. Creating a Remarkable First Visit

🎙 Episode 60 – Creating a Remarkable First Visit In this episode of The Practice Builders Podcast, Dr. Vince Leone shares a micro-training on how to create a first visit that builds trust before the patient ever meets the doctor. Patients are forming opinions from the moment they pull into the parking lot. The way your office looks, sounds, smells, and feels can either reinforce confidence or quietly work against you. Vince breaks down a simple Weekend First Impression Audit to help you identify the small details you and your team may have stopped noticing, from the front desk and waiting area to the bathroom, treatment rooms, paperwork, and patient greeting. The goal isn’t a major remodel. It’s making a few low-cost, high-leverage improvements that create a more professional and intentional patient experience. Key topics include: Why first impressions directly impact trust and close ratesHow to audit your practice through a new patient’s eyesSimple improvements to your front desk, waiting room, bathroom, and treatment areasWhy your team’s greeting and communication matter just as much as the physical spaceThe challenge to identify 3–5 small improvements you can make this weekThe big takeaway: clinical excellence matters, but patients experience your practice before they experience your clinical skill. Make sure those first few minutes tell them they came to the right place. 🎧 Listen now on your favorite platform!
Aug 3

59. Do You Need That MRI?

🎙 Episode 59 – Should Every Patient Get an MRI and How Imaging Decisions Affect Diagnosis Case Acceptance and Treatment Outcomes In this episode of The Practice Builders Podcast, Dr. Kyle Pankonin breaks down a nuanced framework for deciding when an MRI actually belongs in your decompression practice. Most doctors fall into one of two traps: never ordering imaging, or ordering an MRI for every patient. Neither is right. The real question isn't whether a scan looks impressive — it's whether it will change your management plan. History and exam always come first; the MRI is there to confirm or clarify, not to replace them. He also discusses why over-relying on brief medical radiologist reports can leave you with incomplete information, how to avoid scaring patients with scary-sounding terminology, and why an MRI is just as valuable for identifying good decompression candidates as it is for ruling out surgery. Key topics include: Why an MRI should only be ordered when it will change the diagnosis, treatment plan, or referral decisionWhen x-rays are enough — and when persistent radiculopathy or worsening neurological deficits mean it's time to scanWhy Modic Type 1 changes matter and what they can signalHow a $30 chiropractic radiologist review can catch what a brief medical report missesWhy treating the image instead of the patient is one of the costliest mistakes in decompression careHow to use the MRI as a communication tool — simple analogies like "blown tire" build trust and case acceptanceThe big takeaway: an MRI isn't a shortcut to a diagnosis, and it isn't optional busywork either. Used well, it's a tool that sharpens your clinical picture and helps patients understand exactly why your treatment plan makes sense. 🎧 Listen now on your favorite platform!
Jul 28

58. Specialists Win: Why the Future of Chiropractic Belongs to Specialists

🎙 Episode 58 – Specialists Win: Why the Future of Chiropractic Belongs to Specialists In this episode of The Practice Builders Podcast, Dr. Vince Leone breaks down a nuanced framework for deciding when every patient really needs an MRI in your decompression practice. Most doctors fall into one of two traps: chasing every high-value cash service, or staying stuck as a generalist competing on insurance and price. Neither builds a lasting practice. The real question isn't how many modalities you offer — it's whether you're becoming known for solving one or two specific, high-value problems exceptionally well. He also discusses why clinical excellence alone can't save a practice from becoming commoditized, how positioning and marketing are what actually let patients see the difference before they walk in the door, and why the doctors who reinvest in their specialty create a flywheel that compounds over time. Key topics include: Why "commodity chiropractic" happens and how it traps practices into competing only on insurance and priceThe Practice Nirvana model — a general chiropractic base feeding one or two high-value specialties like decompression or knee painWhy specialization builds authority, better protocols, and stronger referrals over timeHow generalists compete on price while specialists compete on value, trust, and outcomesDr. Leone's own journey from a struggling generalist to scaling a specialized practice to multiple seven figuresThe 3 practical questions every doctor should ask about their practice's positioning The big takeaway: generalists compete, specialists differentiate. The future belongs to doctors who stop trying to be everything to everyone and instead become exceptional at solving specific, high-value problems. 🎧 Listen now on your favorite platform!

5

out of 5

3 Ratings

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.

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Dr. Vince Leone and Dr. Kyle Pankonin
Years Active

2025 - 2026
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65
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Clean
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© Dr. Vince Leone and Dr. Kyle Pankonin
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