The Dark Side of Implementation

The Dark Side of Implementation: Change Your Podiatry Practice Without Permission Michele McGowan explains why getting excited about new ideas, buying technology, or attending conferences is easy, but implementing change in a podiatry practice is hard because of fear, money conversations, and worry about peer judgment. She emphasizes doing homework on evidence and indications, communicating ethically without promising miracles, and getting comfortable discussing cash-pay options as informed decision-making. McGowan argues that true implementation requires elimination—removing low-value or undesired services and creating schedule space—because “implementation without elimination is just accumulation.” She shares how adding services like Shockwave, laser, PRP, and a MediPedi spa worked through trial and error, packaging, and staff workflows, ultimately transforming the practice one uncomfortable decision at a time. 00:00 Dark Side of Implementation 00:52 Fear After Buying In 01:59 Peer Judgment and Permission 02:49 Evidence Without Hype 04:09 Talking Money Confidently 05:53 Fail Upward to Improve 07:02 Eliminate to Implement 09:16 What Actually Pays 11:47 MediPedi Spa Case Study 15:20 Systems and Staying in Lane 19:17 Profit Ethics and Patient Demand 21:50 Practice Transformation Over Time 24:47 One Thing Add One Remove 26:23 Final Encouragement and Wrap