The Practice Builders

🎙 Episode 44 – Why Most Doctors Struggle Growing DecompressionIn this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin break down one of the biggest frustrations doctors face after buying a decompression table:“Why isn’t this growing the way I thought it would?”They explain that success with decompression does not come from owning the equipment alone. It comes from building the right system around it, including clinical confidence, patient selection, structured exams, a strong report of findings, and a proven treatment protocol.You’ll learn:• Why buying a decompression table without a complete system is a major mistake• How weak clinical confidence hurts conversions and patient trust• Why world-class exams are essential for identifying the true pain generator and positioning yourself as the expert• The problem with treating on day one before fully evaluating the patient and ruling out contraindications• How a structured Report of Findings creates clarity, certainty, and confidence for the patient• Why poor patient selection and unrealistic expectations can sabotage outcomesDr. Leone and Dr. Pankonin also emphasize that spinal decompression patients are often comparing your recommendations against surgeons, physical therapists, other chiropractors, and countless online solutions. That means doctors must elevate their expertise, systems, and communication if they want to stand out and consistently grow.If you already have a decompression table, or you’re considering adding one, this episode will help you identify the bottlenecks that may be holding your practice back and show you where to focus next.

In this solo episode of The Practice Builders Podcast, Dr. Vince Leone breaks down one of the most common questions chiropractors ask when entering the decompression space:“Which decompression table should I buy?”Dr. Leone reviews several of the most common systems on the market — including Chattanooga, DOC Table, Hill DT, AccuSpina, and DRX9000 — explaining their approximate price points, functionality, and key pros and cons so doctors can make an informed decision.You’ll learn:• The major decompression tables available and their general price ranges • Key differences between cable-based and actuator-based systems • When entry-level tables make sense vs. investing in premium equipment • Why clinic space, workflow, and growth plans should influence your decision • The most important takeaway: the doctor’s expertise matters far more than the table itselfDr. Leone also emphasizes that success with decompression comes from mastering disc diagnosis, world-class exams, treatment protocols, and patient communication, not just purchasing equipment.If you’re considering adding spinal decompression — or upgrading your current table — this episode provides a practical overview to help you choose the right system for your clinic.

In this episode of The Practice Builders Podcast, Dr. Vince Leone interviews Dr. Bao Thai, founder of Simplicity AI and former seven-figure neuropathy clinic owner, about one of the biggest hidden profit leaks in modern practices: poor lead management.After building and scaling large cash-based clinics with massive overhead and staff stress, Dr. Thai shares how he turned to AI to eliminate bottlenecks, reduce chaos, and dramatically improve speed-to-lead — without hiring more people.You’ll learn:Why speed-to-lead is the #1 reason practices waste marketing dollarsHow missed calls after 5pm silently cost you tens of thousands per monthThe real problem with relying on staff to manually follow up with every leadHow AI can answer calls, qualify prospects, book appointments, and send nurture content automaticallyWhy tracking lead response and follow-up data is critical for real growthA case study where better systems — not more ad spend — generated an extra $80,000 in one monthIf you’re running ads for decompression, neuropathy, or any high-value service and suspect leads are slipping through the cracks, this episode will open your eyes.🎧 Tune in to learn how better systems, smarter automation, and consistent follow-up can help you squeeze more revenue and profit out of the marketing you’re already paying for — while making practice enjoyable again.

🎙 Episode 42 – Spinal Decompression Report Review - Part 1In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin introduces the State of Spinal Decompression 2026 Report: benchmarks, insights, and predictions for chiropractors who want to build a real decompression niche.Dr. Leone explains why decompression has been too inconsistent across the profession (random visit counts, inconsistent protocols, dabbling). The goal is to professionalize decompression using proven systems, market research, and published evidence so clinics can deliver consistent outcomes and stand out as specialists.You’ll learn:Why decompression adoption is growing ~4% per year and why competition is comingThe real differentiator isn’t owning a table, it’s mastery: world-class exam, protocols, and trained staff executionWhy patient demand is massive (surgery volume + patients actively seeking non-surgical options)Pricing benchmarks (most clinics land around $3K–$7K, commonly $4.5K–$5K) and why just 3–10 starts/month can be practice-changingWhy marketing must be diversified (multiple “buckets,” not one fragile channel)A key clinical insight: research suggests lower-force decompression can perform as well or better than heavy pull in some cases.Give it a listen — and start thinking like a specialist, not just a table owner.

🎙 Episode 40 – When To Add A Second Decompression Table or LaserIn this episode of The Practice Builders Podcast, Dr. Kyle Pankonin lays out a clear, practical framework for one of the biggest decisions growing clinics face:When is it actually time to buy another decompression table, laser, or piece of tech?Most chiropractors assume their next leap comes from buying more equipment. But in reality, Dr. Pankonin argues that the real problem in most clinics isn’t capacity… its utilization.This conversation is a short but high-impact breakdown of how to scale intelligently, avoid shiny-object purchases, and expand only when the demand is real.You’ll learn:Why most clinics have a utilization problem, not an equipment problemThe 70–80% rule: the real threshold that signals it’s time to expandHow to spot true bottlenecks like waitlists, peak-hour overbooking, and scheduling pressureWhy buying more machines too early won’t fix lack of confidence, protocols, or marketingA real example of a doctor ready to sell a $60k laser… when the issue wasn’t the laser at allWhy laser therapy is often the first and smartest expansion (before decompression)How robotic laser systems allow staff delegation, reduced doctor strain, and faster ROIThe difference between scalable therapies (laser) vs selective therapies (decompression)Key business considerations: staffing, space, financial readiness, and timingWhen NOT to add equipment: boredom purchases, marketing gaps, staff burnout, and underused assetsThe exact next steps doctors should take to track utilization and make the right callIf you’re debating a second laser, another decompression unit, or the next big investment in your clinic, this episode gives you the clarity to expand with confidence, not impulse.🎧 Tune in to learn the smartest growth path: optimize first, scale second, and build capacity only when demand forces your hand.

🎙 Episode 39 – How To Add Knee Pain NicheIn this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin break down why chronic knee pain is one of the most overlooked and profitable niches chiropractors can add once spinal decompression is dialed in.They unpack the data, clinical realities, equipment, pricing, and simple internal marketing strategies that make a knee program a powerful second niche without ads, funnels, or added burnout. This is a practical, experience-driven conversation rooted in real clinic outcomes, not theory.You’ll learn:Why chronic knee pain affects nearly 25% of U.S. adults and represents a massive, underserved patient baseWhy knee osteoarthritis is especially well-suited for non-surgical, technology-driven careThe essential tools for an effective knee protocol (knee decompression, laser, shockwave, and supporting therapies)What a typical knee decompression care plan looks like and how practices price single vs bilateral casesThe most common clinical and perception-based pitfalls doctors face when adding knee careWhy internal marketing beats paid ads for launching a knee programSimple systems to identify knee pain in existing patients and stack revenue sequentiallyHow addressing knee and hip issues can dramatically improve spinal decompression outcomesWhy knee patients are often highly motivated, active, and ideal candidates for careHow a staff-driven, technology-forward knee program protects the doctor’s energy while adding a strong revenue streamIf you’ve optimized spinal decompression and want to add another high-impact, high-demand niche without complicating your practice, this episode lays out exactly why knee care deserves serious consideration in 2026.🎧 Tune in to learn how a dedicated knee program can help patients avoid surgery, restore activity, and create a simpler, scalable growth path for your practice.

🎙 Episode 38 – Protecting the ThoroughbredIn this episode of The Practice Builders Podcast, Dr. Vince Leone pulls back the curtain on a members-only micro training designed to help doctors build a practice that grows without burning them out. Using the “thoroughbred” analogy, he explains why the doctor is the seven-figure asset that must be protected first, and how energy, recovery, and role clarity directly determine the ceiling of the practice.You’ll learn:Why most burnout comes from mismanagement, not weakness (over-racing, poor fuel, wrong work, no recovery)How your energy and decision-making drive practice growth more than any system or tacticThe simplest ways to improve performance through sleep, nutrition, training, and recovery rhythmsHow to identify and eliminate the tasks that drain your energy (and what to delegate instead)Why planned downtime and true separation from work is disciplined maintenance, not indulgenceThe “protect the asset and the practice will follow” framework for long-term success and longevityIf you’re planning for your best year yet, this episode will help you grow revenue without sacrificing your health, clarity, or happiness.🎧 Tune in and learn how to protect the doctor first so the practice can thrive for the long haul.

🎙 Episode 37 – Marketing From Inside the TrenchesIn this episode of The Practice Builders Podcast, Dr. Kyle Pankonin breaks down a proven, multi-channel marketing strategy for chiropractors who want consistent patient flow without relying on one platform or trend.This episode addresses a common mistake: over-reliance on a single marketing channel, often social media, and why that approach leads to frustration and inconsistency.Instead, Dr. Pankonin outlines how to build an education-based marketing system that positions the doctor as the local expert and compounds over time.You’ll learn:Why diversifying marketing channels creates stability and predictabilityHow education-first marketing builds trust and long-term demandHow to combine external marketing (Facebook, radio, newspaper) with internal systemsWhy community involvement often outperforms paid ads for trust and referralsThis episode is a must-listen for doctors who want steady growth, stronger visibility, and a marketing strategy that holds up long-term — even as platforms and algorithms change.🎧 Tune in to learn how to build a marketing engine that compounds year after year.

🎙 Episode 36 – Let's Play Ball - Singles, Doubles, Homeruns, and Grand SlamsIn this episode of The Practice Builders Podcast, Dr. Pankonin introduces the “Let’s Play Ball” strategy — a simple, proven framework for growing your practice by focusing on Singles and Doubles instead of chasing rare “Home Run” cases.This episode breaks down how consistent revenue is built through smaller, more frequent cash-based care plans, not just big decompression cases.You’ll learn:Why 6–12 visit packages are the real driver of sustainable growthHow recommending laser or shockwave to nearly every patient increases cash revenue without increasing volumeThe hybrid care model that combines insurance services with cash-based technologyHow acute, chronic, and decompression cases fit into one simple growth frameworkWhy consistent wins build trust and make larger care plans easier to enrollThis episode is a must-listen for doctors who want predictable growth, stronger patient buy-in, and higher cash collections — without working more hours.🎧 Tune in and learn how to stop swinging for home runs and start building a practice that wins consistently.

🎙 Episode 35 – Process Over ResultsIn this episode of The Practice Builders Podcast, Dr. Vince breaks down why most practices stall despite having ambitious goals — and what actually drives sustainable growth instead.Using lessons from elite coaching and real-world practice building, this training introduces the “Process Over Results” framework and shows how consistent daily execution, not outcome chasing, creates predictable growth in spinal decompression and other high-value niches.You’ll learn:Why goals without systems create frustration instead of progressHow focusing on daily inputs builds a growth “flywheel” that compounds over time The exact high-value processes that drive decompression starts, conversions, and revenueHow to simplify your clinic by running Day 1, Day 2, ROFs, and staff roles the same way every timeWhy internal marketing, follow-up systems, and staff execution matter as much as adsThis episode is a must-listen for doctors planning for 2026 who want cleaner systems, stronger teams, and growth that doesn’t require working more hours.🎧 Tune in and learn how to stop chasing goals — and start building a practice that grows by design.

🎙 Episode 34 – Future of Spinal Decompression (Part 2)In this episode of The Practice Builders Podcast, Dr. Leone and Dr. Pankonin break down the newest research in spinal decompression and what it means for clinical results, care plans, and patient expectations.✅ Learn why the minimum effective dose is 20–24 sessions and how a 267-patient study showed 90.5% success at this level✅ Understand why lower pull forces (10–15%) outperform high-force protocols, reducing iatrogenesis and improving long-term outcomes✅ Discover why modern decompression isn’t just traction and how dynamic pull-and-release cycles create true negative intradiscal pressure✅ Get clarity on case selection, including why even large herniations (10mm+) can often be treated successfully✅ Improve patient retention with better pre-framing: most patients feel meaningful relief in 3–6 weeks, not 3–6 visitsPerfect for chiropractors who want science-backed protocols, stronger ROFs, and more predictable outcomes with complex disc cases.🎧 Listen now to understand the real biomechanics behind decompression — and how to use the research to elevate your clinical expertise and patient results.

🎙 Episode 33 – Future of Spinal Decompression (Part 1)In this episode of The Practice Builders Podcast, Dr. Leone and Dr. Pankonin break down the future of spinal decompression and why the next 5–10 years will be the biggest growth window the profession has ever seen.✅ Understand why fears of “market saturation” are completely unfounded✅ Learn how 100M Americans with back pain and rising chronic disc cases are fueling exploding demand✅ Get clarity on how modern decompression tables, sensors, and actuators are transforming clinical outcomes✅ See why adjunct therapies like shockwave and Class IV laser are becoming essential partners to decompression✅ Discover the gap in clinical training and why manufacturers can’t provide what real doctors need Perfect for chiropractors who want to stay ahead of the curve, upgrade their clinical certainty, and dominate their market as the go-to disc specialist.🎧 Listen now to see why decompression is entering its next major renaissance — and how to position your clinic to lead it.

🎙 Episode 32 – How to Start a PodcastIn this episode of The Practice Builders Podcast, Dr. Leone and Dr. Pankonin pulls back the curtain on how to launch and systemize your own podcast without adding chaos to your schedule.✅ Learn how to use a podcast as a long-term authority builder — not a quick lead-gen tool✅ See the full workflow: record → delegate editing → repurpose into short-form video✅ Discover why a simple setup and consistent cadence beat fancy gear or big budgets✅ Get clarity on when a podcast makes sense in your marketing strategy (hint: after Facebook and Google are dialed in)✅ Hear how The Practice Builders Podcast stays consistent while avoiding burnoutPerfect for doctors ready to expand their reach, build credibility, and connect deeper with their community.🎧 Listen now to learn how to turn your expertise into a powerful content engine.

In this week’s episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin sit down with Dr. Doug DeSalvo, a 7-figure chiropractor from Northern California who’s mastered the art of combining advanced technology, staff training, and patient education to create a thriving specialty practice.Dr. DeSalvo shares exactly how he doubled his practice in a year after adding spinal decompression and neuropathy treatments, and how he built a team culture that runs like a high-performing business—without sacrificing patient care.💡 In this episode, you’ll learn:✅ How adding specialized services like decompression, neuropathy, and laser therapy can rapidly scale your practice revenue✅ Why ongoing staff training and patient education are the foundation of long-term success✅ How Dr. DeSalvo uses AI (including ChatGPT) to create content and educate patients more efficiently✅ The key to structuring systems, leadership, and compensation to retain top-tier staff✅ How to design treatment plans that drive results and build patient trust🎧 Listen now to learn how one doctor built a 7-figure practice by mastering specialization, systems, and leadership.

In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin recap the 2025 Decompression Summit Certification and share the biggest clinical, marketing, and business takeaways from the event.You’ll discover:Why 109 attendees made this year’s summit feel electric—and what’s changing for 2026 with expanded space and Friday afternoon sessionsThe latest decompression research on biomechanics, outcomes, and exam techniques that position you as the true spine expert in your communityHow to contrast medical options like drugs, injections, and surgery with decompression to elevate your authority and attract more disc casesThe 7 marketing pillars from “The Last Decompression Marketing Plan You’ll Ever Need” to dominate your market and avoid ad fatigueThe simple math behind the patient journey—why only 3% are problem/solution aware and 37% are still in research mode, and how to capture bothHow Specialized Practice just had its best month ever with 10 new clients and what that momentum means for doctors in the decompression nicheWhether you were in the room or missed this year’s summit, this episode gives you a front-row seat to the breakthroughs, strategies, and next steps shaping the future of spinal decompression.🎧 Listen now and start preparing for the 2026 Decompression Summit, September 25–27