From Scalpel to Strategy: How Dr. Brandon Maijala is Redefining Podiatry Growth in California

Introduction and Dr. Maiellau2019s Vision 0:00

Building a successful clinic takes more than great medicine. It takes vision and the courage to innovate. My guest today, Dr. Brandon Maiella, he's a respected foot and ankle surgeon and vice president of the Los Angeles County Podiatric Medical Association, South Harbor. In just a few years, it turned his Anaheim practice, care podiatry, into a model of modern patient care, healthcare, combining surgical expertise, community leadership, and technology and the post-op board box that he got for himself for the patient experience.

We are going to unpack his journey, how he balances medicine with entrepreneurship, and what it takes to build a thriving practice in today's healthcare world. Dr. Mayala, welcome to Healthcare Business Growth Conversations. Thank you, Rakesh. Yeah, I want to start from the top. You have grown care podiatry into a driving practice and Anaheim has become your anchor location. What was the vision when you started out? When I started out, I wanted to really focus on patient care. I want to bring back care into healthcare.

And I noticed a growing shift and change into more less community-based doctors or patient-centered doctors and more into profits or corporation- based ideologies. So I knew I wanna do a private practice, one that was focused on the communities where I live. Got it. That's interesting. And then I love the way that you said you want to bring care into healthcare that has a deep meaning. So like, you know, a lot of doctors struggle to separate their clinical identity from their business role. How do you balance being both a practicing surgeon and a business owner?

It's difficult. It is a hard, it's very hard task to do both of those. takes a lot of skill, but having a good team beside you, being very organized and making sure that you take time for both of those things to make sure. Your skills at both managing an office as well as managing your skills in surgery or attended to it is something that. Again. Yeah, right. Now I think focusing on the right team and setting up the rights systems is the way to go. So, and you are also the vice president of the Los Angeles County Podiatric Medical Association.

Balancing Surgery and Practice Ownership 2:25

That's no small robe, like you know, I imagine being in that position gives you a bird eye view of where podiatry as a profession is heading. Has that perspective influenced you? How you lead your own team in your practice? It helps me stay connected with the profession and then connect more with, you know, my colleagues throughout California, especially at the sponsored events like the Western. This is happening once a year and it's a large freight show that I try and go to every year. And also with delegation too, it helps bring awareness to our profession.

and also it also helps help out our professionals by potentially influencing future laws or things that can lead to reimbursements for our profession. Got it. So, let's talk something that really fascinated me, the post-op part box. Now, I was really surprised whenever I heard it and when I looked at it, so where did that idea come from? It came from when i was in residency and as a resident, i worked under and I being trained by a lot of different surgeons and Post-operative swelling is a big issue with any foot or ankle.

procedure is done. Swelling is one of the most common side effects and can last the longest. So a lot of my attendings would recommend different products and different things to help decrease the amount of post-operative inflammation and long-term swelling. I found the ones that I've found were the best and I curated the products. And I tested them myself and created a kit. that people can then use after surgery. Now that I'm out and doing my own surgeries, I give this to each of my patients just to help with the pain and swelling post-operatively.

And it's just a way that, you know, we can do a little bit more to have people be cared for and in less pain.

Professional Leadership and Association Work 4:38

Well, that's brilliant. And what I like about it is how intentional it feels. It is not just a product, it's a part of a patient experience strategy. So I really liked it. Let's say, you know, if I were to visit your Anaheim clinic tomorrow as a, patient, now what would stand out? How do you create a strong patient experienced at your clinic? Well as soon as, we try to make it as. easy and less stressful as we can for the patients. They're already stressed because of whatever injury or ailment that they're having.

If there's check-ins available that we made mobile so that you can check in on their phone. You can also check right outside the clinic. We have a QR code. we have very open waiting room so it doesn't get too crowded. I don't I don't like people being crowded or waiting. So another thing is that I only book 30 minute slots for each patient. I, so this time I'm not double booking anybody. It's. They all get their own time slot that way that I can, you know, have that time for them and not have to go to another patient.

We also, once you get in the room with me, I don't bring in a computer in. I do have either somebody else there scribing or I have a tablet. with either virtual scribe or a scriber recording so that I can focus on you, the patient, and talk to you one-on-one. And there's nothing between you me and your issue.

Creating the Post-Op Care Kit 6:12

So that's really care, right? Like that is your strategy. So just make sure nothing else in between the patient and the doctor is just focusing on the care. As you said, in the healthcare, that's what you wanted to bring and then that you are preaching and that is what we are doing. That's impressive. And also I noticed that he wrote surgery in a pro dietary book. So that was an impressive accomplishment. Did that process change how you communicate with your patient or staff? That is a good question.

Writing is a whole different, writing for other people is, is very different than writing. For yourself, whether you're in medical school or residency, you write to help you learn and remember. But then when you writing, for somebody else, You have to use language that will help your audience learn. And remember, and that is the key thing that I think that helped me with is that everyone hears things a different way. Everyone remembers things through different ways. So it helped me more like a soft skill when talking to patients, realize that I have to speak in a way that'll get them to hear.

Got it. In a sense, writing forces clarity and then that helps you. to think in clear. So that's really a good way. That's an impressive accomplishment. On the same line, for smaller single-doctor practices, what are the one or two low-cost ways they can elevate the patient experience? That is also a great question. I think one of the ways that we have used is using, this is a very specific example, is virtual assistant. you know, kind of the backend work that you would be doing instead of providing patient care off of you.

It can help with telephones, insurances, it's helped tremendously. Well, that's good. You know like, you're just delegating the work you are not supposed to do and then you put it like hiding a virtual assistant that also brings in that resource at the lowest cost possible and in turn that helps you to care the patient and eventually you create that patient trust,

Designing a Better Patient Experience 8:26

give them the comfort and you know I think you're creating that invisible marketing for your brand by following this and it follows the word of mouth reference as well. That's really a good advice that you have given. So like Anaheim, the location, I just want to ask about the locations because it is such an interesting city. you know, very active, young, fast-paced, like I was just searching about the Anaheim as a location. And then I just wanted to understand much more because now you are running the community, you have got families, professionals, athletes, all with different needs, right?

So how do you keep your care consistent while adapting to such dynamic patient base? I think one of the ways it is very dynamic, because it's a very large city. When I And I'm just in like one small part of it. Yeah, Anaheim is huge. I have to specifically tell patients too where I am at in the city of Anahan because it's big. Treating everybody with the same amount of care is the goal and the way to do that for that different type of population. You can guess what kind of patient is going to be or what kinda encounter it's gonna be with them and how they're gonna act, but you always get surprises, both good and bad.

You think this person's going be a really great patient and then they come in and they are nothing but difficult. Or the same thing. Either internal bias or known bias to somebody and you think they're going to be difficult. And then they come in and they are completely not. They're the best patient of the day. So trying to treat everybody as if they were going be the patient end of day if that works for you or that you're gonna be best doctor for them usually helps me with that dynamic population.

Well, I love that you mentioned you want to be the best doctor for your patient. So that's a perfect setup. Where I want go into next, because your clinic seems to adapt innovation early, especially when it aligns with patient outcomes. You recently introduced some cutting edge technologies. I just want you to talk about it and also what convinced you that that was the right next step for you practice. Yeah, there's a few things that we have that, we use lasers for photobiomodulation tissues to help increase healing with things like skin fungus, toenail fungus is things we adopted.

And that's, you know, that that has been around for not, not relatively soon, but it's been for a little while.

Writing, Communication, and Delegation 11:20

I've used lasers to toenails fungus. I think the first time I was introduced to that was maybe four years ago and it showed great results. You know, as currently evolving and we're currently involving with that and using different ways of doing that photo by modulation. And we have some new stuff coming out soon actually also, you know. Being. a one-stop place. I don't, I, don' want to be a primary care doctor, but it seems to me like, like an organization tends to kind of go that way. Cause you know, we're, w we are treating a lot more than just those.

We have studies for check out vascular studies where things for nerve conditions, We, were doing all systems of the body in and around the now. So it's, um, It's comprehensive and we're trying to do as much as we can for our patients. Right. Like it makes sense from the care point of view, but I imagine a lot of doctors listening are cautious about adapting new tech either because of the investment or uncertainty. So what helped you to evaluate the ROI? Right? And then you spoke about the patient impact, right?

But from a business side, now these are all the investments that you've got to make. And like, you know, I just wanted to hear your approach of making the decision, adapting this new deck. I don't want to adapt anything that I haven't. Personally dried, overseen, or it's been documented for, you know, the efficacy has been document for decades. Um, so that's the, like the trade show I mentioned, I like going and seeing and hearing other testimonials. And, salespeople are good and bad. Their main job is to sell you something, but to get them to sale, sometimes they will give you trials.

And then if you have patients that are willing to do trials, you can't do trails of these products to see your own effort to seeing, tailor that with research that you've done or found elsewhere for the same.

Serving a Diverse Anaheim Patient Base 13:35

If you, it just goes back to being what we learned in medical school research. You search, well, we can, and then once you find something that do you think will help your patients, then research how to make it a net positive for business. Well, you know, it does not make sense to do anything that's negative and you won't be in business and then you will be able to help anybody. Well now that say very strategic way of thinking, not just technology for the sake of it, but as a part of a patient experience and in the journey.

So some of the technologies I said have just come out that we use and some like I'm actively building right now. And then there's some that we just got for like for our vascular studies that's been out for almost two decades. So it's not always the newest one is the best. It still works and it still good for the patients and good further the business. Right. That's a way to find a balance, right? Just care and the business. So when you look ahead, maybe two to three years from now, you're actively involved in associations and all.

What do you think will define successful podiatric clinics? I think it's a good question. The scope of our practice is very different for each state that we're in. So there's certain things that I can do here in California that, you know, podiatrists in say Montana can't do. I think more, I, think all of us, you know, getting, especially the ones with lower scope rising up to the, ones that are higher scope is one of the biggest issues in podiatry as well as, You know getting people to know more about the profession.

This is a great profession I. Think it's a very good one to be in both, for taking care of your patients, but also for You know, the quality of life as a doctor and for this, you know whether we're limited into a region in our scope, but we can do a lot of things in that region. So I think there's a variety in here.

Adopting New Technology Thoughtfully 15:55

And I. Expanding that variety and being able to offer more things to our patient is what I determine as successful. If you can own your own practice and stay afloat and then do what you be the doctor that you want to be. That's to me, that's success. It increases competition and doctors running their own, maybe single location clinic. Now what, like those doctors, what should be, you know, they paying attention to? Oh yeah. They should being paying to their population, to the patients. Like there will be areas of this country where it's not feasible to do that, unfortunately.

It could be almost 100% of the population is under managed care, and it would not make it feasible. You may have to join somebody and not open up. Unfortunately, there's no affluent areas in Anaheim, but there are also some very affulent areas near and around it. They can help support a practice so that you can treat all those different populations. But if you're in an area where you don't have that wide variety of patients, it may not be feasible. So doing a patient demographic research on the area that want to be in before opening up the type of place you want is very important.

That's an inspiring way to think about the future. like looking at the demographics, the patient experience, and then the innovations that you want to bring. Location, location. Got it, got it. So like, you know, on the lines of running the clinic, what is the one mindset shift that changed how you run your clinic? Yeah, it's, this is interesting. It's the same and different. Like you have to take care of yourself now more so. You have take of your staff and your colleagues more. So then you used to, you know, there's a lot of tasks or, You know being the owner that you didn't, or you don't have when you're not.

A lot a little things that, and all of it. You know, it does take attention, and it doesn't take you caring about things that you didn't used to not care about. And you have to then try and find a way to take, you know the care that give your patients and then extend it to yourself and your employees as well. It's not easy unless you're just, that type of person. I don't know if I'm that kind of a person yet. How good I am at that. Yeah, yeah. It's not easy. That's why I said like, you know, it is a mindset shift.

You know treating a patient versus managing a clinic, both are totally different skills. Like, what is the best investment you have made?

Evaluating ROI and Practice Growth 18:58

I know not in terms of equipment, but something that changed your business. I think, yeah, not in terms of equipment. I want to care, it's pretty good. It's really good, I don't want a lie or anything. Okay. I mean, I think it's between Orange Carrot and the virtual assistant. Both of those things have really offloaded a lot of work that I would do that didn't lead directly to patient care. And it was just, you know, a lotta stuff that had to be done to get where I wanted the organization to go, but wasn't super directed towards the patient.

It was outside stuff, that just hadn't to done. It's hard for me to focus if I'm not focused on the patient. That was a vision, right? Like to give the care. So you had a focus on it. Yeah, that's a good one. What are the common mistakes that you see a new podiatrist make when they start their own clinic? Not having, not being organized a hundred percent. The organization feels it's not taught to people in medicine at all. We organize and, you know, clinically, but we're not organized and learning how to organize an actual organization.

It's, you know, a lot of times it's very linear things that we do, the step-wise approach to things, that does not work with an organization is very branching. So I think really trying to separate how you do things for your care, patients on the clinical side. and then separate how you think about and how to organize for the structure of your clinic, your organization. You have to view them differently. And you have really plan out things more.

Future of Podiatry and Clinic Success 21:08

Got it. Especially with finances. Definitely. On the same note, like the patient experience and all, when we talk about it, the first moment of truth is the friend desk. It's not you, right? So, you know, whenever a patient walk in or whenever the patients make a phone call, it is not who you're going to talk. first conversation with a, with the patient. So like, how do you organize the friend desk or what is in your mind of now giving that experience to the. Especially when you are not facing the patients as a first touch point.

Right in our front window. Sign not signed, but you know, a decal it has our name. care, but I tree and you can see it from the front desk. It's kind of all over on the desk, the very big first word in there is care. Yes. You know, I tell everybody to care about when they come in and, you know the good thing for us is that is, that has helped us and it's helped um, you know, the experience for patients. The bad thing is, is good and bad patients say, and we hear positive feedback about it. You guys are one of the most caring clinics and doctors.

Um, then the bad part is they say doctors aren't like that anymore these days. Got it, I'm really glad that you like the name care poriatry because I remember working on a few names initially when we started working for you. So I am glad the, uh, name is working out. So yeah, the first 10 seconds I was like, I don't like it when after 10 second, someone's perfect. Well, that's, uh, now I'm glad to hear. So, and then finally one piece of advice you would give your anger self, you know, when you were just starting out, it gone.

That's it. Like, I just want to give an advice to yourself. You started out this right after your college.

Lessons for New Practice Owners 23:28

I know you as a doctor might have gone through a lot, studying a a world as business owner. You might've made a lot of mistakes, learned a load of lessons. So like, you know, what is it now? Even I made lot mistakes when I started out Orange Carrot along with my partner. Yeah. so we all have a story to tell and then you as a doctor, that would be an interesting story. That's what I wanted to hear. Well, thank you. yeah, I know. Maybe one day I'll write a book or another book. Another book coming in.

Okay. Definitely another podcast coming about the book? Yeah, let's do it. That's fantastic. That was great. This was fun. Yes. Now I enjoyed the conversation. It has been a valuable conversation, but thank you for your valuable time. it is not just for me or for Podiatrist, it's for anyone building healthcare brand with purpose and your purpose is care. I'm glad to hear that. Thanks again for joining me on healthcare business growth conversations. Thank you. For your time, Dr. Baila. You're welcome.