The Practice Builders

🎙 Episode 35 – Process Over Results

In 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...

Duration: 00:37:42

🎙 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...

Duration: 00:39:53

🎙 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...

Duration: 00:22:08

🎙 Episode 32 – How to Start a Podcast

In 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...

Duration: 00:33:10

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...

Duration: 00:37:05

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 cas...

Duration: 00:29:33

In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin reveal how to confidently overcome the most common objections in Report of Findings for spinal decompression and other niche services.

You’ll discover:

Why handling objections on Day 1 prevents stalls and rescues on Day 2How to use the Four Horsemen framework to clear non-financial objections before you ever discuss moneyThe right way to respond when patients say, “Let me think about it” or “Can I just do chiropractic?”How to explain session counts using research-backed protocols with an 85–90% success rateProven strategies for reframin...

Duration: 00:42:38

In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin break down the exact roadmap to scale a chiropractic practice to $100K/month in just 12 months.

You’ll discover:

Why a spinal decompression table and two high-end lasers are essential for rapid growthHow to structure your team with 3–4 CAs, a patient ambassador, and an operations managerThe three core systems—patient processing, marketing, and financials—that drive predictability and profitabilityMarketing strategies that turn $2K into $20K using Google Ads for decompressionHow to evolve from hands-on adjusting to stepping into the CEO role of your...

Duration: 00:35:03

In this episode of The Practice Builders Podcast, Dr. Leone and Dr. Pankonin dive into one of the most underrated yet powerful strategies for building patient trust and long-term success in your decompression practice:

The Prognosis Playbook.

You’ll discover why setting realistic expectations—like aiming for 50% improvement—doesn’t just protect your credibility, it sets you up to over-deliver and blow patients away.

In this episode, we cover:

✅ The psychology of under-promising and over-delivering in a cash-based decompression practice ✅ Why 50% improvement is a valid benchmark (even in spine surgery studies!) ✅ How to positio...

Duration: 00:24:09

Episode Summary: In this powerful episode, Dr. Vince sits down with Dr. Josiah Fitzsimmons—one of the most successful chiropractic practice owners in the country. From humble beginnings to building a thriving, multi-location, staff-driven practice, Dr. Fitzsimmons shares the systems, mindset, and strategies that helped him scale efficiently while maintaining high-quality care.

Whether you're just getting started or looking to break through a growth plateau, this conversation is packed with real-world insights you can apply immediately.

What You’ll Learn:

How Dr. Fitzsimmons positioned his clinic as the go-to provider in his regionThe clinical and...

Duration: 00:51:23

In this episode of the Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin sit down with Dr. Matt Houchin — a chiropractor and entrepreneur who owns five clinics across multiple states.

Dr. Matt shares his journey from starting as an associate to acquiring multiple practices, and the lessons he’s learned along the way about leadership, financing, and scaling with the right associates.

You’ll discover:

How Dr. Matt acquired and grew five clinics without private equity backingFinancing strategies that make acquisitions possible (even with student loan debt)What banks and sellers look for wh...

Duration: 00:48:18

In this episode of the Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin reveal how to transform your consultations into efficient, stress-free, and enrollment-driving experiences.

You’ll discover:

Why your front desk team is the true “ambassador” of your clinic and how to train them for successThe role of paperwork in creating a smooth patient flow (without frustrating new patients)How to leverage CAs or scribes to streamline consults and examsThe importance of creating a wow experience that sets your clinic apart from “every other office”Why most Day 2 problems are really Day 1 deficiencies — and how to f...

Duration: 00:22:38

In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankenin reveal a powerful yet often-overlooked tool for growing your practice and reclaiming your time — the

Not To-Do List.

You’ll discover:

Why eliminating certain tasks can be just as important as completing your to-do listHow to identify low-value, energy-draining activities in your work and home lifePractical steps for creating your own Not To-Do ListReal-world examples of how delegating tasks can boost patient volume, revenue, and personal freedomHow to shift your mindset from “doing it all” to focusing on the highest...

Duration: 00:29:18

In this episode, Dr. Vince Leone reveals The Ultimate Decompression Marketing Blueprint — the same strategy that’s helped scale his own clinic to seven figures and empowered clients across the country to consistently hit $100K/month with spinal decompression.

You’ll learn:

Why most decompression marketing plans fail (and the fixes that work)How to reach the 37% of your market that most clinics overlookThe 6 pillars of a dominant, long-term decompression marketing planPractical systems to generate high-quality leads, build authority, and increase conversions year after year

If you’re ready to stop chasing unqualified leads, avoid the race...

Duration: 00:50:09

We just dropped a brand-new episode of The Practice Builders Podcast — and if you’ve ever thought about adding shockwave therapy or expanding your practice with a high-profit cash niche, this is one you can’t afford to miss.

In this episode, Dr. Vince Leone sits down with Dr. Kyle Pankonin and Dr. Tony DiCesaro to go behind the scenes on two powerful new initiatives that are helping clinics scale fast — without the insurance grind.

Here’s what you’ll learn:

💥 The Shockwave Sprint: 90-Day Implementation Program • The exact clinical and marketing systems used to generate...

Duration: 00:48:09

🎙 Episode Title: The Shockwave Sprint & Joint Pain Express: A New Era in Pain Care

In This Episode: We’re pulling back the curtain on two exciting new ventures in the world of cash-based pain care — the Shockwave Sprint and the Joint Pain Express franchise model.

Join Dr. Vince Leone, Dr. Kyle Pankonin, and Dr. Tony DiCesaro as they break down:

✅ The Shockwave Sprint — a 90-day, high-impact program teaching doctors how to implement shockwave therapy clinically and profitably. Learn how one client generated $46k in just two days with this system.

✅ The Joint Pain Ex...

Duration: 00:48:09

🎙 Episode Title: The Shockwave Sprint & Joint Pain Express: A New Era in Pain Care

In This Episode: We’re pulling back the curtain on two exciting new ventures in the world of cash-based pain care — the Shockwave Sprint and the Joint Pain Express franchise model.

Join Dr. Vince Leone, Dr. Kyle Pankonin, and Dr. Tony DiCesaro as they break down:

✅ The Shockwave Sprint — a 90-day, high-impact program teaching doctors how to implement shockwave therapy clinically and profitably. Learn how one client generated $46k in just two days with this system.

✅ The Joint Pain Ex...

Duration: 00:48:09

In this episode, we’re giving you a behind-the-scenes preview of the 2025 Decompression Summit Certification, the most anticipated event of the year for growth-minded chiropractors focused on growing Spinal Decompression.

Join Dr. Vince, Dr. Kyle and Dr. Tim Burkhart as they break down:

Why decompression is the #1 cash niche to scale in 2025The exact clinical and marketing systems being taught at the SummitNew additions this year: breakout sessions, advanced protocols, and real-time implementation toolsHow the certification will position you as the go-to disc specialist in your areaWhat to expect from the 3-day im...

Duration: 00:35:01

📅 Episode Summary:

In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin dive into a powerful strategy that can dramatically improve your patient conversion rates: pre-framing the close. Before ever discussing money, there are four critical questions every chiropractor should ask during the report of findings.

These questions are designed to eliminate common objections before they come up — like time, spouse approval, readiness, or overall fit. This episode walks you through how and when to ask these questions, why they matter, and how they help create a smoother path to patie...

Duration: 00:29:17

Episode Summary: In this powerful episode, Dr. Vince sits down with Dr. Josiah Fitzsimmons—one of the most successful chiropractic practice owners in the country. From humble beginnings to building a thriving, multi-location, staff-driven practice, Dr. Fitzsimmons shares the systems, mindset, and strategies that helped him scale efficiently while maintaining high-quality care.

Whether you're just getting started or looking to break through a growth plateau, this conversation is packed with real-world insights you can apply immediately.

What You’ll Learn:

How Dr. Fitzsimmons positioned his clinic as the go-to provider in h...

Duration: 00:51:23

Hiring an associate can either be one of the best growth decisions you make—or a costly mistake. In this episode, Dr. Vince Leone and Dr. Kyle Pankonin break down the when, why, and how behind bringing on an associate. From practice structure and revenue benchmarks to onboarding, expectations, and red flags, this episode gives you the playbook for hiring smart.

What You’ll Learn:

When your practice is truly ready for an associate (hint: it's not just about being "busy")The ideal team structure to have in place before hiringKey metrics to evaluate (volume, collections, conv...

Duration: 00:33:41

In this episode of The Practice Builders Podcast, Dr. Vince Leone and Dr. Kyle Pankonin dive into one of the most common (and costly) pitfalls growing practices face—scaling too fast or too sloppy. If you’ve ever wondered “Should I hire another CA?”, “When should I invest in better software?”, or “How do I get out of the day-to-day chaos?”—this one’s for you.

Inside This Episode:

The 3 warning signs you're overdue for new systems or staffWhy throwing bodies at problems is NOT the solutionHow to scale profitably with lean, efficient teamsWhen to bring on an operations man...

Duration: 00:38:52

In this episode of the Practice Builders podcast, we share our top book recommendations for personal and professional growth. Between the two of us, we highlight seven impactful books that have shaped our thinking around clinical mastery, business development, and mindset.

We dive into why we often prefer older, time-tested books—written by people who’ve lived what they teach—over many modern titles that feel more like sales funnels. Our conversation emphasizes the importance of lifelong learning and staying growth-minded, both for delivering better care and building a thriving, sustainable practice.

We hope you find v...

Duration: 00:35:21

You know the saying, "don't judge a book by its cover?" Well, in healthcare, first impressions really do matter. We're diving into the research and sharing practical strategies for enhancing your doctor's attire, staff presentation, and overall clinic environment.

Hey everyone, welcome back to Practice Builders! We're Dr. Vince Leone and Dr. Kyle Pankonin, and today we're tackling a topic that might surprise you: the impact of appearance on your practice.

Tune in to discover how simple changes can boost patient confidence, increase conversions, and elevate your practice to the next level!

To...

Duration: 00:32:04

Want more high quality patients who have the problem, the desire and the means to invest in your protocols?

If so, you'll love today's episode!

We are excited to share a super important topic with you today: how to attract high-quality patients who are pre-educated, pre-motivated, and ready to invest in their health.

We're going to break down a three-part process that will help you create a more successful and fulfilling practice. We'll cover how to use education-based marketing to build trust and confidence in your patients...

Duration: 00:26:29

Feeling stuck in the traditional chiropractic model?

This podcast episode reveals the top 3 reasons why adding cash-based services can transform your practice.

Discover how to break free from insurance limitations, stand out from the competition, and attract a wider range of patients. Get ready to level up your practice and unlock new possibilities!

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule a 1:1 Free Practice Consultation, use this link: https://calendly.com/drvinceleone/dr-vince-profit-niche-consultation

Duration: 00:26:31

Ready to level up your chiropractic practice?

Doctors Vince Leone and Kyle Pankonin unveil their 7-step blueprint for success, packed with practical strategies to boost your bottom line, build a rockstar team, and achieve your biggest goals.

They also share a powerful "one-word theme" concept to keep you focused and motivated. Get ready to transform your practice – listen now!

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule a 1:1 Free Practice Consultation, use this link: https://calendly.com/drvinceleone/dr...

Duration: 00:54:22

Ready to take your chiropractic practice to the next level with Laser Therapy? This Practice Builders podcast episode is a must-listen!

Discover the MLS laser, "Deep Tissue Robotic Laser" that's changing the game for chiropractors. Learn how to attract new patients, increase revenue, and deliver exceptional pain relief with this cutting-edge technology. Don't miss out on this powerful episode!

Thinking about purchasing an MLS Laser? To get the "Dr. Vince Discount" text Harold Kendrick at Cutting Edge (248-760-7217) and give him the code word "Leone"!

To...

Duration: 00:44:49

Tired of relying on insurance? Want to boost your chiropractic practice's cash flow?

Tune in to this episode of Practice Builders, where Doctors Vince Leone and Kyle Pankonin reveal the secrets to "hitting singles and doubles" with laser therapy and shockwave therapy. Learn how to offer these valuable services, increase patient lifetime value, and grow your practice without breaking the bank!

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule a 1:1 Free Practice Consultation, use this link: https://calendly.com/drvinceleone/dr-vince-profit-niche-consultation

Duration: 00:21:33

Tired of insurance headaches and want to boost your chiropractic practice's revenue?

This Practice Builders podcast episode dives into the world of laser therapy, specifically the MLS laser, and how it can transform your practice. Learn how this innovative technology can help you treat patients faster, increase patient satisfaction, and generate significant revenue.

Get ready to unlock the potential of laser therapy and take your practice to the next level!

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule...

Duration: 00:49:52

Want to take your chiropractic practice to the next level?

This episode of the Practice Builders podcast dives deep into the world of coaching, sharing real-life experiences and actionable advice on how to choose the right coach for YOU.

From accountability and proven models to accelerating your growth, discover the power of coaching and why it's essential for any chiropractor looking to achieve their full potential.

Hit play and get ready to be inspired!

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule...

Duration: 00:40:29

Chiropractors, get ready for the Practice Nirvana Blueprint!

Insurance is fading, and the value of adjustments is shrinking. It's time for a new approach to chiropractic practice.

Practice Nirvana focuses on cash-based services, niche specialization, and a premium patient experience. Build a team, invest in high-end equipment, and create a practice that thrives. Achieve financial freedom and build a career you love, all while delivering exceptional care.

Embrace the future of chiropractic with Practice Nirvana. Ready to ditch the old model and take your practice to the...

Duration: 00:34:18

This podcast with Sachin Patel is a game-changer! He's a chiropractor who's figured out how to unlock your body's potential through breathwork and functional medicine. He's also got the secret sauce for scaling your practice with simple solutions that actually work. You're going to want to hear this!

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule a 1:1 Free Practice Consultation, use this link: https://calendly.com/drvinceleone/dr-vince-profit-niche-consultation

Duration: 00:43:51

Hey chiropractors, want to build confidence in spinal decompression? Here's the secret:

Master the exam: Go beyond the basics, show your expertise.Track your wins: See those success rates, build your confidence.Follow a proven plan: Don't reinvent the wheel, use a system that works.

Get ready to build a thriving practice and help your patients get the results they deserve! Want to learn more? Check out the full podcast episode for all the details!

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule a 1:1...

Duration: 00:24:55

This episode is all about the gear you need to level up your practice and start treating those tough chronic cases! We're talking decompression tables, lasers, shockwave therapy, and even electroanalgesia. We'll break down the different options, their price points, and what makes them stand out. It's all about investing in yourself and your practice to deliver the best possible results for your patients. Get ready to learn how to build a practice that's truly cutting-edge!

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule a 1:1 Free...

Duration: 00:30:18

Hey everyone, ready to boost your practice with high-value cash services? This episode is all about finding the perfect niche for you. We'll break down why decompression is a top choice, explore other exciting options, and give you the tools to make the right decision for your practice. Get ready to level up and start making a real difference!

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule a 1:1 Free Practice Consultation, use this link: https://calendly.com/drvinceleone/dr-vince-profit-niche-consultation

Duration: 00:30:32

I built a million-dollar chiropractic practice in a town of 850—and you can too! Ten years of traditional practice got me nowhere, but switching to niche care and smart marketing strategies exploded my cash flow. Learn how I went from struggling to six-figures a month, and discover the secrets to building your dream practice, no matter your location. - Dr. Kyle Pankonin.

To learn more about Specialized Practice, please visit us at: https://specializedpractice.com/

To schedule a 1:1 Free Practice Consultation, use this link: https://calendly.com/drvinceleone/dr-vince-profit-niche-consultation

Duration: 00:22:22

Chiropractors, want to grow your practice and reduce reliance on insurance? We're Dr. Vince Leone and Dr. Kyle Pankonin, hosts of the Practice Builders podcast, and we're here to share the secrets to building a thriving practice through cash-based services, or "niches."

In this first episode, I'll share my journey from struggling to survive to building a million-dollar practice by specializing in neuropathy and decompression. We'll discuss the benefits of niches, how to choose the right one for you, and how to achieve significant growth in just 90 days.

The future of...

Duration: 00:24:42