3 Hidden Benefits of Learning Minimally Invasive Surgery

Minimally Invasive Surgery (MIS) has been around for more than 40/50 years. There’s been some upturn and downturn.

Now as I accidentally found out about MIS in a cadaver lab in New Orleans, something struck me. This could be it! I remember I was about to quit and go into another business but something struck me. There’s an attractive side to MIS, that little portal that most patients are not aware of. Nowadays, all other parts of the body are been done using a minimal incision approach so why not the foot?

MIS has a steep learning curve but once you can go over that hump there are a lot of benefits.

MIS reduces post-op swelling

If you are traditionally trained like I was, you know that it is difficult to avoid the post-op swelling. No matter how you dissect that tissue, it’s difficult to avoid it.  But just by the fact that you have to create a larger incision, it’s almost unavoidable to develop some post-op swelling.

It’s very different if you start doing MIS. You’ll be shocked! There is very little swelling typically if it’s done properly. Just prepare yourself not to show your emotions in front of your patients when you first do it. Patients will eventually see it and leave great reviews. Their word of mouth feedback is not something you can manipulate.

MIS: Revenue up + cost down = higher profit

Increased Revenue

Your revenue will increase because of your reputation in your niche. You may opt-out from insurance plans (by the way my book about opt-out is coming out soon). Once you start opting out, you would be able to provide patients with great all-inclusive service at a premium price.

Reduced Expenses

You will unintentionally save on advertising costs. This is because you won’t have to spend much money to promote. Most times MIS promotes itself and your patients will promote you because they’re happy. Your biggest expense is the tax which you can’t do anything about. However, your second biggest expense is payroll.

If you check out the post about my office, you’ll see it’s efficient and modern. You can run your practice with just a few employees. You don’t need to have 4 or 5 employees. You don’t have to see 200 patients a week. And these approaches to your practice will significantly decrease your payroll expense. Very economical surgery equipment will drive your supply cost down too.

MIS fosters improved mental health

Think about this. You have to deal with your job, patients, employees. When do you have time to enjoy your family? You have to be mindful of your stress level. With MIS, you do surgeries at your office so you don’t have to commute or wait your turn at the hospital. You can enjoy your own place; it’s smaller with less work time and fewer patients.

These benefits I don’t mind repeating because I want you to know. But you have to follow the system and a good process so you don’t have to go through on your own. That’s why my mission came about. My passion was to coach and develop a proven system.

If you’re interested in learning more check out my program.


Office-Based Surgical Suite for Podiatrist or Foot Surgeon

Hello Doctors,

I made the video above to show you a complete tour of my podiatry office which includes my office-based surgical suite. Read below for more details.

So let’s start.

Now you don’t need a big, fancy 5,000 or 6,000 square feet office. What I’m showing is 1,800 square feet which I created for a foot and ankle practice with a built-in surgical suite.

This is my clean modern waiting area. I don’t participate in most insurance plans so I don’t have 50 patients a day. I only see 10 to 12 patients a day, working three and a half days a week.

Primary Treatment Rooms

Treatment room #1: This room is about 8’ by 8’ or 8’ by 10’. I have an MLS laser machine for post-op swelling or sports injury.
Treatment room #2: I have my shock wave and diagnostic ultrasound machines.
Treatment room #3: This room is 1,800 square feet. I do ABI tests for vascular study before surgery.

The Surgical Suite

The most important things for me are a mini C-arm and an Osada drill set for cutting bones and shaving bones. There’s also a digital pneumatic tourniquet but I don’t even use it anymore. Most MIS procedures are performed without tourniquets, avoiding possible vascular complications. Here’s a traditional digital x-ray setting.

My office-based surgery suite is about 15’ by 15’. It used to be about 12’ by 15’ but I opened the wall and made it bigger. You really need a 10’ by 12’ or 12’ by 12’ room for your office space. This is my office where I do most of my computer work, consulting work, and rest.
I also have a couple of bathrooms and then two autoclaves in a small room which is also a kitchen area. I also have one ultrasonic cleaner because as long as you have an office-based surgical suite, you have to sterilize everything.
So that was a quick tour of my MIS practice with an office-based surgical suite.

Benefits of having an office-based surgical suite

Everything’s done right here. When patients come to my office, they enjoy so many benefits:

  • They don’t have to go to the hospital or a surgery center.
  • They save lots of money for coinsurance.
  • They don’t have to pay facility usage to a hospital or surgery center.
  • They enjoy comfort conveniences.
  • They don’t have to meet new people.

In another setting, patients usually have to go to a pre-op room along with many other patients. They have to wait for their turn to go to war then come out to the recovery room. Instead, they come here to the same office and the same staff that they’re used to. They just walk in from the treatment room, get the surgery done and go back to the treatment room.

The treatment room works as a recovery room. Most MIS procedures are done using local anesthetic, twilight sedation. But most of them can be done locally which is another plus. So patients don’t have to worry about complications from sedation anesthesia.

If you want to have an office-based surgical suite like mine join my MIFAS Accelerator 2.0 Program

As I said, I have a very flexible schedule: three-and-a-half days a week. Most of the time when I don’t see patients, I basically talk to doctors.

With my MIFAS Accelerator 2.0 program, I meet with my current clients every week on Friday evenings. We do live coaching calls to discuss their surgery cases and their minimally invasive surgical skills. We also discuss office-based surgical suites like the one I showed you to help them set up their own custom layout. A lot of documentation is very important for office-based surgery which I provide during the coaching program.

If you are even remotely interested then watch this quick video on MIFAS Accelerator 2.0

Watch my free webinar on how you can skyrocket your practice profits with MIFAS and an OBS.

To your wealth and success,


How to Build a Profitable Practice Without Spending a Lot of Money

Do you think you need a huge practice to grow to seven-figures, or that you’ve got to be a big player to earn a big profit?

ou may think you need three doctors working for you and 10 to 15 employees to run your practice in order to reach a huge revenue goal.

You may think you need to have 3 to 4,000 square feet of space to have so many patients with expensive equipment to build a profitable practice.

Well, none of those could be further from the truth nor are they necessary.

Huge practice means huge costs, not anymore.

Associates, employees, space, equipment, none of them is important to build a successful practice. In fact, it would be harder for you to build a dream practice that way. Here is why. Those are the overheads. Those are your fixed costs to run your practice every single day, every single month and every year. Those are the expenses you cannot avoid. It doesn’t matter if your revenue is two million a year because your overhead is 70 to 80%. Your take home after expenses and tax is about 300K. Is it really worth running that kind of practice with blown up overhead?

We’re talking simple business math looking at the numbers. It’s all a numbers game when it comes to running a business. You’ve got to start treating your practice as a business. You are healing patients and fixing patients’ problems for the better. Of course, that’s given. But are you also trying to build a profitable podiatry practice so you can continue to provide the best care for your patients in optimal status?

A few coaching clients of mine have a large scale practice. When I interviewed them to assess their situations, they’re running everywhere like doomsday is coming onto them. So many broken holes to cover, chasing 10 rabbits at the same time, chaotic, hectic, constant anxieties!

Let’s think about your status as a person mentally and physically. The simpler your practice model is, the more stable your mind, body, and spirit. As a matter of fact, in which model are you going to be tested? A huge practice with gigantic overheads or an efficient practice where you can focus on patients’ real problems? You can absolutely run a very efficient, yet profitable practice and still build a high six-figure or even seven-figure practice.

How can you achieve a profitable practice?

Consider these three key steps:

Create your own niche within your specialty. Be the best in your field of expertise. Continue to learn, practice and get better in your chosen niche, so when it comes to your specialized skill set, you become the authority. You are the go-to doctor.

Do not reinvent the wheel. Get some help from someone who has done it. Why? You don’t have time for this. How long will you sustain your practice like you’re running right now? Invest in yourself. Learn the foundation and techniques and tactics from someone who has actually done it and is ready to coach you with a proven system.

Do not waste another dollar in marketing and advertising agencies blindly. All those generic contents they’re blasting for you, they’re frankly fading away. You don’t need to waste your money blindly in advertising and marketing. You don’t even know what to advertise for, what your potential patients are looking for, yet how do you expect to bring high-quality leads?

Those are three key things you need to work on, not dream about those fancy 3,000 square feet blown up practices. Now, you may be wondering, “Dr. TJ, that’s great. But how do I do that step by step?” If you seriously consider building this type of lean, efficient, successful practice, don’t do this alone. You need to invest in coaching and mentoring.

If you are committed, coachable and resourceful and if you’re ready to take some massive action in the shortest possible time with accountability, consider it done. How? Register and watch my webinar. Connect with me. I’ll sit down with you on the phone just you and me, analyze together if you are a good fit for this. I included my calendar booking link below as well. Remember, you don’t need to spend huge overhead expenses to build a successful practice. In this era, you need to think differently and evolve to a new breed of modern podiatry practice: Lean, profitable, yet patient-focused practice, and not those outdated ways of thinking around the insurance-focused practice.

Let’s do this together. A 45-minute strategy session may be the best 45 minutes you will spend on your practice.

Click here to book a call with me.

4 Reasons Why You Must Consider Providing Minimally Invasive Foot & Ankle Surgery

Here are four reasons why you need to consider minimally invasive foot & ankle surgery

Minimally invasive foot & ankle surgery is a great alternative surgical solution to your patients.

Patients know about minimally invasive surgery so if you can provide an equivalent solution to traditional open surgery, why not?

MACRA and MIPS are value-based healthcare that are in place.

As you know, government and insurance companies are running out of money, and our reimbursement rate is going down every year.

Based on big data, if you happen to spend a lot of money doing surgery, for example, using an expensive fixation system or taking up a lot of OR time, you’ll be penalized. On the other hand, if you can save government or insurance company money, you’ll be rewarded. So, why not consider minimally invasive surgery because you don’t use expensive fixation system with MIS.

That’s what the market wants.

Most surgical procedures nowadays, if you see a market, social media, Internet, everything’s minimally invasive surgery. Arthroscopic, laparoscopic, non-surgical and now, with the surgical foot, why not percutaneous minimally invasive surgery? Two-millimeter and three-millimeter incisions a lot of times don’t need internal hardware fixation.

Minimally invasive surgery has been proven to be effective.

We’ve been kind of blind from the world of minimally invasive surgery, especially percutaneous techniques. If you look at the outside world, even “Foot & Ankle International” magazine, and a lot of studies, the percutaneous minimally invasive surgical techniques have been published, and then proven to be effective.

So, if you look a little bit outside of the box, it is out there. And now the US is catching up: the Orthopedic Society and podiatrists in the US. You can see a cadaver lab doing minimally invasive surgeries everywhere in the US, especially in the past two years.

Let’s recap why the trend is heading towards minimally invasive foot & ankle surgery:

This is a great alternative to traditional open surgery.
Good protection to value-based healthcare such as MACRA and MIPS.
Minimally invasive surgery is what the market wants, and this is what is in trend right now.
Minimally invasive surgery has been proven to be effective.

There you have it, four reasons why you must consider minimally invasive foot & ankle surgery in your practice.

Please do not hesitate to leave comments, concerns, and questions. I am passionate about minimally invasive surgery. I am passionate about promoting and increasing awareness and to create and provide an educational source to help you learn about minimally invasive surgery.

If you need help setting up OBS or learning MIFAS please don’t hesitate to book a free strategy session with me and my team – Click here to book a time.

All the best,

Dr. TJ Ahn

Benefits of Office-based Surgery

Why Office-based Surgery?

1. Convenience and comfort for your patients

Patients usually feel much more comfortable coming to your office and to see the same staff instead of going to big hospitals or surgery centers where they have to meet new people just for the surgery.

2. Lower out-of-pocket cost for your patients

This is obvious, but patients could save much more if the surgery is performed at your office.  As their deductible, co-insurance, and co-pays are increasing at outrageous rate every year, patients are afraid of having any kind of medical procedures done in these days.  By providing office-based surgery, patients will be more likely inclined to accept your surgical treatment plan since it saves them huge cost in most cases.

3. Insurance networks rewards more for physicians

You will be surprised to see 20% more reimbursement if you perform procedures in your office.  This is true for many states.  Even Medicare will rewards you more for office-based procedures.  Why? It is simple.  It saves them lots of money since patients don’t need to be admitted to the hospitals or ambulatory surgery centers.

4. It saves time and you create your own schedule

You don’t have to travel to hospitals through traffic.  You don’t have to wait around for your turn.  You will have more free time for you and your family.  You control your schedule and you can utilize time much more efficiently with office-based surgery.

What is MIFAS?

Minimally invasive foot surgery refers to a type of surgery done with a very small incision that requires little or no stitching.  Through these extremely small incisions, surgeons insert specially designed instruments to perform the operation.  Interventions are carried out through these small incisions and they have minimal exposure to the surgical field, causing minimal or no injury to the adjacent tissue.  Because of this, minimally invasive foot surgery allows us to be able to control and predict a patient’s recovery and outcome more manageable.

Minimally invasive surgery is first pioneered by Dr. Morton Polokoff in 1945, he developed these techniques as a system of sub dermal surgery using very small instruments.  In the decades since then, further surgical advancements have led to the state of art procedures that we perform today, making minimally invasive surgery much safer and more comfortable for patients.  However, these minimally invasive foot surgeries should be performed only by trained surgeons.  They acquire these specialized surgical skills only after extensive training, continuing education, seminars, and fellowship within minimally invasive foot surgery community.


We strongly believe MIS is a very effective surgical technique.  It is best summarized by one of my colleagues’ website of The Coeur d’Alene Foot and Ankle Clinic and Surgery Center. It says,

“Today, ambulatory foot surgery is a developed art. Over 2,000 international physicians and surgeons specializing in this technique are members of The Academy of Ambulatory Foot and Ankle Surgery, and with each year the number increases. The triangular academy seal depicts its dedication to ambulation, rehabilitation, and education….

It is now over forty years since the original pioneers began the development of this art. They sought the means of ending discomfort and suffering for a wider cross section of the population. They reasoned that if the necessity for hospitalization and prolonged disability was eliminated, more people could afford to avail themselves of these advanced services.
As their development progressed they found that it was rarely necessary to incapacitate their patients. Painful bunions, recurring corns, heel spurs, contracted toes and hammertoes were corrected by this new technique and the patients remained ambulatory. Through the years, other interested physicians and surgeons made worthwhile contributions until we have reached today’s state of the art. Cost effective, minimal invasive foot surgery is a reality.”


Minimally invasive foot surgeries provide many benefits, including:

  • Less injury – With minimally invasive foot surgery there is less injury to soft tissue. Compared to traditional open surgery where long incisions are made that may create more trauma to the soft tissue, minimally invasive surgery uses much smaller incisions disturbing less tissue and leading to a quicker recovery time.
  • Less pain – Studies have shown that patients of minimally invasive surgery report less pain than those patients undergoing traditional surgery.  As a result, patients of minimally invasive surgery require less use of pain relievers.
  • Shorter surgery time – Because there is a small incision, surgery times for minimally invasive foot surgery procedures are often shorter than traditional open surgeries.
  • Less anesthesia, more qualifying patients – Due to the nature of minimally invasive foot surgery procedures, patients often remain awake during surgery after careful local anesthesia to the foot area, reducing the use of general anesthesia.  Therefore, what happens during these procedures is just the foot is asleep. This opens up surgery possibilities for patients who may have been previously considered at risk for traditional surgeries due to medical history.
  • Less scaring – As a result of minimally invasive foot surgeries’ smaller incisions, scars left by these procedures are smaller and less noticeable. Of the scars that do form, they are often have less of a jagged edge than those left by traditional open surgeries.