Episode Summary: Building a Patient-First Podiatry Practice with Dr. Adam Shapiro

Podcast: Becker Business (also Becker’s Healthcare Podcast)
Host: Scott Becker
Guest: Dr. Adam Shapiro, Podiatric Foot and Ankle Surgeon, Entrepreneur
Date: September 28, 2025

Overview

This episode features Dr. Adam Shapiro, founder of the Carolinas’ largest independent podiatry practice. Dr. Shapiro shares the journey of building and scaling a patient-centered podiatry operation, his approach to culture and growth, strategies for physician and patient satisfaction, and his vision for a comprehensive lower extremity health platform. Key themes include patient-first philosophy, physician well-being, practice scaling, multidisciplinary integration, and adapting to healthcare trends.

Key Discussion Points & Insights

1. Dr. Shapiro’s Background and Practice Philosophy

• Introduction: Dr. Shapiro traces his career from residency in Washington, D.C. to launching his Charlotte-based practice in 1999, now the largest independent podiatry practice in the Carolinas.
• Growth Approach: The practice’s expansion was “organic,” focusing consistently on patient experience as the core of its success.
  • “We’re proud to be the largest independent podiatry practice... we’re building out a multidisciplinary lower extremity health platform.” (B, 00:30)

2. Building a Patient-First Practice

• Guiding Principle: “Good medicine is good business.” The practice’s culture is fundamentally a patient-first approach.
• Patient Journey Focus: Every touchpoint is optimized—the initial phone call, the office environment, clinical protocols, and the checkout process.
• Cultural Standard: The “golden rule” is applied across all staff interactions.
  • “Our goal each and every day is to exceed patient expectations, and that's what fuels our growth.” (B, 01:43)
• Training Young Doctors: New physicians are taught not just clinical skills, but also the practice’s ethos and high-touch patient care model.
  • “We give them a masterclass in how to be successful... it’s not just throwing them in.” (B, 03:46)

3. Preserving Traditional Values in a Modern Environment

• Continuity of Care: Despite the evolution of healthcare, the “old school” patient-by-patient approach remains effective and sustainable.
• Recruitment and Onboarding: Young physicians are developed through an intensive onboarding process to align with the practice’s patient philosophy.
• Cultural Buy-in: Compare patient care to a superior service experience (e.g., Chick-fil-A vs. fast food).
  • “It’s important that everyone buys into that culture.” (B, 03:46)

4. Physician Well-being and Motivation

• Burnout Prevention: Structured schedules, promotion of autonomy, and attention to mental health are core strategies.
• Work-Life Balance: Three-year associateship leading to partnership, with increased vacation (up to six weeks) for mental health as tenure increases.
  • “It's not a sprint, it's a marathon, these careers.” (B, 05:47)
• Technology as a Tool: Adoption of AI transcription to reduce documentation burden and allow doctors to finish work at reasonable hours.
  • “AI transcription has been phenomenal in reducing... the burden on physicians.” (B, 07:09)

5. Collaboration Across Disciplines

• Cooperation vs. Competition: Dr. Shapiro describes a collegial relationship with orthopedic surgeons and other specialists, focusing on shared care.
  • “The pie is big enough for everyone.” (B, 07:49)

6. Innovation and Practice Growth

• Scaling Operations: The business is moving into a new phase of “de novo growth,” adding new specialties, service lines, and building out the C-suite team.
• Fall Risk Program: Focused initiative addressing hospitalizations due to falls—patients are screened during intake, and those at risk are referred to in-house physical therapists.
  • “Falls are the leading cause of hospitalizations in folks 60 and older... No one is addressing fall risk.” (B, 08:28)
• Integrated Services: Emphasis on creating a “one-stop-shop” for lower extremity health, integrating podiatry, physical therapy, and vascular specialists.
  • “The goal is... to be the leading lower extremity health platform.” (B, 09:42)

7. Sustaining Passion and Energy

• Purpose-Driven Practice: Passion and sense of purpose are key motivators.
  • “To become a physician, you have to have a certain sense of purpose, and with that purpose comes happiness.” (B, 10:23)
• Non-Surgical Focus: Podiatry’s strength lies in comprehensive non-surgical intervention.
  • “We really have a knack of getting folks better non-surgically... and that is what most people want.” (B, 10:23)
• Industry Outlook: High demand for podiatric services as population ages and the need for lower extremity care increases.

Notable Quotes & Memorable Moments

• Dr. Shapiro:

  • “Good medicine is good business.” (B, 01:43)
  • “I always tell physicians, when you join our team… it’s not a sprint, it’s a marathon.” (B, 05:47)
  • “AI transcription has been phenomenal in reducing the burden on physicians and getting home at a reasonable hour.” (B, 07:09)
  • “Falls are the leading cause of hospitalizations in folks 60 and older. No one is addressing fall risk. Right. So we… refer to in-house physical therapists.” (B, 08:28)
  • “To become a physician, you have to have a certain sense of purpose... with that purpose comes happiness.” (B, 10:23)
  • “One of the greatest things about our specialty... it’s just such early innings.” (B, 10:23)
  • “The pie is big enough for everyone.” (B, 07:49)

• Scott Becker:

  • “You can’t see 40 patients a day and stay in a good headspace and love your patients how you want to love them.” (A, 05:47)
  • “Traditional practice never goes out of style in terms of actually taking care of patients well and building a great practice.” (A, 02:45)
  • “All of us live on our feet…” (A, 11:42)

Timestamps for Important Segments

• 00:30 — Dr. Shapiro's background and practice history
• 01:43 — The patient-first philosophy and culture
• 03:46 — Training and onboarding young physicians
• 05:47 — Structuring physician schedules for longevity and well-being
• 07:09 — Embracing technology to prevent burnout
• 07:49 — Collaboration between podiatry and orthopedics
• 08:28 — New service lines: fall risk, multidisciplinary expansion
• 10:23 — Sustaining energy and passion in medicine; non-surgical focus
• 11:42 — The universal importance of lower extremity health

Conclusion

Dr. Adam Shapiro’s practice growth is firmly rooted in patient-first values, physician well-being, and strategic innovation. His multidisciplinary vision aims to address gaps in lower extremity health, with a strong commitment to culture, collaboration, and adaptability in a changing healthcare environment. Dr. Shapiro’s message is clear: combining passion, purpose, and solid business practices creates not only better patient care, but also a thriving, resilient organization.