How to effectively incorporate ToeFX into your practice

Interview with Dr Joanne Lih, Podiatrist, about the ToeFX ClearToe Therapy System

You currently have 17 patients using ToeFX, with 10 more waiting to begin their treatment. How has it been incorporating ToeFX into your busy schedule?

As a solo practitioner, I recommend to start slow, space patients as you need, and watch your timing. I’ve learned that scheduling ToeFX patients first thing in the morning and at the end of the day works best for my practice. Also, I use a colour coded system for scheduling, with one colour unique for my ToeFX visits, which has helped me plan my days.

How do you approach patient expectations about treatment?

When a patient agrees to begin treatment, I schedule 10 appointments every two weeks at their initial visit, so that the appointments are locked in and there is no confusion about expectations. Patients without extended health benefits or insurance will often pay for an entire year of treatment at once. I tell the patients that their appointments will be 35 minutes long, and they can use that time any way they like (read, listen to music, do work). The ToeFX treatment room is more comfortable than my other rooms, and has full WiFi access.

Tell us more about your ToeFX treatment room, what does that look like?

I keep my office running on time, and part of that is having everything I need on hand and organized. I’ve setup my ToeFX treatment room to include:

  • ToeFX ClearToe Light system;

  • ToeFX ClearToe Serum packs (one pack per patient);

  • Cotton swabs;

  • Sterilized pipettes;

  • Bottle of topcoat (fast acting, fast drying);

  • Bottle of alcohol;

  • Toe spacers, one per patient (attached to their pack of ClearToe Serum);

  • Burrs which are kept separate for ToeFX patients and autoclaved independently;

  • Patient take home “Kit”:  this is a ziplog bag which contains a small bottle of acetone and cotton swabs (so they can remove the top coat after 3 days), and the ToeFX handout entitled Tips For Keeping Toenail Fungus Away;

  • A handheld timer! I set the timer, and then carry it in my pocket. That way I can do charting or see other patients (I have four treatment rooms in total), but also keep track of when I need to return.

Any tips and tricks as an experienced ClearToe system clinician?

If a patient has hammertoes or a high arch, I use felt padding to elevate the toes. I’ve also found that using a rougher burr with a finer point, but then finishing off with a diamond burr for smoothness, works best before applying the ClearToe serum. I apply the serum on all 10 toes even if only one nail is affected (as the pen is one time use), and I like to apply THREE coats of serum while letting each coat dry in between (which takes about 15min total). After the light treatment, I apply a fast drying 5 second topcoat, which I drop on the nail with a pipette and smooth with a gloved finger.

The timer mentioned above is a great apparatus for encouraging new patients to come into the ToeFX program. I will tell other patients that I may need to leave when the timer goes off as someone in the other room is receiving toe fungus treatment. I have ToeFX brochures handy so if they ask what the treatment is, I can easily show them.

What has the patient response been like?

I explain to my patients that they will have blue toenails – why they are blue, and why some areas are darker blue (those areas have a great ponderance of fungus). Sometimes I have to make modifications for some patients, and hearing what their concerns are and addressing them is important to overall patient satisfaction.

Thank you to Dr. Joanne Lih, a Podiatrist based in Abbotsford, British Columbia, for her tips and insights into the ToeFX ClearToe Light therapy system. If you have any questions for ToeFX or Joanne, email us at