June 13, 2025

Are PT Mills Bad? The Debate Nobody Wants to Have (But Needs To)

Are PT Mills Bad? The Debate Nobody Wants to Have (But Needs To)

In this no-holds-barred discussion, Jimmy McKay sits down with Tony Maritato and Dave Kittle to ask a question most PTs avoid: is operating like a “mill” really that bad? They break down the realities of modern reimbursement, how patients actually perceive care models, and what savvy clinic owners can do today to thrive — even in a crowded system.

Topics Covered:

  • Clinic scheduling & reimbursement challenges
  • Perception vs. reality: What “mill” clinics get right (and wrong)
  • The power of telehealth: Turning intake calls into evaluations
  • How trust is built (or broken) before the first visit
  • Leveraging Medicare’s current rules to innovate service

Links & Resources:

WEBVTT

00:00:09.632 --> 00:00:09.893
All right.

00:00:09.913 --> 00:00:10.233
Good morning.

00:00:10.272 --> 00:00:11.173
PT Breakfast Club.

00:00:11.233 --> 00:00:11.512
Dave.

00:00:11.573 --> 00:00:12.454
Dave's out on a run.

00:00:12.874 --> 00:00:14.314
Did you get that on Instagram?

00:00:15.413 --> 00:00:16.353
He's at mile one of

00:00:16.414 --> 00:00:17.673
something like a half hour ago.

00:00:17.934 --> 00:00:19.535
So Dave's running back.

00:00:20.074 --> 00:00:20.695
Hurry up, Dave.

00:00:20.795 --> 00:00:21.855
Or he's the one person

00:00:21.914 --> 00:00:23.054
watching us live right now.

00:00:24.096 --> 00:00:25.236
What do you want to kick off with first?

00:00:25.335 --> 00:00:26.655
I didn't know this about Topgolf.

00:00:26.696 --> 00:00:28.115
I've been to Topgolf two or three times.

00:00:28.256 --> 00:00:29.396
You sent a video to us and

00:00:29.417 --> 00:00:29.957
you were giving me the

00:00:29.996 --> 00:00:30.977
beats a second ago.

00:00:32.377 --> 00:00:33.716
Topgolf was designed to turn

00:00:33.777 --> 00:00:34.838
non-golfers into golfers.

00:00:35.457 --> 00:00:36.578
Feels like a smart idea.

00:00:36.597 --> 00:00:37.258
Yeah.

00:00:37.378 --> 00:00:38.018
Did it work?

00:00:38.338 --> 00:00:38.738
Spoiler,

00:00:38.759 --> 00:00:40.500
I wouldn't be bringing up if it did.

00:00:40.539 --> 00:00:42.121
So if you I don't have access to it,

00:00:42.161 --> 00:00:43.301
if you share the link to

00:00:43.322 --> 00:00:44.423
that YouTube video.

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Yeah.

00:00:45.584 --> 00:00:46.143
Yeah.

00:00:46.164 --> 00:00:47.744
Before we hit go live,

00:00:47.784 --> 00:00:48.786
Jimmy and I were talking.

00:00:48.845 --> 00:00:50.186
I said, I listen to this.

00:00:50.226 --> 00:00:51.167
This is the stuff that I

00:00:51.207 --> 00:00:52.548
listen to when I'm on a run,

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when I'm doing anything.

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It's it's these like, you know,

00:00:57.271 --> 00:00:58.871
did you know about business

00:00:58.893 --> 00:00:59.372
kind of stuff?

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So when Topgolf first started,

00:01:02.136 --> 00:01:03.338
the original founders,

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they were totally failing at business.

00:01:05.280 --> 00:01:06.561
They were running up debt.

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They were using all of their

00:01:07.923 --> 00:01:08.804
personal savings.

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And the problem was they

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were trying to make Topgolf

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a way for real golfers to

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get better at golf.

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Nobody cared about it.

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Nobody wanted to do that.

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Eventually, they, you know,

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they did the radio frequency.

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They gamified it.

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They eventually pivoted to, hey,

00:01:28.099 --> 00:01:29.740
maybe we're wasting our time.

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This reminds me of therapy.

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We're wasting our time,

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forcing our ideal customer

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to want what we want them

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to want instead of serving

00:01:39.405 --> 00:01:41.286
them what they actually want.

00:01:42.046 --> 00:01:45.009
And so eventually they pivoted to, okay,

00:01:45.069 --> 00:01:46.930
this is a sports bar where

00:01:46.950 --> 00:01:48.411
you can hit golf balls

00:01:48.611 --> 00:01:50.192
rather than this is a golf

00:01:50.212 --> 00:01:51.614
training performance center.

00:01:51.634 --> 00:01:54.176
And that's when the idea blew up.

00:01:54.417 --> 00:01:55.496
All of a sudden you could

00:01:55.516 --> 00:01:56.718
take somebody that's never

00:01:56.739 --> 00:01:57.838
hit a golf ball before.

00:01:57.879 --> 00:01:58.900
And if you think about it,

00:01:58.959 --> 00:02:01.822
like I'm not a golfer, I will golf,

00:02:01.882 --> 00:02:03.043
but I am not a golfer.

00:02:03.343 --> 00:02:04.864
The only thing I enjoy about

00:02:04.924 --> 00:02:06.606
golf is smashing the ball

00:02:06.667 --> 00:02:07.427
as hard as I can,

00:02:07.468 --> 00:02:08.508
no matter where it goes.

00:02:09.568 --> 00:02:12.191
Um, the drinks, the hanging out, you know,

00:02:12.251 --> 00:02:13.532
like those are the elements,

00:02:13.592 --> 00:02:14.393
maybe the bedding.

00:02:15.152 --> 00:02:17.275
And so you pull those things out,

00:02:17.435 --> 00:02:19.175
you package it in an

00:02:19.216 --> 00:02:20.977
appealing way and you sell

00:02:21.016 --> 00:02:22.899
it to the consumer who wants to do that.

00:02:23.378 --> 00:02:26.320
So like you could take, um, you know,

00:02:26.381 --> 00:02:27.681
what used to be a four hour

00:02:27.722 --> 00:02:29.543
event and sell it by the hour.

00:02:30.084 --> 00:02:31.305
You don't have to get carts.

00:02:31.344 --> 00:02:31.604
You don't,

00:02:32.064 --> 00:02:33.325
I guess driving the golf cart's

00:02:33.346 --> 00:02:34.366
a fun part, but yeah.

00:02:37.058 --> 00:02:38.864
So basically, long story short,

00:02:39.145 --> 00:02:40.288
they were failing, failing,

00:02:40.307 --> 00:02:41.330
failing until they found

00:02:41.371 --> 00:02:42.794
the formula that their

00:02:42.935 --> 00:02:44.258
customer actually wanted.

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Eventually it was acquired by Callaway.

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Problem is when Callaway bought it,

00:02:49.873 --> 00:02:51.155
they bought it with the

00:02:51.215 --> 00:02:52.594
intent that we're going to

00:02:52.615 --> 00:02:54.395
turn non-golfers into golfers.

00:02:54.475 --> 00:02:55.496
If we can convert even a

00:02:55.556 --> 00:02:57.956
fraction of them into

00:02:58.097 --> 00:03:00.176
actual golfers who are buying equipment,

00:03:00.396 --> 00:03:02.198
we're going to explode our revenue.

00:03:02.538 --> 00:03:03.557
It just never happened

00:03:03.578 --> 00:03:04.878
because those people don't

00:03:04.899 --> 00:03:06.158
want to be golfers.

00:03:06.338 --> 00:03:06.639
Right.

00:03:07.239 --> 00:03:08.340
I love going to Topgolf.

00:03:08.439 --> 00:03:09.419
I don't want to go golf.

00:03:10.479 --> 00:03:12.381
Is there a parallel here to

00:03:13.561 --> 00:03:14.360
Savannah Bananas?

00:03:14.842 --> 00:03:17.603
Because it's not golf, it's not baseball,

00:03:17.643 --> 00:03:19.383
but for Savannah Bananas,

00:03:19.763 --> 00:03:21.324
they're solving a boredom problem.

00:03:22.383 --> 00:03:23.784
And that's what Topgolf did,

00:03:23.824 --> 00:03:26.526
but how often are you going to do that?

00:03:26.566 --> 00:03:27.645
Savannah Bananas is okay if

00:03:27.665 --> 00:03:28.485
you come out and see us

00:03:28.586 --> 00:03:29.445
once or twice a year.

00:03:29.926 --> 00:03:30.947
Topgolf needs you to come

00:03:31.007 --> 00:03:32.227
out once a month if they're

00:03:32.247 --> 00:03:33.687
going to be successful in a community.

00:03:36.679 --> 00:03:38.500
I think the underlying theme

00:03:38.539 --> 00:03:40.882
here is what are the best parts?

00:03:40.923 --> 00:03:42.604
What's the twenty percent, you know,

00:03:42.623 --> 00:03:43.465
that generates eighty

00:03:43.504 --> 00:03:45.706
percent of the revenue and profitability?

00:03:45.787 --> 00:03:48.169
What is the true product market fit?

00:03:49.030 --> 00:03:51.532
And let's just focus on that, you know.

00:03:52.013 --> 00:03:52.954
So Dave is back.

00:03:52.993 --> 00:03:53.974
Dave, how was your run?

00:03:55.455 --> 00:03:55.936
It was good.

00:03:56.417 --> 00:03:57.918
I'm still not showered,

00:03:58.038 --> 00:03:59.939
but you guys come first and

00:04:00.000 --> 00:04:00.881
shower and breakfast later.

00:04:01.437 --> 00:04:01.856
Smart man.

00:04:02.137 --> 00:04:02.418
Smart man.

00:04:02.557 --> 00:04:04.139
Well, it's not smell-o-vision,

00:04:04.218 --> 00:04:06.580
so we're good.

00:04:06.599 --> 00:04:07.401
So I had to steal this

00:04:07.420 --> 00:04:08.861
strategy if you want to kick this off.

00:04:08.921 --> 00:04:09.241
Or wait,

00:04:09.282 --> 00:04:10.141
we had something else we were

00:04:10.162 --> 00:04:11.223
going to talk about in the group chat.

00:04:11.242 --> 00:04:11.864
I always forget about it.

00:04:11.883 --> 00:04:13.144
We were going to talk about mills,

00:04:13.183 --> 00:04:15.126
but let's do steal this strategy.

00:04:15.445 --> 00:04:18.528
So the stealer strategy is a quick one,

00:04:18.627 --> 00:04:19.949
and it has to do with...

00:04:20.819 --> 00:04:22.959
Donuts.

00:04:23.560 --> 00:04:24.521
I do not live in a place

00:04:24.560 --> 00:04:26.341
that has Krispy Kreme right now,

00:04:26.762 --> 00:04:27.702
but someone taught me this

00:04:27.742 --> 00:04:28.283
weekend when I was

00:04:28.302 --> 00:04:31.024
traveling that there is a hot now sign.

00:04:31.064 --> 00:04:32.005
Are you familiar with the

00:04:32.045 --> 00:04:34.206
Krispy Kreme hot now sign, Tony?

00:04:34.666 --> 00:04:35.146
Tony's not.

00:04:35.166 --> 00:04:35.567
That's good.

00:04:35.668 --> 00:04:36.007
I wasn't.

00:04:36.247 --> 00:04:36.648
Dave is.

00:04:36.708 --> 00:04:37.108
All right.

00:04:37.149 --> 00:04:38.649
So how do you explain the

00:04:38.709 --> 00:04:41.211
hot now sign at a Krispy Kreme donut?

00:04:42.694 --> 00:04:45.076
So if it's lit up,

00:04:46.117 --> 00:04:46.978
I think more people

00:04:47.137 --> 00:04:50.281
potentially pull over because listen, I'm,

00:04:50.622 --> 00:04:52.122
I'm maybe some family

00:04:52.142 --> 00:04:53.004
members say I have a sweet tooth.

00:04:53.043 --> 00:04:53.685
I don't buy,

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I don't go out of my way to

00:04:54.404 --> 00:04:56.487
buy sweet stuff, but if it's there,

00:04:56.807 --> 00:04:57.387
if it's there,

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You know,

00:04:59.730 --> 00:05:01.632
I'm on the road with my family

00:05:02.232 --> 00:05:04.033
visiting South Jersey and like here,

00:05:04.052 --> 00:05:06.415
like a lemon icy cake, you know?

00:05:06.654 --> 00:05:06.875
Yeah.

00:05:06.915 --> 00:05:08.196
So, okay.

00:05:08.216 --> 00:05:10.158
So the Krispy Kreme sign, if it's lit up,

00:05:10.478 --> 00:05:13.480
it's like it attracts the way that,

00:05:13.579 --> 00:05:16.562
you know, a bug zapper attracts bugs.

00:05:16.923 --> 00:05:19.303
It will attract a human that

00:05:19.324 --> 00:05:20.444
has had Krispy Kreme donuts

00:05:20.464 --> 00:05:21.425
that are hot because there

00:05:21.545 --> 00:05:23.226
is a big difference between

00:05:23.247 --> 00:05:24.148
when they're hot off the

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press versus six or twelve hours later.

00:05:27.386 --> 00:05:27.886
Correct.

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So it essentially it is

00:05:29.326 --> 00:05:30.648
literally quite literally a

00:05:30.747 --> 00:05:32.249
neon sign that is in the

00:05:32.269 --> 00:05:33.970
window that is not lit

00:05:34.690 --> 00:05:36.651
unless they're like donuts

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are rolling off the line.

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So they're not making donuts

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as much as I wanted to

00:05:41.435 --> 00:05:43.817
believe the the Dunkin Donuts commercial.

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Time to make the donuts, right?

00:05:46.458 --> 00:05:48.899
But it's quite literally a beacon.

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And then I believe this is a

00:05:50.959 --> 00:05:52.540
smart move if you have the app.

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Yeah, here it is.

00:05:53.060 --> 00:05:54.279
This is exactly what it looks like.

00:05:54.319 --> 00:05:55.201
It's hot now,

00:05:55.600 --> 00:05:56.740
but it's off when they're not

00:05:56.781 --> 00:05:57.300
making donuts.

00:05:57.321 --> 00:05:58.901
So you drive by and you're like, hey, bro,

00:05:58.942 --> 00:05:59.422
hot now.

00:05:59.502 --> 00:06:00.382
I'm picking up a dozen and

00:06:00.403 --> 00:06:01.423
coming back to the office.

00:06:02.083 --> 00:06:04.283
So they're pulling levers of psychology.

00:06:05.540 --> 00:06:07.961
And they're saying like, why is it?

00:06:07.980 --> 00:06:08.641
Why does it work?

00:06:08.961 --> 00:06:11.161
Scarcity, it's better hot.

00:06:11.882 --> 00:06:12.781
It's hot now,

00:06:12.822 --> 00:06:14.182
but in twenty minutes it might not be.

00:06:14.581 --> 00:06:16.742
It quite literally is a Pavlovian trigger.

00:06:16.802 --> 00:06:17.963
It's the bell that is making

00:06:17.983 --> 00:06:18.682
your mouth water.

00:06:19.142 --> 00:06:20.343
FOMO and ritual.

00:06:20.744 --> 00:06:21.223
It's like, hey,

00:06:21.264 --> 00:06:22.163
I brought them in for the office.

00:06:22.444 --> 00:06:23.863
People like us do things like this.

00:06:23.903 --> 00:06:24.985
This is what we do when they're hot.

00:06:25.024 --> 00:06:26.264
Now we bring them into the office.

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And visibility,

00:06:27.466 --> 00:06:29.387
it makes the invisible visible.

00:06:29.648 --> 00:06:31.050
So how could healthcare or

00:06:31.089 --> 00:06:33.151
PT clinics steal this?

00:06:33.692 --> 00:06:35.415
And I wanted to do something

00:06:35.735 --> 00:06:36.855
with a rep counter.

00:06:37.872 --> 00:06:39.975
Imagine you had an analog,

00:06:39.995 --> 00:06:40.574
we're gonna talk about

00:06:40.675 --> 00:06:41.636
analog and paper in a

00:06:41.696 --> 00:06:42.836
digital world with AI,

00:06:43.216 --> 00:06:44.958
but imagine you could, you installed,

00:06:44.978 --> 00:06:45.557
you had a clinic,

00:06:45.577 --> 00:06:46.298
I got a buddy who has a

00:06:46.338 --> 00:06:47.218
clinic up the road on a

00:06:47.300 --> 00:06:48.279
decently busy road,

00:06:48.620 --> 00:06:50.802
and you had an analog counter,

00:06:51.182 --> 00:06:51.641
like the little,

00:06:51.663 --> 00:06:52.802
like the flip down counter.

00:06:52.882 --> 00:06:54.103
You could do a digital too, right?

00:06:54.144 --> 00:06:55.305
Digital billboards are expensive,

00:06:55.324 --> 00:06:56.305
but they're not that expensive.

00:06:56.826 --> 00:06:58.206
Could you have some sort of

00:06:58.348 --> 00:07:01.250
metric like squats, deadlifts?

00:07:01.711 --> 00:07:03.211
Could you have a group goal

00:07:03.312 --> 00:07:04.494
in the community to get to

00:07:04.774 --> 00:07:06.576
ten thousand squats in a month?

00:07:06.615 --> 00:07:07.416
And if we do,

00:07:07.776 --> 00:07:08.958
we'll help buy a new park

00:07:08.997 --> 00:07:09.778
down the street.

00:07:10.098 --> 00:07:11.360
So what you're doing is

00:07:11.961 --> 00:07:13.021
you're removing the black

00:07:13.062 --> 00:07:14.202
box mentality of.

00:07:14.843 --> 00:07:16.225
There's a PT clinic over there.

00:07:16.487 --> 00:07:17.127
What happens?

00:07:17.408 --> 00:07:17.709
PT.

00:07:18.290 --> 00:07:20.593
You can't use the word in the definition.

00:07:20.874 --> 00:07:21.475
What's PT?

00:07:21.654 --> 00:07:22.156
I don't know.

00:07:22.276 --> 00:07:22.776
Stuff.

00:07:23.016 --> 00:07:24.038
They do a little of this

00:07:24.119 --> 00:07:25.240
rubbing and then they make

00:07:25.261 --> 00:07:26.382
you move and they do bridges.

00:07:26.824 --> 00:07:27.865
This makes the invisible

00:07:27.884 --> 00:07:28.867
visible and I like it.

00:07:30.694 --> 00:07:32.254
It actually builds curiosity,

00:07:32.314 --> 00:07:33.656
especially for people driving by.

00:07:34.036 --> 00:07:35.317
What is going on in there?

00:07:35.697 --> 00:07:36.499
The best marketing you

00:07:36.519 --> 00:07:37.399
didn't have to pay for is

00:07:37.420 --> 00:07:38.379
you're having people do that.

00:07:38.641 --> 00:07:40.262
So the community challenge would be nice.

00:07:40.322 --> 00:07:41.642
Ten thousand reps this month

00:07:41.682 --> 00:07:42.983
and we'll donate to a local cause.

00:07:43.305 --> 00:07:43.944
You're probably going to do

00:07:43.964 --> 00:07:44.906
it to that cause anyway.

00:07:45.125 --> 00:07:45.726
But now you're helping

00:07:45.747 --> 00:07:47.728
people help you earn that thing.

00:07:48.069 --> 00:07:49.389
And it makes the clinic feel alive.

00:07:49.470 --> 00:07:49.629
Like,

00:07:49.810 --> 00:07:52.172
could you have this hot now mentality?

00:07:52.432 --> 00:07:52.872
P.T.

00:07:52.892 --> 00:07:53.773
is happening here.

00:07:54.814 --> 00:07:56.353
uh outside of the clinic you

00:07:56.374 --> 00:07:57.435
know bonus points is every

00:07:57.475 --> 00:07:58.654
time someone does something

00:07:58.995 --> 00:07:59.834
you know youtube is really

00:07:59.855 --> 00:08:00.615
great at this when you hit

00:08:00.634 --> 00:08:02.076
a milestone you get an

00:08:02.255 --> 00:08:03.396
email saying you hit number

00:08:03.415 --> 00:08:04.935
of views but they frame it

00:08:04.975 --> 00:08:06.576
up in a badge for you to

00:08:07.016 --> 00:08:08.817
share externally right

00:08:08.857 --> 00:08:10.577
which is so dumb and even

00:08:10.598 --> 00:08:11.497
when I know the trick is

00:08:11.538 --> 00:08:13.057
happening to me I still

00:08:13.098 --> 00:08:14.178
fall for it because I'm a

00:08:14.218 --> 00:08:15.959
big dumb animal so how

00:08:15.978 --> 00:08:17.939
could you steal the hot now

00:08:18.579 --> 00:08:20.019
strategy from krispy kreme

00:08:20.839 --> 00:08:21.641
my vote is make the

00:08:21.680 --> 00:08:23.000
invisible visible and put

00:08:23.062 --> 00:08:24.081
it out there somewhere.

00:08:24.482 --> 00:08:26.163
I actually like the digital version,

00:08:26.202 --> 00:08:26.384
right?

00:08:26.403 --> 00:08:27.483
Like posted on Instagram,

00:08:27.824 --> 00:08:29.204
but that's done so much.

00:08:29.526 --> 00:08:31.005
I like the analog thing.

00:08:31.086 --> 00:08:32.707
Like now bell bottoms are

00:08:32.727 --> 00:08:33.927
coming back in kids.

00:08:33.967 --> 00:08:34.729
And in two years,

00:08:34.749 --> 00:08:35.909
all bottles will be back in

00:08:35.929 --> 00:08:36.549
because they were in,

00:08:36.590 --> 00:08:37.350
then they were out and then

00:08:37.370 --> 00:08:38.091
they're back in again.

00:08:38.390 --> 00:08:39.652
So that's my still the strategy.

00:08:40.615 --> 00:08:41.894
I want to hear how Dave can

00:08:41.955 --> 00:08:44.235
roll that into a mobile kind of business.

00:08:44.336 --> 00:08:45.115
I know for me,

00:08:45.235 --> 00:08:46.975
like the easiest thing is always,

00:08:47.035 --> 00:08:49.616
you know, create a team, whether it's a,

00:08:49.897 --> 00:08:52.136
it's an actual team or a virtual team,

00:08:52.157 --> 00:08:53.957
but group patients together.

00:08:54.418 --> 00:08:56.038
Hey, you're purple, you're black,

00:08:56.077 --> 00:08:56.658
you're blue.

00:08:56.717 --> 00:08:58.318
We're going to compete against each other.

00:08:58.379 --> 00:09:00.078
We're going to achieve so many steps,

00:09:00.099 --> 00:09:02.139
so many reps, so many pounds lifted.

00:09:02.980 --> 00:09:05.580
Um, I think Strava and a couple other,

00:09:05.700 --> 00:09:06.980
you know, apps or do,

00:09:07.181 --> 00:09:09.020
do that kind of gamification, um,

00:09:09.866 --> 00:09:11.748
And then just run a monthly

00:09:12.008 --> 00:09:13.947
competition every twenty eight days,

00:09:14.008 --> 00:09:16.808
you know, which team won this this month.

00:09:17.528 --> 00:09:19.870
And if you do discharge a patient,

00:09:19.970 --> 00:09:20.990
then you fill that spot

00:09:21.029 --> 00:09:22.191
with another patient.

00:09:22.291 --> 00:09:23.130
You could even you could

00:09:23.191 --> 00:09:26.672
even go to like what the NFL does.

00:09:26.711 --> 00:09:28.732
You could have teams draft new patients.

00:09:28.773 --> 00:09:30.173
Like imagine you're a new

00:09:30.212 --> 00:09:31.293
patient coming into a

00:09:31.333 --> 00:09:32.453
physical therapy clinic.

00:09:32.793 --> 00:09:33.494
You're scared.

00:09:33.514 --> 00:09:34.335
You're in pain.

00:09:34.375 --> 00:09:36.394
You don't have any connection to anybody.

00:09:36.855 --> 00:09:37.794
And all of a sudden you're

00:09:37.855 --> 00:09:39.096
up on the draft board and

00:09:39.135 --> 00:09:40.775
like teams are battling for you.

00:09:40.836 --> 00:09:42.596
And we want John to be on our team.

00:09:42.636 --> 00:09:43.756
And, you know, you,

00:09:43.836 --> 00:09:45.418
you establish that culture.

00:09:45.758 --> 00:09:46.998
I think it's such a warm

00:09:47.057 --> 00:09:49.058
invitation into the community,

00:09:49.678 --> 00:09:51.458
but I would struggle to see

00:09:51.499 --> 00:09:53.440
how you do it in a mobile business.

00:09:54.977 --> 00:09:56.719
yeah I I was thinking tony

00:09:56.739 --> 00:09:58.039
would maybe not even like

00:09:58.320 --> 00:10:00.461
like it uh and and say uh

00:10:00.480 --> 00:10:01.981
jokingly like you know

00:10:02.001 --> 00:10:03.023
tallying up units like

00:10:03.062 --> 00:10:04.583
billable units and for us

00:10:04.663 --> 00:10:05.684
you know mobile visits like

00:10:06.065 --> 00:10:06.804
I guess it's more about

00:10:06.946 --> 00:10:08.505
visits and maybe less about

00:10:08.546 --> 00:10:10.126
reps because you can't uh

00:10:10.227 --> 00:10:11.008
group people together I

00:10:11.048 --> 00:10:13.068
think the the best idea so

00:10:13.089 --> 00:10:14.830
far from this is already

00:10:14.870 --> 00:10:15.650
what tony just said about

00:10:15.691 --> 00:10:16.871
groups there's something called

00:10:17.432 --> 00:10:19.052
uh the athletic I believe it

00:10:19.072 --> 00:10:19.932
started in new york city it

00:10:19.952 --> 00:10:21.513
was invested by um ann

00:10:21.552 --> 00:10:22.913
malum and was the one that

00:10:22.974 --> 00:10:24.234
sold solid core for like

00:10:24.553 --> 00:10:25.474
eighty million dollars or

00:10:25.514 --> 00:10:26.274
something she raised

00:10:26.394 --> 00:10:27.634
private equity money and

00:10:27.695 --> 00:10:29.134
she invested in a company

00:10:29.796 --> 00:10:30.895
in new york city it's like

00:10:30.956 --> 00:10:32.956
group fitness but it's like

00:10:33.596 --> 00:10:35.336
if I sign up I'm with the

00:10:35.397 --> 00:10:37.118
same people tuesday and

00:10:37.158 --> 00:10:38.658
thursday at six thirty pm

00:10:38.697 --> 00:10:40.038
it's the same six or eight

00:10:40.078 --> 00:10:40.818
or whatever people

00:10:41.658 --> 00:10:43.200
And obviously it builds community.

00:10:43.759 --> 00:10:45.421
And obviously people know

00:10:45.500 --> 00:10:47.643
like if I'm out and I'm not

00:10:47.663 --> 00:10:48.964
there at the workout class together.

00:10:49.443 --> 00:10:50.605
So I think the grouping

00:10:50.644 --> 00:10:51.424
patients together actually

00:10:51.445 --> 00:10:52.164
would be a great idea.

00:10:52.205 --> 00:10:52.946
Then you could, you know,

00:10:53.066 --> 00:10:55.427
maybe you could group

00:10:55.466 --> 00:10:56.347
people together based off

00:10:56.388 --> 00:10:57.227
of like conditions or

00:10:57.249 --> 00:10:58.489
diagnosis or whatever to

00:10:58.548 --> 00:10:59.610
make sure it's somewhat

00:10:59.730 --> 00:11:00.650
even or fair or whatever.

00:11:00.691 --> 00:11:00.890
But yeah.

00:11:01.530 --> 00:11:02.332
I think the group thing,

00:11:02.373 --> 00:11:03.774
like at Tony's clinic, Tony,

00:11:04.196 --> 00:11:04.996
do you think it would be,

00:11:05.116 --> 00:11:06.519
if you were to do this, would it be,

00:11:06.940 --> 00:11:07.240
you know,

00:11:07.400 --> 00:11:09.465
groups of two or four or six or like what,

00:11:09.544 --> 00:11:11.168
what type of number would that even like,

00:11:11.628 --> 00:11:12.308
how would it even make

00:11:12.350 --> 00:11:14.714
sense based off of like your volume?

00:11:15.345 --> 00:11:17.245
Yeah, it's totally arbitrary,

00:11:17.265 --> 00:11:18.606
but I would say groups of four,

00:11:18.706 --> 00:11:20.327
four seems to be a good number.

00:11:21.568 --> 00:11:23.288
When I look at our patient volume,

00:11:23.389 --> 00:11:25.650
I look at the actual physical space,

00:11:25.671 --> 00:11:26.750
like how many people could

00:11:26.791 --> 00:11:28.572
we fit into the physical space?

00:11:29.312 --> 00:11:31.474
And these groups form naturally, you know,

00:11:31.533 --> 00:11:33.414
so we have a non-covered

00:11:33.455 --> 00:11:35.755
maintenance program, a wellness program,

00:11:35.876 --> 00:11:36.917
independent exercise,

00:11:36.937 --> 00:11:38.018
whatever you want to call it.

00:11:38.618 --> 00:11:41.698
But these little subsets of individuals,

00:11:41.778 --> 00:11:43.200
we have our Tuesday morning,

00:11:44.059 --> 00:11:46.380
nine thirty to ten thirty a.m.

00:11:46.441 --> 00:11:46.760
group.

00:11:46.900 --> 00:11:48.241
They just they come together.

00:11:48.302 --> 00:11:49.221
They socialize.

00:11:49.241 --> 00:11:50.341
Some of them are neighbors.

00:11:50.721 --> 00:11:51.582
And then we have a different

00:11:51.602 --> 00:11:53.003
group on Monday, Wednesday,

00:11:53.043 --> 00:11:53.764
Friday mornings.

00:11:53.803 --> 00:11:55.783
We have a third group Tuesday,

00:11:55.823 --> 00:11:56.924
Thursday afternoon and a

00:11:56.965 --> 00:11:59.245
fourth group Monday, Monday,

00:11:59.285 --> 00:12:00.105
Wednesday afternoon.

00:12:00.981 --> 00:12:03.203
So they naturally kind of

00:12:03.264 --> 00:12:04.745
congregate and come in together.

00:12:04.764 --> 00:12:05.664
And once they've started

00:12:05.725 --> 00:12:07.166
seeing each other for a while,

00:12:07.586 --> 00:12:08.807
they're like, hey, where's John?

00:12:08.866 --> 00:12:09.648
Where's Dave?

00:12:09.847 --> 00:12:11.109
Where's Mary?

00:12:12.509 --> 00:12:13.591
But it seems to me just

00:12:13.750 --> 00:12:16.172
based on my experience, groups of four,

00:12:16.413 --> 00:12:17.413
probably ideal.

00:12:18.193 --> 00:12:20.495
I would do twenty, thirty minute sessions.

00:12:20.575 --> 00:12:21.615
I'd get them out of here.

00:12:22.255 --> 00:12:24.018
I shared that video with you guys.

00:12:24.238 --> 00:12:25.658
I don't know if we want to show it,

00:12:26.820 --> 00:12:27.220
but yeah.

00:12:28.880 --> 00:12:30.241
One of the features

00:12:30.302 --> 00:12:31.562
mentioned in that video,

00:12:31.582 --> 00:12:33.683
besides all the innovation and technology,

00:12:34.345 --> 00:12:36.466
a ten-minute session.

00:12:37.046 --> 00:12:37.826
I don't even remember the

00:12:37.846 --> 00:12:38.548
name of the company,

00:12:38.607 --> 00:12:39.847
but the girl was like, yeah,

00:12:39.888 --> 00:12:41.690
in ten minutes I get my workout in.

00:12:42.543 --> 00:12:44.985
People don't need sixty minutes.

00:12:45.205 --> 00:12:47.005
It depends on what you are selling.

00:12:47.405 --> 00:12:49.386
Topgolf became more popular

00:12:49.407 --> 00:12:50.628
than golf because you could

00:12:50.668 --> 00:12:52.109
do it in less than an hour.

00:12:52.129 --> 00:12:53.509
You could leave whenever you want.

00:12:53.549 --> 00:12:55.311
You could hit the balls and go.

00:12:55.652 --> 00:12:56.371
You don't have to be

00:12:56.412 --> 00:12:57.873
committed to a four hour,

00:12:58.013 --> 00:12:59.274
eighteen hole course.

00:12:59.889 --> 00:13:00.870
I played a six and a half

00:13:00.889 --> 00:13:02.671
hour round this week because of rain.

00:13:02.730 --> 00:13:03.750
And it was a charity tournament.

00:13:03.770 --> 00:13:04.631
So we're backed up a little bit,

00:13:04.672 --> 00:13:05.471
six and a half hours.

00:13:05.511 --> 00:13:06.513
Listen, I like golf.

00:13:06.832 --> 00:13:08.673
If golf had twelve to fourteen holes,

00:13:08.734 --> 00:13:10.274
I'd be more apt to play.

00:13:10.674 --> 00:13:11.995
When I hit like fifteen, I'm like,

00:13:12.216 --> 00:13:12.975
I turn to my best friend

00:13:13.015 --> 00:13:13.517
most of the time.

00:13:13.856 --> 00:13:14.957
How many more holes we got?

00:13:15.018 --> 00:13:16.698
He's like, he'd play thirty six.

00:13:17.078 --> 00:13:17.979
I want to play nine.

00:13:18.379 --> 00:13:18.679
Right.

00:13:18.919 --> 00:13:19.779
And I think more people are

00:13:19.820 --> 00:13:20.500
probably like me.

00:13:21.221 --> 00:13:22.863
yeah I'll play I'll play

00:13:22.942 --> 00:13:24.745
nine on an executive I

00:13:24.764 --> 00:13:26.606
would rather do six six

00:13:26.667 --> 00:13:28.448
holes on a par three I'm

00:13:28.568 --> 00:13:29.730
I'm in heaven like let's go

00:13:29.750 --> 00:13:30.770
get a drink now and hang

00:13:30.850 --> 00:13:31.871
out there's the tournament

00:13:31.892 --> 00:13:33.833
we do it's the it's the uh

00:13:33.894 --> 00:13:34.995
breck pc breakfast club

00:13:35.034 --> 00:13:37.298
invitational six holes you

00:13:37.337 --> 00:13:38.979
cannot start hole two until

00:13:38.999 --> 00:13:40.100
you finish your first beer

00:13:40.400 --> 00:13:41.542
so you finish a six pack

00:13:41.881 --> 00:13:44.264
and six holes in forty nine minutes

00:13:45.663 --> 00:13:46.582
Let's go do it down in

00:13:46.623 --> 00:13:49.644
Florida at the indoor facility.

00:13:49.683 --> 00:13:50.943
What, six-pack per person?

00:13:51.464 --> 00:13:51.984
A beer hole.

00:13:52.043 --> 00:13:52.703
In nine minutes?

00:13:53.144 --> 00:13:55.304
A beer hole.

00:13:55.325 --> 00:13:56.605
But a six-pack in an hour,

00:13:56.625 --> 00:13:58.166
that's chugging.

00:13:58.666 --> 00:13:58.926
Listen,

00:13:59.005 --> 00:14:00.566
we called it bad boy golf in college.

00:14:00.686 --> 00:14:01.265
This wasn't good.

00:14:01.446 --> 00:14:03.647
All right, I asked a question on Tuesday.

00:14:03.687 --> 00:14:04.846
This was Hot Take Tuesday,

00:14:05.307 --> 00:14:06.386
and this is what we wanted to talk about,

00:14:06.427 --> 00:14:06.626
right?

00:14:07.126 --> 00:14:08.048
And I brought this up before.

00:14:08.107 --> 00:14:09.128
It sounds like I'm nitpicking,

00:14:09.347 --> 00:14:10.508
and maybe I am, but that's what I do.

00:14:10.528 --> 00:14:11.508
I'm a professional nitpicker.

00:14:12.248 --> 00:14:14.188
Everybody in PT seems to

00:14:14.229 --> 00:14:15.089
hate mill clinics.

00:14:16.104 --> 00:14:18.184
but nobody can point to one.

00:14:18.205 --> 00:14:19.245
You can't actually tell me what it is.

00:14:19.265 --> 00:14:19.745
When I ask,

00:14:19.765 --> 00:14:20.826
the numbers are all over the place.

00:14:21.246 --> 00:14:22.427
Is it the number of locations,

00:14:22.467 --> 00:14:24.688
the volume of patients, or is it vibe?

00:14:25.690 --> 00:14:26.610
Is it cookie cutter?

00:14:26.951 --> 00:14:27.831
So is it objective?

00:14:27.871 --> 00:14:28.631
Is it subjective?

00:14:28.652 --> 00:14:30.013
Do you only know it when you see it?

00:14:30.232 --> 00:14:31.634
If so, hey,

00:14:31.854 --> 00:14:33.294
touch your ear when you're in

00:14:33.335 --> 00:14:34.515
front of one, show me one.

00:14:34.615 --> 00:14:36.037
I don't know what it is.

00:14:36.397 --> 00:14:37.116
So I was like, okay,

00:14:37.658 --> 00:14:38.999
let's create a checklist.

00:14:39.759 --> 00:14:40.840
Is it number of locations?

00:14:40.899 --> 00:14:42.842
Patients seen per hour by one PT?

00:14:42.962 --> 00:14:44.725
Average time spent per session?

00:14:44.764 --> 00:14:46.066
Everybody's in love or for a

00:14:46.105 --> 00:14:46.907
while I feel like they were

00:14:46.927 --> 00:14:49.250
in love with the one-on-one for an hour.

00:14:49.590 --> 00:14:50.971
Is it using text or aids?

00:14:51.611 --> 00:14:52.734
Is it plan of care driven

00:14:52.754 --> 00:14:53.615
more by insurance?

00:14:53.894 --> 00:14:54.836
Like what is it?

00:14:55.336 --> 00:14:56.096
And then how many do you

00:14:56.136 --> 00:14:58.460
need to check off of a list

00:14:58.519 --> 00:14:59.620
before you're deemed a mill?

00:15:00.402 --> 00:15:02.504
fun fact I had two different

00:15:02.543 --> 00:15:05.025
people who work for large

00:15:05.086 --> 00:15:07.028
pt organizations dm me I'm

00:15:07.048 --> 00:15:07.729
not going to say who they

00:15:07.749 --> 00:15:08.870
were and they were like

00:15:09.269 --> 00:15:10.591
thank you for saying this

00:15:10.850 --> 00:15:12.133
because that that person

00:15:12.173 --> 00:15:13.614
gets accused at working for

00:15:13.653 --> 00:15:15.154
a pt mill a lot and they're

00:15:15.174 --> 00:15:15.995
like but you can't tell me

00:15:16.015 --> 00:15:17.277
what it is so they agreed

00:15:17.297 --> 00:15:17.977
with me of course now

00:15:17.998 --> 00:15:18.938
they're getting they're

00:15:18.958 --> 00:15:20.360
getting called this spade

00:15:20.399 --> 00:15:21.260
is getting called a spade

00:15:21.280 --> 00:15:22.142
right I don't know if

00:15:22.682 --> 00:15:23.243
If there are milkers,

00:15:23.283 --> 00:15:24.124
I can't identify one.

00:15:24.423 --> 00:15:25.745
When you hear these questions,

00:15:26.186 --> 00:15:28.067
you guys are sort of opposites, right?

00:15:28.168 --> 00:15:29.589
Mobile one on one cash pay

00:15:29.609 --> 00:15:30.811
New York City and then

00:15:30.870 --> 00:15:32.192
Tony's brick and mortar in Ohio.

00:15:33.133 --> 00:15:34.254
What is this question or

00:15:34.293 --> 00:15:35.054
what does this prompt set

00:15:35.075 --> 00:15:37.336
off for both of you?

00:15:37.356 --> 00:15:38.678
Dave, why don't you go off?

00:15:39.895 --> 00:15:40.596
Well,

00:15:40.636 --> 00:15:42.538
I commented on Jimmy's post and I

00:15:42.577 --> 00:15:44.259
said a physical therapy

00:15:44.298 --> 00:15:46.541
practice that books and

00:15:46.740 --> 00:15:48.682
treats for patients per hour,

00:15:49.442 --> 00:15:51.043
I think could be defined as a mill.

00:15:51.104 --> 00:15:52.725
Now, the funny thing is,

00:15:52.764 --> 00:15:53.745
is like Tony always says,

00:15:53.785 --> 00:15:54.567
is there's a lot of

00:15:54.606 --> 00:15:55.647
patients across the country

00:15:56.008 --> 00:15:57.629
that are okay with that experience.

00:15:57.649 --> 00:15:58.509
They're fine with that.

00:15:58.850 --> 00:16:00.030
It's the therapists that are

00:16:00.211 --> 00:16:00.870
not okay with it.

00:16:00.890 --> 00:16:01.731
It's the therapists that

00:16:01.792 --> 00:16:02.511
actually have had

00:16:02.692 --> 00:16:03.513
challenges or issues

00:16:03.533 --> 00:16:04.913
because it's more documentation,

00:16:04.953 --> 00:16:05.575
it's more notes.

00:16:06.315 --> 00:16:07.535
uh management is you know

00:16:07.596 --> 00:16:08.895
forcing productivity and

00:16:09.576 --> 00:16:10.777
having them see twelve or

00:16:10.856 --> 00:16:11.917
sixteen or eighteen or

00:16:11.976 --> 00:16:13.618
twenty or thirty patients a

00:16:13.638 --> 00:16:14.477
day in some clinics it

00:16:14.498 --> 00:16:15.798
depends on obviously the

00:16:15.839 --> 00:16:17.479
clinic uh and and tony is

00:16:17.519 --> 00:16:18.620
brick and mortar in network

00:16:18.639 --> 00:16:19.960
but still very different

00:16:19.980 --> 00:16:21.801
than a lot of the uh bigger

00:16:21.841 --> 00:16:23.241
corporates out there so my

00:16:23.282 --> 00:16:24.642
comment was like I like

00:16:24.662 --> 00:16:26.222
jimmy posed as he usually

00:16:26.243 --> 00:16:28.202
does and oftentimes um tony

00:16:28.222 --> 00:16:30.504
does like a question and I

00:16:30.524 --> 00:16:31.605
was like here's an answer

00:16:31.625 --> 00:16:32.745
like no one in the comments

00:16:32.764 --> 00:16:33.806
was giving an actual answer

00:16:35.346 --> 00:16:36.346
and that's my opinion on an

00:16:36.447 --> 00:16:37.628
answer all the other things

00:16:37.648 --> 00:16:38.868
are kind of like you know

00:16:39.009 --> 00:16:41.309
symptoms of the thing but

00:16:41.350 --> 00:16:42.311
the thing is obviously it's

00:16:42.331 --> 00:16:43.510
like a productivity measure

00:16:43.551 --> 00:16:44.631
coming down from corporate

00:16:44.652 --> 00:16:46.133
or the ownership because

00:16:46.173 --> 00:16:47.354
reimbursement has plateaued

00:16:47.394 --> 00:16:48.615
or in some cases decreased

00:16:48.695 --> 00:16:49.956
from the last ten or

00:16:49.995 --> 00:16:50.916
fifteen or twenty or

00:16:50.936 --> 00:16:52.817
whatever years and so a

00:16:52.878 --> 00:16:53.918
really simple thing is like

00:16:53.977 --> 00:16:54.778
how is the schedule

00:16:54.798 --> 00:16:55.778
developed when I my first

00:16:55.798 --> 00:16:56.620
job out of school it was a

00:16:56.679 --> 00:16:57.520
physician-owned practice

00:16:57.561 --> 00:16:59.061
but a great mentor a

00:16:59.101 --> 00:16:59.782
physical therapist that

00:16:59.802 --> 00:17:00.942
brought me in there and it

00:17:00.962 --> 00:17:02.303
was three patients booked

00:17:03.104 --> 00:17:04.445
And typically arrive and treated,

00:17:04.486 --> 00:17:05.866
obviously, ten percent, cancel,

00:17:05.906 --> 00:17:06.708
no shorty or whatever.

00:17:07.189 --> 00:17:08.369
But the schedule was three

00:17:08.410 --> 00:17:09.510
patients an hour.

00:17:10.432 --> 00:17:12.394
But there was an aid and at

00:17:12.453 --> 00:17:13.375
times it was busy.

00:17:13.955 --> 00:17:16.038
And now more and more

00:17:16.057 --> 00:17:16.699
therapists coming out of

00:17:16.719 --> 00:17:18.340
school do not want to work in that model.

00:17:18.401 --> 00:17:19.801
And so therefore, that model has been.

00:17:21.084 --> 00:17:22.605
uh you know I don't know

00:17:22.665 --> 00:17:24.728
poked at it's been a part

00:17:24.748 --> 00:17:25.910
of the focus of the

00:17:25.930 --> 00:17:26.851
profession with therapists

00:17:27.230 --> 00:17:27.811
whether it's facebook

00:17:27.832 --> 00:17:28.532
groups it's linkedin

00:17:28.573 --> 00:17:29.954
whatever so that's my

00:17:29.994 --> 00:17:31.596
thought is like and now

00:17:31.616 --> 00:17:32.778
just because if tony's

00:17:32.858 --> 00:17:33.579
practice or some other

00:17:33.619 --> 00:17:35.162
practice does book and

00:17:35.182 --> 00:17:36.103
treat four patients per

00:17:36.123 --> 00:17:38.184
hour per therapist per pt or pta

00:17:39.557 --> 00:17:40.718
It's not necessarily a bad thing.

00:17:40.758 --> 00:17:41.538
I think it's a bad thing

00:17:41.598 --> 00:17:43.080
when all the patients are

00:17:43.101 --> 00:17:43.701
just getting the same

00:17:43.741 --> 00:17:45.903
exercise or they're all

00:17:45.923 --> 00:17:46.965
getting billed four units,

00:17:47.006 --> 00:17:47.826
but they're all being

00:17:47.886 --> 00:17:49.669
treated like simultaneously

00:17:49.689 --> 00:17:50.690
and it's not one-on-one and

00:17:50.730 --> 00:17:52.132
obviously that would be fraudulent.

00:17:52.192 --> 00:17:54.894
So I think four patients an

00:17:54.934 --> 00:17:56.656
hour booked and treated would be a mill,

00:17:56.737 --> 00:17:57.857
but I'm saying a mill is

00:17:57.897 --> 00:17:59.240
not necessarily a bad thing.

00:18:00.665 --> 00:18:01.987
Yeah, I love it.

00:18:02.086 --> 00:18:02.527
I agree.

00:18:02.567 --> 00:18:03.627
Like a mill is not

00:18:03.688 --> 00:18:04.988
necessarily a bad thing.

00:18:06.128 --> 00:18:07.490
We all want to complain

00:18:07.950 --> 00:18:10.672
about how expensive health care is.

00:18:11.352 --> 00:18:13.212
Yet once we develop an

00:18:13.252 --> 00:18:14.814
effective system to deliver

00:18:14.854 --> 00:18:16.795
an outcome for lower costs,

00:18:16.914 --> 00:18:17.875
everybody freaks out.

00:18:18.846 --> 00:18:21.108
It's one of those deals where it's like,

00:18:21.128 --> 00:18:23.089
all right, let's dig deeper.

00:18:23.130 --> 00:18:24.530
Let's go behind the question.

00:18:24.611 --> 00:18:25.991
What does this really mean?

00:18:26.832 --> 00:18:29.012
I've never heard a patient come in and say,

00:18:29.212 --> 00:18:30.814
oh, that place is a therapy mill.

00:18:30.854 --> 00:18:31.795
They don't know.

00:18:31.835 --> 00:18:32.515
They don't care.

00:18:33.536 --> 00:18:34.596
I've shared this story.

00:18:35.876 --> 00:18:37.719
I took a picture two days ago.

00:18:38.749 --> 00:18:39.769
Inside my clinic.

00:18:40.049 --> 00:18:41.230
So I took a picture because

00:18:41.289 --> 00:18:42.691
I was teaching my Medicare

00:18:42.730 --> 00:18:43.432
billing course.

00:18:43.451 --> 00:18:44.352
And I was like, look, guys,

00:18:44.392 --> 00:18:45.833
this is a scene inside my

00:18:45.873 --> 00:18:46.732
clinic this morning.

00:18:47.314 --> 00:18:49.934
I had a mother son to both patients.

00:18:50.635 --> 00:18:52.115
I had a husband and wife,

00:18:52.696 --> 00:18:54.397
both independent exercisers

00:18:54.417 --> 00:18:55.798
that had been patients now

00:18:55.837 --> 00:18:58.019
transition to a wellness program.

00:18:58.480 --> 00:19:00.701
And I had a third or yeah,

00:19:00.721 --> 00:19:01.821
I guess a third patient.

00:19:02.461 --> 00:19:05.604
So five people, one therapist.

00:19:06.259 --> 00:19:07.380
We had an amazing time.

00:19:07.661 --> 00:19:08.560
Everybody was happy.

00:19:08.621 --> 00:19:09.961
Everyone was having fun.

00:19:10.001 --> 00:19:11.422
Like everybody was getting better.

00:19:11.541 --> 00:19:13.522
And I would tell you that

00:19:13.982 --> 00:19:15.263
nobody felt ignored.

00:19:15.884 --> 00:19:18.464
Nobody felt like this is the real problem.

00:19:18.545 --> 00:19:19.705
Patients complain,

00:19:19.786 --> 00:19:21.546
not about too many people.

00:19:21.586 --> 00:19:23.507
They complain about feeling ignored.

00:19:23.547 --> 00:19:25.008
They complain about the

00:19:25.048 --> 00:19:26.608
therapist in the computer

00:19:26.769 --> 00:19:28.368
and not focused on, you know,

00:19:28.828 --> 00:19:30.609
making me feel paid

00:19:30.630 --> 00:19:32.770
attention to listen to their jokes,

00:19:32.830 --> 00:19:34.771
laugh at them, listen to their stories.

00:19:35.132 --> 00:19:36.992
connect people to each other,

00:19:37.532 --> 00:19:39.253
nobody feels like they're

00:19:39.273 --> 00:19:40.433
getting a bad experience.

00:19:41.694 --> 00:19:44.455
And so back to you bill appropriately,

00:19:44.496 --> 00:19:46.175
like Dave said, there are, you know,

00:19:46.236 --> 00:19:48.717
CPT codes, there's one on one services,

00:19:48.757 --> 00:19:49.877
there's this stuff.

00:19:50.698 --> 00:19:52.439
But if you can check those boxes,

00:19:53.483 --> 00:19:55.305
you can make a person in a

00:19:55.345 --> 00:19:57.486
group feel just as special

00:19:57.546 --> 00:19:59.548
as a person in an individual setting.

00:19:59.567 --> 00:20:01.087
And I would say there's

00:20:01.189 --> 00:20:03.890
probably more advantage to that group.

00:20:05.050 --> 00:20:06.912
So to Jimmy's question, you know,

00:20:07.112 --> 00:20:08.212
what is a mill first?

00:20:08.593 --> 00:20:09.153
Who cares?

00:20:09.272 --> 00:20:10.094
Why does it matter?

00:20:11.193 --> 00:20:11.674
Second,

00:20:12.515 --> 00:20:14.675
If you're delivering a negative experience,

00:20:14.715 --> 00:20:15.256
guess what?

00:20:15.576 --> 00:20:16.856
Those patients will leave.

00:20:17.217 --> 00:20:18.657
Those patients won't come back.

00:20:19.097 --> 00:20:20.097
I can't even tell you how

00:20:20.137 --> 00:20:21.679
many people come in my door

00:20:21.919 --> 00:20:23.319
every single week saying

00:20:23.720 --> 00:20:25.260
they tried to send me to the hospital.

00:20:25.280 --> 00:20:26.921
They tried to send me to NovaCare.

00:20:27.561 --> 00:20:28.241
And I said, no,

00:20:28.301 --> 00:20:29.663
I want to go to total therapy.

00:20:29.962 --> 00:20:32.483
I want to go see Tony and Jeremy, you know,

00:20:32.644 --> 00:20:33.784
and we're just as busy,

00:20:33.844 --> 00:20:35.625
probably more busy than everybody else,

00:20:35.684 --> 00:20:37.425
because we will let six

00:20:37.486 --> 00:20:39.126
people at a time come in

00:20:39.166 --> 00:20:40.186
with two clinicians.

00:20:40.907 --> 00:20:41.827
But the patients love it.

00:20:43.237 --> 00:20:45.117
Here's the kicker that I had also written,

00:20:45.238 --> 00:20:45.798
which is, go ahead, Dave.

00:20:45.818 --> 00:20:46.939
No, no, go ahead.

00:20:46.979 --> 00:20:49.941
I'll swing back.

00:20:50.381 --> 00:20:51.221
The kicker is if you run a

00:20:51.261 --> 00:20:52.201
clinic and pride yourself

00:20:52.241 --> 00:20:53.462
on being the opposite of a mill,

00:20:53.583 --> 00:20:54.163
shouldn't you actually

00:20:54.182 --> 00:20:55.523
appreciate that it exists?

00:20:55.964 --> 00:20:57.625
Without them, who are you the opposite of,

00:20:57.826 --> 00:20:58.086
right?

00:20:58.685 --> 00:21:00.207
But to Tony's point,

00:21:01.028 --> 00:21:02.147
I worked with someone who

00:21:02.268 --> 00:21:03.048
all they wanted to do is

00:21:03.088 --> 00:21:04.288
post about we're not a mill.

00:21:04.390 --> 00:21:04.809
And I was like,

00:21:04.829 --> 00:21:05.869
but you're talking to patients.

00:21:06.451 --> 00:21:08.152
That isn't a problem that they have.

00:21:08.291 --> 00:21:08.392
Now,

00:21:08.451 --> 00:21:09.712
that might be something for

00:21:09.772 --> 00:21:11.874
recruitment or retention, right?

00:21:12.034 --> 00:21:13.977
Hey, we're the opposite of this, right?

00:21:14.237 --> 00:21:16.420
But just be the thing that

00:21:16.461 --> 00:21:17.642
you are and people will

00:21:17.721 --> 00:21:19.384
either love it and stay or

00:21:19.424 --> 00:21:20.385
hate it and leave.

00:21:20.666 --> 00:21:22.108
But don't change for that.

00:21:22.328 --> 00:21:23.611
If this is how you want to operate,

00:21:23.790 --> 00:21:24.551
operate that way.

00:21:24.571 --> 00:21:25.513
You got to like it first.

00:21:27.058 --> 00:21:27.239
All right,

00:21:27.259 --> 00:21:28.739
I get the pushback on both of

00:21:28.778 --> 00:21:29.558
what you just said,

00:21:29.618 --> 00:21:33.319
because there are people that call us,

00:21:33.480 --> 00:21:34.599
now this is in the New York City area,

00:21:34.640 --> 00:21:35.480
but I'm assuming it's

00:21:35.519 --> 00:21:37.000
similar in most cities or metros.

00:21:37.381 --> 00:21:38.560
There are people that call

00:21:38.760 --> 00:21:41.060
us and they will specifically say,

00:21:41.922 --> 00:21:43.301
or sometimes we have to ask, like, oh,

00:21:43.541 --> 00:21:44.442
like you had back pain?

00:21:44.461 --> 00:21:44.642
Like,

00:21:44.682 --> 00:21:45.821
isn't this the first time you had it?

00:21:45.882 --> 00:21:46.461
Like, oh,

00:21:46.481 --> 00:21:48.383
you've had it on and off for ten years?

00:21:48.903 --> 00:21:49.823
What else have you done for it?

00:21:49.843 --> 00:21:52.262
Like, what other providers, procedures,

00:21:52.282 --> 00:21:52.742
what have you done?

00:21:53.063 --> 00:21:55.163
And if they say physical therapy, so...

00:21:56.084 --> 00:21:57.444
you had physical therapy

00:21:57.505 --> 00:21:59.207
like why aren't you calling

00:21:59.227 --> 00:22:00.166
them like I'm curious as to

00:22:00.207 --> 00:22:00.907
why you're not going back

00:22:00.928 --> 00:22:01.749
to where you were before or

00:22:01.769 --> 00:22:02.689
whatever so some people

00:22:02.709 --> 00:22:03.450
will either directly or

00:22:03.509 --> 00:22:05.391
indirectly call us and say

00:22:06.031 --> 00:22:06.833
I'm not going to that

00:22:06.952 --> 00:22:08.094
outpatient office and

00:22:08.114 --> 00:22:09.153
they'll mention names and

00:22:09.173 --> 00:22:09.755
sometimes they don't want

00:22:09.775 --> 00:22:10.295
to mention them because

00:22:10.315 --> 00:22:11.435
they don't want to you know

00:22:11.476 --> 00:22:12.497
bash people or whatever but

00:22:12.537 --> 00:22:14.137
they will say I'm not going

00:22:14.157 --> 00:22:15.799
back to that office because it was

00:22:16.420 --> 00:22:17.059
It was busy.

00:22:17.160 --> 00:22:17.980
It was a frenzy.

00:22:18.000 --> 00:22:19.340
They don't always say the word mill.

00:22:19.621 --> 00:22:21.101
The factory patients,

00:22:21.141 --> 00:22:22.401
the layman term is factory.

00:22:22.421 --> 00:22:24.402
They'll say there were too many patients.

00:22:24.821 --> 00:22:25.882
I want more attention.

00:22:26.402 --> 00:22:27.102
They weren't giving me

00:22:27.142 --> 00:22:28.122
enough attention or

00:22:28.162 --> 00:22:28.863
treatment or whatever.

00:22:29.002 --> 00:22:30.063
And it was they were

00:22:30.083 --> 00:22:31.022
treating three or four or

00:22:31.083 --> 00:22:32.163
more patients per hour at

00:22:32.182 --> 00:22:33.624
the same time as me.

00:22:33.663 --> 00:22:34.663
So I'm pushing back on both

00:22:34.683 --> 00:22:35.824
of you because there are at

00:22:35.864 --> 00:22:37.344
least folks that have had

00:22:37.384 --> 00:22:38.265
physical therapy elsewhere

00:22:38.565 --> 00:22:39.805
that then go on Google or

00:22:39.904 --> 00:22:40.785
Yelp or whatever.

00:22:40.805 --> 00:22:43.806
They find us online and or

00:22:43.826 --> 00:22:44.746
they ask their physician.

00:22:45.605 --> 00:22:46.287
And then when they want to

00:22:46.307 --> 00:22:46.906
want to experience.

00:22:46.946 --> 00:22:48.828
So there are some folks that

00:22:48.909 --> 00:22:50.250
have had that and look elsewhere.

00:22:50.351 --> 00:22:51.731
And if you're not hearing that, Tony,

00:22:51.751 --> 00:22:53.292
it's because maybe they

00:22:53.472 --> 00:22:54.413
like the folks that wanted

00:22:54.433 --> 00:22:55.255
the one on one care.

00:22:55.575 --> 00:22:56.296
They're looking at your

00:22:56.455 --> 00:22:57.958
offering first and you're

00:22:57.978 --> 00:22:58.597
not going to hear those

00:22:58.637 --> 00:23:00.200
calls the way I'm hearing, in my opinion.

00:23:01.029 --> 00:23:01.390
I agree.

00:23:01.450 --> 00:23:02.611
Confirmation bias,

00:23:02.691 --> 00:23:04.451
like absolutely no doubt.

00:23:04.912 --> 00:23:05.653
You're going to get the

00:23:05.692 --> 00:23:08.013
people that want the one on one attention,

00:23:08.354 --> 00:23:09.694
just like the manual therapy.

00:23:09.835 --> 00:23:10.474
You know, again,

00:23:10.915 --> 00:23:11.576
you're going to get the

00:23:11.615 --> 00:23:13.096
people that want manual.

00:23:13.136 --> 00:23:14.356
They want hands on.

00:23:14.617 --> 00:23:15.597
I might get the people who

00:23:15.637 --> 00:23:16.538
don't care about it,

00:23:16.578 --> 00:23:17.598
don't even know about it.

00:23:18.920 --> 00:23:20.280
And that's the whole idea

00:23:20.320 --> 00:23:22.082
behind find the gap in the

00:23:22.122 --> 00:23:23.942
market and go fill that gap.

00:23:24.471 --> 00:23:24.750
You know,

00:23:24.770 --> 00:23:26.673
when I was doing a lot of rehab

00:23:26.692 --> 00:23:27.554
for patients that had

00:23:27.594 --> 00:23:29.955
fibromyalgia and other chronic conditions,

00:23:30.395 --> 00:23:30.596
yeah,

00:23:30.616 --> 00:23:33.259
we tended to do more one-on-one private,

00:23:33.519 --> 00:23:34.680
you know, office,

00:23:34.760 --> 00:23:36.142
like go in the exam room.

00:23:36.582 --> 00:23:37.022
Today,

00:23:37.103 --> 00:23:38.824
I haven't been in an exam room for

00:23:38.864 --> 00:23:39.644
like ten years.

00:23:40.526 --> 00:23:42.748
It's just understand the

00:23:42.867 --> 00:23:45.069
audience you're serving and double down.

00:23:45.089 --> 00:23:47.071
Because you have motorcycles

00:23:47.132 --> 00:23:47.672
in your exam rooms.

00:23:47.692 --> 00:23:49.534
That's right.

00:23:49.554 --> 00:23:50.335
Makes complete sense.

00:23:52.159 --> 00:23:54.401
water water finds its level

00:23:54.840 --> 00:23:56.061
like people like and and

00:23:56.122 --> 00:23:57.483
dislike and that's good I

00:23:57.523 --> 00:23:58.324
think that's good it's

00:23:58.443 --> 00:24:00.905
choice and the choice is

00:24:01.006 --> 00:24:03.167
what you know we should I

00:24:03.188 --> 00:24:04.169
don't want to get political

00:24:04.328 --> 00:24:05.349
choices what we should be

00:24:05.410 --> 00:24:07.051
protecting in this example

00:24:07.571 --> 00:24:09.153
like if if you don't want

00:24:09.192 --> 00:24:10.554
to do what I do awesome

00:24:10.634 --> 00:24:11.694
don't freaking do it I

00:24:11.714 --> 00:24:12.596
don't care that's less

00:24:12.635 --> 00:24:14.538
competition for me but let me do

00:24:15.218 --> 00:24:16.538
what I think is best.

00:24:16.960 --> 00:24:18.980
Let me deliver a ten-minute visit.

00:24:19.422 --> 00:24:21.403
Let me, I don't know if you guys saw it,

00:24:21.502 --> 00:24:23.404
I'm curious to hear your perspective.

00:24:23.984 --> 00:24:26.067
Let me take a new patient

00:24:26.086 --> 00:24:28.248
phone call and convert them

00:24:28.388 --> 00:24:30.089
into a telehealth visit

00:24:30.369 --> 00:24:32.030
while they're on the phone

00:24:32.511 --> 00:24:33.772
to make that available

00:24:33.833 --> 00:24:35.153
event so I'm not giving

00:24:35.193 --> 00:24:37.174
away that time anymore.

00:24:38.496 --> 00:24:39.317
And the people who don't

00:24:39.336 --> 00:24:40.238
want to do telehealth,

00:24:40.478 --> 00:24:41.018
Don't do it.

00:24:41.578 --> 00:24:42.179
It's good.

00:24:42.618 --> 00:24:43.220
Who cares?

00:24:43.599 --> 00:24:44.780
But if I can offer a quick

00:24:44.820 --> 00:24:45.980
solution to somebody who's

00:24:46.020 --> 00:24:47.862
suffering right now and

00:24:47.942 --> 00:24:49.784
never be in person with them,

00:24:49.923 --> 00:24:53.105
I think I have the right to do that.

00:24:53.205 --> 00:24:55.166
Agreed.

00:24:55.186 --> 00:24:56.146
Did you guys see that post?

00:24:56.307 --> 00:24:58.229
What are your thoughts on that post?

00:24:58.348 --> 00:24:58.969
I didn't see the post.

00:24:59.009 --> 00:24:59.849
I want to talk more about it.

00:24:59.869 --> 00:25:02.550
Are there any other practices that do this,

00:25:03.011 --> 00:25:03.172
Tony?

00:25:03.192 --> 00:25:05.692
To my knowledge, so let me break it down.

00:25:05.873 --> 00:25:06.693
Why wouldn't they do that?

00:25:07.461 --> 00:25:10.144
Let me break it down kind of like I did,

00:25:10.304 --> 00:25:11.404
and then you guys can tell

00:25:11.444 --> 00:25:11.984
me what you think.

00:25:12.026 --> 00:25:13.126
So the whole idea is

00:25:13.586 --> 00:25:15.128
Medicare continues to pay

00:25:15.169 --> 00:25:16.670
for telehealth through the

00:25:16.750 --> 00:25:17.510
end of September,

00:25:17.550 --> 00:25:18.692
two thousand twenty five.

00:25:19.192 --> 00:25:21.575
Unless the laws change and extend,

00:25:22.115 --> 00:25:24.518
we lose that ability end of September,

00:25:24.557 --> 00:25:25.479
two thousand twenty five.

00:25:26.038 --> 00:25:27.380
When a new patient calls my

00:25:27.420 --> 00:25:28.861
clinic and the comparison I

00:25:28.901 --> 00:25:30.643
made in the video, as I said, look,

00:25:31.182 --> 00:25:33.243
imagine you've got a toothache.

00:25:33.744 --> 00:25:35.746
You call the dental practice.

00:25:36.106 --> 00:25:37.988
You're like, my tooth is killing me.

00:25:38.008 --> 00:25:40.289
Oh, yeah,

00:25:40.609 --> 00:25:41.770
that's a different version of the

00:25:41.810 --> 00:25:42.211
same thing.

00:25:42.250 --> 00:25:43.811
But my tooth is killing me.

00:25:44.031 --> 00:25:45.292
The dentist can't get you in

00:25:45.333 --> 00:25:46.574
for seventy two hours.

00:25:46.974 --> 00:25:49.056
But the person on the phone says, Tony,

00:25:49.096 --> 00:25:49.896
just hang on.

00:25:50.076 --> 00:25:52.218
If you want me to get Dr. Dave,

00:25:52.258 --> 00:25:53.700
the dentist on the phone.

00:25:54.579 --> 00:25:56.122
Switch to a video call.

00:25:56.521 --> 00:25:57.682
He can take a look at your

00:25:57.742 --> 00:25:59.105
situation and give you some

00:25:59.144 --> 00:26:01.006
recommendations for temporary relief.

00:26:01.646 --> 00:26:01.826
Now,

00:26:02.106 --> 00:26:04.189
I was talking to Michael Derry last

00:26:04.250 --> 00:26:04.569
night.

00:26:04.849 --> 00:26:06.471
Michael wrote a book.

00:26:06.511 --> 00:26:07.553
He's working on getting it

00:26:07.593 --> 00:26:08.814
published about sciatica.

00:26:09.535 --> 00:26:10.394
I think, Dave Kittle,

00:26:10.414 --> 00:26:11.777
you're probably in this world.

00:26:11.817 --> 00:26:13.198
There's probably things you

00:26:13.218 --> 00:26:14.199
can do for somebody

00:26:14.640 --> 00:26:17.702
suffering from sciatica who

00:26:17.742 --> 00:26:18.864
went to the emergency room.

00:26:19.664 --> 00:26:20.845
nothing they could do to help them,

00:26:20.904 --> 00:26:22.205
got them discharged with

00:26:22.286 --> 00:26:24.026
muscle relaxers and pain meds.

00:26:24.866 --> 00:26:26.866
And if they got on a video call with you,

00:26:27.067 --> 00:26:28.327
even if it wasn't as good

00:26:28.387 --> 00:26:29.748
as seeing you in person,

00:26:30.407 --> 00:26:32.189
they couldn't get your magic fingers.

00:26:32.528 --> 00:26:33.929
You could probably give them

00:26:33.969 --> 00:26:35.049
two or three things to do

00:26:35.089 --> 00:26:36.190
to manage the symptoms.

00:26:36.849 --> 00:26:39.131
So with Medicare guidelines,

00:26:39.171 --> 00:26:41.771
the way it is like absolutely right now,

00:26:41.852 --> 00:26:43.592
we could go from a voice

00:26:43.632 --> 00:26:44.972
call to book an appointment and

00:26:45.810 --> 00:26:47.172
Send them a link because

00:26:47.231 --> 00:26:48.053
most people are calling

00:26:48.073 --> 00:26:49.294
from a cell phone anyway.

00:26:49.933 --> 00:26:50.654
Send them a link,

00:26:51.075 --> 00:26:52.817
switch them to a video and

00:26:52.977 --> 00:26:55.578
audio live chat or live call,

00:26:55.618 --> 00:26:57.901
which is on a HIPAA compliant platform.

00:26:58.661 --> 00:26:59.541
And now that becomes a

00:26:59.642 --> 00:27:00.883
billable evaluation.

00:27:00.923 --> 00:27:01.743
And when you look at the

00:27:01.763 --> 00:27:04.184
Medicare guidelines, CMS chapter fifteen,

00:27:04.224 --> 00:27:05.105
section two twenty,

00:27:05.727 --> 00:27:07.948
it says very clearly all

00:27:07.988 --> 00:27:11.111
you need is a diagnosis, sciatica,

00:27:11.510 --> 00:27:12.471
shoulder pain, whatever,

00:27:13.272 --> 00:27:14.594
and a functional assessment.

00:27:15.272 --> 00:27:15.492
John,

00:27:15.532 --> 00:27:17.733
can you can you bend over and put on

00:27:17.773 --> 00:27:18.114
a sock?

00:27:18.173 --> 00:27:18.433
No.

00:27:18.733 --> 00:27:20.253
OK, my functional assessment is done.

00:27:20.775 --> 00:27:20.954
Now,

00:27:20.994 --> 00:27:22.394
let me give you something to help the

00:27:22.434 --> 00:27:24.135
sciatic pain right now.

00:27:24.675 --> 00:27:25.736
And then I'll be at your

00:27:25.776 --> 00:27:28.537
house tomorrow in a couple of days,

00:27:28.576 --> 00:27:29.436
whatever you need to do.

00:27:30.096 --> 00:27:31.057
You know, like this.

00:27:31.317 --> 00:27:32.218
Nobody is doing it.

00:27:32.317 --> 00:27:33.458
Nobody is considering it.

00:27:33.498 --> 00:27:34.818
Nobody is talking about it.

00:27:35.679 --> 00:27:37.398
I've shared this idea for a long time.

00:27:37.778 --> 00:27:38.599
I don't do it.

00:27:38.900 --> 00:27:39.539
Disclosure.

00:27:40.039 --> 00:27:41.181
Just because I'm too busy.

00:27:41.721 --> 00:27:43.701
But there are a lot of practice owners,

00:27:43.801 --> 00:27:44.583
new startups,

00:27:44.643 --> 00:27:46.463
small independents that are

00:27:46.523 --> 00:27:48.565
not too busy who could be

00:27:48.625 --> 00:27:52.768
doing this right now.

00:27:52.788 --> 00:27:53.087
Thoughts?

00:27:55.630 --> 00:27:56.490
Dave probably hates it

00:27:56.509 --> 00:27:57.911
because it has to do with his Zoom call.

00:27:58.432 --> 00:27:59.592
I think he loves it because

00:27:59.853 --> 00:28:01.353
he can use his knowledge.

00:28:03.315 --> 00:28:03.934
We did this,

00:28:03.994 --> 00:28:06.076
or I did this during COVID for

00:28:06.096 --> 00:28:06.717
folks that were like,

00:28:07.946 --> 00:28:09.768
too far away outside of the

00:28:09.788 --> 00:28:14.509
new york city area jimmy

00:28:14.568 --> 00:28:17.049
what do you think uh dave

00:28:17.069 --> 00:28:17.671
you're cutting out a little

00:28:17.691 --> 00:28:18.451
bit the audio is cutting

00:28:18.490 --> 00:28:19.391
out I think yeah I mean we

00:28:19.431 --> 00:28:20.432
did it but we would charge

00:28:20.451 --> 00:28:21.672
like at that time two fifty

00:28:21.692 --> 00:28:22.531
up front so they would have

00:28:22.551 --> 00:28:23.792
to have already paid two fifty

00:28:24.690 --> 00:28:25.009
Yeah.

00:28:25.109 --> 00:28:26.330
And that's, that's reasonable.

00:28:26.550 --> 00:28:28.590
I mean, it's, it's an emergency situation.

00:28:28.731 --> 00:28:30.231
I need help right now.

00:28:30.791 --> 00:28:32.472
If Medicare didn't cover it,

00:28:32.593 --> 00:28:34.073
it would be a self-pay service.

00:28:34.594 --> 00:28:35.054
Agreed.

00:28:35.074 --> 00:28:35.433
Yeah.

00:28:35.493 --> 00:28:35.653
I mean,

00:28:35.673 --> 00:28:37.535
this is an increasing to access and

00:28:37.575 --> 00:28:38.755
the audience is going to

00:28:38.954 --> 00:28:40.796
decide the water is going

00:28:40.816 --> 00:28:41.355
to find its level.

00:28:41.395 --> 00:28:42.396
If people hate this idea,

00:28:42.876 --> 00:28:43.896
your phone will say silent.

00:28:43.916 --> 00:28:44.817
If they like this idea,

00:28:44.856 --> 00:28:46.678
it'll ring or somewhere in the middle,

00:28:46.837 --> 00:28:47.038
right?

00:28:47.117 --> 00:28:48.419
Is this going to be only right?

00:28:49.058 --> 00:28:50.220
The quote I used just the other day,

00:28:50.359 --> 00:28:52.121
only a Sith deals in absolutes.

00:28:52.161 --> 00:28:53.061
That's Obi-Wan Kenobi.

00:28:53.221 --> 00:28:55.064
I know you're Star Wars fans.

00:28:55.144 --> 00:28:56.003
So I don't think it's an

00:28:57.184 --> 00:28:58.165
always or a never.

00:28:58.346 --> 00:28:59.787
I think it's when it fits, it's really,

00:28:59.826 --> 00:29:00.228
really great.

00:29:00.248 --> 00:29:03.029
And then the next layer to

00:29:03.069 --> 00:29:05.551
this is imagine the rapport,

00:29:05.592 --> 00:29:06.853
imagine the relationship,

00:29:06.893 --> 00:29:08.073
the trust that is built

00:29:08.193 --> 00:29:09.193
right then and there,

00:29:09.694 --> 00:29:10.816
because this person has a

00:29:10.875 --> 00:29:12.656
real problem with real urgency.

00:29:12.696 --> 00:29:13.438
And you're like, hey,

00:29:13.857 --> 00:29:15.898
I realize I can't make it, you know,

00:29:15.919 --> 00:29:17.299
get you in person right now.

00:29:18.000 --> 00:29:19.321
But I can help you a little bit.

00:29:19.461 --> 00:29:20.923
I can help you for now.

00:29:21.423 --> 00:29:23.345
And then when I'm in person with you,

00:29:23.384 --> 00:29:24.246
then we can take care of

00:29:24.266 --> 00:29:25.105
this permanently.

00:29:25.527 --> 00:29:25.807
You know,

00:29:25.846 --> 00:29:26.907
like that's a person that's a

00:29:26.948 --> 00:29:27.667
patient for life.

00:29:27.728 --> 00:29:28.828
That is somebody that is

00:29:28.868 --> 00:29:31.290
going to be so like deeply

00:29:31.351 --> 00:29:32.971
indebted to you because

00:29:33.153 --> 00:29:34.933
nobody else is even considering this.

00:29:35.334 --> 00:29:36.855
But this is an idea that can

00:29:36.894 --> 00:29:38.155
go out to any service

00:29:38.215 --> 00:29:39.416
professional plumbers.

00:29:39.837 --> 00:29:41.078
Hey, I got a leaky sink.

00:29:41.179 --> 00:29:42.259
Well, it's not an emergency.

00:29:42.339 --> 00:29:43.721
I can't get out there for a week.

00:29:43.901 --> 00:29:44.101
Sure.

00:29:44.280 --> 00:29:45.661
switch over to a video call,

00:29:45.721 --> 00:29:46.641
show me the sink.

00:29:46.740 --> 00:29:47.942
I'll tell you what you can

00:29:47.981 --> 00:29:50.281
do at home on your own to

00:29:50.342 --> 00:29:52.502
at least temporarily fix the problem.

00:29:53.002 --> 00:29:53.982
And then when I come out there,

00:29:54.002 --> 00:29:55.063
I'll fix it permanently.

00:29:55.563 --> 00:29:58.084
Like car, my, my car is, you know,

00:29:58.124 --> 00:29:59.064
making this weird noise.

00:29:59.084 --> 00:30:00.743
Well, let's switch over to a video call.

00:30:00.784 --> 00:30:01.804
Let me see what's going on.

00:30:01.864 --> 00:30:02.403
Let me hear it.

00:30:02.443 --> 00:30:03.144
Let me look at it.

00:30:03.605 --> 00:30:03.904
Okay.

00:30:03.944 --> 00:30:04.605
Try this, this,

00:30:04.644 --> 00:30:06.704
and this I'll get you in next week.

00:30:06.785 --> 00:30:08.566
Like everybody should be

00:30:08.605 --> 00:30:10.266
doing this across all services.

00:30:12.127 --> 00:30:15.068
Computers will create a paperless world.

00:30:15.288 --> 00:30:17.009
I heard that in second grade

00:30:17.449 --> 00:30:19.949
when I first was brought

00:30:19.989 --> 00:30:21.390
into computer class in

00:30:21.430 --> 00:30:22.670
second grade and we sat in

00:30:22.690 --> 00:30:23.589
front of a bunch of like

00:30:23.829 --> 00:30:26.790
Macs and yet we're gonna

00:30:26.830 --> 00:30:28.151
crack up because Tony just

00:30:28.171 --> 00:30:29.070
got a call from a local

00:30:29.131 --> 00:30:30.830
doctor's office right across the street,

00:30:31.270 --> 00:30:32.412
a hospital owned primary

00:30:32.432 --> 00:30:34.392
care physician group and he

00:30:34.531 --> 00:30:36.092
asked for paper referral pads.

00:30:36.551 --> 00:30:39.012
He wanted, so hit the,

00:30:39.032 --> 00:30:39.952
what did I miss in the story?

00:30:41.304 --> 00:30:43.625
So real quick backstory, you know,

00:30:44.164 --> 00:30:46.286
I've always done paper referral pads.

00:30:46.346 --> 00:30:47.826
I've done group referral pads.

00:30:47.846 --> 00:30:48.747
So like I'll get all the

00:30:48.767 --> 00:30:50.267
physical therapy providers

00:30:50.287 --> 00:30:51.627
within a geographic area,

00:30:51.688 --> 00:30:53.107
put them on my referral

00:30:53.147 --> 00:30:54.628
pads at my expense,

00:30:55.108 --> 00:30:56.608
send them to the doc office.

00:30:56.670 --> 00:30:58.049
I've done lots of different

00:30:58.089 --> 00:30:59.631
kind of things like this.

00:31:00.211 --> 00:31:01.711
And I really started to feel like,

00:31:01.851 --> 00:31:03.432
all right, it's probably, you know,

00:31:03.531 --> 00:31:04.372
run its course.

00:31:04.451 --> 00:31:06.133
Nobody cares about this anymore.

00:31:06.153 --> 00:31:06.173
A

00:31:09.673 --> 00:31:11.115
And so yesterday I'm sitting

00:31:11.154 --> 00:31:11.775
here at lunch.

00:31:11.875 --> 00:31:12.654
The phone rings.

00:31:12.815 --> 00:31:14.615
I know it's the doc group next door.

00:31:14.635 --> 00:31:16.797
And I'm like, I don't want to answer that.

00:31:16.896 --> 00:31:17.817
Either they're requesting

00:31:17.856 --> 00:31:19.117
medical records or they

00:31:19.137 --> 00:31:20.519
want to schedule an appointment.

00:31:20.558 --> 00:31:22.558
And I don't want more patients.

00:31:23.059 --> 00:31:24.200
So I just I let it ring.

00:31:24.960 --> 00:31:25.921
It went to voicemail,

00:31:25.941 --> 00:31:26.961
but they didn't leave a message.

00:31:27.020 --> 00:31:29.001
Five minutes later, rings again.

00:31:29.041 --> 00:31:29.682
I'm like, all right,

00:31:29.701 --> 00:31:31.163
I got to be a big boy.

00:31:31.343 --> 00:31:32.563
Put on my big boy pants.

00:31:33.003 --> 00:31:34.763
I answer the phone and they're like, hey,

00:31:34.804 --> 00:31:36.664
can you send us over more referral pads?

00:31:36.684 --> 00:31:37.546
We've got patients.

00:31:37.566 --> 00:31:38.246
And we ran out.

00:31:38.846 --> 00:31:40.686
I was like, oh, OK.

00:31:40.727 --> 00:31:41.788
I send my son who's doing a

00:31:41.827 --> 00:31:43.067
summer internship with us

00:31:43.469 --> 00:31:44.288
across the street.

00:31:44.409 --> 00:31:45.329
He drops them off.

00:31:46.130 --> 00:31:47.750
The point in that story, though,

00:31:47.851 --> 00:31:49.192
is these guys are all

00:31:49.271 --> 00:31:50.873
hospital owned physicians.

00:31:50.913 --> 00:31:52.053
They're great physicians.

00:31:52.094 --> 00:31:53.213
I've known them for years.

00:31:54.414 --> 00:31:55.915
They are pressured to send

00:31:55.955 --> 00:31:58.317
to to the hospital outpatient clinic.

00:31:58.336 --> 00:31:59.278
There's zero doubt,

00:31:59.978 --> 00:32:01.719
but they still need their

00:32:01.759 --> 00:32:02.859
patients to be seen.

00:32:02.920 --> 00:32:05.121
The hospital outpatient is full now.

00:32:05.982 --> 00:32:09.164
They give the patient the internal EMR,

00:32:09.204 --> 00:32:11.105
the Epic EMR referral,

00:32:11.727 --> 00:32:12.846
but they also wanted the

00:32:12.886 --> 00:32:13.788
referral that has our

00:32:13.827 --> 00:32:15.148
address and our information

00:32:15.189 --> 00:32:16.209
and the other stuff on it.

00:32:16.670 --> 00:32:19.191
So we sent over a handful of pads.

00:32:20.451 --> 00:32:22.673
It reminded me that this is still a thing.

00:32:23.054 --> 00:32:24.213
And now I'll go and I'll

00:32:24.233 --> 00:32:25.194
start sending them out to

00:32:25.295 --> 00:32:26.935
all the other docs in the area.

00:32:29.892 --> 00:32:31.113
Dave had a comment.

00:32:31.133 --> 00:32:31.773
Dave, you're grinning.

00:32:32.273 --> 00:32:34.895
No, Jimmy,

00:32:34.935 --> 00:32:36.657
you shared the screenshot with

00:32:36.678 --> 00:32:37.518
my comment that I had

00:32:37.577 --> 00:32:38.499
messaged you guys yesterday.

00:32:38.939 --> 00:32:39.839
I screenshotted that.

00:32:39.880 --> 00:32:40.980
I was going to post it publicly.

00:32:41.642 --> 00:32:43.502
But the comment under Tony's post,

00:32:43.583 --> 00:32:44.064
I didn't post it,

00:32:44.084 --> 00:32:45.744
but it had said something like,

00:32:47.086 --> 00:32:47.686
in health care,

00:32:47.727 --> 00:32:49.307
paper referral pads and fax

00:32:49.327 --> 00:32:50.568
machines are still used.

00:32:51.589 --> 00:32:52.911
But Tony Maritato thinks

00:32:52.951 --> 00:32:54.711
artificial intelligence is taking over.

00:32:55.373 --> 00:32:56.113
Think again.

00:32:57.314 --> 00:32:58.855
And I believe that.

00:32:58.914 --> 00:33:00.816
I know Tony has a lot of

00:33:00.875 --> 00:33:06.238
faith and enthusiasm for

00:33:06.278 --> 00:33:07.219
artificial intelligence.

00:33:08.086 --> 00:33:10.007
But we don't, I mean, our practice,

00:33:10.047 --> 00:33:10.846
we don't have a fax machine.

00:33:11.106 --> 00:33:12.047
We have referrals and people

00:33:12.087 --> 00:33:13.708
call up or nurses or whoever,

00:33:13.728 --> 00:33:14.909
and they're like, what's your fax number?

00:33:15.269 --> 00:33:16.868
I used to say our fax is down.

00:33:17.388 --> 00:33:17.990
Can you email it?

00:33:18.049 --> 00:33:19.410
Now I just say, can you just email it?

00:33:20.431 --> 00:33:24.471
So we have opted out of the fax machine.

00:33:24.872 --> 00:33:26.272
I've never had a fax line,

00:33:26.333 --> 00:33:26.952
even though you can have

00:33:27.012 --> 00:33:27.692
one for five dollars a

00:33:27.732 --> 00:33:29.973
month and have like a whatever over Wi-Fi,

00:33:29.993 --> 00:33:30.974
you can have a fax line.

00:33:31.875 --> 00:33:33.915
And I'm just like, I just don't do it,

00:33:34.036 --> 00:33:34.276
right?

00:33:35.596 --> 00:33:37.156
It's so funny, like Tony's,

00:33:37.797 --> 00:33:40.701
handing out paper for all

00:33:40.721 --> 00:33:42.142
pads that are still being requested.

00:33:43.123 --> 00:33:45.965
He may or may not have a fax machine,

00:33:46.846 --> 00:33:50.230
but he thinks artificial

00:33:50.250 --> 00:33:53.734
intelligence is taking over.

00:33:53.755 --> 00:33:54.635
It's very ironic.

00:33:56.057 --> 00:33:57.419
The thing with that is...

00:33:58.428 --> 00:34:00.669
AI is replacing the stuff

00:34:00.709 --> 00:34:02.549
that we thought would never be replaced,

00:34:02.970 --> 00:34:05.050
but it's not replacing stuff.

00:34:05.471 --> 00:34:06.730
Like you hear the people say,

00:34:06.871 --> 00:34:08.271
I don't need AI to do this.

00:34:08.371 --> 00:34:10.032
I need AI to vacuum my carpet.

00:34:10.353 --> 00:34:11.253
Like you're right.

00:34:12.793 --> 00:34:14.554
I will be replaced because

00:34:14.873 --> 00:34:16.795
my perception of value in

00:34:16.835 --> 00:34:18.215
the physical therapy world

00:34:18.356 --> 00:34:20.577
is my brain's ability to

00:34:20.637 --> 00:34:22.936
process dynamic information, right?

00:34:23.018 --> 00:34:23.797
Dave comes in,

00:34:24.338 --> 00:34:26.739
Dave's like, I play recreational baseball.

00:34:26.820 --> 00:34:28.221
My shoulder's been bugging me.

00:34:28.800 --> 00:34:31.023
Oh, I also got a COVID injection a couple,

00:34:31.123 --> 00:34:32.503
you know, whatever years ago.

00:34:32.563 --> 00:34:33.364
And ever since then,

00:34:33.403 --> 00:34:34.684
my shoulder's never been the same.

00:34:35.905 --> 00:34:36.967
Making the connection

00:34:37.007 --> 00:34:38.887
between the chemistry and

00:34:38.947 --> 00:34:39.869
all the other stuff,

00:34:39.909 --> 00:34:41.088
Dave came in thinking it

00:34:41.108 --> 00:34:42.130
was something related to

00:34:42.210 --> 00:34:43.431
mechanical pathology.

00:34:43.630 --> 00:34:45.472
I think it's more chemical pathology.

00:34:46.313 --> 00:34:47.333
I thought that was safe.

00:34:47.373 --> 00:34:47.914
That's gone.

00:34:48.134 --> 00:34:50.416
Like that is what AI is going to replace.

00:34:51.307 --> 00:34:52.168
What AI is not going to

00:34:52.188 --> 00:34:53.969
replace is the human who

00:34:54.028 --> 00:34:55.849
rubs Dave's shoulder while

00:34:56.190 --> 00:34:58.110
Dave tells him jokes and he

00:34:58.170 --> 00:34:59.291
laughs at those jokes.

00:34:59.331 --> 00:35:00.751
Like those are the things.

00:35:01.152 --> 00:35:04.614
So the fax machine, it's nineteen,

00:35:04.673 --> 00:35:07.275
you know, eighty seven technology.

00:35:07.815 --> 00:35:08.335
You're right.

00:35:08.556 --> 00:35:09.996
AI is not replacing that.

00:35:10.056 --> 00:35:12.177
Like there's still people on

00:35:12.356 --> 00:35:13.777
old systems that are using

00:35:13.858 --> 00:35:14.617
old technology.

00:35:14.677 --> 00:35:15.318
We're one of them.

00:35:15.458 --> 00:35:17.278
I have a fax machine in every office.

00:35:17.298 --> 00:35:18.659
I have a fax machine at home.

00:35:18.820 --> 00:35:20.420
I get faxes every single day.

00:35:21.961 --> 00:35:24.264
But what AI is replacing is

00:35:24.304 --> 00:35:25.244
the stuff that we thought

00:35:25.304 --> 00:35:26.445
was irreplaceable.

00:35:26.947 --> 00:35:29.389
Our intelligence, our analytical sense,

00:35:29.429 --> 00:35:31.311
our ability to put pieces

00:35:31.351 --> 00:35:32.632
of a puzzle together.

00:35:32.652 --> 00:35:33.132
That's gone.

00:35:34.994 --> 00:35:35.894
Yeah, I think it's the simple,

00:35:35.914 --> 00:35:37.315
tangible things that people like,

00:35:37.416 --> 00:35:38.096
like a reminder.

00:35:39.177 --> 00:35:41.177
How many times I take a business card,

00:35:41.278 --> 00:35:42.039
I actually still do.

00:35:42.139 --> 00:35:43.280
I do snap a picture of it,

00:35:43.559 --> 00:35:45.021
but I stick the card in my

00:35:45.081 --> 00:35:46.702
pocket because I know it's

00:35:46.742 --> 00:35:47.802
solving a forgetting

00:35:47.842 --> 00:35:50.204
problem or a losing it problem, right?

00:35:50.545 --> 00:35:51.746
I can store anything I want

00:35:51.766 --> 00:35:53.487
in Google Drive and I do,

00:35:53.688 --> 00:35:54.728
and then I can't find it.

00:35:55.208 --> 00:35:56.409
Have you guys ever used Notion?

00:35:57.670 --> 00:35:58.731
I have it now.

00:35:58.751 --> 00:35:59.411
Notion's essentially a

00:35:59.431 --> 00:36:00.632
little world you can create

00:36:00.992 --> 00:36:02.532
like an internal Wiki and

00:36:02.572 --> 00:36:03.773
companies I've worked for of like,

00:36:04.112 --> 00:36:05.494
that's over here, how to do that.

00:36:05.514 --> 00:36:06.514
A lot of SOPs,

00:36:06.534 --> 00:36:07.954
a lot of like internal data.

00:36:08.474 --> 00:36:09.074
And I, you know,

00:36:09.175 --> 00:36:10.195
use the phrase and I don't know,

00:36:10.235 --> 00:36:11.476
probably not the first person to use it.

00:36:11.496 --> 00:36:12.695
I'm like, it's in Notion.

00:36:12.835 --> 00:36:14.197
The answer kept, it's in Notion.

00:36:14.237 --> 00:36:15.197
Hey, does anybody know how to do this?

00:36:15.416 --> 00:36:16.016
It's in Notion.

00:36:16.036 --> 00:36:17.717
I'm like, yeah, but Notion's in Notion.

00:36:17.818 --> 00:36:19.318
Like I know it's in there

00:36:19.697 --> 00:36:20.518
and I'm here for you.

00:36:20.559 --> 00:36:21.759
Can you tell me how to do it?

00:36:21.778 --> 00:36:23.039
Or can you point to where that thing is?

00:36:23.079 --> 00:36:24.219
Cause I looked there already

00:36:24.579 --> 00:36:25.579
and I can't find it cause

00:36:25.599 --> 00:36:26.860
it's in a sea of everything.

00:36:27.320 --> 00:36:28.523
So when everything's important,

00:36:28.583 --> 00:36:29.324
nothing's important.

00:36:29.603 --> 00:36:30.525
And it's just a pendulum.

00:36:30.844 --> 00:36:31.405
But I think you're right.

00:36:31.706 --> 00:36:33.289
It's repetitive tasks.

00:36:33.708 --> 00:36:35.871
It's the things that just should be done.

00:36:36.231 --> 00:36:39.195
Seth Godin said this ten years ago.

00:36:39.576 --> 00:36:41.057
I'll go ask AI when the

00:36:41.097 --> 00:36:42.340
actual blog post was from

00:36:42.380 --> 00:36:43.460
Seth Godin when he said this.

00:36:43.822 --> 00:36:45.023
And it's something stunningly,

00:36:45.123 --> 00:36:45.983
stupidly simple.

00:36:47.025 --> 00:36:48.025
When you're buying something

00:36:48.045 --> 00:36:49.887
from an online retailer and

00:36:49.907 --> 00:36:51.168
I'm putting in my address

00:36:51.188 --> 00:36:52.429
to either have the product

00:36:52.471 --> 00:36:54.112
shipped to me or for my

00:36:54.172 --> 00:36:55.853
credit card information verification,

00:36:56.554 --> 00:36:58.195
I type in two pieces of information.

00:36:58.577 --> 00:36:59.577
And his question is why?

00:37:00.057 --> 00:37:02.460
I type in my zip code and then my state.

00:37:03.822 --> 00:37:05.003
You know what state I live

00:37:05.063 --> 00:37:06.445
in based on the zip code.

00:37:06.625 --> 00:37:07.965
That's how zip codes work.

00:37:08.385 --> 00:37:10.246
But I've been across very

00:37:10.286 --> 00:37:11.447
few websites in the last

00:37:11.547 --> 00:37:13.108
twenty five years of buying

00:37:13.148 --> 00:37:14.769
stuff online that actually

00:37:14.809 --> 00:37:15.990
just ask for the zip code

00:37:16.311 --> 00:37:18.532
and will auto fill the state.

00:37:18.891 --> 00:37:19.213
And now,

00:37:19.253 --> 00:37:20.713
since I read that from Godin ten

00:37:20.753 --> 00:37:22.414
years ago, every time I do it,

00:37:22.815 --> 00:37:24.476
I get a little bit more pissed off.

00:37:24.695 --> 00:37:25.956
Because someone hasn't taken

00:37:25.976 --> 00:37:26.737
that experience.

00:37:27.117 --> 00:37:27.838
Now,

00:37:28.139 --> 00:37:30.402
the paper referral pad to me is just a

00:37:30.501 --> 00:37:31.963
physical embodiment of that.

00:37:32.222 --> 00:37:34.125
That's a psychological nudge, right?

00:37:34.144 --> 00:37:34.766
You're probably going to

00:37:34.806 --> 00:37:35.646
lose that or throw it away.

00:37:35.686 --> 00:37:36.608
Or maybe you do actually

00:37:36.648 --> 00:37:38.429
tack it up on the refrigerator.

00:37:38.789 --> 00:37:41.552
But I think it's a yes and, right?

00:37:41.652 --> 00:37:43.114
Is AI going to take over everything?

00:37:43.253 --> 00:37:44.054
No.

00:37:44.135 --> 00:37:44.554
Hopefully,

00:37:44.574 --> 00:37:46.097
it's the repetitive tasks or

00:37:46.117 --> 00:37:47.197
filling in what state I

00:37:47.237 --> 00:37:48.179
live in after I tell you

00:37:48.219 --> 00:37:49.360
what zip code I live at.

00:37:50.925 --> 00:37:52.927
So that goes back to one of

00:37:52.967 --> 00:37:54.168
the things that when I

00:37:54.208 --> 00:37:55.608
started my business back in

00:37:55.648 --> 00:37:57.851
two thousand and one, I said,

00:37:58.010 --> 00:37:59.693
I am never going to do this.

00:38:00.373 --> 00:38:01.753
I am never going to give a

00:38:01.853 --> 00:38:03.114
patient a packet of new

00:38:03.155 --> 00:38:04.076
patient paperwork.

00:38:04.536 --> 00:38:05.637
I'm never going to give the

00:38:05.677 --> 00:38:06.418
patient a health

00:38:06.438 --> 00:38:07.338
questionnaire that they

00:38:07.358 --> 00:38:08.840
have to answer questions on

00:38:08.880 --> 00:38:10.262
and fill all this stuff out.

00:38:11.021 --> 00:38:11.983
one of the things that I do

00:38:12.003 --> 00:38:12.702
when I'm teaching my

00:38:12.742 --> 00:38:13.983
Medicare course is I go to

00:38:14.043 --> 00:38:15.844
random PT websites and I

00:38:15.885 --> 00:38:17.786
show their admission paperwork.

00:38:18.226 --> 00:38:18.547
And I'm like,

00:38:18.806 --> 00:38:20.827
why are we even asking these questions?

00:38:20.867 --> 00:38:23.010
Like these questions has have no relevance,

00:38:23.289 --> 00:38:25.871
or I can get all of this information.

00:38:25.931 --> 00:38:28.333
If I get this one piece, you know,

00:38:28.393 --> 00:38:30.393
give me your Medicare subscriber ID,

00:38:30.414 --> 00:38:31.614
your name and your date of birth.

00:38:32.074 --> 00:38:32.976
I'll get your address.

00:38:33.056 --> 00:38:33.715
I'll get your phone.

00:38:33.795 --> 00:38:35.396
I'll get all of these other things.

00:38:35.416 --> 00:38:36.097
And again,

00:38:37.132 --> 00:38:39.755
we don't do that because we're so used to,

00:38:39.976 --> 00:38:41.639
Oh, well you fill out the paperwork.

00:38:41.679 --> 00:38:43.942
You answer the, how many times I've,

00:38:43.961 --> 00:38:45.804
I'm asking you guys in real world,

00:38:46.505 --> 00:38:48.708
if you see a patient and you're like,

00:38:48.728 --> 00:38:50.250
do you have a hypertension?

00:38:50.329 --> 00:38:50.530
No.

00:38:50.670 --> 00:38:51.630
Do you have diabetes?

00:38:51.731 --> 00:38:51.911
No.

00:38:52.211 --> 00:38:53.494
What medications are you taking?

00:38:53.634 --> 00:38:53.773
Well,

00:38:53.813 --> 00:38:55.896
I take like Cinepryl and Metformin and,

00:38:56.317 --> 00:38:56.817
Well, wait a minute.

00:38:56.836 --> 00:38:58.637
You just said you don't have those.

00:38:59.137 --> 00:38:59.418
Well, no,

00:38:59.478 --> 00:39:00.518
I don't have those conditions

00:39:00.539 --> 00:39:01.818
because I'm taking those drugs.

00:39:01.858 --> 00:39:02.079
Right.

00:39:02.759 --> 00:39:04.639
To ask a patient to answer

00:39:04.699 --> 00:39:06.501
health care questions on a

00:39:06.561 --> 00:39:08.902
piece of paper makes no sense to me.

00:39:08.942 --> 00:39:09.961
They are not equipped to

00:39:10.041 --> 00:39:11.302
answer those questions.

00:39:12.023 --> 00:39:12.682
And you're going to have

00:39:12.742 --> 00:39:14.083
those conversations anyway.

00:39:14.844 --> 00:39:16.244
And so that's what made me

00:39:16.304 --> 00:39:18.186
rethink my whole patient experience.

00:39:18.226 --> 00:39:18.846
I'm like, look,

00:39:19.365 --> 00:39:21.387
this person pulled into the parking lot.

00:39:21.447 --> 00:39:22.887
I saw them get out of the car.

00:39:23.329 --> 00:39:24.989
Do I really have to sit here

00:39:25.110 --> 00:39:26.489
and go into an exam room?

00:39:27.070 --> 00:39:28.451
I watched them get out of the car,

00:39:28.510 --> 00:39:29.632
close the car door.

00:39:29.851 --> 00:39:31.572
I saw if they have an assistive device.

00:39:31.753 --> 00:39:33.114
I saw them come in my clinic

00:39:33.153 --> 00:39:34.755
like they're standing at the front desk.

00:39:35.175 --> 00:39:36.655
My evaluation is finished.

00:39:37.016 --> 00:39:38.737
Let's go start making you feel better.

00:39:39.356 --> 00:39:40.637
That's what I want to work on.

00:39:41.538 --> 00:39:43.358
But I don't think we either

00:39:43.418 --> 00:39:45.199
we don't teach these skills

00:39:45.380 --> 00:39:47.882
or we don't tell therapists like, hey,

00:39:47.942 --> 00:39:50.222
you your evaluation starts

00:39:50.282 --> 00:39:53.445
at that first moment of contact.

00:39:53.565 --> 00:39:53.844
Agreed.

00:39:53.925 --> 00:39:54.885
We do it at the airport.

00:39:55.166 --> 00:39:56.106
We watch people walk.

00:39:56.206 --> 00:39:57.206
We watch people move.

00:39:57.467 --> 00:39:59.188
We analyze all of their stuff.

00:39:59.248 --> 00:39:59.547
Right.

00:40:01.088 --> 00:40:01.889
The question is.

00:40:03.409 --> 00:40:04.431
I think the question is.

00:40:05.635 --> 00:40:06.715
how does this change?

00:40:07.195 --> 00:40:08.277
So how does that change?

00:40:08.317 --> 00:40:09.478
How does that model change?

00:40:09.677 --> 00:40:10.978
If this is the way it's always been,

00:40:10.998 --> 00:40:11.599
and these are the things

00:40:11.619 --> 00:40:12.599
that are always required?

00:40:13.121 --> 00:40:13.360
I mean,

00:40:14.041 --> 00:40:15.382
Craig's pointing out HIPAA makes

00:40:15.443 --> 00:40:16.864
facts or effects necessary

00:40:16.903 --> 00:40:17.744
for plan of cares when

00:40:17.784 --> 00:40:18.704
clients use insurance,

00:40:18.724 --> 00:40:20.987
like so is it chicken or the egg?

00:40:21.007 --> 00:40:22.407
Like, how does this thing actually change?

00:40:25.088 --> 00:40:26.210
Is that not doing it?

00:40:26.449 --> 00:40:28.331
Is it, you know, is it, is it the same?

00:40:28.471 --> 00:40:29.751
Is it the same question of like,

00:40:30.152 --> 00:40:31.572
how do PTs get paid more?

00:40:31.893 --> 00:40:32.014
Well,

00:40:32.034 --> 00:40:33.614
we all have to opt out at the same

00:40:33.675 --> 00:40:35.315
time and then we'll show them demand.

00:40:35.856 --> 00:40:37.077
And my, my response,

00:40:37.097 --> 00:40:37.898
whenever I see that is,

00:40:37.918 --> 00:40:38.898
have you tried to get eight

00:40:38.938 --> 00:40:40.219
people to go to dinner on

00:40:40.259 --> 00:40:41.599
time and agree on a restaurant?

00:40:41.940 --> 00:40:42.860
You're going to get a

00:40:42.920 --> 00:40:44.001
hundred thousand physical

00:40:44.021 --> 00:40:45.163
therapists to do all

00:40:45.222 --> 00:40:45.643
something that's

00:40:45.702 --> 00:40:46.103
threatening their

00:40:46.143 --> 00:40:47.583
livelihood at the same time.

00:40:48.085 --> 00:40:49.184
I mean, that's never going to happen.

00:40:49.505 --> 00:40:50.726
So the question is, how does this, this,

00:40:50.766 --> 00:40:51.547
how does this ever actually

00:40:51.586 --> 00:40:53.047
progress or does it?

00:40:54.351 --> 00:40:55.952
I think someone like Dave, you know,

00:40:56.012 --> 00:40:57.733
Dave starts laying the groundwork.

00:40:58.914 --> 00:40:59.514
I'm shocked.

00:40:59.713 --> 00:41:01.295
I am that Dave doesn't have

00:41:01.394 --> 00:41:02.755
any kind of fax system,

00:41:02.815 --> 00:41:04.416
not even an e-fax system.

00:41:05.576 --> 00:41:06.297
But it's either going to

00:41:06.336 --> 00:41:07.077
take somebody on the

00:41:07.117 --> 00:41:08.597
provider side or somebody

00:41:08.637 --> 00:41:10.257
on the consumer side who's

00:41:10.318 --> 00:41:11.378
going to be like, no,

00:41:11.438 --> 00:41:12.699
I'm not going to do this anymore.

00:41:13.159 --> 00:41:15.500
Why am I still giving you

00:41:15.599 --> 00:41:16.639
all filling out all of

00:41:16.679 --> 00:41:18.081
these forms when you have

00:41:18.161 --> 00:41:20.601
all of that information at your disposal?

00:41:22.132 --> 00:41:23.034
I think it'll only change

00:41:23.074 --> 00:41:24.855
when the people that are asking for it,

00:41:25.416 --> 00:41:26.896
so insurance companies, right?

00:41:27.356 --> 00:41:28.257
When they actually think

00:41:28.318 --> 00:41:29.458
it's either better or

00:41:29.498 --> 00:41:31.099
cheaper or more in their

00:41:31.219 --> 00:41:32.860
interest to not require it.

00:41:33.121 --> 00:41:34.422
But for them, it doesn't add anything.

00:41:34.762 --> 00:41:35.322
Like for me,

00:41:35.362 --> 00:41:36.623
like the more documentation a

00:41:36.664 --> 00:41:37.625
PT fills out or a

00:41:37.644 --> 00:41:39.166
healthcare provider fills out,

00:41:39.487 --> 00:41:40.668
the more opportunity there

00:41:40.708 --> 00:41:41.547
is to deny something.

00:41:42.148 --> 00:41:43.449
Like you're giving them ammunition.

00:41:43.610 --> 00:41:45.291
Like the line in radio that

00:41:45.331 --> 00:41:46.311
I was taught was hand them

00:41:46.331 --> 00:41:47.393
enough microphone cable and

00:41:47.432 --> 00:41:48.574
someone will hang themselves with it.

00:41:48.833 --> 00:41:49.393
Let them talk.

00:41:49.695 --> 00:41:51.115
They will talk themselves into a box.

00:41:51.983 --> 00:41:54.943
Um, I want to go to Dave and, um,

00:41:54.983 --> 00:41:57.965
the guy who was talking about, but last,

00:41:58.025 --> 00:42:00.565
last thing, closing thought on that topic,

00:42:01.306 --> 00:42:03.427
I literally tell therapists, I'm like,

00:42:03.507 --> 00:42:04.867
look, you've got a CMS,

00:42:04.887 --> 00:42:06.027
fifteen hundred claim form.

00:42:06.047 --> 00:42:06.969
You've got all of these

00:42:07.028 --> 00:42:09.429
forms are all of these fields.

00:42:09.889 --> 00:42:10.550
Leave them blank.

00:42:10.769 --> 00:42:13.170
Do not put something in a

00:42:13.190 --> 00:42:15.371
field that isn't absolutely required.

00:42:15.952 --> 00:42:17.452
And when you're doing an evaluation,

00:42:17.492 --> 00:42:18.012
guess what?

00:42:18.652 --> 00:42:20.014
More information doesn't

00:42:20.074 --> 00:42:21.153
help justification.

00:42:21.684 --> 00:42:23.405
Do not give them anything

00:42:23.445 --> 00:42:25.885
that isn't absolutely required.

00:42:26.425 --> 00:42:29.827
Because to Jimmy's point, like all that is,

00:42:29.927 --> 00:42:31.847
is increased justification to say, well,

00:42:31.867 --> 00:42:33.469
wait a minute, you said this.

00:42:33.909 --> 00:42:35.148
If this is related to that

00:42:35.190 --> 00:42:36.469
and that ties into that and

00:42:36.489 --> 00:42:37.690
then the other part comes in,

00:42:37.891 --> 00:42:39.190
that's not a covered benefit.

00:42:39.731 --> 00:42:40.831
You give them the bare

00:42:40.891 --> 00:42:42.913
minimum to get the job done.

00:42:43.632 --> 00:42:45.873
So I know Dave's not getting

00:42:45.914 --> 00:42:46.853
a good connection.

00:42:47.414 --> 00:42:48.034
Galloway.

00:42:49.161 --> 00:42:50.041
Yeah, I've seen this guy.

00:42:50.061 --> 00:42:51.242
I don't even know his backstory.

00:42:51.262 --> 00:42:52.342
Like he showed up on my

00:42:53.181 --> 00:42:54.922
algorithm probably because, you know,

00:42:54.963 --> 00:42:56.782
ten people that I follow watch him.

00:42:56.822 --> 00:42:58.023
But he's got some unique thoughts.

00:42:58.403 --> 00:43:00.244
And you said you agree with

00:43:00.324 --> 00:43:01.264
fifty percent of what he

00:43:01.284 --> 00:43:02.925
says and disagree staunchly

00:43:03.385 --> 00:43:05.045
with fifty percent of what he says.

00:43:05.505 --> 00:43:07.045
So what do you disagree with?

00:43:08.672 --> 00:43:09.893
Let's put that on hold

00:43:09.914 --> 00:43:11.494
because Dave was the one

00:43:11.514 --> 00:43:12.777
that brought it up first, right?

00:43:13.077 --> 00:43:13.277
Right.

00:43:13.777 --> 00:43:14.018
Yeah.

00:43:14.418 --> 00:43:16.000
I want to hear what Dave has to say.

00:43:16.079 --> 00:43:18.461
I mean, effectively, he's got, you know,

00:43:18.501 --> 00:43:20.204
a hundred plus million dollars.

00:43:21.244 --> 00:43:23.166
He has the freedom to talk

00:43:23.206 --> 00:43:24.387
about certain things and

00:43:24.527 --> 00:43:25.748
choose a certain path.

00:43:25.789 --> 00:43:28.630
And I'd be curious to see what Dave says.

00:43:29.371 --> 00:43:31.094
If Dave doesn't come back,

00:43:31.353 --> 00:43:31.934
what were you going to say?

00:43:32.434 --> 00:43:32.514
Well,

00:43:32.534 --> 00:43:33.315
I was going to go to the rundown

00:43:33.335 --> 00:43:34.896
because he did share a thread.

00:43:35.356 --> 00:43:36.398
And this was so it wasn't

00:43:36.458 --> 00:43:37.418
just about like who this

00:43:37.458 --> 00:43:38.579
guy is and do we agree with him?

00:43:38.940 --> 00:43:39.739
I was sort of trying to buy

00:43:39.760 --> 00:43:40.621
time there for Dave to get

00:43:40.740 --> 00:43:41.661
back on the Wi-Fi in the

00:43:41.681 --> 00:43:42.983
diner that he's at on vacation.

00:43:43.302 --> 00:43:44.483
But he but in this thread,

00:43:44.884 --> 00:43:46.164
he Scott Galloway is

00:43:46.184 --> 00:43:47.726
talking about the war on young people.

00:43:48.447 --> 00:43:50.809
And Dave in the group chat was saying, hey,

00:43:50.889 --> 00:43:53.130
maybe it's not a business

00:43:53.190 --> 00:43:54.871
model or PT making less.

00:43:56.331 --> 00:43:58.934
His view here was it's everybody.

00:43:59.333 --> 00:44:00.614
So since nineteen seventy four,

00:44:00.735 --> 00:44:02.476
the median in median labor

00:44:02.577 --> 00:44:04.278
income is up forty percent,

00:44:04.559 --> 00:44:05.840
but the S&P five hundred is

00:44:05.880 --> 00:44:07.501
up four thousand percent.

00:44:07.961 --> 00:44:09.103
So essentially he's saying

00:44:09.384 --> 00:44:12.346
the contract was work hard, go to school.

00:44:13.146 --> 00:44:15.889
you know, grind, play by the rules.

00:44:15.969 --> 00:44:16.750
And of course you'll do

00:44:16.789 --> 00:44:17.610
better than your parents

00:44:17.650 --> 00:44:18.411
because that's the way it

00:44:18.451 --> 00:44:19.911
was for a couple of generations.

00:44:20.331 --> 00:44:22.653
But today's youth or today's

00:44:22.713 --> 00:44:23.775
worker makes less than

00:44:23.795 --> 00:44:25.096
their parents did at the same age,

00:44:25.615 --> 00:44:26.836
even with a college degree.

00:44:26.856 --> 00:44:29.179
So deeper in debt and lower income.

00:44:29.438 --> 00:44:30.559
So we got bamboozled.

00:44:31.059 --> 00:44:32.320
So he's essentially saying

00:44:32.701 --> 00:44:34.101
that it's not a resource problem,

00:44:34.121 --> 00:44:35.043
it's a values problem.

00:44:36.097 --> 00:44:37.900
We have to fix it,

00:44:38.239 --> 00:44:39.121
but all these things that

00:44:39.161 --> 00:44:42.164
he lists is not a me fixing

00:44:42.184 --> 00:44:43.204
it for myself problem.

00:44:43.686 --> 00:44:45.827
Expanded public college access,

00:44:45.907 --> 00:44:47.889
reforming tax code to reward labor,

00:44:48.550 --> 00:44:50.532
loosening zoning to lower housing costs.

00:44:50.592 --> 00:44:51.432
All these things are things

00:44:51.452 --> 00:44:53.114
that a municipality or a

00:44:53.235 --> 00:44:54.235
government would need to do.

00:44:54.976 --> 00:44:57.197
Because right now in eighty three,

00:44:57.297 --> 00:44:58.818
sixty percent of thirty

00:44:58.878 --> 00:45:00.980
year olds had one child.

00:45:01.099 --> 00:45:02.161
Today it's twenty seven.

00:45:02.380 --> 00:45:04.101
So like we've we've halved

00:45:04.541 --> 00:45:05.902
and this is not like this

00:45:05.922 --> 00:45:07.503
is not a we're sterile

00:45:07.543 --> 00:45:09.264
problem or people don't enjoy sex.

00:45:09.704 --> 00:45:11.266
This is we understand math

00:45:11.306 --> 00:45:11.885
and we're saying,

00:45:12.246 --> 00:45:14.168
do I want to be child poor?

00:45:14.427 --> 00:45:14.588
Like,

00:45:14.648 --> 00:45:15.789
do I want to be able to really take

00:45:15.809 --> 00:45:18.349
care of one kid or sort of, OK,

00:45:18.389 --> 00:45:20.190
take care of two or three?

00:45:21.931 --> 00:45:23.072
Housing prices have three

00:45:23.132 --> 00:45:24.474
acts since nineteen sixty three.

00:45:24.793 --> 00:45:25.934
Student debt is over one

00:45:25.974 --> 00:45:27.496
point three trillion

00:45:27.536 --> 00:45:30.197
dollars and depression,

00:45:30.257 --> 00:45:31.237
self-harm and loneliness.

00:45:31.277 --> 00:45:31.978
So we're poorer.

00:45:32.298 --> 00:45:33.880
We're more unhappy and we're

00:45:33.920 --> 00:45:35.960
more in debt than the people before us.

00:45:36.081 --> 00:45:37.663
And I think over the last

00:45:37.682 --> 00:45:38.282
couple of years they've

00:45:38.322 --> 00:45:39.724
charted the average life

00:45:39.764 --> 00:45:41.445
expectancy has actually gone down,

00:45:41.905 --> 00:45:43.025
even though we're smarter.

00:45:43.186 --> 00:45:44.266
Why is this happening?

00:45:44.867 --> 00:45:46.288
And depending on who you talk to,

00:45:46.307 --> 00:45:47.588
they'll list the reasons why it is.

00:45:48.110 --> 00:45:49.349
But they're saying, well,

00:45:49.369 --> 00:45:50.490
who benefits from this?

00:45:50.990 --> 00:45:51.231
Well,

00:45:52.132 --> 00:45:53.853
Older Americans, people, seventy and up,

00:45:53.952 --> 00:45:54.653
got rich,

00:45:55.034 --> 00:45:56.295
but then closed the door behind

00:45:56.335 --> 00:45:58.235
them to secure themselves.

00:45:58.315 --> 00:45:59.596
Those are the people that were in power.

00:45:59.655 --> 00:46:02.157
So over seventies now hold

00:46:02.318 --> 00:46:03.418
thirty percent of US health

00:46:03.458 --> 00:46:04.079
called wealth.

00:46:04.498 --> 00:46:05.900
That's up from nineteen

00:46:05.920 --> 00:46:07.360
percent in nineteen eighty nine.

00:46:07.400 --> 00:46:08.722
That is a big, big difference.

00:46:09.422 --> 00:46:10.342
The example here is

00:46:10.422 --> 00:46:11.463
Harvard's endowment has

00:46:11.483 --> 00:46:12.523
grown five hundred percent.

00:46:13.043 --> 00:46:13.965
since eighty but their

00:46:13.985 --> 00:46:14.985
freshman class hasn't

00:46:15.005 --> 00:46:15.885
changed so they've gotten

00:46:15.945 --> 00:46:16.666
richer but they're not

00:46:16.686 --> 00:46:17.967
helping more people I would

00:46:17.987 --> 00:46:18.827
push back on the harvard

00:46:18.867 --> 00:46:19.708
thing they sort of like

00:46:20.047 --> 00:46:21.369
research a bunch of things

00:46:21.429 --> 00:46:22.730
that they sort of give away

00:46:22.769 --> 00:46:24.311
to the world and cure

00:46:24.351 --> 00:46:25.291
different things or figure

00:46:25.311 --> 00:46:27.012
things out um so

00:46:27.052 --> 00:46:28.494
essentially he was uh

00:46:28.574 --> 00:46:29.914
dave's reason for pointing

00:46:29.934 --> 00:46:31.255
this out with galloway was

00:46:31.856 --> 00:46:33.175
is it a we doing it wrong

00:46:33.215 --> 00:46:34.657
problem or is the system

00:46:34.697 --> 00:46:35.938
sort of stacked against us

00:46:36.338 --> 00:46:38.420
and pt and healthcare is

00:46:38.500 --> 00:46:39.659
not immune from all of this

00:46:39.721 --> 00:46:41.842
in every industry no matter what you are

00:46:42.903 --> 00:46:44.746
And so my issue with all of

00:46:44.786 --> 00:46:48.230
that is that that is a very

00:46:48.570 --> 00:46:50.132
victim mentality.

00:46:50.213 --> 00:46:51.614
That is a, hey,

00:46:51.775 --> 00:46:53.155
it makes you feel good

00:46:53.195 --> 00:46:54.418
because you're failing and

00:46:54.438 --> 00:46:55.059
I'm going to give you all

00:46:55.079 --> 00:46:55.980
the reasons why you're

00:46:56.019 --> 00:46:56.800
failing and you're going to

00:46:56.820 --> 00:46:58.523
blame all the successful people.

00:46:59.056 --> 00:47:01.617
for your insecurities and your failures,

00:47:01.958 --> 00:47:02.938
that doesn't help anyone.

00:47:02.978 --> 00:47:04.199
That doesn't help anything.

00:47:04.619 --> 00:47:06.000
I'm sure every generation

00:47:06.019 --> 00:47:07.141
can make the same argument

00:47:07.181 --> 00:47:09.442
in some capacity for that.

00:47:09.521 --> 00:47:11.563
The reality is there are

00:47:11.623 --> 00:47:13.523
successful young people in this world.

00:47:13.943 --> 00:47:16.025
Just because more are not

00:47:16.106 --> 00:47:17.485
successful doesn't mean

00:47:17.525 --> 00:47:19.768
that the system is sacked against them.

00:47:20.148 --> 00:47:20.708
And if you're going to

00:47:20.728 --> 00:47:21.688
cherry pick a whole bunch

00:47:21.728 --> 00:47:22.869
of stats on one side,

00:47:23.170 --> 00:47:24.170
let's cherry pick a whole

00:47:24.190 --> 00:47:25.550
bunch of stats on the other side.

00:47:26.130 --> 00:47:28.311
And so this is the

00:47:28.331 --> 00:47:29.652
fundamental problem that I

00:47:29.692 --> 00:47:32.052
have with his general content.

00:47:32.753 --> 00:47:33.273
I like him.

00:47:33.494 --> 00:47:34.353
I like his ideas.

00:47:34.474 --> 00:47:35.315
I've watched them on my

00:47:35.355 --> 00:47:37.195
first Million podcast and a

00:47:37.215 --> 00:47:38.235
bunch of other shows.

00:47:39.275 --> 00:47:40.516
I just try to balance the

00:47:40.556 --> 00:47:43.858
propaganda with what...

00:47:44.398 --> 00:47:45.938
the value that he might be

00:47:45.978 --> 00:47:47.420
able to deliver to some people.

00:47:47.840 --> 00:47:48.902
He's kind of crossed the

00:47:48.942 --> 00:47:50.063
tipping point for me.

00:47:50.643 --> 00:47:51.983
I don't even click on the

00:47:52.063 --> 00:47:53.164
interviews anymore because

00:47:53.204 --> 00:47:54.726
it's just too far down that

00:47:54.806 --> 00:47:56.007
victimhood mentality.

00:47:56.706 --> 00:47:57.987
I do like identifying a problem.

00:47:58.246 --> 00:47:59.128
Like, hey, listen,

00:47:59.148 --> 00:48:00.068
there are some things out

00:48:00.088 --> 00:48:01.148
there that are set up where

00:48:01.168 --> 00:48:02.268
if you try to fight against it,

00:48:02.307 --> 00:48:02.949
you're going to lose.

00:48:03.289 --> 00:48:04.349
So don't fight that.

00:48:04.409 --> 00:48:05.449
Figure it out somewhere else.

00:48:06.768 --> 00:48:08.329
I did the math a few months

00:48:08.369 --> 00:48:10.150
ago that said I was paying

00:48:10.190 --> 00:48:11.190
off my student loans at a

00:48:11.271 --> 00:48:12.891
pretty good clip, well above average.

00:48:12.911 --> 00:48:14.391
And I did the math and said,

00:48:14.510 --> 00:48:15.130
if I paid this,

00:48:15.692 --> 00:48:16.592
if I paid seventy two

00:48:16.612 --> 00:48:17.891
thousand dollars off at the

00:48:17.992 --> 00:48:18.891
interest rate I had,

00:48:18.931 --> 00:48:19.472
I was going to pay a

00:48:19.532 --> 00:48:21.032
quarter million dollars over ten years.

00:48:21.987 --> 00:48:22.809
Quarter million dollars,

00:48:22.829 --> 00:48:23.869
one hundred eighty thousand

00:48:23.889 --> 00:48:25.291
dollars in interest on seventy thousand.

00:48:25.590 --> 00:48:26.351
So I did the math that I'd

00:48:26.371 --> 00:48:27.211
rather be poor for two

00:48:27.231 --> 00:48:28.233
years and not go on

00:48:28.253 --> 00:48:29.494
vacations for the next two years.

00:48:30.134 --> 00:48:30.434
Jimmy,

00:48:30.494 --> 00:48:31.454
in twenty years is going to

00:48:31.474 --> 00:48:32.076
appreciate that.

00:48:32.496 --> 00:48:35.057
Like that wasn't that wasn't the way,

00:48:35.617 --> 00:48:36.398
you know, two decades,

00:48:36.438 --> 00:48:37.380
two generations ago.

00:48:37.460 --> 00:48:37.599
Right.

00:48:37.619 --> 00:48:38.701
People talked all about all

00:48:38.721 --> 00:48:40.001
the time about working a

00:48:40.061 --> 00:48:41.503
summer job to pay off college.

00:48:41.922 --> 00:48:42.063
Well,

00:48:42.123 --> 00:48:43.224
I could just get pissed off that

00:48:43.244 --> 00:48:44.266
college is expensive,

00:48:44.487 --> 00:48:45.447
but I signed into that.

00:48:45.768 --> 00:48:47.110
So I decided to be poor now

00:48:47.291 --> 00:48:48.411
and worked extra now.

00:48:48.853 --> 00:48:49.994
And I didn't, and I'm not going to,

00:48:50.235 --> 00:48:52.478
it's not the give up the latte a day,

00:48:52.538 --> 00:48:53.099
whatever it was.

00:48:53.199 --> 00:48:53.539
No, no, no.

00:48:53.579 --> 00:48:54.380
It was bite very,

00:48:54.420 --> 00:48:55.702
very hard on your bank

00:48:55.742 --> 00:48:57.003
account and understand that

00:48:57.704 --> 00:48:58.846
you want to make sure you're secure.

00:48:59.226 --> 00:49:00.706
I understand what he's saying here,

00:49:00.786 --> 00:49:01.407
but I agree.

00:49:01.788 --> 00:49:02.548
And, you know,

00:49:02.588 --> 00:49:03.710
sort of both sides

00:49:03.889 --> 00:49:05.650
understand how the game works.

00:49:05.690 --> 00:49:07.452
The game is get people riled up.

00:49:07.733 --> 00:49:08.472
If they're riled up,

00:49:08.492 --> 00:49:09.333
they love or hate you.

00:49:09.673 --> 00:49:10.655
And both of those things,

00:49:11.014 --> 00:49:11.795
both of those things are

00:49:12.096 --> 00:49:13.097
good for business.

00:49:13.416 --> 00:49:14.577
If you're in the attention business.

00:49:15.157 --> 00:49:16.838
yeah yeah and and I've

00:49:16.918 --> 00:49:17.778
played the game the other

00:49:17.818 --> 00:49:19.280
way you know I've put out

00:49:19.360 --> 00:49:20.842
posts where I'm like I

00:49:20.902 --> 00:49:22.422
understand everybody I just

00:49:22.463 --> 00:49:23.704
watched a little video clip

00:49:23.724 --> 00:49:24.485
where they were showing

00:49:24.525 --> 00:49:25.284
like a mcdonald's

00:49:25.324 --> 00:49:27.086
commercial and you get two

00:49:27.106 --> 00:49:28.427
big macs and drinks and

00:49:28.467 --> 00:49:30.108
fries for two dollars and

00:49:30.409 --> 00:49:32.650
fifty eight cents uh now

00:49:32.710 --> 00:49:33.831
it's twenty five dollars

00:49:33.871 --> 00:49:34.972
and sixty eight cents you

00:49:34.992 --> 00:49:36.753
know but on the flip side

00:49:37.614 --> 00:49:39.375
I was also the person who

00:49:39.414 --> 00:49:40.596
spent seven thousand

00:49:40.635 --> 00:49:41.936
dollars on one hundred

00:49:41.976 --> 00:49:43.635
thousand words of content

00:49:43.775 --> 00:49:44.936
in two thousand twenty

00:49:44.976 --> 00:49:47.677
three that I can now get

00:49:47.717 --> 00:49:48.797
for twenty dollars.

00:49:49.157 --> 00:49:51.398
You know, like there have been some.

00:49:51.478 --> 00:49:51.818
Yes,

00:49:52.018 --> 00:49:54.358
my house today is worth double what it

00:49:54.438 --> 00:49:56.778
was when I bought it in two thousand six.

00:49:57.358 --> 00:49:58.478
That's horrible if I want to

00:49:58.498 --> 00:49:59.338
buy a house today.

00:49:59.500 --> 00:49:59.900
Right.

00:49:59.940 --> 00:50:01.159
But on the flip side.

00:50:02.119 --> 00:50:03.862
There is access to AI and

00:50:03.882 --> 00:50:06.364
other technology that now I

00:50:06.384 --> 00:50:08.146
can run a clinic just as

00:50:08.206 --> 00:50:09.387
profitably with three

00:50:09.427 --> 00:50:10.949
people that I used to have

00:50:10.989 --> 00:50:13.530
to hire ten people for, you know.

00:50:13.610 --> 00:50:15.172
So there's always going to

00:50:15.213 --> 00:50:16.594
be opportunities and we see

00:50:16.653 --> 00:50:17.315
it all the time.

00:50:17.355 --> 00:50:19.896
We see young people that are doing things,

00:50:20.338 --> 00:50:21.639
generating millions of

00:50:21.699 --> 00:50:24.322
dollars that are no smarter

00:50:24.342 --> 00:50:26.143
than anyone watching this show right now.

00:50:27.344 --> 00:50:29.005
They just chose a different path.

00:50:29.065 --> 00:50:30.867
So we can acknowledge the

00:50:30.907 --> 00:50:31.786
golden handcuffs.

00:50:31.847 --> 00:50:32.608
We can say, look,

00:50:33.088 --> 00:50:34.088
I spent a lot of money on

00:50:34.108 --> 00:50:35.168
my college degree.

00:50:35.949 --> 00:50:37.150
I know that I've got these

00:50:37.210 --> 00:50:38.110
responsibilities,

00:50:38.170 --> 00:50:40.251
but if finance is important to me,

00:50:40.672 --> 00:50:41.853
financial security,

00:50:41.893 --> 00:50:43.054
financial independence,

00:50:43.474 --> 00:50:44.494
then maybe I'm going to go

00:50:44.514 --> 00:50:45.596
where the money is.

00:50:45.976 --> 00:50:47.817
And then I can come back to

00:50:47.836 --> 00:50:49.257
the thing that I'm passionate about.

00:50:49.697 --> 00:50:50.878
Like we all have to clean

00:50:50.898 --> 00:50:52.039
the toilet at some point.

00:50:52.639 --> 00:50:54.420
Nobody loves cleaning a toilet,

00:50:54.880 --> 00:50:55.681
but it's just something

00:50:55.702 --> 00:50:56.541
that needs to get done.

00:50:56.601 --> 00:50:58.782
So go do that and then come

00:50:58.802 --> 00:51:00.063
back to the thing that you love.

00:51:00.923 --> 00:51:02.144
You had a post every day

00:51:02.244 --> 00:51:04.826
about love and the way to

00:51:04.846 --> 00:51:06.547
get work life balance is to

00:51:06.586 --> 00:51:07.427
work on something you don't

00:51:07.467 --> 00:51:08.208
care that much about.

00:51:08.608 --> 00:51:09.789
And that pissed people off.

00:51:11.237 --> 00:51:12.717
tell, tell me why you wrote it.

00:51:12.898 --> 00:51:14.378
And I sort of agree with you.

00:51:14.940 --> 00:51:15.199
Yeah.

00:51:15.219 --> 00:51:15.420
Like,

00:51:15.559 --> 00:51:18.282
I mean how all this fantasy about like,

00:51:18.322 --> 00:51:19.302
do what you love and you'll

00:51:19.322 --> 00:51:20.623
never work a day in your life.

00:51:20.764 --> 00:51:21.445
Total BS.

00:51:21.585 --> 00:51:22.525
Like the,

00:51:23.045 --> 00:51:24.867
the best professional athletes

00:51:25.268 --> 00:51:26.528
spend the majority of their

00:51:26.588 --> 00:51:28.050
time doing things they hate

00:51:28.490 --> 00:51:29.490
just so they have a

00:51:29.570 --> 00:51:31.172
fraction of the time doing

00:51:31.233 --> 00:51:32.233
something that they love.

00:51:32.673 --> 00:51:35.016
But you know, if I don't want

00:51:35.969 --> 00:51:38.871
that emotion to control my existence,

00:51:38.891 --> 00:51:40.172
like the highs and the lows,

00:51:40.231 --> 00:51:41.413
if I wanna cut some of

00:51:41.452 --> 00:51:43.653
those peaks and troughs,

00:51:43.795 --> 00:51:45.215
you do something you're good at,

00:51:45.255 --> 00:51:46.275
but maybe not something

00:51:46.295 --> 00:51:47.916
you're crazy passionate about.

00:51:48.396 --> 00:51:50.898
Like I'm good at this, whatever,

00:51:50.938 --> 00:51:51.398
accounting.

00:51:52.018 --> 00:51:53.760
I've got a mind for organization.

00:51:54.161 --> 00:51:56.202
I don't love accounting, but I can do it.

00:51:56.342 --> 00:51:57.262
I can do it well.

00:51:57.402 --> 00:51:58.963
I can make a great living at it.

00:51:59.364 --> 00:52:01.744
So I spend my time making my

00:52:01.804 --> 00:52:02.985
money in accounting

00:52:03.666 --> 00:52:05.590
But then on the side, I have my passion.

00:52:06.492 --> 00:52:07.373
I always say cooking.

00:52:07.414 --> 00:52:08.094
I love cooking.

00:52:08.155 --> 00:52:08.936
I cook every day.

00:52:09.016 --> 00:52:10.059
I cook three meals a day.

00:52:10.099 --> 00:52:11.161
I'll cook six meals a day.

00:52:12.429 --> 00:52:14.172
I would never want to open a

00:52:14.271 --> 00:52:16.172
restaurant because I will

00:52:16.193 --> 00:52:17.614
immediately hate cooking

00:52:17.833 --> 00:52:19.255
when my mortgage and my

00:52:19.335 --> 00:52:21.157
livelihood is tied to cooking.

00:52:21.717 --> 00:52:23.039
And I'm not cooking because

00:52:23.099 --> 00:52:24.219
I love cooking anymore,

00:52:24.260 --> 00:52:25.681
but I'm cooking to make money.

00:52:25.920 --> 00:52:27.842
That is the worst thing to possibly do.

00:52:28.242 --> 00:52:30.043
So if you love helping people,

00:52:30.585 --> 00:52:31.826
maybe helping people for

00:52:31.885 --> 00:52:33.246
money is not the thing you

00:52:33.266 --> 00:52:35.128
should do and go do

00:52:35.188 --> 00:52:36.889
something else to fill the bank account.

00:52:37.355 --> 00:52:38.195
I told this story before

00:52:38.215 --> 00:52:39.074
when I was in college.

00:52:39.416 --> 00:52:40.735
I was like, you know what's cool?

00:52:41.315 --> 00:52:42.175
Bars are cool.

00:52:42.456 --> 00:52:43.257
I want to own a bar.

00:52:43.757 --> 00:52:44.996
And my Uncle Frank owned a bar.

00:52:45.336 --> 00:52:46.577
And I don't know if it was brilliance,

00:52:47.057 --> 00:52:47.577
genius,

00:52:47.677 --> 00:52:49.318
or just sheer accident that he said, well,

00:52:49.338 --> 00:52:49.518
hey,

00:52:49.538 --> 00:52:51.278
the summer between junior and senior year,

00:52:51.659 --> 00:52:54.079
I was interning at K-Rock

00:52:54.099 --> 00:52:54.840
where Howard Stern was an

00:52:54.880 --> 00:52:55.860
intern because I was also like,

00:52:55.920 --> 00:52:56.619
maybe radio.

00:52:56.920 --> 00:52:58.221
And I did both for a summer.

00:52:58.501 --> 00:52:59.460
At the end of the summer, I mean,

00:52:59.481 --> 00:53:00.880
I had a ton of fun doing both jobs.

00:53:01.282 --> 00:53:02.041
But at the end of the summer,

00:53:02.081 --> 00:53:03.001
Uncle Frank came to me and goes,

00:53:03.262 --> 00:53:04.521
so what are the thoughts on owning a bar?

00:53:04.581 --> 00:53:06.003
And I said, I want to go to bars.

00:53:06.123 --> 00:53:06.663
I think I want to go.

00:53:06.822 --> 00:53:07.503
go to bars.

00:53:07.523 --> 00:53:09.083
I want to hang out at bars

00:53:09.123 --> 00:53:10.045
for a little while and then

00:53:10.105 --> 00:53:10.905
go do other stuff.

00:53:11.364 --> 00:53:12.766
And that's what I wanted my outlet to be.

00:53:13.146 --> 00:53:13.967
Even though, I mean,

00:53:14.007 --> 00:53:15.166
at the time it was a pretty

00:53:15.206 --> 00:53:16.788
lucrative job to just be a bartender.

00:53:16.807 --> 00:53:17.788
It's a cash business.

00:53:18.268 --> 00:53:19.208
Cash was right in front of you.

00:53:19.228 --> 00:53:19.809
By the end of the night,

00:53:19.829 --> 00:53:21.269
you got paid every night on time.

00:53:21.670 --> 00:53:23.130
And even though I was like, you know,

00:53:23.170 --> 00:53:23.550
twenty,

00:53:23.771 --> 00:53:25.132
twenty years old knowing I don't

00:53:25.152 --> 00:53:25.711
want to do this when I'm

00:53:25.751 --> 00:53:27.813
forty one and to get what out of it,

00:53:27.833 --> 00:53:30.795
what I would need to put so much into it,

00:53:30.855 --> 00:53:31.894
I wouldn't get enough out of it.

00:53:31.976 --> 00:53:33.695
I said, not my thing.

00:53:33.735 --> 00:53:34.556
So I went and did another thing.

00:53:35.137 --> 00:53:36.641
Did I ever tell you about my

00:53:36.681 --> 00:53:37.503
mom's nightclub?

00:53:37.923 --> 00:53:39.467
No, your mom at a nightclub?

00:53:39.809 --> 00:53:39.949
Yeah.

00:53:41.152 --> 00:53:41.711
So this will be an

00:53:41.751 --> 00:53:43.193
interesting story for everyone.

00:53:43.853 --> 00:53:45.175
I've had such a random

00:53:46.315 --> 00:53:47.836
existence throughout my life.

00:53:48.237 --> 00:53:48.978
There was a phase.

00:53:49.458 --> 00:53:51.239
So my mom came from South America.

00:53:51.478 --> 00:53:53.019
She was the first in her family.

00:53:53.081 --> 00:53:54.400
She immigrated to the US.

00:53:54.420 --> 00:53:56.503
She got a job in Queens, New York,

00:53:57.202 --> 00:53:58.643
and then kind of grew and

00:53:58.764 --> 00:53:59.764
bought real estate.

00:53:59.844 --> 00:54:01.847
And this was a teenager coming,

00:54:02.226 --> 00:54:03.427
didn't even speak the language.

00:54:03.668 --> 00:54:05.869
So this was kind of her by nature.

00:54:06.489 --> 00:54:07.590
She always loved the business,

00:54:07.630 --> 00:54:08.672
was always an entrepreneur.

00:54:09.639 --> 00:54:11.641
Her dream had always been to

00:54:11.860 --> 00:54:13.123
own a Spanish nightclub.

00:54:13.682 --> 00:54:15.364
And so when she had kind of

00:54:15.385 --> 00:54:16.505
gotten out of the fashion

00:54:16.545 --> 00:54:17.668
industry and what she was

00:54:17.728 --> 00:54:19.929
doing for most of her life,

00:54:20.391 --> 00:54:22.552
she bought a restaurant down in Bradenton,

00:54:22.572 --> 00:54:23.072
Florida.

00:54:23.614 --> 00:54:25.036
It was a huge building.

00:54:25.835 --> 00:54:27.117
They converted it from

00:54:27.177 --> 00:54:28.840
full-time restaurant with a

00:54:28.920 --> 00:54:30.320
full liquor license into a

00:54:30.380 --> 00:54:31.181
Latin nightclub.

00:54:32.123 --> 00:54:33.623
And she tried to do what she

00:54:33.643 --> 00:54:34.824
thought everybody did.

00:54:34.864 --> 00:54:36.043
You're open seven days a

00:54:36.083 --> 00:54:37.184
week and you do all these things.

00:54:37.204 --> 00:54:38.385
And she was like, no, no, no, no,

00:54:38.425 --> 00:54:39.204
that's not working.

00:54:39.804 --> 00:54:41.266
She got rid of everything.

00:54:41.846 --> 00:54:44.186
She went to only one night a week.

00:54:45.047 --> 00:54:47.427
She could fit about six hundred occupancy,

00:54:47.487 --> 00:54:49.387
six hundred people in the building.

00:54:49.867 --> 00:54:51.188
She charged a twenty dollar

00:54:51.228 --> 00:54:53.228
cover so that she she had

00:54:53.268 --> 00:54:55.090
kind of a higher level clientele,

00:54:55.750 --> 00:54:59.590
but no glasses, no bottled beer.

00:55:00.150 --> 00:55:01.652
It was only canned beer.

00:55:02.152 --> 00:55:03.632
You only had three choices.

00:55:03.693 --> 00:55:05.614
It was like Corona, Bud Light,

00:55:05.655 --> 00:55:06.596
and something else.

00:55:07.896 --> 00:55:10.018
All mixed drinks came in plastic cups,

00:55:10.038 --> 00:55:11.418
so nobody got into fights

00:55:11.480 --> 00:55:12.659
and people weren't getting

00:55:13.001 --> 00:55:14.081
cut with glass.

00:55:15.422 --> 00:55:16.483
She hired a couple of local

00:55:16.523 --> 00:55:18.505
police and had a security team.

00:55:18.704 --> 00:55:20.527
And I mean, it was just...

00:55:21.086 --> 00:55:22.268
printing cash.

00:55:22.909 --> 00:55:24.831
I remember growing up as a kid,

00:55:25.132 --> 00:55:25.753
she'd be like, Hey,

00:55:25.773 --> 00:55:26.454
can you get me something

00:55:26.474 --> 00:55:27.215
out of the closet?

00:55:27.295 --> 00:55:28.717
I'd go in and it'd be a

00:55:28.817 --> 00:55:30.239
stack of five thousand

00:55:30.278 --> 00:55:32.161
dollars in twenties just

00:55:32.201 --> 00:55:34.804
because she had so much cash everywhere.

00:55:36.126 --> 00:55:37.327
And, you know,

00:55:37.447 --> 00:55:39.148
I learned so many lessons through that.

00:55:39.188 --> 00:55:40.527
I became a bartender and I

00:55:40.547 --> 00:55:42.007
would serve drinks and all

00:55:42.068 --> 00:55:42.989
of these different things.

00:55:43.048 --> 00:55:46.148
But I just think, like you said,

00:55:46.309 --> 00:55:48.469
you've got this idea of

00:55:48.670 --> 00:55:50.369
what you think you want and

00:55:50.389 --> 00:55:52.411
then you get into it and then you're like,

00:55:52.590 --> 00:55:54.751
oh, that's not actually what I want.

00:55:55.271 --> 00:55:55.931
Patient comes in.

00:55:55.972 --> 00:55:56.811
I've got shoulder pain.

00:55:56.851 --> 00:55:57.891
I want to throw the football.

00:55:58.251 --> 00:55:59.472
OK, let's start lifting weights.

00:55:59.532 --> 00:56:00.492
No, I don't want to do that.

00:56:01.693 --> 00:56:03.393
There's a disconnect between

00:56:03.434 --> 00:56:04.713
what we think we want and

00:56:04.753 --> 00:56:05.795
what we actually want.

00:56:05.855 --> 00:56:07.295
I think I want to throw a football.

00:56:07.655 --> 00:56:08.476
I actually just want my

00:56:08.496 --> 00:56:09.476
shoulder to stop hurting.

00:56:09.695 --> 00:56:09.876
Right.

00:56:10.155 --> 00:56:10.717
I don't care.

00:56:11.016 --> 00:56:12.036
I'm happy with the dream.

00:56:12.436 --> 00:56:12.697
Right.

00:56:13.358 --> 00:56:13.538
Yeah.

00:56:13.577 --> 00:56:14.478
People want the result,

00:56:14.498 --> 00:56:16.059
but not the process to get the result.

00:56:16.139 --> 00:56:16.699
I'm very sorry.

00:56:16.719 --> 00:56:18.239
That's what makes it unachievable,

00:56:18.440 --> 00:56:19.320
which is funny too,

00:56:19.340 --> 00:56:20.960
because now like the whole Ozempic

00:56:21.681 --> 00:56:23.460
And those things are coming out.

00:56:23.601 --> 00:56:24.802
And and there was, you know,

00:56:24.862 --> 00:56:25.902
Corey Doctorow.

00:56:26.541 --> 00:56:27.681
He writes like he writes

00:56:27.722 --> 00:56:29.762
like he wrote for like the

00:56:29.882 --> 00:56:31.802
website or still does for Boing Boing.

00:56:31.842 --> 00:56:33.242
Essentially, he's just like this tech guy.

00:56:33.884 --> 00:56:34.664
And I started reading some

00:56:34.684 --> 00:56:36.324
of his stuff ten to fifteen years ago,

00:56:36.403 --> 00:56:37.443
being like, this is cool.

00:56:37.483 --> 00:56:38.304
This is sci fi.

00:56:38.684 --> 00:56:40.465
And then slowly after I

00:56:40.485 --> 00:56:41.364
stopped reading his books,

00:56:41.425 --> 00:56:41.985
the stuff that he was

00:56:42.045 --> 00:56:43.626
talking about started happening.

00:56:43.786 --> 00:56:44.945
Like he was the first person

00:56:44.965 --> 00:56:46.606
I ever like read a fiction

00:56:46.646 --> 00:56:48.005
book about three printing

00:56:48.425 --> 00:56:49.527
before I ever heard any

00:56:49.626 --> 00:56:50.646
article on three printing.

00:56:51.146 --> 00:56:52.206
And he talked about.

00:56:53.068 --> 00:56:54.568
Three D printing and what would happen?

00:56:54.648 --> 00:56:55.188
Ten years.

00:56:55.829 --> 00:56:57.108
What will that do to the economy?

00:56:57.128 --> 00:56:58.449
What will that do to value?

00:56:58.489 --> 00:56:59.489
Where does value shift?

00:56:59.530 --> 00:57:01.670
If I can just steal a plan

00:57:02.050 --> 00:57:03.371
from an object that you

00:57:03.411 --> 00:57:04.431
took years to figure out

00:57:04.452 --> 00:57:05.632
how to make an ingenuity to make,

00:57:05.672 --> 00:57:06.672
I can just download it and

00:57:06.692 --> 00:57:07.411
then print it myself.

00:57:07.431 --> 00:57:08.193
I don't need you anymore.

00:57:09.112 --> 00:57:09.833
In parallel,

00:57:09.873 --> 00:57:10.514
he was talking about

00:57:10.554 --> 00:57:12.014
biohacking and talking

00:57:12.034 --> 00:57:13.014
about one of the characters

00:57:13.034 --> 00:57:14.956
was always was a genius,

00:57:14.996 --> 00:57:16.777
but always obese and overweight.

00:57:17.097 --> 00:57:18.157
But he started doing this

00:57:18.557 --> 00:57:19.717
biohacking thing.

00:57:20.139 --> 00:57:21.818
And of course, now he became this version,

00:57:21.938 --> 00:57:22.639
a good looking,

00:57:22.780 --> 00:57:24.960
a good looking guy in shape,

00:57:25.021 --> 00:57:26.621
but didn't have to do any of the stuff.

00:57:27.242 --> 00:57:28.063
He, in turn,

00:57:28.123 --> 00:57:29.864
had to ingest like six

00:57:29.905 --> 00:57:31.327
thousand calories a day or

00:57:31.367 --> 00:57:32.628
something to keep up with.

00:57:32.909 --> 00:57:34.690
It was an increased metabolism drug,

00:57:34.971 --> 00:57:35.472
essentially.

00:57:36.472 --> 00:57:37.434
But what that did to his

00:57:37.494 --> 00:57:39.496
life in the later years was not good.

00:57:39.657 --> 00:57:40.418
And I'm looking at this

00:57:40.438 --> 00:57:41.960
saying these people say parallel.

00:57:42.179 --> 00:57:43.101
They want the result,

00:57:43.161 --> 00:57:44.583
but aren't doing the work.

00:57:44.663 --> 00:57:45.784
But they're like, well, I can get a pill.

00:57:46.670 --> 00:57:48.271
or I can get a shot and I'll get that.

00:57:48.692 --> 00:57:49.251
Yes.

00:57:49.612 --> 00:57:51.273
We talk about what I, my right.

00:57:51.353 --> 00:57:53.295
I have the right to be in shape,

00:57:53.777 --> 00:57:55.177
but not the responsibilities.

00:57:55.257 --> 00:57:56.878
And this is political or this is,

00:57:57.260 --> 00:57:58.059
this is just math.

00:57:58.481 --> 00:57:58.800
Yes.

00:57:58.880 --> 00:57:59.842
You get rights.

00:58:00.161 --> 00:58:01.282
What people forget to talk

00:58:01.302 --> 00:58:02.724
about is the responsibility

00:58:02.744 --> 00:58:04.746
that you are actually you, uh,

00:58:04.766 --> 00:58:06.208
that you owe to that, whether that be,

00:58:06.628 --> 00:58:09.309
political and government or biology?

00:58:09.429 --> 00:58:09.791
Yes,

00:58:09.951 --> 00:58:11.411
I'm injecting something and it's going

00:58:11.452 --> 00:58:12.532
to make me lose weight.

00:58:12.952 --> 00:58:14.134
What else are you

00:58:14.213 --> 00:58:15.554
responsible for that it's

00:58:15.755 --> 00:58:16.876
also going to be doing?

00:58:16.976 --> 00:58:18.657
I think people rush in for those rights,

00:58:18.697 --> 00:58:19.378
the outcomes,

00:58:20.117 --> 00:58:21.820
and they don't stick around

00:58:21.840 --> 00:58:22.519
too long for those

00:58:22.559 --> 00:58:26.903
responsibilities or when the bill comes,

00:58:26.923 --> 00:58:28.003
when the check comes due,

00:58:28.224 --> 00:58:29.405
they don't want to pay it, of course.

00:58:29.826 --> 00:58:29.925
Yeah.

00:58:30.065 --> 00:58:30.346
All right.

00:58:30.365 --> 00:58:31.367
So Dave's somewhere in a

00:58:31.427 --> 00:58:32.387
diner in South Jersey.

00:58:32.407 --> 00:58:33.186
Want to do parting shots?

00:58:33.626 --> 00:58:34.447
Yeah, let's do it.

00:58:34.487 --> 00:58:38.989
So Larry Benz, I just saw his article.

00:58:39.088 --> 00:58:40.989
He's talking about Ozempic and how,

00:58:41.190 --> 00:58:41.429
you know,

00:58:41.449 --> 00:58:42.411
what the role physical

00:58:42.451 --> 00:58:43.251
therapists are going to

00:58:43.291 --> 00:58:46.391
play in that whole weight

00:58:46.431 --> 00:58:47.753
loss Ozempic world.

00:58:48.393 --> 00:58:50.293
Um, if you're not,

00:58:50.494 --> 00:58:51.494
my parting shot is if you

00:58:51.514 --> 00:58:52.795
guys aren't out there,

00:58:52.856 --> 00:58:53.896
like seeing what the

00:58:53.916 --> 00:58:55.016
thought leaders are talking

00:58:55.056 --> 00:58:57.539
about inside and outside the profession.

00:58:57.579 --> 00:58:57.639
Uh,

00:58:58.599 --> 00:59:00.601
I was on an interview yesterday with

00:59:00.681 --> 00:59:02.742
Neil Trickett from practice promotions,

00:59:02.902 --> 00:59:04.702
and we talked about, you know,

00:59:04.842 --> 00:59:05.824
who do I follow?

00:59:05.864 --> 00:59:06.744
Who do I look at?

00:59:06.864 --> 00:59:08.626
I don't look at anybody within the field.

00:59:09.786 --> 00:59:10.467
And they're great.

00:59:10.626 --> 00:59:13.409
I just I want new ideas, fresh ideas,

00:59:13.469 --> 00:59:14.670
different concepts.

00:59:15.130 --> 00:59:16.391
So I go outside the

00:59:16.431 --> 00:59:17.771
profession of physical therapy.

00:59:17.831 --> 00:59:19.152
I look at other business

00:59:19.213 --> 00:59:21.253
models and I reflect on that.

00:59:21.713 --> 00:59:22.894
And I think about how we can

00:59:22.934 --> 00:59:24.275
bring those concepts into

00:59:24.315 --> 00:59:25.657
what we we're doing to

00:59:25.717 --> 00:59:27.958
deliver a better patient care experience.

00:59:28.318 --> 00:59:29.619
So don't don't be afraid to

00:59:29.639 --> 00:59:30.679
go outside of PT.

00:59:31.460 --> 00:59:31.681
I would.

00:59:31.900 --> 00:59:32.121
Yes.

00:59:32.201 --> 00:59:33.161
And that which is don't be

00:59:33.202 --> 00:59:33.942
afraid to do it.

00:59:33.983 --> 00:59:34.963
I'm going to say you have to

00:59:35.202 --> 00:59:36.403
if you're just photocopying

00:59:36.423 --> 00:59:37.324
what everybody else is doing.

00:59:37.605 --> 00:59:38.565
I remember being in radio.

00:59:39.965 --> 00:59:41.686
And when I got to run my

00:59:41.706 --> 00:59:42.527
first radio station,

00:59:42.907 --> 00:59:43.387
there were all these

00:59:43.547 --> 00:59:45.568
industry conferences and stuff like that.

00:59:45.608 --> 00:59:46.429
And I remember my boss,

00:59:46.469 --> 00:59:47.309
the general manager, would be like,

00:59:47.329 --> 00:59:47.969
do you want to go to this?

00:59:47.989 --> 00:59:48.730
Do you want to go to this?

00:59:49.170 --> 00:59:51.251
And I got to be like, I was like, no,

00:59:51.431 --> 00:59:52.652
I'm figuring it out here.

00:59:52.731 --> 00:59:53.891
I'm watching commercials and

00:59:53.931 --> 00:59:54.913
figuring out what huge,

00:59:54.972 --> 00:59:56.333
huge corporations are doing.

00:59:56.773 --> 00:59:58.233
And then I'm stealing that idea.

00:59:58.293 --> 00:59:59.094
Or how can I?

00:59:59.434 --> 01:00:00.614
Or even just understanding it.

01:00:00.916 --> 01:00:01.775
I didn't steal everything

01:00:01.795 --> 01:00:03.556
that I saw because it wouldn't fit.

01:00:04.237 --> 01:00:05.617
Not because I was too proud

01:00:05.657 --> 01:00:06.358
to steal something.

01:00:06.697 --> 01:00:07.719
right I got I got a lesson

01:00:07.840 --> 01:00:09.221
early in my radio career it

01:00:09.242 --> 01:00:10.063
doesn't matter that it was

01:00:10.083 --> 01:00:11.164
a radio lesson which is

01:00:11.505 --> 01:00:12.885
good artist bardo great

01:00:12.925 --> 01:00:14.027
artists steal like every

01:00:14.208 --> 01:00:14.929
the thing that you're

01:00:15.349 --> 01:00:16.391
thinking about stealing but

01:00:16.411 --> 01:00:17.431
you don't want to they

01:00:17.472 --> 01:00:18.673
stole it from someone else

01:00:18.793 --> 01:00:19.715
they stole it from someone

01:00:19.755 --> 01:00:21.677
else in a different industry uh

01:00:21.838 --> 01:00:23.980
Staying within healthcare or PT,

01:00:24.360 --> 01:00:26.222
you will not find those

01:00:26.302 --> 01:00:27.382
ideas unless you're

01:00:27.402 --> 01:00:28.003
stealing from somebody

01:00:28.023 --> 01:00:29.224
who's already stolen from outside,

01:00:29.543 --> 01:00:30.425
and that's stealing from

01:00:30.485 --> 01:00:31.304
outside by proxy.

01:00:31.846 --> 01:00:32.706
We're back on Tuesday.

01:00:32.766 --> 01:00:33.726
Dave will be probably off

01:00:33.887 --> 01:00:34.788
vacation somewhere,

01:00:34.827 --> 01:00:35.708
not on the Jersey Shore.

01:00:36.610 --> 01:00:38.690
Take a listen and subscribe to everything.

01:00:38.992 --> 01:00:39.911
What do you got going on this weekend,

01:00:39.952 --> 01:00:40.172
Tony?

01:00:40.353 --> 01:00:40.713
Anything good?

01:00:41.820 --> 01:00:44.742
Oh man, kids, kids are getting into sports,

01:00:44.762 --> 01:00:44.942
you know,

01:00:44.961 --> 01:00:46.483
already like the next year

01:00:46.503 --> 01:00:47.443
hasn't even started.

01:00:47.463 --> 01:00:48.943
And we're, we've got basketball,

01:00:48.983 --> 01:00:49.864
we've got baseball,

01:00:49.923 --> 01:00:51.304
we've got some football starting.

01:00:51.384 --> 01:00:51.943
What about you?

01:00:52.945 --> 01:00:53.565
Father's day,

01:00:53.644 --> 01:00:55.505
hanging out with dad's steak.

01:00:55.806 --> 01:00:56.445
Probably that pool.

01:00:56.465 --> 01:00:57.505
It's going to be some good weather.

01:00:57.606 --> 01:00:59.186
Finally, in the first, first time,

01:00:59.226 --> 01:01:00.086
I think there were thirty

01:01:00.226 --> 01:01:01.467
one weekends in a row with

01:01:01.527 --> 01:01:03.588
some precipitation in New York state.

01:01:03.807 --> 01:01:05.108
So fingers crossed we get a

01:01:05.148 --> 01:01:07.090
father's day weekend without some rain.

01:01:07.570 --> 01:01:08.750
We'll see you guys here back next week.

01:01:08.769 --> 01:01:09.849
Thanks for spending time with us.

01:01:10.190 --> 01:01:10.570
We appreciate it.

01:01:10.590 --> 01:01:11.170
We'll see you.