Breaking Down Virtual PT Solutions with Jimmy McKay & Tony Maritato

WEBVTT

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Good morning, PT Breakfast Club,

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Tony Maritato, and the great Jimmy McKay.

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Jimmy, I'm so glad you got back on today.

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And we're back.

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That's what you have to do when you come.

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And we're back.

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I don't know why they always

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would hold their ear.

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I'm not really sure.

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Good to be back.

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Bright and early.

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I think I picked a great day where I am.

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It's super bright, super sunny, super warm,

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so...

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What is the temperature there?

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Like here in Ohio, it's perfect.

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It's like 72 degrees, sunny,

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just gorgeous day.

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Yeah,

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it's pretty nice here in upstate New

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York.

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We haven't had,

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I was just actually

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commenting on with a couple

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of friends like, oh, it's been a great,

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you know, spring, early summer.

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I'm like, yeah,

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we haven't had any crazy hot days.

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62 degrees right now.

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And then like, yeah, 90s coming next week.

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So buckle up.

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Same for us.

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Yeah.

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So what's on the agenda?

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What's going on?

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So this was something that I

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wanted to bring to attention.

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It's really,

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really cool when you see PT

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pop up and not being spoken

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about or the conversation

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not started by physical therapists.

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We talk about ourselves and

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what we do all the time.

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We talk about it with each other.

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We talk about it with patients.

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We talk about it with people

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who don't even know what we do.

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But there was a recent report.

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About a week ago that came

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up that came out from this

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organization called Peterson Health.

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I'll bring it on the screen

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for those of you watching

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the live stream and we'll

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put the link in the show notes.

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This is an independent organization.

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So it's called Peterson Health Technology.

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And I don't really know a

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ton of the background on

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this organization,

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but if you scroll to the

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bottom of their website,

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they've got not only

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Peterson Health Technology,

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but like Peterson Philanthropy,

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stuff like that.

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So they're an organization

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that sort of does these

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third party reports.

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They pick a topic and then they say,

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all right,

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let's get to sort of the bottom of this.

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So the thing I wanted to

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highlight was this report that came out.

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Let me switch screens here.

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So this report came out.

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It was great to see APTA jumped on it,

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probably because the

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results were pretty good for PT.

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But it's around what you and

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Dave and myself have been

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talking about for the last

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couple of weeks.

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And that's around virtual MSK solutions.

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So I think the two hot

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topics in the last couple

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of months have been

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artificial intelligence.

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We've been talking about that.

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We'll continue to talk about that.

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Our grandkids will be talking about that.

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And this other virtual MSK solution.

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And remember back to 2020

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when virtual care was not possible.

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And then all of a sudden it

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was absolutely necessary.

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And necessity is the mother of invention.

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So this independent report,

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I'll share the breakdown.

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They do some cost analysis too,

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which we can get into the weeds.

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But I thought this chart

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that they put up summed it up.

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So here's what they did.

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They called it Peterson

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Health Technology Institute

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category level rankings for

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virtual MSK solutions.

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And I do want to preface this.

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Right.

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So while this report is

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about physical therapy,

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our friends who do

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neurologic or vestibular care,

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this is focused on, you know,

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MSK care, right?

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Because I got some people who work with,

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you know,

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patients post-stroke or post

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traumatic brain injury.

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That's not what this report

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was looking at.

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This was looking at what

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they called traditional low back pain.

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They mentioned several times in the report,

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right?

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So they broke it down to three categories.

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App-based exercise therapy,

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and they give some examples.

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Kaya Health being one of them.

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I hadn't heard of the other

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one that they had.

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Dario, had you heard of Dario?

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I have not.

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Okay.

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Physical therapist guided solutions.

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So the first category is

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app-based sort of PT hands-off.

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The second being physical

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therapist guided solutions.

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Good to be back.

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And then the third would be RTM,

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remote therapeutic monitoring,

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augmented PT solutions.

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Okay.

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Now it broke those three categories,

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app-based, PT-guided, PT-augmented,

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and then it ranked it in

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clinical effectiveness.

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Does it do what it actually claims to do?

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Right.

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Does it actually get the job done?

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And then it looks at the number.

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So it's it's matching or

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it's pairing value plus cost.

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And that's a value proposition.

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And then it sort of gives it

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a breakdown and a summary.

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And it ranked it in a couple

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of different ways.

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Positive, negative and moderate.

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So positive, negative and neutral.

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And then higher clinical

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evidence certainty and

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lower clinical evidence certainty.

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So like how positive, how neutral,

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how negative was it?

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And then how sure are they about that?

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So they were, it was in my view,

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just from this cursory look,

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it was looking at it and saying, okay,

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how well are these things?

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And then how well can we

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actually rank them?

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And before you looked at this,

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what would you have thought

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would have been the best

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and the highest ranked level?

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Would it have been app based

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physical therapist guided

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or RTM or physical

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therapist augmented solutions?

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I mean,

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I would have said physical

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therapist guided just

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because you have that human

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accountability aspect.

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There's a relationship there.

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Yeah.

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Yeah.

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Yeah, me too.

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I would have said, and of course,

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as physical therapists,

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we want to see that pop up, right?

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Because we're all nervous, myself included,

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that, hey,

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maybe we're going to get replaced.

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And that's why I mentioned

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AI at the top of the intro for this.

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But that's what it was.

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So let's go through it.

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So yeah,

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so physical therapists guided solutions,

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and they used examples.

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and I'm sure you've heard,

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we've talked about a couple

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of these platforms, uh, hinge.

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Yeah.

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Uh, Omeda recovery, one sword Vori.

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I'd heard of hinge sword and recovery one.

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I hadn't heard of Omeda or Vori.

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Have you?

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No.

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Same with you.

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Hinge and sword were the two

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that jumped out at me.

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Right.

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And the results for physical

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therapist guided solutions

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were this clinical effectiveness.

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It gave it a positive ranking, a positive,

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uh, um, uh, uh,

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ranking or grade.

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It also said lower clinical

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evidence certainty.

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So what it's saying is the

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results we got were positive,

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but we need more evidence

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to actually back this up

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before we give this an A plus.

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So that was good.

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They were able to,

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with higher clinical evidence,

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go into the economic impact.

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So in terms of results for

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physical therapists and guided solutions,

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They said these platforms

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overall improve both pain

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and function comparable to in-person PT.

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And that makes people real nervous, right?

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Because like, wow,

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it's comparable to in-person PT,

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except it was still delivered by a PT.

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Right.

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We're just talking about a where and a how,

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right?

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Going down the line, well,

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now what's the money?

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Where's the money go?

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Is this going to continue?

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Will things get funded?

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Will insurance companies

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reimburse for this?

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The economic impact,

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they had a higher clinical

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evidence certainty,

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and their impact was positive.

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And it said it decreases net

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spending relative to

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in-person PT with savings

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from avoided care.

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Essentially...

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What they're saying or how I

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read this is overall

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spending is lower when

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compared to traditional how

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we're receiving care right now.

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And they're accrediting this

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to what they're avoiding down the line,

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which is also harder to prove.

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It's harder to see.

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It's harder to sell, right?

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This is like when Allstate

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does the ad campaign with mayhem.

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It's harder to sell.

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You need to actually make it tangible.

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So what they're saying is it

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is a decreased net spending,

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so a net savings relative

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to in-person PT with

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savings from avoided care.

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And then their overall

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rating for guided solutions

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is evidence supports broader adoption.

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positive ranking in terms of

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physical therapist guided solutions.

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Now,

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I would say the next best or the next

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highest ranking for them was app based.

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And that's like Kaya Health or Dario.

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I'd heard of Kaya Health.

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I got a friend who works there,

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but I hadn't heard of Dario.

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Their clinical effectiveness,

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they said it improves pain

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but not function, not suitable – sorry,

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not substitutable.

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Is that even a word?

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I mean, it's on the report.

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Don't replace it for in-person PT.

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Evidence certainty lower.

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So it was giving it a

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moderate ranking in terms of effective.

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Like, yeah,

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it improves the pain but not

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necessarily function.

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Don't swap it out for your in-person PT.

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They do need more evidence.

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They said economic impact

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pricing data wasn't available.

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And overall,

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their summary rating was

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evidence supports broader

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adoption depending on price.

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So they're saying, like, listen,

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if we're going to give this

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a juice versus squeeze rating,

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we need more information on

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economic impact.

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We can't do it.

00:08:55.524 --> 00:08:57.745
And then RTM or remote

00:08:57.785 --> 00:08:58.706
therapeutic monitoring

00:08:58.966 --> 00:09:00.647
augmented PT solutions.

00:09:01.596 --> 00:09:03.116
They were saying clinical effectiveness,

00:09:03.736 --> 00:09:05.437
same grade as PT guided in

00:09:05.479 --> 00:09:06.318
terms of needs more

00:09:06.359 --> 00:09:08.299
information or lower clinical evidence,

00:09:08.640 --> 00:09:10.000
but a positive ranking

00:09:10.721 --> 00:09:11.783
saying it may perform

00:09:11.842 --> 00:09:12.923
better than in-person,

00:09:13.023 --> 00:09:15.044
may perform better than

00:09:15.205 --> 00:09:17.125
in-person PT alone.

00:09:18.147 --> 00:09:18.246
Now,

00:09:18.287 --> 00:09:20.548
the economic impact was it increased

00:09:20.707 --> 00:09:23.149
net spending and the

00:09:23.210 --> 00:09:24.630
savings from avoided care

00:09:24.671 --> 00:09:26.211
are less than when you add

00:09:26.231 --> 00:09:27.373
in that RTM billing.

00:09:27.934 --> 00:09:29.315
So looking into that overall,

00:09:29.375 --> 00:09:30.436
it gave it a neutral rating.

00:09:30.596 --> 00:09:32.275
Ongoing evidence generation may be needed,

00:09:32.677 --> 00:09:33.756
may justify broader

00:09:33.797 --> 00:09:35.336
adoption for patients with

00:09:35.517 --> 00:09:37.758
higher acuity MSK conditions.

00:09:38.337 --> 00:09:39.658
So it broke this thing down.

00:09:39.698 --> 00:09:40.519
But now we're seeing an

00:09:40.658 --> 00:09:42.099
independent monitoring agency,

00:09:42.119 --> 00:09:42.700
an independent.

00:09:42.720 --> 00:09:45.500
This isn't us talking about us saying, OK,

00:09:45.520 --> 00:09:46.841
if we're talking about

00:09:46.941 --> 00:09:49.001
virtual with this is this is a big,

00:09:49.101 --> 00:09:50.001
ambiguous term.

00:09:51.535 --> 00:09:52.636
Virtual means a lot of things.

00:09:52.677 --> 00:09:53.778
It can mean a lot of different things.

00:09:54.178 --> 00:09:54.820
What are they?

00:09:55.059 --> 00:09:55.801
They're starting to break

00:09:55.841 --> 00:09:56.621
those things down into

00:09:56.682 --> 00:09:57.623
those three categories.

00:09:58.504 --> 00:10:00.346
And they're starting to at least say,

00:10:00.525 --> 00:10:01.346
what are the results?

00:10:01.827 --> 00:10:04.029
We've been doing this for a while now,

00:10:04.070 --> 00:10:04.951
or these platforms have

00:10:04.971 --> 00:10:06.773
been around for a while now.

00:10:06.813 --> 00:10:07.715
We're seeing adoption.

00:10:08.174 --> 00:10:09.756
What does this thing look like?

00:10:09.917 --> 00:10:11.778
What does it shake down for

00:10:11.818 --> 00:10:12.360
our profession?

00:10:13.347 --> 00:10:13.769
I love it.

00:10:13.828 --> 00:10:14.568
I think it's awesome.

00:10:14.609 --> 00:10:15.330
Anything that brings

00:10:15.409 --> 00:10:17.913
attention to what we do is amazing.

00:10:19.294 --> 00:10:21.576
My first thought, my brain always goes to,

00:10:21.677 --> 00:10:23.399
okay, how can we leverage this today?

00:10:23.799 --> 00:10:25.741
Not when the research is done,

00:10:25.841 --> 00:10:27.283
not 17 years from now.

00:10:27.543 --> 00:10:28.825
How can I make an impact,

00:10:29.426 --> 00:10:30.687
make this work today?

00:10:31.447 --> 00:10:32.528
And one of the things that

00:10:32.548 --> 00:10:33.649
I'm looking at is,

00:10:35.270 --> 00:10:36.631
and I've talked about this before.

00:10:36.731 --> 00:10:39.514
So I think, you know, Hinge and Sword,

00:10:39.754 --> 00:10:41.817
they used to claim like no

00:10:41.856 --> 00:10:42.878
physical therapist,

00:10:42.898 --> 00:10:44.359
they were available if needed,

00:10:44.379 --> 00:10:46.581
but then they got some

00:10:46.620 --> 00:10:48.341
backlash and now there are

00:10:48.402 --> 00:10:49.743
physical therapists that

00:10:49.783 --> 00:10:50.803
are involved in it.

00:10:51.684 --> 00:10:54.147
My family members, brothers-in-law,

00:10:54.267 --> 00:10:55.227
sisters-in-law,

00:10:55.768 --> 00:10:57.249
they send me articles and

00:10:57.629 --> 00:10:59.591
stuff that their employer sends them.

00:11:00.631 --> 00:11:02.413
always offering hinge and

00:11:02.474 --> 00:11:04.035
sword every single one of them.

00:11:04.537 --> 00:11:05.898
They work for large companies.

00:11:06.318 --> 00:11:08.221
Some are engineers and different things.

00:11:08.642 --> 00:11:10.903
They always have like mail.

00:11:11.083 --> 00:11:12.966
And in the newsletter, it talks about,

00:11:13.006 --> 00:11:13.267
you know,

00:11:13.386 --> 00:11:15.229
free access to musculoskeletal care.

00:11:16.118 --> 00:11:19.481
through Sword or Hinge, but the apps.

00:11:19.902 --> 00:11:21.664
So the app only isn't as

00:11:21.745 --> 00:11:23.606
effective as the PT guided.

00:11:24.206 --> 00:11:26.090
So why don't we get involved

00:11:26.250 --> 00:11:27.912
with the app only solution

00:11:28.471 --> 00:11:29.453
since we're not gonna be in

00:11:29.494 --> 00:11:31.216
with Hinge or Sword and we

00:11:31.255 --> 00:11:33.398
just find an app that we like

00:11:34.119 --> 00:11:36.419
We know users are on the apps already.

00:11:36.760 --> 00:11:38.020
Let's start marketing to

00:11:38.061 --> 00:11:39.422
those apps specifically.

00:11:39.621 --> 00:11:41.844
And I then become the

00:11:41.923 --> 00:11:43.865
provider of choice for

00:11:43.985 --> 00:11:45.065
whatever that app is.

00:11:45.105 --> 00:11:46.725
And I don't remember any of the names,

00:11:47.386 --> 00:11:48.847
but I think there's a real

00:11:48.908 --> 00:11:49.947
opportunity there.

00:11:50.469 --> 00:11:52.210
Somewhere in the world, there's a user.

00:11:52.230 --> 00:11:53.389
They buy the app.

00:11:53.591 --> 00:11:54.571
They don't use the app.

00:11:54.610 --> 00:11:56.131
The app isn't as effective.

00:11:56.192 --> 00:11:56.591
Kaya.

00:11:56.731 --> 00:11:57.712
Kaya was one that I

00:11:57.753 --> 00:11:58.793
researched a while ago.

00:12:00.794 --> 00:12:03.235
Why wouldn't I generate SEO

00:12:03.296 --> 00:12:06.017
optimized content, create video content,

00:12:06.798 --> 00:12:09.198
showing how I can be your

00:12:09.239 --> 00:12:11.840
therapist if you're already using Kaya?

00:12:11.860 --> 00:12:13.280
Because Kaya alone is not as

00:12:13.341 --> 00:12:15.001
effective as using Kaya

00:12:15.142 --> 00:12:16.403
with me as your therapist.

00:12:17.722 --> 00:12:19.303
Peloton Peloton is out there.

00:12:19.724 --> 00:12:21.384
Thousands of Peloton users.

00:12:21.964 --> 00:12:24.024
I can be the Peloton physical therapist.

00:12:24.105 --> 00:12:25.985
I don't have to be employed by Peloton.

00:12:26.065 --> 00:12:28.025
I don't have to be contracted by Peloton.

00:12:28.566 --> 00:12:29.946
I just create content

00:12:30.025 --> 00:12:31.647
talking about how I can

00:12:31.706 --> 00:12:33.287
help a Peloton user

00:12:34.788 --> 00:12:36.128
position their bike and use

00:12:36.148 --> 00:12:37.327
their bike more effectively,

00:12:37.447 --> 00:12:38.528
overcome knee pain when

00:12:38.548 --> 00:12:39.448
you're on your Peloton,

00:12:39.489 --> 00:12:40.109
that kind of stuff.

00:12:40.924 --> 00:12:41.946
So you'd be like a,

00:12:42.206 --> 00:12:45.029
like a remora fish spinning around, like,

00:12:45.070 --> 00:12:45.250
you know,

00:12:45.269 --> 00:12:47.032
it'd be a symbiotic relationship.

00:12:47.091 --> 00:12:47.552
Like, listen,

00:12:47.572 --> 00:12:48.813
we don't have a formal agreement,

00:12:48.874 --> 00:12:50.176
but you're doing this thing.

00:12:50.275 --> 00:12:50.936
Go do you.

00:12:50.956 --> 00:12:53.339
I'm going to be over here

00:12:53.379 --> 00:12:54.059
and I could help you.

00:12:54.279 --> 00:12:55.841
I mean, it would, you know, you know,

00:12:55.861 --> 00:12:56.802
I can see like an organization,

00:12:56.822 --> 00:12:58.625
like the Peloton example is good, right?

00:12:58.745 --> 00:12:59.586
It's easy to see.

00:13:00.505 --> 00:13:01.667
Peloton is like, great,

00:13:01.726 --> 00:13:03.227
keep our riders riding

00:13:03.268 --> 00:13:05.389
longer because we want that $40 a month.

00:13:05.509 --> 00:13:06.450
We want more people to buy

00:13:06.450 --> 00:13:09.993
$2,000 bikes and, I don't know,

00:13:09.993 --> 00:13:10.472
$4,000 treadmills,

00:13:10.513 --> 00:13:13.014
which is a wacky – never buy a $4,000.

00:13:13.014 --> 00:13:13.674
Buy it used.

00:13:13.995 --> 00:13:14.916
That's my recommendation.

00:13:16.976 --> 00:13:18.599
Yeah, so you're saying, listen,

00:13:18.639 --> 00:13:20.639
the guided solutions at Hinge and Sword,

00:13:20.659 --> 00:13:21.561
you're not going to get in,

00:13:21.640 --> 00:13:22.801
but where's the opportunity?

00:13:22.841 --> 00:13:23.642
The opportunity is on the

00:13:23.662 --> 00:13:24.802
top row if you're watching

00:13:24.822 --> 00:13:25.342
my live stream.

00:13:25.363 --> 00:13:26.183
That's app-based.

00:13:27.216 --> 00:13:27.918
because it's not

00:13:28.018 --> 00:13:30.163
substitutable for in-person PT, great.

00:13:31.186 --> 00:13:32.870
So apply that, make it supplementary.

00:13:33.091 --> 00:13:35.856
Add you plus a Kaya or a Dario.

00:13:36.879 --> 00:13:38.220
And it's technology that I'm

00:13:38.279 --> 00:13:39.201
never going to build.

00:13:39.321 --> 00:13:41.140
I'm never going to create, right?

00:13:41.181 --> 00:13:43.121
Like I'm not going to create Facebook,

00:13:43.201 --> 00:13:44.722
but I build a business on

00:13:44.783 --> 00:13:45.982
the Facebook platform.

00:13:46.842 --> 00:13:48.504
And you just look at the different levels.

00:13:48.543 --> 00:13:49.783
Like Facebook can exist

00:13:49.823 --> 00:13:50.703
without the internet,

00:13:51.345 --> 00:13:53.264
but Facebook didn't build the internet.

00:13:53.404 --> 00:13:55.245
They built a business on the internet.

00:13:55.686 --> 00:13:56.966
I can't build Facebook.

00:13:57.005 --> 00:13:58.447
I build a business on Facebook.

00:13:58.586 --> 00:13:59.907
These are the same kind of

00:14:00.047 --> 00:14:01.447
opportunities that we see.

00:14:02.187 --> 00:14:03.668
So I think this is where

00:14:03.749 --> 00:14:05.429
kind of stage two of

00:14:05.769 --> 00:14:07.730
private practice ownership is going.

00:14:08.630 --> 00:14:11.393
And this can be a one person business.

00:14:11.712 --> 00:14:12.613
You don't need staff.

00:14:12.653 --> 00:14:13.653
You don't need admin.

00:14:13.714 --> 00:14:15.235
This could all be virtual or

00:14:15.254 --> 00:14:16.215
it could be in person.

00:14:16.774 --> 00:14:17.775
I could be the local

00:14:17.875 --> 00:14:20.177
Cincinnati provider of

00:14:20.376 --> 00:14:21.437
in-person services.

00:14:21.498 --> 00:14:22.057
I meet with these

00:14:22.118 --> 00:14:23.259
individuals once a month.

00:14:23.839 --> 00:14:24.938
There's just so many ways

00:14:24.958 --> 00:14:26.000
that we can make this work

00:14:26.200 --> 00:14:27.701
today in our businesses.

00:14:28.779 --> 00:14:30.441
What if you added like a Movement X,

00:14:30.640 --> 00:14:31.481
like who already sort of

00:14:31.542 --> 00:14:32.883
have an infrastructure?

00:14:32.903 --> 00:14:34.083
Are you familiar with Movement X?

00:14:34.163 --> 00:14:34.744
Yes, I am.

00:14:35.083 --> 00:14:35.224
Yeah.

00:14:35.664 --> 00:14:36.445
Like if you took a Movement

00:14:36.565 --> 00:14:38.386
X and you were like, hey, add this, like,

00:14:38.547 --> 00:14:40.307
okay, instead of us being a competition,

00:14:40.467 --> 00:14:40.908
we're not.

00:14:41.168 --> 00:14:42.929
I'm not an app and you're not,

00:14:43.450 --> 00:14:44.171
you don't have physical

00:14:44.211 --> 00:14:45.250
therapists on staff.

00:14:45.711 --> 00:14:46.711
How do we come together?

00:14:46.751 --> 00:14:47.932
It doesn't need to be formal

00:14:48.614 --> 00:14:49.975
necessarily to start anyway.

00:14:50.195 --> 00:14:53.596
How do we, how do we, how do we yes and?

00:14:54.238 --> 00:14:54.437
Right.

00:14:54.457 --> 00:14:54.557
Yeah.

00:14:55.500 --> 00:14:57.602
And yes, and have you seen,

00:14:58.063 --> 00:15:00.427
I've got it queued up here, the,

00:15:00.447 --> 00:15:02.208
I'm going to pull it up,

00:15:02.769 --> 00:15:04.230
the APTA Digital Health

00:15:04.410 --> 00:15:05.913
Transparency Campaign.

00:15:06.413 --> 00:15:07.073
Have you seen this?

00:15:07.114 --> 00:15:08.014
Are you aware of this?

00:15:08.034 --> 00:15:09.876
Tell the community about it.

00:15:10.278 --> 00:15:10.738
Is this...

00:15:12.934 --> 00:15:14.297
Go into it, but I'm pretty sure I did.

00:15:14.356 --> 00:15:16.698
Is this with how they're

00:15:16.739 --> 00:15:20.322
sort of like giving the nod to apps?

00:15:20.403 --> 00:15:21.203
Like essentially if you're

00:15:21.224 --> 00:15:23.426
an app and you want to be, I don't know,

00:15:23.446 --> 00:15:25.489
like kind of given a badge by the APTA,

00:15:25.509 --> 00:15:26.028
you go through their

00:15:26.068 --> 00:15:26.889
process and then you get

00:15:26.909 --> 00:15:27.931
put on their list and given

00:15:27.951 --> 00:15:28.432
their blessings.

00:15:29.072 --> 00:15:29.753
Basically,

00:15:29.793 --> 00:15:33.095
they want to keep the PT in virtual PT.

00:15:33.254 --> 00:15:33.455
Right.

00:15:33.875 --> 00:15:34.235
You know,

00:15:34.355 --> 00:15:36.096
so all of these companies have

00:15:36.135 --> 00:15:37.557
made the commitment to say,

00:15:37.657 --> 00:15:38.597
we're going to keep the

00:15:38.618 --> 00:15:40.197
physical therapist involved.

00:15:40.258 --> 00:15:42.759
We're not going to remove

00:15:42.799 --> 00:15:44.340
the physical therapist with

00:15:44.580 --> 00:15:46.041
AI physical therapy.

00:15:46.660 --> 00:15:48.341
And there's a ton of, you know,

00:15:48.422 --> 00:15:50.582
well-known companies on this list.

00:15:50.663 --> 00:15:51.724
I think it's great on there.

00:15:52.423 --> 00:15:54.105
Uh, hinge and sword are on there.

00:15:54.184 --> 00:15:54.926
Yeah.

00:15:54.946 --> 00:15:55.105
Yeah.

00:15:55.365 --> 00:15:56.147
Hinge sword.

00:15:56.167 --> 00:15:56.206
Um,

00:15:57.126 --> 00:15:59.168
I only found out about this when I was

00:15:59.208 --> 00:16:00.408
working with hippo scribe

00:16:00.448 --> 00:16:03.572
and we wanted to get on the list, but the,

00:16:03.591 --> 00:16:05.773
uh, city PT, I don't know,

00:16:05.832 --> 00:16:06.714
this would be a great

00:16:06.793 --> 00:16:09.014
connection for you and anybody watching,

00:16:09.034 --> 00:16:11.136
uh, the founder of hip, uh,

00:16:11.517 --> 00:16:13.177
city PT is just amazing.

00:16:13.378 --> 00:16:15.620
And he's got a really, really great story,

00:16:15.639 --> 00:16:15.679
uh,

00:16:16.299 --> 00:16:18.921
But I think we see this, you know, finally,

00:16:19.561 --> 00:16:21.442
the community is embracing, OK,

00:16:21.501 --> 00:16:22.461
this is technology.

00:16:22.501 --> 00:16:23.461
This is where we're going.

00:16:24.363 --> 00:16:25.342
We don't need to worry about

00:16:25.383 --> 00:16:26.263
losing our jobs.

00:16:26.283 --> 00:16:27.124
There's always going to be a

00:16:27.163 --> 00:16:28.144
place for the human,

00:16:28.384 --> 00:16:30.384
at least in the foreseeable future.

00:16:30.945 --> 00:16:32.845
So let's use this technology

00:16:32.884 --> 00:16:34.586
to make what we do even better.

00:16:35.306 --> 00:16:40.414
This is I mean, this goes back to 1997,

00:16:40.414 --> 00:16:42.221
1998.

00:16:42.221 --> 00:16:43.802
And some of the people listening, right?

00:16:43.822 --> 00:16:44.763
Some of the younger PTs are

00:16:44.783 --> 00:16:45.123
going to go like,

00:16:45.143 --> 00:16:45.682
I don't know what the hell

00:16:45.702 --> 00:16:46.403
you're talking about.

00:16:47.023 --> 00:16:47.943
There was an app called

00:16:48.583 --> 00:16:50.705
Napster and Napster.

00:16:50.945 --> 00:16:53.004
All it was was a file sharing service.

00:16:53.065 --> 00:16:54.405
They were just the first, or I mean,

00:16:55.326 --> 00:16:55.645
we need,

00:16:55.686 --> 00:16:58.126
there were not apps to share large files.

00:16:59.147 --> 00:17:00.888
And in terms of files,

00:17:00.947 --> 00:17:02.368
they focused on music.

00:17:02.427 --> 00:17:04.669
They focused on MP3s and

00:17:04.689 --> 00:17:06.128
they were the first ones to say,

00:17:06.769 --> 00:17:08.410
you come here, you get these songs for,

00:17:08.569 --> 00:17:09.049
it was amazing.

00:17:10.480 --> 00:17:11.141
It was in it.

00:17:11.622 --> 00:17:13.762
It's insane to sit here right now in 2024.

00:17:13.762 --> 00:17:14.384
Not that long.

00:17:14.644 --> 00:17:15.785
Not when this was not that

00:17:15.805 --> 00:17:17.486
long ago to think like the

00:17:17.605 --> 00:17:19.086
barrier to get music

00:17:19.186 --> 00:17:20.387
delivered to you was the

00:17:20.448 --> 00:17:22.449
radio where you just sat there passively.

00:17:22.469 --> 00:17:23.230
Yeah.

00:17:23.609 --> 00:17:24.990
Actively go spend lots and

00:17:25.030 --> 00:17:26.711
lots of money on a disc.

00:17:27.092 --> 00:17:29.614
But even then it was not portable,

00:17:29.673 --> 00:17:30.554
not really portable to

00:17:30.594 --> 00:17:31.835
bring your whole CD collection.

00:17:32.215 --> 00:17:33.215
And they just they didn't

00:17:33.256 --> 00:17:34.096
build the Internet.

00:17:35.486 --> 00:17:36.626
but they were able to build

00:17:36.666 --> 00:17:38.127
a business on the internet.

00:17:38.327 --> 00:17:39.387
Although famously,

00:17:41.409 --> 00:17:42.190
Justin Timberlake's

00:17:42.230 --> 00:17:43.851
character in the social network was like,

00:17:43.891 --> 00:17:44.810
it's not much of a business

00:17:44.851 --> 00:17:45.531
in free music.

00:17:46.692 --> 00:17:47.772
But the situation I wanna

00:17:47.833 --> 00:17:49.773
talk about was really like one band,

00:17:51.650 --> 00:17:52.431
who should have been the

00:17:52.490 --> 00:17:54.212
face of anarchy and

00:17:54.333 --> 00:17:56.115
sticking it to the machine,

00:17:56.796 --> 00:17:58.298
Karen has no idea about Napster.

00:17:59.118 --> 00:18:00.480
They were just a file sharing service.

00:18:00.500 --> 00:18:02.001
So you went on this app, opened it,

00:18:02.403 --> 00:18:03.183
searched a file,

00:18:03.223 --> 00:18:04.885
you said Foo Fighters Everlong,

00:18:05.006 --> 00:18:06.227
and now you could download

00:18:06.247 --> 00:18:07.127
it from someone else's

00:18:07.167 --> 00:18:08.809
computer and it would be on yours.

00:18:09.755 --> 00:18:10.214
Everybody's like, well,

00:18:10.234 --> 00:18:11.415
that's what Spotify is.

00:18:11.435 --> 00:18:12.016
I'm like, right.

00:18:12.036 --> 00:18:13.877
But before Spotify, there was no barrier.

00:18:14.337 --> 00:18:16.078
And now the solution is so obvious.

00:18:16.138 --> 00:18:17.140
But Metallica,

00:18:17.539 --> 00:18:18.701
who should have been the band,

00:18:19.340 --> 00:18:20.902
the face of anarchy and

00:18:20.961 --> 00:18:21.962
stick it to the man,

00:18:22.563 --> 00:18:23.884
was the band doing press

00:18:23.943 --> 00:18:25.104
conferences saying,

00:18:25.525 --> 00:18:26.785
you have to outlaw this.

00:18:26.825 --> 00:18:28.226
This is going to kill music.

00:18:29.406 --> 00:18:30.307
Starving artists.

00:18:30.367 --> 00:18:31.428
We're millionaires.

00:18:31.468 --> 00:18:32.009
We're not doing this.

00:18:32.169 --> 00:18:33.549
We're doing it for the bands

00:18:33.589 --> 00:18:34.769
that are out there now who

00:18:34.849 --> 00:18:35.691
aren't going to make it.

00:18:37.657 --> 00:18:38.798
And I thought it was cool

00:18:38.838 --> 00:18:40.098
because it's also one of my favorite,

00:18:40.618 --> 00:18:42.019
you know, band leaders,

00:18:42.099 --> 00:18:43.200
which was Dave Grohl.

00:18:43.319 --> 00:18:45.101
And he was like, number one,

00:18:45.121 --> 00:18:45.921
a solution we'll find.

00:18:45.961 --> 00:18:47.902
You can't legislate against technology.

00:18:48.201 --> 00:18:48.762
You can try,

00:18:49.442 --> 00:18:51.083
but it's like shoveling against the tide.

00:18:51.243 --> 00:18:53.483
It's going to find its level.

00:18:53.724 --> 00:18:54.424
It's like water.

00:18:54.444 --> 00:18:55.765
It's just going to find its level.

00:18:56.506 --> 00:18:58.066
So you can say, oh,

00:18:58.385 --> 00:18:59.386
we're going to pledge to

00:18:59.467 --> 00:19:00.926
never let the PT out of this,

00:19:01.528 --> 00:19:02.288
all those things,

00:19:02.887 --> 00:19:04.509
but be the better solution.

00:19:05.491 --> 00:19:06.452
And Dave Grohl was saying,

00:19:06.673 --> 00:19:08.715
even if we give your music away,

00:19:09.215 --> 00:19:10.458
let anybody download it,

00:19:11.199 --> 00:19:13.521
it's the what can you do as

00:19:13.622 --> 00:19:14.762
the Foo Fighters or the

00:19:14.823 --> 00:19:15.804
band that hasn't broken

00:19:15.864 --> 00:19:17.846
next that technology can't.

00:19:17.886 --> 00:19:19.608
He's like, give the music away for free.

00:19:19.648 --> 00:19:21.230
Listen to it on your phone all you want.

00:19:23.549 --> 00:19:25.431
Make your money on the live

00:19:25.471 --> 00:19:26.892
shows and the experience

00:19:26.991 --> 00:19:28.112
and the relationship you

00:19:28.132 --> 00:19:28.992
build with people who

00:19:29.053 --> 00:19:30.053
listen to your music.

00:19:30.653 --> 00:19:31.993
That's what's going to support you.

00:19:32.213 --> 00:19:32.914
I forget who said it,

00:19:32.954 --> 00:19:33.994
but the whole idea of a

00:19:34.055 --> 00:19:34.955
thousand true fans.

00:19:34.976 --> 00:19:36.395
If you had a thousand true fans to Eve.

00:19:36.455 --> 00:19:37.076
Kevin Kelly.

00:19:37.673 --> 00:19:39.275
give you a thousand dollars a year.

00:19:39.375 --> 00:19:41.635
If you provided $5,000 in

00:19:41.796 --> 00:19:43.336
value and asked for a thousand dollars,

00:19:43.797 --> 00:19:44.758
you're net positive and

00:19:44.798 --> 00:19:46.838
people will have the relationship.

00:19:47.419 --> 00:19:48.140
So he said that,

00:19:48.180 --> 00:19:49.701
but now like the solution

00:19:49.721 --> 00:19:51.781
is somewhere in the middle

00:19:51.942 --> 00:19:54.083
because for Napster or Apple music,

00:19:54.542 --> 00:19:56.484
I happily pay 10 bucks a

00:19:56.525 --> 00:19:58.326
month and I have access to

00:19:58.905 --> 00:20:00.707
every song in the world.

00:20:01.106 --> 00:20:02.147
Now, I don't know how it is.

00:20:02.188 --> 00:20:03.288
And every couple of years,

00:20:03.808 --> 00:20:04.690
the debate comes up.

00:20:04.869 --> 00:20:06.151
Is it worth it for the artists?

00:20:06.211 --> 00:20:07.490
Are the artists getting enough?

00:20:07.932 --> 00:20:08.571
That sort of thing.

00:20:09.252 --> 00:20:10.993
And that they should get enough, right?

00:20:11.213 --> 00:20:11.753
We're sort of like

00:20:11.894 --> 00:20:14.695
democratizing the experience.

00:20:16.176 --> 00:20:17.258
But I think the solution

00:20:17.298 --> 00:20:18.679
will be somewhere in the middle.

00:20:18.759 --> 00:20:19.900
It will not be the apps that

00:20:19.920 --> 00:20:21.000
we just talked about in the

00:20:21.040 --> 00:20:22.000
way that they exist now.

00:20:22.362 --> 00:20:24.202
It will not be just PT either.

00:20:24.343 --> 00:20:26.104
It will not just be PT how it is now.

00:20:26.183 --> 00:20:26.644
It will not.

00:20:26.724 --> 00:20:27.305
I'm very sorry.

00:20:27.484 --> 00:20:28.346
Don't be Metallica.

00:20:28.726 --> 00:20:29.906
Don't try to be Metallica.

00:20:30.467 --> 00:20:30.666
Right.

00:20:31.028 --> 00:20:31.769
The answer is going to be

00:20:31.828 --> 00:20:32.730
somewhere in the middle.

00:20:33.170 --> 00:20:35.332
Those who lean in, in my opinion,

00:20:35.393 --> 00:20:38.015
who leaned in and say, let's try this.

00:20:38.276 --> 00:20:39.576
What do I bring to the table?

00:20:39.938 --> 00:20:41.398
Those are going to be, in my opinion,

00:20:41.419 --> 00:20:42.599
the people who come out on

00:20:42.661 --> 00:20:44.061
top and have the best time

00:20:44.102 --> 00:20:44.823
and deliver the best care.

00:20:45.615 --> 00:20:47.976
I mean, it's likely that without Napster,

00:20:48.876 --> 00:20:50.917
we never would have had the

00:20:51.057 --> 00:20:52.538
access to music that we have today.

00:20:53.859 --> 00:20:55.901
They forced the hand of all

00:20:55.980 --> 00:20:58.863
the gatekeepers to figure

00:20:58.982 --> 00:21:01.064
out how can we get music out cheaper?

00:21:01.104 --> 00:21:03.045
How can we get music more accessible?

00:21:03.885 --> 00:21:06.507
And I would argue that while, yes,

00:21:06.547 --> 00:21:09.128
it probably brings down net

00:21:09.169 --> 00:21:11.931
profitability for the content producer,

00:21:11.971 --> 00:21:13.290
you still have somebody like...

00:21:14.914 --> 00:21:15.796
What's the girl's name?

00:21:15.875 --> 00:21:16.496
Oh my gosh.

00:21:17.116 --> 00:21:17.797
Every girl, who?

00:21:19.057 --> 00:21:19.999
Taylor Swift, you mean?

00:21:20.019 --> 00:21:20.999
Yeah, Taylor Swift.

00:21:21.038 --> 00:21:22.200
She's making hundreds of

00:21:22.259 --> 00:21:23.080
millions of dollars.

00:21:23.401 --> 00:21:25.563
You still have the success

00:21:25.623 --> 00:21:27.104
because of the exchange in value.

00:21:27.124 --> 00:21:28.525
Of course, they've built community.

00:21:28.605 --> 00:21:31.126
There's the whole Swifties movement.

00:21:32.106 --> 00:21:33.127
But what's interesting in this,

00:21:33.167 --> 00:21:34.429
and I'm curious to hear

00:21:34.489 --> 00:21:35.289
your thought on this,

00:21:36.130 --> 00:21:39.673
Why is there not a Napster for research?

00:21:40.273 --> 00:21:41.634
So my understanding,

00:21:41.654 --> 00:21:43.096
and I think you've said it before,

00:21:43.195 --> 00:21:44.076
clinical research.

00:21:44.477 --> 00:21:46.058
If you reach out to the author,

00:21:46.138 --> 00:21:47.299
the author is allowed to

00:21:47.380 --> 00:21:49.461
give you the clinical research for free.

00:21:49.521 --> 00:21:51.022
Is that correct or am I wrong?

00:21:51.738 --> 00:21:52.018
Yeah.

00:21:52.238 --> 00:21:52.478
Yeah.

00:21:52.638 --> 00:21:53.719
I mean, I think there's, you know,

00:21:53.739 --> 00:21:54.720
there's always like, you know,

00:21:54.779 --> 00:21:55.559
some stipulations,

00:21:55.619 --> 00:21:56.921
but typically from what I,

00:21:57.040 --> 00:21:57.961
and this was like one of

00:21:57.981 --> 00:21:58.942
those aha moments where

00:21:58.981 --> 00:21:59.722
when someone told me like,

00:21:59.742 --> 00:22:00.343
this can't be true.

00:22:00.363 --> 00:22:01.443
And people were like, it's actually true.

00:22:02.003 --> 00:22:02.924
But if you reach out to an

00:22:03.085 --> 00:22:04.746
author who produced a piece

00:22:04.766 --> 00:22:05.665
of clinical work,

00:22:05.726 --> 00:22:07.047
they're allowed to give you some,

00:22:07.346 --> 00:22:07.948
and there might be a

00:22:07.988 --> 00:22:09.169
limitation on they can send

00:22:09.209 --> 00:22:10.128
out 50 copies.

00:22:10.148 --> 00:22:10.890
Sure.

00:22:11.349 --> 00:22:12.230
I was actually just reading

00:22:12.289 --> 00:22:12.830
something about,

00:22:12.931 --> 00:22:14.471
I believe the publisher was Elsevier.

00:22:15.924 --> 00:22:18.405
and how they can embed and figure out.

00:22:18.685 --> 00:22:21.708
Like if you somehow went to Sci-Hub,

00:22:21.807 --> 00:22:23.528
which is a website no one

00:22:23.568 --> 00:22:24.568
should go to because you'd

00:22:24.608 --> 00:22:25.609
get free research, right?

00:22:25.630 --> 00:22:26.911
You should never go there, it's bad.

00:22:27.631 --> 00:22:29.832
But if you get a PDF and

00:22:29.852 --> 00:22:30.913
then I send it to you and

00:22:30.932 --> 00:22:32.413
you send it to someone else,

00:22:32.733 --> 00:22:33.733
even though it's a PDF,

00:22:33.753 --> 00:22:35.355
there's metadata on there,

00:22:35.375 --> 00:22:36.515
they can track those things.

00:22:36.915 --> 00:22:37.915
Like they're so

00:22:37.976 --> 00:22:39.116
sophisticated because

00:22:39.136 --> 00:22:39.977
they're gatekeepers.

00:22:40.376 --> 00:22:40.778
And yeah,

00:22:40.857 --> 00:22:41.938
clinical research is a really

00:22:41.958 --> 00:22:42.818
great example of like,

00:22:43.558 --> 00:22:44.299
Shouldn't this have been –

00:22:44.299 --> 00:22:46.163
how are these people still making money?

00:22:46.182 --> 00:22:47.304
Like the wild thing is like

00:22:48.705 --> 00:22:49.867
we pay money for like

00:22:50.749 --> 00:22:52.832
national – NIH grants,

00:22:53.231 --> 00:22:54.574
like National Institutes of Health.

00:22:54.693 --> 00:22:57.057
We, the taxpayer, fund research.

00:22:58.200 --> 00:22:59.621
pay researchers because

00:22:59.641 --> 00:23:00.500
they're doing work.

00:23:00.701 --> 00:23:03.042
They should get paid for this, right?

00:23:03.282 --> 00:23:04.063
Then the research gets

00:23:04.144 --> 00:23:06.265
published in for-profit journals.

00:23:07.164 --> 00:23:08.746
And then we who funded it

00:23:09.227 --> 00:23:11.567
have to pay to read the

00:23:11.647 --> 00:23:13.108
research that we funded.

00:23:13.588 --> 00:23:14.549
So it's like, hey,

00:23:14.609 --> 00:23:15.829
my kid is playing in a

00:23:16.490 --> 00:23:17.791
middle school soccer game.

00:23:18.731 --> 00:23:19.833
I got to pay to watch him.

00:23:19.893 --> 00:23:20.873
I got to pay tickets,

00:23:21.294 --> 00:23:22.334
a ticket to watch my kids.

00:23:22.413 --> 00:23:23.494
My kid's the show, man.

00:23:23.755 --> 00:23:24.375
I'm the show.

00:23:25.316 --> 00:23:26.436
I produced that, right?

00:23:26.957 --> 00:23:28.378
So yeah, this is a good question.

00:23:28.419 --> 00:23:29.138
Like how would you

00:23:29.179 --> 00:23:30.299
democratize or how would

00:23:30.319 --> 00:23:31.981
you level the playing field on research?

00:23:32.801 --> 00:23:35.183
It's a multi-billion dollar market.

00:23:35.384 --> 00:23:35.904
And you're right.

00:23:36.005 --> 00:23:36.644
I'm surprised.

00:23:37.086 --> 00:23:38.826
I think Sci-Hub is the, I mean,

00:23:38.866 --> 00:23:42.170
it's been called the Napster of research.

00:23:42.529 --> 00:23:44.131
And it was like invented by like some like,

00:23:45.291 --> 00:23:45.792
I'm going to say,

00:23:45.813 --> 00:23:46.834
I think she was a teenager,

00:23:46.874 --> 00:23:47.914
teenage Russian girl,

00:23:47.974 --> 00:23:50.376
I believe was the story that I heard.

00:23:50.817 --> 00:23:52.077
And she saw the same thing.

00:23:52.117 --> 00:23:52.759
This is stupid.

00:23:53.663 --> 00:23:55.526
And my friend, you know, my friend Mike,

00:23:55.946 --> 00:23:57.828
who's done YouTube videos on,

00:23:58.169 --> 00:24:00.151
have you ever seen the

00:24:00.171 --> 00:24:01.853
YouTube video on why your

00:24:01.873 --> 00:24:02.753
scientific poster is

00:24:02.814 --> 00:24:03.674
horrible and how to fix it?

00:24:03.694 --> 00:24:05.155
I'll hear that.

00:24:05.195 --> 00:24:06.057
We'll do an episode on that.

00:24:06.076 --> 00:24:08.298
But he's like, this stops progress.

00:24:08.599 --> 00:24:08.900
He's like,

00:24:09.381 --> 00:24:11.041
this could stop the progress of

00:24:11.082 --> 00:24:12.144
the cure for the disease

00:24:12.183 --> 00:24:13.464
that kills someone that you know,

00:24:13.545 --> 00:24:14.046
and it could have been

00:24:14.066 --> 00:24:14.987
there five years earlier

00:24:15.406 --> 00:24:16.188
because of friction.

00:24:17.355 --> 00:24:17.575
Right.

00:24:18.215 --> 00:24:18.476
Right.

00:24:18.855 --> 00:24:19.957
I just can't understand.

00:24:20.037 --> 00:24:22.239
Like we see how, you know,

00:24:22.479 --> 00:24:23.059
I don't even know.

00:24:23.099 --> 00:24:24.820
So you said Spotify.

00:24:25.020 --> 00:24:26.461
I remember Rhapsody.

00:24:26.622 --> 00:24:27.643
I remember all these

00:24:27.722 --> 00:24:29.325
subscription services that came out,

00:24:29.384 --> 00:24:30.404
even Amazon music.

00:24:31.766 --> 00:24:34.648
So, yeah, I used to go to the store and.

00:24:35.469 --> 00:24:36.651
uh you probably remember

00:24:36.711 --> 00:24:37.932
some of the big names I

00:24:37.971 --> 00:24:38.952
don't remember but I'd go

00:24:38.992 --> 00:24:40.314
to the mall let's let's go

00:24:40.433 --> 00:24:42.115
back 20 steps I'd go to the

00:24:42.215 --> 00:24:44.479
mall I'd go into the store

00:24:44.499 --> 00:24:45.759
I would look through

00:24:45.819 --> 00:24:46.901
cassettes I was at a

00:24:46.921 --> 00:24:48.261
buddy's house this weekend

00:24:48.281 --> 00:24:48.782
they were having a

00:24:48.823 --> 00:24:51.065
graduation party for their middle child

00:24:52.046 --> 00:24:54.567
And on the wall was a radio

00:24:54.667 --> 00:24:55.868
built into the house.

00:24:56.369 --> 00:24:57.711
And there was a cassette in

00:24:57.750 --> 00:24:58.511
the cassette player.

00:24:58.531 --> 00:25:00.153
So I grabbed my 15-year-old son,

00:25:00.192 --> 00:25:02.815
who loves technology, super smart kid.

00:25:02.875 --> 00:25:04.096
I'm like, hey, Lucas, come over here.

00:25:04.135 --> 00:25:04.757
Check this out.

00:25:05.217 --> 00:25:06.557
I push the eject button.

00:25:06.618 --> 00:25:09.780
It's got that slow, like, I pull it out.

00:25:09.800 --> 00:25:10.221
And I'm like, hey,

00:25:10.241 --> 00:25:11.082
do you know what this is?

00:25:12.103 --> 00:25:14.224
And he asked me if it was a VHS tape.

00:25:14.385 --> 00:25:15.567
That's what he asked me.

00:25:15.586 --> 00:25:16.807
VHS tape.

00:25:16.948 --> 00:25:17.929
No, no, no, that can't be right.

00:25:17.969 --> 00:25:18.569
That's video.

00:25:19.611 --> 00:25:20.030
But anyway,

00:25:20.092 --> 00:25:21.913
so we would go to those stores.

00:25:21.973 --> 00:25:22.534
Sam Goody.

00:25:22.753 --> 00:25:23.615
Yes, Bo.

00:25:23.634 --> 00:25:26.878
I mean, I don't want to brag,

00:25:26.898 --> 00:25:28.079
but I used to work at The Wall.

00:25:31.113 --> 00:25:32.134
We would buy them.

00:25:32.214 --> 00:25:34.517
Anyway, now fast forward, you know,

00:25:34.758 --> 00:25:37.099
unlimited music, $10 subscription,

00:25:37.160 --> 00:25:38.060
no commercials,

00:25:38.122 --> 00:25:39.482
and it gets cheaper and cheaper.

00:25:39.502 --> 00:25:40.183
Yes, sir.

00:25:40.223 --> 00:25:40.724
Hold on, though.

00:25:40.744 --> 00:25:42.426
So the progression was the

00:25:42.446 --> 00:25:44.388
progression was if I wanted music,

00:25:44.608 --> 00:25:45.450
I could listen to it

00:25:45.490 --> 00:25:46.832
passively on the radio and

00:25:46.872 --> 00:25:47.932
just wait for whatever

00:25:48.032 --> 00:25:49.775
idiot radio DJ was going to play next.

00:25:49.875 --> 00:25:50.076
Right.

00:25:50.766 --> 00:25:52.386
I'd be sitting there waiting

00:25:52.406 --> 00:25:53.807
to hit the record button on

00:25:53.968 --> 00:25:54.808
the cassette tape.

00:26:20.766 --> 00:26:22.306
criminal what the artists

00:26:22.326 --> 00:26:24.386
got in terms of cents on the dollar.

00:26:24.846 --> 00:26:26.346
But remember it was pay for

00:26:26.366 --> 00:26:29.167
it per CD and you're paying, I don't know,

00:26:29.167 --> 00:26:31.708
25 bucks for 10 songs or whatever,

00:26:31.708 --> 00:26:32.368
12 songs,

00:26:32.828 --> 00:26:34.068
seven of which you were never

00:26:34.088 --> 00:26:34.749
going to listen to.

00:26:34.989 --> 00:26:36.689
Then singles came out.

00:26:37.089 --> 00:26:38.329
You could buy just one song,

00:26:38.809 --> 00:26:39.670
inflated price,

00:26:39.730 --> 00:26:40.589
but it felt like a better

00:26:40.769 --> 00:26:41.631
return on investment.

00:26:42.471 --> 00:26:43.671
But then when we went digital,

00:26:45.851 --> 00:26:48.893
Apple said songs are 99 cents.

00:26:49.433 --> 00:26:50.374
So it was like, well,

00:26:50.394 --> 00:26:51.154
you could own a million

00:26:51.194 --> 00:26:52.635
songs for a million dollars.

00:26:52.996 --> 00:26:58.940
That is still an insane value proposition.

00:26:58.960 --> 00:26:59.861
If I wanted a million songs,

00:26:59.921 --> 00:27:00.520
although you're never going

00:27:00.540 --> 00:27:01.402
to listen to a million songs.

00:27:01.801 --> 00:27:03.563
And now the deal is 10 bucks

00:27:03.604 --> 00:27:04.903
you can sort of listen to

00:27:05.825 --> 00:27:06.704
whatever you want.

00:27:07.145 --> 00:27:08.685
But this is the blockbuster

00:27:08.786 --> 00:27:10.186
versus Netflix argument,

00:27:10.586 --> 00:27:11.508
which is if you went into a

00:27:11.567 --> 00:27:13.969
blockbuster and rented a million movies,

00:27:13.989 --> 00:27:15.430
you'd have to pay $10 million.

00:27:16.230 --> 00:27:17.170
But if you go to Netflix,

00:27:17.190 --> 00:27:18.810
you could have access to all of them.

00:27:19.290 --> 00:27:22.633
You're never going to watch all of them.

00:27:22.992 --> 00:27:24.294
We should do this on Thursday.

00:27:24.314 --> 00:27:26.434
I just gave a presentation

00:27:26.474 --> 00:27:28.556
to an organization using this methodology,

00:27:28.596 --> 00:27:28.736
but

00:27:29.958 --> 00:27:32.679
It feels like I have this much value,

00:27:32.919 --> 00:27:34.220
infinite value when I pay

00:27:34.359 --> 00:27:36.921
Apple $10 a month to get Apple Music.

00:27:37.520 --> 00:27:38.402
I'm going to listen to the

00:27:38.422 --> 00:27:40.563
same 40 or 50 or 100 songs

00:27:40.643 --> 00:27:42.284
anyway that I would have paid $100 for.

00:27:42.884 --> 00:27:46.144
But I can at random at 2

00:27:46.144 --> 00:27:46.986
o'clock in the morning get

00:27:47.006 --> 00:27:48.787
that one song without

00:27:48.807 --> 00:27:49.446
having to feel like they're

00:27:49.467 --> 00:27:50.626
dipping their hand in my pocket.

00:27:50.846 --> 00:27:52.087
That's just perceived value.

00:27:52.587 --> 00:27:54.108
All value is perceived value.

00:27:55.858 --> 00:27:57.839
versus an exchange every

00:27:57.880 --> 00:27:59.421
time or here's 10 bucks a

00:27:59.461 --> 00:28:00.741
month take my 120 bucks a

00:28:00.781 --> 00:28:01.923
year I feel like I'm coming

00:28:01.942 --> 00:28:03.964
out on top anyway how do we

00:28:04.045 --> 00:28:05.265
translate that to health

00:28:05.305 --> 00:28:07.166
care the things that we had

00:28:07.287 --> 00:28:09.407
on the screen are beginning

00:28:09.468 --> 00:28:11.509
to do those things right if

00:28:11.609 --> 00:28:13.851
you knew you had access to

00:28:13.891 --> 00:28:15.792
this app like kaya health

00:28:16.673 --> 00:28:18.314
If you had that at any time

00:28:18.794 --> 00:28:19.894
and then could hit a button

00:28:20.115 --> 00:28:21.275
and either a PT would jump

00:28:21.336 --> 00:28:23.096
on the screen with you or

00:28:23.317 --> 00:28:25.057
if we feel like the app and

00:28:25.077 --> 00:28:26.198
the PT I'm talking to

00:28:26.657 --> 00:28:28.358
thinks that this is worth

00:28:28.900 --> 00:28:31.401
them coming to my house and I'm saying,

00:28:31.480 --> 00:28:33.321
yeah, I want this.

00:28:33.501 --> 00:28:34.261
This is what I want.

00:28:34.301 --> 00:28:35.603
I want you to come out to my house.

00:28:36.182 --> 00:28:38.144
Then I feel like I come out

00:28:38.183 --> 00:28:39.325
ahead and I'm paying a

00:28:39.384 --> 00:28:41.665
monthly fee and now we can

00:28:41.746 --> 00:28:42.646
math that math.

00:28:43.891 --> 00:28:45.172
Now the economic data where

00:28:45.192 --> 00:28:46.272
it says not applicable,

00:28:46.393 --> 00:28:47.492
pricing data not available,

00:28:47.833 --> 00:28:49.354
we do this enough, we'll have data.

00:28:49.575 --> 00:28:50.134
So remember,

00:28:50.255 --> 00:28:52.155
it wasn't cassettes and CDs

00:28:52.215 --> 00:28:54.478
and Blu-ray to Spotify.

00:28:54.778 --> 00:28:55.959
There was a thing in the middle.

00:28:56.058 --> 00:28:57.278
There's always that messy

00:28:57.318 --> 00:28:58.500
middle before we come to

00:28:59.280 --> 00:29:00.260
the best solution.

00:29:00.421 --> 00:29:01.281
Not even saying that we're

00:29:01.301 --> 00:29:03.942
done doing $10 a month, but I don't know.

00:29:03.982 --> 00:29:04.864
I can't imagine a better

00:29:05.344 --> 00:29:07.085
solution than what we have here.

00:29:07.105 --> 00:29:08.125
I think we're sort of done.

00:29:09.934 --> 00:29:11.037
in terms of subscription

00:29:11.076 --> 00:29:12.078
models are the way to do it.

00:29:12.759 --> 00:29:14.843
How do we yes and app and

00:29:15.183 --> 00:29:17.807
PTs to a subscription model?

00:29:18.249 --> 00:29:18.930
We're in the middle.

00:29:18.990 --> 00:29:21.213
We're not there yet, but we're on our way.

00:29:22.182 --> 00:29:22.761
I, you know,

00:29:23.241 --> 00:29:26.143
you saying all of that made me realize,

00:29:26.542 --> 00:29:27.544
so we,

00:29:27.983 --> 00:29:29.523
let's just say I've got a Spotify

00:29:29.584 --> 00:29:30.023
account.

00:29:30.104 --> 00:29:31.825
I'm paying a monthly subscription.

00:29:31.944 --> 00:29:33.444
I'm never going to possibly

00:29:33.665 --> 00:29:36.326
use like listen to music 24 seven.

00:29:37.027 --> 00:29:38.067
It's really a similar

00:29:38.126 --> 00:29:40.508
pricing strategy to planet fitness.

00:29:40.607 --> 00:29:42.387
So planet fitness wants to

00:29:42.448 --> 00:29:43.588
sell memberships.

00:29:43.628 --> 00:29:45.028
They want that $10 a month

00:29:45.088 --> 00:29:45.929
recurring revenue.

00:29:46.388 --> 00:29:48.089
There is no way every human

00:29:48.130 --> 00:29:49.150
that signs up is going to

00:29:49.190 --> 00:29:50.651
be in the gym all the time.

00:29:51.611 --> 00:29:52.853
um so like you said it's

00:29:52.873 --> 00:29:54.535
like okay I can kind of

00:29:54.615 --> 00:29:55.496
understand the planet

00:29:55.516 --> 00:29:57.357
fitness model relative to

00:29:57.377 --> 00:29:59.119
an outpatient orthopedic pt

00:29:59.140 --> 00:30:00.882
clinic and then I can kind

00:30:00.922 --> 00:30:02.564
of understand the spotify

00:30:02.604 --> 00:30:04.906
model to a planet fitness

00:30:04.946 --> 00:30:06.828
model we're getting closer

00:30:07.509 --> 00:30:08.250
one of the things that

00:30:08.310 --> 00:30:09.352
keeps coming back to me

00:30:10.386 --> 00:30:11.268
For the therapist that

00:30:11.327 --> 00:30:12.468
doesn't want to go virtual,

00:30:12.628 --> 00:30:13.388
because I know a lot of

00:30:13.409 --> 00:30:14.369
them are resistant to it.

00:30:14.390 --> 00:30:16.590
A lot of them don't want to do that.

00:30:17.090 --> 00:30:19.792
I think back to early 2000s

00:30:19.873 --> 00:30:20.673
when I first got into

00:30:20.713 --> 00:30:21.815
physical therapy and I was

00:30:21.835 --> 00:30:22.914
a business owner and I was

00:30:22.974 --> 00:30:23.875
looking at this.

00:30:24.696 --> 00:30:25.856
And back then,

00:30:25.876 --> 00:30:28.858
I remember thinking to myself, OK,

00:30:28.959 --> 00:30:30.800
so if I'm going to get paid

00:30:31.361 --> 00:30:34.423
the most per interaction

00:30:34.522 --> 00:30:36.785
for an evaluation and then

00:30:36.964 --> 00:30:38.286
reimbursements is going to

00:30:38.326 --> 00:30:39.686
decline for follow up care.

00:30:40.767 --> 00:30:42.428
How can I do this so that I

00:30:42.528 --> 00:30:44.549
leverage and optimize the evaluations?

00:30:44.630 --> 00:30:46.530
But then is there something

00:30:46.570 --> 00:30:48.352
better I can do for follow up care?

00:30:48.392 --> 00:30:51.114
Is there something that is good enough?

00:30:51.574 --> 00:30:51.854
Right.

00:30:52.355 --> 00:30:54.036
Listening on the radio was

00:30:54.115 --> 00:30:55.497
good enough for most people.

00:30:55.997 --> 00:30:57.538
And then some of the people

00:30:57.597 --> 00:30:59.578
wanted like I want on demand.

00:30:59.618 --> 00:31:00.400
So I'm going to pay the

00:31:00.440 --> 00:31:02.201
dollar to buy the song to get it.

00:31:02.520 --> 00:31:03.942
And then, of course, at the fringe,

00:31:04.021 --> 00:31:05.063
you've got people who will

00:31:05.083 --> 00:31:06.263
pay a million dollars to

00:31:06.304 --> 00:31:07.523
have Taylor Swift come and

00:31:07.564 --> 00:31:09.445
sing at their child's birthday party.

00:31:09.566 --> 00:31:09.726
Right.

00:31:10.726 --> 00:31:12.126
But I think when I look at

00:31:12.326 --> 00:31:13.667
old models and I'm like, well,

00:31:13.847 --> 00:31:15.528
if I optimize the therapist

00:31:15.568 --> 00:31:18.230
time for evaluations and I

00:31:18.289 --> 00:31:19.411
know evaluations are an

00:31:19.471 --> 00:31:21.291
untimed code and I know

00:31:21.332 --> 00:31:22.613
that I'm treating an

00:31:22.772 --> 00:31:23.993
outpatient orthopedic,

00:31:24.094 --> 00:31:26.035
relatively high functioning population,

00:31:26.075 --> 00:31:27.115
they're driving themselves,

00:31:27.174 --> 00:31:27.976
bathing themselves,

00:31:28.036 --> 00:31:29.696
dressing and grooming and sleeping.

00:31:30.116 --> 00:31:30.957
They're just dealing with

00:31:30.997 --> 00:31:32.357
these nuisance conditions

00:31:32.397 --> 00:31:34.078
that have been developing over time.

00:31:34.898 --> 00:31:37.381
Why do I not see more therapists,

00:31:37.441 --> 00:31:38.882
more business owners say, okay,

00:31:39.721 --> 00:31:40.902
I'm going to reserve the

00:31:40.923 --> 00:31:42.782
therapist time for what the

00:31:42.843 --> 00:31:45.344
therapist does best, the evaluation,

00:31:45.403 --> 00:31:46.183
the assessment,

00:31:46.244 --> 00:31:47.704
synthesizing the information,

00:31:47.765 --> 00:31:49.445
looking for those red flags,

00:31:49.526 --> 00:31:50.986
looking for the hidden cause,

00:31:51.026 --> 00:31:52.146
the root cause of the problem.

00:31:53.143 --> 00:31:54.124
And then the therapist is

00:31:54.144 --> 00:31:55.105
going to create the

00:31:55.165 --> 00:31:57.147
treatment plan that doesn't

00:31:57.208 --> 00:31:58.409
have to be delivered by the

00:31:58.450 --> 00:31:59.510
therapist every time.

00:32:00.090 --> 00:32:03.695
And for $100 a month, unlimited therapy,

00:32:04.115 --> 00:32:06.479
the client can come in five days a week.

00:32:06.538 --> 00:32:08.521
They probably won't, but they can.

00:32:10.002 --> 00:32:10.984
That's kind of the model

00:32:11.005 --> 00:32:11.986
that we've always run.

00:32:13.567 --> 00:32:15.607
I continue to pay PTs and

00:32:15.627 --> 00:32:17.288
PTAs to deliver that model,

00:32:17.307 --> 00:32:18.228
even though it doesn't need

00:32:18.268 --> 00:32:19.528
a PT or a PTA.

00:32:20.148 --> 00:32:21.929
And so I bring the cost of care down.

00:32:21.949 --> 00:32:23.849
I can maintain the live element,

00:32:24.009 --> 00:32:24.930
in-person element.

00:32:24.970 --> 00:32:26.851
It doesn't have to be a virtual program.

00:32:27.351 --> 00:32:28.211
I can optimize the

00:32:28.250 --> 00:32:29.892
clinician's time for the

00:32:29.971 --> 00:32:31.531
highest value service we

00:32:31.551 --> 00:32:33.272
can deliver to a third party payer.

00:32:33.772 --> 00:32:34.972
If the individual wants to

00:32:35.012 --> 00:32:36.032
pay out of pocket because

00:32:36.053 --> 00:32:37.473
they do want the therapist,

00:32:37.513 --> 00:32:38.794
they want that next level

00:32:39.054 --> 00:32:41.855
up kind of service, they can pay for it.

00:32:42.515 --> 00:32:43.797
I just don't see that

00:32:43.876 --> 00:32:45.640
happening at scale right now.

00:32:46.641 --> 00:32:47.563
All right, so let's review.

00:32:47.583 --> 00:32:48.183
I wanna make sure I

00:32:48.443 --> 00:32:49.685
understand the audience understand.

00:32:51.048 --> 00:32:52.670
You're saying, and I agree with you,

00:32:52.710 --> 00:32:52.990
I think,

00:32:54.901 --> 00:32:56.882
The PTs biggest bang for

00:32:56.902 --> 00:32:58.923
their buck and not minute

00:32:58.962 --> 00:32:59.804
because it's not a times

00:32:59.864 --> 00:33:01.263
code is the evaluation.

00:33:01.503 --> 00:33:01.644
Right.

00:33:01.785 --> 00:33:03.945
PTA or a tech can't do an evaluation.

00:33:04.566 --> 00:33:04.726
Right.

00:33:04.786 --> 00:33:06.227
Legally or bill for it.

00:33:06.666 --> 00:33:07.326
So you're saying, well,

00:33:07.366 --> 00:33:08.387
if the PTs can do that,

00:33:08.428 --> 00:33:09.888
let's fill them up with evals.

00:33:10.009 --> 00:33:11.609
You're you're an evaluation machine.

00:33:11.950 --> 00:33:12.130
Right.

00:33:12.549 --> 00:33:14.790
And then based on that evaluation,

00:33:14.830 --> 00:33:15.731
that diagnosis,

00:33:15.791 --> 00:33:16.852
that plan of care is then

00:33:16.912 --> 00:33:17.633
created by the PT.

00:33:18.432 --> 00:33:20.233
And then not hand it off,

00:33:20.354 --> 00:33:22.215
but explain to their team member,

00:33:22.256 --> 00:33:24.436
their partner, their PTA with the patient,

00:33:24.857 --> 00:33:26.378
okay, from here you do this.

00:33:27.578 --> 00:33:28.359
And you're saying,

00:33:28.960 --> 00:33:34.263
I understand what we can deliver.

00:33:34.564 --> 00:33:36.546
If the person values coming

00:33:36.605 --> 00:33:37.826
in five days a week,

00:33:38.166 --> 00:33:39.567
that's not economically feasible.

00:33:39.607 --> 00:33:40.307
The insurance company is

00:33:40.327 --> 00:33:41.028
going to pay for it.

00:33:41.308 --> 00:33:42.230
And if I'm going to charge

00:33:42.269 --> 00:33:44.010
you for that PT's one-on-one time,

00:33:44.250 --> 00:33:45.192
the cost is too much.

00:33:46.351 --> 00:33:47.352
So at a lower rate,

00:33:47.511 --> 00:33:49.693
at a subscription model, like Apple Music,

00:33:50.054 --> 00:33:51.695
you can pay $500 a month,

00:33:51.915 --> 00:33:53.116
come in as many times as you want,

00:33:53.557 --> 00:33:54.798
knowing that there's a bell curve.

00:33:55.058 --> 00:33:55.700
Some people are going to

00:33:55.920 --> 00:33:57.181
just absolutely abuse it, right?

00:33:57.201 --> 00:33:58.701
They're going to come in 10 times a month,

00:33:58.721 --> 00:33:59.222
twice a day.

00:33:59.603 --> 00:34:00.844
Some people are never going to come in,

00:34:01.003 --> 00:34:01.704
and most of the people are

00:34:01.724 --> 00:34:02.306
going to fall in the middle

00:34:02.326 --> 00:34:02.865
of that bell curve,

00:34:03.105 --> 00:34:03.606
and they're going to come

00:34:03.626 --> 00:34:04.607
in two to three times a week.

00:34:04.807 --> 00:34:05.509
I'm making these numbers up.

00:34:05.528 --> 00:34:05.689
Right.

00:34:07.227 --> 00:34:10.369
But is the PT still in the

00:34:10.469 --> 00:34:12.610
clinic when they're coming

00:34:12.650 --> 00:34:14.170
for their third follow-up with the PTA?

00:34:14.431 --> 00:34:15.411
And could they bend their

00:34:15.512 --> 00:34:16.652
ear for a minute or just

00:34:16.672 --> 00:34:18.733
get a quick aside with them?

00:34:19.594 --> 00:34:21.155
I would take it another step.

00:34:21.235 --> 00:34:23.217
And I would say the PT,

00:34:23.257 --> 00:34:26.498
and I'm using my biases in this example.

00:34:26.619 --> 00:34:30.541
Like my passion is not to count 10 reps,

00:34:30.641 --> 00:34:30.882
right?

00:34:30.942 --> 00:34:31.682
And I know most of the

00:34:31.702 --> 00:34:32.503
people watching this,

00:34:32.682 --> 00:34:33.423
they're the same way.

00:34:33.463 --> 00:34:34.483
Like they want to analyze

00:34:34.543 --> 00:34:35.385
and they want to critique

00:34:35.405 --> 00:34:36.246
and they want to improve.

00:34:36.965 --> 00:34:38.427
But the idea is if I'm going

00:34:38.467 --> 00:34:39.927
to deliver a good enough

00:34:39.987 --> 00:34:40.949
product that's going to get

00:34:41.009 --> 00:34:42.550
improvement and all of those things,

00:34:43.170 --> 00:34:44.990
me as the PT, I do the evaluation.

00:34:45.110 --> 00:34:47.432
I love being an evaluation machine.

00:34:47.652 --> 00:34:48.753
I'm sorry, but I do.

00:34:48.833 --> 00:34:50.434
I can generate $1,000 an

00:34:50.474 --> 00:34:52.356
hour being an evaluation machine.

00:34:52.817 --> 00:34:54.338
And I feel like it gives me

00:34:54.418 --> 00:34:55.898
the most reward for the

00:34:55.938 --> 00:34:56.898
time and the knowledge and

00:34:56.918 --> 00:34:57.920
the experience that I've

00:34:57.980 --> 00:34:59.280
cultivated over my life.

00:35:00.282 --> 00:35:01.362
But that being said,

00:35:02.043 --> 00:35:03.583
potentially you're looking

00:35:03.684 --> 00:35:05.324
at levels of membership, $100 a month.

00:35:06.945 --> 00:35:08.606
There doesn't have to be a PT on site.

00:35:08.666 --> 00:35:10.307
It's not billable through insurance.

00:35:10.387 --> 00:35:11.568
There's an individual in the

00:35:11.608 --> 00:35:12.648
clinic that I've trained,

00:35:13.068 --> 00:35:14.909
that I've educated to carry

00:35:15.050 --> 00:35:16.931
out my recommended protocol

00:35:16.971 --> 00:35:18.052
for a person that doesn't

00:35:18.072 --> 00:35:19.132
need direct supervision.

00:35:19.592 --> 00:35:20.672
This is that classic

00:35:20.713 --> 00:35:21.934
individual that just needs

00:35:21.994 --> 00:35:22.693
to do the reps.

00:35:22.733 --> 00:35:23.715
They need to work out.

00:35:23.755 --> 00:35:24.675
They're not going to see

00:35:24.715 --> 00:35:26.956
gains in two or three or four weeks.

00:35:27.036 --> 00:35:29.237
They just need to keep working at it.

00:35:30.239 --> 00:35:32.603
So I can hire somebody that's not licensed,

00:35:32.943 --> 00:35:34.485
that is not delivering, quote,

00:35:34.545 --> 00:35:35.306
skilled care,

00:35:35.606 --> 00:35:37.010
and it's not billable to insurance,

00:35:37.050 --> 00:35:38.371
but they're an amazing person.

00:35:38.731 --> 00:35:39.614
They're great at telling

00:35:39.653 --> 00:35:41.456
jokes and socializing and

00:35:41.876 --> 00:35:43.318
connecting with the consumer.

00:35:44.454 --> 00:35:45.514
Then at the next level,

00:35:45.574 --> 00:35:47.396
maybe it is a PT or a PTA

00:35:47.735 --> 00:35:49.356
who's delivering the services.

00:35:49.836 --> 00:35:51.577
But at the highest level, yeah,

00:35:51.739 --> 00:35:54.059
the PT is the project manager.

00:35:54.119 --> 00:35:55.880
The project is the plan of care.

00:35:56.481 --> 00:35:57.521
I'm going to utilize the

00:35:57.561 --> 00:35:59.003
resources that I've pulled

00:35:59.043 --> 00:36:01.764
together to find that sweet

00:36:01.824 --> 00:36:02.864
spot of value.

00:36:02.925 --> 00:36:04.365
The sweet spot of value is

00:36:04.987 --> 00:36:07.108
the price is one tenth of

00:36:07.228 --> 00:36:08.128
what it's worth.

00:36:08.889 --> 00:36:09.429
It's worth $1,000.

00:36:09.789 --> 00:36:11.072
I'm going to charge $100.

00:36:12.492 --> 00:36:13.974
Can I do that at scale and

00:36:14.014 --> 00:36:15.336
can I do that profitably?

00:36:15.516 --> 00:36:16.538
And can I deliver an

00:36:16.958 --> 00:36:18.500
experience that exceeds the

00:36:18.519 --> 00:36:19.722
client's expectation?

00:36:20.443 --> 00:36:22.125
I think all of those boxes

00:36:22.204 --> 00:36:23.827
can be checked right now.

00:36:24.047 --> 00:36:26.168
I think we all have the capacity to do it.

00:36:26.769 --> 00:36:28.289
And at the end of the day,

00:36:28.349 --> 00:36:29.731
it makes the therapist's

00:36:30.070 --> 00:36:31.610
time more profitable,

00:36:32.130 --> 00:36:33.492
which means they don't have

00:36:33.532 --> 00:36:34.632
to see as many patients.

00:36:34.652 --> 00:36:36.152
They don't have to work as hard.

00:36:36.192 --> 00:36:38.813
Historically, we would use that model,

00:36:39.273 --> 00:36:39.793
not us,

00:36:39.893 --> 00:36:41.793
but therapists would use that model.

00:36:41.833 --> 00:36:44.034
They bill for techs to

00:36:44.074 --> 00:36:45.833
deliver therapy inappropriately,

00:36:46.394 --> 00:36:47.715
and they would do it and

00:36:47.835 --> 00:36:49.434
burn the heck out of their therapist.

00:36:49.474 --> 00:36:50.635
Their therapist would be seeing 60,

00:36:50.635 --> 00:36:51.155
70 visits a week.

00:36:52.916 --> 00:36:54.664
I think we reinvent the model.

00:36:54.704 --> 00:36:57.094
We innovate on what we know is effective.

00:36:57.844 --> 00:36:59.724
but we make it better.

00:37:00.306 --> 00:37:01.425
That's the easiest way for me to say it.

00:37:01.445 --> 00:37:02.027
Dr. Justin Marchegiani Well,

00:37:02.047 --> 00:37:02.746
then how do we learn?

00:37:02.766 --> 00:37:03.927
I mean, you know,

00:37:04.088 --> 00:37:05.708
I've been taking my dad to

00:37:05.728 --> 00:37:06.949
a lot of doctor's appointments.

00:37:07.250 --> 00:37:08.391
And if you look at the doctor,

00:37:08.951 --> 00:37:11.012
similarly to a doctor of physical therapy,

00:37:11.552 --> 00:37:12.893
do you think my dad's doctor,

00:37:12.994 --> 00:37:15.074
who's a fantastic woman, by the way,

00:37:15.375 --> 00:37:17.637
great, great manner, great personality,

00:37:17.936 --> 00:37:18.717
great clinically,

00:37:19.117 --> 00:37:20.277
my dad loves her and he

00:37:20.297 --> 00:37:21.239
doesn't love a lot of people,

00:37:21.358 --> 00:37:22.159
but he loves her, right?

00:37:22.179 --> 00:37:23.019
Dr. Justin Marchegiani

00:37:23.199 --> 00:37:24.541
So do you think she's giving

00:37:24.561 --> 00:37:25.860
him any injections?

00:37:26.342 --> 00:37:27.202
Do you think she's checking

00:37:27.262 --> 00:37:27.862
blood pressure?

00:37:27.981 --> 00:37:28.922
Do I think she could give

00:37:28.943 --> 00:37:30.204
injections or give blood

00:37:30.244 --> 00:37:32.105
pressure or hand my dad medication?

00:37:32.244 --> 00:37:32.724
Absolutely.

00:37:33.065 --> 00:37:33.505
Does she?

00:37:34.146 --> 00:37:34.385
No.

00:37:34.646 --> 00:37:36.407
She's there maximizing her time.

00:37:36.907 --> 00:37:38.327
When she's in front of my dad,

00:37:38.387 --> 00:37:39.467
the only thing she has to

00:37:39.507 --> 00:37:41.668
work or think about is what

00:37:41.708 --> 00:37:43.130
I'm hearing since last time.

00:37:43.730 --> 00:37:45.670
What you're telling me is going well,

00:37:45.811 --> 00:37:46.672
needs to be fixed.

00:37:47.242 --> 00:37:49.043
And then she's a project manager.

00:37:49.063 --> 00:37:51.286
And I think that's a way for

00:37:51.327 --> 00:37:52.447
her to be most efficient.

00:37:52.708 --> 00:37:54.309
She understands her role on the team.

00:37:54.389 --> 00:37:55.692
She's the team captain, right?

00:37:55.711 --> 00:37:57.713
According to me and my dad anyway.

00:37:58.574 --> 00:37:59.615
And then she has a

00:37:59.976 --> 00:38:01.498
well-trained team around

00:38:01.538 --> 00:38:03.079
her that's able to deliver that.

00:38:04.485 --> 00:38:06.146
So let's run some very

00:38:06.206 --> 00:38:08.449
simple math and I'm going to,

00:38:08.949 --> 00:38:09.809
you guys will see me,

00:38:09.849 --> 00:38:10.530
but I'm going to pull up a

00:38:10.570 --> 00:38:11.550
calculator because I can't

00:38:11.570 --> 00:38:13.592
do public math here in Ohio.

00:38:13.612 --> 00:38:15.655
A typical Medicare covered

00:38:15.735 --> 00:38:17.056
initial evaluation,

00:38:17.556 --> 00:38:19.758
low complexity reimburses about 98, $96,

00:38:19.758 --> 00:38:19.818
$98.

00:38:19.818 --> 00:38:21.460
Let's just say a hundred dollars.

00:38:21.480 --> 00:38:21.719
Okay.

00:38:21.760 --> 00:38:22.820
I'll do the math for you.

00:38:22.840 --> 00:38:23.601
A hundred dollars.

00:38:23.902 --> 00:38:23.961
Go.

00:38:26.043 --> 00:38:27.125
Okay.

00:38:27.144 --> 00:38:28.465
20 minute commitment.

00:38:29.565 --> 00:38:31.367
I could do three an hour easily.

00:38:31.487 --> 00:38:33.228
Remember, this is low complexity.

00:38:33.309 --> 00:38:34.429
Look at the requirements for

00:38:34.449 --> 00:38:35.969
a low complexity evaluation.

00:38:36.351 --> 00:38:37.391
This is your typical

00:38:37.471 --> 00:38:39.092
Medicare beneficiary who's

00:38:39.132 --> 00:38:40.373
golfing on the weekends.

00:38:40.413 --> 00:38:41.653
They're socializing.

00:38:41.693 --> 00:38:42.574
They're going to church.

00:38:42.974 --> 00:38:43.896
They're doing everything.

00:38:44.155 --> 00:38:45.516
They just have a little shoulder pain.

00:38:45.597 --> 00:38:46.757
They have a kink in their neck.

00:38:47.038 --> 00:38:47.697
They have a hitch.

00:38:48.038 --> 00:38:48.398
What is it?

00:38:48.418 --> 00:38:49.398
A hitch in their giddy up.

00:38:49.478 --> 00:38:50.239
Something like that.

00:38:50.260 --> 00:38:50.340
Yep.

00:38:51.052 --> 00:38:51.932
And they're like, hey,

00:38:52.213 --> 00:38:53.193
I wanna get this taken care

00:38:53.233 --> 00:38:54.213
of before it gets worse.

00:38:54.574 --> 00:38:56.496
This is not the most complex

00:38:56.536 --> 00:38:58.777
neuro case that has cardiac

00:38:58.797 --> 00:39:01.059
complications and falling twice a week.

00:39:01.320 --> 00:39:03.742
This is a very simple case to treat.

00:39:04.503 --> 00:39:05.563
I could do three an hour,

00:39:05.804 --> 00:39:06.503
that's $300 an hour.

00:39:06.543 --> 00:39:07.304
I could do 10 hours

00:39:07.324 --> 00:39:09.246
committed to that a week,

00:39:09.266 --> 00:39:10.306
that's $3,000 a week.

00:39:10.306 --> 00:39:10.806
50 weeks a year,

00:39:10.847 --> 00:39:11.847
that's $150,000 just doing that.

00:39:20.672 --> 00:39:21.992
Now from there,

00:39:22.233 --> 00:39:24.393
that's 10 hours of my time a week.

00:39:24.432 --> 00:39:25.914
That leaves me 30 hours if I

00:39:25.954 --> 00:39:27.653
was willing to work a 40-hour week.

00:39:28.074 --> 00:39:29.355
That's a whole lot of extra

00:39:29.394 --> 00:39:31.295
time to do anything that I want to do,

00:39:31.414 --> 00:39:32.596
anything that I enjoy,

00:39:32.675 --> 00:39:35.556
like have experiences that

00:39:35.617 --> 00:39:37.956
maybe I wouldn't otherwise have.

00:39:38.597 --> 00:39:39.117
And of course,

00:39:39.177 --> 00:39:40.378
if we double it and we take

00:39:40.398 --> 00:39:41.958
it to 300,000 because I'm

00:39:41.978 --> 00:39:43.398
working 20 hours a week,

00:39:43.798 --> 00:39:46.701
that extra 150,000,

00:39:46.701 --> 00:39:47.721
I can build a pretty good

00:39:47.780 --> 00:39:49.762
team to deliver the

00:39:49.822 --> 00:39:51.121
protocols that don't need a

00:39:51.181 --> 00:39:52.382
lot of complexity and

00:39:52.422 --> 00:39:53.521
medical supervision.

00:39:53.541 --> 00:39:55.643
I can hire great people for

00:39:55.682 --> 00:39:58.043
an extra $150,000 in

00:39:58.163 --> 00:39:59.503
revenue that can deliver

00:39:59.543 --> 00:40:00.364
better patient care.

00:40:00.824 --> 00:40:03.423
And that's not counting the

00:40:03.423 --> 00:40:04.483
$100 a month that would be

00:40:04.724 --> 00:40:06.465
paid by the consumer if

00:40:06.525 --> 00:40:07.905
they wanted to do a month

00:40:08.545 --> 00:40:12.045
of this kind of post-evaluation protocol.

00:40:12.545 --> 00:40:12.766
Right.

00:40:13.432 --> 00:40:14.333
Now, hold on a second.

00:40:14.534 --> 00:40:15.994
The people on the other side might say,

00:40:16.074 --> 00:40:18.077
but I like spending an hour

00:40:18.237 --> 00:40:19.737
one-on-one care with my patient.

00:40:20.478 --> 00:40:21.498
I like doing that.

00:40:21.579 --> 00:40:22.320
You said, listen,

00:40:22.340 --> 00:40:23.981
I have no problem being an eval machine.

00:40:24.001 --> 00:40:25.362
I think there are people who

00:40:25.382 --> 00:40:25.822
agree with you.

00:40:26.222 --> 00:40:27.844
But some people say our

00:40:27.963 --> 00:40:29.184
profession is built on the

00:40:29.224 --> 00:40:31.047
fact that we get the most time.

00:40:31.586 --> 00:40:32.887
We build this relationship.

00:40:33.068 --> 00:40:34.128
What would you say to that?

00:40:35.737 --> 00:40:36.577
I would say, you know what?

00:40:36.717 --> 00:40:38.278
I like eating chocolate cake too.

00:40:38.900 --> 00:40:40.420
I like going on vacation.

00:40:40.561 --> 00:40:41.541
I love fishing.

00:40:42.282 --> 00:40:44.103
Those are awesome things.

00:40:44.184 --> 00:40:46.365
You love the hour with your patient.

00:40:46.385 --> 00:40:48.246
You love building the connection rapport.

00:40:48.286 --> 00:40:49.608
You love all of those things.

00:40:50.289 --> 00:40:50.628
Awesome.

00:40:51.230 --> 00:40:53.751
Those are selfish desires

00:40:53.831 --> 00:40:55.112
that we should fulfill and

00:40:55.132 --> 00:40:56.893
we should honor and we should recognize.

00:40:57.394 --> 00:40:59.396
But as soon as you start with I love,

00:41:00.217 --> 00:41:01.217
we stop right there.

00:41:01.717 --> 00:41:03.400
That is what you want.

00:41:03.460 --> 00:41:05.481
That is the fulfillment you are seeking.

00:41:06.161 --> 00:41:07.443
And back to one more time,

00:41:07.463 --> 00:41:08.784
if I'm generating 150,000

00:41:08.784 --> 00:41:11.626
in 10 hours a week of work,

00:41:12.148 --> 00:41:13.429
you can do all the stuff

00:41:13.469 --> 00:41:16.471
you love in the other 30 hours.

00:41:16.570 --> 00:41:18.213
That's my whole point here

00:41:18.393 --> 00:41:20.034
is everybody wants to take

00:41:20.074 --> 00:41:20.934
it to the extreme.

00:41:20.974 --> 00:41:22.356
The extreme is, oh, well,

00:41:22.536 --> 00:41:23.237
how are you going to do

00:41:23.277 --> 00:41:24.157
that 40 hours a week?

00:41:24.177 --> 00:41:24.699
You're not.

00:41:25.298 --> 00:41:26.320
You're going to generate the

00:41:26.360 --> 00:41:27.619
money you need to survive.

00:41:27.659 --> 00:41:28.641
You're going to generate the

00:41:28.701 --> 00:41:31.842
revenue you need to live in

00:41:32.023 --> 00:41:33.224
a fraction of the time.

00:41:33.664 --> 00:41:34.563
And then you can do whatever

00:41:34.623 --> 00:41:35.545
you want with the time.

00:41:35.625 --> 00:41:37.445
Something that I don't ever talk about,

00:41:37.806 --> 00:41:38.907
but I think needs to be

00:41:38.987 --> 00:41:41.407
recognized is in my clinic,

00:41:41.467 --> 00:41:42.528
in my operation.

00:41:42.688 --> 00:41:43.769
I have never in 22, 23 years.

00:41:46.471 --> 00:41:47.351
told somebody,

00:41:47.952 --> 00:41:49.893
your insurance is exhausted.

00:41:49.952 --> 00:41:51.273
You cannot come to therapy

00:41:51.313 --> 00:41:52.795
unless you pay the full cash rate.

00:41:53.295 --> 00:41:55.056
I've never had to turn somebody away.

00:41:55.476 --> 00:41:57.097
I've never had to refuse care.

00:41:57.456 --> 00:41:58.438
I've never had to send

00:41:58.478 --> 00:41:59.577
somebody to collections.

00:42:00.338 --> 00:42:02.440
Finances have never been a

00:42:02.519 --> 00:42:03.559
limiting factor for

00:42:03.599 --> 00:42:04.840
somebody who wants to come

00:42:04.880 --> 00:42:06.202
to therapy at my clinic, but

00:42:06.621 --> 00:42:08.103
The only reason I can do

00:42:08.143 --> 00:42:09.744
that is because I have the

00:42:09.804 --> 00:42:11.646
profitability from other

00:42:11.726 --> 00:42:13.567
things to make that happen.

00:42:13.586 --> 00:42:14.568
And when I say other things,

00:42:14.608 --> 00:42:15.489
I'm not even talking about

00:42:15.568 --> 00:42:16.509
outside of patient care.

00:42:16.528 --> 00:42:18.590
I'm saying I can operate a

00:42:18.650 --> 00:42:19.811
profitable clinic in a

00:42:19.871 --> 00:42:21.032
conventional model.

00:42:21.672 --> 00:42:23.034
And that profitability

00:42:23.094 --> 00:42:24.594
allows me to do all the

00:42:24.735 --> 00:42:25.635
other things that I

00:42:25.715 --> 00:42:26.836
wouldn't be able to do.

00:42:27.016 --> 00:42:28.697
If I'm struggling to survive,

00:42:28.818 --> 00:42:30.280
I can't help other people.

00:42:30.380 --> 00:42:31.960
I need to have that

00:42:32.021 --> 00:42:34.121
abundance to help other people.

00:42:34.141 --> 00:42:34.822
Mm hmm.

00:42:38.280 --> 00:42:39.440
I was going to use this as

00:42:39.480 --> 00:42:40.221
my parting shot.

00:42:40.260 --> 00:42:41.862
Maybe I'll hold it for my parting shot.

00:42:42.442 --> 00:42:43.003
Yeah, hold it.

00:42:44.202 --> 00:42:45.643
But I would love to hear

00:42:45.664 --> 00:42:47.324
what people think about this, right?

00:42:47.364 --> 00:42:48.585
So we started talking about

00:42:49.306 --> 00:42:51.047
apps and the review of this

00:42:51.086 --> 00:42:53.188
third-party agency in terms of like these,

00:42:53.748 --> 00:42:55.429
you know, replacing PT,

00:42:55.489 --> 00:42:57.170
PT augmented and like, you know,

00:42:57.251 --> 00:42:59.512
remote therapeutic monitoring,

00:42:59.592 --> 00:43:02.673
sort of a PT's eyes and making... I mean,

00:43:02.693 --> 00:43:03.074
really that's...

00:43:04.405 --> 00:43:05.146
remote therapeutic

00:43:05.166 --> 00:43:06.228
monitoring really that's

00:43:06.248 --> 00:43:07.228
just that's just

00:43:07.289 --> 00:43:09.231
accountability if you're

00:43:09.251 --> 00:43:10.612
paying for this we have to

00:43:10.652 --> 00:43:11.474
be able to make sure you're

00:43:11.494 --> 00:43:12.195
doing it and you have to

00:43:12.275 --> 00:43:13.896
prove it it's the digital

00:43:13.976 --> 00:43:15.177
way of being able to prove

00:43:15.277 --> 00:43:16.559
it from the insurance

00:43:16.579 --> 00:43:17.521
standpoint I sort of agree

00:43:17.541 --> 00:43:18.501
with them if you're

00:43:18.521 --> 00:43:19.202
charging me something I

00:43:19.222 --> 00:43:19.742
want to make sure they're

00:43:19.762 --> 00:43:21.125
actually doing it because I

00:43:21.144 --> 00:43:21.925
don't want to be paying for

00:43:21.945 --> 00:43:22.887
this six months from now I

00:43:22.927 --> 00:43:23.646
want to be I want to be

00:43:23.666 --> 00:43:25.570
done in three months um

00:43:26.963 --> 00:43:28.204
Yeah, that's all I had on that.

00:43:28.684 --> 00:43:29.505
APTA, of course,

00:43:29.565 --> 00:43:30.786
jumps all over this when

00:43:30.806 --> 00:43:31.766
they see the report and

00:43:31.786 --> 00:43:33.166
they issue a press release saying,

00:43:33.887 --> 00:43:35.248
absolutely, this is fantastic,

00:43:35.288 --> 00:43:36.248
showing the value of

00:43:36.289 --> 00:43:38.911
physical therapists and technology.

00:43:39.311 --> 00:43:40.112
I haven't seen anything

00:43:40.152 --> 00:43:42.393
public from my friend, Drew Contreras,

00:43:42.793 --> 00:43:44.333
whose job at the APTA is

00:43:44.373 --> 00:43:45.994
sort of innovation and technology.

00:43:46.054 --> 00:43:47.135
But my assumption is he's

00:43:47.416 --> 00:43:48.297
super excited and

00:43:48.376 --> 00:43:49.318
intimately aware of all

00:43:49.358 --> 00:43:50.197
these different apps that

00:43:50.237 --> 00:43:51.199
were mentioned in the report.

00:43:51.239 --> 00:43:51.318
So

00:43:51.775 --> 00:43:53.096
I know APTA is excited about

00:43:53.135 --> 00:43:54.036
it as they should be.

00:43:54.956 --> 00:43:56.177
If you're nervous about it,

00:43:56.996 --> 00:43:57.797
you're playing like

00:43:57.858 --> 00:43:59.398
Metallica and I'm going to

00:43:59.478 --> 00:44:01.679
tell you to stop doing that, right?

00:44:02.398 --> 00:44:03.519
Metallica changed their tune

00:44:03.559 --> 00:44:04.659
fast enough to not get

00:44:04.719 --> 00:44:06.001
washed away by technology.

00:44:07.159 --> 00:44:09.239
Or they just realized,

00:44:09.480 --> 00:44:10.481
go along or get along,

00:44:10.541 --> 00:44:11.201
or you're going to get run

00:44:11.280 --> 00:44:12.280
over by technology.

00:44:12.661 --> 00:44:13.681
The line that kept coming up

00:44:13.702 --> 00:44:14.461
to me was you can't

00:44:14.583 --> 00:44:16.342
legislate against technology.

00:44:16.764 --> 00:44:17.503
You can try,

00:44:18.123 --> 00:44:19.565
but it's going to find its way.

00:44:20.085 --> 00:44:22.646
And that was why in 2008,

00:44:22.646 --> 00:44:23.847
I looked at the world and said,

00:44:24.027 --> 00:44:26.148
I'm a radio DJ in Northeast Pennsylvania.

00:44:26.827 --> 00:44:27.548
I don't know what that's

00:44:27.568 --> 00:44:29.048
going to look like five years from now.

00:44:29.369 --> 00:44:30.809
And I'm not in the position

00:44:31.309 --> 00:44:32.251
to change my life.

00:44:33.635 --> 00:44:35.016
I was just whatever the

00:44:35.056 --> 00:44:36.476
radio company was going to tell me to do,

00:44:36.516 --> 00:44:37.117
I was going to do.

00:44:37.478 --> 00:44:38.418
That's why I got out.

00:44:38.518 --> 00:44:39.858
People are like, why did you leave radio?

00:44:40.579 --> 00:44:41.800
It looked like such a disruptor.

00:44:41.840 --> 00:44:42.740
And a lot of my friends

00:44:42.840 --> 00:44:45.222
don't have jobs anymore.

00:44:46.003 --> 00:44:47.123
When I started at radio stations,

00:44:47.143 --> 00:44:48.905
there were, let's say, 100 employees.

00:44:49.226 --> 00:44:51.387
By the time I left 10, 15 years later,

00:44:51.947 --> 00:44:53.288
there were 30 employees.

00:44:53.307 --> 00:44:53.849
I mean, that's like 70%.

00:44:56.300 --> 00:44:58.344
attrition or 70%, you know,

00:44:59.726 --> 00:45:01.188
less people being involved

00:45:01.208 --> 00:45:02.972
because when I left,

00:45:03.032 --> 00:45:03.873
I never said this before,

00:45:04.293 --> 00:45:06.657
my last day as a radio program director,

00:45:06.958 --> 00:45:08.601
they made me fire my morning guy.

00:45:09.717 --> 00:45:10.518
That was my last day.

00:45:10.938 --> 00:45:11.719
Like, hey, by the way,

00:45:11.798 --> 00:45:12.619
bring that guy in you've

00:45:12.639 --> 00:45:13.480
been working with for eight

00:45:13.519 --> 00:45:14.460
years and fire him.

00:45:15.021 --> 00:45:15.681
And here's why.

00:45:16.041 --> 00:45:16.942
Not because we're bringing

00:45:17.021 --> 00:45:18.023
in a new morning team

00:45:18.643 --> 00:45:19.463
that's going to sit in

00:45:19.503 --> 00:45:20.443
northeast Pennsylvania.

00:45:20.784 --> 00:45:21.445
We're going to bring in a

00:45:21.485 --> 00:45:23.146
show from Dallas that we're

00:45:23.186 --> 00:45:24.246
now just going to plug in.

00:45:24.467 --> 00:45:25.407
And this show is now going

00:45:25.427 --> 00:45:27.429
to be simulcast on forty

00:45:27.469 --> 00:45:28.789
nine stations and not forty

00:45:28.849 --> 00:45:29.610
eight or forty.

00:45:29.630 --> 00:45:29.809
You know,

00:45:30.210 --> 00:45:31.490
they just they just added one

00:45:31.530 --> 00:45:32.731
more syndicated market.

00:45:33.231 --> 00:45:34.853
And that sort of cemented my decision.

00:45:34.893 --> 00:45:35.474
Like I didn't.

00:45:36.434 --> 00:45:37.275
I don't know which way the

00:45:37.315 --> 00:45:38.076
wind's going to blow,

00:45:38.556 --> 00:45:40.559
but I'm not in a position

00:45:40.978 --> 00:45:42.139
to be able to ride this wave.

00:45:42.239 --> 00:45:42.721
So I'm out.

00:45:43.141 --> 00:45:44.483
I'm out on media.

00:45:44.762 --> 00:45:44.902
Now,

00:45:45.163 --> 00:45:46.905
there was some weird murky stuff in

00:45:46.925 --> 00:45:47.306
the middle,

00:45:47.385 --> 00:45:48.947
but now we arrive at I have a

00:45:48.987 --> 00:45:50.548
talk show in my living room right now,

00:45:50.608 --> 00:45:51.630
and I'm talking to Tony,

00:45:52.070 --> 00:45:53.853
and we don't need anybody's permission,

00:45:54.452 --> 00:45:54.614
right?

00:45:54.634 --> 00:45:55.675
The barrier is zero.

00:45:56.797 --> 00:45:58.498
Except the difficulty of

00:45:58.539 --> 00:45:59.539
getting noticed is now

00:45:59.699 --> 00:46:00.639
infinitely harder because

00:46:00.978 --> 00:46:02.639
anybody can do a live stream.

00:46:02.679 --> 00:46:03.920
So you get give and take

00:46:04.260 --> 00:46:06.280
whether it was designed or not.

00:46:07.161 --> 00:46:08.422
So understand that the

00:46:08.461 --> 00:46:09.021
people that are going to

00:46:09.081 --> 00:46:10.063
come out on top in this

00:46:10.083 --> 00:46:11.302
situation are going to be

00:46:11.322 --> 00:46:13.543
the people that figure out how to bring,

00:46:13.784 --> 00:46:15.184
give, not build a wall,

00:46:15.204 --> 00:46:16.684
but build a bridge with

00:46:16.744 --> 00:46:17.664
this technology because

00:46:17.684 --> 00:46:18.344
you're not going to be able

00:46:18.385 --> 00:46:19.266
to legislate against it.

00:46:19.326 --> 00:46:19.826
You're just not.

00:46:21.057 --> 00:46:21.958
Which for the record,

00:46:21.998 --> 00:46:25.099
there's 53 viewers that are

00:46:25.219 --> 00:46:26.378
on the live stream across

00:46:26.438 --> 00:46:27.380
multiple platforms.

00:46:27.440 --> 00:46:28.719
I mean, that's just amazing.

00:46:29.719 --> 00:46:32.721
I saw Will Boyd on here.

00:46:33.081 --> 00:46:34.641
Guys, thank you so much for coming.

00:46:35.141 --> 00:46:35.422
You know,

00:46:35.442 --> 00:46:37.342
the saying that everybody's using,

00:46:37.402 --> 00:46:38.661
and I say it too,

00:46:39.121 --> 00:46:40.643
it's not that AI is going

00:46:40.663 --> 00:46:41.842
to take away your job.

00:46:41.902 --> 00:46:44.063
It's people using AI are

00:46:44.083 --> 00:46:45.264
going to take away your job.

00:46:45.905 --> 00:46:47.987
Even within my little clinic, I mean,

00:46:48.226 --> 00:46:50.108
we're using AI.

00:46:50.530 --> 00:46:51.831
There's AI Scribes now.

00:46:51.911 --> 00:46:53.532
Today, I'm doing a webinar.

00:46:53.873 --> 00:46:55.155
We're talking to Hippo

00:46:55.175 --> 00:46:56.215
Scribe and HelloNote,

00:46:56.235 --> 00:46:56.976
and we're talking about

00:46:58.177 --> 00:47:00.460
what I'm doing today using

00:47:00.661 --> 00:47:02.643
AI Scribe technology to

00:47:03.063 --> 00:47:04.525
optimize my workflow.

00:47:04.945 --> 00:47:05.885
You know, stuff that...

00:47:06.806 --> 00:47:08.268
I couldn't do before because

00:47:08.307 --> 00:47:09.789
I didn't have enough minutes in the day.

00:47:10.389 --> 00:47:11.148
I can do now.

00:47:11.590 --> 00:47:13.490
I can use AI to listen to my

00:47:13.530 --> 00:47:15.271
patient interaction and

00:47:15.351 --> 00:47:16.871
generate an email report.

00:47:17.172 --> 00:47:18.373
Never would have done that before.

00:47:18.432 --> 00:47:20.153
The email will summarize the

00:47:20.213 --> 00:47:21.534
accomplishments of my

00:47:21.594 --> 00:47:22.936
patient for that particular

00:47:22.976 --> 00:47:23.496
treatment day.

00:47:24.016 --> 00:47:25.197
And what's interesting is I

00:47:25.237 --> 00:47:26.398
could tell the AI, hey,

00:47:26.438 --> 00:47:27.938
I want you to start the

00:47:28.018 --> 00:47:30.940
email with a motivational quote,

00:47:30.960 --> 00:47:32.221
and I want you to end with this.

00:47:32.280 --> 00:47:32.340
And

00:47:33.161 --> 00:47:35.302
It opens new doors that I

00:47:35.402 --> 00:47:36.623
didn't think were possible

00:47:36.663 --> 00:47:38.403
because now if I've got an

00:47:38.503 --> 00:47:40.204
auto-generated email that

00:47:40.284 --> 00:47:41.525
is unique to the patient

00:47:41.545 --> 00:47:42.905
care experience for that day,

00:47:43.025 --> 00:47:44.847
I can also embed affiliate

00:47:44.887 --> 00:47:46.168
links for equipment that we

00:47:46.208 --> 00:47:47.909
might've used that day that

00:47:48.128 --> 00:47:49.230
gives that patient the

00:47:49.289 --> 00:47:50.469
opportunity to buy the

00:47:50.510 --> 00:47:52.851
shoulder pulleys that I mentioned,

00:47:52.972 --> 00:47:54.432
which obviously pays me

00:47:54.472 --> 00:47:56.594
back a commission on that transaction.

00:47:57.153 --> 00:47:58.875
It gives me opportunities to

00:47:58.914 --> 00:48:00.416
build an email list, you know,

00:48:00.916 --> 00:48:01.657
A decade ago,

00:48:01.717 --> 00:48:03.219
if you mentioned a newsletter,

00:48:03.239 --> 00:48:04.440
I would have laughed at you

00:48:04.780 --> 00:48:06.161
thinking who in the world

00:48:06.222 --> 00:48:07.364
is going to read a newsletter.

00:48:07.903 --> 00:48:08.425
Meanwhile,

00:48:08.605 --> 00:48:09.987
we see newsletters that are

00:48:10.027 --> 00:48:11.487
being sold for seven and

00:48:11.588 --> 00:48:12.530
eight figure exits.

00:48:13.407 --> 00:48:15.409
Everything has functionality

00:48:15.449 --> 00:48:17.068
as long as you apply it correctly.

00:48:17.608 --> 00:48:19.530
And so I still say it.

00:48:19.690 --> 00:48:20.670
I think this is the most

00:48:20.750 --> 00:48:22.510
exciting time in the PT

00:48:22.570 --> 00:48:25.331
profession for those PTs

00:48:25.391 --> 00:48:27.391
who are willing to look at

00:48:27.431 --> 00:48:28.771
the technology that's out there,

00:48:28.811 --> 00:48:30.132
the tools we have available,

00:48:30.652 --> 00:48:32.713
and really put them to the test.

00:48:32.932 --> 00:48:34.713
We don't know how it's going to affect us.

00:48:34.853 --> 00:48:36.034
I've been using this AI

00:48:36.074 --> 00:48:37.213
Scribe for over a month.

00:48:37.753 --> 00:48:39.454
I still change the way I use

00:48:39.514 --> 00:48:40.615
it almost every single day.

00:48:40.655 --> 00:48:41.577
Cause I haven't quite

00:48:41.657 --> 00:48:43.559
figured out exactly the

00:48:43.619 --> 00:48:44.900
perfect way that it fits

00:48:44.960 --> 00:48:46.001
into my business model.

00:48:46.280 --> 00:48:48.563
You're still, we're still in the,

00:48:48.822 --> 00:48:52.505
I guess I'll pay 99 cents per song.

00:48:52.545 --> 00:48:54.367
And then I think jobs went up to like a,

00:48:54.407 --> 00:48:56.588
you know, a dollar 50 or $2 a song.

00:48:57.010 --> 00:48:58.331
We're still in this weird

00:48:58.391 --> 00:48:59.972
sort of place where we're figuring it out,

00:49:00.532 --> 00:49:01.793
but it's going to find its level.

00:49:02.534 --> 00:49:04.876
And you have first mover advantage now.

00:49:05.315 --> 00:49:05.637
And yeah,

00:49:06.297 --> 00:49:07.878
They say it, you know, again,

00:49:07.918 --> 00:49:09.038
I'll save it for my parting

00:49:09.077 --> 00:49:09.998
shot because I got a good one.

00:49:10.498 --> 00:49:12.338
But yeah, I mean,

00:49:13.278 --> 00:49:14.599
legislate all you want or

00:49:15.239 --> 00:49:16.340
run around telling people

00:49:16.400 --> 00:49:19.382
it's not as good as me and

00:49:19.422 --> 00:49:20.521
yell in the sky is falling.

00:49:20.762 --> 00:49:22.342
That's not going to play out well.

00:49:22.463 --> 00:49:23.402
That's what Metallica did.

00:49:24.123 --> 00:49:25.706
You know, Will Boyd,

00:49:25.945 --> 00:49:27.847
I interviewed him a couple weeks ago,

00:49:28.289 --> 00:49:29.570
and he and Alex are doing

00:49:29.610 --> 00:49:31.211
some really cool stuff in finance.

00:49:31.773 --> 00:49:31.952
Like,

00:49:32.052 --> 00:49:35.117
I have no idea the role AI plays in

00:49:35.197 --> 00:49:37.599
finance, but I have to imagine between,

00:49:38.000 --> 00:49:38.280
you know,

00:49:38.340 --> 00:49:40.842
projections and SWOT analysis and...

00:49:41.583 --> 00:49:43.764
predictive analysis, all this stuff,

00:49:44.264 --> 00:49:45.764
there has to be stuff going

00:49:45.905 --> 00:49:48.025
on in there that's so interesting to me.

00:49:48.045 --> 00:49:50.626
I probably need to get Will

00:49:50.666 --> 00:49:51.927
back on the podcast so we

00:49:51.967 --> 00:49:52.847
can talk about some of

00:49:52.887 --> 00:49:53.708
those things because I'm

00:49:53.807 --> 00:49:55.108
sure he is leveraging that

00:49:55.208 --> 00:49:56.829
technology in ways that I

00:49:56.869 --> 00:49:58.108
don't even know it's available.

00:49:58.588 --> 00:49:59.670
I would imagine taxes.

00:50:00.329 --> 00:50:00.530
Yeah.

00:50:00.909 --> 00:50:02.690
Predicting what you can do and saying, hey,

00:50:02.710 --> 00:50:04.471
listen, if you do this, you know,

00:50:04.630 --> 00:50:05.791
based on the code that

00:50:05.851 --> 00:50:07.130
you've given me and what I

00:50:07.150 --> 00:50:07.951
know about your business,

00:50:09.072 --> 00:50:10.592
you could save money by doing this.

00:50:10.891 --> 00:50:11.771
Or, hey, did you know that?

00:50:11.791 --> 00:50:11.992
Yeah.

00:50:12.072 --> 00:50:12.331
I mean,

00:50:12.612 --> 00:50:16.313
it's able to think for you of

00:50:16.373 --> 00:50:17.353
what's coming down the road

00:50:17.393 --> 00:50:19.132
in ways that maybe you're not skilled,

00:50:19.373 --> 00:50:20.873
don't have the bandwidth or don't like.

00:50:21.193 --> 00:50:23.494
So again, AI won't replace you,

00:50:23.653 --> 00:50:24.875
but a person using AI will

00:50:24.914 --> 00:50:26.155
sure run you over like a truck.

00:50:26.414 --> 00:50:27.114
And that's my opinion.

00:50:27.920 --> 00:50:28.742
And for the record,

00:50:28.902 --> 00:50:30.704
people that are still here, you know,

00:50:30.884 --> 00:50:33.407
for 50 minutes in this

00:50:33.467 --> 00:50:34.407
morning before I got on the

00:50:34.427 --> 00:50:35.369
podcast with you,

00:50:35.769 --> 00:50:36.831
I had somebody reach out to

00:50:36.871 --> 00:50:37.472
me last night.

00:50:37.972 --> 00:50:39.112
They said, hey, you know,

00:50:39.253 --> 00:50:40.894
I'm desperately seeking a

00:50:40.934 --> 00:50:42.036
physical therapist to give

00:50:42.056 --> 00:50:44.159
me a quote on these

00:50:44.318 --> 00:50:45.539
questions from a journalist.

00:50:46.240 --> 00:50:48.802
Jimmy, I know you know what HARO is,

00:50:48.842 --> 00:50:50.262
Help a Reporter Out.

00:50:51.202 --> 00:50:52.963
The individual who reached out to me,

00:50:53.023 --> 00:50:54.023
I had worked with him on a

00:50:54.083 --> 00:50:55.844
digital marketing campaign

00:50:55.885 --> 00:50:57.545
when I was boosting the

00:50:57.686 --> 00:50:59.505
ranking for ChoosePT First,

00:51:00.166 --> 00:51:01.047
and I hadn't talked to him

00:51:01.067 --> 00:51:01.847
for about a year.

00:51:02.527 --> 00:51:05.469
His original company got disrupted by AI.

00:51:05.909 --> 00:51:07.909
Tons of writers went out of business,

00:51:07.969 --> 00:51:08.809
all this kind of stuff.

00:51:09.429 --> 00:51:10.710
But I found it interesting

00:51:10.771 --> 00:51:11.490
that two years later,

00:51:13.771 --> 00:51:14.972
He's reaching out to me

00:51:15.534 --> 00:51:17.556
because reporters are still

00:51:17.675 --> 00:51:19.438
looking for original sources.

00:51:19.498 --> 00:51:21.599
They're still looking for direct quotes.

00:51:21.639 --> 00:51:23.382
They're still looking for professionals.

00:51:24.202 --> 00:51:25.324
And it was great.

00:51:25.423 --> 00:51:26.385
And what did I do?

00:51:27.306 --> 00:51:29.307
I wrote original content.

00:51:29.969 --> 00:51:33.632
that I then had ChatGPT review and revise,

00:51:34.112 --> 00:51:36.293
that I then brought back my

00:51:36.353 --> 00:51:37.193
original voice.

00:51:37.233 --> 00:51:38.795
So it was like a three-step

00:51:38.835 --> 00:51:41.617
iteration to create the final product,

00:51:41.677 --> 00:51:44.159
but it is my content, my ideas,

00:51:44.259 --> 00:51:45.539
my structure, my name,

00:51:46.480 --> 00:51:47.601
And now that reporter is

00:51:47.621 --> 00:51:50.123
going to publish it in GQ.com.

00:51:50.163 --> 00:51:51.483
Like this is not, you know,

00:51:51.503 --> 00:51:52.443
a little publication.

00:51:53.144 --> 00:51:54.246
Obviously that reporter

00:51:54.286 --> 00:51:56.407
could have used his own AI to write this,

00:51:56.487 --> 00:51:57.728
but they still need that

00:51:57.827 --> 00:51:58.668
human connection.

00:51:59.248 --> 00:52:01.771
So again, we are not going anywhere,

00:52:01.831 --> 00:52:03.271
but we don't have the tools

00:52:03.672 --> 00:52:04.413
and the resources.

00:52:04.572 --> 00:52:05.733
I couldn't have created that

00:52:05.773 --> 00:52:08.815
content in 15 or 20 minutes

00:52:09.356 --> 00:52:10.938
and have it come out as

00:52:11.077 --> 00:52:12.619
well or as good as it did

00:52:12.639 --> 00:52:14.159
if I didn't use those tools.

00:52:14.981 --> 00:52:15.141
Yeah.

00:52:15.844 --> 00:52:17.326
All right, we're almost at the top,

00:52:17.346 --> 00:52:18.847
almost at the hour.

00:52:18.867 --> 00:52:20.367
So what's your parting shot here, Tony?

00:52:21.329 --> 00:52:23.289
I think we as therapists

00:52:23.349 --> 00:52:24.891
know better than anyone else.

00:52:25.650 --> 00:52:27.391
There are tools that serve a purpose.

00:52:27.753 --> 00:52:29.313
I use a cane when I need a cane.

00:52:29.393 --> 00:52:31.034
I use a walker when I need a walker.

00:52:31.215 --> 00:52:32.195
I'm going to use computers

00:52:32.235 --> 00:52:33.876
and technology when I want

00:52:33.916 --> 00:52:35.958
to improve my level of communication.

00:52:38.920 --> 00:52:41.121
I would say that the biggest gains,

00:52:41.161 --> 00:52:42.083
this is someone else's

00:52:42.143 --> 00:52:42.742
quote that's going to come

00:52:42.762 --> 00:52:43.884
out of my mouth kind of sideways,

00:52:43.943 --> 00:52:44.744
not word for word,

00:52:45.204 --> 00:52:46.425
but the biggest gains that

00:52:46.445 --> 00:52:47.525
we've seen in history have

00:52:47.626 --> 00:52:48.706
always happened when people

00:52:49.146 --> 00:52:50.827
double down in times of flux.

00:52:51.889 --> 00:52:53.731
when there's the biggest change,

00:52:53.771 --> 00:52:54.530
when there's the biggest

00:52:54.811 --> 00:52:57.213
risk by leaning in and

00:52:57.293 --> 00:52:58.233
actually not playing it

00:52:58.293 --> 00:52:59.554
safe is when we see people

00:52:59.735 --> 00:53:00.856
really get the biggest gains.

00:53:01.336 --> 00:53:02.958
It is counterintuitive, right?

00:53:02.998 --> 00:53:04.920
We have fight, flight, freeze,

00:53:05.360 --> 00:53:06.920
or there's another F in there somewhere,

00:53:07.601 --> 00:53:08.842
but we have fight or flight.

00:53:09.023 --> 00:53:10.764
And right now the answer is

00:53:10.824 --> 00:53:11.525
probably freeze.

00:53:11.565 --> 00:53:12.425
I don't know what's going on.

00:53:12.465 --> 00:53:13.226
So I'm just going to hold

00:53:13.286 --> 00:53:14.067
onto what I'm doing.

00:53:14.086 --> 00:53:14.927
I don't want to do a lot.

00:53:16.048 --> 00:53:17.690
You don't need to go all in though.

00:53:19.416 --> 00:53:20.137
What I'm telling you,

00:53:20.197 --> 00:53:21.217
if you want to invest,

00:53:21.257 --> 00:53:22.318
it doesn't mean pushing all

00:53:22.358 --> 00:53:23.599
your chips to the middle of the table.

00:53:24.119 --> 00:53:25.420
You can invest in something

00:53:25.460 --> 00:53:26.599
like playing around with

00:53:26.619 --> 00:53:27.860
someone like Hipposcribe or

00:53:27.920 --> 00:53:30.802
ChatGPT for $20 a month or $0 a month.

00:53:31.001 --> 00:53:31.181
Yeah.

00:53:31.722 --> 00:53:32.902
So the biggest gains we've

00:53:32.922 --> 00:53:35.324
seen in history have always

00:53:35.364 --> 00:53:37.405
been because someone leaned

00:53:37.465 --> 00:53:38.605
in and invested in a time

00:53:38.625 --> 00:53:40.126
of change and uncertainty.

00:53:40.713 --> 00:53:42.856
I'm telling you to do that now in some way,

00:53:42.876 --> 00:53:43.356
shape or form.

00:53:43.376 --> 00:53:44.257
And an investment could just

00:53:44.277 --> 00:53:45.699
be your time and trying to understand it,

00:53:45.759 --> 00:53:46.639
listening to shows like

00:53:46.659 --> 00:53:49.302
this or reading articles on the topic.

00:53:49.782 --> 00:53:50.523
So that's what I would say

00:53:50.543 --> 00:53:51.744
to people is in the biggest

00:53:51.784 --> 00:53:53.304
times of change and flux, double down.

00:53:54.326 --> 00:53:54.947
Awesome, buddy.

00:53:55.027 --> 00:53:56.588
We are back, guys.

00:53:56.608 --> 00:53:57.449
830 Thursday.

00:53:58.550 --> 00:53:59.391
We'll see you then.

00:53:59.610 --> 00:54:00.152
Thanks, Jimmy.

00:54:00.172 --> 00:54:00.811
All right.

00:54:01.152 --> 00:54:01.432
See you guys.