March 5, 2026
“Discharge Monkey” Isn’t A Job Title

A comment calling hospital PTs “discharge monkeys” kicks off a real conversation about burnout, autonomy, and what the system incentivizes. Rebekah Griffith and Jimmy McKay unpack why acute care PTs feel boxed into discharge throughput, how that attitude spreads through teams (presenteeism), and what leaders can do to get great clinicians back to practicing with purpose.
What You’ll Learn
- Why “we’re all just PTs” can still ignore real specialization and skill differences
- How payer-centered constraints quietly strip autonomy in discharge planning
- Why arguing online rarely fixes burnout (emotion first, logic second)
- Presenteeism: when someone shows up but becomes a net negative
- A leader’s playbook: how to actually listen, reset, and decide what’s salvageable
- The one controllable lever: what energy you bring into the patient room
Transcript
WEBVTT
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You're listening to the PT Pinecast,
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where smart people in healthcare come to
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make noise.
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Here's your host, Jimmy McKay.
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If I had a time machine,
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I would go back.
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I wouldn't name it PT Pinecast.
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That was a goof.
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This was because we drank beers after
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class and we're like, oh, I get it.
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We want it to be fun and like
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a happy hour.
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I don't even, I mean, I like beer,
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but I don't love it.
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Like people like,
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they want to talk to me about beers
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and I'm like, I don't know, man.
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I like regular beers.
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It's not my identity.
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That's my problem.
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But now that beer follows me everywhere.
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Although it is good at CSM because you
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know what people...
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When they see me walking through the hotel
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bar, everybody wants to buy me a beer.
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So I saved myself a couple of bucks.
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Rebecca Griffith, Drew McKay.
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We were just chatting before we hit go
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live.
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You got a... Someone commented.
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They didn't DM you.
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They commented on something.
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So set the story up.
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And I was going to put the thing
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on the screen, but I don't want to...
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I don't want to blast the person.
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Yeah,
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I don't want to put this person on
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blast,
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but let's talk about the reason this
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person...
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Yeah,
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so kind of the context is I posted
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a video about the difference between an
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emergency department physical therapist
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and an acute care physical therapist.
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Got it.
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It's a question that I get asked, like,
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how is that different than regular acute
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care?
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How is it different than an outpatient PT?
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And so it was really just sort of
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clarifying that.
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And then the person just sort of said,
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like,
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sounds like a physical therapist who works
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in the emergency department.
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There's no such thing as an ED physical
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therapist.
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Which, you know,
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if you want to split hairs, fine.
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I personally feel like a physical
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therapist, no matter where you are,
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you're a physical therapist.
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I'm fine with that.
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That's okay.
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But then the person went on to say
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in the hospital,
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we're all just physical therapists.
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There are no specialized PTs in the acute
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or emergency department world,
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whether we're ED or acute,
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we're all just discharge monkeys.
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And that made me really sad.
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In the Oxford debate at CSM this year,
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too, for the acute care academy,
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the question was, float or focus?
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Should we be generalists or should we be
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really specialized in the acute care
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world?
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But I think what bothers me here is
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that I feel like this person has lost
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their agency.
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Yeah, like their way.
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Yeah.
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And I feel like a lot of physical
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therapists are feeling like that,
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regardless of the setting that they're in,
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whether they're in the rehab setting,
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the acute care setting,
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the home health setting.
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I feel like we're all sort of feeling
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like we're practicing the way that we're
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told,
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not the way that we could or should
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be practicing.
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So number one, I'm on purpose,
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like just being quiet,
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which is painful for me,
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but I'm going to jump in now.
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So like this person is having a bad
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experience where they are.
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So like, I think this person,
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that's why I don't want to put them
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on blast as the kids say,
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I don't even know what the kids say
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that anymore.
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This sucks.
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Like this part, like, okay,
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so let's unpack.
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The person actually said there are no
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EDPTs.
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There's no difference.
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Listen, Rebecca is not, you are special.
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but you're not special because you work in
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the ED,
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but there are some skills you pick up
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there versus working in peds or
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geriatrics.
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We are all PTs.
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Yes.
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You're just playing a different position,
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right?
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Like I'll use a sports analogy.
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We're both baseball players,
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but if you put Jimmy at third base,
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that doesn't make any sense.
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Right.
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I could learn it maybe,
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but I'm also left-handed.
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That doesn't make any sense.
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But anyway, I digress.
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This person's in a bad,
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this person's in a bad system, right?
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And maybe they're too far gone.
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Maybe they're just like, if we're like,
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all I am is a discharge monkey,
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I'm really sorry you feel that way.
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Well,
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and that was exactly how I responded.
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I literally said,
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I'm really sorry that's been your
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experience.
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Yeah.
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You're in a bad system.
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That sucks because I also don't think this
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is isolated.
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I think a lot of people will start
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to feel like this.
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No,
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and I know there are more trends in
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the acute care setting where physical
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therapists are told that you can't make a
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specific discharge recommendation.
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You can't say acute rehab or sub-acute
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rehab.
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You have to say post-acute rehab or,
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and that's not isolated to any one
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hospital system.
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I've been hearing that from people across
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the country.
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And the reason for that,
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like if we really stop and think,
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is it to strip physical therapists of
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their autonomy and their discharge
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planning and their expertise?
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No,
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it's because we work in payer-centered
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healthcare, right?
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It's not patient-centered,
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it's payer-centered care.
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And so when the case managers go and
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they have to actually find a discharge
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plan for this patient,
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and we've narrowed it down to this one
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thing,
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that patient may not have access to that,
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right?
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So by changing it to a more general
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recommendation,
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our case managers may actually be able to
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get the patient some level of care.
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So I think it's
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Instead of fighting that system,
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we're accommodating to that system.
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And I think that's the frustrating part.
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And I think therapists who are also
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accommodating to that, right?
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And that's top of facility.
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Like you're just doing what you're told at
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the place where you work.
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It does not lessen your expertise.
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But when you think about who is really
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taking away your autonomy and authority,
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it's really the healthcare system around
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us.
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It's payer-centered care.
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It's not that hospitals don't value your
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expertise.
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This is also a situation where if you
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go back at this person like a keyboard
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cowboy and you're like, you're wrong.
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All you're going to do is bark at
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each other like two dogs through a fence.
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This person is talking from emotion.
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So if we come back with logic,
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we miss.
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If we're like, but you're wrong.
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The person, I'm going to defend them.
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They're not wrong because they're talking
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about how they feel.
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Yeah, and it's been their experience.
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And it's their experience.
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And I've consulted with enough hospitals
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to know that that's not a unique
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experience right and there is also this
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conversation too like in in acute care
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settings are you an interventionalist are
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you a consultant are you a discharge
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consultant or are you an interventionalist
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and i think there's space for both right
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and i think hospitals might also benefit
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from dividing their teams and these are
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the people that make discharge
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recommendations and these are the people
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that intervene on the patients that can't
00:06:19.149 --> 00:06:19.649
discharge
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And maybe you are a little more effective
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that way.
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And people get to do what they want
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a little bit more,
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but I don't think anybody went to PT
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school to become a discharge monkey and
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tell people like, I,
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I am going to say this patient can
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discharge or not.
00:06:33.769 --> 00:06:34.470
Like, that's not,
00:06:35.089 --> 00:06:36.550
I would say that's not the dream.
00:06:36.630 --> 00:06:36.831
Right.
00:06:38.028 --> 00:06:38.528
Of course not.
00:06:38.629 --> 00:06:39.749
I mean, maybe for some people.
00:06:39.809 --> 00:06:40.569
I mean, I don't know.
00:06:40.589 --> 00:06:40.990
Some people.
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But I would say a majority.
00:06:42.910 --> 00:06:43.910
Like in the middle of the bell curve,
00:06:43.930 --> 00:06:44.550
the answer is no.
00:06:44.891 --> 00:06:46.310
What would you say to this person if
00:06:46.331 --> 00:06:48.550
they were like in front of you?
00:06:49.112 --> 00:06:51.312
I think your first move would be you'd
00:06:51.351 --> 00:06:53.533
wait to let them get all the air
00:06:53.612 --> 00:06:55.353
out and get all their...
00:06:56.112 --> 00:06:57.612
That's the smart move, right?
00:06:57.894 --> 00:06:59.473
But after the person did that,
00:07:00.213 --> 00:07:03.274
what would a conversation like this person
00:07:03.334 --> 00:07:04.074
and you look like?
00:07:04.990 --> 00:07:06.511
I think the first question that I would
00:07:06.630 --> 00:07:07.310
ask, obviously,
00:07:07.350 --> 00:07:08.812
is just like receiving a patient history.
00:07:08.831 --> 00:07:09.831
I would say, tell me, like,
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tell me all about it.
00:07:10.692 --> 00:07:11.932
Tell me about your experience so I can
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understand what your experience is,
00:07:13.512 --> 00:07:14.752
both in the acute care setting and the
00:07:14.773 --> 00:07:15.793
emergency department setting.
00:07:16.153 --> 00:07:17.392
And then once, as you said,
00:07:17.413 --> 00:07:18.733
they like let all the air out and
00:07:18.754 --> 00:07:20.574
they feel like they've really been heard
00:07:20.754 --> 00:07:21.814
because they think that's the thing.
00:07:22.074 --> 00:07:23.634
This person clearly doesn't feel heard,
00:07:23.654 --> 00:07:25.975
valued, or respected for their expertise.
00:07:26.274 --> 00:07:26.855
I would ask them,
00:07:26.894 --> 00:07:29.276
what do you want it to look like?
00:07:29.536 --> 00:07:30.315
What changed?
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What would you like, like,
00:07:32.175 --> 00:07:33.976
what would success look like for you in
00:07:34.016 --> 00:07:34.737
your current role?
00:07:36.875 --> 00:07:38.396
And what does it look like?
00:07:38.557 --> 00:07:40.017
Because right now they would describe it
00:07:40.057 --> 00:07:41.759
as discharge monkey, which is valid.
00:07:42.718 --> 00:07:43.939
It sounds like I'm being like real
00:07:44.019 --> 00:07:45.060
woo-woo, but I'm not.
00:07:45.081 --> 00:07:45.761
I'm just like, okay,
00:07:46.000 --> 00:07:47.442
to get this person to see something
00:07:47.482 --> 00:07:49.163
differently, potentially,
00:07:49.642 --> 00:07:51.444
I have to try to understand what they
00:07:51.504 --> 00:07:52.223
think they're seeing.
00:07:52.245 --> 00:07:53.384
Because whatever they think they're
00:07:53.425 --> 00:07:54.425
seeing, they are seeing.
00:07:55.386 --> 00:07:57.786
Most likely, you and I both know this,
00:07:58.747 --> 00:07:59.709
it's the system they're in.
00:07:59.988 --> 00:08:01.449
We can be mad at a system,
00:08:01.488 --> 00:08:03.009
but then recognize the system's just made
00:08:03.029 --> 00:08:04.630
up of a bunch of people who are
00:08:04.670 --> 00:08:05.831
all in constraints.
00:08:07.136 --> 00:08:08.358
And they might not have a lot of
00:08:08.399 --> 00:08:08.718
like, well,
00:08:08.738 --> 00:08:09.560
I want to blow up the system and
00:08:09.600 --> 00:08:09.961
change it.
00:08:09.982 --> 00:08:11.223
It's like the system is people.
00:08:11.244 --> 00:08:12.807
We're going to all come back together.
00:08:12.867 --> 00:08:13.387
I understand.
00:08:13.728 --> 00:08:15.793
But the system is also massive and
00:08:15.973 --> 00:08:16.694
interconnected.
00:08:16.875 --> 00:08:17.836
I'm not saying it can't be done.
00:08:18.177 --> 00:08:18.858
I know it should be done.
00:08:20.406 --> 00:08:22.329
But that stops so many conversations.
00:08:22.348 --> 00:08:23.970
This is not a great social media strategy
00:08:24.310 --> 00:08:25.550
is when someone comments on one of my
00:08:25.571 --> 00:08:25.891
videos.
00:08:26.190 --> 00:08:26.331
Well,
00:08:26.351 --> 00:08:29.074
then they need to lower tuition costs.
00:08:29.194 --> 00:08:29.514
And I was like,
00:08:29.673 --> 00:08:31.615
who are they and how will they accomplish
00:08:31.636 --> 00:08:33.297
this by yelling at schools?
00:08:33.336 --> 00:08:33.756
What do they do?
00:08:33.777 --> 00:08:36.139
Stand outside the school like from the
00:08:36.158 --> 00:08:36.379
movie,
00:08:36.418 --> 00:08:37.980
say anything with a boombox and just stand
00:08:38.000 --> 00:08:38.760
there until it changes.
00:08:38.841 --> 00:08:39.721
No, it's not going to work.
00:08:40.121 --> 00:08:40.663
What would you do?
00:08:41.243 --> 00:08:43.365
This is when other organizations go,
00:08:43.706 --> 00:08:44.947
APTA doesn't do it right.
00:08:45.027 --> 00:08:46.048
I go, how would you do it?
00:08:46.288 --> 00:08:47.249
I would just accomplish it.
00:08:47.590 --> 00:08:47.850
Great.
00:08:47.909 --> 00:08:48.571
How would you do that?
00:08:48.971 --> 00:08:49.532
No answer.
00:08:49.951 --> 00:08:50.471
No answer.
00:08:50.793 --> 00:08:52.293
I would just make them with what?
00:08:52.394 --> 00:08:52.715
A gun?
00:08:52.894 --> 00:08:53.294
What would you do?
00:08:54.120 --> 00:08:56.001
What would you do realistically?
00:08:56.042 --> 00:08:58.063
And the answer is they don't know.
00:08:58.803 --> 00:09:00.404
I love when people do lobbying.
00:09:00.664 --> 00:09:01.666
Like I would love to have just,
00:09:01.725 --> 00:09:02.907
I've talked to Justin Alley before.
00:09:03.326 --> 00:09:04.227
I would love,
00:09:04.967 --> 00:09:06.149
he would never be able to answer my
00:09:06.188 --> 00:09:06.668
questions.
00:09:07.090 --> 00:09:07.549
He shouldn't.
00:09:07.990 --> 00:09:09.010
As a media professional, I'll be like,
00:09:09.030 --> 00:09:10.331
Justin, do not answer my questions.
00:09:10.371 --> 00:09:11.832
Because I would love to hear what people
00:09:11.913 --> 00:09:12.413
yell at him.
00:09:12.472 --> 00:09:14.153
Like, why don't you just do this?
00:09:14.234 --> 00:09:15.735
And he's like, he's probably thinking,
00:09:15.875 --> 00:09:17.056
I freaking do do that.
00:09:17.316 --> 00:09:19.097
Me and a team of people who this
00:09:19.538 --> 00:09:21.818
is our freaking job and we've been doing
00:09:21.839 --> 00:09:22.820
it for decades.
00:09:23.100 --> 00:09:24.020
We do that.
00:09:24.441 --> 00:09:25.501
or they're like why don't you do this
00:09:25.522 --> 00:09:26.902
you're like that doesn't that's not the
00:09:26.922 --> 00:09:29.143
way it works like that's like me yelling
00:09:29.163 --> 00:09:31.063
at my auto mechanic to blah blah blah
00:09:31.104 --> 00:09:32.225
it's like that ain't the way it works
00:09:32.784 --> 00:09:34.625
numb nuts and it's funny that you
00:09:34.645 --> 00:09:36.346
mentioned that i was interviewed for
00:09:36.386 --> 00:09:37.947
research studies today about prescriptive
00:09:37.966 --> 00:09:39.727
authority for physical therapists for
00:09:39.868 --> 00:09:43.210
imaging labs or imaging image labs and
00:09:43.250 --> 00:09:45.071
durable medical equipment and one of the
00:09:45.110 --> 00:09:46.971
questions they asked me were like how did
00:09:47.011 --> 00:09:49.153
you get that authority and what were the
00:09:49.173 --> 00:09:50.592
barriers that you had and how did you
00:09:50.613 --> 00:09:51.594
overcome those barriers
00:09:52.073 --> 00:09:52.914
And I was like, well,
00:09:52.995 --> 00:09:53.695
let me tell you.
00:09:53.894 --> 00:09:55.216
I was a member of the APTA.
00:09:55.355 --> 00:09:57.697
I became the APTA president.
00:09:57.878 --> 00:09:59.678
Advocacy, working with our lobbyists,
00:09:59.698 --> 00:10:03.061
testifying with many, many, many,
00:10:03.100 --> 00:10:03.780
many steps.
00:10:04.182 --> 00:10:05.121
I didn't stand there and say,
00:10:05.282 --> 00:10:06.903
physical therapists should have this,
00:10:06.962 --> 00:10:09.284
and that's that, or be mad about it.
00:10:09.625 --> 00:10:11.865
So it was interesting to actually have to
00:10:11.926 --> 00:10:12.506
explain that.
00:10:12.947 --> 00:10:14.587
But I think for somebody like this,
00:10:15.969 --> 00:10:17.690
the place that I would start with that
00:10:18.429 --> 00:10:18.549
is,
00:10:18.811 --> 00:10:20.892
are you behaving like a discharge monkey?
00:10:22.023 --> 00:10:23.822
Okay, great.
00:10:23.883 --> 00:10:24.703
So step one is,
00:10:25.624 --> 00:10:26.964
what does a discharge monkey mean?
00:10:27.024 --> 00:10:28.004
Help me understand.
00:10:28.283 --> 00:10:28.604
Yes,
00:10:28.764 --> 00:10:31.625
and you can control what you can control,
00:10:31.705 --> 00:10:31.945
right?
00:10:31.965 --> 00:10:32.465
Correct.
00:10:33.225 --> 00:10:34.525
And I talk about top of license,
00:10:34.546 --> 00:10:35.946
top of facility, and top of scope,
00:10:35.985 --> 00:10:37.586
and that we have limitations at every
00:10:37.625 --> 00:10:38.605
single one of those layers.
00:10:38.966 --> 00:10:40.047
But for this patient,
00:10:40.326 --> 00:10:42.307
let's say they're not able or willing to
00:10:42.366 --> 00:10:44.748
do anything at the licensure level or even
00:10:44.788 --> 00:10:45.847
at the facility level.
00:10:46.128 --> 00:10:48.587
They still have their own scope, right?
00:10:48.889 --> 00:10:50.548
When you walk into a room,
00:10:51.383 --> 00:10:52.562
in the acute care setting,
00:10:52.984 --> 00:10:54.663
are you walking in there bringing
00:10:54.724 --> 00:10:56.164
discharge monkey energy,
00:10:56.644 --> 00:10:59.306
or are you bringing comprehensive doctor
00:10:59.326 --> 00:11:00.326
of physical therapy,
00:11:00.546 --> 00:11:02.807
patient management energy into that room?
00:11:03.547 --> 00:11:04.366
It may be, you know,
00:11:04.466 --> 00:11:05.207
they may be telling you,
00:11:05.227 --> 00:11:06.368
you have to see this many patients a
00:11:06.388 --> 00:11:06.707
day.
00:11:07.008 --> 00:11:08.609
We really need discharge recommendations.
00:11:08.629 --> 00:11:10.408
That's our focus here and that's okay.
00:11:10.789 --> 00:11:12.850
But how are you interacting and engaging
00:11:12.870 --> 00:11:13.711
with that patient?
00:11:14.010 --> 00:11:16.091
You can still be the discharge monkey and
00:11:16.211 --> 00:11:17.932
add value to that patient encounter.
00:11:18.513 --> 00:11:19.153
Yeah, I mean,
00:11:20.975 --> 00:11:22.296
I've got experience outside PT.
00:11:22.316 --> 00:11:23.576
It's where most of my career was.
00:11:24.778 --> 00:11:26.440
I could have done the exact same things
00:11:26.460 --> 00:11:27.500
that I did to,
00:11:27.581 --> 00:11:28.381
and I'm using air quotes here,
00:11:28.461 --> 00:11:30.602
be innovative and be energetic and bring
00:11:30.623 --> 00:11:31.264
good energy.
00:11:31.563 --> 00:11:33.025
And I could have had a crappy boss
00:11:33.505 --> 00:11:35.768
and I would have never gotten promoted.
00:11:35.967 --> 00:11:36.908
I would have been dumped on,
00:11:36.989 --> 00:11:38.049
not allowed to do things.
00:11:38.971 --> 00:11:40.392
And I would have been the same person
00:11:40.451 --> 00:11:42.072
in a different system and got crappy
00:11:42.113 --> 00:11:42.514
results.
00:11:42.614 --> 00:11:43.934
And then I would have been jaded and
00:11:43.975 --> 00:11:44.855
said, the system sucks.
00:11:45.395 --> 00:11:46.216
I think I lucked out.
00:11:48.529 --> 00:11:50.892
this person might be or might have been
00:11:51.032 --> 00:11:53.214
a very optimistic, energetic,
00:11:53.433 --> 00:11:54.835
let's go change the world in a good
00:11:54.875 --> 00:11:56.135
way, however I can.
00:11:56.437 --> 00:11:57.977
And if you're in a system where someone
00:11:58.038 --> 00:12:00.000
just, I mean, let's be honest,
00:12:00.019 --> 00:12:01.441
like if you got a crappy boss or
00:12:01.461 --> 00:12:02.442
you're in a crappy system with no
00:12:02.461 --> 00:12:04.604
rigidity, I've worked in hospital systems,
00:12:04.844 --> 00:12:05.804
in communications.
00:12:06.404 --> 00:12:08.025
And I came in there ready to change
00:12:08.046 --> 00:12:08.385
the world.
00:12:08.427 --> 00:12:08.667
I was like,
00:12:08.687 --> 00:12:10.248
look at all these great things that happen
00:12:10.268 --> 00:12:10.888
at a hospital.
00:12:11.249 --> 00:12:12.389
This is going to be the easiest and
00:12:12.589 --> 00:12:13.590
greatest job in the world.
00:12:13.610 --> 00:12:14.850
All I have to do is tell stories
00:12:14.890 --> 00:12:16.412
of great people doing great things every
00:12:16.432 --> 00:12:16.672
day.
00:12:17.253 --> 00:12:19.293
And then I got slapped with so many
00:12:19.354 --> 00:12:21.556
rules and constraints that someone like
00:12:21.596 --> 00:12:23.596
me, I was like, I can't do this.
00:12:24.158 --> 00:12:25.879
It takes me forty nine steps to tell
00:12:26.058 --> 00:12:27.220
one story on Facebook.
00:12:27.440 --> 00:12:27.779
I'm out.
00:12:28.301 --> 00:12:29.260
I got that way.
00:12:29.522 --> 00:12:30.842
But I recognize it was the system.
00:12:30.863 --> 00:12:32.082
I'm like, I just can't operate here.
00:12:32.102 --> 00:12:32.783
I got to go somewhere else.
00:12:33.120 --> 00:12:34.100
Well, and that's the thing.
00:12:34.120 --> 00:12:35.542
So people will come to me and they'll
00:12:35.581 --> 00:12:35.923
say, well,
00:12:36.062 --> 00:12:37.423
I really want to practice the top of
00:12:37.443 --> 00:12:38.684
my scope, but they will let me.
00:12:39.065 --> 00:12:40.647
So we have that conversation, right?
00:12:40.706 --> 00:12:41.386
Who is they?
00:12:41.427 --> 00:12:42.368
Why won't they let you?
00:12:42.729 --> 00:12:44.149
And what can you do about it?
00:12:44.309 --> 00:12:46.371
And you can advocate for change within
00:12:46.392 --> 00:12:47.011
your facility.
00:12:47.052 --> 00:12:48.653
You can advocate for change within your
00:12:48.673 --> 00:12:49.153
license,
00:12:49.674 --> 00:12:51.296
but you can also advocate for change
00:12:51.316 --> 00:12:51.937
within yourself.
00:12:52.336 --> 00:12:54.198
And if you're not able to bring that
00:12:54.759 --> 00:12:55.980
expertise, that authority,
00:12:56.020 --> 00:12:57.822
that energy that you want to the place
00:12:57.841 --> 00:12:58.663
that you work,
00:12:59.696 --> 00:13:02.317
You're making the choice to do that every
00:13:02.336 --> 00:13:02.557
day.
00:13:02.657 --> 00:13:03.736
Like bottom line.
00:13:04.716 --> 00:13:06.697
I mean, that's what you can control.
00:13:06.836 --> 00:13:09.378
And, and I, I know that we,
00:13:09.677 --> 00:13:10.998
it's more nuanced than that.
00:13:11.177 --> 00:13:12.859
I know we have golden handcuffs.
00:13:13.019 --> 00:13:14.078
I know we have to pay off our
00:13:14.119 --> 00:13:14.359
debt.
00:13:14.418 --> 00:13:15.499
We have children to support.
00:13:15.519 --> 00:13:16.879
Like I have three kids.
00:13:17.000 --> 00:13:19.840
I understand that.
00:13:20.159 --> 00:13:22.400
But I also know that I've chosen different
00:13:22.441 --> 00:13:24.020
paths so that I can
00:13:25.386 --> 00:13:27.168
feel comfortable about what I'm doing so I
00:13:27.187 --> 00:13:29.928
can advocate for the change and still meet
00:13:29.969 --> 00:13:30.428
those goals.
00:13:30.528 --> 00:13:31.969
And I know not everyone has the freedom
00:13:32.009 --> 00:13:32.509
to do that.
00:13:32.749 --> 00:13:33.870
Yes.
00:13:33.889 --> 00:13:36.650
So if you don't, I totally respect that.
00:13:36.770 --> 00:13:38.410
But who are you showing up as?
00:13:38.530 --> 00:13:40.412
Don't let them take that from you.
00:13:40.772 --> 00:13:43.092
That should be the one thing you try
00:13:43.113 --> 00:13:43.793
to hold on to.
00:13:43.952 --> 00:13:45.274
I mean, I had bad bosses.
00:13:45.553 --> 00:13:47.094
I had bosses who stole my ideas.
00:13:47.615 --> 00:13:49.115
I had bosses who just wouldn't let me
00:13:49.154 --> 00:13:49.634
do anything.
00:13:50.495 --> 00:13:51.395
And I was just like, okay.
00:13:51.916 --> 00:13:53.876
I looked, I stole a line from Mr.
00:13:53.937 --> 00:13:54.736
Rogers was like,
00:13:55.745 --> 00:13:56.666
that whole line where he says,
00:13:56.926 --> 00:13:57.765
look for the helpers.
00:13:58.947 --> 00:14:00.587
He was teaching kids how not to be
00:14:00.607 --> 00:14:03.529
traumatized in a crazy event.
00:14:03.890 --> 00:14:05.150
He was like, just focus on the positive.
00:14:05.491 --> 00:14:07.293
So I would look and they're there.
00:14:07.332 --> 00:14:08.714
They're the ones that make eye contact
00:14:08.874 --> 00:14:10.034
with you in a meeting when you brought
00:14:10.054 --> 00:14:11.215
a good idea or a good idea is
00:14:11.254 --> 00:14:12.897
said and watch them,
00:14:13.096 --> 00:14:14.717
even if they don't nod because maybe they
00:14:14.758 --> 00:14:15.138
can't.
00:14:15.477 --> 00:14:16.678
Their eyebrows go up and they start
00:14:16.698 --> 00:14:17.740
looking around the room going,
00:14:19.201 --> 00:14:20.422
who are the...
00:14:20.581 --> 00:14:21.822
Alan Jetty taught me a term.
00:14:22.903 --> 00:14:24.184
Is Alan Jetty still the editor of PTJ?
00:14:25.385 --> 00:14:25.726
He was.
00:14:26.427 --> 00:14:28.408
I haven't.
00:14:28.428 --> 00:14:30.551
Anyway, he taught me this phrase.
00:14:30.610 --> 00:14:31.412
He gave a talk.
00:14:32.352 --> 00:14:34.153
It was called positive deviance.
00:14:34.215 --> 00:14:34.355
Yes.
00:14:36.263 --> 00:14:38.024
So a lot of times people...
00:14:38.364 --> 00:14:39.644
If I were to describe myself as a
00:14:39.724 --> 00:14:41.524
deviant, that sounds negative.
00:14:42.105 --> 00:14:44.264
But deviant just means to deviate.
00:14:44.485 --> 00:14:46.066
I know it's used a lot of times.
00:14:46.105 --> 00:14:47.025
Kids are just deviants.
00:14:47.046 --> 00:14:48.667
They're down there with the skateboards
00:14:49.386 --> 00:14:50.407
and whatever.
00:14:50.447 --> 00:14:51.307
It's looked as negative.
00:14:51.326 --> 00:14:53.008
But when you put that word positive in
00:14:53.048 --> 00:14:53.427
front of it...
00:14:54.441 --> 00:14:55.462
Um, it's like,
00:14:55.503 --> 00:14:57.404
I'm here to shake things up because I
00:14:57.485 --> 00:14:58.846
want the same things you do,
00:14:59.567 --> 00:15:01.210
but I have to hold up a mirror
00:15:01.230 --> 00:15:02.932
a lot of times in projects and meetings
00:15:03.393 --> 00:15:04.394
to people and be like,
00:15:04.875 --> 00:15:07.017
you're telling me to do it the same
00:15:07.057 --> 00:15:08.479
way and expecting a different outcome.
00:15:08.499 --> 00:15:10.522
And we know that's the cliche of cliches.
00:15:10.542 --> 00:15:10.642
Yeah.
00:15:11.763 --> 00:15:13.583
So how can we do it differently?
00:15:13.844 --> 00:15:16.024
And I can give you ten ideas knowing
00:15:16.043 --> 00:15:16.904
we can only do one.
00:15:17.325 --> 00:15:17.865
That's okay.
00:15:17.924 --> 00:15:18.884
I'm the idea machine.
00:15:19.504 --> 00:15:21.166
You help me pick and then we'll execute.
00:15:21.645 --> 00:15:23.666
And the problem is sometimes the machine
00:15:23.706 --> 00:15:24.567
doesn't want to change.
00:15:25.287 --> 00:15:26.006
Sometimes it's too big.
00:15:27.727 --> 00:15:28.528
Or it doesn't know how.
00:15:28.548 --> 00:15:29.187
Or it doesn't know how.
00:15:29.227 --> 00:15:30.727
That's what I look at myself or I
00:15:30.788 --> 00:15:36.029
try to be the idea to change Sherpa.
00:15:36.490 --> 00:15:36.970
Which is like,
00:15:37.250 --> 00:15:39.510
I don't know the way but I know
00:15:39.530 --> 00:15:39.831
that there's
00:15:41.095 --> 00:15:41.875
I just steal.
00:15:42.015 --> 00:15:43.236
Like, look, look what they did.
00:15:43.277 --> 00:15:43.856
Look what they did.
00:15:43.876 --> 00:15:46.460
Could we steal the elements of that that
00:15:46.519 --> 00:15:47.561
made that successful?
00:15:47.620 --> 00:15:48.100
Hold on.
00:15:48.761 --> 00:15:50.844
Like, I know like in PT school,
00:15:51.364 --> 00:15:52.985
everybody loved case studies.
00:15:53.085 --> 00:15:54.125
They're great, right?
00:15:54.186 --> 00:15:55.206
Because they're real.
00:15:55.226 --> 00:15:55.807
And like,
00:15:55.847 --> 00:15:57.249
look at the elements of a case study.
00:15:57.609 --> 00:15:59.591
A thirty nine year old woman like, oh,
00:15:59.630 --> 00:16:00.652
I can I can see that.
00:16:00.792 --> 00:16:01.152
OK.
00:16:01.493 --> 00:16:03.214
And she does this and she lives.
00:16:03.514 --> 00:16:04.855
I loved case study because there are many
00:16:04.895 --> 00:16:05.336
stories.
00:16:05.355 --> 00:16:05.515
Right.
00:16:05.576 --> 00:16:05.755
Right.
00:16:06.537 --> 00:16:08.577
I love case studies in marketing and
00:16:08.597 --> 00:16:11.477
communications and ideas and ideation and
00:16:11.518 --> 00:16:12.739
innovation because it's like,
00:16:13.438 --> 00:16:16.799
I know we're not Yahoo or Netflix or
00:16:16.919 --> 00:16:18.399
Amazon, but you can be like,
00:16:18.539 --> 00:16:19.240
they were faced.
00:16:19.640 --> 00:16:20.341
I learned one today.
00:16:20.360 --> 00:16:20.961
I'll teach it to you.
00:16:21.880 --> 00:16:22.761
This was a while ago.
00:16:22.802 --> 00:16:23.621
This was years ago.
00:16:24.642 --> 00:16:26.783
Netflix was getting a lot of complaints
00:16:26.863 --> 00:16:27.363
early on.
00:16:28.325 --> 00:16:30.105
They used to be, kids,
00:16:30.485 --> 00:16:32.986
they used to be a DVD mail service.
00:16:33.366 --> 00:16:36.548
So DVDs were like videos on discs,
00:16:36.727 --> 00:16:37.269
on coasters.
00:16:37.969 --> 00:16:39.690
When they went to All Streaming,
00:16:40.491 --> 00:16:43.072
They were the first streaming platform.
00:16:43.113 --> 00:16:45.592
You use a remote control to go on
00:16:45.633 --> 00:16:47.513
the internet on your TV and watch things.
00:16:48.374 --> 00:16:49.953
And they were receiving their number one
00:16:49.994 --> 00:16:52.734
complaint was not what movies they had or
00:16:52.774 --> 00:16:54.534
didn't have or any of those things.
00:16:54.934 --> 00:16:57.475
It was, you're buffering a lot.
00:16:57.875 --> 00:16:59.056
I'm in the middle of a movie and
00:16:59.096 --> 00:17:00.855
it's grainy or it buffers.
00:17:01.635 --> 00:17:04.757
And Netflix could have done a national ad
00:17:04.797 --> 00:17:05.896
campaign saying,
00:17:07.058 --> 00:17:09.140
We don't control your internet speed.
00:17:09.880 --> 00:17:12.980
It's buffering because Spectrum or Optum
00:17:13.020 --> 00:17:14.862
or all the different, wherever you live,
00:17:16.241 --> 00:17:17.541
they're lying to you.
00:17:17.663 --> 00:17:19.942
When you say you're buying your plan at
00:17:20.103 --> 00:17:21.943
however many gigabytes per minute
00:17:21.983 --> 00:17:23.144
download, whatever,
00:17:23.223 --> 00:17:24.984
I don't even know what good is.
00:17:26.962 --> 00:17:28.163
That isn't the actual speed.
00:17:28.202 --> 00:17:30.243
They could have done this education
00:17:30.263 --> 00:17:31.844
campaign where they just pointed and
00:17:31.884 --> 00:17:33.585
placed, they moved the blame.
00:17:33.984 --> 00:17:34.865
They didn't do that.
00:17:35.204 --> 00:17:36.164
Somebody in the room was like,
00:17:36.184 --> 00:17:36.826
it's not going to work.
00:17:36.846 --> 00:17:36.945
Great.
00:17:37.945 --> 00:17:38.746
What should we do?
00:17:39.185 --> 00:17:40.866
They launched a website called,
00:17:41.146 --> 00:17:43.487
I think it was called fast.com.
00:17:45.627 --> 00:17:47.548
And it's similar to like internet speed
00:17:47.587 --> 00:17:48.387
test.com.
00:17:48.407 --> 00:17:49.548
Have you ever done internet speed
00:17:49.588 --> 00:17:50.169
test.com?
00:17:51.334 --> 00:17:53.798
It's just a way of actually measuring your
00:17:54.097 --> 00:17:55.901
speed right now in this moment, upload,
00:17:55.921 --> 00:17:57.282
download speed.
00:17:57.323 --> 00:17:59.707
So they were like, hey, test this out.
00:18:00.448 --> 00:18:02.109
And then when you got the data,
00:18:02.150 --> 00:18:03.412
like this was your speed,
00:18:04.255 --> 00:18:06.195
this is what you need to actually stream
00:18:06.236 --> 00:18:09.796
a movie reliably without problems we don't
00:18:10.277 --> 00:18:12.896
offer the streaming so that's okay like
00:18:13.297 --> 00:18:15.258
they were bringing people to like the two
00:18:15.278 --> 00:18:18.818
yard line going who's problem who is
00:18:18.939 --> 00:18:21.338
actually the person screwing you over on
00:18:21.378 --> 00:18:22.819
watching this movie we're giving you the
00:18:22.920 --> 00:18:25.400
access you need the person who's bringing
00:18:25.420 --> 00:18:26.760
you here is the internet service provider
00:18:26.780 --> 00:18:27.161
the isp
00:18:28.040 --> 00:18:29.520
So it was a great power play.
00:18:29.681 --> 00:18:31.682
So my example is like, oh,
00:18:31.721 --> 00:18:33.021
if we're getting a lot of complaints,
00:18:33.563 --> 00:18:35.542
let's look at people who solved complaints
00:18:35.962 --> 00:18:38.384
innovatively.
00:18:38.483 --> 00:18:42.204
And I think when you're this person and
00:18:42.345 --> 00:18:45.685
you are probably objectively pretty burnt
00:18:45.766 --> 00:18:47.886
out and kind of given up on things,
00:18:47.906 --> 00:18:51.948
I think you're lacking that feeling of
00:18:52.008 --> 00:18:52.347
power,
00:18:52.488 --> 00:18:53.087
that lack of
00:18:53.682 --> 00:18:55.003
the agency, the control.
00:18:55.183 --> 00:18:57.005
And probably there's some moral injury
00:18:57.025 --> 00:18:57.905
that goes with that too.
00:18:58.486 --> 00:18:59.886
Because you're not being who you want to
00:18:59.926 --> 00:19:00.086
be.
00:19:00.107 --> 00:19:01.709
Yeah, that sucks.
00:19:01.749 --> 00:19:03.009
That's not the person that's probably
00:19:03.049 --> 00:19:03.630
going to solve that.
00:19:03.670 --> 00:19:05.351
But I read a quote this morning that
00:19:05.371 --> 00:19:05.912
was like,
00:19:06.112 --> 00:19:07.913
excellence in healthcare comes at a cost.
00:19:08.012 --> 00:19:08.794
Pay it anyways.
00:19:10.615 --> 00:19:12.796
What we give doesn't always return,
00:19:12.955 --> 00:19:14.738
but what we give is always what we
00:19:14.857 --> 00:19:15.077
are.
00:19:17.219 --> 00:19:19.661
And that's like the kind of therapist that
00:19:19.861 --> 00:19:20.481
I want to be.
00:19:20.662 --> 00:19:22.143
So that's why I feel like
00:19:23.529 --> 00:19:26.111
when you go into that room whether you're
00:19:26.171 --> 00:19:28.290
tasked with being a discharge monkey or
00:19:28.351 --> 00:19:31.372
not do you bring that energy with you
00:19:32.633 --> 00:19:34.272
or are you bringing the physical therapist
00:19:34.353 --> 00:19:37.413
energy with you yeah like you can be
00:19:37.594 --> 00:19:40.234
angry you can be angry about it but
00:19:40.275 --> 00:19:41.555
are you taking that anger out on your
00:19:41.575 --> 00:19:43.976
patients yeah right right right right
00:19:44.016 --> 00:19:45.916
don't become the thing that don't become
00:19:45.957 --> 00:19:47.416
the thing that you're raging against
00:19:48.419 --> 00:19:50.299
Rage against the machine didn't say rage
00:19:50.339 --> 00:19:51.220
against the machine,
00:19:51.300 --> 00:19:52.401
then become a machine.
00:19:52.500 --> 00:19:53.541
It said rage against it.
00:19:53.582 --> 00:19:56.542
But like, what are the different ways?
00:19:56.603 --> 00:19:57.703
It's not throw a brick.
00:19:58.344 --> 00:20:00.944
And even just like that little act of
00:20:01.046 --> 00:20:03.946
resistance where you're bringing the best
00:20:03.987 --> 00:20:05.548
you can into every room,
00:20:06.208 --> 00:20:08.189
even if you don't have the energy,
00:20:08.669 --> 00:20:09.769
if you don't have the skill set,
00:20:09.789 --> 00:20:11.451
you don't have the knowledge of how to
00:20:11.550 --> 00:20:14.112
advocate within your facility,
00:20:14.132 --> 00:20:15.813
within your profession, within your state,
00:20:15.873 --> 00:20:17.094
at the national level,
00:20:18.353 --> 00:20:21.415
please like advocate within yourself.
00:20:21.476 --> 00:20:21.736
Yeah.
00:20:22.236 --> 00:20:23.336
It's going to be frustrating too,
00:20:23.356 --> 00:20:24.898
because I'm sure like in your role,
00:20:24.939 --> 00:20:26.119
you've been with, you've been, I mean,
00:20:26.140 --> 00:20:27.901
now you're APTA Colorado president,
00:20:27.921 --> 00:20:28.862
but you've done other things.
00:20:28.902 --> 00:20:29.122
Right.
00:20:30.303 --> 00:20:31.824
And when you get a bunch of really
00:20:31.884 --> 00:20:33.506
motivated, passionate people together,
00:20:34.352 --> 00:20:37.413
who want to do fifty different things a
00:20:37.452 --> 00:20:39.854
hundred different ways knowing that you
00:20:39.913 --> 00:20:41.734
can't there are constraints there is
00:20:41.894 --> 00:20:45.797
bandwidth so you know which problem do you
00:20:45.817 --> 00:20:47.616
just I mean even deciding which problem to
00:20:47.678 --> 00:20:50.378
solve is a problem because you're going to
00:20:50.419 --> 00:20:52.358
make more enemies than friends I used to
00:20:52.398 --> 00:20:55.520
hate doing contests on the radio here's
00:20:55.560 --> 00:20:55.800
why
00:20:57.131 --> 00:20:58.251
Most of our audience,
00:20:58.372 --> 00:21:00.374
most of the listeners didn't participate
00:21:00.794 --> 00:21:01.414
for whatever reason.
00:21:01.434 --> 00:21:02.855
They're busy.
00:21:03.175 --> 00:21:04.156
We surveyed people this.
00:21:04.557 --> 00:21:05.337
A lot of times they were like,
00:21:06.358 --> 00:21:07.480
mathematically, I'm not an idiot.
00:21:07.500 --> 00:21:08.000
I'm not going to win.
00:21:08.020 --> 00:21:08.901
So you're going to ask me to try
00:21:08.961 --> 00:21:09.241
something.
00:21:09.261 --> 00:21:09.741
I'm not going to win.
00:21:09.761 --> 00:21:10.061
I get it.
00:21:10.762 --> 00:21:11.403
I was the same way.
00:21:12.423 --> 00:21:14.266
I didn't always try to actively
00:21:14.286 --> 00:21:15.186
participate in contests.
00:21:15.571 --> 00:21:18.574
I mean, I did win one once.
00:21:18.674 --> 00:21:19.935
What'd you win?
00:21:19.955 --> 00:21:21.997
I won a signed copy of the Ray
00:21:22.017 --> 00:21:22.577
soundtrack.
00:21:24.538 --> 00:21:25.921
Remember that movie with Jamie Foxx?
00:21:25.941 --> 00:21:27.521
I won that and I won tickets to
00:21:27.642 --> 00:21:30.744
Evanescence.
00:21:30.865 --> 00:21:31.585
So I won twice, I guess.
00:21:31.605 --> 00:21:33.006
I used to love taking phone calls because
00:21:33.046 --> 00:21:34.647
the phone calls were great payoff, right?
00:21:34.748 --> 00:21:36.209
Always record the phone call as a radio
00:21:36.229 --> 00:21:37.869
DJ and then play it back because it's
00:21:37.910 --> 00:21:38.651
great energy.
00:21:38.691 --> 00:21:40.112
The person's happy, right?
00:21:40.492 --> 00:21:41.973
And I used to love,
00:21:42.153 --> 00:21:43.595
but one of my schticks was because I
00:21:43.634 --> 00:21:44.076
heard it enough.
00:21:44.115 --> 00:21:44.496
People were like,
00:21:44.855 --> 00:21:45.817
Oh my God, I can't believe I won.
00:21:45.856 --> 00:21:46.777
I never won things.
00:21:46.957 --> 00:21:48.577
And I was like, I would be like,
00:21:48.637 --> 00:21:49.398
Rebecca, Rebecca.
00:21:49.419 --> 00:21:50.138
And like, yeah,
00:21:50.179 --> 00:21:54.342
like you can never say that again ever.
00:21:54.461 --> 00:21:55.942
Cause you won one thing for the rest
00:21:55.962 --> 00:21:56.282
of your life.
00:21:56.462 --> 00:21:57.022
Like play with it.
00:21:57.064 --> 00:21:57.263
Right.
00:21:57.644 --> 00:21:57.963
I always,
00:21:58.163 --> 00:21:59.144
I would also have fun with it.
00:21:59.184 --> 00:21:59.964
I would push back.
00:22:00.846 --> 00:22:03.406
So of course we would like Pavlovian dog,
00:22:03.467 --> 00:22:07.089
have a sound effect, be colored X,
00:22:07.210 --> 00:22:08.309
be color tan right now.
00:22:08.369 --> 00:22:08.589
Right.
00:22:08.871 --> 00:22:10.791
And people would call, Hey,
00:22:12.612 --> 00:22:13.413
This is the radio station.
00:22:13.873 --> 00:22:14.334
Who's this?
00:22:14.473 --> 00:22:14.914
Rebecca.
00:22:15.595 --> 00:22:16.175
Did I win?
00:22:17.657 --> 00:22:18.679
I would twist it.
00:22:19.058 --> 00:22:21.823
I'd be like, what are you calling for?
00:22:22.282 --> 00:22:23.724
And if you didn't know what the contest
00:22:23.765 --> 00:22:27.509
was, I clung up on you.
00:22:28.069 --> 00:22:29.711
And that pissed off one person.
00:22:30.696 --> 00:22:32.858
But I made a hundred friends because they
00:22:32.878 --> 00:22:33.919
were like, good.
00:22:34.159 --> 00:22:35.200
I really wanted that.
00:22:35.701 --> 00:22:36.560
And I didn't win it.
00:22:36.840 --> 00:22:38.082
And I don't want her to have it
00:22:38.102 --> 00:22:39.542
because she didn't even know what it was.
00:22:40.003 --> 00:22:41.084
So that is the way,
00:22:41.104 --> 00:22:41.865
because I just said,
00:22:41.924 --> 00:22:43.846
I didn't like doing contests because in
00:22:43.905 --> 00:22:44.507
contests,
00:22:44.747 --> 00:22:46.969
you make one friend and ninety nine people
00:22:47.009 --> 00:22:47.509
get pissed.
00:22:47.788 --> 00:22:48.710
That math don't math.
00:22:49.069 --> 00:22:49.871
But I did.
00:22:49.971 --> 00:22:50.671
I twisted it.
00:22:50.711 --> 00:22:51.612
And I was like, no,
00:22:51.751 --> 00:22:52.732
you don't get it because you don't know
00:22:52.752 --> 00:22:53.212
what it was.
00:22:53.512 --> 00:22:55.214
You were caller ten and you can take
00:22:55.234 --> 00:22:56.035
this up with our lawyers.
00:22:56.194 --> 00:22:56.655
No one did.
00:22:57.215 --> 00:22:58.297
But I would have fun with it.
00:22:59.308 --> 00:23:00.169
I would also say,
00:23:00.449 --> 00:23:01.630
I'm going to ask for caller ten.
00:23:01.930 --> 00:23:03.309
You better know what you're trying to win.
00:23:04.250 --> 00:23:04.829
Just tell me.
00:23:04.869 --> 00:23:05.770
You don't have to be like, exactly.
00:23:05.790 --> 00:23:06.191
You're just like, oh,
00:23:06.211 --> 00:23:07.510
the tickets for the evidence.
00:23:07.651 --> 00:23:07.891
Got it.
00:23:07.931 --> 00:23:08.790
Yeah, you pay attention.
00:23:09.191 --> 00:23:10.491
But if you didn't, I push back.
00:23:11.932 --> 00:23:13.112
That was a way of like me sort
00:23:13.132 --> 00:23:16.633
of combating the people listening going,
00:23:16.853 --> 00:23:17.613
I never win.
00:23:17.853 --> 00:23:19.453
They were okay with not winning as long
00:23:19.493 --> 00:23:21.134
as someone who in their eyes didn't
00:23:21.153 --> 00:23:22.894
deserve it didn't win either.
00:23:23.295 --> 00:23:24.615
Sometimes you win by losing.
00:23:26.909 --> 00:23:30.230
So whose job is it to talk to
00:23:30.271 --> 00:23:32.792
this guy at a hospital and be like,
00:23:32.932 --> 00:23:37.196
hey, man, tomorrow you're not working.
00:23:37.217 --> 00:23:37.817
We're going to pay you.
00:23:37.856 --> 00:23:38.498
You're coming to work.
00:23:38.538 --> 00:23:39.417
We're going to go hang out.
00:23:40.479 --> 00:23:43.201
And I need to listen to you and
00:23:43.300 --> 00:23:45.163
figure out how to get you back on
00:23:45.603 --> 00:23:45.962
our team.
00:23:46.222 --> 00:23:47.403
Is there a job for that?
00:23:47.703 --> 00:23:48.424
What job is that?
00:23:48.545 --> 00:23:49.185
I want that job.
00:23:49.865 --> 00:23:50.026
Well,
00:23:50.246 --> 00:23:52.387
I think that I would love that job.
00:23:52.448 --> 00:23:53.909
I wish I could be a guidance counselor
00:23:53.949 --> 00:23:54.990
for physical therapists.
00:23:55.628 --> 00:23:57.369
Guidance counselors for companies.
00:23:57.671 --> 00:23:57.810
Yeah.
00:23:57.851 --> 00:23:58.891
Isn't that a job?
00:23:59.372 --> 00:24:01.874
I mean, HR, isn't that HR?
00:24:02.314 --> 00:24:03.434
I don't think so.
00:24:03.515 --> 00:24:05.757
Cause I think HR is all defense, right?
00:24:05.777 --> 00:24:07.077
They just work for the company.
00:24:07.657 --> 00:24:09.558
It's like defense and procedure, right?
00:24:09.578 --> 00:24:11.260
Like, I don't know that it's investment.
00:24:12.101 --> 00:24:13.501
Like there has to be like a human
00:24:13.682 --> 00:24:14.843
assets department,
00:24:15.324 --> 00:24:16.785
like a development department.
00:24:16.924 --> 00:24:19.826
Like, and I think,
00:24:19.846 --> 00:24:21.327
I think then you get into that like
00:24:21.387 --> 00:24:24.990
rabbit hole of management or leadership,
00:24:25.010 --> 00:24:25.111
right?
00:24:26.666 --> 00:24:28.648
you have a management team or do you
00:24:28.689 --> 00:24:30.611
have a leadership team right totally
00:24:30.651 --> 00:24:34.193
different and i think unfortunately the
00:24:34.233 --> 00:24:36.457
way most companies i don't just even want
00:24:36.477 --> 00:24:37.817
to throw hospitals under the bus most
00:24:37.837 --> 00:24:39.539
companies are set up to have supervisors
00:24:39.559 --> 00:24:42.863
and managers not like leaders and leaders
00:24:42.982 --> 00:24:45.404
also don't necessarily make good managers
00:24:45.464 --> 00:24:46.705
right so i feel like you have to
00:24:46.726 --> 00:24:48.448
have some combination of both but i feel
00:24:48.468 --> 00:24:50.089
like this is where your leadership
00:24:52.176 --> 00:24:52.817
maybe not your managers,
00:24:52.836 --> 00:24:55.798
have to step in and help lead people
00:24:55.837 --> 00:24:56.077
through.
00:24:56.117 --> 00:24:58.138
But I don't think there is a job
00:24:58.199 --> 00:24:58.679
for that.
00:25:00.239 --> 00:25:01.599
I think that the organization would have
00:25:01.619 --> 00:25:05.020
to be big enough to financially afford
00:25:05.080 --> 00:25:07.361
that and then allow that person to...
00:25:07.381 --> 00:25:09.301
Invest in people.
00:25:09.321 --> 00:25:10.082
Invest in people.
00:25:10.442 --> 00:25:11.722
Did you ever hear of a story from
00:25:11.843 --> 00:25:12.143
Zappos?
00:25:12.163 --> 00:25:13.343
You know what Zappos is, right?
00:25:13.363 --> 00:25:14.482
It's like an online shoe store.
00:25:15.163 --> 00:25:16.023
And people were...
00:25:17.010 --> 00:25:19.393
People were like, to Jeff Bezos,
00:25:19.413 --> 00:25:20.394
when he launched Amazon,
00:25:20.413 --> 00:25:21.454
when he was just going to sell books,
00:25:21.474 --> 00:25:21.815
they were like,
00:25:21.994 --> 00:25:24.057
that is the dumbest idea ever.
00:25:24.116 --> 00:25:25.538
Who's going to buy a book online?
00:25:25.999 --> 00:25:28.381
And then you go to like, I know,
00:25:28.441 --> 00:25:28.760
me too.
00:25:29.082 --> 00:25:30.843
And then you go to shoes and people
00:25:30.863 --> 00:25:32.924
are like, you have to try shoes on.
00:25:33.346 --> 00:25:34.626
You have to walk around.
00:25:34.646 --> 00:25:36.307
Do you remember before the first day of
00:25:36.347 --> 00:25:36.709
school,
00:25:36.749 --> 00:25:38.190
how important it was to try it on?
00:25:38.529 --> 00:25:39.330
And your mom was like,
00:25:39.490 --> 00:25:40.471
walk around in it.
00:25:41.448 --> 00:25:43.108
And then everyone's like watching you walk
00:25:43.148 --> 00:25:43.489
around.
00:25:43.509 --> 00:25:45.128
You're like, yeah, they're new shoes.
00:25:45.489 --> 00:25:45.929
Yeah.
00:25:45.989 --> 00:25:46.409
I don't know.
00:25:46.509 --> 00:25:47.930
Like, what am I supposed to feel?
00:25:48.029 --> 00:25:49.170
Anyway, I digress.
00:25:49.690 --> 00:25:51.550
So then someone launches Zappos.com and
00:25:51.570 --> 00:25:52.171
they're like,
00:25:52.290 --> 00:25:54.211
that's not going to work because shoes are
00:25:54.231 --> 00:25:56.112
all about touching the shoes and putting
00:25:56.132 --> 00:25:57.913
them on and feeling them.
00:25:57.932 --> 00:26:01.294
They had a problem with complaints.
00:26:02.253 --> 00:26:04.535
And the guy who launched Zappos was one
00:26:04.575 --> 00:26:04.954
guy.
00:26:04.974 --> 00:26:05.894
And then it was two people.
00:26:05.914 --> 00:26:06.234
And then it was
00:26:08.971 --> 00:26:10.731
All complaints went through this guy.
00:26:11.051 --> 00:26:12.271
Someone's going to Google the name of the
00:26:12.432 --> 00:26:14.613
CEO or whatever who came up with it.
00:26:14.732 --> 00:26:16.432
The Jeff Bezos of Zappos.
00:26:17.252 --> 00:26:20.114
And he realized he was handling every
00:26:20.153 --> 00:26:22.134
complaint because in his mind,
00:26:22.154 --> 00:26:22.535
he was like,
00:26:22.555 --> 00:26:23.674
I want to touch every complaint.
00:26:24.135 --> 00:26:25.756
Good idea, but...
00:26:26.172 --> 00:26:28.192
bad execution because there were so many.
00:26:28.413 --> 00:26:29.634
You're an online retailer.
00:26:30.374 --> 00:26:32.795
And then the longer someone's complaint
00:26:33.075 --> 00:26:34.195
takes to get solved,
00:26:34.536 --> 00:26:35.636
the more pissed they are.
00:26:35.856 --> 00:26:38.478
You can't blame them, right?
00:26:38.817 --> 00:26:39.798
It's like an ounce of prevention,
00:26:39.838 --> 00:26:40.538
pound of cure.
00:26:40.778 --> 00:26:42.079
But that ounce of prevention needed to
00:26:42.119 --> 00:26:42.960
come in the first
00:26:51.161 --> 00:26:52.943
And I forget the exact dollar amount,
00:26:52.983 --> 00:26:53.525
but it was like,
00:26:53.684 --> 00:26:55.888
if you're taking the complaint,
00:26:55.969 --> 00:26:59.114
if you're John Smith on the phone at
00:26:59.153 --> 00:26:59.615
Zappos,
00:27:00.566 --> 00:27:02.387
And it's your complaint to handle.
00:27:02.807 --> 00:27:05.830
And the solution to make this person happy
00:27:06.872 --> 00:27:09.355
is less than two hundred dollars.
00:27:09.734 --> 00:27:10.536
Just solve it.
00:27:10.576 --> 00:27:11.576
Just do it.
00:27:11.616 --> 00:27:12.538
Just write in the computer.
00:27:12.917 --> 00:27:14.559
This guy had a legit complaint.
00:27:14.900 --> 00:27:15.800
It was this and this.
00:27:15.901 --> 00:27:17.603
And I just gave him a two hundred
00:27:17.623 --> 00:27:18.123
dollar credit.
00:27:18.363 --> 00:27:19.304
And the guy was thrilled.
00:27:19.904 --> 00:27:21.906
And he was like, the time it took.
00:27:23.450 --> 00:27:25.574
was worth just solving it.
00:27:25.994 --> 00:27:26.095
Yeah.
00:27:26.115 --> 00:27:27.477
That's why like sometimes if you order
00:27:27.498 --> 00:27:28.740
like furniture is a big one.
00:27:28.960 --> 00:27:30.262
If you order something with furniture...
00:27:31.249 --> 00:27:32.549
And there's a problem with it.
00:27:32.569 --> 00:27:33.830
And you can prove it with a picture.
00:27:33.951 --> 00:27:35.092
And this is where also people start
00:27:35.132 --> 00:27:35.872
scamming the system.
00:27:36.071 --> 00:27:37.594
But a lot of times,
00:27:37.614 --> 00:27:38.433
they'll just be like, keep it.
00:27:38.453 --> 00:27:39.255
We'll send you a new one.
00:27:39.835 --> 00:27:41.615
And now you have a slightly damaged
00:27:41.675 --> 00:27:42.136
whatever.
00:27:42.537 --> 00:27:43.798
That's why you see them on Facebook.
00:27:43.817 --> 00:27:44.178
My buddy,
00:27:44.498 --> 00:27:45.719
you see them on Facebook Marketplace a
00:27:45.778 --> 00:27:45.999
lot.
00:27:46.200 --> 00:27:47.160
Because people are like, I don't know.
00:27:47.200 --> 00:27:48.681
Wayfair sent me a hot...
00:27:48.721 --> 00:27:51.702
My buddy's neighbor bought a nine thousand
00:27:51.722 --> 00:27:54.464
dollar hot tub or something crazy on
00:27:54.565 --> 00:27:55.205
Wayfair.
00:27:55.566 --> 00:27:56.787
And there was a giant scratch in it.
00:27:56.846 --> 00:27:57.748
And no offense, but like...
00:27:58.648 --> 00:27:59.670
I dropped nine grand.
00:27:59.809 --> 00:28:01.190
I want the version without the scratch in
00:28:01.230 --> 00:28:01.330
it.
00:28:01.351 --> 00:28:01.611
Right.
00:28:02.191 --> 00:28:02.711
So they were like,
00:28:02.770 --> 00:28:03.551
we'll send you a new one.
00:28:04.031 --> 00:28:04.311
And he's like,
00:28:04.412 --> 00:28:05.313
what do I do with the old one?
00:28:05.333 --> 00:28:07.193
They're like, it's your problem now.
00:28:08.051 --> 00:28:08.971
He gave it to my buddy.
00:28:08.991 --> 00:28:10.073
He was like, do you want this?
00:28:10.093 --> 00:28:11.173
And my buddy was like, yes.
00:28:11.252 --> 00:28:13.453
And he's like, there's a scratch in it.
00:28:13.493 --> 00:28:15.214
And he goes, I don't care.
00:28:15.615 --> 00:28:16.655
But somewhere along the line,
00:28:16.695 --> 00:28:17.816
someone did the math and was like,
00:28:18.375 --> 00:28:19.596
I need that guy to be happy because
00:28:19.636 --> 00:28:19.997
that guy's,
00:28:20.257 --> 00:28:21.657
if he's dropping nine grand on a hot
00:28:21.698 --> 00:28:21.978
tub,
00:28:22.397 --> 00:28:24.838
his lifetime value of products is more
00:28:24.858 --> 00:28:25.378
than nine grand.
00:28:25.419 --> 00:28:26.019
Make him happy.
00:28:26.279 --> 00:28:28.060
How much does it cost to ship the
00:28:28.101 --> 00:28:28.800
first one back?
00:28:29.965 --> 00:28:30.705
Ship a new one.
00:28:31.967 --> 00:28:33.728
We already had to ship the second one.
00:28:34.268 --> 00:28:35.409
What do we do with the first one?
00:28:35.788 --> 00:28:37.009
And then we ship it back?
00:28:37.269 --> 00:28:39.411
What are we going to do with it?
00:28:39.570 --> 00:28:40.810
I need to warehouse that.
00:28:40.871 --> 00:28:41.832
Now it's going to sit here.
00:28:41.892 --> 00:28:42.632
Now it's damaged.
00:28:42.672 --> 00:28:43.593
It's like, dude, deal with it.
00:28:45.114 --> 00:28:45.294
Well,
00:28:45.354 --> 00:28:47.054
and I think one thing that you point
00:28:47.115 --> 00:28:48.835
out really well and often,
00:28:48.934 --> 00:28:50.375
especially about communications,
00:28:50.496 --> 00:28:52.977
is that nobody owns it.
00:28:53.037 --> 00:28:53.857
Nobody owns that.
00:28:54.018 --> 00:28:56.118
And I think that's the same problem with
00:28:56.378 --> 00:28:57.619
this therapist, right?
00:28:57.660 --> 00:28:57.880
Like,
00:28:59.001 --> 00:29:00.843
the people making the decisions about how
00:29:00.863 --> 00:29:02.825
they will implement and utilize physical
00:29:02.865 --> 00:29:05.946
therapists are not taking any
00:29:06.007 --> 00:29:08.528
responsibility for that impact on that
00:29:08.588 --> 00:29:10.410
therapist, on how that impacts them,
00:29:10.470 --> 00:29:11.931
on how that impacts morale,
00:29:11.971 --> 00:29:14.071
because their job is not to advance
00:29:14.092 --> 00:29:14.873
physical therapy.
00:29:15.232 --> 00:29:16.433
Their job is to advance the mission of
00:29:16.453 --> 00:29:18.154
the hospital in the healthcare context
00:29:18.174 --> 00:29:19.036
that it exists in.
00:29:19.455 --> 00:29:22.117
So there isn't anybody who is responsible
00:29:22.478 --> 00:29:24.640
for making sure that their therapists are
00:29:25.539 --> 00:29:26.401
feeling like
00:29:28.202 --> 00:29:29.203
They're well utilized,
00:29:29.324 --> 00:29:31.545
that they're competent and taken care of
00:29:31.726 --> 00:29:33.326
and practicing at the top of their scope.
00:29:33.346 --> 00:29:34.386
Like no one owns that.
00:29:34.426 --> 00:29:35.929
So when you say whose job is that?
00:29:36.449 --> 00:29:36.729
Nobody's.
00:29:37.209 --> 00:29:37.730
Nobody's.
00:29:37.769 --> 00:29:38.569
There's a hole there.
00:29:38.589 --> 00:29:40.432
And it's going to be a very expensive
00:29:40.511 --> 00:29:42.532
hole for a shortage.
00:29:42.772 --> 00:29:43.054
Good.
00:29:43.733 --> 00:29:44.354
But Rebecca,
00:29:44.434 --> 00:29:46.536
hiring someone just for that job?
00:29:47.135 --> 00:29:48.237
How will they ever meet their
00:29:48.257 --> 00:29:48.897
productivity?
00:29:49.617 --> 00:29:50.338
Well, not even that.
00:29:50.378 --> 00:29:52.240
Like we're going to pay someone to do
00:29:52.319 --> 00:29:53.961
this job that should just not be a
00:29:54.020 --> 00:29:54.501
problem.
00:29:54.721 --> 00:29:55.623
Sorry, it is.
00:29:56.519 --> 00:29:58.500
And then we can't pay for that.
00:29:58.840 --> 00:30:00.602
I would push back and go, you are.
00:30:01.083 --> 00:30:02.544
It's just hidden in your P&L.
00:30:03.184 --> 00:30:04.945
And it's because you hired someone and
00:30:04.965 --> 00:30:06.748
they stuck around for two years and left.
00:30:07.167 --> 00:30:09.450
And now you had a vacancy for a
00:30:09.490 --> 00:30:11.451
year and you didn't fill it.
00:30:11.832 --> 00:30:13.073
And now you burn the rest of your
00:30:13.093 --> 00:30:14.854
staff out because they had to fill in
00:30:14.874 --> 00:30:16.415
because that's what people with a Peace
00:30:16.435 --> 00:30:17.276
Corps gene do.
00:30:17.696 --> 00:30:18.616
And we appreciate that.
00:30:18.837 --> 00:30:20.338
So we take advantage of it.
00:30:20.898 --> 00:30:21.720
You're paying for it,
00:30:21.740 --> 00:30:22.701
whether you're doing it or not.
00:30:23.185 --> 00:30:24.046
Well, statistically,
00:30:24.105 --> 00:30:26.446
presenteeism is worse than absenteeism.
00:30:26.847 --> 00:30:28.127
Wait, what is presenteeism?
00:30:28.407 --> 00:30:29.509
Presenteeism,
00:30:30.028 --> 00:30:31.148
you might have to look up the exact
00:30:31.169 --> 00:30:31.589
definition.
00:30:31.609 --> 00:30:33.150
I learned this from a course that I
00:30:33.170 --> 00:30:34.250
took with Mike Eisenhardt.
00:30:34.651 --> 00:30:36.632
Presenteeism is that person that shows up
00:30:36.672 --> 00:30:39.472
to work every day with that attitude.
00:30:39.914 --> 00:30:41.115
Which with, with which attitude?
00:30:41.575 --> 00:30:43.395
Like the discharge monkey attitude.
00:30:43.415 --> 00:30:44.296
It doesn't matter.
00:30:44.355 --> 00:30:45.876
Like that, that person,
00:30:46.057 --> 00:30:48.576
the person who's like present,
00:30:49.038 --> 00:30:51.198
but pulling everybody down with them.
00:30:51.258 --> 00:30:52.939
They're like the vacuum in the room.
00:30:52.999 --> 00:30:54.278
The person's going to ruin it.
00:30:54.618 --> 00:30:55.638
Even if their stats,
00:30:55.719 --> 00:30:57.420
even if like their output was great,
00:30:58.099 --> 00:30:59.661
they're net negative by a lot.
00:30:59.681 --> 00:31:00.560
Cause they're going to make a lot of
00:31:00.621 --> 00:31:01.401
good people leave.
00:31:01.820 --> 00:31:03.761
And you would rather have that person not
00:31:03.801 --> 00:31:04.342
come to work.
00:31:04.826 --> 00:31:05.346
Yeah.
00:31:05.366 --> 00:31:08.489
Work every day and be this like net
00:31:08.949 --> 00:31:09.409
drag.
00:31:09.489 --> 00:31:09.749
Right.
00:31:10.108 --> 00:31:13.951
So they found that people who go to
00:31:13.990 --> 00:31:15.771
work like that just they just drain the
00:31:15.791 --> 00:31:16.271
system.
00:31:16.432 --> 00:31:18.432
And so if you're looking at like physical
00:31:18.452 --> 00:31:19.614
there to work with,
00:31:19.653 --> 00:31:21.775
like direct to employer type services will
00:31:21.835 --> 00:31:23.576
focus on those folks.
00:31:23.675 --> 00:31:23.895
Right.
00:31:24.875 --> 00:31:26.556
They'll focus on the absentee folks too,
00:31:26.636 --> 00:31:26.836
right?
00:31:26.856 --> 00:31:28.077
Like, is that a health condition?
00:31:28.117 --> 00:31:29.239
But they're going to focus on all of
00:31:29.259 --> 00:31:30.920
those people to help bring them back to
00:31:30.960 --> 00:31:31.740
the pack, right?
00:31:31.800 --> 00:31:33.643
And make sure that everybody's attitude is
00:31:33.682 --> 00:31:33.942
better.
00:31:34.442 --> 00:31:36.565
But do you work on keeping everybody happy
00:31:36.625 --> 00:31:37.885
or do you have to focus on those
00:31:37.905 --> 00:31:39.948
people that are really causing the
00:31:40.107 --> 00:31:41.529
problem?
00:31:41.789 --> 00:31:42.790
Are you a hockey fan or are you
00:31:42.810 --> 00:31:43.290
a baseball fan?
00:31:43.310 --> 00:31:43.912
Are you a hockey fan at all?
00:31:43.932 --> 00:31:44.291
I'm a baseball fan.
00:31:45.230 --> 00:31:45.549
All right,
00:31:45.609 --> 00:31:47.471
so there is a stat for this in
00:31:47.530 --> 00:31:47.971
baseball.
00:31:47.991 --> 00:31:49.571
It's called WAR, W-A-R,
00:31:49.632 --> 00:31:51.292
Wins Above Replacement.
00:31:51.713 --> 00:31:52.594
I'm a baseball fan too,
00:31:52.614 --> 00:31:53.734
and I can't understand WAR.
00:31:53.954 --> 00:31:57.136
The idea is, as a right fielder,
00:31:57.396 --> 00:31:59.298
how are you compared to other right
00:31:59.397 --> 00:31:59.917
fielders?
00:32:00.018 --> 00:32:01.358
When you're in the game,
00:32:02.680 --> 00:32:06.342
do you do the intangibles well that never
00:32:06.382 --> 00:32:08.383
before showed up on the stat sheet?
00:32:08.883 --> 00:32:10.624
It's a little easier to explain in hockey.
00:32:10.683 --> 00:32:12.125
Even not a hockey fan, you'll get this.
00:32:13.761 --> 00:32:16.183
So how do you get things in the
00:32:16.203 --> 00:32:17.265
back of your hockey card?
00:32:17.525 --> 00:32:22.710
Goals, assists, penalty minutes,
00:32:22.789 --> 00:32:24.632
time on the ice, how much you work.
00:32:24.751 --> 00:32:28.134
Those are easier to measure, right?
00:32:28.154 --> 00:32:29.636
Then they come up with this statistic
00:32:29.656 --> 00:32:30.617
called plus-minus.
00:32:31.670 --> 00:32:34.031
So let's say I'm on the ice and
00:32:34.132 --> 00:32:34.832
I actually...
00:32:35.333 --> 00:32:36.653
So the way to get an assist is
00:32:36.814 --> 00:32:38.234
I pass it to you and you score.
00:32:38.734 --> 00:32:39.516
I get an assist.
00:32:40.135 --> 00:32:41.917
Another way would be I pass it to
00:32:41.998 --> 00:32:42.458
Steve.
00:32:42.718 --> 00:32:43.939
Steve passes it to you.
00:32:44.579 --> 00:32:45.259
You get a goal.
00:32:45.420 --> 00:32:46.260
Steve gets an assist.
00:32:46.560 --> 00:32:48.663
I get an assist.
00:32:48.722 --> 00:32:50.124
But there's a lot of stuff going on
00:32:50.324 --> 00:32:51.144
on a hockey rink
00:32:52.109 --> 00:32:53.171
That isn't just that.
00:32:53.330 --> 00:32:55.413
Like maybe I needed to dig the puck
00:32:55.452 --> 00:32:57.114
out of the corner of my own zone,
00:32:57.374 --> 00:32:59.655
then pass it to Steve, then Mike,
00:32:59.875 --> 00:33:00.557
then Rebecca.
00:33:00.676 --> 00:33:01.257
She scores.
00:33:01.538 --> 00:33:02.678
I got nothing on that.
00:33:03.638 --> 00:33:05.520
That's okay, but that's a thing.
00:33:05.961 --> 00:33:07.721
Or the guy who is always really good
00:33:07.782 --> 00:33:08.383
at communicating.
00:33:08.603 --> 00:33:09.483
But how do you put that on a
00:33:09.523 --> 00:33:09.943
stat sheet?
00:33:09.963 --> 00:33:11.125
So they came up with plus minus,
00:33:11.885 --> 00:33:14.028
which is when a goal is scored,
00:33:14.248 --> 00:33:16.148
the person in the booth and stats just
00:33:16.189 --> 00:33:18.631
writes everybody's name down who was on
00:33:18.671 --> 00:33:19.231
the ice.
00:33:19.692 --> 00:33:20.712
And that's a plus one.
00:33:21.942 --> 00:33:23.785
When a goal is scored against us,
00:33:24.346 --> 00:33:25.287
who is on the ice?
00:33:25.527 --> 00:33:26.428
That's a minus one.
00:33:26.909 --> 00:33:28.250
And just like a running count,
00:33:28.289 --> 00:33:30.333
if you're card counting in blackjack,
00:33:30.692 --> 00:33:32.375
what's the running count on Jimmy?
00:33:32.394 --> 00:33:34.037
Yeah.
00:33:34.257 --> 00:33:35.818
Man, every time Jimmy steps on the ice,
00:33:35.858 --> 00:33:36.740
we get scored on.
00:33:37.240 --> 00:33:39.663
But we don't measure that because...
00:33:40.579 --> 00:33:41.701
I didn't get a goal.
00:33:42.402 --> 00:33:44.804
The goalie gets a goal against her or
00:33:44.864 --> 00:33:46.765
him because they're the goalie,
00:33:47.006 --> 00:33:48.066
but I'm just a forward.
00:33:48.326 --> 00:33:49.867
But it is my responsibility to guard my
00:33:49.907 --> 00:33:50.167
guy.
00:33:50.248 --> 00:33:51.028
And when I'm out there,
00:33:51.128 --> 00:33:52.089
I just sort of don't.
00:33:52.509 --> 00:33:53.730
And then that leads to a pass,
00:33:53.750 --> 00:33:54.491
which leads to a goal.
00:33:54.872 --> 00:33:56.993
So the answer was plus minus.
00:33:57.634 --> 00:33:58.976
So you want to be as plus as
00:33:59.036 --> 00:33:59.455
possible,
00:33:59.496 --> 00:34:01.478
which is like we get scored on as
00:34:01.518 --> 00:34:02.159
little as possible.
00:34:02.179 --> 00:34:04.000
We score as much as possible.
00:34:04.361 --> 00:34:07.603
It's an imperfect way of measuring the
00:34:07.623 --> 00:34:08.224
intangibles.
00:34:09.501 --> 00:34:10.922
That's hard to do in business.
00:34:11.342 --> 00:34:11.702
It is.
00:34:11.983 --> 00:34:12.764
Where would you do that?
00:34:13.523 --> 00:34:15.326
That's not a net promoter score.
00:34:15.346 --> 00:34:16.385
It's not NPS.
00:34:17.226 --> 00:34:20.108
I also would love to see outcomes for
00:34:20.148 --> 00:34:21.728
people who feel like that,
00:34:22.329 --> 00:34:24.030
for those therapists who are really burned
00:34:24.170 --> 00:34:27.612
out and aren't bringing that energy into
00:34:27.632 --> 00:34:28.313
the room with them.
00:34:29.574 --> 00:34:31.094
Are you delaying people's discharge
00:34:31.255 --> 00:34:32.896
because you're not intervening the way
00:34:32.916 --> 00:34:33.496
that you should?
00:34:34.177 --> 00:34:37.139
Are your patients more hesitant to go home
00:34:37.179 --> 00:34:37.739
because they're
00:34:38.657 --> 00:34:40.559
Your attitude does not inspire confidence.
00:34:41.159 --> 00:34:43.059
Do your patients need home health more
00:34:43.199 --> 00:34:43.601
often?
00:34:44.081 --> 00:34:45.501
Are the home health therapists like,
00:34:45.561 --> 00:34:47.922
why is this patient in this bad of
00:34:47.943 --> 00:34:48.882
shape coming home?
00:34:49.724 --> 00:34:51.905
Are you discharging more people to rehab
00:34:51.945 --> 00:34:54.585
than home with an assistive device?
00:34:55.266 --> 00:34:57.527
What do your outcomes look like compared
00:34:57.547 --> 00:34:59.789
to people who are operating
00:35:00.798 --> 00:35:03.480
positively within their scope as opposed
00:35:03.519 --> 00:35:05.920
to walking into every room being like i'm
00:35:05.940 --> 00:35:08.400
just here to just make a trash
00:35:08.440 --> 00:35:12.460
recommendation and then leave i mean there
00:35:12.501 --> 00:35:14.101
was a guy who had the same job
00:35:14.141 --> 00:35:15.822
as me in radio there were four radio
00:35:15.842 --> 00:35:17.442
stations in one building all owned by the
00:35:17.481 --> 00:35:20.463
same company right and a guy ran a
00:35:20.523 --> 00:35:22.324
country station his office was next to
00:35:22.384 --> 00:35:24.443
mine and he was sort of an eeyore
00:35:25.717 --> 00:35:27.818
So I got told one day on a
00:35:27.918 --> 00:35:30.119
Tuesday that I had to go home and
00:35:30.139 --> 00:35:31.599
come back the next day and fire someone
00:35:31.619 --> 00:35:32.240
from my staff.
00:35:32.260 --> 00:35:33.161
Have I told you this story before?
00:35:33.181 --> 00:35:35.641
I had to go home, Jimmy.
00:35:35.922 --> 00:35:37.003
You have to come home tomorrow,
00:35:37.123 --> 00:35:37.943
come back to work tomorrow.
00:35:38.679 --> 00:35:39.440
And my boss was like,
00:35:39.539 --> 00:35:40.300
tell me who to fire.
00:35:40.320 --> 00:35:41.800
It's your job.
00:35:41.860 --> 00:35:42.440
You're the boss.
00:35:42.780 --> 00:35:45.661
You get to get handed the trophies when
00:35:45.681 --> 00:35:46.121
you win.
00:35:46.942 --> 00:35:47.902
And then you got to do the bad
00:35:47.922 --> 00:35:48.123
work.
00:35:48.503 --> 00:35:49.163
So I went home,
00:35:49.503 --> 00:35:51.563
had a couple of Chardonnays because I was
00:35:51.603 --> 00:35:51.963
pissed.
00:35:52.264 --> 00:35:53.364
None of my people did anything wrong.
00:35:53.603 --> 00:35:55.065
They were all on the plus side and
00:35:55.085 --> 00:35:55.744
the plus minus.
00:35:55.784 --> 00:35:56.445
They were hard work.
00:35:56.625 --> 00:35:57.664
But I had to fire one of them
00:35:58.105 --> 00:35:59.186
because numbers.
00:35:59.806 --> 00:36:01.146
And that's a reality.
00:36:01.746 --> 00:36:03.246
So I went home and I thought about
00:36:03.266 --> 00:36:05.047
it similarly to how we're thinking about
00:36:05.086 --> 00:36:05.367
this.
00:36:05.907 --> 00:36:07.007
But I didn't think about it from my...
00:36:08.106 --> 00:36:09.887
particular small radio stations point of
00:36:09.907 --> 00:36:10.106
view.
00:36:10.748 --> 00:36:12.148
I thought about it from the entire
00:36:12.188 --> 00:36:12.528
building.
00:36:12.909 --> 00:36:13.989
So four radio stations.
00:36:14.070 --> 00:36:14.510
And I was like,
00:36:15.030 --> 00:36:17.273
this guy over here is a,
00:36:17.333 --> 00:36:19.713
this he's a net negative guy.
00:36:20.574 --> 00:36:22.637
And he makes more money than my people.
00:36:23.875 --> 00:36:26.257
And the station he's running isn't
00:36:26.277 --> 00:36:29.039
performing well because of, I mean,
00:36:29.139 --> 00:36:31.521
my extrapolation because of his attitude,
00:36:31.541 --> 00:36:33.242
this guy could, you know,
00:36:33.802 --> 00:36:35.184
so I went back in the next morning,
00:36:35.405 --> 00:36:37.606
a little hungover and I said, Hey boss,
00:36:38.226 --> 00:36:39.288
I got a crazy idea.
00:36:39.608 --> 00:36:40.789
And he was used to me saying that.
00:36:40.809 --> 00:36:41.349
And he's like, Jimmy,
00:36:41.369 --> 00:36:42.690
this is not the time for a crazy
00:36:42.751 --> 00:36:43.030
idea.
00:36:43.351 --> 00:36:44.132
This is the time for an,
00:36:44.311 --> 00:36:45.373
I need an answer, dude.
00:36:46.134 --> 00:36:46.614
And I was like,
00:36:47.494 --> 00:36:48.695
I have an answer that is going to
00:36:48.715 --> 00:36:49.836
give you an answer that
00:36:51.172 --> 00:36:53.233
You're going to save more money and you're
00:36:53.253 --> 00:36:54.434
going to give me a raise.
00:36:54.554 --> 00:36:55.333
And he was like, oh,
00:36:55.393 --> 00:36:56.755
I can't wait to hear this.
00:36:57.655 --> 00:36:58.235
And I was like,
00:36:58.356 --> 00:36:59.416
and I just made my case.
00:36:59.436 --> 00:36:59.615
I'm like,
00:36:59.635 --> 00:37:01.577
you got a guy over here running an
00:37:01.617 --> 00:37:02.697
entire radio station.
00:37:03.418 --> 00:37:04.298
And we both know
00:37:05.833 --> 00:37:06.653
He ain't going to get it done.
00:37:07.273 --> 00:37:08.494
And it's nothing he's doing.
00:37:08.534 --> 00:37:09.074
It's who he is.
00:37:09.355 --> 00:37:10.034
He's an Eeyore.
00:37:10.534 --> 00:37:12.655
And you can't out Eeyore this guy.
00:37:13.195 --> 00:37:13.496
And I was like,
00:37:13.715 --> 00:37:14.516
you're going to fire him.
00:37:14.817 --> 00:37:16.237
I'm going to take over his radio station.
00:37:16.496 --> 00:37:17.556
This was a country radio station.
00:37:17.916 --> 00:37:19.538
I knew nothing about country.
00:37:19.637 --> 00:37:21.418
And I said that, Bill, you know me.
00:37:21.677 --> 00:37:22.219
I'm a rock guy.
00:37:22.358 --> 00:37:23.259
I know nothing about country.
00:37:23.278 --> 00:37:23.659
He goes, yeah.
00:37:23.679 --> 00:37:24.458
How are you going to get around that?
00:37:25.139 --> 00:37:26.760
There's a staff on that radio station that
00:37:26.780 --> 00:37:27.780
knows all about country.
00:37:28.420 --> 00:37:29.661
I know how to work with people and
00:37:29.681 --> 00:37:30.380
be creative.
00:37:30.860 --> 00:37:32.320
I also know how to listen to people.
00:37:32.822 --> 00:37:34.262
So I'm going to do that guy's job.
00:37:35.505 --> 00:37:37.146
You're going to save money because you're
00:37:37.166 --> 00:37:37.547
going to hire,
00:37:37.586 --> 00:37:38.907
you're going to fire another manager.
00:37:39.126 --> 00:37:40.367
You asked me to follow, you know,
00:37:40.887 --> 00:37:41.668
fire one of my people.
00:37:41.827 --> 00:37:42.909
He makes more money than them.
00:37:43.248 --> 00:37:44.349
You're going to give me a little bit
00:37:44.369 --> 00:37:45.389
of that money because now I'm going to
00:37:45.409 --> 00:37:50.190
do two jobs and net positive, we will,
00:37:50.210 --> 00:37:52.751
the team will be stronger for it.
00:37:52.851 --> 00:37:55.572
You're going to fire a good person and
00:37:55.652 --> 00:37:58.574
let a net negative person,
00:37:58.614 --> 00:37:59.355
what do you call them again?
00:37:59.554 --> 00:37:59.755
Like a...
00:38:01.047 --> 00:38:03.590
presentism you let that person stick
00:38:03.630 --> 00:38:05.090
around and when i made the case he
00:38:05.110 --> 00:38:07.652
was like you're right by five o'clock that
00:38:07.672 --> 00:38:08.974
day i was running two radio stations and
00:38:08.994 --> 00:38:11.976
someone was like sorry but i protected my
00:38:12.036 --> 00:38:14.117
people they did nothing wrong they were
00:38:14.217 --> 00:38:17.179
all plus plus minus people and you were
00:38:17.199 --> 00:38:19.179
a minus plus minus person and i want
00:38:19.221 --> 00:38:21.081
plus plus minus people and we would have
00:38:21.101 --> 00:38:22.663
been net negative if i hadn't pulled that
00:38:22.682 --> 00:38:24.543
move and i will do it ten times
00:38:24.583 --> 00:38:26.385
out of ten that's how i got my
00:38:26.485 --> 00:38:27.166
second radio station
00:38:28.242 --> 00:38:28.583
And I think,
00:38:28.822 --> 00:38:30.103
I think the question that people are
00:38:30.143 --> 00:38:32.485
probably asking if they are in management
00:38:32.706 --> 00:38:35.166
is how do I screen for those people
00:38:35.367 --> 00:38:37.148
to keep them onto our team?
00:38:37.507 --> 00:38:40.210
How do I avoid the conversion from a
00:38:40.269 --> 00:38:41.391
positive to a negative?
00:38:41.411 --> 00:38:42.650
Because I think that's a big one.
00:38:42.690 --> 00:38:42.952
Yeah.
00:38:42.972 --> 00:38:43.552
Cause everybody, yeah.
00:38:43.592 --> 00:38:45.132
No one shows up to be that right.
00:38:45.552 --> 00:38:47.094
And it does happen and it happens a
00:38:47.213 --> 00:38:49.916
lot and I see it and I see
00:38:49.936 --> 00:38:52.637
it everywhere in our profession, right?
00:38:52.657 --> 00:38:54.257
You just have to look at social media
00:38:54.297 --> 00:38:54.797
comments.
00:38:55.518 --> 00:38:55.719
Like,
00:39:00.367 --> 00:39:02.248
i tell people not to become a physical
00:39:02.289 --> 00:39:03.891
therapist because of x y like you're
00:39:03.931 --> 00:39:06.112
poisoning the well before they even got in
00:39:06.152 --> 00:39:08.693
the water right like why are we not
00:39:08.733 --> 00:39:10.416
making the profession better why are we
00:39:10.456 --> 00:39:12.777
just like i think what they're with i
00:39:13.018 --> 00:39:15.378
mean they're i mean a psychologist would
00:39:15.418 --> 00:39:18.461
say they're projecting right yeah and i've
00:39:18.722 --> 00:39:20.342
made videos i will not talk out of
00:39:20.362 --> 00:39:22.025
both sides of my mouth i am pissed
00:39:22.164 --> 00:39:24.326
off at the math because math don't care
00:39:24.346 --> 00:39:25.226
about vibes totally
00:39:26.273 --> 00:39:27.434
So I would like to change the system
00:39:27.474 --> 00:39:27.775
as well.
00:39:27.974 --> 00:39:29.615
But yes, I agree with that.
00:39:29.735 --> 00:39:29.896
I mean,
00:39:29.956 --> 00:39:31.297
I put a comment every day that got...
00:39:31.916 --> 00:39:35.079
Someone asked about, should I become a PT?
00:39:35.119 --> 00:39:36.239
And I was like, do the math.
00:39:36.860 --> 00:39:38.059
If you really want to do this and
00:39:38.079 --> 00:39:39.481
you understand what it costs and you still
00:39:39.501 --> 00:39:40.201
go with it, great.
00:39:40.362 --> 00:39:41.362
Go with God.
00:39:41.382 --> 00:39:42.041
Knock yourself out.
00:39:42.523 --> 00:39:43.762
But like someone said,
00:39:44.224 --> 00:39:45.784
schools should do a better job educating.
00:39:45.824 --> 00:39:46.485
And I'm like, my man,
00:39:47.085 --> 00:39:48.405
they gave you the papers.
00:39:49.490 --> 00:39:50.831
All the numbers were in there.
00:39:51.371 --> 00:39:55.795
You're not looking at them as your fault.
00:39:56.014 --> 00:39:57.215
So I'm not saying don't pay back the
00:39:57.255 --> 00:39:58.516
loans or any of those things.
00:39:58.996 --> 00:40:01.197
I'm saying let's change that because this
00:40:01.257 --> 00:40:01.639
sucks.
00:40:01.958 --> 00:40:02.898
And down the line,
00:40:03.139 --> 00:40:05.501
we're going to have less good people on
00:40:05.541 --> 00:40:06.061
our team.
00:40:06.402 --> 00:40:08.483
And that's going to screw everybody.
00:40:09.431 --> 00:40:11.132
So I'm not saying let's just erase it
00:40:11.152 --> 00:40:12.653
and say, ah, you made a bad move.
00:40:12.994 --> 00:40:14.275
Let's change the whole damn thing because
00:40:14.315 --> 00:40:15.416
it's not good.
00:40:15.775 --> 00:40:17.617
Never mind fair or equitable.
00:40:18.358 --> 00:40:18.918
It's deeper.
00:40:19.039 --> 00:40:21.942
It's not good for the system,
00:40:21.981 --> 00:40:23.342
for the person, for the people,
00:40:23.643 --> 00:40:24.324
for the organization.
00:40:24.344 --> 00:40:25.445
It's not good.
00:40:25.885 --> 00:40:27.346
So if something's not good,
00:40:27.987 --> 00:40:29.427
I thought we were supposed to be able
00:40:29.447 --> 00:40:29.969
to change it.
00:40:30.268 --> 00:40:32.050
And here's the problem.
00:40:32.771 --> 00:40:36.253
The parts of the system that make the
00:40:36.273 --> 00:40:38.715
decisions for not good, I'll talk to them.
00:40:38.875 --> 00:40:40.255
They're not listening to my podcast.
00:40:40.376 --> 00:40:41.356
I could talk about them for months.
00:40:41.637 --> 00:40:43.617
The people who decide what PT programs
00:40:43.657 --> 00:40:45.318
cost, from my understanding,
00:40:46.039 --> 00:40:46.659
I talk to people.
00:40:47.079 --> 00:40:48.581
It's not the professors, guys.
00:40:48.800 --> 00:40:49.141
Trust me.
00:40:49.481 --> 00:40:51.943
They are not rolling in cash.
00:40:52.262 --> 00:40:53.443
I'm not saying they're not making money.
00:40:53.543 --> 00:40:54.103
They should be.
00:40:54.384 --> 00:40:55.885
They have a ton of experience and do
00:40:55.925 --> 00:40:56.385
a great job.
00:40:56.885 --> 00:40:58.746
It is not the chairs of the department.
00:40:59.947 --> 00:41:01.509
It is not the deans.
00:41:03.427 --> 00:41:06.389
people you've never met who are doing jobs
00:41:06.648 --> 00:41:07.829
that you have no idea.
00:41:08.650 --> 00:41:09.429
It's those people.
00:41:09.650 --> 00:41:10.831
They're not listening to you.
00:41:11.231 --> 00:41:11.670
They're not.
00:41:11.831 --> 00:41:12.672
That's probably their problem,
00:41:12.692 --> 00:41:14.472
but they are not incentivized to make you
00:41:14.512 --> 00:41:14.833
happy.
00:41:15.152 --> 00:41:17.554
They win the minute you apply and sign
00:41:18.034 --> 00:41:18.894
and someone gets paid.
00:41:19.235 --> 00:41:20.456
So how to fix it?
00:41:20.556 --> 00:41:21.556
I'm not saying I know how,
00:41:21.775 --> 00:41:23.536
but you're yelling at the wrong person.
00:41:23.856 --> 00:41:25.077
You're mad at the wrong people.
00:41:25.097 --> 00:41:27.458
It's also like saying that the APTA is
00:41:27.478 --> 00:41:29.019
somehow like in a hundred percent control
00:41:29.079 --> 00:41:29.800
of what we get paid.
00:41:29.860 --> 00:41:30.280
Correct.
00:41:31.360 --> 00:41:32.300
I'm not saying you're not.
00:41:32.521 --> 00:41:33.702
You're yawning at the wrong people.
00:41:33.722 --> 00:41:35.023
Like they're doing the things,
00:41:35.382 --> 00:41:37.905
but you need to take all that energy
00:41:37.985 --> 00:41:39.726
and take it to where those decisions are
00:41:39.766 --> 00:41:40.027
made.
00:41:40.507 --> 00:41:41.947
And then talk is doing that.
00:41:42.248 --> 00:41:42.467
Right.
00:41:42.588 --> 00:41:44.469
And then talk to them in a language
00:41:44.750 --> 00:41:45.650
that they can understand.
00:41:45.751 --> 00:41:47.512
Listen, they know what they're doing.
00:41:48.293 --> 00:41:48.652
Right.
00:41:48.853 --> 00:41:50.153
They know what they're doing.
00:41:51.135 --> 00:41:53.036
There's just no reason for them not to
00:41:53.096 --> 00:41:53.456
do it.
00:41:53.637 --> 00:41:55.418
Oh, we should stop applying.
00:41:55.498 --> 00:41:57.318
And I go, would you have stopped applying?
00:41:57.460 --> 00:41:57.599
No.
00:41:58.358 --> 00:41:59.480
You wouldn't have.
00:41:59.599 --> 00:42:02.961
It will not change until the pain of
00:42:03.121 --> 00:42:04.563
inaction is greater than the pain of
00:42:04.623 --> 00:42:04.882
action.
00:42:05.123 --> 00:42:05.704
Did I do that right?
00:42:06.204 --> 00:42:06.364
Yeah.
00:42:06.664 --> 00:42:07.885
The pain of inaction is greater than.
00:42:08.025 --> 00:42:09.246
That's the only reason you get off the
00:42:09.266 --> 00:42:11.387
couch because you feel an internal pain
00:42:11.628 --> 00:42:13.349
that staying here hurts more than what it
00:42:13.369 --> 00:42:14.429
does when I just got to go run
00:42:14.449 --> 00:42:14.949
a couple of miles.
00:42:15.530 --> 00:42:17.311
There's no reason for them to lower costs.
00:42:17.811 --> 00:42:19.431
This whole thing with the unprofessional
00:42:19.472 --> 00:42:20.092
Malone's thing,
00:42:20.231 --> 00:42:20.891
it's not going to change it.
00:42:21.371 --> 00:42:22.293
Not going to change cost.
00:42:22.853 --> 00:42:24.474
It will screw people because they won't be
00:42:24.514 --> 00:42:24.753
able to...
00:42:25.134 --> 00:42:28.235
It'll change who is able to apply from
00:42:28.414 --> 00:42:29.576
the smart people that I've talked to.
00:42:30.275 --> 00:42:32.177
I would love when people are in my
00:42:32.217 --> 00:42:35.838
DMs going, but, but, but...
00:42:36.177 --> 00:42:38.059
If there are forty seats at a program,
00:42:38.259 --> 00:42:39.940
as long as there's forty-one qualified
00:42:39.980 --> 00:42:40.400
applicants...
00:42:42.489 --> 00:42:43.168
Ta-da!
00:42:43.188 --> 00:42:44.349
There's no change.
00:42:44.971 --> 00:42:48.612
You need to have six applicants at most
00:42:48.693 --> 00:42:50.273
for five years before it would change.
00:42:50.373 --> 00:42:51.195
And I'm making up numbers,
00:42:51.235 --> 00:42:51.974
but you get what I mean.
00:42:52.315 --> 00:42:54.476
You need to be bleeding before you call
00:42:54.516 --> 00:42:54.996
the ambulance.
00:42:55.016 --> 00:42:56.297
It's not going to happen.
00:42:56.318 --> 00:42:57.199
It's just like PT payment, right?
00:42:57.239 --> 00:43:00.800
PTs have been taking the payment the way
00:43:00.840 --> 00:43:02.402
that it is for so long.
00:43:03.003 --> 00:43:05.284
Why on earth would insurance companies
00:43:05.344 --> 00:43:06.684
suddenly be like, you know what?
00:43:06.744 --> 00:43:07.344
We were wrong.
00:43:07.706 --> 00:43:08.146
Correct.
00:43:08.365 --> 00:43:09.347
Let's pay you more money.
00:43:10.318 --> 00:43:11.519
The other way too, hey,
00:43:11.539 --> 00:43:13.760
we're taking jobs at salaries we shouldn't
00:43:13.800 --> 00:43:13.960
do.
00:43:14.001 --> 00:43:15.300
And you're saying we should unionize.
00:43:15.340 --> 00:43:16.121
And I'm going, great.
00:43:16.202 --> 00:43:18.603
Are you any good at organizing people?
00:43:18.623 --> 00:43:19.422
Yeah.
00:43:19.443 --> 00:43:20.563
I'm not saying don't do it.
00:43:20.744 --> 00:43:21.864
I'm saying the likelihood of that
00:43:21.903 --> 00:43:22.844
happening is low.
00:43:23.465 --> 00:43:23.764
Yes.
00:43:23.804 --> 00:43:25.425
I would love to be wrong here though.
00:43:25.525 --> 00:43:26.387
I would love to be.
00:43:26.746 --> 00:43:27.706
Maybe that is the only way.
00:43:27.827 --> 00:43:28.547
I don't know it.
00:43:30.608 --> 00:43:34.190
But being mad at the wrong people,
00:43:34.230 --> 00:43:35.570
it's a real waste of energy.
00:43:39.385 --> 00:43:39.985
I don't blame them.
00:43:40.065 --> 00:43:41.306
I don't either.
00:43:42.628 --> 00:43:43.228
I don't blame them.
00:43:43.728 --> 00:43:44.929
We're measuring the wrong things.
00:43:44.949 --> 00:43:46.371
I don't know.
00:43:46.391 --> 00:43:48.452
It's easier to be wrong or being angry
00:43:48.512 --> 00:43:51.114
at a group of people or a perceived
00:43:52.034 --> 00:43:55.096
person in the entire system because if
00:43:55.115 --> 00:43:56.056
you're mad at the system,
00:43:57.097 --> 00:43:58.298
it feels too big to solve.
00:43:58.699 --> 00:44:03.222
Who gets yelled at when you don't like
00:44:03.242 --> 00:44:04.503
what a PT program is doing?
00:44:04.563 --> 00:44:06.043
The chair and the professors.
00:44:07.021 --> 00:44:09.304
They are not the ones setting the prices.
00:44:09.364 --> 00:44:11.367
My friends, if they were,
00:44:11.407 --> 00:44:13.208
they'd be setting their own salaries and
00:44:13.268 --> 00:44:14.670
trust me, they'd be higher.
00:44:15.512 --> 00:44:17.735
Like it's just not, it's not it.
00:44:18.074 --> 00:44:19.657
You're not wrong for being mad.
00:44:20.157 --> 00:44:21.980
You're just yelling at the wrong thing.
00:44:22.380 --> 00:44:23.161
In my opinion,
00:44:23.320 --> 00:44:24.603
this is just everything here is my
00:44:24.623 --> 00:44:24.902
opinion.
00:44:26.621 --> 00:44:26.880
All right.
00:44:26.940 --> 00:44:29.222
So to make this tactical,
00:44:29.443 --> 00:44:31.744
let's say you did work for this person
00:44:31.764 --> 00:44:33.045
that we started this whole conversation
00:44:33.065 --> 00:44:33.505
around with.
00:44:33.666 --> 00:44:36.909
You work and you are in a position
00:44:37.068 --> 00:44:39.650
of leadership, not management,
00:44:40.291 --> 00:44:42.092
but management and or let's say
00:44:42.132 --> 00:44:42.632
leadership.
00:44:43.673 --> 00:44:44.695
What would you do?
00:44:44.715 --> 00:44:47.356
I would want to hear everything.
00:44:48.257 --> 00:44:48.538
Say it.
00:44:48.976 --> 00:44:50.916
Like, no holds barred.
00:44:50.936 --> 00:44:51.536
Like,
00:44:51.677 --> 00:44:53.217
this will not reflect poorly on you on
00:44:53.257 --> 00:44:54.478
your performance evaluation.
00:44:54.498 --> 00:44:55.697
This will not be held against you.
00:44:55.717 --> 00:44:57.338
Like, tell me everything.
00:44:58.018 --> 00:44:58.318
Tell me.
00:44:58.378 --> 00:44:59.179
Like, lay it on me.
00:44:59.599 --> 00:45:01.378
I even want to hear your personal stuff,
00:45:01.398 --> 00:45:01.619
too.
00:45:02.019 --> 00:45:03.380
Because maybe this person is under a lot
00:45:03.400 --> 00:45:04.579
of personal duress as well.
00:45:04.659 --> 00:45:05.981
Like, they have a health problem.
00:45:06.021 --> 00:45:07.800
They aren't making enough money for their
00:45:07.840 --> 00:45:08.101
family.
00:45:08.121 --> 00:45:09.222
They've had to pick up a second job.
00:45:09.262 --> 00:45:10.782
Like, I want to hear all of it.
00:45:10.902 --> 00:45:12.523
I want to hear why they wanted to
00:45:12.563 --> 00:45:13.023
be a PT.
00:45:13.043 --> 00:45:14.202
I want to hear why they're still a
00:45:14.242 --> 00:45:14.623
PT.
00:45:14.722 --> 00:45:17.103
I want to know why they feel the
00:45:17.143 --> 00:45:17.643
way they feel.
00:45:19.047 --> 00:45:20.208
And I just want to receive all that.
00:45:20.309 --> 00:45:21.588
I think that's step one, right?
00:45:21.608 --> 00:45:22.650
Just receiving all of it,
00:45:23.010 --> 00:45:24.389
not telling them, not explaining,
00:45:24.429 --> 00:45:24.931
not defending.
00:45:24.971 --> 00:45:25.251
Well,
00:45:25.291 --> 00:45:26.630
the hospital had to make this decision
00:45:26.650 --> 00:45:27.612
because I was like,
00:45:27.632 --> 00:45:28.632
we're not doing that today.
00:45:29.552 --> 00:45:31.112
We're just receiving all of that.
00:45:31.994 --> 00:45:33.835
What do you love about this job?
00:45:34.215 --> 00:45:35.335
I want to hear all of that too.
00:45:35.494 --> 00:45:37.076
Like, why did you take this job?
00:45:37.396 --> 00:45:38.896
Why are you still at this job?
00:45:39.237 --> 00:45:41.358
What would make this job feel worth it
00:45:41.398 --> 00:45:42.057
to you again?
00:45:42.617 --> 00:45:44.059
And then like that stretch goal too,
00:45:44.099 --> 00:45:46.059
like what would make this job magical to
00:45:46.099 --> 00:45:46.199
you?
00:45:47.608 --> 00:45:49.309
Like what would make this job someplace
00:45:49.349 --> 00:45:51.550
that you wanted to be every day?
00:45:51.989 --> 00:45:54.010
And if you can't see a path to
00:45:54.050 --> 00:45:56.012
that, like if there's like nothing,
00:45:56.152 --> 00:45:57.773
if you're, if your answer is nothing,
00:45:57.813 --> 00:45:59.373
it's never going to be like, I don't.
00:46:00.193 --> 00:46:01.454
Then maybe we just be done.
00:46:02.195 --> 00:46:03.516
Maybe it's time for you to look for
00:46:03.556 --> 00:46:04.016
something else.
00:46:04.036 --> 00:46:04.157
Like,
00:46:04.177 --> 00:46:06.358
because I'm fully receptive to hearing
00:46:06.378 --> 00:46:06.637
from you,
00:46:06.657 --> 00:46:08.579
like what it would take to get you
00:46:08.619 --> 00:46:09.478
back on the horse.
00:46:10.380 --> 00:46:11.280
I want to get you back on the
00:46:11.360 --> 00:46:12.760
unicorn, but.
00:46:14.831 --> 00:46:16.411
If you can't see a path to that,
00:46:16.472 --> 00:46:18.632
I can't even meet you halfway.
00:46:18.713 --> 00:46:20.233
So I'm probably going to decrease my
00:46:20.293 --> 00:46:22.956
investment in you because you've decreased
00:46:22.976 --> 00:46:25.077
your investment in the organization.
00:46:25.297 --> 00:46:27.378
And realistically,
00:46:27.398 --> 00:46:28.858
if you're bringing that energy into rooms,
00:46:28.878 --> 00:46:30.280
you've decreased your investment in your
00:46:30.320 --> 00:46:30.760
patients.
00:46:30.800 --> 00:46:31.661
And maybe at this point,
00:46:31.681 --> 00:46:33.101
you're a little bit of a liability.
00:46:33.222 --> 00:46:34.181
I don't know that for sure.
00:46:34.483 --> 00:46:36.884
I'm not like if I felt like I
00:46:36.903 --> 00:46:38.824
was in the hole that deeply,
00:46:38.945 --> 00:46:40.346
I would be worried about my ability to
00:46:40.405 --> 00:46:42.547
provide care.
00:46:42.746 --> 00:46:42.827
Yeah.
00:46:42.847 --> 00:46:43.608
So I would start there.
00:46:44.766 --> 00:46:46.208
Oprah said people want to be seen, heard,
00:46:46.228 --> 00:46:46.688
and understood.
00:46:46.708 --> 00:46:46.807
Yes.
00:46:46.847 --> 00:46:49.989
That's where I would start.
00:46:50.530 --> 00:46:52.471
And if there's the movie Jersey up in
00:46:52.510 --> 00:46:53.791
the air with George Clooney and Anna
00:46:53.811 --> 00:46:54.070
Kendrick.
00:46:54.090 --> 00:46:54.170
Yeah.
00:46:54.190 --> 00:46:56.431
Where they fire everybody.
00:46:56.452 --> 00:46:56.572
Well,
00:46:56.592 --> 00:46:58.012
their job is to be brought in and
00:46:58.052 --> 00:46:59.713
he had the one who's the guy from
00:46:59.733 --> 00:47:00.454
the drumming movie.
00:47:00.474 --> 00:47:00.514
Um,
00:47:00.534 --> 00:47:04.036
the guy that was in Top Gun too.
00:47:05.074 --> 00:47:05.534
No, J.K.
00:47:05.576 --> 00:47:07.378
Simmons, the drumming instructor.
00:47:07.818 --> 00:47:08.478
Yeah.
00:47:08.518 --> 00:47:09.159
Not Miles Teller.
00:47:09.900 --> 00:47:10.240
So anyway,
00:47:10.302 --> 00:47:12.483
George Clooney is firing Miles Teller in
00:47:12.523 --> 00:47:12.925
this scene.
00:47:12.945 --> 00:47:13.525
It's a great scene.
00:47:14.507 --> 00:47:15.728
And of course, like J.K.,
00:47:17.452 --> 00:47:19.253
is pissed his character jk simmons
00:47:19.594 --> 00:47:21.815
characters piss and he's like who are you
00:47:21.876 --> 00:47:24.398
you know f you and clooney and of
00:47:24.438 --> 00:47:25.719
course it's a movie guys i get it
00:47:26.119 --> 00:47:27.981
but he turns it into a story he
00:47:28.081 --> 00:47:29.923
read that guy's whole file before he
00:47:29.963 --> 00:47:31.505
brought him in to fire him whole file
00:47:31.766 --> 00:47:33.367
and jk simmons is in his fifties or
00:47:33.407 --> 00:47:36.650
sixties or whatever in this scene and he's
00:47:36.690 --> 00:47:38.371
essentially he's framing this as like a
00:47:38.472 --> 00:47:40.554
rebirth and he's like
00:47:44.588 --> 00:47:47.090
The whole pitch is he saw in the
00:47:47.110 --> 00:47:49.831
guy's file that he studied French culinary
00:47:50.373 --> 00:47:51.373
arts in college.
00:47:51.853 --> 00:47:54.596
Like, that's not a gimme major.
00:47:54.976 --> 00:47:55.737
Like, that's hard.
00:47:55.936 --> 00:47:56.297
And, like,
00:47:57.338 --> 00:47:58.920
you're not going to make a billion dollars
00:47:59.019 --> 00:47:59.880
doing that, right?
00:48:00.561 --> 00:48:02.001
So he's like, and he's like,
00:48:02.123 --> 00:48:03.764
and you waited tables at El Picador.
00:48:03.844 --> 00:48:05.644
Like, he read the guy's file.
00:48:05.684 --> 00:48:06.846
And now he's in, like, some cubicle.
00:48:08.067 --> 00:48:10.148
And he's like, and his question was,
00:48:10.309 --> 00:48:11.791
how much did they pay you to give
00:48:11.831 --> 00:48:12.590
up on your dream?
00:48:13.112 --> 00:48:13.492
Ooh.
00:48:14.050 --> 00:48:14.650
And he was like,
00:48:15.431 --> 00:48:17.652
thirty eight thousand dollars in health
00:48:17.672 --> 00:48:18.152
insurance.
00:48:18.733 --> 00:48:20.434
And he's like, I'm not he's like,
00:48:20.474 --> 00:48:21.255
this is happening.
00:48:22.215 --> 00:48:22.655
But he's like,
00:48:22.735 --> 00:48:25.117
your next step is your choice to make.
00:48:26.217 --> 00:48:28.438
And you lose your job.
00:48:28.458 --> 00:48:29.778
It's not softening the blow,
00:48:30.239 --> 00:48:32.059
but at least it's at least saying like
00:48:33.001 --> 00:48:34.382
you could go find another one of these
00:48:34.422 --> 00:48:36.001
jobs and this could happen again.
00:48:36.163 --> 00:48:37.523
And also you hate it here.
00:48:37.583 --> 00:48:38.643
Why aren't you in a kitchen?
00:48:39.164 --> 00:48:40.764
You wanted to be in that kitchen.
00:48:41.827 --> 00:48:44.188
And you made the smart move of getting
00:48:44.228 --> 00:48:46.550
a reliable job with four Oh one K
00:48:46.590 --> 00:48:47.329
and health insurance.
00:48:47.409 --> 00:48:47.851
I get it.
00:48:48.291 --> 00:48:49.931
But he made the guy look at himself.
00:48:50.192 --> 00:48:51.492
Cause you could be mad at the company
00:48:51.913 --> 00:48:53.873
or the machine or the world.
00:48:54.454 --> 00:48:56.215
And that isn't going to change it.
00:48:56.295 --> 00:48:57.737
But you reframing how you're going to look
00:48:57.797 --> 00:49:00.177
at it is the only, it sucks.
00:49:00.197 --> 00:49:02.259
You can control what you can control,
00:49:02.280 --> 00:49:03.400
but you can control it.
00:49:03.659 --> 00:49:04.460
So that was a great,
00:49:04.641 --> 00:49:07.443
I thought a great scene from that movie.
00:49:07.543 --> 00:49:08.884
Cause at least Clooney's character was
00:49:08.923 --> 00:49:09.143
like,
00:49:10.148 --> 00:49:10.768
Can you imagine?
00:49:10.949 --> 00:49:11.748
I couldn't do that job.
00:49:11.929 --> 00:49:13.150
The guy where you just fire everybody.
00:49:13.931 --> 00:49:16.092
Although someone's going to do it.
00:49:16.572 --> 00:49:17.353
Someone's going to do it.
00:49:17.373 --> 00:49:17.994
It's happened.
00:49:18.393 --> 00:49:19.355
That was one of the lines.
00:49:19.394 --> 00:49:19.994
This is happening.
00:49:23.177 --> 00:49:25.798
But it showed he actually took the time
00:49:26.780 --> 00:49:28.521
because people want to be seen, heard,
00:49:28.561 --> 00:49:29.322
and understood,
00:49:29.501 --> 00:49:30.722
according to our friend Oprah.
00:49:31.023 --> 00:49:31.864
That's probably why she was pretty
00:49:31.884 --> 00:49:32.423
successful.
00:49:34.364 --> 00:49:35.666
To do that with that guy and the
00:49:35.766 --> 00:49:37.447
idea there is his character is now going
00:49:37.487 --> 00:49:38.068
to leave and
00:49:39.012 --> 00:49:40.994
inhale exhale while he takes his stuff to
00:49:41.034 --> 00:49:42.373
his car in a cardboard box and go
00:49:42.474 --> 00:49:44.275
what do i got twenty more years man
00:49:44.894 --> 00:49:46.876
what do i want to do go do
00:49:46.916 --> 00:49:50.496
that yeah go do that all right parting
00:49:50.516 --> 00:49:53.518
shots what do you got parting shots i
00:49:53.538 --> 00:49:55.418
think my parting shot is is to this
00:49:55.458 --> 00:49:57.480
therapist and in any therapist that feels
00:49:57.500 --> 00:49:58.659
like this we don't want to lose you
00:49:58.679 --> 00:50:00.701
like so
00:50:03.088 --> 00:50:04.469
Figure out what it would take for you
00:50:04.510 --> 00:50:05.710
to get back on the unicorn.
00:50:06.050 --> 00:50:07.472
And if PT is not it,
00:50:07.532 --> 00:50:08.072
I get that.
00:50:08.211 --> 00:50:09.713
If it's the place where you work,
00:50:09.793 --> 00:50:10.273
I get that.
00:50:10.773 --> 00:50:12.574
But advocate within yourself,
00:50:12.675 --> 00:50:14.476
advocate within your facility and advocate
00:50:14.496 --> 00:50:15.436
within your profession.
00:50:15.896 --> 00:50:17.036
And if that feels like too much,
00:50:18.277 --> 00:50:18.818
then let it go.
00:50:19.318 --> 00:50:20.398
But we want you.
00:50:20.619 --> 00:50:22.059
We want you in this profession.
00:50:22.320 --> 00:50:24.762
And so do the best that you can.
00:50:24.822 --> 00:50:26.141
Control what you can control,
00:50:26.202 --> 00:50:27.663
which is what you bring to your job,
00:50:27.682 --> 00:50:28.903
what you bring to your patients every day.
00:50:30.422 --> 00:50:31.563
If I repeat it a couple times,
00:50:31.583 --> 00:50:32.923
it probably has to be a parting shot,
00:50:32.943 --> 00:50:34.184
which is people want to be seen, heard,
00:50:34.204 --> 00:50:34.686
and understood.
00:50:35.746 --> 00:50:36.327
I ain't magic.
00:50:36.766 --> 00:50:38.329
When I was a boss in radio,
00:50:38.809 --> 00:50:40.170
I didn't have a lot of levers I
00:50:40.190 --> 00:50:40.650
could pull.
00:50:41.550 --> 00:50:43.413
But I learned from my dad,
00:50:43.452 --> 00:50:44.393
who was a fireman.
00:50:44.454 --> 00:50:45.655
He was like, when you get promoted,
00:50:45.735 --> 00:50:46.695
you work for them.
00:50:46.755 --> 00:50:48.516
You work for the people you oversee.
00:50:49.197 --> 00:50:51.179
So my job was like, how are you?
00:50:51.739 --> 00:50:52.681
And I can't be like,
00:50:52.721 --> 00:50:54.101
here's a bucket load more money.
00:50:54.302 --> 00:50:55.302
That wasn't an option.
00:50:56.215 --> 00:50:57.916
So how else can we creatively make this
00:50:57.956 --> 00:50:59.918
place something that you want to do again?
00:50:59.938 --> 00:51:01.579
Because supposedly when you came here to
00:51:01.619 --> 00:51:03.362
work, you wanted to do this.
00:51:04.802 --> 00:51:06.043
So people want to be seen, heard,
00:51:06.184 --> 00:51:06.764
and understood.
00:51:07.605 --> 00:51:09.027
Find Rebecca online, website.
00:51:09.827 --> 00:51:10.969
BDDPT.com.
00:51:11.748 --> 00:51:12.769
And we'll talk again soon.
00:51:12.869 --> 00:51:15.152
I think we need an actual official name
00:51:15.211 --> 00:51:16.713
for your recurring segment.
00:51:18.340 --> 00:51:19.501
I don't want to use AI to get
00:51:19.541 --> 00:51:19.621
it.
00:51:19.641 --> 00:51:21.402
I want it to be au natural.
00:51:21.603 --> 00:51:21.802
Maybe,
00:51:21.963 --> 00:51:24.625
but I will take comments or suggestions
00:51:24.644 --> 00:51:25.846
from someone watching or listening,
00:51:25.885 --> 00:51:28.708
but we'll be back next week with Rebecca.
00:51:30.632 --> 00:51:31.693
That's it for this one,
00:51:31.972 --> 00:51:33.653
but we're just getting warmed up.
00:51:34.114 --> 00:51:36.056
Smash follow, send it to a friend,
00:51:36.255 --> 00:51:37.938
or crank up the next episode.
00:51:38.438 --> 00:51:39.318
Want to go deeper?
00:51:39.798 --> 00:51:43.842
Hit us at pgpinecast.com or find us on
00:51:43.882 --> 00:51:46.443
YouTube and socials at pgpinecast.
00:51:46.864 --> 00:51:49.146
And legally, none of this was advice.
00:51:49.226 --> 00:51:50.967
It's for entertainment purposes only.
00:51:52.628 --> 00:51:53.208
See, Keith?
00:51:53.409 --> 00:51:54.489
We read the script.
00:51:54.789 --> 00:51:55.451
Happy now?
00:00:01.129 --> 00:00:03.170
You're listening to the PT Pinecast,
00:00:03.310 --> 00:00:05.291
where smart people in healthcare come to
00:00:05.333 --> 00:00:06.012
make noise.
00:00:06.033 --> 00:00:10.816
Here's your host, Jimmy McKay.
00:00:10.836 --> 00:00:11.436
If I had a time machine,
00:00:11.516 --> 00:00:12.037
I would go back.
00:00:12.096 --> 00:00:13.637
I wouldn't name it PT Pinecast.
00:00:13.718 --> 00:00:14.519
That was a goof.
00:00:14.659 --> 00:00:16.160
This was because we drank beers after
00:00:16.260 --> 00:00:17.800
class and we're like, oh, I get it.
00:00:17.821 --> 00:00:19.181
We want it to be fun and like
00:00:19.202 --> 00:00:19.882
a happy hour.
00:00:20.702 --> 00:00:22.103
I don't even, I mean, I like beer,
00:00:22.143 --> 00:00:22.923
but I don't love it.
00:00:22.963 --> 00:00:23.464
Like people like,
00:00:23.504 --> 00:00:24.864
they want to talk to me about beers
00:00:24.885 --> 00:00:25.865
and I'm like, I don't know, man.
00:00:25.885 --> 00:00:26.766
I like regular beers.
00:00:27.734 --> 00:00:28.934
It's not my identity.
00:00:28.954 --> 00:00:29.714
That's my problem.
00:00:29.995 --> 00:00:32.817
But now that beer follows me everywhere.
00:00:32.917 --> 00:00:34.158
Although it is good at CSM because you
00:00:34.179 --> 00:00:34.918
know what people...
00:00:34.939 --> 00:00:36.100
When they see me walking through the hotel
00:00:36.119 --> 00:00:38.701
bar, everybody wants to buy me a beer.
00:00:38.841 --> 00:00:40.262
So I saved myself a couple of bucks.
00:00:40.622 --> 00:00:43.604
Rebecca Griffith, Drew McKay.
00:00:43.645 --> 00:00:45.627
We were just chatting before we hit go
00:00:45.726 --> 00:00:46.127
live.
00:00:46.347 --> 00:00:49.509
You got a... Someone commented.
00:00:49.530 --> 00:00:50.289
They didn't DM you.
00:00:50.310 --> 00:00:52.011
They commented on something.
00:00:52.051 --> 00:00:53.012
So set the story up.
00:00:53.192 --> 00:00:54.253
And I was going to put the thing
00:00:54.292 --> 00:00:55.314
on the screen, but I don't want to...
00:00:56.475 --> 00:00:57.817
I don't want to blast the person.
00:00:57.837 --> 00:00:57.917
Yeah,
00:00:57.936 --> 00:00:58.758
I don't want to put this person on
00:00:58.798 --> 00:00:59.098
blast,
00:00:59.118 --> 00:01:00.640
but let's talk about the reason this
00:01:00.679 --> 00:01:01.020
person...
00:01:02.033 --> 00:01:03.594
Yeah,
00:01:03.615 --> 00:01:05.057
so kind of the context is I posted
00:01:05.076 --> 00:01:06.558
a video about the difference between an
00:01:06.617 --> 00:01:08.260
emergency department physical therapist
00:01:08.420 --> 00:01:09.960
and an acute care physical therapist.
00:01:09.980 --> 00:01:11.121
Got it.
00:01:11.341 --> 00:01:12.584
It's a question that I get asked, like,
00:01:12.623 --> 00:01:14.484
how is that different than regular acute
00:01:14.504 --> 00:01:14.846
care?
00:01:14.906 --> 00:01:16.647
How is it different than an outpatient PT?
00:01:17.147 --> 00:01:18.328
And so it was really just sort of
00:01:18.349 --> 00:01:19.168
clarifying that.
00:01:19.709 --> 00:01:21.831
And then the person just sort of said,
00:01:22.091 --> 00:01:22.331
like,
00:01:22.471 --> 00:01:23.993
sounds like a physical therapist who works
00:01:24.013 --> 00:01:25.094
in the emergency department.
00:01:25.135 --> 00:01:26.936
There's no such thing as an ED physical
00:01:26.956 --> 00:01:27.337
therapist.
00:01:27.757 --> 00:01:28.356
Which, you know,
00:01:28.376 --> 00:01:29.537
if you want to split hairs, fine.
00:01:29.938 --> 00:01:31.518
I personally feel like a physical
00:01:31.537 --> 00:01:33.558
therapist, no matter where you are,
00:01:33.599 --> 00:01:34.539
you're a physical therapist.
00:01:34.578 --> 00:01:35.239
I'm fine with that.
00:01:35.319 --> 00:01:35.838
That's okay.
00:01:36.879 --> 00:01:39.099
But then the person went on to say
00:01:39.579 --> 00:01:40.359
in the hospital,
00:01:40.400 --> 00:01:41.840
we're all just physical therapists.
00:01:41.881 --> 00:01:45.081
There are no specialized PTs in the acute
00:01:45.201 --> 00:01:46.561
or emergency department world,
00:01:46.682 --> 00:01:48.203
whether we're ED or acute,
00:01:48.283 --> 00:01:49.862
we're all just discharge monkeys.
00:01:53.274 --> 00:01:54.433
And that made me really sad.
00:01:54.554 --> 00:01:57.174
In the Oxford debate at CSM this year,
00:01:57.215 --> 00:01:59.575
too, for the acute care academy,
00:01:59.875 --> 00:02:02.536
the question was, float or focus?
00:02:02.555 --> 00:02:04.615
Should we be generalists or should we be
00:02:04.656 --> 00:02:06.337
really specialized in the acute care
00:02:06.376 --> 00:02:06.677
world?
00:02:07.117 --> 00:02:08.497
But I think what bothers me here is
00:02:08.516 --> 00:02:10.356
that I feel like this person has lost
00:02:10.457 --> 00:02:10.837
their agency.
00:02:10.858 --> 00:02:15.198
Yeah, like their way.
00:02:15.338 --> 00:02:15.739
Yeah.
00:02:19.794 --> 00:02:21.235
And I feel like a lot of physical
00:02:21.276 --> 00:02:22.858
therapists are feeling like that,
00:02:23.157 --> 00:02:25.039
regardless of the setting that they're in,
00:02:25.599 --> 00:02:27.282
whether they're in the rehab setting,
00:02:27.301 --> 00:02:28.203
the acute care setting,
00:02:28.223 --> 00:02:29.163
the home health setting.
00:02:29.443 --> 00:02:31.906
I feel like we're all sort of feeling
00:02:31.945 --> 00:02:33.907
like we're practicing the way that we're
00:02:33.967 --> 00:02:34.407
told,
00:02:34.908 --> 00:02:36.710
not the way that we could or should
00:02:36.729 --> 00:02:40.774
be practicing.
00:02:40.813 --> 00:02:42.354
So number one, I'm on purpose,
00:02:42.395 --> 00:02:43.256
like just being quiet,
00:02:43.276 --> 00:02:44.396
which is painful for me,
00:02:44.437 --> 00:02:45.217
but I'm going to jump in now.
00:02:45.873 --> 00:02:48.175
So like this person is having a bad
00:02:48.235 --> 00:02:49.617
experience where they are.
00:02:50.217 --> 00:02:51.800
So like, I think this person,
00:02:51.819 --> 00:02:52.741
that's why I don't want to put them
00:02:52.800 --> 00:02:54.602
on blast as the kids say,
00:02:54.622 --> 00:02:55.383
I don't even know what the kids say
00:02:55.402 --> 00:02:55.763
that anymore.
00:02:58.105 --> 00:02:58.947
This sucks.
00:02:59.167 --> 00:03:00.747
Like this part, like, okay,
00:03:00.848 --> 00:03:01.729
so let's unpack.
00:03:01.788 --> 00:03:02.990
The person actually said there are no
00:03:03.129 --> 00:03:04.211
EDPTs.
00:03:04.231 --> 00:03:05.012
There's no difference.
00:03:05.312 --> 00:03:08.656
Listen, Rebecca is not, you are special.
00:03:10.010 --> 00:03:11.572
but you're not special because you work in
00:03:11.592 --> 00:03:11.991
the ED,
00:03:12.032 --> 00:03:13.592
but there are some skills you pick up
00:03:13.632 --> 00:03:15.173
there versus working in peds or
00:03:15.193 --> 00:03:15.812
geriatrics.
00:03:16.032 --> 00:03:16.853
We are all PTs.
00:03:16.872 --> 00:03:17.073
Yes.
00:03:17.834 --> 00:03:19.413
You're just playing a different position,
00:03:20.435 --> 00:03:20.615
right?
00:03:20.655 --> 00:03:22.014
Like I'll use a sports analogy.
00:03:22.034 --> 00:03:22.974
We're both baseball players,
00:03:23.014 --> 00:03:24.295
but if you put Jimmy at third base,
00:03:24.376 --> 00:03:25.116
that doesn't make any sense.
00:03:25.135 --> 00:03:26.497
Right.
00:03:26.657 --> 00:03:27.637
I could learn it maybe,
00:03:27.676 --> 00:03:28.576
but I'm also left-handed.
00:03:28.637 --> 00:03:29.337
That doesn't make any sense.
00:03:29.397 --> 00:03:30.258
But anyway, I digress.
00:03:31.837 --> 00:03:32.758
This person's in a bad,
00:03:33.118 --> 00:03:36.199
this person's in a bad system, right?
00:03:36.485 --> 00:03:37.605
And maybe they're too far gone.
00:03:37.626 --> 00:03:39.287
Maybe they're just like, if we're like,
00:03:39.426 --> 00:03:40.967
all I am is a discharge monkey,
00:03:41.328 --> 00:03:42.649
I'm really sorry you feel that way.
00:03:43.049 --> 00:03:43.209
Well,
00:03:43.229 --> 00:03:44.750
and that was exactly how I responded.
00:03:44.870 --> 00:03:45.890
I literally said,
00:03:45.991 --> 00:03:47.752
I'm really sorry that's been your
00:03:47.771 --> 00:03:48.353
experience.
00:03:48.812 --> 00:03:49.092
Yeah.
00:03:49.713 --> 00:03:50.633
You're in a bad system.
00:03:50.774 --> 00:03:52.455
That sucks because I also don't think this
00:03:52.474 --> 00:03:53.116
is isolated.
00:03:53.175 --> 00:03:54.195
I think a lot of people will start
00:03:54.216 --> 00:03:54.817
to feel like this.
00:03:55.986 --> 00:03:56.127
No,
00:03:56.206 --> 00:03:57.448
and I know there are more trends in
00:03:57.467 --> 00:03:59.348
the acute care setting where physical
00:03:59.388 --> 00:04:02.149
therapists are told that you can't make a
00:04:02.188 --> 00:04:03.830
specific discharge recommendation.
00:04:03.870 --> 00:04:05.969
You can't say acute rehab or sub-acute
00:04:05.990 --> 00:04:06.330
rehab.
00:04:07.211 --> 00:04:09.512
You have to say post-acute rehab or,
00:04:09.831 --> 00:04:11.532
and that's not isolated to any one
00:04:11.572 --> 00:04:12.293
hospital system.
00:04:12.372 --> 00:04:13.812
I've been hearing that from people across
00:04:13.832 --> 00:04:14.312
the country.
00:04:14.793 --> 00:04:15.653
And the reason for that,
00:04:15.713 --> 00:04:17.394
like if we really stop and think,
00:04:17.494 --> 00:04:19.095
is it to strip physical therapists of
00:04:19.154 --> 00:04:20.696
their autonomy and their discharge
00:04:20.716 --> 00:04:21.716
planning and their expertise?
00:04:22.536 --> 00:04:22.937
No,
00:04:23.358 --> 00:04:25.319
it's because we work in payer-centered
00:04:25.358 --> 00:04:26.300
healthcare, right?
00:04:26.699 --> 00:04:28.841
It's not patient-centered,
00:04:28.920 --> 00:04:30.062
it's payer-centered care.
00:04:30.461 --> 00:04:32.103
And so when the case managers go and
00:04:32.144 --> 00:04:33.884
they have to actually find a discharge
00:04:33.925 --> 00:04:35.086
plan for this patient,
00:04:35.446 --> 00:04:36.987
and we've narrowed it down to this one
00:04:37.206 --> 00:04:37.646
thing,
00:04:38.048 --> 00:04:39.749
that patient may not have access to that,
00:04:39.788 --> 00:04:40.088
right?
00:04:40.149 --> 00:04:41.870
So by changing it to a more general
00:04:41.910 --> 00:04:42.711
recommendation,
00:04:43.031 --> 00:04:44.512
our case managers may actually be able to
00:04:44.531 --> 00:04:46.473
get the patient some level of care.
00:04:46.894 --> 00:04:48.475
So I think it's
00:04:50.423 --> 00:04:52.084
Instead of fighting that system,
00:04:52.526 --> 00:04:54.406
we're accommodating to that system.
00:04:54.726 --> 00:04:56.528
And I think that's the frustrating part.
00:04:56.569 --> 00:04:58.250
And I think therapists who are also
00:04:58.290 --> 00:04:59.591
accommodating to that, right?
00:04:59.651 --> 00:05:00.791
And that's top of facility.
00:05:00.812 --> 00:05:02.312
Like you're just doing what you're told at
00:05:02.333 --> 00:05:03.334
the place where you work.
00:05:03.853 --> 00:05:06.276
It does not lessen your expertise.
00:05:06.596 --> 00:05:08.117
But when you think about who is really
00:05:08.158 --> 00:05:10.358
taking away your autonomy and authority,
00:05:11.500 --> 00:05:13.262
it's really the healthcare system around
00:05:13.362 --> 00:05:13.541
us.
00:05:13.562 --> 00:05:14.762
It's payer-centered care.
00:05:14.843 --> 00:05:19.586
It's not that hospitals don't value your
00:05:19.646 --> 00:05:20.166
expertise.
00:05:22.882 --> 00:05:26.826
This is also a situation where if you
00:05:26.865 --> 00:05:29.887
go back at this person like a keyboard
00:05:30.108 --> 00:05:31.970
cowboy and you're like, you're wrong.
00:05:32.089 --> 00:05:33.031
All you're going to do is bark at
00:05:33.050 --> 00:05:34.591
each other like two dogs through a fence.
00:05:35.892 --> 00:05:38.033
This person is talking from emotion.
00:05:38.254 --> 00:05:39.654
So if we come back with logic,
00:05:39.694 --> 00:05:40.156
we miss.
00:05:41.297 --> 00:05:42.697
If we're like, but you're wrong.
00:05:43.057 --> 00:05:44.519
The person, I'm going to defend them.
00:05:44.658 --> 00:05:46.420
They're not wrong because they're talking
00:05:46.439 --> 00:05:47.221
about how they feel.
00:05:47.983 --> 00:05:49.586
Yeah, and it's been their experience.
00:05:49.706 --> 00:05:50.608
And it's their experience.
00:05:50.908 --> 00:05:53.192
And I've consulted with enough hospitals
00:05:54.386 --> 00:05:57.088
to know that that's not a unique
00:05:57.269 --> 00:05:59.850
experience right and there is also this
00:05:59.870 --> 00:06:02.233
conversation too like in in acute care
00:06:02.273 --> 00:06:04.516
settings are you an interventionalist are
00:06:04.555 --> 00:06:06.096
you a consultant are you a discharge
00:06:06.137 --> 00:06:08.959
consultant or are you an interventionalist
00:06:09.319 --> 00:06:11.341
and i think there's space for both right
00:06:11.382 --> 00:06:13.764
and i think hospitals might also benefit
00:06:13.843 --> 00:06:15.565
from dividing their teams and these are
00:06:15.586 --> 00:06:16.567
the people that make discharge
00:06:16.586 --> 00:06:17.788
recommendations and these are the people
00:06:17.807 --> 00:06:19.129
that intervene on the patients that can't
00:06:19.149 --> 00:06:19.649
discharge
00:06:20.362 --> 00:06:21.882
And maybe you are a little more effective
00:06:21.923 --> 00:06:22.322
that way.
00:06:22.423 --> 00:06:23.843
And people get to do what they want
00:06:23.884 --> 00:06:24.543
a little bit more,
00:06:24.564 --> 00:06:27.045
but I don't think anybody went to PT
00:06:27.065 --> 00:06:30.007
school to become a discharge monkey and
00:06:30.067 --> 00:06:31.228
tell people like, I,
00:06:31.567 --> 00:06:33.009
I am going to say this patient can
00:06:33.048 --> 00:06:33.709
discharge or not.
00:06:33.769 --> 00:06:34.470
Like, that's not,
00:06:35.089 --> 00:06:36.550
I would say that's not the dream.
00:06:36.630 --> 00:06:36.831
Right.
00:06:38.028 --> 00:06:38.528
Of course not.
00:06:38.629 --> 00:06:39.749
I mean, maybe for some people.
00:06:39.809 --> 00:06:40.569
I mean, I don't know.
00:06:40.589 --> 00:06:40.990
Some people.
00:06:41.230 --> 00:06:42.769
But I would say a majority.
00:06:42.910 --> 00:06:43.910
Like in the middle of the bell curve,
00:06:43.930 --> 00:06:44.550
the answer is no.
00:06:44.891 --> 00:06:46.310
What would you say to this person if
00:06:46.331 --> 00:06:48.550
they were like in front of you?
00:06:49.112 --> 00:06:51.312
I think your first move would be you'd
00:06:51.351 --> 00:06:53.533
wait to let them get all the air
00:06:53.612 --> 00:06:55.353
out and get all their...
00:06:56.112 --> 00:06:57.612
That's the smart move, right?
00:06:57.894 --> 00:06:59.473
But after the person did that,
00:07:00.213 --> 00:07:03.274
what would a conversation like this person
00:07:03.334 --> 00:07:04.074
and you look like?
00:07:04.990 --> 00:07:06.511
I think the first question that I would
00:07:06.630 --> 00:07:07.310
ask, obviously,
00:07:07.350 --> 00:07:08.812
is just like receiving a patient history.
00:07:08.831 --> 00:07:09.831
I would say, tell me, like,
00:07:09.872 --> 00:07:10.672
tell me all about it.
00:07:10.692 --> 00:07:11.932
Tell me about your experience so I can
00:07:11.971 --> 00:07:13.473
understand what your experience is,
00:07:13.512 --> 00:07:14.752
both in the acute care setting and the
00:07:14.773 --> 00:07:15.793
emergency department setting.
00:07:16.153 --> 00:07:17.392
And then once, as you said,
00:07:17.413 --> 00:07:18.733
they like let all the air out and
00:07:18.754 --> 00:07:20.574
they feel like they've really been heard
00:07:20.754 --> 00:07:21.814
because they think that's the thing.
00:07:22.074 --> 00:07:23.634
This person clearly doesn't feel heard,
00:07:23.654 --> 00:07:25.975
valued, or respected for their expertise.
00:07:26.274 --> 00:07:26.855
I would ask them,
00:07:26.894 --> 00:07:29.276
what do you want it to look like?
00:07:29.536 --> 00:07:30.315
What changed?
00:07:30.875 --> 00:07:32.136
What would you like, like,
00:07:32.175 --> 00:07:33.976
what would success look like for you in
00:07:34.016 --> 00:07:34.737
your current role?
00:07:36.875 --> 00:07:38.396
And what does it look like?
00:07:38.557 --> 00:07:40.017
Because right now they would describe it
00:07:40.057 --> 00:07:41.759
as discharge monkey, which is valid.
00:07:42.718 --> 00:07:43.939
It sounds like I'm being like real
00:07:44.019 --> 00:07:45.060
woo-woo, but I'm not.
00:07:45.081 --> 00:07:45.761
I'm just like, okay,
00:07:46.000 --> 00:07:47.442
to get this person to see something
00:07:47.482 --> 00:07:49.163
differently, potentially,
00:07:49.642 --> 00:07:51.444
I have to try to understand what they
00:07:51.504 --> 00:07:52.223
think they're seeing.
00:07:52.245 --> 00:07:53.384
Because whatever they think they're
00:07:53.425 --> 00:07:54.425
seeing, they are seeing.
00:07:55.386 --> 00:07:57.786
Most likely, you and I both know this,
00:07:58.747 --> 00:07:59.709
it's the system they're in.
00:07:59.988 --> 00:08:01.449
We can be mad at a system,
00:08:01.488 --> 00:08:03.009
but then recognize the system's just made
00:08:03.029 --> 00:08:04.630
up of a bunch of people who are
00:08:04.670 --> 00:08:05.831
all in constraints.
00:08:07.136 --> 00:08:08.358
And they might not have a lot of
00:08:08.399 --> 00:08:08.718
like, well,
00:08:08.738 --> 00:08:09.560
I want to blow up the system and
00:08:09.600 --> 00:08:09.961
change it.
00:08:09.982 --> 00:08:11.223
It's like the system is people.
00:08:11.244 --> 00:08:12.807
We're going to all come back together.
00:08:12.867 --> 00:08:13.387
I understand.
00:08:13.728 --> 00:08:15.793
But the system is also massive and
00:08:15.973 --> 00:08:16.694
interconnected.
00:08:16.875 --> 00:08:17.836
I'm not saying it can't be done.
00:08:18.177 --> 00:08:18.858
I know it should be done.
00:08:20.406 --> 00:08:22.329
But that stops so many conversations.
00:08:22.348 --> 00:08:23.970
This is not a great social media strategy
00:08:24.310 --> 00:08:25.550
is when someone comments on one of my
00:08:25.571 --> 00:08:25.891
videos.
00:08:26.190 --> 00:08:26.331
Well,
00:08:26.351 --> 00:08:29.074
then they need to lower tuition costs.
00:08:29.194 --> 00:08:29.514
And I was like,
00:08:29.673 --> 00:08:31.615
who are they and how will they accomplish
00:08:31.636 --> 00:08:33.297
this by yelling at schools?
00:08:33.336 --> 00:08:33.756
What do they do?
00:08:33.777 --> 00:08:36.139
Stand outside the school like from the
00:08:36.158 --> 00:08:36.379
movie,
00:08:36.418 --> 00:08:37.980
say anything with a boombox and just stand
00:08:38.000 --> 00:08:38.760
there until it changes.
00:08:38.841 --> 00:08:39.721
No, it's not going to work.
00:08:40.121 --> 00:08:40.663
What would you do?
00:08:41.243 --> 00:08:43.365
This is when other organizations go,
00:08:43.706 --> 00:08:44.947
APTA doesn't do it right.
00:08:45.027 --> 00:08:46.048
I go, how would you do it?
00:08:46.288 --> 00:08:47.249
I would just accomplish it.
00:08:47.590 --> 00:08:47.850
Great.
00:08:47.909 --> 00:08:48.571
How would you do that?
00:08:48.971 --> 00:08:49.532
No answer.
00:08:49.951 --> 00:08:50.471
No answer.
00:08:50.793 --> 00:08:52.293
I would just make them with what?
00:08:52.394 --> 00:08:52.715
A gun?
00:08:52.894 --> 00:08:53.294
What would you do?
00:08:54.120 --> 00:08:56.001
What would you do realistically?
00:08:56.042 --> 00:08:58.063
And the answer is they don't know.
00:08:58.803 --> 00:09:00.404
I love when people do lobbying.
00:09:00.664 --> 00:09:01.666
Like I would love to have just,
00:09:01.725 --> 00:09:02.907
I've talked to Justin Alley before.
00:09:03.326 --> 00:09:04.227
I would love,
00:09:04.967 --> 00:09:06.149
he would never be able to answer my
00:09:06.188 --> 00:09:06.668
questions.
00:09:07.090 --> 00:09:07.549
He shouldn't.
00:09:07.990 --> 00:09:09.010
As a media professional, I'll be like,
00:09:09.030 --> 00:09:10.331
Justin, do not answer my questions.
00:09:10.371 --> 00:09:11.832
Because I would love to hear what people
00:09:11.913 --> 00:09:12.413
yell at him.
00:09:12.472 --> 00:09:14.153
Like, why don't you just do this?
00:09:14.234 --> 00:09:15.735
And he's like, he's probably thinking,
00:09:15.875 --> 00:09:17.056
I freaking do do that.
00:09:17.316 --> 00:09:19.097
Me and a team of people who this
00:09:19.538 --> 00:09:21.818
is our freaking job and we've been doing
00:09:21.839 --> 00:09:22.820
it for decades.
00:09:23.100 --> 00:09:24.020
We do that.
00:09:24.441 --> 00:09:25.501
or they're like why don't you do this
00:09:25.522 --> 00:09:26.902
you're like that doesn't that's not the
00:09:26.922 --> 00:09:29.143
way it works like that's like me yelling
00:09:29.163 --> 00:09:31.063
at my auto mechanic to blah blah blah
00:09:31.104 --> 00:09:32.225
it's like that ain't the way it works
00:09:32.784 --> 00:09:34.625
numb nuts and it's funny that you
00:09:34.645 --> 00:09:36.346
mentioned that i was interviewed for
00:09:36.386 --> 00:09:37.947
research studies today about prescriptive
00:09:37.966 --> 00:09:39.727
authority for physical therapists for
00:09:39.868 --> 00:09:43.210
imaging labs or imaging image labs and
00:09:43.250 --> 00:09:45.071
durable medical equipment and one of the
00:09:45.110 --> 00:09:46.971
questions they asked me were like how did
00:09:47.011 --> 00:09:49.153
you get that authority and what were the
00:09:49.173 --> 00:09:50.592
barriers that you had and how did you
00:09:50.613 --> 00:09:51.594
overcome those barriers
00:09:52.073 --> 00:09:52.914
And I was like, well,
00:09:52.995 --> 00:09:53.695
let me tell you.
00:09:53.894 --> 00:09:55.216
I was a member of the APTA.
00:09:55.355 --> 00:09:57.697
I became the APTA president.
00:09:57.878 --> 00:09:59.678
Advocacy, working with our lobbyists,
00:09:59.698 --> 00:10:03.061
testifying with many, many, many,
00:10:03.100 --> 00:10:03.780
many steps.
00:10:04.182 --> 00:10:05.121
I didn't stand there and say,
00:10:05.282 --> 00:10:06.903
physical therapists should have this,
00:10:06.962 --> 00:10:09.284
and that's that, or be mad about it.
00:10:09.625 --> 00:10:11.865
So it was interesting to actually have to
00:10:11.926 --> 00:10:12.506
explain that.
00:10:12.947 --> 00:10:14.587
But I think for somebody like this,
00:10:15.969 --> 00:10:17.690
the place that I would start with that
00:10:18.429 --> 00:10:18.549
is,
00:10:18.811 --> 00:10:20.892
are you behaving like a discharge monkey?
00:10:22.023 --> 00:10:23.822
Okay, great.
00:10:23.883 --> 00:10:24.703
So step one is,
00:10:25.624 --> 00:10:26.964
what does a discharge monkey mean?
00:10:27.024 --> 00:10:28.004
Help me understand.
00:10:28.283 --> 00:10:28.604
Yes,
00:10:28.764 --> 00:10:31.625
and you can control what you can control,
00:10:31.705 --> 00:10:31.945
right?
00:10:31.965 --> 00:10:32.465
Correct.
00:10:33.225 --> 00:10:34.525
And I talk about top of license,
00:10:34.546 --> 00:10:35.946
top of facility, and top of scope,
00:10:35.985 --> 00:10:37.586
and that we have limitations at every
00:10:37.625 --> 00:10:38.605
single one of those layers.
00:10:38.966 --> 00:10:40.047
But for this patient,
00:10:40.326 --> 00:10:42.307
let's say they're not able or willing to
00:10:42.366 --> 00:10:44.748
do anything at the licensure level or even
00:10:44.788 --> 00:10:45.847
at the facility level.
00:10:46.128 --> 00:10:48.587
They still have their own scope, right?
00:10:48.889 --> 00:10:50.548
When you walk into a room,
00:10:51.383 --> 00:10:52.562
in the acute care setting,
00:10:52.984 --> 00:10:54.663
are you walking in there bringing
00:10:54.724 --> 00:10:56.164
discharge monkey energy,
00:10:56.644 --> 00:10:59.306
or are you bringing comprehensive doctor
00:10:59.326 --> 00:11:00.326
of physical therapy,
00:11:00.546 --> 00:11:02.807
patient management energy into that room?
00:11:03.547 --> 00:11:04.366
It may be, you know,
00:11:04.466 --> 00:11:05.207
they may be telling you,
00:11:05.227 --> 00:11:06.368
you have to see this many patients a
00:11:06.388 --> 00:11:06.707
day.
00:11:07.008 --> 00:11:08.609
We really need discharge recommendations.
00:11:08.629 --> 00:11:10.408
That's our focus here and that's okay.
00:11:10.789 --> 00:11:12.850
But how are you interacting and engaging
00:11:12.870 --> 00:11:13.711
with that patient?
00:11:14.010 --> 00:11:16.091
You can still be the discharge monkey and
00:11:16.211 --> 00:11:17.932
add value to that patient encounter.
00:11:18.513 --> 00:11:19.153
Yeah, I mean,
00:11:20.975 --> 00:11:22.296
I've got experience outside PT.
00:11:22.316 --> 00:11:23.576
It's where most of my career was.
00:11:24.778 --> 00:11:26.440
I could have done the exact same things
00:11:26.460 --> 00:11:27.500
that I did to,
00:11:27.581 --> 00:11:28.381
and I'm using air quotes here,
00:11:28.461 --> 00:11:30.602
be innovative and be energetic and bring
00:11:30.623 --> 00:11:31.264
good energy.
00:11:31.563 --> 00:11:33.025
And I could have had a crappy boss
00:11:33.505 --> 00:11:35.768
and I would have never gotten promoted.
00:11:35.967 --> 00:11:36.908
I would have been dumped on,
00:11:36.989 --> 00:11:38.049
not allowed to do things.
00:11:38.971 --> 00:11:40.392
And I would have been the same person
00:11:40.451 --> 00:11:42.072
in a different system and got crappy
00:11:42.113 --> 00:11:42.514
results.
00:11:42.614 --> 00:11:43.934
And then I would have been jaded and
00:11:43.975 --> 00:11:44.855
said, the system sucks.
00:11:45.395 --> 00:11:46.216
I think I lucked out.
00:11:48.529 --> 00:11:50.892
this person might be or might have been
00:11:51.032 --> 00:11:53.214
a very optimistic, energetic,
00:11:53.433 --> 00:11:54.835
let's go change the world in a good
00:11:54.875 --> 00:11:56.135
way, however I can.
00:11:56.437 --> 00:11:57.977
And if you're in a system where someone
00:11:58.038 --> 00:12:00.000
just, I mean, let's be honest,
00:12:00.019 --> 00:12:01.441
like if you got a crappy boss or
00:12:01.461 --> 00:12:02.442
you're in a crappy system with no
00:12:02.461 --> 00:12:04.604
rigidity, I've worked in hospital systems,
00:12:04.844 --> 00:12:05.804
in communications.
00:12:06.404 --> 00:12:08.025
And I came in there ready to change
00:12:08.046 --> 00:12:08.385
the world.
00:12:08.427 --> 00:12:08.667
I was like,
00:12:08.687 --> 00:12:10.248
look at all these great things that happen
00:12:10.268 --> 00:12:10.888
at a hospital.
00:12:11.249 --> 00:12:12.389
This is going to be the easiest and
00:12:12.589 --> 00:12:13.590
greatest job in the world.
00:12:13.610 --> 00:12:14.850
All I have to do is tell stories
00:12:14.890 --> 00:12:16.412
of great people doing great things every
00:12:16.432 --> 00:12:16.672
day.
00:12:17.253 --> 00:12:19.293
And then I got slapped with so many
00:12:19.354 --> 00:12:21.556
rules and constraints that someone like
00:12:21.596 --> 00:12:23.596
me, I was like, I can't do this.
00:12:24.158 --> 00:12:25.879
It takes me forty nine steps to tell
00:12:26.058 --> 00:12:27.220
one story on Facebook.
00:12:27.440 --> 00:12:27.779
I'm out.
00:12:28.301 --> 00:12:29.260
I got that way.
00:12:29.522 --> 00:12:30.842
But I recognize it was the system.
00:12:30.863 --> 00:12:32.082
I'm like, I just can't operate here.
00:12:32.102 --> 00:12:32.783
I got to go somewhere else.
00:12:33.120 --> 00:12:34.100
Well, and that's the thing.
00:12:34.120 --> 00:12:35.542
So people will come to me and they'll
00:12:35.581 --> 00:12:35.923
say, well,
00:12:36.062 --> 00:12:37.423
I really want to practice the top of
00:12:37.443 --> 00:12:38.684
my scope, but they will let me.
00:12:39.065 --> 00:12:40.647
So we have that conversation, right?
00:12:40.706 --> 00:12:41.386
Who is they?
00:12:41.427 --> 00:12:42.368
Why won't they let you?
00:12:42.729 --> 00:12:44.149
And what can you do about it?
00:12:44.309 --> 00:12:46.371
And you can advocate for change within
00:12:46.392 --> 00:12:47.011
your facility.
00:12:47.052 --> 00:12:48.653
You can advocate for change within your
00:12:48.673 --> 00:12:49.153
license,
00:12:49.674 --> 00:12:51.296
but you can also advocate for change
00:12:51.316 --> 00:12:51.937
within yourself.
00:12:52.336 --> 00:12:54.198
And if you're not able to bring that
00:12:54.759 --> 00:12:55.980
expertise, that authority,
00:12:56.020 --> 00:12:57.822
that energy that you want to the place
00:12:57.841 --> 00:12:58.663
that you work,
00:12:59.696 --> 00:13:02.317
You're making the choice to do that every
00:13:02.336 --> 00:13:02.557
day.
00:13:02.657 --> 00:13:03.736
Like bottom line.
00:13:04.716 --> 00:13:06.697
I mean, that's what you can control.
00:13:06.836 --> 00:13:09.378
And, and I, I know that we,
00:13:09.677 --> 00:13:10.998
it's more nuanced than that.
00:13:11.177 --> 00:13:12.859
I know we have golden handcuffs.
00:13:13.019 --> 00:13:14.078
I know we have to pay off our
00:13:14.119 --> 00:13:14.359
debt.
00:13:14.418 --> 00:13:15.499
We have children to support.
00:13:15.519 --> 00:13:16.879
Like I have three kids.
00:13:17.000 --> 00:13:19.840
I understand that.
00:13:20.159 --> 00:13:22.400
But I also know that I've chosen different
00:13:22.441 --> 00:13:24.020
paths so that I can
00:13:25.386 --> 00:13:27.168
feel comfortable about what I'm doing so I
00:13:27.187 --> 00:13:29.928
can advocate for the change and still meet
00:13:29.969 --> 00:13:30.428
those goals.
00:13:30.528 --> 00:13:31.969
And I know not everyone has the freedom
00:13:32.009 --> 00:13:32.509
to do that.
00:13:32.749 --> 00:13:33.870
Yes.
00:13:33.889 --> 00:13:36.650
So if you don't, I totally respect that.
00:13:36.770 --> 00:13:38.410
But who are you showing up as?
00:13:38.530 --> 00:13:40.412
Don't let them take that from you.
00:13:40.772 --> 00:13:43.092
That should be the one thing you try
00:13:43.113 --> 00:13:43.793
to hold on to.
00:13:43.952 --> 00:13:45.274
I mean, I had bad bosses.
00:13:45.553 --> 00:13:47.094
I had bosses who stole my ideas.
00:13:47.615 --> 00:13:49.115
I had bosses who just wouldn't let me
00:13:49.154 --> 00:13:49.634
do anything.
00:13:50.495 --> 00:13:51.395
And I was just like, okay.
00:13:51.916 --> 00:13:53.876
I looked, I stole a line from Mr.
00:13:53.937 --> 00:13:54.736
Rogers was like,
00:13:55.745 --> 00:13:56.666
that whole line where he says,
00:13:56.926 --> 00:13:57.765
look for the helpers.
00:13:58.947 --> 00:14:00.587
He was teaching kids how not to be
00:14:00.607 --> 00:14:03.529
traumatized in a crazy event.
00:14:03.890 --> 00:14:05.150
He was like, just focus on the positive.
00:14:05.491 --> 00:14:07.293
So I would look and they're there.
00:14:07.332 --> 00:14:08.714
They're the ones that make eye contact
00:14:08.874 --> 00:14:10.034
with you in a meeting when you brought
00:14:10.054 --> 00:14:11.215
a good idea or a good idea is
00:14:11.254 --> 00:14:12.897
said and watch them,
00:14:13.096 --> 00:14:14.717
even if they don't nod because maybe they
00:14:14.758 --> 00:14:15.138
can't.
00:14:15.477 --> 00:14:16.678
Their eyebrows go up and they start
00:14:16.698 --> 00:14:17.740
looking around the room going,
00:14:19.201 --> 00:14:20.422
who are the...
00:14:20.581 --> 00:14:21.822
Alan Jetty taught me a term.
00:14:22.903 --> 00:14:24.184
Is Alan Jetty still the editor of PTJ?
00:14:25.385 --> 00:14:25.726
He was.
00:14:26.427 --> 00:14:28.408
I haven't.
00:14:28.428 --> 00:14:30.551
Anyway, he taught me this phrase.
00:14:30.610 --> 00:14:31.412
He gave a talk.
00:14:32.352 --> 00:14:34.153
It was called positive deviance.
00:14:34.215 --> 00:14:34.355
Yes.
00:14:36.263 --> 00:14:38.024
So a lot of times people...
00:14:38.364 --> 00:14:39.644
If I were to describe myself as a
00:14:39.724 --> 00:14:41.524
deviant, that sounds negative.
00:14:42.105 --> 00:14:44.264
But deviant just means to deviate.
00:14:44.485 --> 00:14:46.066
I know it's used a lot of times.
00:14:46.105 --> 00:14:47.025
Kids are just deviants.
00:14:47.046 --> 00:14:48.667
They're down there with the skateboards
00:14:49.386 --> 00:14:50.407
and whatever.
00:14:50.447 --> 00:14:51.307
It's looked as negative.
00:14:51.326 --> 00:14:53.008
But when you put that word positive in
00:14:53.048 --> 00:14:53.427
front of it...
00:14:54.441 --> 00:14:55.462
Um, it's like,
00:14:55.503 --> 00:14:57.404
I'm here to shake things up because I
00:14:57.485 --> 00:14:58.846
want the same things you do,
00:14:59.567 --> 00:15:01.210
but I have to hold up a mirror
00:15:01.230 --> 00:15:02.932
a lot of times in projects and meetings
00:15:03.393 --> 00:15:04.394
to people and be like,
00:15:04.875 --> 00:15:07.017
you're telling me to do it the same
00:15:07.057 --> 00:15:08.479
way and expecting a different outcome.
00:15:08.499 --> 00:15:10.522
And we know that's the cliche of cliches.
00:15:10.542 --> 00:15:10.642
Yeah.
00:15:11.763 --> 00:15:13.583
So how can we do it differently?
00:15:13.844 --> 00:15:16.024
And I can give you ten ideas knowing
00:15:16.043 --> 00:15:16.904
we can only do one.
00:15:17.325 --> 00:15:17.865
That's okay.
00:15:17.924 --> 00:15:18.884
I'm the idea machine.
00:15:19.504 --> 00:15:21.166
You help me pick and then we'll execute.
00:15:21.645 --> 00:15:23.666
And the problem is sometimes the machine
00:15:23.706 --> 00:15:24.567
doesn't want to change.
00:15:25.287 --> 00:15:26.006
Sometimes it's too big.
00:15:27.727 --> 00:15:28.528
Or it doesn't know how.
00:15:28.548 --> 00:15:29.187
Or it doesn't know how.
00:15:29.227 --> 00:15:30.727
That's what I look at myself or I
00:15:30.788 --> 00:15:36.029
try to be the idea to change Sherpa.
00:15:36.490 --> 00:15:36.970
Which is like,
00:15:37.250 --> 00:15:39.510
I don't know the way but I know
00:15:39.530 --> 00:15:39.831
that there's
00:15:41.095 --> 00:15:41.875
I just steal.
00:15:42.015 --> 00:15:43.236
Like, look, look what they did.
00:15:43.277 --> 00:15:43.856
Look what they did.
00:15:43.876 --> 00:15:46.460
Could we steal the elements of that that
00:15:46.519 --> 00:15:47.561
made that successful?
00:15:47.620 --> 00:15:48.100
Hold on.
00:15:48.761 --> 00:15:50.844
Like, I know like in PT school,
00:15:51.364 --> 00:15:52.985
everybody loved case studies.
00:15:53.085 --> 00:15:54.125
They're great, right?
00:15:54.186 --> 00:15:55.206
Because they're real.
00:15:55.226 --> 00:15:55.807
And like,
00:15:55.847 --> 00:15:57.249
look at the elements of a case study.
00:15:57.609 --> 00:15:59.591
A thirty nine year old woman like, oh,
00:15:59.630 --> 00:16:00.652
I can I can see that.
00:16:00.792 --> 00:16:01.152
OK.
00:16:01.493 --> 00:16:03.214
And she does this and she lives.
00:16:03.514 --> 00:16:04.855
I loved case study because there are many
00:16:04.895 --> 00:16:05.336
stories.
00:16:05.355 --> 00:16:05.515
Right.
00:16:05.576 --> 00:16:05.755
Right.
00:16:06.537 --> 00:16:08.577
I love case studies in marketing and
00:16:08.597 --> 00:16:11.477
communications and ideas and ideation and
00:16:11.518 --> 00:16:12.739
innovation because it's like,
00:16:13.438 --> 00:16:16.799
I know we're not Yahoo or Netflix or
00:16:16.919 --> 00:16:18.399
Amazon, but you can be like,
00:16:18.539 --> 00:16:19.240
they were faced.
00:16:19.640 --> 00:16:20.341
I learned one today.
00:16:20.360 --> 00:16:20.961
I'll teach it to you.
00:16:21.880 --> 00:16:22.761
This was a while ago.
00:16:22.802 --> 00:16:23.621
This was years ago.
00:16:24.642 --> 00:16:26.783
Netflix was getting a lot of complaints
00:16:26.863 --> 00:16:27.363
early on.
00:16:28.325 --> 00:16:30.105
They used to be, kids,
00:16:30.485 --> 00:16:32.986
they used to be a DVD mail service.
00:16:33.366 --> 00:16:36.548
So DVDs were like videos on discs,
00:16:36.727 --> 00:16:37.269
on coasters.
00:16:37.969 --> 00:16:39.690
When they went to All Streaming,
00:16:40.491 --> 00:16:43.072
They were the first streaming platform.
00:16:43.113 --> 00:16:45.592
You use a remote control to go on
00:16:45.633 --> 00:16:47.513
the internet on your TV and watch things.
00:16:48.374 --> 00:16:49.953
And they were receiving their number one
00:16:49.994 --> 00:16:52.734
complaint was not what movies they had or
00:16:52.774 --> 00:16:54.534
didn't have or any of those things.
00:16:54.934 --> 00:16:57.475
It was, you're buffering a lot.
00:16:57.875 --> 00:16:59.056
I'm in the middle of a movie and
00:16:59.096 --> 00:17:00.855
it's grainy or it buffers.
00:17:01.635 --> 00:17:04.757
And Netflix could have done a national ad
00:17:04.797 --> 00:17:05.896
campaign saying,
00:17:07.058 --> 00:17:09.140
We don't control your internet speed.
00:17:09.880 --> 00:17:12.980
It's buffering because Spectrum or Optum
00:17:13.020 --> 00:17:14.862
or all the different, wherever you live,
00:17:16.241 --> 00:17:17.541
they're lying to you.
00:17:17.663 --> 00:17:19.942
When you say you're buying your plan at
00:17:20.103 --> 00:17:21.943
however many gigabytes per minute
00:17:21.983 --> 00:17:23.144
download, whatever,
00:17:23.223 --> 00:17:24.984
I don't even know what good is.
00:17:26.962 --> 00:17:28.163
That isn't the actual speed.
00:17:28.202 --> 00:17:30.243
They could have done this education
00:17:30.263 --> 00:17:31.844
campaign where they just pointed and
00:17:31.884 --> 00:17:33.585
placed, they moved the blame.
00:17:33.984 --> 00:17:34.865
They didn't do that.
00:17:35.204 --> 00:17:36.164
Somebody in the room was like,
00:17:36.184 --> 00:17:36.826
it's not going to work.
00:17:36.846 --> 00:17:36.945
Great.
00:17:37.945 --> 00:17:38.746
What should we do?
00:17:39.185 --> 00:17:40.866
They launched a website called,
00:17:41.146 --> 00:17:43.487
I think it was called fast.com.
00:17:45.627 --> 00:17:47.548
And it's similar to like internet speed
00:17:47.587 --> 00:17:48.387
test.com.
00:17:48.407 --> 00:17:49.548
Have you ever done internet speed
00:17:49.588 --> 00:17:50.169
test.com?
00:17:51.334 --> 00:17:53.798
It's just a way of actually measuring your
00:17:54.097 --> 00:17:55.901
speed right now in this moment, upload,
00:17:55.921 --> 00:17:57.282
download speed.
00:17:57.323 --> 00:17:59.707
So they were like, hey, test this out.
00:18:00.448 --> 00:18:02.109
And then when you got the data,
00:18:02.150 --> 00:18:03.412
like this was your speed,
00:18:04.255 --> 00:18:06.195
this is what you need to actually stream
00:18:06.236 --> 00:18:09.796
a movie reliably without problems we don't
00:18:10.277 --> 00:18:12.896
offer the streaming so that's okay like
00:18:13.297 --> 00:18:15.258
they were bringing people to like the two
00:18:15.278 --> 00:18:18.818
yard line going who's problem who is
00:18:18.939 --> 00:18:21.338
actually the person screwing you over on
00:18:21.378 --> 00:18:22.819
watching this movie we're giving you the
00:18:22.920 --> 00:18:25.400
access you need the person who's bringing
00:18:25.420 --> 00:18:26.760
you here is the internet service provider
00:18:26.780 --> 00:18:27.161
the isp
00:18:28.040 --> 00:18:29.520
So it was a great power play.
00:18:29.681 --> 00:18:31.682
So my example is like, oh,
00:18:31.721 --> 00:18:33.021
if we're getting a lot of complaints,
00:18:33.563 --> 00:18:35.542
let's look at people who solved complaints
00:18:35.962 --> 00:18:38.384
innovatively.
00:18:38.483 --> 00:18:42.204
And I think when you're this person and
00:18:42.345 --> 00:18:45.685
you are probably objectively pretty burnt
00:18:45.766 --> 00:18:47.886
out and kind of given up on things,
00:18:47.906 --> 00:18:51.948
I think you're lacking that feeling of
00:18:52.008 --> 00:18:52.347
power,
00:18:52.488 --> 00:18:53.087
that lack of
00:18:53.682 --> 00:18:55.003
the agency, the control.
00:18:55.183 --> 00:18:57.005
And probably there's some moral injury
00:18:57.025 --> 00:18:57.905
that goes with that too.
00:18:58.486 --> 00:18:59.886
Because you're not being who you want to
00:18:59.926 --> 00:19:00.086
be.
00:19:00.107 --> 00:19:01.709
Yeah, that sucks.
00:19:01.749 --> 00:19:03.009
That's not the person that's probably
00:19:03.049 --> 00:19:03.630
going to solve that.
00:19:03.670 --> 00:19:05.351
But I read a quote this morning that
00:19:05.371 --> 00:19:05.912
was like,
00:19:06.112 --> 00:19:07.913
excellence in healthcare comes at a cost.
00:19:08.012 --> 00:19:08.794
Pay it anyways.
00:19:10.615 --> 00:19:12.796
What we give doesn't always return,
00:19:12.955 --> 00:19:14.738
but what we give is always what we
00:19:14.857 --> 00:19:15.077
are.
00:19:17.219 --> 00:19:19.661
And that's like the kind of therapist that
00:19:19.861 --> 00:19:20.481
I want to be.
00:19:20.662 --> 00:19:22.143
So that's why I feel like
00:19:23.529 --> 00:19:26.111
when you go into that room whether you're
00:19:26.171 --> 00:19:28.290
tasked with being a discharge monkey or
00:19:28.351 --> 00:19:31.372
not do you bring that energy with you
00:19:32.633 --> 00:19:34.272
or are you bringing the physical therapist
00:19:34.353 --> 00:19:37.413
energy with you yeah like you can be
00:19:37.594 --> 00:19:40.234
angry you can be angry about it but
00:19:40.275 --> 00:19:41.555
are you taking that anger out on your
00:19:41.575 --> 00:19:43.976
patients yeah right right right right
00:19:44.016 --> 00:19:45.916
don't become the thing that don't become
00:19:45.957 --> 00:19:47.416
the thing that you're raging against
00:19:48.419 --> 00:19:50.299
Rage against the machine didn't say rage
00:19:50.339 --> 00:19:51.220
against the machine,
00:19:51.300 --> 00:19:52.401
then become a machine.
00:19:52.500 --> 00:19:53.541
It said rage against it.
00:19:53.582 --> 00:19:56.542
But like, what are the different ways?
00:19:56.603 --> 00:19:57.703
It's not throw a brick.
00:19:58.344 --> 00:20:00.944
And even just like that little act of
00:20:01.046 --> 00:20:03.946
resistance where you're bringing the best
00:20:03.987 --> 00:20:05.548
you can into every room,
00:20:06.208 --> 00:20:08.189
even if you don't have the energy,
00:20:08.669 --> 00:20:09.769
if you don't have the skill set,
00:20:09.789 --> 00:20:11.451
you don't have the knowledge of how to
00:20:11.550 --> 00:20:14.112
advocate within your facility,
00:20:14.132 --> 00:20:15.813
within your profession, within your state,
00:20:15.873 --> 00:20:17.094
at the national level,
00:20:18.353 --> 00:20:21.415
please like advocate within yourself.
00:20:21.476 --> 00:20:21.736
Yeah.
00:20:22.236 --> 00:20:23.336
It's going to be frustrating too,
00:20:23.356 --> 00:20:24.898
because I'm sure like in your role,
00:20:24.939 --> 00:20:26.119
you've been with, you've been, I mean,
00:20:26.140 --> 00:20:27.901
now you're APTA Colorado president,
00:20:27.921 --> 00:20:28.862
but you've done other things.
00:20:28.902 --> 00:20:29.122
Right.
00:20:30.303 --> 00:20:31.824
And when you get a bunch of really
00:20:31.884 --> 00:20:33.506
motivated, passionate people together,
00:20:34.352 --> 00:20:37.413
who want to do fifty different things a
00:20:37.452 --> 00:20:39.854
hundred different ways knowing that you
00:20:39.913 --> 00:20:41.734
can't there are constraints there is
00:20:41.894 --> 00:20:45.797
bandwidth so you know which problem do you
00:20:45.817 --> 00:20:47.616
just I mean even deciding which problem to
00:20:47.678 --> 00:20:50.378
solve is a problem because you're going to
00:20:50.419 --> 00:20:52.358
make more enemies than friends I used to
00:20:52.398 --> 00:20:55.520
hate doing contests on the radio here's
00:20:55.560 --> 00:20:55.800
why
00:20:57.131 --> 00:20:58.251
Most of our audience,
00:20:58.372 --> 00:21:00.374
most of the listeners didn't participate
00:21:00.794 --> 00:21:01.414
for whatever reason.
00:21:01.434 --> 00:21:02.855
They're busy.
00:21:03.175 --> 00:21:04.156
We surveyed people this.
00:21:04.557 --> 00:21:05.337
A lot of times they were like,
00:21:06.358 --> 00:21:07.480
mathematically, I'm not an idiot.
00:21:07.500 --> 00:21:08.000
I'm not going to win.
00:21:08.020 --> 00:21:08.901
So you're going to ask me to try
00:21:08.961 --> 00:21:09.241
something.
00:21:09.261 --> 00:21:09.741
I'm not going to win.
00:21:09.761 --> 00:21:10.061
I get it.
00:21:10.762 --> 00:21:11.403
I was the same way.
00:21:12.423 --> 00:21:14.266
I didn't always try to actively
00:21:14.286 --> 00:21:15.186
participate in contests.
00:21:15.571 --> 00:21:18.574
I mean, I did win one once.
00:21:18.674 --> 00:21:19.935
What'd you win?
00:21:19.955 --> 00:21:21.997
I won a signed copy of the Ray
00:21:22.017 --> 00:21:22.577
soundtrack.
00:21:24.538 --> 00:21:25.921
Remember that movie with Jamie Foxx?
00:21:25.941 --> 00:21:27.521
I won that and I won tickets to
00:21:27.642 --> 00:21:30.744
Evanescence.
00:21:30.865 --> 00:21:31.585
So I won twice, I guess.
00:21:31.605 --> 00:21:33.006
I used to love taking phone calls because
00:21:33.046 --> 00:21:34.647
the phone calls were great payoff, right?
00:21:34.748 --> 00:21:36.209
Always record the phone call as a radio
00:21:36.229 --> 00:21:37.869
DJ and then play it back because it's
00:21:37.910 --> 00:21:38.651
great energy.
00:21:38.691 --> 00:21:40.112
The person's happy, right?
00:21:40.492 --> 00:21:41.973
And I used to love,
00:21:42.153 --> 00:21:43.595
but one of my schticks was because I
00:21:43.634 --> 00:21:44.076
heard it enough.
00:21:44.115 --> 00:21:44.496
People were like,
00:21:44.855 --> 00:21:45.817
Oh my God, I can't believe I won.
00:21:45.856 --> 00:21:46.777
I never won things.
00:21:46.957 --> 00:21:48.577
And I was like, I would be like,
00:21:48.637 --> 00:21:49.398
Rebecca, Rebecca.
00:21:49.419 --> 00:21:50.138
And like, yeah,
00:21:50.179 --> 00:21:54.342
like you can never say that again ever.
00:21:54.461 --> 00:21:55.942
Cause you won one thing for the rest
00:21:55.962 --> 00:21:56.282
of your life.
00:21:56.462 --> 00:21:57.022
Like play with it.
00:21:57.064 --> 00:21:57.263
Right.
00:21:57.644 --> 00:21:57.963
I always,
00:21:58.163 --> 00:21:59.144
I would also have fun with it.
00:21:59.184 --> 00:21:59.964
I would push back.
00:22:00.846 --> 00:22:03.406
So of course we would like Pavlovian dog,
00:22:03.467 --> 00:22:07.089
have a sound effect, be colored X,
00:22:07.210 --> 00:22:08.309
be color tan right now.
00:22:08.369 --> 00:22:08.589
Right.
00:22:08.871 --> 00:22:10.791
And people would call, Hey,
00:22:12.612 --> 00:22:13.413
This is the radio station.
00:22:13.873 --> 00:22:14.334
Who's this?
00:22:14.473 --> 00:22:14.914
Rebecca.
00:22:15.595 --> 00:22:16.175
Did I win?
00:22:17.657 --> 00:22:18.679
I would twist it.
00:22:19.058 --> 00:22:21.823
I'd be like, what are you calling for?
00:22:22.282 --> 00:22:23.724
And if you didn't know what the contest
00:22:23.765 --> 00:22:27.509
was, I clung up on you.
00:22:28.069 --> 00:22:29.711
And that pissed off one person.
00:22:30.696 --> 00:22:32.858
But I made a hundred friends because they
00:22:32.878 --> 00:22:33.919
were like, good.
00:22:34.159 --> 00:22:35.200
I really wanted that.
00:22:35.701 --> 00:22:36.560
And I didn't win it.
00:22:36.840 --> 00:22:38.082
And I don't want her to have it
00:22:38.102 --> 00:22:39.542
because she didn't even know what it was.
00:22:40.003 --> 00:22:41.084
So that is the way,
00:22:41.104 --> 00:22:41.865
because I just said,
00:22:41.924 --> 00:22:43.846
I didn't like doing contests because in
00:22:43.905 --> 00:22:44.507
contests,
00:22:44.747 --> 00:22:46.969
you make one friend and ninety nine people
00:22:47.009 --> 00:22:47.509
get pissed.
00:22:47.788 --> 00:22:48.710
That math don't math.
00:22:49.069 --> 00:22:49.871
But I did.
00:22:49.971 --> 00:22:50.671
I twisted it.
00:22:50.711 --> 00:22:51.612
And I was like, no,
00:22:51.751 --> 00:22:52.732
you don't get it because you don't know
00:22:52.752 --> 00:22:53.212
what it was.
00:22:53.512 --> 00:22:55.214
You were caller ten and you can take
00:22:55.234 --> 00:22:56.035
this up with our lawyers.
00:22:56.194 --> 00:22:56.655
No one did.
00:22:57.215 --> 00:22:58.297
But I would have fun with it.
00:22:59.308 --> 00:23:00.169
I would also say,
00:23:00.449 --> 00:23:01.630
I'm going to ask for caller ten.
00:23:01.930 --> 00:23:03.309
You better know what you're trying to win.
00:23:04.250 --> 00:23:04.829
Just tell me.
00:23:04.869 --> 00:23:05.770
You don't have to be like, exactly.
00:23:05.790 --> 00:23:06.191
You're just like, oh,
00:23:06.211 --> 00:23:07.510
the tickets for the evidence.
00:23:07.651 --> 00:23:07.891
Got it.
00:23:07.931 --> 00:23:08.790
Yeah, you pay attention.
00:23:09.191 --> 00:23:10.491
But if you didn't, I push back.
00:23:11.932 --> 00:23:13.112
That was a way of like me sort
00:23:13.132 --> 00:23:16.633
of combating the people listening going,
00:23:16.853 --> 00:23:17.613
I never win.
00:23:17.853 --> 00:23:19.453
They were okay with not winning as long
00:23:19.493 --> 00:23:21.134
as someone who in their eyes didn't
00:23:21.153 --> 00:23:22.894
deserve it didn't win either.
00:23:23.295 --> 00:23:24.615
Sometimes you win by losing.
00:23:26.909 --> 00:23:30.230
So whose job is it to talk to
00:23:30.271 --> 00:23:32.792
this guy at a hospital and be like,
00:23:32.932 --> 00:23:37.196
hey, man, tomorrow you're not working.
00:23:37.217 --> 00:23:37.817
We're going to pay you.
00:23:37.856 --> 00:23:38.498
You're coming to work.
00:23:38.538 --> 00:23:39.417
We're going to go hang out.
00:23:40.479 --> 00:23:43.201
And I need to listen to you and
00:23:43.300 --> 00:23:45.163
figure out how to get you back on
00:23:45.603 --> 00:23:45.962
our team.
00:23:46.222 --> 00:23:47.403
Is there a job for that?
00:23:47.703 --> 00:23:48.424
What job is that?
00:23:48.545 --> 00:23:49.185
I want that job.
00:23:49.865 --> 00:23:50.026
Well,
00:23:50.246 --> 00:23:52.387
I think that I would love that job.
00:23:52.448 --> 00:23:53.909
I wish I could be a guidance counselor
00:23:53.949 --> 00:23:54.990
for physical therapists.
00:23:55.628 --> 00:23:57.369
Guidance counselors for companies.
00:23:57.671 --> 00:23:57.810
Yeah.
00:23:57.851 --> 00:23:58.891
Isn't that a job?
00:23:59.372 --> 00:24:01.874
I mean, HR, isn't that HR?
00:24:02.314 --> 00:24:03.434
I don't think so.
00:24:03.515 --> 00:24:05.757
Cause I think HR is all defense, right?
00:24:05.777 --> 00:24:07.077
They just work for the company.
00:24:07.657 --> 00:24:09.558
It's like defense and procedure, right?
00:24:09.578 --> 00:24:11.260
Like, I don't know that it's investment.
00:24:12.101 --> 00:24:13.501
Like there has to be like a human
00:24:13.682 --> 00:24:14.843
assets department,
00:24:15.324 --> 00:24:16.785
like a development department.
00:24:16.924 --> 00:24:19.826
Like, and I think,
00:24:19.846 --> 00:24:21.327
I think then you get into that like
00:24:21.387 --> 00:24:24.990
rabbit hole of management or leadership,
00:24:25.010 --> 00:24:25.111
right?
00:24:26.666 --> 00:24:28.648
you have a management team or do you
00:24:28.689 --> 00:24:30.611
have a leadership team right totally
00:24:30.651 --> 00:24:34.193
different and i think unfortunately the
00:24:34.233 --> 00:24:36.457
way most companies i don't just even want
00:24:36.477 --> 00:24:37.817
to throw hospitals under the bus most
00:24:37.837 --> 00:24:39.539
companies are set up to have supervisors
00:24:39.559 --> 00:24:42.863
and managers not like leaders and leaders
00:24:42.982 --> 00:24:45.404
also don't necessarily make good managers
00:24:45.464 --> 00:24:46.705
right so i feel like you have to
00:24:46.726 --> 00:24:48.448
have some combination of both but i feel
00:24:48.468 --> 00:24:50.089
like this is where your leadership
00:24:52.176 --> 00:24:52.817
maybe not your managers,
00:24:52.836 --> 00:24:55.798
have to step in and help lead people
00:24:55.837 --> 00:24:56.077
through.
00:24:56.117 --> 00:24:58.138
But I don't think there is a job
00:24:58.199 --> 00:24:58.679
for that.
00:25:00.239 --> 00:25:01.599
I think that the organization would have
00:25:01.619 --> 00:25:05.020
to be big enough to financially afford
00:25:05.080 --> 00:25:07.361
that and then allow that person to...
00:25:07.381 --> 00:25:09.301
Invest in people.
00:25:09.321 --> 00:25:10.082
Invest in people.
00:25:10.442 --> 00:25:11.722
Did you ever hear of a story from
00:25:11.843 --> 00:25:12.143
Zappos?
00:25:12.163 --> 00:25:13.343
You know what Zappos is, right?
00:25:13.363 --> 00:25:14.482
It's like an online shoe store.
00:25:15.163 --> 00:25:16.023
And people were...
00:25:17.010 --> 00:25:19.393
People were like, to Jeff Bezos,
00:25:19.413 --> 00:25:20.394
when he launched Amazon,
00:25:20.413 --> 00:25:21.454
when he was just going to sell books,
00:25:21.474 --> 00:25:21.815
they were like,
00:25:21.994 --> 00:25:24.057
that is the dumbest idea ever.
00:25:24.116 --> 00:25:25.538
Who's going to buy a book online?
00:25:25.999 --> 00:25:28.381
And then you go to like, I know,
00:25:28.441 --> 00:25:28.760
me too.
00:25:29.082 --> 00:25:30.843
And then you go to shoes and people
00:25:30.863 --> 00:25:32.924
are like, you have to try shoes on.
00:25:33.346 --> 00:25:34.626
You have to walk around.
00:25:34.646 --> 00:25:36.307
Do you remember before the first day of
00:25:36.347 --> 00:25:36.709
school,
00:25:36.749 --> 00:25:38.190
how important it was to try it on?
00:25:38.529 --> 00:25:39.330
And your mom was like,
00:25:39.490 --> 00:25:40.471
walk around in it.
00:25:41.448 --> 00:25:43.108
And then everyone's like watching you walk
00:25:43.148 --> 00:25:43.489
around.
00:25:43.509 --> 00:25:45.128
You're like, yeah, they're new shoes.
00:25:45.489 --> 00:25:45.929
Yeah.
00:25:45.989 --> 00:25:46.409
I don't know.
00:25:46.509 --> 00:25:47.930
Like, what am I supposed to feel?
00:25:48.029 --> 00:25:49.170
Anyway, I digress.
00:25:49.690 --> 00:25:51.550
So then someone launches Zappos.com and
00:25:51.570 --> 00:25:52.171
they're like,
00:25:52.290 --> 00:25:54.211
that's not going to work because shoes are
00:25:54.231 --> 00:25:56.112
all about touching the shoes and putting
00:25:56.132 --> 00:25:57.913
them on and feeling them.
00:25:57.932 --> 00:26:01.294
They had a problem with complaints.
00:26:02.253 --> 00:26:04.535
And the guy who launched Zappos was one
00:26:04.575 --> 00:26:04.954
guy.
00:26:04.974 --> 00:26:05.894
And then it was two people.
00:26:05.914 --> 00:26:06.234
And then it was
00:26:08.971 --> 00:26:10.731
All complaints went through this guy.
00:26:11.051 --> 00:26:12.271
Someone's going to Google the name of the
00:26:12.432 --> 00:26:14.613
CEO or whatever who came up with it.
00:26:14.732 --> 00:26:16.432
The Jeff Bezos of Zappos.
00:26:17.252 --> 00:26:20.114
And he realized he was handling every
00:26:20.153 --> 00:26:22.134
complaint because in his mind,
00:26:22.154 --> 00:26:22.535
he was like,
00:26:22.555 --> 00:26:23.674
I want to touch every complaint.
00:26:24.135 --> 00:26:25.756
Good idea, but...
00:26:26.172 --> 00:26:28.192
bad execution because there were so many.
00:26:28.413 --> 00:26:29.634
You're an online retailer.
00:26:30.374 --> 00:26:32.795
And then the longer someone's complaint
00:26:33.075 --> 00:26:34.195
takes to get solved,
00:26:34.536 --> 00:26:35.636
the more pissed they are.
00:26:35.856 --> 00:26:38.478
You can't blame them, right?
00:26:38.817 --> 00:26:39.798
It's like an ounce of prevention,
00:26:39.838 --> 00:26:40.538
pound of cure.
00:26:40.778 --> 00:26:42.079
But that ounce of prevention needed to
00:26:42.119 --> 00:26:42.960
come in the first
00:26:51.161 --> 00:26:52.943
And I forget the exact dollar amount,
00:26:52.983 --> 00:26:53.525
but it was like,
00:26:53.684 --> 00:26:55.888
if you're taking the complaint,
00:26:55.969 --> 00:26:59.114
if you're John Smith on the phone at
00:26:59.153 --> 00:26:59.615
Zappos,
00:27:00.566 --> 00:27:02.387
And it's your complaint to handle.
00:27:02.807 --> 00:27:05.830
And the solution to make this person happy
00:27:06.872 --> 00:27:09.355
is less than two hundred dollars.
00:27:09.734 --> 00:27:10.536
Just solve it.
00:27:10.576 --> 00:27:11.576
Just do it.
00:27:11.616 --> 00:27:12.538
Just write in the computer.
00:27:12.917 --> 00:27:14.559
This guy had a legit complaint.
00:27:14.900 --> 00:27:15.800
It was this and this.
00:27:15.901 --> 00:27:17.603
And I just gave him a two hundred
00:27:17.623 --> 00:27:18.123
dollar credit.
00:27:18.363 --> 00:27:19.304
And the guy was thrilled.
00:27:19.904 --> 00:27:21.906
And he was like, the time it took.
00:27:23.450 --> 00:27:25.574
was worth just solving it.
00:27:25.994 --> 00:27:26.095
Yeah.
00:27:26.115 --> 00:27:27.477
That's why like sometimes if you order
00:27:27.498 --> 00:27:28.740
like furniture is a big one.
00:27:28.960 --> 00:27:30.262
If you order something with furniture...
00:27:31.249 --> 00:27:32.549
And there's a problem with it.
00:27:32.569 --> 00:27:33.830
And you can prove it with a picture.
00:27:33.951 --> 00:27:35.092
And this is where also people start
00:27:35.132 --> 00:27:35.872
scamming the system.
00:27:36.071 --> 00:27:37.594
But a lot of times,
00:27:37.614 --> 00:27:38.433
they'll just be like, keep it.
00:27:38.453 --> 00:27:39.255
We'll send you a new one.
00:27:39.835 --> 00:27:41.615
And now you have a slightly damaged
00:27:41.675 --> 00:27:42.136
whatever.
00:27:42.537 --> 00:27:43.798
That's why you see them on Facebook.
00:27:43.817 --> 00:27:44.178
My buddy,
00:27:44.498 --> 00:27:45.719
you see them on Facebook Marketplace a
00:27:45.778 --> 00:27:45.999
lot.
00:27:46.200 --> 00:27:47.160
Because people are like, I don't know.
00:27:47.200 --> 00:27:48.681
Wayfair sent me a hot...
00:27:48.721 --> 00:27:51.702
My buddy's neighbor bought a nine thousand
00:27:51.722 --> 00:27:54.464
dollar hot tub or something crazy on
00:27:54.565 --> 00:27:55.205
Wayfair.
00:27:55.566 --> 00:27:56.787
And there was a giant scratch in it.
00:27:56.846 --> 00:27:57.748
And no offense, but like...
00:27:58.648 --> 00:27:59.670
I dropped nine grand.
00:27:59.809 --> 00:28:01.190
I want the version without the scratch in
00:28:01.230 --> 00:28:01.330
it.
00:28:01.351 --> 00:28:01.611
Right.
00:28:02.191 --> 00:28:02.711
So they were like,
00:28:02.770 --> 00:28:03.551
we'll send you a new one.
00:28:04.031 --> 00:28:04.311
And he's like,
00:28:04.412 --> 00:28:05.313
what do I do with the old one?
00:28:05.333 --> 00:28:07.193
They're like, it's your problem now.
00:28:08.051 --> 00:28:08.971
He gave it to my buddy.
00:28:08.991 --> 00:28:10.073
He was like, do you want this?
00:28:10.093 --> 00:28:11.173
And my buddy was like, yes.
00:28:11.252 --> 00:28:13.453
And he's like, there's a scratch in it.
00:28:13.493 --> 00:28:15.214
And he goes, I don't care.
00:28:15.615 --> 00:28:16.655
But somewhere along the line,
00:28:16.695 --> 00:28:17.816
someone did the math and was like,
00:28:18.375 --> 00:28:19.596
I need that guy to be happy because
00:28:19.636 --> 00:28:19.997
that guy's,
00:28:20.257 --> 00:28:21.657
if he's dropping nine grand on a hot
00:28:21.698 --> 00:28:21.978
tub,
00:28:22.397 --> 00:28:24.838
his lifetime value of products is more
00:28:24.858 --> 00:28:25.378
than nine grand.
00:28:25.419 --> 00:28:26.019
Make him happy.
00:28:26.279 --> 00:28:28.060
How much does it cost to ship the
00:28:28.101 --> 00:28:28.800
first one back?
00:28:29.965 --> 00:28:30.705
Ship a new one.
00:28:31.967 --> 00:28:33.728
We already had to ship the second one.
00:28:34.268 --> 00:28:35.409
What do we do with the first one?
00:28:35.788 --> 00:28:37.009
And then we ship it back?
00:28:37.269 --> 00:28:39.411
What are we going to do with it?
00:28:39.570 --> 00:28:40.810
I need to warehouse that.
00:28:40.871 --> 00:28:41.832
Now it's going to sit here.
00:28:41.892 --> 00:28:42.632
Now it's damaged.
00:28:42.672 --> 00:28:43.593
It's like, dude, deal with it.
00:28:45.114 --> 00:28:45.294
Well,
00:28:45.354 --> 00:28:47.054
and I think one thing that you point
00:28:47.115 --> 00:28:48.835
out really well and often,
00:28:48.934 --> 00:28:50.375
especially about communications,
00:28:50.496 --> 00:28:52.977
is that nobody owns it.
00:28:53.037 --> 00:28:53.857
Nobody owns that.
00:28:54.018 --> 00:28:56.118
And I think that's the same problem with
00:28:56.378 --> 00:28:57.619
this therapist, right?
00:28:57.660 --> 00:28:57.880
Like,
00:28:59.001 --> 00:29:00.843
the people making the decisions about how
00:29:00.863 --> 00:29:02.825
they will implement and utilize physical
00:29:02.865 --> 00:29:05.946
therapists are not taking any
00:29:06.007 --> 00:29:08.528
responsibility for that impact on that
00:29:08.588 --> 00:29:10.410
therapist, on how that impacts them,
00:29:10.470 --> 00:29:11.931
on how that impacts morale,
00:29:11.971 --> 00:29:14.071
because their job is not to advance
00:29:14.092 --> 00:29:14.873
physical therapy.
00:29:15.232 --> 00:29:16.433
Their job is to advance the mission of
00:29:16.453 --> 00:29:18.154
the hospital in the healthcare context
00:29:18.174 --> 00:29:19.036
that it exists in.
00:29:19.455 --> 00:29:22.117
So there isn't anybody who is responsible
00:29:22.478 --> 00:29:24.640
for making sure that their therapists are
00:29:25.539 --> 00:29:26.401
feeling like
00:29:28.202 --> 00:29:29.203
They're well utilized,
00:29:29.324 --> 00:29:31.545
that they're competent and taken care of
00:29:31.726 --> 00:29:33.326
and practicing at the top of their scope.
00:29:33.346 --> 00:29:34.386
Like no one owns that.
00:29:34.426 --> 00:29:35.929
So when you say whose job is that?
00:29:36.449 --> 00:29:36.729
Nobody's.
00:29:37.209 --> 00:29:37.730
Nobody's.
00:29:37.769 --> 00:29:38.569
There's a hole there.
00:29:38.589 --> 00:29:40.432
And it's going to be a very expensive
00:29:40.511 --> 00:29:42.532
hole for a shortage.
00:29:42.772 --> 00:29:43.054
Good.
00:29:43.733 --> 00:29:44.354
But Rebecca,
00:29:44.434 --> 00:29:46.536
hiring someone just for that job?
00:29:47.135 --> 00:29:48.237
How will they ever meet their
00:29:48.257 --> 00:29:48.897
productivity?
00:29:49.617 --> 00:29:50.338
Well, not even that.
00:29:50.378 --> 00:29:52.240
Like we're going to pay someone to do
00:29:52.319 --> 00:29:53.961
this job that should just not be a
00:29:54.020 --> 00:29:54.501
problem.
00:29:54.721 --> 00:29:55.623
Sorry, it is.
00:29:56.519 --> 00:29:58.500
And then we can't pay for that.
00:29:58.840 --> 00:30:00.602
I would push back and go, you are.
00:30:01.083 --> 00:30:02.544
It's just hidden in your P&L.
00:30:03.184 --> 00:30:04.945
And it's because you hired someone and
00:30:04.965 --> 00:30:06.748
they stuck around for two years and left.
00:30:07.167 --> 00:30:09.450
And now you had a vacancy for a
00:30:09.490 --> 00:30:11.451
year and you didn't fill it.
00:30:11.832 --> 00:30:13.073
And now you burn the rest of your
00:30:13.093 --> 00:30:14.854
staff out because they had to fill in
00:30:14.874 --> 00:30:16.415
because that's what people with a Peace
00:30:16.435 --> 00:30:17.276
Corps gene do.
00:30:17.696 --> 00:30:18.616
And we appreciate that.
00:30:18.837 --> 00:30:20.338
So we take advantage of it.
00:30:20.898 --> 00:30:21.720
You're paying for it,
00:30:21.740 --> 00:30:22.701
whether you're doing it or not.
00:30:23.185 --> 00:30:24.046
Well, statistically,
00:30:24.105 --> 00:30:26.446
presenteeism is worse than absenteeism.
00:30:26.847 --> 00:30:28.127
Wait, what is presenteeism?
00:30:28.407 --> 00:30:29.509
Presenteeism,
00:30:30.028 --> 00:30:31.148
you might have to look up the exact
00:30:31.169 --> 00:30:31.589
definition.
00:30:31.609 --> 00:30:33.150
I learned this from a course that I
00:30:33.170 --> 00:30:34.250
took with Mike Eisenhardt.
00:30:34.651 --> 00:30:36.632
Presenteeism is that person that shows up
00:30:36.672 --> 00:30:39.472
to work every day with that attitude.
00:30:39.914 --> 00:30:41.115
Which with, with which attitude?
00:30:41.575 --> 00:30:43.395
Like the discharge monkey attitude.
00:30:43.415 --> 00:30:44.296
It doesn't matter.
00:30:44.355 --> 00:30:45.876
Like that, that person,
00:30:46.057 --> 00:30:48.576
the person who's like present,
00:30:49.038 --> 00:30:51.198
but pulling everybody down with them.
00:30:51.258 --> 00:30:52.939
They're like the vacuum in the room.
00:30:52.999 --> 00:30:54.278
The person's going to ruin it.
00:30:54.618 --> 00:30:55.638
Even if their stats,
00:30:55.719 --> 00:30:57.420
even if like their output was great,
00:30:58.099 --> 00:30:59.661
they're net negative by a lot.
00:30:59.681 --> 00:31:00.560
Cause they're going to make a lot of
00:31:00.621 --> 00:31:01.401
good people leave.
00:31:01.820 --> 00:31:03.761
And you would rather have that person not
00:31:03.801 --> 00:31:04.342
come to work.
00:31:04.826 --> 00:31:05.346
Yeah.
00:31:05.366 --> 00:31:08.489
Work every day and be this like net
00:31:08.949 --> 00:31:09.409
drag.
00:31:09.489 --> 00:31:09.749
Right.
00:31:10.108 --> 00:31:13.951
So they found that people who go to
00:31:13.990 --> 00:31:15.771
work like that just they just drain the
00:31:15.791 --> 00:31:16.271
system.
00:31:16.432 --> 00:31:18.432
And so if you're looking at like physical
00:31:18.452 --> 00:31:19.614
there to work with,
00:31:19.653 --> 00:31:21.775
like direct to employer type services will
00:31:21.835 --> 00:31:23.576
focus on those folks.
00:31:23.675 --> 00:31:23.895
Right.
00:31:24.875 --> 00:31:26.556
They'll focus on the absentee folks too,
00:31:26.636 --> 00:31:26.836
right?
00:31:26.856 --> 00:31:28.077
Like, is that a health condition?
00:31:28.117 --> 00:31:29.239
But they're going to focus on all of
00:31:29.259 --> 00:31:30.920
those people to help bring them back to
00:31:30.960 --> 00:31:31.740
the pack, right?
00:31:31.800 --> 00:31:33.643
And make sure that everybody's attitude is
00:31:33.682 --> 00:31:33.942
better.
00:31:34.442 --> 00:31:36.565
But do you work on keeping everybody happy
00:31:36.625 --> 00:31:37.885
or do you have to focus on those
00:31:37.905 --> 00:31:39.948
people that are really causing the
00:31:40.107 --> 00:31:41.529
problem?
00:31:41.789 --> 00:31:42.790
Are you a hockey fan or are you
00:31:42.810 --> 00:31:43.290
a baseball fan?
00:31:43.310 --> 00:31:43.912
Are you a hockey fan at all?
00:31:43.932 --> 00:31:44.291
I'm a baseball fan.
00:31:45.230 --> 00:31:45.549
All right,
00:31:45.609 --> 00:31:47.471
so there is a stat for this in
00:31:47.530 --> 00:31:47.971
baseball.
00:31:47.991 --> 00:31:49.571
It's called WAR, W-A-R,
00:31:49.632 --> 00:31:51.292
Wins Above Replacement.
00:31:51.713 --> 00:31:52.594
I'm a baseball fan too,
00:31:52.614 --> 00:31:53.734
and I can't understand WAR.
00:31:53.954 --> 00:31:57.136
The idea is, as a right fielder,
00:31:57.396 --> 00:31:59.298
how are you compared to other right
00:31:59.397 --> 00:31:59.917
fielders?
00:32:00.018 --> 00:32:01.358
When you're in the game,
00:32:02.680 --> 00:32:06.342
do you do the intangibles well that never
00:32:06.382 --> 00:32:08.383
before showed up on the stat sheet?
00:32:08.883 --> 00:32:10.624
It's a little easier to explain in hockey.
00:32:10.683 --> 00:32:12.125
Even not a hockey fan, you'll get this.
00:32:13.761 --> 00:32:16.183
So how do you get things in the
00:32:16.203 --> 00:32:17.265
back of your hockey card?
00:32:17.525 --> 00:32:22.710
Goals, assists, penalty minutes,
00:32:22.789 --> 00:32:24.632
time on the ice, how much you work.
00:32:24.751 --> 00:32:28.134
Those are easier to measure, right?
00:32:28.154 --> 00:32:29.636
Then they come up with this statistic
00:32:29.656 --> 00:32:30.617
called plus-minus.
00:32:31.670 --> 00:32:34.031
So let's say I'm on the ice and
00:32:34.132 --> 00:32:34.832
I actually...
00:32:35.333 --> 00:32:36.653
So the way to get an assist is
00:32:36.814 --> 00:32:38.234
I pass it to you and you score.
00:32:38.734 --> 00:32:39.516
I get an assist.
00:32:40.135 --> 00:32:41.917
Another way would be I pass it to
00:32:41.998 --> 00:32:42.458
Steve.
00:32:42.718 --> 00:32:43.939
Steve passes it to you.
00:32:44.579 --> 00:32:45.259
You get a goal.
00:32:45.420 --> 00:32:46.260
Steve gets an assist.
00:32:46.560 --> 00:32:48.663
I get an assist.
00:32:48.722 --> 00:32:50.124
But there's a lot of stuff going on
00:32:50.324 --> 00:32:51.144
on a hockey rink
00:32:52.109 --> 00:32:53.171
That isn't just that.
00:32:53.330 --> 00:32:55.413
Like maybe I needed to dig the puck
00:32:55.452 --> 00:32:57.114
out of the corner of my own zone,
00:32:57.374 --> 00:32:59.655
then pass it to Steve, then Mike,
00:32:59.875 --> 00:33:00.557
then Rebecca.
00:33:00.676 --> 00:33:01.257
She scores.
00:33:01.538 --> 00:33:02.678
I got nothing on that.
00:33:03.638 --> 00:33:05.520
That's okay, but that's a thing.
00:33:05.961 --> 00:33:07.721
Or the guy who is always really good
00:33:07.782 --> 00:33:08.383
at communicating.
00:33:08.603 --> 00:33:09.483
But how do you put that on a
00:33:09.523 --> 00:33:09.943
stat sheet?
00:33:09.963 --> 00:33:11.125
So they came up with plus minus,
00:33:11.885 --> 00:33:14.028
which is when a goal is scored,
00:33:14.248 --> 00:33:16.148
the person in the booth and stats just
00:33:16.189 --> 00:33:18.631
writes everybody's name down who was on
00:33:18.671 --> 00:33:19.231
the ice.
00:33:19.692 --> 00:33:20.712
And that's a plus one.
00:33:21.942 --> 00:33:23.785
When a goal is scored against us,
00:33:24.346 --> 00:33:25.287
who is on the ice?
00:33:25.527 --> 00:33:26.428
That's a minus one.
00:33:26.909 --> 00:33:28.250
And just like a running count,
00:33:28.289 --> 00:33:30.333
if you're card counting in blackjack,
00:33:30.692 --> 00:33:32.375
what's the running count on Jimmy?
00:33:32.394 --> 00:33:34.037
Yeah.
00:33:34.257 --> 00:33:35.818
Man, every time Jimmy steps on the ice,
00:33:35.858 --> 00:33:36.740
we get scored on.
00:33:37.240 --> 00:33:39.663
But we don't measure that because...
00:33:40.579 --> 00:33:41.701
I didn't get a goal.
00:33:42.402 --> 00:33:44.804
The goalie gets a goal against her or
00:33:44.864 --> 00:33:46.765
him because they're the goalie,
00:33:47.006 --> 00:33:48.066
but I'm just a forward.
00:33:48.326 --> 00:33:49.867
But it is my responsibility to guard my
00:33:49.907 --> 00:33:50.167
guy.
00:33:50.248 --> 00:33:51.028
And when I'm out there,
00:33:51.128 --> 00:33:52.089
I just sort of don't.
00:33:52.509 --> 00:33:53.730
And then that leads to a pass,
00:33:53.750 --> 00:33:54.491
which leads to a goal.
00:33:54.872 --> 00:33:56.993
So the answer was plus minus.
00:33:57.634 --> 00:33:58.976
So you want to be as plus as
00:33:59.036 --> 00:33:59.455
possible,
00:33:59.496 --> 00:34:01.478
which is like we get scored on as
00:34:01.518 --> 00:34:02.159
little as possible.
00:34:02.179 --> 00:34:04.000
We score as much as possible.
00:34:04.361 --> 00:34:07.603
It's an imperfect way of measuring the
00:34:07.623 --> 00:34:08.224
intangibles.
00:34:09.501 --> 00:34:10.922
That's hard to do in business.
00:34:11.342 --> 00:34:11.702
It is.
00:34:11.983 --> 00:34:12.764
Where would you do that?
00:34:13.523 --> 00:34:15.326
That's not a net promoter score.
00:34:15.346 --> 00:34:16.385
It's not NPS.
00:34:17.226 --> 00:34:20.108
I also would love to see outcomes for
00:34:20.148 --> 00:34:21.728
people who feel like that,
00:34:22.329 --> 00:34:24.030
for those therapists who are really burned
00:34:24.170 --> 00:34:27.612
out and aren't bringing that energy into
00:34:27.632 --> 00:34:28.313
the room with them.
00:34:29.574 --> 00:34:31.094
Are you delaying people's discharge
00:34:31.255 --> 00:34:32.896
because you're not intervening the way
00:34:32.916 --> 00:34:33.496
that you should?
00:34:34.177 --> 00:34:37.139
Are your patients more hesitant to go home
00:34:37.179 --> 00:34:37.739
because they're
00:34:38.657 --> 00:34:40.559
Your attitude does not inspire confidence.
00:34:41.159 --> 00:34:43.059
Do your patients need home health more
00:34:43.199 --> 00:34:43.601
often?
00:34:44.081 --> 00:34:45.501
Are the home health therapists like,
00:34:45.561 --> 00:34:47.922
why is this patient in this bad of
00:34:47.943 --> 00:34:48.882
shape coming home?
00:34:49.724 --> 00:34:51.905
Are you discharging more people to rehab
00:34:51.945 --> 00:34:54.585
than home with an assistive device?
00:34:55.266 --> 00:34:57.527
What do your outcomes look like compared
00:34:57.547 --> 00:34:59.789
to people who are operating
00:35:00.798 --> 00:35:03.480
positively within their scope as opposed
00:35:03.519 --> 00:35:05.920
to walking into every room being like i'm
00:35:05.940 --> 00:35:08.400
just here to just make a trash
00:35:08.440 --> 00:35:12.460
recommendation and then leave i mean there
00:35:12.501 --> 00:35:14.101
was a guy who had the same job
00:35:14.141 --> 00:35:15.822
as me in radio there were four radio
00:35:15.842 --> 00:35:17.442
stations in one building all owned by the
00:35:17.481 --> 00:35:20.463
same company right and a guy ran a
00:35:20.523 --> 00:35:22.324
country station his office was next to
00:35:22.384 --> 00:35:24.443
mine and he was sort of an eeyore
00:35:25.717 --> 00:35:27.818
So I got told one day on a
00:35:27.918 --> 00:35:30.119
Tuesday that I had to go home and
00:35:30.139 --> 00:35:31.599
come back the next day and fire someone
00:35:31.619 --> 00:35:32.240
from my staff.
00:35:32.260 --> 00:35:33.161
Have I told you this story before?
00:35:33.181 --> 00:35:35.641
I had to go home, Jimmy.
00:35:35.922 --> 00:35:37.003
You have to come home tomorrow,
00:35:37.123 --> 00:35:37.943
come back to work tomorrow.
00:35:38.679 --> 00:35:39.440
And my boss was like,
00:35:39.539 --> 00:35:40.300
tell me who to fire.
00:35:40.320 --> 00:35:41.800
It's your job.
00:35:41.860 --> 00:35:42.440
You're the boss.
00:35:42.780 --> 00:35:45.661
You get to get handed the trophies when
00:35:45.681 --> 00:35:46.121
you win.
00:35:46.942 --> 00:35:47.902
And then you got to do the bad
00:35:47.922 --> 00:35:48.123
work.
00:35:48.503 --> 00:35:49.163
So I went home,
00:35:49.503 --> 00:35:51.563
had a couple of Chardonnays because I was
00:35:51.603 --> 00:35:51.963
pissed.
00:35:52.264 --> 00:35:53.364
None of my people did anything wrong.
00:35:53.603 --> 00:35:55.065
They were all on the plus side and
00:35:55.085 --> 00:35:55.744
the plus minus.
00:35:55.784 --> 00:35:56.445
They were hard work.
00:35:56.625 --> 00:35:57.664
But I had to fire one of them
00:35:58.105 --> 00:35:59.186
because numbers.
00:35:59.806 --> 00:36:01.146
And that's a reality.
00:36:01.746 --> 00:36:03.246
So I went home and I thought about
00:36:03.266 --> 00:36:05.047
it similarly to how we're thinking about
00:36:05.086 --> 00:36:05.367
this.
00:36:05.907 --> 00:36:07.007
But I didn't think about it from my...
00:36:08.106 --> 00:36:09.887
particular small radio stations point of
00:36:09.907 --> 00:36:10.106
view.
00:36:10.748 --> 00:36:12.148
I thought about it from the entire
00:36:12.188 --> 00:36:12.528
building.
00:36:12.909 --> 00:36:13.989
So four radio stations.
00:36:14.070 --> 00:36:14.510
And I was like,
00:36:15.030 --> 00:36:17.273
this guy over here is a,
00:36:17.333 --> 00:36:19.713
this he's a net negative guy.
00:36:20.574 --> 00:36:22.637
And he makes more money than my people.
00:36:23.875 --> 00:36:26.257
And the station he's running isn't
00:36:26.277 --> 00:36:29.039
performing well because of, I mean,
00:36:29.139 --> 00:36:31.521
my extrapolation because of his attitude,
00:36:31.541 --> 00:36:33.242
this guy could, you know,
00:36:33.802 --> 00:36:35.184
so I went back in the next morning,
00:36:35.405 --> 00:36:37.606
a little hungover and I said, Hey boss,
00:36:38.226 --> 00:36:39.288
I got a crazy idea.
00:36:39.608 --> 00:36:40.789
And he was used to me saying that.
00:36:40.809 --> 00:36:41.349
And he's like, Jimmy,
00:36:41.369 --> 00:36:42.690
this is not the time for a crazy
00:36:42.751 --> 00:36:43.030
idea.
00:36:43.351 --> 00:36:44.132
This is the time for an,
00:36:44.311 --> 00:36:45.373
I need an answer, dude.
00:36:46.134 --> 00:36:46.614
And I was like,
00:36:47.494 --> 00:36:48.695
I have an answer that is going to
00:36:48.715 --> 00:36:49.836
give you an answer that
00:36:51.172 --> 00:36:53.233
You're going to save more money and you're
00:36:53.253 --> 00:36:54.434
going to give me a raise.
00:36:54.554 --> 00:36:55.333
And he was like, oh,
00:36:55.393 --> 00:36:56.755
I can't wait to hear this.
00:36:57.655 --> 00:36:58.235
And I was like,
00:36:58.356 --> 00:36:59.416
and I just made my case.
00:36:59.436 --> 00:36:59.615
I'm like,
00:36:59.635 --> 00:37:01.577
you got a guy over here running an
00:37:01.617 --> 00:37:02.697
entire radio station.
00:37:03.418 --> 00:37:04.298
And we both know
00:37:05.833 --> 00:37:06.653
He ain't going to get it done.
00:37:07.273 --> 00:37:08.494
And it's nothing he's doing.
00:37:08.534 --> 00:37:09.074
It's who he is.
00:37:09.355 --> 00:37:10.034
He's an Eeyore.
00:37:10.534 --> 00:37:12.655
And you can't out Eeyore this guy.
00:37:13.195 --> 00:37:13.496
And I was like,
00:37:13.715 --> 00:37:14.516
you're going to fire him.
00:37:14.817 --> 00:37:16.237
I'm going to take over his radio station.
00:37:16.496 --> 00:37:17.556
This was a country radio station.
00:37:17.916 --> 00:37:19.538
I knew nothing about country.
00:37:19.637 --> 00:37:21.418
And I said that, Bill, you know me.
00:37:21.677 --> 00:37:22.219
I'm a rock guy.
00:37:22.358 --> 00:37:23.259
I know nothing about country.
00:37:23.278 --> 00:37:23.659
He goes, yeah.
00:37:23.679 --> 00:37:24.458
How are you going to get around that?
00:37:25.139 --> 00:37:26.760
There's a staff on that radio station that
00:37:26.780 --> 00:37:27.780
knows all about country.
00:37:28.420 --> 00:37:29.661
I know how to work with people and
00:37:29.681 --> 00:37:30.380
be creative.
00:37:30.860 --> 00:37:32.320
I also know how to listen to people.
00:37:32.822 --> 00:37:34.262
So I'm going to do that guy's job.
00:37:35.505 --> 00:37:37.146
You're going to save money because you're
00:37:37.166 --> 00:37:37.547
going to hire,
00:37:37.586 --> 00:37:38.907
you're going to fire another manager.
00:37:39.126 --> 00:37:40.367
You asked me to follow, you know,
00:37:40.887 --> 00:37:41.668
fire one of my people.
00:37:41.827 --> 00:37:42.909
He makes more money than them.
00:37:43.248 --> 00:37:44.349
You're going to give me a little bit
00:37:44.369 --> 00:37:45.389
of that money because now I'm going to
00:37:45.409 --> 00:37:50.190
do two jobs and net positive, we will,
00:37:50.210 --> 00:37:52.751
the team will be stronger for it.
00:37:52.851 --> 00:37:55.572
You're going to fire a good person and
00:37:55.652 --> 00:37:58.574
let a net negative person,
00:37:58.614 --> 00:37:59.355
what do you call them again?
00:37:59.554 --> 00:37:59.755
Like a...
00:38:01.047 --> 00:38:03.590
presentism you let that person stick
00:38:03.630 --> 00:38:05.090
around and when i made the case he
00:38:05.110 --> 00:38:07.652
was like you're right by five o'clock that
00:38:07.672 --> 00:38:08.974
day i was running two radio stations and
00:38:08.994 --> 00:38:11.976
someone was like sorry but i protected my
00:38:12.036 --> 00:38:14.117
people they did nothing wrong they were
00:38:14.217 --> 00:38:17.179
all plus plus minus people and you were
00:38:17.199 --> 00:38:19.179
a minus plus minus person and i want
00:38:19.221 --> 00:38:21.081
plus plus minus people and we would have
00:38:21.101 --> 00:38:22.663
been net negative if i hadn't pulled that
00:38:22.682 --> 00:38:24.543
move and i will do it ten times
00:38:24.583 --> 00:38:26.385
out of ten that's how i got my
00:38:26.485 --> 00:38:27.166
second radio station
00:38:28.242 --> 00:38:28.583
And I think,
00:38:28.822 --> 00:38:30.103
I think the question that people are
00:38:30.143 --> 00:38:32.485
probably asking if they are in management
00:38:32.706 --> 00:38:35.166
is how do I screen for those people
00:38:35.367 --> 00:38:37.148
to keep them onto our team?
00:38:37.507 --> 00:38:40.210
How do I avoid the conversion from a
00:38:40.269 --> 00:38:41.391
positive to a negative?
00:38:41.411 --> 00:38:42.650
Because I think that's a big one.
00:38:42.690 --> 00:38:42.952
Yeah.
00:38:42.972 --> 00:38:43.552
Cause everybody, yeah.
00:38:43.592 --> 00:38:45.132
No one shows up to be that right.
00:38:45.552 --> 00:38:47.094
And it does happen and it happens a
00:38:47.213 --> 00:38:49.916
lot and I see it and I see
00:38:49.936 --> 00:38:52.637
it everywhere in our profession, right?
00:38:52.657 --> 00:38:54.257
You just have to look at social media
00:38:54.297 --> 00:38:54.797
comments.
00:38:55.518 --> 00:38:55.719
Like,
00:39:00.367 --> 00:39:02.248
i tell people not to become a physical
00:39:02.289 --> 00:39:03.891
therapist because of x y like you're
00:39:03.931 --> 00:39:06.112
poisoning the well before they even got in
00:39:06.152 --> 00:39:08.693
the water right like why are we not
00:39:08.733 --> 00:39:10.416
making the profession better why are we
00:39:10.456 --> 00:39:12.777
just like i think what they're with i
00:39:13.018 --> 00:39:15.378
mean they're i mean a psychologist would
00:39:15.418 --> 00:39:18.461
say they're projecting right yeah and i've
00:39:18.722 --> 00:39:20.342
made videos i will not talk out of
00:39:20.362 --> 00:39:22.025
both sides of my mouth i am pissed
00:39:22.164 --> 00:39:24.326
off at the math because math don't care
00:39:24.346 --> 00:39:25.226
about vibes totally
00:39:26.273 --> 00:39:27.434
So I would like to change the system
00:39:27.474 --> 00:39:27.775
as well.
00:39:27.974 --> 00:39:29.615
But yes, I agree with that.
00:39:29.735 --> 00:39:29.896
I mean,
00:39:29.956 --> 00:39:31.297
I put a comment every day that got...
00:39:31.916 --> 00:39:35.079
Someone asked about, should I become a PT?
00:39:35.119 --> 00:39:36.239
And I was like, do the math.
00:39:36.860 --> 00:39:38.059
If you really want to do this and
00:39:38.079 --> 00:39:39.481
you understand what it costs and you still
00:39:39.501 --> 00:39:40.201
go with it, great.
00:39:40.362 --> 00:39:41.362
Go with God.
00:39:41.382 --> 00:39:42.041
Knock yourself out.
00:39:42.523 --> 00:39:43.762
But like someone said,
00:39:44.224 --> 00:39:45.784
schools should do a better job educating.
00:39:45.824 --> 00:39:46.485
And I'm like, my man,
00:39:47.085 --> 00:39:48.405
they gave you the papers.
00:39:49.490 --> 00:39:50.831
All the numbers were in there.
00:39:51.371 --> 00:39:55.795
You're not looking at them as your fault.
00:39:56.014 --> 00:39:57.215
So I'm not saying don't pay back the
00:39:57.255 --> 00:39:58.516
loans or any of those things.
00:39:58.996 --> 00:40:01.197
I'm saying let's change that because this
00:40:01.257 --> 00:40:01.639
sucks.
00:40:01.958 --> 00:40:02.898
And down the line,
00:40:03.139 --> 00:40:05.501
we're going to have less good people on
00:40:05.541 --> 00:40:06.061
our team.
00:40:06.402 --> 00:40:08.483
And that's going to screw everybody.
00:40:09.431 --> 00:40:11.132
So I'm not saying let's just erase it
00:40:11.152 --> 00:40:12.653
and say, ah, you made a bad move.
00:40:12.994 --> 00:40:14.275
Let's change the whole damn thing because
00:40:14.315 --> 00:40:15.416
it's not good.
00:40:15.775 --> 00:40:17.617
Never mind fair or equitable.
00:40:18.358 --> 00:40:18.918
It's deeper.
00:40:19.039 --> 00:40:21.942
It's not good for the system,
00:40:21.981 --> 00:40:23.342
for the person, for the people,
00:40:23.643 --> 00:40:24.324
for the organization.
00:40:24.344 --> 00:40:25.445
It's not good.
00:40:25.885 --> 00:40:27.346
So if something's not good,
00:40:27.987 --> 00:40:29.427
I thought we were supposed to be able
00:40:29.447 --> 00:40:29.969
to change it.
00:40:30.268 --> 00:40:32.050
And here's the problem.
00:40:32.771 --> 00:40:36.253
The parts of the system that make the
00:40:36.273 --> 00:40:38.715
decisions for not good, I'll talk to them.
00:40:38.875 --> 00:40:40.255
They're not listening to my podcast.
00:40:40.376 --> 00:40:41.356
I could talk about them for months.
00:40:41.637 --> 00:40:43.617
The people who decide what PT programs
00:40:43.657 --> 00:40:45.318
cost, from my understanding,
00:40:46.039 --> 00:40:46.659
I talk to people.
00:40:47.079 --> 00:40:48.581
It's not the professors, guys.
00:40:48.800 --> 00:40:49.141
Trust me.
00:40:49.481 --> 00:40:51.943
They are not rolling in cash.
00:40:52.262 --> 00:40:53.443
I'm not saying they're not making money.
00:40:53.543 --> 00:40:54.103
They should be.
00:40:54.384 --> 00:40:55.885
They have a ton of experience and do
00:40:55.925 --> 00:40:56.385
a great job.
00:40:56.885 --> 00:40:58.746
It is not the chairs of the department.
00:40:59.947 --> 00:41:01.509
It is not the deans.
00:41:03.427 --> 00:41:06.389
people you've never met who are doing jobs
00:41:06.648 --> 00:41:07.829
that you have no idea.
00:41:08.650 --> 00:41:09.429
It's those people.
00:41:09.650 --> 00:41:10.831
They're not listening to you.
00:41:11.231 --> 00:41:11.670
They're not.
00:41:11.831 --> 00:41:12.672
That's probably their problem,
00:41:12.692 --> 00:41:14.472
but they are not incentivized to make you
00:41:14.512 --> 00:41:14.833
happy.
00:41:15.152 --> 00:41:17.554
They win the minute you apply and sign
00:41:18.034 --> 00:41:18.894
and someone gets paid.
00:41:19.235 --> 00:41:20.456
So how to fix it?
00:41:20.556 --> 00:41:21.556
I'm not saying I know how,
00:41:21.775 --> 00:41:23.536
but you're yelling at the wrong person.
00:41:23.856 --> 00:41:25.077
You're mad at the wrong people.
00:41:25.097 --> 00:41:27.458
It's also like saying that the APTA is
00:41:27.478 --> 00:41:29.019
somehow like in a hundred percent control
00:41:29.079 --> 00:41:29.800
of what we get paid.
00:41:29.860 --> 00:41:30.280
Correct.
00:41:31.360 --> 00:41:32.300
I'm not saying you're not.
00:41:32.521 --> 00:41:33.702
You're yawning at the wrong people.
00:41:33.722 --> 00:41:35.023
Like they're doing the things,
00:41:35.382 --> 00:41:37.905
but you need to take all that energy
00:41:37.985 --> 00:41:39.726
and take it to where those decisions are
00:41:39.766 --> 00:41:40.027
made.
00:41:40.507 --> 00:41:41.947
And then talk is doing that.
00:41:42.248 --> 00:41:42.467
Right.
00:41:42.588 --> 00:41:44.469
And then talk to them in a language
00:41:44.750 --> 00:41:45.650
that they can understand.
00:41:45.751 --> 00:41:47.512
Listen, they know what they're doing.
00:41:48.293 --> 00:41:48.652
Right.
00:41:48.853 --> 00:41:50.153
They know what they're doing.
00:41:51.135 --> 00:41:53.036
There's just no reason for them not to
00:41:53.096 --> 00:41:53.456
do it.
00:41:53.637 --> 00:41:55.418
Oh, we should stop applying.
00:41:55.498 --> 00:41:57.318
And I go, would you have stopped applying?
00:41:57.460 --> 00:41:57.599
No.
00:41:58.358 --> 00:41:59.480
You wouldn't have.
00:41:59.599 --> 00:42:02.961
It will not change until the pain of
00:42:03.121 --> 00:42:04.563
inaction is greater than the pain of
00:42:04.623 --> 00:42:04.882
action.
00:42:05.123 --> 00:42:05.704
Did I do that right?
00:42:06.204 --> 00:42:06.364
Yeah.
00:42:06.664 --> 00:42:07.885
The pain of inaction is greater than.
00:42:08.025 --> 00:42:09.246
That's the only reason you get off the
00:42:09.266 --> 00:42:11.387
couch because you feel an internal pain
00:42:11.628 --> 00:42:13.349
that staying here hurts more than what it
00:42:13.369 --> 00:42:14.429
does when I just got to go run
00:42:14.449 --> 00:42:14.949
a couple of miles.
00:42:15.530 --> 00:42:17.311
There's no reason for them to lower costs.
00:42:17.811 --> 00:42:19.431
This whole thing with the unprofessional
00:42:19.472 --> 00:42:20.092
Malone's thing,
00:42:20.231 --> 00:42:20.891
it's not going to change it.
00:42:21.371 --> 00:42:22.293
Not going to change cost.
00:42:22.853 --> 00:42:24.474
It will screw people because they won't be
00:42:24.514 --> 00:42:24.753
able to...
00:42:25.134 --> 00:42:28.235
It'll change who is able to apply from
00:42:28.414 --> 00:42:29.576
the smart people that I've talked to.
00:42:30.275 --> 00:42:32.177
I would love when people are in my
00:42:32.217 --> 00:42:35.838
DMs going, but, but, but...
00:42:36.177 --> 00:42:38.059
If there are forty seats at a program,
00:42:38.259 --> 00:42:39.940
as long as there's forty-one qualified
00:42:39.980 --> 00:42:40.400
applicants...
00:42:42.489 --> 00:42:43.168
Ta-da!
00:42:43.188 --> 00:42:44.349
There's no change.
00:42:44.971 --> 00:42:48.612
You need to have six applicants at most
00:42:48.693 --> 00:42:50.273
for five years before it would change.
00:42:50.373 --> 00:42:51.195
And I'm making up numbers,
00:42:51.235 --> 00:42:51.974
but you get what I mean.
00:42:52.315 --> 00:42:54.476
You need to be bleeding before you call
00:42:54.516 --> 00:42:54.996
the ambulance.
00:42:55.016 --> 00:42:56.297
It's not going to happen.
00:42:56.318 --> 00:42:57.199
It's just like PT payment, right?
00:42:57.239 --> 00:43:00.800
PTs have been taking the payment the way
00:43:00.840 --> 00:43:02.402
that it is for so long.
00:43:03.003 --> 00:43:05.284
Why on earth would insurance companies
00:43:05.344 --> 00:43:06.684
suddenly be like, you know what?
00:43:06.744 --> 00:43:07.344
We were wrong.
00:43:07.706 --> 00:43:08.146
Correct.
00:43:08.365 --> 00:43:09.347
Let's pay you more money.
00:43:10.318 --> 00:43:11.519
The other way too, hey,
00:43:11.539 --> 00:43:13.760
we're taking jobs at salaries we shouldn't
00:43:13.800 --> 00:43:13.960
do.
00:43:14.001 --> 00:43:15.300
And you're saying we should unionize.
00:43:15.340 --> 00:43:16.121
And I'm going, great.
00:43:16.202 --> 00:43:18.603
Are you any good at organizing people?
00:43:18.623 --> 00:43:19.422
Yeah.
00:43:19.443 --> 00:43:20.563
I'm not saying don't do it.
00:43:20.744 --> 00:43:21.864
I'm saying the likelihood of that
00:43:21.903 --> 00:43:22.844
happening is low.
00:43:23.465 --> 00:43:23.764
Yes.
00:43:23.804 --> 00:43:25.425
I would love to be wrong here though.
00:43:25.525 --> 00:43:26.387
I would love to be.
00:43:26.746 --> 00:43:27.706
Maybe that is the only way.
00:43:27.827 --> 00:43:28.547
I don't know it.
00:43:30.608 --> 00:43:34.190
But being mad at the wrong people,
00:43:34.230 --> 00:43:35.570
it's a real waste of energy.
00:43:39.385 --> 00:43:39.985
I don't blame them.
00:43:40.065 --> 00:43:41.306
I don't either.
00:43:42.628 --> 00:43:43.228
I don't blame them.
00:43:43.728 --> 00:43:44.929
We're measuring the wrong things.
00:43:44.949 --> 00:43:46.371
I don't know.
00:43:46.391 --> 00:43:48.452
It's easier to be wrong or being angry
00:43:48.512 --> 00:43:51.114
at a group of people or a perceived
00:43:52.034 --> 00:43:55.096
person in the entire system because if
00:43:55.115 --> 00:43:56.056
you're mad at the system,
00:43:57.097 --> 00:43:58.298
it feels too big to solve.
00:43:58.699 --> 00:44:03.222
Who gets yelled at when you don't like
00:44:03.242 --> 00:44:04.503
what a PT program is doing?
00:44:04.563 --> 00:44:06.043
The chair and the professors.
00:44:07.021 --> 00:44:09.304
They are not the ones setting the prices.
00:44:09.364 --> 00:44:11.367
My friends, if they were,
00:44:11.407 --> 00:44:13.208
they'd be setting their own salaries and
00:44:13.268 --> 00:44:14.670
trust me, they'd be higher.
00:44:15.512 --> 00:44:17.735
Like it's just not, it's not it.
00:44:18.074 --> 00:44:19.657
You're not wrong for being mad.
00:44:20.157 --> 00:44:21.980
You're just yelling at the wrong thing.
00:44:22.380 --> 00:44:23.161
In my opinion,
00:44:23.320 --> 00:44:24.603
this is just everything here is my
00:44:24.623 --> 00:44:24.902
opinion.
00:44:26.621 --> 00:44:26.880
All right.
00:44:26.940 --> 00:44:29.222
So to make this tactical,
00:44:29.443 --> 00:44:31.744
let's say you did work for this person
00:44:31.764 --> 00:44:33.045
that we started this whole conversation
00:44:33.065 --> 00:44:33.505
around with.
00:44:33.666 --> 00:44:36.909
You work and you are in a position
00:44:37.068 --> 00:44:39.650
of leadership, not management,
00:44:40.291 --> 00:44:42.092
but management and or let's say
00:44:42.132 --> 00:44:42.632
leadership.
00:44:43.673 --> 00:44:44.695
What would you do?
00:44:44.715 --> 00:44:47.356
I would want to hear everything.
00:44:48.257 --> 00:44:48.538
Say it.
00:44:48.976 --> 00:44:50.916
Like, no holds barred.
00:44:50.936 --> 00:44:51.536
Like,
00:44:51.677 --> 00:44:53.217
this will not reflect poorly on you on
00:44:53.257 --> 00:44:54.478
your performance evaluation.
00:44:54.498 --> 00:44:55.697
This will not be held against you.
00:44:55.717 --> 00:44:57.338
Like, tell me everything.
00:44:58.018 --> 00:44:58.318
Tell me.
00:44:58.378 --> 00:44:59.179
Like, lay it on me.
00:44:59.599 --> 00:45:01.378
I even want to hear your personal stuff,
00:45:01.398 --> 00:45:01.619
too.
00:45:02.019 --> 00:45:03.380
Because maybe this person is under a lot
00:45:03.400 --> 00:45:04.579
of personal duress as well.
00:45:04.659 --> 00:45:05.981
Like, they have a health problem.
00:45:06.021 --> 00:45:07.800
They aren't making enough money for their
00:45:07.840 --> 00:45:08.101
family.
00:45:08.121 --> 00:45:09.222
They've had to pick up a second job.
00:45:09.262 --> 00:45:10.782
Like, I want to hear all of it.
00:45:10.902 --> 00:45:12.523
I want to hear why they wanted to
00:45:12.563 --> 00:45:13.023
be a PT.
00:45:13.043 --> 00:45:14.202
I want to hear why they're still a
00:45:14.242 --> 00:45:14.623
PT.
00:45:14.722 --> 00:45:17.103
I want to know why they feel the
00:45:17.143 --> 00:45:17.643
way they feel.
00:45:19.047 --> 00:45:20.208
And I just want to receive all that.
00:45:20.309 --> 00:45:21.588
I think that's step one, right?
00:45:21.608 --> 00:45:22.650
Just receiving all of it,
00:45:23.010 --> 00:45:24.389
not telling them, not explaining,
00:45:24.429 --> 00:45:24.931
not defending.
00:45:24.971 --> 00:45:25.251
Well,
00:45:25.291 --> 00:45:26.630
the hospital had to make this decision
00:45:26.650 --> 00:45:27.612
because I was like,
00:45:27.632 --> 00:45:28.632
we're not doing that today.
00:45:29.552 --> 00:45:31.112
We're just receiving all of that.
00:45:31.994 --> 00:45:33.835
What do you love about this job?
00:45:34.215 --> 00:45:35.335
I want to hear all of that too.
00:45:35.494 --> 00:45:37.076
Like, why did you take this job?
00:45:37.396 --> 00:45:38.896
Why are you still at this job?
00:45:39.237 --> 00:45:41.358
What would make this job feel worth it
00:45:41.398 --> 00:45:42.057
to you again?
00:45:42.617 --> 00:45:44.059
And then like that stretch goal too,
00:45:44.099 --> 00:45:46.059
like what would make this job magical to
00:45:46.099 --> 00:45:46.199
you?
00:45:47.608 --> 00:45:49.309
Like what would make this job someplace
00:45:49.349 --> 00:45:51.550
that you wanted to be every day?
00:45:51.989 --> 00:45:54.010
And if you can't see a path to
00:45:54.050 --> 00:45:56.012
that, like if there's like nothing,
00:45:56.152 --> 00:45:57.773
if you're, if your answer is nothing,
00:45:57.813 --> 00:45:59.373
it's never going to be like, I don't.
00:46:00.193 --> 00:46:01.454
Then maybe we just be done.
00:46:02.195 --> 00:46:03.516
Maybe it's time for you to look for
00:46:03.556 --> 00:46:04.016
something else.
00:46:04.036 --> 00:46:04.157
Like,
00:46:04.177 --> 00:46:06.358
because I'm fully receptive to hearing
00:46:06.378 --> 00:46:06.637
from you,
00:46:06.657 --> 00:46:08.579
like what it would take to get you
00:46:08.619 --> 00:46:09.478
back on the horse.
00:46:10.380 --> 00:46:11.280
I want to get you back on the
00:46:11.360 --> 00:46:12.760
unicorn, but.
00:46:14.831 --> 00:46:16.411
If you can't see a path to that,
00:46:16.472 --> 00:46:18.632
I can't even meet you halfway.
00:46:18.713 --> 00:46:20.233
So I'm probably going to decrease my
00:46:20.293 --> 00:46:22.956
investment in you because you've decreased
00:46:22.976 --> 00:46:25.077
your investment in the organization.
00:46:25.297 --> 00:46:27.378
And realistically,
00:46:27.398 --> 00:46:28.858
if you're bringing that energy into rooms,
00:46:28.878 --> 00:46:30.280
you've decreased your investment in your
00:46:30.320 --> 00:46:30.760
patients.
00:46:30.800 --> 00:46:31.661
And maybe at this point,
00:46:31.681 --> 00:46:33.101
you're a little bit of a liability.
00:46:33.222 --> 00:46:34.181
I don't know that for sure.
00:46:34.483 --> 00:46:36.884
I'm not like if I felt like I
00:46:36.903 --> 00:46:38.824
was in the hole that deeply,
00:46:38.945 --> 00:46:40.346
I would be worried about my ability to
00:46:40.405 --> 00:46:42.547
provide care.
00:46:42.746 --> 00:46:42.827
Yeah.
00:46:42.847 --> 00:46:43.608
So I would start there.
00:46:44.766 --> 00:46:46.208
Oprah said people want to be seen, heard,
00:46:46.228 --> 00:46:46.688
and understood.
00:46:46.708 --> 00:46:46.807
Yes.
00:46:46.847 --> 00:46:49.989
That's where I would start.
00:46:50.530 --> 00:46:52.471
And if there's the movie Jersey up in
00:46:52.510 --> 00:46:53.791
the air with George Clooney and Anna
00:46:53.811 --> 00:46:54.070
Kendrick.
00:46:54.090 --> 00:46:54.170
Yeah.
00:46:54.190 --> 00:46:56.431
Where they fire everybody.
00:46:56.452 --> 00:46:56.572
Well,
00:46:56.592 --> 00:46:58.012
their job is to be brought in and
00:46:58.052 --> 00:46:59.713
he had the one who's the guy from
00:46:59.733 --> 00:47:00.454
the drumming movie.
00:47:00.474 --> 00:47:00.514
Um,
00:47:00.534 --> 00:47:04.036
the guy that was in Top Gun too.
00:47:05.074 --> 00:47:05.534
No, J.K.
00:47:05.576 --> 00:47:07.378
Simmons, the drumming instructor.
00:47:07.818 --> 00:47:08.478
Yeah.
00:47:08.518 --> 00:47:09.159
Not Miles Teller.
00:47:09.900 --> 00:47:10.240
So anyway,
00:47:10.302 --> 00:47:12.483
George Clooney is firing Miles Teller in
00:47:12.523 --> 00:47:12.925
this scene.
00:47:12.945 --> 00:47:13.525
It's a great scene.
00:47:14.507 --> 00:47:15.728
And of course, like J.K.,
00:47:17.452 --> 00:47:19.253
is pissed his character jk simmons
00:47:19.594 --> 00:47:21.815
characters piss and he's like who are you
00:47:21.876 --> 00:47:24.398
you know f you and clooney and of
00:47:24.438 --> 00:47:25.719
course it's a movie guys i get it
00:47:26.119 --> 00:47:27.981
but he turns it into a story he
00:47:28.081 --> 00:47:29.923
read that guy's whole file before he
00:47:29.963 --> 00:47:31.505
brought him in to fire him whole file
00:47:31.766 --> 00:47:33.367
and jk simmons is in his fifties or
00:47:33.407 --> 00:47:36.650
sixties or whatever in this scene and he's
00:47:36.690 --> 00:47:38.371
essentially he's framing this as like a
00:47:38.472 --> 00:47:40.554
rebirth and he's like
00:47:44.588 --> 00:47:47.090
The whole pitch is he saw in the
00:47:47.110 --> 00:47:49.831
guy's file that he studied French culinary
00:47:50.373 --> 00:47:51.373
arts in college.
00:47:51.853 --> 00:47:54.596
Like, that's not a gimme major.
00:47:54.976 --> 00:47:55.737
Like, that's hard.
00:47:55.936 --> 00:47:56.297
And, like,
00:47:57.338 --> 00:47:58.920
you're not going to make a billion dollars
00:47:59.019 --> 00:47:59.880
doing that, right?
00:48:00.561 --> 00:48:02.001
So he's like, and he's like,
00:48:02.123 --> 00:48:03.764
and you waited tables at El Picador.
00:48:03.844 --> 00:48:05.644
Like, he read the guy's file.
00:48:05.684 --> 00:48:06.846
And now he's in, like, some cubicle.
00:48:08.067 --> 00:48:10.148
And he's like, and his question was,
00:48:10.309 --> 00:48:11.791
how much did they pay you to give
00:48:11.831 --> 00:48:12.590
up on your dream?
00:48:13.112 --> 00:48:13.492
Ooh.
00:48:14.050 --> 00:48:14.650
And he was like,
00:48:15.431 --> 00:48:17.652
thirty eight thousand dollars in health
00:48:17.672 --> 00:48:18.152
insurance.
00:48:18.733 --> 00:48:20.434
And he's like, I'm not he's like,
00:48:20.474 --> 00:48:21.255
this is happening.
00:48:22.215 --> 00:48:22.655
But he's like,
00:48:22.735 --> 00:48:25.117
your next step is your choice to make.
00:48:26.217 --> 00:48:28.438
And you lose your job.
00:48:28.458 --> 00:48:29.778
It's not softening the blow,
00:48:30.239 --> 00:48:32.059
but at least it's at least saying like
00:48:33.001 --> 00:48:34.382
you could go find another one of these
00:48:34.422 --> 00:48:36.001
jobs and this could happen again.
00:48:36.163 --> 00:48:37.523
And also you hate it here.
00:48:37.583 --> 00:48:38.643
Why aren't you in a kitchen?
00:48:39.164 --> 00:48:40.764
You wanted to be in that kitchen.
00:48:41.827 --> 00:48:44.188
And you made the smart move of getting
00:48:44.228 --> 00:48:46.550
a reliable job with four Oh one K
00:48:46.590 --> 00:48:47.329
and health insurance.
00:48:47.409 --> 00:48:47.851
I get it.
00:48:48.291 --> 00:48:49.931
But he made the guy look at himself.
00:48:50.192 --> 00:48:51.492
Cause you could be mad at the company
00:48:51.913 --> 00:48:53.873
or the machine or the world.
00:48:54.454 --> 00:48:56.215
And that isn't going to change it.
00:48:56.295 --> 00:48:57.737
But you reframing how you're going to look
00:48:57.797 --> 00:49:00.177
at it is the only, it sucks.
00:49:00.197 --> 00:49:02.259
You can control what you can control,
00:49:02.280 --> 00:49:03.400
but you can control it.
00:49:03.659 --> 00:49:04.460
So that was a great,
00:49:04.641 --> 00:49:07.443
I thought a great scene from that movie.
00:49:07.543 --> 00:49:08.884
Cause at least Clooney's character was
00:49:08.923 --> 00:49:09.143
like,
00:49:10.148 --> 00:49:10.768
Can you imagine?
00:49:10.949 --> 00:49:11.748
I couldn't do that job.
00:49:11.929 --> 00:49:13.150
The guy where you just fire everybody.
00:49:13.931 --> 00:49:16.092
Although someone's going to do it.
00:49:16.572 --> 00:49:17.353
Someone's going to do it.
00:49:17.373 --> 00:49:17.994
It's happened.
00:49:18.393 --> 00:49:19.355
That was one of the lines.
00:49:19.394 --> 00:49:19.994
This is happening.
00:49:23.177 --> 00:49:25.798
But it showed he actually took the time
00:49:26.780 --> 00:49:28.521
because people want to be seen, heard,
00:49:28.561 --> 00:49:29.322
and understood,
00:49:29.501 --> 00:49:30.722
according to our friend Oprah.
00:49:31.023 --> 00:49:31.864
That's probably why she was pretty
00:49:31.884 --> 00:49:32.423
successful.
00:49:34.364 --> 00:49:35.666
To do that with that guy and the
00:49:35.766 --> 00:49:37.447
idea there is his character is now going
00:49:37.487 --> 00:49:38.068
to leave and
00:49:39.012 --> 00:49:40.994
inhale exhale while he takes his stuff to
00:49:41.034 --> 00:49:42.373
his car in a cardboard box and go
00:49:42.474 --> 00:49:44.275
what do i got twenty more years man
00:49:44.894 --> 00:49:46.876
what do i want to do go do
00:49:46.916 --> 00:49:50.496
that yeah go do that all right parting
00:49:50.516 --> 00:49:53.518
shots what do you got parting shots i
00:49:53.538 --> 00:49:55.418
think my parting shot is is to this
00:49:55.458 --> 00:49:57.480
therapist and in any therapist that feels
00:49:57.500 --> 00:49:58.659
like this we don't want to lose you
00:49:58.679 --> 00:50:00.701
like so
00:50:03.088 --> 00:50:04.469
Figure out what it would take for you
00:50:04.510 --> 00:50:05.710
to get back on the unicorn.
00:50:06.050 --> 00:50:07.472
And if PT is not it,
00:50:07.532 --> 00:50:08.072
I get that.
00:50:08.211 --> 00:50:09.713
If it's the place where you work,
00:50:09.793 --> 00:50:10.273
I get that.
00:50:10.773 --> 00:50:12.574
But advocate within yourself,
00:50:12.675 --> 00:50:14.476
advocate within your facility and advocate
00:50:14.496 --> 00:50:15.436
within your profession.
00:50:15.896 --> 00:50:17.036
And if that feels like too much,
00:50:18.277 --> 00:50:18.818
then let it go.
00:50:19.318 --> 00:50:20.398
But we want you.
00:50:20.619 --> 00:50:22.059
We want you in this profession.
00:50:22.320 --> 00:50:24.762
And so do the best that you can.
00:50:24.822 --> 00:50:26.141
Control what you can control,
00:50:26.202 --> 00:50:27.663
which is what you bring to your job,
00:50:27.682 --> 00:50:28.903
what you bring to your patients every day.
00:50:30.422 --> 00:50:31.563
If I repeat it a couple times,
00:50:31.583 --> 00:50:32.923
it probably has to be a parting shot,
00:50:32.943 --> 00:50:34.184
which is people want to be seen, heard,
00:50:34.204 --> 00:50:34.686
and understood.
00:50:35.746 --> 00:50:36.327
I ain't magic.
00:50:36.766 --> 00:50:38.329
When I was a boss in radio,
00:50:38.809 --> 00:50:40.170
I didn't have a lot of levers I
00:50:40.190 --> 00:50:40.650
could pull.
00:50:41.550 --> 00:50:43.413
But I learned from my dad,
00:50:43.452 --> 00:50:44.393
who was a fireman.
00:50:44.454 --> 00:50:45.655
He was like, when you get promoted,
00:50:45.735 --> 00:50:46.695
you work for them.
00:50:46.755 --> 00:50:48.516
You work for the people you oversee.
00:50:49.197 --> 00:50:51.179
So my job was like, how are you?
00:50:51.739 --> 00:50:52.681
And I can't be like,
00:50:52.721 --> 00:50:54.101
here's a bucket load more money.
00:50:54.302 --> 00:50:55.302
That wasn't an option.
00:50:56.215 --> 00:50:57.916
So how else can we creatively make this
00:50:57.956 --> 00:50:59.918
place something that you want to do again?
00:50:59.938 --> 00:51:01.579
Because supposedly when you came here to
00:51:01.619 --> 00:51:03.362
work, you wanted to do this.
00:51:04.802 --> 00:51:06.043
So people want to be seen, heard,
00:51:06.184 --> 00:51:06.764
and understood.
00:51:07.605 --> 00:51:09.027
Find Rebecca online, website.
00:51:09.827 --> 00:51:10.969
BDDPT.com.
00:51:11.748 --> 00:51:12.769
And we'll talk again soon.
00:51:12.869 --> 00:51:15.152
I think we need an actual official name
00:51:15.211 --> 00:51:16.713
for your recurring segment.
00:51:18.340 --> 00:51:19.501
I don't want to use AI to get
00:51:19.541 --> 00:51:19.621
it.
00:51:19.641 --> 00:51:21.402
I want it to be au natural.
00:51:21.603 --> 00:51:21.802
Maybe,
00:51:21.963 --> 00:51:24.625
but I will take comments or suggestions
00:51:24.644 --> 00:51:25.846
from someone watching or listening,
00:51:25.885 --> 00:51:28.708
but we'll be back next week with Rebecca.
00:51:30.632 --> 00:51:31.693
That's it for this one,
00:51:31.972 --> 00:51:33.653
but we're just getting warmed up.
00:51:34.114 --> 00:51:36.056
Smash follow, send it to a friend,
00:51:36.255 --> 00:51:37.938
or crank up the next episode.
00:51:38.438 --> 00:51:39.318
Want to go deeper?
00:51:39.798 --> 00:51:43.842
Hit us at pgpinecast.com or find us on
00:51:43.882 --> 00:51:46.443
YouTube and socials at pgpinecast.
00:51:46.864 --> 00:51:49.146
And legally, none of this was advice.
00:51:49.226 --> 00:51:50.967
It's for entertainment purposes only.
00:51:52.628 --> 00:51:53.208
See, Keith?
00:51:53.409 --> 00:51:54.489
We read the script.
00:51:54.789 --> 00:51:55.451
Happy now?
