Do you own a business or just a job?

0:03 Broadcasting way too early from three separate Wi-Fi connections. It's PT Breakfast Club with Tony Meritato, Dave Kittle, and Jimmy McKay. Tuesday morning to you here on PT Breakfast Club. Tony Meritato, I'm Jimmy McKay, Dave Kittle. HR. HR gave me the day off today. So Dave Kittle's off today. But I will tease you with this. I think in two weeks I fly to Florida for APTA Florida. I think they asked me to do the keynote there because someone else named Jimmy McKay was on the docket. They just happened to Google me and they got me by accident.

0:45 So they asked me to do the talk, but both of you are making an appearance in the talk. What do you mean? Both of you, you and Dave, Dave. Oh, okay. So Florida or go to Orlando. Okay. I think they do their annual conference at the same spot every year. It's in Orlando. Of course, it's me. I'm not talking about anything clinical. I'm not doing that. So part of it, I was using AI to create the outline. I was using it as sort of as a bouncing off partner. And then I was like, this needs, I need some speed here.

1:26 You know, I think I told like a serious story and then lessen and it slowed it down. I'm like, I got to bring these people back up before we close, big close. So part of the speed round is I want to show people In the audience, it's going to be a couple hundred people there. Students, clinicians, everybody. People doing things differently. Like I'd like them to think, not to steal the idea straight, but be like, oh, what's my twist? So do you know Farley Schweigert? Yeah, of course. Like horseback equine. Well, it's way better when you say cowboy PT because like a New Yorker like me, I don't know. You ride a horse. You're a cowboy. Yeah. Cowboy PT. Or I talked about Steven Burkert up in Vermont. Snow Beast performance just hangs out with.

2:08 And I just want people to be like, wait, I've never I've never seen a job. You know, description like that, you know, someone trying to get me to click and apply. I'm like, yeah, you click and apply. You work at a place and you learn some stuff and maybe you go and do your own thing like what Dave does, like what Tony does. So it'll be like a speed round where I'm just want to put this. Here's this part, like almost like Chris Corner. Look at this guy. She just drives around to all these shows and treats people on horseback. You know, Alyssa arms is a dance PT. She goes to these dance competitions and she's like, boom, set up a table. She also dances. That's her hobby. But she's like, not only is my trip now covered, uh, I'm getting clients that'll see me, you know, for weeks and months virtually or in person.

2:51 So you guys made this, you guys made the, uh, the speed round. Are we talking about you guys? Yeah, that sounds awesome. All right, what do we want to talk about today? What was on the docket? You got a couple things. Yeah. First off, you said this, and I'm curious when we're going to stop saying this. You said, quote, I used AI, too. At some point, it's just going to be standard. Like, you assume you used AI. Like, I used a computer. I almost say it because I want to make sure people, like, I don't, like, I'm not trying to take ownership. Like, I'm not trying to, like, you know. But it was me, right, with the AI. But I think that's why I still say it. Yeah, I think we're going to hit the point where it's just assumed everything is built on the back of some sort of AI platform.

3:34 So I went to chat GPT. I just did it this morning on the way to work. And I was like, hey, you know, what is it? September first. Hey, September first. What are some ideas? Search LinkedIn. Now, I've never queued it to do that. I've never prompted it. But I said, search LinkedIn to see what kind of interesting business topics are out there for the podcast. You came up. Now, my chat GPT knows you, me, Dave, we do the podcast. But, you know, you came up as one of the posts that it recommended. Awesome. The ones that I thought were really interesting though that this audience might benefit from are some of the bigger business stuff.

4:18 You know, so like number one, traditional insurance versus cash pay, like nobody cares about that anymore. Should PT clinics stop selling visits? That was your post. The private equity. So I shared the screenshot with you, but it brought up, a post that talked about private equity, it talked about acquisitions, it talked about who owns PT clinics. And it got me thinking the person who shared the post said, if you're going to partner with a non-PT, you should not do it.

4:58 You should not have a business person come into your business. PTs should own PT clinics. We've had this discussion before, maybe not recently. That's the dumbest thing I've ever heard. I understand the emotion behind it and the intent behind it. And the person goes through the post and is like, a business person doesn't understand documentation. They don't understand patient engagement. They don't understand the alliance between the patient and the provider. You're right. That's what makes them so freaking good at running a business. How do you think somebody gets an MBA, spends all of those years studying and understanding business, And isn't better than you, a PT who is amazing at PT-ing, but you're not a business person.

5:46 You don't understand the value propositions and the exchange, and you haven't studied the history of business. And we see that negative business sentiment of we got to get business people out of healthcare. Yeah. It's a business. Yes. It's the business of healthcare. There's a, it says it right there. The business of healthcare served over breakfast right on the bottom. There's a line and I forget who said it. And it says something like, we judge others by their actions and we judge ourselves by our intentions. So this is what I think it means here in this situation.

6:27 Well, I understand healthcare because I'm a physical therapist. I have the schooling and the experience. And I understand business because I've been to businesses and I see how they work. Well, then isn't the reverse true? If someone's been to BT, then they, of course, figure it out. Well, no. You have insight into what you do and the little nuances. People see the outcome, but maybe they don't know the steps that go into it. Well, the same is business. Just because you're like, well, I get it. There's a door and a bunch of stuff and a cash register, and you sell stuff. It's like, well, how do you know what stuff to put on the shelf three months before it would be... popular. How'd you know how to do that? How'd you know how to work inventory? So I think it's, I think mismatching people with skill sets and knowledge is we learned about why this was valuable in the eighties, man.

7:17 It was called the a team. If you had four, you know, what, you know, howling mad Murdoch's that's a crappy team because there's no plan, but you do need one guy who's nuts enough to fly the helicopter under the bridge. Right? So saying a business person doesn't add tremendous value to a healthcare business. Now that doesn't mean that they're going to come in and say, well, let's do it this way. I've done it before. And then the person needs to say, okay, well, actually, we can't do that because ABC. This goes into my second saying, right? Everybody wants me to think outside the box. First, you got to put me in a box, right? Because if the same rules apply from retail to PT, some of them do, and some of them just plain old don't.

8:00 That's not a negative. That's just how it is. The smart person acts as if they're in the box and thinks their way out. They create their way out. So saying a business person isn't valuable in a PT or healthcare business. I mean, think about that because there it is. It's a healthcare business. You need to know how business works. Right. And then we go back into the circle. We've talked about this, which is there should be more business in PT school. There should be no business in PT school. And I'm like, everybody wants PT school to be cheaper, shorter, faster, get them out of the workforce. But also we're going to add an MBA. Like, where are we going to why not psychology then if all, you know, so we can go round and round in that. But yet saying a business person doesn't belong in a health care business.

8:43 Good luck. You do that. I'll do the other one. You do that. Yeah. So, you know, that I hate the negative sentiment toward business, but I guess everything is about balancing personalities. And so you need that, you know, person that empathy driven, you know, I can relate to my patient. I can give the best patient care experience. I want to do this because the business person is not going to be that person. And when you take on the challenge of, I'm going to be an amazing therapist and be an amazing business owner and be an amazing employer and be an amazing janitor and be an amazing marketer, you know, you're starting to dilute the water so deeply.

9:30 That's why we suffer when we try to do all of it at once. I will say this, a physical therapist in business becomes a business person. You gain knowledge in business, right? So it's not that I think this is one or the other, but I think as you've sort of highlighted, at some point, your capacity for the things that you can effectively oversee... hits a ceiling, right? You can't be the person doing, you know, the patient care and then worrying about the schedule and the finances. Like you can until you can't. And this is going to vary by setting. It's going to vary by person and place and all the different variables. But there is a point when you are doing all the things, but now you're doing them poorly.

10:15 And that's not a, I know you're saving money by doing everything, but at some point, listen, I could probably figure out how to, I got a leak in my roof. I could probably figure it out, but I'm forty six and I'm like, I'm not getting on the roof because if I fall off, I'm screwed. Right. And I'm out. I don't want to I don't want to risk me doing that poorly because winter's coming. Right. And now it's going to leak and cause more damage. So there's a we do this juice versus squeeze ratio all the time. Yeah. So that led me down that road. And I was like, well, what are the real businesses doing these days? So I prompted it again. I was like, hey, what's going on with... And when I think, this is kind of interesting, when I think of the real businesses in the physical therapy space, immediately my mind goes to Hinge Health, Sword, I had forgotten about Luna Physical Therapy.

11:07 Like they've been off my radar for a long time. And before Hinge and Sword, Luna Physical Therapy was like the business that I was following for everything. They were the leaders in innovation. They were pushing the envelope. So then I prompted, I was like, hey, what's going on with these businesses? And it was kind of interesting. Sword and Hinge, you know, they're making acquisitions. They're expanding outside of just physical therapy. You, me, Dave, we talked about them being like digital physical therapy platforms, but based on what they are doing. It looks like they're moving into like multiple spaces, not just the rehab space.

11:47 And, you know, hinge in two or three years, I think, grew faster and is just the same size or slightly larger than U.S. physical therapy, which has been around over twenty years. wow it's just these businesses can scale so quickly um so those are some interesting kind of business things what's on your mind about that isn't the isn't the um the setup with luna that you're not they're not full-time employees right they're ten they're they're they're independent like you're an independent operator right and you and they're your business you you contract with them or i don't want to say the wrong word here but you know what i'm saying Yeah, so Luna has positioned themselves, at least from what I've understood, as Uber.

12:35 Uber positions itself as a digital platform connecting drivers and passengers. You're not an employee of Uber, you're contracting, you're paying to use the Uber platform. And what's interesting about Luna is, you know, prior to this, so like, yeah, it was we're going to connect therapists who want to deliver in-home therapy services with patients who want in-home therapy services. We're the digital platform. We're the Uber of PT. They had the EMR that was like the most advanced, most revolutionary, most innovative EMR on the market. Every single therapist I spoke to who worked for Luna Love the EMR because you would literally get back in your car.

13:22 You'd call it on the phone. It would ask you questions. You would answer those questions and the documentation would be done in that capacity. And that's something I think we should discuss is back to even the most innovative EMRs on the market right now, kind of in the space. I don't think they're changing the fundamental way documentation is being done. Like, yes, there's AI scribes, there's ambient listening. I can't live without an AI scribe. I'm the first one to admit that. But I still find myself with this interaction with the computer and the keyboard and the AI scribe, I don't feel like it's fundamentally changed the way I document.

14:05 Or I should say the way most people are documenting. It's kind of changed for me, but I've got some tech background and I can make it do what I want. If you're looking at this from an outside perspective looking in, what are you seeing on the documentation front? Because obviously you have connections. Yeah. I thought it was really funny. I'd love to do like a timeline. I remember when scribes first came out, the argument was, it's always or never. We will never allow this. And then that went away real quick once people, even the biggest naysayers for a scribe or a sidekick or whatever you want to call them, went away real quick once people understood Because a lot of times, and now, you know, I think I'm long enough in the tooth where I can see, if you own a business, you're getting sold something every twenty minutes.

14:57 Like, you got a part-time job of saying, no, thank you. And the things that you try to pitch are time and money, time and money, time and money, time and money. We're going to save you time and money, time and money. And by the time you've heard that four hundred times, man, you are numb. Your brain is like, absolutely. And I don't blame business people for being numb and pessimistic and just not believing the hype. but what are you looking for like are people adopting it will it change does it actually save money and speed the one the one bit of research that surprised me from a big study that prompt just did was having the scribe didn't make people happier having described didn't save time unless the person liked the tool If you're a lumberjack and all you do is use axes and then all of a sudden it's chainsaw time, but you're still fighting it.

15:49 Yeah, you're not going to be effective with a chainsaw because the entire time, well, these kids today don't know what it's like to chop down a tree with an axe or whatever reason that is that you're not adopting it. So it's not necessarily just the skill, the tool, the effectiveness. It's as big as humans are big, dumb animals. Do you like it or not? Then if you do, it does do those things. It saves time. It saves money. That was the thing that made me go, oh, damn, that adage holds up. Humans are big, dumb animals. And whether we like it or not, are we going to drag our feet or not? I still think I just did a big overhaul on my AI documentation system over the past week.

16:34 I was falling behind on notes again. You know, I've got the recordings and I've got all of these things in place, but I'm like, I need to update the AIs have gotten better. The scribes have gotten better, but I'm still using old templates. So I did this major overhaul. and what i still find is it's really it needs to be a back and forth it's not it needs to identify why does it need to be a back and forth and not just a fourth Historically, it's been all about what I can process in my head. And I'm like, why? Why would it ever be like that? It has access to millions of data points. Why am I gonna think that I'm gonna be the perfect, get all the facts right, get all the details right, make all the clinical decisions right?

17:22 We've talked about at some point, the scale's gonna tip where if you're not using AI to double check, your clinical decision-making, it is malpractice. We are coming to that at this stage in the game. So I'm like, I should say, okay, hey, AI scribe, ambient listening, what do you think about this? What should I do about that? I've seen this. I noticed this. These are some of the indications that are popping up. Have this conversation back and forth. We're not at the point that we can do video yet. It's still not at the point where you could do photos yet, but if you look at some of the large language models coming out of China and some of the other things, that stuff is available.

18:06 Why is it not in our AI scribe under a HIPAA compliant guardian? I bought a three-D printer. I need a fall winter hobby. I bought a guitar, more to come with this. I bought a guitar and a three printer. I was like, I need to make something and I've got to do something. I have no music ability whatsoever. I get the three D printer. I follow all the directions. It's not working. So of course, what am I doing? I'm using voice mode on chat GPT to be like, it's giving me this error. The company that owns the printer does have like a AI companion, but it's giving me like error codes thing. I'm like, I'm a man. I just opened this eleven minutes ago. You're you're a thirty thousand foot.

18:46 So I'm using chat GPT and of course it's accessing probably their database, but it's giving me like better prompts to figure out what the thing is wrong. Finally, it says. do that process, shoot a fifteen second video and give me the video. I'll let you know. And I literally was like, can you can you do that? Because I haven't done that. I haven't given it video yet. I've given it photos. And yes, it was able to say in that part of the process, oh, yeah, that thing's touching that move that out of the way because it could see that. So what you're saying is not would would it be nice to have? It's it's fixing Jimmy's new three D printer. Why isn't it?

19:27 Why aren't we giving it video inpatient interactions? You know, this is going to happen when within twelve months. Got to be within. It'll be. And so even going back to companies like Hinge Health and some of the companies that are out there, they have the video. They can watch you do your home exercises. They can determine when you're out of alignment or whatever they think is important for that. It's not coming into the EMR experience. and so i just i think we need to expand that interface i'm not sure how it's going to happen um you didn't seem to think it was a big deal but i i was genuinely surprised i saw the announcement of spry working with luna physical therapy and this goes back to what i was saying earlier like the biggest thing about luna anybody could do mobile pt right But it was their documentation platform.

20:23 And now to see them partnering with an EMR company that's an established EMR, I was surprised about that. I don't know how old that announcement is. I think it's pretty fresh. Yeah. Yeah, I think it's pretty fresh. I mean, that's the thing, right, is if I'm going to take an extra job, it better be really, really easy or the juice isn't worth the squeeze, right? It's got to be easy money. Like Dave was talking about this the other day. No moonlighting, right? It's got to be terribly simple or like, yeah, I've already just put in eight hours. Why am I going to do two more unless the pay or the simplicity are high or low enough? So like Dave's paying way more than Luna. Luna pays on average between, I think it's like, sixty eight and seventy two dollars for an in-home visit.

21:06 You could get a home health contract with a home health company and get paid over one hundred dollars. Right. You know, so why are therapists taking a lower rate, twenty five percent less? better documentation better experience it's a different clientele these aren't your typical home health referrals these are outpatient referrals living in the home you know so um yeah that's that's a huge differentiator for anyone who has a mobile business and is looking to hire yeah if you can catch two patients on the way home if you you know if you get out of work at three or four o'clock and you're like i can catch two patients on the way home Why wouldn't you? If the lift is low and the juice is enough... Well, we talked about that Van Westendorp pricing model, the Van Westendorp.

21:52 I'll get the exact four questions. Yeah. But... But Uber does this to figure out, because I think when the thing beeps on your phone, if you have a ride in your area, you've got like, thirty or forty or less than sixty seconds to actually say, yes, I'll take it. And what they're doing is they're testing how low is too low How high is someone taking it quickly? All you are data. You all of this is data. So, you know, the first one, the first ride might be twenty dollars. And then if you accept that, the next one ain't going to be higher. Right. The next one's not going to be higher.

22:33 It's going to be a little lower. So you can test those different things out of what people are willing to take. It's wild. So wrapping up, I'm just looking at the comments that we have here. Teresa said, home health documentation platforms don't utilize AI enough. Like I've never done an Oasis, I've never done home health documentation, but everything says it's a nightmare, she said, because Oasis sucks, way too much documentation. I went for a general physical health, you know, saw my, saw my doctor, nurse practitioner. What do you call, like you would call an MD, Dr. Jones.

23:16 What do you call a nurse practitioner? Oh, it's a great question. Whatever they introduce themselves to me as, I don't know. I had to ask chat GPT and it was like, you can call them by their name. There, there was no like professional designation, which is so weird to me. Yeah. anyway um she was like yeah we're not using ai i i hate it it took more time to to get it to you know do what i want i have a sister-in-law who's a primary care physician at the va here in town She was like, I am ready to quit. I need to get out of here. They're switching EMRs.

23:57 The new EMR has an AI scribe, but it doesn't even matter. None of the old data. Imagine a patient panel for a medical doctor. None of the patient data is transitioning to the new EMR. Every single patient is a new patient. She has to get all of the information. They're seeing one patient per physician per day. They have thousands of patients on their panel. They're only scheduling one a day because it takes so long to get everything into the new EMR system. Why are they not transferring it over? Is it too hard?

24:38 You hire a new company for a three-year period to do that, right? I mean, go back to Elon Musk. Go back to Doge. There are people retiring from the government. Their files are paper files going down an elevator into a side of a mountain. This is what we're dealing with. Wow. It is. It is unreal. And then we wonder back to why why all this stuff is so expensive. It's not because the providers are getting paid so much money. It's because of all the administrative hassle and the old technology and the old platforms. Yeah. It's the same now. It's back to school time and people are like, oh, my taxes are so high.

25:20 And I'm like, I got friends that are all teachers and they're doing GoFundMes for index cards and pens. And I'm like, I don't think it's the... I'm not saying they're not paid, but they're putting up their own nickel to buy high letters and Crayolas. And I'm like, that's not where... It is in this transfer of money or information from one thing to the next. This is interesting. RV, I haven't talked to RV in a long time. We're currently using Prompt at the Lewis DPT program. Excited to explore how it can be integrated more intentionally into documentation, instruction, broader educational experience for students.

26:02 This is what I've always said. I'm like, the AI scribe, the ability to use AI in clinical education, it is such a powerful tool. Now, I've asked multiple times in like the DPT student group and stuff, I don't hear educators really leveraging the power of AI to help their students in real life scenarios. All right. So here's why educators don't do it. Educators are not lazy. They're usually hustlers. Harvey, you got to tell me if Jimmy is right or wrong. Yeah. So educators are not lazy. A lot of times, they are doing it. It's just the process.

26:43 I've got to get my school to OK this. So the program he's talking about at Prompt, I know the people who are in charge of it, they're on my team. So I hear what they're doing. They just hit their one hundredth program that they're in. So they started at zero. And the goal was, well, usually, I mean, you tell me if I'm wrong. In my first clinical experience, I got the big rundown of the EMR approximately thirty six seconds before my first patient walked in as a student. It was like, yeah, yeah, yeah. Top left is add new and then you'll figure it out. You're smart. You're smart. And then I'm like trying to look at a human as now I'm playing the role of of James McKay SPT. I still have my name tag and you're never I was never taught was never given an EMR onboarding.

27:29 So Prompt is saying, listen, if you're gonna be using this, use the real stuff. So they don't get like an education version. They don't get a diet version. They get the EMR. And they can use it in class. So if you're going to do a subjective exam in class, great, you're getting those words. What do you have to do with them? So you get all of it, sidekick, the EMR, the whole nine. And the idea is use it in an environment that's low stakes. Use it when you can screw up. What happens if you delete everything in a blank? What do you do? You go deer in headlights? No, do it when you can screw up in lab. That's what lab is for. I'd love to hear Arvi's... experience because he's currently using it because I think it's I think it's great but like as you know full disclosure I work there but I don't think we'd hit a hundred programs enrolling because these educators talk to each other because you have to do a little bit of work right RV had to like figure this program out and that probably wasn't on his bingo card but in his brain I'm guessing they're saying okay I can see where it's gonna be this much work and this much reward this is the thing we'll implement this semester You know, it'd be really interesting whether there's an opportunity for somebody who's like, I want to stay involved in the profession, but I want to get out of patient care, but I want a non-clinical role.

28:50 There's got to be prompt, like power users, the clinician who absolutely like, like I'm going to use myself and my EMR. For example, I'm with patient studio. I can take just a regular browser. I can use ChatGPT to create code in a regular browser so that when I push a button, it does things to the EMR on screen. I can manipulate my EMR in certain ways that I don't think a lot of, if anybody else does it, I would be considered a power user for what I'm trying to do. I should be the person involved with the university teaching those kids, those young adults, they're not kids, how to really extract the most value out of the EMR.

29:42 And I don't think that's probably not happening right now. It's probably somebody who generally understands the fundamentals of the system. We have a lot of former clinicians as customer service, like the people who are saying, okay, I see what you're doing. Let me see your screen. They are those kind of people. I was that person back in radio. There was a couple of different programs, and this was showing our age. The programs were compact disc players, but then we started to use apps while we were on the air, and I think I just lucked out and got one of these companies, and we started using it. It was a giveaway platform, right? Like if I did a live read for your PT clinic at twelve oh two, how do we like document that.

30:26 How can my promotions director turn around and be like, your thing was read thirty-six times. It was just in a piece of paper. So I grabbed onto that. I was like, this is going to be dope. I think I did the math where this is money. Now I can prove how many times I did it. And you can put a dollar amount to that. And then the company was like, this guy's super hyped and he's one of you. So I would jump on calls with people and be like, okay, this is how they tell you to use it? this is how I use it. Like do that. Yeah. Yeah. But also do this or do it like this. Cause I understood what it was like to be waiting for a song to end, taking a phone call, doing a giveaway and trying to operate this app. So doing, as you said, is we know how the off the shelf label is, but I've been in your seat before those, that, that insight, that institutional knowledge or occupation knowledge, terribly valuable.

31:14 Now, that's awesome. You have clinicians that are kind of CSRs and they've had experience. I'm curious, you and I have talked about this. Are any of them, when they do a demo, every demo I've ever gone through has never been a real patient engagement demo. You can show me all the most amazing stuff about the platform. I don't care. I want to see it in use with a real patient. I've always been astounded that EMRs are not scheduling. Okay, book an appointment, real patient. You are the CSR is going to demo the system with me. It could be a sandbox. It could be, you know, we sign a BAA. We do it all HIPAA compliant. But the idea is like, let me see this in action with a real patient.

31:58 How are you doing this? What's the workflow? What's already in there so that when my patient comes back with me and we start the eval, where do I begin on this? Right. So I'll check because I don't touch that, but that's a great idea. I did the same thing when I was helping out Doug Adams from Run DNA with marketing. He was like, well, we should do this and this. I'm like, Doug, your stuff is so damn cool and visual. Do you know what my marketing plan for you would be? He's like, what? I'm like, give away free running evaluations, but talk me through what you're doing and seeing. Do a real running evaluation, right? Take a four... Give it away for free. Whatever that eval that you're going to give away for free is worth a hundred times because it's real.

32:42 And then I'm like, do multicam. Do a cam on the side, a cam on the back, and then a cam on the screen of what the RunDNA awesome three-dimensional camera is showing. So, yeah. Don't give me a demo. Do the thing. Don't give me a video. I want to go drive the Ferrari. I want to feel the Ferrari. I think what you're saying is pretty powerful. I've demoed an AI scribe for someone before. at where do you think Jimmy McKay is meeting people? I'm at the bar, right? I'm at the conference in the happy hour. So I've said, yeah, I can give you a demo. And they go, let's set something up. And then I fire right back and I go, let's do the demo right now.

33:23 Pick a body part. I'll be the PT, you be the patient. And their whole thing was like, it's loud in here. And there's a dude over there talking about his trip to Toledo. I'm like, good. Is your clinic dead quiet? No. So I wanted people to hear. I was like, let's I just said this thing's badass. Let's beat on it right now. So when it's done, I'm the ShamWow, you know, be the ShamWow guy. I'm going to show you right now. I'm going to do slap. Remember Slap Chop? Slap Chop. All right. What's Arby saying? Oh, OK. Yeah. It's a shameless plug. APTA First Network will host a Beyond the Prom. Tune Judgment AI. Yes. Evan's great. Tough Seattle. Rich Severin, Chicago. Kendra Gagnon.

34:03 Ooh, lineup is solid on that one, if you know those people. Because now you've got the thing. The educators, again, they know how this rolls. Something comes out, and they've got to wait for the rules to get created by... boards and you know university boards and presidents and then it finally gets okayed because this thing's a wave like no one's thinking this is a this isn't a fad this is internet right so that's good to see and i love the fact that like the first network i know i'm doing a webinar tomorrow night with uh academy of leadership and innovation about a lot of the topics that we're talking about here i'll share the link in the in the in the show notes when i release the podcast today The thing that I'm curious, and I know Rich.

34:47 I know of Rich. I've never met Rich. The other two names I'm not familiar with. Evan's the program director at Tufts Seattle and Kendra Gagnon, she's in academics and thinks deep and It'll be great because they're smart and they speak well. But what were you going to say? No doubt they're smart. No doubt they speak well. I'm curious if they tend to be more of an AI bull or a bear. This has been a big topic I've been following just in business generally. U.S. tends to be more AI bear. China tends to be more AI bull on a population level, not just individuals. Which one? I always get confused because they're animals.

35:27 It doesn't say anything. Which one's pro and which bullish means you think you're going to invest in it. Bearish means you're going to hold on. Yeah, bearish is negative sentiment. It's going to go down. In the US, generally, there's so much fear and so much concern around AI taking our jobs, AI using water, AI running up the cost of electricity, negative, negative, negative. On the China side, the population in general tends to be very pro AI. It's going to improve quality of life. It's going to improve medical discovery. It's going to improve efficiency and all of these things. this would be no different like we see in the facebook groups there are people who think ai is a negative in general for the profession um i i saw that it said education ai responsibly in physical therapy responsibly tends to put up a flag for me we want responsible use but is that code for you know this is going to be bad for us or is is this going to be something looked at as Hey, I have access to millions of data points that my brain could never process in a millisecond.

36:38 I think... I forget who said it. Again, I'm good with quotes and sayings. I just can't remember who says them. Someone said, do you really think we're going to recycle our way out of making up too much plastic? Are we going to regulate ourselves out of it? It's like, no. It's some kid who's six years old right now is going to invent a process or a chemical that actually turns used plastic bottles into candy canes or something. It's like... You can't put genies back in bottles. That's sort of how genies in bottles work. So, you know, mass production of plastic. We're not going to regulate. We're not going to downregulate. I think I saw a statistic on some documentary.

37:19 In the eighties, everything was about recycling programs. Let's get all these bottles. And you feel good. I feel good when I go get a pile of nickels at the thing. You know, after a couple of parties at my house, I bring the sack full of empty cans and it feels great. And then I saw the statistic and they were like, half of a third of a tenth of a percent actually gets recycled i was like wait wait what what do you mean i thought we were saving the world here it's like nah it's sort of not the way it works man like we're not gonna we're not gonna regulate or reduce reduce uh recycle our way out of it you're gonna go forward and create the thing that will stop that that's just how it works Hey, perfect timing. We're going to wrap up by nine fifteen.

38:01 Will Boyd just jumped on. I wanted to close the episode with this post from Uncaged Clinicians. And it's basically an individual, Jamie, who's saying that is there any way for her to sell her single owner operator solopreneur business? I think she mentions in here that she has a special niche within myofascial and some manual therapy stuff. Basically, the business is her. People are coming for her. She's got a long list of people waiting to see her. And I think she might be dealing with some issues and wants to get out.

38:41 So Jimmy, we've talked about it, but let's review kind of what do you tell somebody who hasn't built a business that can sustain without you, but there's still value there. How do you extract some of that value? Um, how do you do it? Or how do you explain to this person that they might not be selling what they think they're selling? What would you tell this person? Let's start there. Um, I would say, okay, well, let's talk about. Let's talk about the difference between buying a job and buying a business, which is if you can go... The test is always these big pundits. And I think I'm starting to say, I got it. You need to build a business that you can walk away from.

39:23 And the guy said for six weeks. You got to be able to walk away for six weeks and the business has to be able to have a problem or several and have processes to self-correct. Not, I guess we'll figure that back out in six months or six weeks when the boss comes back. So the question is, they're a solopreneur. If she went away for six weeks, what happens? Well, she's not doing, you know, she's not selling things on the internet where a robot makes them and ships them. She's the person providing the care. So she owns a job right now. She is the one hundred percent sole owner of a job that when she goes on vacation, the business earns zero zero dollars.

40:04 And there it is right there. Scott coming in on cue. She owns a customer list and that is terribly valuable. But my guess is most of the time when people start throwing figures around, It's not what you think it is, right? Like you think this list is worth lots of money. It could be worth lots of money. Well, so could my LinkedIn login, right? There's lots of people there. I could get lots of gigs. I could do lots of consulting work. Yes, yes, yes. But that's the option to do that. So it is valuable if you're a practice... Now, I think what I might tell this person is, how long do you want to go before you sell it? And if the answer is like three to five years, or I mean, hopefully it's some time, you do what the dentists used to do, right?

40:47 The dentist or the general practitioners, the family doctor in the neighborhood, a lot of times had their office in their house, like in the basement, is you find a student, you find a girl or a guy at a medical school or dental school, and you go, hey... You want to figure out how to do all this stuff or I'll apprentice you, show you business, show you dental, show you how to give out lollipops at the end so they go get cavities before they come back to you, like all the ins and outs. And then I will start to do what Homer Simpson does in that gif. I'll start to sort of fade into the background and you'll start to fade into the foreground and this will be your practice. So if this person thinks they're just going to dangle this offer sheet and someone's going to take it, Yeah, you got to find the right, that's a needle in a stack of, it's a needle in a haystack there to find the right person, I guess.

41:34 I don't know. What do you think? Am I wrong? Am I right? Yeah, yeah. No, you're right. The thing with the customer list is it's a list of customers who want her, not necessarily a list of customers. I feel that I could sell a list of customers who want physical therapy. They don't care who's delivering it. They just want a place in this building at this address that bills insurance for the services they receive. I kind of could sell that. In her unique situation, now there were great comments down below that post. One person said, and I think this is the most powerful option, is if you really feel like you have something that's unique, that you have a special approach, you have something that you've created with experience and time and effort, teach other people, you know, package that as something you can sell and teach to other people.

42:29 And it doesn't have to be the PTs. Like we've talked, the license doesn't really matter. There's nobody who's aggressively going to the massage therapy space, focus on licensed massage therapists. There are PTs coaching and training trainers, personal trainers, go teach a bunch of massage therapists how to do what you do because it's a manual technique. They're licensed to do it. And then that's where you make your money. That's where you sell that. Or create the digital product that shows a spouse, a mother, a father, a husband, whatever, how to do what you do. Sell the digital product to the consumer who needs it.

43:09 In regards to a conventional business sale, though, it's really hard. And even if you brought in an apprentice to kind of work under you, They're never going to do it the way you do it, you know, and that's going to take a long time to kind of transition out of. And I think the real value, at least as you're bringing it across in the post, is you've developed something kind of proprietary. There's John Barnes and there's all these people that are out there that have created their systems, that they're selling their systems. that's really what you would probably look at selling. Or you suck out as much cash as you possibly can while you can, and you put that cash into something else that's going to give you a bigger return.

43:56 And when you're ready to close the door, you close the door. Like we closed the doors down the street where it was a fully operational clinic. Theoretically, it could have been sold, but we decided, you know what? The equipment is useless. I'm throwing away most of the equipment. I'm getting rid of a bunch of stuff. I'm just closing the door. I pulled out as much cash as I could leading up to the closure. Yeah. And now it's done. It did what it was supposed to do. Yep. Parting shots. Parting shots. What do you got, Tony? um we talked about a lot of stuff today i don't know you know business business is exciting business is a creative process for me business fills a role that probably physical therapy and patient care used to fill up one time and that's okay i'm good with that yeah I would say, because that last story, the last topic is on my mind, understand what business you're in.

44:52 So if you're a solopreneur, if you're that person, you're in the interaction business. You are the getting liked and getting chosen business. That doesn't always transfer when you go to leave. Because unfortunately, you the star, and they see your name or your logo and they go, I want that person. And the problem is when you go to sell that, that pop goes, it doesn't transfer to the next person. So understand what business you're actually in. We'll be back on Thursday, and we'll have Dave with us. Tony, have a good week, man. You too, buddy. That's it. We're out. Boys, what the hell are you doing? Follow Tony Maritato on YouTube at Total Therapy Solution. Find Dave Kittle at conciergepainrelief.com and on YouTube at The Dave Kittle Show.

45:33 And follow Jimmy McKay at PT Podcasts on YouTube, the socials, and wherever you binge podcasts you pretend are for CEU. And hey, just a reminder, none of this was for advice. This was for entertainment only. Our lawyers say that counts. Thanks, Keith.