How to Build a Cash-Based PT Clinic You Can Actually Sell

WEBVTT

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And we are live.

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So Dave Kittle, Tony Meritato,

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Jimmy is going to be up in the

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air at some point here.

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So he is not with us today.

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Dave, how's it going, man?

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What's the weather like in New York right

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now?

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It's beautiful.

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It's a sixty seven right now,

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high of eighty today,

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but nice kind of like pre-fall morning.

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So how about you?

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Yeah, same thing.

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It's beautiful.

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It's sunny.

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We're like mid-seventies.

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I've been running so much,

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just taking advantage of like the coming

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fall weather.

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I think I developed some shin splints.

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Do you know anyone who could treat that?

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I don't, man,

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because I don't believe there's a

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treatment for it.

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The treatment is rest and nutrition.

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So that's what I'm going to do.

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I'm taking today off.

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There you go.

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All right.

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So I grabbed a couple screenshots from

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some Facebook posts that I thought would

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be interesting to talk about.

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They kind of fall into your area of

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expertise.

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But before we hit that,

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do you have any thoughts or topics or

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anything that's been on your mind?

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So one was something you and I were

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messaging publicly on,

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I almost said YouTube,

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on LinkedIn about selling or the

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possibility of selling out-of-network

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practices or solo versus staff.

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Yeah, let's talk about that.

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Let me just tease this for the audience.

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So that's one thing.

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Another thing I had sent you guys last

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week was, should practices have a...

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irritable client price or tax if you if

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you wanted to not surge pricing i know

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there's there's a certain amount of ethics

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around pricing uh and all that but um

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let's just say about if a practice had

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someone who was a little rude or

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moderately rude uh you know what how do

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you know i know you probably will just

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say um you know i'm not the right

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fit and you know you'd probably refer them

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elsewhere but let's say a practice

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Didn't want to necessarily refer them

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elsewhere,

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but they also wanted to potentially

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capture some extra dollars,

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some extra value.

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Is that right?

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Is that OK?

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That's another thing.

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That's the second thing.

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Third thing is that I recently got a

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trial sample of Perfect Packs with some

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supplements.

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And I just about to open them today,

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and I was able to, for free,

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get a trial pack of creatine and melatonin

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and some AM and some PM supplements.

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And so my question to Tony is that,

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first of all,

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should physical therapy practices do that?

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Should they sell that?

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Should they upcharge it?

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This is like a white label, this company.

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They white label it.

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So I could charge whatever to my patients

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and clients.

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They have a base amount to cover.

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Should physical therapy practices consider

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selling supplements like that?

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And what's the liability if the client

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gets, you know,

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irritable bowels and I don't know,

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whatever?

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Do they, you know,

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is the physical therapy practice on the

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hook?

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Do they get in trouble?

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If so, Tony is going to say,

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stay away from me.

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I never want to do it.

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That's just another topic.

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And then any of the screenshots that I

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didn't even get a chance to look at

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yet.

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Yeah, that's awesome.

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That's a great show.

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So I'm going to put it out there.

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One other thing,

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if we have a couple of minutes at

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the end,

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there was a dental practice that sued a

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person who started posting negative

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reviews.

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It was a client of this dental practice.

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I just heard the preliminary information

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and the dental practice sued the person

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because they were posting negative reviews

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and probably took it a little too far.

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Defamation or we'll get into it.

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That's what I'm assuming.

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Yeah, defamation, but...

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All right, let's go back.

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So let's talk about,

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let's say it was a week,

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two weeks ago,

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I had shared a post on LinkedIn where

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I said, look, just give it up.

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Stop fighting for something we don't want.

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We don't want to fight for low

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reimbursement.

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We don't want third party payer

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reimbursement.

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We don't want all the regulation and the

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burden and the compliance that comes along

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with low paying third party reimbursement.

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I said, just let it go.

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Let the hospitals have it.

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Let the corporate physical therapy,

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businesses have it they are built to deal

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with that they have legal departments

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compliance departments they have

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venture-backed funding that will pay for

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all that stuff and they have the risk

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tolerance i can't risk medicare or some

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other third-party payer coming back and

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saying hey we want ten percent twenty

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percent of all the payments we made to

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you because you had ten or twenty percent

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deficiencies in this documentation i don't

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want that kind of liability um

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So then some of the comments that came

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along with that post,

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one theme of the comments was, well,

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if you don't build an insurance based

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practice, you don't have value.

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You don't have something that you can

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resell.

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You don't have something that somebody is

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going to want to buy.

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And I totally get it because I've said

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the same thing myself.

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The thing is,

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now we live in a world where even

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if I built an insurance based practice,

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which I have.

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It doesn't have any value either.

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It doesn't have something that people want

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to buy.

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But for this conversation,

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we wanted to go into, okay,

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can we build a cash-based practice that

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has resale value?

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How do we do that?

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yes absolutely um the owner ideally should

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be out of treatment or not be fully

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involved in the majority of delivering the

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core service they shouldn't be involved in

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you know everything uh how do you do

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it um doing what i'm doing like i'm

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treating like one patient two patients a

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week

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like very basically no caseload and i'm

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trying to continue to set up other systems

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all in google drive setting up this

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playbook and the playbook is basically

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like if i get hit by a bus

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you know, a robot,

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Tony's massage robot could come in and run

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this business and know exactly like,

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here's the post that we,

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here's exactly the post and the images

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that we post for organic,

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attracting organic potential physical

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therapists on LinkedIn or whatever.

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And here's the new client paperwork and

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here's the emails that we send out.

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And here's, you know,

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every little thing in a playbook.

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That's one thing that I think most

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practice owners are not doing.

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Either they still love the treat and they

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want to continue treating.

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Maybe it's a little bit,

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maybe because they're probably great at

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treating.

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They love it.

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It's fulfilling for them and that's fine.

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But to have something that's sellable,

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it has to transfer value.

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The value has to transfer from how it

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currently is to another buyer.

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basically like without you in the mix,

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like that's when it becomes more and more

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valuable.

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And that's the conundrum for physical

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therapy practice owners because they want

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to be treating patients.

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They want to be getting outcomes.

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They want, you know,

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they want to be known in the community.

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They, you know, are the go-to person,

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like go see Tony, not,

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not go see total therapy solutions,

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but go see Tony.

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So if that is how it is, um,

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that could be a challenge.

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I, I like to, um,

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I'm basically out of treatment,

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but I will then send emails,

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send handwritten letters,

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that type of stuff.

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Eventually,

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it needs to not be coming from me,

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but I want to stay in the mix

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a little bit of the patients who,

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because we're doing mostly home visits.

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Or even in the office,

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the office patients,

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I don't always see because I'm not always

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in the office.

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getting out of the vital roles is how

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a practice or any type of business has

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the highest resale value and it's you know

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physical therapy is no different than if

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you and i were going to buy an

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hvac business or i don't know a

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landscaping business or whatever like uh

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plumbing it literally doesn't matter so if

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it's almost that's why you said before

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tony that like

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Buyers that are not physical therapists

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that come into the physical therapy world

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are oftentimes more savvy because they're

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not attached to the core service.

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They don't even know how to do the

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core service.

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They don't know how to evaluate and treat

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patients because they didn't go to school

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for it.

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They're not licensed for it.

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And they often can have more of a

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focus on how to like improve the practice

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and they could buy a practice and then

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they could improve it for three to five

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years and then they could sell it to

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somebody else.

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Yeah.

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Yeah.

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I've shared this before, but back,

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I think it was two thousand.

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So we started the business in two thousand

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one into two thousand two.

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I think it was two thousand three.

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We we were growing.

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We had tons of money coming in,

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but we were killing ourselves.

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We were working every patient,

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every visit.

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I'd come in at like four thirty a.m.

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because I had realtors that wanted to work

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with me at five a.m.

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and then I'd stay till like seven thirty

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eight p.m.

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because I had other professionals that

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wanted to come see me after work.

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And when I say we, it was myself.

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I was not a physical therapist when we

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started.

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Most people know that story.

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The person who was the physical therapist

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wasn't my wife at the time.

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She's now my wife.

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But the idea was, you know,

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we were just running ourselves into the

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ground.

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We had tons of money, but who cares?

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Nothing to do with it.

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Nothing to spend it on.

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But we had no kids, no family,

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no real commitments.

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And so we said,

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we cannot do this for twenty years.

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Like we have to figure out the formula

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to turning this into a real business,

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because at that point you would call it

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a job.

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We invested thirty,

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thirty two thousand dollars.

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We went through the consulting route.

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We learned how to turn everything into a

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procedure.

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How do you answer the phone?

00:09:45.121 --> 00:09:46.222
How do you empty the trash?

00:09:46.263 --> 00:09:48.062
How do you turn off the computers?

00:09:49.524 --> 00:09:51.764
And that was really what gave us the

00:09:51.964 --> 00:09:53.245
the skeleton,

00:09:53.284 --> 00:09:56.245
the framework to step out of the business.

00:09:56.284 --> 00:09:57.485
Then we could start hiring.

00:09:57.525 --> 00:09:58.985
We could start, you know,

00:09:59.025 --> 00:10:01.126
growing the business that wasn't dependent

00:10:01.187 --> 00:10:01.586
on us.

00:10:01.667 --> 00:10:03.206
Now, my question to you.

00:10:04.548 --> 00:10:04.727
So.

00:10:05.715 --> 00:10:07.956
I would still say third party

00:10:08.015 --> 00:10:10.496
reimbursement basically takes a business

00:10:10.517 --> 00:10:12.116
that would have, you know,

00:10:12.216 --> 00:10:15.138
four thousand customers a year and gives

00:10:15.177 --> 00:10:17.078
you four customers a year.

00:10:17.658 --> 00:10:19.058
Humana, Med Mutual,

00:10:19.119 --> 00:10:20.779
Blue Cross Blue Shield, United.

00:10:20.879 --> 00:10:21.220
Right.

00:10:21.419 --> 00:10:23.201
Darwin, Medicare and Medicaid.

00:10:23.221 --> 00:10:25.181
And there you got six customers.

00:10:25.701 --> 00:10:28.763
So it does simplify things in one respect.

00:10:29.182 --> 00:10:31.003
But you you pay a big premium,

00:10:31.023 --> 00:10:32.244
you pay a big price for that

00:10:32.303 --> 00:10:33.203
simplification.

00:10:33.820 --> 00:10:36.081
Because now those big customers that are

00:10:36.101 --> 00:10:38.283
going to represent all of your patient

00:10:38.323 --> 00:10:38.924
referrals,

00:10:39.485 --> 00:10:40.865
they're going to have their own unique

00:10:40.905 --> 00:10:41.527
demands.

00:10:41.866 --> 00:10:44.269
And twenty five years ago,

00:10:44.308 --> 00:10:45.870
we had higher reimbursement.

00:10:45.931 --> 00:10:47.932
We were able to handle those demands.

00:10:48.712 --> 00:10:51.255
We it's harder and harder today.

00:10:51.316 --> 00:10:52.456
So my question to you is.

00:10:53.240 --> 00:10:55.260
if we're looking at the procedures that

00:10:55.301 --> 00:10:57.402
run a business the frameworks the systems

00:10:57.861 --> 00:10:59.903
what are like two or three in your

00:10:59.962 --> 00:11:03.083
opinion of the most important i mean i'll

00:11:03.124 --> 00:11:07.365
start i think the most important is how

00:11:07.405 --> 00:11:09.466
do you find and recruit clinicians like it

00:11:09.485 --> 00:11:11.126
doesn't matter how good or bad they are

00:11:11.147 --> 00:11:12.788
it doesn't matter how many referrals you

00:11:12.827 --> 00:11:14.508
get doesn't matter a bunch of the other

00:11:14.548 --> 00:11:18.009
stuff one of the core operating kind of

00:11:18.049 --> 00:11:21.030
procedures in a business cash or otherwise

00:11:21.850 --> 00:11:22.890
You need staff.

00:11:22.931 --> 00:11:25.374
You can't sell services if you don't have

00:11:25.433 --> 00:11:25.974
staff.

00:11:26.375 --> 00:11:28.336
You need a way to find and recruit

00:11:28.397 --> 00:11:30.038
staff that fit the culture,

00:11:30.177 --> 00:11:31.659
fit the mold of what you're trying to

00:11:31.700 --> 00:11:32.200
build.

00:11:32.760 --> 00:11:35.403
So I would spend time trying to

00:11:35.462 --> 00:11:37.284
understand, OK, how am I going to recruit?

00:11:37.365 --> 00:11:38.485
How am I going to attract?

00:11:38.525 --> 00:11:40.388
How am I going to compete against higher

00:11:40.788 --> 00:11:44.231
paying operators and other hospitals and

00:11:44.772 --> 00:11:46.274
nursing facilities, home health?

00:11:47.148 --> 00:11:49.208
What are some of the other things that

00:11:49.249 --> 00:11:50.669
you would look at to say, okay,

00:11:51.051 --> 00:11:54.312
this is really an important procedure for

00:11:54.332 --> 00:11:56.193
a business to be successful and have

00:11:56.234 --> 00:11:58.195
resale value?

00:11:58.274 --> 00:11:58.514
Yes.

00:11:58.575 --> 00:12:01.557
Well, initially, years ago, years ago,

00:12:01.576 --> 00:12:03.557
I was more focused on the marketing.

00:12:03.597 --> 00:12:04.318
I was obsessed.

00:12:04.918 --> 00:12:06.320
I was customer first.

00:12:06.440 --> 00:12:07.480
I was client first.

00:12:08.547 --> 00:12:09.327
whatever, you know,

00:12:09.368 --> 00:12:10.969
we live and die by the marketing and

00:12:11.009 --> 00:12:12.690
them, and they're more important.

00:12:12.889 --> 00:12:14.150
And, you know,

00:12:14.171 --> 00:12:15.451
what I've learned a little bit more

00:12:15.491 --> 00:12:18.073
recently in the previous most couple years

00:12:18.715 --> 00:12:20.875
is being more employee focused and

00:12:21.937 --> 00:12:22.778
employee first.

00:12:23.138 --> 00:12:25.240
And so, yes, part of what you said,

00:12:25.659 --> 00:12:26.821
I a hundred percent agree with the

00:12:27.301 --> 00:12:27.740
recruiting.

00:12:28.601 --> 00:12:30.682
the hiring the onboarding but then also

00:12:31.043 --> 00:12:33.583
the if that's if that's one a one

00:12:33.644 --> 00:12:35.264
b is the retention of those therapists i

00:12:35.303 --> 00:12:36.403
think you kind of hinted at it but

00:12:36.524 --> 00:12:37.445
i know that's kind of what you mean

00:12:37.485 --> 00:12:39.164
like finding great talent finding great

00:12:39.184 --> 00:12:42.206
team members and then retaining them so if

00:12:42.285 --> 00:12:44.027
you have therapists that come in and they

00:12:44.047 --> 00:12:44.746
only work for you for

00:12:45.734 --> 00:12:46.754
three to nine months at a time,

00:12:46.774 --> 00:12:48.895
and then they leave and they churn out.

00:12:49.395 --> 00:12:50.037
That's a big challenge.

00:12:50.057 --> 00:12:51.057
You're always gonna be on the hamster

00:12:51.097 --> 00:12:51.918
wheel of hiring,

00:12:51.957 --> 00:12:53.999
similar to the whole new patient marketing

00:12:54.038 --> 00:12:54.519
hamster wheel.

00:12:54.620 --> 00:12:57.741
So yes, if you, I mean,

00:12:57.761 --> 00:12:58.361
the most important,

00:12:58.863 --> 00:13:00.263
Serti McKee says the most important thing

00:13:00.303 --> 00:13:01.904
in a physical therapy business is

00:13:02.725 --> 00:13:04.085
initial evaluations because if you don't

00:13:04.105 --> 00:13:06.206
have evaluations you don't have follow

00:13:06.245 --> 00:13:07.745
visits you don't have the plans to care

00:13:07.765 --> 00:13:10.447
you don't have a full patient schedule

00:13:10.486 --> 00:13:12.668
built out right and so you kind of

00:13:12.748 --> 00:13:14.447
reverse engineer from that which would be

00:13:14.488 --> 00:13:15.509
like well how do you how do you

00:13:15.548 --> 00:13:17.788
have initial evaluations of course you

00:13:17.808 --> 00:13:19.429
need the new patients calling in but you

00:13:19.450 --> 00:13:20.909
also need the licensed physical therapist

00:13:20.929 --> 00:13:23.051
to actually perform the evaluations to

00:13:23.150 --> 00:13:25.130
have a calendar that's open that's

00:13:25.150 --> 00:13:27.331
available to do the evaluations

00:13:28.152 --> 00:13:30.453
So it's kind of like new employee

00:13:32.115 --> 00:13:34.037
recruiting, interviewing, hiring,

00:13:34.136 --> 00:13:34.677
onboarding.

00:13:34.856 --> 00:13:35.738
If that's like one A,

00:13:36.879 --> 00:13:38.419
one B is actually retaining them.

00:13:38.500 --> 00:13:40.621
So whatever it is with like coaching,

00:13:40.701 --> 00:13:45.125
support, mentorship, clinical education,

00:13:45.284 --> 00:13:47.647
journal clubs, giving them,

00:13:48.587 --> 00:13:49.467
asking what they really want,

00:13:49.688 --> 00:13:50.469
ask what they care about.

00:13:50.589 --> 00:13:52.090
Like you said this also before, Tony,

00:13:52.130 --> 00:13:53.792
like do they care more about money?

00:13:53.812 --> 00:13:56.193
Do they care more about PTO and flexible

00:13:56.234 --> 00:13:56.714
schedule?

00:13:56.774 --> 00:13:57.634
And, you know, like-

00:13:58.879 --> 00:14:00.240
those types of things will go a long

00:14:00.280 --> 00:14:02.601
way and another therapist that works in a

00:14:02.621 --> 00:14:04.363
hospital like if they want to you know

00:14:04.403 --> 00:14:06.624
leave early on some days or come late

00:14:06.663 --> 00:14:08.203
on some days whatever like a hospital

00:14:08.224 --> 00:14:09.565
schedule is going to be very rigid and

00:14:09.664 --> 00:14:12.166
you and i could be a lot more

00:14:12.667 --> 00:14:14.506
adaptive to those types of therapists like

00:14:14.527 --> 00:14:16.248
if they have you know child care issues

00:14:16.268 --> 00:14:17.889
they get a flat tire or whatever like

00:14:17.908 --> 00:14:20.649
those types of things um can certainly go

00:14:20.669 --> 00:14:23.831
a long way right so retaining staff is

00:14:25.171 --> 00:14:26.312
you know, maybe one B,

00:14:26.552 --> 00:14:27.432
then right after that,

00:14:27.572 --> 00:14:29.192
two would probably be the new patient

00:14:29.232 --> 00:14:29.613
marketing.

00:14:29.753 --> 00:14:30.974
And I mean, of course,

00:14:31.014 --> 00:14:32.235
from there is everything else like the

00:14:32.274 --> 00:14:34.416
processes and having everything documented

00:14:34.436 --> 00:14:34.836
and all that.

00:14:34.855 --> 00:14:35.336
But those are,

00:14:36.376 --> 00:14:38.418
those are kind of like the foundational

00:14:38.638 --> 00:14:43.760
few that would begin the foundation of a

00:14:43.821 --> 00:14:46.201
practice that you can then build on for

00:14:46.221 --> 00:14:47.543
the eventual resale value that we're

00:14:47.562 --> 00:14:47.982
talking about.

00:14:49.008 --> 00:14:49.207
You know,

00:14:49.227 --> 00:14:50.750
it was interesting yesterday I was

00:14:50.809 --> 00:14:55.214
listening to an interview with a YouTuber

00:14:55.533 --> 00:14:57.035
and then a couple of guys that just

00:14:57.076 --> 00:14:57.956
do Facebook ads.

00:14:58.437 --> 00:15:00.259
And so it reminded me of Will Boyd.

00:15:00.278 --> 00:15:02.561
We had Will Boyd on the podcast multiple

00:15:02.600 --> 00:15:03.041
times.

00:15:03.902 --> 00:15:06.384
He switched from all organic to all paid

00:15:06.504 --> 00:15:06.804
ads.

00:15:07.304 --> 00:15:08.427
And one of the things that were

00:15:08.486 --> 00:15:10.908
interesting that they said was.

00:15:11.760 --> 00:15:13.402
They need to manage capacity.

00:15:13.461 --> 00:15:15.643
Now, I think they were into retail sales.

00:15:15.682 --> 00:15:17.683
They did ads for big companies.

00:15:17.744 --> 00:15:19.985
Crumble Cookie was one of the companies

00:15:20.024 --> 00:15:21.125
that they worked with.

00:15:21.826 --> 00:15:22.527
And they said, you know,

00:15:22.586 --> 00:15:26.349
the beautiful part about paid ads is when

00:15:26.369 --> 00:15:28.009
you need customers, you turn it on.

00:15:28.269 --> 00:15:29.730
When you don't want customers,

00:15:29.750 --> 00:15:30.471
you turn it off.

00:15:30.967 --> 00:15:32.389
And we know from therapy,

00:15:32.769 --> 00:15:34.611
like one of the biggest barriers is

00:15:34.731 --> 00:15:36.494
managing lead flow.

00:15:37.075 --> 00:15:39.778
We get new patients trying to get those

00:15:39.817 --> 00:15:41.559
new patients on the schedule when you're

00:15:41.600 --> 00:15:42.160
busy.

00:15:43.042 --> 00:15:44.062
That's a challenge.

00:15:44.082 --> 00:15:44.403
So it

00:15:45.788 --> 00:15:48.089
I still don't feel like I understand and

00:15:48.129 --> 00:15:50.450
have cracked the code to running effective

00:15:50.490 --> 00:15:51.009
paid ads.

00:15:51.490 --> 00:15:53.370
That's why you do it really well.

00:15:53.610 --> 00:15:54.610
I do it horribly.

00:15:55.130 --> 00:15:57.451
I can get a ton of organic traffic,

00:15:57.971 --> 00:16:01.232
but I cannot run an effective paid ad

00:16:01.253 --> 00:16:01.933
campaign.

00:16:03.234 --> 00:16:04.995
And I'm really trying to buckle down on

00:16:05.034 --> 00:16:05.274
that.

00:16:05.355 --> 00:16:08.436
I really want to work well and figure

00:16:08.456 --> 00:16:10.517
that out because I feel like that's such

00:16:10.537 --> 00:16:11.716
an important component.

00:16:12.462 --> 00:16:14.563
And I love the idea because we also

00:16:14.604 --> 00:16:15.364
hear the downside.

00:16:15.384 --> 00:16:17.543
The downside of paid ads is once you

00:16:17.583 --> 00:16:18.304
turn them off,

00:16:18.625 --> 00:16:21.926
you have no customers coming in.

00:16:22.566 --> 00:16:24.145
So for me, organic,

00:16:24.605 --> 00:16:26.246
I get a ton of organic traffic that

00:16:26.287 --> 00:16:28.147
costs me nothing and brings leads,

00:16:28.187 --> 00:16:28.947
brings things.

00:16:29.587 --> 00:16:31.908
But I don't have the control to go

00:16:31.927 --> 00:16:32.607
with paid ads.

00:16:33.208 --> 00:16:36.929
And Hilda said PT burnout continues to be

00:16:36.970 --> 00:16:37.529
an issue.

00:16:37.590 --> 00:16:39.809
Some PTs have chosen to do part-time

00:16:39.870 --> 00:16:41.610
clinical, part-time sports PT.

00:16:43.254 --> 00:16:46.918
Would there be other pieces of advice that

00:16:46.957 --> 00:16:48.779
you could recommend?

00:16:48.799 --> 00:16:50.461
We'll talk about burnout in just a second.

00:16:51.361 --> 00:16:53.004
So back to,

00:16:53.663 --> 00:16:56.027
I think the same marketing strategies and

00:16:56.106 --> 00:16:57.928
understanding marketing that you would use

00:16:57.948 --> 00:17:00.770
to attract the right patient is the same

00:17:00.811 --> 00:17:03.474
kind of infrastructure you would use to

00:17:03.514 --> 00:17:04.575
attract the right PT.

00:17:04.934 --> 00:17:06.757
And to Hilda's comment,

00:17:07.317 --> 00:17:08.038
Let me see if I can put it

00:17:08.098 --> 00:17:08.398
up here.

00:17:08.699 --> 00:17:10.819
I haven't been in charge of the back

00:17:10.900 --> 00:17:12.161
end in such a long time.

00:17:12.201 --> 00:17:13.061
There we go.

00:17:14.603 --> 00:17:17.765
In terms of like this, so, you know,

00:17:18.325 --> 00:17:18.845
marketing,

00:17:19.226 --> 00:17:20.886
understanding how paid ads work,

00:17:21.106 --> 00:17:22.208
how targeting works,

00:17:22.248 --> 00:17:23.709
how the algorithm works.

00:17:24.929 --> 00:17:28.412
If we wanted to attract a sports-based PT,

00:17:29.051 --> 00:17:29.392
you know,

00:17:30.613 --> 00:17:32.773
having that skill set is important.

00:17:33.375 --> 00:17:35.296
I would say more important is knowing how

00:17:35.336 --> 00:17:36.436
to attract the right PT.

00:17:37.502 --> 00:17:39.344
than it is knowing how to treat the

00:17:39.384 --> 00:17:39.743
patient.

00:17:40.585 --> 00:17:44.467
Because I just think you can always find

00:17:44.507 --> 00:17:45.907
PTs to treat patients.

00:17:46.669 --> 00:17:49.871
You don't necessarily have the ability

00:17:49.951 --> 00:17:52.112
intuitively to attract the right PTs.

00:17:52.152 --> 00:17:53.613
Does that make sense?

00:17:53.633 --> 00:17:57.055
I agree, a hundred percent.

00:17:57.075 --> 00:17:58.715
So let's talk about burnout real quick

00:17:58.736 --> 00:17:59.876
since Hilda brought it up.

00:18:00.978 --> 00:18:02.778
I still think the biggest contributing

00:18:02.798 --> 00:18:05.420
factor to burnout is just being forced to

00:18:05.460 --> 00:18:06.401
treat the wrong people.

00:18:07.173 --> 00:18:09.855
you know being in a setting where you

00:18:09.954 --> 00:18:12.196
have to treat everybody who walks in the

00:18:12.217 --> 00:18:14.357
door no matter what no matter whether they

00:18:14.417 --> 00:18:16.839
want you to treat them no matter whether

00:18:16.880 --> 00:18:19.662
they want what you have no matter you

00:18:19.701 --> 00:18:22.723
know their personality this will be a

00:18:22.784 --> 00:18:28.268
segue into the the um personality tax

00:18:28.388 --> 00:18:31.431
we'll call it where you know you are

00:18:31.471 --> 00:18:33.592
in a situation where there is an

00:18:33.652 --> 00:18:35.634
individual that um

00:18:36.413 --> 00:18:38.556
Just the personalities didn't jive like

00:18:38.596 --> 00:18:39.698
they were in a match.

00:18:40.117 --> 00:18:41.480
I've got patients like that.

00:18:41.579 --> 00:18:43.001
I come into my clinic and what I

00:18:43.041 --> 00:18:45.503
do is I intentionally split them between

00:18:45.564 --> 00:18:46.766
my PTA and myself.

00:18:47.707 --> 00:18:50.490
I took two challenging personalities

00:18:50.609 --> 00:18:52.792
recently because before that,

00:18:52.972 --> 00:18:54.775
a lot of the challenging personalities

00:18:54.815 --> 00:18:55.596
went to my PTA.

00:18:57.026 --> 00:18:58.667
I took the last two challenging

00:18:58.708 --> 00:18:59.508
personalities,

00:18:59.587 --> 00:19:02.471
but then the third challenging personality

00:19:02.510 --> 00:19:03.731
that came in the door went to my

00:19:03.791 --> 00:19:05.493
PTA because I was like,

00:19:06.273 --> 00:19:07.315
my docket is full.

00:19:07.756 --> 00:19:09.156
No more room for challenging

00:19:09.196 --> 00:19:10.057
personalities.

00:19:10.999 --> 00:19:12.940
So, we're in a third-party payer model.

00:19:13.080 --> 00:19:14.981
I can't charge a premium.

00:19:15.702 --> 00:19:17.144
Obviously, you can.

00:19:17.684 --> 00:19:20.086
So, let's talk about that experience.

00:19:21.407 --> 00:19:21.827
Real quick.

00:19:21.867 --> 00:19:22.088
So,

00:19:23.307 --> 00:19:26.429
How the Gallup poll from last year,

00:19:26.489 --> 00:19:27.269
from twenty twenty four,

00:19:27.289 --> 00:19:29.390
the state of the global workforce report,

00:19:29.410 --> 00:19:31.250
I want to talk about we're talking about

00:19:31.290 --> 00:19:31.651
burnout,

00:19:31.671 --> 00:19:33.872
but we're also talking about just either

00:19:33.932 --> 00:19:38.693
disengagement or dissatisfaction,

00:19:39.193 --> 00:19:40.994
unsatisfied employees across the country.

00:19:42.675 --> 00:19:44.596
Sixty two percent of employees globally,

00:19:44.977 --> 00:19:46.336
globally, not even domestically,

00:19:46.356 --> 00:19:47.298
excuse me, globally,

00:19:47.337 --> 00:19:49.498
sixty two percent of employees globally

00:19:49.538 --> 00:19:50.519
are disengaged.

00:19:53.156 --> 00:19:55.641
Fifteen percent are actively disengaged,

00:19:55.661 --> 00:19:58.144
which would be you're purposefully

00:19:58.243 --> 00:20:00.166
disengaging from your work,

00:20:00.186 --> 00:20:01.910
which would be seventy seven percent.

00:20:02.830 --> 00:20:04.593
So how is that?

00:20:04.773 --> 00:20:06.115
So I'm stepping out of health care for

00:20:06.175 --> 00:20:06.375
a second.

00:20:06.415 --> 00:20:08.219
I'm talking about this is global and this

00:20:08.298 --> 00:20:09.621
is across all industries.

00:20:12.490 --> 00:20:13.590
This has to be part of the problem.

00:20:13.611 --> 00:20:14.832
This is not just healthcare.

00:20:14.912 --> 00:20:16.232
I pulled up something else separately,

00:20:17.534 --> 00:20:20.796
another blog that said the top five most

00:20:20.836 --> 00:20:22.497
burned out industries in America in twenty

00:20:22.517 --> 00:20:23.477
twenty five, of course.

00:20:23.897 --> 00:20:25.479
OK, yes, health care is number one,

00:20:25.838 --> 00:20:27.079
but then education, right?

00:20:27.099 --> 00:20:28.861
All the teachers that are doing great work

00:20:28.921 --> 00:20:32.982
that are not recognized or they're

00:20:33.002 --> 00:20:34.983
underpaid or whatever hospitality.

00:20:35.085 --> 00:20:38.145
So, you know, servers, waiters,

00:20:39.346 --> 00:20:40.107
hotel workers.

00:20:40.827 --> 00:20:42.147
Number four, construction,

00:20:42.188 --> 00:20:43.209
the construction industry.

00:20:43.249 --> 00:20:44.548
Number five, I.T..

00:20:45.669 --> 00:20:48.130
So those are some pretty big and prominent

00:20:48.190 --> 00:20:49.529
industries, and it's not just health care,

00:20:49.589 --> 00:20:50.611
even though health care is number one on

00:20:50.651 --> 00:20:51.191
this list.

00:20:51.971 --> 00:20:53.330
But let me ask you again, Tony,

00:20:54.211 --> 00:20:56.872
sixty two percent of workers across the

00:20:56.951 --> 00:20:59.252
entire globe are disengaged,

00:20:59.373 --> 00:21:01.614
meaning they must have something that they

00:21:01.653 --> 00:21:03.913
don't like about their job or something.

00:21:04.835 --> 00:21:06.414
I think that's the bigger conversation.

00:21:06.714 --> 00:21:08.536
I agree with you that maybe the health

00:21:08.556 --> 00:21:09.375
care thing is there.

00:21:10.375 --> 00:21:13.118
therapists or employees are being either

00:21:13.239 --> 00:21:14.759
they're they're being forced to treat

00:21:14.779 --> 00:21:16.582
patients they don't want to treat or if

00:21:16.602 --> 00:21:17.982
you're in a hospital system and you're

00:21:18.163 --> 00:21:19.503
having more and more roles and

00:21:19.545 --> 00:21:21.145
responsibilities and tests added to your

00:21:21.185 --> 00:21:24.028
plate when uh you didn't realize that was

00:21:24.068 --> 00:21:25.750
the case when you signed on and joined

00:21:25.769 --> 00:21:27.872
or i don't know but whether you want

00:21:27.892 --> 00:21:29.413
to talk about and answer just directly

00:21:29.453 --> 00:21:31.635
about uh healthcare tony that's fine

00:21:32.276 --> 00:21:33.557
But this, I think,

00:21:33.597 --> 00:21:35.118
is the root root cause of like,

00:21:35.378 --> 00:21:37.422
how are sixty two percent of global

00:21:37.461 --> 00:21:39.002
workers across every industry,

00:21:39.324 --> 00:21:40.605
how are sixty two percent of people

00:21:40.845 --> 00:21:41.445
disengaged?

00:21:42.227 --> 00:21:43.327
Are we meant to not work?

00:21:43.387 --> 00:21:44.148
I don't understand.

00:21:44.169 --> 00:21:44.930
Like, it's crazy.

00:21:46.003 --> 00:21:47.365
No, I think we know.

00:21:47.664 --> 00:21:50.145
I think we know every human needs work,

00:21:50.507 --> 00:21:52.407
needs something challenging,

00:21:52.827 --> 00:21:54.269
needs something productive,

00:21:54.348 --> 00:21:55.970
needs something that has a meaningful

00:21:56.029 --> 00:21:56.430
impact.

00:21:56.750 --> 00:21:58.090
I think in our core,

00:21:58.490 --> 00:22:01.212
that is a fundamental part of life is

00:22:01.313 --> 00:22:04.115
we need something to challenge us and to

00:22:04.154 --> 00:22:04.694
work towards.

00:22:05.345 --> 00:22:07.747
Now, I think that, you know,

00:22:08.067 --> 00:22:09.367
and I don't want to sound like the

00:22:09.407 --> 00:22:11.890
classic boomer or Gen X,

00:22:11.970 --> 00:22:16.472
but I also think we have to understand,

00:22:16.532 --> 00:22:19.434
like, what are young people being told?

00:22:19.996 --> 00:22:21.477
What is the expectation?

00:22:21.537 --> 00:22:21.856
Like,

00:22:22.798 --> 00:22:24.578
I don't think I'm going to go with

00:22:24.598 --> 00:22:25.619
the benefit of the doubt.

00:22:25.980 --> 00:22:29.041
I just don't think younger employees,

00:22:29.563 --> 00:22:30.683
older employees,

00:22:32.444 --> 00:22:33.846
I don't think they expect everything to be

00:22:33.885 --> 00:22:35.047
amazing all the time.

00:22:35.702 --> 00:22:36.663
But on the flip side,

00:22:36.682 --> 00:22:38.663
we're talking about subjective judgments.

00:22:38.923 --> 00:22:40.943
You know, it's like, this is hard.

00:22:41.064 --> 00:22:42.423
Well, what the heck does hard mean?

00:22:42.523 --> 00:22:45.585
Hard is a very subjective word to use.

00:22:45.664 --> 00:22:47.464
I hate when somebody says something's not

00:22:47.484 --> 00:22:48.845
fair, something is hard,

00:22:48.904 --> 00:22:49.865
something is whatever.

00:22:50.586 --> 00:22:52.486
There's zero objectivity in that.

00:22:53.385 --> 00:22:55.686
And what I want to look at is,

00:22:56.247 --> 00:22:56.467
okay,

00:22:56.527 --> 00:22:58.126
where's the fulfillment you're looking

00:22:58.166 --> 00:22:58.406
for?

00:22:58.507 --> 00:22:59.787
What are you expecting?

00:23:00.988 --> 00:23:02.347
And then when that doesn't happen,

00:23:03.136 --> 00:23:04.218
What do you do next?

00:23:04.837 --> 00:23:05.958
And that's the question.

00:23:05.978 --> 00:23:07.318
So you get a job as a physical

00:23:07.358 --> 00:23:07.838
therapist.

00:23:07.878 --> 00:23:08.078
Why?

00:23:08.098 --> 00:23:09.680
Because I want to help people.

00:23:09.960 --> 00:23:10.680
Okay.

00:23:10.700 --> 00:23:11.401
You get there.

00:23:11.661 --> 00:23:13.161
You realize a lot of people don't want

00:23:13.182 --> 00:23:13.662
your help.

00:23:14.041 --> 00:23:15.261
They don't want your help at all,

00:23:15.702 --> 00:23:17.083
or they don't want your help in the

00:23:17.123 --> 00:23:18.864
way you want to help them.

00:23:19.384 --> 00:23:21.224
You want to do manual therapy.

00:23:21.265 --> 00:23:21.924
They don't want it.

00:23:21.984 --> 00:23:24.105
You want to do exercise-based functional

00:23:24.145 --> 00:23:24.567
therapy.

00:23:24.626 --> 00:23:25.267
They don't want it.

00:23:25.326 --> 00:23:26.807
Whatever the thing is,

00:23:27.667 --> 00:23:30.189
now you're sitting on a decision.

00:23:30.489 --> 00:23:32.009
What do I do next?

00:23:32.991 --> 00:23:34.333
So Hilda was saying, okay,

00:23:34.373 --> 00:23:37.153
we move out of home health,

00:23:37.193 --> 00:23:37.954
skilled nursing,

00:23:38.015 --> 00:23:39.695
we move out of these environments,

00:23:40.195 --> 00:23:41.777
but maybe we can't find a full-time

00:23:41.817 --> 00:23:43.978
position doing what we want to do.

00:23:44.618 --> 00:23:46.119
So then you say, well,

00:23:46.559 --> 00:23:47.840
I'm going to take a job that's going

00:23:47.861 --> 00:23:49.521
to pay me a ton of money.

00:23:49.701 --> 00:23:51.803
There was a post that I had ready

00:23:52.343 --> 00:23:53.483
where somebody was saying,

00:23:53.624 --> 00:23:55.505
I love outpatient ortho PT.

00:23:55.724 --> 00:23:57.645
I'm thinking about going into home health

00:23:57.665 --> 00:23:59.027
because there's so much more money,

00:23:59.106 --> 00:24:00.347
so much more flexibility.

00:24:01.868 --> 00:24:03.770
And you kind of say, okay, look,

00:24:03.851 --> 00:24:05.771
I know I need to afford a lifestyle.

00:24:06.492 --> 00:24:07.913
I'm going to do this for the money

00:24:08.013 --> 00:24:08.554
I want.

00:24:09.375 --> 00:24:10.155
And on the side,

00:24:10.195 --> 00:24:12.238
I'm going to do this to fuel my

00:24:12.298 --> 00:24:14.098
passion, to do the things I enjoy.

00:24:14.819 --> 00:24:16.780
The people that I want to treat,

00:24:17.442 --> 00:24:19.363
delivering the service that I want to

00:24:19.383 --> 00:24:19.844
deliver,

00:24:20.304 --> 00:24:23.086
it's just not that valuable to the people

00:24:23.227 --> 00:24:24.488
I have available.

00:24:24.907 --> 00:24:25.909
So I'll take less money.

00:24:26.909 --> 00:24:28.549
But I'm going to put on my big

00:24:28.589 --> 00:24:29.851
boy pants and I'm going to go get

00:24:29.891 --> 00:24:31.592
a job that pays me what I need

00:24:31.612 --> 00:24:34.294
to make to support my family and my

00:24:34.334 --> 00:24:35.755
lifestyle and the other things that I

00:24:35.795 --> 00:24:36.075
want.

00:24:36.734 --> 00:24:37.134
You know,

00:24:37.174 --> 00:24:38.896
but I think if you go in thinking,

00:24:39.297 --> 00:24:39.777
well, no,

00:24:40.057 --> 00:24:42.098
I want to get paid one hundred and

00:24:42.118 --> 00:24:43.920
fifty thousand a year doing the things

00:24:43.940 --> 00:24:44.759
that I want to do,

00:24:44.819 --> 00:24:45.961
the way I want to do them,

00:24:46.101 --> 00:24:47.382
the time frame that I want.

00:24:47.422 --> 00:24:49.002
Plus, I want work life balance.

00:24:49.022 --> 00:24:50.763
Plus, I want all of these other things.

00:24:51.650 --> 00:24:53.590
that's where you're gonna be disengaged.

00:24:53.631 --> 00:24:56.152
That's where you're gonna be frustrated.

00:24:56.211 --> 00:24:58.653
You're not gonna have the alignment that

00:24:58.673 --> 00:24:59.493
you're looking for.

00:24:59.773 --> 00:25:00.993
But that's a personal decision.

00:25:01.294 --> 00:25:04.016
It is totally your choice to get

00:25:04.076 --> 00:25:04.796
frustrated,

00:25:04.875 --> 00:25:07.257
remain frustrated because you're choosing

00:25:07.376 --> 00:25:09.478
not to do the things that move you

00:25:09.518 --> 00:25:10.337
toward your goal.

00:25:10.377 --> 00:25:11.358
Okay?

00:25:11.378 --> 00:25:11.858
Yes.

00:25:12.679 --> 00:25:14.980
Yes, it is your situation.

00:25:15.780 --> 00:25:16.601
If you're burnout,

00:25:16.701 --> 00:25:18.021
find a different situation, right?

00:25:19.028 --> 00:25:20.669
Maybe you need to change jobs.

00:25:20.709 --> 00:25:22.609
Maybe you need to move states.

00:25:22.650 --> 00:25:23.009
I don't know.

00:25:23.430 --> 00:25:26.050
But if you stay in that situation and

00:25:26.090 --> 00:25:29.373
complain on Facebook groups anonymously,

00:25:29.593 --> 00:25:30.534
I think you're a little bit part of

00:25:30.554 --> 00:25:31.054
the problem.

00:25:31.413 --> 00:25:34.075
I think you're just feeding into the group

00:25:34.194 --> 00:25:36.336
think where now you just start shouting

00:25:36.356 --> 00:25:37.317
what other people are shouting.

00:25:38.837 --> 00:25:39.718
Yeah.

00:25:39.738 --> 00:25:41.038
I never understood.

00:25:41.759 --> 00:25:42.559
And I get it.

00:25:42.660 --> 00:25:44.681
Like, yes, there's family.

00:25:44.780 --> 00:25:46.942
There's other commitments that are going

00:25:47.102 --> 00:25:47.281
on.

00:25:48.228 --> 00:25:49.969
But there's always options,

00:25:50.068 --> 00:25:51.869
even even if you just take your clinical

00:25:51.890 --> 00:25:53.931
brain outside of health care,

00:25:54.030 --> 00:25:55.612
like you are kind of referencing.

00:25:56.051 --> 00:25:57.633
There are so many other things that we

00:25:57.673 --> 00:25:58.233
can do.

00:25:58.574 --> 00:26:00.615
The skills we developed as a therapist

00:26:00.694 --> 00:26:03.836
roll over into everything, even from,

00:26:03.896 --> 00:26:04.176
you know,

00:26:04.356 --> 00:26:05.978
plumbing and electrical equipment.

00:26:06.317 --> 00:26:08.680
to party planning,

00:26:08.779 --> 00:26:11.021
like taking your clinical knowledge,

00:26:11.061 --> 00:26:13.324
taking your ability to identify a problem,

00:26:13.364 --> 00:26:15.506
develop a plan to solve the problem and

00:26:15.625 --> 00:26:18.749
move the customer from where they are to

00:26:18.788 --> 00:26:20.230
where they want to be.

00:26:20.269 --> 00:26:23.212
That would apply to every single other

00:26:23.252 --> 00:26:24.153
profession out there.

00:26:24.173 --> 00:26:25.595
And so if people are willing to pay

00:26:25.674 --> 00:26:27.977
more for you to be a party planner,

00:26:28.778 --> 00:26:30.318
then go be a party planner to make

00:26:30.358 --> 00:26:30.898
the money.

00:26:31.299 --> 00:26:32.961
And then you can still treat patients on

00:26:32.980 --> 00:26:33.961
the side as a hobby.

00:26:38.806 --> 00:26:40.507
Another thing real quick and we'll wrap it

00:26:40.527 --> 00:26:40.606
up.

00:26:40.627 --> 00:26:42.368
The Gallup poll of,

00:26:43.109 --> 00:26:44.351
seventy-seven percent of employees are

00:26:44.391 --> 00:26:45.291
disengaged at work.

00:26:45.412 --> 00:26:48.354
Seventy percent of the variance in team

00:26:48.394 --> 00:26:51.096
engagement is due to the manager.

00:26:51.217 --> 00:26:52.557
If that's part of the problem,

00:26:53.700 --> 00:26:54.681
you find a new manager.

00:26:54.760 --> 00:26:56.340
And if you're, you talk above, you know,

00:26:56.361 --> 00:26:57.541
if you try to go above the manager

00:26:57.602 --> 00:26:58.982
and you know, the management's like, well,

00:26:59.462 --> 00:27:00.523
they're a good clinic director,

00:27:00.624 --> 00:27:01.723
they're a good manager and they're

00:27:01.763 --> 00:27:02.404
treating patients.

00:27:02.424 --> 00:27:03.664
So they're productive and whatever,

00:27:04.266 --> 00:27:05.405
then you might just have to leave the

00:27:05.425 --> 00:27:05.726
company.

00:27:05.786 --> 00:27:07.047
You might have to go find another job.

00:27:07.146 --> 00:27:08.508
If they're not gonna change the manager,

00:27:08.988 --> 00:27:10.729
if the manager is not gonna change or,

00:27:10.828 --> 00:27:13.631
you know, improve or lead differently, or,

00:27:13.790 --> 00:27:14.070
you know,

00:27:16.238 --> 00:27:18.140
change how they're managing you.

00:27:18.740 --> 00:27:20.102
If that doesn't change, then yes,

00:27:20.142 --> 00:27:22.002
you have the ability to look elsewhere.

00:27:22.042 --> 00:27:22.784
Go on LinkedIn,

00:27:23.644 --> 00:27:26.748
ask colleagues what else is available out

00:27:26.768 --> 00:27:27.888
there, probably nearby,

00:27:28.209 --> 00:27:29.450
probably in your town or city,

00:27:30.070 --> 00:27:31.412
maybe a little bit further away.

00:27:31.451 --> 00:27:32.932
Maybe it's a state or two away,

00:27:32.992 --> 00:27:35.536
but there's a lot of great opportunities

00:27:35.556 --> 00:27:35.736
out there.

00:27:35.776 --> 00:27:37.297
You have to just go look for them,

00:27:37.376 --> 00:27:39.239
but please don't go into Facebook groups

00:27:39.298 --> 00:27:42.301
anonymously and continue the chant.

00:27:44.414 --> 00:27:48.056
I saw you appreciated my call out of

00:27:48.096 --> 00:27:51.337
the anonymous person who is like, hey,

00:27:51.877 --> 00:27:53.499
I'm thinking about going into business.

00:27:53.538 --> 00:27:55.138
I want you to tell me who your

00:27:55.179 --> 00:27:56.740
customers are, how much you charge,

00:27:56.779 --> 00:27:57.500
what you get paid.

00:27:58.480 --> 00:28:00.901
It was like five direct questions for

00:28:01.000 --> 00:28:03.162
pretty personal information about

00:28:03.701 --> 00:28:04.323
business,

00:28:04.782 --> 00:28:06.403
and they want to ask it anonymous.

00:28:06.864 --> 00:28:07.463
I don't care.

00:28:07.604 --> 00:28:10.105
I don't generally mind anonymous posts,

00:28:10.484 --> 00:28:12.766
but that one was over the top.

00:28:15.087 --> 00:28:16.648
Yes, you called it out,

00:28:16.809 --> 00:28:17.851
and then they got mad at you.

00:28:17.871 --> 00:28:19.333
There you go.

00:28:19.993 --> 00:28:22.576
Which, after they made their comment,

00:28:22.596 --> 00:28:24.159
or I don't remember what it was,

00:28:24.699 --> 00:28:26.741
I don't think that was a therapist looking

00:28:26.801 --> 00:28:28.243
to start their own business.

00:28:28.523 --> 00:28:30.686
It was somebody doing market research on

00:28:30.747 --> 00:28:31.106
something.

00:28:31.126 --> 00:28:31.788
Yep, yep, yep, definitely.

00:28:31.807 --> 00:28:33.109
So anyway...

00:28:34.628 --> 00:28:38.069
Having crappy managers is nothing new.

00:28:38.130 --> 00:28:39.730
That's gone on since the beginning of

00:28:39.790 --> 00:28:40.090
time.

00:28:40.151 --> 00:28:42.912
The whole function of a manager is to

00:28:42.971 --> 00:28:44.751
kind of squash creativity,

00:28:45.113 --> 00:28:47.413
to move the business toward the average.

00:28:48.374 --> 00:28:50.173
It always works against the best.

00:28:50.594 --> 00:28:52.115
It always protects the worst.

00:28:52.954 --> 00:28:54.556
When you get to a size of an

00:28:54.615 --> 00:28:56.596
organization that actually has a

00:28:56.675 --> 00:28:58.396
management team in the middle,

00:28:59.740 --> 00:29:01.602
It's not the kind of thing that's going

00:29:01.622 --> 00:29:05.103
to support and promote you as a innovative

00:29:05.163 --> 00:29:05.742
individual.

00:29:06.782 --> 00:29:08.203
But I had crappy managers.

00:29:08.223 --> 00:29:08.884
And like you said,

00:29:08.923 --> 00:29:10.664
like the reason why I went into business

00:29:10.684 --> 00:29:13.424
for myself was because I knew I could

00:29:13.444 --> 00:29:14.645
get better outcomes.

00:29:14.885 --> 00:29:16.826
I could I could be more creative.

00:29:16.905 --> 00:29:18.426
I could build a business that I wanted

00:29:18.467 --> 00:29:21.367
to build outside of working for a

00:29:21.407 --> 00:29:21.807
hospital.

00:29:22.394 --> 00:29:23.555
But, you know,

00:29:23.615 --> 00:29:25.455
hospitals and larger corporate,

00:29:25.476 --> 00:29:28.537
they're always going to attract a certain

00:29:28.576 --> 00:29:29.477
type of person.

00:29:29.497 --> 00:29:31.156
And the most successful in those

00:29:31.237 --> 00:29:33.657
organizations are never going to be the

00:29:33.698 --> 00:29:35.558
most successful outside of those

00:29:35.598 --> 00:29:36.338
organizations.

00:29:36.759 --> 00:29:39.500
It just it pushes toward mediocrity.

00:29:39.559 --> 00:29:41.900
And that's what they were designed to do.

00:29:42.500 --> 00:29:42.640
Right.

00:29:42.661 --> 00:29:44.701
What was what was the second topic you

00:29:44.740 --> 00:29:45.040
had?

00:29:45.101 --> 00:29:46.240
Another really good one.

00:29:47.402 --> 00:29:49.082
The the supplements, the pill pack thing,

00:29:49.162 --> 00:29:51.303
or was it the what was the other

00:29:51.383 --> 00:29:51.462
one?

00:29:52.490 --> 00:29:54.451
we talked about transferring value,

00:29:54.511 --> 00:29:56.093
selling, you know, practices.

00:29:57.515 --> 00:29:58.194
Oh, the,

00:29:58.576 --> 00:30:00.497
if you have a rude prospective patient.

00:30:00.517 --> 00:30:01.678
Yeah, yeah, let's go into that.

00:30:02.378 --> 00:30:03.579
Charging them a,

00:30:04.980 --> 00:30:06.442
I called it something different privately.

00:30:06.682 --> 00:30:07.683
I'm sure you don't want to mention that,

00:30:07.723 --> 00:30:08.304
but I call,

00:30:08.644 --> 00:30:10.967
I said like a rude person tax.

00:30:11.186 --> 00:30:13.067
So if you get a rude caller,

00:30:14.161 --> 00:30:15.601
they want to do business with you because

00:30:15.621 --> 00:30:18.721
they were referred by a very big physician

00:30:18.922 --> 00:30:22.143
or a hospital group, whatever, you know?

00:30:22.442 --> 00:30:22.963
And they're like,

00:30:23.044 --> 00:30:24.983
we heard about you from so-and-so.

00:30:25.023 --> 00:30:25.523
So it's not,

00:30:25.564 --> 00:30:27.204
it's not like they're just picking anyone.

00:30:27.464 --> 00:30:29.025
They called us, they called us,

00:30:29.045 --> 00:30:30.145
they called you for a reason.

00:30:30.625 --> 00:30:31.046
They're like,

00:30:31.086 --> 00:30:36.207
you were referred by so-and-so and yeah.

00:30:36.247 --> 00:30:37.228
So do you want me to tell the

00:30:37.268 --> 00:30:38.428
story or you want to just kind of

00:30:38.448 --> 00:30:39.768
go into like what you would do with

00:30:39.807 --> 00:30:42.028
this type of a personality calling in?

00:30:42.932 --> 00:30:43.571
Well,

00:30:43.652 --> 00:30:45.432
I want you to kind of give some

00:30:45.492 --> 00:30:47.594
context, but I'll go a little bit here,

00:30:48.214 --> 00:30:50.296
just like with pricing.

00:30:50.756 --> 00:30:53.297
So you could go the route of saying,

00:30:53.336 --> 00:30:55.458
Hey, this is surge pricing.

00:30:56.077 --> 00:30:58.199
When, when competition goes up,

00:30:58.239 --> 00:31:00.180
when more consumers want a limited

00:31:00.220 --> 00:31:01.601
service, you raise the price.

00:31:01.621 --> 00:31:03.761
Like that's standard market dynamics

00:31:03.801 --> 00:31:06.002
across all of history.

00:31:06.563 --> 00:31:08.223
But if you call it surge pricing,

00:31:08.263 --> 00:31:09.785
you're going to get hammered on social

00:31:09.825 --> 00:31:10.164
media.

00:31:10.204 --> 00:31:11.806
So you can't call it surge pricing.

00:31:12.409 --> 00:31:14.570
Instead, you say, this is our price,

00:31:14.872 --> 00:31:16.973
but we're going to discount the slower

00:31:17.013 --> 00:31:17.394
times.

00:31:17.453 --> 00:31:18.375
We're going to discount.

00:31:18.394 --> 00:31:19.616
We're going to give you a forty percent

00:31:19.656 --> 00:31:20.076
discount,

00:31:20.096 --> 00:31:22.359
fifty percent discount if you choose less

00:31:22.420 --> 00:31:23.520
popular times.

00:31:24.758 --> 00:31:26.138
this is something similar.

00:31:26.219 --> 00:31:28.260
So when you have a high maintenance,

00:31:28.681 --> 00:31:30.162
complex individual,

00:31:30.221 --> 00:31:32.124
and when I say complex, I mean,

00:31:32.463 --> 00:31:34.305
they expect more than the typical

00:31:34.345 --> 00:31:34.846
customer.

00:31:35.506 --> 00:31:37.186
It's not that you're charging them more

00:31:37.207 --> 00:31:38.868
because that would be unethical and that

00:31:38.888 --> 00:31:39.709
would be bad.

00:31:40.210 --> 00:31:43.352
It's that this is our premium pricing for

00:31:43.372 --> 00:31:46.054
somebody who has the needs of somebody

00:31:46.114 --> 00:31:49.556
like you and everybody else can get

00:31:49.615 --> 00:31:51.417
discount pricing because they don't have

00:31:51.478 --> 00:31:53.239
quite the standard that you have.

00:31:53.769 --> 00:31:56.109
So that would be my approach to something

00:31:56.150 --> 00:31:56.529
like that.

00:31:58.630 --> 00:31:59.170
You know what?

00:31:59.349 --> 00:32:03.191
I think that's a great idea to use.

00:32:03.250 --> 00:32:05.592
Like, let's say on a future phone call,

00:32:05.791 --> 00:32:06.592
I could use that.

00:32:06.912 --> 00:32:07.332
Okay.

00:32:07.392 --> 00:32:09.093
I could use the higher dollar amount as

00:32:09.113 --> 00:32:10.093
a price anchor and be like, well,

00:32:10.113 --> 00:32:11.313
do you have these expectations?

00:32:11.353 --> 00:32:13.294
And do you need us to, you know,

00:32:13.334 --> 00:32:14.733
you're out of state and you're calling for

00:32:14.753 --> 00:32:15.433
your son or daughter.

00:32:15.673 --> 00:32:16.473
That happens all the time.

00:32:16.614 --> 00:32:18.295
Or it's you're out of state and you're

00:32:18.315 --> 00:32:19.055
calling for your daughter.

00:32:20.090 --> 00:32:21.851
mother or father right it could be the

00:32:21.871 --> 00:32:23.711
the parents sometimes pulling for a twenty

00:32:24.311 --> 00:32:28.393
thirty year old yeah which first that that

00:32:28.452 --> 00:32:31.253
right there is a red flag right there

00:32:31.794 --> 00:32:34.815
exactly it typically is a red flag it

00:32:34.954 --> 00:32:37.394
is typically continues to be a red flag

00:32:38.055 --> 00:32:40.175
um sometimes the family is called there's

00:32:40.256 --> 00:32:40.375
the

00:32:41.532 --> 00:32:42.693
the adult is calling for their mother or

00:32:42.713 --> 00:32:44.294
father who's, you know, sixty, seventy,

00:32:44.394 --> 00:32:44.654
eighty.

00:32:44.974 --> 00:32:46.796
But the son or daughter is out of

00:32:46.915 --> 00:32:49.336
town, out of state, and they want,

00:32:50.196 --> 00:32:52.597
you know, weekly notes and, you know,

00:32:52.659 --> 00:32:53.459
things to be sent.

00:32:53.538 --> 00:32:55.119
And sometimes there's like multiple

00:32:56.846 --> 00:32:57.446
family members,

00:32:57.487 --> 00:32:59.268
so it's someone who's calling in that's

00:32:59.307 --> 00:33:00.269
fifty or sixty years old,

00:33:00.288 --> 00:33:01.650
they're calling in for their mother or

00:33:01.670 --> 00:33:03.871
father, but then there's like, you know,

00:33:03.892 --> 00:33:04.971
their brother or sister,

00:33:05.051 --> 00:33:06.373
so sometimes it's like two or three people

00:33:06.413 --> 00:33:06.913
in the mix,

00:33:07.634 --> 00:33:09.355
and it's like a group text or it's

00:33:09.375 --> 00:33:11.978
a group email, and they want, you know,

00:33:12.738 --> 00:33:15.059
notes sent weekly or whatever, so yes,

00:33:15.601 --> 00:33:18.102
I could say to prospective patients today,

00:33:19.699 --> 00:33:20.900
if you don't need any of that like

00:33:20.940 --> 00:33:22.820
that that cost and if you want we

00:33:22.901 --> 00:33:24.041
can get into some of the pricing that

00:33:24.122 --> 00:33:27.203
i that i pitched that cost this but

00:33:27.223 --> 00:33:28.304
it doesn't sound like you need all that

00:33:28.344 --> 00:33:29.565
so by but i'm going to say it

00:33:29.585 --> 00:33:30.566
to you tony i'm going to say it

00:33:30.586 --> 00:33:31.946
to you over the phone and say this

00:33:31.967 --> 00:33:34.448
is how much this costs you hear it

00:33:35.028 --> 00:33:36.628
it actually would be a price anchor we

00:33:36.650 --> 00:33:38.691
price anchor anyway we price anchor by

00:33:38.750 --> 00:33:40.311
saying the weekend visits are a little bit

00:33:40.332 --> 00:33:41.873
more expensive and the weekday visits are

00:33:41.893 --> 00:33:44.233
a little a little less expensive weekend

00:33:44.253 --> 00:33:46.596
visits are premium and week uh weekday

00:33:46.615 --> 00:33:48.156
visits are this um

00:33:48.936 --> 00:33:50.838
So I could potentially save that dollar

00:33:50.858 --> 00:33:53.661
amount on every single phone call as a

00:33:53.721 --> 00:33:57.002
price anchor and most of the time folks

00:33:57.042 --> 00:33:58.684
are not gonna pay that because what I

00:33:58.944 --> 00:34:00.046
sent to you guys is,

00:34:01.499 --> 00:34:04.000
the highest that I've ever charged ever.

00:34:04.540 --> 00:34:04.821
Uh,

00:34:05.162 --> 00:34:06.102
and we can get into some of the

00:34:06.123 --> 00:34:08.643
details of why or, and what else, uh,

00:34:08.664 --> 00:34:10.405
what other expectations, but, um,

00:34:10.545 --> 00:34:11.987
part of the story was the,

00:34:12.007 --> 00:34:15.429
the parent was calling us to, uh,

00:34:15.449 --> 00:34:17.670
get a portable treatment table, uh,

00:34:17.871 --> 00:34:19.331
purchased with their card, not,

00:34:19.413 --> 00:34:21.813
not my card purchased with their card and

00:34:21.833 --> 00:34:24.717
then sent to the home in Manhattan.

00:34:24.777 --> 00:34:26.077
But it's a

00:34:28.451 --> 00:34:30.195
It's a walk-up, like a brownstone.

00:34:30.976 --> 00:34:32.739
There's no doorman or anything like that.

00:34:32.760 --> 00:34:33.661
It's not like I can just have a

00:34:33.742 --> 00:34:34.242
ship there,

00:34:35.378 --> 00:34:39.800
And then the client wants someone to kind

00:34:39.820 --> 00:34:42.681
of like bring the treatment table inside,

00:34:42.742 --> 00:34:44.061
walk it up the stairs, set it up,

00:34:44.081 --> 00:34:44.342
whatever,

00:34:44.382 --> 00:34:47.043
and have it ready for when my therapist

00:34:47.103 --> 00:34:49.983
actually is going to be doing the visit.

00:34:50.103 --> 00:34:51.844
So, of course, you know,

00:34:51.864 --> 00:34:53.505
you could use TaskRabbit type folks for

00:34:53.525 --> 00:34:53.684
that.

00:34:53.724 --> 00:34:55.005
You could have your physical therapist do

00:34:55.045 --> 00:34:55.965
it and pay them for that.

00:34:56.945 --> 00:34:58.706
But that's kind of the situation.

00:34:58.806 --> 00:35:01.628
And from this phone call,

00:35:01.788 --> 00:35:02.507
as a little cliffhanger,

00:35:02.527 --> 00:35:03.347
do you want me to go into the

00:35:03.387 --> 00:35:03.668
pricing?

00:35:03.708 --> 00:35:04.789
I'm happy to disclose it.

00:35:04.929 --> 00:35:05.610
Yeah,

00:35:05.710 --> 00:35:07.532
I think that's what people need to hear

00:35:07.731 --> 00:35:10.135
because they will not believe it in most

00:35:10.175 --> 00:35:10.615
cases.

00:35:11.998 --> 00:35:12.637
Yeah, so.

00:35:14.360 --> 00:35:18.125
So because of pattern recognition and

00:35:18.164 --> 00:35:19.507
hearing some of these things on the phone

00:35:19.527 --> 00:35:21.829
call and what the parent, what the actual.

00:35:23.949 --> 00:35:24.610
Part of the decision,

00:35:24.891 --> 00:35:25.630
one of the decision makers,

00:35:25.690 --> 00:35:27.072
even though the patient is an adult

00:35:27.271 --> 00:35:30.452
legally, I said, well, yeah,

00:35:30.492 --> 00:35:33.934
so we have a concierge fee of nine

00:35:33.954 --> 00:35:35.235
hundred and fifty dollars per month.

00:35:36.576 --> 00:35:39.197
And then it's five fifty per visit.

00:35:40.050 --> 00:35:43.152
Now, that is for this case,

00:35:43.193 --> 00:35:45.213
and now we're going to call that –

00:35:44.172 --> 00:35:45.653
you're helping me call that like that's

00:35:45.693 --> 00:35:47.255
like our standard pricing now.

00:35:47.994 --> 00:35:48.494
On the fly,

00:35:48.534 --> 00:35:51.297
you're helping me say this is our standard

00:35:51.336 --> 00:35:51.777
pricing.

00:35:52.478 --> 00:35:53.978
If you're outside of New York City or

00:35:54.318 --> 00:35:56.420
San Francisco or Chicago or, I don't know,

00:35:56.460 --> 00:35:57.320
Miami or something,

00:35:57.739 --> 00:35:59.400
I know those dollar amounts sound insane.

00:35:59.860 --> 00:36:00.302
I get it.

00:36:02.003 --> 00:36:03.123
I can't even believe they said yes,

00:36:03.163 --> 00:36:05.043
but then again, I did Google the family,

00:36:05.063 --> 00:36:07.244
and I was like, oh, okay, yeah, yeah.

00:36:07.284 --> 00:36:08.606
They have –

00:36:08.826 --> 00:36:10.588
very expensive homes that are on google

00:36:10.608 --> 00:36:11.809
let's just let's just put it like that

00:36:12.009 --> 00:36:15.012
so uh so real quick let's pause right

00:36:15.032 --> 00:36:16.313
there a second let me break down a

00:36:16.353 --> 00:36:19.237
couple things so i've been going down this

00:36:19.396 --> 00:36:22.079
new grad and student pt rabbit hole on

00:36:22.119 --> 00:36:23.501
tick tock i sent you a couple of

00:36:23.521 --> 00:36:26.704
videos and one of the things that you

00:36:26.724 --> 00:36:29.726
know recent grads new grad students i

00:36:29.766 --> 00:36:31.449
don't think they fully comprehend

00:36:32.458 --> 00:36:34.699
You said it when you said pattern

00:36:34.739 --> 00:36:35.420
recognition,

00:36:35.699 --> 00:36:37.521
whether we're talking clinical or

00:36:37.601 --> 00:36:38.481
personality,

00:36:38.981 --> 00:36:42.023
like we can generally understand the

00:36:42.384 --> 00:36:44.706
pattern of the individual coming in the

00:36:44.746 --> 00:36:45.106
door,

00:36:45.166 --> 00:36:48.148
talking to us on the phone pretty quickly

00:36:48.188 --> 00:36:50.449
because we've got so many years of

00:36:50.550 --> 00:36:52.490
examples that have kind of confirmed.

00:36:52.530 --> 00:36:54.052
Now, do they establish a bias?

00:36:54.172 --> 00:36:54.411
Yes.

00:36:54.612 --> 00:36:55.413
One million percent.

00:36:56.253 --> 00:36:58.153
I try to recognize my biases.

00:36:58.293 --> 00:36:58.875
I have them.

00:36:59.789 --> 00:37:01.351
I try to put them on a shelf,

00:37:01.371 --> 00:37:03.791
but I don't completely ignore them because

00:37:03.831 --> 00:37:05.932
they do help guide clinical decision

00:37:05.952 --> 00:37:07.934
making, business decision making.

00:37:08.434 --> 00:37:10.715
And I think the true value between you

00:37:10.755 --> 00:37:12.815
and a new grad who might be just

00:37:12.896 --> 00:37:14.657
as clinically skilled as you

00:37:15.336 --> 00:37:17.119
is the fact that you can layer on

00:37:17.159 --> 00:37:20.483
these other deeper analyses of the

00:37:20.543 --> 00:37:23.307
personality, even for you,

00:37:23.367 --> 00:37:25.090
like we do this at times,

00:37:25.150 --> 00:37:25.931
we have done it,

00:37:25.992 --> 00:37:28.755
where you go on the property tax records,

00:37:28.775 --> 00:37:29.797
you see where they live,

00:37:29.836 --> 00:37:30.737
you see their house,

00:37:30.958 --> 00:37:32.440
you find all of this information.

00:37:33.161 --> 00:37:34.822
It's not just about saying, well,

00:37:34.862 --> 00:37:36.083
how much money can I charge?

00:37:36.103 --> 00:37:37.463
How can I maximize my rate?

00:37:37.503 --> 00:37:39.846
It's also about who is this person?

00:37:40.465 --> 00:37:41.646
What can I expect?

00:37:42.226 --> 00:37:44.449
How can I kind of predict a little

00:37:44.469 --> 00:37:46.610
bit about what to expect from this

00:37:46.690 --> 00:37:49.751
individual based on the information I can

00:37:49.791 --> 00:37:50.253
collect?

00:37:52.333 --> 00:37:53.795
What are they going to demand of me

00:37:53.835 --> 00:37:55.135
in terms of time or effort?

00:37:55.876 --> 00:37:57.516
And what are their expectations?

00:37:57.637 --> 00:38:00.478
I think all that goes into it.

00:38:00.559 --> 00:38:00.820
Yes.

00:38:01.840 --> 00:38:02.661
Okay, so keep going.

00:38:05.083 --> 00:38:07.844
So they said yes, and I was like,

00:38:07.963 --> 00:38:08.585
oh my gosh,

00:38:08.644 --> 00:38:09.905
I can't wait to tell Jimmy and Tony,

00:38:09.925 --> 00:38:10.985
that is crazy.

00:38:12.045 --> 00:38:13.347
So yeah, anyway,

00:38:13.367 --> 00:38:15.387
we're in the process of the table,

00:38:16.228 --> 00:38:17.548
the portable treatment table has been

00:38:17.608 --> 00:38:19.630
purchased and will be sent there.

00:38:19.670 --> 00:38:21.791
But part of that about,

00:38:22.884 --> 00:38:26.284
the impromptu boosting of prices and

00:38:26.364 --> 00:38:28.045
adding a monthly concierge fee,

00:38:28.085 --> 00:38:29.905
which I've always kind of thought about

00:38:30.465 --> 00:38:31.666
whether annual or monthly.

00:38:32.565 --> 00:38:38.088
Um, but, uh, the, the caller was saying,

00:38:38.248 --> 00:38:41.188
well, cause I, I, she was like, oh,

00:38:41.208 --> 00:38:41.849
you know,

00:38:41.869 --> 00:38:43.309
you bring a portable treatment table or,

00:38:43.329 --> 00:38:43.768
you know, whatever.

00:38:43.789 --> 00:38:45.329
And I was like, no, no, we don't.

00:38:45.449 --> 00:38:46.130
Cause we're, you know,

00:38:46.150 --> 00:38:47.849
our therapists are in the subway and all

00:38:47.869 --> 00:38:48.030
that.

00:38:48.050 --> 00:38:49.931
And they're like, well,

00:38:50.871 --> 00:38:51.391
you know, well,

00:38:52.311 --> 00:38:55.672
you were referred to us by so-and-so and,

00:38:55.833 --> 00:38:58.635
you know,

00:38:58.974 --> 00:39:00.936
she's not gonna get treated on a couch

00:39:01.536 --> 00:39:05.318
or her bed or a carpeted floor on

00:39:05.338 --> 00:39:05.838
a yoga mat.

00:39:06.097 --> 00:39:07.358
Those are things I usually say,

00:39:07.418 --> 00:39:08.780
that we usually say on the phone call,

00:39:08.800 --> 00:39:08.980
like,

00:39:09.922 --> 00:39:11.804
know and we have some people that we

00:39:11.824 --> 00:39:13.106
have some clients by the way that like

00:39:13.445 --> 00:39:14.726
they've been with us for like a year

00:39:14.766 --> 00:39:16.849
or two and they're fine being on a

00:39:16.889 --> 00:39:18.969
carpeted floor or a yoga mat or their

00:39:19.010 --> 00:39:21.192
couch or whatever and they're fine with

00:39:21.853 --> 00:39:23.813
not buying a portable treatment table

00:39:23.833 --> 00:39:25.074
because some clients just don't want to

00:39:25.114 --> 00:39:27.036
have they don't want to they don't have

00:39:27.056 --> 00:39:27.976
the extra room for it they don't want

00:39:27.998 --> 00:39:30.358
to slide it under the bed they don't

00:39:30.398 --> 00:39:31.300
want to put they don't have room in

00:39:31.340 --> 00:39:35.443
a closet whatever and so this caller was

00:39:35.744 --> 00:39:35.844
uh

00:39:37.427 --> 00:39:39.168
I said to you guys almost like berating

00:39:39.208 --> 00:39:43.130
me about like, and also saying like, here,

00:39:43.331 --> 00:39:44.811
here's a tip to it.

00:39:44.851 --> 00:39:46.331
Here's a tip to improve your business

00:39:46.351 --> 00:39:48.092
model for clients like us.

00:39:48.233 --> 00:39:50.293
And I was like, Oh, I was like,

00:39:50.333 --> 00:39:51.014
wait, I was like,

00:39:51.034 --> 00:39:54.916
wait till you hear the new pricing.

00:39:55.815 --> 00:39:56.175
Yeah.

00:39:56.215 --> 00:39:57.376
So pricing didn't phaser.

00:39:58.608 --> 00:40:01.751
In your own words, in your own mind,

00:40:02.251 --> 00:40:04.653
like forget the sales part of it,

00:40:04.693 --> 00:40:05.574
forget the customer,

00:40:05.635 --> 00:40:06.655
forget all the other stuff.

00:40:06.735 --> 00:40:09.597
Like how do you rationalize in your own

00:40:09.637 --> 00:40:12.340
mind why you would charge almost a

00:40:12.380 --> 00:40:15.302
thousand dollar a month fee on top of

00:40:15.362 --> 00:40:16.905
the per visit fee?

00:40:17.085 --> 00:40:18.826
Like what does that allow you to do?

00:40:19.226 --> 00:40:21.349
What is the benefit, you know,

00:40:21.568 --> 00:40:23.610
to the customer for paying a fee like

00:40:23.630 --> 00:40:23.731
that?

00:40:25.760 --> 00:40:28.804
so directly how i make sense of it

00:40:28.903 --> 00:40:32.007
is if the if a parent is calling

00:40:32.188 --> 00:40:33.831
in for their child but the child is

00:40:33.851 --> 00:40:38.096
an adult i already know in general i'm

00:40:38.135 --> 00:40:40.418
generalizing i already know the type of

00:40:40.478 --> 00:40:42.521
family and and and

00:40:43.262 --> 00:40:45.864
patient and the expectations that the

00:40:45.963 --> 00:40:48.224
caller, the parent, expects.

00:40:48.264 --> 00:40:50.146
They're going to expect a lot of

00:40:50.166 --> 00:40:51.045
communication.

00:40:51.445 --> 00:40:53.766
They're going to expect promptness of the

00:40:53.786 --> 00:40:54.646
therapist's arrival.

00:40:54.686 --> 00:40:55.248
So now it's like,

00:40:55.307 --> 00:40:57.327
I got to tell my therapist, hey,

00:40:57.829 --> 00:40:59.528
the client at this address,

00:40:59.789 --> 00:41:00.909
you need to wear

00:41:01.690 --> 00:41:02.411
Professional clothes.

00:41:02.670 --> 00:41:03.411
I know you always do,

00:41:03.452 --> 00:41:04.371
but I'm just reminding you,

00:41:04.391 --> 00:41:06.054
like you need to like be, you know,

00:41:06.094 --> 00:41:08.916
your hair groomed and like you need to

00:41:09.036 --> 00:41:09.536
be prompt.

00:41:09.597 --> 00:41:11.599
You can't just be thirty minutes late and

00:41:11.679 --> 00:41:12.260
not text them.

00:41:12.280 --> 00:41:13.800
Like if you're in stuck in the subway,

00:41:14.141 --> 00:41:16.923
you need to be texting the client like

00:41:16.943 --> 00:41:19.887
we need to be fully prompt on every

00:41:19.967 --> 00:41:20.327
aspect.

00:41:20.347 --> 00:41:22.268
So professional dress arrival

00:41:22.369 --> 00:41:23.250
expectations.

00:41:23.949 --> 00:41:26.371
That's with the adult client.

00:41:27.213 --> 00:41:29.795
but then the caller the parent might also

00:41:29.855 --> 00:41:31.836
want i don't know they might want some

00:41:32.257 --> 00:41:34.039
you know weekly or monthly or whatever

00:41:34.079 --> 00:41:36.000
check-in so all that takes time and effort

00:41:36.101 --> 00:41:38.081
even if it's mine even if the therapist

00:41:38.121 --> 00:41:39.684
is sending emails or text or whatever to

00:41:39.724 --> 00:41:44.768
the parent um the the the the client

00:41:44.867 --> 00:41:46.208
is an adult right so i think i'd

00:41:46.228 --> 00:41:47.909
have to get like and this is rare

00:41:47.949 --> 00:41:49.170
but i think we'd have to get like

00:41:49.251 --> 00:41:50.873
a like a hipaa release sign i'm not

00:41:50.913 --> 00:41:53.974
sure because they're an adult um so it's

00:41:53.994 --> 00:41:54.215
like

00:41:55.230 --> 00:41:58.451
I already can tell that I'm going to

00:41:58.471 --> 00:42:00.112
be not spinning a lot of plates,

00:42:00.132 --> 00:42:01.931
but there might be a lot of extra

00:42:02.012 --> 00:42:06.074
random admin requests and burdens and

00:42:06.134 --> 00:42:07.153
tasks and things to do.

00:42:07.313 --> 00:42:10.394
So you pitch this type of pricing because

00:42:10.434 --> 00:42:11.335
I've anticipated this.

00:42:11.456 --> 00:42:12.635
I've been in these homes before.

00:42:12.715 --> 00:42:14.617
I've treated both of these types of people

00:42:14.657 --> 00:42:14.896
before.

00:42:14.936 --> 00:42:16.317
I've treated the parent.

00:42:16.878 --> 00:42:19.338
I've treated the son or daughter of this

00:42:19.358 --> 00:42:20.039
type of a parent.

00:42:20.159 --> 00:42:21.938
I know exactly what...

00:42:23.780 --> 00:42:27.842
might be demanded of us and i thought

00:42:28.324 --> 00:42:29.585
uh i thought you know there might be

00:42:29.605 --> 00:42:30.684
some pushback on the price and there

00:42:30.724 --> 00:42:31.905
wasn't and i joked with you guys that

00:42:31.925 --> 00:42:33.728
like i didn't ask for enough money haha

00:42:33.768 --> 00:42:37.530
but um i think also this pay structure

00:42:37.630 --> 00:42:41.092
might also uh get their attention because

00:42:41.132 --> 00:42:43.514
when i happened to call the caller when

00:42:43.574 --> 00:42:46.317
i called the parent she was receiving

00:42:46.657 --> 00:42:47.878
physical therapy somewhere else

00:42:48.873 --> 00:42:50.077
Like she was literally in a physical

00:42:50.097 --> 00:42:50.717
therapy visit.

00:42:52.000 --> 00:42:57.271
So I also know that most likely that

00:42:57.311 --> 00:42:59.135
the physical therapist she was going to

00:43:00.409 --> 00:43:01.550
does not charge like we do.

00:43:02.050 --> 00:43:03.891
So that's another way to catch someone's

00:43:03.952 --> 00:43:04.391
attention.

00:43:04.492 --> 00:43:08.333
This type of a client, they didn't say,

00:43:08.614 --> 00:43:09.653
she could have said to me, oh wow,

00:43:09.673 --> 00:43:11.755
that's more than my other PT elsewhere,

00:43:12.175 --> 00:43:13.496
because I know that that physical

00:43:13.516 --> 00:43:14.835
therapist elsewhere is not charging a

00:43:14.856 --> 00:43:15.617
five-fifty visit,

00:43:15.936 --> 00:43:17.958
and definitely not charging nine-fifty per

00:43:17.998 --> 00:43:19.778
month as a concierge fee.

00:43:19.838 --> 00:43:22.239
So that's another thing that's kind of,

00:43:23.519 --> 00:43:24.860
maybe you can elaborate more for me,

00:43:24.880 --> 00:43:26.320
because it's more of something that would

00:43:27.561 --> 00:43:29.682
catch someone's attention in this

00:43:31.617 --> 00:43:32.898
this style, you know what I mean?

00:43:32.918 --> 00:43:33.278
Like they would,

00:43:33.418 --> 00:43:34.659
they would take us a little bit more

00:43:34.679 --> 00:43:35.181
seriously.

00:43:36.061 --> 00:43:38.682
It's you're speaking the same language,

00:43:38.822 --> 00:43:39.143
you know?

00:43:39.204 --> 00:43:40.465
And, and I was just, again,

00:43:40.565 --> 00:43:42.065
I listened to a lot of media.

00:43:42.766 --> 00:43:44.327
I was listening to a public speaker

00:43:44.367 --> 00:43:45.847
yesterday and she was saying how,

00:43:45.867 --> 00:43:47.809
when she had her first offer to do

00:43:47.889 --> 00:43:50.231
a paid public speaking event,

00:43:50.751 --> 00:43:52.693
the company that wanted to bring her in

00:43:52.733 --> 00:43:54.514
said, you know, how much do you charge?

00:43:54.554 --> 00:43:55.215
What's your fee?

00:43:55.235 --> 00:43:56.036
We want an hour.

00:43:56.056 --> 00:43:56.376
She said,

00:43:57.817 --> 00:43:58.797
And in her mind,

00:43:58.878 --> 00:44:01.360
five hundred dollars was unbelievable

00:44:01.820 --> 00:44:03.722
because she was used to making fifty

00:44:03.742 --> 00:44:06.204
dollars an hour in a W-two paid job.

00:44:06.644 --> 00:44:07.184
And she was like,

00:44:07.264 --> 00:44:08.365
I would have done it for free.

00:44:08.445 --> 00:44:09.146
So I thought, oh,

00:44:09.226 --> 00:44:10.847
I'll ten X what I'm what I make

00:44:10.927 --> 00:44:13.210
normally and charge five hundred.

00:44:13.889 --> 00:44:15.371
Then the story goes,

00:44:15.552 --> 00:44:18.273
the company chose not to hire her and

00:44:18.293 --> 00:44:19.735
they went with somebody who was charging

00:44:19.795 --> 00:44:21.617
five thousand for the hour.

00:44:22.320 --> 00:44:23.141
And then she asked him,

00:44:23.240 --> 00:44:24.722
why did you not hire me?

00:44:24.762 --> 00:44:26.121
And she said, well, truthfully,

00:44:26.541 --> 00:44:28.143
you were only charging five hundred.

00:44:28.182 --> 00:44:29.882
This person's charging five thousand.

00:44:29.963 --> 00:44:33.224
We're used to paying for, you know, five,

00:44:33.264 --> 00:44:33.643
ten,

00:44:34.664 --> 00:44:36.625
even one hundred thousand dollar speaker.

00:44:37.364 --> 00:44:39.525
We can't deal with a five hundred dollar

00:44:39.545 --> 00:44:40.806
speaker, you know.

00:44:40.905 --> 00:44:45.288
And so just by speaking the language of

00:44:45.327 --> 00:44:46.628
a wealthy individual,

00:44:47.572 --> 00:44:49.554
they don't understand those rates.

00:44:49.594 --> 00:44:49.773
Like,

00:44:50.173 --> 00:44:52.436
why would somebody who I expect to be

00:44:52.496 --> 00:44:55.278
premier, best in class, top of the line,

00:44:55.699 --> 00:44:57.840
why would they be charging so little?

00:44:58.340 --> 00:44:59.842
So you kind of have to get into

00:44:59.882 --> 00:45:00.682
that world.

00:45:01.224 --> 00:45:02.704
And then, of course, once you get there,

00:45:02.744 --> 00:45:04.465
you know, you start to realize, oh,

00:45:04.746 --> 00:45:06.907
these zeros don't really have the same

00:45:06.987 --> 00:45:08.730
impact to them as they do to me.

00:45:09.349 --> 00:45:09.911
If anything,

00:45:09.951 --> 00:45:11.992
an extra zero just means I'm that much

00:45:12.032 --> 00:45:13.132
better, you know?

00:45:13.193 --> 00:45:13.514
And so...

00:45:15.795 --> 00:45:18.297
I think that's a huge barrier for so

00:45:18.356 --> 00:45:20.438
many clinicians because so many are

00:45:20.478 --> 00:45:23.599
struggling day to day to just pay their

00:45:23.659 --> 00:45:24.159
loans.

00:45:24.199 --> 00:45:27.161
Like they can't even fathom an extra zero

00:45:27.280 --> 00:45:29.422
or two on the end of what they're

00:45:29.481 --> 00:45:30.181
used to making.

00:45:30.202 --> 00:45:31.802
So I think it's awesome.

00:45:31.822 --> 00:45:32.402
And like you said,

00:45:32.682 --> 00:45:34.503
I think the whole idea behind that kind

00:45:34.523 --> 00:45:37.304
of monthly fee is it just builds in

00:45:37.324 --> 00:45:39.606
the cushion to allow you to deliver what

00:45:39.626 --> 00:45:41.007
the client actually wants.

00:45:41.768 --> 00:45:43.789
These aren't individuals that are looking

00:45:43.829 --> 00:45:45.791
for government-funded healthcare.

00:45:46.152 --> 00:45:48.672
These are individuals that have the means

00:45:48.713 --> 00:45:51.496
and the resources to get what they want

00:45:51.655 --> 00:45:54.358
well beyond what government-funded

00:45:54.418 --> 00:45:56.358
healthcare is designed to deliver.

00:45:58.521 --> 00:46:00.282
Let me pull this up real quick,

00:46:00.302 --> 00:46:02.123
because this is still kind of in line

00:46:02.143 --> 00:46:03.565
with what we were talking about.

00:46:04.445 --> 00:46:05.826
This, I'm going to share it.

00:46:06.726 --> 00:46:08.307
Let's share this instead,

00:46:08.949 --> 00:46:10.690
and let me pull it into the screen.

00:46:11.809 --> 00:46:14.331
This was shared, I know it's small,

00:46:14.371 --> 00:46:15.253
but I'll read it,

00:46:15.914 --> 00:46:17.954
in the Doctor of Physical Therapy students

00:46:17.974 --> 00:46:18.295
group.

00:46:19.016 --> 00:46:20.536
And I think this kind of goes along

00:46:20.577 --> 00:46:21.458
with the same idea.

00:46:21.478 --> 00:46:22.159
It says, hello,

00:46:22.639 --> 00:46:24.940
I'm writing out of curiosity and insight a

00:46:24.960 --> 00:46:26.481
couple years out of PT school,

00:46:26.561 --> 00:46:28.463
working in an outpatient orthopedic

00:46:29.364 --> 00:46:30.945
setting since graduating.

00:46:31.485 --> 00:46:34.007
I was curious if anyone has any previous

00:46:34.088 --> 00:46:34.389
work,

00:46:34.789 --> 00:46:37.210
previously worked in outpatient ortho,

00:46:37.791 --> 00:46:39.413
and they've been thinking about switching

00:46:39.552 --> 00:46:40.614
into home health.

00:46:41.231 --> 00:46:42.552
I guess the main question is,

00:46:42.753 --> 00:46:44.594
has anyone been in the same boat,

00:46:44.755 --> 00:46:45.715
made the switch?

00:46:46.755 --> 00:46:47.657
What's your take,

00:46:47.677 --> 00:46:49.257
your experience on the decision?

00:46:50.579 --> 00:46:51.179
There's that,

00:46:51.219 --> 00:46:52.679
but before you answer that one,

00:46:53.420 --> 00:46:56.782
the other one, I'm going to share it.

00:46:56.902 --> 00:46:57.963
Let's see if it's showing.

00:46:58.003 --> 00:46:58.885
Yeah.

00:46:58.925 --> 00:46:59.945
This one says,

00:47:01.226 --> 00:47:05.188
recent grad got extended a job offer in

00:47:05.228 --> 00:47:06.530
a cash-based practice.

00:47:07.079 --> 00:47:08.980
So one is an ortho PT thinking about

00:47:09.019 --> 00:47:10.500
going to home health really because it

00:47:10.519 --> 00:47:11.139
pays more.

00:47:11.679 --> 00:47:14.240
The other one is new grad getting an

00:47:14.300 --> 00:47:15.621
offer from a cash clinic.

00:47:16.181 --> 00:47:18.322
Following successful interview process,

00:47:18.362 --> 00:47:19.202
the clinic owner,

00:47:20.342 --> 00:47:22.304
I was asked to provide a desired

00:47:22.344 --> 00:47:23.264
compensation.

00:47:23.903 --> 00:47:27.105
So first question, Dave, in negotiation,

00:47:27.125 --> 00:47:27.744
they always say,

00:47:27.824 --> 00:47:29.925
don't put the first number out there.

00:47:30.505 --> 00:47:32.746
Let the other party put the first number

00:47:32.867 --> 00:47:33.327
out there.

00:47:34.193 --> 00:47:36.693
but this person saying the clinic's hourly

00:47:36.753 --> 00:47:38.273
rate is two hundred and forty dollars an

00:47:38.393 --> 00:47:41.255
hour i'll be responsible for attracting

00:47:41.315 --> 00:47:43.436
patients and managing my own schedule the

00:47:43.476 --> 00:47:45.115
clinic owner has agreed to cover

00:47:45.155 --> 00:47:49.697
malpractice ehr utilities which i thought

00:47:49.717 --> 00:47:53.697
that was weird and other expenses um

00:47:53.717 --> 00:47:55.798
they're also offering a retirement plan

00:47:55.858 --> 00:47:57.458
health insurance what do you think would

00:47:57.478 --> 00:47:59.519
be a fair compensation package for me to

00:47:59.559 --> 00:47:59.920
request

00:48:02.492 --> 00:48:02.791
All right.

00:48:02.811 --> 00:48:03.492
Which one do you want me to hit

00:48:03.512 --> 00:48:03.893
on first?

00:48:04.532 --> 00:48:05.273
Let's do this one.

00:48:05.293 --> 00:48:07.094
Cause this one's more in your world.

00:48:07.936 --> 00:48:11.277
Like what would they be looking at?

00:48:11.418 --> 00:48:12.298
You want a dollar amount?

00:48:13.338 --> 00:48:15.601
Like just, it could be a dollar amount.

00:48:15.661 --> 00:48:16.460
It could be, Hey,

00:48:17.041 --> 00:48:21.184
if this practice is billing two forties

00:48:21.244 --> 00:48:21.965
session,

00:48:22.485 --> 00:48:24.847
like how do you even go about figuring

00:48:25.007 --> 00:48:26.188
out what you would charge?

00:48:30.489 --> 00:48:32.652
If they're being paid hourly.

00:48:34.956 --> 00:48:37.260
It didn't say whether it's hourly or being

00:48:37.300 --> 00:48:38.161
paid per session.

00:48:38.222 --> 00:48:40.244
I'm going to say they're probably offered

00:48:40.465 --> 00:48:41.586
a per session rate.

00:48:43.045 --> 00:48:46.487
Because it says they're responsible for

00:48:46.547 --> 00:48:49.288
attracting patients and managing their

00:48:49.307 --> 00:48:50.947
schedule.

00:48:51.108 --> 00:48:51.668
I don't agree.

00:48:51.688 --> 00:48:52.467
There's no way.

00:48:52.547 --> 00:48:53.307
I know this is anonymous,

00:48:53.327 --> 00:48:54.768
so we can't even ask the person because

00:48:54.789 --> 00:48:55.829
they wanted to post anonymously.

00:48:57.869 --> 00:48:58.969
There's hardly any practice.

00:48:58.989 --> 00:49:00.230
I don't even care if they're cash-based.

00:49:00.409 --> 00:49:02.030
If you're a cash-based practice,

00:49:03.090 --> 00:49:05.291
you are not really relying on your staff

00:49:05.311 --> 00:49:06.452
physical therapist to attract new

00:49:06.492 --> 00:49:06.911
patients.

00:49:07.931 --> 00:49:10.413
So I don't think that that is a

00:49:10.472 --> 00:49:10.693
thing.

00:49:10.793 --> 00:49:11.172
I don't even...

00:49:12.277 --> 00:49:15.679
Why do you say that?

00:49:15.719 --> 00:49:17.099
Because if there's a cash practice out

00:49:17.139 --> 00:49:18.641
there, they've already,

00:49:18.721 --> 00:49:19.621
and if they're hiring,

00:49:19.661 --> 00:49:21.242
that means they typically have already

00:49:21.282 --> 00:49:22.121
figured out the marketing.

00:49:22.161 --> 00:49:24.402
They already have a customer client base.

00:49:25.083 --> 00:49:26.903
There's for me, for me, Tony,

00:49:27.023 --> 00:49:28.304
like when I hire new therapists,

00:49:28.744 --> 00:49:29.744
they're not doing marketing.

00:49:30.304 --> 00:49:31.106
I want them to be,

00:49:31.226 --> 00:49:32.485
I want their calendar to be open and

00:49:32.505 --> 00:49:34.226
available for evaluations and

00:49:34.927 --> 00:49:35.728
and follow-up visits.

00:49:35.748 --> 00:49:37.028
They can't get busy unless they do

00:49:37.048 --> 00:49:37.688
evaluations.

00:49:38.269 --> 00:49:39.269
I'm not sending them out.

00:49:40.871 --> 00:49:41.472
I've considered it.

00:49:41.512 --> 00:49:41.931
I thought about it.

00:49:41.952 --> 00:49:43.152
I have some therapists that have asked

00:49:43.193 --> 00:49:43.514
about it.

00:49:43.914 --> 00:49:44.614
Like, oh,

00:49:44.635 --> 00:49:46.275
do we have to do marketing or whatever?

00:49:46.295 --> 00:49:46.556
But no,

00:49:46.635 --> 00:49:48.858
I put that in my FAQ document that

00:49:48.918 --> 00:49:50.818
I send to every potential candidate that's

00:49:50.858 --> 00:49:52.460
like seven or eight pages long.

00:49:52.860 --> 00:49:54.762
And I'm like, read this once or twice,

00:49:55.342 --> 00:49:56.463
and then we're going to talk for the

00:49:56.503 --> 00:49:56.963
first time.

00:49:57.344 --> 00:50:00.327
Like when we're messaging or I message

00:50:00.347 --> 00:50:00.907
someone on LinkedIn.

00:50:01.286 --> 00:50:02.969
And in that seven-page document,

00:50:03.088 --> 00:50:04.130
one of the lines is like,

00:50:04.929 --> 00:50:06.469
one of the questions that FAQ is like,

00:50:06.730 --> 00:50:08.751
do I need to attract and do marketing

00:50:08.771 --> 00:50:09.510
for new patients?

00:50:10.070 --> 00:50:10.590
Question mark.

00:50:10.990 --> 00:50:12.512
And then my reply is, no,

00:50:12.831 --> 00:50:13.592
we do the marketing.

00:50:13.632 --> 00:50:14.431
We're the business.

00:50:14.831 --> 00:50:15.692
That's our responsibility.

00:50:15.711 --> 00:50:16.192
We're the owner.

00:50:16.211 --> 00:50:18.132
That's that's our responsibility to be the

00:50:18.172 --> 00:50:19.652
PT Barnum to drum up business.

00:50:20.092 --> 00:50:21.172
That's your responsibility, Tony.

00:50:21.193 --> 00:50:21.713
You know that.

00:50:22.173 --> 00:50:24.574
So the fact that this says that the

00:50:24.634 --> 00:50:27.235
new grad team member is responsible for

00:50:27.275 --> 00:50:28.094
attracting patients

00:50:29.813 --> 00:50:31.474
What practice anywhere is making their

00:50:31.494 --> 00:50:33.815
employees go drum up new business?

00:50:33.835 --> 00:50:34.375
That's insane.

00:50:34.474 --> 00:50:36.655
I don't think it is.

00:50:37.077 --> 00:50:38.817
I really think there are a lot of

00:50:38.896 --> 00:50:42.278
smaller cash-based practices that expect

00:50:42.298 --> 00:50:44.840
the therapist to attract more patients.

00:50:44.860 --> 00:50:46.300
And I'll tell you the typical example.

00:50:46.440 --> 00:50:47.300
Usually what it is,

00:50:47.340 --> 00:50:48.702
is these are operating out of

00:50:49.302 --> 00:50:51.882
CrossFit gym or fitness facility or yoga

00:50:51.902 --> 00:50:53.063
studio or Pilates.

00:50:53.523 --> 00:50:55.065
They want their therapist.

00:50:55.085 --> 00:50:58.527
And I see this in personal training also.

00:50:58.947 --> 00:51:01.288
They want the therapist to go connect,

00:51:01.568 --> 00:51:02.168
network,

00:51:02.248 --> 00:51:05.050
make connections and bring business in.

00:51:05.110 --> 00:51:07.590
I think these business owners think that.

00:51:07.931 --> 00:51:11.293
The value prop is I've got the platform.

00:51:11.632 --> 00:51:13.313
You go out and get customers,

00:51:13.695 --> 00:51:15.815
bring them in and we'll do a fifty

00:51:15.856 --> 00:51:17.976
fifty or a sixty forty split.

00:51:18.338 --> 00:51:21.599
I think they think their business is so

00:51:21.719 --> 00:51:24.902
amazing that they shouldn't have to do

00:51:24.942 --> 00:51:27.182
their own recruiting and marketing and

00:51:27.222 --> 00:51:27.923
stuff like that.

00:51:28.583 --> 00:51:30.625
A therapist who's so lucky to come work

00:51:30.644 --> 00:51:31.085
for me.

00:51:31.445 --> 00:51:33.306
It's your responsibility to go do it.

00:51:34.525 --> 00:51:37.067
Okay, let's unpack this a little bit more.

00:51:37.166 --> 00:51:38.548
Bo said there's a few like that in

00:51:38.588 --> 00:51:40.329
Colorado.

00:51:40.349 --> 00:51:40.851
Who said that?

00:51:41.050 --> 00:51:41.311
Bo?

00:51:41.490 --> 00:51:41.670
Bo.

00:51:42.931 --> 00:51:43.871
That's crazy, man.

00:51:45.393 --> 00:51:47.052
OK, well, so it's a new grad.

00:51:47.432 --> 00:51:49.452
It says, hello, I'm a recent graduate.

00:51:49.793 --> 00:51:51.434
That means respect, respectively,

00:51:51.454 --> 00:51:52.713
because we all were there.

00:51:53.173 --> 00:51:54.594
And man, Tony,

00:51:54.635 --> 00:51:56.655
can you imagine my ego in the first

00:51:56.775 --> 00:51:57.875
one, two, three years out of school?

00:51:58.054 --> 00:51:59.436
I thought I knew everything.

00:51:59.916 --> 00:52:02.476
And then I realized whatever the quote is,

00:52:02.516 --> 00:52:04.297
like you realize how much you didn't know

00:52:04.356 --> 00:52:05.117
or how much you don't know.

00:52:05.797 --> 00:52:07.679
so the first couple years out of school

00:52:07.719 --> 00:52:09.659
like you might have a little bit of

00:52:09.679 --> 00:52:11.802
an ego like you had rotations and you

00:52:11.842 --> 00:52:14.143
think you can fix any injury and all

00:52:14.164 --> 00:52:16.105
that and maybe you do have great clinical

00:52:16.125 --> 00:52:18.706
skills but as a recent grad you're going

00:52:18.806 --> 00:52:20.347
to also require some

00:52:21.309 --> 00:52:22.690
some coaching, some support.

00:52:23.552 --> 00:52:24.373
You're going to get a case,

00:52:24.393 --> 00:52:25.414
you're going to get a diagnosis,

00:52:25.434 --> 00:52:26.614
a presentation in front of you,

00:52:26.695 --> 00:52:28.538
and you're going to have no idea what

00:52:28.577 --> 00:52:28.898
to do.

00:52:29.219 --> 00:52:31.021
You're going to come out of the evaluation

00:52:31.041 --> 00:52:31.782
and be like, I don't know.

00:52:31.802 --> 00:52:32.442
I have to blur.

00:52:32.461 --> 00:52:33.483
I don't know what just happened.

00:52:33.923 --> 00:52:35.286
And I don't know if I even made

00:52:35.326 --> 00:52:36.507
a dent in their situation.

00:52:37.268 --> 00:52:37.427
So

00:52:38.518 --> 00:52:40.181
real quick so the clinic rate they're

00:52:40.201 --> 00:52:42.702
charging two forty visit if the new grad

00:52:42.802 --> 00:52:46.085
is pulling clients from crossfit or some

00:52:46.126 --> 00:52:47.467
other you know running club or they're

00:52:47.487 --> 00:52:49.889
bringing in patients to be treated there

00:52:50.210 --> 00:52:51.331
then i agree with you tony i think

00:52:51.351 --> 00:52:53.411
maybe like a fifty fifty split per hour

00:52:53.733 --> 00:52:55.293
so the therapy the new grad therapist is

00:52:55.313 --> 00:52:57.456
making one twenty an hour if you're doing

00:52:57.476 --> 00:53:00.278
a pre-tax fifty fifty split on that

00:53:01.331 --> 00:53:05.092
If the cash practice is supplying the new

00:53:05.132 --> 00:53:05.492
patients,

00:53:05.512 --> 00:53:07.514
the marketing and the malpractice and the

00:53:07.653 --> 00:53:10.054
EMR and the overhead of the practice and

00:53:10.074 --> 00:53:11.615
all that, then we're talking like,

00:53:12.576 --> 00:53:15.077
twenty-five to thirty-three percent.

00:53:15.117 --> 00:53:17.119
We're talking about sixty dollars to

00:53:17.159 --> 00:53:18.920
eighty dollars per visit if a cash

00:53:18.960 --> 00:53:21.141
practice is charging two-forty because

00:53:21.621 --> 00:53:22.581
ideally that would be a great,

00:53:22.601 --> 00:53:23.422
that would be a sweet spot.

00:53:25.998 --> 00:53:27.862
the therapist is then making, you know,

00:53:27.902 --> 00:53:31.849
twenty five to thirty three percent of the

00:53:31.889 --> 00:53:33.793
top line revenue of the of the two

00:53:33.813 --> 00:53:34.574
forty per visit.

00:53:35.315 --> 00:53:37.519
So it depends on the marketing.

00:53:38.856 --> 00:53:39.818
If you're a practice owner out there,

00:53:39.838 --> 00:53:41.778
if you're watching this and you are making

00:53:41.798 --> 00:53:43.780
your team members attract new patients,

00:53:44.601 --> 00:53:46.643
you're teaching them how to be a business

00:53:46.702 --> 00:53:48.123
owner and they're going to leave you and

00:53:48.143 --> 00:53:49.244
they're going to take all these patients

00:53:49.284 --> 00:53:49.764
from you.

00:53:50.425 --> 00:53:52.086
So please just go learn marketing,

00:53:52.106 --> 00:53:53.608
go watch Alex Ramosi videos,

00:53:53.648 --> 00:53:54.748
go watch Tony Meritato,

00:53:55.128 --> 00:53:56.489
learn Medicare billing on YouTube and

00:53:56.550 --> 00:53:58.130
learn more about, you know, marketing.

00:53:58.992 --> 00:53:59.811
What's Beau saying here?

00:54:00.992 --> 00:54:03.394
Clinician gets about forty four percent.

00:54:04.114 --> 00:54:05.275
I agree with Dave.

00:54:05.496 --> 00:54:07.358
I think thirty three percent at the top

00:54:07.418 --> 00:54:07.677
level

00:54:08.646 --> 00:54:12.608
if if um the business is bringing the

00:54:12.648 --> 00:54:15.150
client if the business is bringing the

00:54:15.170 --> 00:54:18.251
client thirty three percent top level is

00:54:18.311 --> 00:54:21.253
totally reasonable that leaves a third for

00:54:21.353 --> 00:54:23.195
profitability that leaves a third for

00:54:23.235 --> 00:54:25.976
covering expenses and overhead forty four

00:54:26.016 --> 00:54:28.978
percent now you're you're starting to step

00:54:29.077 --> 00:54:29.498
into

00:54:30.255 --> 00:54:33.757
That therapist better be an asset to the

00:54:33.797 --> 00:54:34.257
business.

00:54:34.277 --> 00:54:36.838
That therapist better start building a

00:54:36.938 --> 00:54:37.880
book of business.

00:54:39.179 --> 00:54:40.501
They're kind of, you know,

00:54:40.561 --> 00:54:42.742
consistently their clients are not

00:54:42.981 --> 00:54:45.023
canceling, not no showing,

00:54:45.983 --> 00:54:47.483
completing plans of care,

00:54:48.224 --> 00:54:49.344
all of that kind of stuff.

00:54:50.226 --> 00:54:53.086
But for a typical kind of, you know,

00:54:53.766 --> 00:54:54.947
I'm a good enough therapist.

00:54:54.987 --> 00:54:56.226
I can get my patients better.

00:54:56.286 --> 00:54:57.527
My patients don't hate me.

00:54:58.588 --> 00:54:59.688
Thirty three percent, I think,

00:54:59.728 --> 00:55:03.289
is where you pretty much top out.

00:55:03.309 --> 00:55:03.668
Right on.

00:55:03.989 --> 00:55:04.369
Agreed.

00:55:05.429 --> 00:55:05.809
All right.

00:55:05.889 --> 00:55:08.230
We're at the nine thirty mark.

00:55:08.349 --> 00:55:09.829
Let's do parting shots.

00:55:10.391 --> 00:55:12.831
So I'll go and then, Dave, you go.

00:55:13.030 --> 00:55:14.972
I'm going to say the biggest thing,

00:55:15.072 --> 00:55:16.672
the biggest theme from today is.

00:55:17.284 --> 00:55:19.967
is understanding the balance between the

00:55:20.027 --> 00:55:23.527
business of physical therapy and the

00:55:23.628 --> 00:55:24.829
treatment, the care,

00:55:24.869 --> 00:55:27.831
the other side of physical therapy.

00:55:28.731 --> 00:55:29.572
We're all going to change.

00:55:29.592 --> 00:55:31.193
We're all going to go through evolution.

00:55:31.813 --> 00:55:33.954
I spent a lot of my twenty five

00:55:33.994 --> 00:55:36.355
years focused on the patient care.

00:55:36.394 --> 00:55:37.956
It was all about the patient care.

00:55:37.996 --> 00:55:39.137
I'd go home and research.

00:55:39.197 --> 00:55:40.097
I'd read studies.

00:55:40.557 --> 00:55:42.798
I'd learn things that I didn't know if

00:55:42.878 --> 00:55:44.920
I had a case that I didn't understand.

00:55:45.454 --> 00:55:48.077
Like everything was about the patient.

00:55:48.817 --> 00:55:52.179
Now I've kind of moved past that to

00:55:52.360 --> 00:55:53.521
my passion is the business.

00:55:53.601 --> 00:55:54.460
I love the business.

00:55:54.501 --> 00:55:56.021
I love the systems of the business.

00:55:56.342 --> 00:55:58.724
I want to make the business better to

00:55:58.784 --> 00:56:00.985
support other clinicians who are more

00:56:01.045 --> 00:56:03.106
interested in focusing on the patient at

00:56:03.146 --> 00:56:03.708
this point.

00:56:04.768 --> 00:56:05.869
Doesn't matter where you are in the

00:56:05.909 --> 00:56:06.190
journey,

00:56:06.230 --> 00:56:09.072
just understand where you are and,

00:56:09.431 --> 00:56:10.713
you know,

00:56:10.753 --> 00:56:12.853
put your time and effort into what has

00:56:12.893 --> 00:56:13.894
the greatest impact.

00:56:14.195 --> 00:56:14.856
Dave, what you got?

00:56:16.063 --> 00:56:18.126
love it if you're watching and listening

00:56:18.166 --> 00:56:20.489
this far in if you're a physical therapist

00:56:20.590 --> 00:56:21.831
out there that wants to make a hundred

00:56:21.851 --> 00:56:23.835
thousand dollars and treat four to six

00:56:23.875 --> 00:56:26.960
patients per day call us reach out find

00:56:26.980 --> 00:56:28.481
me you'll i'm easy to find on the

00:56:28.501 --> 00:56:31.226
internet uh send me an email apply we

00:56:31.246 --> 00:56:32.146
would love to speak with you

00:56:33.007 --> 00:56:34.050
If you're a practice owner out there,

00:56:34.329 --> 00:56:35.572
it doesn't matter if you're in network.

00:56:35.612 --> 00:56:37.333
We do prefer a little bit more of

00:56:37.353 --> 00:56:38.996
the out-of-network cash pay models.

00:56:39.056 --> 00:56:40.699
But if you're a practice owner looking for

00:56:40.719 --> 00:56:42.300
a transition, looking for a buyer,

00:56:43.163 --> 00:56:44.384
we have practice owners reaching out to us

00:56:44.423 --> 00:56:44.965
all the time,

00:56:45.005 --> 00:56:46.186
whether they have a broker or not.

00:56:46.226 --> 00:56:47.088
If you're looking to sell,

00:56:47.128 --> 00:56:47.829
if you're looking to sell

00:56:48.710 --> 00:56:50.050
sixty seventy eighty percent of your

00:56:50.070 --> 00:56:52.331
practice and then keep some of the upside

00:56:52.753 --> 00:56:54.554
while we grow it reach out if you're

00:56:54.574 --> 00:56:55.894
looking to get out a hundred percent and

00:56:55.914 --> 00:56:57.695
you're looking to sell and go on to

00:56:57.715 --> 00:56:59.476
the next chapter of your life reach out

00:56:59.496 --> 00:57:01.998
to us uh at the field maker group

00:57:02.079 --> 00:57:03.458
or send me an email find me again

00:57:03.539 --> 00:57:04.880
on linkedin or on the internet somewhere

00:57:05.481 --> 00:57:07.882
and that's it for me all right guys

00:57:07.922 --> 00:57:09.963
come back and see us tuesdays thursdays

00:57:10.143 --> 00:57:13.626
eight thirty a.m we'll catch you hi my

00:57:13.666 --> 00:57:15.606
name is karen and welcome to the pt

00:57:15.626 --> 00:57:16.788
breakfast club podcast