How to Fix the Most Expensive Mistakes in Your PT Clinic

WEBVTT

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You're listening to the P.T.

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Pinecast,

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where smart people in healthcare come to

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make noise.

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Here's your host, Jimmy McKay.

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i want to say big thanks to empower

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emr if your clinic is stuck in an

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emr that slows you down that's not cool

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man empower gives you speed clean

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workflows and features pts actually asked

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for the stuff you asked for better notes

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faster documentation smoother operations

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those three those are the things people

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keep asking for them i know because i'm

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in the facebook groups with you and those

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are the things you're asking for all those

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things wrapped up in customer support that

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doesn't ghost you that's also what you're

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asking for upgrade your clinic's brain

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with empower emr they also know switching

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gives you a feeling way down deep.

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They understand that.

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They make it easy.

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So go kick the tires.

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Go slow.

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Do it right.

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EmpowerEMR.com.

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That is EmpowerEMR.com.

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Wow, look at this.

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Surprise.

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Today's guest.

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Where most physical therapy clinics,

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they don't fail because of bad clinicians.

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They struggle because of invisible

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systems.

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This was not on the syllabus, kids,

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in PT school, unfortunately.

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I can't change that,

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but I can at least enlighten you now.

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And every day,

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time just leaks out through scheduling

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friction.

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Listen right now.

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You can hear it.

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Oh, it's not good.

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How do I fix it?

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Documentation drag, billing delays,

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workflow bottlenecks that nobody ever

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trained you to see.

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It's not your fault.

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You weren't trained,

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but you do have to own it because

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if you don't,

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oh, that dripping,

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you're still going to pay for it.

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And it doesn't really show up on a

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balance sheet.

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It does,

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but you don't know where to look on

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the balance sheet.

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It's sort of in between the lines.

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It shows up as burnout, staffing stress,

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cashflow anxiety.

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Where's it coming from?

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I have a full schedule,

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then why do I feel fragile?

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We're going to talk about those things,

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the invisible, hairy, scary things.

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So our guest today has spent more than

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two decades,

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I want to see how he feels about

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that, two decades I get to say now,

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inside of those invisible systems where

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the leaks are,

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helping design and evolve the operational

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backbone of PT practices that are still

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around.

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Because if you don't fix the leaks,

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your boat don't float.

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From first patient contact to discharge

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and beyond, this guy's, again,

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two decades, you see things come and go.

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He's worked across product, sales,

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marketing, and operations in this space.

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His resume and theory is boring.

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Just one thing,

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doing this for twenty-one years.

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That's when you know you know the nooks

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and crannies.

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So let's bring him in, Sharif Zeed.

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Sharif, welcome back to the show, man.

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Hey, thanks for having me, Jimmy.

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Always a pleasure to be here and excited.

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Yeah,

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there's always something new to talk

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about.

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That's for sure.

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Isn't that crazy that there's always

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something new to talk about and you look

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at this one little area of our practice

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and even that little area of our

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profession still is enough to annoy

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people, scare people,

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put people out of business and enough

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things always changing to still have stuff

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to talk about, right?

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Totally.

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I mean,

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I jokingly say I started in the PT

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EMR world when it was a covered wagon.

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And now we've got space space shuttles

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going to Mars or whatever.

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So it's definitely a change.

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And we still call it an EMR.

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And when when I started,

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it really was EMR like documentation.

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And now it's the everything engine or

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that's what it's supposed to be.

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Right.

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That's the promise.

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So, yeah, things are changing.

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And I will say.

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The pace of change,

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it's not linear anymore.

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It's exponential.

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I mean, sort of the expectations,

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the desires,

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the promise continues to grow.

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And so do the challenges.

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So it's just a mixed thing.

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And there's always good things.

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There's always bad things.

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There's challenges.

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There's opportunities and the whole thing

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in between.

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Yep.

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So you sit down with practices that are

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across specialties, across timelines,

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brand new, maybe not started yet,

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brand new, legacy, all those things.

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Someone like you can sort of see things

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coming.

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I imagine most of the time,

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the clinician or the business owner is

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sitting there explaining things to you.

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And you're probably biting your tongue,

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waiting for them to run out of air

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before you go, Oh, okay,

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I've seen this before.

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You probably have it figured out in the

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first

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Yeah.

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I mean, first of all,

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definitely working with practices all

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across the spectrum, right?

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So what's the same and what's different?

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They're all outpatient rehab.

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That's our thing.

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That's what we do.

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So PTOT speech, no inpatient,

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no skilled nursing, nothing like that.

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So that's the same,

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if you could even call that the same.

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And yeah,

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what's different is where they are in

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their practice life, you know,

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start up to mature and

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the size of the practice solo to the

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supporting,

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trying to support dozens or hundreds of

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clinicians, the single location,

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the multi-location,

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and then really an increasingly

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differentiating factor is just where they

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are in their business cycle.

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Are they shooting for growth?

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Are they trying to maintain stability?

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Are they struggling?

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What are they trying to achieve?

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Like you said,

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some are pushing for that next level of

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profit or revenue and others are just

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like, hey,

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I've just got to make it to hire

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the next clinician.

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Others yet are like,

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I just got to get out of treatment.

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I need to hire some people and kind

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of change my role in the clinic from

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being working in the business to working

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on the business kind of thing,

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as they say.

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All right.

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So if I changed your role for just

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a second,

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we pretend if you go from what you

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do in EMR and technology to a plumber,

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when you walk in to a practice where

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the plumber's like something's leaking,

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they're like in their mind,

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they're probably like,

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it's one of these four places.

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Let me go check those in order of

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importance.

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When you get brought into a practice from

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across hundreds of clinics that you've

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seen,

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Where are the practices that you work with

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quietly losing the most time every week

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without realizing it?

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So we'll start with time.

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Where are they losing time the most?

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Yeah,

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I think the number one answer I would

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give to that is what I would just

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put under an umbrella called one word,

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adoption.

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So many practices have lots of tools and

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they don't know what to do with them

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or they're not using them to the fullest

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extent that they can.

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And that happens for a variety of reasons.

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But the one I see the most often,

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and honestly, if I'm being honest,

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the most frustrating is adoption.

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They're letting perfect be the enemy of

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good.

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So there is no perfect system.

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There is no software product you can buy

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that's going to be check off every single

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box.

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And I see some practices trading off, hey,

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it can't do this last ten percent I

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want it to do,

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so I'm not going to do the ninety

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percent that it can do.

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There are always trade-offs.

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If you have a seven-figure budget for

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software and you want to go have something

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purpose-built for your practice,

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you can get exactly what you want.

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Honestly, maybe not even in that case,

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but let's just be high level here.

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You could probably get what you want if

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you're willing to spend that kind of

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money.

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even the largest practices,

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even the largest chains are not building

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custom software.

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So that means that no matter what you

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hear from whomever is selling you on a

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product, there's always going to be some,

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um, you know, imperfection,

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something that's not a hundred percent

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target on target with what you're trying

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to do with your workflow or your people

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or your patients or whatever.

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A great concrete example of this is very

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simple.

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Um,

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online booking used to be a very taboo

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some years ago.

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Now it's much more accepted,

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but there are still a lot of practices

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we talk to that won't let patients book

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online.

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Why?

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Because it's not perfect.

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They can't replace the front desk.

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They know I'm special.

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I have this special scheduling process

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that needs to be done.

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And, you know, you can, you know,

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say with Empower,

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you can usually mimic the vast majority of

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those rules in those settings.

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But yeah,

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there might be an edge case or a

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fringe case where, you know,

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the system may allow a booking where your

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front desk person would have blocked them

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out or vice versa,

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disallows a booking that you may have

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wanted.

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But, you know, again,

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if you're hitting ninety,

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ninety five percent of cases,

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like what are you doing?

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Why aren't you offering that?

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That's your time that you're leaking right

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there in your front desk.

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That's your patient visits that you're

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leaking on the side there.

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Because you're, again,

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letting perfect be the enemy of, frankly,

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great in some cases,

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but certainly better in most.

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So it's just one example.

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There are dozens of them.

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But implement, adopt, use, do.

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Those are the verbs I would try and

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I would harp on constantly.

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Does adoption also encompass...

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What I talked about in the intro,

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which is change.

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Listen, I like my bank.

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Maybe I don't like my bank,

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but I'm thinking, God,

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the amount of things I'll have to do

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to get rid of my bank.

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Even if great was right across the street,

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I'm like, I'd be so much better.

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I'm thinking, not even thinking,

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I'm feeling of what change feels like.

00:08:47.322 --> 00:08:48.203
And I don't even,

00:08:48.224 --> 00:08:49.404
it doesn't even crack the top ten.

00:08:49.686 --> 00:08:50.466
Does that prevent,

00:08:50.485 --> 00:08:51.888
I imagine that's got to be up there.

00:08:53.166 --> 00:08:53.788
Absolutely.

00:08:53.947 --> 00:08:54.831
I mean,

00:08:54.890 --> 00:08:56.995
change is like this concept that's far

00:08:57.035 --> 00:08:58.760
beyond just business and practice, right?

00:08:58.801 --> 00:09:00.245
It's hard to change in your personal life.

00:09:00.284 --> 00:09:00.907
It's hard to

00:09:01.590 --> 00:09:03.451
deal with somebody who is changing for

00:09:03.490 --> 00:09:04.572
better or for worse.

00:09:04.611 --> 00:09:06.013
You know, there's these, you know,

00:09:06.052 --> 00:09:08.354
all these books about self-help and change

00:09:08.374 --> 00:09:09.054
and all these things.

00:09:09.575 --> 00:09:11.015
In business, it can be true.

00:09:11.375 --> 00:09:14.378
There oftentimes can be friction that is,

00:09:14.477 --> 00:09:15.879
you know, also being generated,

00:09:15.958 --> 00:09:17.340
I would say, from external, like,

00:09:17.460 --> 00:09:17.679
you know,

00:09:17.700 --> 00:09:19.280
your team might be giving you friction,

00:09:19.321 --> 00:09:20.902
your patients might be giving you friction

00:09:21.782 --> 00:09:24.063
in just beyond your own innate, you know,

00:09:24.183 --> 00:09:26.784
inertia that's causing you to have

00:09:26.965 --> 00:09:27.826
heartburn with change.

00:09:27.865 --> 00:09:27.966
But

00:09:29.125 --> 00:09:31.326
This is also a surmountable problem in the

00:09:31.346 --> 00:09:32.326
business world, I think,

00:09:32.365 --> 00:09:33.506
or in the practice world, right?

00:09:33.547 --> 00:09:35.488
Just make the changes modest,

00:09:35.628 --> 00:09:36.668
make them consistent.

00:09:36.827 --> 00:09:38.769
So you're changing regularly,

00:09:39.129 --> 00:09:40.850
but you're biting off small things.

00:09:41.551 --> 00:09:43.951
The other end of the scale with adoption

00:09:44.011 --> 00:09:45.692
of too little adoption is too much

00:09:45.751 --> 00:09:46.873
adoption too fast.

00:09:47.452 --> 00:09:49.053
and this is how you trash your team

00:09:49.173 --> 00:09:50.714
right as if like you know if let's

00:09:50.734 --> 00:09:52.455
say you watch this podcast like i'm really

00:09:52.495 --> 00:09:54.936
motivated by sharif which would be a

00:09:55.316 --> 00:09:56.416
miracle and you're like i'm gonna go

00:09:56.475 --> 00:09:58.397
implement ninety three things on monday

00:09:58.437 --> 00:10:00.357
morning and you go in there the way

00:10:00.398 --> 00:10:01.878
your team's gonna perceive it is now

00:10:01.898 --> 00:10:04.019
you're just yelling at them there's no

00:10:04.298 --> 00:10:06.779
rhyme or reason too much too fast and

00:10:06.820 --> 00:10:08.880
then all of your initiatives will fail so

00:10:09.746 --> 00:10:12.128
Got to find the seesaw balance between,

00:10:12.248 --> 00:10:12.687
you know,

00:10:12.707 --> 00:10:14.849
trying to make steady incremental progress

00:10:14.869 --> 00:10:16.889
in the practice and blowing everybody out

00:10:17.090 --> 00:10:18.931
and and or not doing anything at all,

00:10:19.091 --> 00:10:21.231
which is without naming anything specific.

00:10:21.351 --> 00:10:22.131
Yeah.

00:10:22.292 --> 00:10:24.293
How does someone pick which one?

00:10:24.773 --> 00:10:25.894
Hey, I've got a list of ninety three.

00:10:26.014 --> 00:10:27.094
I'm hearing what Sharif is saying.

00:10:27.234 --> 00:10:27.575
I get it.

00:10:27.595 --> 00:10:28.014
He's right.

00:10:28.855 --> 00:10:30.437
How do you know which is the one

00:10:30.477 --> 00:10:31.499
to say, okay,

00:10:31.578 --> 00:10:33.402
I'm going to do this one this quarter?

00:10:34.524 --> 00:10:35.043
How do you pick?

00:10:35.063 --> 00:10:35.926
How do you decide?

00:10:36.807 --> 00:10:37.086
Yeah.

00:10:37.508 --> 00:10:39.130
I mean, here's the two answers, right?

00:10:39.171 --> 00:10:40.673
The formal answer,

00:10:40.712 --> 00:10:42.576
which I actually think is a good exercise,

00:10:42.596 --> 00:10:43.397
and if you can do it,

00:10:43.437 --> 00:10:43.998
it would be great.

00:10:44.768 --> 00:10:46.730
You take the ninety three things you you

00:10:46.769 --> 00:10:49.413
try and rank them by effort and pay

00:10:49.493 --> 00:10:49.753
off.

00:10:50.354 --> 00:10:51.754
And then you make a grid and you

00:10:51.774 --> 00:10:53.756
do the low effort, high payoff ones.

00:10:53.777 --> 00:10:55.798
That's like the business textbook answer.

00:10:56.278 --> 00:10:58.240
The not business textbook answer is you're

00:10:58.280 --> 00:10:58.861
the owner.

00:10:59.182 --> 00:11:01.724
You probably already intuitively know what

00:11:01.744 --> 00:11:03.365
your biggest like you just I don't have

00:11:03.405 --> 00:11:05.988
enough patients or I have too many

00:11:06.028 --> 00:11:06.489
patients.

00:11:07.284 --> 00:11:09.346
And, or I don't have enough profit,

00:11:09.407 --> 00:11:11.347
which can often be like too many patients,

00:11:11.368 --> 00:11:11.989
but you know,

00:11:12.068 --> 00:11:14.070
not the right mix of patients to deliver

00:11:14.110 --> 00:11:15.270
the profitability that you want.

00:11:15.311 --> 00:11:16.371
So, you know,

00:11:17.113 --> 00:11:18.874
I think a lot of effort, you know,

00:11:18.894 --> 00:11:21.056
and I'm a, I'm a business guy, right?

00:11:21.096 --> 00:11:21.897
By education,

00:11:21.956 --> 00:11:23.116
I went to business school and all that

00:11:23.158 --> 00:11:23.437
stuff.

00:11:23.477 --> 00:11:24.678
And you can get really wrapped up in

00:11:24.719 --> 00:11:27.120
the consulting method of, of thinking.

00:11:27.681 --> 00:11:28.861
Sometimes it's just too much,

00:11:28.902 --> 00:11:30.423
like intuitively, what's your issue?

00:11:30.462 --> 00:11:31.744
Like, what's going on this week?

00:11:31.783 --> 00:11:32.004
Wow.

00:11:32.043 --> 00:11:33.424
Really high cancels and no shows.

00:11:33.485 --> 00:11:33.785
Okay.

00:11:33.905 --> 00:11:34.505
There's your problem.

00:11:34.525 --> 00:11:35.067
Let's work it.

00:11:35.726 --> 00:11:37.148
um not enough patience we didn't bring

00:11:37.168 --> 00:11:39.587
enough evals in last week so our

00:11:39.628 --> 00:11:41.469
pipeline's a little bit low okay work that

00:11:41.509 --> 00:11:44.110
problem that's a top of funnel problem um

00:11:44.129 --> 00:11:45.830
we looked at the numbers and we're billing

00:11:45.909 --> 00:11:48.091
record amounts and our reimbursements are

00:11:48.150 --> 00:11:49.931
in the trash can okay now you have

00:11:49.951 --> 00:11:52.871
a billing problem so intuition's fine and

00:11:53.111 --> 00:11:55.113
and i think it's underrated sometimes and

00:11:55.153 --> 00:11:56.893
people want to go read the book or

00:11:57.033 --> 00:11:58.474
ask your favorite ai

00:11:59.333 --> 00:12:00.894
What should I work on in my practice

00:12:00.934 --> 00:12:02.375
when you probably already know?

00:12:03.035 --> 00:12:04.576
Last thought is if you don't know,

00:12:04.616 --> 00:12:05.836
if you really have no idea,

00:12:05.856 --> 00:12:06.658
which would be crazy,

00:12:06.717 --> 00:12:07.697
then go ask your team.

00:12:08.139 --> 00:12:09.359
Maybe they'll tell you what the problem

00:12:09.418 --> 00:12:09.558
is.

00:12:09.619 --> 00:12:09.719
Hey,

00:12:10.419 --> 00:12:12.380
I'm burned out on this or I can

00:12:12.421 --> 00:12:15.042
see the cancellations hitting my desk or

00:12:15.201 --> 00:12:16.682
I'm having trouble collecting money and

00:12:16.722 --> 00:12:18.923
here's why, and work those problems.

00:12:19.832 --> 00:12:22.793
If you ask people for their opinion,

00:12:23.114 --> 00:12:23.953
they will give it to you.

00:12:24.134 --> 00:12:25.294
Don't worry about that.

00:12:25.394 --> 00:12:25.995
They will give it to you.

00:12:26.054 --> 00:12:26.875
Sure, sure.

00:12:26.894 --> 00:12:28.115
If you have a team of ten,

00:12:28.255 --> 00:12:29.576
you'll have twelve opinions.

00:12:29.615 --> 00:12:31.417
Because you can ask the same person and

00:12:31.437 --> 00:12:32.857
get the same different opinions on two

00:12:32.878 --> 00:12:33.977
different days on the same thing.

00:12:34.726 --> 00:12:36.466
All right, let's go to bottlenecks.

00:12:36.947 --> 00:12:39.607
Points of friction is the fancy word,

00:12:39.648 --> 00:12:39.868
right?

00:12:40.188 --> 00:12:42.168
If you had to name three most common,

00:12:42.208 --> 00:12:43.629
the things that pop up, again,

00:12:43.649 --> 00:12:44.830
you've been doing this for twenty one

00:12:44.870 --> 00:12:45.269
years,

00:12:45.750 --> 00:12:47.910
the three most common workflow bottlenecks

00:12:48.010 --> 00:12:49.530
in outpatient PT today,

00:12:49.951 --> 00:12:52.611
what shows up almost everywhere?

00:12:53.971 --> 00:12:54.831
Almost everywhere.

00:12:55.052 --> 00:12:55.672
I have to say,

00:12:57.533 --> 00:13:00.096
the owner oftentimes pops up as a

00:13:00.135 --> 00:13:00.615
bottleneck.

00:13:00.635 --> 00:13:01.937
They don't want to hear that though.

00:13:02.336 --> 00:13:04.139
It's maybe not the most popular thing to

00:13:04.178 --> 00:13:04.538
say,

00:13:04.658 --> 00:13:06.740
but I think there's some level of

00:13:06.841 --> 00:13:08.302
understanding that this is an issue.

00:13:08.562 --> 00:13:10.482
And sometimes it can be too much control.

00:13:10.563 --> 00:13:12.924
Like one of the biggest windows we get

00:13:13.004 --> 00:13:15.346
into a practice is during onboarding.

00:13:15.567 --> 00:13:16.967
It's a time of great change.

00:13:16.988 --> 00:13:18.068
They're switching systems.

00:13:18.089 --> 00:13:19.750
The team is doing stuff.

00:13:22.235 --> 00:13:24.077
I would never call an onboarding a stress

00:13:24.118 --> 00:13:24.717
free time.

00:13:24.738 --> 00:13:25.639
There's no such thing.

00:13:25.658 --> 00:13:27.200
So you're watching a practice under

00:13:27.279 --> 00:13:27.740
stress.

00:13:27.821 --> 00:13:28.782
And, you know,

00:13:28.961 --> 00:13:30.763
usually the ones that go well are where

00:13:30.802 --> 00:13:33.105
it's for lack of a better sort of

00:13:33.125 --> 00:13:34.505
a democratic process, right?

00:13:34.525 --> 00:13:35.888
The different constituencies in the

00:13:35.927 --> 00:13:37.509
practice, the front desk, the billers,

00:13:37.528 --> 00:13:39.451
the providers are all involved in their

00:13:39.510 --> 00:13:40.932
respective ways in that onboarding.

00:13:42.014 --> 00:13:44.054
It has a tendency to go less well

00:13:44.134 --> 00:13:46.615
when there's a singular point of contact

00:13:46.655 --> 00:13:48.277
and it's always the owner and the other

00:13:48.297 --> 00:13:50.477
folks aren't on the calls and they're not

00:13:50.498 --> 00:13:53.499
given leeway to ask their own questions.

00:13:53.678 --> 00:13:55.379
That's just one window into how you look

00:13:55.440 --> 00:13:55.639
at it,

00:13:55.659 --> 00:13:57.020
but you can look at all of those

00:13:57.041 --> 00:13:57.341
things.

00:13:59.961 --> 00:14:01.883
When I review a call, for example,

00:14:02.062 --> 00:14:03.682
and I hear at the end that all

00:14:03.722 --> 00:14:05.604
the tasks in the call were assigned to

00:14:05.624 --> 00:14:06.544
the owner, all of them.

00:14:06.884 --> 00:14:07.384
I'll do that.

00:14:07.544 --> 00:14:08.544
I'll put that on my plate.

00:14:08.605 --> 00:14:09.706
I'll take that to my list.

00:14:10.306 --> 00:14:12.167
that's really when you start to have now

00:14:12.506 --> 00:14:13.927
it ties into the same theme,

00:14:13.947 --> 00:14:16.988
which is delegation also has to include

00:14:17.028 --> 00:14:18.408
some measure of letting go,

00:14:18.528 --> 00:14:20.869
some measure of accepting good and not

00:14:20.908 --> 00:14:22.149
perfect at some cases.

00:14:22.188 --> 00:14:23.969
And sometimes, but you know what,

00:14:24.028 --> 00:14:25.409
like the good that you had to put

00:14:25.450 --> 00:14:26.169
in,

00:14:26.509 --> 00:14:28.370
the perfect that you had to put a

00:14:28.389 --> 00:14:30.110
hundred and twenty percent effort into as

00:14:30.130 --> 00:14:32.451
an owner with all these different things

00:14:32.471 --> 00:14:33.250
that you've got to do.

00:14:33.932 --> 00:14:34.831
Uh, so that's number one.

00:14:34.892 --> 00:14:35.812
Number two is, um,

00:14:36.606 --> 00:14:39.128
you know not in not investing uh in

00:14:39.168 --> 00:14:41.389
your systems so you know it's funny

00:14:41.448 --> 00:14:43.009
transition to go from this onboarding

00:14:43.049 --> 00:14:45.250
conversation but like that's a time of of

00:14:45.431 --> 00:14:48.251
known in investment of time into a system

00:14:48.292 --> 00:14:49.232
you know you're going to have to put

00:14:49.273 --> 00:14:52.033
some time in don't stop you have to

00:14:52.053 --> 00:14:54.335
keep investing in the systems and in the

00:14:54.375 --> 00:14:56.355
people who run those systems in order to

00:14:56.395 --> 00:14:58.256
continue to maximize and first of all like

00:14:58.277 --> 00:15:00.057
we just talked about the system itself is

00:15:00.097 --> 00:15:01.658
probably changing like there's new stuff

00:15:01.677 --> 00:15:03.538
happening so where are you are you keeping

00:15:03.599 --> 00:15:04.759
up with that stuff are you taking

00:15:04.779 --> 00:15:05.399
advantage of it

00:15:06.552 --> 00:15:08.813
And AI is just the latest in that

00:15:08.894 --> 00:15:10.174
litany of things.

00:15:10.195 --> 00:15:10.554
And again,

00:15:10.595 --> 00:15:12.697
it's driving the pace up very high.

00:15:13.356 --> 00:15:15.719
And you shouldn't worry about chasing an

00:15:15.859 --> 00:15:17.500
unholy pace that's going to kill your

00:15:17.541 --> 00:15:17.980
practice.

00:15:18.020 --> 00:15:20.903
But you need to continue to evolve and

00:15:20.923 --> 00:15:21.442
do things.

00:15:21.482 --> 00:15:23.965
And so if you talk to a practice

00:15:24.024 --> 00:15:25.767
and they essentially tell you they're

00:15:25.787 --> 00:15:27.548
doing things the same way they were doing

00:15:27.587 --> 00:15:29.970
them, say, five years ago, I mean,

00:15:30.629 --> 00:15:33.232
You know, COVID now was in twenty twenty,

00:15:33.332 --> 00:15:33.613
right?

00:15:33.732 --> 00:15:34.673
The five years ago,

00:15:34.734 --> 00:15:36.015
like just five years ago,

00:15:36.076 --> 00:15:37.136
that was twenty twenty one.

00:15:37.277 --> 00:15:38.738
So where are we at?

00:15:38.778 --> 00:15:40.120
Like if you're doing something the same

00:15:40.139 --> 00:15:40.299
way,

00:15:40.320 --> 00:15:42.062
then if you're doing the same processes

00:15:42.081 --> 00:15:43.543
you were doing in twenty eighteen,

00:15:44.144 --> 00:15:44.344
you know,

00:15:44.364 --> 00:15:45.905
things have definitely moved and

00:15:45.966 --> 00:15:46.745
definitely changed.

00:15:46.765 --> 00:15:49.668
So a bottleneck is just not investing into

00:15:49.688 --> 00:15:51.171
the system, into the time,

00:15:51.390 --> 00:15:53.212
the time that's needed into continuing

00:15:53.232 --> 00:15:53.352
growth.

00:15:54.344 --> 00:15:55.725
to to make the most and then the

00:15:55.745 --> 00:15:57.166
last one i i guess i would say

00:15:57.206 --> 00:15:59.587
for bottleneck is like i i would call

00:15:59.648 --> 00:16:02.990
it um metric fatigue so there's a lot

00:16:03.051 --> 00:16:05.493
of you know information like copious

00:16:05.513 --> 00:16:07.154
amounts of information out there that you

00:16:07.174 --> 00:16:08.755
can read from all sorts of different

00:16:08.775 --> 00:16:11.357
sources and every month somebody invents a

00:16:11.398 --> 00:16:13.559
new metric that is like super interesting

00:16:13.600 --> 00:16:14.681
and you can read about it and it

00:16:14.701 --> 00:16:16.422
sounds great and then you're just

00:16:16.481 --> 00:16:17.943
bottlenecking everybody because you're

00:16:17.984 --> 00:16:20.164
pushing them into some new metric that you

00:16:20.205 --> 00:16:21.846
just woke up and decided was important

00:16:21.886 --> 00:16:23.148
that day and it's not

00:16:23.856 --> 00:16:27.639
consistent whereas the core metrics that

00:16:27.659 --> 00:16:29.780
hasn't changed you know what's your day

00:16:29.821 --> 00:16:32.043
plus ar that hasn't really changed and for

00:16:32.123 --> 00:16:33.844
good reason how many visits did you bring

00:16:33.884 --> 00:16:36.885
in how many evaluations so i think a

00:16:36.926 --> 00:16:38.587
balance there would would be better

00:16:38.827 --> 00:16:40.408
instead of just trying to slow everybody

00:16:40.448 --> 00:16:42.129
down with too much stuff to focus on

00:16:42.169 --> 00:16:44.030
and i've seen practices where they're

00:16:44.051 --> 00:16:46.393
trying to track like three dozen metrics

00:16:46.432 --> 00:16:48.715
and it's so overwhelming that actually

00:16:48.754 --> 00:16:50.475
none of them get any meaningful attention

00:16:51.115 --> 00:16:51.576
and um

00:16:52.403 --> 00:16:54.104
people end up slowing themselves down to

00:16:54.163 --> 00:16:55.664
try and meet one of them and probably

00:16:55.705 --> 00:16:57.505
have unintended consequences with others.

00:16:57.566 --> 00:16:59.047
So it just becomes like a cluster.

00:16:59.407 --> 00:17:00.187
You don't want that.

00:17:00.408 --> 00:17:02.908
I just ask people to envision the,

00:17:03.309 --> 00:17:03.529
you know,

00:17:03.570 --> 00:17:06.431
the middle school custodian and how many

00:17:06.491 --> 00:17:08.011
keys they have around their,

00:17:08.272 --> 00:17:08.932
their key chain.

00:17:09.252 --> 00:17:10.933
You can't have seventy eight KPIs.

00:17:10.973 --> 00:17:11.775
That's not yet.

00:17:12.035 --> 00:17:13.536
You should have, you know, three.

00:17:13.556 --> 00:17:14.296
I don't know the answer,

00:17:14.316 --> 00:17:15.416
but it's not seventy eight.

00:17:15.676 --> 00:17:15.856
Right.

00:17:15.876 --> 00:17:17.577
It's not zero, but it's not seventy eight.

00:17:18.259 --> 00:17:18.659
Right.

00:17:19.019 --> 00:17:21.180
So we talk a lot about clinician burnout.

00:17:21.259 --> 00:17:22.140
We didn't think we were going to get

00:17:22.180 --> 00:17:22.880
into this here,

00:17:22.940 --> 00:17:25.641
but this is where the friction is.

00:17:25.941 --> 00:17:26.740
So a lot of people will say,

00:17:26.800 --> 00:17:27.661
where's the burnout?

00:17:27.701 --> 00:17:29.342
And they'll look around and say, well,

00:17:29.362 --> 00:17:29.882
it's in here.

00:17:29.922 --> 00:17:31.862
It's in my gut, it's in my heart,

00:17:31.882 --> 00:17:32.521
it's in my head.

00:17:33.222 --> 00:17:36.522
But you can actually show friction equals

00:17:36.803 --> 00:17:39.124
heat and heat equals burn and burnout.

00:17:39.743 --> 00:17:41.084
How much of burnout today,

00:17:41.183 --> 00:17:43.065
I won't hold you to an actual number,

00:17:43.664 --> 00:17:45.164
but how much of burnout today is actually

00:17:45.285 --> 00:17:47.266
operational and not clinical?

00:17:49.028 --> 00:17:50.949
Yeah, it's a good question.

00:17:51.148 --> 00:17:52.308
As a joke, I would have to say,

00:17:52.328 --> 00:17:53.549
because the kids are always on me,

00:17:53.569 --> 00:17:54.849
I would have to say six, seven,

00:17:54.890 --> 00:17:57.611
just because I'm not actually sure what it

00:17:57.631 --> 00:17:59.290
means, but I hear it constantly.

00:17:59.310 --> 00:18:00.011
I don't know what it means either,

00:18:00.031 --> 00:18:01.172
but we're still mocking it.

00:18:01.192 --> 00:18:03.393
You got to stop saying this.

00:18:03.712 --> 00:18:05.532
I would actually take a bold statement and

00:18:05.573 --> 00:18:07.713
say the majority of it is really

00:18:07.794 --> 00:18:09.835
operational.

00:18:10.035 --> 00:18:10.855
That's, of course,

00:18:10.894 --> 00:18:12.316
coming from somebody who's buried in

00:18:12.415 --> 00:18:14.596
operational software and so forth,

00:18:14.635 --> 00:18:15.777
so take it with a grain of salt.

00:18:16.497 --> 00:18:18.939
The majority of it is operational.

00:18:18.979 --> 00:18:23.123
And AI has, again, mixed promise,

00:18:23.182 --> 00:18:24.845
mixed delivery so far in terms of what

00:18:24.865 --> 00:18:25.384
it can do.

00:18:25.685 --> 00:18:26.926
That's not the sales talking.

00:18:26.946 --> 00:18:27.948
That's just reality.

00:18:27.988 --> 00:18:30.009
And that's not just PT.

00:18:30.028 --> 00:18:31.590
That's across all industries, right?

00:18:31.611 --> 00:18:32.832
There's a huge burst of...

00:18:33.365 --> 00:18:35.586
big bubble of AI.

00:18:35.665 --> 00:18:36.946
We're still all trying to figure out

00:18:36.987 --> 00:18:38.247
exactly what it can and can't do.

00:18:38.326 --> 00:18:41.388
But I do think in the documentation realm,

00:18:41.449 --> 00:18:44.109
things like Ambient Scribe and other AI

00:18:44.150 --> 00:18:46.230
tools for documentation are showing some

00:18:46.270 --> 00:18:48.711
meaningful promise after many years of you

00:18:49.011 --> 00:18:52.213
just write your note.

00:18:52.614 --> 00:18:54.375
You've got to take advantage of some of

00:18:54.414 --> 00:18:55.435
these newer tools.

00:18:55.675 --> 00:18:57.115
Again,

00:18:57.175 --> 00:18:58.977
I'm amazed at the range I see out

00:18:59.017 --> 00:19:01.397
there in practices from the cutting edge

00:19:01.478 --> 00:19:02.459
AI everything to

00:19:03.536 --> 00:19:06.336
basically using an emr like sort of like

00:19:06.356 --> 00:19:08.337
a word processor and and not really

00:19:08.417 --> 00:19:10.498
evolving it much more than that and then

00:19:10.538 --> 00:19:12.118
there's many practices that are in the

00:19:12.138 --> 00:19:13.799
middle of that bell curve which is crazy

00:19:13.819 --> 00:19:15.500
people are still using dragon and i was

00:19:15.519 --> 00:19:19.261
like my man dragon was in cutting edge

00:19:19.301 --> 00:19:21.041
when i was starting in college that shows

00:19:21.061 --> 00:19:22.403
you how old i am i'm like you're

00:19:22.442 --> 00:19:24.022
still legitimately using dragon and

00:19:24.042 --> 00:19:26.743
they're like yeah and i am i'm not

00:19:26.784 --> 00:19:28.164
in the seat that you're in and i'm

00:19:28.224 --> 00:19:28.484
still

00:19:29.265 --> 00:19:31.007
Yeah.

00:19:31.126 --> 00:19:31.946
Yeah.

00:19:32.007 --> 00:19:32.907
Well, it's a lot.

00:19:33.808 --> 00:19:35.430
The other thing I have to say is,

00:19:36.351 --> 00:19:36.651
you know,

00:19:37.692 --> 00:19:40.713
it's funny how the waves of themes happen.

00:19:40.835 --> 00:19:41.894
Like you've lived through these because

00:19:41.914 --> 00:19:42.655
you do this all the time.

00:19:42.695 --> 00:19:44.436
But like compliance seems to be one of

00:19:44.457 --> 00:19:45.557
these roller coasters run.

00:19:45.597 --> 00:19:45.718
Right.

00:19:45.738 --> 00:19:47.279
There'll be high points where everybody's

00:19:47.299 --> 00:19:48.820
talking about compliance and then it kind

00:19:48.840 --> 00:19:50.082
of dips and then it comes back.

00:19:50.955 --> 00:19:53.818
And but like one one area is I

00:19:53.898 --> 00:19:55.540
see that's often needs to be talked about

00:19:55.601 --> 00:19:57.723
and isn't enough is over documentation,

00:19:57.763 --> 00:19:59.625
for example, has become these.

00:19:59.685 --> 00:20:00.426
So like,

00:20:00.467 --> 00:20:02.429
what are you asking your your therapist to

00:20:02.469 --> 00:20:02.749
do?

00:20:03.089 --> 00:20:04.832
The worst case example I can tell you

00:20:04.852 --> 00:20:07.134
is when we see a practice that effectively

00:20:07.173 --> 00:20:07.974
is writing therapy.

00:20:08.654 --> 00:20:10.977
an initial evaluation level note for every

00:20:11.017 --> 00:20:12.377
visit, including for daily.

00:20:12.438 --> 00:20:13.858
So they're seeing the patient, you know,

00:20:14.159 --> 00:20:16.221
three times a week and writing effectively

00:20:16.300 --> 00:20:17.781
three evaluations a week.

00:20:17.942 --> 00:20:19.282
And they're saying, well, we, you know,

00:20:19.363 --> 00:20:19.923
compliance,

00:20:19.942 --> 00:20:21.044
we want to make sure our notes are

00:20:21.084 --> 00:20:22.545
good and that's all like fair.

00:20:22.825 --> 00:20:23.085
Okay.

00:20:23.144 --> 00:20:23.705
I get that.

00:20:24.205 --> 00:20:25.227
But yeah, I mean,

00:20:25.307 --> 00:20:27.347
you're going to burn people out and create

00:20:27.528 --> 00:20:29.329
friction and problems.

00:20:29.390 --> 00:20:31.651
If you ask everybody to write that level

00:20:31.730 --> 00:20:33.612
note for every visit,

00:20:33.873 --> 00:20:35.493
every time for every patient,

00:20:35.554 --> 00:20:36.253
that's a lot.

00:20:36.473 --> 00:20:37.214
And so again,

00:20:37.518 --> 00:20:38.638
what I would say is you need to

00:20:38.679 --> 00:20:41.361
really look at all the processes you do

00:20:41.701 --> 00:20:42.781
that you do repeatedly,

00:20:42.821 --> 00:20:44.522
because if you can shave a few minutes

00:20:44.583 --> 00:20:45.884
off of one of those and you do

00:20:45.923 --> 00:20:47.345
it five hundred times a week, you know,

00:20:47.505 --> 00:20:48.605
now you get some time back.

00:20:49.346 --> 00:20:50.386
So, you know,

00:20:50.467 --> 00:20:52.488
I just there's so many things and so

00:20:52.508 --> 00:20:54.369
many themes and they come and they go.

00:20:54.630 --> 00:20:55.450
And, you know,

00:20:55.671 --> 00:20:57.451
it's it's kind of crazy sometimes to keep

00:20:57.491 --> 00:20:57.832
up with them.

00:20:57.852 --> 00:20:59.653
But I've I've sort of seen all of

00:20:59.692 --> 00:20:59.953
them.

00:21:00.534 --> 00:21:01.315
And last year,

00:21:01.394 --> 00:21:03.236
I feel like was the big year of

00:21:03.928 --> 00:21:04.409
maybe twenty,

00:21:04.449 --> 00:21:05.830
twenty four to but like the big year

00:21:05.871 --> 00:21:07.313
of hiring conversations,

00:21:07.353 --> 00:21:09.095
you probably had a lot of guests talk

00:21:09.115 --> 00:21:10.616
about how to hire and how to make

00:21:10.718 --> 00:21:14.182
really great job postings and use AI and

00:21:14.201 --> 00:21:14.942
all that stuff.

00:21:15.084 --> 00:21:16.125
And then, you know,

00:21:17.201 --> 00:21:18.042
I found anyways,

00:21:18.083 --> 00:21:19.844
that conversations quieted down a little

00:21:19.864 --> 00:21:20.025
bit.

00:21:20.045 --> 00:21:21.405
And I don't know if it's because everybody

00:21:21.445 --> 00:21:24.788
hired who they wanted or more likely,

00:21:24.848 --> 00:21:25.709
you know, that they're just,

00:21:25.729 --> 00:21:26.690
we're just in a trough.

00:21:26.730 --> 00:21:28.050
Like people are just need to take a

00:21:28.090 --> 00:21:29.952
break from that conversation because the

00:21:29.972 --> 00:21:31.693
market is the labor market is what it

00:21:31.773 --> 00:21:31.994
is.

00:21:32.035 --> 00:21:33.635
And they can't either can't hire or

00:21:33.655 --> 00:21:35.356
they've scrounged up what they can and

00:21:35.376 --> 00:21:36.018
they're moving on.

00:21:36.097 --> 00:21:38.059
So it'll come back.

00:21:38.140 --> 00:21:39.361
Everything always comes back.

00:21:39.421 --> 00:21:42.042
Burnout is a constant thing, et cetera.

00:21:42.163 --> 00:21:44.105
And compensation's a constant thing,

00:21:44.144 --> 00:21:45.425
but they all play in together.

00:21:46.483 --> 00:21:48.184
don't want you to name this person not

00:21:48.204 --> 00:21:49.385
that i think you would i don't want

00:21:49.405 --> 00:21:51.887
to hear who they are but what give

00:21:51.907 --> 00:21:53.128
me an example of what maybe one of

00:21:53.169 --> 00:21:55.089
the most expensive inefficiency you've

00:21:55.130 --> 00:21:57.672
ever seen in a clinic that maybe owners

00:21:57.692 --> 00:21:59.272
don't track like maybe you're doing a deep

00:21:59.292 --> 00:22:00.614
dive with a clinic owner who's like

00:22:00.713 --> 00:22:02.915
onboarding with you and you're like hang

00:22:02.976 --> 00:22:04.477
on a second like that moment you're like

00:22:04.537 --> 00:22:06.858
am i reading this right what's something

00:22:06.878 --> 00:22:08.700
you've seen that like just even shocked

00:22:08.740 --> 00:22:10.300
you even with twenty one years experience

00:22:11.163 --> 00:22:13.465
yeah the ones that often blow my mind

00:22:13.486 --> 00:22:15.769
are actually in in the billing realm like

00:22:15.828 --> 00:22:17.830
when i talk to a biller and they

00:22:17.851 --> 00:22:21.534
are like i effectively manually do

00:22:21.693 --> 00:22:24.237
anything one thing five things on each

00:22:24.277 --> 00:22:27.640
claim like really dumb examples like i

00:22:27.680 --> 00:22:29.622
look at every fifteen hundred form

00:22:29.721 --> 00:22:30.403
individually

00:22:31.101 --> 00:22:32.582
you know, before it's sent.

00:22:32.682 --> 00:22:33.862
And I won't,

00:22:33.942 --> 00:22:36.143
can't or won't trust any automation or

00:22:36.202 --> 00:22:37.864
anything for it to do it for me.

00:22:37.903 --> 00:22:39.305
I'm going to review every one and like

00:22:39.384 --> 00:22:40.144
in an extreme case,

00:22:40.184 --> 00:22:41.265
review it more than once.

00:22:42.326 --> 00:22:44.366
This isn't normal stuff.

00:22:44.386 --> 00:22:46.928
You know, again, no one can,

00:22:47.087 --> 00:22:49.308
no one should say that a hundred percent

00:22:49.328 --> 00:22:51.089
of claims will go perfectly a hundred

00:22:51.130 --> 00:22:52.009
percent of the time.

00:22:52.611 --> 00:22:56.435
But you have to rely on systems and

00:22:56.496 --> 00:22:56.997
automation.

00:22:57.037 --> 00:22:58.159
And frankly,

00:22:58.179 --> 00:23:00.080
it's not even just a convenience thing

00:23:00.101 --> 00:23:00.382
anymore.

00:23:00.402 --> 00:23:01.542
It's a matter of survival.

00:23:02.023 --> 00:23:04.426
So if you're going to review every claim

00:23:04.446 --> 00:23:07.090
manually and spend two minutes per claim,

00:23:07.111 --> 00:23:07.551
and you've got

00:23:08.092 --> 00:23:08.372
you know,

00:23:08.451 --> 00:23:10.753
a modest size clinic and doing a few

00:23:10.773 --> 00:23:12.875
hundred visits over the course of a week,

00:23:12.935 --> 00:23:13.636
nothing big deal.

00:23:13.656 --> 00:23:14.497
But I mean, right there,

00:23:14.537 --> 00:23:15.939
like this will blow your day out.

00:23:16.019 --> 00:23:17.799
It'll blow your week out to do this.

00:23:17.819 --> 00:23:19.320
So it blows my mind when I hear

00:23:19.361 --> 00:23:22.403
that because doing individual claim level

00:23:22.443 --> 00:23:24.645
stuff, it just breaks down so quickly,

00:23:25.006 --> 00:23:25.826
even at the most.

00:23:26.267 --> 00:23:27.688
So and you still have that.

00:23:27.768 --> 00:23:29.470
You still see that or even checking each

00:23:29.529 --> 00:23:30.770
individual billing code.

00:23:30.810 --> 00:23:32.571
And here's the thing that you correct.

00:23:32.592 --> 00:23:33.732
Correct me if I'm right or wrong.

00:23:33.932 --> 00:23:34.733
Correct me if I'm wrong.

00:23:35.013 --> 00:23:37.434
Just because you're doing that doesn't

00:23:37.535 --> 00:23:39.415
even guarantee it's being done well.

00:23:39.476 --> 00:23:42.436
So you are guaranteed a lot of effort,

00:23:42.657 --> 00:23:44.919
but you're not guaranteeing the outcome is

00:23:44.979 --> 00:23:45.598
even better.

00:23:46.460 --> 00:23:46.720
Yeah.

00:23:47.019 --> 00:23:48.181
Well, I mean, listen, you know,

00:23:48.240 --> 00:23:49.902
people will make their, so no, Jimmy,

00:23:49.922 --> 00:23:50.301
you're wrong.

00:23:50.342 --> 00:23:51.801
Of course we're guaranteeing the outcome,

00:23:51.842 --> 00:23:54.884
but reality is no one can guarantee the

00:23:54.943 --> 00:23:55.324
outcome.

00:23:55.384 --> 00:23:56.163
And reality is,

00:23:56.203 --> 00:23:58.265
is the insurance is using the same things

00:23:58.345 --> 00:24:00.926
on their, in their quiver, you know,

00:24:00.967 --> 00:24:01.866
they're using automation.

00:24:01.886 --> 00:24:03.407
That's why they screw up claims sometimes,

00:24:03.448 --> 00:24:03.627
right?

00:24:03.647 --> 00:24:05.127
Cause they follow a playbook and they just

00:24:05.188 --> 00:24:05.628
follow it.

00:24:05.828 --> 00:24:06.308
And, you know,

00:24:06.348 --> 00:24:08.609
there's going to be five percent of claims

00:24:08.630 --> 00:24:10.990
that have an appeal or a denial that

00:24:11.010 --> 00:24:12.412
has to be dealt with and so forth.

00:24:12.471 --> 00:24:12.592
But

00:24:13.211 --> 00:24:14.571
you know they're not going to go through

00:24:14.613 --> 00:24:16.512
every claim individually that's crazy uh

00:24:17.093 --> 00:24:19.493
and unnecessary in a lot of ways and

00:24:20.013 --> 00:24:21.815
so you need to run the business from

00:24:21.894 --> 00:24:24.476
forty thousand feet like what is our what

00:24:24.496 --> 00:24:26.256
are our high level metrics what are we

00:24:26.316 --> 00:24:29.017
doing how many yeah i mean if you're

00:24:29.096 --> 00:24:30.817
if you're having to work on if half

00:24:30.837 --> 00:24:32.238
of your claims are denying you have a

00:24:32.298 --> 00:24:34.578
problem if two percent of your claims are

00:24:34.618 --> 00:24:34.999
denying

00:24:35.605 --> 00:24:36.727
that's not bad.

00:24:36.926 --> 00:24:37.906
I mean, you know, you, you,

00:24:38.086 --> 00:24:39.488
you can't get away with zero percent.

00:24:39.528 --> 00:24:42.068
You'd love to, but you, so yeah,

00:24:42.170 --> 00:24:42.730
it's really the,

00:24:42.869 --> 00:24:44.590
the manual processes are the ones that

00:24:44.631 --> 00:24:46.172
really blow my mind when I hear about

00:24:46.192 --> 00:24:46.951
stuff like that.

00:24:46.991 --> 00:24:47.551
And, and it's,

00:24:47.652 --> 00:24:50.114
it's a lot of it sometimes it's not

00:24:50.173 --> 00:24:52.035
of course, ill intent by any stretch.

00:24:52.055 --> 00:24:53.395
It's usually a lot of it's driven by

00:24:53.435 --> 00:24:53.855
inertia.

00:24:53.895 --> 00:24:55.317
Like this is how we did it.

00:24:55.717 --> 00:24:56.916
This is how we've always done it,

00:24:56.957 --> 00:24:58.298
or we've done it since the nineties,

00:24:58.337 --> 00:24:59.959
or we had a billing system back then.

00:25:00.019 --> 00:25:01.299
And, or, you know, even five,

00:25:01.339 --> 00:25:02.039
ten years ago,

00:25:02.079 --> 00:25:03.201
and here's how we did it then.

00:25:03.240 --> 00:25:03.340
And

00:25:03.780 --> 00:25:05.402
we learned we had to do this because

00:25:05.442 --> 00:25:07.222
if we didn't, then, you know,

00:25:07.303 --> 00:25:08.403
and people start making weird

00:25:08.423 --> 00:25:09.183
associations.

00:25:09.284 --> 00:25:10.744
Like if I eat a ham sandwich while

00:25:10.785 --> 00:25:11.424
I do my billing,

00:25:11.464 --> 00:25:12.486
I never get any denial.

00:25:12.546 --> 00:25:14.166
So I always have a ham sandwich when

00:25:14.247 --> 00:25:15.507
I do my billing claims and you're like,

00:25:15.547 --> 00:25:17.087
well, hard to argue with results.

00:25:17.147 --> 00:25:17.367
I mean,

00:25:17.508 --> 00:25:18.709
I do like a good ham sandwich,

00:25:18.749 --> 00:25:19.950
so I don't know what to say.

00:25:20.009 --> 00:25:20.730
Like it's hard, you know,

00:25:20.750 --> 00:25:21.911
and this is the life of a software

00:25:21.951 --> 00:25:24.132
person trying to make these weird

00:25:24.172 --> 00:25:25.231
connections with things,

00:25:25.291 --> 00:25:26.952
but people have their superstitions.

00:25:26.972 --> 00:25:27.012
So.

00:25:27.093 --> 00:25:27.492
All right.

00:25:28.054 --> 00:25:30.095
So when clinics do, let's talk about

00:25:31.277 --> 00:25:32.277
What happens after?

00:25:32.356 --> 00:25:33.718
Let's talk about the transformation,

00:25:33.778 --> 00:25:34.617
as we would say, right?

00:25:35.018 --> 00:25:38.038
When clinics do introduce real automation,

00:25:38.720 --> 00:25:40.940
not just eat a ham sandwich and now

00:25:40.960 --> 00:25:41.840
we get better results,

00:25:42.320 --> 00:25:44.221
not just faster clicks or less clicks,

00:25:44.582 --> 00:25:46.021
what start real automation?

00:25:46.142 --> 00:25:48.863
What usually changes first?

00:25:49.002 --> 00:25:51.384
Is it staff stress reduces,

00:25:51.503 --> 00:25:53.744
revenue goes up, what should they expect?

00:25:54.085 --> 00:25:54.984
What's the canary?

00:25:55.025 --> 00:25:55.424
Like, oh,

00:25:55.625 --> 00:25:57.566
we were doing what this guy Sharif said.

00:25:57.885 --> 00:26:00.047
What should they look for in real terms?

00:26:01.505 --> 00:26:03.307
Yeah, I mean, I think, you know,

00:26:03.426 --> 00:26:05.689
definitely the team feeling,

00:26:06.048 --> 00:26:07.869
staff feeling is probably the one that is

00:26:07.930 --> 00:26:10.031
just, it's in front of you every day.

00:26:10.112 --> 00:26:12.034
It's not a metric, you're just seeing it.

00:26:12.114 --> 00:26:15.016
So there's no higher compliment to,

00:26:15.376 --> 00:26:15.616
you know,

00:26:15.656 --> 00:26:17.578
to the change or for us as a

00:26:17.638 --> 00:26:18.439
vendor, for example,

00:26:18.479 --> 00:26:20.260
when we hear that from clients, like, hey,

00:26:20.300 --> 00:26:21.662
everybody on the team's loving it,

00:26:22.303 --> 00:26:23.683
they're feeling better about it,

00:26:23.723 --> 00:26:25.464
they're coming to work more excited,

00:26:25.505 --> 00:26:27.207
they're more productive, more happy,

00:26:27.846 --> 00:26:29.548
and that we've solved a lot of problems

00:26:30.229 --> 00:26:31.449
uh that we had with the say a

00:26:31.489 --> 00:26:33.190
legacy system or a prior system that we

00:26:33.210 --> 00:26:34.650
were transitioning from so that's

00:26:34.690 --> 00:26:36.891
definitely just front and center um you

00:26:36.911 --> 00:26:38.751
have to get through the woods you know

00:26:38.811 --> 00:26:41.031
of the of that onboarding process which is

00:26:41.432 --> 00:26:42.653
you know made to be as easy as

00:26:42.673 --> 00:26:44.473
it can but again everybody's got to travel

00:26:44.513 --> 00:26:46.013
through those woods to get to the other

00:26:46.054 --> 00:26:47.994
side and and not kind of fall off

00:26:48.015 --> 00:26:50.976
the wagon uh prematurely or unnecessarily

00:26:51.016 --> 00:26:52.455
because it's you know we just had a

00:26:52.496 --> 00:26:53.976
bad day or there's something that's not

00:26:54.057 --> 00:26:55.277
perfectly going the same way

00:26:56.378 --> 00:26:57.762
So I think the staff one and then

00:26:57.923 --> 00:26:59.287
longer term, you know,

00:27:01.169 --> 00:27:04.670
I think a lot of vendors in my

00:27:04.750 --> 00:27:07.529
space make a lot of hay about,

00:27:07.549 --> 00:27:09.069
we can make you more money and so

00:27:09.130 --> 00:27:09.410
forth.

00:27:09.810 --> 00:27:11.290
I'm not as sure that those are the

00:27:11.310 --> 00:27:12.990
right claims to be making or that they're

00:27:13.050 --> 00:27:14.070
fair claims to be making.

00:27:14.090 --> 00:27:15.551
Because really, I don't know,

00:27:15.832 --> 00:27:18.031
unless there's a different Aetna out there

00:27:18.051 --> 00:27:18.932
or a different United,

00:27:18.971 --> 00:27:20.152
they're all the same insurance.

00:27:20.172 --> 00:27:21.573
The fee schedules are all the same.

00:27:22.133 --> 00:27:24.452
A modern system should be able to help

00:27:24.492 --> 00:27:26.093
you or get your claims out in a

00:27:26.153 --> 00:27:26.952
pretty short order.

00:27:26.972 --> 00:27:28.773
So there's some convergence there on those

00:27:28.814 --> 00:27:29.753
basic things where

00:27:30.386 --> 00:27:32.730
where we're seeing more differentiation

00:27:32.769 --> 00:27:34.191
and the things we focus on are the

00:27:34.250 --> 00:27:37.035
marketing, the automation of core tasks,

00:27:37.134 --> 00:27:39.837
obviously AI driven workflows to help cut

00:27:39.857 --> 00:27:41.278
down on manual workflows.

00:27:41.318 --> 00:27:42.780
And that's really where the money's at

00:27:43.141 --> 00:27:45.223
these days in terms of what are you

00:27:45.243 --> 00:27:45.924
really looking for?

00:27:46.605 --> 00:27:48.846
and predicated upon the practice actually

00:27:49.626 --> 00:27:50.468
implementing them.

00:27:51.607 --> 00:27:53.229
But you can definitely get some more

00:27:53.249 --> 00:27:54.369
visibility into stuff,

00:27:54.410 --> 00:27:56.611
hopefully make some better decisions about

00:27:56.651 --> 00:27:59.192
where the practice should go and that sort

00:27:59.212 --> 00:27:59.613
of thing.

00:28:00.193 --> 00:28:01.013
So I think, yeah,

00:28:01.054 --> 00:28:02.595
staff team is where you'd see it.

00:28:02.654 --> 00:28:04.135
Hopefully you hang on to an employee who

00:28:04.175 --> 00:28:05.156
is maybe borderline.

00:28:05.196 --> 00:28:06.738
Maybe they come in and they're like,

00:28:06.758 --> 00:28:07.157
you know what,

00:28:07.198 --> 00:28:08.598
this change really helped me.

00:28:08.659 --> 00:28:10.319
I'm spending more time with my family and

00:28:10.599 --> 00:28:11.299
I'm going to stay.

00:28:11.440 --> 00:28:11.961
Or I'm

00:28:12.521 --> 00:28:13.604
I don't need that raise.

00:28:13.903 --> 00:28:14.726
Nobody ever says that.

00:28:14.766 --> 00:28:17.230
But something like that to help ease

00:28:17.270 --> 00:28:18.492
things a little bit.

00:28:18.512 --> 00:28:21.699
So you're saying you're making the more

00:28:21.759 --> 00:28:22.340
real claim,

00:28:22.361 --> 00:28:23.563
which is something I don't see a lot

00:28:23.583 --> 00:28:23.903
of people...

00:28:24.622 --> 00:28:27.103
who do what you do often, which is,

00:28:27.323 --> 00:28:29.243
hey, listen, can we make you more money?

00:28:29.384 --> 00:28:33.045
I think the more clear line and the

00:28:33.305 --> 00:28:35.726
shorter line is I can show you where

00:28:35.766 --> 00:28:37.145
to stop losing time.

00:28:38.186 --> 00:28:39.507
And I learned a long time ago that

00:28:39.787 --> 00:28:40.508
time equals money.

00:28:40.587 --> 00:28:42.867
So, but you're saying I can prove this.

00:28:42.887 --> 00:28:43.808
I'm not gonna lie to you.

00:28:43.828 --> 00:28:45.048
I'm not gonna dangle the carrot,

00:28:45.068 --> 00:28:47.529
like more money, save more.

00:28:47.569 --> 00:28:49.090
But what you're saying is, hey, listen,

00:28:49.451 --> 00:28:50.971
this is a process if we,

00:28:51.310 --> 00:28:52.432
going back to my plumber analogy,

00:28:53.031 --> 00:28:56.133
If we shore up the leaks, in theory,

00:28:56.972 --> 00:28:58.413
we should be able to see more money.

00:28:58.453 --> 00:29:00.273
But what we can really work on now

00:29:00.334 --> 00:29:01.674
is put your head down to this.

00:29:02.234 --> 00:29:04.776
It's spending less or losing less.

00:29:05.715 --> 00:29:07.696
That should be a very straight line and

00:29:07.717 --> 00:29:09.557
a very short line to making more.

00:29:09.577 --> 00:29:10.857
But those two things are not the same.

00:29:12.017 --> 00:29:13.538
They're not they're not precisely the

00:29:13.577 --> 00:29:13.798
same.

00:29:13.837 --> 00:29:13.958
Yeah.

00:29:14.018 --> 00:29:15.338
And working happier, too.

00:29:15.419 --> 00:29:16.459
I think there's something about

00:29:16.558 --> 00:29:18.420
satisfaction that that does matter,

00:29:18.619 --> 00:29:20.060
especially matters to your team.

00:29:20.080 --> 00:29:20.320
You know,

00:29:20.361 --> 00:29:21.882
they don't have the ownership maybe that

00:29:21.922 --> 00:29:22.741
you do, obviously,

00:29:22.781 --> 00:29:24.502
where you have a direct like, hey,

00:29:24.542 --> 00:29:26.324
if I make this company practice worth

00:29:26.364 --> 00:29:28.224
more, I'm worth more at exit,

00:29:28.765 --> 00:29:30.665
which was never a conversation five years

00:29:30.685 --> 00:29:30.905
ago.

00:29:30.965 --> 00:29:32.906
But now any conference you go to,

00:29:32.946 --> 00:29:34.867
all you hear about is multiples and exits

00:29:34.907 --> 00:29:36.588
and private equity and all these different

00:29:36.628 --> 00:29:39.050
terms that never were in the lexicon a

00:29:39.090 --> 00:29:39.631
few years ago.

00:29:40.230 --> 00:29:40.951
But your team,

00:29:41.834 --> 00:29:43.916
these folks are working hard for your

00:29:43.977 --> 00:29:44.457
practice.

00:29:44.477 --> 00:29:45.598
They're working hard for their own

00:29:45.638 --> 00:29:46.460
personal future.

00:29:46.519 --> 00:29:48.563
So there's a happiness factor quotient

00:29:48.603 --> 00:29:50.506
there that's been that intangible in the

00:29:50.526 --> 00:29:52.067
hiring process that you can try and hear

00:29:52.087 --> 00:29:53.349
people articulate all the time.

00:29:54.546 --> 00:29:56.547
And so that's meaningful as well.

00:29:57.107 --> 00:29:58.028
And you just want to run.

00:29:58.169 --> 00:29:58.429
I mean,

00:29:59.049 --> 00:30:01.090
I have very traditional business values,

00:30:01.172 --> 00:30:01.491
I guess.

00:30:01.511 --> 00:30:01.991
So, you know,

00:30:02.011 --> 00:30:03.093
I think you should just run a good,

00:30:03.153 --> 00:30:05.394
clean, well-functioning business.

00:30:05.556 --> 00:30:06.997
And that means like your system and

00:30:07.037 --> 00:30:07.958
processes are good.

00:30:08.018 --> 00:30:10.180
And when I'm given the opportunity to talk

00:30:10.220 --> 00:30:11.441
to or address a group.

00:30:12.338 --> 00:30:14.079
i always ask them to think about what

00:30:14.140 --> 00:30:15.319
companies they're having the best

00:30:15.380 --> 00:30:17.661
experiences with right now and then when

00:30:17.701 --> 00:30:20.482
you do a little exercise why are they

00:30:20.502 --> 00:30:22.123
doing well it always comes down the same

00:30:22.143 --> 00:30:24.364
thing their operations are really smooth

00:30:24.505 --> 00:30:27.145
like that's what makes a great experience

00:30:27.306 --> 00:30:29.686
with a business so it is the amazon

00:30:29.707 --> 00:30:32.028
model like amazon's website hasn't changed

00:30:32.067 --> 00:30:33.548
that much actually if you look at it

00:30:33.588 --> 00:30:35.148
in the last ten years you know they

00:30:35.308 --> 00:30:37.069
kind of still looks the same the product

00:30:37.089 --> 00:30:39.171
pages look similar they've made more

00:30:39.191 --> 00:30:40.811
information but it's a similar layout

00:30:41.271 --> 00:30:43.815
but their operations are unbelievable.

00:30:43.894 --> 00:30:45.695
I mean, the next day, the two day,

00:30:46.497 --> 00:30:47.678
as soon as you add something to your

00:30:47.718 --> 00:30:48.058
cart,

00:30:48.078 --> 00:30:49.660
they're moving the product closer to you

00:30:49.700 --> 00:30:50.641
if it's not already.

00:30:51.080 --> 00:30:52.942
So when you think about practices,

00:30:53.103 --> 00:30:54.785
the ones that are making the booking easy,

00:30:54.805 --> 00:30:56.365
the ones that are making the intake easy,

00:30:56.385 --> 00:30:57.728
the ones that are sending you like nice

00:30:57.768 --> 00:30:58.828
curated emails,

00:30:59.269 --> 00:31:01.111
this is all a level of professionalism

00:31:01.151 --> 00:31:02.913
that really resonates with people.

00:31:02.992 --> 00:31:04.334
And it's a subtle resonation.

00:31:04.673 --> 00:31:05.295
It's not like

00:31:06.317 --> 00:31:07.578
man, that was the best thing ever.

00:31:07.598 --> 00:31:08.259
It's just like, wow,

00:31:08.278 --> 00:31:09.560
they kind of have it together.

00:31:09.840 --> 00:31:11.282
Like they just seem like they have it

00:31:11.303 --> 00:31:11.742
together.

00:31:11.823 --> 00:31:14.727
And that's what I think impresses patients

00:31:14.807 --> 00:31:17.190
and referring sources is when it all just

00:31:17.210 --> 00:31:19.132
seems to just work and nobody thinks about

00:31:19.172 --> 00:31:19.251
it.

00:31:19.271 --> 00:31:20.433
It's all background stuff.

00:31:20.493 --> 00:31:21.515
And like, it's pretty good.

00:31:23.136 --> 00:31:23.997
I want to make this part of a

00:31:24.076 --> 00:31:24.577
series.

00:31:24.958 --> 00:31:26.337
I sent you a couple of topics because

00:31:26.377 --> 00:31:29.419
I think these things are not in a

00:31:29.519 --> 00:31:29.939
silo.

00:31:30.318 --> 00:31:31.618
So this will be part one.

00:31:32.400 --> 00:31:33.920
I do want what's called front tees,

00:31:33.940 --> 00:31:35.200
which is look for part two.

00:31:35.500 --> 00:31:37.260
We're going to focus next on AI and

00:31:37.300 --> 00:31:38.961
PT, what's real, what's hype,

00:31:38.980 --> 00:31:40.122
what will actually change.

00:31:41.101 --> 00:31:42.882
Instead of buying the hype, right?

00:31:43.221 --> 00:31:45.063
And then the third part of this really

00:31:45.083 --> 00:31:46.804
will be from full schedules to full

00:31:46.844 --> 00:31:47.284
profit.

00:31:47.544 --> 00:31:49.045
How do you go from beginning to end?

00:31:49.265 --> 00:31:49.585
Why?

00:31:49.644 --> 00:31:52.346
And then where most busy clinics still

00:31:52.386 --> 00:31:53.227
struggle financially.

00:31:53.267 --> 00:31:54.288
So those will be coming up.

00:31:54.647 --> 00:31:56.068
But before we wrap up this episode,

00:31:56.548 --> 00:31:57.648
we bring you the parting shot.

00:31:57.669 --> 00:32:00.891
This is the parting shot.

00:32:01.431 --> 00:32:02.832
One last mic drop moment.

00:32:03.511 --> 00:32:04.313
No pressure.

00:32:04.752 --> 00:32:06.874
Just your legacy on the line.

00:32:12.470 --> 00:32:17.492
I feel like you could pick six, seven,

00:32:17.573 --> 00:32:18.633
eight things, six,

00:32:18.673 --> 00:32:21.615
seven things from the episode today to

00:32:21.654 --> 00:32:22.316
reiterate,

00:32:22.355 --> 00:32:24.176
but what would you want to stamp on

00:32:24.217 --> 00:32:25.076
people's brains,

00:32:25.156 --> 00:32:26.837
particularly people either who are running

00:32:26.877 --> 00:32:28.179
a practice who want to do that?

00:32:28.740 --> 00:32:30.259
What's your parting shot that they should

00:32:30.279 --> 00:32:30.560
just,

00:32:30.840 --> 00:32:31.861
if you're going to give them one thing

00:32:31.901 --> 00:32:32.922
to hold on to, what is it?

00:32:34.363 --> 00:32:35.604
My parting shot would be,

00:32:37.082 --> 00:32:38.163
It's twenty twenty six.

00:32:38.383 --> 00:32:40.325
Your biggest task this year is to separate

00:32:40.424 --> 00:32:41.685
out signal from noise.

00:32:42.446 --> 00:32:42.906
That's it.

00:32:43.047 --> 00:32:45.009
Like there's too too much.

00:32:45.368 --> 00:32:45.710
I don't know.

00:32:45.769 --> 00:32:47.191
Am I contributing to too much on this

00:32:47.230 --> 00:32:47.671
podcast?

00:32:47.730 --> 00:32:48.152
I hope not.

00:32:48.192 --> 00:32:49.752
I hope I've delivered something valuable

00:32:49.792 --> 00:32:51.875
to some people and something resonates.

00:32:51.914 --> 00:32:54.176
But there's so much signal out there.

00:32:55.496 --> 00:32:57.136
There's also so much noise.

00:32:57.817 --> 00:33:01.077
You cannot possibly keep up with

00:33:01.138 --> 00:33:01.979
everything you're hearing.

00:33:01.999 --> 00:33:04.019
You cannot possibly do everything every

00:33:04.059 --> 00:33:05.420
talking head is suggesting.

00:33:05.921 --> 00:33:07.881
You've got to think about what is your

00:33:07.901 --> 00:33:08.402
practice.

00:33:08.902 --> 00:33:10.102
It's January right now.

00:33:10.142 --> 00:33:11.403
Where do you want to be in December?

00:33:11.423 --> 00:33:12.682
What are you going to do to get

00:33:12.702 --> 00:33:13.344
from here to there?

00:33:14.384 --> 00:33:14.743
I don't know.

00:33:15.884 --> 00:33:16.884
In my experience,

00:33:17.365 --> 00:33:19.666
you're judged or your outcomes are as much

00:33:19.707 --> 00:33:20.987
by what you say no to as what

00:33:21.007 --> 00:33:21.748
you say yes to.

00:33:21.788 --> 00:33:23.348
So if you can't get some focus,

00:33:23.368 --> 00:33:24.729
your team won't have any focus.

00:33:25.230 --> 00:33:26.710
And you'll be sitting here in another year

00:33:26.750 --> 00:33:27.009
saying,

00:33:27.150 --> 00:33:28.711
we didn't really make any progress because

00:33:28.730 --> 00:33:30.912
we didn't really know exactly what finally

00:33:30.932 --> 00:33:31.813
we wanted to work on.

00:33:31.873 --> 00:33:32.012
So

00:33:32.821 --> 00:33:36.423
Find your signal and get on that.

00:33:36.484 --> 00:33:36.984
I like that.

00:33:37.025 --> 00:33:37.724
Find your signal.

00:33:39.125 --> 00:33:39.767
I would end with,

00:33:39.807 --> 00:33:40.906
and I heard this from someone else.

00:33:40.946 --> 00:33:41.708
I forget who it was.

00:33:41.748 --> 00:33:42.087
They said,

00:33:42.107 --> 00:33:43.568
there are people dumber than you making

00:33:43.608 --> 00:33:44.970
more money with less trust.

00:33:44.990 --> 00:33:47.231
So that should piss you off.

00:33:47.791 --> 00:33:49.333
And it should also motivate you like, hey,

00:33:49.393 --> 00:33:49.973
maybe I'm...

00:33:50.874 --> 00:33:52.273
overthinking a lot of these things.

00:33:52.334 --> 00:33:54.174
Maybe I'm listening to too much noise and

00:33:54.214 --> 00:33:54.934
not enough signal.

00:33:55.575 --> 00:33:57.895
And there are people dumber than you

00:33:57.915 --> 00:33:59.175
making more money with less stress.

00:33:59.215 --> 00:34:00.215
Let's focus on that.

00:34:00.556 --> 00:34:01.396
Don't be jealous.

00:34:01.876 --> 00:34:02.916
Be motivated by that.

00:34:03.497 --> 00:34:05.597
EmpowerEMR.com if you want to go a little

00:34:05.617 --> 00:34:06.438
bit deeper into this.

00:34:06.478 --> 00:34:07.577
Take one little step.

00:34:08.338 --> 00:34:09.358
Sharif's not going to handcuff you to

00:34:09.398 --> 00:34:10.518
anything.

00:34:10.539 --> 00:34:11.719
But reach out to Empower as an

00:34:11.759 --> 00:34:12.278
organization.

00:34:12.358 --> 00:34:13.438
I appreciate your time, Sharif.

00:34:13.460 --> 00:34:14.079
Thanks for this, man.

00:34:14.139 --> 00:34:14.639
Thank you.

00:34:14.659 --> 00:34:15.219
Thanks for having me.

00:34:15.606 --> 00:34:17.307
And we'll see you back at part two

00:34:17.347 --> 00:34:18.208
and part three.

00:34:18.989 --> 00:34:21.592
And maybe this is your signal versus noise

00:34:21.632 --> 00:34:24.355
ratio that we need to focus on.

00:34:24.474 --> 00:34:24.755
Right on.

00:34:27.355 --> 00:34:28.396
That's it for this one,

00:34:28.695 --> 00:34:30.376
but we're just getting warmed up.

00:34:30.838 --> 00:34:32.739
Smash follow, send it to a friend,

00:34:32.958 --> 00:34:34.621
or crank up the next episode.

00:34:35.141 --> 00:34:36.061
Want to go deeper?

00:34:36.342 --> 00:34:40.545
Hit us at pgpinecast.com or find us on

00:34:40.585 --> 00:34:43.146
YouTube and socials at pgpinecast.

00:34:43.567 --> 00:34:45.849
And legally, none of this was advice.

00:34:45.909 --> 00:34:47.690
It's for entertainment purposes only.

00:34:48.331 --> 00:34:49.311
Bullshit!

00:34:49.331 --> 00:34:49.891
See, Keith?

00:34:50.112 --> 00:34:51.193
We read the script.

00:34:51.492 --> 00:34:52.134
Happy now?