In-Person vs. Virtual Physical Therapy: The Future of Care

WEBVTT

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I'm getting some microphone issues here.

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Hang on.

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Hang on.

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There we go.

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MacBook speakers.

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There we are.

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All right.

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Now I can hear you guys

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without the headphones.

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Good morning.

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I'm a little bit bundled up.

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We've actually felt winter

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or fall for the first time

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here in upstate New York.

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What about you guys?

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Yeah,

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we've got flurries coming down behind me.

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We hit winter finally.

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I think Jimmy,

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you guys used to give me

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crap about lighting and audio,

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and I think I need to send

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Jimmy a ring light desktop

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camera or something because

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it looks like he's in

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detention or something.

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Yeah, so ongoing building the studio.

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I have two lights,

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or I've got good lighting,

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but one of them died this morning.

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So one of them is actually like,

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if I can rotate the camera,

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like one of them is just

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like out and won't turn on.

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So I'm like, here it is.

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So it looks like it's a,

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I told people yesterday,

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it's like a proof of life video.

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It looks like I'm in like a

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basement somewhere.

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Sure.

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You got the uncovered outlet behind you,

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the block wall.

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Yeah.

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So I was I was having a

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buddy to like this is also

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like a great cheat code,

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which is I could go online

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and watch fifty YouTube

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videos about key lights and

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other lights and light one and yada yada.

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And I've done that.

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And then I was just, oh,

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I know a guy who makes really,

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really great videos.

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Let me just pick his brain

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and like jump on a zoom with him.

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And I walked around with my phone.

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He's like, oh, yeah,

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get your camera like like

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seven feet away from the

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wall when you're shooting

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because you need depth.

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And then we're going to put

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a key light there.

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And I'm like, good writing this.

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I'm like,

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I don't know what a key light is.

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Remember, I'm from radio.

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I have no idea.

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So we're figuring this out.

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So the answer is usually people.

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The cheat code is usually people,

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YouTube or people in person.

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So let's bring Julie on.

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Yeah, we're going to bring Julia on.

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How do we give her a setup?

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You know what?

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Let's have her do the setup.

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Julia LaRonde, Julia,

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welcome to the live stream.

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We haven't done a lot of guests.

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I want to do more guests,

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but kudos on you for

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jumping in and a couple of

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yahoos that slid into your

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DM on LinkedIn and said, yeah, okay,

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I'll do your weird live stream.

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So Julia, what's your superhero backstory?

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Yeah, absolutely.

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So I actually have a pretty

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cool superhero backstory.

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I used to be a professional

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figure skater and skated on

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Team USA for six years,

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competed internationally,

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retired at the ripe old age of eighteen,

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and then went to PT school.

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So here we are.

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And was it an injury?

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Are you the cliche of injury

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to a physical therapist?

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Ironically, no.

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I was just tall.

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I'm five four,

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and that's really tall for a

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figure skater.

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So here we are.

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five four is tall for a

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figure skater yep really

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okay perfect and then where

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are you now geographically

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I am in california southern

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california so it is a

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wonderful five thirty four

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a.m yeah you're coming from

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the left coast um and then

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okay so what was your what

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was your your your

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superhero story in the

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profession of physical

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therapy where'd you go to

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pt school again I know I

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saw them on linkedin page

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yeah florida international

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university hey I went to

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fiu I'm an fiu grad

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Yeah.

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Yeah.

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And then where's your career taken you?

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Which is like sort of the

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reason we bring you in.

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Like your career has taken you,

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like being a professional figure skater,

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your career has taken you

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in some pretty interesting directions.

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It has, it has.

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And as most PTs started out

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in outpatient ortho because

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we all graduate school and think that,

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you know,

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that's the latest and greatest

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and that's where we land.

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Did outpatient ortho for a couple of years,

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then transitioned into

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workers' comp for a couple of years,

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and then realized that

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working nine to five wasn't

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my jam and transitioned

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into digital health because

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working from home is way cooler.

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Working from home is cooler.

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Do you get to stand in your

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basement and do a live

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stream every once in a while like me?

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So that's sort of one of the

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part of the reasons we

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bring you in today in terms

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of like digital health.

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I feel like that's like digital media.

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Like digital health can mean so many,

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so many different things, right?

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It's just like sort of a

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combination of two different words.

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Take us into your day-to-day experience.

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I mean,

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you worked particularly with SORT

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Health to be specific.

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what was it like working in

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a digital physical therapy

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setting which sounds like

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those two phrases some

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people think they're in

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opposition what was it like

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working in that setting how

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patient responds to this

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you know sort of new you

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know mode of care like give

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us the what's what's the t

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Yeah, no, it was really neat.

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And honestly,

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when I was like transitioning

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out of the clinic,

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my main goal was just to work from home.

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I didn't really know what

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that would look like.

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I didn't know what to expect.

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And, you know,

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got the really cool opportunity,

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got hired on at Sword Health as a PT.

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And, you know, starting off,

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it was it was a startup.

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And so there was no real

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kind of training or anything like that.

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They were like, all right,

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here's a platform.

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Have fun with it.

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Figure it out.

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Yeah.

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Make it work.

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And honestly,

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that was the really cool part

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because we kind of

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developed our own processes,

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developed our own way of treating online.

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And the way that, you know,

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we functioned is it wasn't

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necessarily like telehealth,

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like a lot of people think.

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Like there wasn't Zoom conversations.

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We didn't physically see

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patients doing exercises.

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We really just used the technology.

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The patients did their

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exercises on their own time,

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which was great for them.

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They loved that.

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I had patients doing exercise at five a.m.,

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eleven p.m., whenever they so chose.

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And then I would get

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feedback based on how they

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did their exercises on my time,

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which was also fantastic for me.

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And that model was really neat where,

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you know, there was no limitations.

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It wasn't like you had to

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make an appointment for eight thirty,

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miss work and drive half an hour,

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sit in traffic and then do

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the same thing in reverse.

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So I think that's where, you know,

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digital therapy is,

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is really great and really amazing.

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And there are just so many

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benefits to that just from

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a movement standpoint, right?

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We all know just even moving,

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even if it's not right, right movement,

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even if it's not, you know,

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a specific exercise,

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it's just getting people to move.

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It's huge.

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Yeah.

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What about difficulties?

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Like what were the friction

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points or like the things, I mean,

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you said you're making this

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up as you went along in a good way.

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What were some of the things

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you guys were like, Hey, this is hard.

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Yeah, you know,

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it's difficult because

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obviously you're not seeing

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the patients do exercises.

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So as much as we know that

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movement is great,

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sometimes we don't know if

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they're doing it right.

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We don't know if, you know, how

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how well they're moving,

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the feedback that you get

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sometimes isn't great.

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And technology is developing,

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it's developing by the minute, right?

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And sometimes it's not quite there yet.

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And I think that's where

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we've kind of landed in

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this space at this point is

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the technology is starting to develop,

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but it's not a hundred percent there.

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And so there would be a lot

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of kind of tech concerns of,

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I'm lifting my arm,

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but the technology is not

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seeing it and things like that.

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um so I think that's where

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the main friction points

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were yeah all right so

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outside of just technology

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limitations my last

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question for you is so

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given this experience what

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do you think needs to

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change or evolve for

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digital physical therapy to

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actually reach its full

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potential how would you as

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someone who's done it make

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it better where do you see

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the future of this going

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what's what's six months

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six years from now look like or feel like

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Yeah, that's a really cool question.

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I actually spent a lot of

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time kind of thinking of

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how would I make this better?

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Like if I ran my own company,

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what would I do and how

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would I make it work?

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And I think that it can go

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in so many different

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directions based on the

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patient population, right?

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Are we going to be able to

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treat everybody virtually?

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Absolutely not.

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As therapists,

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we know we still need hands.

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We still need that hands-on

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component for a lot of people.

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You know,

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range of motion isn't just going

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to happen because I said so.

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But there's so many populations where,

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you know,

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they can do things on their own.

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They don't have to walk into a clinic.

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We don't have to, you know,

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count three sets of ten for them and,

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you know,

00:08:23.255 --> 00:08:25.096
just sit there writing our notes.

00:08:25.516 --> 00:08:28.119
And so I think in the future, you know,

00:08:28.838 --> 00:08:31.461
having platforms based on population,

00:08:31.500 --> 00:08:33.961
having platforms specific

00:08:34.022 --> 00:08:35.143
to specific things.

00:08:35.182 --> 00:08:37.083
So really just, you know,

00:08:37.524 --> 00:08:38.904
post-op patients have their

00:08:39.004 --> 00:08:41.206
own platform and have their own space.

00:08:42.868 --> 00:08:44.188
That's where I think a lot of the

00:08:45.400 --> 00:08:46.902
kind of future can lie right now.

00:08:46.961 --> 00:08:48.383
It's so general that, you know,

00:08:48.403 --> 00:08:49.543
we were treating fingers

00:08:49.583 --> 00:08:50.683
and necks and backs and

00:08:50.803 --> 00:08:52.024
ankles and hips and knees

00:08:52.044 --> 00:08:53.145
and people that could

00:08:53.186 --> 00:08:54.527
barely move and athletes.

00:08:54.586 --> 00:08:56.508
And it was just, it's so spread out.

00:08:57.087 --> 00:08:57.607
Um,

00:08:57.668 --> 00:08:58.528
and making it a little bit more

00:08:58.568 --> 00:09:00.049
specialized in that sense,

00:09:00.129 --> 00:09:02.831
I think can be really powerful.

00:09:02.871 --> 00:09:03.572
Dave, what do you got?

00:09:04.514 --> 00:09:05.015
That's awesome.

00:09:05.056 --> 00:09:08.559
Julia, in regards to any patient feedback,

00:09:08.639 --> 00:09:09.480
patient or client feedback,

00:09:09.500 --> 00:09:10.982
and I don't know, since it was a startup,

00:09:11.003 --> 00:09:12.183
I don't know if they shared

00:09:12.203 --> 00:09:13.285
this with you or if you had

00:09:13.346 --> 00:09:15.447
any text email or any

00:09:15.488 --> 00:09:18.351
communication with these members,

00:09:18.432 --> 00:09:18.951
patients, clients,

00:09:18.971 --> 00:09:19.712
whatever we're going to call them.

00:09:19.732 --> 00:09:19.972
I don't know.

00:09:19.993 --> 00:09:20.975
You can correct me on that.

00:09:22.275 --> 00:09:23.636
Any constructive feedback from them,

00:09:23.856 --> 00:09:25.878
maybe some percentage of the folks,

00:09:25.898 --> 00:09:27.700
they get the login,

00:09:27.720 --> 00:09:29.681
they touch base with you or

00:09:29.721 --> 00:09:30.780
someone else on the team,

00:09:31.422 --> 00:09:33.023
and they give you feedback

00:09:33.062 --> 00:09:34.864
like they don't like it.

00:09:35.063 --> 00:09:36.965
Tech things aside, not Wi-Fi issues,

00:09:37.004 --> 00:09:38.145
not laptop issues, whatever,

00:09:38.645 --> 00:09:40.467
but someone that comes in and is like, oh,

00:09:41.648 --> 00:09:42.548
I'm not a fan of this,

00:09:42.649 --> 00:09:43.970
or I had in-person physical

00:09:43.990 --> 00:09:45.171
therapy before, and

00:09:45.870 --> 00:09:47.972
this doesn't seem, I don't know,

00:09:48.212 --> 00:09:48.673
good enough.

00:09:49.553 --> 00:09:50.414
That's my bias.

00:09:50.514 --> 00:09:52.316
And that's my question to you is like any,

00:09:52.557 --> 00:09:52.777
you know,

00:09:53.037 --> 00:09:54.038
constructive feedback from the

00:09:54.077 --> 00:09:54.999
patient member side.

00:09:55.748 --> 00:09:56.668
Yeah, absolutely.

00:09:56.687 --> 00:09:58.109
And we would talk to the

00:09:58.129 --> 00:09:59.149
patients every single day.

00:09:59.969 --> 00:10:00.908
I had chat threads with

00:10:01.269 --> 00:10:02.629
everyone that I treated.

00:10:03.250 --> 00:10:07.009
And I think the nice thing

00:10:07.230 --> 00:10:08.571
and the negative at this

00:10:08.630 --> 00:10:09.831
point in time is that there

00:10:10.051 --> 00:10:11.071
are still a lot of people

00:10:11.110 --> 00:10:13.331
that haven't had PT experience.

00:10:13.711 --> 00:10:14.351
And those are the people

00:10:14.371 --> 00:10:15.211
that really benefited the

00:10:15.231 --> 00:10:16.532
most because they didn't

00:10:16.652 --> 00:10:18.052
come in with those expectations.

00:10:18.712 --> 00:10:19.552
People that had

00:10:20.013 --> 00:10:22.294
had therapy in person before,

00:10:22.695 --> 00:10:23.576
maybe they were like, well,

00:10:23.635 --> 00:10:24.557
where's my hands on?

00:10:24.596 --> 00:10:25.417
Like a lot of people are

00:10:25.496 --> 00:10:26.337
used to their stim and

00:10:26.357 --> 00:10:27.219
their ice and their heat

00:10:27.259 --> 00:10:28.078
and all of the other

00:10:28.198 --> 00:10:29.860
modality things that we

00:10:29.900 --> 00:10:30.841
like to throw at people

00:10:31.201 --> 00:10:31.881
that they don't have in

00:10:31.922 --> 00:10:32.763
this virtual world.

00:10:33.322 --> 00:10:33.964
And I think that's where the

00:10:33.984 --> 00:10:35.845
education really comes in is that, yes,

00:10:35.884 --> 00:10:36.625
those things are great.

00:10:36.645 --> 00:10:37.687
You can do those on your own.

00:10:38.126 --> 00:10:39.768
But the movement side is

00:10:39.847 --> 00:10:40.629
really where we're going to

00:10:40.649 --> 00:10:42.610
see the benefit both in

00:10:42.669 --> 00:10:43.650
person and virtually.

00:10:43.730 --> 00:10:43.971
Right.

00:10:44.932 --> 00:10:46.452
And so I think that was the

00:10:46.472 --> 00:10:47.333
biggest complaint is

00:10:48.154 --> 00:10:49.157
Yeah, movement's great,

00:10:49.177 --> 00:10:50.217
but it's also boring.

00:10:50.258 --> 00:10:51.541
It's also painful sometimes.

00:10:52.000 --> 00:10:52.942
I don't really want to do it

00:10:53.082 --> 00:10:54.385
where I used to go into a

00:10:54.426 --> 00:10:55.628
clinic and just lay there

00:10:55.668 --> 00:10:57.169
on my back with a little

00:10:57.190 --> 00:10:58.172
bit of tinglys and some

00:10:58.211 --> 00:10:59.173
heat and I felt better.

00:11:01.278 --> 00:11:02.859
So I'm curious real quick,

00:11:03.379 --> 00:11:05.299
from a fulfillment perspective, you know,

00:11:05.340 --> 00:11:06.801
as a therapist, as a clinician,

00:11:07.341 --> 00:11:08.701
you were in PT school,

00:11:09.042 --> 00:11:09.881
you had a certain

00:11:10.503 --> 00:11:11.722
preconceived notion of what

00:11:11.743 --> 00:11:12.724
you were going to be doing.

00:11:12.764 --> 00:11:13.524
Most of us say, well,

00:11:13.563 --> 00:11:14.625
we want to help people.

00:11:16.346 --> 00:11:17.826
Did you find fulfillment in

00:11:17.885 --> 00:11:18.846
what you were doing?

00:11:18.886 --> 00:11:19.206
You know,

00:11:19.346 --> 00:11:22.688
what was the most like fun or

00:11:22.729 --> 00:11:25.090
enjoyable part of that kind of career?

00:11:25.590 --> 00:11:26.711
compared to maybe a

00:11:26.750 --> 00:11:27.851
therapist who's in the

00:11:27.892 --> 00:11:30.695
clinic who maybe sees fewer people.

00:11:30.715 --> 00:11:31.556
And I don't know what kind

00:11:31.596 --> 00:11:33.378
of volume of caseload you are doing,

00:11:33.857 --> 00:11:35.320
but talk to me a little bit

00:11:35.340 --> 00:11:36.581
about the fulfillment side

00:11:36.620 --> 00:11:38.562
of it for you personally as a clinician.

00:11:39.163 --> 00:11:39.803
Absolutely.

00:11:40.404 --> 00:11:41.205
And I think that's huge.

00:11:41.404 --> 00:11:42.346
I'm one of those really

00:11:42.385 --> 00:11:44.226
weird data people that I

00:11:44.326 --> 00:11:45.827
track data on pretty much everything.

00:11:46.327 --> 00:11:48.548
And so prior to going digital,

00:11:48.950 --> 00:11:50.029
I had a spreadsheet on my

00:11:50.070 --> 00:11:52.432
laptop of how many exact

00:11:52.491 --> 00:11:55.153
visits I had seen in my career as a PT.

00:11:55.833 --> 00:11:56.114
And

00:11:57.264 --> 00:11:57.946
think it was something like

00:11:57.985 --> 00:11:59.408
ten thousand one hundred

00:11:59.447 --> 00:12:01.070
something like that and

00:12:01.629 --> 00:12:02.711
going into the digital

00:12:02.731 --> 00:12:04.754
space where I mean we had

00:12:05.274 --> 00:12:06.316
two hundred to start with

00:12:06.355 --> 00:12:07.376
and three hundred and four

00:12:07.417 --> 00:12:08.437
hundred and five hundred

00:12:08.519 --> 00:12:09.720
patients you know on our

00:12:09.759 --> 00:12:11.101
roster at any given time

00:12:12.366 --> 00:12:13.967
That to me was really neat

00:12:14.008 --> 00:12:15.928
because I was touching so

00:12:15.969 --> 00:12:20.270
many more people every single day,

00:12:20.791 --> 00:12:21.692
where in a clinic,

00:12:22.331 --> 00:12:23.613
when you see twenty patients a day,

00:12:23.653 --> 00:12:25.153
that's already like super overwhelming.

00:12:25.994 --> 00:12:26.734
So I think that's where I

00:12:26.774 --> 00:12:27.654
got my fulfillment.

00:12:28.575 --> 00:12:30.115
Not everybody got that, right?

00:12:30.216 --> 00:12:31.316
And it's not for everybody

00:12:31.375 --> 00:12:32.135
where you're like, well,

00:12:32.176 --> 00:12:33.475
I'm not giving that personal touch.

00:12:33.495 --> 00:12:34.277
I'm not, you know,

00:12:34.496 --> 00:12:36.736
specifically touching these

00:12:36.996 --> 00:12:38.238
specific individuals.

00:12:38.697 --> 00:12:39.677
But to me,

00:12:40.258 --> 00:12:42.158
if I can get five hundred people

00:12:42.698 --> 00:12:44.399
to do ten squats a day,

00:12:44.938 --> 00:12:46.620
then that's the fulfillment

00:12:46.639 --> 00:12:47.899
that I wanted for myself.

00:12:49.139 --> 00:12:50.520
And that was the help that I was giving.

00:12:50.640 --> 00:12:53.140
Am I necessarily fully treating back pain,

00:12:53.160 --> 00:12:54.000
knee pain, hip pain?

00:12:54.041 --> 00:12:56.381
Maybe not, but I'm getting people to move.

00:12:57.119 --> 00:12:58.522
Okay.

00:12:58.962 --> 00:12:59.784
And so you're looking for your,

00:13:00.105 --> 00:13:01.528
do you want to stay in this vertical?

00:13:01.587 --> 00:13:03.211
I mean, you know, at the top of the show,

00:13:03.231 --> 00:13:04.113
we were talking about how, you know,

00:13:04.214 --> 00:13:04.354
you're,

00:13:04.494 --> 00:13:05.535
you're looking for something now

00:13:05.657 --> 00:13:06.238
that you've left.

00:13:07.259 --> 00:13:08.543
What's next for you personally?

00:13:09.215 --> 00:13:09.875
Yeah, absolutely.

00:13:09.936 --> 00:13:10.976
So ironically enough,

00:13:11.437 --> 00:13:12.899
I did get laid off on the

00:13:12.940 --> 00:13:14.922
same exact day that I finished my MBA.

00:13:15.423 --> 00:13:17.644
So, you know, it was a great day.

00:13:18.225 --> 00:13:19.086
It was a weird Friday.

00:13:20.489 --> 00:13:21.289
So I think for me,

00:13:21.330 --> 00:13:22.991
next is really moving into

00:13:23.011 --> 00:13:23.893
the operational sphere.

00:13:23.932 --> 00:13:25.153
I've been in operations,

00:13:25.615 --> 00:13:26.395
even at Sword Health,

00:13:26.436 --> 00:13:28.678
I developed their on-call platform.

00:13:29.379 --> 00:13:30.298
kind of did both jobs.

00:13:30.359 --> 00:13:32.039
I was a PT and operations.

00:13:32.879 --> 00:13:34.020
So really transitioning more

00:13:34.041 --> 00:13:36.221
into the operational sphere and, you know,

00:13:36.760 --> 00:13:38.642
using what I know now as a PT,

00:13:38.701 --> 00:13:40.142
as a clinician and to kind

00:13:40.182 --> 00:13:41.543
of develop the next best thing and,

00:13:42.222 --> 00:13:42.982
you know,

00:13:43.423 --> 00:13:44.943
not let someone that's not

00:13:44.984 --> 00:13:46.083
clinical that doesn't know

00:13:46.124 --> 00:13:48.085
the healthcare as much as, you know,

00:13:48.225 --> 00:13:50.306
we all do take over.

00:13:50.365 --> 00:13:51.525
So that's where we go.

00:13:52.267 --> 00:13:53.086
Julia, good luck.

00:13:53.126 --> 00:13:54.107
Thanks for giving us a

00:13:54.128 --> 00:13:54.947
little insight from

00:13:55.008 --> 00:13:55.748
somebody who's done it.

00:13:55.788 --> 00:13:56.769
People like, you know, me,

00:13:56.828 --> 00:13:57.869
I just sort of like gas.

00:13:57.889 --> 00:13:58.308
I don't know.

00:13:58.328 --> 00:14:00.289
It looks like this, but having you give us,

00:14:00.610 --> 00:14:02.270
give it some colors is much appreciated.

00:14:02.291 --> 00:14:02.951
So thank you for doing that.

00:14:02.971 --> 00:14:03.350
Absolutely.

00:14:03.370 --> 00:14:04.851
Anytime.

00:14:04.871 --> 00:14:05.172
Go back.

00:14:05.192 --> 00:14:06.032
You can go back to bed for a

00:14:06.052 --> 00:14:06.611
few hours now.

00:14:06.631 --> 00:14:09.192
I think I will.

00:14:09.212 --> 00:14:09.332
Thanks.

00:14:09.352 --> 00:14:13.054
Awesome.

00:14:14.177 --> 00:14:14.938
It's good to have guests.

00:14:15.239 --> 00:14:17.220
I thought we'd have more guests.

00:14:17.360 --> 00:14:17.860
Maybe we should.

00:14:17.880 --> 00:14:18.380
I don't know.

00:14:18.421 --> 00:14:18.980
That was, you know,

00:14:19.041 --> 00:14:20.701
ten minutes or a hot thirteen minutes,

00:14:20.721 --> 00:14:20.842
right?

00:14:20.903 --> 00:14:21.383
Yeah,

00:14:21.403 --> 00:14:22.903
I don't think people know it's an option.

00:14:22.964 --> 00:14:24.504
I was just talking to somebody yesterday.

00:14:24.524 --> 00:14:26.265
I was like, you should call in.

00:14:26.787 --> 00:14:27.986
We used to do the call in.

00:14:28.207 --> 00:14:29.207
Yeah, well, now I've got the setup.

00:14:29.248 --> 00:14:33.250
I can do just phones if they

00:14:33.270 --> 00:14:34.011
want to do just that,

00:14:34.091 --> 00:14:36.994
if they don't want to do video.

00:14:37.673 --> 00:14:38.934
I'm trying to bring up my LinkedIn poll.

00:14:40.102 --> 00:14:42.304
Yeah, I wanted to talk about that.

00:14:42.445 --> 00:14:44.066
What else we should be doing

00:14:44.105 --> 00:14:45.106
or considering from an

00:14:45.167 --> 00:14:46.648
educational perspective?

00:14:48.169 --> 00:14:49.870
When you get it up, let us know.

00:14:50.191 --> 00:14:52.874
I said marketing and communication.

00:14:53.073 --> 00:14:55.134
Like to Julia's point,

00:14:56.515 --> 00:14:58.397
I think the whole experience

00:14:58.496 --> 00:15:00.337
of digital health, virtual health,

00:15:00.437 --> 00:15:01.837
synchronous, asynchronous,

00:15:02.337 --> 00:15:03.458
everything pivots on your

00:15:03.499 --> 00:15:04.578
ability to communicate.

00:15:05.019 --> 00:15:08.221
Can you communicate empathy, compassion?

00:15:08.421 --> 00:15:10.081
Can you communicate expertise?

00:15:10.100 --> 00:15:11.701
Can you communicate all of

00:15:11.721 --> 00:15:13.241
these things through your voice,

00:15:13.261 --> 00:15:14.702
through your image on video?

00:15:16.313 --> 00:15:17.913
So there's the poll we have

00:15:17.953 --> 00:15:19.014
if you're watching a live stream.

00:15:19.095 --> 00:15:20.654
Yesterday, I think I said,

00:15:21.215 --> 00:15:22.534
I made the bold statement, right?

00:15:22.575 --> 00:15:23.375
You aren't going to get

00:15:23.416 --> 00:15:24.716
ahead in twenty twenty five

00:15:25.596 --> 00:15:27.135
if you are or if you're

00:15:27.155 --> 00:15:28.297
going to get ahead in twenty twenty five.

00:15:28.317 --> 00:15:29.437
You need to do the things

00:15:29.697 --> 00:15:31.716
most others aren't.

00:15:32.638 --> 00:15:33.658
And then maybe I could ask

00:15:33.697 --> 00:15:34.937
better questions, too, because I said,

00:15:34.998 --> 00:15:36.018
what's the most valuable

00:15:36.057 --> 00:15:37.818
degree a physical therapist can add?

00:15:38.719 --> 00:15:39.799
uh in twenty twenty five and

00:15:39.820 --> 00:15:40.360
then some of the things

00:15:40.380 --> 00:15:41.461
aren't degrees like so I

00:15:41.481 --> 00:15:42.182
literally asked for a

00:15:42.202 --> 00:15:43.144
degree question that I said

00:15:43.183 --> 00:15:43.724
like clinical

00:15:43.764 --> 00:15:44.745
certifications I should have

00:15:44.764 --> 00:15:45.605
said just what's the thing

00:15:45.625 --> 00:15:47.347
you can add to your dpt

00:15:47.368 --> 00:15:48.509
degree but the four options

00:15:48.568 --> 00:15:50.591
I gave were an mba which

00:15:50.630 --> 00:15:51.652
has about a third of the

00:15:51.731 --> 00:15:53.594
answers right now clinical

00:15:53.634 --> 00:15:55.855
certification ocs gcs pcs

00:15:56.035 --> 00:15:59.259
scs telehealth certification

00:16:00.239 --> 00:16:02.380
which has which has five percent.

00:16:02.701 --> 00:16:03.861
And even people in the comments were like,

00:16:03.922 --> 00:16:04.923
that's a certification.

00:16:05.283 --> 00:16:05.682
And I'm like,

00:16:06.364 --> 00:16:07.203
you knew it was going to be a

00:16:07.264 --> 00:16:08.465
certification like ten

00:16:08.485 --> 00:16:09.785
minutes after it became a thing,

00:16:09.826 --> 00:16:10.706
someone scrambling to

00:16:10.746 --> 00:16:11.488
figure out how to do it.

00:16:11.967 --> 00:16:13.850
And then what sort of

00:16:13.870 --> 00:16:15.191
shocked me or the one thing

00:16:15.230 --> 00:16:16.572
that made me my eyebrows go

00:16:16.611 --> 00:16:18.393
up or about a third of the

00:16:18.432 --> 00:16:19.754
responses are other.

00:16:20.153 --> 00:16:22.096
But I asked people like, what's the other?

00:16:23.136 --> 00:16:24.097
No one's really answering.

00:16:24.880 --> 00:16:25.861
Everybody's just saying, I don't know.

00:16:25.881 --> 00:16:26.662
It's not an MBA.

00:16:26.682 --> 00:16:27.743
It's not a clinical cert.

00:16:27.863 --> 00:16:28.763
It's something else.

00:16:28.863 --> 00:16:29.082
What?

00:16:29.363 --> 00:16:30.104
I don't really know.

00:16:30.183 --> 00:16:30.604
Something.

00:16:30.923 --> 00:16:31.465
I don't know what it is.

00:16:31.485 --> 00:16:32.245
It's in the aura.

00:16:32.524 --> 00:16:33.865
But look what Julia just did.

00:16:34.005 --> 00:16:35.267
She literally gets laid off

00:16:35.287 --> 00:16:37.168
from Sword Health the day

00:16:37.207 --> 00:16:39.269
she finishes that first

00:16:39.308 --> 00:16:40.208
choice there on the list,

00:16:40.249 --> 00:16:41.470
which is an MBA.

00:16:43.390 --> 00:16:44.892
Is this a bad sign, though?

00:16:45.293 --> 00:16:47.293
Because a third of those people are saying,

00:16:47.313 --> 00:16:48.294
I'm getting an MBA.

00:16:48.696 --> 00:16:49.937
Why do you think they're getting that,

00:16:49.996 --> 00:16:50.356
Dave?

00:16:50.496 --> 00:16:52.859
Is it to be their own boss,

00:16:53.278 --> 00:16:54.639
or is it to go into

00:16:54.701 --> 00:16:55.821
administration within these

00:16:55.860 --> 00:16:56.682
organizations?

00:16:57.663 --> 00:16:59.364
Are we still doing a bad job

00:16:59.403 --> 00:17:00.565
of making that first job

00:17:00.605 --> 00:17:03.067
being a PT so unenticing?

00:17:03.107 --> 00:17:04.729
Everyone's just looking to get out and up.

00:17:06.205 --> 00:17:08.047
The MBA most likely is to

00:17:08.547 --> 00:17:09.948
excel higher up in some

00:17:09.968 --> 00:17:10.788
other organization.

00:17:11.088 --> 00:17:12.209
If you're going to start your own practice,

00:17:12.348 --> 00:17:13.910
like it makes basically no

00:17:13.970 --> 00:17:15.270
sense to go and get an MBA.

00:17:15.911 --> 00:17:17.251
So for Julia, like if she wants to,

00:17:17.392 --> 00:17:19.492
you know, have some operations level,

00:17:19.992 --> 00:17:22.315
like COO type level, or, you know,

00:17:22.335 --> 00:17:22.694
I don't know,

00:17:23.214 --> 00:17:24.336
uh senior vice president of

00:17:24.395 --> 00:17:25.276
operations clinical

00:17:25.316 --> 00:17:26.476
operations whatever like

00:17:26.855 --> 00:17:27.936
then you know maybe maybe

00:17:27.977 --> 00:17:30.758
it makes sense uh but I

00:17:30.817 --> 00:17:32.377
commented on that and I

00:17:32.397 --> 00:17:33.719
like I think that the

00:17:33.778 --> 00:17:34.898
clinical things are table

00:17:34.939 --> 00:17:35.980
stakes right so that's what

00:17:36.079 --> 00:17:37.299
I comment I tag both of you

00:17:37.400 --> 00:17:40.040
on this post I said uh you

00:17:40.060 --> 00:17:40.641
know if you don't if you

00:17:40.661 --> 00:17:41.342
don't have the clinical

00:17:41.382 --> 00:17:42.721
skills if you can't if you

00:17:42.781 --> 00:17:43.722
can't like whoever your

00:17:43.782 --> 00:17:44.883
ideal population is right

00:17:44.923 --> 00:17:46.604
like is it geriatrics is it

00:17:47.243 --> 00:17:48.284
uh sports medicine and

00:17:48.344 --> 00:17:49.924
athletes is it like

00:17:50.365 --> 00:17:51.526
workers comp, I don't know, whatever,

00:17:51.566 --> 00:17:52.546
whatever it is, I don't know,

00:17:52.566 --> 00:17:54.406
whatever your ideal population is.

00:17:54.887 --> 00:17:56.067
If you don't have the

00:17:56.087 --> 00:17:57.229
differential diagnosis skills,

00:17:57.269 --> 00:17:59.390
if you don't have the clinical skills to,

00:17:59.410 --> 00:18:01.590
I don't know, maybe, I think I said,

00:18:01.750 --> 00:18:03.132
eighty percent, but seventy,

00:18:03.192 --> 00:18:04.133
eighty percent of the

00:18:04.292 --> 00:18:05.272
population that walks in,

00:18:05.373 --> 00:18:06.294
if you don't have the

00:18:06.374 --> 00:18:07.513
differential diagnosis skills,

00:18:07.554 --> 00:18:10.195
the ability to improve

00:18:10.215 --> 00:18:11.276
someone's situation in the

00:18:11.317 --> 00:18:12.717
first visit for a lot of

00:18:12.737 --> 00:18:14.758
these normal conditions,

00:18:17.659 --> 00:18:20.080
Yeah, then you need more clinical skills.

00:18:20.121 --> 00:18:21.442
It might not even be a cert though.

00:18:21.461 --> 00:18:23.082
It might not be one of the SCS, OCS,

00:18:23.102 --> 00:18:23.423
whatever.

00:18:23.522 --> 00:18:25.163
It could be, I said something from,

00:18:25.324 --> 00:18:27.305
I said a cert through ICE,

00:18:27.825 --> 00:18:28.766
Jeff Moore's Institute of

00:18:28.806 --> 00:18:29.506
Clinical Excellence.

00:18:29.905 --> 00:18:31.507
Like those are certs that

00:18:31.527 --> 00:18:33.327
they have different tracks for geriatrics,

00:18:33.387 --> 00:18:36.130
for pelvic floor, pelvic health,

00:18:36.150 --> 00:18:36.809
all that type of stuff.

00:18:36.849 --> 00:18:38.671
So if you don't have that, yeah,

00:18:38.730 --> 00:18:39.192
you should.

00:18:39.592 --> 00:18:40.772
You should absolutely go get that.

00:18:41.432 --> 00:18:42.894
But I clicked other because

00:18:43.314 --> 00:18:44.755
I think these clinical things

00:18:45.269 --> 00:18:46.411
components or table stakes

00:18:46.510 --> 00:18:48.051
after your first two,

00:18:48.092 --> 00:18:49.573
three years working in the profession.

00:18:50.752 --> 00:18:52.294
And Tony, you said communications,

00:18:52.334 --> 00:18:53.095
which of course,

00:18:53.234 --> 00:18:55.855
obviously is going to resonate with me.

00:18:56.676 --> 00:18:57.436
I don't think you need to go

00:18:57.477 --> 00:18:58.657
get a degree in communication,

00:19:00.259 --> 00:19:01.098
but you definitely should

00:19:01.358 --> 00:19:02.380
hone your skills and you

00:19:02.400 --> 00:19:03.800
can do that a billion different ways.

00:19:04.368 --> 00:19:06.651
Yeah, I have half read the post.

00:19:06.852 --> 00:19:08.472
I didn't see that it said degree.

00:19:08.693 --> 00:19:09.453
I was just saying,

00:19:09.535 --> 00:19:10.655
what else should we add?

00:19:11.115 --> 00:19:11.497
Yeah.

00:19:11.916 --> 00:19:13.798
And so, but even within that, you know,

00:19:13.838 --> 00:19:15.039
listening to Julia talk,

00:19:15.119 --> 00:19:15.820
one of the things that I

00:19:15.861 --> 00:19:17.762
always think about is are

00:19:17.803 --> 00:19:18.864
there generational

00:19:18.983 --> 00:19:21.767
differences here in what, you know,

00:19:21.826 --> 00:19:22.728
the three of us are

00:19:22.788 --> 00:19:24.810
generally in the same generation.

00:19:24.851 --> 00:19:25.751
I think Dave's probably the

00:19:25.791 --> 00:19:26.893
younger out of the three.

00:19:27.512 --> 00:19:29.015
But within that,

00:19:29.756 --> 00:19:31.758
when we were at PPS up in DC,

00:19:31.917 --> 00:19:33.559
I talked to some other clinicians,

00:19:33.599 --> 00:19:34.401
therapists that I had

00:19:34.421 --> 00:19:35.342
worked with in the past,

00:19:35.382 --> 00:19:36.683
and they all kind of said the same thing.

00:19:36.723 --> 00:19:37.124
They were like,

00:19:37.904 --> 00:19:40.008
a lot of the newer generation,

00:19:40.028 --> 00:19:41.528
now this is a generalization,

00:19:42.170 --> 00:19:43.490
They don't have the same

00:19:43.671 --> 00:19:45.031
impact on their patients.

00:19:45.051 --> 00:19:47.333
Their patients don't kind of, air quotes,

00:19:47.513 --> 00:19:48.673
fall in love with them on

00:19:48.693 --> 00:19:49.654
that first visit.

00:19:50.035 --> 00:19:50.935
They don't seem to get the

00:19:50.976 --> 00:19:52.457
same kind of response that

00:19:52.517 --> 00:19:53.377
we used to get.

00:19:54.038 --> 00:19:54.718
But I don't know,

00:19:55.098 --> 00:19:56.619
is it because that

00:19:56.660 --> 00:19:58.141
generation of therapists is

00:19:58.201 --> 00:19:59.862
looking to achieve different things?

00:20:00.301 --> 00:20:02.763
And so from a metric perspective,

00:20:03.243 --> 00:20:04.325
they're getting the outcome

00:20:04.365 --> 00:20:05.346
that they want,

00:20:05.605 --> 00:20:06.946
but maybe not the same

00:20:07.027 --> 00:20:09.067
connection that we all did

00:20:09.407 --> 00:20:11.009
as young clinicians growing up.

00:20:12.830 --> 00:20:13.971
I don't know how you make

00:20:14.011 --> 00:20:15.452
those judgment calls on a

00:20:15.512 --> 00:20:16.733
generational basis,

00:20:16.855 --> 00:20:18.695
but I agree with Dave.

00:20:19.037 --> 00:20:19.217
Yeah,

00:20:19.237 --> 00:20:21.459
you basically need to impress upon

00:20:21.479 --> 00:20:22.279
your patient

00:20:23.003 --> 00:20:23.984
look, this is important.

00:20:24.384 --> 00:20:25.164
I'm the expert.

00:20:25.565 --> 00:20:27.046
I'm going to get you that first win.

00:20:27.185 --> 00:20:29.367
I remember talking to Jerry Durham early,

00:20:29.567 --> 00:20:30.909
like in social media.

00:20:31.469 --> 00:20:32.249
And one of the main things

00:20:32.269 --> 00:20:34.130
we talked about was my top

00:20:34.170 --> 00:20:35.830
priority day number one is

00:20:36.010 --> 00:20:37.432
letting that patient leave

00:20:37.811 --> 00:20:39.073
in a successful way,

00:20:39.492 --> 00:20:41.434
meaning I'm not going to challenge them.

00:20:41.535 --> 00:20:42.535
I'm not going to do special

00:20:42.575 --> 00:20:43.976
tests that make them fail

00:20:44.455 --> 00:20:45.757
in an effort to show them

00:20:45.876 --> 00:20:47.057
how deficient they are.

00:20:47.397 --> 00:20:48.578
They already failed with

00:20:48.598 --> 00:20:49.439
their primary care.

00:20:49.459 --> 00:20:50.599
They failed with their ortho.

00:20:50.619 --> 00:20:51.839
They failed with everybody else.

00:20:51.859 --> 00:20:52.701
They're coming in here

00:20:53.121 --> 00:20:54.422
They're going to leave a success.

00:20:54.461 --> 00:20:56.281
They're going to have an easy win.

00:20:56.642 --> 00:20:58.303
That's going to make them feel good.

00:20:58.343 --> 00:20:59.042
And they're going to leave

00:20:59.083 --> 00:21:00.163
before they want to leave

00:21:00.203 --> 00:21:01.463
so that they want to come back.

00:21:01.983 --> 00:21:03.585
That is my top priority.

00:21:04.105 --> 00:21:06.205
And so, you know, I don't know.

00:21:06.246 --> 00:21:07.445
Is that something you learn?

00:21:07.506 --> 00:21:08.467
Is that something you have

00:21:08.507 --> 00:21:09.767
to you're born with?

00:21:09.807 --> 00:21:11.087
How do you figure that stuff out?

00:21:11.127 --> 00:21:11.887
What do you guys think?

00:21:12.215 --> 00:21:15.998
I think it's something you have to, I,

00:21:16.038 --> 00:21:17.118
I think it might be something if,

00:21:17.259 --> 00:21:18.619
if someone was going to agree with Tony,

00:21:18.640 --> 00:21:19.319
which I do,

00:21:19.400 --> 00:21:20.220
I think it's something you

00:21:20.240 --> 00:21:22.662
have to unlearn from PT school,

00:21:23.321 --> 00:21:25.423
not in a bad way, but PT school says,

00:21:25.522 --> 00:21:26.824
go in there and do the PT things.

00:21:26.943 --> 00:21:27.865
Like what's the first thing

00:21:27.884 --> 00:21:28.704
you do would be the

00:21:28.845 --> 00:21:30.385
opposite of what Tony said, which is like,

00:21:30.625 --> 00:21:30.746
well,

00:21:30.786 --> 00:21:32.307
special tests because it's a shoulder.

00:21:32.326 --> 00:21:33.167
I'm going to do all those things.

00:21:34.127 --> 00:21:35.367
again I'm still sitting on

00:21:35.387 --> 00:21:36.367
this idea I even have the

00:21:36.407 --> 00:21:38.308
title of a course I want to

00:21:38.348 --> 00:21:39.568
pitch to pt schools which

00:21:39.628 --> 00:21:40.628
is hey why are these soft

00:21:40.669 --> 00:21:42.309
skills so damn hard which

00:21:42.349 --> 00:21:43.710
is it's not that that those

00:21:43.750 --> 00:21:45.230
things psychology and

00:21:45.250 --> 00:21:46.730
communications and what is

00:21:46.769 --> 00:21:48.790
the goal of of the of the

00:21:48.851 --> 00:21:50.711
first treatment goal the

00:21:50.750 --> 00:21:51.530
first treatment is to get

00:21:51.550 --> 00:21:52.270
them there the second

00:21:52.310 --> 00:21:53.352
treatment right you think

00:21:53.372 --> 00:21:53.811
you're gonna make

00:21:53.912 --> 00:21:55.571
monumental change in one in

00:21:55.672 --> 00:21:56.332
one treatment and maybe

00:21:56.372 --> 00:21:57.211
some people will push back

00:21:57.271 --> 00:21:59.153
on me and go I can I have

00:21:59.212 --> 00:22:00.792
magic fingers um

00:22:01.692 --> 00:22:03.775
But I think it's really like

00:22:03.994 --> 00:22:04.915
expectation set of

00:22:04.976 --> 00:22:06.317
realistic expectation

00:22:06.357 --> 00:22:08.119
setting and being able to

00:22:08.259 --> 00:22:09.941
read and recognize because

00:22:09.980 --> 00:22:10.862
some people want to dig

00:22:10.922 --> 00:22:12.584
right in and some people don't.

00:22:13.003 --> 00:22:13.845
But why are those soft

00:22:13.865 --> 00:22:15.006
skills so damn hard?

00:22:16.027 --> 00:22:16.847
Because there are things you

00:22:16.867 --> 00:22:17.808
develop over reps.

00:22:17.868 --> 00:22:20.392
Yeah, there's some basics you can teach,

00:22:20.692 --> 00:22:22.032
but a lot of it is figure

00:22:22.053 --> 00:22:23.454
it out and you've got to do

00:22:23.494 --> 00:22:24.435
repetitions on that.

00:22:26.173 --> 00:22:26.972
I still wanna debrief a

00:22:26.992 --> 00:22:28.814
little bit more with Julia's conversation,

00:22:28.854 --> 00:22:29.773
but with the soft skills,

00:22:29.794 --> 00:22:30.374
do you guys think that

00:22:30.394 --> 00:22:31.434
there's some component of

00:22:32.035 --> 00:22:33.315
the younger therapists that

00:22:33.355 --> 00:22:35.476
are newer grads and they've

00:22:35.516 --> 00:22:36.375
come up with like,

00:22:36.715 --> 00:22:37.715
they've only known

00:22:37.776 --> 00:22:39.656
technology and tablets and social media.

00:22:39.836 --> 00:22:40.517
And I mean,

00:22:40.537 --> 00:22:41.577
you go to a restaurant and a

00:22:41.637 --> 00:22:42.357
ton of families

00:22:43.442 --> 00:22:44.962
parents throwing phones and

00:22:45.042 --> 00:22:45.682
iPads right in front of

00:22:45.702 --> 00:22:46.823
their kids to shut them up.

00:22:46.903 --> 00:22:48.763
And yeah, I mean, it's wild.

00:22:48.804 --> 00:22:49.983
Like people, you know, kid, I,

00:22:50.765 --> 00:22:52.704
now that like our son is seven months old,

00:22:52.765 --> 00:22:54.425
like I'm legitimately

00:22:54.465 --> 00:22:56.207
thinking like maybe when he's a,

00:22:56.227 --> 00:22:56.826
I don't know,

00:22:58.044 --> 00:22:59.605
seven, ten, whatever years old,

00:22:59.644 --> 00:23:02.507
like getting an analog flip

00:23:02.527 --> 00:23:04.689
phone for texts and phone calls,

00:23:04.729 --> 00:23:05.749
but not the whole internet,

00:23:05.809 --> 00:23:06.970
not all the apps and games

00:23:06.990 --> 00:23:07.631
and things like that.

00:23:08.111 --> 00:23:10.113
Do you think the new grads

00:23:10.232 --> 00:23:12.854
are affected by social media technology,

00:23:12.913 --> 00:23:14.635
tabless devices?

00:23:14.756 --> 00:23:16.136
One thousand percent.

00:23:16.217 --> 00:23:17.857
There's no way you couldn't.

00:23:18.617 --> 00:23:19.878
It's not a little change.

00:23:19.939 --> 00:23:21.140
This wasn't going from like

00:23:21.200 --> 00:23:22.740
five TV channels to fifty

00:23:22.780 --> 00:23:23.662
five TV channels.

00:23:24.182 --> 00:23:24.722
This was like

00:23:26.352 --> 00:23:27.512
We can't even wrap our heads

00:23:27.553 --> 00:23:28.292
around what it's like to

00:23:28.333 --> 00:23:29.054
grow up right now.

00:23:29.094 --> 00:23:29.213
I mean,

00:23:29.233 --> 00:23:30.414
I've got friends with kids that are

00:23:30.575 --> 00:23:32.556
eight to eighteen and

00:23:32.596 --> 00:23:33.236
they're looking at me like,

00:23:33.276 --> 00:23:36.238
what do you mean a phone?

00:23:36.397 --> 00:23:37.259
Ask someone under the age of

00:23:37.298 --> 00:23:38.640
twenty five why we call it

00:23:38.720 --> 00:23:39.579
hang up the phone.

00:23:39.759 --> 00:23:41.060
They have no idea because

00:23:41.080 --> 00:23:42.781
they haven't hung a phone on a wall.

00:23:43.122 --> 00:23:44.363
They don't understand why that is.

00:23:44.663 --> 00:23:45.963
There's no satisfaction in

00:23:46.044 --> 00:23:47.204
hanging up with a finger.

00:23:47.325 --> 00:23:48.746
Slamming the phone.

00:23:48.766 --> 00:23:50.426
Slam that phone down and be like, yeah,

00:23:50.846 --> 00:23:51.387
my favorite line when

00:23:51.407 --> 00:23:52.127
you're going to hang up on

00:23:52.188 --> 00:23:52.949
someone was like, hey, man.

00:23:53.848 --> 00:23:54.890
Tell me if my dial tone is

00:23:54.950 --> 00:23:55.569
working properly.

00:23:55.589 --> 00:23:56.371
When they're like, what?

00:23:56.550 --> 00:23:57.731
Click, right?

00:23:58.051 --> 00:23:58.752
But they don't understand

00:23:58.772 --> 00:23:59.333
that because there's no

00:23:59.354 --> 00:24:00.253
dial tone anymore.

00:24:00.334 --> 00:24:01.535
So, one thousand percent.

00:24:01.575 --> 00:24:02.296
There's no way you can

00:24:02.355 --> 00:24:04.637
separate the nature part of

00:24:04.718 --> 00:24:05.759
nature versus nurture.

00:24:06.719 --> 00:24:06.980
Yeah.

00:24:07.039 --> 00:24:07.700
Now, Sammy said,

00:24:07.740 --> 00:24:10.122
what about post-COVID PT generation?

00:24:10.162 --> 00:24:11.762
Different approach, new grad,

00:24:11.782 --> 00:24:13.724
didn't have much personal one-on-one.

00:24:14.546 --> 00:24:15.105
I agree.

00:24:15.145 --> 00:24:19.108
You know, now to cite Gary Vee,

00:24:19.789 --> 00:24:21.971
he had said years ago, he was like, look,

00:24:22.491 --> 00:24:24.393
Parents are getting obsessed

00:24:24.452 --> 00:24:26.053
with kids on phones and

00:24:26.073 --> 00:24:28.273
devices and iPad kids and all this stuff,

00:24:28.294 --> 00:24:28.874
which I agree.

00:24:29.493 --> 00:24:31.335
We limited access to phones

00:24:31.375 --> 00:24:32.535
and all that stuff when our

00:24:32.555 --> 00:24:33.296
kids were younger.

00:24:33.596 --> 00:24:34.875
But we also acknowledge, look,

00:24:34.915 --> 00:24:35.916
this is the way people

00:24:35.957 --> 00:24:38.538
communicate in the current landscape.

00:24:38.738 --> 00:24:40.077
We need to let our kids

00:24:40.097 --> 00:24:41.499
figure out what's going to

00:24:41.519 --> 00:24:43.679
happen when I get on Snapchat,

00:24:43.759 --> 00:24:44.519
on Instagram.

00:24:44.579 --> 00:24:45.660
How do I communicate?

00:24:45.680 --> 00:24:46.420
How do I text?

00:24:46.460 --> 00:24:48.441
How do I manage social media?

00:24:48.861 --> 00:24:51.382
So we started letting our kids get in and

00:24:51.721 --> 00:24:54.203
seventh grade, definitely by eighth grade,

00:24:54.584 --> 00:24:55.384
we're like, look,

00:24:55.404 --> 00:24:57.946
we're going to give you a longer leash.

00:24:57.987 --> 00:24:58.527
I don't know.

00:24:59.027 --> 00:25:00.367
I think none of us actually

00:25:00.449 --> 00:25:01.469
know what this is going to

00:25:01.528 --> 00:25:03.290
mean because my

00:25:03.330 --> 00:25:04.731
grandparents' generation

00:25:04.771 --> 00:25:05.632
complained about my

00:25:05.692 --> 00:25:06.972
generation in the same way

00:25:07.032 --> 00:25:08.314
my generation's complaining

00:25:08.334 --> 00:25:09.694
about future generations.

00:25:10.195 --> 00:25:11.557
So it might just be part of life.

00:25:11.596 --> 00:25:13.538
And this is, you know, what we live in.

00:25:14.818 --> 00:25:16.140
But like Gary Vee said,

00:25:16.319 --> 00:25:18.020
I do think we have to

00:25:18.121 --> 00:25:19.402
understand different modes

00:25:19.442 --> 00:25:20.403
of communication.

00:25:20.883 --> 00:25:23.066
And how we work in those

00:25:23.105 --> 00:25:24.347
different modes is going to

00:25:24.367 --> 00:25:25.829
be so impactful to our

00:25:25.890 --> 00:25:27.531
businesses moving forward,

00:25:27.913 --> 00:25:29.835
but also to our personal relationships.

00:25:30.296 --> 00:25:30.556
So Dave,

00:25:30.615 --> 00:25:33.140
what else were you thinking about

00:25:33.180 --> 00:25:33.980
that conversation?

00:25:34.997 --> 00:25:36.557
Yeah, so with Julia, I mean,

00:25:37.358 --> 00:25:39.461
she's talking about having, I don't know,

00:25:39.520 --> 00:25:42.222
hundreds of patients, members, whatever,

00:25:42.323 --> 00:25:44.424
customers on her census or

00:25:44.464 --> 00:25:45.185
roster or whatever.

00:25:46.946 --> 00:25:47.907
I mean,

00:25:47.948 --> 00:25:49.588
we had like a concise amount of

00:25:49.628 --> 00:25:50.670
questions and we wanted to

00:25:50.710 --> 00:25:52.811
kind of get back to the

00:25:52.832 --> 00:25:53.372
rest of the episode.

00:25:53.412 --> 00:25:56.934
But my question to you guys would be,

00:25:58.207 --> 00:26:00.469
To do the things that she's doing,

00:26:01.190 --> 00:26:01.730
do you need to be a

00:26:01.769 --> 00:26:03.191
licensed physical therapist to do that?

00:26:03.471 --> 00:26:05.192
Couldn't I just get virtual assistants?

00:26:05.252 --> 00:26:06.753
I can train virtual

00:26:06.773 --> 00:26:08.816
assistants in another

00:26:08.855 --> 00:26:10.396
country and kind of do

00:26:10.457 --> 00:26:11.597
those same types of things.

00:26:12.618 --> 00:26:13.839
We could undercut sword

00:26:13.859 --> 00:26:14.580
health and hinge health.

00:26:14.601 --> 00:26:15.981
We could call it bitter health.

00:26:16.021 --> 00:26:17.163
We can call it revenge health.

00:26:17.202 --> 00:26:19.664
We can undercut them and we

00:26:19.684 --> 00:26:21.626
can make it even cheaper for them.

00:26:22.007 --> 00:26:22.708
And we can have...

00:26:23.667 --> 00:26:27.030
Dagger, dagger, dagger, dagger.

00:26:27.090 --> 00:26:28.412
It doesn't sound negative at all.

00:26:29.133 --> 00:26:30.374
And we can undercut them

00:26:30.413 --> 00:26:31.974
with cheaper labor because

00:26:32.295 --> 00:26:33.536
what she was describing and guys,

00:26:33.635 --> 00:26:34.696
please correct me if I'm wrong,

00:26:34.737 --> 00:26:35.998
Julie and the comments, you know,

00:26:36.038 --> 00:26:36.578
LinkedIn, whatever,

00:26:36.638 --> 00:26:37.338
correct me if I'm wrong,

00:26:37.358 --> 00:26:39.320
but you have hundreds of patients.

00:26:39.421 --> 00:26:41.041
She said she doesn't even

00:26:41.061 --> 00:26:42.042
see them do their exercise.

00:26:42.643 --> 00:26:43.163
I mean, like,

00:26:44.914 --> 00:26:45.896
Couldn't just anyone do this?

00:26:45.936 --> 00:26:46.959
Can we just have personal

00:26:46.999 --> 00:26:47.519
trainers do this?

00:26:47.539 --> 00:26:49.282
Couldn't you have someone in, you know,

00:26:49.804 --> 00:26:50.965
the Philippines, India,

00:26:51.006 --> 00:26:52.048
some other country do these

00:26:52.067 --> 00:26:52.568
types of things?

00:26:53.150 --> 00:26:53.790
Tony says no.

00:26:54.453 --> 00:26:54.753
No,

00:26:55.314 --> 00:26:56.834
I talked about this last night in my

00:26:56.894 --> 00:26:57.755
zero to paid course.

00:26:57.775 --> 00:27:01.174
Like this is the perfect example of saying,

00:27:01.434 --> 00:27:03.375
what are the actual skills

00:27:03.415 --> 00:27:04.115
of a therapist?

00:27:04.155 --> 00:27:06.215
What requires the skills of a therapist?

00:27:06.655 --> 00:27:07.955
The therapist does not need

00:27:07.996 --> 00:27:11.277
to watch you do tens, seven repetitions,

00:27:11.297 --> 00:27:13.037
three sets of seated lap.

00:27:13.477 --> 00:27:15.137
Like that can be delegated out.

00:27:15.278 --> 00:27:15.837
A robot,

00:27:15.877 --> 00:27:17.617
a machine can watch you do that

00:27:17.657 --> 00:27:18.698
and analyze your movement.

00:27:18.718 --> 00:27:20.238
A therapist does not have to do that.

00:27:20.698 --> 00:27:22.439
What the therapist does is

00:27:22.699 --> 00:27:23.878
manage the case.

00:27:24.332 --> 00:27:25.991
the therapist oversees.

00:27:26.032 --> 00:27:27.373
And then when there was a problem,

00:27:27.813 --> 00:27:29.653
now the therapist gets more involved.

00:27:29.713 --> 00:27:31.534
Now we get more granular and

00:27:31.554 --> 00:27:32.733
we go into it deeper.

00:27:33.335 --> 00:27:35.255
Go ahead.

00:27:35.275 --> 00:27:35.994
In your office,

00:27:36.015 --> 00:27:37.935
when you guys bill in network insurances,

00:27:38.355 --> 00:27:40.517
are they paying you to manage the case,

00:27:40.596 --> 00:27:40.856
Tony?

00:27:40.916 --> 00:27:42.317
Or are they paying you for

00:27:42.356 --> 00:27:43.218
therapeutic exercise,

00:27:43.258 --> 00:27:44.157
the ten squats that she was

00:27:44.178 --> 00:27:44.577
talking about?

00:27:45.019 --> 00:27:46.260
So I would tell you,

00:27:46.881 --> 00:27:48.902
and I'm going to pull a screenshot up.

00:27:48.922 --> 00:27:49.762
You guys keep talking.

00:27:49.803 --> 00:27:50.823
I'll pull a screenshot up.

00:27:50.903 --> 00:27:52.324
Medicare has a list of seven

00:27:52.364 --> 00:27:54.565
things that they consider

00:27:54.605 --> 00:27:56.645
rehabilitative therapy by definition.

00:27:57.126 --> 00:27:58.227
It's evaluation,

00:27:58.768 --> 00:27:59.867
the physical therapy

00:27:59.988 --> 00:28:01.828
evaluation that is done by

00:28:01.868 --> 00:28:02.630
a physical therapist.

00:28:02.650 --> 00:28:03.829
You can't delegate that out

00:28:03.869 --> 00:28:04.810
to a massage therapist.

00:28:05.696 --> 00:28:07.018
developing the plan of care,

00:28:07.317 --> 00:28:08.817
establishing goals specific

00:28:08.837 --> 00:28:10.638
to the patient's physical limitation,

00:28:11.179 --> 00:28:13.779
monitoring and assessing at

00:28:13.859 --> 00:28:15.040
regular intervals,

00:28:15.121 --> 00:28:16.401
not every single session,

00:28:16.560 --> 00:28:18.102
assessing at intervals,

00:28:19.041 --> 00:28:21.843
prescribing equipment for

00:28:21.883 --> 00:28:23.223
home to augment function,

00:28:23.779 --> 00:28:25.039
and training or teaching the

00:28:25.161 --> 00:28:26.520
patient and the caregiver

00:28:26.641 --> 00:28:27.760
what to do at home.

00:28:28.142 --> 00:28:29.382
That is what Medicare says.

00:28:29.481 --> 00:28:30.561
Nowhere in the guideline

00:28:30.602 --> 00:28:32.502
does it say manual therapy,

00:28:32.563 --> 00:28:33.762
therapeutic exercise,

00:28:33.843 --> 00:28:35.604
doing the actual treatment.

00:28:36.243 --> 00:28:38.664
I believe third party payers, yes,

00:28:38.704 --> 00:28:39.826
that's what they want us to do.

00:28:39.865 --> 00:28:41.105
They want us to evaluate

00:28:41.385 --> 00:28:42.426
to develop the plan,

00:28:42.467 --> 00:28:44.887
to delegate out that plan and oversee,

00:28:45.348 --> 00:28:47.170
not sit there for an hour,

00:28:47.630 --> 00:28:48.590
actually treating the

00:28:48.631 --> 00:28:49.932
patient that could be

00:28:49.971 --> 00:28:52.633
delegated to a personal trainer, to a,

00:28:52.794 --> 00:28:54.515
you know, a robot, to AI,

00:28:54.535 --> 00:29:00.378
to anything else.

00:29:00.398 --> 00:29:00.499
Dave.

00:29:00.519 --> 00:29:01.558
I mean, on visit number two,

00:29:01.618 --> 00:29:03.119
visit number three, visit number four,

00:29:03.921 --> 00:29:04.881
you're billing Medicare for

00:29:04.901 --> 00:29:06.382
therapeutic exercise or whatever,

00:29:06.563 --> 00:29:07.803
you know, therapeutic intervention,

00:29:07.923 --> 00:29:10.204
neuromuscular reeducation, uh,

00:29:12.801 --> 00:29:14.623
Isn't that a, those are billable units.

00:29:14.663 --> 00:29:15.702
I understand your argument

00:29:15.742 --> 00:29:16.763
on the assessment side,

00:29:16.784 --> 00:29:17.564
the evaluation side.

00:29:17.604 --> 00:29:18.003
I get that.

00:29:18.023 --> 00:29:18.625
And then on, you know,

00:29:18.644 --> 00:29:19.765
the tenth visit or whatever

00:29:19.805 --> 00:29:20.605
the interval is,

00:29:21.625 --> 00:29:23.145
a reassessment and progress notes.

00:29:23.185 --> 00:29:24.247
I get that.

00:29:27.847 --> 00:29:29.009
Tony's going to pull that image up.

00:29:29.644 --> 00:29:32.425
So I just shared last night, Jimmy,

00:29:32.465 --> 00:29:34.307
if you want to look or I'm

00:29:34.326 --> 00:29:35.387
looking at it while I talk,

00:29:35.928 --> 00:29:37.307
I just shared last night a

00:29:37.367 --> 00:29:38.868
quote right out of Medicare

00:29:40.029 --> 00:29:41.369
that basically said, look,

00:29:41.670 --> 00:29:43.431
once you've evaluated and

00:29:43.451 --> 00:29:44.372
assessed the patient,

00:29:44.531 --> 00:29:45.932
once you've shown them what to do,

00:29:46.291 --> 00:29:47.613
therapeutic exercise is no

00:29:47.633 --> 00:29:48.752
longer a covered service.

00:29:48.993 --> 00:29:49.413
You're done.

00:29:50.114 --> 00:29:51.694
right here I know you guys

00:29:51.714 --> 00:29:52.655
can't see it but I'll just

00:29:52.715 --> 00:29:54.596
read it many therapeutic

00:29:54.656 --> 00:29:56.198
exercises may require the

00:29:56.278 --> 00:29:57.118
unique skills of a

00:29:57.159 --> 00:29:58.720
therapist to evaluate the

00:29:58.759 --> 00:30:00.840
patient design the program

00:30:01.319 --> 00:30:02.480
instruct the patient or

00:30:02.520 --> 00:30:03.520
caregiver in safe

00:30:03.560 --> 00:30:05.642
completion of the special technique.

00:30:06.021 --> 00:30:06.582
However,

00:30:07.082 --> 00:30:08.542
after the teaching has been

00:30:08.623 --> 00:30:09.903
successfully completed,

00:30:09.943 --> 00:30:12.204
repetition of the exercise and monitoring,

00:30:12.625 --> 00:30:13.144
it says,

00:30:13.765 --> 00:30:16.165
and monitoring for the completion

00:30:16.226 --> 00:30:17.787
of the task in the absence

00:30:17.886 --> 00:30:19.548
of additional skilled care,

00:30:19.688 --> 00:30:22.388
we'll talk about that, is not covered,

00:30:22.608 --> 00:30:22.969
period.

00:30:23.634 --> 00:30:24.756
So what do most of us do?

00:30:24.816 --> 00:30:25.556
The reality,

00:30:26.036 --> 00:30:27.676
most of us are billing inappropriately.

00:30:28.298 --> 00:30:29.679
I fully agree,

00:30:30.058 --> 00:30:31.220
most of us are billing

00:30:31.319 --> 00:30:32.640
inappropriately based on

00:30:32.701 --> 00:30:33.941
the published guidelines.

00:30:34.602 --> 00:30:36.462
I would also say the ones

00:30:36.502 --> 00:30:38.384
that make it appropriate,

00:30:38.523 --> 00:30:39.744
I'm showing air quotes again,

00:30:40.384 --> 00:30:41.326
I can sit there and

00:30:41.365 --> 00:30:42.866
helicopter around the patient.

00:30:42.906 --> 00:30:43.386
I can be like,

00:30:43.406 --> 00:30:44.268
you gotta do this and you

00:30:44.288 --> 00:30:45.107
gotta do that and let's

00:30:45.127 --> 00:30:45.907
talk about this and let's

00:30:45.929 --> 00:30:46.509
talk about that.

00:30:46.788 --> 00:30:48.450
the reality is the patient

00:30:48.471 --> 00:30:49.411
just needs to do the work.

00:30:49.872 --> 00:30:50.612
This is the bike.

00:30:50.833 --> 00:30:51.613
This is the pedal.

00:30:51.772 --> 00:30:53.394
This is how you make it go around.

00:30:53.775 --> 00:30:55.215
Now for the next six weeks,

00:30:55.656 --> 00:30:57.298
make the pedals go around

00:30:57.959 --> 00:31:00.221
faster for longer periods of time.

00:31:00.681 --> 00:31:02.142
You are going to get just as

00:31:02.201 --> 00:31:03.884
much benefit from getting

00:31:03.923 --> 00:31:05.204
the patient to do that

00:31:05.305 --> 00:31:06.806
without charging Medicare

00:31:07.227 --> 00:31:08.688
as you would from me

00:31:08.728 --> 00:31:09.388
sitting there and

00:31:09.409 --> 00:31:11.711
micromanaging every little nuance of it.

00:31:11.770 --> 00:31:11.891
Now,

00:31:12.191 --> 00:31:13.311
Does the patient enjoy it?

00:31:13.432 --> 00:31:13.653
No.

00:31:13.932 --> 00:31:14.993
Is the patient going to do it?

00:31:15.295 --> 00:31:15.535
No.

00:31:15.815 --> 00:31:17.416
But Medicare tells us also

00:31:17.497 --> 00:31:18.117
in the guidelines,

00:31:18.157 --> 00:31:19.199
they're not paying us to

00:31:19.239 --> 00:31:20.319
motivate the patient.

00:31:20.559 --> 00:31:21.662
They're not paying us to

00:31:21.701 --> 00:31:22.623
make it more exciting.

00:31:22.643 --> 00:31:23.604
They're not paying us to

00:31:23.624 --> 00:31:25.425
make it fun or make the patient do it.

00:31:25.746 --> 00:31:26.846
They're paying us to show

00:31:26.886 --> 00:31:27.929
the patient what to do

00:31:28.209 --> 00:31:29.509
based on the evaluation

00:31:29.529 --> 00:31:30.431
that we've completed.

00:31:31.251 --> 00:31:33.214
I just think that for decades,

00:31:33.255 --> 00:31:34.596
we've gone so far down the

00:31:34.656 --> 00:31:36.219
road of billing for

00:31:36.259 --> 00:31:37.621
services that aren't really

00:31:37.661 --> 00:31:38.782
covered by the policy.

00:31:39.262 --> 00:31:40.664
We can't even understand

00:31:40.925 --> 00:31:42.387
what the policy is supposed to be.

00:31:43.710 --> 00:31:44.290
I agree with that.

00:31:44.550 --> 00:31:45.393
We've talked about it before

00:31:45.692 --> 00:31:46.634
across the entire country.

00:31:46.673 --> 00:31:48.696
People are billing Medicare, therapists,

00:31:48.737 --> 00:31:49.498
practice owners billing

00:31:49.538 --> 00:31:52.080
Medicare when their goal is like,

00:31:52.121 --> 00:31:52.842
I want to be able to walk

00:31:52.862 --> 00:31:53.823
like a mile and it's

00:31:53.863 --> 00:31:54.903
already beyond medical

00:31:54.943 --> 00:31:56.465
necessity and clinics all

00:31:56.506 --> 00:31:57.867
over the country are billing Medicare.

00:31:58.148 --> 00:31:59.410
That's why there's all these cuts,

00:31:59.470 --> 00:31:59.911
by the way,

00:32:00.351 --> 00:32:01.271
because they know that there's

00:32:01.373 --> 00:32:02.153
overutilization.

00:32:03.153 --> 00:32:04.055
But in terms of the

00:32:04.115 --> 00:32:05.717
situation between in-person

00:32:05.978 --> 00:32:08.480
versus digital, are you telling me, Tony,

00:32:08.641 --> 00:32:09.602
let's say we got a million

00:32:09.662 --> 00:32:10.544
people that million

00:32:10.584 --> 00:32:11.825
patients that go to brick

00:32:11.845 --> 00:32:13.047
and mortar clinics across the country,

00:32:13.287 --> 00:32:13.948
one million people.

00:32:14.288 --> 00:32:15.229
Then we got another million

00:32:15.269 --> 00:32:16.790
people that do telehealth

00:32:16.892 --> 00:32:17.833
only where Julia,

00:32:18.513 --> 00:32:19.474
they don't even see them do

00:32:19.494 --> 00:32:20.016
the movements.

00:32:21.363 --> 00:32:22.784
Jimmy, which population gets better?

00:32:22.824 --> 00:32:24.065
Which population has better

00:32:24.125 --> 00:32:26.047
function at six weeks or

00:32:26.086 --> 00:32:26.867
six months or whatever?

00:32:26.928 --> 00:32:29.069
Which one gets results

00:32:29.109 --> 00:32:30.029
better in terms of getting

00:32:30.049 --> 00:32:31.111
back to their ADLs,

00:32:31.151 --> 00:32:32.772
their activities of daily living,

00:32:33.133 --> 00:32:34.213
sleeping better, moving better?

00:32:34.473 --> 00:32:35.434
Which one in your opinion do

00:32:35.454 --> 00:32:36.935
you think gets better faster?

00:32:37.096 --> 00:32:37.957
I'm going to stay in the middle.

00:32:37.977 --> 00:32:38.637
I'm going to say whichever

00:32:38.698 --> 00:32:39.698
one does it the most.

00:32:40.338 --> 00:32:42.401
whichever one does it.

00:32:42.441 --> 00:32:44.241
So Tony, which do you think is better?

00:32:44.301 --> 00:32:45.042
Is it the digital?

00:32:45.143 --> 00:32:46.002
Is it, is it equal?

00:32:46.443 --> 00:32:47.505
What I would say is whatever

00:32:47.585 --> 00:32:49.965
one does it the most, I think right now,

00:32:50.027 --> 00:32:52.067
because we're changing, we're changing,

00:32:52.387 --> 00:32:53.288
we're changing culture.

00:32:53.509 --> 00:32:54.529
I still think it's the one

00:32:54.569 --> 00:32:55.310
person right now.

00:32:56.009 --> 00:32:57.211
yes it is it's the one that

00:32:57.250 --> 00:32:58.532
has the most accountability

00:32:58.553 --> 00:32:59.292
the one that has the most

00:32:59.333 --> 00:33:00.054
accountability where

00:33:00.094 --> 00:33:01.194
someone has to put on their

00:33:01.234 --> 00:33:02.155
calendar I'm going to total

00:33:02.175 --> 00:33:04.458
therapy solutions and tony

00:33:04.499 --> 00:33:05.740
sometimes watches me

00:33:05.799 --> 00:33:06.780
sometimes he's making too

00:33:06.800 --> 00:33:08.603
many youtube videos and you

00:33:08.623 --> 00:33:09.363
know he's running around

00:33:09.383 --> 00:33:10.384
the clinic he's answering

00:33:10.403 --> 00:33:11.746
phones and all that that

00:33:11.786 --> 00:33:13.007
group will absolutely get

00:33:13.067 --> 00:33:15.509
better and medicare is like

00:33:15.549 --> 00:33:16.830
hey great because you know

00:33:16.851 --> 00:33:17.490
we're paying for these

00:33:17.731 --> 00:33:18.732
medicare beneficiaries

00:33:19.163 --> 00:33:21.306
You had me right to the last sentence.

00:33:22.067 --> 00:33:23.028
I totally agree.

00:33:23.107 --> 00:33:24.549
That group will get better.

00:33:24.569 --> 00:33:24.869
I agree.

00:33:24.910 --> 00:33:25.151
Right.

00:33:25.191 --> 00:33:26.291
That group will get better.

00:33:26.913 --> 00:33:29.394
How much better and how much faster?

00:33:29.496 --> 00:33:31.237
Those are, you know, to be discussed.

00:33:31.698 --> 00:33:32.878
But that is not what

00:33:32.939 --> 00:33:35.001
Medicare pays me to do, period.

00:33:35.501 --> 00:33:37.703
Medicare does not pay me to

00:33:37.824 --> 00:33:39.664
sit there and make you get better.

00:33:40.085 --> 00:33:41.346
I've got a patient who can't

00:33:41.365 --> 00:33:42.227
get up from a chair.

00:33:42.787 --> 00:33:43.988
I evaluate that patient.

00:33:44.028 --> 00:33:45.969
I make the determination that, yes,

00:33:46.849 --> 00:33:47.849
with the appropriate

00:33:47.971 --> 00:33:50.832
exercise dosing and exercise selection,

00:33:51.313 --> 00:33:52.874
they can get out of a chair.

00:33:53.394 --> 00:33:55.255
Medicare pays me to evaluate them,

00:33:55.655 --> 00:33:56.816
to make the determination

00:33:56.855 --> 00:33:58.217
that this is what they need

00:33:58.257 --> 00:33:59.959
to do and show them what to do.

00:34:00.038 --> 00:34:02.160
Medicare does not pay me to

00:34:02.259 --> 00:34:04.240
get them to get out of the chair,

00:34:04.280 --> 00:34:05.402
to work with them until

00:34:05.442 --> 00:34:06.522
they're capable of getting

00:34:06.563 --> 00:34:07.182
out of the chair.

00:34:07.624 --> 00:34:10.065
It's only to evaluate, to prescribe,

00:34:10.105 --> 00:34:11.306
to show them what to do.

00:34:11.746 --> 00:34:13.347
If I determine they don't have the,

00:34:13.527 --> 00:34:15.489
now this is in the Medicare literature.

00:34:15.548 --> 00:34:16.550
If I determine they don't

00:34:16.590 --> 00:34:18.411
have the cognitive ability

00:34:18.431 --> 00:34:20.291
to understand how to do

00:34:20.331 --> 00:34:21.152
what needs to be done,

00:34:21.652 --> 00:34:22.954
They're finished, they're discharged.

00:34:23.135 --> 00:34:24.436
I am not treating them

00:34:24.496 --> 00:34:25.597
anymore because Medicare

00:34:25.617 --> 00:34:27.418
says it is no longer a covered benefit.

00:34:28.000 --> 00:34:29.822
Just because I realize that

00:34:29.862 --> 00:34:31.384
they cannot do it on their

00:34:31.463 --> 00:34:32.224
own and they don't have

00:34:32.264 --> 00:34:33.826
people around to help them do it,

00:34:34.427 --> 00:34:34.987
we're finished.

00:34:35.367 --> 00:34:36.469
So yeah, that'll get better.

00:34:37.210 --> 00:34:38.472
But that's not what Medicare

00:34:38.492 --> 00:34:39.211
is paying me to do.

00:34:39.291 --> 00:34:41.315
If they pay me like your situation,

00:34:41.355 --> 00:34:43.476
then absolutely, man, all day long,

00:34:43.516 --> 00:34:44.257
five days a week,

00:34:44.297 --> 00:34:46.079
like let's make people healthy.

00:34:46.541 --> 00:34:48.081
I want to go down that road,

00:34:48.422 --> 00:34:50.025
but I'm in a third party payer system.

00:34:50.105 --> 00:34:50.925
I'm going to do what the

00:34:50.965 --> 00:34:52.126
payer is telling me to do.

00:34:53.961 --> 00:34:54.242
Okay.

00:34:55.043 --> 00:34:57.045
I was talking way less about

00:34:57.125 --> 00:34:58.186
the payer and Medicare.

00:34:58.326 --> 00:34:59.907
I'm talking about in-person

00:34:59.947 --> 00:35:00.827
versus digital.

00:35:00.867 --> 00:35:01.909
I'm talking about my

00:35:01.929 --> 00:35:02.889
practice and your practice

00:35:02.909 --> 00:35:04.731
versus Sword Health and digital.

00:35:05.731 --> 00:35:06.753
I don't really care what

00:35:06.793 --> 00:35:07.693
Medicare talks about

00:35:08.215 --> 00:35:09.135
because we don't take it.

00:35:09.295 --> 00:35:10.155
I don't even have to know it.

00:35:10.657 --> 00:35:12.137
Thank goodness you post these things.

00:35:12.157 --> 00:35:12.958
I don't even look at them,

00:35:13.039 --> 00:35:13.719
the Medicare posts,

00:35:13.739 --> 00:35:14.260
because I don't even have

00:35:14.280 --> 00:35:14.800
to worry about it.

00:35:15.581 --> 00:35:16.983
and yes I've said we agree

00:35:17.003 --> 00:35:18.684
that everyone over bills

00:35:18.704 --> 00:35:20.005
medicare because people

00:35:20.045 --> 00:35:21.188
walk in and they're able to

00:35:21.327 --> 00:35:22.168
you know play weekend

00:35:22.228 --> 00:35:23.550
softball and they they have

00:35:23.610 --> 00:35:25.112
you know they they then

00:35:25.132 --> 00:35:25.833
they you build their

00:35:25.873 --> 00:35:27.134
medicare you meaning the

00:35:27.213 --> 00:35:28.135
clinics across the country

00:35:28.795 --> 00:35:29.797
um I'm talking about

00:35:30.518 --> 00:35:31.179
in person,

00:35:31.719 --> 00:35:32.960
either in an office like yours

00:35:33.021 --> 00:35:33.822
or home visit like us.

00:35:33.842 --> 00:35:34.862
I'm talking about in person

00:35:34.902 --> 00:35:35.884
versus sword health,

00:35:35.963 --> 00:35:37.304
in person versus digital.

00:35:37.585 --> 00:35:38.487
That's what I was talking about.

00:35:38.547 --> 00:35:39.947
You take a million people

00:35:39.987 --> 00:35:41.449
that do in person physical

00:35:41.489 --> 00:35:42.731
therapy in some form or fashion.

00:35:42.751 --> 00:35:43.492
You take another million

00:35:43.532 --> 00:35:44.753
people that do digital,

00:35:44.773 --> 00:35:46.434
they do hinge health, they do sword.

00:35:46.675 --> 00:35:47.896
They're doing movements with

00:35:47.936 --> 00:35:49.639
sensors and it's not even

00:35:50.059 --> 00:35:50.920
reading it properly.

00:35:52.762 --> 00:35:54.103
they're doing movements and

00:35:54.143 --> 00:35:54.583
then they're just,

00:35:54.663 --> 00:35:55.824
they're logging in like

00:35:55.844 --> 00:35:56.804
what they did or whatever.

00:35:56.885 --> 00:35:57.724
And this therapist is

00:35:57.764 --> 00:35:59.246
tracking five hundred members.

00:35:59.565 --> 00:36:01.947
There is no comparison which

00:36:01.987 --> 00:36:02.789
group gets better.

00:36:03.768 --> 00:36:04.530
It's in person.

00:36:04.550 --> 00:36:06.150
And listen, by the way,

00:36:06.210 --> 00:36:07.452
you guys know me very well.

00:36:08.291 --> 00:36:09.632
if digital was better if

00:36:09.652 --> 00:36:10.813
that was more profitable if

00:36:10.853 --> 00:36:11.773
it got better outcomes all

00:36:11.813 --> 00:36:12.775
that I would be in that

00:36:12.815 --> 00:36:15.016
business okay you know this

00:36:15.056 --> 00:36:17.739
now here's my take is as

00:36:17.818 --> 00:36:19.019
soon as this came on and I

00:36:19.079 --> 00:36:20.061
feel like the hinges and

00:36:20.121 --> 00:36:22.302
swords I I don't have their

00:36:22.342 --> 00:36:23.543
wikipedia page up in their

00:36:23.583 --> 00:36:25.105
history but this is within

00:36:25.164 --> 00:36:26.266
a year and a half right I'm

00:36:26.286 --> 00:36:27.067
not saying the companies

00:36:27.106 --> 00:36:28.588
aren't older to get to this point

00:36:29.469 --> 00:36:31.130
And Tony, I think you had even said,

00:36:32.271 --> 00:36:34.353
this is the first shot across the bow.

00:36:34.373 --> 00:36:35.653
There's no way this is going

00:36:35.673 --> 00:36:37.355
to be the way three years

00:36:37.375 --> 00:36:38.916
from now or five years from now.

00:36:39.992 --> 00:36:40.811
will be like every other

00:36:41.032 --> 00:36:41.932
every other thing this is

00:36:41.972 --> 00:36:42.873
where I get to sound like a

00:36:42.972 --> 00:36:44.594
genius just because this is

00:36:44.634 --> 00:36:45.974
why we study history it's

00:36:46.034 --> 00:36:47.615
not going to be sword or

00:36:47.655 --> 00:36:48.936
that delivery and it's not

00:36:48.956 --> 00:36:50.157
going to be fully in person

00:36:50.197 --> 00:36:51.137
though there will be

00:36:51.257 --> 00:36:53.237
elements of both and it'll

00:36:53.257 --> 00:36:54.679
be what the customer is

00:36:54.719 --> 00:36:55.998
demanding what the payer is

00:36:56.039 --> 00:36:57.179
willing to pay and what we

00:36:57.219 --> 00:36:58.300
can prove works it'll be

00:36:58.320 --> 00:37:00.181
this this amalgamation of

00:37:00.221 --> 00:37:01.202
all these different things

00:37:01.836 --> 00:37:02.356
I mean, look,

00:37:02.737 --> 00:37:04.599
now I passed that generation.

00:37:05.179 --> 00:37:06.820
I am not in this world,

00:37:06.860 --> 00:37:08.981
but my understanding is a

00:37:09.021 --> 00:37:10.182
lot of people are meeting

00:37:10.443 --> 00:37:12.543
wives and husbands and, you know,

00:37:13.184 --> 00:37:14.164
on social media,

00:37:14.224 --> 00:37:15.425
they're meeting through apps,

00:37:15.445 --> 00:37:16.706
they're meeting through all

00:37:16.766 --> 00:37:18.148
of these matchmaking

00:37:18.527 --> 00:37:19.708
electronic platforms.

00:37:20.342 --> 00:37:22.623
Yes, there's still an in-person component.

00:37:22.643 --> 00:37:23.244
Yeah.

00:37:23.264 --> 00:37:24.827
But the idea is if you would

00:37:24.847 --> 00:37:25.867
have come to us thirty

00:37:25.887 --> 00:37:27.889
years ago and you would have been like,

00:37:27.969 --> 00:37:28.349
look,

00:37:28.431 --> 00:37:29.851
you're going to find your wife or

00:37:29.911 --> 00:37:31.273
husband through an app.

00:37:31.673 --> 00:37:32.934
People would have been shocked.

00:37:32.954 --> 00:37:34.056
I would have said no way.

00:37:34.137 --> 00:37:35.237
Never in a million years.

00:37:35.697 --> 00:37:36.117
Here's the thing.

00:37:36.137 --> 00:37:36.818
In the beginning,

00:37:38.139 --> 00:37:39.759
this was a thing so built

00:37:39.798 --> 00:37:41.159
into culture in movies and

00:37:41.199 --> 00:37:43.240
TV shows where the husband

00:37:43.260 --> 00:37:44.380
and wife are meeting the

00:37:44.420 --> 00:37:45.420
friends or the parents for

00:37:45.440 --> 00:37:46.641
the first time at Christmas.

00:37:46.681 --> 00:37:48.202
And they'd go like, hey,

00:37:48.681 --> 00:37:49.983
how we met is going to come up.

00:37:50.282 --> 00:37:50.762
We met.

00:37:50.922 --> 00:37:52.003
Let's get our story straight.

00:37:52.023 --> 00:37:52.983
Because everybody was so

00:37:53.023 --> 00:37:55.565
embarrassed of meeting online.

00:37:55.905 --> 00:37:58.766
And now it's like, dude, swipe right is...

00:37:59.806 --> 00:38:00.686
is, is ubiquitous.

00:38:00.726 --> 00:38:01.686
Like it's everywhere, right?

00:38:01.706 --> 00:38:02.907
Swipe right means I like you.

00:38:02.947 --> 00:38:03.528
It's like, Oh, that's,

00:38:03.628 --> 00:38:04.528
that's totally normal.

00:38:04.588 --> 00:38:06.550
So I think there's pendulums.

00:38:07.090 --> 00:38:08.371
It's not a pinwheel though.

00:38:08.552 --> 00:38:09.231
It's a pendulum.

00:38:09.592 --> 00:38:10.773
It goes from everything's in

00:38:10.833 --> 00:38:11.994
person to like all met.

00:38:12.034 --> 00:38:13.155
This digital thing is here.

00:38:13.175 --> 00:38:14.074
It's going to take over.

00:38:14.414 --> 00:38:15.056
I'm like, it's new.

00:38:15.115 --> 00:38:16.195
It's shiny right now.

00:38:16.777 --> 00:38:17.217
It's going to be,

00:38:17.257 --> 00:38:18.338
it's going to pendulum back

00:38:18.358 --> 00:38:18.978
the other way.

00:38:19.579 --> 00:38:20.478
I'm looking at this now.

00:38:20.539 --> 00:38:21.239
Let's take this like,

00:38:22.039 --> 00:38:22.760
in a different direction.

00:38:23.061 --> 00:38:24.280
I work with other organizations,

00:38:24.380 --> 00:38:26.541
APTA organizations, the AMs of the world.

00:38:27.302 --> 00:38:28.463
I'm looking at twenty twenty

00:38:28.483 --> 00:38:29.423
to twenty twenty five.

00:38:29.583 --> 00:38:30.623
And here's the pendulum I

00:38:30.664 --> 00:38:31.704
see to give you an example.

00:38:32.465 --> 00:38:33.626
Everything was a virtual

00:38:33.666 --> 00:38:35.286
conference in twenty twenty

00:38:35.527 --> 00:38:37.027
twenty twenty one twenty twenty two.

00:38:37.407 --> 00:38:37.628
Right.

00:38:37.947 --> 00:38:39.068
Everything went digital.

00:38:39.188 --> 00:38:40.248
Everything was an online.

00:38:40.389 --> 00:38:42.130
Everything courses the whole nine.

00:38:43.090 --> 00:38:45.012
I'm predicting and where I'd like to skate,

00:38:45.052 --> 00:38:46.371
maybe we could do something together.

00:38:47.072 --> 00:38:48.452
I say if you start offering

00:38:48.492 --> 00:38:51.255
people in person experiences,

00:38:52.260 --> 00:38:52.862
There's a couple

00:38:52.922 --> 00:38:54.364
organizations that do this well.

00:38:55.105 --> 00:38:56.967
Jet Set Rehab, I think, is one of them.

00:38:57.427 --> 00:38:57.889
They're like, hey,

00:38:57.909 --> 00:38:59.271
you want to learn shoulder

00:38:59.311 --> 00:39:00.492
from this shoulder expert?

00:39:00.572 --> 00:39:00.813
Great.

00:39:00.833 --> 00:39:01.733
We're going to Aruba,

00:39:02.534 --> 00:39:03.737
and we're going to do seven

00:39:03.757 --> 00:39:04.458
days in Aruba.

00:39:04.498 --> 00:39:05.438
The course is three days,

00:39:05.478 --> 00:39:06.460
which means you got four.

00:39:06.840 --> 00:39:08.483
So you're getting to use Con Ed money.

00:39:08.643 --> 00:39:08.784
Oh.

00:39:09.204 --> 00:39:10.864
to fly to Aruba to do the Con Ed,

00:39:10.885 --> 00:39:11.746
like a portion of it.

00:39:12.166 --> 00:39:13.346
So what I'm getting at is I

00:39:13.385 --> 00:39:14.847
think the pendulum swings back.

00:39:14.867 --> 00:39:16.549
You don't need to be an –

00:39:15.768 --> 00:39:16.208
you don't need to be a

00:39:16.228 --> 00:39:17.909
genius to figure this out.

00:39:18.248 --> 00:39:19.869
If everything swung towards

00:39:19.909 --> 00:39:21.351
digital and people are sort

00:39:21.391 --> 00:39:22.090
of getting like – it's like

00:39:22.110 --> 00:39:22.931
they're just eating too

00:39:22.952 --> 00:39:23.871
much vanilla ice cream,

00:39:24.152 --> 00:39:24.693
they're going to want

00:39:25.112 --> 00:39:26.134
chocolate and chocolate's

00:39:26.153 --> 00:39:27.153
in the other direction.

00:39:27.193 --> 00:39:28.715
So if it's digital, digital, digital,

00:39:29.255 --> 00:39:30.096
it'll swing back.

00:39:30.115 --> 00:39:32.577
But the answer is definitely a mix,

00:39:32.777 --> 00:39:33.637
something in the middle.

00:39:34.077 --> 00:39:35.278
Did –

00:39:35.398 --> 00:39:37.021
Maybe.

00:39:37.041 --> 00:39:37.942
Tony proved my point.

00:39:37.981 --> 00:39:40.224
The whole social media,

00:39:40.505 --> 00:39:41.646
two people get connected.

00:39:41.927 --> 00:39:44.510
They're in some Facebook

00:39:44.530 --> 00:39:45.052
group or whatever.

00:39:45.072 --> 00:39:46.193
They get connected digitally.

00:39:47.047 --> 00:39:48.369
They start talking digitally,

00:39:48.469 --> 00:39:49.809
texting on the platform.

00:39:49.829 --> 00:39:50.570
They start texting or

00:39:50.630 --> 00:39:52.130
emailing off the platform,

00:39:52.150 --> 00:39:52.891
but still digitally.

00:39:53.431 --> 00:39:54.833
But then it moves to in-person.

00:39:54.913 --> 00:39:56.273
And the only way for that

00:39:56.333 --> 00:39:58.295
whole arrangement to then

00:39:58.335 --> 00:40:00.157
get closer is to do the in-person,

00:40:00.217 --> 00:40:01.538
like Jimmy said, in-person experiences.

00:40:01.557 --> 00:40:03.239
You go on dates, you go to the movies,

00:40:03.259 --> 00:40:05.039
you get popcorn, you go walk on the beach,

00:40:05.079 --> 00:40:06.900
you do all the things in person.

00:40:07.382 --> 00:40:08.882
That proves my point.

00:40:08.963 --> 00:40:09.963
Yes, I agree, Jimmy.

00:40:09.983 --> 00:40:11.483
There might be a compromise

00:40:11.503 --> 00:40:14.186
in the middle where in three, four, five,

00:40:14.206 --> 00:40:14.786
whatever years,

00:40:15.266 --> 00:40:16.547
maybe there's some digital stuff.

00:40:17.108 --> 00:40:18.248
there's some in-person stuff

00:40:18.588 --> 00:40:20.509
but there's absolutely no

00:40:20.608 --> 00:40:23.028
way that it'll be full one

00:40:23.068 --> 00:40:25.309
hundred percent telehealth

00:40:25.349 --> 00:40:26.909
virtual care for physical

00:40:26.949 --> 00:40:28.329
therapy tony said it also

00:40:28.349 --> 00:40:29.369
before on the platform on

00:40:29.389 --> 00:40:30.951
the show telehealth is

00:40:30.971 --> 00:40:32.391
great for like triaging and

00:40:32.451 --> 00:40:33.570
you know communication and

00:40:33.610 --> 00:40:35.811
coaching and potentially

00:40:35.952 --> 00:40:38.291
early diagnosing and using

00:40:38.311 --> 00:40:39.072
the physical therapist's

00:40:39.112 --> 00:40:41.072
brain but then also some of

00:40:41.092 --> 00:40:41.853
the treatment needs to get

00:40:41.893 --> 00:40:43.273
done in person and the

00:40:43.313 --> 00:40:44.474
accountability and the in

00:40:44.494 --> 00:40:46.333
the in-person assessment so

00:40:47.898 --> 00:40:49.159
I would say it's a little

00:40:49.199 --> 00:40:50.440
less about a pendulum, though.

00:40:50.539 --> 00:40:52.500
I think it's maybe some virtual,

00:40:52.519 --> 00:40:53.500
maybe some in-person,

00:40:53.539 --> 00:40:55.360
but there's no way these

00:40:55.400 --> 00:40:56.021
companies are going to be

00:40:56.041 --> 00:40:56.800
around in ten years.

00:40:57.280 --> 00:40:59.181
See, you agree with me.

00:40:59.202 --> 00:41:02.782
See, you agree with me.

00:41:02.862 --> 00:41:02.961
No,

00:41:03.061 --> 00:41:05.523
I agree with your premise of two people

00:41:05.583 --> 00:41:06.762
find each other on social media.

00:41:06.802 --> 00:41:07.623
They start talking.

00:41:08.623 --> 00:41:08.864
Tony,

00:41:08.884 --> 00:41:10.164
did they ever end up married with

00:41:10.204 --> 00:41:11.583
kids without ever meeting in person?

00:41:12.324 --> 00:41:13.105
No, it's impossible.

00:41:13.125 --> 00:41:13.364
I don't know.

00:41:13.644 --> 00:41:14.065
Very difficult.

00:41:14.085 --> 00:41:14.385
I don't know.

00:41:16.369 --> 00:41:16.550
All right.

00:41:16.610 --> 00:41:17.630
The bariatric PT,

00:41:17.650 --> 00:41:18.771
which I don't know who you are.

00:41:18.972 --> 00:41:20.632
Let me know who you are.

00:41:20.693 --> 00:41:21.934
That's Christine Corgine.

00:41:21.954 --> 00:41:23.375
Oh, okay.

00:41:23.956 --> 00:41:24.755
She took my advice.

00:41:25.016 --> 00:41:25.757
I threatened her.

00:41:25.797 --> 00:41:26.737
I think I talked about this

00:41:26.757 --> 00:41:29.280
offline and I said,

00:41:29.679 --> 00:41:30.340
what do you want to do?

00:41:30.420 --> 00:41:31.942
And she's like, I think her name was like,

00:41:32.282 --> 00:41:33.704
PT in your pocket or something.

00:41:33.744 --> 00:41:34.164
And I was like,

00:41:34.204 --> 00:41:34.905
but what do you want to be?

00:41:34.945 --> 00:41:36.206
And she said the bariatric PT.

00:41:36.507 --> 00:41:38.090
So I pulled a Tony move and

00:41:38.130 --> 00:41:39.672
I went to like Squarespace

00:41:39.692 --> 00:41:41.554
and looked up the bariatric PT.com.

00:41:41.614 --> 00:41:41.934
And I said,

00:41:42.215 --> 00:41:44.097
I'm buying the bariatric PT.com

00:41:44.137 --> 00:41:45.139
domain name for fourteen

00:41:45.179 --> 00:41:46.440
dollars in twenty four

00:41:46.481 --> 00:41:47.541
hours and I'll sell it to

00:41:47.561 --> 00:41:48.302
you for a thousand.

00:41:48.344 --> 00:41:49.324
So it looks like she went and bought it.

00:41:49.525 --> 00:41:50.025
So good on you.

00:41:50.385 --> 00:41:51.925
I remember now, but I forgot.

00:41:52.025 --> 00:41:53.746
I love the bariatric PT.

00:41:53.865 --> 00:41:54.005
I mean,

00:41:54.025 --> 00:41:55.726
we need a better logo about that

00:41:55.766 --> 00:41:57.146
tonight in my marketing course,

00:41:57.186 --> 00:41:59.126
because hold on, hold on.

00:41:59.146 --> 00:42:00.547
We need a better logo, Christine.

00:42:00.568 --> 00:42:02.688
Here's why it's so small on the screen.

00:42:02.728 --> 00:42:03.527
Look at that thumbnail.

00:42:03.827 --> 00:42:04.867
I want it bigger.

00:42:05.469 --> 00:42:05.929
I want it.

00:42:06.309 --> 00:42:08.728
I want less there and bigger in your face,

00:42:08.748 --> 00:42:09.610
but here's her question.

00:42:09.730 --> 00:42:11.170
Barry, she's asking what Tony?

00:42:12.407 --> 00:42:14.128
If I missed it,

00:42:14.148 --> 00:42:15.269
how is she billing for

00:42:15.329 --> 00:42:17.152
services through SWORD?

00:42:17.731 --> 00:42:18.934
I would imagine it's just

00:42:18.994 --> 00:42:20.715
like an employer funded, you know,

00:42:20.795 --> 00:42:22.918
these employers are self

00:42:22.938 --> 00:42:24.699
funding their health care stuff.

00:42:25.099 --> 00:42:26.621
So the employer is just paying for it.

00:42:26.722 --> 00:42:27.123
I don't know.

00:42:27.483 --> 00:42:28.704
What are your thoughts?

00:42:28.804 --> 00:42:29.445
So, yeah, I mean,

00:42:29.925 --> 00:42:31.146
probably bill billing their

00:42:31.186 --> 00:42:31.887
plans that wouldn't they

00:42:31.907 --> 00:42:33.327
still have to build the network plans?

00:42:33.347 --> 00:42:34.809
Just like if it was in an

00:42:34.869 --> 00:42:36.010
outpatient physical therapy office,

00:42:36.030 --> 00:42:37.050
how would that be any different?

00:42:38.751 --> 00:42:39.192
I thought they were

00:42:39.251 --> 00:42:40.293
advertising these or

00:42:40.353 --> 00:42:41.434
promote someone correct us

00:42:41.474 --> 00:42:42.074
or someone give us,

00:42:42.155 --> 00:42:43.034
maybe Julia still watching.

00:42:43.135 --> 00:42:43.356
It was,

00:42:43.456 --> 00:42:44.456
I thought it was like an added

00:42:44.496 --> 00:42:46.338
benefit for these

00:42:46.378 --> 00:42:48.280
self-funded plans where it was like, Hey,

00:42:48.320 --> 00:42:49.019
we offered it.

00:42:49.119 --> 00:42:50.221
It reduces costs.

00:42:50.260 --> 00:42:51.302
And the, and again,

00:42:51.621 --> 00:42:52.663
now you have a Julia hold

00:42:52.742 --> 00:42:53.923
handling like five, six,

00:42:53.943 --> 00:42:55.125
seven hundred people and,

00:42:56.219 --> 00:42:57.199
There's that math game.

00:42:57.661 --> 00:42:58.360
Seth Peterson,

00:42:58.380 --> 00:42:59.541
if you guys know Seth Peterson,

00:42:59.942 --> 00:43:00.902
he's out in Arizona, I think.

00:43:01.501 --> 00:43:03.302
He won an award for this

00:43:03.322 --> 00:43:04.284
like innovative practice model.

00:43:04.304 --> 00:43:04.503
He's like,

00:43:04.523 --> 00:43:05.844
I just use telehealth for triage.

00:43:05.945 --> 00:43:07.485
Like I was saving people ER visits.

00:43:08.206 --> 00:43:08.646
But he's like,

00:43:09.025 --> 00:43:10.085
he's sitting in his brick

00:43:10.106 --> 00:43:11.266
and mortar clinic saying like,

00:43:11.706 --> 00:43:13.148
I still think this is the end game.

00:43:13.168 --> 00:43:13.947
But he's like, I was able to,

00:43:14.188 --> 00:43:15.548
we were able to processize

00:43:15.909 --> 00:43:17.110
this triage thing.

00:43:18.210 --> 00:43:19.771
Yeah, my understanding,

00:43:19.811 --> 00:43:20.731
and we have a couple of big

00:43:20.791 --> 00:43:21.871
local employers,

00:43:21.891 --> 00:43:23.572
they have self-funded health care.

00:43:23.693 --> 00:43:25.653
It's managed through like

00:43:25.793 --> 00:43:27.355
UnitedHealthcare or Anthem,

00:43:27.735 --> 00:43:29.356
but they are paying for all

00:43:29.416 --> 00:43:30.596
of it internally.

00:43:30.675 --> 00:43:32.536
And so they would hire or

00:43:32.617 --> 00:43:34.398
pay Sword or Hinge or any

00:43:34.438 --> 00:43:36.338
of these places to deliver

00:43:36.358 --> 00:43:38.000
this service because if it

00:43:38.039 --> 00:43:40.541
does reduce the, you know,

00:43:40.641 --> 00:43:42.681
workers going out to orthopedics,

00:43:43.061 --> 00:43:43.943
they're going to see that

00:43:43.983 --> 00:43:44.623
on the back end.

00:43:45.085 --> 00:43:47.286
Yeah, there's a nod to does it work?

00:43:47.306 --> 00:43:48.306
It's like these people hate

00:43:48.327 --> 00:43:49.748
spending money because it's their money.

00:43:49.768 --> 00:43:50.987
The less money they spend, they keep it.

00:43:51.347 --> 00:43:52.469
Julia is saying it's an

00:43:52.528 --> 00:43:53.389
added employee benefit.

00:43:53.588 --> 00:43:54.309
It's also early.

00:43:54.409 --> 00:43:55.929
Like who knows if it saves

00:43:55.969 --> 00:43:56.789
money like in ten years?

00:43:56.809 --> 00:43:57.650
I don't know.

00:43:57.670 --> 00:43:58.731
So, Julia, I'm curious.

00:43:59.271 --> 00:43:59.971
Is the company,

00:44:00.030 --> 00:44:01.431
are you guys billing via

00:44:01.532 --> 00:44:03.192
CPT codes or is it just like, hey,

00:44:03.251 --> 00:44:04.293
I completed like an

00:44:04.333 --> 00:44:06.452
interaction or I did an interaction with,

00:44:07.092 --> 00:44:09.994
you know, patient number five oh one?

00:44:10.394 --> 00:44:12.434
Like how does that work?

00:44:12.655 --> 00:44:13.456
She might not know the back

00:44:13.516 --> 00:44:14.076
end on the payments.

00:44:14.096 --> 00:44:14.416
I don't know.

00:44:14.795 --> 00:44:16.657
Or are they just getting paid per patient,

00:44:16.938 --> 00:44:17.838
whether they use it or not?

00:44:17.938 --> 00:44:19.880
Like, I want to be in that business model,

00:44:19.920 --> 00:44:20.181
right?

00:44:20.221 --> 00:44:21.442
Like, that's the insurance company.

00:44:21.722 --> 00:44:22.382
Hey, you pay me.

00:44:22.443 --> 00:44:24.284
And if you use it.

00:44:24.324 --> 00:44:24.965
Then, of course,

00:44:25.005 --> 00:44:27.126
we want a thousand of your patients.

00:44:27.387 --> 00:44:28.909
And we have one therapist to

00:44:29.128 --> 00:44:30.329
manage a thousand patients.

00:44:30.349 --> 00:44:31.751
Yeah, of course.

00:44:31.952 --> 00:44:32.211
Yeah.

00:44:33.409 --> 00:44:34.291
We were going to talk about

00:44:34.351 --> 00:44:34.971
something else.

00:44:35.911 --> 00:44:37.172
We had it on the agenda and

00:44:37.231 --> 00:44:38.152
I can't remember now.

00:44:38.293 --> 00:44:40.273
We need an assistant or an intern.

00:44:40.833 --> 00:44:41.414
Intern.

00:44:41.875 --> 00:44:43.576
Free volunteer intern.

00:44:43.596 --> 00:44:46.697
That's what we need.

00:44:46.737 --> 00:44:47.577
We need one intern for the

00:44:47.597 --> 00:44:48.699
next five hundred topics.

00:44:50.443 --> 00:44:51.264
No CPT codes.

00:44:51.643 --> 00:44:52.324
Oops, sorry, Jimmy.

00:44:52.364 --> 00:44:53.143
Go ahead.

00:44:53.184 --> 00:44:55.605
No CPT codes just based on how many times.

00:44:55.925 --> 00:44:58.166
So it is per episode.

00:44:58.186 --> 00:44:59.166
So how many times the

00:44:59.226 --> 00:45:01.347
patients were completing sessions.

00:45:01.827 --> 00:45:02.668
And then what's a session?

00:45:02.708 --> 00:45:04.429
Was a session like a – this

00:45:04.469 --> 00:45:05.289
is like perfect for the

00:45:05.329 --> 00:45:06.509
next generation because she was like,

00:45:06.568 --> 00:45:07.809
I was having chat conversation.

00:45:08.190 --> 00:45:10.490
Julia was doing PT in the DMs.

00:45:12.677 --> 00:45:13.498
So hold on, hold on.

00:45:13.518 --> 00:45:14.657
The company is going to pay

00:45:14.757 --> 00:45:16.338
Sword Health for more of

00:45:16.378 --> 00:45:17.199
the completed sessions.

00:45:17.219 --> 00:45:18.420
The completed sessions, she said,

00:45:18.460 --> 00:45:20.382
it could be something like ten squats.

00:45:20.621 --> 00:45:21.682
So now the more that the

00:45:22.362 --> 00:45:23.483
employee exercises,

00:45:23.523 --> 00:45:24.684
the more the company has to pay.

00:45:25.025 --> 00:45:26.746
The company's alignment in

00:45:26.826 --> 00:45:28.067
incentives are not aligned

00:45:28.106 --> 00:45:30.628
with the patient, the employee.

00:45:30.648 --> 00:45:31.650
Does that make sense or no?

00:45:32.349 --> 00:45:33.630
It depends on how deep you go,

00:45:33.690 --> 00:45:34.692
because the theory is,

00:45:34.731 --> 00:45:36.132
and this has always been my problem,

00:45:36.172 --> 00:45:38.793
like I hate worker like

00:45:38.873 --> 00:45:40.655
wellness programs and stuff like that,

00:45:40.695 --> 00:45:42.217
because like you said,

00:45:42.956 --> 00:45:44.577
If I'm the employer, I'm sitting here,

00:45:44.617 --> 00:45:46.699
I'm like, I'm wasting all this money.

00:45:46.818 --> 00:45:47.898
You have to be able to show

00:45:47.918 --> 00:45:48.579
on the back end.

00:45:48.679 --> 00:45:51.960
OK, the more the employee exercises,

00:45:52.021 --> 00:45:53.141
logs in, uses it,

00:45:53.501 --> 00:45:56.041
the lower my payments for

00:45:56.141 --> 00:45:58.463
surgeries and medication

00:45:58.523 --> 00:46:00.304
and imaging and all the other stuff.

00:46:01.445 --> 00:46:02.925
I treat an individual who

00:46:02.965 --> 00:46:04.027
manages benefits for a

00:46:04.086 --> 00:46:05.969
large local employer and

00:46:06.088 --> 00:46:07.349
she sees these numbers like

00:46:07.389 --> 00:46:09.070
she can tell me how many

00:46:09.130 --> 00:46:10.572
times their employees are

00:46:10.592 --> 00:46:11.273
getting surgeries,

00:46:11.293 --> 00:46:12.253
how many workers comp

00:46:12.293 --> 00:46:13.273
claims they're having,

00:46:13.375 --> 00:46:14.556
all of this kind of stuff.

00:46:15.255 --> 00:46:16.157
And they're big numbers.

00:46:16.563 --> 00:46:17.864
This is the crux of our profession,

00:46:17.885 --> 00:46:18.806
what Julie is saying.

00:46:18.865 --> 00:46:19.867
It's like the theory is if

00:46:19.927 --> 00:46:21.148
patients do more exercise,

00:46:21.168 --> 00:46:21.867
they prevent injuries.

00:46:22.429 --> 00:46:23.389
This is the thing on the

00:46:23.449 --> 00:46:24.751
intro to PT school,

00:46:24.771 --> 00:46:25.731
which is if you do what we

00:46:25.771 --> 00:46:28.153
say and what we know, we stop the doubt.

00:46:28.853 --> 00:46:30.315
This is ultimate upstream.

00:46:30.416 --> 00:46:31.056
So again,

00:46:31.155 --> 00:46:32.257
I don't think it's going to be everything,

00:46:32.297 --> 00:46:32.637
but right?

00:46:32.657 --> 00:46:33.197
Isn't that the idea?

00:46:33.217 --> 00:46:34.099
It's ultimate upstream.

00:46:34.699 --> 00:46:35.179
To me,

00:46:35.219 --> 00:46:36.920
what's so amazing about this is you

00:46:36.940 --> 00:46:38.380
have real objective data.

00:46:38.481 --> 00:46:40.041
At least you can see when

00:46:40.722 --> 00:46:42.543
the patient is logging in,

00:46:42.963 --> 00:46:43.983
when the patient is

00:46:44.023 --> 00:46:46.905
complying with the medical prescription.

00:46:47.846 --> 00:46:50.327
In my physical therapy clinic, guess what?

00:46:50.487 --> 00:46:51.487
I can prescribe the best

00:46:51.527 --> 00:46:53.128
home exercise program in the world.

00:46:53.588 --> 00:46:54.789
I have no tracking system.

00:46:54.889 --> 00:46:56.090
I have no way to know if the

00:46:56.150 --> 00:46:57.831
person's actually doing it or not.

00:46:58.311 --> 00:47:00.152
Where in Julia's case, like,

00:47:00.452 --> 00:47:02.074
There is some level of

00:47:02.134 --> 00:47:03.853
objective data coming back in and say,

00:47:03.873 --> 00:47:04.034
look,

00:47:04.094 --> 00:47:07.215
at least the person did log in and

00:47:07.275 --> 00:47:11.617
we tracked some sort of objective metric.

00:47:11.637 --> 00:47:12.797
Dave's getting a call from the president.

00:47:14.431 --> 00:47:17.393
plumber uh uh broken uh pipe

00:47:17.413 --> 00:47:18.333
that was rusted out and I

00:47:18.353 --> 00:47:19.014
wish there was like a

00:47:19.153 --> 00:47:20.375
telehealth like virtual

00:47:20.414 --> 00:47:21.335
service but you know they

00:47:21.355 --> 00:47:22.275
need to come in person it's

00:47:22.295 --> 00:47:23.036
just the way it is in the

00:47:23.056 --> 00:47:24.157
world that we live in oh

00:47:24.277 --> 00:47:25.378
how great it would be like

00:47:25.418 --> 00:47:26.619
to facetime with someone

00:47:26.639 --> 00:47:27.518
and be like let me see what

00:47:27.559 --> 00:47:28.639
I've got here what are we

00:47:28.679 --> 00:47:29.639
looking at I do that with

00:47:29.659 --> 00:47:31.362
my buddies all the time I

00:47:31.521 --> 00:47:32.081
walk them through my

00:47:32.121 --> 00:47:32.902
basement and go to what I

00:47:32.922 --> 00:47:33.882
need here what do we oh

00:47:33.902 --> 00:47:35.164
I'll make sure I bring that I bring the

00:47:35.423 --> 00:47:36.425
So again, I shared this,

00:47:36.585 --> 00:47:37.846
I shared this on the show.

00:47:38.686 --> 00:47:40.248
A neighbor of mine owns like

00:47:40.307 --> 00:47:42.329
a multimillion dollar plumbing company.

00:47:42.449 --> 00:47:44.271
He is not a plumber in any way.

00:47:44.692 --> 00:47:45.132
I was like,

00:47:45.192 --> 00:47:46.634
why don't you guys offer

00:47:46.693 --> 00:47:48.014
virtual consults?

00:47:48.675 --> 00:47:50.996
I can do enough plumbing to, you know,

00:47:51.797 --> 00:47:52.858
Fix basic things.

00:47:52.998 --> 00:47:54.599
I'm like, I would love to get a plumber.

00:47:54.920 --> 00:47:56.840
I'll pay sixty dollars for ten minutes.

00:47:57.302 --> 00:47:58.021
Look at this.

00:47:58.081 --> 00:47:59.222
Tell me what I need to do.

00:47:59.543 --> 00:48:00.364
Give me the tools.

00:48:00.643 --> 00:48:02.164
Give me the recommendations

00:48:02.224 --> 00:48:03.346
and then I will do it.

00:48:03.706 --> 00:48:05.226
I mean, that's exactly, you know,

00:48:05.286 --> 00:48:07.668
as a therapist, assess my shoulder.

00:48:07.969 --> 00:48:09.250
This is what you need to do.

00:48:09.630 --> 00:48:09.809
OK,

00:48:09.849 --> 00:48:11.391
now let's bring in the personal trainer.

00:48:11.451 --> 00:48:13.753
Let's bring in the aid to

00:48:13.893 --> 00:48:16.273
actually do the things with you.

00:48:16.514 --> 00:48:17.815
You don't need me to do the thing.

00:48:17.914 --> 00:48:18.916
You don't need me to lift

00:48:18.936 --> 00:48:19.637
the heavy object.

00:48:20.137 --> 00:48:21.518
Let's just get somebody else to do it.

00:48:24.019 --> 00:48:25.081
Jared, agreeing with you.

00:48:25.121 --> 00:48:26.123
Even if computer vision is

00:48:26.163 --> 00:48:27.143
not perfectly accurate for

00:48:27.184 --> 00:48:27.844
range of motion,

00:48:27.945 --> 00:48:29.246
which I'm going to be doing

00:48:29.266 --> 00:48:31.548
an episode with Holly.

00:48:32.329 --> 00:48:33.010
It looks like Haley.

00:48:34.110 --> 00:48:35.152
It's spelled H-A.

00:48:35.172 --> 00:48:36.233
She was commenting on some

00:48:36.253 --> 00:48:36.954
of your stuff yesterday.

00:48:36.974 --> 00:48:38.115
Oh, yeah.

00:48:38.155 --> 00:48:39.237
She's with ViFive.

00:48:40.583 --> 00:48:41.063
And it's like this,

00:48:41.304 --> 00:48:42.766
it creates a wireframe out

00:48:42.786 --> 00:48:43.746
of a human being and they

00:48:43.806 --> 00:48:44.568
measure like range of

00:48:44.608 --> 00:48:46.489
motion and movement and stuff like that.

00:48:46.530 --> 00:48:48.231
But even if computer vision

00:48:48.251 --> 00:48:49.132
is not perfectly accurate

00:48:49.152 --> 00:48:49.713
for range of motion,

00:48:49.733 --> 00:48:50.815
at least it serves as a rep

00:48:50.855 --> 00:48:52.777
counter and an accountability tool.

00:48:53.117 --> 00:48:54.778
Man, I thought Jared was on my side,

00:48:54.818 --> 00:48:58.043
but there's no sides here, guys.

00:48:58.282 --> 00:48:59.385
How is computer vision an

00:48:59.425 --> 00:49:00.226
accountability tool?

00:49:01.581 --> 00:49:02.262
Look,

00:49:02.302 --> 00:49:03.443
Scott did a FaceTime with a friend

00:49:03.463 --> 00:49:04.663
that diagnosed his AC.

00:49:04.882 --> 00:49:06.583
Is it AC joint or air conditioning?

00:49:06.603 --> 00:49:07.284
I'm going to guess it's air

00:49:07.324 --> 00:49:08.644
conditioning issue.

00:49:09.025 --> 00:49:11.105
But you know what?

00:49:11.266 --> 00:49:12.405
To Dave's point,

00:49:13.005 --> 00:49:15.706
I'm in my clinic right now.

00:49:15.766 --> 00:49:17.748
There's probably six people out there.

00:49:18.228 --> 00:49:19.407
They're not doing it virtually.

00:49:19.447 --> 00:49:20.568
They're doing it in person.

00:49:20.608 --> 00:49:21.469
They're telling jokes.

00:49:21.489 --> 00:49:22.208
They're cracking up.

00:49:22.248 --> 00:49:23.230
They're having a good time.

00:49:23.329 --> 00:49:24.610
I'm trying to mute myself so

00:49:24.630 --> 00:49:26.010
you guys don't hear all of it.

00:49:26.490 --> 00:49:27.952
But there is always going to

00:49:27.972 --> 00:49:29.072
be a place for in-person.

00:49:29.789 --> 00:49:30.990
Jared straddle sides.

00:49:31.592 --> 00:49:33.474
He is not a party affiliated.

00:49:33.534 --> 00:49:35.996
He is he is issue issue oriented.

00:49:37.157 --> 00:49:38.659
Haley will be on the show pretty soon.

00:49:39.159 --> 00:49:39.719
I encouraged her.

00:49:39.780 --> 00:49:40.760
I said to her, I was like, look,

00:49:40.780 --> 00:49:42.983
you have a wireframe app in Vi five.

00:49:43.423 --> 00:49:44.625
I jumped on for fifteen minutes.

00:49:44.644 --> 00:49:45.565
I was like, that was dope.

00:49:45.905 --> 00:49:46.286
I'm like,

00:49:46.347 --> 00:49:48.307
why aren't you have a very visual

00:49:48.349 --> 00:49:48.829
product?

00:49:49.048 --> 00:49:51.251
Why are not why can I not see the visuals?

00:49:52.204 --> 00:49:53.326
And it's the same thing.

00:49:53.365 --> 00:49:54.206
Like when I talk about stuff

00:49:54.226 --> 00:49:54.746
that I'm doing with

00:49:54.766 --> 00:49:55.766
Vestibular First with you

00:49:55.786 --> 00:49:56.987
guys on and off the show,

00:49:57.407 --> 00:49:57.867
you guys are like,

00:49:57.887 --> 00:49:58.708
how come you're not doing this?

00:49:58.728 --> 00:49:59.849
I'm like, yeah, we need to.

00:50:00.329 --> 00:50:01.730
And I'm like, yeah, okay.

00:50:02.190 --> 00:50:04.170
Like we sell infrared video goggles.

00:50:04.331 --> 00:50:04.590
I'm like,

00:50:04.891 --> 00:50:05.771
and this has been in the works

00:50:05.811 --> 00:50:06.452
too for a while.

00:50:06.552 --> 00:50:06.952
I just had,

00:50:07.373 --> 00:50:08.413
maybe I just convinced someone

00:50:08.452 --> 00:50:08.813
internally.

00:50:09.152 --> 00:50:11.173
I'm like, we need to be having, I want the,

00:50:11.755 --> 00:50:12.894
you know what night vision

00:50:12.934 --> 00:50:13.735
goggles look like?

00:50:13.775 --> 00:50:14.655
They have that sort of like

00:50:15.096 --> 00:50:15.797
black and white,

00:50:15.836 --> 00:50:17.518
maybe like a little greenish bluish tint.

00:50:17.858 --> 00:50:19.858
I'm like, we need five of those a week.

00:50:20.398 --> 00:50:22.320
If we're, we can't say we're that thing.

00:50:22.340 --> 00:50:23.340
We need to show that we're

00:50:23.360 --> 00:50:24.181
in show business.

00:50:24.501 --> 00:50:25.563
We need to show, show, show.

00:50:25.862 --> 00:50:27.103
And it also doesn't need to be perfect.

00:50:27.445 --> 00:50:28.465
I want to go back just in

00:50:28.505 --> 00:50:29.887
case anybody from my job

00:50:29.967 --> 00:50:31.148
was watching before I get

00:50:31.168 --> 00:50:31.768
work in a minute.

00:50:31.947 --> 00:50:32.588
Um,

00:50:32.608 --> 00:50:33.650
just in case anybody from vestibular

00:50:33.690 --> 00:50:34.230
versus watching,

00:50:34.250 --> 00:50:35.530
it's like we in show business, baby.

00:50:35.951 --> 00:50:36.791
And I don't want to tell

00:50:36.831 --> 00:50:37.833
people how great the product is.

00:50:37.873 --> 00:50:38.172
I want to,

00:50:38.293 --> 00:50:39.514
I want to punch them in the nose

00:50:39.534 --> 00:50:40.155
with it every day.

00:50:40.905 --> 00:50:42.885
I will say something that's interesting.

00:50:42.945 --> 00:50:44.806
I know Julia said that.

00:50:46.025 --> 00:50:48.586
I was listening to Peter Diamandis,

00:50:48.706 --> 00:50:49.666
I think is his name.

00:50:49.806 --> 00:50:51.108
He's got a YouTube channel,

00:50:51.128 --> 00:50:51.708
and he's always talking

00:50:51.748 --> 00:50:52.827
about futuristic stuff.

00:50:53.188 --> 00:50:54.489
This was like two years ago.

00:50:54.528 --> 00:50:55.648
This isn't anything recent.

00:50:55.668 --> 00:50:57.369
But he said even back then,

00:50:57.869 --> 00:50:59.090
they were at the point with

00:50:59.150 --> 00:51:03.831
VR in certain VC-funded programs.

00:51:04.431 --> 00:51:05.472
You could put on a glove.

00:51:06.211 --> 00:51:08.733
you could reach to something

00:51:08.773 --> 00:51:10.114
a physical object and the

00:51:10.153 --> 00:51:11.255
glove would give you the

00:51:11.315 --> 00:51:12.695
sensation of touching that

00:51:12.795 --> 00:51:14.496
physical object even though

00:51:14.516 --> 00:51:15.436
there is nothing actually

00:51:15.476 --> 00:51:17.518
there in space so I could

00:51:17.557 --> 00:51:19.579
see a world where dave is

00:51:19.599 --> 00:51:21.780
saying okay we've got now

00:51:21.800 --> 00:51:23.061
dave didn't say this but we

00:51:23.081 --> 00:51:24.081
know we've got declining

00:51:24.121 --> 00:51:25.922
population I want to do an

00:51:25.963 --> 00:51:27.103
episode where we talk about

00:51:27.222 --> 00:51:28.364
how we build a physical

00:51:28.384 --> 00:51:29.965
therapy business for the future

00:51:30.344 --> 00:51:31.425
where populations are

00:51:31.445 --> 00:51:32.606
declining I want to talk

00:51:32.626 --> 00:51:34.746
about that um but a world

00:51:34.766 --> 00:51:35.568
where there's somebody

00:51:35.628 --> 00:51:36.728
somewhere else in the world

00:51:36.869 --> 00:51:38.088
that has the technology on

00:51:38.128 --> 00:51:39.309
their end I have it on my

00:51:40.010 --> 00:51:40.971
end vr is to the point

00:51:40.990 --> 00:51:41.891
where it looks like you're

00:51:41.951 --> 00:51:43.012
sitting in the room next to

00:51:43.032 --> 00:51:44.132
me you're not pixelated

00:51:44.253 --> 00:51:45.293
you're not on latency

00:51:45.313 --> 00:51:46.934
delays and I can put on a

00:51:46.954 --> 00:51:48.335
glove and I could touch

00:51:48.355 --> 00:51:49.434
your shoulder I could rub

00:51:49.454 --> 00:51:50.596
your butt like we always

00:51:50.635 --> 00:51:52.637
say and I could feel it in

00:51:52.717 --> 00:51:54.418
my fingers at the same time

00:51:54.458 --> 00:51:56.059
that you feel it on your skin

00:51:56.579 --> 00:51:57.480
So even though we're a

00:51:57.519 --> 00:51:58.501
thousand miles apart,

00:51:58.681 --> 00:52:00.702
I think that world will exist.

00:52:01.003 --> 00:52:01.884
We're in the last ten

00:52:01.903 --> 00:52:02.684
minutes of the show and I'm

00:52:02.724 --> 00:52:04.025
debating whether or not I

00:52:04.085 --> 00:52:07.489
go R rated or stay PG rated with this.

00:52:08.369 --> 00:52:09.170
Screw it.

00:52:09.251 --> 00:52:10.512
Porn drives everything.

00:52:10.592 --> 00:52:12.353
You knew exactly where I was

00:52:12.393 --> 00:52:12.954
going with that.

00:52:12.994 --> 00:52:14.675
They are the innovators in

00:52:14.795 --> 00:52:16.257
all of this technology.

00:52:16.336 --> 00:52:18.057
There's no reason to cover it up.

00:52:18.159 --> 00:52:19.300
No kids are watching.

00:52:19.780 --> 00:52:21.101
They are leading the way in

00:52:21.141 --> 00:52:21.942
this kind of stuff.

00:52:22.447 --> 00:52:23.027
here's what I was going to

00:52:23.068 --> 00:52:24.367
say like you guys heard and

00:52:24.548 --> 00:52:25.489
some of the kids out there

00:52:25.509 --> 00:52:26.650
are not going to know what

00:52:26.750 --> 00:52:27.771
either of these platforms

00:52:27.851 --> 00:52:28.371
are but there was a

00:52:28.431 --> 00:52:29.132
different there was a

00:52:29.211 --> 00:52:30.813
choice that the that

00:52:30.913 --> 00:52:32.873
hollywood had to make in

00:52:32.914 --> 00:52:33.894
the I don't know seventies

00:52:33.914 --> 00:52:35.536
or eighties about vhs

00:52:35.556 --> 00:52:37.777
versus betamax and betamax

00:52:38.038 --> 00:52:38.838
I feel like I don't know

00:52:38.858 --> 00:52:39.798
what betamax is there's a

00:52:39.858 --> 00:52:41.139
reason for it it was a

00:52:41.239 --> 00:52:42.740
superior technology it had

00:52:42.840 --> 00:52:44.262
better I don't know visual

00:52:44.302 --> 00:52:45.222
better audio whatever when

00:52:45.242 --> 00:52:46.983
you had movies at home but

00:52:47.003 --> 00:52:48.465
the reason we went vhs is

00:52:49.045 --> 00:52:50.286
Somebody dropped off bags of

00:52:50.326 --> 00:52:51.646
money at adult movie

00:52:51.847 --> 00:52:52.768
facilities and they were like,

00:52:53.027 --> 00:52:53.768
we're going to go in this

00:52:53.789 --> 00:52:56.050
direction and we're that direction,

00:52:56.090 --> 00:52:57.391
the most human connection

00:52:57.711 --> 00:52:59.813
business or lack of human

00:52:59.952 --> 00:53:00.653
connection business.

00:53:00.934 --> 00:53:01.695
But my point is,

00:53:01.715 --> 00:53:02.996
and you knew exactly where I was going,

00:53:03.036 --> 00:53:04.096
so maybe I'm maybe I'm not

00:53:04.135 --> 00:53:05.137
as innovative as I thought.

00:53:06.257 --> 00:53:07.318
If it shows up there,

00:53:08.018 --> 00:53:09.179
it'll show up in PT clinics

00:53:09.219 --> 00:53:10.001
a year and a half later.

00:53:10.340 --> 00:53:11.202
Hasn't shown up there.

00:53:11.262 --> 00:53:11.422
I mean,

00:53:11.442 --> 00:53:12.483
I haven't done a ton of research on

00:53:13.583 --> 00:53:16.005
haptics and adult alone time.

00:53:16.545 --> 00:53:17.766
My guess is it's coming.

00:53:18.652 --> 00:53:21.898
In more ways than one.

00:53:22.539 --> 00:53:23.099
Tony left.

00:53:23.119 --> 00:53:23.760
He's like, I'm out.

00:53:23.780 --> 00:53:24.481
I'm out.

00:53:24.541 --> 00:53:25.302
I'm out.

00:53:29.150 --> 00:53:29.849
All right.

00:53:29.869 --> 00:53:30.510
For the record,

00:53:30.590 --> 00:53:34.092
my family did have a beta version of VCR.

00:53:34.172 --> 00:53:36.614
It was beta before we went to VHS.

00:53:37.855 --> 00:53:39.476
I think we also had an eight

00:53:39.496 --> 00:53:40.657
track cassette player.

00:53:40.737 --> 00:53:42.217
We had a CB radio.

00:53:42.318 --> 00:53:43.278
Like there were so many

00:53:43.318 --> 00:53:44.500
things back in the day.

00:53:44.960 --> 00:53:46.440
I love seeing those Facebook

00:53:46.481 --> 00:53:48.041
memes and pictures of like

00:53:48.322 --> 00:53:51.543
kids toys that I actually had, like the,

00:53:51.603 --> 00:53:53.644
the roll of caps and it says,

00:53:53.664 --> 00:53:55.005
you can smell this photo,

00:53:55.907 --> 00:53:56.626
all of that stuff.

00:53:56.766 --> 00:53:57.907
Like I love all of that stuff.

00:53:58.320 --> 00:53:59.420
I saw a great post.

00:53:59.561 --> 00:54:00.862
This will tie in with what we do.

00:54:01.302 --> 00:54:02.744
Someone literally, someone shared,

00:54:03.324 --> 00:54:05.527
there should be some sort

00:54:05.547 --> 00:54:08.190
of technology where we could listen.

00:54:08.230 --> 00:54:09.090
We could all listen to a

00:54:09.150 --> 00:54:11.052
podcast at the same time if

00:54:11.092 --> 00:54:12.094
there's breaking news.

00:54:12.114 --> 00:54:13.815
And someone below is like, radio,

00:54:13.875 --> 00:54:15.137
you just invented radio.

00:54:15.157 --> 00:54:17.458
Everything's a pendulum, people.

00:54:17.918 --> 00:54:19.420
That's live streaming, right?

00:54:19.501 --> 00:54:20.461
Same stuff, different day.

00:54:22.653 --> 00:54:23.375
all right we don't have

00:54:23.394 --> 00:54:23.815
enough time to start

00:54:23.835 --> 00:54:25.157
another topic we'll get our

00:54:25.257 --> 00:54:27.380
intern uh just email one of

00:54:27.420 --> 00:54:28.141
us if you want to be our

00:54:28.201 --> 00:54:28.902
intern send your

00:54:28.942 --> 00:54:30.483
applications and that job

00:54:30.543 --> 00:54:32.206
title looks like keeping us

00:54:33.311 --> 00:54:35.293
relatively on track, just keeping notes.

00:54:35.773 --> 00:54:36.114
You'll get,

00:54:36.833 --> 00:54:37.893
this is what I used to do in radio,

00:54:38.215 --> 00:54:39.534
write bad job descriptions

00:54:39.574 --> 00:54:41.376
or bad solicitations.

00:54:42.117 --> 00:54:44.358
No pay, horrible, well, unlimited hours,

00:54:44.438 --> 00:54:46.077
like work whenever you want.

00:54:47.079 --> 00:54:48.579
We're live twice a week and

00:54:48.599 --> 00:54:49.639
you get to see behind the

00:54:49.679 --> 00:54:51.101
scenes at my proof of life.

00:54:51.360 --> 00:54:52.762
So you get to hang out with

00:54:52.822 --> 00:54:54.121
us when we're not broadcasting.

00:54:54.141 --> 00:54:55.922
So we wanna do parting shots or what?

00:54:55.963 --> 00:54:57.143
Well, real quick, just, yeah,

00:54:57.164 --> 00:54:58.284
let's do parting shots.

00:54:59.204 --> 00:55:00.346
This one will be a little bit longer.

00:55:01.306 --> 00:55:03.429
Talking about ways to make connections,

00:55:03.469 --> 00:55:04.610
the right way and the wrong way.

00:55:04.871 --> 00:55:05.172
You know,

00:55:05.211 --> 00:55:06.534
when somebody reaches out through

00:55:06.693 --> 00:55:07.675
LinkedIn to me,

00:55:08.076 --> 00:55:09.137
the first thing I do is I

00:55:09.177 --> 00:55:10.079
look for the credentials

00:55:10.139 --> 00:55:10.760
after their name.

00:55:10.800 --> 00:55:13.443
If they're not a PT, I almost, or PT, OT,

00:55:13.563 --> 00:55:15.706
SOP, I almost always ignore it.

00:55:17.574 --> 00:55:21.097
But Haley Jones, I never saw your name.

00:55:21.237 --> 00:55:22.418
I never heard of this person.

00:55:22.478 --> 00:55:23.918
I have no connection to this person.

00:55:24.458 --> 00:55:26.581
She left such an interesting

00:55:26.621 --> 00:55:28.442
comment on one of my videos

00:55:28.742 --> 00:55:29.963
that I screenshotted it and

00:55:30.023 --> 00:55:31.565
I sent it to you guys last night.

00:55:32.284 --> 00:55:33.106
And I said, look,

00:55:33.306 --> 00:55:35.748
this was such an impactful comment.

00:55:36.248 --> 00:55:37.449
Now, instantly,

00:55:37.489 --> 00:55:39.030
when you said Haley Jones today,

00:55:39.110 --> 00:55:40.132
I knew exactly who you were

00:55:40.152 --> 00:55:40.672
talking about.

00:55:41.092 --> 00:55:41.972
She didn't message me.

00:55:42.012 --> 00:55:42.733
We didn't connect.

00:55:42.853 --> 00:55:43.574
Outside of that,

00:55:43.614 --> 00:55:45.655
she just left a really good

00:55:46.016 --> 00:55:47.697
kind of impactful comment

00:55:48.036 --> 00:55:49.318
and it's stuck in my head.

00:55:50.318 --> 00:55:51.978
You guys, we need connections.

00:55:52.039 --> 00:55:53.780
We're in a networking world.

00:55:53.820 --> 00:55:55.041
We need to know, you know,

00:55:55.101 --> 00:55:57.382
different people reach out,

00:55:57.561 --> 00:55:59.182
make those organic connections.

00:55:59.382 --> 00:56:01.623
Even if you can't touch them in person,

00:56:02.083 --> 00:56:04.164
you can connect with them virtually.

00:56:05.126 --> 00:56:06.206
I think that's going to do

00:56:06.266 --> 00:56:07.266
more to move your business

00:56:07.306 --> 00:56:08.106
forward than just about

00:56:08.168 --> 00:56:09.387
anything else that you could do.

00:56:10.027 --> 00:56:10.809
Dave, what you got?

00:56:13.666 --> 00:56:15.427
Well, you said Haley Jones, she's a PT.

00:56:15.706 --> 00:56:17.469
It's the screenshot you sent says PT.

00:56:18.248 --> 00:56:19.889
Yeah.

00:56:19.969 --> 00:56:21.130
Oh, I thought you were saying she wasn't.

00:56:21.650 --> 00:56:21.992
No, no.

00:56:22.351 --> 00:56:22.992
Yeah, she is.

00:56:23.371 --> 00:56:27.094
I had no connection to her prior to that,

00:56:27.974 --> 00:56:29.155
but that was the best way

00:56:29.195 --> 00:56:30.396
to make a cold connection.

00:56:30.436 --> 00:56:31.637
Not that she was even trying.

00:56:31.677 --> 00:56:33.139
I'm just saying that was

00:56:33.199 --> 00:56:34.119
such a good way to make a

00:56:34.179 --> 00:56:35.199
cold connection to me

00:56:35.280 --> 00:56:36.300
better than trying to

00:56:36.400 --> 00:56:38.382
direct message me and, you know,

00:56:38.422 --> 00:56:39.222
sell me something.

00:56:41.067 --> 00:56:42.708
All right, parting shot.

00:56:42.788 --> 00:56:44.829
So with the virtual stuff,

00:56:45.150 --> 00:56:46.271
but let's put them in two buckets.

00:56:46.331 --> 00:56:48.233
We have the employee wellness.

00:56:48.512 --> 00:56:50.153
It's an added benefit for

00:56:50.273 --> 00:56:51.894
all the employees of

00:56:51.974 --> 00:56:53.056
whichever large company.

00:56:53.856 --> 00:56:55.538
And it's typically free.

00:56:55.717 --> 00:56:57.400
And this is like, hey, do ten squats,

00:56:57.420 --> 00:56:58.079
do this, do that.

00:56:58.760 --> 00:57:01.402
And these employees might be healthy.

00:57:01.563 --> 00:57:02.844
They may not really have any

00:57:02.903 --> 00:57:05.425
major musculoskeletal orthopedic issue,

00:57:05.465 --> 00:57:05.666
right?

00:57:05.826 --> 00:57:06.666
Like that's one bucket.

00:57:06.686 --> 00:57:07.487
Then the other bucket is

00:57:08.501 --> 00:57:09.543
Employees of these companies

00:57:09.583 --> 00:57:11.545
who actually have carpal tunnel sciatica,

00:57:11.985 --> 00:57:12.847
migraine headaches,

00:57:13.387 --> 00:57:14.548
a stiff knee where they're

00:57:14.588 --> 00:57:16.451
limping and they can't walk,

00:57:16.472 --> 00:57:17.393
they have plantar fasciitis,

00:57:17.413 --> 00:57:18.132
different things like that

00:57:18.193 --> 00:57:19.114
orthopedically that are

00:57:19.155 --> 00:57:21.317
somewhere between medium to

00:57:21.898 --> 00:57:22.958
moderately complex.

00:57:23.938 --> 00:57:25.018
The first bucket, yes,

00:57:25.119 --> 00:57:26.719
it can help those people virtually,

00:57:26.900 --> 00:57:28.159
this whole virtual thing, sword health,

00:57:28.179 --> 00:57:28.860
hinge health, whatever.

00:57:29.440 --> 00:57:31.001
When someone has these orthopedic issues,

00:57:31.041 --> 00:57:32.362
carpal tunnel, sciatica,

00:57:32.782 --> 00:57:33.981
radicular symptoms,

00:57:34.782 --> 00:57:36.702
persistent low back pain,

00:57:36.802 --> 00:57:37.884
all this type of thing,

00:57:37.923 --> 00:57:39.764
Achilles tendonitis, tendinopathy,

00:57:39.804 --> 00:57:40.465
that type of stuff,

00:57:41.284 --> 00:57:42.625
this is where virtual will

00:57:42.784 --> 00:57:45.306
never solve or help most of

00:57:45.326 --> 00:57:46.806
that population, in my opinion.

00:57:46.827 --> 00:57:47.646
So that's my parting shot.

00:57:49.177 --> 00:57:50.659
Yeah,

00:57:50.679 --> 00:57:52.000
I would piggyback on a statistic I

00:57:52.019 --> 00:57:52.599
heard years ago,

00:57:52.619 --> 00:57:55.461
which was most mid-sized

00:57:55.501 --> 00:57:57.523
companies under-communicate

00:57:57.844 --> 00:58:00.226
by a factor of four hundred percent.

00:58:00.746 --> 00:58:01.927
What they were talking about

00:58:01.947 --> 00:58:03.088
was internal communications.

00:58:03.108 --> 00:58:03.708
Like if you're going to try

00:58:03.728 --> 00:58:04.829
to get culture change at

00:58:04.849 --> 00:58:06.889
your organization, we send an email.

00:58:06.949 --> 00:58:09.572
It's on our internal social network,

00:58:09.612 --> 00:58:10.172
things like that.

00:58:10.193 --> 00:58:12.594
We brought it up in meetings.

00:58:13.114 --> 00:58:14.815
Even when you've exhausted everything,

00:58:15.155 --> 00:58:17.077
you're still under-communicating

00:58:17.958 --> 00:58:18.858
by a factor of four hundred

00:58:18.878 --> 00:58:20.298
percent to reach that

00:58:20.438 --> 00:58:21.759
culture change or to

00:58:21.878 --> 00:58:22.599
actually get someone to

00:58:22.679 --> 00:58:24.579
know something never mind

00:58:24.619 --> 00:58:25.900
if they actually do it your

00:58:25.920 --> 00:58:26.521
job is to get them to

00:58:26.601 --> 00:58:28.181
understand their job is to

00:58:28.240 --> 00:58:29.262
hopefully eventually do it

00:58:29.822 --> 00:58:32.402
so I think the idea here is

00:58:32.422 --> 00:58:33.382
that I want to piggyback

00:58:33.422 --> 00:58:34.322
off of what tony was saying

00:58:34.342 --> 00:58:36.764
which is say it more do it

00:58:36.824 --> 00:58:38.585
more a hundred times more

00:58:38.784 --> 00:58:39.704
and if you think that

00:58:40.045 --> 00:58:41.505
you've done it you're still

00:58:41.545 --> 00:58:42.405
three hundred times

00:58:43.186 --> 00:58:44.547
under doing it in terms of

00:58:44.807 --> 00:58:45.688
of reaching that culture

00:58:45.708 --> 00:58:47.610
change so share more do it

00:58:47.710 --> 00:58:49.092
ugly I mean do you think

00:58:49.112 --> 00:58:49.952
this is what I walk around

00:58:49.972 --> 00:58:51.394
in public in no but I woke

00:58:51.454 --> 00:58:52.295
up late because I had a

00:58:52.335 --> 00:58:53.097
beer league hockey game

00:58:53.137 --> 00:58:54.177
until one a.m so I'm

00:58:54.378 --> 00:58:55.278
rolling out of bed a little

00:58:55.298 --> 00:58:56.119
beat up this morning

00:58:56.199 --> 00:58:57.181
rubbing moving a little

00:58:57.201 --> 00:58:59.123
slow so communicate more

00:59:00.655 --> 00:59:01.936
I actually just saw Sword

00:59:01.976 --> 00:59:02.896
Health for the first time

00:59:02.996 --> 00:59:04.797
now putting up Instagram reels.

00:59:04.856 --> 00:59:05.657
And I'm like, really?

00:59:05.956 --> 00:59:06.277
Really?

00:59:06.737 --> 00:59:07.036
Really?

00:59:07.257 --> 00:59:08.538
Million, billion dollar company,

00:59:08.557 --> 00:59:09.117
whatever they are.

00:59:09.418 --> 00:59:10.257
And now they're just putting

00:59:10.297 --> 00:59:11.697
up Instagram reels.

00:59:11.777 --> 00:59:12.018
Cool.

00:59:12.298 --> 00:59:13.739
Hey, well, thanks for coming to the party.

00:59:14.039 --> 00:59:16.059
We'll be back on Tuesday.

00:59:16.079 --> 00:59:16.898
What are you guys doing this weekend?

00:59:17.219 --> 00:59:18.159
Give me something good that

00:59:18.179 --> 00:59:18.579
you guys are doing.

00:59:18.599 --> 00:59:19.800
I need motivation for the weekend.

00:59:20.179 --> 00:59:20.639
Tony's like, no,

00:59:20.659 --> 00:59:22.701
I'm not doing anything good.

00:59:22.721 --> 00:59:23.621
We're going to be doing kids

00:59:23.661 --> 00:59:24.440
stuff all weekend.

00:59:24.460 --> 00:59:27.402
Basketball tournaments, shows, theater.

00:59:28.222 --> 00:59:28.621
That's it.

00:59:29.157 --> 00:59:29.358
Good.

00:59:29.398 --> 00:59:31.403
Take care of that baby.

00:59:31.423 --> 00:59:32.867
Nothing crazy for me.

00:59:32.887 --> 00:59:33.188
Perfect.

00:59:33.208 --> 00:59:34.954
All right, gentlemen, have a great weekend,

00:59:35.193 --> 00:59:36.376
and we'll see you back on Tuesday.