Feb. 3, 2026

Is PT Education Broken? A Candid Talk with Benz, Flynn & Childs

Larry Benz, John Childs, and Tim Flynn join Jimmy to tackle some of the most urgent—and uncomfortable—questions in physical therapy. Are we educating students into a broken system?

LINK TO THEIR LATEST ARTICLE

LINK TO LARRY'S SUBSTACK

Why do most PTs say they wouldn't want their kids to become PTs?

And what would it take to fix this before the next generation gives up?

From the burden of tuition to the unintended consequences of accreditation rigidity, this episode pulls no punches. It's a high-stakes conversation with voices that have shaped PT education, and who believe it's time to reshape it again.

Topics Discussed:

The unsustainable cost of DPT education
Why hybrid programs faced institutional resistance
What accreditation bodies are getting wrong
How young entrepreneurs might save the profession
The question every PT should ask: "Would I want my kids to do this?"

Featured Guests:

Larry Benz — Confluent Health
Dr. John Childs — South College
Dr. Tim Flynn — Evidence in Motion

Transcript

WEBVTT

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You're listening to the PT Pinecast,

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where smart people in healthcare come to

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make noise.

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Here's your host, Jimmy McKay.

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All right, thanks, voice guy.

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Big thanks to Sarah Health,

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a remote care platform helping clinics

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Sarah automates daily patient check-ins

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via text.

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just better outcomes.

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It's a simple way to meet RTM

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requirements, improve follow-through,

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and actually get you reimbursed for care

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between visits.

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Find them online at sarahhealth.com.

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That's S-A-R-A health.com.

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Now imagine...

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You're in a DeLorean.

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But instead of checking the time circuits,

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you're scanning tuition statements,

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burnout rates.

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The year on the dashboard,

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twenty twenty six and the dashboards

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flashing red.

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Something's wrong in the timeline of PT

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education.

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It's bloated.

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It's broken.

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And it's barreling towards a cliff,

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or maybe we went over one already.

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So three longtime disruptors,

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part educators, part entrepreneurs,

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part Doc Brown with spreadsheets,

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grab the keys and hit eighty eight miles

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an hour.

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Together, they founded programs,

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launched companies,

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taken on the APTA and lived to tell

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about it.

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And they're back not just to warn the

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profession.

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but to rebuild it.

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This is Back to the Future, part one,

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the radical proposal to save physical

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therapy through a five-year DPT redesign.

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Let's welcome in the show, Tim Flynn,

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Larry Pence, John Childs.

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Gentlemen,

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how was my Back to the Future intro?

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Was it DeLorean-worthy?

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I would say it was Rivian worthy.

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Rivian worthy.

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There you go.

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Now, I got to tell you,

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I started this podcast by accident ten

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years ago when I was still a student.

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And I remember.

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A couple,

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and I think it was John walked by

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and you were having a conversation with

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someone and I said, who's that?

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And I remember someone saying, oh no,

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you don't want to talk to that guy.

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He does crazy stuff.

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And I remember hearing about you guys

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because I was still in school and hearing

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about you guys over the years going,

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all the crazy stuff they're doing feels

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like it makes sense.

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Am I the crazy one?

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So let's start out with this.

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What year would you set the time machine

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back to?

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When did PT education go off the rails?

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If we were going to go back in

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time to sort of change it before it

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sort of forked, when was it okay?

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And then when did Biff Tannen show up

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and ruin everything?

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Well,

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I'll just start off with a lighthearted

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comment.

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I should defer to my elders,

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Larry and Tim.

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They have more of the history than I

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do.

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We live the history.

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In fact,

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we graduated pretty close together,

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Tim before me, so he should go first.

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All right, Tim, when did we mess up?

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Well,

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I started as a bachelor's and actually

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with a bachelor's was teaching people like

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Larry who was getting a master's at Army

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Baylor.

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So I guess I am the oldest.

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So I think from my perspective, probably,

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and I think I was part of the

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problem just when I look back at the

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time.

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But it was really when we went to

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the DPT,

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when you look at how that came about,

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the the conversation around that time was

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such that none of the universities are

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going to buy buy this you know it's

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going to be such a heavy lift to

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really go from a master's degree because

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the ninety it went to the masters to

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the doctorate and but what was fascinating

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uh literally you know within about five

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years everybody went there and i as you

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look back you go hmm

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You sit around the university and at the

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board of trustees or even down below.

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So let me get this right.

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You want to go from two years to

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three years and with the same number of

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faculty.

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So you basically we get another years of

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tuition with really little cost.

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Yeah, we should do that.

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We should do that.

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So basically all these universities went

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from zero to sixty and all of a

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sudden we have seven years of education.

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but i'll defer to my my junior colleague

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uh dr benz here because he he really

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has the most uh detailed perspective i

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think yeah so i think there's a couple

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surprises here and when i talk about this

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sometimes people look at me kind of

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strange but let's rewind the clock to how

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the profession looked at it by the

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profession i mean apta international

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organization because

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they led and carried the banner.

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And you also have to remember CAPT is

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to an extent intimately tied to them.

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So, you know,

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when I was in graduate school,

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in nineteen eighty four, Tim,

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you were getting out probably nineteen

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eighty five.

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You got up right at the beginning of

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eighty six.

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And so Tim is correct.

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He actually was one of our clinical

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instructors while he had a bachelor's.

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I chose a master's program.

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in part because it was the Army Baylor

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program and it was subsidized,

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but also in part because it was one

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of the few master's programs that was

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available then.

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Again, think about that.

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In nineteen eighty-four,

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there weren't many master's programs.

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So what drove the master's degree?

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What drove the master's degree was our

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profession.

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APTA said by nineteen ninety,

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and I think it was nineteen ninety,

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I'm going to be directionally correct

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here,

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All one hundred and eight programs at that

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time, whatever the number was,

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need to be at a master's level with

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whether they're both private or public.

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And obviously the privates exceed the

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public's because they have the flexibility

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and the autonomy to do so.

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Unfortunately,

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it wasn't until likely the last master's

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program probably hung around until the

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late nineties.

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We could look this up.

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but um there were a few laggards and

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lo and behold by the time the last

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master's program actually complied with

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the regulations by the way ot tried to

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do this very unsuccessfully just a few

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years ago it didn't work for them they

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tried to do it to the dpt or

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to the otd but in any event our

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profession said the body of knowledge is

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worthy of a master's degree

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Not everybody complied on time.

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And even though the mandate was,

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let's say, nineteen ninety,

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it took another ten years.

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Unfortunately,

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it only took a few years to convert

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from master's to DPT.

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And why was that?

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As Tim alluded to,

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it was driven by higher education.

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It was driven by the desire to get

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more bites of the apple in the tuition

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dollar from students.

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It just affect PT.

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It affected almost everything.

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They call that academic creep.

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Accounting went through it by way of

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example.

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Pharmacy went through it.

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Speech and hearing went through it.

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OTD obviously did as well.

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Many others did.

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And so that's a really fundamental thing

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we have to remember.

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At some point then the profession,

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Creighton I believe was the first program

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to go to a DPT level.

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And again, private schools exceeded,

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many states had to pass things within the

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regulatory bodies of their state's own

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higher ed to get

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physical therapy to a doctorate education.

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But the point,

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main point being is that it transitioned.

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It didn't take, let's say,

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fifteen years to go from bachelor's to

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master's.

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It was supposed to take ten.

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It only took about five.

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It was like,

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it just absolutely exploded because the

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tuition went crazy.

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So much so that when I have lots

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of friends and when I first started to

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employ PTs, we used to actually pay,

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we were still out of undergraduate

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programs when I was first in business,

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we used to actually pay scholarships.

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for PTs to get their bachelor's degree and

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then come work for us.

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Obviously by the time I got to a

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master's and certainly a DPT,

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who's gonna be able to afford three and

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four years of tuition dollars.

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One last point, I'll let John speak.

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We should not let higher education

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continue to dictate our profession because

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our profession has migrated.

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We'll talk about COVID and the impact it's

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had on quality and types of education and

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hybrid and all that kind of stuff.

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But we have the control.

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We have the ability to retrain this and

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go back to the future if we want

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to.

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It will take some regulatory changes.

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It'll take some gnashing of the teeth.

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But it really is going to take our

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profession to go back to commanding

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control of itself like it did from the

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bachelor's to the master's.

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Yeah,

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I think the primary comment I would have,

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and this is being as a critic to

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some extent of higher ed,

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I'm absolutely convinced if there was

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enough demand for a ten-year DPT program,

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higher ed would absolutely support it and

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move in that direction tomorrow.

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Now, that's a little bit facetious,

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but the reality is to some extent we

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are a victim of our own success.

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There is such demand for our services

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and a lack of therapists that are out

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there, that there's this motivation,

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obviously,

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to produce more and more therapists as

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needed.

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And the demand is so high and the

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willingness of the federal government to

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subsidize these loans,

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higher ed is just sitting on this heyday

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of extended academic creep, as Larry said.

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And again,

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that might be a little bit of an

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overly cynical view,

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But I think back to the time when

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I was in PT school in the Army

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Baylor program, similar to Larry,

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it was a master's program.

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And at that time,

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every program was a master's program,

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and most every program was two years in

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length.

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You know,

00:09:48.438 --> 00:09:51.120
we were being sponsored by the Army or

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the Air Force, in my case,

00:09:52.480 --> 00:09:55.139
who was incredibly interested in getting

00:09:55.200 --> 00:09:57.841
us out of school as soon as possible.

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Right.

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The motivation is entirely different.

00:10:00.520 --> 00:10:03.261
They're paying us salaries as lieutenants

00:10:03.302 --> 00:10:06.162
and captains to sit in a classroom and

00:10:06.221 --> 00:10:07.643
be relatively unproductive.

00:10:07.663 --> 00:10:07.822
Right.

00:10:07.842 --> 00:10:08.842
We're not seeing patients.

00:10:08.903 --> 00:10:10.903
We're on a pathway to get a degree.

00:10:10.942 --> 00:10:13.543
So the motivation was acceleration.

00:10:13.583 --> 00:10:14.783
The motivation was motivation.

00:10:15.024 --> 00:10:17.806
full time class, you know, eight to five.

00:10:17.885 --> 00:10:20.527
The motivation was no summers off.

00:10:20.908 --> 00:10:22.509
And so the Army Baylor program,

00:10:23.168 --> 00:10:24.048
even when I was there,

00:10:24.089 --> 00:10:25.149
was eighteen months.

00:10:25.269 --> 00:10:25.470
I mean,

00:10:25.490 --> 00:10:29.072
it was six months shorter than the

00:10:29.172 --> 00:10:31.014
average, quote unquote, two years master.

00:10:31.173 --> 00:10:31.553
And so

00:10:32.053 --> 00:10:32.293
you know,

00:10:32.453 --> 00:10:34.875
I think even with the master's program,

00:10:34.914 --> 00:10:37.437
we saw academic creep because there were

00:10:37.456 --> 00:10:40.398
at least some models where the incentives

00:10:41.138 --> 00:10:41.918
were different,

00:10:42.298 --> 00:10:45.519
where the time from inception to

00:10:46.080 --> 00:10:47.980
graduation was significantly shorter.

00:10:48.000 --> 00:10:49.721
All right.

00:10:49.741 --> 00:10:51.982
So now we fast forward and we've got

00:10:52.062 --> 00:10:53.724
regulations that are coming into play.

00:10:53.803 --> 00:10:56.024
So that rise rule, which everybody read,

00:10:56.655 --> 00:10:57.397
but they didn't read it.

00:10:57.437 --> 00:10:59.758
They read the abstract and panicked or

00:10:59.817 --> 00:11:01.419
they read it and said, well,

00:11:01.440 --> 00:11:02.701
you guys are the guys who actually read

00:11:02.721 --> 00:11:03.701
and understand this stuff.

00:11:04.221 --> 00:11:05.982
The rise rule could change everything.

00:11:06.624 --> 00:11:08.205
Are we about to see the federal government

00:11:08.264 --> 00:11:11.988
make DPT education impossible or is this a

00:11:12.048 --> 00:11:12.628
good thing?

00:11:12.648 --> 00:11:14.188
Help me read these tea leaves here.

00:11:16.971 --> 00:11:18.893
Let me comment on a couple of things

00:11:18.932 --> 00:11:20.854
before we go there a bit because there

00:11:20.874 --> 00:11:24.297
are some monumental inflection points in

00:11:24.397 --> 00:11:25.618
our profession.

00:11:26.707 --> 00:11:28.245
Um, two thousand one

00:11:29.955 --> 00:11:31.735
And the teaching point here is that we've

00:11:31.775 --> 00:11:34.618
never tried to control for supply demand

00:11:34.677 --> 00:11:36.099
or volume of PTs.

00:11:36.200 --> 00:11:37.539
And when the profession has tried to,

00:11:37.559 --> 00:11:38.721
they've been grossly wrong.

00:11:39.341 --> 00:11:41.243
So in two thousand one at that time,

00:11:41.283 --> 00:11:43.884
there were about ten thousand new graduate

00:11:44.004 --> 00:11:45.145
new PTs per year,

00:11:45.186 --> 00:11:46.667
ten thousand in two thousand one,

00:11:46.726 --> 00:11:50.570
five thousand American graduates of

00:11:50.629 --> 00:11:52.711
schools that would take their exam.

00:11:52.831 --> 00:11:53.532
And most of them,

00:11:53.912 --> 00:11:55.013
if not all of them,

00:11:55.033 --> 00:11:56.313
would practice clinically.

00:11:56.933 --> 00:11:57.434
At that time,

00:11:57.455 --> 00:11:58.817
there would be ten thousand foreign

00:11:58.859 --> 00:12:00.120
trained therapists that would come in the

00:12:00.221 --> 00:12:00.623
US.

00:12:00.883 --> 00:12:02.888
Half would pass the exam statistically.

00:12:03.248 --> 00:12:04.951
So another five thousand would become

00:12:05.011 --> 00:12:06.274
employed in the US.

00:12:07.048 --> 00:12:07.207
Now,

00:12:07.347 --> 00:12:08.607
up until about a year or two ago,

00:12:08.628 --> 00:12:09.928
we're now graduating about twelve

00:12:09.969 --> 00:12:10.448
thousand,

00:12:10.769 --> 00:12:12.048
although not all twelve thousand are

00:12:12.089 --> 00:12:13.048
practicing clinically,

00:12:13.109 --> 00:12:14.809
not all of them are passing the exam.

00:12:15.190 --> 00:12:17.230
But we are literally now in two thousand

00:12:17.269 --> 00:12:19.071
twenty six,

00:12:19.211 --> 00:12:21.390
roughly where we're at in two thousand one

00:12:21.431 --> 00:12:22.672
in terms of the same numbers.

00:12:23.292 --> 00:12:24.672
That is when we should have made a

00:12:24.711 --> 00:12:27.873
decision on PT education because we needed

00:12:27.913 --> 00:12:28.692
more PTs.

00:12:30.452 --> 00:12:31.793
Surprisingly, though,

00:12:32.333 --> 00:12:34.575
the academic community actually predicted

00:12:34.615 --> 00:12:36.115
that we were going to have this huge

00:12:36.196 --> 00:12:36.796
surplus.

00:12:37.517 --> 00:12:40.557
And that huge surplus caused this pushback

00:12:40.577 --> 00:12:42.899
for developing not only programs,

00:12:43.059 --> 00:12:44.880
expanding programs or innovation.

00:12:45.682 --> 00:12:46.583
Those three things,

00:12:46.604 --> 00:12:48.443
when you halt program development,

00:12:48.504 --> 00:12:49.585
you halt innovation,

00:12:49.625 --> 00:12:51.605
and you halt the expansion of programs,

00:12:52.086 --> 00:12:55.807
you literally are trying to restrict PTs

00:12:55.947 --> 00:12:57.229
in order to be able to get the

00:12:57.269 --> 00:12:58.149
number that we need.

00:12:58.190 --> 00:13:00.471
And now what we have is literally

00:13:01.130 --> 00:13:02.972
Seventy to eighty percent of people who

00:13:02.993 --> 00:13:05.034
apply for a PT education somewhere are

00:13:05.054 --> 00:13:05.875
going to get accepted.

00:13:06.375 --> 00:13:07.798
We have seats that are open.

00:13:07.898 --> 00:13:09.580
Who would have ever predicted in my

00:13:09.639 --> 00:13:11.181
monologue to this week's post,

00:13:11.201 --> 00:13:12.643
which will come out tomorrow or Wednesday,

00:13:13.062 --> 00:13:14.764
who would have ever predicted there'd be a

00:13:14.845 --> 00:13:16.546
time where anybody could become a PT?

00:13:17.787 --> 00:13:20.089
The qualifier is actually quite low.

00:13:20.708 --> 00:13:23.490
That has its own unintended consequences.

00:13:23.529 --> 00:13:25.130
So when we talk about rise here,

00:13:25.171 --> 00:13:26.412
we need to also, of course,

00:13:26.451 --> 00:13:29.033
correct the quality of students,

00:13:29.614 --> 00:13:31.173
coupled with those who are passionate and

00:13:31.193 --> 00:13:32.554
really want to become a PT,

00:13:32.914 --> 00:13:34.316
coupled with the ability to do it,

00:13:34.355 --> 00:13:36.017
the affordability and student loans,

00:13:36.076 --> 00:13:36.677
all those things.

00:13:37.038 --> 00:13:38.717
So we have to really kind of address

00:13:38.859 --> 00:13:40.759
all the challenges simultaneously,

00:13:41.120 --> 00:13:42.600
but we're going to keep pushing on one

00:13:42.701 --> 00:13:44.301
part of the sweater and another part is

00:13:44.321 --> 00:13:45.201
going to get a flaw in it.

00:13:46.245 --> 00:13:48.287
I sat in a room with two hundred

00:13:48.366 --> 00:13:49.868
ninety nine other applicants.

00:13:49.908 --> 00:13:51.288
They had narrowed it down for how many

00:13:51.349 --> 00:13:53.890
applications to three hundred in-person

00:13:54.030 --> 00:13:54.711
interviews,

00:13:55.110 --> 00:13:57.253
three one hundred person sessions for

00:13:57.312 --> 00:13:58.313
thirty eight seats.

00:13:58.354 --> 00:13:59.374
And I remember doing the math when I

00:13:59.434 --> 00:14:00.674
walked in going, man,

00:14:00.715 --> 00:14:02.056
I got it for every ten person,

00:14:02.096 --> 00:14:02.797
people that walk in.

00:14:02.836 --> 00:14:03.898
I got to be one of them.

00:14:03.957 --> 00:14:04.837
Sorry, I'd be nine of them.

00:14:04.898 --> 00:14:05.818
I got to be the one.

00:14:06.298 --> 00:14:07.460
And that gets a little intimidating.

00:14:07.500 --> 00:14:09.280
And now you hear some of the application

00:14:09.341 --> 00:14:12.283
rates falling through the floor.

00:14:13.024 --> 00:14:13.826
which is again,

00:14:13.846 --> 00:14:15.308
shocking in that short time span.

00:14:15.349 --> 00:14:17.292
Again, that was twenty thirteen for me,

00:14:17.312 --> 00:14:17.873
twenty twelve.

00:14:18.153 --> 00:14:18.455
All right.

00:14:18.475 --> 00:14:19.235
So where do we go next?

00:14:19.255 --> 00:14:20.317
Do we go do you want to fast

00:14:20.357 --> 00:14:22.121
forward to the to what's happening now or

00:14:22.162 --> 00:14:23.203
is there still some context?

00:14:25.798 --> 00:14:28.259
Well, I'll take briefly the rise question.

00:14:28.299 --> 00:14:29.980
It's obviously still out for comment.

00:14:30.000 --> 00:14:34.144
I think we're all hopeful that PT is

00:14:34.183 --> 00:14:36.745
going to get its due recognition as a

00:14:37.404 --> 00:14:38.785
profession, so to speak.

00:14:38.826 --> 00:14:40.226
It's to some extent,

00:14:40.567 --> 00:14:42.488
I don't know if it's humorous and or

00:14:42.869 --> 00:14:45.629
sad, probably some of both,

00:14:45.669 --> 00:14:48.432
that many other disciplines not to be

00:14:48.471 --> 00:14:50.493
named here are considered professions when

00:14:50.533 --> 00:14:52.313
we're not.

00:14:53.374 --> 00:14:54.914
But if we go down the path of

00:14:54.995 --> 00:14:56.934
sort of this worst case scenario where all

00:14:56.975 --> 00:14:59.696
of a sudden graduate loans are

00:14:59.755 --> 00:15:02.176
significantly curtailed, right,

00:15:02.216 --> 00:15:02.916
wrong or indifferent,

00:15:02.936 --> 00:15:05.557
it will absolutely force innovation in PT

00:15:05.616 --> 00:15:06.157
education.

00:15:06.576 --> 00:15:09.197
We will overnight see programs getting

00:15:09.258 --> 00:15:11.739
shorter, faster, more innovative.

00:15:11.818 --> 00:15:13.499
I'm not saying that's necessarily the path

00:15:13.958 --> 00:15:15.219
I wanna see us go down,

00:15:15.659 --> 00:15:19.100
but smaller under-resourced programs that

00:15:19.120 --> 00:15:21.461
have big buildings and lots of fixed costs

00:15:21.860 --> 00:15:23.182
they're all of a sudden, I mean,

00:15:23.221 --> 00:15:25.844
if you don't have more than fifty to

00:15:25.884 --> 00:15:27.544
sixty students in your program,

00:15:27.825 --> 00:15:28.926
you're going to go away.

00:15:29.005 --> 00:15:31.807
You simply don't have enough revenues at

00:15:31.847 --> 00:15:34.429
that level to support the cost of running

00:15:35.211 --> 00:15:35.870
a program.

00:15:36.350 --> 00:15:38.113
And so I think what we'll see in

00:15:38.133 --> 00:15:40.014
that worst case scenario is the strong

00:15:40.033 --> 00:15:40.894
getting stronger.

00:15:41.434 --> 00:15:42.115
And boy,

00:15:42.135 --> 00:15:44.616
there will be a third of DPT programs

00:15:44.636 --> 00:15:47.479
that will immediately start to struggle

00:15:47.639 --> 00:15:49.600
and or, you know, at some point,

00:15:50.086 --> 00:15:51.005
you know, disappear.

00:15:51.125 --> 00:15:51.907
Now, having said that,

00:15:51.947 --> 00:15:53.466
I've been predicting this, you know,

00:15:53.547 --> 00:15:55.807
third of PT programs going away for ten

00:15:55.847 --> 00:15:56.168
years,

00:15:56.768 --> 00:15:59.009
and it's just not happening at the pace

00:15:59.028 --> 00:15:59.708
at which I thought.

00:15:59.769 --> 00:16:01.149
So I'm guilty of, you know,

00:16:01.349 --> 00:16:03.289
maybe early forecasting,

00:16:03.990 --> 00:16:07.671
but certainly a significant change like

00:16:07.691 --> 00:16:09.032
we're talking about with some of the RISE

00:16:09.072 --> 00:16:12.312
regulations would absolutely force that,

00:16:12.773 --> 00:16:14.553
you know,

00:16:14.573 --> 00:16:16.573
those smaller under-resourced programs to

00:16:16.953 --> 00:16:18.375
rethink whether they want to be in the

00:16:18.414 --> 00:16:19.095
PT business.

00:16:20.187 --> 00:16:21.206
And you guys are going to go into

00:16:21.246 --> 00:16:24.447
detail with a series of articles,

00:16:24.488 --> 00:16:25.607
as I'll mention in the show notes.

00:16:25.648 --> 00:16:27.328
We'll give a link to that as well.

00:16:28.009 --> 00:16:29.369
So let's get to the solution.

00:16:29.509 --> 00:16:29.668
I mean,

00:16:29.688 --> 00:16:31.110
I think people are pretty familiar with at

00:16:31.129 --> 00:16:33.009
least some, if not all the problems.

00:16:33.649 --> 00:16:34.311
So great.

00:16:34.750 --> 00:16:37.431
As my research professor in PT school said

00:16:37.451 --> 00:16:39.272
with a great Irish accent, we know what?

00:16:40.032 --> 00:16:42.654
now what i'm sorry what so what now

00:16:42.715 --> 00:16:45.618
what break down that five-year dpt

00:16:45.638 --> 00:16:47.419
proposal is this the hoverboard

00:16:47.440 --> 00:16:49.100
everybody's been waiting for you know what

00:16:49.140 --> 00:16:50.663
how does it look what does it do

00:16:50.682 --> 00:16:52.465
to solve some of the problems we're we're

00:16:52.504 --> 00:16:57.149
currently in have at it well i'll i'll

00:16:57.168 --> 00:16:58.530
speak to that and um

00:16:59.508 --> 00:17:01.048
to say that really,

00:17:01.649 --> 00:17:04.549
all of us here probably had many

00:17:04.589 --> 00:17:07.289
undergraduate courses that really didn't

00:17:07.550 --> 00:17:11.771
prepare us to be excel and PT.

00:17:12.271 --> 00:17:13.852
And what I would mean by that are

00:17:14.292 --> 00:17:16.153
certain we're certain heavily on certain

00:17:16.173 --> 00:17:17.894
courses that just didn't translate.

00:17:18.453 --> 00:17:22.355
So but just as we've accelerated the DPT

00:17:22.375 --> 00:17:25.016
from three to two, at the bottom line,

00:17:25.096 --> 00:17:25.155
our

00:17:25.968 --> 00:17:28.191
our entry into the PT world should be

00:17:28.290 --> 00:17:28.711
quicker.

00:17:28.852 --> 00:17:29.092
I mean,

00:17:29.471 --> 00:17:32.015
three years as a three-year bachelor's

00:17:32.055 --> 00:17:32.516
degree,

00:17:33.136 --> 00:17:36.381
heavily focused on the skills of

00:17:36.421 --> 00:17:38.884
healthcare professionals so that the

00:17:38.923 --> 00:17:39.924
skills really are.

00:17:40.700 --> 00:17:43.001
Yes, a strong liberal arts background,

00:17:43.102 --> 00:17:44.102
actually, but liberal arts,

00:17:44.182 --> 00:17:47.865
it's applied to those skills that make you

00:17:48.045 --> 00:17:50.166
great at communicating with others.

00:17:50.467 --> 00:17:50.686
You know,

00:17:50.727 --> 00:17:53.148
those skills that actually translate

00:17:53.169 --> 00:17:55.529
across all the health care professions.

00:17:55.549 --> 00:17:58.332
So whether you go into a DPT or

00:17:58.352 --> 00:17:59.692
an OT program,

00:17:59.732 --> 00:18:02.035
a PA program or to medicine,

00:18:03.255 --> 00:18:05.976
You essentially have the background of the

00:18:06.115 --> 00:18:07.037
people skills.

00:18:07.517 --> 00:18:10.337
And that three-year bachelor's should

00:18:10.397 --> 00:18:15.059
include credit for

00:18:15.891 --> 00:18:17.912
people that are working in the health care

00:18:17.932 --> 00:18:20.653
industry already that are in people

00:18:20.933 --> 00:18:23.414
focused business or even people focused

00:18:23.474 --> 00:18:23.934
business.

00:18:24.035 --> 00:18:25.175
I often say, you know,

00:18:25.195 --> 00:18:28.377
I've always felt that bartenders and

00:18:28.617 --> 00:18:31.880
servers and waiters and waitresses are

00:18:31.920 --> 00:18:33.780
some of the best people to come into

00:18:33.820 --> 00:18:35.741
our profession because you basically have

00:18:35.761 --> 00:18:36.721
to think on your feet.

00:18:37.001 --> 00:18:38.343
You have to look people in the eye.

00:18:38.363 --> 00:18:40.003
You have to communicate with people.

00:18:40.364 --> 00:18:41.724
And when shit goes wrong,

00:18:42.204 --> 00:18:44.728
You have to think on your feet and

00:18:44.788 --> 00:18:47.329
pivot and make things right.

00:18:47.369 --> 00:18:50.693
That to me are a skill set that

00:18:50.733 --> 00:18:54.678
people should have credit for as you go

00:18:54.758 --> 00:18:57.540
into health care professions.

00:18:58.487 --> 00:18:59.948
To me, you know,

00:19:00.107 --> 00:19:03.169
there's heavily on the the sciences that

00:19:03.209 --> 00:19:06.029
are focused to what we need in PT

00:19:06.490 --> 00:19:08.810
and heavily on the humanities side of it,

00:19:09.310 --> 00:19:13.972
but also with practical skill sets that

00:19:13.992 --> 00:19:15.114
are people facing.

00:19:15.253 --> 00:19:16.673
And just one last comment.

00:19:18.174 --> 00:19:21.196
The thing that comes back always is, oh,

00:19:21.478 --> 00:19:24.640
you know, that's higher ed, you know,

00:19:25.019 --> 00:19:25.980
it's, you know,

00:19:26.040 --> 00:19:27.122
they're not going to pivot.

00:19:27.281 --> 00:19:28.363
And like we've said,

00:19:28.803 --> 00:19:30.345
people pivot immediately,

00:19:30.505 --> 00:19:31.726
like we did in COVID,

00:19:32.125 --> 00:19:34.728
when the situation requires it.

00:19:34.887 --> 00:19:36.869
But that's how I had probably started.

00:19:36.890 --> 00:19:39.131
I'll start on that kind of the entry

00:19:39.171 --> 00:19:39.791
point side.

00:19:42.978 --> 00:19:45.057
Just a couple observations.

00:19:45.238 --> 00:19:46.098
One on RISE,

00:19:46.798 --> 00:19:48.699
I'm going to predict that it's not going

00:19:48.759 --> 00:19:51.619
to end up being anything of significant,

00:19:51.700 --> 00:19:53.119
even if it stays intact,

00:19:53.160 --> 00:19:55.640
it'll get kicked down the road many years

00:19:56.180 --> 00:19:57.760
before it actually gets implemented.

00:19:57.800 --> 00:19:59.740
Again, this is just my opinion in part,

00:19:59.760 --> 00:20:01.681
not because of PTs, but because nurses,

00:20:01.740 --> 00:20:02.761
nurses usually win.

00:20:02.781 --> 00:20:04.902
They have strong advocates, advocacy.

00:20:05.382 --> 00:20:08.201
The reality is healthcare shortages are

00:20:08.261 --> 00:20:09.323
not in dispute.

00:20:10.143 --> 00:20:10.722
And, you know,

00:20:11.722 --> 00:20:14.703
putting forth an old reg on new student

00:20:14.743 --> 00:20:16.664
loan limitations doesn't make any sense

00:20:16.684 --> 00:20:17.244
for anybody.

00:20:17.565 --> 00:20:18.846
You think we have one of the lowest

00:20:18.885 --> 00:20:21.807
diversity percentages in PT would only get

00:20:21.886 --> 00:20:23.846
worse under those scenarios of rise.

00:20:23.926 --> 00:20:25.428
I think brighter minds will prevail.

00:20:25.887 --> 00:20:27.468
Having said that, regardless,

00:20:27.528 --> 00:20:29.709
we need more innovation in PT.

00:20:29.749 --> 00:20:31.509
The best example I'll go back to is

00:20:31.569 --> 00:20:31.970
nursing.

00:20:32.430 --> 00:20:33.871
You could get a nursing at an RN

00:20:33.911 --> 00:20:35.411
level, a BSN, MSN,

00:20:35.550 --> 00:20:37.751
a doctorate and nurse practice now.

00:20:38.527 --> 00:20:42.669
And we have to have some tools to

00:20:42.709 --> 00:20:43.009
do that.

00:20:43.048 --> 00:20:45.410
So I do like the three-year bachelor's

00:20:45.509 --> 00:20:46.890
into a two-year DPT.

00:20:47.250 --> 00:20:49.612
But I also like other flavors too.

00:20:49.771 --> 00:20:53.492
I like the idea of graduating in two,

00:20:53.673 --> 00:20:55.574
you know, baccalaureate for four even,

00:20:55.614 --> 00:20:57.954
two years in a DPT.

00:20:58.875 --> 00:21:00.395
Okay, that's an additional year,

00:21:00.455 --> 00:21:01.796
but then you would get a master's and

00:21:01.816 --> 00:21:02.477
you'd get paid.

00:21:03.297 --> 00:21:05.598
The reason why that's you get your license

00:21:05.778 --> 00:21:06.538
and you get masters,

00:21:06.558 --> 00:21:08.359
that's critical because we have horrible

00:21:08.400 --> 00:21:10.142
regulations that basically say if you

00:21:10.221 --> 00:21:13.042
treat a Medicare patient that is in,

00:21:13.784 --> 00:21:16.346
you know, life threatening Part A,

00:21:16.846 --> 00:21:18.586
you can do so independently without

00:21:18.646 --> 00:21:19.267
supervision.

00:21:19.287 --> 00:21:20.288
But in Part B,

00:21:20.567 --> 00:21:22.490
you can't get billed or reimbursed unless

00:21:22.529 --> 00:21:25.491
you are consuming the same oxygen as a

00:21:25.551 --> 00:21:27.212
licensed PT standing next to you.

00:21:27.913 --> 00:21:29.053
And so that regulation,

00:21:29.073 --> 00:21:30.013
we're not going to change.

00:21:30.054 --> 00:21:32.513
We failed at every Medicare regulation

00:21:32.554 --> 00:21:32.953
change.

00:21:32.993 --> 00:21:34.795
We take shallow victories and things that

00:21:34.835 --> 00:21:37.355
don't matter and things like direct access

00:21:37.375 --> 00:21:39.375
and things like the regulatory supervision

00:21:39.415 --> 00:21:40.115
requirements,

00:21:40.656 --> 00:21:43.017
eight minute rule and student supervision.

00:21:43.076 --> 00:21:45.298
We're not going to win, in my opinion.

00:21:45.857 --> 00:21:47.679
And so let's play the game and say,

00:21:47.719 --> 00:21:50.118
let's give them a license two years or

00:21:50.159 --> 00:21:51.799
halfway through PT school.

00:21:52.200 --> 00:21:54.180
So that way their billing will count.

00:21:54.279 --> 00:21:55.681
They will not be as productive.

00:21:55.701 --> 00:21:56.901
They do not have to start as a

00:21:56.941 --> 00:21:57.980
full time salary.

00:21:58.560 --> 00:22:00.582
Residents and interns don't get full time

00:22:00.622 --> 00:22:02.342
salaries either in the medical model.

00:22:02.843 --> 00:22:04.423
And that can become a pathway when you

00:22:04.462 --> 00:22:06.242
complete that time frame of a year,

00:22:06.262 --> 00:22:06.784
whatever it is,

00:22:06.824 --> 00:22:08.044
then you can get your DPT.

00:22:08.784 --> 00:22:11.204
So my point being is I think we

00:22:11.224 --> 00:22:14.125
have to develop a multitude of pathways,

00:22:14.526 --> 00:22:16.967
all of which uphold the rigor of academic

00:22:16.987 --> 00:22:18.646
and the competency and the knowledge base.

00:22:19.007 --> 00:22:19.948
But to Tim's point,

00:22:19.968 --> 00:22:22.368
what scares me the most is we will

00:22:22.409 --> 00:22:24.709
oftentimes default to too much technology,

00:22:24.729 --> 00:22:25.930
and then you're going to lose all tacit

00:22:25.970 --> 00:22:26.609
knowledge skills.

00:22:26.630 --> 00:22:27.990
You're going to lose collaboration and

00:22:28.049 --> 00:22:29.711
teamwork and empathy and compassion.

00:22:30.230 --> 00:22:32.032
And the things that really, you know,

00:22:32.053 --> 00:22:33.914
we're a victim of our success because we

00:22:33.974 --> 00:22:35.537
have the hands-on skills,

00:22:36.037 --> 00:22:37.558
we have the quantitative skills,

00:22:37.598 --> 00:22:40.461
but we also have the qualitative parts to

00:22:40.501 --> 00:22:41.603
our profession as well.

00:22:41.623 --> 00:22:43.265
And I'd hate to see that also be

00:22:43.325 --> 00:22:45.667
sacrificed for efficiency purposes.

00:22:47.833 --> 00:22:48.252
Yeah,

00:22:48.512 --> 00:22:49.673
I don't have a whole lot to add

00:22:49.733 --> 00:22:51.194
other than I do think nursing is a

00:22:51.234 --> 00:22:53.496
good example of, I mean,

00:22:53.935 --> 00:22:55.757
they have their own, you know,

00:22:55.896 --> 00:22:57.877
issues with so many accreditors and some

00:22:57.897 --> 00:22:58.699
of those kinds of things,

00:22:58.739 --> 00:23:00.619
but they've certainly been innovative in

00:23:00.660 --> 00:23:03.300
having lots of different pathways to all

00:23:03.361 --> 00:23:05.102
sorts of variations of

00:23:05.541 --> 00:23:07.864
master's degrees, bachelor's degrees,

00:23:07.923 --> 00:23:10.965
doctoral degrees to specifically equip you

00:23:10.986 --> 00:23:12.748
for the role that you're going to play

00:23:12.928 --> 00:23:15.309
in the nursing ecosystem.

00:23:15.490 --> 00:23:17.131
And at least in PT at this point,

00:23:17.171 --> 00:23:19.993
we sort of have a one-size-fits-all kind

00:23:20.034 --> 00:23:21.394
of an approach.

00:23:22.695 --> 00:23:24.217
And I would say I think the good

00:23:24.257 --> 00:23:26.699
news is we've got a lot of room

00:23:26.719 --> 00:23:27.318
to innovate.

00:23:27.439 --> 00:23:27.700
I mean,

00:23:27.720 --> 00:23:29.941
if you go back to the four-year bachelor,

00:23:31.241 --> 00:23:33.223
there was a time where there was

00:23:34.423 --> 00:23:35.344
I don't know if it was ever a

00:23:35.384 --> 00:23:36.505
third, a third, a third,

00:23:36.545 --> 00:23:38.707
but you'd be working in the same clinic

00:23:38.747 --> 00:23:40.989
with bachelor PTs, master's PTs,

00:23:41.229 --> 00:23:42.931
and doctoral PTs.

00:23:42.971 --> 00:23:44.352
Everybody would be in the same.

00:23:44.873 --> 00:23:46.314
And as you looked around at each other,

00:23:46.394 --> 00:23:47.694
I don't think any one of us would

00:23:47.755 --> 00:23:48.095
say, well,

00:23:48.115 --> 00:23:49.516
I'm a better PT than you are,

00:23:49.557 --> 00:23:51.117
or you're a better PT than I am.

00:23:51.498 --> 00:23:53.359
You've just had a different degree.

00:23:53.839 --> 00:23:54.059
Right.

00:23:54.421 --> 00:23:57.362
And now we're in a situation where there's

00:23:57.402 --> 00:24:00.023
probably few to there's probably still

00:24:00.064 --> 00:24:00.304
some,

00:24:00.324 --> 00:24:02.105
but there's probably very little bachelor

00:24:02.125 --> 00:24:03.606
PTs that are still practicing.

00:24:03.646 --> 00:24:06.248
And it's a mix of mostly doctoral PTs

00:24:06.268 --> 00:24:07.568
and some and some masters.

00:24:07.608 --> 00:24:09.550
My point in saying all that is we've

00:24:09.590 --> 00:24:12.412
got we've got like three years of room

00:24:12.471 --> 00:24:13.393
to kind of play with.

00:24:13.472 --> 00:24:13.692
Right.

00:24:13.833 --> 00:24:16.055
We went from four years all the way

00:24:16.095 --> 00:24:17.316
up to seven years.

00:24:18.316 --> 00:24:22.519
And so surely there are some innovative

00:24:22.579 --> 00:24:24.922
opportunities to bridge that gap.

00:24:25.782 --> 00:24:27.664
I think about it from the perspective of,

00:24:27.724 --> 00:24:27.904
you know,

00:24:27.924 --> 00:24:30.646
when we went from the master's degree to

00:24:30.686 --> 00:24:32.528
the DPT, you know,

00:24:32.669 --> 00:24:33.930
if you really look at it at its

00:24:33.970 --> 00:24:35.010
most foundational level,

00:24:35.030 --> 00:24:37.073
you have to ask yourself, OK, well,

00:24:37.393 --> 00:24:39.615
what else are PTs going to be learning

00:24:39.934 --> 00:24:41.957
in order to go from this master's degree

00:24:41.977 --> 00:24:42.538
to the DPT?

00:24:43.171 --> 00:24:44.251
At the end of the day,

00:24:44.571 --> 00:24:46.773
it was like diagnostic imaging,

00:24:48.275 --> 00:24:50.596
some primary care, medical screening.

00:24:51.037 --> 00:24:53.739
Think all things that would prepare us for

00:24:53.778 --> 00:24:55.299
direct access, right?

00:24:56.500 --> 00:24:59.242
Most programs were two years in length and

00:24:59.383 --> 00:25:00.323
higher ed, again,

00:25:00.383 --> 00:25:03.486
found a way to justify that that amount

00:25:03.526 --> 00:25:06.988
of content deserves an entire another year

00:25:07.107 --> 00:25:07.808
of education.

00:25:08.338 --> 00:25:09.859
When in reality, I mean,

00:25:09.900 --> 00:25:11.441
if we're really honest with ourselves,

00:25:11.721 --> 00:25:13.182
could we have done that in three months?

00:25:13.582 --> 00:25:14.823
Could we have done it in six months?

00:25:14.863 --> 00:25:15.482
For sure,

00:25:15.502 --> 00:25:16.804
we could have done it in six months.

00:25:17.884 --> 00:25:19.605
And so, you know,

00:25:19.765 --> 00:25:20.826
I don't think we have to get rid

00:25:20.865 --> 00:25:22.366
of the DPT and go back to the

00:25:22.406 --> 00:25:22.886
masters.

00:25:22.906 --> 00:25:24.748
I don't think anyone thinks that's really

00:25:24.788 --> 00:25:26.009
the path we're gonna take,

00:25:26.388 --> 00:25:28.390
but we can absolutely create these

00:25:29.711 --> 00:25:31.311
milestones along the way,

00:25:31.392 --> 00:25:33.633
like Larry alluded to, where, you know,

00:25:33.752 --> 00:25:34.773
we get a,

00:25:35.233 --> 00:25:36.174
a bachelor's degree,

00:25:36.214 --> 00:25:37.836
whether it's three years or four years,

00:25:37.915 --> 00:25:40.417
we go to a master's where we become

00:25:40.478 --> 00:25:42.240
licensed and we have the opportunity then

00:25:42.279 --> 00:25:44.922
to complete our, our DPT on the backside.

00:25:46.063 --> 00:25:47.143
And so there's just,

00:25:47.463 --> 00:25:48.805
there's a lot of opportunity,

00:25:49.184 --> 00:25:53.028
but we do have to have a regulatory

00:25:53.087 --> 00:25:55.990
body and a professional association that

00:25:56.009 --> 00:25:59.192
will embrace that, that innovation.

00:25:59.252 --> 00:26:00.473
If we continue to just

00:26:00.854 --> 00:26:01.173
You know,

00:26:01.273 --> 00:26:03.336
hit the hit the nail with the hammer

00:26:03.796 --> 00:26:05.196
and say it's a, you know,

00:26:05.317 --> 00:26:07.858
seven year DPT program.

00:26:08.720 --> 00:26:09.940
You know, we're never going to get there.

00:26:09.960 --> 00:26:10.840
Right.

00:26:10.861 --> 00:26:13.282
So who decides this or who needs to

00:26:13.303 --> 00:26:15.644
be the person that says this has to

00:26:15.683 --> 00:26:16.585
happen or else?

00:26:16.625 --> 00:26:16.724
Right.

00:26:16.744 --> 00:26:18.086
There needs to be consequences.

00:26:18.445 --> 00:26:20.086
It's a nice thing to have or it's

00:26:20.106 --> 00:26:20.887
a need to do.

00:26:21.248 --> 00:26:22.328
Who's in charge of that?

00:26:25.000 --> 00:26:27.701
Yeah, so just to allude to this,

00:26:27.741 --> 00:26:30.644
but employers of PTs are severely

00:26:30.703 --> 00:26:32.986
underrepresented in this argument.

00:26:33.605 --> 00:26:35.146
We grouse, we complain,

00:26:35.847 --> 00:26:38.130
but we seldom have any voice or influence.

00:26:38.190 --> 00:26:40.431
And so we have to have employers banding

00:26:40.471 --> 00:26:41.971
together and locking arms with our

00:26:42.031 --> 00:26:43.854
academics and our higher education with

00:26:43.894 --> 00:26:45.315
our regulators around this.

00:26:45.980 --> 00:26:46.141
You know,

00:26:46.161 --> 00:26:47.803
there's this other interesting phenomenon

00:26:47.843 --> 00:26:48.864
that sort of happened,

00:26:48.903 --> 00:26:50.987
I refer to as the post-COVID hangover.

00:26:51.626 --> 00:26:53.849
And that is the reality that during the

00:26:53.990 --> 00:26:55.050
COVID time period,

00:26:55.090 --> 00:26:56.873
things were incredibly relaxed

00:26:56.953 --> 00:26:57.954
regulation-wise,

00:26:58.095 --> 00:26:59.557
which allowed people to do remote

00:26:59.596 --> 00:26:59.916
learning.

00:27:01.653 --> 00:27:03.795
We were deemed heretics by our own

00:27:03.974 --> 00:27:06.036
profession for trying to do a two-year

00:27:06.076 --> 00:27:08.076
hybrid PT program.

00:27:08.616 --> 00:27:10.278
And we had decent number of years,

00:27:10.357 --> 00:27:12.199
even prior to COVID launching.

00:27:12.239 --> 00:27:12.939
COVID launched,

00:27:12.979 --> 00:27:14.460
our phones were ringing off the hook with

00:27:14.480 --> 00:27:15.500
people, how do we do this?

00:27:15.539 --> 00:27:17.820
Because we suddenly had academics,

00:27:17.861 --> 00:27:19.301
particularly in our own profession, said,

00:27:19.422 --> 00:27:20.162
never, ever,

00:27:20.221 --> 00:27:22.323
ever over my dead body will I teach

00:27:22.383 --> 00:27:22.863
online.

00:27:22.903 --> 00:27:24.483
Now, wanting calling and saying,

00:27:24.523 --> 00:27:26.263
how do I teach instructional design?

00:27:26.304 --> 00:27:27.265
How do I learn?

00:27:27.785 --> 00:27:28.865
and do things online.

00:27:29.425 --> 00:27:29.945
All good.

00:27:30.625 --> 00:27:31.385
Things have changed.

00:27:31.405 --> 00:27:32.646
There are a lot more programs.

00:27:32.686 --> 00:27:34.307
That's a step in the right direction,

00:27:34.327 --> 00:27:35.587
but it hasn't cured anything.

00:27:36.107 --> 00:27:37.769
And the reality is, as an employer,

00:27:37.828 --> 00:27:40.470
I can tell you that PTs are coming

00:27:40.650 --> 00:27:41.849
out with less reps.

00:27:41.890 --> 00:27:43.851
They're coming out with less clinical

00:27:43.891 --> 00:27:45.971
confidence and less clinical readiness.

00:27:45.991 --> 00:27:48.452
That's not an old fogey saying, you know,

00:27:48.853 --> 00:27:50.192
they're not as good as they were when

00:27:50.232 --> 00:27:50.753
we were there.

00:27:50.794 --> 00:27:52.794
That is well documented amongst the

00:27:52.834 --> 00:27:53.634
employer groups.

00:27:53.654 --> 00:27:54.474
So what do we have to do?

00:27:54.494 --> 00:27:56.655
We have to even put more resources

00:27:57.316 --> 00:27:59.596
into the training of new pts that have

00:27:59.876 --> 00:28:02.417
suddenly paid for six or seven years of

00:28:02.478 --> 00:28:04.157
school and aren't clinically ready now

00:28:04.178 --> 00:28:06.078
this just isn't a pt phenomenon i work

00:28:06.118 --> 00:28:07.679
in dentistry now it's the same thing there

00:28:07.700 --> 00:28:09.579
it's the same thing in primary care it's

00:28:09.619 --> 00:28:12.040
the same thing across because the regs

00:28:12.121 --> 00:28:14.182
relaxed enough were enough reps enough

00:28:14.221 --> 00:28:15.922
clinical experience so we do have to go

00:28:15.961 --> 00:28:17.863
back to a more lengthier

00:28:18.303 --> 00:28:18.544
you know,

00:28:18.584 --> 00:28:21.166
time period and on the clinical side and

00:28:21.227 --> 00:28:21.847
regain that.

00:28:21.928 --> 00:28:23.711
Is it a less quality student?

00:28:24.031 --> 00:28:24.392
I don't know.

00:28:24.412 --> 00:28:26.013
I'm not willing to go there necessarily,

00:28:26.074 --> 00:28:27.876
other than the failure rates seem to seem

00:28:27.896 --> 00:28:29.459
to suggest a correlation there.

00:28:30.000 --> 00:28:32.604
But I want to get a better clinical

00:28:33.484 --> 00:28:34.086
education,

00:28:34.165 --> 00:28:34.606
which we've

00:28:35.017 --> 00:28:37.200
collectively referred to as the big black

00:28:37.240 --> 00:28:37.441
hole.

00:28:37.461 --> 00:28:41.006
And we have some strong opinions about how

00:28:41.046 --> 00:28:41.767
to correct that.

00:28:42.208 --> 00:28:44.290
But I'll let Tim comment on the regulatory

00:28:44.391 --> 00:28:44.671
side,

00:28:44.711 --> 00:28:46.934
how we can figure out a way amongst

00:28:46.954 --> 00:28:48.797
the key stakeholders to get this thing

00:28:48.836 --> 00:28:49.157
turned.

00:28:51.969 --> 00:28:54.311
Well, thanks for that, Larry, I think.

00:28:57.214 --> 00:29:00.137
Part of it is...

00:29:00.337 --> 00:29:02.339
As the most current practicing academic,

00:29:02.380 --> 00:29:05.282
I thought you might have some ideas on

00:29:05.323 --> 00:29:06.163
how we can do that.

00:29:06.203 --> 00:29:06.723
Maybe not.

00:29:06.743 --> 00:29:08.266
Well,

00:29:08.405 --> 00:29:11.009
I was always offended when I was called,

00:29:11.128 --> 00:29:11.849
and I still am.

00:29:12.589 --> 00:29:13.691
called an academician.

00:29:13.871 --> 00:29:14.632
And I mean,

00:29:15.332 --> 00:29:17.094
I just have always felt that I'm a

00:29:17.114 --> 00:29:19.875
clinician and I never fit in the world

00:29:19.915 --> 00:29:23.258
of academia because it just,

00:29:23.618 --> 00:29:25.779
it's an area where, and again,

00:29:26.039 --> 00:29:28.882
I have wonderful colleagues in academia,

00:29:29.563 --> 00:29:33.526
but the difference between sitting around

00:29:33.546 --> 00:29:35.467
a table for an hour and a half

00:29:36.407 --> 00:29:38.829
and discussing things

00:29:39.773 --> 00:29:43.256
and debating things that just,

00:29:44.356 --> 00:29:46.778
you can't do that when you're actually

00:29:47.679 --> 00:29:48.960
trying to make payroll.

00:29:49.200 --> 00:29:51.421
I mean, that just, it just doesn't happen.

00:29:54.403 --> 00:29:57.144
Unfortunately, you know, you think about,

00:29:57.464 --> 00:29:57.704
you know,

00:29:57.744 --> 00:30:00.526
academia being liberal thinking and out

00:30:00.566 --> 00:30:01.707
there new ideas,

00:30:01.767 --> 00:30:03.367
and I would argue it is not.

00:30:03.548 --> 00:30:04.689
It is very much

00:30:05.410 --> 00:30:07.211
rooted in, you know,

00:30:07.830 --> 00:30:12.193
tradition and the threats of, you know,

00:30:12.253 --> 00:30:14.035
something doing something different.

00:30:14.134 --> 00:30:16.256
And that's just so I don't think

00:30:17.277 --> 00:30:18.237
unfortunately,

00:30:18.557 --> 00:30:20.398
universities are where we're going to look

00:30:20.459 --> 00:30:22.460
to see change happen.

00:30:23.180 --> 00:30:27.002
And and when it comes to regulatory

00:30:27.042 --> 00:30:30.223
bodies, you know, that's that's again,

00:30:30.243 --> 00:30:32.105
you know,

00:30:32.385 --> 00:30:32.786
rigid

00:30:33.507 --> 00:30:36.128
hard to push through hard to do anything

00:30:36.308 --> 00:30:39.289
innovative i really think the change

00:30:39.549 --> 00:30:43.833
happens unfortunately through the through

00:30:43.853 --> 00:30:45.814
a crisis is what we're seeing you know

00:30:45.834 --> 00:30:48.935
as we see you know this huge demand

00:30:49.435 --> 00:30:52.156
for our services but not able to create

00:30:52.176 --> 00:30:55.078
a product out there that that

00:30:56.536 --> 00:30:57.676
can meet that demand.

00:30:57.737 --> 00:31:01.741
So I'm more hopeful that, you know,

00:31:02.082 --> 00:31:06.847
our business leaders and our actually work

00:31:07.228 --> 00:31:09.590
areas will be able to

00:31:11.258 --> 00:31:13.778
change and partner with higher ed in a

00:31:13.838 --> 00:31:17.020
way that other businesses have to say this

00:31:17.060 --> 00:31:19.280
is what we need and we're willing to

00:31:19.340 --> 00:31:22.303
come and partner with you to create this

00:31:23.782 --> 00:31:25.284
if you know we know that you're gonna

00:31:25.344 --> 00:31:28.884
feed us a quality person to work in

00:31:29.005 --> 00:31:30.746
our in our in our field so that

00:31:32.727 --> 00:31:35.307
I guess my sense is it's going to

00:31:35.347 --> 00:31:35.468
be

00:31:36.457 --> 00:31:38.298
going to be hard but the second thing

00:31:38.377 --> 00:31:41.078
is with the this quote-unquote educational

00:31:41.118 --> 00:31:43.359
cliff I think the bachelor's thing isn't

00:31:43.400 --> 00:31:47.142
going to be that difficult because there's

00:31:47.281 --> 00:31:50.303
so fewer students that everybody's

00:31:50.343 --> 00:31:52.384
competing for and that bachelor's level

00:31:52.923 --> 00:31:56.566
that those that are innovative there

00:31:57.268 --> 00:31:58.788
I think we'll be able to scale up

00:31:58.828 --> 00:32:00.230
and have larger programs,

00:32:00.289 --> 00:32:03.311
especially if they really focus like some

00:32:03.332 --> 00:32:05.814
of these private, dare I say,

00:32:05.874 --> 00:32:08.595
for profit institutions that are actually

00:32:08.714 --> 00:32:11.497
responsive to a bottom line to say, hey,

00:32:11.916 --> 00:32:14.038
we can scale up and get more people

00:32:14.078 --> 00:32:15.900
through a bachelor's program in three

00:32:15.940 --> 00:32:18.121
years and feed into all these different

00:32:18.181 --> 00:32:22.243
health care programs that we all need kind

00:32:22.263 --> 00:32:23.644
of a similar skill set, I think.

00:32:24.484 --> 00:32:25.505
Whoever does that,

00:32:25.545 --> 00:32:26.905
and maybe some people are,

00:32:26.945 --> 00:32:29.046
but it's definitely not common.

00:32:29.405 --> 00:32:30.826
Whoever does that quickly,

00:32:31.227 --> 00:32:34.227
I think can rapidly fill seats and be

00:32:34.267 --> 00:32:36.928
able to help that side of the workforce

00:32:36.988 --> 00:32:38.868
and roll them into DPT.

00:32:38.929 --> 00:32:41.449
So that was a long-winded answer to say

00:32:43.769 --> 00:32:47.290
I'm not real hopeful that I can see

00:32:47.351 --> 00:32:48.730
disruption happening

00:32:49.619 --> 00:32:52.544
anytime soon but maybe i'm curious what

00:32:52.584 --> 00:32:55.048
larry's thoughts are actually because you

00:32:55.107 --> 00:32:58.232
always have those uh oh go ahead john

00:32:58.887 --> 00:32:59.627
Well, no, I was going to say,

00:32:59.647 --> 00:33:01.368
I'll just add one anecdote that sort of

00:33:01.409 --> 00:33:03.470
touches on sort of the resistance in

00:33:03.509 --> 00:33:06.611
higher ed and amongst accrediting bodies.

00:33:06.671 --> 00:33:08.251
And in our case, that's CAPTI.

00:33:09.173 --> 00:33:10.712
I mean, this is ten years ago,

00:33:10.752 --> 00:33:13.153
but I will never forget the moment that

00:33:14.295 --> 00:33:16.016
we sat across the site visitors.

00:33:16.036 --> 00:33:17.915
This was the very first hybrid two year

00:33:17.935 --> 00:33:19.836
DPT program at South College.

00:33:20.857 --> 00:33:22.218
This was probably I don't know if it

00:33:22.238 --> 00:33:23.519
was twenty thirteen,

00:33:23.979 --> 00:33:25.839
something around that time frame.

00:33:26.859 --> 00:33:29.461
This was the hybrid model where all the

00:33:29.681 --> 00:33:31.741
didactics were going to be done online,

00:33:31.781 --> 00:33:33.843
synchronously, asynchronously.

00:33:33.883 --> 00:33:35.323
Then when they came onto the campus,

00:33:35.363 --> 00:33:36.384
it was going to be eight,

00:33:36.423 --> 00:33:38.344
nine hours a day on your feet,

00:33:38.963 --> 00:33:40.105
getting all those reps in.

00:33:40.384 --> 00:33:42.506
This idea that psychomotor practice over

00:33:42.526 --> 00:33:43.246
and over and over,

00:33:43.746 --> 00:33:43.986
you know,

00:33:44.086 --> 00:33:45.807
over a seven to ten day period,

00:33:46.087 --> 00:33:46.268
you know,

00:33:46.288 --> 00:33:49.130
maybe those skills could be retained in a

00:33:49.190 --> 00:33:52.231
more effective way than this sort of

00:33:52.471 --> 00:33:53.292
lecture lab,

00:33:53.333 --> 00:33:55.634
lecture lab model that's very inefficient

00:33:55.674 --> 00:33:57.596
in a lot of traditional programs.

00:33:57.695 --> 00:33:59.597
And I will never forget when one of

00:33:59.637 --> 00:34:01.439
the site visitors looked across from me

00:34:01.479 --> 00:34:04.121
with this sort of blank stare and said,

00:34:04.181 --> 00:34:04.882
but John,

00:34:05.301 --> 00:34:07.343
by having them in labs all day long,

00:34:07.482 --> 00:34:09.284
you're going to exhaust these students.

00:34:10.329 --> 00:34:11.811
And I'm sitting there and I'll never

00:34:11.871 --> 00:34:12.871
forget my reaction.

00:34:12.952 --> 00:34:16.034
I had a really hard time not almost

00:34:16.173 --> 00:34:16.893
lashing out.

00:34:16.954 --> 00:34:18.094
I mean, I wanted to be like,

00:34:18.815 --> 00:34:21.016
that's exactly what we do as clinicians.

00:34:21.056 --> 00:34:23.378
We stand on our feet going from patient

00:34:23.398 --> 00:34:23.958
to patient.

00:34:23.998 --> 00:34:25.659
I mean,

00:34:26.119 --> 00:34:28.161
it's a marathon in the day of the

00:34:28.201 --> 00:34:29.862
life of a clinician.

00:34:30.021 --> 00:34:31.063
And so my point is,

00:34:31.103 --> 00:34:34.744
is that you have these sort of incumbents,

00:34:35.266 --> 00:34:36.606
dare I say gray hairs,

00:34:37.755 --> 00:34:39.996
that have not been in practice for many

00:34:40.056 --> 00:34:40.536
years,

00:34:40.836 --> 00:34:43.318
who've completely lost perspective with

00:34:43.398 --> 00:34:45.478
what a clinician does every day.

00:34:46.519 --> 00:34:48.159
And so, you know,

00:34:48.179 --> 00:34:50.181
we have to get the perspective of

00:34:50.260 --> 00:34:51.621
clinicians to Larry's point,

00:34:52.001 --> 00:34:55.583
employers have to band together, you know,

00:34:55.623 --> 00:34:56.664
without employers,

00:34:56.684 --> 00:34:57.824
we don't have clinical sites,

00:34:57.844 --> 00:34:59.106
employers have far more

00:34:59.746 --> 00:35:03.887
potential influence than I think we've

00:35:03.947 --> 00:35:05.409
realized as employers.

00:35:05.429 --> 00:35:09.351
So I think employers are a bright spot.

00:35:10.452 --> 00:35:11.311
Nursing, again,

00:35:11.331 --> 00:35:12.213
we've talked about nursing.

00:35:12.233 --> 00:35:13.713
They have so many different pathways.

00:35:14.054 --> 00:35:14.434
In part,

00:35:14.454 --> 00:35:16.494
that's because they have so many different

00:35:16.534 --> 00:35:17.215
accreditors.

00:35:18.215 --> 00:35:20.317
And so those different accreditors have

00:35:20.356 --> 00:35:23.119
sort of different flavors of kind of risk

00:35:23.199 --> 00:35:24.579
appetite for innovation.

00:35:25.139 --> 00:35:27.221
And it depends on the state you're in.

00:35:28.181 --> 00:35:29.902
I personally think we should have more

00:35:29.943 --> 00:35:30.724
than one accreditor.

00:35:30.784 --> 00:35:32.385
Right now we have one in CAPTI.

00:35:33.326 --> 00:35:36.487
The problem is individuals have looked at

00:35:36.547 --> 00:35:38.168
starting other accrediting bodies,

00:35:38.228 --> 00:35:40.952
but I'll forget how many states it is,

00:35:40.992 --> 00:35:42.813
but in let's call it twenty to thirty,

00:35:42.833 --> 00:35:44.273
it might even be forty states.

00:35:44.693 --> 00:35:49.657
CAPTI is specifically named in the

00:35:49.697 --> 00:35:51.519
practice act as you have to graduate from

00:35:51.619 --> 00:35:51.639
a

00:35:52.039 --> 00:35:53.300
CAPTI accredited program,

00:35:53.360 --> 00:35:55.181
not just an accredited program, right?

00:35:55.641 --> 00:35:58.364
And so in order to compete,

00:35:58.643 --> 00:36:00.063
so to speak, with CAPTI,

00:36:00.764 --> 00:36:02.306
you'd have to literally change practice

00:36:02.385 --> 00:36:03.266
acts in all these states,

00:36:03.306 --> 00:36:05.047
which would take fifty years to do and

00:36:05.067 --> 00:36:05.786
it may never happen.

00:36:05.847 --> 00:36:06.947
So, you know,

00:36:07.007 --> 00:36:08.028
at the at the end of the day,

00:36:08.068 --> 00:36:10.429
we need more competition and we need more

00:36:10.489 --> 00:36:13.251
willingness to accept really innovative

00:36:13.592 --> 00:36:16.713
practice models or educational models.

00:36:17.134 --> 00:36:18.393
What happens if it doesn't change?

00:36:18.574 --> 00:36:19.755
And we mean we need more

00:36:22.235 --> 00:36:22.755
Well,

00:36:22.795 --> 00:36:25.217
part of the unintended consequence of all

00:36:25.257 --> 00:36:26.579
this is, you know,

00:36:26.619 --> 00:36:30.282
physical therapy tuition in the higher ed

00:36:30.362 --> 00:36:31.402
level, I'll start there,

00:36:32.244 --> 00:36:34.646
has been unabated relative to their

00:36:34.766 --> 00:36:37.849
increases in cost and tuition factors.

00:36:39.090 --> 00:36:41.652
And so as that has exceeded inflation for

00:36:41.692 --> 00:36:42.411
so many years,

00:36:42.472 --> 00:36:45.355
it's finally starting to have, you know,

00:36:45.394 --> 00:36:47.295
some counterbalance in it because of some

00:36:47.335 --> 00:36:48.416
other disruption that's going on.

00:36:48.556 --> 00:36:49.378
I'm not talking about PT,

00:36:49.398 --> 00:36:50.699
I'm talking about higher ed in general.

00:36:51.322 --> 00:36:53.123
But the reality is who would go into

00:36:53.143 --> 00:36:55.324
the profession for the ROI that you get

00:36:55.664 --> 00:36:56.885
at this particular stage?

00:36:56.905 --> 00:36:58.905
That is our selfish motivation for wanting

00:36:58.925 --> 00:36:59.467
to correct this.

00:36:59.487 --> 00:37:00.827
We want our best and brightest to go

00:37:00.907 --> 00:37:01.226
into it.

00:37:01.588 --> 00:37:03.969
There is absolutely, in fact,

00:37:04.009 --> 00:37:05.548
the way you can tell the ROI is

00:37:05.588 --> 00:37:09.271
so bad is only about on an FTE

00:37:09.311 --> 00:37:09.931
basis,

00:37:10.592 --> 00:37:14.333
only north of of all licensed PTs practice

00:37:14.512 --> 00:37:17.474
PT, okay, on a full-time basis.

00:37:18.353 --> 00:37:20.014
What other profession can you name in

00:37:20.054 --> 00:37:22.376
health care that has that obstacle?

00:37:22.797 --> 00:37:24.697
What other profession, period,

00:37:24.737 --> 00:37:26.500
health care, unrelated to health care,

00:37:26.760 --> 00:37:28.721
can honestly say we've had less

00:37:28.780 --> 00:37:31.222
productivity today than we had ten and

00:37:31.262 --> 00:37:32.744
fifteen and twenty years ago?

00:37:33.625 --> 00:37:35.686
I don't know of any other occupation in

00:37:35.746 --> 00:37:37.447
America that can say that.

00:37:37.746 --> 00:37:38.947
But PT, we have.

00:37:39.469 --> 00:37:41.570
So the issue is we are overregulated.

00:37:42.282 --> 00:37:44.463
And unless you get a combination of

00:37:44.543 --> 00:37:47.547
decreased regulations and or enhancement

00:37:47.947 --> 00:37:49.507
of reimbursement,

00:37:49.949 --> 00:37:51.150
certainly don't see that coming.

00:37:51.590 --> 00:37:53.751
You're gonna have a degree that has priced

00:37:53.811 --> 00:37:57.554
itself out of competition for the souls

00:37:57.574 --> 00:37:58.795
and the minds of young people.

00:37:59.516 --> 00:38:01.480
I think the other issue is you have

00:38:01.519 --> 00:38:02.420
to get, you know,

00:38:02.460 --> 00:38:04.742
the problem is the states are relatively

00:38:04.784 --> 00:38:05.543
the easy ones.

00:38:05.625 --> 00:38:07.266
They basically say to get a license,

00:38:07.867 --> 00:38:09.489
you have to graduate from accredited

00:38:09.528 --> 00:38:10.010
program.

00:38:10.110 --> 00:38:11.190
I think we can get the ones that

00:38:11.210 --> 00:38:13.293
say CAPTI reverse with probably opening up

00:38:13.313 --> 00:38:14.255
that practice act.

00:38:14.295 --> 00:38:15.597
But, you know, it's an obstacle,

00:38:15.657 --> 00:38:17.157
but they're the easiest.

00:38:17.219 --> 00:38:18.780
The more difficult one is CAPTI.

00:38:19.320 --> 00:38:22.324
And CAPTI is intertwined, co-located,

00:38:22.764 --> 00:38:25.869
and housed by APTA and needs to respond

00:38:25.889 --> 00:38:26.911
to its constituents,

00:38:26.951 --> 00:38:29.092
which are PTs and employers and

00:38:29.152 --> 00:38:29.954
academicians.

00:38:30.675 --> 00:38:35.001
And we failed the first two times to

00:38:35.041 --> 00:38:36.442
try to get a hybrid PT program.

00:38:37.043 --> 00:38:38.543
We failed at it because it was

00:38:38.663 --> 00:38:40.224
unacceptable in the view of the

00:38:40.244 --> 00:38:40.844
accreditors.

00:38:40.864 --> 00:38:41.963
I don't know if that's public knowledge.

00:38:41.983 --> 00:38:42.784
I don't even know if I'm allowed to

00:38:42.804 --> 00:38:43.405
say that, John.

00:38:43.445 --> 00:38:46.646
But it's absolutely because they could not

00:38:46.726 --> 00:38:48.385
handle that type of innovation.

00:38:49.045 --> 00:38:51.987
Now you've got highbrow universities doing

00:38:52.047 --> 00:38:53.307
two-year hybrid programs.

00:38:54.367 --> 00:38:56.007
And we have to go down that same

00:38:56.068 --> 00:38:57.088
route, unfortunately.

00:38:57.128 --> 00:38:58.228
But what we can't do,

00:38:58.809 --> 00:39:00.349
we thought within a few years of the

00:39:00.389 --> 00:39:02.170
first hybrid program that there would be

00:39:02.269 --> 00:39:02.849
imitators.

00:39:03.150 --> 00:39:04.731
It didn't take till post-COVID.

00:39:05.210 --> 00:39:07.213
until, you know, two thousand twenty two,

00:39:07.253 --> 00:39:08.373
two thousand twenty three.

00:39:08.393 --> 00:39:09.514
These other programs came out.

00:39:09.554 --> 00:39:10.556
Meanwhile, we've got, I don't know,

00:39:10.596 --> 00:39:11.956
fifteen or seventeen of these.

00:39:12.338 --> 00:39:13.878
And now it's becoming more and more

00:39:13.958 --> 00:39:14.478
normalized.

00:39:14.800 --> 00:39:16.541
That's a good thing, but it's not enough.

00:39:16.822 --> 00:39:17.983
We need multiple pathways,

00:39:18.023 --> 00:39:20.105
but we've got to get the creditors in

00:39:20.144 --> 00:39:22.186
a room with employers and academicians.

00:39:23.126 --> 00:39:24.128
And like we said,

00:39:24.148 --> 00:39:25.849
the States are the easiest ones I think

00:39:25.869 --> 00:39:26.550
to overcome.

00:39:27.090 --> 00:39:28.552
And then you've got to get,

00:39:29.032 --> 00:39:30.833
you've got to get some pioneers out there

00:39:30.913 --> 00:39:32.094
and it's probably going to come from the

00:39:32.153 --> 00:39:34.456
for profits because they tend to be the

00:39:34.496 --> 00:39:35.836
most innovative and flexible.

00:39:36.898 --> 00:39:39.940
You cannot name great innovation with the

00:39:39.981 --> 00:39:41.561
exception of maybe Arizona state,

00:39:41.601 --> 00:39:42.543
not on the PT side,

00:39:42.563 --> 00:39:43.463
just talking generally,

00:39:43.784 --> 00:39:45.425
there are not a lot of high innovators

00:39:45.485 --> 00:39:46.865
on the public side that

00:39:46.945 --> 00:39:48.246
private side or even fewer.

00:39:48.286 --> 00:39:49.887
And so it's the for-profits that got to

00:39:49.907 --> 00:39:50.047
say,

00:39:50.086 --> 00:39:51.807
we'll do a bachelor completer program in

00:39:51.827 --> 00:39:53.068
three years and get you ready for a

00:39:53.128 --> 00:39:55.068
PT program that you can do a three

00:39:55.088 --> 00:39:55.869
plus two model.

00:39:56.349 --> 00:39:57.668
I think there's a pathway there and

00:39:57.688 --> 00:39:58.750
there's an opportunity,

00:39:59.630 --> 00:40:01.090
but it's going to take probably a younger

00:40:01.130 --> 00:40:03.570
set than Tim, Tim, John, I,

00:40:03.590 --> 00:40:05.072
and Rob Wainer to get it done this

00:40:05.112 --> 00:40:05.452
time.

00:40:06.621 --> 00:40:07.661
Maybe not.

00:40:07.681 --> 00:40:09.422
Follow along in the series as these guys

00:40:09.443 --> 00:40:10.403
keep writing about it.

00:40:10.603 --> 00:40:11.884
I'll share the link in the show notes.

00:40:11.923 --> 00:40:13.264
Do you want to say thanks to Empower

00:40:13.364 --> 00:40:14.664
EMR for supporting the show?

00:40:14.684 --> 00:40:16.626
If your clinic is stuck on an EMR

00:40:16.646 --> 00:40:18.867
that slows you down, you have to innovate.

00:40:19.407 --> 00:40:21.148
Empower gives you speed, clean workflows,

00:40:21.188 --> 00:40:22.907
and features PTs actually ask for.

00:40:22.967 --> 00:40:24.509
Better notes, faster documentation,

00:40:25.248 --> 00:40:26.349
smooth operations,

00:40:26.449 --> 00:40:27.750
all wrapped in customer support.

00:40:27.769 --> 00:40:28.590
It doesn't ghost you.

00:40:29.110 --> 00:40:30.411
EmpowerEMR.com.

00:40:30.811 --> 00:40:33.132
EmpowerEMR.com.

00:40:33.192 --> 00:40:34.972
If we don't change the timeline...

00:40:35.753 --> 00:40:36.753
If nothing changes,

00:40:36.813 --> 00:40:39.114
what does twenty thirty look like if there

00:40:39.735 --> 00:40:41.315
if Marty can't lose?

00:40:41.735 --> 00:40:41.936
Right.

00:40:41.956 --> 00:40:43.416
There's no tension in the story.

00:40:43.476 --> 00:40:44.617
People won't pay attention.

00:40:44.717 --> 00:40:44.956
I mean,

00:40:45.077 --> 00:40:47.277
I'm guessing if there if there isn't some

00:40:47.318 --> 00:40:48.398
consequence on the line,

00:40:48.438 --> 00:40:50.239
which we can see very clearly,

00:40:50.278 --> 00:40:51.960
even someone like me who's an amateur at

00:40:52.000 --> 00:40:53.159
this can see there's consequence.

00:40:53.740 --> 00:40:54.860
If we don't change the timeline,

00:40:54.900 --> 00:40:56.641
what does twenty thirty look like for the

00:40:56.681 --> 00:40:57.362
profession?

00:40:57.481 --> 00:41:02.603
And then we'll do parting shots.

00:41:02.623 --> 00:41:03.264
Looking at you, Tim.

00:41:04.465 --> 00:41:08.248
Okay, well, I guess if nothing changes,

00:41:09.748 --> 00:41:13.291
we'll continue to see fewer seats filled

00:41:13.451 --> 00:41:14.931
in DPT education.

00:41:15.952 --> 00:41:19.213
The type of applicant that we'll get

00:41:19.914 --> 00:41:22.275
probably in no shade here,

00:41:22.355 --> 00:41:23.815
it'll be people that love it.

00:41:24.425 --> 00:41:25.447
the profession,

00:41:25.847 --> 00:41:28.588
but probably have a trust fund or

00:41:28.648 --> 00:41:30.349
something else that allows them to go

00:41:30.409 --> 00:41:33.052
through higher ed without debt,

00:41:34.293 --> 00:41:37.094
but also probably would rather work

00:41:37.215 --> 00:41:40.677
part-time on the outside of it.

00:41:41.297 --> 00:41:43.619
We'll continue to see people doing it as

00:41:43.820 --> 00:41:47.041
more of a hobby, if you will.

00:41:47.922 --> 00:41:48.242
Again,

00:41:48.722 --> 00:41:50.643
more and more people working less

00:41:50.684 --> 00:41:51.344
full-time

00:41:52.108 --> 00:41:54.929
doing other things and having side gigs in

00:41:54.949 --> 00:41:55.710
the profession.

00:41:56.449 --> 00:41:58.231
And what fills the gap?

00:41:58.690 --> 00:42:02.692
Then it's just every other flavor of body

00:42:02.751 --> 00:42:06.913
worker will fill the gap out there.

00:42:07.592 --> 00:42:08.974
And the health of our society,

00:42:09.193 --> 00:42:11.554
I firmly believe will go down.

00:42:11.775 --> 00:42:14.514
As a physical therapist that sees over and

00:42:14.594 --> 00:42:16.936
over the failure of our system

00:42:17.873 --> 00:42:19.356
I'm not it's going to get a lot

00:42:19.456 --> 00:42:21.577
worse in terms of health care outcomes in

00:42:21.637 --> 00:42:24.059
our society.

00:42:24.159 --> 00:42:25.161
All right, Larry, John,

00:42:25.260 --> 00:42:26.563
anything he missed there is going to get

00:42:26.623 --> 00:42:28.324
harder as we go along because he's covered

00:42:28.344 --> 00:42:28.864
a lot of bases.

00:42:28.925 --> 00:42:30.907
Anything you'd want to add to that?

00:42:33.340 --> 00:42:34.559
I'll just sort of, I think,

00:42:34.639 --> 00:42:35.800
amplify what Tim said.

00:42:35.880 --> 00:42:39.181
We'll see less diversity in PT.

00:42:39.340 --> 00:42:42.702
It'll be largely Caucasian, affluent,

00:42:43.641 --> 00:42:47.242
passionate people that maybe had a real

00:42:47.282 --> 00:42:50.862
positive experience in PT and debt to

00:42:50.922 --> 00:42:52.103
income sort of ratios.

00:42:52.262 --> 00:42:53.943
They don't even think about what that

00:42:54.103 --> 00:42:55.923
means for them because they have no debt.

00:42:56.923 --> 00:43:00.005
I think we'll see certainly a contraction

00:43:00.065 --> 00:43:00.764
in the number of

00:43:01.211 --> 00:43:02.311
of PT programs.

00:43:02.632 --> 00:43:04.092
There's just no way these smaller

00:43:04.193 --> 00:43:06.152
under-resourced programs will be able to,

00:43:06.552 --> 00:43:07.793
you know, I think, you know,

00:43:07.813 --> 00:43:10.313
survive in that scenario.

00:43:10.414 --> 00:43:12.635
So, you know,

00:43:12.835 --> 00:43:14.355
I'm always a glass half full.

00:43:15.014 --> 00:43:16.534
I think the crisis is in front of

00:43:16.594 --> 00:43:18.416
us, like literally as we speak.

00:43:19.235 --> 00:43:22.797
So I'm hopeful we can, you know, really

00:43:24.317 --> 00:43:26.217
you know hopefully eyes are opened uh even

00:43:26.257 --> 00:43:28.998
amongst the the those that are that have

00:43:29.018 --> 00:43:31.519
been most resistant to change and realize

00:43:32.099 --> 00:43:34.760
um uh you know without significant reform

00:43:35.141 --> 00:43:37.581
you know our profession is in uh some

00:43:37.601 --> 00:43:40.983
amount of of peril yeah all right larry

00:43:41.023 --> 00:43:42.643
no pressure but twenty thirty nothing

00:43:42.684 --> 00:43:43.425
happens yeah just a

00:43:46.001 --> 00:43:46.141
Well,

00:43:46.601 --> 00:43:48.762
I expect if you think there's twenty to

00:43:48.782 --> 00:43:50.605
thirty thousand shortage of PTs now,

00:43:50.625 --> 00:43:52.385
that'll increase five to seven thousand

00:43:52.445 --> 00:43:53.045
per year,

00:43:54.568 --> 00:43:56.289
notwithstanding because you have less

00:43:56.329 --> 00:43:58.530
graduates that actually practice clinical

00:43:58.550 --> 00:43:59.411
PT than ever.

00:43:59.931 --> 00:44:02.494
We will have less clinicians per year than

00:44:02.534 --> 00:44:04.195
we had prior to two thousand one,

00:44:04.215 --> 00:44:05.735
which is actually quite scary given the

00:44:05.775 --> 00:44:06.757
demand for PT.

00:44:07.097 --> 00:44:09.039
But the unfortunate thing is that PT will

00:44:09.239 --> 00:44:11.221
continue to be highly undifferentiated.

00:44:11.740 --> 00:44:14.802
Digital front doors and digital exercise

00:44:14.822 --> 00:44:16.563
will be conflated with PT,

00:44:16.802 --> 00:44:19.164
as will at-home remote therapeutic

00:44:19.244 --> 00:44:22.445
monitoring and YouTube.

00:44:22.545 --> 00:44:24.226
And so there'll be this bifurcation.

00:44:24.266 --> 00:44:26.088
If you've got money and you're young and

00:44:26.108 --> 00:44:26.608
you're healthy,

00:44:26.628 --> 00:44:28.208
you'll be able to access PT.

00:44:28.228 --> 00:44:30.130
But if you're sick and you're elderly,

00:44:30.530 --> 00:44:32.951
your access points for PT, my goodness,

00:44:32.971 --> 00:44:34.731
if you're in a long-term care setting or

00:44:34.751 --> 00:44:35.692
a home health setting,

00:44:36.172 --> 00:44:37.532
even in acute care setting,

00:44:38.032 --> 00:44:39.213
certainly neuro rehab,

00:44:39.574 --> 00:44:41.235
you're going to have a hard time accessing

00:44:41.275 --> 00:44:44.795
hands-on PTs and pediatrics is probably on

00:44:44.815 --> 00:44:45.677
that list as well.

00:44:45.996 --> 00:44:47.898
So the specialties are really, really be,

00:44:48.438 --> 00:44:50.259
be bludgeoned in terms of numbers.

00:44:51.398 --> 00:44:53.300
Those who are getting PT that are more

00:44:53.340 --> 00:44:55.101
into longevity and health and fitness and

00:44:55.141 --> 00:44:57.101
wellness are generally musculoskeletal.

00:44:57.802 --> 00:44:59.583
They'll fake their way into a conflated

00:44:59.623 --> 00:45:00.063
PT.

00:45:00.083 --> 00:45:02.103
That'll be a combination of a digital

00:45:02.143 --> 00:45:03.985
front door and YouTube.

00:45:04.005 --> 00:45:05.686
Yep.

00:45:05.965 --> 00:45:06.146
All right.

00:45:06.186 --> 00:45:07.126
Last thing we do on the show is

00:45:07.146 --> 00:45:08.447
called the parting shots.

00:45:10.577 --> 00:45:11.737
This is The Parting Shot.

00:45:12.277 --> 00:45:13.677
One last mic drop moment.

00:45:14.358 --> 00:45:15.139
No pressure.

00:45:15.599 --> 00:45:17.721
Just your legacy on the line.

00:45:19.500 --> 00:45:19.980
Pressure there.

00:45:20.039 --> 00:45:21.380
Today's episode brought to you by U.S.

00:45:21.420 --> 00:45:22.061
Physical Therapy,

00:45:22.081 --> 00:45:23.702
a national network of clinics focused on

00:45:23.742 --> 00:45:24.724
developing clinicians,

00:45:25.344 --> 00:45:26.105
not burning them out.

00:45:26.244 --> 00:45:27.545
Leadership tracks, mentorship,

00:45:27.565 --> 00:45:28.367
and career growth,

00:45:28.507 --> 00:45:29.467
as long as we have a profession,

00:45:29.768 --> 00:45:31.708
and the stability to build your future in

00:45:31.748 --> 00:45:32.090
PT.

00:45:32.150 --> 00:45:33.210
If you want a place that supports how

00:45:33.231 --> 00:45:35.311
you want to practice, that's USPH.

00:45:35.411 --> 00:45:36.393
USPH.com.

00:45:36.413 --> 00:45:37.994
That's USPH.com.

00:45:38.034 --> 00:45:38.213
Tim,

00:45:38.233 --> 00:45:39.735
you've done this before with me a bunch

00:45:39.755 --> 00:45:40.135
of times.

00:45:40.496 --> 00:45:41.476
You get to lead off.

00:45:41.657 --> 00:45:42.818
So what's your parting shot?

00:45:43.557 --> 00:45:44.940
Final thoughts, soapbox statement,

00:45:44.980 --> 00:45:45.400
what do you got?

00:45:46.724 --> 00:45:48.684
okay well i still love this profession and

00:45:48.784 --> 00:45:51.686
i still feel like from a societal

00:45:51.726 --> 00:45:55.186
perspective we have so so much to offer

00:45:55.367 --> 00:45:57.467
and despite the gloom and doomed said

00:45:57.487 --> 00:46:00.288
today uh i i still believe the future

00:46:00.527 --> 00:46:03.429
is bright and we just need to accept

00:46:03.809 --> 00:46:05.329
what's in front of us and just like

00:46:05.489 --> 00:46:08.751
you know we we have rehabilitated people

00:46:09.425 --> 00:46:11.847
We can rehabilitate our system.

00:46:13.086 --> 00:46:14.708
And so I'll leave it with that.

00:46:14.788 --> 00:46:17.108
It's time for some serious,

00:46:17.588 --> 00:46:18.909
deep rehabilitation.

00:46:19.710 --> 00:46:20.170
Love it.

00:46:20.210 --> 00:46:20.550
John,

00:46:20.590 --> 00:46:21.630
what do you got for your parting shot

00:46:21.650 --> 00:46:21.929
today?

00:46:22.791 --> 00:46:23.170
Yeah,

00:46:23.190 --> 00:46:24.550
I think I would just end with a

00:46:24.590 --> 00:46:26.032
little bit of optimism.

00:46:26.692 --> 00:46:28.231
There are some, you know,

00:46:28.251 --> 00:46:30.293
when I look at all the engagement on

00:46:30.652 --> 00:46:32.454
the initial post that both Larry and Tim

00:46:32.474 --> 00:46:34.454
did, there's some really well-informed,

00:46:34.934 --> 00:46:35.355
smart,

00:46:35.474 --> 00:46:38.735
younger entrepreneurs in our profession.

00:46:39.260 --> 00:46:42.163
that are probably hell bent and have ideas

00:46:42.202 --> 00:46:44.583
we haven't even thought about in making

00:46:44.623 --> 00:46:45.164
change.

00:46:45.425 --> 00:46:48.367
And, you know, that's where we were ten,

00:46:48.447 --> 00:46:49.786
fifteen, twenty years ago.

00:46:50.987 --> 00:46:53.309
And I'm very optimistic that those

00:46:53.349 --> 00:46:55.590
individuals are not going to take no for

00:46:55.630 --> 00:46:56.110
an answer.

00:46:56.731 --> 00:46:58.353
And they're going to you know,

00:46:58.532 --> 00:46:59.893
they're going to couple themselves with

00:46:59.913 --> 00:47:00.653
some mentors,

00:47:00.853 --> 00:47:02.034
whether it be us or many of the

00:47:02.114 --> 00:47:02.275
other

00:47:02.742 --> 00:47:03.021
you know,

00:47:03.061 --> 00:47:04.802
leaders in the profession that have done,

00:47:04.983 --> 00:47:05.824
you know,

00:47:05.864 --> 00:47:07.864
contributed to some significant reforms.

00:47:08.385 --> 00:47:09.065
And so, you know,

00:47:09.126 --> 00:47:13.409
hopefully that energy and youthfulness,

00:47:14.389 --> 00:47:16.731
you know, will thrive in a way where,

00:47:17.132 --> 00:47:17.572
you know,

00:47:17.592 --> 00:47:19.413
we'll see progress perhaps in a way that

00:47:20.014 --> 00:47:22.715
us gray hairs ourselves, you know,

00:47:22.755 --> 00:47:24.456
may not even be able to see ourselves.

00:47:24.476 --> 00:47:26.217
So, you know,

00:47:26.358 --> 00:47:28.840
so to any of those young entrepreneurs in

00:47:28.880 --> 00:47:30.460
PT, whether you're an academician,

00:47:30.501 --> 00:47:31.041
a clinician,

00:47:32.804 --> 00:47:33.204
you know,

00:47:34.027 --> 00:47:36.273
dare to dream and don't take no for

00:47:36.293 --> 00:47:36.673
an answer.

00:47:37.918 --> 00:47:38.800
All right, Larry, no pressure.

00:47:38.820 --> 00:47:39.541
You got to wrap this up.

00:47:42.112 --> 00:47:44.514
Well, while I share in my friends,

00:47:44.554 --> 00:47:46.856
colleagues and partners empowerment

00:47:46.896 --> 00:47:48.577
message that we do in fact have the

00:47:48.617 --> 00:47:50.920
ability to course correct here,

00:47:51.659 --> 00:47:54.222
I am also bothered by a serious data

00:47:54.282 --> 00:47:54.722
point.

00:47:55.063 --> 00:47:55.603
How many,

00:47:55.682 --> 00:47:56.824
if you just look at Tim and I,

00:47:56.864 --> 00:47:58.304
our kids are all older, John,

00:47:58.646 --> 00:48:00.086
your kids may still be in a way

00:48:00.106 --> 00:48:00.827
that they can,

00:48:00.867 --> 00:48:02.148
but how many will become physical

00:48:02.168 --> 00:48:02.708
therapists?

00:48:03.489 --> 00:48:06.271
And the reality is that most PTs when

00:48:06.351 --> 00:48:06.911
interviewed,

00:48:07.012 --> 00:48:09.273
do you want this career for your children?

00:48:09.413 --> 00:48:11.414
Absolutely unequivocally say no.

00:48:11.454 --> 00:48:13.675
The same thing happens for physicians as

00:48:13.715 --> 00:48:14.056
well.

00:48:14.757 --> 00:48:16.637
And so my parting shot would be a

00:48:16.697 --> 00:48:17.298
question.

00:48:17.478 --> 00:48:20.079
If the answer to your question is,

00:48:20.139 --> 00:48:21.842
do I want my children to become a

00:48:21.902 --> 00:48:22.782
physical therapist?

00:48:22.822 --> 00:48:24.983
If that answer is no, what action,

00:48:25.264 --> 00:48:27.545
what activities and what do we need to

00:48:27.605 --> 00:48:29.626
do and what are you willing to do

00:48:29.766 --> 00:48:31.768
and help so that you can answer that

00:48:31.807 --> 00:48:32.929
question in the affirmative?

00:48:33.528 --> 00:48:33.809
Wow.

00:48:34.110 --> 00:48:34.329
Yeah.

00:48:34.570 --> 00:48:35.230
Bold questions.

00:48:36.170 --> 00:48:38.572
We'll put the link to the series of

00:48:38.652 --> 00:48:40.413
articles that are going to be dropping

00:48:40.713 --> 00:48:42.032
throughout the next couple of weeks.

00:48:42.594 --> 00:48:43.594
Thanks for the insight, guys.

00:48:43.614 --> 00:48:44.375
We appreciate it.

00:48:44.494 --> 00:48:46.376
And thanks for setting a little optimism,

00:48:46.416 --> 00:48:47.675
then also putting some tension in the

00:48:47.695 --> 00:48:50.818
story because no pressure, no diamonds.

00:48:53.157 --> 00:48:54.237
That's it for this one,

00:48:54.498 --> 00:48:56.159
but we're just getting warmed up.

00:48:56.639 --> 00:48:58.541
Smash follow, send it to a friend,

00:48:58.762 --> 00:49:00.422
or crank up the next episode.

00:49:00.943 --> 00:49:01.543
Want to go deeper?

00:49:01.603 --> 00:49:06.349
Hit us at pgpinecast.com or find us on

00:49:06.409 --> 00:49:08.971
YouTube and socials at pgpinecast.

00:49:09.371 --> 00:49:11.652
And legally, none of this was advice.

00:49:11.713 --> 00:49:13.454
It's for entertainment purposes only.

00:49:14.114 --> 00:49:15.115
Bullshit!

00:49:15.135 --> 00:49:15.717
See, Keith?

00:49:15.936 --> 00:49:16.998
We read the script.

00:49:17.277 --> 00:49:17.938
Happy now?

Is PT Education Broken? A Candid Talk with Benz, Flynn & Childs

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