Manual Therapy Is Paid Like Copper — But You’re Delivering Gold

WEBVTT

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Hello?

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Good morning.

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All right.

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We are back.

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PT Breakfast Club, eight thirty a.m.

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Eastern.

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Jimmy McKay,

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Dave Kittle will jump in when

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he is available.

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Tony Maritato.

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So, Jimmy,

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let's let's just go right into this post.

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I don't know if you have it queued up.

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Yeah, Chris Miller.

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Chris Miller is a golf performance.

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There's Dave.

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Golf performance PT down in Florida.

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He you know,

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I've been following Chris for

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a long time.

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He's been doing cool stuff

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for a long time.

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this is a video he created, uh,

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showing the inside of his facility,

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beautiful facility.

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And he shared a program that

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he's launching where for a

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hundred and ninety nine dollars a month,

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you get twenty four seven

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access to this golf simulator.

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Now, I'm not a golfer,

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so I'm going to do my best.

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You can play any course.

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You get all your stats.

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It measures everything.

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You know,

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it's like a man cave on steroids.

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Exactly what we want.

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Uh,

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what, what was your first,

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you shared this with me, you found it.

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What were you thinking?

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I mean, just brilliant.

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Like they,

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he understood the life cycle of a golfer.

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Golfers are like, um,

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Horses are like runners.

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We're big, dumb animals.

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We'll pay anything to play

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golf one more time.

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If we can sneak in around in

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between tornadoes, you're like,

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there's a two-hour window.

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We'll sneak it in, right?

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So as you can see in the

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video that we're showing, it's a gym.

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right?

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Full like gym, rubber floors, heavy stuff,

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you know, kettlebells, whatever.

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And then he walks you

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through this door and it's Shangri-La.

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It is, looks like a double bay, uh,

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the bad-ass golf simulators

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right off like green carpet

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hitting mats the whole night.

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So these are the toys

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golfers want to play with.

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So instead of him just saying,

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I've got this gym lift strong,

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hit bombs down the middle.

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He's like, come play too.

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So he, he thinking of a vertical, uh,

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He's taking this whole life cycle of like,

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what do golfers need?

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And then you and I started

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playing around with like, well,

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what next?

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What accessories could we put on it?

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We can get into that.

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But this is brilliant

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because golfers don't just

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want to do like

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single-legged rotational

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explosive exercises.

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They want to hit golf balls

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and they want the golf

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balls not to just be into a net.

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You can play Augusta.

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on these golf simulators.

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You can play like legit

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courses and stuff like that.

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Again, I'm a crappy golfer,

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but my best friend would

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drool over this for two

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hundred bucks a month.

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It's a layup.

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Dave, what do you think?

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Yeah, I love it.

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The only like area that I

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would say maybe is like a

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ticky tacky suggestion is

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the video instead of just

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showing like that long

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rectangular clinic area,

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I would start the video

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with the simulator,

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then show some of the

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clinic space and then come

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back to the simulator,

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like the clinic space very

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briefly and not like a

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slower walkthrough.

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But again,

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that's just such like a ticky

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tacky little thing like overall.

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You know, clear offer is really important.

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It shows it tells exactly

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what you get for what dollar amount.

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Also in Florida, I love how he says, like,

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you know, play, you know, play anytime,

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even when it's whatever he said,

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like really hot or during

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thunderstorms or whatever.

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So like those things are he

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obviously knows his target

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customer and client.

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So it's awesome.

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You know,

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we have a twenty four hour fitness or no,

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it's anytime fitness across the street.

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There's multiple places like this.

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And even when I was in

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Sarasota in South Florida,

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there were places where you would buy in.

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You would buy either an

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equity stake or you would

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just pay a membership and

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you had a key and it was a

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twenty four hour access facility.

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I've never heard of a

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physical therapy clinic

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doing something like that.

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I think we're so freaked out, risk averse,

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so terrified somebody is

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going to fall or get hurt.

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But we see these proven models.

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It got me thinking, I was like,

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why wouldn't I make it

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available as a premium service?

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Hey,

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You're going through rehab.

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Rehab is a twenty four seven commitment.

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This is your full time job.

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Here's your key.

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Here's your gold card membership.

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You have twenty four hour access,

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even if you never use it.

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Right.

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But this is a service that

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is sold to allow people to

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come into the clinic.

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Because they're familiar.

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They've done their therapy here.

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They know what's going on.

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I just I've never seen

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another therapist do something like that.

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So let's go through the

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things that it includes,

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as you just mentioned.

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So twenty four seven access to the gym.

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but also twenty four seven

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access to the simulators.

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If you know what these

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simulators cost and I was

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pricing a good one because

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this is one of those things

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where if you spend like two

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thousand dollars, you get crappy.

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So it's like don't spend any money.

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Don't get it.

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You sort of have to hit a tipping point.

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And I've talked to a few

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people who've done this and

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it's not cheap because like

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some of these things just don't do it.

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So right off the bat for two

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hundred dollars a month,

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Access to the simulator is

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twenty four seven.

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You win very first bucket.

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Got it done.

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Two hundred bucks a month.

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I can simulate right then.

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Twenty four seven access to the gym.

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I don't I don't know what

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gym you're paying for in a

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major city like this.

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That's going to be two

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hundred bucks a month.

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Yeah, I guess a little bit,

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but not with the simulators.

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They don't have that.

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free tpi assessment and

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custom uh custom program

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and then he goes into like

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a little bit like feel

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loose have less pay and hit

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more bumps so the tpi

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assessment I don't know

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what what they charge for

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those but those aren't

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cheap like because the tpi

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certification is number one

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expensive to get and then

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you have to re-up it every

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couple years so you get a

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tpi assessment like that'd

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be awesome like smart dude

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if he was like I'll give

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you a free assessment every

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year as long as you

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maintain membership that

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would be another thing I

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would add uh play in weekly tournaments

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at tour courses.

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Like, Hey, this week we're going to all,

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cause it's master's week.

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We're going to play Augusta.

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Like he's gamifying Augusta.

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He's already gamifying golf, obviously,

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because it's a game.

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But he's making people

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compete because that's what

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golfers like to do.

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And there's a perfect setup

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with golf called a handicap system.

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So even if Tony's way better than me,

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I still feel good about

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competing because there's a

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handicap system.

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And then he highlights what Dave did.

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It's in Tampa.

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Play when it's too hot.

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Play when it's muggy.

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Play when there's

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thunderstorms because

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there's a lot of them.

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And then he adds access issue,

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access to coaches, trainers,

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physical therapists,

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and a stretch therapy service.

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Plus, he goes one extra step.

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I think I didn't even read

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this the first time.

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There's a co-working space.

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Where are you, honey?

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I'm working.

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I'm working.

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We know where the deals are done.

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They're done on the ninth hole.

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One hundred and ninety nine a month.

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Cancel any time.

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So he's like, if you're risk averse,

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I don't know.

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Pay two hundred bucks.

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Use it for a month and then bail.

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I think you're going to like

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it so much you come back.

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It's not a good idea.

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It's a great idea.

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It seems like he's stacking

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so many things to try to

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make this an irresistible offer.

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So even the TPI assessment,

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like he's going to basically,

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him or one of his therapists,

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I don't know if he's got therapists,

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but they're going to lose

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money on that first interaction, right?

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So like maybe it's the current,

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he's saying this to

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Facebook or his email list or whatever.

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So maybe there's no customer

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acquisition cost.

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So he's like offering this

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to his followers, his previous patients,

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whatever, right?

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for that he's trying to make

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this an irresistible offer

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for someone to say for

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someone to do a couple

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things one take the credit

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card out and take them up

00:07:34.975 --> 00:07:36.757
on this offer but then also

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more and more it seems like

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people are hesitant like

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consumers are hesitant to

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sign up for subscriptions

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like whether it's a jam or

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or some you know whether

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it's a streaming service or whatever

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Cause then it's like, oh,

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if I don't use it or if I don't like it,

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then I have to like go and

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like do a thing.

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I have to like go find how

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to cancel it or whatever.

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So he's saying like easy peasy on how to,

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you know, how to cancel, cancel anytime,

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month to month.

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But you have to sweeten the

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offer like this.

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You have to make it an irresistible offer.

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You have to make it so that

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golfers in Tampa read this

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and would think like,

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that would be like dumb if

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I didn't sign up for it.

00:08:10.776 --> 00:08:11.255
Right.

00:08:11.495 --> 00:08:13.557
He took the bullets out of everybody's...

00:08:13.877 --> 00:08:14.958
Well, it's a simulator.

00:08:15.017 --> 00:08:15.819
I'm in Tampa.

00:08:15.899 --> 00:08:16.759
I come here because I want

00:08:16.779 --> 00:08:18.000
to play golf outside.

00:08:18.040 --> 00:08:19.000
Why would I come inside?

00:08:19.382 --> 00:08:19.461
Dude,

00:08:19.482 --> 00:08:20.382
it's hot and muggy and there's

00:08:20.403 --> 00:08:22.184
tornadoes and whatever.

00:08:22.303 --> 00:08:23.425
And you know you need to do

00:08:23.444 --> 00:08:24.105
this other stuff.

00:08:24.185 --> 00:08:24.985
You know you do.

00:08:25.406 --> 00:08:26.447
So instead of doing this

00:08:26.507 --> 00:08:28.629
plus this plus this, dude, it's all in.

00:08:28.850 --> 00:08:31.031
He understood the price value seesaw.

00:08:31.552 --> 00:08:32.373
He understood it and he

00:08:32.533 --> 00:08:34.014
overloaded on price.

00:08:34.033 --> 00:08:35.434
He quadrupled down on price.

00:08:35.855 --> 00:08:37.136
So then, Tony, you – oh, go ahead, Dave.

00:08:38.197 --> 00:08:39.717
I'm curious as to when it's

00:08:39.778 --> 00:08:40.719
twenty four seven access,

00:08:40.778 --> 00:08:41.840
if there's some digital

00:08:41.899 --> 00:08:44.182
scheduler so that I don't

00:08:44.201 --> 00:08:46.383
show up at schedule time or

00:08:46.423 --> 00:08:47.504
I just pop at any time.

00:08:47.624 --> 00:08:48.445
And it's like the old school

00:08:48.485 --> 00:08:49.926
batting cages where I got

00:08:49.946 --> 00:08:51.386
to wait for Tony to finish.

00:08:51.907 --> 00:08:52.768
And then I'm sitting there

00:08:52.827 --> 00:08:53.928
and I'm waiting seven

00:08:53.969 --> 00:08:55.450
minutes or I'm waiting twenty minutes.

00:08:55.470 --> 00:08:56.029
I don't know.

00:08:56.049 --> 00:08:57.211
So maybe that's something

00:08:57.250 --> 00:08:58.272
that we can ask him.

00:08:58.312 --> 00:08:58.552
I don't know.

00:08:58.888 --> 00:09:00.349
The other thing is with those simulators,

00:09:00.789 --> 00:09:01.910
it's not just one person

00:09:02.051 --> 00:09:03.111
like you play around like

00:09:03.172 --> 00:09:04.232
Jimmy hits the ball like

00:09:04.273 --> 00:09:05.634
you can like the good ones anyway.

00:09:05.653 --> 00:09:06.955
It's like Jimmy hits the ball.

00:09:07.255 --> 00:09:08.277
A smart one would be like

00:09:08.336 --> 00:09:09.577
Dave started on hole one.

00:09:09.618 --> 00:09:10.458
Now he's on hole seven.

00:09:10.499 --> 00:09:11.759
Jimmy walks in at seven a.m.

00:09:12.080 --> 00:09:13.260
I want to jump in and play in.

00:09:13.961 --> 00:09:15.023
But like, yes, brilliant.

00:09:15.082 --> 00:09:16.183
Like so understand the

00:09:16.203 --> 00:09:17.404
friction points and reducing them.

00:09:18.379 --> 00:09:19.539
So we're therapists.

00:09:19.580 --> 00:09:20.780
Therapists are amazing at

00:09:20.821 --> 00:09:21.842
finding problems.

00:09:22.462 --> 00:09:24.565
Let's find some of the problems.

00:09:24.705 --> 00:09:27.128
What would make this a failure?

00:09:27.168 --> 00:09:29.110
What would make this not work?

00:09:29.470 --> 00:09:30.630
Because it sounds amazing

00:09:30.650 --> 00:09:31.851
with all the stuff that we're saying,

00:09:31.913 --> 00:09:33.333
but what are either the

00:09:33.374 --> 00:09:34.975
blind spots that maybe

00:09:35.056 --> 00:09:36.157
Chris isn't seeing?

00:09:36.496 --> 00:09:37.999
What are some of the biggest issues?

00:09:38.038 --> 00:09:38.719
I'll tell you the first

00:09:38.739 --> 00:09:39.799
thing that came to my mind.

00:09:40.480 --> 00:09:42.121
he needs to get the word out

00:09:42.162 --> 00:09:43.602
to the right people, right?

00:09:43.702 --> 00:09:45.364
Like, how is he going to market this?

00:09:45.403 --> 00:09:46.445
How is he going to get the

00:09:46.485 --> 00:09:47.186
information out?

00:09:47.206 --> 00:09:49.147
That's why I put his stuff

00:09:49.246 --> 00:09:51.908
into ChatGPT and I started

00:09:51.948 --> 00:09:52.909
to play around with some

00:09:52.970 --> 00:09:55.530
sales copy because I'm like, one,

00:09:55.691 --> 00:09:56.951
he doesn't have a huge

00:09:56.991 --> 00:09:58.113
social media following.

00:09:58.232 --> 00:09:58.833
I don't know what his

00:09:58.894 --> 00:10:01.595
networking is like there, but I'm just,

00:10:01.975 --> 00:10:03.537
I can see this being the

00:10:03.576 --> 00:10:05.217
best kept secret in town

00:10:05.457 --> 00:10:07.139
and failing because nobody

00:10:07.178 --> 00:10:07.820
knows about it.

00:10:08.259 --> 00:10:09.961
So is he going to put paid ads behind it?

00:10:10.022 --> 00:10:11.682
Is he going to do the direct mail?

00:10:11.702 --> 00:10:12.644
Is he going to go out and

00:10:12.663 --> 00:10:14.566
get local pros to come in?

00:10:15.186 --> 00:10:17.227
Is he going to host events

00:10:17.368 --> 00:10:19.350
locally so people see what he's doing?

00:10:19.549 --> 00:10:20.650
What is he going to do?

00:10:21.311 --> 00:10:22.613
But what other problems is

00:10:22.673 --> 00:10:24.173
he maybe not seeing right

00:10:24.234 --> 00:10:26.056
now that need to be addressed?

00:10:26.596 --> 00:10:27.995
Well, let's do the problem list first.

00:10:28.437 --> 00:10:28.636
I mean,

00:10:28.797 --> 00:10:29.636
everybody's going to have a problem.

00:10:29.677 --> 00:10:31.076
All businesses, if no one knows about it,

00:10:31.096 --> 00:10:31.618
it's going to fail.

00:10:31.638 --> 00:10:32.457
So let's do the problem,

00:10:32.498 --> 00:10:33.597
and then we'll do some solutions.

00:10:34.038 --> 00:10:35.558
So that's a big problem that

00:10:35.619 --> 00:10:36.399
every business is going to have.

00:10:36.418 --> 00:10:37.178
If you don't know about it,

00:10:37.938 --> 00:10:39.059
you're the best kept secret in town.

00:10:39.080 --> 00:10:39.600
That sucks.

00:10:40.000 --> 00:10:41.220
What else can you see, Dave?

00:10:41.341 --> 00:10:44.500
I don't think you need to be a golfer.

00:10:44.520 --> 00:10:45.741
I actually think if you're not a golfer,

00:10:45.761 --> 00:10:48.582
this might be easier to see.

00:10:49.102 --> 00:10:49.942
Other problems?

00:10:51.062 --> 00:10:52.464
In twelve months, if this failed, why?

00:10:53.802 --> 00:10:54.423
I don't know if this,

00:10:54.823 --> 00:10:56.485
I doubt this is actually going to fail.

00:10:56.544 --> 00:10:57.085
He might have some

00:10:57.125 --> 00:10:59.066
projections of like how many people, how,

00:10:59.245 --> 00:10:59.405
you know,

00:10:59.426 --> 00:11:00.986
how much recurring revenue could

00:11:01.027 --> 00:11:01.847
come from this.

00:11:02.168 --> 00:11:03.168
And like, to Tony's point,

00:11:03.408 --> 00:11:04.729
I think the biggest challenge with that,

00:11:04.749 --> 00:11:05.809
like if he thinks it's going to be,

00:11:06.250 --> 00:11:06.570
I don't know,

00:11:06.590 --> 00:11:07.671
an extra hundred K in

00:11:07.691 --> 00:11:08.892
revenue or even fifty K in

00:11:08.912 --> 00:11:09.532
revenue or whatever,

00:11:10.032 --> 00:11:11.452
if he thinks it's going to be some number,

00:11:11.832 --> 00:11:12.153
the,

00:11:12.212 --> 00:11:14.414
the way that that's not going to be

00:11:14.475 --> 00:11:15.235
hit those,

00:11:15.674 --> 00:11:16.735
those targets or those

00:11:16.755 --> 00:11:19.037
assumptions is that like Tony said,

00:11:19.256 --> 00:11:20.437
not getting enough word out.

00:11:20.477 --> 00:11:21.558
So, um,

00:11:22.239 --> 00:11:24.142
There might be maybe you

00:11:24.241 --> 00:11:25.244
sweeten the offer even more.

00:11:25.283 --> 00:11:26.184
Maybe you do like a lower

00:11:26.225 --> 00:11:27.768
dollar amount for the first thirty days.

00:11:28.227 --> 00:11:29.110
No, Tony's saying no.

00:11:30.051 --> 00:11:30.851
I think keep it high.

00:11:30.912 --> 00:11:31.572
So feel I mean,

00:11:31.613 --> 00:11:32.894
a round of golf is two hundred bucks.

00:11:33.638 --> 00:11:35.198
Yeah, I was going to say,

00:11:35.599 --> 00:11:36.798
I think what he's going to find,

00:11:37.200 --> 00:11:38.360
if he does get the word out,

00:11:38.440 --> 00:11:39.421
he's going to find that one

00:11:39.461 --> 00:11:41.321
ninety nine is ridiculously low.

00:11:41.942 --> 00:11:42.881
I think he's going to need

00:11:42.902 --> 00:11:44.523
to go anywhere upwards of

00:11:44.582 --> 00:11:45.363
four ninety nine.

00:11:45.423 --> 00:11:46.303
I mean, guys,

00:11:46.323 --> 00:11:47.583
it's two thousand twenty five.

00:11:50.024 --> 00:11:52.785
We're stuck in like twenty years ago.

00:11:52.926 --> 00:11:53.826
Price points.

00:11:54.307 --> 00:11:54.527
Yeah.

00:11:54.586 --> 00:11:55.368
Twenty years ago,

00:11:55.488 --> 00:11:56.307
one ninety nine would have

00:11:56.327 --> 00:11:57.107
been reasonable.

00:11:58.489 --> 00:11:59.649
But go ahead, Dave.

00:11:59.708 --> 00:12:00.669
I didn't mean to cut you off.

00:12:01.403 --> 00:12:01.822
No, I mean,

00:12:02.783 --> 00:12:04.504
it really depends on how well

00:12:04.524 --> 00:12:05.384
he knows his folks.

00:12:05.404 --> 00:12:06.806
Also,

00:12:06.846 --> 00:12:08.647
how close is this to the dollar

00:12:08.667 --> 00:12:09.668
amount that he charges for

00:12:09.967 --> 00:12:10.587
one-on-one visits?

00:12:10.648 --> 00:12:12.428
I think he does some cash services,

00:12:12.469 --> 00:12:13.470
and maybe he does Medicare.

00:12:13.490 --> 00:12:13.730
I'm not sure.

00:12:13.769 --> 00:12:13.889
Yeah.

00:12:13.909 --> 00:12:16.630
All right.

00:12:16.870 --> 00:12:18.351
He should know his target customer,

00:12:18.672 --> 00:12:19.932
his client, his patient.

00:12:20.753 --> 00:12:21.894
What do they, like Jimmy said,

00:12:22.014 --> 00:12:23.235
I don't know what it is,

00:12:23.274 --> 00:12:24.095
but if it's two hundred

00:12:24.115 --> 00:12:25.015
dollars a round down there,

00:12:25.235 --> 00:12:25.755
whatever it is.

00:12:26.756 --> 00:12:28.217
Also, I'm sure he's done this.

00:12:29.498 --> 00:12:30.219
he could have asked and

00:12:30.278 --> 00:12:31.580
pitched different folks

00:12:31.600 --> 00:12:34.041
like hey uh before I even

00:12:34.360 --> 00:12:35.942
am buying this ten twenty

00:12:35.982 --> 00:12:37.062
thirty thousand dollar golf

00:12:37.082 --> 00:12:37.803
simulator I don't know how

00:12:37.823 --> 00:12:39.705
much they cost um I think

00:12:39.725 --> 00:12:40.566
jimmy put it somewhere or

00:12:40.625 --> 00:12:42.886
tony put it somewhere um

00:12:42.927 --> 00:12:44.347
asking those folks like is

00:12:44.388 --> 00:12:45.089
it something that you'd be

00:12:45.129 --> 00:12:46.369
interested in and then if

00:12:46.389 --> 00:12:47.210
they are like you could

00:12:47.230 --> 00:12:48.691
have even done pre-sales of

00:12:48.730 --> 00:12:49.552
the membership before you

00:12:49.572 --> 00:12:50.932
even bought it that's also

00:12:51.052 --> 00:12:52.072
a huge takeaway for anyone

00:12:52.312 --> 00:12:53.533
watching or listening take

00:12:53.573 --> 00:12:54.754
the same offer put it on

00:12:54.815 --> 00:12:55.796
your facebook page send it

00:12:55.816 --> 00:12:56.475
to your patients and

00:12:56.495 --> 00:12:57.777
clients and see if folks

00:12:57.797 --> 00:12:58.597
are going to sign up for

00:12:59.758 --> 00:13:00.979
hundred dollar, two hundred dollar,

00:13:01.119 --> 00:13:01.679
three hundred dollar a

00:13:01.740 --> 00:13:03.801
month membership as as

00:13:03.941 --> 00:13:05.341
founders rates or whatever

00:13:05.361 --> 00:13:07.623
you want to call it to get

00:13:07.663 --> 00:13:10.985
folks to pay up front and say, you know,

00:13:11.044 --> 00:13:14.447
that you're procuring, you know,

00:13:14.508 --> 00:13:16.208
different technology or

00:13:16.229 --> 00:13:17.568
whatever for the golf simulator.

00:13:17.589 --> 00:13:18.370
You know,

00:13:18.429 --> 00:13:19.210
you could you could actually

00:13:19.250 --> 00:13:20.150
offer this ahead of time.

00:13:20.331 --> 00:13:21.292
So, yeah.

00:13:21.840 --> 00:13:23.061
Remember the Van West Endort

00:13:23.100 --> 00:13:24.162
pricing model questions?

00:13:24.182 --> 00:13:25.121
Those are the four questions.

00:13:25.163 --> 00:13:26.423
Like these are the questions you actually,

00:13:26.624 --> 00:13:27.683
because if you say like, hey,

00:13:27.924 --> 00:13:29.326
I'm charging this, is it too much?

00:13:29.385 --> 00:13:30.746
Everyone's going to say yes, right?

00:13:30.807 --> 00:13:32.067
Because they're thinking I'm your buddy.

00:13:32.288 --> 00:13:32.988
If you ever go through with

00:13:33.008 --> 00:13:33.808
this or I'm your client,

00:13:33.969 --> 00:13:35.690
like so the Van West Endort

00:13:35.730 --> 00:13:36.890
pricing model questions are

00:13:37.152 --> 00:13:38.011
at what price would you

00:13:38.032 --> 00:13:38.913
consider the product to be

00:13:38.993 --> 00:13:40.134
so inexpensive?

00:13:40.474 --> 00:13:41.654
You would question its quality.

00:13:41.735 --> 00:13:43.155
I think if you drop the price right there,

00:13:43.176 --> 00:13:44.537
you're thinking it can't be that good.

00:13:45.197 --> 00:13:45.998
At what price would you

00:13:46.038 --> 00:13:46.818
consider the product to be

00:13:46.839 --> 00:13:49.181
a bargain or a great buy for the money?

00:13:49.961 --> 00:13:50.682
At what price would you

00:13:50.721 --> 00:13:51.461
begin to think the product

00:13:51.481 --> 00:13:52.302
is getting expensive,

00:13:52.342 --> 00:13:53.743
but you'd still consider buying it?

00:13:54.104 --> 00:13:55.024
And at what price would you

00:13:55.063 --> 00:13:55.884
consider the product to be

00:13:55.945 --> 00:13:57.065
so expensive you would not

00:13:57.105 --> 00:13:57.826
consider buying it?

00:13:58.245 --> 00:13:59.527
And then you take those four

00:13:59.567 --> 00:14:01.447
numbers because they're

00:14:01.508 --> 00:14:02.369
ricochet questions.

00:14:02.688 --> 00:14:03.469
And then your answer is

00:14:03.570 --> 00:14:04.649
somewhere in the middle.

00:14:04.769 --> 00:14:05.650
Like, that's the thing.

00:14:05.691 --> 00:14:06.291
But I think it's

00:14:06.490 --> 00:14:08.091
understanding what a round of golf costs.

00:14:08.192 --> 00:14:09.212
And I'm pretty sure it's like two,

00:14:09.472 --> 00:14:10.854
especially in Tampa, two hundred plus.

00:14:11.114 --> 00:14:12.174
This is one round of golf.

00:14:13.222 --> 00:14:13.462
Yeah,

00:14:13.643 --> 00:14:14.744
those questions are trying to

00:14:14.783 --> 00:14:15.984
triangulate around the

00:14:16.004 --> 00:14:17.125
approximate dollar amount.

00:14:17.544 --> 00:14:19.206
But at the end of the day, it's like, hey,

00:14:20.067 --> 00:14:20.687
are you actually going to

00:14:20.706 --> 00:14:21.547
take your credit card out?

00:14:21.567 --> 00:14:22.467
Correct.

00:14:22.548 --> 00:14:25.509
And put it into a web page, a secure,

00:14:25.610 --> 00:14:26.289
you know, checkout,

00:14:27.049 --> 00:14:29.010
order form or whatever, and sign up.

00:14:29.191 --> 00:14:29.772
That's one.

00:14:29.831 --> 00:14:30.451
And then also,

00:14:30.672 --> 00:14:31.653
what's the lifetime value of

00:14:31.692 --> 00:14:32.092
those clients?

00:14:32.113 --> 00:14:33.274
How long are they sticking?

00:14:33.313 --> 00:14:34.933
How long do they stay as a

00:14:34.994 --> 00:14:35.794
monthly recurring member?

00:14:36.095 --> 00:14:37.475
The only discount I might

00:14:37.515 --> 00:14:38.775
give is if you sign up for a year.

00:14:39.017 --> 00:14:40.096
If you said here's twelve months,

00:14:40.136 --> 00:14:41.298
I might give you I would

00:14:41.337 --> 00:14:42.477
have no problem being like here.

00:14:42.498 --> 00:14:42.739
Sure.

00:14:43.058 --> 00:14:44.919
Ten, twenty percent, maybe ten,

00:14:44.960 --> 00:14:45.460
twenty percent.

00:14:45.480 --> 00:14:46.581
It might be as high as I would go.

00:14:47.160 --> 00:14:48.581
So in terms of getting the word out,

00:14:49.201 --> 00:14:50.163
paid ads, obviously.

00:14:50.643 --> 00:14:50.863
Right.

00:14:51.102 --> 00:14:52.203
Geofencing paid ads.

00:14:53.244 --> 00:14:54.985
I would talk to the people

00:14:55.005 --> 00:14:56.027
that he mentioned in his ad,

00:14:56.086 --> 00:14:57.649
which is TPI professionals.

00:14:58.009 --> 00:15:01.153
Like he might be a TPI certified PT.

00:15:01.173 --> 00:15:02.934
And let's just assume he's not a golf pro.

00:15:03.115 --> 00:15:04.356
There's a difference, right?

00:15:04.596 --> 00:15:07.139
A PT is not a triathlon coach.

00:15:07.460 --> 00:15:08.441
Maybe they might be,

00:15:08.461 --> 00:15:09.022
but they might not be.

00:15:09.322 --> 00:15:10.903
So use that network.

00:15:11.124 --> 00:15:12.345
How do I help you get clients?

00:15:12.905 --> 00:15:14.866
How can this thing I just bought feed you?

00:15:15.128 --> 00:15:15.908
How do I help you?

00:15:16.168 --> 00:15:16.649
I've got this thing.

00:15:16.688 --> 00:15:17.809
Hey, by the way, you know what?

00:15:18.110 --> 00:15:19.331
I'm having beers on the

00:15:19.371 --> 00:15:20.472
ninth hole at my thing.

00:15:20.732 --> 00:15:21.994
Let's all get in here pro

00:15:22.033 --> 00:15:23.754
professionals from all the local courses.

00:15:24.316 --> 00:15:25.216
It's a quick way to get free

00:15:25.256 --> 00:15:26.118
rounds of golf too, right?

00:15:26.138 --> 00:15:26.837
Those guys are going to let

00:15:26.857 --> 00:15:28.279
you come to the golf course, right?

00:15:28.440 --> 00:15:29.139
How do I help you?

00:15:29.941 --> 00:15:31.162
How do I put brochures for

00:15:31.221 --> 00:15:32.482
your golf course or your

00:15:32.523 --> 00:15:35.024
golf school in my simulator bay?

00:15:35.063 --> 00:15:35.764
Or how do I, hey,

00:15:35.784 --> 00:15:36.684
could I get your golf

00:15:36.705 --> 00:15:37.926
course on my screen?

00:15:37.966 --> 00:15:38.667
Can I play that?

00:15:38.726 --> 00:15:41.248
Is that a playable course to get good at?

00:15:41.989 --> 00:15:42.609
And you can do that.

00:15:42.629 --> 00:15:44.250
Do you have leagues right now?

00:15:44.509 --> 00:15:44.750
Great.

00:15:45.030 --> 00:15:45.951
When I give a discount,

00:15:46.231 --> 00:15:47.552
we can work something out, right?

00:15:47.652 --> 00:15:49.052
Buy one of both of ours and

00:15:49.092 --> 00:15:50.134
get something like, you know,

00:15:51.235 --> 00:15:52.635
the last thing I might move was price.

00:15:53.535 --> 00:15:54.756
So that I love people

00:15:54.777 --> 00:15:55.456
because people are going to

00:15:55.476 --> 00:15:56.278
be their best sellers if

00:15:56.298 --> 00:15:57.879
they feel like it's in the best interest,

00:15:57.899 --> 00:15:58.840
like an affiliate program.

00:15:59.700 --> 00:16:02.423
And then, of course, we've got interviews.

00:16:02.543 --> 00:16:04.486
Hey, get in here, golf pro.

00:16:05.067 --> 00:16:06.068
Let's do an interview.

00:16:06.129 --> 00:16:07.750
Let's record some content.

00:16:07.811 --> 00:16:09.212
Let's answer some of the

00:16:09.253 --> 00:16:10.355
most common questions.

00:16:10.394 --> 00:16:12.017
Put that out on social media.

00:16:12.618 --> 00:16:12.937
Yeah.

00:16:14.134 --> 00:16:15.955
So I think Jimmy was starting to say this.

00:16:15.995 --> 00:16:17.455
Let's take it this direction.

00:16:17.615 --> 00:16:17.835
Okay,

00:16:17.914 --> 00:16:21.255
so now we've got the person coming in.

00:16:21.316 --> 00:16:23.057
We've got the monthly membership.

00:16:23.657 --> 00:16:25.238
Where are we going with that?

00:16:25.357 --> 00:16:26.758
Where is the next level of

00:16:26.817 --> 00:16:27.878
value coming in?

00:16:28.119 --> 00:16:29.798
Jimmy mentioned Topgolf.

00:16:29.839 --> 00:16:31.240
We have one here locally.

00:16:31.840 --> 00:16:33.000
They have amazing food.

00:16:33.440 --> 00:16:34.660
I'll go there just for the food.

00:16:34.721 --> 00:16:36.201
I don't even care to swing a golf club.

00:16:36.240 --> 00:16:38.162
I'll just go hang out, watch my kids play.

00:16:38.182 --> 00:16:38.562
Top food.

00:16:39.121 --> 00:16:39.302
Yeah.

00:16:40.243 --> 00:16:41.423
So like, okay,

00:16:41.484 --> 00:16:43.566
maybe he doesn't want to do a hot kitchen,

00:16:43.905 --> 00:16:45.547
but what are some things

00:16:45.567 --> 00:16:46.707
that he can bring in?

00:16:47.729 --> 00:16:49.409
I know here in Ohio there is,

00:16:49.509 --> 00:16:51.272
and I looked this up before we started,

00:16:51.591 --> 00:16:53.953
BYOB business licenses.

00:16:54.014 --> 00:16:56.676
So there's specific laws and rules,

00:16:56.716 --> 00:16:57.817
but if you follow them,

00:16:57.917 --> 00:16:59.638
you can have customers

00:16:59.717 --> 00:17:01.720
bring their own drinks, their own alcohol,

00:17:01.759 --> 00:17:03.020
liquor, whatever they want to bring.

00:17:03.981 --> 00:17:04.383
What else?

00:17:04.462 --> 00:17:06.047
What other services is this

00:17:06.067 --> 00:17:06.949
community looking for?

00:17:07.329 --> 00:17:08.512
Are either of you like golfers?

00:17:08.532 --> 00:17:08.633
Like,

00:17:08.653 --> 00:17:09.915
would you consider yourself a golfer?

00:17:10.056 --> 00:17:10.156
No.

00:17:10.277 --> 00:17:10.416
Okay.

00:17:10.436 --> 00:17:13.904
So I am a C minus golfer.

00:17:13.924 --> 00:17:14.026
Okay.

00:17:14.352 --> 00:17:16.653
but bringing your own beers

00:17:16.692 --> 00:17:18.232
or alcohol to the golf

00:17:18.272 --> 00:17:19.732
course is a sport because

00:17:19.752 --> 00:17:21.013
it's not allowed but the

00:17:21.054 --> 00:17:22.054
golf course isn't going to

00:17:22.134 --> 00:17:23.134
search your bags but

00:17:23.193 --> 00:17:24.074
everybody does it but

00:17:24.114 --> 00:17:25.494
nobody does it but then

00:17:25.515 --> 00:17:27.414
there's a cart girl right

00:17:27.474 --> 00:17:28.515
and it's always a cart girl

00:17:28.535 --> 00:17:29.194
I mean I'm sure this cart

00:17:29.214 --> 00:17:29.895
guy is not trying to

00:17:29.915 --> 00:17:30.935
discriminate there's a cart

00:17:30.955 --> 00:17:32.635
girl like drinking and golf

00:17:32.796 --> 00:17:34.237
is like they are in

00:17:34.356 --> 00:17:35.297
lockstep so I'll be right

00:17:35.317 --> 00:17:36.997
back I'm sorry to run you

00:17:37.037 --> 00:17:38.498
to alcohol but like alcohol

00:17:38.577 --> 00:17:39.798
is a thing alcohol

00:17:40.498 --> 00:17:42.480
makes me a better golfer in my mind.

00:17:42.941 --> 00:17:44.021
Or if I'm a crappy golfer,

00:17:44.041 --> 00:17:46.325
I care about how crappy of a golfer I am.

00:17:46.644 --> 00:17:48.386
So yeah, like if there's a social network,

00:17:49.008 --> 00:17:50.289
we haven't even touched

00:17:50.349 --> 00:17:51.570
upon the fact that when he

00:17:51.611 --> 00:17:52.752
said coworking space,

00:17:52.792 --> 00:17:53.854
I was sort of joking about

00:17:53.894 --> 00:17:54.894
like getting away from the

00:17:54.974 --> 00:17:55.816
spouse or whatever.

00:17:55.855 --> 00:17:55.915
Um,

00:17:56.909 --> 00:18:00.890
Business deals are done in golf.

00:18:00.910 --> 00:18:01.910
Business deals can be done

00:18:01.970 --> 00:18:03.089
on the digital golf course.

00:18:03.289 --> 00:18:06.411
Yeah, in-person, digital,

00:18:06.431 --> 00:18:07.631
right on the screen.

00:18:07.931 --> 00:18:08.750
This is a thing.

00:18:09.791 --> 00:18:11.571
I might suggest he zhuzh up

00:18:11.592 --> 00:18:12.511
that gym a little bit.

00:18:12.592 --> 00:18:13.672
I feel like his golf base

00:18:13.692 --> 00:18:14.972
looked cool with the grass floor,

00:18:15.012 --> 00:18:16.232
but I might zhuzh up the

00:18:16.313 --> 00:18:18.012
aesthetics of that gym.

00:18:18.053 --> 00:18:19.933
Make it feel like it's worth

00:18:19.953 --> 00:18:21.034
a thousand dollars a month,

00:18:21.074 --> 00:18:21.594
even if you're only

00:18:21.634 --> 00:18:22.534
charging them four hundred.

00:18:23.755 --> 00:18:25.454
The business aspect of golf

00:18:26.115 --> 00:18:27.115
like you could write this

00:18:27.276 --> 00:18:28.836
off if you're doing

00:18:28.875 --> 00:18:29.576
meetings there because he

00:18:29.596 --> 00:18:30.977
said co-work space like you

00:18:30.997 --> 00:18:31.977
might want to talk to a tax

00:18:32.017 --> 00:18:32.738
attorney but like you might

00:18:32.758 --> 00:18:33.337
be able to write some of

00:18:33.357 --> 00:18:34.518
this off because it's a

00:18:34.637 --> 00:18:36.219
membership to be able to

00:18:36.239 --> 00:18:37.660
bring clients in there so

00:18:37.779 --> 00:18:39.259
food alcohol and networking

00:18:39.279 --> 00:18:41.080
for business is a layup

00:18:41.381 --> 00:18:42.521
partnerships with people

00:18:42.582 --> 00:18:44.201
who uh feed the ecosystem

00:18:44.221 --> 00:18:45.962
and local courses lay up to

00:18:46.002 --> 00:18:50.744
me dave I'm good

00:18:52.199 --> 00:18:52.519
All right.

00:18:52.538 --> 00:18:53.839
So let's take this.

00:18:54.221 --> 00:18:55.922
Let's let's pivot just a little bit.

00:18:56.082 --> 00:18:57.103
I shared a post about a

00:18:57.143 --> 00:18:58.523
company called D-Bat.

00:18:59.125 --> 00:19:01.165
And basically these are like super nice,

00:19:01.226 --> 00:19:01.946
super high end.

00:19:01.987 --> 00:19:03.268
Now we're getting into Dave's world.

00:19:04.028 --> 00:19:05.088
Batting cages.

00:19:05.130 --> 00:19:06.069
They're all indoor.

00:19:06.130 --> 00:19:08.112
You know, I remember you'd get the tokens.

00:19:08.132 --> 00:19:09.613
You'd go down to the literal

00:19:09.653 --> 00:19:11.994
like chain link outdoor batting cage.

00:19:12.976 --> 00:19:14.156
These things are like the

00:19:14.217 --> 00:19:16.538
top golf of batting cages.

00:19:17.219 --> 00:19:17.398
Yeah.

00:19:18.299 --> 00:19:18.941
So, you know,

00:19:19.340 --> 00:19:21.201
I look at Chris's situation

00:19:21.221 --> 00:19:22.103
and I have no idea.

00:19:22.282 --> 00:19:24.263
I'm just I'm guessing my

00:19:24.324 --> 00:19:26.365
hunch is he really wanted

00:19:26.425 --> 00:19:27.846
this equipment for himself

00:19:27.886 --> 00:19:29.708
as much as he wanted it for his business.

00:19:29.807 --> 00:19:31.269
Now he's looking at it as like,

00:19:31.669 --> 00:19:34.230
how else can I cover the cost of this?

00:19:35.531 --> 00:19:37.032
So for other things, you know,

00:19:37.313 --> 00:19:38.493
other therapists that are

00:19:38.534 --> 00:19:39.555
out there that are like, man,

00:19:39.875 --> 00:19:40.796
I've got this hobby.

00:19:40.816 --> 00:19:42.057
It's a really expensive hobby,

00:19:42.096 --> 00:19:43.557
but I'm super passionate about it.

00:19:44.198 --> 00:19:46.239
How do I monetize this hobby

00:19:46.318 --> 00:19:47.819
to make a little extra money,

00:19:47.920 --> 00:19:48.740
leverage it?

00:19:49.319 --> 00:19:51.161
What are some other things

00:19:51.201 --> 00:19:52.981
that are out there?

00:19:53.001 --> 00:19:54.222
We've got the batting cages.

00:19:54.722 --> 00:19:55.603
So Jimmy,

00:19:55.663 --> 00:19:56.963
I don't know if you're a hockey player,

00:19:57.003 --> 00:19:57.344
but like,

00:19:57.503 --> 00:19:58.805
what about something like this for,

00:19:59.065 --> 00:19:59.845
I don't play hockey,

00:19:59.964 --> 00:20:00.925
never been on skates.

00:20:01.526 --> 00:20:02.326
What about hockey?

00:20:02.807 --> 00:20:03.126
You know,

00:20:03.146 --> 00:20:05.867
like any of these sports or any

00:20:06.028 --> 00:20:07.328
recreational activity,

00:20:08.108 --> 00:20:09.789
get into a booth for singing.

00:20:09.849 --> 00:20:11.210
Like my son loves singing.

00:20:11.269 --> 00:20:12.471
He sings constantly.

00:20:13.191 --> 00:20:14.632
I bet you could bring something in.

00:20:14.751 --> 00:20:16.232
I talked to a speech

00:20:16.272 --> 00:20:17.553
language pathologist about

00:20:17.692 --> 00:20:20.494
singing and voice coaching

00:20:20.535 --> 00:20:21.295
and stuff like that.

00:20:21.315 --> 00:20:22.516
Like there are so many

00:20:22.556 --> 00:20:24.076
directions you can take.

00:20:25.196 --> 00:20:26.417
Any ideas for you guys off

00:20:26.438 --> 00:20:27.157
the top of your heads

00:20:27.178 --> 00:20:28.578
before we move to the next topic?

00:20:29.058 --> 00:20:32.221
synthetic ice is plastic ice

00:20:32.280 --> 00:20:32.902
you could have a little

00:20:32.981 --> 00:20:34.702
rink somewhere and you work

00:20:34.762 --> 00:20:35.784
on shooting like I would

00:20:35.804 --> 00:20:37.404
take hockey and break it

00:20:37.424 --> 00:20:38.605
down to one is it shooting

00:20:38.645 --> 00:20:39.547
is it goaltending is it

00:20:39.626 --> 00:20:41.208
skating and then what can I

00:20:41.268 --> 00:20:42.888
put into a facility to

00:20:42.969 --> 00:20:45.089
specialize in that I've got a buddy

00:20:45.891 --> 00:20:47.971
who locally runs a – he's

00:20:48.172 --> 00:20:48.991
got a pool business.

00:20:49.031 --> 00:20:50.071
They used to install pools.

00:20:50.551 --> 00:20:51.492
But now he's moving the

00:20:51.532 --> 00:20:52.432
market because the margins

00:20:52.452 --> 00:20:53.573
in pools are getting smaller,

00:20:54.073 --> 00:20:54.993
and he's doing, like,

00:20:55.233 --> 00:20:56.594
bougie hot tubs and

00:20:56.713 --> 00:20:58.335
infrared spas for people's homes.

00:20:58.795 --> 00:21:01.334
He's got those longer –

00:21:00.234 --> 00:21:01.695
they're longer than a hot tub,

00:21:01.776 --> 00:21:03.135
and they blow water at you

00:21:03.175 --> 00:21:04.416
so you can swim in place.

00:21:04.957 --> 00:21:05.436
I've seen that.

00:21:05.457 --> 00:21:06.576
So you could have a swim spa,

00:21:07.176 --> 00:21:10.098
and they're expensive –

00:21:09.198 --> 00:21:10.019
But they're not crazy.

00:21:10.578 --> 00:21:11.378
You could own this.

00:21:11.859 --> 00:21:13.201
But it's a little on the high end.

00:21:13.240 --> 00:21:14.181
So if you don't want to buy

00:21:14.260 --> 00:21:15.741
it and I just want access

00:21:15.761 --> 00:21:17.723
to it and you had that at your facility,

00:21:17.884 --> 00:21:18.624
I would buy in.

00:21:18.804 --> 00:21:19.904
Now it's about traffic.

00:21:20.204 --> 00:21:21.766
I did a Blueprint business

00:21:21.806 --> 00:21:23.727
episode with a PT who's

00:21:23.767 --> 00:21:25.147
doing those cryo chambers.

00:21:25.808 --> 00:21:26.788
She's doing fire and ice.

00:21:26.808 --> 00:21:27.910
She's doing the cryo chamber

00:21:27.970 --> 00:21:28.730
and the infrared.

00:21:29.490 --> 00:21:30.791
They're a wellness facility.

00:21:31.011 --> 00:21:32.893
It's a Trojan horse because she's a PT,

00:21:33.173 --> 00:21:33.313
right?

00:21:33.333 --> 00:21:34.213
There's nowhere on PT.

00:21:34.253 --> 00:21:36.075
It doesn't say PT on the sign at all.

00:21:36.355 --> 00:21:37.276
But she's a PT.

00:21:37.576 --> 00:21:39.317
So you come in for the bougie wellness.

00:21:39.336 --> 00:21:40.298
She does bachelorette

00:21:40.337 --> 00:21:41.479
parties and stuff like that.

00:21:41.778 --> 00:21:43.359
Come in and have some mimosas.

00:21:43.400 --> 00:21:43.700
And, oh,

00:21:43.740 --> 00:21:44.921
everybody's cold and we're getting

00:21:44.961 --> 00:21:45.580
rejuvenated.

00:21:45.621 --> 00:21:48.182
Look, zhuzh up my body, whatever.

00:21:48.702 --> 00:21:49.743
And through the back door,

00:21:50.084 --> 00:21:51.384
she's sitting there going, I'm a PT.

00:21:51.484 --> 00:21:52.805
But PT, I've got eyes on you.

00:21:52.865 --> 00:21:53.826
So, I mean,

00:21:54.506 --> 00:21:55.865
I love hearing stories like this.

00:21:55.905 --> 00:21:57.166
I don't think Chris's idea is good.

00:21:57.247 --> 00:21:57.987
I think it's – I mean,

00:21:58.426 --> 00:21:59.787
are we franchising this, Chris?

00:21:59.906 --> 00:22:01.107
Are we coming upstate New York?

00:22:01.188 --> 00:22:02.147
Let's do this thing, bro.

00:22:03.448 --> 00:22:04.608
Someone commented pickleball.

00:22:04.628 --> 00:22:05.469
Who was that?

00:22:05.588 --> 00:22:06.328
Colleen something?

00:22:06.348 --> 00:22:07.128
Yeah, Colleen Green.

00:22:07.148 --> 00:22:09.769
Like with the simulator?

00:22:09.849 --> 00:22:10.150
I don't know.

00:22:10.210 --> 00:22:11.590
How could you use – Well,

00:22:11.790 --> 00:22:12.411
I don't think – How can you

00:22:12.431 --> 00:22:13.230
do pickleball with a simulator?

00:22:13.790 --> 00:22:14.751
I think what Tony's saying

00:22:14.771 --> 00:22:16.031
is like take the sport and

00:22:16.132 --> 00:22:19.093
how can you gamify it, right?

00:22:19.133 --> 00:22:19.732
Like –

00:22:19.833 --> 00:22:20.973
yeah maybe you're bold maybe

00:22:20.993 --> 00:22:21.574
you understand that

00:22:21.614 --> 00:22:22.634
pickleball courts are

00:22:22.674 --> 00:22:23.395
popping up like they're

00:22:23.415 --> 00:22:24.957
tearing down little league

00:22:24.977 --> 00:22:26.337
fields and tennis courts

00:22:26.357 --> 00:22:26.739
and they're putting

00:22:26.759 --> 00:22:28.240
pickleball courts up what

00:22:28.259 --> 00:22:29.480
if you at municipal at

00:22:29.520 --> 00:22:30.741
municipalities what if you

00:22:30.761 --> 00:22:31.722
said screw that I'll buy

00:22:31.742 --> 00:22:32.963
some square footage and

00:22:32.983 --> 00:22:35.025
I'll create the facility

00:22:35.065 --> 00:22:37.086
for it you create the stage

00:22:37.106 --> 00:22:38.327
to use tony's singing

00:22:38.347 --> 00:22:39.848
analogy and then you get to

00:22:39.888 --> 00:22:41.049
come sing and dance on it

00:22:41.069 --> 00:22:43.412
for me that's what chris did for golf

00:22:43.832 --> 00:22:44.073
Right?

00:22:44.113 --> 00:22:45.153
Like, what could you do?

00:22:45.213 --> 00:22:46.596
What could you do that?

00:22:46.736 --> 00:22:47.798
There's the local rink that

00:22:47.837 --> 00:22:49.380
I play old man beer hockey

00:22:49.460 --> 00:22:50.401
at twice a week.

00:22:51.021 --> 00:22:52.243
They have a shooter tutor.

00:22:52.423 --> 00:22:54.006
It's like blaze pods, but with pucks,

00:22:54.066 --> 00:22:54.266
right?

00:22:54.385 --> 00:22:55.428
The light up and you try to

00:22:55.448 --> 00:22:56.068
hit it or whatever.

00:22:56.670 --> 00:22:57.851
I've never seen it in use.

00:22:58.132 --> 00:22:59.894
It's sitting there behind a locked door.

00:23:00.233 --> 00:23:02.637
But it's just they're not marketing it.

00:23:02.657 --> 00:23:03.759
They're not they haven't

00:23:03.819 --> 00:23:05.221
understood their target

00:23:06.002 --> 00:23:07.125
audience because a buddy of

00:23:07.144 --> 00:23:08.606
mine's kid plays in a

00:23:08.646 --> 00:23:10.089
tournament in a different

00:23:10.150 --> 00:23:11.711
time zone like every other weekend.

00:23:11.791 --> 00:23:12.993
They are spending not a

00:23:13.013 --> 00:23:15.076
little bit of money, a ton of money.

00:23:15.972 --> 00:23:17.273
And I know even the fact

00:23:17.294 --> 00:23:18.334
that I'm in rural New York,

00:23:18.674 --> 00:23:19.575
there are guys that are

00:23:20.214 --> 00:23:22.336
NHL-quality guys are trying

00:23:22.356 --> 00:23:23.797
to get to the league, even in this area,

00:23:23.836 --> 00:23:24.637
in the New York area,

00:23:24.798 --> 00:23:25.617
that live around here.

00:23:26.019 --> 00:23:28.759
You hire that guy to be your guy, right?

00:23:28.880 --> 00:23:29.641
That's your guy.

00:23:30.040 --> 00:23:31.342
And then have him run the machine,

00:23:31.862 --> 00:23:33.403
and you come up with a deal, a split,

00:23:33.803 --> 00:23:34.864
or use rink time.

00:23:34.963 --> 00:23:36.664
But it's underutilized, in my opinion.

00:23:36.744 --> 00:23:38.625
I think this is a good idea.

00:23:39.446 --> 00:23:40.650
one last thing as we're

00:23:40.690 --> 00:23:42.314
talking I think the league

00:23:42.453 --> 00:23:43.557
setting up a league for the

00:23:43.576 --> 00:23:45.301
golf simulator is genius

00:23:45.342 --> 00:23:47.066
because you'll have some

00:23:47.105 --> 00:23:48.009
percentage of folks

00:23:49.070 --> 00:23:51.332
from the league that might

00:23:51.451 --> 00:23:52.711
all might sign up for this

00:23:52.852 --> 00:23:53.613
monthly recurring

00:23:53.633 --> 00:23:54.593
membership so that they can

00:23:54.633 --> 00:23:56.272
practice extra on their own

00:23:56.513 --> 00:23:58.653
whenever they want perhaps

00:23:58.693 --> 00:24:00.954
consider you're in tampa so

00:24:01.035 --> 00:24:02.375
sometimes it's hot like

00:24:02.596 --> 00:24:03.435
probably now and in the

00:24:03.476 --> 00:24:04.655
summer and then it's uh

00:24:05.497 --> 00:24:06.396
stormy and rainy or

00:24:06.416 --> 00:24:07.836
whatever right you could

00:24:07.896 --> 00:24:08.678
also potentially have

00:24:08.758 --> 00:24:11.057
leagues like before sunrise

00:24:11.159 --> 00:24:12.419
like you know golfers are

00:24:12.439 --> 00:24:14.119
crazy I yes we have a

00:24:14.160 --> 00:24:14.920
family we have a family

00:24:14.940 --> 00:24:16.019
friend who's a cardiologist

00:24:16.539 --> 00:24:17.961
he plays a round of golf

00:24:18.661 --> 00:24:20.080
in the morning sometimes

00:24:20.201 --> 00:24:21.461
before he goes to work and

00:24:21.541 --> 00:24:22.981
sees patients for eight to

00:24:23.001 --> 00:24:23.862
twelve hours or whatever

00:24:24.102 --> 00:24:25.682
he's a maniac you could

00:24:25.721 --> 00:24:26.923
have you know you could

00:24:26.942 --> 00:24:28.182
have eleven p.m or or

00:24:28.242 --> 00:24:29.222
twelve midnight golf

00:24:29.242 --> 00:24:30.823
leagues like twilight golf

00:24:30.863 --> 00:24:32.523
league because at that time

00:24:32.544 --> 00:24:33.943
slot you can't go golf

00:24:34.044 --> 00:24:35.923
outside regardless you can

00:24:35.943 --> 00:24:37.345
you can they have a

00:24:37.384 --> 00:24:40.085
simulator they have golf

00:24:40.105 --> 00:24:41.425
things with lights that you

00:24:41.486 --> 00:24:43.726
push a button at the tee box and it

00:24:44.686 --> 00:24:46.107
Cause they thought of that golf courses.

00:24:46.127 --> 00:24:46.728
Don't make any money.

00:24:47.107 --> 00:24:47.567
Every, every,

00:24:47.728 --> 00:24:48.989
every golf course has lights.

00:24:49.028 --> 00:24:50.549
Not every, not every, not every,

00:24:50.569 --> 00:24:51.549
but they have glow in the

00:24:51.569 --> 00:24:52.990
dark balls that some

00:24:53.030 --> 00:24:54.092
courses around here will do

00:24:54.112 --> 00:24:54.951
every once in a while,

00:24:55.231 --> 00:24:57.292
but they have like stadium lighting.

00:24:57.313 --> 00:24:58.413
You push a button and the

00:24:58.453 --> 00:24:59.733
whole thing's lit for twenty, you know,

00:24:59.773 --> 00:25:00.615
fifteen minutes or however

00:25:00.654 --> 00:25:01.815
long it takes to play a whole golf.

00:25:02.576 --> 00:25:04.656
It's insane cause they're like, screw it.

00:25:04.676 --> 00:25:05.517
We'll just put lights on the

00:25:05.537 --> 00:25:06.597
course and some idiot did

00:25:06.637 --> 00:25:07.518
it and that idiot laughed

00:25:07.538 --> 00:25:08.198
all the way to the bank.

00:25:08.739 --> 00:25:10.720
It's not common, but it happens.

00:25:11.220 --> 00:25:13.141
So do you guys remember speed golf?

00:25:14.090 --> 00:25:14.431
Oh yeah.

00:25:14.471 --> 00:25:15.251
You get like a minute,

00:25:15.332 --> 00:25:16.593
it's like a stroke per minute.

00:25:16.613 --> 00:25:17.113
So you run.

00:25:17.733 --> 00:25:18.213
Yeah.

00:25:18.233 --> 00:25:19.674
These guys would take their

00:25:20.194 --> 00:25:21.476
bare essential clubs.

00:25:21.496 --> 00:25:23.156
They would run through the whole course,

00:25:23.196 --> 00:25:23.758
you know, there,

00:25:23.877 --> 00:25:25.538
there was a time component to it,

00:25:26.119 --> 00:25:27.160
but you take something like

00:25:27.200 --> 00:25:27.840
that and you're like, well,

00:25:27.861 --> 00:25:29.541
what's the biggest pain point for,

00:25:29.582 --> 00:25:32.003
for someone like me who is not a golfer,

00:25:32.403 --> 00:25:34.204
but would even consider golf.

00:25:34.786 --> 00:25:36.406
I can't invest four hours.

00:25:36.527 --> 00:25:37.728
I can't invest the time.

00:25:37.788 --> 00:25:37.968
I don't,

00:25:38.327 --> 00:25:40.107
So if I could go in and just

00:25:40.148 --> 00:25:41.808
play three holes and then

00:25:41.868 --> 00:25:43.429
go go hit the gym and go to

00:25:43.469 --> 00:25:45.369
work or I can do these other things,

00:25:46.289 --> 00:25:46.930
you know, of course,

00:25:46.970 --> 00:25:48.830
you could have a father, son, father,

00:25:48.851 --> 00:25:50.391
daughter, mother, son league.

00:25:50.431 --> 00:25:51.191
You can have all these

00:25:51.230 --> 00:25:52.852
different variations on it.

00:25:52.892 --> 00:25:53.592
But again,

00:25:54.092 --> 00:25:56.252
the biggest barrier is nobody

00:25:56.292 --> 00:25:57.032
knows about it.

00:25:57.373 --> 00:25:58.813
How are people going to find out?

00:25:58.893 --> 00:25:59.752
How are people going to

00:25:59.833 --> 00:26:01.054
understand the things that

00:26:01.074 --> 00:26:01.673
you're offering?

00:26:02.074 --> 00:26:04.336
So for Chris, I think you take Tony's idea,

00:26:04.416 --> 00:26:05.417
what Tony and Dave probably

00:26:05.438 --> 00:26:05.999
would have done already,

00:26:06.019 --> 00:26:06.759
which is you invite

00:26:06.920 --> 00:26:08.020
everybody that I just

00:26:08.060 --> 00:26:08.781
mentioned on the list.

00:26:09.281 --> 00:26:10.784
I would invite your best

00:26:10.844 --> 00:26:14.729
players from the local in-person courses.

00:26:15.009 --> 00:26:16.830
I would invite your TPI golf coaches.

00:26:17.151 --> 00:26:18.092
And I would be like, hey, guys,

00:26:18.173 --> 00:26:19.173
it's beer and wine.

00:26:19.193 --> 00:26:20.595
And let's just whack some balls around.

00:26:20.855 --> 00:26:22.657
And then I would video the crap out of it.

00:26:23.218 --> 00:26:24.219
This is where you bring in a

00:26:24.259 --> 00:26:25.159
videographer that says,

00:26:25.460 --> 00:26:28.000
we need a hundred reels out of this.

00:26:28.080 --> 00:26:31.143
So bring three people, shoot, shoot, shoot,

00:26:31.222 --> 00:26:31.963
edit, edit, edit,

00:26:32.284 --> 00:26:34.484
and you get them a movie premiere.

00:26:34.525 --> 00:26:35.385
Broadway's great.

00:26:36.165 --> 00:26:36.826
On opening night,

00:26:36.846 --> 00:26:37.928
when people come out and they're like,

00:26:37.968 --> 00:26:39.648
how was Les Miserables?

00:26:39.868 --> 00:26:41.470
Oh my God, I was so touched,

00:26:41.549 --> 00:26:42.349
and oh my God.

00:26:42.369 --> 00:26:43.211
Get that.

00:26:43.371 --> 00:26:45.372
Get that a hundred and fifty times.

00:26:45.653 --> 00:26:46.432
Who cares if they had a

00:26:46.452 --> 00:26:47.834
couple of soda pops on the course?

00:26:48.614 --> 00:26:50.395
And let them sell it for you.

00:26:50.556 --> 00:26:52.257
Let's do a green carpet event.

00:26:52.576 --> 00:26:53.637
Green carpet.

00:26:53.877 --> 00:26:54.298
Yes.

00:26:56.221 --> 00:26:57.301
Do the green carpet.

00:26:57.561 --> 00:26:57.761
Right.

00:26:57.781 --> 00:26:59.364
Like come up with like like

00:26:59.423 --> 00:27:01.425
we have a keg of beer that

00:27:01.546 --> 00:27:02.866
sits on the counter at the

00:27:02.906 --> 00:27:03.748
local hockey rink.

00:27:04.307 --> 00:27:04.489
Right.

00:27:04.509 --> 00:27:06.570
There's four men's leagues, A, B,

00:27:06.631 --> 00:27:09.093
C and D. And we get our name,

00:27:09.292 --> 00:27:11.055
our stupid team name on the thing.

00:27:11.394 --> 00:27:12.215
And every time you walk in

00:27:12.236 --> 00:27:13.037
with your wife and yeah,

00:27:13.116 --> 00:27:14.838
that's look at we won it six years ago.

00:27:15.648 --> 00:27:17.190
what's your, what's your big dumb trophy.

00:27:17.569 --> 00:27:18.230
Maybe it's a,

00:27:18.250 --> 00:27:20.912
maybe it's a WWE belt that you get to do.

00:27:20.951 --> 00:27:22.212
And who's got the, who's got the,

00:27:22.353 --> 00:27:23.653
whatever the green carpet belt.

00:27:23.693 --> 00:27:23.874
Yeah.

00:27:24.275 --> 00:27:25.095
Have fun with it, man.

00:27:26.276 --> 00:27:27.896
All right, Dave, we,

00:27:28.237 --> 00:27:30.318
we were talking on a thread.

00:27:30.838 --> 00:27:31.839
It had something to do with

00:27:31.880 --> 00:27:32.640
manual therapy.

00:27:32.700 --> 00:27:32.960
I said,

00:27:32.980 --> 00:27:34.621
Dave would be in for this conversation.

00:27:34.641 --> 00:27:37.143
And I completely forgot Scott's here.

00:27:37.202 --> 00:27:38.683
Maybe Scott can remind us if

00:27:38.784 --> 00:27:39.664
you don't remember,

00:27:40.184 --> 00:27:41.465
what were we going to talk about?

00:27:42.999 --> 00:27:44.400
Was that on LinkedIn?

00:27:44.420 --> 00:27:45.201
I think it was.

00:27:45.240 --> 00:27:46.362
And I don't have access to

00:27:46.382 --> 00:27:47.603
my LinkedIn account here.

00:27:47.623 --> 00:27:49.964
I got it.

00:27:50.986 --> 00:27:51.205
Yeah.

00:27:51.246 --> 00:27:52.326
Let us know in the chat.

00:27:52.386 --> 00:27:53.587
What were we talking about

00:27:53.828 --> 00:27:55.650
related to manual therapy

00:27:55.990 --> 00:27:58.492
and some other stuff in the meantime,

00:27:58.512 --> 00:28:00.213
while you're doing that, I got in.

00:28:00.454 --> 00:28:00.855
Go ahead.

00:28:01.335 --> 00:28:02.816
No, I got it.

00:28:03.135 --> 00:28:04.855
So you posted on LinkedIn a day ago,

00:28:04.895 --> 00:28:06.777
the post that says, when,

00:28:06.916 --> 00:28:08.057
so this is Tony's post.

00:28:08.538 --> 00:28:09.417
When does Medicare stop

00:28:09.438 --> 00:28:10.518
paying for the bike?

00:28:10.538 --> 00:28:12.919
A lesson from the total knee journey.

00:28:13.720 --> 00:28:14.720
All right.

00:28:14.740 --> 00:28:15.660
So it was a long post.

00:28:16.019 --> 00:28:17.201
You want to pull it up or do

00:28:17.221 --> 00:28:18.721
you want me to review it?

00:28:18.901 --> 00:28:19.461
I don't have it.

00:28:19.501 --> 00:28:20.682
You can just give me the

00:28:20.701 --> 00:28:21.863
highlights and what we were

00:28:21.883 --> 00:28:22.563
going to talk about.

00:28:24.311 --> 00:28:25.452
Just lost it.

00:28:25.553 --> 00:28:26.334
All right.

00:28:26.354 --> 00:28:28.955
But Scott had chimed in and commented.

00:28:28.996 --> 00:28:30.676
But the post was more about,

00:28:32.817 --> 00:28:34.740
is the bike warm up still a

00:28:34.779 --> 00:28:36.000
covered service under Medicare?

00:28:36.500 --> 00:28:37.521
Tony says no.

00:28:38.001 --> 00:28:39.143
And going into,

00:28:41.845 --> 00:28:43.025
there's a critical concept here.

00:28:43.465 --> 00:28:45.846
An intervention may still be helpful,

00:28:46.147 --> 00:28:47.367
but that doesn't make it covered.

00:28:47.428 --> 00:28:48.588
Doesn't make it a covered service.

00:28:49.849 --> 00:28:52.030
Tony dropped some references in the link.

00:28:52.050 --> 00:28:52.230
Guys,

00:28:52.270 --> 00:28:53.672
if you're not following Tony Meritato

00:28:53.692 --> 00:28:54.231
on LinkedIn,

00:28:54.271 --> 00:28:55.133
make sure you connect with him,

00:28:55.613 --> 00:28:56.413
Anthony Meritato.

00:28:56.973 --> 00:28:59.015
But Scott Embry commented,

00:28:59.555 --> 00:29:00.635
and Scott said he was about

00:29:00.655 --> 00:29:01.655
to post something similar

00:29:02.517 --> 00:29:03.517
from his recent post.

00:29:04.057 --> 00:29:05.117
Scott says he finds it

00:29:05.137 --> 00:29:05.917
interesting how manual

00:29:05.958 --> 00:29:06.999
therapy is reimbursed at a

00:29:07.058 --> 00:29:08.859
lower rate than most all

00:29:08.940 --> 00:29:09.921
other therapy services,

00:29:09.980 --> 00:29:11.540
yet requires the most skill

00:29:11.621 --> 00:29:13.903
and training as a PT or OT

00:29:14.323 --> 00:29:16.144
to practice at the top of our license.

00:29:16.763 --> 00:29:17.666
This would be a great topic

00:29:17.707 --> 00:29:18.830
to discuss on the next

00:29:18.871 --> 00:29:21.538
episode of Right Now at Breakfast Club.

00:29:22.067 --> 00:29:22.288
Yeah.

00:29:22.307 --> 00:29:23.688
So, so, and I hear that a lot.

00:29:23.768 --> 00:29:24.688
I hear that all the time.

00:29:24.728 --> 00:29:25.088
In fact,

00:29:25.108 --> 00:29:26.848
when I'm teaching my Medicare course,

00:29:26.888 --> 00:29:28.128
the main thing that I

00:29:28.169 --> 00:29:29.328
emphasize when we get to

00:29:29.368 --> 00:29:31.750
this section is I love to

00:29:31.809 --> 00:29:33.309
pull stuff up that shocks

00:29:33.390 --> 00:29:34.849
and appalls therapists.

00:29:34.910 --> 00:29:36.830
So I go into, you know,

00:29:36.971 --> 00:29:38.111
Medicare Mac portal.

00:29:38.230 --> 00:29:39.351
I pull up the fee schedule.

00:29:39.371 --> 00:29:40.871
I'm like, look, therapeutic activity,

00:29:40.911 --> 00:29:42.332
thirty two dollar reimbursement,

00:29:42.352 --> 00:29:43.392
therapeutic exercise,

00:29:43.432 --> 00:29:44.632
thirty dollar reimbursement,

00:29:44.951 --> 00:29:45.771
manual therapy,

00:29:45.832 --> 00:29:47.613
twenty five dollar reimbursement.

00:29:48.292 --> 00:29:49.712
And I reference I'm like, look,

00:29:50.313 --> 00:29:52.934
You know, if I'm a manual therapist,

00:29:53.154 --> 00:29:54.496
I'm not doing manual on two

00:29:54.516 --> 00:29:55.737
or three patients at a time,

00:29:55.757 --> 00:29:56.938
but I bet I could do good

00:29:57.117 --> 00:29:58.479
therapeutic exercise for

00:29:58.519 --> 00:30:00.140
two or three patients at the same time.

00:30:00.480 --> 00:30:02.040
If I'm a pelvic floor therapist,

00:30:02.080 --> 00:30:02.961
I'm not doing manual

00:30:03.001 --> 00:30:04.163
therapy on three pelvic

00:30:04.182 --> 00:30:05.644
floor patients at the same time,

00:30:05.763 --> 00:30:07.025
one hand here and one hand there.

00:30:07.704 --> 00:30:09.007
So like there are

00:30:09.287 --> 00:30:11.368
limitations on manual therapy.

00:30:11.429 --> 00:30:11.548
Now,

00:30:11.588 --> 00:30:12.990
I'm going to disagree with Scott

00:30:13.371 --> 00:30:14.092
because I think there are a

00:30:14.152 --> 00:30:15.614
lot of great exercise based

00:30:15.634 --> 00:30:16.515
therapists and other

00:30:16.535 --> 00:30:17.596
therapists that don't even

00:30:17.635 --> 00:30:19.018
need manual therapy at all.

00:30:19.438 --> 00:30:20.499
I'm not going to say it

00:30:20.579 --> 00:30:21.701
requires the most skill.

00:30:21.740 --> 00:30:23.403
It requires some knowledge and some skill.

00:30:24.364 --> 00:30:26.105
But I'm also not a great manual therapist.

00:30:26.145 --> 00:30:27.386
So maybe it's my bias.

00:30:28.268 --> 00:30:29.830
Point being, point being,

00:30:30.372 --> 00:30:31.674
the differentiation,

00:30:31.795 --> 00:30:32.876
this is a really hard

00:30:32.916 --> 00:30:34.621
concept for therapists to grasp,

00:30:34.661 --> 00:30:35.742
and I'm pushing the

00:30:35.823 --> 00:30:37.546
envelope with this idea a little bit.

00:30:38.557 --> 00:30:41.079
There are things that we have invested.

00:30:41.900 --> 00:30:43.942
The golf simulator, that's an investment.

00:30:43.961 --> 00:30:44.821
That was a financial

00:30:44.862 --> 00:30:46.683
investment that was made by Chris Miller.

00:30:47.324 --> 00:30:48.424
There are things that we

00:30:48.444 --> 00:30:50.046
have invested in that go

00:30:50.125 --> 00:30:52.086
way above and beyond what

00:30:52.207 --> 00:30:55.128
is covered by Medicare at

00:30:55.289 --> 00:30:56.549
the base threshold.

00:30:56.711 --> 00:30:57.750
Medicare will pay for

00:30:57.891 --> 00:30:59.853
entry-level physical therapy, period.

00:31:00.413 --> 00:31:01.535
They don't pay more for

00:31:01.595 --> 00:31:02.776
better physical therapy.

00:31:02.796 --> 00:31:04.557
They don't pay more for more education.

00:31:04.578 --> 00:31:06.019
They don't pay more for better equipment.

00:31:06.059 --> 00:31:06.942
This goes to Jimmy's

00:31:06.981 --> 00:31:08.663
conversation about the

00:31:08.703 --> 00:31:10.605
headset for the vestibular

00:31:10.625 --> 00:31:11.688
therapist assessment.

00:31:13.150 --> 00:31:14.431
So we went down this rabbit

00:31:14.471 --> 00:31:15.532
hole and we were like, Guys,

00:31:15.692 --> 00:31:16.534
realistically,

00:31:17.619 --> 00:31:19.121
If I was an entry-level

00:31:19.161 --> 00:31:22.282
therapist doing entry-level therapy,

00:31:22.722 --> 00:31:24.304
that is what Medicare is paying for.

00:31:24.443 --> 00:31:25.384
Once I finished that

00:31:25.484 --> 00:31:26.905
entry-level plan of care,

00:31:27.385 --> 00:31:28.527
anything above and beyond

00:31:28.567 --> 00:31:30.407
that really should be self-pay,

00:31:30.847 --> 00:31:33.670
should be charged a premium for.

00:31:33.750 --> 00:31:35.990
Why would anybody ever want to learn more,

00:31:36.070 --> 00:31:36.632
be better,

00:31:36.692 --> 00:31:38.972
do better if they couldn't

00:31:38.992 --> 00:31:40.054
charge for that?

00:31:40.374 --> 00:31:42.375
And Medicare is like, yeah,

00:31:42.414 --> 00:31:43.236
if you want to give me a

00:31:43.276 --> 00:31:44.376
Rolls Royce for free,

00:31:45.037 --> 00:31:45.557
heck yeah,

00:31:45.876 --> 00:31:47.718
I'm going to pay for a Honda Civic.

00:31:48.157 --> 00:31:49.157
Give me the Rolls Royce.

00:31:49.698 --> 00:31:52.218
But we as therapists need to

00:31:52.258 --> 00:31:53.659
start identifying where

00:31:53.699 --> 00:31:55.959
this extra value is within

00:31:55.979 --> 00:31:57.378
the confines of Medicare

00:31:57.419 --> 00:31:58.660
reimbursement or any third

00:31:58.720 --> 00:31:59.880
party payer contract.

00:32:00.240 --> 00:32:01.240
And we need to stop,

00:32:01.539 --> 00:32:03.621
stop giving away all of

00:32:03.661 --> 00:32:05.641
this insane extra value

00:32:05.681 --> 00:32:07.642
that we're not being paid for.

00:32:07.682 --> 00:32:09.321
We're not being incentivized for.

00:32:10.682 --> 00:32:12.321
I probably went way off the rails on that,

00:32:12.362 --> 00:32:14.143
but go ahead, Dave, bring me back in.

00:32:15.709 --> 00:32:18.769
so okay a couple things um I

00:32:18.829 --> 00:32:19.990
know what you mean by

00:32:20.810 --> 00:32:21.971
manual therapy might not be

00:32:22.011 --> 00:32:24.833
the most uh top of license

00:32:25.012 --> 00:32:26.794
as scott describes it

00:32:26.834 --> 00:32:28.994
because you could you you

00:32:29.015 --> 00:32:30.115
tony you've given a great

00:32:30.536 --> 00:32:31.516
uh rebuttal and example

00:32:32.135 --> 00:32:32.957
previously on the show

00:32:32.977 --> 00:32:36.077
where you said getting two

00:32:36.097 --> 00:32:36.897
or three patients at the

00:32:36.938 --> 00:32:38.598
same time or any time to

00:32:38.778 --> 00:32:40.779
move more and exercise and

00:32:40.940 --> 00:32:41.921
and build that empowerment

00:32:41.980 --> 00:32:42.881
and build those healthy

00:32:42.921 --> 00:32:44.000
habits and lifestyle

00:32:44.040 --> 00:32:44.842
components and changes

00:32:45.999 --> 00:32:47.661
arguably could be more

00:32:47.701 --> 00:32:48.721
valuable to those people,

00:32:48.761 --> 00:32:49.823
to those patients and clients.

00:32:50.242 --> 00:32:51.503
That's actually, I think,

00:32:51.624 --> 00:32:53.145
the best rebuttal I've ever

00:32:53.205 --> 00:32:56.348
heard regarding movement-based therapy,

00:32:57.089 --> 00:32:58.171
therapeutic exercise,

00:32:58.730 --> 00:33:00.092
why even insurance pays

00:33:00.173 --> 00:33:01.773
more for that versus manual therapy.

00:33:02.615 --> 00:33:03.154
But then there's other

00:33:03.214 --> 00:33:04.797
owners like Mick Aglani.

00:33:04.817 --> 00:33:07.179
He had three or four or five locations.

00:33:07.219 --> 00:33:09.101
He sold them to Alliance Physical Therapy,

00:33:09.141 --> 00:33:09.642
Private Equity.

00:33:11.383 --> 00:33:12.845
Even though the manual

00:33:12.865 --> 00:33:14.866
therapy code was billed and

00:33:14.906 --> 00:33:16.608
paid at a lower rate than

00:33:16.628 --> 00:33:17.549
therapeutic exercise,

00:33:17.990 --> 00:33:22.174
he would only hire and keep

00:33:22.214 --> 00:33:23.457
therapists and train

00:33:23.477 --> 00:33:25.057
therapists who were doing hands-on,

00:33:25.179 --> 00:33:26.259
some component of hands-on.

00:33:26.740 --> 00:33:28.701
Now, they don't have to be doing twenty,

00:33:28.742 --> 00:33:29.002
thirty,

00:33:29.042 --> 00:33:30.423
forty minutes of manual therapy

00:33:30.523 --> 00:33:31.305
per patient.

00:33:31.986 --> 00:33:33.306
But there is the argument of

00:33:33.346 --> 00:33:35.047
the therapeutic touch and

00:33:35.067 --> 00:33:36.426
the therapeutic feel and

00:33:36.807 --> 00:33:37.946
building a therapeutic alliance.

00:33:38.667 --> 00:33:39.627
Not everyone wants that.

00:33:40.188 --> 00:33:44.288
Tony wants hot tub based massage,

00:33:44.308 --> 00:33:45.929
but he doesn't want massage on land.

00:33:46.288 --> 00:33:47.930
It's a joke between us on the show.

00:33:49.390 --> 00:33:50.670
And then you also don't want to deliver it,

00:33:50.750 --> 00:33:51.891
or you'll do manual therapy.

00:33:51.911 --> 00:33:54.530
You'll do soft touch over the clothes,

00:33:54.550 --> 00:33:54.830
whatever.

00:33:54.871 --> 00:33:56.471
So everyone does something differently.

00:33:58.132 --> 00:34:00.275
But the manual therapy code

00:34:00.654 --> 00:34:02.897
is also for like tactile cueing, right?

00:34:02.917 --> 00:34:05.560
So like if Tony needs tactile cueing from,

00:34:05.701 --> 00:34:07.303
no, it's not, I thought it was.

00:34:08.545 --> 00:34:09.646
There's things that fall

00:34:09.666 --> 00:34:11.108
within manual therapy.

00:34:11.168 --> 00:34:13.409
And if I reference Medicare specifically,

00:34:13.489 --> 00:34:15.371
soft tissue mobilization is

00:34:15.411 --> 00:34:17.092
specifically listed in the

00:34:17.211 --> 00:34:18.152
Medicare guideline.

00:34:19.193 --> 00:34:21.896
You know, there's five things,

00:34:22.275 --> 00:34:23.516
manual emphatic drainage

00:34:23.556 --> 00:34:24.137
being one of them,

00:34:24.157 --> 00:34:24.938
but there's five things

00:34:24.958 --> 00:34:25.938
that are listed within the

00:34:25.978 --> 00:34:27.239
Medicare guideline under

00:34:27.298 --> 00:34:28.940
manual therapy CPT code.

00:34:29.581 --> 00:34:31.922
So there's some interpretation,

00:34:31.943 --> 00:34:33.563
but then there's some objective measure.

00:34:33.603 --> 00:34:34.384
So I'm not going to say it's not.

00:34:34.603 --> 00:34:36.226
I didn't mean to respond.

00:34:37.106 --> 00:34:37.586
Hold on a minute.

00:34:37.847 --> 00:34:39.009
Is this something that we

00:34:39.068 --> 00:34:40.170
fundamentally still go

00:34:40.190 --> 00:34:41.592
around in circles about in

00:34:41.632 --> 00:34:42.333
our profession?

00:34:42.693 --> 00:34:43.173
Yes, absolutely.

00:34:43.253 --> 00:34:44.516
Why is manual therapy

00:34:44.936 --> 00:34:46.358
reimbursed so low compared

00:34:46.378 --> 00:34:47.599
to other PT services

00:34:48.460 --> 00:34:50.603
despite requiring greater skill?

00:34:50.702 --> 00:34:52.184
It's that second part that I'm like,

00:34:53.106 --> 00:34:53.547
does it?

00:34:54.268 --> 00:34:55.027
Scott says yes.

00:34:55.835 --> 00:34:56.376
You know what?

00:34:56.456 --> 00:34:57.617
I have to take a side here.

00:34:58.197 --> 00:34:58.737
Yes, it does.

00:34:58.998 --> 00:34:59.637
Here's an example.

00:35:00.139 --> 00:35:01.500
There's new grad physical therapist.

00:35:01.519 --> 00:35:02.601
I'm not even going to say any names,

00:35:03.021 --> 00:35:04.643
but a new grad physical

00:35:04.682 --> 00:35:05.643
therapist who let's say

00:35:05.742 --> 00:35:07.445
used to be a personal trainer or, or,

00:35:07.664 --> 00:35:08.144
you know,

00:35:08.164 --> 00:35:09.567
was like a semi bodybuilder or

00:35:09.606 --> 00:35:10.847
someone that like exercised a lot.

00:35:11.108 --> 00:35:12.068
They graduated physical

00:35:12.088 --> 00:35:13.230
therapy school in their

00:35:13.269 --> 00:35:14.391
first couple of years,

00:35:14.431 --> 00:35:15.851
the first year of school,

00:35:15.871 --> 00:35:17.012
first year as a new grad,

00:35:17.333 --> 00:35:18.353
first one or two or three

00:35:18.373 --> 00:35:19.014
years out of school.

00:35:19.875 --> 00:35:20.795
you don't have the manual

00:35:20.815 --> 00:35:21.697
therapy skills you don't

00:35:21.737 --> 00:35:23.400
understand like you don't

00:35:23.420 --> 00:35:25.663
know like how great your

00:35:25.682 --> 00:35:26.324
treatment is going to be

00:35:26.364 --> 00:35:27.626
necessarily you that takes

00:35:27.885 --> 00:35:29.288
that takes months or years

00:35:29.327 --> 00:35:31.050
to get feedback from

00:35:31.110 --> 00:35:32.552
patients and did I go too

00:35:32.592 --> 00:35:34.253
much did I go too soft am I

00:35:34.273 --> 00:35:35.956
doing soft tissue treatment am I doing

00:35:36.456 --> 00:35:37.418
joint mobilizations am I

00:35:37.458 --> 00:35:38.659
doing neurodynamics am I

00:35:38.760 --> 00:35:40.442
flossing a nerve what pnf

00:35:40.461 --> 00:35:41.523
like what am I doing

00:35:42.164 --> 00:35:43.987
someone that's a new grad

00:35:44.186 --> 00:35:46.048
or even let's say someone

00:35:46.068 --> 00:35:47.311
that's shadowing as a

00:35:47.590 --> 00:35:48.311
physical therapy student

00:35:48.331 --> 00:35:48.952
they don't even have to

00:35:48.972 --> 00:35:51.094
have their dbt license

00:35:51.695 --> 00:35:52.336
And they can do the

00:35:52.356 --> 00:35:53.416
therapeutic movements and

00:35:53.438 --> 00:35:54.438
exercise with two or three

00:35:54.458 --> 00:35:55.199
or more patients that

00:35:55.219 --> 00:35:56.059
Tony's talking about.

00:35:56.539 --> 00:35:57.161
But you can't,

00:35:57.721 --> 00:35:59.543
to Scott's point that I now agree with,

00:35:59.702 --> 00:36:00.402
I was on the fence.

00:36:00.503 --> 00:36:01.563
I have to take Scott's side.

00:36:02.105 --> 00:36:02.824
No offense, Tony.

00:36:03.806 --> 00:36:06.367
I'm saying I'm against Tony once again,

00:36:06.728 --> 00:36:06.989
but...

00:36:08.048 --> 00:36:09.730
For manual therapy skills to

00:36:09.809 --> 00:36:10.951
actually get people better

00:36:11.791 --> 00:36:13.313
or to get – I don't know if

00:36:13.333 --> 00:36:14.193
it's necessarily better

00:36:14.213 --> 00:36:15.313
because it's kind of subjective,

00:36:15.353 --> 00:36:17.914
but it takes more time.

00:36:18.054 --> 00:36:19.215
It takes more time to build

00:36:19.396 --> 00:36:20.336
manual therapy skills.

00:36:20.396 --> 00:36:21.436
If we can agree on that,

00:36:21.858 --> 00:36:23.179
then – I don't know if we

00:36:23.199 --> 00:36:25.440
can because there's been

00:36:25.480 --> 00:36:28.542
studies showing that like –

00:36:27.420 --> 00:36:28.601
It doesn't like, I mean,

00:36:28.661 --> 00:36:29.342
how many of the studies we

00:36:29.362 --> 00:36:30.423
can go to the extreme example,

00:36:30.443 --> 00:36:30.844
which is like,

00:36:30.903 --> 00:36:32.786
like manual therapy studies,

00:36:32.806 --> 00:36:34.507
like I can palpate your psoas.

00:36:34.527 --> 00:36:35.887
And it's like, can you though?

00:36:36.509 --> 00:36:37.188
Can you though?

00:36:37.309 --> 00:36:38.590
Like how much of it is like

00:36:38.610 --> 00:36:40.452
a little bit of theater?

00:36:40.472 --> 00:36:41.393
Yeah.

00:36:41.452 --> 00:36:42.853
How much is that?

00:36:43.367 --> 00:36:43.987
Here's the thing.

00:36:44.248 --> 00:36:44.748
Here's the thing.

00:36:45.327 --> 00:36:46.668
And real quick, for reference,

00:36:47.028 --> 00:36:50.329
if you go to CGS Medicare,

00:36:50.489 --> 00:36:51.710
that's my Medicare Mac,

00:36:51.869 --> 00:36:53.050
under manual therapy,

00:36:53.090 --> 00:36:54.570
there's five things listed I mentioned.

00:36:55.010 --> 00:36:57.391
Manual traction, joint mobilization,

00:36:57.630 --> 00:36:58.710
myofascial release,

00:36:58.831 --> 00:37:00.592
and soft tissue mobilization.

00:37:01.251 --> 00:37:03.532
Manual therapy, manual lymphatic drainage.

00:37:03.592 --> 00:37:03.811
Okay,

00:37:03.833 --> 00:37:05.253
so those are the five things that

00:37:05.873 --> 00:37:07.572
Medicare in my area lists

00:37:07.713 --> 00:37:08.773
under manual therapy.

00:37:08.833 --> 00:37:10.054
But the point in this is,

00:37:10.813 --> 00:37:11.393
Medicare,

00:37:11.693 --> 00:37:13.554
and we're just using them as an example,

00:37:14.155 --> 00:37:15.815
is paying for manual therapy,

00:37:16.135 --> 00:37:18.217
manual therapy, not great manual therapy,

00:37:18.257 --> 00:37:19.297
not good manual therapy,

00:37:19.338 --> 00:37:20.617
not this is manual therapy

00:37:20.637 --> 00:37:21.478
that makes you better.

00:37:21.579 --> 00:37:23.358
You guys are in a different world.

00:37:23.378 --> 00:37:24.519
You're in a different league.

00:37:24.860 --> 00:37:25.940
You're talking professional

00:37:25.981 --> 00:37:27.981
sports versus third grade little league.

00:37:28.621 --> 00:37:29.742
I can go out there.

00:37:30.001 --> 00:37:31.603
I can go out there right now

00:37:32.083 --> 00:37:33.643
and rub someone's back.

00:37:34.224 --> 00:37:35.684
pat them on the back a little bit,

00:37:35.784 --> 00:37:36.784
pinch them a little bit,

00:37:36.824 --> 00:37:38.286
like flick them a little bit,

00:37:38.326 --> 00:37:39.146
and they're going to have

00:37:39.226 --> 00:37:40.306
altered sensation.

00:37:40.407 --> 00:37:42.228
And I can call that manual therapy.

00:37:44.768 --> 00:37:45.208
It's just,

00:37:45.268 --> 00:37:46.309
it's one of those things where

00:37:46.329 --> 00:37:48.231
I'm not getting paid for the outcome.

00:37:48.291 --> 00:37:49.690
I'm not getting paid for how

00:37:49.731 --> 00:37:50.672
good or bad it feels.

00:37:50.692 --> 00:37:52.032
I'm not getting paid for any of that.

00:37:52.072 --> 00:37:53.012
I'm getting paid for the

00:37:53.072 --> 00:37:54.753
delivery of what is called

00:37:55.153 --> 00:37:56.434
manual therapy.

00:37:56.835 --> 00:37:58.376
I don't need special certification.

00:37:58.476 --> 00:37:59.536
I don't need any advanced

00:37:59.556 --> 00:38:00.836
degrees beyond my licensure.

00:38:01.730 --> 00:38:03.130
And this is the disconnect.

00:38:03.150 --> 00:38:04.411
So to Scott's point,

00:38:05.213 --> 00:38:06.414
you guys are delivering

00:38:06.474 --> 00:38:08.436
gold for the price of copper.

00:38:08.536 --> 00:38:09.996
I would say it's the price of lead.

00:38:10.257 --> 00:38:11.579
Like, seriously,

00:38:13.139 --> 00:38:15.762
we are confusing what we want to give,

00:38:15.802 --> 00:38:16.742
what we want to deliver,

00:38:16.762 --> 00:38:17.844
the experience we want to

00:38:17.864 --> 00:38:18.945
provide with what we are

00:38:19.045 --> 00:38:20.465
actually getting paid to do.

00:38:20.907 --> 00:38:22.447
There is a standard of care.

00:38:22.847 --> 00:38:24.789
It goes down to a minimum standard.

00:38:25.188 --> 00:38:26.568
That is what Medicare is paying for.

00:38:26.608 --> 00:38:28.130
And from the payer's perspective,

00:38:28.829 --> 00:38:30.650
I can't I can't send the

00:38:30.690 --> 00:38:32.891
therapist's hands home with my patient.

00:38:33.490 --> 00:38:36.192
So where is the most value

00:38:36.351 --> 00:38:38.331
as a payer to make that

00:38:38.371 --> 00:38:39.932
patient stop therapy?

00:38:40.432 --> 00:38:42.695
It's exercise, it's functional activity,

00:38:43.056 --> 00:38:43.916
because those are the

00:38:43.956 --> 00:38:44.637
things that are going to

00:38:44.657 --> 00:38:46.318
get them out of there the quickest.

00:38:46.498 --> 00:38:48.621
And I, personal opinion,

00:38:49.141 --> 00:38:50.342
manual therapy is amazing.

00:38:50.382 --> 00:38:51.423
I would never take anything

00:38:51.443 --> 00:38:52.925
away from great manual therapists,

00:38:52.965 --> 00:38:54.507
but for decades,

00:38:54.606 --> 00:38:56.208
it's been used as a bribe

00:38:56.449 --> 00:38:58.170
to keep patients in the clinic

00:38:58.527 --> 00:38:59.668
to keep them coming,

00:38:59.728 --> 00:39:01.809
to keep them utilizing more services.

00:39:02.351 --> 00:39:03.771
I'm shocked that payers will

00:39:03.791 --> 00:39:04.992
still even pay for manual

00:39:05.032 --> 00:39:06.735
therapy just because of the

00:39:06.795 --> 00:39:09.157
negative impact on the cost

00:39:09.277 --> 00:39:10.418
of therapy services.

00:39:10.798 --> 00:39:12.219
People quit manual therapy,

00:39:12.239 --> 00:39:13.621
they'll quit therapy quicker.

00:39:14.081 --> 00:39:14.481
Scott asks,

00:39:14.521 --> 00:39:15.682
what professions can perform

00:39:15.722 --> 00:39:17.644
manual therapy?

00:39:17.804 --> 00:39:19.606
I quickly got a list.

00:39:21.380 --> 00:39:21.659
So I don't,

00:39:21.760 --> 00:39:22.900
I don't know if that helps or

00:39:22.940 --> 00:39:23.561
hurts this cause.

00:39:23.601 --> 00:39:24.481
Like it's house.

00:39:24.822 --> 00:39:25.742
I think we're trying to sell

00:39:25.802 --> 00:39:27.643
like a skill that you can't,

00:39:28.025 --> 00:39:29.565
it's very difficult to measure, right?

00:39:29.646 --> 00:39:30.545
Well, but,

00:39:30.565 --> 00:39:31.907
but my wife goes and gets a

00:39:31.967 --> 00:39:34.148
pedicure and they mobilize

00:39:34.168 --> 00:39:35.610
her toe joints and they rub

00:39:35.630 --> 00:39:37.311
her feet and they do these things.

00:39:37.530 --> 00:39:38.871
So because that person that

00:39:38.911 --> 00:39:39.592
rubs her feet has been

00:39:39.612 --> 00:39:40.592
doing it for ten years,

00:39:41.153 --> 00:39:42.014
she's better than a new

00:39:42.054 --> 00:39:42.855
grad physical therapist.

00:39:42.875 --> 00:39:44.096
She's better than it.

00:39:44.275 --> 00:39:45.657
But is it manual therapy?

00:39:45.836 --> 00:39:47.217
Like this is where we go round and round.

00:39:48.677 --> 00:39:50.039
I think by definition it is.

00:39:50.478 --> 00:39:52.000
It's not a covered service

00:39:52.059 --> 00:39:53.440
under Medicare because she

00:39:53.481 --> 00:39:55.181
doesn't have the letters after her name.

00:39:55.242 --> 00:39:58.443
But that person who does a pedicure,

00:39:59.525 --> 00:40:01.186
she is making my wife feel better.

00:40:01.286 --> 00:40:02.346
My wife is willing to pay

00:40:02.385 --> 00:40:03.186
the price for it.

00:40:03.306 --> 00:40:05.307
And, you know, it's a positive experience.

00:40:05.327 --> 00:40:06.148
All right.

00:40:06.268 --> 00:40:08.489
I have a question for both of you guys.

00:40:08.530 --> 00:40:09.791
Have you ever thought of

00:40:09.811 --> 00:40:13.213
yourself as the hero in your own story?

00:40:16.902 --> 00:40:18.445
I think I used to, when I was a new grad,

00:40:18.485 --> 00:40:19.625
I thought I was like, you know,

00:40:19.664 --> 00:40:20.306
the best ever.

00:40:20.346 --> 00:40:24.688
And then after, yo, I was going to ask,

00:40:24.708 --> 00:40:26.251
as we were like, ten minutes ago,

00:40:26.331 --> 00:40:27.552
I saw some of this on Facebook.

00:40:28.032 --> 00:40:29.012
I saw some of this action

00:40:29.032 --> 00:40:29.833
figure stuff on Facebook.

00:40:29.853 --> 00:40:30.753
And I was going to ask you guys,

00:40:30.773 --> 00:40:31.534
because I saw some of our

00:40:31.554 --> 00:40:32.315
colleagues on Facebook

00:40:32.355 --> 00:40:33.235
posting this stuff.

00:40:33.735 --> 00:40:34.237
And I was going to say,

00:40:34.277 --> 00:40:35.518
what is this action figure thing?

00:40:36.358 --> 00:40:37.699
I cannot believe you threw this up here.

00:40:38.099 --> 00:40:39.862
You guys have to check out YouTube.

00:40:39.902 --> 00:40:41.422
Go to PT podcast,

00:40:41.443 --> 00:40:42.364
learn Medicare billing or

00:40:42.384 --> 00:40:43.164
the Dave Kittle show right

00:40:43.204 --> 00:40:44.164
now for this episode.

00:40:44.246 --> 00:40:45.887
Stop listening on iTunes or Spotify.

00:40:45.907 --> 00:40:47.108
Jump over to YouTube at the

00:40:47.168 --> 00:40:47.688
forty minute mark.

00:40:47.989 --> 00:40:49.170
So there's always these

00:40:49.210 --> 00:40:50.110
trends that go around.

00:40:50.130 --> 00:40:51.032
I don't know how they start.

00:40:51.411 --> 00:40:52.273
I wish I could figure it out

00:40:52.313 --> 00:40:52.952
so I could start one.

00:40:53.454 --> 00:40:55.175
But there was the one with the Funko pop.

00:40:57.719 --> 00:40:58.360
figurines.

00:40:58.420 --> 00:40:59.679
It's like a specific kind of figurine.

00:40:59.699 --> 00:41:00.740
That was like six months ago.

00:41:01.121 --> 00:41:02.681
Somebody just typed into chat GPT,

00:41:02.961 --> 00:41:04.181
make me an action figure.

00:41:04.681 --> 00:41:06.163
And then these things started to pop up.

00:41:06.643 --> 00:41:07.943
I didn't wear that shirt today.

00:41:08.003 --> 00:41:09.423
I wore the, I wore the lavender one,

00:41:09.443 --> 00:41:10.063
not the blue one.

00:41:10.384 --> 00:41:12.804
So what I've done is I asked chat GP,

00:41:12.824 --> 00:41:13.846
what it knows about whoever

00:41:13.865 --> 00:41:14.306
I'm going to make the

00:41:14.365 --> 00:41:15.206
action figure about.

00:41:15.846 --> 00:41:17.226
And then it surprising.

00:41:17.286 --> 00:41:18.327
Cause now it can search the web.

00:41:18.387 --> 00:41:19.668
It'll find a lot of information.

00:41:20.088 --> 00:41:20.688
And then it's like,

00:41:20.807 --> 00:41:21.929
give me some photos so I

00:41:21.949 --> 00:41:22.929
can get photo realistic.

00:41:22.949 --> 00:41:23.809
So I think I found like five

00:41:23.829 --> 00:41:24.869
or six photos of Dave and,

00:41:25.449 --> 00:41:28.510
That's pretty good.

00:41:28.951 --> 00:41:30.391
That's one iteration, right?

00:41:30.550 --> 00:41:31.731
I might have sent the

00:41:31.771 --> 00:41:32.972
picture of you doing the flex thing.

00:41:33.271 --> 00:41:35.813
But what I like about it is

00:41:35.833 --> 00:41:36.672
the accessories.

00:41:37.012 --> 00:41:38.572
It's like laptop, phone.

00:41:38.833 --> 00:41:40.173
There's a pom-pom there

00:41:40.434 --> 00:41:40.893
because you're a

00:41:40.974 --> 00:41:42.293
cheerleader for other businesses.

00:41:42.333 --> 00:41:42.753
Okay.

00:41:43.353 --> 00:41:44.594
Jump rope and barbell.

00:41:44.974 --> 00:41:45.494
And then, Tony,

00:41:45.534 --> 00:41:46.235
what do you think your

00:41:46.295 --> 00:41:47.695
accessories would be based

00:41:47.755 --> 00:41:48.896
on what chat you've been doing?

00:41:48.936 --> 00:41:49.195
Here we go.

00:41:49.215 --> 00:41:49.456
Here we go.

00:41:51.333 --> 00:41:52.436
I have no idea.

00:41:52.456 --> 00:41:53.197
His real estate.

00:41:54.137 --> 00:41:54.277
Oh.

00:41:54.898 --> 00:41:56.420
Push button to educate.

00:41:56.501 --> 00:41:57.802
The knee.

00:41:57.842 --> 00:41:58.804
The knee, of course.

00:41:59.144 --> 00:42:01.146
How incredible is that?

00:42:01.407 --> 00:42:01.907
Look.

00:42:01.989 --> 00:42:03.389
And again, look at the shirt.

00:42:03.409 --> 00:42:06.375
Look at the logo on the shirt.

00:42:06.454 --> 00:42:06.875
Wow.

00:42:07.054 --> 00:42:07.275
It is.

00:42:07.715 --> 00:42:07.976
Wow.

00:42:08.336 --> 00:42:09.719
You have to send me that or

00:42:09.778 --> 00:42:11.380
share it or do something.

00:42:11.521 --> 00:42:12.722
Tony might get that three-D printed.

00:42:12.802 --> 00:42:14.664
I think he actually wants that.

00:42:15.085 --> 00:42:15.567
That's the thing.

00:42:15.606 --> 00:42:16.728
I was thinking about exactly

00:42:16.748 --> 00:42:17.648
that last night.

00:42:17.969 --> 00:42:19.692
What's to stop me from making this?

00:42:20.032 --> 00:42:21.494
I mean, I have to buy a three-D printer.

00:42:21.514 --> 00:42:22.074
I'm going to buy it for

00:42:22.094 --> 00:42:23.096
myself for Christmas maybe,

00:42:23.135 --> 00:42:24.338
but I've got one too.

00:42:25.514 --> 00:42:26.695
It's even got my tagline,

00:42:26.715 --> 00:42:28.597
the best conversation happy hour.

00:42:28.936 --> 00:42:29.777
Welcome to ours.

00:42:29.838 --> 00:42:31.838
Push button to enter interview mode.

00:42:32.599 --> 00:42:33.719
I'm going to share these.

00:42:33.900 --> 00:42:34.740
Where should I share them?

00:42:34.780 --> 00:42:36.802
In our Facebook group, on LinkedIn?

00:42:37.023 --> 00:42:37.983
Because what I want people

00:42:38.003 --> 00:42:38.784
to do is look at them,

00:42:38.804 --> 00:42:40.003
but I want to see what theirs are.

00:42:40.125 --> 00:42:41.666
I want to see their version of that.

00:42:42.065 --> 00:42:43.786
So you got that from what?

00:42:44.447 --> 00:42:46.068
One prompt on ChatGPT,

00:42:46.349 --> 00:42:48.050
and I have it connected to Dolly.

00:42:48.070 --> 00:42:49.550
Wow.

00:42:50.403 --> 00:42:52.565
That blows me away.

00:42:52.867 --> 00:42:53.507
Other than that,

00:42:53.547 --> 00:42:54.327
have you guys searched

00:42:54.367 --> 00:42:56.489
yourselves in any of the AIs?

00:42:56.510 --> 00:42:59.713
Yeah, I have, yep.

00:43:01.208 --> 00:43:01.527
Yeah.

00:43:01.867 --> 00:43:03.289
I get messages all the time

00:43:03.309 --> 00:43:04.409
from people that are like, hey,

00:43:04.489 --> 00:43:06.130
I was asking ChatGPT or

00:43:06.150 --> 00:43:07.592
Gemini or whatever,

00:43:08.353 --> 00:43:10.514
and your information came up.

00:43:12.717 --> 00:43:14.117
I mean, Jimmy asked the other day,

00:43:14.177 --> 00:43:14.898
yesterday maybe,

00:43:15.559 --> 00:43:17.079
about SEO and changing

00:43:17.139 --> 00:43:18.440
domains and stuff like that.

00:43:18.920 --> 00:43:21.083
I still think traditional

00:43:21.322 --> 00:43:23.264
SEO is virtually worthless.

00:43:24.005 --> 00:43:25.585
I don't think SEO the way it

00:43:25.626 --> 00:43:27.427
was even two years ago has

00:43:27.487 --> 00:43:30.108
the power that it used to.

00:43:32.030 --> 00:43:33.210
But if you guys are

00:43:33.231 --> 00:43:36.393
listening and you haven't, go to ChatGPT,

00:43:36.454 --> 00:43:38.114
go to Amazon Alexa.

00:43:38.315 --> 00:43:39.576
I've asked that one also.

00:43:40.436 --> 00:43:42.797
Go to any of these tools

00:43:42.818 --> 00:43:44.418
that are out there and say, hey,

00:43:45.119 --> 00:43:47.240
what do you know about Anthony Meritato,

00:43:47.260 --> 00:43:48.681
the physical therapist in Middletown?

00:43:49.081 --> 00:43:50.222
That's how I say it.

00:43:50.242 --> 00:43:51.204
That's how I say it to you.

00:43:51.304 --> 00:43:52.364
What do you know about?

00:43:52.443 --> 00:43:53.565
I'm like, give me some context.

00:43:54.106 --> 00:43:55.005
And I'm showing the new

00:43:55.045 --> 00:43:56.726
webpage that pod page was

00:43:56.746 --> 00:43:57.427
trying to sell me.

00:43:58.007 --> 00:43:58.528
And I,

00:43:58.588 --> 00:43:59.789
it would take me six months to build

00:43:59.829 --> 00:44:00.250
this page.

00:44:00.289 --> 00:44:01.451
And Tony knows how much I

00:44:01.710 --> 00:44:04.253
just hate websites and updating websites.

00:44:04.652 --> 00:44:07.355
So this, this does, this does that.

00:44:07.394 --> 00:44:08.355
That's why I was asking, like,

00:44:08.494 --> 00:44:09.496
should I just jump ship?

00:44:09.516 --> 00:44:10.536
Or is that a bad idea?

00:44:11.237 --> 00:44:12.057
And I think what I'm hearing

00:44:12.117 --> 00:44:12.697
is just do it.

00:44:12.757 --> 00:44:13.239
Cause it's gonna,

00:44:13.318 --> 00:44:13.898
it's gonna update

00:44:13.918 --> 00:44:14.840
everything automatically.

00:44:17.644 --> 00:44:19.885
Has anyone ever seen Jimmy wearing a tie?

00:44:20.666 --> 00:44:21.206
I've worn a tie.

00:44:21.226 --> 00:44:23.467
Yeah, conferences.

00:44:24.088 --> 00:44:24.548
Conferences.

00:44:24.869 --> 00:44:26.230
I go out of my way now not

00:44:26.250 --> 00:44:28.231
to do that because, I don't know,

00:44:28.271 --> 00:44:28.972
I just don't like it.

00:44:29.032 --> 00:44:30.172
But I have worn a tie.

00:44:30.893 --> 00:44:32.173
When you had the orange suit

00:44:32.253 --> 00:44:33.414
on for Fox Rehab,

00:44:33.434 --> 00:44:34.896
was that with an orange tie

00:44:34.916 --> 00:44:36.916
or was it no tie?

00:44:37.117 --> 00:44:39.297
I think it was with an orange tie.

00:44:39.398 --> 00:44:41.099
I bought that off of Appa Suits.

00:44:42.291 --> 00:44:44.793
Um, that was, that's a throwback.

00:44:45.132 --> 00:44:46.034
I'll find that picture.

00:44:46.454 --> 00:44:47.295
Steven Dunn.

00:44:47.554 --> 00:44:48.916
I'm a manual therapist and

00:44:49.036 --> 00:44:50.076
exercise therapist.

00:44:50.096 --> 00:44:51.516
Find the combo really helps.

00:44:51.637 --> 00:44:52.237
Absolutely.

00:44:52.398 --> 00:44:54.199
You know, there's,

00:44:54.219 --> 00:44:55.440
I think I was just hung up on like,

00:44:55.800 --> 00:44:56.940
does it does,

00:44:57.121 --> 00:44:58.681
is that the highest skill or

00:44:58.882 --> 00:44:59.483
what was the actual,

00:45:00.023 --> 00:45:02.744
who it requires more skill

00:45:02.985 --> 00:45:03.686
or greater skill?

00:45:03.706 --> 00:45:04.085
And I'm like,

00:45:05.827 --> 00:45:06.329
Does it?

00:45:07.030 --> 00:45:07.951
I don't know, man.

00:45:08.050 --> 00:45:10.193
Like we start to drift off into guruism.

00:45:10.233 --> 00:45:11.235
Like my Kung Fu is better

00:45:11.275 --> 00:45:11.916
than your Kung Fu.

00:45:11.956 --> 00:45:12.016
Uh,

00:45:16.507 --> 00:45:18.588
I kind of see both sides of the argument,

00:45:19.188 --> 00:45:21.670
but the bad side of manual

00:45:21.690 --> 00:45:22.570
therapy would be like

00:45:22.811 --> 00:45:24.391
literally someone just gets

00:45:24.411 --> 00:45:25.472
their knee or their back

00:45:25.552 --> 00:45:26.632
rubbed for way too many

00:45:26.672 --> 00:45:27.492
minutes and it's a waste of

00:45:27.532 --> 00:45:29.554
time where there's actually no benefit.

00:45:29.873 --> 00:45:31.213
It's the McKay method of rubbing.

00:45:31.353 --> 00:45:32.695
And if you rub it this way,

00:45:32.735 --> 00:45:33.195
that's the thing.

00:45:33.235 --> 00:45:33.494
Right.

00:45:33.514 --> 00:45:35.235
So I mean,

00:45:35.255 --> 00:45:38.137
that's when it's actually maybe

00:45:38.177 --> 00:45:39.177
even harmful or hurtful

00:45:39.297 --> 00:45:41.119
because it's wasting time

00:45:41.458 --> 00:45:42.900
of the therapist and the patient.

00:45:43.519 --> 00:45:46.380
I think this is where Adam

00:45:46.400 --> 00:45:48.621
Meekins like eats people's lunch.

00:45:48.862 --> 00:45:49.943
He's like, you can't prove it.

00:45:50.023 --> 00:45:50.663
Yes, we can.

00:45:51.103 --> 00:45:52.003
And he's like, show me.

00:45:52.143 --> 00:45:52.784
And then he brings the

00:45:52.804 --> 00:45:53.664
receipts and people are mad

00:45:53.684 --> 00:45:54.965
because Adam says the F-bomb.

00:45:57.010 --> 00:45:59.130
It would help Adam to maybe curse less,

00:45:59.471 --> 00:46:00.650
but Adam's Adam.

00:46:00.851 --> 00:46:03.570
No, it would not help him to curse less.

00:46:04.451 --> 00:46:05.072
It wouldn't.

00:46:05.771 --> 00:46:06.771
If you actually listen to

00:46:06.791 --> 00:46:08.152
what Adam is saying and you

00:46:08.172 --> 00:46:10.393
could ignore the bleeps and the F-bombs,

00:46:10.793 --> 00:46:11.132
he's like,

00:46:11.333 --> 00:46:13.612
you keep arguing this specific

00:46:13.632 --> 00:46:14.313
thing that we've all

00:46:14.333 --> 00:46:15.833
decided you can't prove, but you're like,

00:46:15.954 --> 00:46:17.094
but I feel like it is.

00:46:17.114 --> 00:46:18.293
And I'm like, a feeling's not proof.

00:46:18.753 --> 00:46:19.954
That's the crux of Adam's

00:46:20.014 --> 00:46:21.815
argument with manual therapy.

00:46:21.835 --> 00:46:22.675
It's like, you can't prove it.

00:46:23.567 --> 00:46:25.666
So let me go back to what we

00:46:25.847 --> 00:46:27.007
had started to talk about

00:46:27.068 --> 00:46:27.887
just a little bit ago,

00:46:27.927 --> 00:46:28.887
because I want to get your

00:46:28.907 --> 00:46:30.128
guys' opinion on this.

00:46:30.947 --> 00:46:32.748
And the comparisons I had

00:46:32.768 --> 00:46:33.809
been making for people who

00:46:33.849 --> 00:46:34.989
haven't seen some of the posts.

00:46:35.009 --> 00:46:37.389
So we know Biodex has like a

00:46:37.489 --> 00:46:39.369
hundred and twenty thousand

00:46:39.409 --> 00:46:41.550
dollar isokinetic machine.

00:46:42.791 --> 00:46:43.871
We know that there's great

00:46:43.911 --> 00:46:44.811
research talking about

00:46:44.951 --> 00:46:46.652
isokinetic testing and ACL

00:46:46.692 --> 00:46:47.891
return to sport and all

00:46:47.911 --> 00:46:48.612
this kind of stuff.

00:46:49.231 --> 00:46:50.873
but I don't have that machine.

00:46:51.032 --> 00:46:53.074
So I can do an evaluation

00:46:53.094 --> 00:46:53.994
for a patient who had an

00:46:54.034 --> 00:46:56.434
ACL reconstruction without

00:46:56.514 --> 00:46:57.376
the technology.

00:46:57.916 --> 00:46:59.496
If I bring the technology in,

00:47:00.436 --> 00:47:01.697
I should charge a premium

00:47:01.737 --> 00:47:03.318
price beyond what insurance

00:47:03.338 --> 00:47:05.978
allows for use of that technology.

00:47:06.480 --> 00:47:06.719
Now,

00:47:07.199 --> 00:47:08.960
I think most therapists would agree

00:47:09.001 --> 00:47:09.280
with that.

00:47:09.320 --> 00:47:10.922
They'd be like, okay, that makes sense.

00:47:11.442 --> 00:47:15.302
Then we go to the headsets from vestibular,

00:47:15.563 --> 00:47:15.983
what is it?

00:47:16.664 --> 00:47:17.483
vestibular first.

00:47:18.164 --> 00:47:18.885
And I'm like, look,

00:47:18.925 --> 00:47:19.925
it's the standard of care

00:47:19.945 --> 00:47:22.646
for you guys who are so deep into it.

00:47:22.686 --> 00:47:25.146
You can't imagine not using the headset,

00:47:25.626 --> 00:47:27.186
but I am a therapist.

00:47:27.407 --> 00:47:28.527
I have the licensure.

00:47:28.766 --> 00:47:29.947
I can do a horrible

00:47:30.007 --> 00:47:31.947
evaluation and still get paid.

00:47:32.027 --> 00:47:33.487
It is not the standard of

00:47:33.547 --> 00:47:35.909
care to have an invest in the headset.

00:47:35.949 --> 00:47:37.329
If I do use the headset,

00:47:37.509 --> 00:47:38.949
I should charge for access

00:47:38.989 --> 00:47:39.610
to the headset.

00:47:40.469 --> 00:47:41.751
You take that three or four

00:47:41.791 --> 00:47:43.612
levels deeper and now we're like, OK,

00:47:43.672 --> 00:47:44.972
I've got my I don't.

00:47:45.092 --> 00:47:46.233
But for therapists who have

00:47:46.273 --> 00:47:48.853
their OCS or any specialization,

00:47:48.914 --> 00:47:50.255
any extra certification,

00:47:50.275 --> 00:47:51.556
you take somebody like Dave

00:47:51.576 --> 00:47:53.396
who's invested thousands of dollars,

00:47:53.836 --> 00:47:54.876
countless years.

00:47:55.416 --> 00:47:55.677
Like,

00:47:56.057 --> 00:47:58.059
why would I give that knowledge base

00:47:58.099 --> 00:47:59.699
away just because it's in my head?

00:48:00.679 --> 00:48:02.260
for what I'm getting paid

00:48:02.300 --> 00:48:03.262
for through insurance,

00:48:03.282 --> 00:48:05.264
which is the basic standard of care.

00:48:06.045 --> 00:48:08.367
The OCS is not the standard of care.

00:48:08.427 --> 00:48:11.309
Why wouldn't I deliver a

00:48:11.548 --> 00:48:13.210
good enough standard of

00:48:13.271 --> 00:48:14.972
care treatment protocol

00:48:15.072 --> 00:48:16.213
covered by insurance,

00:48:16.793 --> 00:48:18.375
complete that plan of care,

00:48:18.514 --> 00:48:19.536
and then if the patient

00:48:19.576 --> 00:48:20.516
wants something more,

00:48:20.956 --> 00:48:22.057
then they can hire me out

00:48:22.097 --> 00:48:24.679
of pocket to deliver the extra value,

00:48:24.739 --> 00:48:25.860
the extra education,

00:48:25.900 --> 00:48:27.682
the extra training that I went through.

00:48:28.682 --> 00:48:29.764
I know it gets dicey,

00:48:29.804 --> 00:48:30.804
but what do you guys think

00:48:30.844 --> 00:48:31.746
about something like that?

00:48:31.806 --> 00:48:34.608
Same person, but two different, you know,

00:48:34.887 --> 00:48:35.768
modes of delivery.

00:48:37.369 --> 00:48:38.329
Well, there's a couple of questions.

00:48:38.451 --> 00:48:38.690
It won't,

00:48:38.710 --> 00:48:40.271
it won't work because the person

00:48:40.291 --> 00:48:41.012
who's like, Oh,

00:48:41.032 --> 00:48:42.373
do you take my insurance and all that?

00:48:42.413 --> 00:48:43.454
They just think everything

00:48:43.514 --> 00:48:44.255
comes with that.

00:48:44.295 --> 00:48:45.596
They're, they're, they're not,

00:48:45.615 --> 00:48:47.577
they're assuming Tony most, in my opinion,

00:48:48.077 --> 00:48:48.597
I would love to hear what

00:48:48.617 --> 00:48:49.619
you think about your patients,

00:48:49.639 --> 00:48:51.579
but like people in the,

00:48:51.599 --> 00:48:53.882
I don't know where I'm New Jersey,

00:48:53.961 --> 00:48:55.402
Pennsylvania, New York area, um,

00:48:55.663 --> 00:48:56.704
like if they're looking to

00:48:56.744 --> 00:48:58.003
use their insurance their

00:48:58.043 --> 00:48:59.023
in-network their medicare

00:48:59.043 --> 00:49:00.485
whatever they just assume

00:49:00.505 --> 00:49:02.025
like oh I get all that I I

00:49:02.065 --> 00:49:03.226
would get all that I get I

00:49:03.266 --> 00:49:04.686
get at least the the

00:49:04.706 --> 00:49:05.586
licensed professional who

00:49:05.626 --> 00:49:06.887
has the minimum standard of

00:49:06.927 --> 00:49:08.307
care but then I also get

00:49:08.387 --> 00:49:09.969
like you know the hands-on

00:49:10.009 --> 00:49:11.250
and I get like if I want

00:49:11.289 --> 00:49:12.269
more hands-on I could kind

00:49:12.309 --> 00:49:13.289
of say hey can I get some

00:49:13.311 --> 00:49:15.590
more hands-on work and whatever so

00:49:17.192 --> 00:49:19.494
and someone else is paying for it, yeah,

00:49:19.554 --> 00:49:20.775
I don't think that's possible.

00:49:20.795 --> 00:49:21.436
Especially,

00:49:21.536 --> 00:49:22.476
it's definitely not possible

00:49:22.496 --> 00:49:23.396
with the same professional.

00:49:23.478 --> 00:49:24.018
If anything,

00:49:24.458 --> 00:49:26.179
it's I go to some office for

00:49:26.239 --> 00:49:28.141
the in-network cover, whatever,

00:49:28.161 --> 00:49:29.021
and then if I want extra,

00:49:29.121 --> 00:49:30.182
I have to either go to a

00:49:30.242 --> 00:49:31.083
different professional in

00:49:31.103 --> 00:49:32.945
the building or some other building.

00:49:33.505 --> 00:49:34.146
I don't think it's even

00:49:34.186 --> 00:49:35.947
possible to have the same person say,

00:49:36.208 --> 00:49:37.168
I'll do X, Y, Z,

00:49:37.969 --> 00:49:40.731
this defined thing for your insurance,

00:49:40.771 --> 00:49:41.512
but your insurance doesn't

00:49:41.532 --> 00:49:42.333
pay for this other stuff.

00:49:42.353 --> 00:49:43.173
So if you want this other stuff,

00:49:43.213 --> 00:49:44.014
it's this dollar amount.

00:49:44.422 --> 00:49:46.463
yeah uh that I mean when

00:49:46.523 --> 00:49:47.445
someone put it this way in

00:49:47.485 --> 00:49:48.824
pt school I was like even I

00:49:48.885 --> 00:49:50.065
as a consumer of healthcare

00:49:50.146 --> 00:49:50.706
and then coming to

00:49:50.905 --> 00:49:51.827
healthcare as a second

00:49:51.847 --> 00:49:53.367
career once they said it

00:49:53.387 --> 00:49:54.268
like this please don't

00:49:54.307 --> 00:49:55.349
confuse health insurance

00:49:55.369 --> 00:49:56.769
with health care you pay

00:49:56.929 --> 00:49:57.449
you pay for health

00:49:57.469 --> 00:49:59.291
insurance now that doesn't

00:49:59.311 --> 00:50:00.552
mean it covers everything

00:50:00.791 --> 00:50:01.791
like that's the funny part

00:50:01.811 --> 00:50:03.032
too is like this would

00:50:03.152 --> 00:50:05.373
never maybe it's a good

00:50:05.414 --> 00:50:06.414
comparison when I have a

00:50:06.494 --> 00:50:08.416
warranty on my car I know

00:50:08.456 --> 00:50:10.197
it covers lots of stuff

00:50:11.052 --> 00:50:12.492
but not a flat tire, right?

00:50:12.532 --> 00:50:14.235
Flat tire is like sort of, it's on you,

00:50:14.255 --> 00:50:14.514
bro.

00:50:14.574 --> 00:50:15.496
Like, hey man, sorry.

00:50:15.516 --> 00:50:17.398
But like if your transmission drops out,

00:50:17.438 --> 00:50:18.518
five thousand miles down the road,

00:50:18.539 --> 00:50:20.201
we got that because it's within warranty.

00:50:20.601 --> 00:50:21.922
As long as you didn't violate the warranty,

00:50:22.262 --> 00:50:22.463
right?

00:50:23.423 --> 00:50:25.126
So when someone framed it that way,

00:50:25.166 --> 00:50:26.967
I sort of understood it a

00:50:27.007 --> 00:50:27.547
little bit better.

00:50:27.887 --> 00:50:28.989
Now let's get into the

00:50:29.048 --> 00:50:30.990
nuance because I think that

00:50:31.030 --> 00:50:32.152
little thread on LinkedIn

00:50:33.083 --> 00:50:34.184
was was good because it

00:50:34.204 --> 00:50:34.963
played out a lot of the

00:50:34.983 --> 00:50:36.465
things so we'll take

00:50:36.485 --> 00:50:36.925
something like the

00:50:36.945 --> 00:50:38.126
vestibular first goggles

00:50:38.365 --> 00:50:40.347
right so high level used to

00:50:40.367 --> 00:50:41.387
work for them right they're

00:50:41.427 --> 00:50:42.688
great right they're

00:50:42.708 --> 00:50:44.608
fantastic this thing should

00:50:44.648 --> 00:50:45.849
be and I think will in five

00:50:45.889 --> 00:50:47.391
years be the gold standard

00:50:47.490 --> 00:50:48.110
if you're working in

00:50:48.150 --> 00:50:50.371
vestibular care you need to

00:50:50.393 --> 00:50:51.132
put people's eyes in the

00:50:51.152 --> 00:50:52.853
dark to see the things that

00:50:52.873 --> 00:50:53.793
you need to see they're

00:50:54.054 --> 00:50:55.014
stethoscopes for your eyes

00:50:55.215 --> 00:50:55.815
if you have a vestibular

00:50:55.876 --> 00:50:57.476
issue but you can't charge

00:50:57.516 --> 00:51:00.038
for it there's no code for it so

00:51:01.518 --> 00:51:02.739
If I were sending someone

00:51:02.760 --> 00:51:04.481
that I knew to a vestibular therapist,

00:51:04.681 --> 00:51:05.442
now that I know that

00:51:05.461 --> 00:51:06.702
because I never practiced it, I would say,

00:51:06.762 --> 00:51:07.884
do they use goggles, yes or no?

00:51:07.983 --> 00:51:10.204
To me, it is a red or green flag.

00:51:10.585 --> 00:51:12.126
You're winging it or you're using it.

00:51:14.088 --> 00:51:15.748
But should they charge extra for it?

00:51:15.949 --> 00:51:16.050
Well,

00:51:16.070 --> 00:51:17.090
they had to drop twenty five hundred

00:51:17.110 --> 00:51:17.931
bucks for the goggles.

00:51:18.331 --> 00:51:20.313
So like in my mind, yes.

00:51:21.012 --> 00:51:21.193
Well,

00:51:21.233 --> 00:51:22.713
then should I charge extra for

00:51:22.773 --> 00:51:23.534
post-it notes?

00:51:23.934 --> 00:51:25.496
Well, you understand how business works,

00:51:25.556 --> 00:51:25.775
right?

00:51:25.795 --> 00:51:27.677
Like you need to make money

00:51:27.717 --> 00:51:29.157
on the thing that you bought.

00:51:29.538 --> 00:51:30.639
The doctor isn't charging

00:51:30.659 --> 00:51:32.079
you every time he uses a stethoscope,

00:51:32.320 --> 00:51:34.302
but it's built into the cost, right?

00:51:34.402 --> 00:51:35.581
Like that's the way I look at it.

00:51:35.621 --> 00:51:37.643
So should it be a line item

00:51:37.784 --> 00:51:39.244
or should it just be

00:51:39.304 --> 00:51:40.666
covered under overhead?

00:51:40.746 --> 00:51:42.146
Like the doctor also needed

00:51:42.166 --> 00:51:43.527
a treatment chair and a

00:51:43.586 --> 00:51:45.409
plant in the corner and a clipboard.

00:51:46.188 --> 00:51:46.849
But they don't charge you

00:51:46.869 --> 00:51:47.829
every time they use the clipboard,

00:51:47.889 --> 00:51:48.831
but he needed it to write

00:51:48.851 --> 00:51:50.251
his note on or back in the day.

00:51:50.291 --> 00:51:51.393
Now we're not using kids

00:51:51.413 --> 00:51:52.773
clipboards or what we used to write.

00:51:52.833 --> 00:51:52.994
No.

00:51:53.894 --> 00:51:55.617
So you use the EHR.

00:51:55.637 --> 00:51:56.597
Do you charge for it?

00:51:56.878 --> 00:51:57.257
Yes.

00:51:57.838 --> 00:51:58.838
But it's not a line item.

00:51:58.958 --> 00:52:00.000
Like that's where I think I

00:52:00.039 --> 00:52:01.760
get it because it touches the patient.

00:52:02.202 --> 00:52:03.422
Are we charging for it?

00:52:03.543 --> 00:52:04.362
Yes, but no.

00:52:04.402 --> 00:52:05.523
But should we?

00:52:05.623 --> 00:52:06.025
I don't know.

00:52:07.610 --> 00:52:09.572
So if you look at the

00:52:09.652 --> 00:52:11.813
definitions of certain CPT

00:52:11.853 --> 00:52:13.376
codes and what is covered,

00:52:13.416 --> 00:52:14.215
what is not covered,

00:52:14.275 --> 00:52:15.336
we look at something like a

00:52:15.376 --> 00:52:17.059
passive modality, like an E-STEM.

00:52:17.079 --> 00:52:17.159
Okay.

00:52:18.480 --> 00:52:20.521
The supplies required for

00:52:20.902 --> 00:52:22.342
electric stimulation are

00:52:22.402 --> 00:52:23.342
covered within the

00:52:23.382 --> 00:52:24.905
definition of the CPT code.

00:52:25.505 --> 00:52:27.347
So I can't separately charge

00:52:27.387 --> 00:52:29.387
a patient for those pads.

00:52:29.447 --> 00:52:31.170
That is covered in the reimbursement.

00:52:32.896 --> 00:52:36.458
But, you know, we look at, okay, balance.

00:52:36.657 --> 00:52:38.159
We look at slip and trip.

00:52:38.239 --> 00:52:39.639
We look at, you know,

00:52:39.679 --> 00:52:41.820
a gait belt is enough

00:52:41.880 --> 00:52:43.222
equipment for me to take a

00:52:43.262 --> 00:52:44.702
patient who's been falling,

00:52:45.123 --> 00:52:46.123
give them a jostle,

00:52:46.184 --> 00:52:47.503
give them a little shove.

00:52:48.344 --> 00:52:51.106
I can treat them and work

00:52:51.166 --> 00:52:52.427
and build gait training or

00:52:52.487 --> 00:52:53.608
neuro rehab or whatever the

00:52:53.648 --> 00:52:54.829
code I'm going to use for that is.

00:52:55.608 --> 00:52:56.588
I don't have to have a

00:52:56.648 --> 00:52:57.690
thirty thousand dollar

00:52:57.769 --> 00:52:59.429
biodex reactive step trainer.

00:52:59.690 --> 00:53:01.931
You know, that is something separate.

00:53:01.971 --> 00:53:02.070
Now,

00:53:02.150 --> 00:53:05.092
the easy solution to this is what we

00:53:05.112 --> 00:53:06.492
did was we just said, OK, well,

00:53:06.512 --> 00:53:07.532
when you're on the biodex,

00:53:07.552 --> 00:53:08.373
you're independent.

00:53:08.414 --> 00:53:10.414
It's not part of your therapy program.

00:53:10.454 --> 00:53:11.474
You pay a separate fee.

00:53:11.554 --> 00:53:12.954
It's one hundred or five

00:53:12.974 --> 00:53:13.896
hundred dollars a month.

00:53:14.755 --> 00:53:15.335
You're not going to be

00:53:15.376 --> 00:53:16.416
working with a therapist.

00:53:16.456 --> 00:53:17.197
It's not part of your

00:53:17.237 --> 00:53:18.117
covered plan of care.

00:53:18.876 --> 00:53:21.257
But I do think we need to get into, well,

00:53:21.378 --> 00:53:23.159
even within a visit.

00:53:24.146 --> 00:53:25.146
Am I going to allow my

00:53:25.186 --> 00:53:26.527
patients to spend more for

00:53:26.568 --> 00:53:28.728
a premium anything, you know?

00:53:28.789 --> 00:53:31.989
So, okay, we have a broken,

00:53:32.130 --> 00:53:33.891
literally broken recumbent

00:53:33.911 --> 00:53:36.331
bike that has a manual

00:53:36.391 --> 00:53:37.552
timer because the electric

00:53:37.572 --> 00:53:38.932
timer on the bike doesn't even work,

00:53:38.972 --> 00:53:39.873
but the patients who are

00:53:39.952 --> 00:53:41.653
using it don't need anything fancy.

00:53:41.693 --> 00:53:43.054
They just need to move their legs.

00:53:43.474 --> 00:53:44.195
So it's like, well,

00:53:44.394 --> 00:53:45.815
I can throw that in for the

00:53:45.855 --> 00:53:47.155
price of the CPT code.

00:53:47.516 --> 00:53:48.755
But if somebody wants to use

00:53:48.775 --> 00:53:50.556
a five thousand dollar recumbent bike,

00:53:50.577 --> 00:53:50.757
you know,

00:53:50.797 --> 00:53:52.358
the broken one cost me fifty bucks.

00:53:53.248 --> 00:53:54.409
Shouldn't I have the

00:53:54.449 --> 00:53:56.431
capacity to allow them to

00:53:56.510 --> 00:53:58.112
pay a premium rate for

00:53:58.251 --> 00:53:59.833
access to premium equipment,

00:53:59.873 --> 00:54:00.815
premium knowledge,

00:54:00.855 --> 00:54:03.137
premium services that

00:54:03.277 --> 00:54:04.577
aren't specifically covered

00:54:04.637 --> 00:54:05.739
within the CPT code?

00:54:06.059 --> 00:54:06.880
I think we should,

00:54:07.099 --> 00:54:08.320
but I think we need to test

00:54:08.380 --> 00:54:09.621
that model a little bit and

00:54:09.641 --> 00:54:10.163
figure it out.

00:54:10.806 --> 00:54:12.586
I think this comes from our

00:54:12.746 --> 00:54:14.347
internal desire to just

00:54:14.369 --> 00:54:16.550
give and give it like we buy into the,

00:54:17.010 --> 00:54:18.590
everything should be free model too.

00:54:19.072 --> 00:54:19.891
And the insurance companies

00:54:19.911 --> 00:54:20.972
just sit there and laugh

00:54:21.132 --> 00:54:21.693
because they're like,

00:54:21.853 --> 00:54:23.153
they're going to give it away anyway,

00:54:23.353 --> 00:54:23.835
probably.

00:54:24.594 --> 00:54:25.896
And they're going to expect it.

00:54:26.215 --> 00:54:26.496
And there,

00:54:26.577 --> 00:54:27.998
there they are with the bleeding heart.

00:54:28.498 --> 00:54:29.559
I can help this person.

00:54:30.018 --> 00:54:30.239
Right.

00:54:30.378 --> 00:54:31.900
And so when you start running it like that,

00:54:31.960 --> 00:54:33.541
not a business, then you can,

00:54:33.661 --> 00:54:34.681
then six months later,

00:54:34.702 --> 00:54:35.382
you get mad because you're

00:54:35.422 --> 00:54:37.744
not being paid for your skill,

00:54:37.804 --> 00:54:38.925
for all the things that you did.

00:54:39.385 --> 00:54:40.505
Cause you're not asking for it.

00:54:41.106 --> 00:54:42.447
And I think it goes back to

00:54:42.567 --> 00:54:43.407
twenty years ago.

00:54:43.889 --> 00:54:45.769
We were competing for patients.

00:54:46.030 --> 00:54:47.751
We're not competing for patients anymore.

00:54:47.791 --> 00:54:48.911
There's more patients than

00:54:48.952 --> 00:54:50.253
therapists could ever treat.

00:54:50.773 --> 00:54:52.454
Like nobody is struggling

00:54:52.494 --> 00:54:54.135
for new patients unless you

00:54:54.155 --> 00:54:55.456
just are brand new into the

00:54:55.496 --> 00:54:56.338
profession and you don't

00:54:56.358 --> 00:54:57.259
have your marketing down.

00:54:57.759 --> 00:54:58.659
So there's more than a

00:54:58.739 --> 00:55:00.139
surplus of patients out there.

00:55:00.179 --> 00:55:01.480
We're not competing anymore,

00:55:01.539 --> 00:55:03.659
but we're stuck in the mindset of, well,

00:55:03.739 --> 00:55:04.800
I need to do more than the

00:55:04.820 --> 00:55:05.820
clinic down the street.

00:55:06.740 --> 00:55:08.221
The objection I get every

00:55:08.280 --> 00:55:09.902
single time about manual therapy,

00:55:09.942 --> 00:55:11.922
when I say, look, okay,

00:55:11.942 --> 00:55:13.063
manual therapy is probably

00:55:13.103 --> 00:55:14.262
a covered service for one

00:55:14.302 --> 00:55:15.083
or two sessions.

00:55:15.143 --> 00:55:15.702
Beyond that,

00:55:15.742 --> 00:55:17.143
it's not covered anymore based

00:55:17.202 --> 00:55:18.403
on Medicare guidelines.

00:55:18.884 --> 00:55:19.603
Well, Tony,

00:55:19.864 --> 00:55:21.123
the clinic next door is going

00:55:21.143 --> 00:55:22.125
to keep doing manual

00:55:22.164 --> 00:55:23.125
therapy and patients are

00:55:23.144 --> 00:55:23.764
going to go there.

00:55:24.556 --> 00:55:25.097
No, they're not.

00:55:25.197 --> 00:55:26.018
Because the clinic who's

00:55:26.038 --> 00:55:27.099
doing manual therapy has

00:55:27.119 --> 00:55:28.239
got a six week wait list.

00:55:28.358 --> 00:55:29.440
They're not going to go there.

00:55:29.559 --> 00:55:30.400
And if the patient

00:55:30.481 --> 00:55:31.762
absolutely wants to go there,

00:55:31.782 --> 00:55:32.382
they're not the right

00:55:32.402 --> 00:55:33.262
patient for me anyway.

00:55:33.782 --> 00:55:34.842
But point being,

00:55:35.704 --> 00:55:37.244
just like we opened the show,

00:55:37.264 --> 00:55:38.606
one hundred and ninety nine

00:55:38.646 --> 00:55:39.666
dollars a month was a

00:55:39.726 --> 00:55:41.668
premium rate back in, you know,

00:55:41.748 --> 00:55:42.869
early two thousands.

00:55:42.889 --> 00:55:43.228
Yeah.

00:55:43.829 --> 00:55:46.210
We are not competing for patience anymore.

00:55:46.271 --> 00:55:47.431
We don't have to over

00:55:47.472 --> 00:55:49.134
deliver on value like we

00:55:49.313 --> 00:55:50.635
used to to try and attract

00:55:50.655 --> 00:55:52.396
them away from where they're going.

00:55:52.757 --> 00:55:53.717
They're going to come to us

00:55:53.797 --> 00:55:54.498
no matter what.

00:55:54.978 --> 00:55:56.019
The question is,

00:55:56.780 --> 00:55:58.882
now we're running an economy airline.

00:55:59.163 --> 00:56:01.025
We have to charge for the pretzels.

00:56:01.045 --> 00:56:01.905
We can't just give the

00:56:01.945 --> 00:56:03.027
pretzels away for free.

00:56:04.025 --> 00:56:05.206
Do we have to though?

00:56:05.445 --> 00:56:06.666
And I couldn't find the video,

00:56:06.686 --> 00:56:07.467
but there was that video

00:56:07.487 --> 00:56:08.547
that I shared amongst us

00:56:08.606 --> 00:56:09.547
with the guy who was

00:56:09.588 --> 00:56:11.148
talking about the thousand dollar steak.

00:56:11.668 --> 00:56:13.489
No, we don't, we don't, I want,

00:56:13.509 --> 00:56:14.150
I want to get into that,

00:56:14.170 --> 00:56:15.289
but we only have four minutes left.

00:56:15.309 --> 00:56:16.891
So I don't want to,

00:56:16.911 --> 00:56:18.130
I think next time I love that video.

00:56:18.170 --> 00:56:19.572
We, I have so,

00:56:19.672 --> 00:56:20.492
I want to talk about that a

00:56:20.532 --> 00:56:21.492
lot more than four minutes.

00:56:21.652 --> 00:56:22.472
So we can tease it,

00:56:22.512 --> 00:56:24.514
which is I think the reason

00:56:24.534 --> 00:56:25.695
that this conversation

00:56:25.715 --> 00:56:27.436
needs to be longer is we

00:56:27.496 --> 00:56:28.596
assume everybody wants to

00:56:28.635 --> 00:56:29.657
pay as little as possible

00:56:30.336 --> 00:56:31.737
instead of assuming people

00:56:31.777 --> 00:56:33.237
want to get as much as possible.

00:56:33.797 --> 00:56:35.719
And there's a Van Westendorp price model,

00:56:35.739 --> 00:56:35.898
right?

00:56:35.918 --> 00:56:38.300
There's a triangulation of those things.

00:56:38.820 --> 00:56:40.802
And if you are not selling

00:56:40.902 --> 00:56:43.463
or if you are not offering

00:56:43.503 --> 00:56:44.443
a thousand dollar steak

00:56:44.463 --> 00:56:45.483
worth of value on the menu...

00:56:46.947 --> 00:56:47.869
no one's going to just give

00:56:47.889 --> 00:56:48.849
you a thousand dollars.

00:56:48.909 --> 00:56:50.349
Like they're not,

00:56:50.690 --> 00:56:52.010
but they could if you can

00:56:52.030 --> 00:56:53.311
provide this much value.

00:56:53.490 --> 00:56:54.891
You don't have to because

00:56:55.012 --> 00:56:56.012
Arby's is down the street

00:56:56.072 --> 00:56:57.032
and it's a very good model.

00:56:57.052 --> 00:56:57.693
It's still around.

00:56:58.594 --> 00:56:59.253
I actually learned it's

00:56:59.273 --> 00:57:00.173
called Arby's because they

00:57:00.193 --> 00:57:02.034
sell roast beef sandwich, Arby's.

00:57:02.235 --> 00:57:04.635
I didn't know that.

00:57:04.755 --> 00:57:05.257
I didn't know that.

00:57:05.277 --> 00:57:05.916
I was like, oh my God,

00:57:05.936 --> 00:57:06.556
it makes perfect sense.

00:57:07.297 --> 00:57:08.117
But I think it is a good

00:57:08.157 --> 00:57:08.938
conversation to have

00:57:08.958 --> 00:57:10.018
because I think the question is,

00:57:11.980 --> 00:57:12.739
Tony does this.

00:57:12.900 --> 00:57:13.661
Dave does this.

00:57:14.362 --> 00:57:16.643
You have to ask yourself pretty frequently,

00:57:16.983 --> 00:57:19.284
what business am I actually in?

00:57:19.766 --> 00:57:20.646
Because if I'm a billing

00:57:20.686 --> 00:57:21.586
service who provides

00:57:21.626 --> 00:57:22.527
service to an insurance

00:57:22.568 --> 00:57:24.389
company by way of their patients,

00:57:24.708 --> 00:57:25.429
different business.

00:57:25.889 --> 00:57:28.092
If I'm a concierge provider

00:57:28.152 --> 00:57:30.554
in New York City, different business.

00:57:30.974 --> 00:57:32.414
Same license though, right?

00:57:32.835 --> 00:57:34.115
Same umbrella term that we'd

00:57:34.135 --> 00:57:35.097
say physical therapist.

00:57:35.536 --> 00:57:37.318
Vastly different, which is great.

00:57:38.268 --> 00:57:39.849
All right, that's Jimmy's parting shot.

00:57:39.909 --> 00:57:42.331
Dave, what do you got?

00:57:42.391 --> 00:57:43.371
Parting shot going back to

00:57:44.673 --> 00:57:45.634
the action figure.

00:57:46.335 --> 00:57:47.655
Parting shot going back.

00:57:47.715 --> 00:57:48.876
I like how we deconstructed

00:57:48.936 --> 00:57:50.297
the Chris Miller offer.

00:57:50.699 --> 00:57:52.079
A lot of it is very clear.

00:57:52.780 --> 00:57:54.141
It shows exactly what you get,

00:57:54.242 --> 00:57:55.802
what do you get for what dollar amount,

00:57:56.664 --> 00:57:57.525
plus the video.

00:57:57.724 --> 00:58:00.067
So overall, I think it was a great offer.

00:58:00.507 --> 00:58:02.128
very clear and you have to

00:58:02.168 --> 00:58:03.429
be clear for consumers to

00:58:03.510 --> 00:58:05.010
even understand it also the

00:58:05.050 --> 00:58:06.733
side benefit that golfers

00:58:06.773 --> 00:58:07.652
see that and they're like

00:58:07.713 --> 00:58:08.313
well you're not talking

00:58:08.333 --> 00:58:09.034
about pain you're not

00:58:09.114 --> 00:58:09.914
talking about insurance

00:58:09.936 --> 00:58:10.556
you're not talking about a

00:58:10.576 --> 00:58:11.697
covered service whatever so

00:58:11.757 --> 00:58:14.059
no one's going to say does

00:58:14.099 --> 00:58:15.340
my insurance cover this you

00:58:15.360 --> 00:58:16.380
know like it's obviously

00:58:16.420 --> 00:58:17.641
clear to the consumer this

00:58:17.681 --> 00:58:18.822
is something that's out of

00:58:18.842 --> 00:58:20.585
pocket and they're gonna

00:58:20.724 --> 00:58:21.306
they either wheel or

00:58:21.326 --> 00:58:22.005
whatnot pull out their

00:58:22.025 --> 00:58:23.246
credit card to sign up for

00:58:23.266 --> 00:58:23.807
that membership

00:58:26.192 --> 00:58:26.731
All right, guys,

00:58:26.791 --> 00:58:27.873
I think today was a great show.

00:58:27.913 --> 00:58:28.773
And I think the reason why

00:58:28.813 --> 00:58:29.833
it was so great was because

00:58:29.873 --> 00:58:30.855
you guys were bringing

00:58:31.195 --> 00:58:32.815
ideas and messages to us

00:58:32.856 --> 00:58:33.896
that we could discuss.

00:58:34.416 --> 00:58:36.197
Scott brought some great content.

00:58:36.659 --> 00:58:38.300
Chris Miller, whether he meant to or not,

00:58:38.340 --> 00:58:39.541
gave us some great ideas.

00:58:40.121 --> 00:58:42.222
Next week or Thursday, whenever,

00:58:42.382 --> 00:58:43.443
next visit, next show,

00:58:43.882 --> 00:58:45.063
I want to talk about Chuck.

00:58:45.164 --> 00:58:47.425
Charles Lockwood put out a

00:58:47.445 --> 00:58:49.186
video about a four thousand

00:58:49.246 --> 00:58:50.887
plus dollar walker.

00:58:50.927 --> 00:58:52.289
That is just awesome.

00:58:52.389 --> 00:58:53.028
It's blowing up.

00:58:53.048 --> 00:58:53.469
Yeah.

00:58:54.210 --> 00:58:55.471
Yeah, yeah.

00:58:55.490 --> 00:58:56.550
He got a demo unit.

00:58:56.672 --> 00:58:57.911
He showed how it works.

00:58:59.193 --> 00:59:01.014
This is the foundation of

00:59:01.034 --> 00:59:03.695
what things are to come for him.

00:59:04.835 --> 00:59:06.257
You guys bring us ideas.

00:59:06.476 --> 00:59:08.619
We will dissect them, break them down,

00:59:08.719 --> 00:59:09.739
disagree, agree.

00:59:10.460 --> 00:59:11.300
Just keep bringing it.

00:59:11.519 --> 00:59:12.581
Eight thirty a.m.

00:59:12.880 --> 00:59:15.523
on Eastern Time, Tuesdays and Thursdays.

00:59:15.682 --> 00:59:18.123
Jimmy McKay, Dave Kittle, Tony Maritato.

00:59:18.164 --> 00:59:19.764
We'll see you guys on the next episode.

00:59:19.804 --> 00:59:20.885
Thank you.