Mastering Soft Skills for Better Patient Outcomes

WEBVTT 0:00:00.529 --> 0:00:01.490 We don't have to because 0:00:01.550 --> 0:00:03.531 conversation trumps presentation. 0:00:06.091 --> 0:00:10.273 All right, Mike, finally, welcome. 0:00:10.374 --> 0:00:11.153 Welcome to the show. 0:00:11.234 --> 0:00:12.195 I appreciate your time. 0:00:12.695 --> 0:00:13.335 Happy to be here. 0:00:13.414 --> 0:00:14.455 I appreciate your time as well. 0:00:14.869 --> 0:00:17.050 What what people don't often know is like, 0:00:17.071 --> 0:00:17.271 you know, 0:00:17.291 --> 0:00:18.792 they hear the moment of us talking. 0:00:18.832 --> 0:00:19.751 What they don't know is, you know, 0:00:19.771 --> 0:00:20.771 the emails and the text 0:00:20.812 --> 0:00:21.832 messages back and forth. 0:00:21.873 --> 0:00:22.972 So and I was saying this to 0:00:22.992 --> 0:00:24.074 Mike before he hit record is like, 0:00:24.173 --> 0:00:25.353 I rarely need to say no to 0:00:25.393 --> 0:00:26.394 an interview because I set 0:00:26.434 --> 0:00:28.315 my calendar up and I give 0:00:28.355 --> 0:00:29.975 the guest a time to choose 0:00:29.995 --> 0:00:30.736 when they're free. 0:00:31.196 --> 0:00:31.315 Yeah. 0:00:31.417 --> 0:00:32.396 And then life happens. 0:00:32.716 --> 0:00:35.018 So I'd say like five out of 0:00:35.058 --> 0:00:36.619 a hundred times I got to 0:00:36.679 --> 0:00:38.021 change or cancel. 0:00:38.521 --> 0:00:39.381 Unless when I do, 0:00:39.421 --> 0:00:41.664 then it's like one person five times. 0:00:41.743 --> 0:00:42.585 And Mike was that guy. 0:00:42.604 --> 0:00:44.345 So it's been a while, 0:00:44.387 --> 0:00:46.268 but I'm excited to talk. 0:00:46.787 --> 0:00:47.149 We're here. 0:00:47.228 --> 0:00:48.750 It just makes the experience 0:00:48.770 --> 0:00:49.970 that much better that we've 0:00:50.011 --> 0:00:51.031 been anticipating it. 0:00:51.414 --> 0:00:52.094 Ramping it up. 0:00:53.255 --> 0:00:54.737 So we got a lot to get into. 0:00:54.817 --> 0:00:56.158 You've done a lot of different things. 0:00:56.298 --> 0:00:58.079 First of all, you've been a clinician, 0:00:58.579 --> 0:01:00.481 educator, clinical researcher. 0:01:00.500 --> 0:01:01.301 So you're sort of touching 0:01:01.401 --> 0:01:03.482 on clinical practice, education, research, 0:01:03.662 --> 0:01:06.265 which is a decent part of our profession. 0:01:06.584 --> 0:01:08.887 And you've been doing it for three decades, 0:01:09.326 --> 0:01:11.248 really focused on the 0:01:11.349 --> 0:01:13.790 neurologic and the older adult population, 0:01:13.829 --> 0:01:15.932 geriatric population in our profession. 0:01:15.951 --> 0:01:16.132 Yeah. 0:01:16.652 --> 0:01:16.772 Um, 0:01:17.233 --> 0:01:20.155 so that is a long time working in a 0:01:20.234 --> 0:01:23.397 specific area, but, but breath, like, 0:01:23.638 --> 0:01:23.817 you know, 0:01:23.878 --> 0:01:25.718 you can kind of go wide with education, 0:01:25.759 --> 0:01:27.079 clinical practice and 0:01:27.140 --> 0:01:27.960 research and you kind of 0:01:27.980 --> 0:01:28.740 can have a finger, 0:01:28.801 --> 0:01:29.682 you can have a hand in a 0:01:29.742 --> 0:01:30.442 lot of different things. 0:01:31.602 --> 0:01:33.063 I wanted to go narrow first. 0:01:33.405 --> 0:01:33.504 Okay. 0:01:33.525 --> 0:01:36.027 Let's talk about dual tasking, right? 0:01:36.046 --> 0:01:36.206 Right. 0:01:36.846 --> 0:01:38.567 dual tasking is I'm I don't 0:01:38.587 --> 0:01:39.287 know about you mike but 0:01:39.347 --> 0:01:40.289 right now I got my phone my 0:01:40.328 --> 0:01:41.269 laptop my thing and I'm 0:01:41.308 --> 0:01:42.168 having a conversation but 0:01:42.188 --> 0:01:43.430 I'm watching my watch so 0:01:43.469 --> 0:01:44.650 I'm doing a lot of things 0:01:44.909 --> 0:01:46.590 yeah my guess is you could 0:01:46.631 --> 0:01:47.792 explain why I'm not 0:01:47.871 --> 0:01:48.831 actually doing those things 0:01:48.951 --> 0:01:51.793 well it's multi-doing so 0:01:51.832 --> 0:01:52.653 how can therapists 0:01:52.993 --> 0:01:54.373 effectively apply dual 0:01:54.414 --> 0:01:55.655 tasking to make therapy 0:01:56.295 --> 0:01:58.195 therapeutic and also maybe even fun 0:01:58.766 --> 0:01:59.486 Yeah, that's great. 0:01:59.865 --> 0:02:01.046 So first off, 0:02:01.346 --> 0:02:04.087 let's define dual tasking and 0:02:04.126 --> 0:02:04.947 let's understand that 0:02:05.227 --> 0:02:06.628 basically it is the 0:02:06.748 --> 0:02:08.807 simultaneous operation of 0:02:08.948 --> 0:02:10.048 two different things you're 0:02:10.087 --> 0:02:12.468 doing that could be done separately. 0:02:13.528 --> 0:02:14.649 And if you just start it and 0:02:14.688 --> 0:02:15.688 stop it right there, 0:02:16.568 --> 0:02:18.810 then that gives us a good framework. 0:02:18.930 --> 0:02:21.129 Those are measurable tasks 0:02:21.169 --> 0:02:22.651 that are clearly discrete 0:02:22.711 --> 0:02:24.811 that could be done separately, meaning 0:02:26.282 --> 0:02:28.926 If I'm carrying a backpack across a room, 0:02:29.709 --> 0:02:30.689 that's actually just a 0:02:30.750 --> 0:02:32.032 single task because the 0:02:32.073 --> 0:02:33.294 backpack doesn't get across 0:02:33.335 --> 0:02:35.038 there unless I'm walking, okay? 0:02:35.497 --> 0:02:36.300 That's a single task. 0:02:36.780 --> 0:02:38.223 But if while I'm walking, 0:02:38.242 --> 0:02:39.344 I take the backpack off, 0:02:40.259 --> 0:02:41.441 and I'm still walking and I 0:02:41.501 --> 0:02:42.661 unzip it and grab a water 0:02:42.700 --> 0:02:44.442 bottle out of it, now I'm at dual task. 0:02:44.542 --> 0:02:45.421 So if we just start with 0:02:45.461 --> 0:02:46.883 that as a framework, 0:02:46.983 --> 0:02:48.443 not everything that's being 0:02:48.483 --> 0:02:50.163 done walking while carrying 0:02:50.223 --> 0:02:53.004 something is a dual task because in fact, 0:02:53.085 --> 0:02:54.205 it's just in the background. 0:02:54.246 --> 0:02:56.167 You're not actually interacting with it. 0:02:56.866 --> 0:02:58.948 You mentioned you were multitasking. 0:02:59.328 --> 0:03:00.908 So multitasking is different 0:03:00.949 --> 0:03:01.889 than dual tasking because 0:03:01.929 --> 0:03:03.288 it's more than two things. 0:03:04.270 --> 0:03:06.311 And now let's get into your question. 0:03:07.218 --> 0:03:09.127 How can therapists utilize it? 0:03:09.288 --> 0:03:11.860 Well, the very succinct answer is this. 0:03:13.114 --> 0:03:16.534 Dual tasking is done throughout our lives, 0:03:16.634 --> 0:03:18.556 so we need to expose our patients to it. 0:03:18.876 --> 0:03:19.695 That's one thing. 0:03:20.195 --> 0:03:21.497 And the second thing is it 0:03:21.537 --> 0:03:22.637 can be an extremely 0:03:22.697 --> 0:03:24.937 efficient way in for us to 0:03:25.098 --> 0:03:26.217 learn something for the 0:03:26.258 --> 0:03:28.459 first time or relearn it 0:03:28.718 --> 0:03:30.579 over again because we take 0:03:30.718 --> 0:03:31.860 our conscious attention 0:03:31.919 --> 0:03:34.281 away from it and learn the automaticity, 0:03:34.320 --> 0:03:36.181 what we call the procedural memory, 0:03:36.621 --> 0:03:38.361 the movement in the background, the 0:03:39.362 --> 0:03:39.622 You know, 0:03:39.763 --> 0:03:41.366 I could do that with my eyes closed, 0:03:41.406 --> 0:03:42.168 the motor memory, 0:03:42.268 --> 0:03:43.349 all those terms that we 0:03:43.409 --> 0:03:44.872 used to use for it by 0:03:44.991 --> 0:03:46.474 subjecting you to a 0:03:46.514 --> 0:03:47.616 constraint where I've taken 0:03:47.657 --> 0:03:48.557 my attention away. 0:03:48.979 --> 0:03:50.521 You can help somebody learn it better. 0:03:52.110 --> 0:03:52.991 and this is different. 0:03:53.170 --> 0:03:54.412 I heard somebody in 0:03:54.451 --> 0:03:55.533 psychology use the term 0:03:55.593 --> 0:03:57.254 multi doing like we think 0:03:57.275 --> 0:03:59.016 we're asking a lot, right? 0:03:59.056 --> 0:04:01.278 I'm getting so much done, but I mean, 0:04:01.539 --> 0:04:01.800 you know, 0:04:02.139 --> 0:04:04.361 and I work a lot in creating things, 0:04:04.443 --> 0:04:05.984 sounds, pictures, videos, whatever. 0:04:06.985 --> 0:04:08.606 And while I'm rendering a video, 0:04:08.646 --> 0:04:09.568 I'm saving a video. 0:04:09.608 --> 0:04:09.807 Okay. 0:04:09.948 --> 0:04:10.949 I got like three minutes. 0:04:10.968 --> 0:04:12.251 Let me do something else. 0:04:12.610 --> 0:04:14.473 And I wind up spinning around. 0:04:14.712 --> 0:04:14.992 So I'm, 0:04:15.774 --> 0:04:16.956 You know, I've heard the phrase, 0:04:17.036 --> 0:04:18.418 I think it was an old hockey coach, 0:04:18.757 --> 0:04:19.218 and he said, 0:04:19.298 --> 0:04:20.841 it's like a monkey humping a football. 0:04:20.860 --> 0:04:22.101 There's a lot moving around, 0:04:22.142 --> 0:04:23.423 but not a whole lot happening. 0:04:24.384 --> 0:04:25.187 That's beautiful. 0:04:25.706 --> 0:04:27.348 And it's easy to talk about 0:04:27.389 --> 0:04:29.512 that because the reality, Jimmy, 0:04:29.651 --> 0:04:31.033 is now you're talking about 0:04:31.153 --> 0:04:32.636 task switching. 0:04:33.247 --> 0:04:34.769 Yeah, that's different. 0:04:34.809 --> 0:04:36.050 So that is what we talk 0:04:36.089 --> 0:04:40.392 about in the field of dual tasking. 0:04:40.793 --> 0:04:42.613 We are simultaneous. 0:04:43.475 --> 0:04:44.795 But in multitasking, 0:04:45.235 --> 0:04:46.576 we're keeping this plate up, 0:04:46.757 --> 0:04:47.838 forgetting about that plate, 0:04:47.898 --> 0:04:48.778 keeping that plate up, 0:04:48.918 --> 0:04:50.178 forgetting about that plate up, 0:04:50.439 --> 0:04:51.740 keeping that plate spinning. 0:04:52.321 --> 0:04:53.641 So it's task switching. 0:04:53.781 --> 0:04:53.901 Now, 0:04:53.961 --> 0:04:56.744 people can become very good at task 0:04:56.803 --> 0:04:57.244 switching, 0:04:57.663 --> 0:04:59.144 but it's not a good environment 0:04:59.245 --> 0:05:00.586 to learn something in. 0:05:01.026 --> 0:05:02.968 So dual tasking is a great environment. 0:05:03.668 --> 0:05:05.908 If it's not a brand new novel task for you, 0:05:05.968 --> 0:05:07.170 it's a great environment to 0:05:07.310 --> 0:05:08.550 learn something in. 0:05:08.870 --> 0:05:10.911 But multitasking can be done, 0:05:10.971 --> 0:05:12.632 but it's not a good learning environment. 0:05:13.293 --> 0:05:14.293 That's the big difference. 0:05:14.752 --> 0:05:14.932 All right. 0:05:14.952 --> 0:05:16.134 So how do you know when 0:05:16.153 --> 0:05:18.514 because you worked with, you know, 0:05:18.535 --> 0:05:19.795 we mentioned neural population. 0:05:20.315 --> 0:05:21.115 How do you know when it's 0:05:21.136 --> 0:05:23.416 good to go from one to two 0:05:23.557 --> 0:05:25.197 to one to more than one? 0:05:25.257 --> 0:05:26.879 How do you where's that tipping point? 0:05:27.252 --> 0:05:28.553 Yeah, that's beautiful. 0:05:28.634 --> 0:05:29.875 And that's where the science 0:05:29.956 --> 0:05:31.216 is really coming along 0:05:31.297 --> 0:05:33.218 nicely right now is you use measurements. 0:05:34.059 --> 0:05:36.000 So you use a timed up and go. 0:05:36.141 --> 0:05:37.362 It took you 14 seconds. 0:05:37.682 --> 0:05:39.464 You do a cognitive timed up and go, 0:05:39.545 --> 0:05:41.446 which is doing the timed up 0:05:41.485 --> 0:05:44.428 and go and subtracting by serial threes, 0:05:44.428 --> 0:05:45.629 101, 98, 95 seconds. 0:05:47.651 --> 0:05:51.774 And if you see an exorbitant 0:05:51.894 --> 0:05:53.394 difference between those two, 0:05:53.975 --> 0:05:55.156 then we know we've got 0:05:55.216 --> 0:05:56.396 somebody that needs this, 0:05:57.016 --> 0:05:58.916 but are they actually 0:05:59.057 --> 0:06:00.658 therapeutically benefiting 0:06:00.718 --> 0:06:02.119 because it is completely 0:06:02.178 --> 0:06:03.899 destroying their psyche? 0:06:04.019 --> 0:06:05.720 Oh, my gosh, I'm terrible at this. 0:06:05.800 --> 0:06:07.100 I'll never get good at this. 0:06:07.540 --> 0:06:07.800 You know, 0:06:07.860 --> 0:06:09.642 so you look at it by dosage and 0:06:09.682 --> 0:06:11.944 you look at it truly objectively. 0:06:12.305 --> 0:06:13.406 Does this person need it? 0:06:14.166 --> 0:06:16.129 And are they making improvements? 0:06:16.509 --> 0:06:17.250 My intervention? 0:06:17.471 --> 0:06:17.571 Oh, 0:06:17.651 --> 0:06:19.752 now that differential between the 0:06:19.812 --> 0:06:21.274 single and dual is shrinking. 0:06:21.454 --> 0:06:22.055 They're improving. 0:06:22.274 --> 0:06:23.495 Now I know I'm on to something. 0:06:23.797 --> 0:06:25.617 And you can apply this, you know, you know, 0:06:25.658 --> 0:06:26.459 I was asking because your 0:06:26.478 --> 0:06:27.459 background is older adults 0:06:27.500 --> 0:06:28.480 and neurologic population. 0:06:28.521 --> 0:06:29.382 But, you know, 0:06:29.401 --> 0:06:30.903 I'm just thinking pretty much everywhere. 0:06:30.963 --> 0:06:32.524 Pediatrics, sports, where couldn't you? 0:06:33.137 --> 0:06:34.117 Yeah, absolutely. 0:06:34.158 --> 0:06:37.040 So I'm a self-described Jerry athlete. 0:06:37.160 --> 0:06:39.502 I'm into my mid-50s and well into them. 0:06:40.221 --> 0:06:41.963 And I also apply those 0:06:42.444 --> 0:06:44.305 matters to myself when I'm 0:06:44.365 --> 0:06:45.346 playing pickleball, 0:06:45.526 --> 0:06:47.706 when I'm doing triathlon, et cetera. 0:06:48.088 --> 0:06:51.029 So it belongs well in that realm. 0:06:51.470 --> 0:06:53.370 Let me just make a couple of quick points. 0:06:53.752 --> 0:06:56.653 Steph Curry, who we most all of us know, 0:06:56.733 --> 0:06:57.875 but for the listening audience, 0:06:57.894 --> 0:06:58.254 I'll tell you, 0:06:58.894 --> 0:07:00.036 one of the most highly paid 0:07:00.096 --> 0:07:01.237 basketball players in the 0:07:01.297 --> 0:07:02.678 National Basketball Association, 0:07:02.838 --> 0:07:05.281 is not the fastest, not the tallest, 0:07:05.901 --> 0:07:07.622 not the best at almost anything, 0:07:07.682 --> 0:07:08.944 but he dual tasks before 0:07:09.004 --> 0:07:09.884 every game because he 0:07:09.925 --> 0:07:11.526 dribbles two basketballs 0:07:11.586 --> 0:07:12.947 and exchanges them between hands, 0:07:13.007 --> 0:07:14.228 between legs, behind the back. 0:07:14.629 --> 0:07:15.329 Why does he do that? 0:07:15.750 --> 0:07:17.271 He does that so that he can 0:07:17.370 --> 0:07:18.812 actually make his handling 0:07:18.851 --> 0:07:20.254 of one ball in the game 0:07:20.874 --> 0:07:22.615 completely automatic so that 0:07:22.656 --> 0:07:24.096 he can make you think he's 0:07:24.117 --> 0:07:25.737 dribbling in he backs up 0:07:26.017 --> 0:07:27.860 and drains a three ball and 0:07:27.899 --> 0:07:29.360 if I'm only six foot four 0:07:29.420 --> 0:07:30.641 in the nba or six foot 0:07:30.701 --> 0:07:32.384 three I need to somehow 0:07:32.444 --> 0:07:33.584 create an open shot dual 0:07:33.625 --> 0:07:35.466 tasking goes there dual 0:07:35.485 --> 0:07:36.846 tasking goes into simone 0:07:36.906 --> 0:07:38.809 biles losing the twisties 0:07:39.209 --> 0:07:40.470 and improving her ability 0:07:40.509 --> 0:07:42.591 to do gymnastics because it 0:07:42.632 --> 0:07:43.713 becomes automatic again 0:07:44.093 --> 0:07:45.134 The more I think about it, 0:07:45.494 --> 0:07:46.774 the less automatic it is, 0:07:46.855 --> 0:07:49.396 and I find myself 17 feet off the air, 0:07:49.797 --> 0:07:50.476 and I'm thinking about 0:07:50.716 --> 0:07:51.718 turning my right arm in. 0:07:52.017 --> 0:07:53.959 So it applies everywhere. 0:07:54.238 --> 0:07:55.660 The most widely studied 0:07:55.740 --> 0:07:58.041 element for fall risk is 0:07:58.382 --> 0:07:59.401 does someone have the 0:07:59.442 --> 0:08:00.622 capacity to dual task? 0:08:01.423 --> 0:08:02.283 Because as you mentioned, 0:08:02.324 --> 0:08:03.725 this is going to come up in 0:08:04.625 --> 0:08:05.586 almost everything. 0:08:05.665 --> 0:08:06.627 Very rarely are we just 0:08:06.666 --> 0:08:07.846 doing just move the 0:08:07.867 --> 0:08:08.867 backpack across the room. 0:08:08.887 --> 0:08:09.788 We're always sort of doing 0:08:09.809 --> 0:08:10.348 the second thing. 0:08:10.824 --> 0:08:11.464 It is our life. 0:08:11.564 --> 0:08:13.084 Whether we subject ourselves 0:08:13.185 --> 0:08:15.685 to texting while on the phone or not, 0:08:15.766 --> 0:08:17.425 there's going to be the dog, 0:08:17.526 --> 0:08:20.266 the grandchild, the jeopardy question, 0:08:21.567 --> 0:08:22.406 whatever that's going to 0:08:22.427 --> 0:08:24.208 dual task people in their lives. 0:08:24.608 --> 0:08:26.288 And if we don't subject our 0:08:26.327 --> 0:08:28.149 patients to this, 0:08:29.069 --> 0:08:31.088 let's just say forced use experience, 0:08:31.149 --> 0:08:33.190 I can circle back to that, then who is? 0:08:33.350 --> 0:08:34.870 Then they're going to be left with, 0:08:35.230 --> 0:08:36.289 I can walk beautifully at 0:08:36.330 --> 0:08:37.210 the rehab center. 0:08:37.730 --> 0:08:39.410 And why can't I walk here at the house? 0:08:40.345 --> 0:08:42.427 I need to go back to rehab, you know? 0:08:43.126 --> 0:08:44.067 So talk about forced use. 0:08:44.908 --> 0:08:45.408 Forced use. 0:08:45.729 --> 0:08:46.830 So basically you can think 0:08:46.870 --> 0:08:47.811 about this in terms of 0:08:47.951 --> 0:08:50.152 forced use or constraint induced. 0:08:50.472 --> 0:08:51.133 Think about this. 0:08:51.854 --> 0:08:53.054 If I'm a person with stroke 0:08:53.475 --> 0:08:54.875 and I have a person 0:08:54.895 --> 0:08:56.876 recovering from stroke and 0:08:56.937 --> 0:08:59.038 I have an intact left arm, 0:08:59.479 --> 0:09:00.899 but my right arm is impaired, 0:09:00.980 --> 0:09:01.441 what do we do? 0:09:01.480 --> 0:09:03.162 A lot of times we use a 0:09:03.241 --> 0:09:04.643 sling and we put it around 0:09:04.682 --> 0:09:05.663 the less impaired arm. 0:09:06.124 --> 0:09:07.024 What I'm doing with dual 0:09:07.044 --> 0:09:08.225 tasking is I'm putting a 0:09:08.306 --> 0:09:09.726 sling around your attention and 0:09:10.436 --> 0:09:10.917 And I'm saying, 0:09:11.116 --> 0:09:12.177 you can't use your attention. 0:09:12.898 --> 0:09:13.519 You have to, 0:09:13.639 --> 0:09:15.280 your attention's busy over here. 0:09:15.701 --> 0:09:19.344 So your brain in the arenas that process, 0:09:19.725 --> 0:09:21.405 how do I do a task without 0:09:21.466 --> 0:09:22.167 thinking about it? 0:09:22.567 --> 0:09:24.028 Those centers have to operate, 0:09:24.068 --> 0:09:25.769 which means my basal ganglia, 0:09:25.971 --> 0:09:28.192 my cerebellum, my premotor cortex, 0:09:28.572 --> 0:09:29.953 my supplementary motor cortex, 0:09:30.434 --> 0:09:31.655 those four areas, 0:09:31.716 --> 0:09:32.336 those are called our 0:09:32.355 --> 0:09:33.336 procedural memory centers. 0:09:33.476 --> 0:09:34.759 They take over because I'm 0:09:34.859 --> 0:09:35.799 forced to take over. 0:09:36.735 --> 0:09:38.357 If your mind's busy elsewhere, 0:09:38.437 --> 0:09:40.360 you can't be thinking heel strike, 0:09:40.961 --> 0:09:42.562 single point cane, right leg, 0:09:42.743 --> 0:09:43.222 heel strike. 0:09:43.283 --> 0:09:44.344 Don't let your knee snap back. 0:09:44.644 --> 0:09:45.966 And if you get caught up in that, 0:09:46.105 --> 0:09:47.548 you can't actually relearn 0:09:47.587 --> 0:09:49.950 how to walk again and make it automatic. 0:09:51.111 --> 0:09:53.634 And being able to educate 0:09:53.693 --> 0:09:55.596 and communicate some of those things, 0:09:55.677 --> 0:09:56.216 I mean, gosh, 0:09:56.236 --> 0:09:57.097 I'm thinking back to some of 0:09:57.118 --> 0:09:58.639 my clinical affiliations as a student. 0:09:59.301 --> 0:10:00.942 You watch a really great clinician, 0:10:00.982 --> 0:10:03.326 they use five words, and a student, 0:10:03.485 --> 0:10:05.749 I'll just call myself, will use 25 words, 0:10:05.769 --> 0:10:06.610 and I should be better, 0:10:06.629 --> 0:10:07.912 because I have five times the words. 0:10:07.932 --> 0:10:09.693 It's actually, it's the opposite. 0:10:10.235 --> 0:10:11.816 Yes, yeah, that is true. 0:10:12.216 --> 0:10:13.298 The when we cue... 0:10:14.176 --> 0:10:16.216 The how we cue, the how much we cue, 0:10:16.256 --> 0:10:17.417 and the how frequently we cue. 0:10:17.456 --> 0:10:18.878 We all know that's well 0:10:18.957 --> 0:10:20.138 studied in motor learning. 0:10:20.739 --> 0:10:21.979 And what we want to elevate 0:10:22.078 --> 0:10:24.120 up to is not 0:10:24.740 --> 0:10:27.321 unintentionally distracting people, 0:10:27.900 --> 0:10:30.001 but intentionally distracting them. 0:10:30.503 --> 0:10:31.523 And there's a nice thing 0:10:31.562 --> 0:10:33.443 that you brought into this, Jimmy, is 0:10:34.443 --> 0:10:36.745 Letting the patient, the person know, 0:10:37.365 --> 0:10:38.785 I'm going to intentionally 0:10:38.846 --> 0:10:40.626 distract you on this trial. 0:10:41.327 --> 0:10:43.229 Try to see how well you can 0:10:43.308 --> 0:10:45.070 do in comparison to your 0:10:45.110 --> 0:10:46.169 performance when I wasn't 0:10:46.190 --> 0:10:46.950 distracting you. 0:10:47.431 --> 0:10:49.371 I expect it to be lower. 0:10:50.552 --> 0:10:51.673 And when you tell them, 0:10:51.972 --> 0:10:53.813 I expect this to be more difficult, 0:10:54.274 --> 0:10:57.456 then at least they know what you're doing, 0:10:57.816 --> 0:10:58.716 why you're doing it. 0:10:58.897 --> 0:11:00.037 I'm doing it so that you can 0:11:00.076 --> 0:11:01.518 be prepared to do this at home. 0:11:02.269 --> 0:11:03.010 And what happens? 0:11:03.291 --> 0:11:03.611 Okay, 0:11:03.731 --> 0:11:05.113 their performance went down a little bit. 0:11:05.212 --> 0:11:06.674 They're not dejected by it, 0:11:07.034 --> 0:11:07.956 but maybe their performance 0:11:07.996 --> 0:11:09.038 stayed equally as good as 0:11:09.077 --> 0:11:09.818 their single task. 0:11:09.979 --> 0:11:10.639 They think, great, 0:11:11.000 --> 0:11:11.961 but maybe their performance 0:11:12.020 --> 0:11:13.543 went up and they think, wow, 0:11:13.602 --> 0:11:14.744 I fooled my therapist. 0:11:15.004 --> 0:11:15.664 Hey, grandson, 0:11:15.705 --> 0:11:17.086 guess what I did today in therapy? 0:11:17.495 --> 0:11:17.735 Right. 0:11:17.855 --> 0:11:19.395 I mean, that's that's so it's so true. 0:11:19.436 --> 0:11:19.655 Right. 0:11:19.777 --> 0:11:21.177 Which which is I mean, 0:11:21.216 --> 0:11:22.138 I guess we just learn this 0:11:22.158 --> 0:11:23.438 about ourselves and we can use it. 0:11:24.178 --> 0:11:25.340 You mentioned being a triathlete. 0:11:25.360 --> 0:11:27.562 And I read a lot because I'm 0:11:27.581 --> 0:11:28.883 a I like triathlon because 0:11:28.923 --> 0:11:29.982 it allows me to be mediocre 0:11:30.003 --> 0:11:31.063 at three things in one day. 0:11:31.124 --> 0:11:32.485 And I like my efficient mediocrity. 0:11:33.426 --> 0:11:35.948 But it's how many times when 0:11:36.068 --> 0:11:37.471 your coach or your plan 0:11:37.551 --> 0:11:39.472 says this is an easy day, you go harder. 0:11:39.493 --> 0:11:41.336 And when it's a hard day, you go easier. 0:11:41.395 --> 0:11:41.895 It's like, wait, 0:11:41.936 --> 0:11:42.677 why don't you just do 0:11:42.697 --> 0:11:44.058 what's actually on the script? 0:11:44.099 --> 0:11:46.000 And that's just how some of 0:11:46.081 --> 0:11:48.144 us are wired for some reason. 0:11:48.543 --> 0:11:48.825 Yeah. 0:11:49.065 --> 0:11:49.764 Yeah, and that's right. 0:11:49.784 --> 0:11:50.985 The psychological 0:11:51.105 --> 0:11:53.567 expectations for what you, 0:11:53.647 --> 0:11:54.628 and this is the analogy 0:11:54.648 --> 0:11:56.249 that you're clearly calling in here, 0:11:56.769 --> 0:11:58.429 setting someone up for 0:11:58.490 --> 0:12:00.291 appropriate psychological expectations, 0:12:00.410 --> 0:12:02.412 if they exceed them, they feel great. 0:12:02.772 --> 0:12:06.014 If they're below or lowered 0:12:06.073 --> 0:12:08.174 psychological expectations, 0:12:08.235 --> 0:12:09.115 if they meet those, 0:12:09.134 --> 0:12:10.015 then they're not dejected. 0:12:10.336 --> 0:12:11.496 We don't want our patients 0:12:11.537 --> 0:12:13.798 to feel that therapy is 0:12:13.857 --> 0:12:15.818 just the reminder of what you can't do. 0:12:16.466 --> 0:12:17.606 And that's the problem with 0:12:17.626 --> 0:12:18.927 a lot of patient engagement. 0:12:19.246 --> 0:12:19.927 Right, right. 0:12:20.347 --> 0:12:21.967 All right, let's switch topics, 0:12:22.008 --> 0:12:22.788 but not really. 0:12:23.068 --> 0:12:24.750 So behavioral economics is 0:12:24.909 --> 0:12:25.690 super fascinating. 0:12:25.769 --> 0:12:28.010 I love reading Adam Grant 0:12:28.410 --> 0:12:30.052 and a lot of the writers. 0:12:30.932 --> 0:12:31.592 I don't think I would have 0:12:31.633 --> 0:12:32.472 picked it as a really 0:12:32.812 --> 0:12:33.953 interesting topic because 0:12:33.994 --> 0:12:34.994 the name doesn't sound it, 0:12:35.033 --> 0:12:36.715 but what they start talking about is. 0:12:36.794 --> 0:12:37.634 So it's really fascinating. 0:12:38.115 --> 0:12:38.875 So how can we use, 0:12:38.916 --> 0:12:40.836 there's concepts in there like nudge, 0:12:41.136 --> 0:12:43.758 gamification, confirmation bias. 0:12:44.418 --> 0:12:45.719 in physical therapy to sort 0:12:45.739 --> 0:12:46.658 of bring those in to 0:12:46.698 --> 0:12:48.279 enhance the patient engagement. 0:12:48.600 --> 0:12:49.480 We're paying attention to 0:12:49.541 --> 0:12:50.741 people and we can use these 0:12:50.802 --> 0:12:52.182 concepts in different ways 0:12:52.523 --> 0:12:53.803 to actually get more out of them. 0:12:53.884 --> 0:12:54.624 Yeah, yeah. 0:12:54.844 --> 0:12:55.485 I'll tell you what, 0:12:55.784 --> 0:12:57.966 maybe an effective thing to do, 0:12:58.405 --> 0:12:59.466 we weren't planning this, 0:12:59.746 --> 0:13:00.628 but maybe an effective 0:13:00.648 --> 0:13:02.629 thing to do for your audience is, 0:13:03.159 --> 0:13:05.802 You throw a term out, any one of them, 0:13:06.182 --> 0:13:07.144 and then I'm on the hot 0:13:07.203 --> 0:13:08.245 seat to tell you how to 0:13:08.284 --> 0:13:09.025 apply it in rehab. 0:13:09.725 --> 0:13:11.368 This is completely untrained. 0:13:12.149 --> 0:13:13.230 Let's do an easy one or one 0:13:13.250 --> 0:13:14.010 that comes up a lot, 0:13:14.030 --> 0:13:15.511 but I think myself included, 0:13:15.532 --> 0:13:16.653 a lot of people might not 0:13:16.692 --> 0:13:17.394 know how to utilize it, 0:13:17.413 --> 0:13:18.455 which is gamification. 0:13:18.575 --> 0:13:20.456 Sounds cool, has the word game in it, 0:13:20.496 --> 0:13:21.518 but how do I use it? 0:13:21.953 --> 0:13:22.193 OK, 0:13:22.495 --> 0:13:23.816 so there's three big things in 0:13:23.836 --> 0:13:24.515 gamification. 0:13:24.556 --> 0:13:26.457 There's levels, points and rewards, 0:13:26.538 --> 0:13:27.778 but I'll make it super easy. 0:13:28.279 --> 0:13:30.100 So the easiest thing is to go for points. 0:13:30.461 --> 0:13:30.721 All right. 0:13:30.802 --> 0:13:32.383 So let's just say, for example, 0:13:32.442 --> 0:13:34.004 I sit somebody down on a 0:13:34.063 --> 0:13:36.606 recumbent elliptical or a 0:13:36.667 --> 0:13:37.967 stepper or whatever. 0:13:38.467 --> 0:13:39.589 And I say, you know, 0:13:39.769 --> 0:13:41.410 my goal is to have them do 0:13:41.451 --> 0:13:43.832 a high intensity intervals training. 0:13:44.133 --> 0:13:45.232 But if I sit there and say, 0:13:45.312 --> 0:13:46.053 you're going to need to do 0:13:46.094 --> 0:13:48.375 this for 30 seconds as hard as you can, 0:13:48.394 --> 0:13:49.075 and I want you to try to 0:13:49.095 --> 0:13:49.955 see if you can make the 0:13:49.975 --> 0:13:51.655 machine go up to 77 watts, 0:13:52.035 --> 0:13:55.817 they might feel some cortisol. 0:13:55.837 --> 0:13:57.018 They might feel some stress. 0:13:57.097 --> 0:13:58.918 They might feel some coercion. 0:13:59.219 --> 0:14:00.639 And they might feel like, gosh, this guy, 0:14:00.659 --> 0:14:01.440 I don't know how hard he 0:14:01.460 --> 0:14:01.899 wants me to work. 0:14:02.220 --> 0:14:03.780 What I'll use is gamification, though. 0:14:04.321 --> 0:14:04.822 So I'll say, 0:14:04.902 --> 0:14:05.881 I want you to just get 0:14:05.962 --> 0:14:07.124 comfortable with the device, 0:14:07.264 --> 0:14:10.326 use it a little bit and see how it goes. 0:14:10.667 --> 0:14:11.998 And then once they're 15, 0:14:11.998 --> 0:14:12.928 30 seconds into it, I'll say, 0:14:13.249 --> 0:14:14.970 just take 15 seconds to use 0:14:14.990 --> 0:14:16.270 it as hard as you think you can. 0:14:17.105 --> 0:14:18.544 And they record 34 watts. 0:14:19.365 --> 0:14:20.946 And then I say, okay, 0:14:20.985 --> 0:14:22.567 take it easy now for 30 seconds. 0:14:22.726 --> 0:14:23.647 And then when you hit the 0:14:24.106 --> 0:14:25.067 minute and a half mark, 0:14:26.048 --> 0:14:27.107 see how hard you can use it. 0:14:27.827 --> 0:14:28.989 Right there is gamification. 0:14:29.328 --> 0:14:30.609 They scored 34 watts. 0:14:30.769 --> 0:14:32.330 You and I both know they're 0:14:32.350 --> 0:14:33.190 going to try to look at 0:14:33.230 --> 0:14:34.929 that and see if they can beat 34 watts. 0:14:35.409 --> 0:14:36.270 Before you know it, 0:14:36.451 --> 0:14:37.711 they've taken themselves 0:14:37.850 --> 0:14:39.912 beyond the 77 watts that I 0:14:39.971 --> 0:14:41.652 told them I would have wanted to get to. 0:14:41.991 --> 0:14:43.273 And I never had to actually 0:14:43.312 --> 0:14:43.932 push that on them. 0:14:44.332 --> 0:14:45.514 I let them gamify because 0:14:45.553 --> 0:14:46.815 they look at points. 0:14:47.375 --> 0:14:47.634 Right. 0:14:47.774 --> 0:14:47.936 I mean, 0:14:47.975 --> 0:14:49.476 this is where like Peloton does a 0:14:49.517 --> 0:14:51.038 great does a great job is there. 0:14:51.298 --> 0:14:53.038 They're measuring different things. 0:14:53.119 --> 0:14:54.519 Do you ride Peloton at all, Mike? 0:14:54.980 --> 0:14:55.399 I don't. 0:14:55.460 --> 0:14:56.341 I'm very familiar. 0:14:56.461 --> 0:14:57.442 I ride my own bike. 0:14:57.481 --> 0:14:58.601 I'll leave it unnamed so I 0:14:58.621 --> 0:14:59.663 don't endorse anything. 0:15:00.364 --> 0:15:00.823 But yes, 0:15:00.884 --> 0:15:02.745 I ride an indoor bike and I take a 0:15:02.784 --> 0:15:04.666 look at, you know, my RPMs. 0:15:04.706 --> 0:15:05.886 I look at my power meter and 0:15:05.907 --> 0:15:07.168 I look at all that stuff. 0:15:07.227 --> 0:15:08.089 And, you know, 0:15:08.168 --> 0:15:10.070 and that's that's all gamification. 0:15:10.421 --> 0:15:11.741 They do a couple things, I think, 0:15:11.842 --> 0:15:12.442 well anyway. 0:15:12.462 --> 0:15:14.745 They do watts and they measure distance, 0:15:14.846 --> 0:15:17.769 obviously, perceived speed. 0:15:18.809 --> 0:15:20.051 And what they also do is 0:15:20.091 --> 0:15:21.033 they bring in people. 0:15:21.572 --> 0:15:23.956 So number one, the classes can be live. 0:15:24.035 --> 0:15:25.157 Social cohesion. 0:15:26.177 --> 0:15:27.178 You can see where you rank. 0:15:27.740 --> 0:15:30.022 And if I'm taking a class from last week, 0:15:30.763 --> 0:15:32.124 it's putting me in terms of 0:15:32.224 --> 0:15:34.504 Watts where other people 0:15:34.544 --> 0:15:36.926 were at that point in the 0:15:37.167 --> 0:15:39.207 ride in the race. 0:15:39.528 --> 0:15:41.188 What they also do is they have this thing. 0:15:41.229 --> 0:15:41.769 I thought it would have 0:15:41.788 --> 0:15:42.950 taken on a little more. 0:15:42.990 --> 0:15:44.149 It's called lane break. 0:15:44.711 --> 0:15:45.051 Okay. 0:15:45.311 --> 0:15:46.552 It's a little like Tron. 0:15:46.572 --> 0:15:48.592 It's like, it's like a six lane track, 0:15:48.932 --> 0:15:49.133 right? 0:15:49.153 --> 0:15:50.313 It's like a, it's like a track. 0:15:50.754 --> 0:15:52.754 And the way you switch lanes is your, 0:15:52.934 --> 0:15:54.355 is your resistance dial. 0:15:54.436 --> 0:15:55.376 So all the way to the left, 0:15:55.417 --> 0:15:57.477 you go to the far left lane, super easy. 0:15:57.498 --> 0:15:57.538 Um, 0:15:58.118 --> 0:15:59.118 And it'll tell you, 0:15:59.357 --> 0:16:00.619 you mentioned like in terms 0:16:00.658 --> 0:16:01.399 of the sprinting, 0:16:01.698 --> 0:16:03.239 there's three different kinds of things. 0:16:03.298 --> 0:16:04.039 There's gates. 0:16:04.399 --> 0:16:05.519 You've got to go through the gate. 0:16:05.539 --> 0:16:06.500 So I need you to be in lane 0:16:06.539 --> 0:16:07.600 three and hit this gate. 0:16:07.659 --> 0:16:08.860 If you miss it, you don't get the points. 0:16:09.520 --> 0:16:11.802 There's sprints where it'll be like, 0:16:11.902 --> 0:16:13.422 I need you to go and do X 0:16:13.461 --> 0:16:14.782 number of watts before your 0:16:14.822 --> 0:16:16.982 bike passes through this thing. 0:16:17.403 --> 0:16:19.102 And then there's tempo where 0:16:19.123 --> 0:16:20.703 it actually says be between 0:16:20.703 --> 0:16:24.184 60 and 80 RPMs, not higher, not lower. 0:16:24.205 --> 0:16:24.284 Yeah. 0:16:25.345 --> 0:16:26.927 So it's not just as hard as you can. 0:16:27.047 --> 0:16:29.370 So I thought that lane break thing, 0:16:29.431 --> 0:16:29.870 the option, 0:16:29.890 --> 0:16:31.212 the feature is kind of buried. 0:16:31.312 --> 0:16:32.995 It's not on the homepage as well, 0:16:33.336 --> 0:16:34.216 but I tried that a few 0:16:34.277 --> 0:16:36.681 times and I was like, this is, this was, 0:16:36.721 --> 0:16:38.202 it was one of the better 0:16:38.582 --> 0:16:40.225 gamification things that I had seen. 0:16:40.245 --> 0:16:40.385 Yeah. 0:16:41.166 --> 0:16:41.606 And remember, 0:16:41.626 --> 0:16:43.347 what you're saying there is 0:16:43.408 --> 0:16:45.809 that people get, remember I told you, 0:16:45.870 --> 0:16:47.171 points, levels, and rewards. 0:16:47.311 --> 0:16:48.731 You get to be level, 0:16:48.812 --> 0:16:50.013 so you get to actually, 0:16:50.113 --> 0:16:51.234 you're qualified now to 0:16:51.313 --> 0:16:52.654 race with the elite racers. 0:16:53.155 --> 0:16:53.995 So that's a level. 0:16:54.397 --> 0:16:55.197 And if you think about it in 0:16:55.256 --> 0:16:57.219 rehabilitation, how do we apply it back? 0:16:57.698 --> 0:17:00.421 So we also like people to have streaks, 0:17:00.620 --> 0:17:02.903 and I'm sure they do that in Peloton, 0:17:02.962 --> 0:17:03.182 right? 0:17:03.543 --> 0:17:05.184 So sometimes I actually used 0:17:05.204 --> 0:17:07.306 to say to my patients, okay, 0:17:08.426 --> 0:17:09.387 let's see if we can get you 0:17:09.448 --> 0:17:10.409 on a fall-free streak. 0:17:11.269 --> 0:17:12.430 And every time you come in 0:17:12.450 --> 0:17:13.309 to start the session, 0:17:13.769 --> 0:17:14.691 hold up the number of 0:17:14.770 --> 0:17:16.070 fingers that represent the 0:17:16.090 --> 0:17:17.231 number of falls you had 0:17:17.672 --> 0:17:19.212 since our last session. 0:17:19.492 --> 0:17:21.294 And they were very prideful coming in. 0:17:21.473 --> 0:17:22.453 Zero, zero. 0:17:22.733 --> 0:17:24.414 And they, oh, and I say to them, hey, 0:17:24.634 --> 0:17:26.175 that's nine days in a row 0:17:26.236 --> 0:17:27.496 you've gone without a fall. 0:17:27.776 --> 0:17:29.376 So that's another way of gamifying. 0:17:29.436 --> 0:17:30.696 So it's just looking at 0:17:30.777 --> 0:17:31.678 streaks and that can be 0:17:31.718 --> 0:17:34.078 done in incontinence, you know, 0:17:34.118 --> 0:17:34.979 in so many different ways. 0:17:34.999 --> 0:17:36.680 So then anyway, gamification, 0:17:36.740 --> 0:17:37.980 we've somewhat tackled there. 0:17:38.000 --> 0:17:39.060 We can move to another one if you want. 0:17:39.201 --> 0:17:39.981 How about nudge? 0:17:40.061 --> 0:17:40.721 What's nudge? 0:17:41.163 --> 0:17:43.163 So nudge is actually making 0:17:43.365 --> 0:17:44.905 a choice more 0:17:45.326 --> 0:17:47.407 geographically present or 0:17:47.587 --> 0:17:48.669 temporally present, 0:17:49.009 --> 0:17:50.369 making it more likely for 0:17:50.411 --> 0:17:51.290 you to choose it because 0:17:51.330 --> 0:17:52.172 it's right here right now. 0:17:52.632 --> 0:17:53.913 So I walk out of my 0:17:54.013 --> 0:17:55.555 workplace and there's a 0:17:55.615 --> 0:17:57.036 bunch of people exercising 0:17:57.115 --> 0:17:58.017 out in the courtyard. 0:17:58.517 --> 0:17:59.577 I don't have to drive. 0:17:59.617 --> 0:18:01.240 I don't have to swipe a membership badge. 0:18:01.940 --> 0:18:03.080 I can just walk right out 0:18:03.121 --> 0:18:03.902 there and it's available. 0:18:04.241 --> 0:18:06.284 It's a track that's close to my house. 0:18:06.844 --> 0:18:09.226 Nudge is easy, readily convenient. 0:18:09.567 --> 0:18:10.827 And an easy way that people 0:18:10.887 --> 0:18:11.868 think about this in their 0:18:11.949 --> 0:18:13.809 own lives is the doctor says, 0:18:13.849 --> 0:18:14.750 you need to start eating 0:18:14.851 --> 0:18:16.031 more healthy foods. 0:18:16.511 --> 0:18:17.532 And you go to the grocery 0:18:17.553 --> 0:18:18.773 aisle and you look at nuts 0:18:18.854 --> 0:18:20.115 and seeds and et cetera, 0:18:20.455 --> 0:18:22.176 and you completely have all 0:18:22.237 --> 0:18:24.058 this paradox of choice, choice, burden. 0:18:24.298 --> 0:18:25.099 You don't know what to choose. 0:18:25.880 --> 0:18:27.361 But it's nudged if it's 0:18:27.621 --> 0:18:30.142 already in your pantry and 0:18:30.201 --> 0:18:31.862 you see it nicely labeled nuts, 0:18:32.001 --> 0:18:33.883 seeds and chips and et cetera. 0:18:34.262 --> 0:18:35.042 But it's even better. 0:18:35.103 --> 0:18:36.624 What happens if you go to a 0:18:36.683 --> 0:18:38.384 party or somebody else's house, 0:18:38.605 --> 0:18:39.785 no matter what the occasion is, 0:18:40.065 --> 0:18:41.846 and there's already foods 0:18:41.885 --> 0:18:42.685 out there on the table, 0:18:43.006 --> 0:18:44.967 you're nudged into 0:18:45.047 --> 0:18:46.387 consuming something healthy 0:18:46.428 --> 0:18:47.347 because it's present. 0:18:47.708 --> 0:18:48.868 It's immediately available. 0:18:48.969 --> 0:18:49.429 It's there. 0:18:49.828 --> 0:18:52.170 So nudge is something like this. 0:18:52.950 --> 0:18:53.810 I'm going to give you a home 0:18:53.891 --> 0:18:55.092 exercise program that's 0:18:55.152 --> 0:18:57.153 built within things that 0:18:57.193 --> 0:18:58.234 you do in your life. 0:18:59.375 --> 0:19:00.457 You tell me what you do. 0:19:00.576 --> 0:19:01.357 And I say, oh, 0:19:02.018 --> 0:19:03.038 when you stand up from the 0:19:03.118 --> 0:19:05.622 couch on a commercial break, 0:19:05.721 --> 0:19:07.462 do five repetitions of sit to stand. 0:19:07.542 --> 0:19:08.064 It's a nudge. 0:19:08.203 --> 0:19:08.884 It's right there. 0:19:09.644 --> 0:19:10.326 It's easy for you. 0:19:11.229 --> 0:19:12.650 Yeah, that's a good use. 0:19:12.710 --> 0:19:13.490 And I think it's good that 0:19:13.509 --> 0:19:14.150 we're talking about this 0:19:14.170 --> 0:19:15.171 just before Christmas when 0:19:15.230 --> 0:19:16.211 I will be at parties where 0:19:16.250 --> 0:19:17.211 there will be things that 0:19:17.612 --> 0:19:19.152 they wouldn't be there in my house, 0:19:19.612 --> 0:19:19.932 right? 0:19:20.212 --> 0:19:22.032 Because they are right there. 0:19:22.094 --> 0:19:23.653 They're geographically right there. 0:19:23.713 --> 0:19:24.855 And it's so easy. 0:19:24.875 --> 0:19:25.474 We get caught in that. 0:19:25.494 --> 0:19:25.714 All right. 0:19:25.994 --> 0:19:26.775 The last one of our 0:19:26.815 --> 0:19:28.215 impromptu sort of batting 0:19:28.256 --> 0:19:30.416 practice is confirmation bias. 0:19:30.797 --> 0:19:31.038 Okay, 0:19:31.357 --> 0:19:33.681 so confirmation bias is something 0:19:33.760 --> 0:19:35.022 that can be used to our 0:19:35.323 --> 0:19:36.444 advantage or our 0:19:36.605 --> 0:19:38.667 disadvantage in rehabilitation. 0:19:39.127 --> 0:19:40.549 It has several things that 0:19:40.589 --> 0:19:42.011 go into confirmation bias. 0:19:42.573 --> 0:19:43.433 One of the things that we 0:19:43.473 --> 0:19:44.394 like to look at that's a 0:19:44.516 --> 0:19:46.097 sub-subject is the halo 0:19:46.137 --> 0:19:47.419 effect and the horns effect. 0:19:47.440 --> 0:19:47.940 Okay. 0:19:49.416 --> 0:19:50.499 Confirmation bias. 0:19:50.878 --> 0:19:50.979 Oh, 0:19:51.058 --> 0:19:52.922 they must be the best physical therapy 0:19:52.961 --> 0:19:53.782 clinic in town. 0:19:53.863 --> 0:19:55.506 They've got seven locations. 0:19:55.726 --> 0:19:56.686 I want to go there. 0:19:57.248 --> 0:19:58.390 Confirmation bias. 0:19:58.769 --> 0:19:59.612 I think I'm going to have a 0:19:59.652 --> 0:20:02.055 great experience because they're popular. 0:20:02.095 --> 0:20:03.416 Their parking lot's full. 0:20:03.656 --> 0:20:05.159 That's again, confirmation bias. 0:20:05.599 --> 0:20:06.760 Their people are all dressed 0:20:06.800 --> 0:20:07.761 in the same uniform. 0:20:07.801 --> 0:20:09.923 The reception staff was nice to me. 0:20:10.443 --> 0:20:11.865 All of those things resonate 0:20:11.904 --> 0:20:13.507 within the halo effect of 0:20:13.547 --> 0:20:14.507 the confirmation bias. 0:20:15.048 --> 0:20:17.450 Because I think these attributes, 0:20:17.910 --> 0:20:19.551 then I automatically 0:20:19.692 --> 0:20:21.532 associate attributes that 0:20:21.573 --> 0:20:22.794 haven't been earned 0:20:23.694 --> 0:20:24.536 to that entity. 0:20:24.996 --> 0:20:25.955 My physical therapist 0:20:26.757 --> 0:20:28.097 automatically seems like 0:20:28.157 --> 0:20:29.038 they're giving me better 0:20:29.057 --> 0:20:32.019 information if they are A, well-dressed. 0:20:32.299 --> 0:20:35.561 The receptionist talked nicely to me. 0:20:35.922 --> 0:20:37.462 I found the place easily. 0:20:37.482 --> 0:20:39.805 The therapist brought me back on time. 0:20:40.404 --> 0:20:40.484 Oh, 0:20:40.704 --> 0:20:42.026 that's what tells me they're a great 0:20:42.066 --> 0:20:42.605 therapist. 0:20:43.267 --> 0:20:45.367 Then, oh, that was my best experience yet. 0:20:45.728 --> 0:20:47.108 I feel so much better after that. 0:20:48.787 --> 0:20:50.167 It's amazing how these things work. 0:20:50.189 --> 0:20:51.490 Have you ever heard how Red Bull, 0:20:51.509 --> 0:20:52.652 when they were trying to launch, 0:20:52.711 --> 0:20:54.354 how they use confirmation bias? 0:20:54.835 --> 0:20:56.156 Yes, yes, yes. 0:20:56.237 --> 0:20:57.919 So that's an interesting one, too. 0:20:58.400 --> 0:20:59.520 And see, that's the thing. 0:20:59.560 --> 0:21:00.762 There's so much placebo 0:21:00.803 --> 0:21:02.085 effect that goes into that, though, 0:21:02.105 --> 0:21:02.505 as well. 0:21:02.684 --> 0:21:02.846 Yeah. 0:21:03.326 --> 0:21:05.106 Did you hear the one about the cans? 0:21:05.527 --> 0:21:06.946 So the idea was this was 0:21:07.027 --> 0:21:09.387 using confirmation bias in public. 0:21:10.127 --> 0:21:11.388 So they were at this music 0:21:11.449 --> 0:21:13.009 festival somewhere, right? 0:21:13.469 --> 0:21:14.430 And they were trying to give 0:21:14.470 --> 0:21:15.230 their cans away. 0:21:15.410 --> 0:21:16.750 But what that does is says, well, 0:21:16.769 --> 0:21:17.550 if it's free, 0:21:17.971 --> 0:21:19.391 how good could it possibly be? 0:21:19.490 --> 0:21:20.511 So they didn't want to do that. 0:21:21.011 --> 0:21:22.152 So what they did was their 0:21:22.231 --> 0:21:23.393 marketing team took a bunch 0:21:23.432 --> 0:21:24.393 of their Red Bull cans, 0:21:25.032 --> 0:21:27.614 poured out the Red Bull, took the cans, 0:21:27.733 --> 0:21:28.673 crushed them, whatever, 0:21:28.814 --> 0:21:29.994 and they put them in the garbage. 0:21:30.654 --> 0:21:32.797 So while people were walking around, 0:21:32.856 --> 0:21:33.416 they were saying, 0:21:33.737 --> 0:21:36.179 this must be good because 0:21:36.479 --> 0:21:38.480 everybody's already had that. 0:21:39.000 --> 0:21:41.702 And imagine, though, trying to pitch that. 0:21:41.742 --> 0:21:42.643 Imagine you're a budding 0:21:42.702 --> 0:21:43.943 marketer who understands 0:21:43.983 --> 0:21:44.684 confirmation bias. 0:21:44.744 --> 0:21:45.224 You're smart. 0:21:45.244 --> 0:21:46.185 You have a background in psychology. 0:21:46.205 --> 0:21:47.686 You're like, so here's what I want to do. 0:21:48.146 --> 0:21:49.387 I want to pour it all out 0:21:49.708 --> 0:21:51.628 and throw it away and throw 0:21:51.669 --> 0:21:52.690 the cans in the garbage 0:21:52.710 --> 0:21:53.369 because I think that'll 0:21:53.390 --> 0:21:54.250 make people like it more. 0:21:54.490 --> 0:21:55.872 Your marketing director 0:21:55.892 --> 0:21:57.492 would look at you like you're insane. 0:21:57.512 --> 0:21:59.913 That story has been told and it's like, 0:22:00.174 --> 0:22:00.694 gosh, 0:22:01.515 --> 0:22:04.176 I would fall for that or I would be 0:22:04.237 --> 0:22:05.298 susceptible to that. 0:22:05.397 --> 0:22:05.678 Yeah. 0:22:05.877 --> 0:22:06.057 Yeah. 0:22:06.337 --> 0:22:07.019 And so, you know, 0:22:07.058 --> 0:22:10.101 that comes in line with frequency bias. 0:22:10.141 --> 0:22:10.861 And I know we don't want to 0:22:10.881 --> 0:22:11.801 go off on another term, 0:22:12.182 --> 0:22:13.623 but frequency bias or the bias. 0:22:13.968 --> 0:22:15.469 the Bader-Meinhof effect. 0:22:15.849 --> 0:22:16.329 Remember, 0:22:16.970 --> 0:22:18.551 whatever car you just bought 0:22:18.652 --> 0:22:20.333 recently or whatever pair 0:22:20.472 --> 0:22:22.074 of shoes you just bought recently, 0:22:22.394 --> 0:22:23.655 you automatically start 0:22:23.756 --> 0:22:25.457 seeing it all over the place. 0:22:25.917 --> 0:22:27.338 So that's frequency bias. 0:22:27.378 --> 0:22:28.599 And now if you see that Red 0:22:28.640 --> 0:22:30.060 Bull can and you see it 0:22:30.101 --> 0:22:32.041 over in that trash can, now you start, 0:22:32.563 --> 0:22:33.523 you don't even realize that 0:22:33.544 --> 0:22:34.884 you're starting to look for it. 0:22:35.224 --> 0:22:36.185 Oh my gosh, there's a banner. 0:22:36.266 --> 0:22:37.205 There was an ad for it. 0:22:37.547 --> 0:22:38.587 I saw that came up on my 0:22:38.627 --> 0:22:39.367 social media feed. 0:22:39.387 --> 0:22:40.128 They're everywhere. 0:22:40.669 --> 0:22:42.128 you weren't paying attention to it. 0:22:42.169 --> 0:22:43.289 But now as soon as it came 0:22:43.369 --> 0:22:44.529 on your attention radar, 0:22:44.829 --> 0:22:45.650 you see it everywhere. 0:22:45.750 --> 0:22:47.830 And that frequency bias is a 0:22:47.931 --> 0:22:49.211 complimentary concept. 0:22:49.471 --> 0:22:50.511 It's wild, right? 0:22:51.311 --> 0:22:53.712 And these things still work. 0:22:53.752 --> 0:22:54.393 They're still present, 0:22:54.532 --> 0:22:55.772 even if you are aware of them. 0:22:55.813 --> 0:22:56.593 That's why they're biased. 0:22:57.114 --> 0:22:58.134 Yes, this is true. 0:22:58.334 --> 0:22:58.574 Yep. 0:22:58.693 --> 0:22:58.874 Yeah. 0:22:58.894 --> 0:23:00.253 And that's what makes it so fascinating. 0:23:00.654 --> 0:23:02.295 And the ability to apply it 0:23:02.394 --> 0:23:04.675 into rehabilitation is one 0:23:04.695 --> 0:23:05.695 of the things that I think 0:23:06.076 --> 0:23:08.117 We talk about motivational interviewing. 0:23:08.157 --> 0:23:09.558 We talk about patient engagement. 0:23:09.578 --> 0:23:11.380 We talk about collaborative goal setting. 0:23:11.700 --> 0:23:12.760 We talk about autonomy and 0:23:12.820 --> 0:23:13.520 all these things. 0:23:14.001 --> 0:23:15.442 And all of that can 0:23:15.623 --> 0:23:18.545 strengthen the therapy experience. 0:23:18.585 --> 0:23:21.126 And why wouldn't we want it to, you know? 0:23:21.487 --> 0:23:23.067 So that's the thing is if 0:23:23.107 --> 0:23:25.170 you're giving great therapy, 0:23:25.710 --> 0:23:27.211 but somebody has a negative 0:23:27.250 --> 0:23:29.532 confirmation bias, a horn's effect, 0:23:30.053 --> 0:23:31.413 That detracts from their 0:23:31.515 --> 0:23:33.536 outcome and your reflection, 0:23:33.715 --> 0:23:35.317 their word of mouth, et cetera. 0:23:35.657 --> 0:23:36.878 So we need to leverage these 0:23:36.919 --> 0:23:38.240 things so that our therapy 0:23:38.259 --> 0:23:39.340 experience is given the 0:23:39.421 --> 0:23:40.883 credit for what it's truly do. 0:23:41.499 --> 0:23:41.798 Yeah. 0:23:42.058 --> 0:23:42.579 It's wild. 0:23:42.640 --> 0:23:43.440 I mean, if I was going to, 0:23:43.480 --> 0:23:44.580 I'm not going back to school. 0:23:44.661 --> 0:23:45.461 I've done that too many times, 0:23:45.760 --> 0:23:47.722 but if I was, psychology is definitely, 0:23:47.782 --> 0:23:48.242 I sort of like, 0:23:48.323 --> 0:23:49.624 I just study it amateurly 0:23:49.703 --> 0:23:51.545 and I just think it's fascinating. 0:23:51.625 --> 0:23:52.865 I think when I was younger, 0:23:52.964 --> 0:23:54.506 I thought psychology was like, it's like, 0:23:54.526 --> 0:23:55.227 there's no way you can 0:23:55.287 --> 0:23:56.647 predict what people do. 0:23:56.667 --> 0:23:57.768 And I think psychologists would say, 0:23:57.807 --> 0:23:58.848 we don't, that's not what we do. 0:23:59.388 --> 0:24:00.509 We just look at patterns and 0:24:00.549 --> 0:24:01.329 how people act. 0:24:01.349 --> 0:24:02.010 And then we try to work 0:24:02.070 --> 0:24:03.010 backwards to figure out 0:24:03.050 --> 0:24:04.872 like what causes that or why, 0:24:04.951 --> 0:24:06.653 what might cause that to 0:24:06.692 --> 0:24:07.933 happen and utilize that. 0:24:08.374 --> 0:24:09.434 Yeah, that's the whole thing. 0:24:09.494 --> 0:24:10.875 Cognitive behavioral therapy 0:24:11.255 --> 0:24:14.196 says this is your pattern of thinking. 0:24:14.757 --> 0:24:16.518 Can we neuroplastically help 0:24:16.637 --> 0:24:18.698 you diverge that stream 0:24:18.838 --> 0:24:20.898 into another tributary so 0:24:20.919 --> 0:24:22.200 you don't follow down that 0:24:22.259 --> 0:24:23.339 same pattern of thinking? 0:24:23.359 --> 0:24:24.141 Yeah. 0:24:24.441 --> 0:24:24.601 Yeah. 0:24:24.760 --> 0:24:26.301 So you mentioned at least 0:24:26.402 --> 0:24:27.343 once or twice in there. 0:24:27.383 --> 0:24:28.344 I know it comes up a lot, 0:24:28.364 --> 0:24:30.705 especially with the audience's fear. 0:24:30.806 --> 0:24:32.968 It's a common barrier in recovery, right? 0:24:33.028 --> 0:24:34.209 Even just to get someone to 0:24:34.249 --> 0:24:36.151 maybe even come to your clinic sometimes. 0:24:36.211 --> 0:24:37.332 How many times they must 0:24:37.372 --> 0:24:38.853 have overcome fear before 0:24:38.893 --> 0:24:40.054 they'll even see you. 0:24:40.634 --> 0:24:41.715 So how can physical 0:24:41.756 --> 0:24:42.477 therapists better 0:24:42.576 --> 0:24:44.538 understand this thing that 0:24:44.617 --> 0:24:46.380 is probably going to be present often, 0:24:46.400 --> 0:24:47.381 fear, 0:24:47.540 --> 0:24:49.182 and address it with their patients 0:24:49.282 --> 0:24:50.683 to get those better outcomes? 0:24:51.359 --> 0:24:52.480 That's a great question. 0:24:52.601 --> 0:24:53.580 I love the fact that you've 0:24:53.601 --> 0:24:54.461 brought that up too. 0:24:54.662 --> 0:24:55.241 For me, 0:24:55.402 --> 0:24:57.403 I think about the omnipresence of fear. 0:24:57.823 --> 0:24:58.804 And I think about the fact 0:24:58.864 --> 0:25:01.765 that it's fear of re-injury, ACL, 0:25:02.465 --> 0:25:04.287 fear of incontinence, 0:25:04.487 --> 0:25:05.928 fear of falling is the most 0:25:06.008 --> 0:25:08.108 widely studied, you know, 0:25:08.189 --> 0:25:09.690 fear of making an error, 0:25:10.009 --> 0:25:11.911 which can be again to the yips, 0:25:11.951 --> 0:25:13.352 the baseball player, the golfer, 0:25:13.372 --> 0:25:14.152 the titting a putt, 0:25:14.632 --> 0:25:16.232 the gymnast that's up in the air, 0:25:16.413 --> 0:25:17.294 fear of making an error. 0:25:17.433 --> 0:25:17.753 And then 0:25:18.213 --> 0:25:20.454 We also think about fear of 0:25:21.714 --> 0:25:23.935 a disease process, dementia. 0:25:23.996 --> 0:25:24.435 Oh my gosh, 0:25:24.455 --> 0:25:25.776 I forgot where I parked my car 0:25:25.855 --> 0:25:27.135 twice in the last month. 0:25:27.536 --> 0:25:28.537 So we think about fear of 0:25:28.817 --> 0:25:30.176 all these types of things, 0:25:30.217 --> 0:25:32.238 and that's a broad spectrum across six. 0:25:32.998 --> 0:25:34.357 The first part of your 0:25:34.438 --> 0:25:35.739 question should be answered 0:25:35.798 --> 0:25:36.499 as number one. 0:25:37.179 --> 0:25:38.660 Physical therapists need to 0:25:38.839 --> 0:25:39.980 improve their skills in 0:25:40.299 --> 0:25:42.260 recognizing fear and 0:25:42.280 --> 0:25:44.182 opening the discussion about fear. 0:25:44.281 --> 0:25:45.541 And it can be extremely 0:25:45.622 --> 0:25:47.823 simple as much as this. 0:25:48.083 --> 0:25:50.663 And it's in the realms of 0:25:50.723 --> 0:25:51.804 vicarious experiences. 0:25:52.124 --> 0:25:53.285 When I've worked with people... 0:25:54.265 --> 0:25:56.007 similar to you going through 0:25:56.047 --> 0:25:57.127 the same condition, 0:25:57.508 --> 0:25:58.888 they've expressed to me a 0:25:58.929 --> 0:26:01.270 degree of fear in terms of 0:26:01.310 --> 0:26:02.090 their mobility. 0:26:02.211 --> 0:26:04.512 Do you find yourself fearful 0:26:05.013 --> 0:26:06.275 as you move across your 0:26:06.315 --> 0:26:09.156 home and walk in comfortable places? 0:26:09.517 --> 0:26:11.058 And you could just start it like that. 0:26:11.219 --> 0:26:12.660 If we don't talk about fear, 0:26:13.200 --> 0:26:14.981 then it becomes the early 0:26:15.382 --> 0:26:16.041 1990s when we weren't 0:26:16.061 --> 0:26:17.282 supposed to talk about pain. 0:26:17.683 --> 0:26:19.384 And then all we did was talk about pain. 0:26:19.404 --> 0:26:20.286 And then people became 0:26:20.766 --> 0:26:20.865 Sure. 0:26:20.926 --> 0:26:21.106 Right. 0:26:32.901 --> 0:26:33.461 So, I mean, 0:26:33.561 --> 0:26:35.104 have you have you read Chris Voss? 0:26:35.243 --> 0:26:36.724 He was a former FBI. 0:26:37.165 --> 0:26:37.766 So, oh, 0:26:37.826 --> 0:26:39.347 so he was a former FBI hostage 0:26:39.387 --> 0:26:39.969 negotiator. 0:26:40.028 --> 0:26:40.950 And the amount of times I 0:26:40.990 --> 0:26:42.070 talk about him on my podcast, 0:26:42.090 --> 0:26:43.772 you would think he sponsors my show, 0:26:43.932 --> 0:26:44.493 but he doesn't. 0:26:44.753 --> 0:26:46.215 But I would take sponsorship from Chris. 0:26:46.715 --> 0:26:47.778 So he essentially said that 0:26:47.837 --> 0:26:48.438 the name of the book that 0:26:48.478 --> 0:26:49.338 he wrote was called Never 0:26:49.378 --> 0:26:50.099 Split the Difference. 0:26:50.421 --> 0:26:52.222 Negotiate like your life depends on it. 0:26:52.323 --> 0:26:53.763 I thought it was a book about negotiating, 0:26:53.784 --> 0:26:54.224 but it's not. 0:26:54.684 --> 0:26:55.506 It's about a lot of the 0:26:55.546 --> 0:26:56.346 things you're talking about. 0:26:56.366 --> 0:26:57.667 So what he'll say is the 0:26:57.708 --> 0:26:58.448 reason the book is called 0:26:58.488 --> 0:26:59.169 that is he's like, 0:26:59.189 --> 0:27:00.190 if I get called for a bank 0:27:00.250 --> 0:27:01.671 robbery and I'm on scene, I can't be like, 0:27:01.711 --> 0:27:02.751 hey, you have 10 hostages. 0:27:02.791 --> 0:27:04.772 Why don't you kill five and 0:27:04.813 --> 0:27:06.194 I'll take five and we'll call it a day. 0:27:06.234 --> 0:27:08.076 He's like, no, I can't do that. 0:27:08.135 --> 0:27:09.037 So neither should you. 0:27:09.596 --> 0:27:10.438 So what he'll talk about is 0:27:10.478 --> 0:27:11.939 things like tactical empathy. 0:27:12.058 --> 0:27:13.420 And you just displayed that, which is. 0:27:14.280 --> 0:27:15.241 It's, you know, 0:27:15.321 --> 0:27:17.005 I've worked with people just like you. 0:27:17.025 --> 0:27:19.788 I'm not I'm not accusing you of having. 0:27:19.948 --> 0:27:20.469 Exactly. 0:27:20.689 --> 0:27:22.991 I'm empathetic that this might be a thing. 0:27:23.011 --> 0:27:24.554 And I've opened the door for 0:27:24.594 --> 0:27:25.934 now them to walk through. 0:27:25.954 --> 0:27:26.916 Yeah, that's it. 0:27:27.257 --> 0:27:28.479 And his famous line or one 0:27:28.499 --> 0:27:30.000 of his lines is it sounds 0:27:30.039 --> 0:27:32.343 as if or it might be or comes across as. 0:27:33.064 --> 0:27:36.305 that you're reluctant to try this. 0:27:36.644 --> 0:27:37.884 And what that does is it 0:27:37.944 --> 0:27:38.704 leaves them an out. 0:27:39.005 --> 0:27:39.744 If you've ever been in an 0:27:39.904 --> 0:27:41.506 argument with a spouse or a friend, 0:27:41.766 --> 0:27:43.125 you got to leave them an out, right? 0:27:43.506 --> 0:27:44.665 Give them a chance to be like, well, 0:27:44.685 --> 0:27:45.826 that's actually not what I'm saying. 0:27:45.846 --> 0:27:46.905 You're trying to put me into 0:27:46.945 --> 0:27:47.987 a corner because when you 0:27:48.007 --> 0:27:48.866 put someone into a corner, 0:27:49.126 --> 0:27:50.826 they don't like it. 0:27:51.007 --> 0:27:51.926 Actually, no, that's not true. 0:27:52.027 --> 0:27:52.326 Okay, 0:27:52.446 --> 0:27:53.428 I'm just trying to figure out what 0:27:53.468 --> 0:27:53.907 that is. 0:27:54.288 --> 0:27:55.488 And it's amazing to listen 0:27:55.567 --> 0:27:57.228 to a hostage negotiator, 0:27:57.248 --> 0:27:58.969 why that would be valuable for clinicians, 0:27:59.409 --> 0:28:00.749 but it's terribly valuable 0:28:00.769 --> 0:28:01.048 for clinicians. 0:28:01.108 --> 0:28:02.289 Tactical empathy. 0:28:02.349 --> 0:28:03.191 I'm learning this. 0:28:03.290 --> 0:28:03.810 I love it. 0:28:04.172 --> 0:28:04.592 I love it. 0:28:04.672 --> 0:28:06.673 It sounds like an oxymoron. 0:28:06.733 --> 0:28:07.934 It's like tactical is very 0:28:08.494 --> 0:28:09.675 forward and aggressive and 0:28:09.796 --> 0:28:10.977 empathy is very heartfelt 0:28:11.096 --> 0:28:11.938 and compassionate. 0:28:12.198 --> 0:28:13.679 But he's like he's because 0:28:13.699 --> 0:28:14.940 he's like a lot of times I 0:28:15.099 --> 0:28:16.280 was just talking to a guy 0:28:16.340 --> 0:28:17.481 I've never met on the phone 0:28:17.582 --> 0:28:18.442 and they are having the 0:28:18.502 --> 0:28:19.983 worst day of their life right now. 0:28:20.464 --> 0:28:22.486 The FBI is outside and, you know, 0:28:22.506 --> 0:28:23.666 this isn't going to go well. 0:28:24.248 --> 0:28:25.828 So, you know, I could threaten them. 0:28:25.909 --> 0:28:26.829 But what's that going to do? 0:28:27.170 --> 0:28:28.089 Yeah, exactly. 0:28:28.410 --> 0:28:29.290 I need to understand. 0:28:29.310 --> 0:28:30.070 I'm also not going to give 0:28:30.090 --> 0:28:31.471 you a helicopter and $10 million. 0:28:31.510 --> 0:28:32.251 It's not happening. 0:28:32.271 --> 0:28:34.833 I'm sorry. 0:28:34.873 --> 0:28:35.992 I need to make a connection 0:28:36.813 --> 0:28:38.013 to figure out what makes 0:28:38.034 --> 0:28:39.733 this guy tick so I can try 0:28:39.753 --> 0:28:42.154 to help them make their own 0:28:42.214 --> 0:28:43.474 decision to walk out the 0:28:43.536 --> 0:28:45.135 front door with their hands in the air. 0:28:45.296 --> 0:28:46.817 And that is every chapter. 0:28:46.896 --> 0:28:47.836 Also, it's just a well-written book. 0:28:47.936 --> 0:28:49.076 Every chapter is like a 0:28:49.156 --> 0:28:51.377 story about a bank robbery or whatever. 0:28:51.637 --> 0:28:52.679 And then boom, how do I, 0:28:52.818 --> 0:28:53.778 what did I take from that 0:28:53.818 --> 0:28:54.578 that you can take? 0:28:54.618 --> 0:28:55.278 And it's a lesson. 0:28:55.318 --> 0:28:56.480 So it was really real well-written. 0:28:57.155 --> 0:28:57.695 I love that. 0:28:57.756 --> 0:28:59.217 I'm going to definitely look that up. 0:28:59.237 --> 0:29:02.179 You said Chris Voss, because I'll tell you, 0:29:02.618 --> 0:29:03.700 earlier this morning, 0:29:03.720 --> 0:29:05.840 I had to go through one of 0:29:05.881 --> 0:29:07.521 those mandatory educational 0:29:07.561 --> 0:29:08.582 things that we all have to 0:29:08.622 --> 0:29:09.803 do for our employers. 0:29:10.199 --> 0:29:11.940 And I had to go take a class 0:29:12.019 --> 0:29:14.180 that was online on 0:29:14.700 --> 0:29:16.181 basically de-escalation, 0:29:16.240 --> 0:29:17.701 workplace violence, and et cetera. 0:29:18.101 --> 0:29:18.862 We were just talking about 0:29:18.902 --> 0:29:19.942 the same exact thing. 0:29:20.422 --> 0:29:22.843 And you think about this in a burgeoning, 0:29:23.022 --> 0:29:24.482 developing relationship 0:29:24.522 --> 0:29:26.243 with me and a person that I 0:29:26.423 --> 0:29:28.284 am committed to rehabilitate. 0:29:28.604 --> 0:29:30.565 I want to demonstrate that. 0:29:30.865 --> 0:29:32.626 things that bring them into 0:29:32.646 --> 0:29:34.847 the relationship, I feel like I'm here. 0:29:34.887 --> 0:29:35.749 And so all those 0:29:35.868 --> 0:29:37.009 motivational interviewing 0:29:37.049 --> 0:29:38.451 and active listening things 0:29:39.051 --> 0:29:40.432 placed into an environment 0:29:40.472 --> 0:29:42.273 of awkwardness of, I don't know, 0:29:42.314 --> 0:29:42.974 is this person, 0:29:43.234 --> 0:29:44.316 do they know what they're doing? 0:29:44.375 --> 0:29:45.557 Are they going to be able to help me? 0:29:45.896 --> 0:29:47.097 I'm looking for a reason to 0:29:47.117 --> 0:29:48.699 either engage or to bail. 0:29:48.960 --> 0:29:50.320 Do I want to schedule more visits? 0:29:50.540 --> 0:29:51.260 And you want to give them 0:29:51.361 --> 0:29:52.602 every opportunity to say, 0:29:52.622 --> 0:29:54.824 I feel like I see you. 0:29:55.163 --> 0:29:55.825 Is this right? 0:29:55.924 --> 0:29:57.326 Am I seeing you correctly? 0:29:58.487 --> 0:29:58.807 And, you know, 0:29:58.866 --> 0:30:00.167 and then the other part of your question, 0:30:00.188 --> 0:30:01.208 we talk about fear. 0:30:02.628 --> 0:30:03.769 We have a lot of science 0:30:03.828 --> 0:30:06.390 with how to combat fear now, 0:30:06.890 --> 0:30:08.671 and it's not through ignoring things. 0:30:08.730 --> 0:30:08.990 Right. 0:30:09.651 --> 0:30:11.872 So our science for combating 0:30:11.912 --> 0:30:16.993 fear now largely comes into acceptance, 0:30:17.074 --> 0:30:19.474 commitment therapy and habituation. 0:30:19.855 --> 0:30:21.715 And you could call it exposure therapy, 0:30:22.175 --> 0:30:23.375 whatever you want to call it. 0:30:23.516 --> 0:30:25.116 But we in rehabilitation, 0:30:25.176 --> 0:30:27.238 we know it best as habituation. 0:30:28.038 --> 0:30:29.539 Successive approximation, 0:30:29.819 --> 0:30:32.804 small stimuli of that same 0:30:33.505 --> 0:30:37.250 threatening environment, situation, 0:30:37.710 --> 0:30:38.971 person, or condition, 0:30:39.393 --> 0:30:40.834 small stimuli that don't 0:30:40.913 --> 0:30:43.037 actually provoke me are 0:30:43.076 --> 0:30:44.358 healthy so that I can 0:30:44.538 --> 0:30:45.840 normalize my response. 0:30:46.925 --> 0:30:47.026 Yeah, 0:30:47.046 --> 0:30:48.967 you mentioned fear of falling being 0:30:49.167 --> 0:30:50.288 probably one of the most prominent, 0:30:50.307 --> 0:30:50.969 especially with older 0:30:51.028 --> 0:30:52.769 adults in the stuff in the 0:30:52.809 --> 0:30:53.611 work that I do. 0:30:53.990 --> 0:30:56.471 It's often feared more than death. 0:30:56.573 --> 0:30:57.633 That's public speaking. 0:30:58.314 --> 0:30:59.634 And I heard someone sort of 0:30:59.674 --> 0:31:00.474 reframe because a lot of 0:31:00.515 --> 0:31:01.455 times I'm standing there in 0:31:01.496 --> 0:31:02.395 the wings with someone 0:31:02.415 --> 0:31:03.497 who's about to go on stage. 0:31:03.737 --> 0:31:04.298 They do not. 0:31:04.798 --> 0:31:06.058 They want to have spoken. 0:31:06.098 --> 0:31:06.818 They don't want to speak. 0:31:07.038 --> 0:31:07.980 They want to be done. 0:31:08.380 --> 0:31:09.099 So then what do we do? 0:31:09.141 --> 0:31:10.080 We rush through it. 0:31:10.201 --> 0:31:10.800 We sweat. 0:31:10.840 --> 0:31:12.402 We get all the physiologic responses. 0:31:12.803 --> 0:31:14.143 And I heard someone recently 0:31:14.163 --> 0:31:15.804 and it changed how I sort 0:31:15.864 --> 0:31:18.665 of prepare people for this, which is, hey, 0:31:18.685 --> 0:31:19.246 are you nervous? 0:31:19.286 --> 0:31:21.307 Like, again, never mentioned pain, 0:31:21.346 --> 0:31:22.147 never mentioned nerves. 0:31:22.307 --> 0:31:23.028 But now we're like, 0:31:23.429 --> 0:31:24.568 are you feeling nerves? 0:31:24.608 --> 0:31:25.349 You feel anxiety? 0:31:26.029 --> 0:31:27.030 Yeah, I am. 0:31:27.291 --> 0:31:28.854 And a lot of times, again, 0:31:28.913 --> 0:31:30.015 the worst advice to give 0:31:30.035 --> 0:31:31.376 someone in a stressful situation is, hey, 0:31:31.416 --> 0:31:31.778 relax. 0:31:32.317 --> 0:31:33.098 Yeah, just ignore it. 0:31:33.400 --> 0:31:34.059 Does that ever work? 0:31:34.181 --> 0:31:35.923 Suppress it. 0:31:36.042 --> 0:31:37.644 What I heard this person say is, listen, 0:31:38.346 --> 0:31:39.446 you're feeling anxiety, 0:31:39.467 --> 0:31:40.308 and I understand why. 0:31:40.568 --> 0:31:42.530 This is an abnormal situation, right? 0:31:43.291 --> 0:31:44.913 um you wouldn't be feeling 0:31:44.952 --> 0:31:46.013 anxiety unless unless you 0:31:46.054 --> 0:31:46.993 kind of cared about how 0:31:47.013 --> 0:31:47.894 you're going to perform out 0:31:47.934 --> 0:31:49.315 there so that's great so I 0:31:49.355 --> 0:31:50.476 like where this anxiety is 0:31:50.516 --> 0:31:51.797 coming from and they said 0:31:51.836 --> 0:31:52.876 to try to treat it like 0:31:52.997 --> 0:31:54.718 judo and judo is famous for 0:31:54.738 --> 0:31:56.058 like I'm not gonna I'm 0:31:56.078 --> 0:31:57.099 gonna use your energy 0:31:57.160 --> 0:31:58.941 against you right I'm gonna 0:31:58.980 --> 0:31:59.740 do I'm gonna do like the 0:31:59.780 --> 0:32:00.561 miyagi I'm just gonna do a 0:32:00.582 --> 0:32:01.761 couple moves and your 0:32:01.842 --> 0:32:02.762 energy is actually gonna be 0:32:02.883 --> 0:32:04.344 countered and they said 0:32:04.604 --> 0:32:05.584 take I don't want you to 0:32:05.624 --> 0:32:06.204 try to get rid of that 0:32:06.244 --> 0:32:07.325 energy that nervous injury 0:32:07.345 --> 0:32:07.925 because it's probably not 0:32:07.945 --> 0:32:08.486 gonna work anyway 0:32:08.905 --> 0:32:09.105 Yeah. 0:32:09.445 --> 0:32:10.886 So I want you to use it. 0:32:11.347 --> 0:32:12.709 So I want you to go up there 0:32:12.749 --> 0:32:14.029 and I want you to use that energy, 0:32:14.069 --> 0:32:16.911 but see if you can control it like judo. 0:32:17.031 --> 0:32:18.432 And that sort of like, you know, hey, 0:32:18.451 --> 0:32:19.272 can we use this? 0:32:19.732 --> 0:32:20.913 Can we use this fear? 0:32:21.273 --> 0:32:21.994 You're paying attention. 0:32:22.015 --> 0:32:22.755 This is a big deal, 0:32:22.775 --> 0:32:23.935 but that's why we're here today. 0:32:23.976 --> 0:32:25.416 We're here for this and 0:32:25.436 --> 0:32:26.758 we're leading into it. 0:32:27.278 --> 0:32:28.358 So it's not just, hey, 0:32:28.378 --> 0:32:30.140 we talk about it and these words heal. 0:32:30.180 --> 0:32:31.020 That's not what we're saying. 0:32:31.040 --> 0:32:32.021 We're saying that this is 0:32:32.082 --> 0:32:33.162 part of the process, 0:32:33.221 --> 0:32:34.103 part of the larger process. 0:32:34.242 --> 0:32:34.403 Yeah. 0:32:34.682 --> 0:32:35.683 And what you did there is 0:32:35.703 --> 0:32:37.424 you normalize it is that's A, 0:32:39.145 --> 0:32:40.547 and experience that most 0:32:40.626 --> 0:32:41.988 people for their first time 0:32:42.229 --> 0:32:43.430 as they're a novice in 0:32:43.509 --> 0:32:45.171 speaking in public should 0:32:45.211 --> 0:32:46.471 experience that's great and 0:32:46.811 --> 0:32:48.292 then b you leveraged it and 0:32:48.353 --> 0:32:49.473 I love that that's that's 0:32:49.493 --> 0:32:50.914 great I get anxious because 0:32:50.954 --> 0:32:51.796 I'm worried about the 0:32:51.836 --> 0:32:52.477 performance I'm like 0:32:52.817 --> 0:32:53.537 especially I'm like shoot 0:32:53.557 --> 0:32:54.178 I'm supposed to be good at 0:32:54.218 --> 0:32:55.298 this I'm supposed to get on 0:32:55.358 --> 0:32:56.219 stage be really great at 0:32:56.259 --> 0:32:57.861 this now if I screw up what 0:32:57.881 --> 0:32:58.520 does that say about what 0:32:58.540 --> 0:32:59.442 kind of person it's because 0:32:59.481 --> 0:33:00.702 it's tied to your identity 0:33:00.823 --> 0:33:02.044 right because a lot of 0:33:02.064 --> 0:33:02.904 times I was coaching up 0:33:02.964 --> 0:33:04.726 scientists or researchers 0:33:04.746 --> 0:33:05.787 and it was like hey you 0:33:05.906 --> 0:33:07.448 just did the work like they 0:33:07.488 --> 0:33:08.528 want to hear from you and 0:33:08.949 --> 0:33:10.329 But I'm good at the work, 0:33:10.451 --> 0:33:11.431 not good at the speaking. 0:33:11.531 --> 0:33:13.512 All right, well, let's tailor your talk. 0:33:13.814 --> 0:33:14.855 This is why I need you to 0:33:14.875 --> 0:33:16.316 call me a month before your talk, 0:33:16.355 --> 0:33:17.978 not 10 minutes before your talk. 0:33:18.278 --> 0:33:19.058 Let's tailor your talk 0:33:19.098 --> 0:33:20.460 around what you're excited to talk about. 0:33:20.500 --> 0:33:22.662 Let's put that at the top of the queue. 0:33:22.682 --> 0:33:24.923 And then before you even 0:33:25.144 --> 0:33:26.525 notice that you're nervous up there, 0:33:26.545 --> 0:33:27.705 you'll be talking about 0:33:27.767 --> 0:33:28.948 things you like talking about. 0:33:29.067 --> 0:33:30.288 And that's why people are in the audience. 0:33:30.689 --> 0:33:33.589 You do such a nice job of helping people, 0:33:34.351 --> 0:33:34.611 you know, 0:33:35.010 --> 0:33:37.291 speak passionately without feeling, 0:33:37.852 --> 0:33:39.252 you know, I guess, 0:33:39.333 --> 0:33:40.854 frightened about the setting, 0:33:40.894 --> 0:33:43.414 the environment and the audience, etc. 0:33:43.734 --> 0:33:44.536 I want to know behind the 0:33:44.576 --> 0:33:45.435 scenes because I've never 0:33:45.455 --> 0:33:46.355 done one of these. 0:33:46.395 --> 0:33:47.616 These are one of my this is 0:33:47.656 --> 0:33:49.877 on my bucket list, which is a TED talk. 0:33:49.938 --> 0:33:51.019 You did TED talk and I'll 0:33:51.058 --> 0:33:52.358 put the link to that in the show note. 0:33:52.378 --> 0:33:53.559 Like how did it come about? 0:33:53.660 --> 0:33:55.000 How they I'm interested in 0:33:55.019 --> 0:33:57.141 the prep process because 0:33:57.181 --> 0:33:58.201 I'll tell people all the time. 0:33:59.660 --> 0:34:01.280 you're going to go give a 90 0:34:01.280 --> 0:34:02.702 minute presentation at CSM 0:34:02.742 --> 0:34:03.963 and you're putting a couple 0:34:04.003 --> 0:34:05.184 hours of preparation into it. 0:34:05.224 --> 0:34:06.244 I'm like, I got news for you. 0:34:06.786 --> 0:34:07.646 Ted talks are typically, 0:34:07.686 --> 0:34:09.628 I think 17 minutes or that. 0:34:09.907 --> 0:34:11.269 And you have a clock ticking 0:34:11.289 --> 0:34:11.849 in front of you. 0:34:11.889 --> 0:34:12.490 Yes, you do. 0:34:12.570 --> 0:34:12.731 Right. 0:34:13.590 --> 0:34:14.052 And then I'm like, 0:34:14.192 --> 0:34:15.132 and you're going to wing it, 0:34:15.172 --> 0:34:16.213 but this person's doing a 0:34:16.514 --> 0:34:19.456 hot skilled 17 minutes and 0:34:19.476 --> 0:34:20.956 they've likely put months into it. 0:34:21.016 --> 0:34:23.159 So curtain, how'd this work? 0:34:23.599 --> 0:34:23.820 Yeah. 0:34:24.239 --> 0:34:25.201 So, um, 0:34:28.023 --> 0:34:29.264 I was able to engage in a 0:34:29.324 --> 0:34:30.724 TED Talk that was hosted at 0:34:30.764 --> 0:34:31.686 my own hometown. 0:34:31.746 --> 0:34:32.487 So that was good. 0:34:32.547 --> 0:34:33.047 That's easy. 0:34:33.086 --> 0:34:34.407 I don't have to travel, etc. 0:34:35.048 --> 0:34:36.130 I knew, I think, 0:34:36.369 --> 0:34:38.010 six months in advance that 0:34:38.132 --> 0:34:39.793 my talk was going to be accepted. 0:34:39.893 --> 0:34:42.295 So you make an application 0:34:42.394 --> 0:34:43.175 and you're accepted. 0:34:43.635 --> 0:34:44.476 And largely, 0:34:44.536 --> 0:34:45.958 there's some luck to do with that. 0:34:46.077 --> 0:34:47.719 But if your theme is 0:34:48.179 --> 0:34:48.978 commensurate with the 0:34:49.039 --> 0:34:51.260 larger theme of that TED Talk, 0:34:51.320 --> 0:34:52.581 that's going to be helpful as well. 0:34:53.262 --> 0:34:54.282 Once you get accepted, 0:34:54.362 --> 0:34:56.903 then at least my experience 0:34:57.023 --> 0:34:58.925 is you are given an 0:34:58.965 --> 0:35:00.626 opportunity to work with the coaches, 0:35:00.706 --> 0:35:01.726 which are the producers and 0:35:01.746 --> 0:35:02.788 the hosts of the TED Talk. 0:35:03.387 --> 0:35:05.610 And so you actually formulate your talk. 0:35:05.670 --> 0:35:07.994 You come in, present it in front of them. 0:35:08.114 --> 0:35:09.235 They've got all the cameras 0:35:09.315 --> 0:35:10.117 out there and they're 0:35:10.177 --> 0:35:11.179 sitting as though they're 0:35:11.219 --> 0:35:12.360 all in their director's chairs, 0:35:12.400 --> 0:35:12.900 et cetera. 0:35:13.402 --> 0:35:14.403 And they're putting you on 0:35:14.443 --> 0:35:16.425 the spot to see how you do 0:35:16.505 --> 0:35:18.730 in the quasi environment. 0:35:19.530 --> 0:35:20.429 And then they give you 0:35:20.469 --> 0:35:21.811 direct feedback right there. 0:35:21.871 --> 0:35:23.371 And then you come back and do it again. 0:35:23.530 --> 0:35:24.992 And then you come back and do it again. 0:35:25.472 --> 0:35:27.291 And it shapes itself up nicely. 0:35:27.572 --> 0:35:29.313 You get the automaticity to it. 0:35:29.652 --> 0:35:31.134 You have enough repetitions. 0:35:31.253 --> 0:35:32.773 You have comfort with the stage. 0:35:33.273 --> 0:35:35.094 All of that is, you know, 0:35:35.215 --> 0:35:36.255 but at that point, 0:35:36.275 --> 0:35:37.856 when I gave that talk in 2020, 0:35:37.856 --> 0:35:39.275 I had already been talking 0:35:39.675 --> 0:35:42.016 professionally since 1994. 0:35:42.016 --> 0:35:42.876 So I don't want to say it 0:35:43.016 --> 0:35:44.438 ever sounds easy because 0:35:44.478 --> 0:35:45.498 it's a different stage. 0:35:46.117 --> 0:35:47.159 But I'll say two things. 0:35:47.199 --> 0:35:47.719 Number one, 0:35:47.739 --> 0:35:50.182 I had 26 years experience going in. 0:35:50.302 --> 0:35:51.043 That's great. 0:35:51.483 --> 0:35:52.364 But number two, 0:35:53.226 --> 0:35:53.786 the quote is 0:35:53.887 --> 0:35:56.128 misappropriated to Abraham 0:35:56.208 --> 0:35:58.751 Lincoln most frequently and 0:35:58.791 --> 0:35:59.612 to many others. 0:35:59.853 --> 0:36:00.893 It's, you know, 0:36:01.355 --> 0:36:03.097 give me a day to talk about 0:36:03.197 --> 0:36:05.018 something and I'm ready right now. 0:36:06.231 --> 0:36:06.632 OK, 0:36:07.132 --> 0:36:09.655 give me an hour to talk about something 0:36:09.695 --> 0:36:10.976 and I need two hours to prepare. 0:36:11.436 --> 0:36:12.996 Give me 15 minutes to talk 0:36:13.036 --> 0:36:14.297 about something and I need 0:36:14.318 --> 0:36:15.219 a day to prepare. 0:36:15.239 --> 0:36:17.519 You know, and, you know, 0:36:17.559 --> 0:36:18.501 that's that's the whole 0:36:18.561 --> 0:36:19.922 thing is that you're going 0:36:19.942 --> 0:36:21.983 to talk impromptu, unstructured. 0:36:22.264 --> 0:36:23.405 You got all the time in the world. 0:36:23.445 --> 0:36:24.144 That's one thing. 0:36:24.465 --> 0:36:25.746 But literally, Jimmy, 0:36:25.865 --> 0:36:28.068 I probably put 25 hours of practice. 0:36:29.855 --> 0:36:31.394 into practicing that speech 0:36:31.514 --> 0:36:32.856 for 15 minutes I'm 0:36:32.896 --> 0:36:35.315 satisfied with it um but 0:36:35.376 --> 0:36:36.356 I'll always look for rooms 0:36:36.376 --> 0:36:37.916 for improvement yeah I 0:36:37.956 --> 0:36:38.936 don't doubt it and and 0:36:39.137 --> 0:36:40.577 that's the funny part is 0:36:41.197 --> 0:36:42.536 people will get a 90 minute 0:36:42.556 --> 0:36:43.858 block at csm and I'm not 0:36:43.878 --> 0:36:44.737 knocking our profession 0:36:44.757 --> 0:36:45.878 this is this is everywhere 0:36:46.257 --> 0:36:47.577 and the funny part is and 0:36:47.597 --> 0:36:48.798 this is what I i like I 0:36:48.818 --> 0:36:49.878 want to grab the person 0:36:49.898 --> 0:36:50.798 whoever the people are that 0:36:50.838 --> 0:36:52.318 design csm I'm like I need 0:36:52.318 --> 0:36:53.360 15 minutes to tell you why 0:36:53.400 --> 0:36:53.940 I think you're doing it 0:36:53.980 --> 0:36:54.860 backwards here's why 0:36:55.820 --> 0:36:57.021 So in radio, 0:36:58.240 --> 0:36:59.501 when FM was a little stronger 0:36:59.541 --> 0:37:00.983 than podcasting now, right? 0:37:01.884 --> 0:37:03.023 The morning show led the 0:37:03.043 --> 0:37:04.664 radio station because they 0:37:04.684 --> 0:37:05.505 do more of the talking. 0:37:05.545 --> 0:37:06.385 They knew the audience was a 0:37:06.405 --> 0:37:07.327 little more hyper-focused 0:37:07.367 --> 0:37:08.507 in terms of a larger audience. 0:37:08.967 --> 0:37:12.088 So if you are a budding radio guy like me, 0:37:12.349 --> 0:37:13.389 you want to get some 0:37:13.489 --> 0:37:14.670 minutes on the morning show. 0:37:14.690 --> 0:37:16.291 You want to get some exposure, right? 0:37:17.152 --> 0:37:19.032 So instead of me just saying, hey, 0:37:19.172 --> 0:37:20.693 I've got a great bit, Mike. 0:37:20.733 --> 0:37:22.275 You're the morning show host, right? 0:37:22.903 --> 0:37:23.943 And you go, all right, Jimmy, 0:37:24.324 --> 0:37:25.445 come in tomorrow at 7.30. 0:37:25.445 --> 0:37:26.465 That doesn't happen. 0:37:26.925 --> 0:37:27.266 No way. 0:37:27.286 --> 0:37:28.126 Because Mike is like, 0:37:28.146 --> 0:37:29.666 the reason my show is great 0:37:29.746 --> 0:37:31.608 is because I have these 0:37:32.248 --> 0:37:34.509 hurdles that I want the best to show up. 0:37:34.548 --> 0:37:35.228 If you've got something. 0:37:35.248 --> 0:37:36.389 So you're in the hallway. 0:37:36.409 --> 0:37:37.050 You're like, pitch. 0:37:37.650 --> 0:37:39.670 And I'm like, hey, Taylor Swift, 0:37:39.690 --> 0:37:40.990 Travis Kelsey, something just happened. 0:37:41.010 --> 0:37:41.572 Here's the thing. 0:37:41.592 --> 0:37:43.371 And here's what I want to do. 0:37:43.731 --> 0:37:44.773 I need 15 minutes. 0:37:44.992 --> 0:37:45.472 I pitched. 0:37:45.492 --> 0:37:46.474 I told you how much I need. 0:37:46.934 --> 0:37:47.094 Mm-mm. 0:37:47.914 --> 0:37:48.454 I pitch. 0:37:48.855 --> 0:37:49.835 You're doing the math in 0:37:49.876 --> 0:37:50.956 your head because you know 0:37:50.996 --> 0:37:52.117 the audience so well. 0:37:52.157 --> 0:37:52.478 You're like, 0:37:52.777 --> 0:37:54.139 I can give you three minutes for that. 0:37:54.639 --> 0:37:55.880 That's exactly right. 0:37:56.219 --> 0:37:57.742 You're pitching to Lorne Michaels. 0:37:58.161 --> 0:37:59.083 Do you think you're telling 0:37:59.163 --> 0:38:00.664 Lorne that you need 12 minutes? 0:38:00.864 --> 0:38:01.364 Not a chance. 0:38:01.423 --> 0:38:03.646 You are pitching because 0:38:04.226 --> 0:38:06.288 time is the currency. 0:38:06.748 --> 0:38:07.007 Yeah. 0:38:07.108 --> 0:38:08.489 And you're saying that is good. 0:38:08.789 --> 0:38:09.150 That's not 20. 0:38:09.489 --> 0:38:10.411 That's not 90 minutes. 0:38:10.451 --> 0:38:10.630 Good. 0:38:11.010 --> 0:38:12.331 That's 12 minutes. 0:38:12.632 --> 0:38:13.914 So it amazes me. 0:38:14.514 --> 0:38:16.195 when we apply for these things, 0:38:16.215 --> 0:38:16.855 and I understand there's a 0:38:16.914 --> 0:38:18.436 logistical element to it, right? 0:38:18.456 --> 0:38:20.336 We want to fit as many things in. 0:38:20.458 --> 0:38:20.978 My way, though, 0:38:20.998 --> 0:38:21.757 would actually give more 0:38:21.818 --> 0:38:22.639 people an opportunity to 0:38:22.679 --> 0:38:23.478 talk at the same amount of time. 0:38:23.498 --> 0:38:24.079 I think you're right. 0:38:24.260 --> 0:38:24.539 Yeah. 0:38:24.780 --> 0:38:25.099 Which is, 0:38:25.561 --> 0:38:26.481 what do you... Because I've done 0:38:26.521 --> 0:38:28.121 presentations where I've submitted, hey, 0:38:28.161 --> 0:38:31.003 I want to talk at your event. 0:38:31.423 --> 0:38:32.184 And they've gone, great, 0:38:32.244 --> 0:38:33.465 you got 90 minutes. 0:38:33.505 --> 0:38:34.346 And I'm like, I can't... 0:38:35.222 --> 0:38:36.782 without stretching this so 0:38:36.862 --> 0:38:38.744 far that I break this rubber band, 0:38:38.903 --> 0:38:40.143 I can't make this 90 minutes. 0:38:40.443 --> 0:38:40.684 Yeah. 0:38:41.005 --> 0:38:42.605 It's just, I'll just be repeating. 0:38:42.784 --> 0:38:44.706 I would be going in circles 0:38:44.885 --> 0:38:46.507 after minute 42. 0:38:46.507 --> 0:38:47.467 So I'm like, I need, 0:38:47.947 --> 0:38:49.668 I need 32 minutes to do this. 0:38:49.829 --> 0:38:51.028 And then I can do 15 minutes 0:38:51.588 --> 0:38:54.110 of Q and a maybe, but they're like, 0:38:54.170 --> 0:38:56.251 you have to fill 90 and it just blows. 0:38:56.391 --> 0:38:57.532 It breaks my heart. 0:38:57.552 --> 0:38:57.831 Cause I'm like, 0:38:58.052 --> 0:39:00.552 give someone else the microphone. 0:39:00.733 --> 0:39:01.333 I don't need 90. 0:39:02.204 --> 0:39:03.405 Yeah, that's so good. 0:39:03.885 --> 0:39:04.547 And so I'm going to 0:39:04.606 --> 0:39:08.208 timestamp this as December 0:39:08.228 --> 0:39:11.351 14th of 2023 when I'm 0:39:11.431 --> 0:39:12.552 hearing you for the first 0:39:12.612 --> 0:39:15.934 time make this pivot of how we do CSM. 0:39:16.233 --> 0:39:17.155 And I'm just going to watch 0:39:17.215 --> 0:39:18.556 to see what year it 0:39:18.655 --> 0:39:19.956 actually becomes your model. 0:39:20.056 --> 0:39:20.757 I love that. 0:39:20.998 --> 0:39:23.498 I've spoken so many years at CSM, 0:39:23.778 --> 0:39:25.420 and I really like your 0:39:25.481 --> 0:39:26.201 effort there because I 0:39:26.221 --> 0:39:26.721 think you're right. 0:39:27.001 --> 0:39:29.543 We could get a lot more programming in. 0:39:29.563 --> 0:39:31.023 Same time, same cost. 0:39:31.405 --> 0:39:31.965 Oh, that's good. 0:39:32.324 --> 0:39:32.905 But it's also, 0:39:32.985 --> 0:39:34.746 are you familiar with Parkinson's law? 0:39:35.927 --> 0:39:36.728 Parkinson's law? 0:39:36.748 --> 0:39:37.108 I'm not. 0:39:37.208 --> 0:39:37.409 Wow. 0:39:37.789 --> 0:39:38.010 Okay. 0:39:38.090 --> 0:39:40.512 Parkinson's law is the time 0:39:40.552 --> 0:39:42.112 it takes to complete a task 0:39:42.233 --> 0:39:43.695 will expand or contract 0:39:43.894 --> 0:39:44.815 based on the amount of time 0:39:44.835 --> 0:39:46.137 you're given to complete the task. 0:39:46.217 --> 0:39:47.036 So it's like you tell your 0:39:47.077 --> 0:39:49.398 kid you got a week to clean your room. 0:39:49.840 --> 0:39:51.581 They get done on day six, hour 23. 0:39:51.621 --> 0:39:53.822 But if you say you don't 0:39:53.862 --> 0:39:55.664 clean that room in the next 24 hours, 0:39:55.885 --> 0:39:56.704 you got 24 hours. 0:39:57.025 --> 0:39:58.947 They get it done in 23 and a half hours. 0:39:59.086 --> 0:39:59.307 Yeah. 0:39:59.387 --> 0:40:00.469 And that goes along with like, 0:40:01.248 --> 0:40:03.108 If you give me six months to write a talk, 0:40:03.208 --> 0:40:04.349 I'll do it in the last week. 0:40:04.550 --> 0:40:04.730 I mean, 0:40:04.769 --> 0:40:06.269 how many times do you go to CSM and 0:40:06.289 --> 0:40:07.190 someone says, well, 0:40:07.210 --> 0:40:07.891 I was putting my slides 0:40:07.931 --> 0:40:08.811 together on the plane. 0:40:09.030 --> 0:40:09.690 And that's cute. 0:40:10.010 --> 0:40:11.911 The first hundred times you hear it. 0:40:12.652 --> 0:40:13.871 Dude, I paid to come here. 0:40:14.072 --> 0:40:15.771 Like a lot of fun and effort. 0:40:15.871 --> 0:40:17.293 I'm hanging on your words. 0:40:17.733 --> 0:40:20.193 So my talk, not to pitch, 0:40:20.353 --> 0:40:21.032 I didn't think I was going 0:40:21.052 --> 0:40:21.653 to pitch my talk, 0:40:21.673 --> 0:40:23.954 but I'm in the Academy of Science, 0:40:24.554 --> 0:40:26.394 or sorry, Education and Research. 0:40:27.215 --> 0:40:27.394 Hang on. 0:40:27.974 --> 0:40:28.394 research. 0:40:28.474 --> 0:40:29.396 I just gave like several. 0:40:29.416 --> 0:40:29.615 All right. 0:40:29.715 --> 0:40:30.255 I'm in research. 0:40:30.335 --> 0:40:31.916 I'm with Sheila Schindler Ivins, 0:40:32.137 --> 0:40:32.898 who is a researcher. 0:40:33.338 --> 0:40:33.737 Yeah. 0:40:33.978 --> 0:40:34.378 She's like, 0:40:34.559 --> 0:40:35.898 I think you should come talk here. 0:40:35.998 --> 0:40:36.619 And I'm like, Sheila, 0:40:36.639 --> 0:40:37.340 walk me through this. 0:40:37.380 --> 0:40:37.760 And she's like, 0:40:37.780 --> 0:40:39.181 you have people who know stuff. 0:40:39.800 --> 0:40:40.541 I go, okay. 0:40:40.942 --> 0:40:41.362 And she goes, 0:40:41.641 --> 0:40:42.963 but they don't have the skill. 0:40:43.543 --> 0:40:44.764 It's not their primary skill 0:40:45.023 --> 0:40:48.005 to explain the stuff everywhere. 0:40:48.585 --> 0:40:50.407 So you do all this work, 0:40:50.626 --> 0:40:51.768 you get published. 0:40:51.788 --> 0:40:52.447 Yeah. 0:40:52.728 --> 0:40:54.068 And that's your end zone? 0:40:54.108 --> 0:40:54.728 You're done? 0:40:54.768 --> 0:40:55.608 And then you just go back 0:40:55.648 --> 0:40:57.150 and receive another kickoff, right? 0:40:57.489 --> 0:40:57.889 No. 0:40:58.130 --> 0:40:58.451 Yes. 0:40:58.510 --> 0:40:59.871 You've hit the end zone, 0:40:59.911 --> 0:41:01.831 and now it's time to kick the extra point, 0:41:01.851 --> 0:41:04.012 which is how do I kick this extra point, 0:41:04.072 --> 0:41:06.034 which is the knowledge into the stands. 0:41:06.554 --> 0:41:07.755 But if you're not given the tools, 0:41:07.795 --> 0:41:09.034 the training, and time to do it, 0:41:09.175 --> 0:41:09.876 how can we fault 0:41:09.936 --> 0:41:11.556 researchers for not doing it? 0:41:11.596 --> 0:41:12.516 Of course they're not going to do it. 0:41:12.536 --> 0:41:13.597 They don't have the tools or any time. 0:41:14.038 --> 0:41:14.938 So I'm going to go teach 0:41:14.978 --> 0:41:16.679 people in however long I have, 0:41:16.699 --> 0:41:17.418 because Sheila said, well, 0:41:17.438 --> 0:41:18.119 how long do you need? 0:41:18.159 --> 0:41:18.920 I was like, I don't know. 0:41:18.960 --> 0:41:20.239 You haven't given me my task yet. 0:41:20.340 --> 0:41:21.541 I don't know the audience well enough. 0:41:22.070 --> 0:41:22.971 So I want her to keep 0:41:23.030 --> 0:41:25.432 pushing me between now and CSM. 0:41:26.373 --> 0:41:27.273 What do they actually care about? 0:41:27.353 --> 0:41:28.634 I can go pontificate on 0:41:28.773 --> 0:41:30.215 communication theory, yada, yada. 0:41:30.235 --> 0:41:31.394 But if that's going to fall on deaf ears, 0:41:31.414 --> 0:41:32.275 I don't want to say it. 0:41:32.896 --> 0:41:34.416 So we're working together to 0:41:34.496 --> 0:41:36.577 satisfy her because she's a researcher. 0:41:36.657 --> 0:41:37.797 And then I'll say, okay, 0:41:37.998 --> 0:41:39.318 you're the middle of my bell curve. 0:41:39.358 --> 0:41:41.780 If I satisfy you, I'll satisfy as many, 0:41:41.800 --> 0:41:43.581 you know, however many I can. 0:41:44.221 --> 0:41:45.422 And if I recall correctly, 0:41:45.461 --> 0:41:46.742 she's at a University of Wisconsin, 0:41:46.782 --> 0:41:47.021 right? 0:41:47.041 --> 0:41:47.943 I believe so. 0:41:48.567 --> 0:41:48.786 Yeah. 0:41:49.206 --> 0:41:50.788 So she already does a great 0:41:50.847 --> 0:41:52.028 job translating because I'm 0:41:52.108 --> 0:41:53.228 pretty certain that I get 0:41:53.329 --> 0:41:55.909 an occasional newsletter from her. 0:41:56.351 --> 0:41:57.471 She does a great job with that. 0:41:57.710 --> 0:41:58.572 And I think that'll be 0:41:58.632 --> 0:41:59.871 exceptional that you'll be 0:41:59.931 --> 0:42:02.333 able to compliment that so nicely. 0:42:02.574 --> 0:42:03.193 I'll look forward to 0:42:03.253 --> 0:42:06.335 attending that if I have the opportunity. 0:42:06.574 --> 0:42:07.916 And I'm going to give you 21 0:42:07.916 --> 0:42:09.396 minutes for it maximum right now. 0:42:09.496 --> 0:42:09.757 Good. 0:42:09.777 --> 0:42:10.356 See? 0:42:10.976 --> 0:42:11.838 Think about that. 0:42:12.458 --> 0:42:14.018 If I say I'm going to teach 0:42:14.097 --> 0:42:15.559 a really great lesson that 0:42:15.659 --> 0:42:17.358 someone is also going to be 0:42:17.398 --> 0:42:18.318 able to digest, 0:42:18.659 --> 0:42:21.059 because if I this is this 0:42:21.119 --> 0:42:22.739 is the analogy that I that 0:42:22.780 --> 0:42:24.980 I say I could be the most efficient, 0:42:25.000 --> 0:42:26.240 cost effective third grade 0:42:26.280 --> 0:42:27.400 teacher that's ever existed. 0:42:27.621 --> 0:42:28.340 I could teach the whole damn 0:42:28.380 --> 0:42:29.340 syllabus in a week and a half. 0:42:29.621 --> 0:42:30.460 Not a kid in the room will 0:42:30.481 --> 0:42:31.481 understand what the hell I'm saying, 0:42:32.001 --> 0:42:32.882 but I've done it. 0:42:32.981 --> 0:42:34.202 So the goal of communication 0:42:34.262 --> 0:42:35.561 is not to have communicated. 0:42:36.001 --> 0:42:37.141 The goal of communication is 0:42:37.202 --> 0:42:38.262 to achieve understanding 0:42:38.302 --> 0:42:39.382 for the audience to achieve 0:42:39.402 --> 0:42:39.902 understanding. 0:42:40.123 --> 0:42:40.922 And that means you say 0:42:40.983 --> 0:42:43.005 something and 60% of the room gets it. 0:42:43.824 --> 0:42:44.125 40% didn't. 0:42:44.144 --> 0:42:44.666 So, okay, 0:42:45.166 --> 0:42:46.527 I'm seeing some looks on your faces. 0:42:46.567 --> 0:42:47.726 Let me say this a different way. 0:42:48.307 --> 0:42:49.807 Okay, I'm seeing a couple. 0:42:49.927 --> 0:42:51.809 Let me come one-on-one to a couple of you. 0:42:52.309 --> 0:42:54.411 So that's one-to-many. 0:42:54.650 --> 0:42:55.972 If you're doing one-to-many, 0:42:56.112 --> 0:42:57.393 could you craft a message 0:42:57.413 --> 0:42:59.134 where a lot of people get 0:42:59.173 --> 0:42:59.833 it the first time? 0:42:59.914 --> 0:43:00.114 Yes, 0:43:00.173 --> 0:43:01.914 it's called a TED Talk because you've 0:43:01.954 --> 0:43:03.416 refined it, refined it, refined it, 0:43:03.456 --> 0:43:03.835 refined it. 0:43:04.416 --> 0:43:05.516 But the thing about mass 0:43:05.556 --> 0:43:07.157 communication now is, I mean, 0:43:07.177 --> 0:43:09.284 when did you do that talk in 2020? 0:43:09.284 --> 0:43:09.945 Yeah, January of 20. 0:43:10.664 --> 0:43:14.128 Ballpark, how many views has it gotten? 0:43:14.248 --> 0:43:15.909 Ballpark is probably only 0:43:15.989 --> 0:43:16.509 something in the 0:43:16.528 --> 0:43:18.130 neighborhood of 12,000 or 13,000. 0:43:18.130 --> 0:43:21.052 I introduced it at one of 0:43:21.092 --> 0:43:23.355 the worst times that could ever be done. 0:43:25.856 --> 0:43:27.157 It got introduced in March 0:43:27.217 --> 0:43:29.338 of 2020 after doing it in January. 0:43:29.358 --> 0:43:30.940 I was like, okay, 0:43:31.219 --> 0:43:32.161 you guys are all on to 0:43:32.221 --> 0:43:33.661 different topics right now. 0:43:33.681 --> 0:43:35.744 You were competing with Tiger King. 0:43:36.257 --> 0:43:37.099 Oh, yeah, yeah. 0:43:37.219 --> 0:43:37.759 Which is different. 0:43:37.838 --> 0:43:38.099 Yes. 0:43:38.518 --> 0:43:39.380 But, you know, 0:43:40.079 --> 0:43:41.221 I work with a lot of organizations, 0:43:41.260 --> 0:43:42.460 help them launch podcasts 0:43:42.501 --> 0:43:44.001 or YouTube channels, and people will say, 0:43:44.021 --> 0:43:45.063 yeah, we're getting, you know, 0:43:45.063 --> 0:43:46.503 500 downloads a month. 0:43:46.583 --> 0:43:48.764 And I'm like, go to your local theater, 0:43:49.445 --> 0:43:49.565 right? 0:43:49.585 --> 0:43:51.025 Because it's also specific, right? 0:43:51.126 --> 0:43:51.226 Like, 0:43:51.246 --> 0:43:52.327 most of the stuff I do is healthcare. 0:43:52.887 --> 0:43:53.867 Go to your local theater in 0:43:53.887 --> 0:43:55.628 your town that holds 500 0:43:55.628 --> 0:43:57.510 people and then picture 500 people 0:43:57.510 --> 0:44:00.190 500 of the right people, 0:44:00.351 --> 0:44:01.251 like 500 physical 0:44:01.371 --> 0:44:02.992 therapists or 500 neuro 0:44:03.072 --> 0:44:03.793 physical therapists. 0:44:04.313 --> 0:44:05.594 They're listening, reading, 0:44:05.855 --> 0:44:07.275 watching every month. 0:44:07.856 --> 0:44:08.257 So it's like, 0:44:08.536 --> 0:44:09.336 and the funny part with 0:44:09.496 --> 0:44:10.878 especially YouTube is that 0:44:10.918 --> 0:44:12.579 thing's got 12,000 views now. 0:44:13.300 --> 0:44:14.940 It only takes one little 0:44:15.061 --> 0:44:16.442 nudge on that ridiculous 0:44:16.661 --> 0:44:19.043 algorithm to become a hockey stick. 0:44:19.083 --> 0:44:20.043 And next thing you know, 0:44:20.063 --> 0:44:21.344 it's got a million. 0:44:21.364 --> 0:44:23.467 I was reviewing my YouTube data. 0:44:23.626 --> 0:44:24.586 I did not, 0:44:24.947 --> 0:44:26.489 I pushed off and resisted 0:44:26.509 --> 0:44:27.568 YouTube because I'm a radio 0:44:27.608 --> 0:44:28.250 guy and I just want, 0:44:28.590 --> 0:44:29.771 to do the voice right now my 0:44:29.791 --> 0:44:30.550 buddies are like you gotta 0:44:30.570 --> 0:44:31.831 do it's just youtube right 0:44:32.411 --> 0:44:35.193 yeah I got 1500 views on 0:44:35.373 --> 0:44:37.074 one video on a couple 0:44:37.094 --> 0:44:38.115 videos last night between 0:44:38.315 --> 0:44:39.115 one and two o'clock in the 0:44:39.157 --> 0:44:40.717 morning I cannot tell you 0:44:40.777 --> 0:44:42.539 why but that is not what I 0:44:42.559 --> 0:44:43.739 would have guessed in the 0:44:43.778 --> 0:44:44.920 last 24 hours I would have 0:44:44.940 --> 0:44:46.860 had a bunch of views but I 0:44:46.920 --> 0:44:49.463 did youtube for six eight months with 0:44:50.063 --> 0:44:50.443 Nothing. 0:44:50.864 --> 0:44:53.867 10, 12 views, and then one thing pops. 0:44:54.288 --> 0:44:55.349 It's Netflix and chill. 0:44:55.469 --> 0:44:56.670 I find a show. 0:44:56.690 --> 0:44:57.751 Oh, what's that? 0:44:57.811 --> 0:44:59.132 Now I go back and I binge 0:44:59.293 --> 0:45:01.775 the first 12 seasons that didn't pop. 0:45:01.835 --> 0:45:03.998 So the internet's wild with that. 0:45:04.237 --> 0:45:04.838 It is, yeah. 0:45:04.918 --> 0:45:05.840 I'm fascinated by it. 0:45:06.099 --> 0:45:07.141 But something else that 0:45:07.161 --> 0:45:08.623 fascinates me about our 0:45:08.682 --> 0:45:09.724 conversation here is you 0:45:09.764 --> 0:45:10.885 talk about being able to 0:45:11.346 --> 0:45:12.306 read the audience, 0:45:12.365 --> 0:45:14.606 and then reposition 0:45:14.646 --> 0:45:16.186 according to the faces you're seeing. 0:45:16.586 --> 0:45:18.327 I think we actually need to 0:45:18.748 --> 0:45:20.547 have some way of doing the 0:45:20.608 --> 0:45:21.527 same type of thing when 0:45:21.568 --> 0:45:22.407 we're doing a remote 0:45:22.447 --> 0:45:23.387 continuing education. 0:45:23.768 --> 0:45:24.648 I mean, Jimmy, right now, 0:45:24.668 --> 0:45:28.108 I probably give 40% of the 0:45:28.289 --> 0:45:30.929 day long or as small as 0:45:31.090 --> 0:45:32.949 three hour long webinars 0:45:33.409 --> 0:45:34.971 that I give will actually 0:45:34.990 --> 0:45:36.411 be delivered from the very 0:45:36.490 --> 0:45:37.690 chair that I'm sitting in 0:45:37.851 --> 0:45:39.572 right here in Las Vegas, Nevada. 0:45:42.105 --> 0:45:43.947 not being able to see all of 0:45:44.007 --> 0:45:45.489 those faces across the screen, 0:45:45.530 --> 0:45:47.552 because if I've got my PowerPoint up, 0:45:47.652 --> 0:45:49.315 I need to pin my video so I 0:45:49.355 --> 0:45:50.516 can only see my video. 0:45:50.876 --> 0:45:52.179 I can't see the other day. 0:45:52.239 --> 0:45:54.583 I talked to 1700 people on a 0:45:54.643 --> 0:45:56.224 webinar that I was delivering. 0:46:00.322 --> 0:46:02.105 That was a three-hour webinar. 0:46:02.625 --> 0:46:04.067 I talked to 1,700 people 0:46:04.146 --> 0:46:05.588 across the world on that, 0:46:05.889 --> 0:46:07.391 but I didn't get to see any of them. 0:46:07.871 --> 0:46:09.873 So it's very difficult for 0:46:09.994 --> 0:46:11.675 me as an engager, 0:46:12.056 --> 0:46:13.338 as a person that likes to 0:46:13.498 --> 0:46:14.659 interact and see, 0:46:15.059 --> 0:46:16.081 it's very difficult for me 0:46:16.161 --> 0:46:16.802 to be able to see 0:46:17.954 --> 0:46:20.077 Am I hitting this message okay? 0:46:20.318 --> 0:46:20.518 I mean, 0:46:20.539 --> 0:46:22.320 I'm getting flooded with questions. 0:46:22.420 --> 0:46:22.981 That's good. 0:46:23.041 --> 0:46:24.483 That's one objective sign. 0:46:24.864 --> 0:46:26.407 I can see that I'm engaging people. 0:46:26.447 --> 0:46:28.028 And I look at the fervor of the questions. 0:46:28.068 --> 0:46:29.351 Yeah, they're interested. 0:46:29.391 --> 0:46:30.793 They want to know more, et cetera. 0:46:30.833 --> 0:46:31.313 That's great. 0:46:32.402 --> 0:46:33.864 But sometimes you can just 0:46:33.905 --> 0:46:35.766 hit an audience of 0:46:35.847 --> 0:46:36.927 individuals at a different 0:46:36.987 --> 0:46:38.851 sector or a different country, 0:46:39.311 --> 0:46:41.454 and their approach is not 0:46:41.494 --> 0:46:42.454 to ask questions. 0:46:42.934 --> 0:46:43.356 So I'm like, 0:46:43.936 --> 0:46:45.297 this is going to be hard for 0:46:45.338 --> 0:46:47.099 me to stay engaged here for 0:46:47.119 --> 0:46:49.163 the next seven hours and 15 minutes. 0:46:49.443 --> 0:46:50.143 How do we do that? 0:46:50.922 --> 0:46:53.362 So there's a thing that I coined. 0:46:53.643 --> 0:46:55.423 It's called empty room syndrome. 0:46:55.844 --> 0:46:59.065 So I would teach bartenders, 0:46:59.945 --> 0:47:01.786 supermarket checkout counter people, 0:47:02.005 --> 0:47:03.547 car salesmen how to become broadcasters. 0:47:03.887 --> 0:47:05.847 You would find radio people everywhere. 0:47:05.907 --> 0:47:06.507 They need to be people. 0:47:07.487 --> 0:47:09.588 And the idea was in between 0:47:09.688 --> 0:47:10.909 Pearl Jam and Nickelback, 0:47:11.070 --> 0:47:12.951 you would say something witty or funny, 0:47:13.130 --> 0:47:13.251 right? 0:47:13.271 --> 0:47:14.331 You would try to interject 0:47:14.452 --> 0:47:15.592 in between songs. 0:47:16.132 --> 0:47:17.193 And a lot of times what I 0:47:17.273 --> 0:47:19.594 kept seeing people do, different people, 0:47:19.653 --> 0:47:20.974 so it must be a thing, right? 0:47:21.014 --> 0:47:23.115 Psychology, is they kept trying, 0:47:23.396 --> 0:47:25.157 they would hit the punchline, 0:47:25.257 --> 0:47:25.958 their zinger, 0:47:26.878 --> 0:47:28.239 And then they'd hit it. 0:47:28.320 --> 0:47:29.340 They tried to hit it again. 0:47:29.360 --> 0:47:30.942 Or maybe they'd go around 0:47:30.961 --> 0:47:32.003 the block a third time. 0:47:32.023 --> 0:47:33.304 I called it going around the block. 0:47:33.384 --> 0:47:34.324 And I still laugh. 0:47:34.385 --> 0:47:34.746 I forget it. 0:47:35.005 --> 0:47:35.186 Sure. 0:47:35.545 --> 0:47:36.967 And I had to remind them 0:47:37.507 --> 0:47:39.550 that if what you said was funny, 0:47:40.150 --> 0:47:40.731 they laughed. 0:47:40.931 --> 0:47:41.572 You couldn't hear them 0:47:41.612 --> 0:47:42.632 because you're in a room by 0:47:42.652 --> 0:47:43.653 yourself talking into a 0:47:43.693 --> 0:47:45.376 microphone and they're out there. 0:47:46.617 --> 0:47:47.538 If they didn't laugh, 0:47:47.597 --> 0:47:48.639 you saying it a second time 0:47:48.818 --> 0:47:49.500 ain't going to fix it. 0:47:50.001 --> 0:47:51.463 And if they did laugh the first time, 0:47:51.543 --> 0:47:52.724 you just ruined it by 0:47:52.784 --> 0:47:54.485 saying it a second or a third time. 0:47:54.706 --> 0:47:56.108 I would call it empty room syndrome. 0:47:56.407 --> 0:48:00.432 But that hurt me as a guy who interacts. 0:48:00.572 --> 0:48:01.393 So as you were saying this, 0:48:01.414 --> 0:48:02.295 I was nodding left. 0:48:02.416 --> 0:48:03.516 Here's how I solved it. 0:48:05.382 --> 0:48:06.983 The budget was not going to 0:48:07.003 --> 0:48:08.045 let me to have a co-host. 0:48:08.105 --> 0:48:09.045 I was the afternoon guy. 0:48:09.106 --> 0:48:10.568 Afternoon guys are in literacy solo. 0:48:10.907 --> 0:48:11.688 Didn't say anything. 0:48:11.708 --> 0:48:13.190 And there was always like 0:48:13.291 --> 0:48:14.391 six or seven colleges 0:48:14.452 --> 0:48:15.574 around where I was in radio 0:48:15.614 --> 0:48:16.875 for the longest in 0:48:16.894 --> 0:48:17.775 Northeast Pennsylvania. 0:48:18.135 --> 0:48:19.318 So I would put out the word 0:48:19.378 --> 0:48:20.719 for interns all the time. 0:48:21.500 --> 0:48:23.081 I will teach you whatever you want. 0:48:23.442 --> 0:48:24.483 I just need you to stand 0:48:24.523 --> 0:48:25.503 there for a couple hours 0:48:25.603 --> 0:48:26.485 and hang out with me. 0:48:26.644 --> 0:48:27.425 There you go. 0:48:27.626 --> 0:48:29.126 I would have a cycle of interns. 0:48:29.166 --> 0:48:29.807 Who's going to be on there? 0:48:30.288 --> 0:48:30.989 It literally was, 0:48:31.048 --> 0:48:32.730 can you make eye contact with me? 0:48:33.391 --> 0:48:34.472 And if I say something, 0:48:34.512 --> 0:48:35.353 it was even better if the 0:48:35.393 --> 0:48:37.313 person didn't just laugh 0:48:37.353 --> 0:48:38.775 all the time because I had to pardon it. 0:48:39.155 --> 0:48:39.356 Yeah. 0:48:39.556 --> 0:48:40.657 And it's amazing what eye 0:48:40.717 --> 0:48:42.619 contact and body language can do. 0:48:43.099 --> 0:48:43.599 Even me. 0:48:43.719 --> 0:48:45.242 So you mentioned COVID. 0:48:45.262 --> 0:48:45.481 Yeah. 0:48:45.961 --> 0:48:47.742 I did everything just audio. 0:48:47.983 --> 0:48:48.943 And then COVID sort of 0:48:48.963 --> 0:48:50.922 brought about everything 0:48:50.963 --> 0:48:52.324 Zoom and Teams and this. 0:48:52.364 --> 0:48:53.224 And then I figured out how 0:48:53.244 --> 0:48:54.063 to hook up my audio 0:48:54.083 --> 0:48:55.605 equipment to this camera 0:48:55.644 --> 0:48:57.744 thing and just making eye 0:48:57.804 --> 0:49:00.385 contact with you here and you nodding. 0:49:00.425 --> 0:49:01.766 I'm not wondering, am I boring him? 0:49:01.786 --> 0:49:02.286 Is he bored? 0:49:02.306 --> 0:49:02.907 Is he want to hang up? 0:49:02.927 --> 0:49:03.286 Are we done? 0:49:04.047 --> 0:49:05.068 I didn't have to worry about 0:49:05.088 --> 0:49:05.668 that anymore because I 0:49:05.688 --> 0:49:07.190 could see you smile or make 0:49:07.289 --> 0:49:09.032 eye contact or when you 0:49:09.072 --> 0:49:09.731 want to interrupt. 0:49:09.791 --> 0:49:10.813 Oh, 0:49:10.833 --> 0:49:12.474 you wave your finger and you lean in 0:49:12.494 --> 0:49:14.356 because that's what people do. 0:49:14.715 --> 0:49:17.358 And it's amazing how our brains are wired, 0:49:17.438 --> 0:49:18.458 but it's also not amazing 0:49:18.478 --> 0:49:19.820 because we're animals and 0:49:19.840 --> 0:49:21.442 we're wired this way. 0:49:21.461 --> 0:49:22.061 Oh, that's right. 0:49:22.161 --> 0:49:22.802 Not weird at all. 0:49:23.567 --> 0:49:23.766 Yeah. 0:49:23.987 --> 0:49:25.188 And that's the thing is that 0:49:25.228 --> 0:49:27.568 I think we don't teach this 0:49:27.628 --> 0:49:28.849 in physical therapy school 0:49:28.909 --> 0:49:30.409 because across the things that I've done, 0:49:30.530 --> 0:49:31.409 continuing education, 0:49:31.469 --> 0:49:32.190 I've also been an 0:49:32.311 --> 0:49:36.092 academician on a few different realms. 0:49:36.492 --> 0:49:38.112 And I don't know that we're 0:49:38.213 --> 0:49:40.253 doing that education in 0:49:40.574 --> 0:49:41.514 physical therapy because we 0:49:41.534 --> 0:49:43.994 have to cram so much content in. 0:49:44.014 --> 0:49:45.976 Are we actually teaching the 0:49:46.096 --> 0:49:47.876 people that are going to be 0:49:47.936 --> 0:49:49.317 representing our profession 0:49:49.617 --> 0:49:50.657 to be communicators? 0:49:50.677 --> 0:49:51.097 Yeah. 0:49:51.257 --> 0:49:53.179 to be able to read the nonverbals, 0:49:53.539 --> 0:49:55.681 to be able to pause, to wait a second. 0:49:55.922 --> 0:49:57.822 You just asked way too many 0:49:57.882 --> 0:49:58.943 different questions within 0:49:59.083 --> 0:50:01.246 one paragraph for this individual. 0:50:01.525 --> 0:50:02.286 Read the nonverbals. 0:50:02.306 --> 0:50:03.226 Because some people, 0:50:03.608 --> 0:50:04.748 if they're not receiving you well, 0:50:04.829 --> 0:50:05.389 they light up. 0:50:05.668 --> 0:50:06.190 And some people, 0:50:06.210 --> 0:50:07.329 if they're not receiving you well, 0:50:07.630 --> 0:50:08.411 they turn it down. 0:50:08.431 --> 0:50:09.811 You've got to be able to know that. 0:50:09.972 --> 0:50:10.693 And what do you do? 0:50:11.032 --> 0:50:12.875 So thanks for the radio 0:50:12.914 --> 0:50:13.795 segue and the setup. 0:50:13.875 --> 0:50:15.797 So I'm piloting this in 2024. 0:50:15.936 --> 0:50:17.557 And because you're in 0:50:17.577 --> 0:50:18.838 education and we're recording, 0:50:18.978 --> 0:50:20.199 why not just do a real thing? 0:50:21.400 --> 0:50:22.981 I do my show live at PT 0:50:23.001 --> 0:50:24.081 programs from now from, 0:50:24.222 --> 0:50:24.882 from time to time. 0:50:24.922 --> 0:50:25.043 Right. 0:50:25.063 --> 0:50:25.503 It's fun. 0:50:25.543 --> 0:50:27.083 Live studio audience, yada, yada. 0:50:27.284 --> 0:50:28.184 And we yuck it up sound 0:50:28.224 --> 0:50:29.465 effects and all night. 0:50:29.985 --> 0:50:30.144 Yeah. 0:50:30.465 --> 0:50:31.246 I'm usually there. 0:50:31.326 --> 0:50:31.965 If I fly, 0:50:32.065 --> 0:50:33.327 I'm there the whole day and I'm 0:50:33.387 --> 0:50:34.007 sitting there going, 0:50:34.266 --> 0:50:35.827 I bet you I could like teach something. 0:50:35.847 --> 0:50:36.668 Like, wouldn't that be fun? 0:50:36.688 --> 0:50:38.949 I don't have a, I'm not an education, 0:50:38.969 --> 0:50:40.230 but like there's something I could teach. 0:50:40.389 --> 0:50:42.990 So I'm putting together sort of a module. 0:50:43.030 --> 0:50:44.092 I don't know how long it's going to be. 0:50:44.192 --> 0:50:44.992 It's only going to be as 0:50:45.032 --> 0:50:45.871 long as it needs to be though. 0:50:45.891 --> 0:50:46.652 I'll tell you that much. 0:50:46.873 --> 0:50:47.052 Right. 0:50:47.253 --> 0:50:48.653 Parkinson's law. 0:50:49.275 --> 0:50:50.737 And the course that I'm coming up with, 0:50:50.757 --> 0:50:51.277 because you come up with 0:50:51.297 --> 0:50:52.038 the headline first, 0:50:52.057 --> 0:50:53.079 because we learned start 0:50:53.099 --> 0:50:53.699 with the end in mind, 0:50:54.579 --> 0:50:57.704 is Science Isn't Finished 0:50:57.724 --> 0:50:58.543 Until It's Understood. 0:50:58.724 --> 0:50:59.445 That's the title. 0:51:00.204 --> 0:51:01.144 Because it's not done until 0:51:01.164 --> 0:51:01.525 you understand. 0:51:01.545 --> 0:51:02.606 So just just because Mike 0:51:02.706 --> 0:51:04.005 knows it and he said it to 0:51:04.045 --> 0:51:05.166 me doesn't mean I understand it. 0:51:05.385 --> 0:51:06.045 You're not done. 0:51:06.065 --> 0:51:08.126 The onus is still on you to 0:51:08.266 --> 0:51:10.047 read that nonverbal to go. 0:51:10.067 --> 0:51:10.447 I don't. 0:51:10.688 --> 0:51:11.168 Do you understand? 0:51:11.188 --> 0:51:12.228 Can you can you give that 0:51:12.268 --> 0:51:13.027 back to me or whatever? 0:51:13.047 --> 0:51:14.248 A lot of tips and tricks and tools. 0:51:14.309 --> 0:51:14.548 Right. 0:51:14.748 --> 0:51:16.228 The sub headline is so the 0:51:16.449 --> 0:51:17.389 title is science isn't 0:51:17.409 --> 0:51:18.309 finished until it's understood. 0:51:18.570 --> 0:51:19.949 Why are these soft skills so damn hard? 0:51:20.668 --> 0:51:21.028 Yeah. 0:51:21.289 --> 0:51:22.429 Because we call them soft skills. 0:51:22.449 --> 0:51:23.550 They must be easy. 0:51:24.050 --> 0:51:24.490 And, you know, 0:51:24.530 --> 0:51:25.431 you speak English and the 0:51:25.471 --> 0:51:26.871 patient speaks English. 0:51:26.911 --> 0:51:28.932 So where's the disconnect? 0:51:28.992 --> 0:51:29.213 It's like, 0:51:29.632 --> 0:51:31.114 have you ever interviewed someone before? 0:51:31.134 --> 0:51:31.173 No. 0:51:31.954 --> 0:51:34.096 Do you know the bad way to do it? 0:51:34.335 --> 0:51:35.856 Are there right and wrong ways to do it? 0:51:35.936 --> 0:51:36.916 Is there only one way? 0:51:37.137 --> 0:51:37.396 No. 0:51:37.536 --> 0:51:38.518 Are there right and wrong ways? 0:51:38.657 --> 0:51:38.938 No, there's... 0:51:39.478 --> 0:51:40.797 landmines you can step on or 0:51:40.858 --> 0:51:41.978 things that are better so 0:51:42.378 --> 0:51:43.639 so my goal is when I do 0:51:43.938 --> 0:51:44.858 these live things if I'm 0:51:45.079 --> 0:51:47.219 already on campus like hey 0:51:47.280 --> 0:51:48.460 could I host an elective 0:51:48.500 --> 0:51:49.541 for a couple hours where 0:51:49.581 --> 0:51:50.721 like yeah I'm gonna use 0:51:50.800 --> 0:51:52.240 chris voss as my textbook 0:51:52.561 --> 0:51:54.161 I'm gonna use movie clips 0:51:54.181 --> 0:51:56.362 from the movie inception or 0:51:56.742 --> 0:51:57.983 uh or you know good morning 0:51:58.043 --> 0:51:59.603 vietnam like why are you 0:51:59.663 --> 0:52:00.483 doing that it's because 0:52:00.603 --> 0:52:01.804 they're highlighting really 0:52:01.844 --> 0:52:04.023 great skills can I use 0:52:04.083 --> 0:52:05.344 multimedia to teach that 0:52:05.364 --> 0:52:05.965 the answer is yes 0:52:06.570 --> 0:52:07.971 Yeah, yeah, absolutely. 0:52:08.291 --> 0:52:08.811 I love that. 0:52:08.891 --> 0:52:11.672 And I'm always resistant to 0:52:13.034 --> 0:52:15.574 pitch anything or to plug anything. 0:52:15.614 --> 0:52:17.115 I don't have a book for sale, et cetera. 0:52:17.637 --> 0:52:20.117 But on an unnamed continuing 0:52:20.157 --> 0:52:23.480 education provider site in January, 0:52:23.960 --> 0:52:25.141 I'm actually teaching a 0:52:25.240 --> 0:52:25.981 course that's actually 0:52:26.021 --> 0:52:26.942 called the soft skills. 0:52:27.322 --> 0:52:27.902 Is it really? 0:52:28.282 --> 0:52:28.882 Yes, it is, 100%. 0:52:28.983 --> 0:52:31.485 And so it's a three segment 0:52:31.605 --> 0:52:33.266 course that looks at the 0:52:33.346 --> 0:52:34.447 initial examination, 0:52:35.666 --> 0:52:37.507 progress examination, treatment, 0:52:37.927 --> 0:52:39.407 home exercise program, 0:52:39.487 --> 0:52:41.527 delivery slash discharge management. 0:52:41.827 --> 0:52:42.967 And we look at those three 0:52:42.987 --> 0:52:44.268 across three courses 0:52:44.648 --> 0:52:46.108 because it's a passion of mine. 0:52:46.369 --> 0:52:47.289 You can say where it's from. 0:52:47.349 --> 0:52:47.849 It's okay. 0:52:48.228 --> 0:52:48.829 It's MedBridge. 0:52:49.130 --> 0:52:50.050 That's what I figured. 0:52:50.110 --> 0:52:51.469 When you said unnamed, I was like, 0:52:51.510 --> 0:52:51.769 come on. 0:52:51.809 --> 0:52:52.030 Yeah. 0:52:52.210 --> 0:52:52.831 Yeah. 0:52:52.891 --> 0:52:53.811 So I'm doing that. 0:52:54.090 --> 0:52:55.650 I think I go up there and I 0:52:55.731 --> 0:52:57.751 actually film in studio. 0:52:58.807 --> 0:53:00.168 on January 9th. 0:53:00.568 --> 0:53:01.429 So it probably won't be 0:53:01.509 --> 0:53:03.650 released until early March or so. 0:53:04.411 --> 0:53:05.891 And I'm so excited because 0:53:05.951 --> 0:53:08.172 I've got patient experience 0:53:08.211 --> 0:53:09.753 where I'm not just talking bullet points. 0:53:09.793 --> 0:53:10.693 This is what you do. 0:53:11.152 --> 0:53:12.213 I've actually created 0:53:13.074 --> 0:53:14.054 interactive experiences 0:53:14.094 --> 0:53:15.275 where we've got models and 0:53:15.315 --> 0:53:17.536 I actually display, all right, 0:53:17.695 --> 0:53:19.456 here's how you show vicarious. 0:53:19.476 --> 0:53:21.217 Here's how you show tactical empathy, 0:53:21.277 --> 0:53:21.998 those types of things. 0:53:22.757 --> 0:53:23.978 Uh, you know, those, uh, you know, 0:53:24.298 --> 0:53:25.539 the analogies of what I 0:53:25.579 --> 0:53:26.539 just learned from you, et cetera. 0:53:26.559 --> 0:53:27.541 It's vital, man, 0:53:27.780 --> 0:53:29.782 because you could know so much, 0:53:30.302 --> 0:53:32.262 but if you can't communicate it, you know, 0:53:32.342 --> 0:53:33.764 I mean, I, somebody said it best. 0:53:33.864 --> 0:53:34.443 You could write the, 0:53:34.543 --> 0:53:35.204 you could have the greatest 0:53:35.224 --> 0:53:36.244 song ever written in your head, 0:53:36.784 --> 0:53:38.206 but if you can't get it out, 0:53:38.226 --> 0:53:38.965 it doesn't matter. 0:53:39.786 --> 0:53:39.987 Yep. 0:53:40.347 --> 0:53:40.847 Doesn't matter. 0:53:40.867 --> 0:53:41.806 You got all the ball to all 0:53:41.827 --> 0:53:42.648 the way to the one yard 0:53:42.668 --> 0:53:43.527 line and you couldn't punch 0:53:43.568 --> 0:53:44.248 it in because you couldn't 0:53:44.289 --> 0:53:44.829 communicate it. 0:53:45.202 --> 0:53:45.782 Yeah, yeah. 0:53:46.043 --> 0:53:48.146 And related to that is they 0:53:48.166 --> 0:53:48.927 don't care how much you 0:53:48.967 --> 0:53:50.268 know until they know how much you care. 0:53:50.730 --> 0:53:53.713 So, you know, that ability to be able to 0:53:54.827 --> 0:53:57.547 listen and display empathy, 0:53:57.628 --> 0:54:00.108 communicate it in a very realistic, 0:54:00.248 --> 0:54:01.748 non-pandering manner. 0:54:02.429 --> 0:54:04.429 And one of the secrets that 0:54:04.449 --> 0:54:06.168 I'll tell you that I've had 0:54:06.268 --> 0:54:09.949 over 33 years is somehow I 0:54:10.030 --> 0:54:11.550 figure out a way to learn 0:54:11.731 --> 0:54:13.550 something about an 0:54:13.590 --> 0:54:14.791 individual that they've 0:54:14.851 --> 0:54:16.431 told me that I don't put in 0:54:16.472 --> 0:54:17.371 their medical record. 0:54:18.152 --> 0:54:19.773 And then I play that again 0:54:19.853 --> 0:54:21.675 for them either later that 0:54:21.735 --> 0:54:24.097 session or what really floors them. 0:54:24.536 --> 0:54:25.918 If I bring that up to them a 0:54:25.978 --> 0:54:28.119 couple sessions from now, wait a second, 0:54:28.159 --> 0:54:29.561 you must have been listening to me. 0:54:29.961 --> 0:54:31.543 How did you remember that my 0:54:31.583 --> 0:54:33.023 husband and I were going to 0:54:33.103 --> 0:54:34.945 my grandson's baseball 0:54:34.985 --> 0:54:36.306 tournament in Tennessee 0:54:36.427 --> 0:54:37.668 over the weekend and you 0:54:37.788 --> 0:54:38.548 asked me about it? 0:54:39.028 --> 0:54:39.309 Boom. 0:54:39.909 --> 0:54:40.030 Well, 0:54:40.050 --> 0:54:42.012 I think there's secrets to patient 0:54:42.032 --> 0:54:42.512 engagement. 0:54:42.652 --> 0:54:44.114 I think it was Oprah that 0:54:44.195 --> 0:54:46.077 said people want to be seen, heard, 0:54:46.117 --> 0:54:46.737 and understood. 0:54:46.818 --> 0:54:49.099 And if you can, I see you, I hear you, 0:54:49.239 --> 0:54:49.860 I understand you, 0:54:49.920 --> 0:54:50.782 or I attempt to understand. 0:54:50.802 --> 0:54:51.262 And this is like, 0:54:51.282 --> 0:54:52.903 and I had my buddy who's a 0:54:52.923 --> 0:54:54.166 psychologist on once. 0:54:54.226 --> 0:54:54.666 And I said, 0:54:54.706 --> 0:54:56.188 pick a topic that healthcare 0:54:56.208 --> 0:54:57.329 providers understand. 0:54:57.728 --> 0:54:59.088 mess up or don't get right 0:54:59.108 --> 0:55:00.289 when treating patients and 0:55:00.329 --> 0:55:01.510 he's a psychologist who 0:55:01.650 --> 0:55:03.112 educates psychology 0:55:03.152 --> 0:55:05.152 students at thomas 0:55:05.193 --> 0:55:06.373 jefferson university so he 0:55:06.474 --> 0:55:07.875 also treats health care 0:55:07.894 --> 0:55:10.217 providers on campus and he 0:55:10.257 --> 0:55:11.436 said empathy and sympathy 0:55:11.797 --> 0:55:13.539 and I go well yeah they're 0:55:13.559 --> 0:55:14.980 like the same and he goes 0:55:15.420 --> 0:55:16.460 you know how words work two 0:55:16.481 --> 0:55:17.161 different words means two 0:55:17.181 --> 0:55:17.802 different meanings they 0:55:17.822 --> 0:55:18.342 might be similar but 0:55:18.362 --> 0:55:19.503 they're not the same and he 0:55:19.523 --> 0:55:21.224 sort of described it as I 0:55:21.264 --> 0:55:22.704 can never have sympathy for 0:55:22.724 --> 0:55:23.726 someone who's given birth 0:55:24.266 --> 0:55:25.786 because I have never given birth. 0:55:26.065 --> 0:55:27.467 I can have empathy for it, 0:55:27.806 --> 0:55:28.887 but it's got to stop there. 0:55:28.927 --> 0:55:30.666 Cause if I'm like, I know how, Oh, 0:55:31.047 --> 0:55:31.568 it's pain. 0:55:31.608 --> 0:55:32.427 I know how that feels. 0:55:32.807 --> 0:55:34.547 You know, I broke my finger once. 0:55:34.728 --> 0:55:36.449 I will get in the face. 0:55:36.869 --> 0:55:38.108 It's going to go a long way. 0:55:38.268 --> 0:55:39.969 Mother be like, you do, you know, nothing. 0:55:40.010 --> 0:55:41.949 Cause I don't, but I can say, listen, 0:55:42.050 --> 0:55:44.471 I imagine that's really, really difficult, 0:55:44.530 --> 0:55:45.150 traumatic. 0:55:45.431 --> 0:55:47.911 And I just amazingly, you know, 0:55:48.030 --> 0:55:49.512 a lot that's empathy. 0:55:50.152 --> 0:55:50.371 And I, 0:55:51.353 --> 0:55:52.896 If you can show, I mean, empathy, 0:55:52.936 --> 0:55:53.637 the bar is lower. 0:55:53.677 --> 0:55:54.639 Maybe you do have the same 0:55:54.679 --> 0:55:56.744 experience as someone and that's sympathy, 0:55:57.164 --> 0:55:58.226 but empathy, we can, 0:55:58.507 --> 0:55:59.929 that's a skill you can hone. 0:55:59.949 --> 0:56:00.650 And that's really what he 0:56:00.670 --> 0:56:02.233 was sort of like really 0:56:02.273 --> 0:56:03.235 pushing and communicating. 0:56:03.715 --> 0:56:03.894 Yeah. 0:56:04.094 --> 0:56:07.896 And if you fit a third concept in there, 0:56:08.617 --> 0:56:10.036 you have a way to be able 0:56:10.077 --> 0:56:11.297 to take someone out of a 0:56:11.356 --> 0:56:13.797 potential catastrophization 0:56:13.878 --> 0:56:14.719 cycle because you have 0:56:14.759 --> 0:56:15.818 vicarious experiences. 0:56:16.418 --> 0:56:18.059 I've worked with people that 0:56:18.360 --> 0:56:20.340 have had a similar experience as yours. 0:56:20.400 --> 0:56:22.900 It's not the same and you're an individual, 0:56:23.161 --> 0:56:25.121 but here's been my experience. 0:56:25.242 --> 0:56:26.422 Do you believe that this 0:56:26.521 --> 0:56:27.623 course that I'm suggesting 0:56:27.682 --> 0:56:30.123 for you might also be healthy for you? 0:56:30.284 --> 0:56:31.463 It's worked for these individuals. 0:56:31.864 --> 0:56:34.545 Because it actually helps to recognize, 0:56:34.885 --> 0:56:36.507 put us in the context, but also says, 0:56:36.748 --> 0:56:37.288 here's how we're going to 0:56:37.307 --> 0:56:38.309 get out of this context. 0:56:38.628 --> 0:56:39.230 Here's how we're going to 0:56:39.250 --> 0:56:41.030 move forward with this work for you. 0:56:41.512 --> 0:56:44.333 This is also like the 0:56:44.373 --> 0:56:46.976 parallels between communication, 0:56:47.556 --> 0:56:48.097 healthcare. 0:56:48.916 --> 0:56:49.898 Donald Miller wrote a book 0:56:49.918 --> 0:56:51.119 called Building the Story Brand, 0:56:51.139 --> 0:56:51.559 where he's like, 0:56:51.579 --> 0:56:53.681 when you write an ad that 0:56:53.721 --> 0:56:55.561 tells everybody how great you are, 0:56:56.182 --> 0:56:57.844 they want to say, cool story, bro. 0:56:57.943 --> 0:56:58.644 Like, good for you. 0:56:59.451 --> 0:57:00.753 But if you write an ad where 0:57:00.893 --> 0:57:03.737 I'm the hero and that you're the Yoda, 0:57:03.757 --> 0:57:05.619 you're the guide that can help me become, 0:57:05.699 --> 0:57:07.802 go from where I am to where I want to go, 0:57:07.983 --> 0:57:08.784 I'll pay attention to you. 0:57:09.186 --> 0:57:10.768 So in a classic one that's 0:57:10.788 --> 0:57:12.851 in plain sight is Nike's saying, 0:57:12.891 --> 0:57:13.771 if you want to be an athlete, 0:57:13.791 --> 0:57:15.074 you know what you have to do? 0:57:15.094 --> 0:57:15.414 Just do it. 0:57:15.862 --> 0:57:16.342 Just do it. 0:57:16.681 --> 0:57:17.581 We don't really make sneakers. 0:57:17.601 --> 0:57:18.503 They don't really sell sneakers. 0:57:18.543 --> 0:57:19.503 They sell the chance, 0:57:19.722 --> 0:57:21.202 the path to becoming an athlete, 0:57:21.302 --> 0:57:22.543 whatever that means to you. 0:57:22.724 --> 0:57:22.963 Right. 0:57:23.023 --> 0:57:24.483 So it's super subtle. 0:57:24.563 --> 0:57:26.144 And it's like, well, that's a trick. 0:57:26.204 --> 0:57:27.204 And I go, it is, 0:57:27.405 --> 0:57:28.666 but it's also not because 0:57:28.706 --> 0:57:30.405 if I'm ET and they're like, well, 0:57:30.425 --> 0:57:31.465 I'm an Ironman and I can do 0:57:31.505 --> 0:57:33.226 this and I can do this and I can do this. 0:57:33.726 --> 0:57:34.407 It's like, all right, well, 0:57:34.427 --> 0:57:35.766 this sounds like it's your story. 0:57:35.806 --> 0:57:37.427 Where do I fit in your story? 0:57:37.447 --> 0:57:37.527 Yeah. 0:57:37.907 --> 0:57:39.528 And I put it in context of relationships, 0:57:39.548 --> 0:57:39.768 you know, 0:57:40.028 --> 0:57:41.128 and I try to make it funny and 0:57:41.148 --> 0:57:42.028 poke fun at myself because 0:57:42.048 --> 0:57:43.130 that's the easiest way to endear. 0:57:43.150 --> 0:57:43.849 I'm like, you know, 0:57:43.929 --> 0:57:44.829 freshman year of college, 0:57:44.869 --> 0:57:46.170 I had some first dates, 0:57:46.190 --> 0:57:47.451 but no second dates, Mike. 0:57:47.471 --> 0:57:48.431 I couldn't figure out why. 0:57:48.931 --> 0:57:50.092 I told every girl I went out 0:57:50.112 --> 0:57:50.931 with that I was the captain 0:57:50.972 --> 0:57:51.992 of the hockey team and I 0:57:52.032 --> 0:57:53.552 was super smart and how 0:57:53.632 --> 0:57:54.652 great I was on the radio. 0:57:54.893 --> 0:57:55.614 No second dates. 0:57:56.612 --> 0:57:57.855 sophomore, junior, senior year, 0:57:57.934 --> 0:57:58.896 I asked a lot of questions 0:57:58.956 --> 0:58:00.079 about them and what was 0:58:00.119 --> 0:58:00.920 important to them. 0:58:00.960 --> 0:58:02.282 And I just listened a lot, 0:58:02.523 --> 0:58:03.485 a lot more second dates. 0:58:03.744 --> 0:58:04.626 Why do you think that is? 0:58:04.827 --> 0:58:05.989 And when you put it in that context, 0:58:06.009 --> 0:58:07.030 it's like, well, obviously I go, 0:58:07.311 --> 0:58:08.213 patient care is the same way. 0:58:09.255 --> 0:58:10.536 It's another human that's hearing you. 0:58:11.262 --> 0:58:12.523 Yeah, that's exactly right. 0:58:12.623 --> 0:58:15.407 I love that experience that 0:58:15.447 --> 0:58:16.728 you relate back to your 0:58:16.768 --> 0:58:18.369 dating experiences as well. 0:58:18.831 --> 0:58:19.291 And, you know, 0:58:19.331 --> 0:58:20.893 the thing that happens to us 0:58:21.012 --> 0:58:23.054 in rehabilitation is that 0:58:23.494 --> 0:58:26.137 sometimes we're so busy in 0:58:26.418 --> 0:58:28.320 educating and informing and 0:58:28.440 --> 0:58:29.862 blowing ourselves up and I 0:58:29.902 --> 0:58:30.822 know how to do this. 0:58:31.382 --> 0:58:32.724 that we actually miss the 0:58:32.764 --> 0:58:34.405 fact that we've disengaged the person. 0:58:34.465 --> 0:58:36.025 So what happens is they go 0:58:36.065 --> 0:58:37.005 up to the front desk, 0:58:37.065 --> 0:58:38.487 they follow our instructions, 0:58:38.786 --> 0:58:39.807 they schedule two times a 0:58:39.827 --> 0:58:41.007 week for the next four weeks, 0:58:41.268 --> 0:58:42.748 and then they proceed to no 0:58:42.829 --> 0:58:44.130 show that next experience 0:58:44.409 --> 0:58:45.231 because they knew they 0:58:45.251 --> 0:58:46.090 weren't going to come back. 0:58:46.331 --> 0:58:47.891 But, you know, whatever. 0:58:48.331 --> 0:58:49.293 I don't think this is it. 0:58:49.353 --> 0:58:51.074 Doc, can you send me to somebody else? 0:58:51.454 --> 0:58:51.753 You know, 0:58:51.914 --> 0:58:53.635 and we're confused and we say 0:58:53.655 --> 0:58:54.376 they're noncompliant. 0:58:54.914 --> 0:58:55.114 Right. 0:58:55.474 --> 0:58:55.715 Yeah. 0:58:55.936 --> 0:58:57.215 I've got a terrible caseload. 0:58:57.235 --> 0:58:58.717 They're noncompliant and et cetera. 0:58:58.737 --> 0:59:00.197 And that's what my whole soft skill, 0:59:01.137 --> 0:59:02.199 you know, course is about. 0:59:02.318 --> 0:59:03.699 It's not about the person. 0:59:04.019 --> 0:59:05.201 It's about what you're doing 0:59:05.260 --> 0:59:06.721 to find the individual. 0:59:07.262 --> 0:59:08.681 And, you know, you know, 0:59:09.382 --> 0:59:11.043 you talk about Yoda, et cetera. 0:59:11.083 --> 0:59:13.565 And you talk about Nike and, you know, 0:59:13.625 --> 0:59:14.746 and all of that is in there. 0:59:14.786 --> 0:59:16.206 Just giving the individual 0:59:16.387 --> 0:59:17.306 some limitless 0:59:17.367 --> 0:59:19.907 possibilities of where I can take you. 0:59:20.007 --> 0:59:21.208 Show me where you want to go 0:59:22.090 --> 0:59:22.710 and let's do it. 0:59:23.130 --> 0:59:24.012 Let's make this about you. 0:59:24.152 --> 0:59:24.431 All right, Mike, 0:59:24.452 --> 0:59:25.652 you ready to play three questions? 0:59:25.934 --> 0:59:26.474 Let's do it. 0:59:26.534 --> 0:59:28.155 I'm ready for any three questions. 0:59:28.275 --> 0:59:30.378 With three questions on the PT Pinecast. 0:59:30.398 --> 0:59:30.777 All right. 0:59:30.797 --> 0:59:32.739 Three questions from our friends at ATI. 0:59:32.760 --> 0:59:33.440 They're leading the charge 0:59:33.480 --> 0:59:34.501 in PT clinical research 0:59:34.521 --> 0:59:35.782 with more than 900 clinics 0:59:35.822 --> 0:59:36.762 achieving top marks in 0:59:36.824 --> 0:59:38.565 CMS's merit-based incentive program. 0:59:38.585 --> 0:59:39.686 They're the team to join for 0:59:39.726 --> 0:59:40.367 career growth. 0:59:40.447 --> 0:59:44.471 Explore opportunities at atipt.com. 0:59:44.550 --> 0:59:44.771 All right. 0:59:44.871 --> 0:59:45.791 Three questions. 0:59:46.012 --> 0:59:46.612 First one. 0:59:48.514 --> 0:59:51.019 Let's go... Fun fact. 0:59:51.059 --> 0:59:52.461 If you could have any superpower, 0:59:52.501 --> 0:59:53.324 what would it be and why? 0:59:54.085 --> 0:59:55.146 Ooh, superpower. 0:59:55.807 --> 0:59:57.010 So let's go with... 0:59:59.639 --> 1:00:01.219 I'm going to go with omniscience. 1:00:01.880 --> 1:00:03.481 I'm going to go with the 1:00:03.541 --> 1:00:05.422 ability to know all. 1:00:05.681 --> 1:00:06.483 Oh, know all. 1:00:06.943 --> 1:00:08.262 Yeah, yeah. 1:00:08.384 --> 1:00:10.224 So because I, 1:00:10.445 --> 1:00:11.485 and I believe I've used the 1:00:11.525 --> 1:00:13.545 term correctly, being omniscient. 1:00:14.847 --> 1:00:16.288 You'll have to fact check me 1:00:16.347 --> 1:00:16.907 on that though. 1:00:17.307 --> 1:00:18.548 Because I think that I can 1:00:18.688 --> 1:00:22.590 keep myself healthy, safe, 1:00:23.010 --> 1:00:24.211 help other people around me, 1:00:24.532 --> 1:00:25.771 help my patients even 1:00:25.831 --> 1:00:27.152 better if I'm omniscient. 1:00:27.172 --> 1:00:27.954 So I'm going to go with that 1:00:27.994 --> 1:00:28.693 as my superpower. 1:00:28.932 --> 1:00:30.273 It feels like, you know, Professor X, 1:00:30.333 --> 1:00:31.713 Charles Xavier was a little omniscient. 1:00:31.753 --> 1:00:32.594 Yeah, there you go. 1:00:32.653 --> 1:00:32.835 Yeah. 1:00:32.855 --> 1:00:33.375 All right. 1:00:33.394 --> 1:00:34.454 Let's look backwards. 1:00:34.735 --> 1:00:35.835 What's the most memorable 1:00:35.876 --> 1:00:37.315 piece of advice that you've 1:00:37.416 --> 1:00:39.577 received from a mentor or colleague? 1:00:39.597 --> 1:00:40.458 What's something you thought 1:00:40.538 --> 1:00:41.498 you were like this stuck? 1:00:42.273 --> 1:00:48.117 Okay, so in about 1997 or 1998, 1:00:48.117 --> 1:00:50.639 I was applying for a 1:00:50.719 --> 1:00:53.039 position within the 1:00:53.099 --> 1:00:55.041 hospital organization that I was working, 1:00:55.681 --> 1:00:56.983 and the vice president of 1:00:57.023 --> 1:00:58.483 the hospital was interviewing me, 1:00:58.603 --> 1:00:59.143 and he says, 1:00:59.925 --> 1:01:02.927 I wish you all the good luck 1:01:03.086 --> 1:01:04.387 that hard work can earn. 1:01:06.242 --> 1:01:07.443 And that has stuck with me. 1:01:07.463 --> 1:01:08.704 And that gentleman remains a 1:01:08.744 --> 1:01:09.925 friend of mine to today. 1:01:10.505 --> 1:01:12.405 So I understand from that, 1:01:13.346 --> 1:01:15.007 there's really not so much 1:01:15.047 --> 1:01:16.668 of a good thing as good luck. 1:01:17.208 --> 1:01:18.268 Let's see you earn it. 1:01:18.307 --> 1:01:19.588 Let's see your work ethic. 1:01:19.688 --> 1:01:21.269 And then that'll put the 1:01:21.730 --> 1:01:23.291 afforded opportunities in 1:01:23.371 --> 1:01:24.831 front of you that you think are lucky. 1:01:24.971 --> 1:01:26.052 So I think that's what I'm 1:01:26.072 --> 1:01:26.452 going to go with. 1:01:26.771 --> 1:01:27.932 I heard a quote similar. 1:01:27.992 --> 1:01:28.452 It was, 1:01:28.572 --> 1:01:30.813 luck is the dying prayer of the man 1:01:30.853 --> 1:01:31.855 who believes that success 1:01:31.894 --> 1:01:32.755 happens by accident. 1:01:33.405 --> 1:01:34.106 Ah, there you go. 1:01:34.126 --> 1:01:35.626 Yeah, I totally get that. 1:01:35.827 --> 1:01:35.987 Yeah. 1:01:36.007 --> 1:01:36.467 All right. 1:01:36.586 --> 1:01:37.626 Unexpected choice. 1:01:37.726 --> 1:01:39.106 If you had to completely 1:01:39.688 --> 1:01:40.608 switch professions, 1:01:40.628 --> 1:01:42.168 you had to choose a different profession. 1:01:42.208 --> 1:01:42.728 What would it be? 1:01:42.768 --> 1:01:43.547 What intrigues you? 1:01:45.208 --> 1:01:46.849 If I had to switch right now, 1:01:47.268 --> 1:01:48.250 it would be different than 1:01:48.309 --> 1:01:49.050 what if I had to switch 1:01:49.070 --> 1:01:50.110 because I tried to become a 1:01:50.150 --> 1:01:51.030 major league baseball 1:01:51.050 --> 1:01:52.411 player that didn't work. 1:01:52.570 --> 1:01:54.090 And I can't look back at that now. 1:01:54.630 --> 1:01:56.952 So one of the things that I 1:01:57.072 --> 1:01:58.134 really like that you talk 1:01:58.173 --> 1:01:59.594 about is psychologist. 1:02:00.016 --> 1:02:01.817 So I probably would look that direction. 1:02:02.237 --> 1:02:04.420 Behavioral economist would 1:02:04.460 --> 1:02:05.561 probably be my other things 1:02:06.001 --> 1:02:07.061 because I tell a lot of 1:02:07.121 --> 1:02:08.523 people over the course of 1:02:09.543 --> 1:02:10.885 the 30 years that I've been 1:02:11.686 --> 1:02:13.067 teaching on a continuing 1:02:13.086 --> 1:02:14.969 education basis is I'm not 1:02:15.068 --> 1:02:16.269 actually sure how good of a 1:02:16.309 --> 1:02:17.431 physical therapist I am. 1:02:18.376 --> 1:02:19.795 I think I'm actually really 1:02:19.835 --> 1:02:21.556 good at listening to people 1:02:22.277 --> 1:02:24.177 and helping them become the 1:02:24.237 --> 1:02:25.998 best that they can be with 1:02:26.059 --> 1:02:27.878 the tools that they think 1:02:27.938 --> 1:02:29.579 and the direction pathway 1:02:29.960 --> 1:02:31.079 that they think is going to 1:02:31.119 --> 1:02:31.699 take them there. 1:02:31.960 --> 1:02:34.420 I think that I can help to maximize people, 1:02:34.820 --> 1:02:35.802 but I'm not certain that 1:02:35.822 --> 1:02:37.202 I'm a great physical therapist. 1:02:37.601 --> 1:02:39.963 So the psychology and 1:02:40.043 --> 1:02:41.563 behavioral economy actually 1:02:41.623 --> 1:02:42.583 fit nicely for me there. 1:02:42.983 --> 1:02:43.204 Yeah. 1:02:43.244 --> 1:02:44.144 I think it's really interesting. 1:02:44.164 --> 1:02:44.304 Yeah. 1:02:44.324 --> 1:02:46.184 I mean, if I had to pick another degree, 1:02:46.224 --> 1:02:47.146 that one would just be fun, 1:02:47.166 --> 1:02:48.646 but it is fun to just read these books. 1:02:48.706 --> 1:02:50.086 Like, like someone like Adam Grant, 1:02:50.106 --> 1:02:51.947 which I talk about a lot, 1:02:52.327 --> 1:02:53.728 he makes it very relatable. 1:02:53.827 --> 1:02:55.489 Like he is talking about these ideas, 1:02:55.528 --> 1:02:57.469 like Daniel Kahneman talks about things, 1:02:57.510 --> 1:02:59.351 but I mean, he's super high level. 1:02:59.371 --> 1:03:01.050 I need to like read a chapter, 1:03:01.170 --> 1:03:03.632 put it down again with Adam Grant. 1:03:03.672 --> 1:03:04.672 He sort of knows he's 1:03:04.713 --> 1:03:05.532 talking to people like me 1:03:05.552 --> 1:03:06.132 who are a little slow. 1:03:06.172 --> 1:03:06.472 Yeah. 1:03:06.753 --> 1:03:06.954 Yeah. 1:03:07.014 --> 1:03:07.353 All right. 1:03:07.373 --> 1:03:07.954 Three questions. 1:03:08.014 --> 1:03:08.974 Last thing we do on the show, 1:03:08.994 --> 1:03:10.255 Mike is the parting shot. 1:03:10.655 --> 1:03:12.396 this is the parting shot all 1:03:12.436 --> 1:03:13.416 right parting shot last 1:03:13.436 --> 1:03:14.235 chance for a mic drop 1:03:14.255 --> 1:03:14.876 moment it's brought to you 1:03:14.896 --> 1:03:15.597 by the academy of 1:03:15.717 --> 1:03:16.956 orthopedic physical therapy 1:03:17.036 --> 1:03:17.657 find them online at 1:03:17.697 --> 1:03:19.777 orthopt.org their 1:03:19.818 --> 1:03:20.998 profession leading current 1:03:21.059 --> 1:03:23.500 concepts of orthopedic pts 1:03:23.539 --> 1:03:24.320 in their fifth edition 1:03:24.699 --> 1:03:25.659 wherever you are in your 1:03:25.719 --> 1:03:27.081 orthopedic career if you uh 1:03:27.101 --> 1:03:27.621 if you're thinking about 1:03:27.641 --> 1:03:29.021 maybe that ocs exam this is 1:03:29.041 --> 1:03:30.302 that road map to get you 1:03:30.362 --> 1:03:32.023 from there to the starting 1:03:32.063 --> 1:03:33.342 line right you're it's your 1:03:33.382 --> 1:03:34.342 job to take the test they 1:03:34.362 --> 1:03:35.204 can get you prepared 1:03:36.244 --> 1:03:37.829 right the luck that uh that 1:03:37.869 --> 1:03:38.911 hard work affords you they 1:03:38.931 --> 1:03:39.773 can do that so find them 1:03:39.793 --> 1:03:42.099 online at ortho pt.org mike 1:03:42.119 --> 1:03:42.902 what's your parting shot 1:03:44.134 --> 1:03:45.454 My parting shot is I want 1:03:45.514 --> 1:03:46.856 therapists to think about 1:03:46.996 --> 1:03:48.817 dual tasking in that 1:03:48.896 --> 1:03:50.157 context that I framed it 1:03:50.197 --> 1:03:51.378 about 40 minutes ago as a 1:03:51.438 --> 1:03:53.480 constraint so that we can 1:03:53.619 --> 1:03:56.081 tie up your attention and 1:03:56.121 --> 1:03:57.603 that we allow people to be 1:03:57.663 --> 1:04:01.204 able to learn things formidably, fully, 1:04:01.326 --> 1:04:02.585 and in a procedural manner 1:04:03.126 --> 1:04:04.527 because we haven't caused 1:04:04.568 --> 1:04:06.068 them to constantly think about it. 1:04:06.108 --> 1:04:07.208 So I think if you think 1:04:07.228 --> 1:04:08.309 about it in that analogy, 1:04:08.389 --> 1:04:09.291 that can be helpful. 1:04:09.630 --> 1:04:11.871 yeah uh links to uh to find 1:04:11.911 --> 1:04:13.032 out more about mike I'll be 1:04:13.052 --> 1:04:14.233 looking for that uh that 1:04:14.293 --> 1:04:15.532 soft skills course because 1:04:15.572 --> 1:04:16.414 why are these soft skills 1:04:16.474 --> 1:04:17.614 so damn hard on medbridge 1:04:18.094 --> 1:04:18.954 and I want to see that 1:04:19.034 --> 1:04:20.054 youtube video pop off so 1:04:20.074 --> 1:04:20.956 I'm gonna put the link in 1:04:20.996 --> 1:04:22.755 the uh the the bio okay 1:04:22.795 --> 1:04:23.697 let's see what happens all 1:04:23.717 --> 1:04:24.976 right thank you for finally 1:04:24.996 --> 1:04:26.038 connecting with me after we 1:04:26.137 --> 1:04:27.117 uh we hit and missed we 1:04:27.137 --> 1:04:27.898 glanced at each other but 1:04:28.097 --> 1:04:29.059 we finally did it it was it 1:04:29.099 --> 1:04:30.219 was uh even better than I 1:04:30.259 --> 1:04:31.659 imagined and I learned so 1:04:31.719 --> 1:04:32.619 much thank you so much 1:04:32.679 --> 1:04:33.701 jimmy I appreciate it all 1:04:33.721 --> 1:04:34.280 right they say the best 1:04:34.340 --> 1:04:35.360 conversations happen at 1:04:35.420 --> 1:04:36.802 happy hour thanks for coming ours