Navigating the Insurance Maze: Elevating the Patient Experience

WEBVTT

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One step closer to the weekend.

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A good Thursday morning to you.

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Today we're talking about

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loyalty and trust.

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I look back at my PT

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textbooks this morning,

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and in the syllabi,

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and I didn't see anything

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about loyalty or trust.

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It's in there.

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It's baked in there.

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But are you paying attention to it now?

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Loyalty and trust.

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And we bring in the guru.

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He's kind of guru-y.

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John Taffer.

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Name sounds familiar.

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Bar rescue.

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You've seen him screaming at

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bar owners and bartenders

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and waiters and waitresses

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on their hit show that's

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done a million episodes.

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What lessons can we take

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from Bar Rescue and Jon

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Taffer to apply to your

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physical therapy business

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or health care or, geez, life?

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So building loyalty in

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physical therapy and beyond,

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how can you earn trust like Jon Taffer?

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Plus, we're going to do a review.

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This is like the dirtiest word.

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Have you heard?

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The dirtiest word in

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healthcare in the last couple of weeks.

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UnitedHealthcare.

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We dig in.

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And poof, there they are on screen.

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No, you're in the wrong position.

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It's always Tony in the

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middle and Dave on the right.

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Good morning, Tony Maritato.

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Good morning, Dave Kittle.

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Still on location in the smoky,

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lost in the smoky mountains

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is Dave Kittle on vacation,

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but he's still doing this live stream.

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Good morning.

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Yeah,

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how long are you going to be on vacation?

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We'll be back the day before Labor Day,

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but I want to try to do

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some Cal Ripken streak, man.

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I don't want to leave you guys out.

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I miss you, so I'm here.

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Yeah.

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All right.

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Yeah.

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I lost my voice last week.

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Still showed up.

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Still just kept putting words on screen.

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That counts.

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That counts as the streak.

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So I've got an interesting

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one for you guys because I

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know we're talking.

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Jimmy,

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what did you say we're talking about?

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Building loyalty and trust.

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Building loyalty and trust.

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Let's talk about that for

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just a second from a staff perspective.

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And this this will give you

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some peek behind the

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curtain on why I'm so

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resistant to try and hire new staff.

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So I I'm on a run yesterday morning.

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I text my team.

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I'm like, hey, guys,

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I'm going to come in about 10 o'clock.

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There's a 10 o'clock evaluation scheduled.

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So I dropped my kids off at school.

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I go for a run.

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I'm about a mile away from the house.

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I've been running a little while now.

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I get a call and it's one of

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my physical therapist assistants.

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And I'm like, hey, what's going on?

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And she was like,

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I just threw up in my car.

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I'm in the parking lot at the clinic.

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I don't think we have any

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patients for another 30 minutes.

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I am so sorry.

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I just, I can't stop throwing up.

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Meanwhile, she's pregnant.

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She's due like early November.

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And I'm like, oh, my gosh, totally.

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Don't worry about it.

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I am going to be there.

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Let me let me get back to the house.

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I'll just get dressed and I'll come in.

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She's like, I'm so sorry.

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I feel so bad.

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I'm like, seriously, you're like seven,

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eight months pregnant.

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You're puking in the parking lot.

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You still showed up to work

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to open the clinic.

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I'm like, it's OK.

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We will be fine.

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Just give me 10 minutes.

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I'll get in the car and I'll

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be right there.

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Like that kind of personality,

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that kind of dedication is

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Um, like,

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I don't even want to interview for that.

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I don't know how you find

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something like that, you know?

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And so dedication, go ahead.

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But look at the reverse.

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Like that is a hard phone call to make.

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I'm guessing I've had to

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make that phone call.

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I've never been eight months pregnant.

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I know it surprises you, but I've,

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but I've had to make that

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call and I can feel a

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visceral reaction when I

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had to call my former boss, Chris.

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or a different boss.

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And if I called Chris and I was like,

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Hey man,

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I'm sick and throw up in the parking lot.

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He would have said, go home.

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Like, are you, are you okay?

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Do you need me to come get you go home?

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Um, so it works both ways.

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Like there is that, Hey,

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I wouldn't even want to look for that.

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How would I find that?

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I don't know if you, I mean,

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I think you need the right ingredients,

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but it needs to be both ways.

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Like it's the ingredients

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and you need to cook it right.

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Yeah.

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Boy, it's never going to happen.

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You don't upgrade ingredients,

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but you cook it wrong.

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So it's on both sides.

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You have to you have to understand.

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I think I wrote this in the

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chat yesterday between us.

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You have to understand,

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does everybody on the field

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understand what game we're playing?

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Do they understand what

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position they're playing

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and do they know how to

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play that position well?

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And I think you just

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described a situation where

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the answer is yes to all three of those.

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So the problem is that Tony

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is just discounting the

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entire available hiring community,

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any therapist.

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Like,

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is everyone going to be like that person?

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Probably not.

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Is every PT or PTA going to be like that?

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Probably not.

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Maybe after a couple of

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years or maybe never.

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But Tony,

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I want to grab you and shake you and say,

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you know, we're here for you.

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We're here for you.

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But at the same time, no,

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not every candidate is

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going to be like that.

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Not every team member is

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going to grow into, you know,

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your exact culture and

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morale and all that.

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But it kills me, Tony,

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because I've known you for

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so long that this is

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affecting your decision to

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hire or grow your team.

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Because if you had an extra PT or PTA,

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couldn't that PT or PTA right now,

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or when that happened, um,

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help cover and absorb some

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of those patients at the very least.

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And then you continue on your run.

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Maybe some of the patients

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you have to slide later in

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the week or reschedule,

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but you continue your run.

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You continue, um,

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some of the home life before

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you go back into the clinic.

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So I understand like the communication and,

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you know, some of these team members,

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cause I've had some of

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these team members over the years,

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like you're describing, like, no,

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I agree.

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They're not everywhere, but I just,

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it kills me when you say

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that this is like

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preventing you at all from

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recruiting and hiring

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anybody like that's that I

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hope we can change.

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I don't know.

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No, you're right.

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It's social media.

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Everything coming in is so

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negative in regards to

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hiring and interviews and new candidates.

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Social media has totally

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warped my perspective.

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There are good humans out there.

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I know they exist.

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Jimmy, you were going to say something.

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Yeah, I was going to say, could you use,

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in a good way,

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use that employee you just talked about,

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the reliable one,

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the one who's going to

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almost fight through

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vomiting to help open the clinic,

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to beta test or to be able

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to use it as a farm system?

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It's like, well,

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having that reliable person

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may allow you to have

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someone you can take a risk on

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It was similar to when I was in radio.

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I was always taught,

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where are your bench players, right?

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Let's say your morning person leaves.

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Who have you been training

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up for the last two or

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three years and giving reps

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to on the weekends, right?

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Where it's safer to fail in radio terms,

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right?

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You didn't want to put the

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person in prime time, but hey,

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where's that person three,

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five years from now?

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That was one thing that made

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me a little bit nervous in

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radio is with all the syndication

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All these big shows being

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sent to multiple markets.

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Where are the bench players?

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Where's the kid who sucked

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in the beginning, right?

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I mean,

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how many times do we hear like the

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starting shortstop or the

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MVP of the World Series was

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the backup in high school?

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Well,

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he had enough reps somewhere along

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the way and was able to

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actually become the

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megastar that they are.

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Yeah, yeah.

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No, I totally agree.

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Simple, not easy, though.

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Simple, not easy.

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Right, right.

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Go ahead.

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What's the topic?

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All right.

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So let's get into this.

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So there's a long clip.

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This clip is four and a half minutes.

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I'm going to play a couple

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of seconds of it.

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And I'll put the link to the

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clip in the chat.

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But this is Jon Taffer, who's the big,

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bellowy, screamy host from Bar Rescue,

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who goes around the country.

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He has a really narrow skill set,

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which is coming in and

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assessing bars and restaurants.

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And he gets a snapshot.

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And some people have said

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his show is formulaic.

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I would say a lot of PTs or

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health care professionals,

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they have an evaluation that's formulaic.

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If I go through the same

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process every time,

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I know where to spot the leaks.

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And he goes through this process,

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and he finds out where the problem,

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can this thing be saved?

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If so, where are the problems?

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And then let's change those problems.

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Spoiler alert, it's mostly,

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most of the times, people in psychology.

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Even though Jon Taffer is a restaurant guy,

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he understands the game that he's in.

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So it's John Taffer, for context,

00:08:39.808 --> 00:08:40.711
talking to Gary Vee.

00:08:40.750 --> 00:08:41.631
And if you don't know Gary Vee,

00:08:41.652 --> 00:08:41.893
I don't know.

00:08:41.913 --> 00:08:42.833
You've been living under a rock.

00:08:43.294 --> 00:08:44.977
Social media guy sort of

00:08:45.097 --> 00:08:46.000
pioneered that whole

00:08:46.039 --> 00:08:47.403
document versus create,

00:08:47.462 --> 00:08:48.544
just recorded everything.

00:08:48.725 --> 00:08:50.427
And it's a conversation between these two.

00:08:51.855 --> 00:08:54.416
And John is highlighting this statistic.

00:08:54.475 --> 00:08:55.416
He did research.

00:08:55.436 --> 00:08:56.416
He doesn't cite his sources.

00:08:56.436 --> 00:08:57.376
That's okay, we still like it.

00:08:57.976 --> 00:08:58.636
Where he said,

00:08:58.736 --> 00:09:00.457
if a person comes into a

00:09:00.518 --> 00:09:04.499
restaurant and has a perfect experience,

00:09:04.839 --> 00:09:05.999
a perfect dining experience,

00:09:06.259 --> 00:09:07.379
the statistical likelihood

00:09:07.399 --> 00:09:08.179
that they come back

00:09:08.879 --> 00:09:09.480
is 40%.

00:09:10.260 --> 00:09:11.881
Ooh, I wish it was higher.

00:09:11.902 --> 00:09:13.602
A perfect experience and only 40%.

00:09:13.863 --> 00:09:16.124
The same statistic holds

00:09:16.183 --> 00:09:17.024
true from their second

00:09:17.063 --> 00:09:18.164
perfect experience to get

00:09:18.205 --> 00:09:20.826
them back for the third, 40%.

00:09:20.826 --> 00:09:23.707
But if they have three perfect experiences,

00:09:23.788 --> 00:09:24.649
if they have a hat trick,

00:09:25.208 --> 00:09:26.288
the statistical likelihood

00:09:26.308 --> 00:09:28.571
that they become a

00:09:28.730 --> 00:09:31.511
long-term return customer, loyal customer,

00:09:31.851 --> 00:09:32.673
goes up to 70%.

00:09:32.673 --> 00:09:35.014
So you've really got to earn

00:09:35.033 --> 00:09:35.774
it in those three.

00:09:35.794 --> 00:09:37.775
And he's talking about these tricks

00:09:38.456 --> 00:09:40.378
Or I mean, these strategies, right?

00:09:40.398 --> 00:09:41.158
It's a nice way of saying

00:09:41.197 --> 00:09:43.120
tricks on how they do that.

00:09:43.200 --> 00:09:44.019
So I'll play just a couple

00:09:44.059 --> 00:09:44.821
seconds of the clip and

00:09:44.841 --> 00:09:45.861
then we can sort of dive in.

00:09:46.962 --> 00:09:47.842
If somebody goes to a

00:09:47.942 --> 00:09:48.984
restaurant for the first

00:09:49.024 --> 00:09:50.826
time and has a flawless experience,

00:09:51.206 --> 00:09:52.626
the statistical likelihood

00:09:52.647 --> 00:09:53.748
of them doing a second

00:09:53.807 --> 00:09:57.024
visit is about 40%.

00:09:57.024 --> 00:09:58.765
They come back a second time

00:09:59.346 --> 00:10:00.826
and have a flawless experience.

00:10:01.086 --> 00:10:02.548
The statistical likelihood

00:10:02.567 --> 00:10:06.910
of a third visit is still about 42%.

00:10:06.910 --> 00:10:09.211
The third time they come,

00:10:09.511 --> 00:10:10.812
the statistical likelihood

00:10:10.832 --> 00:10:15.054
of a fourth visit is over 70%.

00:10:15.054 --> 00:10:17.416
So you got to market to three visits,

00:10:17.556 --> 00:10:18.855
not one visit.

00:10:19.417 --> 00:10:20.616
I think that last line right

00:10:20.636 --> 00:10:21.956
there is why I wanted to play that clip.

00:10:22.037 --> 00:10:24.857
You market to three visits, not one.

00:10:25.298 --> 00:10:25.578
Okay.

00:10:25.818 --> 00:10:27.259
And he goes into, and I'll share the clip.

00:10:27.278 --> 00:10:28.740
He goes into strategies and

00:10:28.779 --> 00:10:29.960
we can talk about hours and

00:10:30.000 --> 00:10:30.620
we can rip through it

00:10:30.659 --> 00:10:31.941
faster than John in that clip,

00:10:32.421 --> 00:10:34.662
but you market to three visits,

00:10:35.121 --> 00:10:37.403
three dinners, three perfect experiences,

00:10:37.423 --> 00:10:37.682
three,

00:10:38.182 --> 00:10:38.722
not one.

00:10:39.123 --> 00:10:40.724
My question is in physical

00:10:40.764 --> 00:10:42.043
therapy or healthcare,

00:10:42.365 --> 00:10:44.384
do we even market to one?

00:10:44.725 --> 00:10:46.865
Or are we just like when the

00:10:46.905 --> 00:10:48.886
patient walked in, walks in and said,

00:10:48.907 --> 00:10:50.187
Oh my gosh, you're here.

00:10:50.226 --> 00:10:51.148
I'm so glad you're here.

00:10:51.227 --> 00:10:51.628
Is it more?

00:10:52.028 --> 00:10:52.508
I'm here.

00:10:52.888 --> 00:10:53.629
Aren't you glad?

00:10:54.229 --> 00:10:56.370
So when you, when you see a clip like that,

00:10:56.429 --> 00:10:57.409
Dave, we'll go to Dave first.

00:10:57.429 --> 00:10:58.269
Cause I think Tony has an

00:10:58.309 --> 00:10:59.951
experience in strategies like this.

00:11:00.030 --> 00:11:01.991
Dave, when you see that number one,

00:11:02.011 --> 00:11:03.451
does that stat surprise you too?

00:11:03.471 --> 00:11:04.533
Do you think it's paralleled

00:11:04.572 --> 00:11:05.072
to healthcare?

00:11:06.471 --> 00:11:08.312
There's some parallels, but not exactly.

00:11:08.393 --> 00:11:11.336
So WebPT, Tony knows this, five,

00:11:11.395 --> 00:11:12.157
six something years ago,

00:11:12.177 --> 00:11:13.298
they put out a study and it

00:11:13.357 --> 00:11:16.000
was like 80 or 90 or some large,

00:11:16.059 --> 00:11:18.142
large majority of patients fall off.

00:11:18.201 --> 00:11:19.744
I think after like the third visit, they

00:11:20.234 --> 00:11:21.095
The study was something like

00:11:21.095 --> 00:11:22.557
80 or 90% of patients do

00:11:22.596 --> 00:11:23.577
not finish their plan of care.

00:11:23.597 --> 00:11:24.778
The plan of care as defined

00:11:24.798 --> 00:11:25.720
by the physical therapist

00:11:25.740 --> 00:11:27.562
who does the evaluation and then writes,

00:11:27.581 --> 00:11:28.844
this is going to be eight

00:11:28.864 --> 00:11:30.004
weeks or three weeks or 12

00:11:30.004 --> 00:11:31.166
weeks or however long,

00:11:31.265 --> 00:11:32.167
depending on that condition.

00:11:32.687 --> 00:11:34.669
So WebPT did this study that

00:11:34.710 --> 00:11:35.711
most patients drop off.

00:11:35.770 --> 00:11:36.672
There's some parallels,

00:11:36.772 --> 00:11:38.333
but it's not exact with the

00:11:38.374 --> 00:11:39.434
restaurant world because

00:11:40.676 --> 00:11:41.697
we all go out, us three,

00:11:41.956 --> 00:11:43.378
we're going to find one restaurant,

00:11:43.398 --> 00:11:44.818
but then we're going to go

00:11:44.859 --> 00:11:45.720
to a different restaurant

00:11:46.179 --> 00:11:47.061
the next night or the next

00:11:47.120 --> 00:11:47.981
week or whatever, right?

00:11:48.001 --> 00:11:48.501
We're going to switch

00:11:48.562 --> 00:11:50.163
restaurants versus physical therapy,

00:11:50.683 --> 00:11:52.745
where if we're deciding to

00:11:52.926 --> 00:11:54.407
get physical therapy for

00:11:54.486 --> 00:11:55.687
back pain or total knee

00:11:55.748 --> 00:11:56.587
replacement or whatever,

00:11:56.889 --> 00:11:57.328
like we're going to

00:11:57.568 --> 00:11:58.549
typically find a place and

00:11:58.570 --> 00:11:59.850
we're going to just most of

00:11:59.890 --> 00:12:02.592
the time continue at that place if it's

00:12:03.013 --> 00:12:04.073
you know, Tony will fill in the gaps.

00:12:04.114 --> 00:12:05.937
Like if the place is like good enough or,

00:12:05.996 --> 00:12:07.057
you know, decent enough or whatever,

00:12:07.077 --> 00:12:09.340
they'll stick around to go

00:12:09.379 --> 00:12:10.662
to that one place as

00:12:10.721 --> 00:12:11.923
opposed to the restaurant

00:12:11.942 --> 00:12:14.285
world where it's very, um, there,

00:12:14.326 --> 00:12:15.967
there's so many options in the community,

00:12:16.028 --> 00:12:17.548
wherever you're at, any city, Metro,

00:12:17.568 --> 00:12:19.311
whatever, or even a rural area.

00:12:19.692 --> 00:12:19.971
And it's,

00:12:20.111 --> 00:12:20.993
you're going to go to a different

00:12:21.033 --> 00:12:21.433
restaurant.

00:12:21.474 --> 00:12:22.575
I'm not going to go like,

00:12:22.615 --> 00:12:23.816
if I have Chipotle yesterday, I'm,

00:12:24.557 --> 00:12:25.717
I might go today, but I'm not,

00:12:25.778 --> 00:12:26.798
I'm not going to go like, you know,

00:12:26.818 --> 00:12:27.499
I'm going to go to Chipotle

00:12:27.519 --> 00:12:28.659
like once a week or whatever,

00:12:28.860 --> 00:12:29.941
or the Mexican restaurant

00:12:29.961 --> 00:12:30.822
or some other place.

00:12:31.543 --> 00:12:33.524
Um, there's some parallels here, but it's,

00:12:33.663 --> 00:12:34.424
it's not, I don't know.

00:12:34.445 --> 00:12:36.125
It's not quite the same because of that.

00:12:37.187 --> 00:12:38.587
But, but doesn't that reinforce it?

00:12:38.668 --> 00:12:39.749
Isn't it more important

00:12:39.849 --> 00:12:41.389
because you're not going to jump around.

00:12:41.490 --> 00:12:42.971
So if you are the person or

00:12:43.011 --> 00:12:44.173
the practice that gets that

00:12:44.253 --> 00:12:45.813
first referral or visit,

00:12:46.193 --> 00:12:47.595
isn't it more important to

00:12:47.634 --> 00:12:48.436
give the experience?

00:12:48.696 --> 00:12:50.577
Cause you just said web PT

00:12:50.597 --> 00:12:51.317
had their data that 80% 80

00:12:51.317 --> 00:12:55.298
is pretty close to 60.

00:12:55.298 --> 00:12:57.360
In terms of a 40%

00:12:57.360 --> 00:12:58.360
statistical likelihood they

00:12:58.380 --> 00:12:59.441
come back for the second dinner,

00:12:59.681 --> 00:13:00.402
which means there's a 60%

00:13:00.402 --> 00:13:02.322
statistical likelihood they

00:13:02.403 --> 00:13:03.222
don't come back.

00:13:03.923 --> 00:13:05.203
So I feel like a plan of

00:13:05.264 --> 00:13:06.985
care would be 10 dinners.

00:13:07.205 --> 00:13:10.307
That's when the host knows your name.

00:13:10.927 --> 00:13:12.528
That's completing the plan of care.

00:13:12.548 --> 00:13:13.528
And can we get another one?

00:13:14.729 --> 00:13:15.408
They might be off by a

00:13:15.448 --> 00:13:16.429
couple percentage points.

00:13:17.169 --> 00:13:18.551
but it feels similar and it

00:13:18.610 --> 00:13:19.631
actually feels more risky

00:13:19.652 --> 00:13:21.552
because once you go to PT,

00:13:21.592 --> 00:13:22.374
we hear this a lot.

00:13:22.533 --> 00:13:23.254
I tried PT.

00:13:23.475 --> 00:13:24.434
It didn't work.

00:13:24.696 --> 00:13:25.556
I didn't go back.

00:13:25.976 --> 00:13:26.456
I didn't go to.

00:13:26.976 --> 00:13:27.437
And the patient,

00:13:27.577 --> 00:13:28.639
the patient went to one place.

00:13:28.658 --> 00:13:29.599
They didn't go to multiple

00:13:29.639 --> 00:13:30.980
physical therapy practices typically.

00:13:31.581 --> 00:13:33.001
So this tells me you're not

00:13:33.022 --> 00:13:33.802
going to get someone who

00:13:33.841 --> 00:13:34.663
had a bad burrito at

00:13:34.702 --> 00:13:36.244
Chipotle and now you're the

00:13:36.283 --> 00:13:37.625
local Mexican point place.

00:13:38.005 --> 00:13:38.485
You're going to have,

00:13:38.586 --> 00:13:40.246
I had a bad burrito at Chipotle.

00:13:40.366 --> 00:13:41.927
I'm never having burritos again.

00:13:41.967 --> 00:13:44.009
That's more of the, that's more of the PT.

00:13:44.090 --> 00:13:46.172
That's more of the healthcare parallel.

00:13:47.011 --> 00:13:49.933
So if that WebPT statistic is correct,

00:13:50.073 --> 00:13:51.875
Tony, if you're a practice,

00:13:52.395 --> 00:13:54.096
how do you make sure

00:13:54.236 --> 00:13:56.038
someone gets to 10 visits

00:13:56.057 --> 00:13:57.879
where the bartender knows their name?

00:13:57.940 --> 00:13:59.299
And what are the strategies

00:13:59.340 --> 00:14:01.402
that we can do to build and

00:14:01.601 --> 00:14:02.663
earn loyalty and trust?

00:14:03.458 --> 00:14:04.980
Yeah, I think there's a ton of ways.

00:14:05.259 --> 00:14:07.059
I'm curious to see what Dave

00:14:07.080 --> 00:14:09.201
has crafted in the self-pay world,

00:14:09.240 --> 00:14:10.442
because that's a whole

00:14:10.501 --> 00:14:11.601
different ballpark.

00:14:13.462 --> 00:14:16.043
Jerry Durham, I think Dave, me,

00:14:16.224 --> 00:14:17.924
and Rob Vining talked about this.

00:14:17.965 --> 00:14:19.645
We've been talking about this for decades,

00:14:19.725 --> 00:14:20.206
literally.

00:14:20.706 --> 00:14:22.326
like for us first things

00:14:22.365 --> 00:14:24.167
first like I never do as an

00:14:24.226 --> 00:14:26.388
example provocative test

00:14:26.408 --> 00:14:27.707
why you're coming to me as

00:14:27.748 --> 00:14:29.509
a client to feel better and

00:14:29.589 --> 00:14:30.649
I'm gonna make you feel

00:14:30.708 --> 00:14:31.528
worse I'm gonna do

00:14:31.609 --> 00:14:33.210
something that flares up

00:14:33.250 --> 00:14:35.269
your symptoms so like I

00:14:35.389 --> 00:14:37.150
understand I need an easy

00:14:37.211 --> 00:14:39.730
win uh my my big thing is

00:14:39.750 --> 00:14:41.351
hey let's get you in here

00:14:41.392 --> 00:14:42.371
let's get you feeling good

00:14:42.412 --> 00:14:43.673
let's get you out the door

00:14:43.793 --> 00:14:44.852
before you even

00:14:45.413 --> 00:14:47.316
think you need to leave and

00:14:47.355 --> 00:14:48.336
I tell them all this like

00:14:48.376 --> 00:14:49.739
this is all part of if you

00:14:49.778 --> 00:14:50.880
guys recorded me in the

00:14:50.900 --> 00:14:52.342
clinic you would hear the

00:14:52.383 --> 00:14:54.065
same thing over and over

00:14:54.125 --> 00:14:55.886
very systematized it's just

00:14:56.628 --> 00:14:58.049
at this point I mean it

00:14:58.090 --> 00:14:59.231
just comes out I don't even

00:14:59.251 --> 00:15:00.393
think about it but it's like

00:15:01.172 --> 00:15:01.812
Let's get you in.

00:15:01.991 --> 00:15:02.972
Let's get you feeling good.

00:15:03.013 --> 00:15:04.452
Let's get you out before you

00:15:04.513 --> 00:15:05.274
want to leave.

00:15:05.293 --> 00:15:07.134
This way you come back tomorrow.

00:15:07.654 --> 00:15:08.955
And then when you come back tomorrow,

00:15:09.014 --> 00:15:10.035
it's going to be the same thing.

00:15:10.076 --> 00:15:10.775
Let's get you in.

00:15:10.895 --> 00:15:12.017
Let's get you feeling good.

00:15:12.216 --> 00:15:14.638
And let's get you out before

00:15:14.697 --> 00:15:16.158
you feel like you have to leave.

00:15:16.219 --> 00:15:17.578
Let's get you doing less

00:15:17.639 --> 00:15:18.620
than you want to do.

00:15:19.139 --> 00:15:21.240
So you come back wanting to do more.

00:15:21.760 --> 00:15:24.461
And every single session is a win.

00:15:24.662 --> 00:15:25.863
Every single session you're

00:15:25.923 --> 00:15:26.783
leaving feeling good.

00:15:26.802 --> 00:15:28.203
Now you can craft that in a

00:15:28.264 --> 00:15:29.104
lot of different ways.

00:15:29.163 --> 00:15:30.445
And I want to talk strategy.

00:15:30.945 --> 00:15:31.985
And I'm sure Dave's got some

00:15:32.046 --> 00:15:33.225
interesting things to say,

00:15:33.546 --> 00:15:35.206
but like as a perfect example,

00:15:35.246 --> 00:15:36.868
so we know how powerful

00:15:36.988 --> 00:15:39.428
saying or hearing your name can be.

00:15:39.929 --> 00:15:41.590
So when I was designing my

00:15:41.649 --> 00:15:43.051
clinics right from the start,

00:15:43.091 --> 00:15:44.932
the very first clinic I ever opened,

00:15:45.511 --> 00:15:47.173
I would notice a new client

00:15:47.212 --> 00:15:47.913
would come in.

00:15:49.214 --> 00:15:51.274
Maybe we knew their name, maybe we didn't,

00:15:51.394 --> 00:15:53.375
maybe my front desk person, you know,

00:15:53.677 --> 00:15:55.136
they're not treating the patient,

00:15:55.157 --> 00:15:56.138
so they're not going to remember.

00:15:56.738 --> 00:15:58.578
So we were still on paper charts.

00:15:58.739 --> 00:16:00.158
I would set the paper charts

00:16:00.359 --> 00:16:02.360
up in a position between

00:16:02.379 --> 00:16:03.860
the receptionist and the

00:16:03.899 --> 00:16:05.100
person walking in the door.

00:16:05.581 --> 00:16:07.221
So the person walks in the door,

00:16:07.280 --> 00:16:08.921
the receptionist literally

00:16:08.980 --> 00:16:10.822
has to look at the paper

00:16:10.881 --> 00:16:12.162
chart and then the person

00:16:12.201 --> 00:16:13.802
behind them to see the name.

00:16:14.503 --> 00:16:16.764
and be able to say, Susan,

00:16:16.825 --> 00:16:17.825
it's so great to see you.

00:16:18.004 --> 00:16:19.105
Not because she remembered

00:16:19.145 --> 00:16:20.746
Susan and what Susan looked like,

00:16:20.787 --> 00:16:22.168
but because she saw Susan's

00:16:22.248 --> 00:16:23.649
chart and the label with

00:16:23.688 --> 00:16:25.389
the name right in front of

00:16:25.450 --> 00:16:26.850
Susan who's walking in the door.

00:16:27.971 --> 00:16:29.773
And we would craft in that

00:16:29.852 --> 00:16:30.874
clip that you shared,

00:16:30.933 --> 00:16:32.014
he talked about having a

00:16:32.075 --> 00:16:33.716
red napkin to indicate this

00:16:33.796 --> 00:16:34.897
is a new customer.

00:16:34.917 --> 00:16:36.918
We would craft that same

00:16:36.977 --> 00:16:37.859
kind of experience.

00:16:37.879 --> 00:16:38.958
So if we had two or three

00:16:38.999 --> 00:16:40.600
clinicians in the practice,

00:16:41.380 --> 00:16:42.581
one of the policies would

00:16:42.601 --> 00:16:43.962
be when a new patient comes in,

00:16:44.842 --> 00:16:45.943
I would introduce that new

00:16:45.985 --> 00:16:46.985
patient to every single

00:16:47.024 --> 00:16:47.806
person on the team.

00:16:48.187 --> 00:16:49.047
This is I'm Tony.

00:16:49.106 --> 00:16:50.187
You know, this is Jeremy.

00:16:50.227 --> 00:16:50.989
This is Jenna.

00:16:51.048 --> 00:16:52.149
Jeremy is the Pittsburgh

00:16:52.169 --> 00:16:53.751
Steelers fan in Ohio.

00:16:53.851 --> 00:16:54.972
I don't know what he's doing here.

00:16:54.993 --> 00:16:56.794
And we would start cracking jokes.

00:16:56.855 --> 00:16:59.236
And then I would bring my patient to,

00:16:59.256 --> 00:17:00.557
let's say, the recumbent bike.

00:17:00.998 --> 00:17:02.799
And next to them would be a

00:17:03.000 --> 00:17:05.041
non covered wellness patient.

00:17:05.423 --> 00:17:07.124
And I would say, you know, John,

00:17:07.344 --> 00:17:09.006
this is this is Kim.

00:17:10.494 --> 00:17:12.596
Kim's been one of our veterans.

00:17:12.635 --> 00:17:13.696
She's been around the clinic

00:17:13.717 --> 00:17:14.938
for like a decade now.

00:17:15.057 --> 00:17:15.978
Kim, this is John.

00:17:16.018 --> 00:17:17.338
This is John's first day.

00:17:17.358 --> 00:17:19.519
I can't share any

00:17:19.579 --> 00:17:21.921
information about your case, but Kim,

00:17:21.980 --> 00:17:23.701
I think if you are willing,

00:17:24.103 --> 00:17:25.002
tell John a little bit

00:17:25.022 --> 00:17:26.044
about your experience.

00:17:26.663 --> 00:17:28.806
And then I would literally walk away.

00:17:29.205 --> 00:17:30.866
And so my patient who had

00:17:30.906 --> 00:17:32.568
been a wellness member for 10 years,

00:17:33.189 --> 00:17:34.911
all of a sudden now becomes

00:17:34.971 --> 00:17:36.051
an ambassador and starts

00:17:36.092 --> 00:17:37.031
telling the brand new

00:17:37.071 --> 00:17:38.953
patient about how amazing it is here,

00:17:39.013 --> 00:17:40.095
how much everybody is so

00:17:40.174 --> 00:17:41.296
thoughtful and caring.

00:17:41.336 --> 00:17:43.037
We have so much fun and I've

00:17:43.057 --> 00:17:44.097
been coming and I started

00:17:44.137 --> 00:17:45.259
for a knee replacement and

00:17:45.298 --> 00:17:47.099
now it's been 10 years and

00:17:47.140 --> 00:17:48.801
I can't imagine starting my

00:17:48.821 --> 00:17:50.182
day without coming to the clinic.

00:17:50.782 --> 00:17:52.726
They become my sales force, you know,

00:17:52.766 --> 00:17:54.768
so these are crafted

00:17:54.989 --> 00:17:56.550
experiences that we've

00:17:56.671 --> 00:17:58.874
created over years of

00:17:58.933 --> 00:18:00.134
figuring this stuff out.

00:18:00.855 --> 00:18:02.719
And like like that clip said,

00:18:03.078 --> 00:18:04.441
I know if I get them out

00:18:04.520 --> 00:18:05.883
the door feeling better and

00:18:05.962 --> 00:18:07.424
wanting to do more than they did.

00:18:07.765 --> 00:18:08.525
They're going to come back

00:18:08.545 --> 00:18:09.705
the next time and the next

00:18:09.746 --> 00:18:10.645
time and the next time.

00:18:10.685 --> 00:18:11.767
And once we get three or

00:18:11.826 --> 00:18:15.107
four finished visits, they're committed.

00:18:15.147 --> 00:18:15.928
There's no way.

00:18:15.968 --> 00:18:17.148
We're part of the family.

00:18:17.249 --> 00:18:19.369
We're ingrained in their schedule.

00:18:20.069 --> 00:18:22.711
And this isn't a model where

00:18:22.730 --> 00:18:24.211
a lot of my patients come

00:18:24.372 --> 00:18:26.012
in very reluctant,

00:18:26.452 --> 00:18:28.193
not interested in doing it.

00:18:28.354 --> 00:18:29.453
They're not paying for it.

00:18:29.513 --> 00:18:30.835
The insurance is paying for it.

00:18:30.875 --> 00:18:33.415
They're kind of coming begrudgingly.

00:18:34.236 --> 00:18:35.757
And so we're trying to win them over.

00:18:35.777 --> 00:18:37.357
We're in Dave's case.

00:18:37.699 --> 00:18:37.979
You know,

00:18:38.019 --> 00:18:39.740
they're paying a lot of money to see him.

00:18:40.941 --> 00:18:41.961
So I'd be curious to see

00:18:41.981 --> 00:18:42.961
what kind of stuff you're doing.

00:18:43.323 --> 00:18:43.803
Well, hang on.

00:18:43.843 --> 00:18:44.063
Hang on.

00:18:44.083 --> 00:18:44.583
Before we go,

00:18:44.603 --> 00:18:45.544
I want to I want to highlight

00:18:45.604 --> 00:18:46.585
three things that I heard.

00:18:46.825 --> 00:18:48.226
I thought I heard you say, yeah,

00:18:48.246 --> 00:18:49.067
Chris Voss, right?

00:18:49.727 --> 00:18:50.627
So it sounds like you

00:18:50.708 --> 00:18:51.748
focused on the number of

00:18:51.807 --> 00:18:52.749
times you could actually

00:18:52.788 --> 00:18:53.809
say that patient's name.

00:18:54.029 --> 00:18:54.230
I mean,

00:18:54.250 --> 00:18:55.391
to the importance of where you put

00:18:55.431 --> 00:18:55.891
the charts,

00:18:55.951 --> 00:18:57.031
the person at the front desk

00:18:57.071 --> 00:18:59.753
had to greet that person by name, not, hi,

00:18:59.874 --> 00:19:00.314
who are you?

00:19:00.634 --> 00:19:01.674
What insurance do you have?

00:19:01.955 --> 00:19:02.135
Right.

00:19:02.215 --> 00:19:02.915
That's not the thing.

00:19:02.955 --> 00:19:03.737
It's about a name.

00:19:05.018 --> 00:19:06.338
You sat them next to someone

00:19:06.358 --> 00:19:07.700
who's been there for a while and said,

00:19:07.720 --> 00:19:08.880
this is one of our veterans.

00:19:09.500 --> 00:19:11.041
What you showed but did not

00:19:11.122 --> 00:19:12.563
say is some people stick

00:19:12.623 --> 00:19:13.503
around for a while.

00:19:14.364 --> 00:19:16.205
You didn't sell them an aftercare thing.

00:19:16.226 --> 00:19:18.426
You said, to quote Seth Godin,

00:19:18.487 --> 00:19:20.288
people like us do things like this.

00:19:20.669 --> 00:19:22.210
So there is a path, not for everybody,

00:19:22.250 --> 00:19:23.411
but this is one of our veterans.

00:19:23.770 --> 00:19:25.112
And then you also let that person,

00:19:25.132 --> 00:19:26.692
when you walked away, sell it.

00:19:26.933 --> 00:19:27.993
We're natural like that.

00:19:28.275 --> 00:19:30.135
That's why third grade teachers,

00:19:30.155 --> 00:19:31.237
when there's a new kid in class,

00:19:31.777 --> 00:19:32.837
puts them next to the kid

00:19:32.857 --> 00:19:33.999
who acts really well and says,

00:19:34.038 --> 00:19:34.638
he's going to show you

00:19:34.659 --> 00:19:35.279
around the building.

00:19:35.299 --> 00:19:35.619
Right?

00:19:35.660 --> 00:19:35.859
Right.

00:19:36.039 --> 00:19:36.840
And then that kid feels

00:19:36.881 --> 00:19:37.921
empowered that I get to be

00:19:37.941 --> 00:19:38.821
the kid who shows the new

00:19:38.842 --> 00:19:39.501
kid around the building.

00:19:39.942 --> 00:19:41.423
And the last thing or the

00:19:41.442 --> 00:19:42.483
thing that stuck out maybe

00:19:42.503 --> 00:19:44.265
the most was you made them

00:19:44.345 --> 00:19:45.306
feel like the star.

00:19:45.665 --> 00:19:46.726
Like this is what I was

00:19:47.166 --> 00:19:48.067
tweeting about for a couple

00:19:48.086 --> 00:19:48.827
of days last week,

00:19:48.867 --> 00:19:50.127
which is it's not about you.

00:19:50.307 --> 00:19:50.828
Never was.

00:19:51.388 --> 00:19:52.670
How much about this can you

00:19:52.690 --> 00:19:53.369
make it about them?

00:19:53.410 --> 00:19:55.111
How personal can you do it?

00:19:55.131 --> 00:19:56.231
Dave, you have a different model,

00:19:56.511 --> 00:19:57.452
vastly different model.

00:19:57.673 --> 00:19:57.893
Right.

00:19:57.992 --> 00:19:58.633
In New York City,

00:19:58.653 --> 00:19:59.673
I'm talking about demographic,

00:19:59.693 --> 00:20:01.295
psychographic expectations.

00:20:01.575 --> 00:20:02.214
But it doesn't mean you

00:20:02.255 --> 00:20:03.155
can't do everything.

00:20:03.556 --> 00:20:04.817
similar things in term of

00:20:04.936 --> 00:20:05.698
trust or loyalty.

00:20:06.018 --> 00:20:07.499
What are one or two things that, uh,

00:20:07.538 --> 00:20:08.259
that you do?

00:20:10.020 --> 00:20:10.221
Yeah.

00:20:10.281 --> 00:20:11.502
So the one thing that we do

00:20:11.583 --> 00:20:13.183
about like John Taver was saying,

00:20:13.223 --> 00:20:13.984
kind of marketing,

00:20:14.285 --> 00:20:15.165
he's saying marketing for

00:20:15.185 --> 00:20:16.467
the first three times,

00:20:16.507 --> 00:20:18.847
like even solidifying and

00:20:18.949 --> 00:20:20.390
having a lockdown close for

00:20:20.410 --> 00:20:21.089
the first visit.

00:20:21.130 --> 00:20:21.990
So I would say let's,

00:20:22.230 --> 00:20:24.873
so Jimmy calls in and we schedule for, uh,

00:20:26.253 --> 00:20:26.954
let's say Monday.

00:20:27.474 --> 00:20:28.916
So, Hey, you know, Jimmy, awesome.

00:20:28.936 --> 00:20:29.557
We have you on the books.

00:20:29.576 --> 00:20:30.278
We have you scheduled for

00:20:30.337 --> 00:20:31.358
Monday at 3 30 PM.

00:20:31.398 --> 00:20:31.439
Uh,

00:20:34.286 --> 00:20:35.365
Dr. Chris is going to be

00:20:35.385 --> 00:20:36.366
coming in and evaluating you.

00:20:36.426 --> 00:20:37.426
He's going to reach out as well.

00:20:37.446 --> 00:20:38.448
He's going to call or text you.

00:20:38.488 --> 00:20:39.667
He's going to touch base with you as well.

00:20:40.769 --> 00:20:41.729
But you know, our clients,

00:20:41.769 --> 00:20:42.509
we know our clients are

00:20:42.528 --> 00:20:44.369
busy and they have a lot going on.

00:20:44.450 --> 00:20:47.151
So is there anything on Monday,

00:20:47.391 --> 00:20:49.112
like work or personal or any, you know,

00:20:49.132 --> 00:20:49.912
doctors or whatever,

00:20:49.951 --> 00:20:50.593
is there anything that

00:20:50.613 --> 00:20:51.393
could like run over?

00:20:51.992 --> 00:20:53.113
or prevent you from doing

00:20:53.153 --> 00:20:53.792
that visit is there

00:20:53.833 --> 00:20:55.513
anything I almost do like a

00:20:55.554 --> 00:20:56.673
takeaway like a semi

00:20:56.713 --> 00:20:57.814
takeaway close like I want

00:20:57.834 --> 00:20:59.213
to say like hey are you

00:20:59.253 --> 00:21:00.315
sure you want this I just

00:21:00.335 --> 00:21:01.494
want to make sure so like

00:21:01.875 --> 00:21:03.994
and if you say no like this

00:21:04.055 --> 00:21:05.275
is important to me I have

00:21:05.295 --> 00:21:06.296
this scheduled I found you

00:21:06.316 --> 00:21:07.175
guys I like your google

00:21:07.195 --> 00:21:08.695
reviews it's booked on my

00:21:08.715 --> 00:21:10.155
calendar it's locked in

00:21:10.635 --> 00:21:12.636
it's confirmed and I look

00:21:12.656 --> 00:21:14.096
forward to dr chris coming

00:21:14.116 --> 00:21:15.196
to my apartment for my

00:21:15.416 --> 00:21:16.176
in-home physical therapy

00:21:16.196 --> 00:21:17.577
visit on monday at 3 30 p.m

00:21:19.337 --> 00:21:20.098
That's what we want to hear.

00:21:21.579 --> 00:21:22.359
So that's one thing that we

00:21:22.380 --> 00:21:23.181
kind of do up front.

00:21:23.221 --> 00:21:23.361
Now,

00:21:23.401 --> 00:21:25.342
in terms of the second visit or the

00:21:25.382 --> 00:21:25.883
third visit.

00:21:25.903 --> 00:21:27.983
So after the first visit in person,

00:21:28.424 --> 00:21:30.026
I evaluate or my Dr. Chris

00:21:30.046 --> 00:21:32.207
evaluates the patient, Jimmy.

00:21:32.607 --> 00:21:33.508
And at the end of the visit,

00:21:33.949 --> 00:21:34.689
my therapist and I,

00:21:34.729 --> 00:21:36.170
we should be saying to our patients,

00:21:36.931 --> 00:21:38.112
we're talking about the plan of care,

00:21:38.132 --> 00:21:38.912
but we're scheduling at

00:21:38.971 --> 00:21:40.093
least the next visit or two.

00:21:40.814 --> 00:21:42.434
And if the patient, Jimmy,

00:21:42.494 --> 00:21:43.454
says something like, oh, like,

00:21:45.017 --> 00:21:45.517
I'll text you.

00:21:46.584 --> 00:21:49.226
Like, like, kind of like leave, like,

00:21:49.986 --> 00:21:50.446
I'll let you know.

00:21:50.527 --> 00:21:51.307
Like, so, you know,

00:21:51.326 --> 00:21:52.167
we've got a schedule out,

00:21:52.208 --> 00:21:53.929
like we're going to do Tuesday, Thursday.

00:21:53.949 --> 00:21:55.630
We're going to do, you know, depending on,

00:21:56.131 --> 00:21:56.891
there's a bunch of things,

00:21:56.931 --> 00:21:58.271
depending on the

00:21:58.311 --> 00:21:59.993
involvement of the situation,

00:22:00.013 --> 00:22:01.253
the diagnosis, the presentation,

00:22:02.095 --> 00:22:03.115
it might be once or twice a week,

00:22:03.316 --> 00:22:04.416
or we have some families

00:22:04.436 --> 00:22:05.336
that start and they're like,

00:22:05.457 --> 00:22:06.597
we want daily.

00:22:06.637 --> 00:22:08.019
We want like, can you guys do like five,

00:22:08.058 --> 00:22:08.940
six, seven days a week?

00:22:09.420 --> 00:22:11.142
So depending on the person

00:22:11.182 --> 00:22:12.482
and the family's financial resources,

00:22:13.323 --> 00:22:14.304
But if we're trying to

00:22:14.324 --> 00:22:15.064
schedule Jimmy for the

00:22:15.124 --> 00:22:16.846
second visit and we say, hey, you know,

00:22:16.865 --> 00:22:17.526
let's get something on the

00:22:17.566 --> 00:22:18.606
books before I leave.

00:22:18.646 --> 00:22:19.988
Why don't we pencil in something?

00:22:20.728 --> 00:22:22.148
And if Jimmy, if the patient says,

00:22:23.711 --> 00:22:24.250
I'll reach out.

00:22:24.711 --> 00:22:25.192
I'll let you know.

00:22:25.971 --> 00:22:27.073
We know that there's a problem.

00:22:27.113 --> 00:22:28.354
Like they didn't see enough value.

00:22:29.275 --> 00:22:30.576
Maybe the therapist talked over them.

00:22:30.996 --> 00:22:31.935
Something happened, right?

00:22:31.977 --> 00:22:33.478
So it's like before the therapist leaves,

00:22:33.518 --> 00:22:36.380
we got to say, hey, Jimmy, it's not you,

00:22:36.420 --> 00:22:36.720
but like,

00:22:37.340 --> 00:22:38.163
we have a pat,

00:22:38.282 --> 00:22:39.163
like there's a pattern like

00:22:39.464 --> 00:22:40.426
other patients over the years.

00:22:40.747 --> 00:22:42.250
And if they say something like, Oh, like,

00:22:42.830 --> 00:22:43.251
I don't know,

00:22:43.332 --> 00:22:44.775
like I'll text you or call

00:22:44.795 --> 00:22:45.375
you or something.

00:22:45.415 --> 00:22:46.277
I don't know.

00:22:46.397 --> 00:22:46.698
And we'll,

00:22:47.673 --> 00:22:48.114
I'll let you know.

00:22:49.154 --> 00:22:49.935
I just want to let you know, like,

00:22:50.016 --> 00:22:51.016
that's fine for you to say that,

00:22:51.036 --> 00:22:52.096
but we've heard that from

00:22:52.196 --> 00:22:53.198
other patients over the years.

00:22:53.238 --> 00:22:53.999
And what we found is when

00:22:54.019 --> 00:22:55.359
they say that there was

00:22:55.400 --> 00:22:56.800
either some disconnect or

00:22:56.820 --> 00:22:57.461
they're not looking to

00:22:57.480 --> 00:22:58.561
schedule that second visit

00:22:58.622 --> 00:22:59.301
or third visit.

00:22:59.823 --> 00:23:02.064
Is there anything that we can not,

00:23:02.203 --> 00:23:03.464
not to confront it like in

00:23:03.505 --> 00:23:06.928
a combative way, but Hey, let's, let's,

00:23:07.208 --> 00:23:07.788
let's flush it out.

00:23:07.828 --> 00:23:08.528
Let's flush out some

00:23:08.568 --> 00:23:09.210
objection or whatever.

00:23:09.250 --> 00:23:10.470
So maybe, maybe it's like, Hey,

00:23:10.509 --> 00:23:11.191
I really don't have the,

00:23:11.631 --> 00:23:12.050
the dollar,

00:23:12.131 --> 00:23:13.090
like I don't have the budget

00:23:13.131 --> 00:23:14.932
for 250 or something per visit,

00:23:15.051 --> 00:23:16.872
or the therapist talked too

00:23:16.912 --> 00:23:17.992
much or didn't do manual

00:23:18.012 --> 00:23:18.833
therapy when the patient

00:23:18.853 --> 00:23:20.532
expected manual therapy or vice versa.

00:23:20.833 --> 00:23:21.933
So there was something,

00:23:21.953 --> 00:23:23.074
but that helps obviously

00:23:23.094 --> 00:23:24.614
the communication with

00:23:24.673 --> 00:23:26.015
scheduling and getting the

00:23:26.055 --> 00:23:27.515
second or third visit booked out.

00:23:28.535 --> 00:23:29.276
Obviously things are

00:23:29.296 --> 00:23:30.115
different in a mobile

00:23:30.655 --> 00:23:32.336
practice versus Tony's brick and mortar,

00:23:32.596 --> 00:23:33.317
but those are some of the

00:23:33.336 --> 00:23:34.237
things that we've seen that will

00:23:35.355 --> 00:23:36.497
be an issue or a challenge

00:23:36.537 --> 00:23:37.297
or a barrier for that

00:23:37.336 --> 00:23:38.117
second or third visit.

00:23:38.557 --> 00:23:39.358
Let me break down what I

00:23:39.398 --> 00:23:40.619
thought I heard you say.

00:23:42.221 --> 00:23:43.362
I think you're increasing

00:23:43.402 --> 00:23:44.903
the status of your first

00:23:45.002 --> 00:23:47.044
visit when you're asking questions like,

00:23:47.144 --> 00:23:47.664
is there anything that

00:23:47.684 --> 00:23:49.205
could come in the way of this?

00:23:49.226 --> 00:23:49.826
What you're saying is,

00:23:50.066 --> 00:23:50.886
this is a super important

00:23:50.926 --> 00:23:51.968
thing that we're going to

00:23:52.008 --> 00:23:52.748
send someone out there.

00:23:52.788 --> 00:23:53.969
This is a big deal to you.

00:23:54.328 --> 00:23:55.390
Is there anything that might

00:23:55.470 --> 00:23:57.050
cause this that would run

00:23:57.111 --> 00:23:59.153
late that would cause you to miss this?

00:23:59.873 --> 00:24:00.433
in my view,

00:24:00.453 --> 00:24:01.535
that's increasing the status of

00:24:01.575 --> 00:24:03.277
that thing or the importance, right?

00:24:03.297 --> 00:24:05.118
So I think that's a way to

00:24:05.219 --> 00:24:08.442
show value without having to say,

00:24:08.462 --> 00:24:09.443
it's a show versus tell.

00:24:10.144 --> 00:24:13.028
And it signals their level of seriousness,

00:24:13.107 --> 00:24:13.288
right?

00:24:13.307 --> 00:24:14.128
So like we want them to-

00:24:15.230 --> 00:24:16.911
We want them to say like, heck yes,

00:24:16.931 --> 00:24:17.490
like this thing is

00:24:17.631 --> 00:24:19.050
confirmed and booked and I

00:24:19.131 --> 00:24:20.192
can't wait to rock and roll

00:24:20.211 --> 00:24:20.672
with you guys.

00:24:20.711 --> 00:24:22.491
I can't wait for this evaluation.

00:24:22.571 --> 00:24:23.712
I really need to address this.

00:24:24.073 --> 00:24:24.712
I've been, you know,

00:24:25.133 --> 00:24:26.292
I've had this issue for too

00:24:26.333 --> 00:24:26.953
long or whatever,

00:24:27.294 --> 00:24:28.134
and I'm looking forward to

00:24:28.173 --> 00:24:29.273
it as opposed to someone

00:24:29.294 --> 00:24:31.055
that's kind of like, like, yeah,

00:24:31.095 --> 00:24:32.954
laid back, wishy-washy, like, you know,

00:24:32.994 --> 00:24:34.476
whatever, you know, who knows?

00:24:34.756 --> 00:24:36.895
And then it's like, oh, well, we need to,

00:24:37.076 --> 00:24:38.537
you know, flush it out and address it.

00:24:38.916 --> 00:24:39.597
dave doesn't want to get

00:24:39.657 --> 00:24:40.518
text messages from his

00:24:40.538 --> 00:24:42.180
therapist on monday

00:24:42.259 --> 00:24:43.461
afternoon that says the guy

00:24:43.520 --> 00:24:44.421
bailed it's like because

00:24:44.461 --> 00:24:45.883
you reinforce this is a big

00:24:45.923 --> 00:24:47.364
deal and instead of saying

00:24:47.663 --> 00:24:48.565
you're not gonna bail on me

00:24:48.625 --> 00:24:49.704
right that's like a neg

00:24:49.726 --> 00:24:50.605
that's that's a way to like

00:24:50.665 --> 00:24:52.106
reduce uh signaling in a

00:24:52.166 --> 00:24:53.407
negative way we're saying

00:24:53.448 --> 00:24:54.088
is there anything that

00:24:54.108 --> 00:24:54.950
could that could get in the

00:24:54.990 --> 00:24:56.351
way of us providing this

00:24:56.790 --> 00:24:57.832
the second thing is you you

00:24:57.872 --> 00:24:58.551
mentioned is you're talking

00:24:58.571 --> 00:24:59.853
about the future you're

00:24:59.913 --> 00:25:00.794
you're sort of signaling

00:25:00.834 --> 00:25:02.115
like it's not one and done

00:25:02.535 --> 00:25:03.856
like let's talk about what's next

00:25:04.856 --> 00:25:06.298
So you're ushering them to that,

00:25:06.318 --> 00:25:07.480
to making sure that instead of saying,

00:25:07.721 --> 00:25:08.923
you understand that the

00:25:08.942 --> 00:25:09.743
magic's not over yet.

00:25:09.763 --> 00:25:11.125
We've got to keep going.

00:25:11.605 --> 00:25:13.689
Help me understand what's good for you.

00:25:14.789 --> 00:25:16.532
You're tailoring this to them.

00:25:16.573 --> 00:25:17.153
You're making sure.

00:25:17.314 --> 00:25:17.933
It sounds like they're part

00:25:17.953 --> 00:25:18.836
of the process too,

00:25:19.296 --> 00:25:20.917
which is we know is the IKEA effect.

00:25:21.519 --> 00:25:24.940
which is if I have some say in the process,

00:25:25.720 --> 00:25:27.200
it's why Legos are so popular.

00:25:27.559 --> 00:25:28.700
It's why I learned Betty

00:25:28.799 --> 00:25:30.881
Crocker used to have cake

00:25:30.941 --> 00:25:33.780
mix that you poured and just added water.

00:25:34.181 --> 00:25:35.582
And they realized that people didn't,

00:25:35.701 --> 00:25:37.561
women in the 60s or 50s,

00:25:37.862 --> 00:25:38.642
60s didn't like it.

00:25:39.102 --> 00:25:40.321
They increased the

00:25:40.362 --> 00:25:41.722
complexity by saying you

00:25:41.742 --> 00:25:43.262
had to add water and one

00:25:43.462 --> 00:25:44.962
egg and sales went through the roof.

00:25:45.022 --> 00:25:46.242
It's the Ikea effect all over again.

00:25:46.262 --> 00:25:46.723
It should have been the

00:25:46.743 --> 00:25:47.463
Betty Crocker effect

00:25:47.483 --> 00:25:48.703
because Betty Crocker was around first.

00:25:49.324 --> 00:25:49.884
And then finally,

00:25:49.903 --> 00:25:51.144
you're there making sure

00:25:51.183 --> 00:25:52.265
expectations were reached.

00:25:53.085 --> 00:25:54.285
The goal of the first date

00:25:54.345 --> 00:25:55.265
is not to get married.

00:25:56.384 --> 00:25:57.345
Goal of the first date is to

00:25:57.384 --> 00:25:58.105
get the second date.

00:25:58.546 --> 00:25:59.605
And when I say it like this,

00:25:59.645 --> 00:26:01.165
people are like, of course it is, Jimmy.

00:26:01.246 --> 00:26:02.405
How did you figure that out?

00:26:02.425 --> 00:26:03.066
You're not married.

00:26:03.626 --> 00:26:04.767
But then I'll flip that on

00:26:04.787 --> 00:26:06.086
people and say the goal of

00:26:06.126 --> 00:26:07.207
the evaluation is to get

00:26:07.227 --> 00:26:07.987
the second visit.

00:26:08.586 --> 00:26:09.688
And they're like, well, no,

00:26:09.708 --> 00:26:10.988
we want to complete the plan of care.

00:26:11.607 --> 00:26:11.988
My man,

00:26:12.107 --> 00:26:13.067
the only way you complete the plan

00:26:13.087 --> 00:26:13.407
of care,

00:26:13.448 --> 00:26:15.189
if we're mathematically saying it's 10,

00:26:15.189 --> 00:26:16.528
is to get to number two.

00:26:17.409 --> 00:26:18.730
But we just say, well,

00:26:18.809 --> 00:26:20.090
I've got them and I've told

00:26:20.131 --> 00:26:21.632
them there's nine more visits.

00:26:21.652 --> 00:26:22.432
They're going to show up.

00:26:22.752 --> 00:26:24.173
You have to earn the second date.

00:26:24.294 --> 00:26:25.695
If the first date is weird

00:26:26.076 --> 00:26:27.817
or crappy or didn't have

00:26:27.876 --> 00:26:30.118
expectations or I can't see myself,

00:26:30.839 --> 00:26:31.779
never mind the second date,

00:26:31.819 --> 00:26:33.402
definitely not the 10th date, you lose.

00:26:34.602 --> 00:26:36.182
This is where we go back to John Taffer.

00:26:36.242 --> 00:26:37.903
You mark it to win that

00:26:38.124 --> 00:26:40.586
third date so that fourth date happens,

00:26:40.645 --> 00:26:42.047
and then the statistical likelihood,

00:26:42.146 --> 00:26:43.366
if we say his math holds

00:26:43.446 --> 00:26:44.127
true somewhere else,

00:26:44.428 --> 00:26:46.148
the statistical likelihood goes way,

00:26:46.628 --> 00:26:47.589
way up.

00:26:48.049 --> 00:26:49.570
And that is about making

00:26:49.611 --> 00:26:50.310
sure everybody on my team

00:26:50.330 --> 00:26:51.211
knows what game we're playing,

00:26:51.251 --> 00:26:52.172
what positions they play,

00:26:52.231 --> 00:26:53.073
and can they play it well.

00:26:54.041 --> 00:26:55.163
I'm surprised Dave hasn't

00:26:55.222 --> 00:26:57.705
said this because Dave's a big copywriter,

00:26:57.746 --> 00:26:59.386
a big fan of copywriting.

00:27:00.147 --> 00:27:01.608
Everything about copywriting

00:27:01.730 --> 00:27:03.310
is what's the purpose of the title,

00:27:03.391 --> 00:27:03.991
the headline?

00:27:04.383 --> 00:27:05.644
to read the next sentence, you know,

00:27:05.703 --> 00:27:07.003
and you just work your way

00:27:07.084 --> 00:27:08.585
down until you've completed

00:27:08.644 --> 00:27:09.546
the whole story.

00:27:10.586 --> 00:27:11.386
Something that I wanted to

00:27:11.426 --> 00:27:13.248
mention here too is, you know,

00:27:13.268 --> 00:27:15.548
I think so many of us think

00:27:15.769 --> 00:27:17.730
we don't have the capacity

00:27:17.829 --> 00:27:20.971
to tailor algorithms in a

00:27:21.031 --> 00:27:23.032
sense that like Dave is saying,

00:27:23.093 --> 00:27:25.374
so when I start to sense some hesitancy,

00:27:25.990 --> 00:27:27.290
When I start to get a sense

00:27:27.391 --> 00:27:29.251
for this person isn't

00:27:29.311 --> 00:27:30.952
really bought in or they're

00:27:30.992 --> 00:27:32.493
here for a different motivation,

00:27:32.693 --> 00:27:34.134
I should have the ability

00:27:34.575 --> 00:27:35.996
to create or tailor a

00:27:36.036 --> 00:27:38.217
customized program for that person.

00:27:38.636 --> 00:27:39.637
Classic example.

00:27:39.837 --> 00:27:42.759
So we used to do a ton of post-surgical,

00:27:42.859 --> 00:27:45.080
non-surgical, low back pain referrals.

00:27:46.021 --> 00:27:47.623
We had two spine surgeons,

00:27:47.722 --> 00:27:48.502
everybody who wasn't

00:27:48.522 --> 00:27:49.544
appropriate for surgery

00:27:49.604 --> 00:27:51.125
would get referred right over to us.

00:27:51.545 --> 00:27:51.704
Well,

00:27:51.724 --> 00:27:53.404
a lot of these patients have zero

00:27:53.464 --> 00:27:55.365
interest in doing physical therapy.

00:27:55.885 --> 00:27:58.146
So we had to create a system

00:27:58.207 --> 00:28:00.527
that could accommodate, okay,

00:28:00.567 --> 00:28:01.767
this person's going to schedule,

00:28:02.287 --> 00:28:04.627
but I can't block a spot on

00:28:04.688 --> 00:28:05.647
the schedule for this

00:28:05.708 --> 00:28:06.667
person who has a high

00:28:06.768 --> 00:28:08.189
likelihood of not showing

00:28:08.269 --> 00:28:09.169
up to that appointment.

00:28:09.788 --> 00:28:11.209
It could be low motivation.

00:28:11.569 --> 00:28:12.710
It could be transportation.

00:28:12.849 --> 00:28:13.930
These are a lot of patients

00:28:13.990 --> 00:28:15.890
that had transportation limitations.

00:28:15.930 --> 00:28:17.111
They were scheduling public

00:28:17.151 --> 00:28:17.911
transportation.

00:28:18.310 --> 00:28:19.392
We had no idea where they

00:28:19.571 --> 00:28:20.231
were going to come.

00:28:20.711 --> 00:28:23.074
So because we as a business

00:28:23.233 --> 00:28:24.994
chose to accept those

00:28:25.115 --> 00:28:27.556
referrals and try to help that population,

00:28:28.076 --> 00:28:29.717
we had to create a custom

00:28:29.777 --> 00:28:30.998
way to serve without

00:28:31.057 --> 00:28:32.439
sacrificing everybody else.

00:28:32.898 --> 00:28:34.119
So what we would do is we

00:28:34.200 --> 00:28:34.980
book an appointment,

00:28:35.039 --> 00:28:36.480
but we would make it gray

00:28:36.641 --> 00:28:37.320
on the schedule.

00:28:37.381 --> 00:28:39.442
Gray indicated this person's

00:28:39.501 --> 00:28:40.383
not likely to come.

00:28:40.843 --> 00:28:42.544
If they come, we will serve them,

00:28:43.003 --> 00:28:45.184
but we are not saving a dedicated spot.

00:28:45.224 --> 00:28:46.184
We will book other

00:28:46.224 --> 00:28:48.905
appointments in that same position.

00:28:50.526 --> 00:28:52.227
And so throughout the years

00:28:52.307 --> 00:28:53.747
having the business, you know,

00:28:53.787 --> 00:28:55.567
we always made decisions about,

00:28:56.008 --> 00:28:58.028
Are we going to accommodate this customer,

00:28:58.148 --> 00:28:58.828
this client?

00:28:58.888 --> 00:29:00.630
And when I say that, I mean a population.

00:29:01.250 --> 00:29:01.990
So are we going to

00:29:02.029 --> 00:29:03.671
accommodate people that may

00:29:03.750 --> 00:29:06.632
need genuine in the room?

00:29:06.711 --> 00:29:08.311
Like I'm in an exam room right now.

00:29:08.612 --> 00:29:09.873
The only thing I do in this

00:29:09.932 --> 00:29:11.313
exam room is talk to you guys.

00:29:11.452 --> 00:29:13.294
I never let a patient in this exam room.

00:29:13.854 --> 00:29:15.335
But there was a time where I

00:29:15.434 --> 00:29:17.234
would accept referrals who

00:29:17.295 --> 00:29:18.496
might have to come into

00:29:18.536 --> 00:29:21.297
this exam room for various reasons.

00:29:21.916 --> 00:29:23.439
I don't have that business these days.

00:29:23.558 --> 00:29:24.098
I don't do that.

00:29:24.599 --> 00:29:26.821
But having the versatility to say,

00:29:27.363 --> 00:29:29.444
like Dave said, patients motivated,

00:29:29.525 --> 00:29:30.405
families dying.

00:29:30.547 --> 00:29:31.407
I'm going to see you five

00:29:31.448 --> 00:29:34.191
days in a row because let's

00:29:34.270 --> 00:29:35.132
take advantage of the

00:29:35.172 --> 00:29:36.272
motivation and the

00:29:36.333 --> 00:29:37.934
enthusiasm you have right now,

00:29:38.595 --> 00:29:40.597
as opposed to somebody who may be like.

00:29:41.097 --> 00:29:42.259
I want to test the waters.

00:29:42.339 --> 00:29:43.280
I'm super busy.

00:29:43.361 --> 00:29:44.020
I'm traveling.

00:29:44.041 --> 00:29:45.063
I'm doing all this stuff.

00:29:45.442 --> 00:29:46.084
No problem.

00:29:46.144 --> 00:29:47.404
I'll see you once in the clinic.

00:29:47.766 --> 00:29:49.748
We'll do two or three telehealth sessions.

00:29:50.189 --> 00:29:50.388
Like,

00:29:50.709 --> 00:29:53.132
can you customize your plan of care

00:29:53.172 --> 00:29:54.413
to meet the patient where

00:29:54.453 --> 00:29:55.233
the patient's at?

00:29:55.575 --> 00:29:56.576
So that goes back to the

00:29:56.635 --> 00:29:57.576
very first thing we talked

00:29:57.616 --> 00:29:58.397
about on this live stream

00:29:58.417 --> 00:29:59.779
that we did not plan, which is

00:30:01.172 --> 00:30:03.073
making sure your employees,

00:30:03.113 --> 00:30:03.992
your team members,

00:30:04.614 --> 00:30:06.555
understand what they're allowed to do,

00:30:06.994 --> 00:30:07.214
right?

00:30:07.275 --> 00:30:09.756
To say, for Jon Taffer, it would be like,

00:30:09.895 --> 00:30:12.136
to make sure you understand as a waiter,

00:30:12.617 --> 00:30:13.478
if you go over there and

00:30:13.498 --> 00:30:14.858
you're getting negative vibes, man,

00:30:15.378 --> 00:30:18.760
you know, the guy, wife, and the kids,

00:30:19.421 --> 00:30:20.842
negative vibes, and they're like, hey,

00:30:20.942 --> 00:30:21.182
is there...

00:30:21.521 --> 00:30:22.762
Waiters and waitresses are always good,

00:30:22.782 --> 00:30:22.923
right?

00:30:22.962 --> 00:30:24.284
Put the entree down, leave,

00:30:24.364 --> 00:30:25.285
come back in five minutes.

00:30:25.345 --> 00:30:27.467
Is there anything that I could fix, right?

00:30:27.487 --> 00:30:29.087
You've all had your first or second bite.

00:30:29.429 --> 00:30:30.209
This is the time.

00:30:30.328 --> 00:30:31.450
This is the choke point of

00:30:31.509 --> 00:30:32.330
when you want to stop a

00:30:32.371 --> 00:30:33.991
problem from progressing 40

00:30:33.991 --> 00:30:34.573
minutes later.

00:30:35.252 --> 00:30:37.434
So making sure your team understands, hey,

00:30:37.615 --> 00:30:37.694
um,

00:30:38.615 --> 00:30:40.497
If their steak's undercooked, number one,

00:30:40.798 --> 00:30:41.877
I'm going to fix that right now.

00:30:42.939 --> 00:30:44.079
And instead of just saying

00:30:44.119 --> 00:30:46.121
it's off the bill, by the way,

00:30:46.141 --> 00:30:47.342
the round of drinks is on me.

00:30:47.602 --> 00:30:47.962
Something.

00:30:48.083 --> 00:30:49.063
Making sure they understand

00:30:49.103 --> 00:30:51.664
what's on their menu for making it right.

00:30:51.984 --> 00:30:53.746
Because their job is to get

00:30:53.807 --> 00:30:55.106
you to the third visit

00:30:55.728 --> 00:30:56.607
because they understand the

00:30:56.647 --> 00:30:57.328
game that they're playing

00:30:57.368 --> 00:30:58.470
and the position that they play.

00:30:59.549 --> 00:31:01.051
I purposefully went to you

00:31:01.071 --> 00:31:02.291
guys before I went into the

00:31:02.352 --> 00:31:03.452
strategies or the things,

00:31:03.532 --> 00:31:04.153
and I want everybody to

00:31:04.193 --> 00:31:05.835
take a look and listen to this clip.

00:31:05.855 --> 00:31:05.994
Mm-hmm.

00:31:07.113 --> 00:31:08.814
But Tony sort of mentioned

00:31:09.094 --> 00:31:10.574
that he puts the chart in a

00:31:10.614 --> 00:31:12.095
certain spot and the person's name.

00:31:12.454 --> 00:31:15.296
John Taffer said in his restaurants,

00:31:15.776 --> 00:31:16.876
if it's your first visit

00:31:16.977 --> 00:31:18.557
and the host knows that because they say,

00:31:18.698 --> 00:31:20.137
is this your first time dining with us?

00:31:20.577 --> 00:31:20.818
Right.

00:31:21.159 --> 00:31:22.538
That's you whispering in their ear.

00:31:22.858 --> 00:31:24.059
They all get red napkins.

00:31:24.599 --> 00:31:26.559
Now, everybody on the team understands.

00:31:26.599 --> 00:31:26.700
Now,

00:31:26.941 --> 00:31:28.361
red napkins are going to blend in if

00:31:28.401 --> 00:31:29.161
I'm just eating dinner.

00:31:29.221 --> 00:31:29.861
I don't notice that.

00:31:29.881 --> 00:31:30.421
It's a napkin.

00:31:30.961 --> 00:31:31.721
Everybody on the team

00:31:31.760 --> 00:31:34.501
understands this is important, right?

00:31:34.721 --> 00:31:35.622
It's not your table,

00:31:35.882 --> 00:31:36.521
but maybe you're going to

00:31:36.541 --> 00:31:37.282
lean over and you're going

00:31:37.323 --> 00:31:38.863
to pay more close attention

00:31:38.903 --> 00:31:40.242
as a waiter or a bartender.

00:31:40.522 --> 00:31:42.023
You're not going to miss on this one.

00:31:42.344 --> 00:31:43.443
At the end of that dinner,

00:31:43.483 --> 00:31:44.624
it's your first red napkin,

00:31:44.844 --> 00:31:46.044
which means you get a free dessert.

00:31:46.364 --> 00:31:48.785
Low cost, high perceived value.

00:31:49.184 --> 00:31:50.384
low actual cost.

00:31:50.765 --> 00:31:51.786
Maybe it's a round of drinks,

00:31:51.826 --> 00:31:53.066
but understanding what

00:31:53.185 --> 00:31:54.846
things bring people back

00:31:55.406 --> 00:31:56.967
and when in the journey you

00:31:57.007 --> 00:31:58.267
should drop them and offer

00:31:58.307 --> 00:31:59.468
them to them because you

00:31:59.488 --> 00:32:00.948
understand the goal to get

00:32:01.008 --> 00:32:02.888
them to the fourth visit.

00:32:02.929 --> 00:32:03.669
Because if you do,

00:32:03.749 --> 00:32:05.588
the statistical likelihood goes way,

00:32:05.648 --> 00:32:05.970
way up.

00:32:08.029 --> 00:32:10.570
Real quick, the exam room analogy about...

00:32:12.179 --> 00:32:13.720
cancellation, no shows, arrival,

00:32:13.759 --> 00:32:14.440
all that type of stuff.

00:32:14.880 --> 00:32:15.980
When I, my first job,

00:32:16.201 --> 00:32:17.621
I feel like in an

00:32:17.661 --> 00:32:18.741
outpatient clinic in New Jersey,

00:32:19.082 --> 00:32:19.662
when I was doing the

00:32:19.682 --> 00:32:20.803
evaluations in the exam

00:32:20.843 --> 00:32:21.803
room that you're talking about, Tony,

00:32:22.144 --> 00:32:23.763
I feel like I got like better.

00:32:23.784 --> 00:32:25.525
I felt like there was an

00:32:25.545 --> 00:32:26.605
acceleration of rapport

00:32:26.645 --> 00:32:27.566
built because it was just

00:32:27.726 --> 00:32:29.047
my patient and I,

00:32:29.906 --> 00:32:32.108
evaluation, hands-on treatment, some HEP,

00:32:32.148 --> 00:32:32.489
whatever,

00:32:32.929 --> 00:32:33.910
as opposed to doing the

00:32:33.930 --> 00:32:35.431
evaluation out in the big

00:32:35.490 --> 00:32:37.212
clinic and it had like 20

00:32:37.212 --> 00:32:38.193
treatment table plants.

00:32:38.273 --> 00:32:39.074
Like it was huge.

00:32:40.154 --> 00:32:40.855
And there was like a lot of

00:32:40.915 --> 00:32:42.076
noise and the overhead

00:32:42.116 --> 00:32:43.657
music and a lot of

00:32:43.678 --> 00:32:44.739
conversations going back and forth.

00:32:45.711 --> 00:32:46.611
And I'd be curious if anyone

00:32:46.631 --> 00:32:47.852
watching or listening comment below,

00:32:47.892 --> 00:32:48.632
wherever you're seeing this

00:32:48.692 --> 00:32:49.873
or live or on the replay,

00:32:50.593 --> 00:32:52.273
what you guys have seen over the years,

00:32:52.413 --> 00:32:53.094
the difference between

00:32:53.114 --> 00:32:54.153
doing an evaluation,

00:32:54.515 --> 00:32:56.214
the first visit in a

00:32:56.295 --> 00:32:57.256
private exam room versus

00:32:57.395 --> 00:32:59.217
out in the open in the clinic.

00:32:59.237 --> 00:33:00.257
And I know that there's pros

00:33:00.297 --> 00:33:00.957
and cons of both.

00:33:01.436 --> 00:33:03.018
And it's funny when he's saying like,

00:33:03.077 --> 00:33:04.338
he only uses the exam room

00:33:04.378 --> 00:33:05.939
for these video calls now.

00:33:06.459 --> 00:33:07.279
And like,

00:33:07.420 --> 00:33:08.941
I did a little bit of both over the years,

00:33:09.560 --> 00:33:11.501
but specifically with the exam room,

00:33:11.721 --> 00:33:12.241
I remember

00:33:12.701 --> 00:33:14.143
that it seemed like I don't

00:33:14.182 --> 00:33:14.923
have any numbers to back it

00:33:14.942 --> 00:33:16.002
up but it seemed like the

00:33:16.502 --> 00:33:18.683
return rate the the the

00:33:19.305 --> 00:33:20.525
completed plans of care it

00:33:20.625 --> 00:33:21.365
seemed like would have been

00:33:21.444 --> 00:33:22.905
better from the evaluations

00:33:22.945 --> 00:33:23.786
that I did with those

00:33:23.826 --> 00:33:26.406
patients um in that exam

00:33:26.426 --> 00:33:27.347
room just like tony sitting

00:33:27.387 --> 00:33:28.847
in right now watching on uh

00:33:28.928 --> 00:33:29.528
if you guys are watching on

00:33:29.548 --> 00:33:30.909
youtube compared to if it

00:33:30.929 --> 00:33:31.989
was out in the busy clinic

00:33:32.368 --> 00:33:33.490
and I still would do the

00:33:33.529 --> 00:33:34.250
thing that tony mentioned

00:33:34.289 --> 00:33:35.171
earlier and every clinic

00:33:35.191 --> 00:33:36.391
should be doing this which

00:33:36.451 --> 00:33:37.191
is you have your new

00:33:37.230 --> 00:33:38.751
patient come in and you

00:33:38.811 --> 00:33:39.951
introduce them to all the

00:33:39.971 --> 00:33:40.972
team members because

00:33:41.712 --> 00:33:43.513
especially because that

00:33:43.535 --> 00:33:45.935
patient or the clinic has

00:33:45.955 --> 00:33:47.538
an issue like Tony just had this morning.

00:33:47.877 --> 00:33:48.719
So that patient might be

00:33:48.798 --> 00:33:50.480
seen by me next time instead of Tony.

00:33:50.960 --> 00:33:52.161
And so if that patient

00:33:52.201 --> 00:33:53.501
already met me in person,

00:33:53.762 --> 00:33:54.983
then the person at the front desk says,

00:33:55.044 --> 00:33:58.526
hey, you know, Tom, hey, Tony got sick.

00:33:58.586 --> 00:33:59.446
He was the one throwing up

00:33:59.487 --> 00:34:00.708
this morning or whatever you say.

00:34:01.008 --> 00:34:02.288
But now you're going to be

00:34:02.328 --> 00:34:04.871
seen by the PT or PTA, you know, Dave.

00:34:05.511 --> 00:34:07.693
And the Tom is like, oh, well, I –

00:34:08.534 --> 00:34:09.215
in the back of his mind,

00:34:09.255 --> 00:34:09.994
he already met me.

00:34:10.056 --> 00:34:11.197
So he's like, all right, it's,

00:34:11.376 --> 00:34:12.217
he's more likely now to

00:34:12.257 --> 00:34:13.778
show up instead of you move

00:34:13.798 --> 00:34:15.000
them over to a clinician

00:34:15.199 --> 00:34:16.681
that the patient has never even met,

00:34:17.001 --> 00:34:18.061
just like a random name.

00:34:18.402 --> 00:34:19.182
And then it's more likely

00:34:19.222 --> 00:34:20.403
that this is going to be canceled.

00:34:20.423 --> 00:34:21.385
So that it does take a whole

00:34:21.425 --> 00:34:23.186
team approach for this to happen.

00:34:24.431 --> 00:34:26.771
So I want you to think about

00:34:26.791 --> 00:34:27.753
this question before I

00:34:27.813 --> 00:34:29.614
respond to the room question.

00:34:30.634 --> 00:34:32.876
I'm curious if you have a

00:34:32.936 --> 00:34:34.356
system for routing new

00:34:34.436 --> 00:34:36.438
referrals to your

00:34:36.557 --> 00:34:37.958
clinicians that are working for you.

00:34:38.559 --> 00:34:40.139
Because what we've always done,

00:34:40.179 --> 00:34:41.579
and I still think to this day,

00:34:41.599 --> 00:34:42.860
this is the best method,

00:34:42.900 --> 00:34:44.081
but it's hard to reproduce.

00:34:45.021 --> 00:34:46.182
Because again,

00:34:46.322 --> 00:34:47.704
I don't do follow-ups or I

00:34:47.744 --> 00:34:49.585
do them as little as I possibly can.

00:34:50.284 --> 00:34:53.007
So I am always routing new referrals.

00:34:53.126 --> 00:34:54.288
Once I do the evaluation,

00:34:54.327 --> 00:34:55.208
who's the appropriate

00:34:55.248 --> 00:34:56.309
person for them to work with?

00:34:56.349 --> 00:34:57.110
And I do it based on

00:34:57.150 --> 00:34:58.851
personality more than anything else.

00:34:59.311 --> 00:35:01.353
This person's personality

00:35:01.474 --> 00:35:04.115
will match that clinician's personality.

00:35:04.376 --> 00:35:05.257
I'm going to put this

00:35:05.376 --> 00:35:06.697
patient with that clinician

00:35:07.478 --> 00:35:08.639
in regards to the room.

00:35:08.880 --> 00:35:09.721
And this is something that

00:35:09.740 --> 00:35:10.601
I've been talking about on

00:35:10.641 --> 00:35:11.922
social media a lot.

00:35:12.733 --> 00:35:13.034
you know,

00:35:13.233 --> 00:35:15.556
I'd be curious to know who's out

00:35:15.596 --> 00:35:17.896
there testing these ideas,

00:35:18.097 --> 00:35:20.077
who's out there testing these hypotheses,

00:35:20.137 --> 00:35:22.958
because here, at least you're right.

00:35:23.320 --> 00:35:24.139
A hundred percent.

00:35:24.179 --> 00:35:26.021
If I truly wanted to build a

00:35:26.081 --> 00:35:27.001
deep rapport with the

00:35:27.041 --> 00:35:28.342
person sitting in front of me,

00:35:28.742 --> 00:35:30.023
I'm going to bring them into the room.

00:35:30.043 --> 00:35:32.523
I'm going to have a quiet chat with them.

00:35:32.543 --> 00:35:34.284
I'm going to offer them some water,

00:35:34.324 --> 00:35:35.206
some tea, like,

00:35:35.746 --> 00:35:37.128
We're going to do all of these things.

00:35:37.668 --> 00:35:39.070
This whole episode today has

00:35:39.090 --> 00:35:40.851
been about kind of giving

00:35:40.931 --> 00:35:43.735
that top of the line experience.

00:35:43.815 --> 00:35:46.338
However, business is about compromise.

00:35:46.418 --> 00:35:47.559
Business is about finding

00:35:47.599 --> 00:35:48.760
that sweet spot between

00:35:48.820 --> 00:35:50.641
price and value and all of those things.

00:35:51.282 --> 00:35:53.184
So when I look at it, I say, yeah,

00:35:53.324 --> 00:35:54.525
I could do that.

00:35:55.347 --> 00:35:58.030
But does that, if I didn't do that,

00:35:58.289 --> 00:35:59.271
how much do I lose?

00:35:59.610 --> 00:36:02.474
I have measured this repeatedly.

00:36:02.494 --> 00:36:05.856
I lose zero in regards to

00:36:05.956 --> 00:36:07.297
patients deciding they

00:36:07.318 --> 00:36:08.318
don't want to come because

00:36:08.378 --> 00:36:09.760
I didn't take them to an exam room.

00:36:10.641 --> 00:36:12.762
I establish the expectation

00:36:12.963 --> 00:36:13.784
right from the start,

00:36:13.804 --> 00:36:14.724
just like Jerry Durham

00:36:14.764 --> 00:36:15.485
always talks about.

00:36:15.545 --> 00:36:16.706
When they walk in the door,

00:36:16.746 --> 00:36:18.708
they don't sit in a reception area.

00:36:19.349 --> 00:36:20.570
We go right back in.

00:36:20.929 --> 00:36:21.871
Most of the time,

00:36:21.931 --> 00:36:22.931
the first thing they're

00:36:22.952 --> 00:36:24.492
going to sit on is not a chair.

00:36:25.153 --> 00:36:26.034
Most of the time,

00:36:26.074 --> 00:36:26.795
the first thing they're

00:36:26.815 --> 00:36:28.336
going to sit on is a recumbent bike,

00:36:28.436 --> 00:36:28.916
a UBE.

00:36:29.117 --> 00:36:30.097
They're going to stand on an

00:36:30.177 --> 00:36:31.139
elliptical trainer,

00:36:31.159 --> 00:36:31.880
and they're going to start

00:36:31.920 --> 00:36:33.862
moving while I'm doing my

00:36:33.922 --> 00:36:35.262
initial interview and my

00:36:35.342 --> 00:36:36.423
intake and asking them

00:36:36.463 --> 00:36:37.704
questions because they're

00:36:37.864 --> 00:36:38.766
I want to plant the

00:36:38.865 --> 00:36:40.086
expectation that you are

00:36:40.166 --> 00:36:42.789
not here for the socialization.

00:36:42.809 --> 00:36:43.391
We'll get that.

00:36:43.451 --> 00:36:44.130
We'll have fun.

00:36:44.170 --> 00:36:44.672
We'll joke.

00:36:44.711 --> 00:36:45.572
We'll do all that stuff.

00:36:45.893 --> 00:36:47.454
But we're not going into a private room.

00:36:47.855 --> 00:36:50.157
We're not that kind of clinic.

00:36:50.257 --> 00:36:51.177
We are going to come.

00:36:51.197 --> 00:36:52.079
We're going to move.

00:36:52.199 --> 00:36:53.139
You're going to feel better

00:36:53.179 --> 00:36:53.880
and you're going to leave.

00:36:54.400 --> 00:36:56.043
And that's the expectation,

00:36:56.083 --> 00:36:57.224
the experience that I want

00:36:57.244 --> 00:36:58.224
to deliver today.

00:36:58.465 --> 00:37:00.047
Not what I used to do 20 years ago,

00:37:00.126 --> 00:37:00.387
but today.

00:37:00.427 --> 00:37:00.827
Right.

00:37:01.568 --> 00:37:01.989
And I just,

00:37:02.108 --> 00:37:04.112
I don't see a decline in report.

00:37:04.211 --> 00:37:05.554
I don't see a decline or a

00:37:05.594 --> 00:37:08.338
drop in returns or anything like that.

00:37:09.000 --> 00:37:10.342
I probably have the highest

00:37:10.461 --> 00:37:11.744
level of plan of care

00:37:11.804 --> 00:37:13.246
completions than I've ever

00:37:13.306 --> 00:37:15.650
had in 24 years of private practice.

00:37:16.509 --> 00:37:17.931
It highlights what we think

00:37:17.971 --> 00:37:19.652
is valuable might not be

00:37:19.692 --> 00:37:20.693
what the other person is

00:37:20.713 --> 00:37:21.554
thinking is valuable.

00:37:21.634 --> 00:37:24.856
I went on a topic deep dive

00:37:24.916 --> 00:37:27.739
in terms of this golden goose,

00:37:27.778 --> 00:37:30.181
this one-on-one for 60

00:37:30.181 --> 00:37:31.983
minutes is the gold standard.

00:37:32.103 --> 00:37:33.164
And I'm like, I got to be honest,

00:37:33.804 --> 00:37:35.405
if you flip that to other businesses,

00:37:36.005 --> 00:37:36.947
shouldn't it be if you can

00:37:36.967 --> 00:37:37.788
provide the best

00:37:39.184 --> 00:37:40.824
the closest experience or

00:37:40.864 --> 00:37:44.025
service to my expectation in less time,

00:37:44.865 --> 00:37:45.065
right?

00:37:45.146 --> 00:37:46.045
The plumber who can do,

00:37:46.346 --> 00:37:47.306
who can unclog my toilet

00:37:47.327 --> 00:37:48.367
and be on his way in 15

00:37:48.367 --> 00:37:50.108
minutes is better in my

00:37:50.188 --> 00:37:50.927
view than the person who

00:37:50.947 --> 00:37:52.527
can do the same thing in 60 minutes.

00:37:53.228 --> 00:37:54.628
So just because we think we

00:37:54.648 --> 00:37:55.389
need 60 minutes,

00:37:55.429 --> 00:37:56.829
does the patient want 60 minutes?

00:37:57.704 --> 00:37:59.226
Unless the person hiring the

00:37:59.246 --> 00:38:02.706
plumber is lonely and wants

00:38:02.786 --> 00:38:04.106
somebody in their house for

00:38:04.106 --> 00:38:05.748
60 minutes and misses their

00:38:05.788 --> 00:38:07.007
children and wants to make

00:38:07.068 --> 00:38:08.329
food for somebody and wants

00:38:08.369 --> 00:38:09.329
to give them drinks and

00:38:09.369 --> 00:38:10.170
wants to hang out.

00:38:10.789 --> 00:38:13.690
But back in there, what are you selling?

00:38:13.851 --> 00:38:15.692
Are you selling companionship?

00:38:15.731 --> 00:38:16.552
What are you selling?

00:38:16.992 --> 00:38:17.733
Amazing.

00:38:18.152 --> 00:38:20.695
Don't put a PTOT SLP label on it.

00:38:20.775 --> 00:38:22.137
Don't bill insurance for it

00:38:22.836 --> 00:38:24.679
and hire more people.

00:38:25.018 --> 00:38:26.500
Open up your ability to

00:38:26.679 --> 00:38:28.141
access a larger population

00:38:28.161 --> 00:38:30.342
of people who can deliver companionship.

00:38:30.704 --> 00:38:30.884
Right.

00:38:30.923 --> 00:38:32.764
But we're not necessarily in

00:38:32.804 --> 00:38:34.407
that business if we're billing insurance.

00:38:34.735 --> 00:38:35.054
Correct.

00:38:35.375 --> 00:38:35.576
Right.

00:38:36.056 --> 00:38:37.336
Actually going outside of

00:38:37.396 --> 00:38:38.777
insurance and not, you know,

00:38:38.818 --> 00:38:39.418
this is where, again,

00:38:39.777 --> 00:38:40.659
I got to bring Megan Brown

00:38:40.699 --> 00:38:41.380
on here because she's a,

00:38:42.559 --> 00:38:43.920
this is all theory, what we're saying,

00:38:44.001 --> 00:38:44.181
right?

00:38:44.201 --> 00:38:45.041
But Megan Brown is an

00:38:45.081 --> 00:38:46.342
example of someone who's doing it.

00:38:46.362 --> 00:38:46.822
So Megan,

00:38:46.922 --> 00:38:47.864
I'll make sure I get you on here.

00:38:47.903 --> 00:38:48.684
But this is,

00:38:48.965 --> 00:38:50.286
this is the question that I ask.

00:38:50.326 --> 00:38:51.246
And it sounds like I'm being

00:38:51.286 --> 00:38:53.068
a jerk when I ask clients this, it's like,

00:38:53.128 --> 00:38:54.168
what business are you in?

00:38:54.568 --> 00:38:56.230
And they repeat back to me their degree.

00:38:56.690 --> 00:38:59.471
Or they repeat back to me, I'm a company,

00:38:59.490 --> 00:39:00.271
I'm a this company,

00:39:00.291 --> 00:39:01.411
or I'm a this association.

00:39:01.431 --> 00:39:02.050
I'm like, great,

00:39:02.090 --> 00:39:03.351
that's how you deliver the

00:39:03.391 --> 00:39:04.911
thing that you think you're delivering.

00:39:05.331 --> 00:39:06.992
What are you actually delivering?

00:39:07.132 --> 00:39:08.112
And I think people are going

00:39:08.132 --> 00:39:11.213
to hold onto this into the ground.

00:39:11.793 --> 00:39:12.693
Companies have run

00:39:12.713 --> 00:39:14.353
themselves into the ground doing this,

00:39:14.914 --> 00:39:15.873
is not understanding what

00:39:15.914 --> 00:39:17.034
business you're actually in,

00:39:17.914 --> 00:39:19.114
who you're trying to serve,

00:39:19.173 --> 00:39:20.775
and is there a mismatch in

00:39:20.815 --> 00:39:22.335
expectation that

00:39:22.628 --> 00:39:25.190
My friends, that's why things decline.

00:39:25.351 --> 00:39:28.052
Sales, membership, people showing up,

00:39:28.092 --> 00:39:29.715
that is why things decline

00:39:29.755 --> 00:39:30.715
is when there's a mismatch

00:39:30.735 --> 00:39:31.516
in expectation.

00:39:31.916 --> 00:39:33.057
It's very rarely because of

00:39:33.077 --> 00:39:34.199
a couple dollars on price.

00:39:35.360 --> 00:39:36.840
And speaking about insurance,

00:39:36.880 --> 00:39:38.483
we have a segue that you want to pull up.

00:39:38.885 --> 00:39:39.545
Yeah, right here.

00:39:39.605 --> 00:39:41.085
So this was the article that, Dave,

00:39:41.106 --> 00:39:41.646
you shared with us.

00:39:41.726 --> 00:39:42.646
I saw this floating around.

00:39:42.686 --> 00:39:43.507
Some people are making some

00:39:43.547 --> 00:39:44.108
comments on it.

00:39:44.467 --> 00:39:46.750
This is from Becker's Hospital Review.

00:39:47.070 --> 00:39:47.750
The headline is,

00:39:48.130 --> 00:39:49.512
one of the worst situations

00:39:49.572 --> 00:39:50.751
a CFO can be in.

00:39:50.791 --> 00:39:51.393
That's the quote.

00:39:51.972 --> 00:39:55.275
Inside a systems split with UnitedHealth.

00:39:55.315 --> 00:39:57.235
And this is a small vignette,

00:39:57.275 --> 00:39:59.637
a small story of Carson

00:39:59.677 --> 00:40:01.179
Tahoe Health out in Utah

00:40:01.659 --> 00:40:03.320
who have decided –

00:40:03.320 --> 00:40:04.880
We're I mean, they're not small.

00:40:04.920 --> 00:40:05.940
There are two hospitals and

00:40:05.981 --> 00:40:07.221
like 20 outpatient centers.

00:40:07.240 --> 00:40:09.521
So that's small and hospital systems speak,

00:40:09.862 --> 00:40:10.722
but they're not small.

00:40:10.963 --> 00:40:11.163
Right.

00:40:11.523 --> 00:40:12.382
And what they've said is

00:40:12.503 --> 00:40:13.043
we've given

00:40:13.123 --> 00:40:15.304
UnitedHealthcare a year's I

00:40:15.324 --> 00:40:16.103
believe it's a year's

00:40:16.204 --> 00:40:17.885
notice that you're fired.

00:40:18.585 --> 00:40:19.764
And we're doing this in a

00:40:19.824 --> 00:40:21.266
year because we care about

00:40:21.286 --> 00:40:22.065
the people in our community.

00:40:22.085 --> 00:40:23.407
We want to give them the biggest heads up.

00:40:23.726 --> 00:40:25.206
But when we negotiate something,

00:40:25.726 --> 00:40:27.168
you're either not paying us

00:40:27.248 --> 00:40:28.367
what we've agreed upon.

00:40:28.387 --> 00:40:31.148
You're paying us 40, 50, 60% less.

00:40:31.648 --> 00:40:33.530
We can't operate and serve

00:40:33.889 --> 00:40:35.490
your customers by doing

00:40:35.530 --> 00:40:37.391
that if you keep doing that.

00:40:37.570 --> 00:40:39.152
And you're taking so long to

00:40:39.211 --> 00:40:40.811
pay us or you're putting up

00:40:40.851 --> 00:40:41.532
so much barrier.

00:40:41.753 --> 00:40:44.452
You're costing us money at every step.

00:40:44.853 --> 00:40:45.614
So you're fired.

00:40:46.467 --> 00:40:46.568
Now,

00:40:46.588 --> 00:40:47.969
the problem here is this is not

00:40:48.188 --> 00:40:48.768
one-to-one.

00:40:49.048 --> 00:40:50.469
There's a triangle here, right?

00:40:50.489 --> 00:40:51.730
Because you have the hospital system,

00:40:51.750 --> 00:40:52.670
you have UnitedHealthcare,

00:40:52.869 --> 00:40:53.889
and then you have all the people.

00:40:54.251 --> 00:40:55.550
And the people, in my opinion,

00:40:55.590 --> 00:40:57.030
are being held hostage this way.

00:40:57.452 --> 00:40:58.831
But what happens is that the

00:40:58.871 --> 00:40:59.811
hostage situation,

00:41:00.132 --> 00:41:01.012
they look at the person

00:41:01.032 --> 00:41:02.592
they're actually in contact with,

00:41:02.932 --> 00:41:04.373
the providers, the hospital,

00:41:04.414 --> 00:41:05.653
the outpatient clinics, and saying,

00:41:05.914 --> 00:41:06.494
why are you going to make

00:41:06.514 --> 00:41:08.534
it so hard for me to access my care?

00:41:08.675 --> 00:41:10.356
When in reality, UnitedHealthcare,

00:41:10.536 --> 00:41:12.016
as it seems in this Becker's article,

00:41:12.577 --> 00:41:13.356
is actually making it

00:41:14.545 --> 00:41:16.907
not even financially rewarding,

00:41:16.967 --> 00:41:17.907
but financially not

00:41:18.027 --> 00:41:20.650
feasible to continue this relationship.

00:41:21.251 --> 00:41:23.072
So this is a big picture example.

00:41:24.963 --> 00:41:26.784
If a hospital system of two

00:41:26.824 --> 00:41:28.487
hospitals and 28 patient

00:41:28.507 --> 00:41:30.447
clinics can fire an entire health system,

00:41:30.989 --> 00:41:31.829
why not you,

00:41:31.989 --> 00:41:34.612
a single preneur or a clinic

00:41:34.891 --> 00:41:35.693
or a couple clinics?

00:41:36.052 --> 00:41:36.954
Why not you?

00:41:37.134 --> 00:41:38.375
Is this the only way as

00:41:38.454 --> 00:41:39.795
providers and business

00:41:39.835 --> 00:41:41.016
owners we get to gain

00:41:41.097 --> 00:41:42.978
leverage and get their attention?

00:41:42.998 --> 00:41:43.920
Because if we keep going,

00:41:44.400 --> 00:41:46.262
it looks like we just continue to lose.

00:41:47.983 --> 00:41:48.884
Dave, what are your thoughts?

00:41:49.882 --> 00:41:50.041
Well,

00:41:50.061 --> 00:41:51.822
so we build UnitedHealthcare at a

00:41:51.842 --> 00:41:52.182
network.

00:41:52.663 --> 00:41:53.302
Tony's been in the

00:41:53.382 --> 00:41:54.623
in-network game way longer.

00:41:54.704 --> 00:41:56.264
So I would say I want to

00:41:56.284 --> 00:41:57.344
hear what Tony has to say.

00:41:57.405 --> 00:41:59.045
First of all, your initial impressions.

00:41:59.606 --> 00:42:00.226
And then also,

00:42:00.666 --> 00:42:01.646
or maybe if you want to start with this,

00:42:02.586 --> 00:42:03.166
are you guys still

00:42:03.186 --> 00:42:04.347
accepting the

00:42:04.487 --> 00:42:05.568
UnitedHealthcare Medicare

00:42:05.588 --> 00:42:06.668
Advantage plans or do you

00:42:06.748 --> 00:42:07.568
not accept those at all?

00:42:08.268 --> 00:42:08.489
We do.

00:42:09.996 --> 00:42:13.277
So since you do, give us some insight.

00:42:13.338 --> 00:42:14.257
Like, what are you seeing?

00:42:14.297 --> 00:42:15.739
Like, obviously you'll have, like,

00:42:15.759 --> 00:42:16.778
tell us either what you're

00:42:16.798 --> 00:42:18.000
seeing with prior authorizations,

00:42:18.039 --> 00:42:21.481
any changes, more callbacks, more of the,

00:42:21.641 --> 00:42:22.541
just like from the article,

00:42:22.581 --> 00:42:23.681
like some of the retro

00:42:23.740 --> 00:42:24.981
payments where they're just

00:42:25.041 --> 00:42:26.101
calling back money from

00:42:26.481 --> 00:42:27.483
like a year ago or

00:42:27.543 --> 00:42:29.543
sometimes further in the past,

00:42:29.583 --> 00:42:30.923
like years ago, which is insane.

00:42:33.211 --> 00:42:33.813
What are your thoughts?

00:42:33.954 --> 00:42:35.315
What are you seeing in your practice?

00:42:35.436 --> 00:42:36.398
Or what are your thoughts in

00:42:36.438 --> 00:42:38.240
general of this shift where

00:42:38.621 --> 00:42:39.422
some of these big health

00:42:39.443 --> 00:42:40.385
systems now are going to

00:42:40.405 --> 00:42:41.025
start dropping

00:42:41.487 --> 00:42:43.070
UnitedHealthcare slash

00:42:43.289 --> 00:42:44.452
UnitedHealthcare Medicare

00:42:44.472 --> 00:42:45.134
Advantage plans?

00:42:46.929 --> 00:42:47.268
I think it,

00:42:47.489 --> 00:42:49.170
I think it's potentially positive.

00:42:49.231 --> 00:42:49.550
I mean, it's,

00:42:50.371 --> 00:42:51.632
but other than the patients

00:42:51.853 --> 00:42:52.873
that live in those communities,

00:42:52.934 --> 00:42:54.835
because now they're,

00:42:55.336 --> 00:42:56.217
they're not at fault.

00:42:56.338 --> 00:42:56.858
Like they're going to,

00:42:57.018 --> 00:42:57.838
they're going to say, Hey,

00:42:57.938 --> 00:42:59.721
like my employer has chosen

00:42:59.740 --> 00:43:00.240
out of healthcare.

00:43:00.280 --> 00:43:01.722
Like they literally have no leverage,

00:43:02.043 --> 00:43:03.043
but then the article also

00:43:03.083 --> 00:43:04.204
shows that the hospital

00:43:04.244 --> 00:43:05.326
systems have no leverage.

00:43:05.846 --> 00:43:06.427
Like Jimmy said,

00:43:06.847 --> 00:43:08.528
the 13,000 patients they're

00:43:08.548 --> 00:43:09.989
serving and two large systems,

00:43:10.050 --> 00:43:10.931
two large hospitals,

00:43:11.490 --> 00:43:13.012
and even they don't have leverage to,

00:43:13.978 --> 00:43:14.960
against UnitedHealthcare.

00:43:14.980 --> 00:43:15.880
So either what's,

00:43:16.099 --> 00:43:17.181
what are you seeing in your practice,

00:43:17.201 --> 00:43:17.481
Tony,

00:43:17.601 --> 00:43:19.742
or even from like the national view

00:43:19.902 --> 00:43:21.643
of this, you know,

00:43:21.862 --> 00:43:23.083
potentially part of the, you know,

00:43:23.103 --> 00:43:25.164
top of the iceberg as a potential shift,

00:43:25.244 --> 00:43:26.266
or maybe it's no big deal.

00:43:26.286 --> 00:43:26.585
I don't know.

00:43:27.594 --> 00:43:29.215
I'm going to say we lived

00:43:29.275 --> 00:43:30.875
through this here in Ohio.

00:43:30.994 --> 00:43:32.255
Where I am, Middletown,

00:43:32.635 --> 00:43:34.336
a little context for everybody.

00:43:34.876 --> 00:43:36.878
There's probably one or two

00:43:37.117 --> 00:43:39.197
large employers in the area.

00:43:40.259 --> 00:43:41.998
They were with United

00:43:42.039 --> 00:43:43.000
Healthcare for a while.

00:43:43.059 --> 00:43:43.980
They switched to Anthem,

00:43:44.000 --> 00:43:45.001
Blue Cross Blue Shield.

00:43:46.121 --> 00:43:46.902
The hospital,

00:43:46.961 --> 00:43:48.503
the primary hospital in the

00:43:48.563 --> 00:43:50.425
city got into a battle with

00:43:50.445 --> 00:43:51.585
the insurance company and

00:43:51.746 --> 00:43:53.728
tried to drop the insurance company.

00:43:54.407 --> 00:43:55.748
I think this article,

00:43:55.849 --> 00:43:56.989
I think this topic is

00:43:57.070 --> 00:43:58.911
largely just posturing, you know,

00:43:58.931 --> 00:43:59.913
because effectively what's

00:43:59.932 --> 00:44:00.733
happening here is.

00:44:01.724 --> 00:44:03.184
They're trying to find leverage.

00:44:03.744 --> 00:44:04.965
The hospital is trying to

00:44:05.025 --> 00:44:06.326
find leverage and saying, look,

00:44:06.806 --> 00:44:08.186
we're dropping the network.

00:44:08.527 --> 00:44:09.867
None of your beneficiaries

00:44:09.927 --> 00:44:11.288
are going to be in network.

00:44:11.467 --> 00:44:12.809
We're the only hospital

00:44:12.849 --> 00:44:14.028
that's available to them or

00:44:14.148 --> 00:44:15.369
one of two hospitals that's

00:44:15.389 --> 00:44:16.250
available to them.

00:44:16.971 --> 00:44:19.150
Your beneficiaries are going

00:44:19.170 --> 00:44:20.731
to drop your insurance and

00:44:20.771 --> 00:44:22.213
switch to a different carrier.

00:44:22.893 --> 00:44:24.393
That's that's the play on

00:44:24.414 --> 00:44:25.275
the hospital side.

00:44:25.876 --> 00:44:27.016
On the insurance side,

00:44:27.777 --> 00:44:28.657
they're going to say, look,

00:44:29.099 --> 00:44:30.280
I've got one hundred

00:44:30.320 --> 00:44:32.601
thousand beneficiaries in this community.

00:44:33.101 --> 00:44:34.884
We're the primary care.

00:44:34.963 --> 00:44:36.364
We have the most people.

00:44:36.826 --> 00:44:38.266
You can drop our contract.

00:44:38.327 --> 00:44:38.887
That's fine.

00:44:38.907 --> 00:44:39.527
But then you're going to

00:44:39.568 --> 00:44:40.889
lose all of these patients.

00:44:41.349 --> 00:44:42.650
Who has the bankroll?

00:44:42.931 --> 00:44:43.992
And this is a real question.

00:44:44.032 --> 00:44:45.873
Like you guys know the financials.

00:44:46.333 --> 00:44:47.494
Who do you think has the

00:44:47.554 --> 00:44:51.177
bank role to be in this standoff longer?

00:44:51.378 --> 00:44:53.420
It's the insurance company, right?

00:44:53.460 --> 00:44:55.061
The hospital does not have

00:44:55.121 --> 00:44:56.041
the resources and the

00:44:56.081 --> 00:44:57.262
finances to do that.

00:44:57.802 --> 00:45:00.766
So here in Ohio, when this has happened,

00:45:00.826 --> 00:45:02.246
it's happened twice in like

00:45:02.327 --> 00:45:04.389
the 20-ish years I've been here.

00:45:05.208 --> 00:45:07.150
Every single time the hospital backs down,

00:45:07.610 --> 00:45:09.893
every single time the hospital loses,

00:45:10.414 --> 00:45:11.934
they might get one or two

00:45:11.994 --> 00:45:12.996
little breadcrumbs of

00:45:13.056 --> 00:45:15.217
negotiation from the third party payer.

00:45:15.878 --> 00:45:17.400
It doesn't matter that the patient,

00:45:17.440 --> 00:45:19.302
the beneficiary is the one that suffers.

00:45:19.362 --> 00:45:20.181
It doesn't matter that

00:45:20.583 --> 00:45:22.043
surgeries get canceled.

00:45:22.505 --> 00:45:24.545
All of this stuff goes on the back burner.

00:45:25.427 --> 00:45:27.329
The hospital always loses.

00:45:27.409 --> 00:45:28.869
The hospital always backs down.

00:45:29.490 --> 00:45:31.371
So that's been my experience

00:45:31.552 --> 00:45:33.293
in this kind of situation.

00:45:34.715 --> 00:45:36.356
From my experience as a

00:45:36.596 --> 00:45:37.978
small provider with a

00:45:38.038 --> 00:45:39.418
company like United Healthcare,

00:45:39.958 --> 00:45:41.800
my Facebook group is full

00:45:41.981 --> 00:45:44.603
of therapists who say a year later,

00:45:45.244 --> 00:45:46.324
United came back and they

00:45:46.364 --> 00:45:47.706
clawed back all this money and

00:45:48.679 --> 00:45:50.681
The thing is, most of the time,

00:45:50.740 --> 00:45:52.322
if you really look into it,

00:45:52.922 --> 00:45:54.043
it's a case of you don't

00:45:54.083 --> 00:45:55.023
know what you don't know.

00:45:55.344 --> 00:45:56.023
Like, okay,

00:45:56.063 --> 00:45:57.684
so UnitedHealthcare for a while

00:45:57.704 --> 00:45:58.985
switched their policy to say,

00:45:59.005 --> 00:46:00.686
we need you to document time in,

00:46:00.726 --> 00:46:01.628
time out.

00:46:02.594 --> 00:46:04.175
If somebody was treated

00:46:04.255 --> 00:46:06.038
during a certain time of

00:46:06.057 --> 00:46:06.797
the calendar year,

00:46:06.818 --> 00:46:08.318
when this policy was in place,

00:46:08.840 --> 00:46:10.721
they they've rescinded the policy since,

00:46:10.760 --> 00:46:12.802
but for a while that policy was in place.

00:46:13.322 --> 00:46:14.403
So you can imagine.

00:46:14.423 --> 00:46:17.125
I treat a patient in March of 2023,

00:46:17.125 --> 00:46:19.827
United healthcare comes

00:46:19.907 --> 00:46:21.108
along and audits those

00:46:21.168 --> 00:46:24.150
accounts sometime in 2024.

00:46:24.150 --> 00:46:26.052
They won't tell you why you

00:46:26.271 --> 00:46:27.313
failed the audit,

00:46:27.532 --> 00:46:29.494
but when they look at the documentation,

00:46:29.534 --> 00:46:30.315
they don't care.

00:46:30.835 --> 00:46:32.315
how much you documented,

00:46:32.355 --> 00:46:34.135
how well you analyzed their gate,

00:46:34.255 --> 00:46:35.376
how well you looked at the

00:46:35.456 --> 00:46:38.077
nuances of their SI joint and all of it.

00:46:38.177 --> 00:46:38.717
They don't care.

00:46:39.317 --> 00:46:41.456
You did not document time in, time out.

00:46:41.617 --> 00:46:43.338
During those dates of service,

00:46:43.358 --> 00:46:45.137
you were required to document time in,

00:46:45.177 --> 00:46:45.717
time out.

00:46:46.077 --> 00:46:46.938
We want the money back.

00:46:47.418 --> 00:46:47.818
And that's it.

00:46:48.018 --> 00:46:49.259
And they get the money back.

00:46:49.759 --> 00:46:51.099
They're not responsible for

00:46:51.159 --> 00:46:52.179
teaching you how to bill.

00:46:52.358 --> 00:46:53.599
They're not responsible for

00:46:53.619 --> 00:46:55.139
making sure you understand the policy.

00:46:55.619 --> 00:46:57.842
But therapists don't understand that.

00:46:57.902 --> 00:46:58.402
And they're like,

00:46:58.481 --> 00:47:00.403
I can't believe they took my money away.

00:47:00.523 --> 00:47:01.364
I worked so hard.

00:47:01.425 --> 00:47:01.664
Yeah.

00:47:01.684 --> 00:47:02.925
They don't want they don't

00:47:02.945 --> 00:47:03.806
want to understand it.

00:47:03.925 --> 00:47:04.126
Right.

00:47:04.186 --> 00:47:05.166
This is an emotional thing.

00:47:05.186 --> 00:47:06.128
It's not a priority.

00:47:06.387 --> 00:47:06.608
Right.

00:47:06.889 --> 00:47:07.088
Right.

00:47:07.248 --> 00:47:08.150
So it's like, listen,

00:47:08.190 --> 00:47:09.490
but this isn't quality care.

00:47:09.510 --> 00:47:11.192
It's like understand what

00:47:11.271 --> 00:47:12.172
game you're playing,

00:47:12.572 --> 00:47:13.753
what position in that game

00:47:13.793 --> 00:47:15.235
you play and how you can

00:47:15.275 --> 00:47:16.235
play that position well.

00:47:16.735 --> 00:47:18.177
I mean, I saw, God,

00:47:18.197 --> 00:47:19.679
I got to find this article, but it was,

00:47:20.420 --> 00:47:21.141
they did, you know,

00:47:21.440 --> 00:47:22.802
a massive artificial

00:47:22.862 --> 00:47:25.105
intelligence review on PT

00:47:25.164 --> 00:47:26.525
documentation specifically.

00:47:26.545 --> 00:47:27.507
And the two main findings

00:47:27.547 --> 00:47:28.909
they found were we were

00:47:28.949 --> 00:47:30.289
documenting more than was

00:47:30.349 --> 00:47:32.172
required by the insurance companies.

00:47:32.251 --> 00:47:33.233
The insurance company said

00:47:33.273 --> 00:47:36.416
do X. We did X times two to be safer.

00:47:36.936 --> 00:47:38.358
Like the insurance company

00:47:38.378 --> 00:47:39.498
didn't make you do all those things.

00:47:39.878 --> 00:47:41.380
They actually said, hit these five things.

00:47:41.500 --> 00:47:42.320
I'm making that number up.

00:47:42.340 --> 00:47:43.661
Hit these five things and you're fine.

00:47:44.061 --> 00:47:45.483
We did 15 and said,

00:47:45.503 --> 00:47:47.103
these guys make us do too much.

00:47:47.244 --> 00:47:48.244
No, you're doing the wrong thing.

00:47:48.344 --> 00:47:49.226
You emotionally thought you

00:47:49.246 --> 00:47:50.487
had to do 15 to be a real saver.

00:47:50.746 --> 00:47:51.666
That's a you problem.

00:47:51.967 --> 00:47:53.929
And the second was in the AI

00:47:53.969 --> 00:47:55.250
review of documentation was

00:47:55.570 --> 00:47:57.231
we did X number of things

00:47:57.431 --> 00:47:58.992
and build for X minus three.

00:47:59.833 --> 00:48:00.972
So we did five things that

00:48:00.992 --> 00:48:01.713
we could bill for,

00:48:01.733 --> 00:48:02.914
but we billed for three of

00:48:02.954 --> 00:48:03.574
them and then said,

00:48:03.653 --> 00:48:04.855
you guys don't pay us enough.

00:48:05.235 --> 00:48:05.494
Actually,

00:48:05.534 --> 00:48:06.655
you left money on the table and

00:48:06.675 --> 00:48:07.556
the insurance company is

00:48:07.635 --> 00:48:08.856
not going to come wipe your butt for you.

00:48:09.235 --> 00:48:10.076
They're not going to come say, hey,

00:48:10.096 --> 00:48:11.757
by the way, you did five things.

00:48:12.157 --> 00:48:13.217
You only asked for three.

00:48:13.257 --> 00:48:14.297
We're just going to go ahead

00:48:14.318 --> 00:48:15.398
and give you five because

00:48:15.418 --> 00:48:17.099
they understand what game they're in.

00:48:17.798 --> 00:48:19.059
what position they play and

00:48:19.099 --> 00:48:20.199
how to play that position well.

00:48:20.519 --> 00:48:21.280
And I'm sorry,

00:48:21.360 --> 00:48:23.380
but wishing it's and saying

00:48:23.420 --> 00:48:24.039
it's not right.

00:48:24.079 --> 00:48:24.679
It's wrong.

00:48:25.201 --> 00:48:26.601
It's not how things get changed.

00:48:26.681 --> 00:48:28.340
I'm very, very sorry.

00:48:28.380 --> 00:48:30.661
Clean up your house before you.

00:48:31.402 --> 00:48:32.422
Now I'm not saying this company,

00:48:32.442 --> 00:48:33.001
by the way, I'm not,

00:48:33.141 --> 00:48:35.063
I'm not pro that these guys are doing.

00:48:35.262 --> 00:48:36.543
These guys are playing a money game,

00:48:36.842 --> 00:48:38.023
which sucks because we're

00:48:38.043 --> 00:48:38.943
not playing a money game.

00:48:39.043 --> 00:48:40.603
We're playing a human being

00:48:40.684 --> 00:48:41.943
relationship care game.

00:48:42.204 --> 00:48:42.943
So that sucks.

00:48:42.963 --> 00:48:44.085
So we're playing two different games.

00:48:44.324 --> 00:48:45.664
So understand those three things.

00:48:47.309 --> 00:48:48.911
Real quick sidebar, Christine Carnegie,

00:48:48.931 --> 00:48:50.431
thank you so much for the question.

00:48:50.452 --> 00:48:53.173
I will answer this next episode.

00:48:53.193 --> 00:48:53.574
How about that?

00:48:53.594 --> 00:48:54.255
Just because we're running

00:48:54.295 --> 00:48:55.054
out of time a little bit.

00:48:55.235 --> 00:48:56.235
It's a longer question,

00:48:56.255 --> 00:48:56.856
but it's a good one.

00:48:57.336 --> 00:48:57.496
Yeah,

00:48:57.556 --> 00:48:59.277
mobile concierge side gig that she's

00:48:59.318 --> 00:49:01.159
starting and she's asking

00:49:02.541 --> 00:49:05.242
how to create a positive,

00:49:05.262 --> 00:49:06.483
fun environment in someone's home.

00:49:06.523 --> 00:49:07.684
So I would love to answer

00:49:07.704 --> 00:49:08.425
that and we can talk about

00:49:08.445 --> 00:49:08.864
that next time.

00:49:09.217 --> 00:49:10.119
What I think she's asking,

00:49:10.159 --> 00:49:11.420
and I can only see part of the comment is,

00:49:11.880 --> 00:49:12.320
hey, listen,

00:49:12.420 --> 00:49:13.380
Tony's creating this cool

00:49:13.400 --> 00:49:14.521
environment with people and

00:49:14.581 --> 00:49:15.983
other patients and other providers.

00:49:17.023 --> 00:49:18.644
Dave's one on one in someone's house.

00:49:18.704 --> 00:49:20.286
Like, how do you do that?

00:49:20.427 --> 00:49:21.387
And there are ways I'm

00:49:21.427 --> 00:49:22.708
guessing that you've loaded

00:49:22.789 --> 00:49:23.909
up and you've done through

00:49:23.949 --> 00:49:24.690
trial and error by

00:49:24.730 --> 00:49:25.851
listening to podcasts and

00:49:25.990 --> 00:49:27.112
yada yada by doing that.

00:49:27.152 --> 00:49:27.853
So that's a good one,

00:49:27.893 --> 00:49:29.673
but probably more than than

00:49:29.673 --> 00:49:30.855
10 minutes that we have left.

00:49:31.431 --> 00:49:31.610
Yeah.

00:49:31.951 --> 00:49:33.291
But so going back to the

00:49:33.952 --> 00:49:34.771
United healthcare thing.

00:49:34.851 --> 00:49:35.751
So like Tony said,

00:49:36.112 --> 00:49:37.552
this is like a little bit of posturing.

00:49:37.992 --> 00:49:40.534
This is basically like a

00:49:40.574 --> 00:49:41.454
negotiation tactic.

00:49:42.054 --> 00:49:43.375
And here, here's like,

00:49:43.414 --> 00:49:45.175
so physical therapy practices, PT,

00:49:45.255 --> 00:49:47.056
OT watching, listening right now.

00:49:48.596 --> 00:49:50.416
Tony is saying, and Tony,

00:49:50.556 --> 00:49:52.637
you're probably right that the hospital,

00:49:52.677 --> 00:49:53.338
it's just some, you know,

00:49:53.398 --> 00:49:55.438
posturing it's puffing their chest out.

00:49:55.697 --> 00:49:56.858
And then eventually they're going to cave.

00:49:57.139 --> 00:49:58.318
Maybe like you said, they're going to get,

00:49:58.358 --> 00:49:58.918
you know, I don't know,

00:49:58.938 --> 00:49:59.920
like a percentage or two

00:49:59.980 --> 00:50:01.119
back or whatever that they're,

00:50:01.900 --> 00:50:02.380
Like Jimmy said,

00:50:02.420 --> 00:50:04.501
they're getting slashed by, I don't know,

00:50:05.681 --> 00:50:06.541
it doesn't say numbers,

00:50:06.601 --> 00:50:08.103
but it could be dozens of

00:50:08.202 --> 00:50:09.903
percentage points plus the

00:50:09.943 --> 00:50:10.664
timeline and all the

00:50:10.724 --> 00:50:12.025
administrative labor and

00:50:12.125 --> 00:50:13.945
burden and frustration of

00:50:14.045 --> 00:50:15.885
trying to get paid what the

00:50:15.925 --> 00:50:16.487
contract says.

00:50:17.626 --> 00:50:18.146
So by the way,

00:50:18.186 --> 00:50:19.708
but for the PT practice listening,

00:50:20.768 --> 00:50:22.148
you actually have the

00:50:22.228 --> 00:50:24.329
ability to not just posture,

00:50:24.849 --> 00:50:26.030
but you can actually say, okay,

00:50:27.286 --> 00:50:27.927
I'm done with it.

00:50:28.208 --> 00:50:29.731
And then when the next patient calls,

00:50:29.771 --> 00:50:31.014
it has a Medicare Advantage plan,

00:50:31.094 --> 00:50:31.956
UnitedHealthcare, whatever.

00:50:33.614 --> 00:50:35.416
You certainly can drop these

00:50:35.476 --> 00:50:37.097
lower paying payers or

00:50:37.157 --> 00:50:38.137
especially UnitedHealthcare,

00:50:38.197 --> 00:50:39.679
the ones that are causing

00:50:39.699 --> 00:50:41.521
some of this frustration in

00:50:41.541 --> 00:50:42.981
your practice and the

00:50:43.021 --> 00:50:44.023
administrative burden of

00:50:44.123 --> 00:50:45.123
chasing some of these dollars.

00:50:45.143 --> 00:50:46.043
And then you get paid and

00:50:46.063 --> 00:50:47.425
then they try to call money

00:50:47.465 --> 00:50:48.626
back six to 12 months later.

00:50:48.706 --> 00:50:49.065
I get it.

00:50:49.126 --> 00:50:49.606
I've been there.

00:50:49.927 --> 00:50:50.907
I've been there specifically

00:50:50.947 --> 00:50:51.628
with UnitedHealthcare,

00:50:51.688 --> 00:50:53.369
even through the out of network.

00:50:54.090 --> 00:50:55.271
And if you want to sleep better,

00:50:55.311 --> 00:50:56.351
if you want to actually do this,

00:50:56.391 --> 00:50:57.913
you can absolutely do this

00:50:58.554 --> 00:50:59.293
without posturing.

00:50:59.313 --> 00:50:59.773
You could just...

00:51:00.715 --> 00:51:02.275
Cancel the contract if you wanted to.

00:51:02.916 --> 00:51:03.856
The next person that calls

00:51:04.215 --> 00:51:05.817
in that has Medicare Advantage plan,

00:51:06.177 --> 00:51:07.356
you just say this.

00:51:07.456 --> 00:51:08.898
You say, hey, Tony.

00:51:09.577 --> 00:51:09.757
Yep,

00:51:09.898 --> 00:51:11.057
we used to take UnitedHealthcare

00:51:11.077 --> 00:51:11.938
Medicare Advantage plan.

00:51:11.958 --> 00:51:13.239
We took it for years.

00:51:13.719 --> 00:51:14.800
We have so many patients in

00:51:14.820 --> 00:51:17.760
the community that we

00:51:17.940 --> 00:51:18.740
accepted it and we've

00:51:19.001 --> 00:51:20.201
helped build our insurance, whatever.

00:51:20.280 --> 00:51:21.521
However, things have changed.

00:51:21.541 --> 00:51:23.322
There's all this paperwork, this issue.

00:51:23.523 --> 00:51:24.382
I can send you a link,

00:51:24.583 --> 00:51:26.143
this newspaper article if you want.

00:51:26.443 --> 00:51:27.704
But basically what it means is

00:51:28.731 --> 00:51:30.833
We used to take it and we no longer do.

00:51:31.315 --> 00:51:32.416
We no longer take it because

00:51:32.456 --> 00:51:33.336
of all this administrative

00:51:33.356 --> 00:51:35.059
burden and they're slashing

00:51:35.079 --> 00:51:35.938
our reimbursement rates.

00:51:35.978 --> 00:51:36.920
And we believe that we're

00:51:37.320 --> 00:51:38.101
providing a valuable

00:51:38.141 --> 00:51:38.963
service to our community.

00:51:39.822 --> 00:51:42.867
And we also now we can help you.

00:51:42.887 --> 00:51:43.887
We can evaluate and treat you.

00:51:45.068 --> 00:51:47.050
It would be on an out of pocket basis.

00:51:49.552 --> 00:51:49.634
And.

00:51:51.751 --> 00:51:52.711
We have many clients,

00:51:52.751 --> 00:51:53.452
many patients in the

00:51:53.472 --> 00:51:54.932
community that have your

00:51:54.972 --> 00:51:55.932
Medicare Advantage plan

00:51:56.434 --> 00:51:57.233
through UnitedHealthcare,

00:51:58.034 --> 00:52:00.215
and they have decided to

00:52:00.255 --> 00:52:01.135
pay us out of pocket.

00:52:01.614 --> 00:52:02.295
It's not for everyone,

00:52:02.775 --> 00:52:04.556
but that is one way that we

00:52:04.596 --> 00:52:05.456
could continue to work with

00:52:05.496 --> 00:52:06.757
you or clients like you

00:52:06.777 --> 00:52:07.657
that have this insurance.

00:52:08.257 --> 00:52:11.639
And you certainly can just drop it.

00:52:11.759 --> 00:52:12.199
Tomorrow,

00:52:12.259 --> 00:52:13.099
you don't have to take this

00:52:13.458 --> 00:52:14.360
insurance ever again if you

00:52:14.380 --> 00:52:14.760
don't want to.

00:52:15.876 --> 00:52:16.817
Yes to what you said.

00:52:17.077 --> 00:52:18.036
It's too many words, though.

00:52:18.838 --> 00:52:20.039
We have there needs to be a

00:52:20.139 --> 00:52:23.221
we don't do we we we do this.

00:52:24.101 --> 00:52:25.722
If you've not been on these calls, though,

00:52:25.762 --> 00:52:26.041
Jimmy,

00:52:26.222 --> 00:52:28.304
with an actual patient going that

00:52:28.443 --> 00:52:29.764
is expecting insurance when

00:52:29.784 --> 00:52:31.005
they call in and you're and

00:52:31.045 --> 00:52:33.007
you're saying and I'm saying like,

00:52:33.786 --> 00:52:34.788
you know, we don't take it.

00:52:34.827 --> 00:52:35.387
We used to take it.

00:52:35.547 --> 00:52:36.289
We no longer do it.

00:52:36.648 --> 00:52:38.931
I believe maybe that this is how we roll.

00:52:40.090 --> 00:52:41.572
It does require a little bit

00:52:41.992 --> 00:52:43.911
of context because they're

00:52:43.952 --> 00:52:44.572
calling in and saying,

00:52:44.592 --> 00:52:45.492
do you take this insurance?

00:52:45.532 --> 00:52:46.873
It says it on your website.

00:52:46.913 --> 00:52:47.672
It says UnitedHealthcare.

00:52:47.713 --> 00:52:49.514
And then we have to say we

00:52:49.554 --> 00:52:50.614
take out a network or whatever.

00:52:50.634 --> 00:52:52.235
Like it takes a little bit

00:52:52.635 --> 00:52:53.434
because it's not like the

00:52:53.474 --> 00:52:54.034
restaurant thing.

00:52:54.255 --> 00:52:54.934
It's not like, hey,

00:52:54.954 --> 00:52:56.135
do you have ribs or chicken

00:52:56.255 --> 00:52:57.896
or do you have a table

00:52:57.916 --> 00:52:58.815
that's available for four

00:52:58.856 --> 00:53:00.257
of us tonight at 8 p.m.?

00:53:00.916 --> 00:53:01.956
It requires some context

00:53:01.976 --> 00:53:03.018
because of this whole third

00:53:03.057 --> 00:53:03.918
party payer system.

00:53:04.380 --> 00:53:05.280
Well,

00:53:05.300 --> 00:53:06.501
I think the difference is because

00:53:06.521 --> 00:53:08.244
you're asking if it's Visa, Discover,

00:53:08.304 --> 00:53:10.126
or Amex before I ever sit down,

00:53:10.405 --> 00:53:12.148
when I'm making the reservation.

00:53:12.688 --> 00:53:13.248
And you have to say,

00:53:13.309 --> 00:53:14.750
we used to take American Express,

00:53:15.130 --> 00:53:16.032
but we don't anymore.

00:53:16.452 --> 00:53:18.014
But people typically don't

00:53:18.054 --> 00:53:19.514
have multiple insurances.

00:53:19.614 --> 00:53:20.536
So I can't just pull out my

00:53:20.596 --> 00:53:21.376
Visa when you say,

00:53:21.396 --> 00:53:22.858
I don't do American Express.

00:53:22.958 --> 00:53:23.259
Why?

00:53:23.518 --> 00:53:24.199
They charge too much.

00:53:25.320 --> 00:53:25.561
It's like,

00:53:25.902 --> 00:53:26.742
I just want to know if I can get

00:53:26.762 --> 00:53:27.603
the table, right?

00:53:27.623 --> 00:53:27.722
Yeah.

00:53:29.085 --> 00:53:30.385
You not getting paid enough

00:53:30.485 --> 00:53:31.545
from UnitedHealthcare as a

00:53:31.585 --> 00:53:32.847
provider is a you problem.

00:53:32.987 --> 00:53:33.847
I don't like sharing my

00:53:33.887 --> 00:53:34.708
problems with them.

00:53:35.307 --> 00:53:36.329
Their problem might be,

00:53:36.568 --> 00:53:37.909
and I would address this,

00:53:38.210 --> 00:53:39.851
we used to take them, we don't anymore.

00:53:40.251 --> 00:53:40.530
Why?

00:53:41.311 --> 00:53:43.193
If they ask why, it's a payment issue.

00:53:44.793 --> 00:53:45.454
Because you're still trying

00:53:45.474 --> 00:53:46.313
to solve the person's on

00:53:46.333 --> 00:53:47.195
the phone's problem,

00:53:47.215 --> 00:53:48.675
which is how do you get them better?

00:53:50.175 --> 00:53:51.077
I've tried it that way.

00:53:51.416 --> 00:53:52.898
It comes off too curt.

00:53:52.998 --> 00:53:54.679
It comes off too like...

00:53:55.608 --> 00:53:57.349
We don't take it anymore, and that's why.

00:53:57.369 --> 00:54:00.012
I don't want to be a sheriff on the phone.

00:54:00.112 --> 00:54:02.735
I want to say... What do you want to be?

00:54:03.534 --> 00:54:06.217
I want to meet them halfway... Sorry,

00:54:06.237 --> 00:54:07.197
I got bees in my face out

00:54:07.217 --> 00:54:07.798
here on the deck.

00:54:09.780 --> 00:54:11.501
I want to come off as...

00:54:13.119 --> 00:54:14.000
like approachable.

00:54:14.141 --> 00:54:15.342
I don't want to come off as

00:54:15.581 --> 00:54:17.224
we're some stuffy practice

00:54:17.264 --> 00:54:18.545
that is only out of pocket.

00:54:18.844 --> 00:54:19.706
I'll tell you right now,

00:54:19.746 --> 00:54:20.586
you're not a sheriff,

00:54:20.867 --> 00:54:22.148
but you're not that right now.

00:54:22.188 --> 00:54:23.130
You're word salad.

00:54:23.190 --> 00:54:25.010
And it sounds like the thing,

00:54:25.050 --> 00:54:26.193
the vibe that I got was you

00:54:26.213 --> 00:54:27.134
were talking about why you

00:54:27.153 --> 00:54:28.235
broke up with your ex-girlfriend.

00:54:29.135 --> 00:54:31.077
I think next time at some point,

00:54:31.157 --> 00:54:33.637
whether it's not the next podcast,

00:54:33.677 --> 00:54:34.958
but at some point we should

00:54:34.978 --> 00:54:36.099
do some role play.

00:54:36.599 --> 00:54:38.420
We should work through this because,

00:54:38.480 --> 00:54:39.721
you know, this is the famous,

00:54:39.740 --> 00:54:41.320
do you take my insurance question?

00:54:41.581 --> 00:54:43.021
Dave's got so much

00:54:43.081 --> 00:54:44.402
experience in that world.

00:54:45.963 --> 00:54:47.204
I also think that there are

00:54:47.224 --> 00:54:49.826
a couple compromises we can

00:54:49.865 --> 00:54:50.666
bring in there.

00:54:50.867 --> 00:54:52.188
I'm happy to share what we

00:54:52.288 --> 00:54:53.688
used to say back in the day

00:54:53.748 --> 00:54:55.429
when we were out of network

00:54:55.510 --> 00:54:56.411
or all cash pay.

00:54:56.550 --> 00:54:56.971
Also,

00:54:56.990 --> 00:55:00.614
I think there's definite different

00:55:00.653 --> 00:55:01.313
approaches to it,

00:55:01.353 --> 00:55:03.315
but having us go through,

00:55:03.356 --> 00:55:04.597
maybe Jimmy's the patient,

00:55:05.556 --> 00:55:06.978
Dave's the provider,

00:55:07.038 --> 00:55:08.438
and just kind of listen to

00:55:08.458 --> 00:55:09.559
the actual conversation.

00:55:09.599 --> 00:55:10.300
I think that'd be great

00:55:10.340 --> 00:55:11.260
content in the future.

00:55:11.641 --> 00:55:13.063
We should have AI do it too.

00:55:13.083 --> 00:55:13.483
Yeah.

00:55:14.382 --> 00:55:15.664
Do you know what I mean?

00:55:15.684 --> 00:55:16.204
Like, yeah, yeah.

00:55:16.284 --> 00:55:17.626
And be like, so you're the bad guy.

00:55:17.746 --> 00:55:19.128
Okay, AI, now switch roles.

00:55:19.208 --> 00:55:20.028
Now you're the provider.

00:55:20.088 --> 00:55:21.150
Okay, AI, switch roles.

00:55:21.210 --> 00:55:21.911
Now you're the patient.

00:55:22.391 --> 00:55:24.574
How do you get that so that

00:55:24.773 --> 00:55:25.695
everybody wins?

00:55:26.635 --> 00:55:28.438
Or, well, so I'll go,

00:55:28.458 --> 00:55:29.099
this is the last thing I'll

00:55:29.119 --> 00:55:29.539
say about this.

00:55:30.000 --> 00:55:31.800
Your goal in that conversation,

00:55:31.820 --> 00:55:32.561
from my opinion,

00:55:32.601 --> 00:55:34.802
and I don't have experience doing this,

00:55:35.422 --> 00:55:36.422
would be your goal is to

00:55:36.463 --> 00:55:37.204
gain understanding,

00:55:37.364 --> 00:55:38.503
not to get them to want to

00:55:38.543 --> 00:55:39.364
choose you at that point.

00:55:39.385 --> 00:55:40.585
Because if that's a deciding

00:55:40.646 --> 00:55:43.467
factor and you're not taking them,

00:55:43.927 --> 00:55:44.688
then you're not the right

00:55:44.728 --> 00:55:45.347
person for them.

00:55:45.487 --> 00:55:47.068
So your goal is to achieve understanding,

00:55:47.108 --> 00:55:47.268
right?

00:55:47.329 --> 00:55:48.429
Not make them feel bad for

00:55:48.489 --> 00:55:51.570
you or want a book despite that.

00:55:52.032 --> 00:55:53.012
I think we need to

00:55:53.032 --> 00:55:53.992
understand what game you're playing,

00:55:54.012 --> 00:55:54.652
what role you play,

00:55:54.693 --> 00:55:55.432
and how to play it well.

00:55:55.652 --> 00:55:56.094
But I don't think...

00:55:56.974 --> 00:55:57.596
I don't think we know the

00:55:57.637 --> 00:55:59.382
answer to the second two in

00:55:59.422 --> 00:56:00.646
this situation because it's sticky.

00:56:00.686 --> 00:56:01.047
It's hard.

00:56:02.621 --> 00:56:03.641
Now it might,

00:56:03.702 --> 00:56:04.681
it might come off as a word

00:56:04.722 --> 00:56:05.362
salad real quick,

00:56:05.382 --> 00:56:07.963
but we do transition very quickly.

00:56:07.983 --> 00:56:08.322
We'll say,

00:56:08.382 --> 00:56:09.563
here's why we don't take it anymore,

00:56:09.583 --> 00:56:10.164
et cetera.

00:56:10.543 --> 00:56:11.224
But then it's like,

00:56:11.403 --> 00:56:12.204
we don't take it anymore

00:56:12.264 --> 00:56:13.364
because we want to provide

00:56:13.583 --> 00:56:14.105
whatever it is.

00:56:14.224 --> 00:56:15.585
We might say one-on-one time,

00:56:15.684 --> 00:56:17.525
or we want to send a doctor

00:56:17.565 --> 00:56:19.646
physical therapy that is excellent.

00:56:19.746 --> 00:56:20.766
And in order for me to,

00:56:21.106 --> 00:56:22.306
and I know it's still some of the,

00:56:22.405 --> 00:56:22.706
you know,

00:56:22.786 --> 00:56:24.047
here's why I broke up with my

00:56:24.126 --> 00:56:25.347
girlfriend before I understand,

00:56:25.907 --> 00:56:27.226
but we want to shift it to them.

00:56:27.327 --> 00:56:28.347
And here's why,

00:56:28.407 --> 00:56:30.047
and we can't retain great talent

00:56:30.507 --> 00:56:31.728
If we were to take these

00:56:31.989 --> 00:56:33.030
contracts or et cetera,

00:56:33.329 --> 00:56:34.570
but really ultimately it's

00:56:34.610 --> 00:56:36.652
so that we can provide the

00:56:36.692 --> 00:56:39.432
service that many other New Yorkers love.

00:56:39.913 --> 00:56:41.014
And maybe it's not right for you,

00:56:41.494 --> 00:56:43.155
but here's the way,

00:56:43.275 --> 00:56:44.956
here is the pathway that we

00:56:44.976 --> 00:56:45.536
can make it happen.

00:56:46.396 --> 00:56:46.617
It would,

00:56:46.717 --> 00:56:47.757
it just happens to be out of pocket.

00:56:48.139 --> 00:56:50.121
And I just believe that it takes some of,

00:56:50.260 --> 00:56:51.242
you can call it word salad.

00:56:51.282 --> 00:56:52.063
It takes some of this

00:56:52.083 --> 00:56:53.023
context on the phone

00:56:53.324 --> 00:56:54.844
because they're calling in a lot of times,

00:56:55.126 --> 00:56:56.176
especially if the patient's like 30,

00:56:56.176 --> 00:56:58.509
40 years old, whatever, 25 years old,

00:56:58.548 --> 00:56:59.369
they don't, they're just like,

00:56:59.909 --> 00:57:01.210
they're conditioned by their parents to

00:57:01.972 --> 00:57:03.271
call ask about insurance

00:57:03.291 --> 00:57:03.972
whatever the everyone's

00:57:04.012 --> 00:57:05.873
condition so in that call

00:57:05.972 --> 00:57:07.253
in a couple seconds or a

00:57:07.293 --> 00:57:08.554
couple minutes I have to

00:57:08.934 --> 00:57:10.193
change their their brain

00:57:10.233 --> 00:57:12.434
from 180 from the insurance

00:57:12.454 --> 00:57:13.835
is my only thing I need to

00:57:14.235 --> 00:57:15.275
find if they are serious

00:57:15.315 --> 00:57:16.596
about finding the best

00:57:16.755 --> 00:57:18.617
results the best outcome um

00:57:19.237 --> 00:57:20.016
someone that can be

00:57:20.077 --> 00:57:21.038
professional on the phone

00:57:21.137 --> 00:57:22.617
can ask them questions get

00:57:22.637 --> 00:57:23.498
them talking about their

00:57:23.518 --> 00:57:24.878
condition oh we have a lot

00:57:24.898 --> 00:57:25.659
of patients and clients

00:57:25.679 --> 00:57:26.498
that have that condition

00:57:26.878 --> 00:57:28.039
you know dr chris or whoever

00:57:29.400 --> 00:57:30.500
back or back pain or whatever.

00:57:30.721 --> 00:57:31.780
So we immediately shift it

00:57:31.820 --> 00:57:33.601
to them and we want to make

00:57:33.661 --> 00:57:35.541
the insurance less of a focus.

00:57:35.581 --> 00:57:36.862
So we have to focus on it for a second.

00:57:36.882 --> 00:57:37.802
We put spotlight for a

00:57:37.842 --> 00:57:38.903
second and then we shift it

00:57:38.923 --> 00:57:39.704
back to the patient.

00:57:39.724 --> 00:57:41.204
So that's, that's what I've seen work.

00:57:41.505 --> 00:57:42.505
And maybe it could be shorter,

00:57:42.545 --> 00:57:44.045
but it is what it is for, you know,

00:57:44.106 --> 00:57:45.126
how I approach it right now.

00:57:45.927 --> 00:57:46.487
Parting shots.

00:57:46.766 --> 00:57:47.646
What do you got, Tony?

00:57:48.427 --> 00:57:50.427
So I'm going to do a parting

00:57:50.447 --> 00:57:51.429
shot based on that.

00:57:51.829 --> 00:57:52.849
And this will be a teaser

00:57:52.889 --> 00:57:54.769
for when we actually have this episode.

00:57:54.849 --> 00:57:56.670
You know, I think one of the easiest,

00:57:56.751 --> 00:57:57.731
and I didn't do this back

00:57:57.771 --> 00:57:58.431
in the day because I didn't

00:57:58.452 --> 00:57:58.952
even think of it.

00:57:59.619 --> 00:58:00.719
The easiest way is to be like,

00:58:01.559 --> 00:58:02.860
what is your goal?

00:58:03.320 --> 00:58:04.601
If you were to give me one goal,

00:58:04.641 --> 00:58:05.221
what's your goal?

00:58:05.581 --> 00:58:07.101
Well, my goal is to be able to travel.

00:58:07.222 --> 00:58:09.523
I just, I can't travel the way I used to.

00:58:09.583 --> 00:58:10.423
I love travel.

00:58:10.483 --> 00:58:11.403
I want to go to Europe.

00:58:11.963 --> 00:58:12.224
Well,

00:58:12.545 --> 00:58:14.445
unfortunately your insurance policy

00:58:14.565 --> 00:58:17.347
does not cover that as a covered service.

00:58:17.847 --> 00:58:19.306
Now your insurance policy

00:58:19.347 --> 00:58:21.188
will pay for you to eat and

00:58:21.288 --> 00:58:23.309
sleep and bathe and dress.

00:58:23.909 --> 00:58:25.389
If you want to stay in network,

00:58:25.429 --> 00:58:26.771
go to an in-network provider,

00:58:26.831 --> 00:58:27.670
those are the goals that they

00:58:27.670 --> 00:58:28.771
They can help you work on,

00:58:28.791 --> 00:58:30.293
but if you're already doing that and your,

00:58:30.474 --> 00:58:32.976
your goal is golf, travel, pickleball,

00:58:32.996 --> 00:58:35.217
whatever, these are the prices, you know,

00:58:35.458 --> 00:58:36.920
just think about that for a second.

00:58:36.940 --> 00:58:39.101
Just start with what is your goal?

00:58:39.181 --> 00:58:41.644
Why do you want to have therapy?

00:58:42.105 --> 00:58:43.766
And then we'll build on that next time.

00:58:43.786 --> 00:58:44.708
That's my parting shot.

00:58:45.387 --> 00:58:45.929
Dave, what do you got?

00:58:47.346 --> 00:58:47.806
Party Chuck,

00:58:47.847 --> 00:58:49.367
going back to the awesome

00:58:49.387 --> 00:58:51.670
video share from Jimmy, the John Taffer,

00:58:51.769 --> 00:58:57.153
Gary Vee, back and forth about the first,

00:58:57.293 --> 00:58:59.135
second, and third visit to a restaurant.

00:58:59.695 --> 00:59:01.978
I love talking about this, obviously,

00:59:01.998 --> 00:59:04.400
and there are certainly parallels to it.

00:59:05.019 --> 00:59:07.079
the restaurant world and physical therapy.

00:59:07.159 --> 00:59:08.681
And so, yeah, I mean,

00:59:08.780 --> 00:59:09.780
if you're not doing some of those things,

00:59:09.820 --> 00:59:10.641
especially if you're a

00:59:10.760 --> 00:59:11.521
brick and mortar office,

00:59:11.581 --> 00:59:12.601
if you're not doing the

00:59:12.661 --> 00:59:13.762
simple things that Tony mentioned,

00:59:13.782 --> 00:59:15.101
like take your new patient,

00:59:15.342 --> 00:59:16.621
you can evaluate them in the office,

00:59:16.681 --> 00:59:16.842
in the,

00:59:16.922 --> 00:59:18.422
in the exam room where Tony is or

00:59:18.481 --> 00:59:20.043
out in the open, in the, in the gym,

00:59:20.382 --> 00:59:21.842
whatever is works for you guys,

00:59:22.682 --> 00:59:24.023
introduce them to all the team members,

00:59:24.764 --> 00:59:26.083
such extra level,

00:59:26.123 --> 00:59:28.324
like genius of Tony's interview, uh,

00:59:28.543 --> 00:59:29.503
introduce the new patient

00:59:29.844 --> 00:59:30.704
to some of the current

00:59:30.744 --> 00:59:32.485
patients or clients, or specifically,

00:59:33.001 --> 00:59:34.561
the long-term patients or

00:59:34.581 --> 00:59:35.121
clients that have been

00:59:35.143 --> 00:59:37.063
there for 10 years or whatever,

00:59:37.483 --> 00:59:38.824
and just do that intro and

00:59:38.844 --> 00:59:39.385
then walk away.

00:59:39.425 --> 00:59:40.005
Like Tony said,

00:59:40.045 --> 00:59:42.246
like just play back what we,

00:59:42.387 --> 00:59:44.009
what Tony said on this and

00:59:44.028 --> 00:59:45.269
just immediately implement it,

00:59:45.289 --> 00:59:46.170
coach your team on it.

00:59:46.650 --> 00:59:47.650
It's really, really simple.

00:59:47.751 --> 00:59:48.692
And the funny thing is like,

00:59:48.731 --> 00:59:49.331
I didn't say it earlier,

00:59:49.371 --> 00:59:51.434
but one of my mentors, Rick Roscoe,

00:59:51.474 --> 00:59:54.135
he sold four clinics to USPH years ago.

00:59:54.835 --> 00:59:55.976
And then he was my mentor

00:59:56.117 --> 00:59:57.878
and helped me get my first

00:59:57.918 --> 00:59:58.759
job out of school and

00:59:58.998 --> 01:00:00.800
And he did that exactly

01:00:00.960 --> 01:00:01.860
everything that Tony said.

01:00:02.141 --> 01:00:02.822
He did all that.

01:00:02.882 --> 01:00:03.702
He kind of coached us,

01:00:03.762 --> 01:00:05.483
but he just did it through.

01:00:05.503 --> 01:00:07.224
He led by example,

01:00:07.284 --> 01:00:08.505
but he did all the things

01:00:08.525 --> 01:00:09.166
that Tony mentioned.

01:00:09.246 --> 01:00:10.766
And then it's like, yeah, success,

01:00:10.806 --> 01:00:11.608
you know, leaves clues.

01:00:12.628 --> 01:00:13.708
Success leaves clues.

01:00:13.748 --> 01:00:14.248
I like that.

01:00:14.769 --> 01:00:16.451
I would say focus on what

01:00:16.471 --> 01:00:17.092
game you're playing,

01:00:17.371 --> 01:00:18.552
what position everybody on

01:00:18.572 --> 01:00:19.634
the team is playing and how

01:00:20.014 --> 01:00:21.255
they can play that position well.

01:00:21.795 --> 01:00:22.655
And a lot of times it has

01:00:22.715 --> 01:00:23.876
nothing to do or I

01:00:23.916 --> 01:00:24.938
shouldn't say nothing less

01:00:24.978 --> 01:00:25.798
to do with anatomy and

01:00:25.838 --> 01:00:27.820
physiology and neuroscience.

01:00:27.940 --> 01:00:29.061
It does have something to do with that.

01:00:29.621 --> 01:00:30.943
But understand what game

01:00:30.963 --> 01:00:32.644
you're actually playing.

01:00:32.684 --> 01:00:34.166
We're in the experience business.

01:00:34.266 --> 01:00:35.427
We're in the attention business.

01:00:36.188 --> 01:00:37.750
And that's the actual thing

01:00:37.769 --> 01:00:38.469
that we're providing.

01:00:38.530 --> 01:00:39.871
Well, back on Tuesday,

01:00:39.891 --> 01:00:41.813
I think I came up with a new tagline.

01:00:42.434 --> 01:00:43.635
This one came to me during the show.

01:00:43.695 --> 01:00:44.876
The number one morning radio

01:00:44.916 --> 01:00:45.976
show for private practice

01:00:45.996 --> 01:00:46.737
physical therapists.

01:00:46.898 --> 01:00:47.197
I don't know.

01:00:47.539 --> 01:00:48.358
Maybe we'll flesh it out and

01:00:48.378 --> 01:00:49.099
knock some words down.

01:00:49.139 --> 01:00:50.902
But that's what we're aiming to do.

01:00:51.262 --> 01:00:51.902
Sounds about right.

01:00:52.103 --> 01:00:52.342
I think so.

01:00:52.362 --> 01:00:53.123
Sounds about right.

01:00:53.224 --> 01:00:54.664
Self-acclaimed.

01:00:54.965 --> 01:00:55.166
Yeah.

01:00:55.606 --> 01:00:56.445
Yeah, just say it.

01:00:56.465 --> 01:00:58.987
As long as one dentist says

01:00:59.047 --> 01:01:00.246
that this is the best toothpaste,

01:01:00.286 --> 01:01:01.726
it's recommended by dentists.

01:01:02.128 --> 01:01:03.387
Two dentists equals dentists.

01:01:04.208 --> 01:01:05.447
Follow Dave on the Dave

01:01:05.467 --> 01:01:07.309
Kittle Show on YouTube.

01:01:07.668 --> 01:01:08.909
Tony will take you from zero

01:01:08.929 --> 01:01:10.750
to paid in his group as well.

01:01:11.070 --> 01:01:12.889
And I sometimes drink beer,

01:01:13.210 --> 01:01:14.070
usually later in the day,

01:01:14.411 --> 01:01:15.130
and interview people.

01:01:15.210 --> 01:01:16.190
We'll see you guys on Tuesday.