Positivity Is Slower… But It Wins.

WEBVTT

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Thanks, Voice Guy.

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I want to say thanks to Sarah Health,

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the remote care platform helping clinics

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boost revenue without adding staff.

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They're supporting the show.

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Sarah automates daily patient check-ins

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via text.

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Read into that via text,

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which means no app and no logins.

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You had me at hello.

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No app to download and no login?

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A password to memorize?

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Great.

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and actually get reimbursed for care

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between visits.

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It's simple to set up,

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which I know you're probably thinking,

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how hard is it?

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It's simple to set up, simple to use,

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and patients actually like it.

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Because they don't have to log in

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anything.

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It meets them where they are.

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Where are we?

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We're in our text message inbox.

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That's where we are.

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SarahHealth.com.

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

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I would say Sarah without the H,

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but then, damn it,

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there's an H in health.

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So it's Sarah, S-A-R-A Health.com.

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Our guest today started in the clinic.

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Like most of us, patients on the schedule,

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a lot of them.

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Documentation to finish, a lot of it.

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Productivity targets looming, always.

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But instead of just treating patients,

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he kept asking bigger questions,

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which usually leads to stuff like answers

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or pathways.

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Why do some clinics scale and others

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stall?

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What are the reasons?

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Why do some PTs plateau financially while

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others build influence and leverage?

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What's the secret sauce or is there one?

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what is the future of musculoskeletal care

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actually look like and who's controlling

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it over twenty five years he moved from

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provider to operator from operator to

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executive left and came back and now

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advises growth across healthcare

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organizations navigating predictive

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analytics value-based care the big hairy

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scary future and all of it what it

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really takes to win

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in modern PT.

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Today,

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we're talking about career progression,

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economics, value-based care,

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and why PT's role in MSK is foundational

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to this healthcare system.

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Let's welcome to the show,

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Jeremy Vandivender.

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Jeremy, welcome to the show.

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Thank you.

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How was that intro?

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Did I overhype?

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Did I overhype?

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Did I miss anything?

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I think you're good.

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Yeah.

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Yeah.

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So you've done a lot of different things

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and you've seen things from different

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angles.

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I think that's even probably more

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important too,

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because you can talk to people at

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different points in their career,

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different spots in this profession,

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and you've even sat in that chair or

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you've worked with people who are sitting

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in that chair.

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So let's start with a huge open-ended

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question.

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When a PT says,

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I want to be successful,

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what do they usually mean from your point

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of view?

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And what are they missing to get there?

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Yeah, unfortunately in our profession,

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I think the pathway to success is pretty

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pretty confusing.

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I mean, in other professions, you know,

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you think about LSUs being an attorney,

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for example.

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You go into corporate law, you know,

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it's a very linear pathway.

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You go in, you're a first year,

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second year,

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you go down the process and either,

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you know,

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you're going to make partner or you're

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going to peel off and do something else.

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And it's clear.

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Banking, you know, all those lines.

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There's a

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Very direct pathway that people are

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brought into.

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I mean, even with physician practice,

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I mean, they go through the residency,

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they go through their internship,

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their fellowship,

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and then it's on a practice.

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In our world,

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and I navigated this very early on in

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my career of what success would look like.

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know originally i wanted to be a professor

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a biomechanist a researcher and a super

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elite physical therapist and to me that

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was success i i was going to be

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the next you know using an iconic name

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kevin wilk from you know twenty five

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thirty years ago that was what i wanted

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to be like

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then i got into the mix of that

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and i wasn't great at research i went

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to get a phd and i just i

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could think about it in my head it

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was amazing but i just it wasn't what

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i executed on so i had to find

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another pathway and for me that was a

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much more of a i'd say an executive

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trajectory pathway i i go back to like

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what physical therapists you know see in

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their career i don't think that they

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come out of PT school or in the

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early, you know, literally that five year,

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first five years of their career where

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that's in so many ways the inflection

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point of where you're going to go.

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There's such an unclear pathway towards

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what

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Determine success,

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so I think that physical therapists look

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at it as a scatter plot.

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I'm going to be.

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You know,

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there's something that's going to be a

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great therapist and take care of a bunch

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of patients and get a do a residency

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and be a star.

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There's others that they want to go into

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more of a.

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administrative route.

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And what I found in a lot of

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those cases, it's not okay, the steps,

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they can say,

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I want to go this direction,

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this direction, and maybe figure that out.

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But the outcome is really unclear.

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And I think there's a bit of a

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maybe it's a glass ceiling,

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maybe much more than a bit of a

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glass ceiling.

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come up through the ranks as being

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providers and are going this direction of

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let's call it executive leadership as an

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example,

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they don't see themselves often beyond the

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role of VP.

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They see themselves kind of landing in

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this static state at, you know, ten,

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fifteen years out and it's okay, now what?

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where I come back to and PTs I've

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talked to,

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I don't think they really know what

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success actually is.

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I think that's lent itself to a little

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bit of maybe a regression around, well,

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if I can't

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see myself on a pathway to economic or

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professional success that's really clear

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and really jumps out and I can define,

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then I'm just going to acquiesce to more

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of a lifestyle career.

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I'm going to focus on having a good

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income, doing something I like,

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and having work-life balance because I

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just don't think they see the opportunity

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for a real destination,

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what you consider financial, professional,

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high level success at the top of the

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industry so I think it's a honestly it's

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you know I'm answering your question with

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a bit of a um a gap here

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which is I don't think most PTs honestly

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know and they all to uh in some

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sense is the easiest pathway which is be

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good I'll be a good clinician I'm going

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to have a nice lifestyle and you know

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that's fine yeah

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Yeah.

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Somebody else,

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I can't remember who answered this said,

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part of it might be the educational

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environment, which is after eighth grade,

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I go to ninth grade.

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After ninth grade, I go to tenth grade.

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There's always something set up for me.

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And then you graduate and it's sort of

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like, well, do whatever you want.

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But you're saying,

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what are those pathways?

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And you would think in a world with...

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smartphones where we can essentially peer

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into corners of the world that we would

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not be able to see.

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Twenty years ago,

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every day someone could be showing you're

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getting ready with me, you know,

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behind the scenes as an executive,

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behind the scenes as an owner.

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People still I guess they choose the path

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of least resistance.

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That's close.

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Like someone said the other day,

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you don't choose the best tax preparer or

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mechanic.

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You choose the best one that you know.

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So if you don't know the pathways,

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if they're not obvious to you,

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It's a self-imposed glass ceiling almost.

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Yeah.

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And that's where I reflect back on my

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early career.

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And I felt that in many ways early

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on, too, where, okay,

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what am I going to do?

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And I didn't really know what I was

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good at until I had the chance to

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fail or succeed on my own.

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You never do.

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Yeah.

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I had my first,

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I got my first director job, uh,

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running one clinic in the two thousand

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one.

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Um,

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I was two years out of PT school.

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I had no idea what to do.

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I, I had no business training.

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I had no leadership training.

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I just said nothing.

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I, I was at health South.

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Uh, the clinic was falling over.

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Um, there was really,

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I think we're seeing like eight visits a

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day.

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it's the kind of clinic you give to

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a first-time director or you it's you know

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it fails it fails it doesn't really matter

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so they give it to you know someone

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two years from out of school and i

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was able to turn that clinic around from

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doing thirty five forty visits a week to

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a hundred eighty visits a week within nine

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months and it was literally just me

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throwing on you know my my backpack and

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my business cards and walking the streets

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of hoboken to talk to all the doctors

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do all the community work,

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do everything you needed to do to build

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the practice.

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And then I realized, you know,

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through doing that,

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that that's actually something I'm really

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good at.

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I'm really good at, you know,

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visualizing what success and visualizing

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what good or great looks like and sharing

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that story and then developing

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followership.

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And it equated to getting a really strong

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following of referrals early on.

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And I realized, oh,

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In some sense,

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I was successful because I was the loudest

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voice in town.

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I was the one who was willing to

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get out there and walk around and knock

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on doors and tell the story.

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I certainly wasn't the best therapist.

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I was two years out of school and

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didn't really know what I was doing,

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but I worked really, really hard.

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And then I realized that this was

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something that is a unique opportunity for

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me to build upon.

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And that's where I went full on to

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be on the business side of physical

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therapy.

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But I would have never, ever known.

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I would have never even known this had

00:09:35.923 --> 00:09:39.304
I not gotten that opportunity to lead a

00:09:39.325 --> 00:09:40.086
failing clinic.

00:09:40.125 --> 00:09:42.447
And that's what actually brought me to Ivy

00:09:42.486 --> 00:09:44.869
a year and a half later to start

00:09:45.408 --> 00:09:45.989
that company.

00:09:47.450 --> 00:09:49.532
But the real thing that I come back

00:09:49.572 --> 00:09:51.113
to at that point in time

00:09:52.202 --> 00:09:53.203
I reflect on that, you know,

00:09:53.244 --> 00:09:54.504
self-imposed glass ceiling.

00:09:55.005 --> 00:09:56.767
I was just never comfortable being held

00:09:56.787 --> 00:09:57.086
back.

00:09:58.307 --> 00:09:58.828
I was like,

00:09:58.849 --> 00:10:00.269
I'm going to find my way.

00:10:00.370 --> 00:10:02.291
So I spent a great deal of my

00:10:02.350 --> 00:10:05.653
time finding really smart people and

00:10:05.913 --> 00:10:07.755
incredibly talented people that I could

00:10:08.635 --> 00:10:10.317
force myself to be mentored by.

00:10:10.717 --> 00:10:12.379
no one wanted to mentor me i forced

00:10:12.418 --> 00:10:15.419
myself in the room every turn and i

00:10:15.779 --> 00:10:18.441
eventually found my footing uh reminds me

00:10:18.461 --> 00:10:20.042
of a you know then this was you

00:10:20.081 --> 00:10:21.261
know not getting paid for this is

00:10:21.282 --> 00:10:22.802
something i talk a lot about you know

00:10:22.863 --> 00:10:25.024
i did a lot of things early on

00:10:25.124 --> 00:10:26.144
that i did not get paid for i

00:10:26.164 --> 00:10:28.424
was making very low my starting salary was

00:10:28.465 --> 00:10:30.245
less than forty thousand dollars a year i

00:10:30.346 --> 00:10:31.907
was a clinic director treating ninety

00:10:31.927 --> 00:10:33.587
visits a week making forty eight thousand

00:10:33.607 --> 00:10:34.187
dollars a year

00:10:34.727 --> 00:10:37.730
those were difficult times and you know i

00:10:37.750 --> 00:10:39.812
was in new york um and i was

00:10:39.832 --> 00:10:41.495
going to the upper east side of manhattan

00:10:41.514 --> 00:10:43.537
to the hospital for special surgery and

00:10:43.576 --> 00:10:46.259
watching surgeries on my own outside of

00:10:46.298 --> 00:10:48.461
hours you know six in the morning uh

00:10:48.501 --> 00:10:49.903
getting up there and you know watching

00:10:49.923 --> 00:10:51.063
four hours of surgery then going to

00:10:51.104 --> 00:10:52.625
hoboken and treating for ten hours and

00:10:52.666 --> 00:10:54.287
going it was a that's what i had

00:10:54.307 --> 00:10:56.929
to do and i remember um one of

00:10:56.950 --> 00:10:58.451
these stories really sticks with me and

00:10:58.471 --> 00:10:59.131
there's this uh

00:10:59.572 --> 00:11:02.933
iconic doctor who was the chair emeritus

00:11:02.953 --> 00:11:04.453
of the Hospital for Special Surgery,

00:11:04.495 --> 00:11:06.095
former team doctor for the New York

00:11:06.154 --> 00:11:07.196
Giants, and Russ Warren,

00:11:07.936 --> 00:11:10.496
just one of the icons of orthopedic

00:11:10.758 --> 00:11:11.278
surgery.

00:11:11.957 --> 00:11:14.739
I remember I was in the locker room

00:11:15.519 --> 00:11:17.801
going into surgery with him and David

00:11:17.841 --> 00:11:19.902
Olchek and a bunch of other big-time

00:11:19.942 --> 00:11:20.442
doctors there,

00:11:20.461 --> 00:11:22.342
and I was this twenty-six-year-old PT who

00:11:22.363 --> 00:11:23.543
didn't know anything up or down.

00:11:24.364 --> 00:11:25.424
And I'm sitting there, you know,

00:11:25.524 --> 00:11:27.466
putting on my scrubs and here's this Dr.

00:11:27.485 --> 00:11:28.086
Moore next to me.

00:11:28.105 --> 00:11:30.187
He's a big imposing guy.

00:11:30.707 --> 00:11:32.568
He looks at me, he's like gruff,

00:11:32.589 --> 00:11:34.009
you know, he's in his seventies,

00:11:34.230 --> 00:11:35.311
just a gruff guy.

00:11:35.350 --> 00:11:35.711
And he's like,

00:11:36.311 --> 00:11:37.312
what are you doing in here?

00:11:37.772 --> 00:11:39.873
And I'm like, you know, it's HSS,

00:11:39.893 --> 00:11:40.874
the residents, the fellows,

00:11:40.894 --> 00:11:42.315
these are ballers.

00:11:42.375 --> 00:11:43.475
I mean, it's a whole different level.

00:11:43.775 --> 00:11:44.515
And I'm just his PT.

00:11:44.535 --> 00:11:45.476
And I just looked at him and I,

00:11:46.076 --> 00:11:47.477
at this moment, I had this like,

00:11:48.317 --> 00:11:49.558
sort of strength of, okay,

00:11:49.799 --> 00:11:50.780
I'm just going to stand up and say

00:11:50.801 --> 00:11:51.221
why I'm here.

00:11:51.480 --> 00:11:52.182
And I said,

00:11:52.883 --> 00:11:54.504
because I want to learn from you.

00:11:54.543 --> 00:11:55.764
You're one of the best doctors in the

00:11:55.784 --> 00:11:56.025
world.

00:11:56.466 --> 00:11:57.667
I want to see you do surgery and

00:11:57.706 --> 00:11:58.067
learn from you.

00:11:58.087 --> 00:11:58.888
And he looked at me and I,

00:11:59.489 --> 00:12:00.730
it's a big risk to say that,

00:12:00.909 --> 00:12:01.671
I guess, because I,

00:12:02.030 --> 00:12:03.692
and he looked down and he's like, oh,

00:12:04.474 --> 00:12:05.094
okay, that's great.

00:12:05.114 --> 00:12:05.394
Let's go.

00:12:06.294 --> 00:12:08.956
Before I knew it, that guy, that doc,

00:12:08.976 --> 00:12:09.937
a couple of things,

00:12:10.597 --> 00:12:12.379
he introduced me to the New York Giants.

00:12:12.679 --> 00:12:13.961
And I started having the opportunity to

00:12:13.980 --> 00:12:16.241
work with the Giants and work with the

00:12:16.283 --> 00:12:17.764
training staff of the Giants at the same

00:12:17.803 --> 00:12:18.903
time, which is really cool.

00:12:19.424 --> 00:12:21.306
And that's actually what led me into Ivy

00:12:21.706 --> 00:12:23.868
because that group of investors,

00:12:23.888 --> 00:12:26.429
that group out of original twenty five

00:12:26.450 --> 00:12:26.750
years ago,

00:12:26.789 --> 00:12:28.071
those are the ones that raised the capital

00:12:28.471 --> 00:12:29.432
to start Ivy Rehab.

00:12:29.451 --> 00:12:31.413
And they knew me and they literally knew

00:12:31.453 --> 00:12:31.594
me.

00:12:32.153 --> 00:12:34.417
because i forced myself in that room i

00:12:34.437 --> 00:12:37.019
was a nobody and that's what gave me

00:12:37.058 --> 00:12:40.363
my launch pad to start a practice and

00:12:40.462 --> 00:12:42.644
ultimately it started a company and you

00:12:42.666 --> 00:12:43.866
know twenty five years later here i am

00:12:43.886 --> 00:12:48.392
there's a lot to unpack there man you

00:12:48.412 --> 00:12:49.393
just covered a lot of ground

00:12:50.438 --> 00:12:51.119
Um,

00:12:51.139 --> 00:12:52.320
I want to go to one thing I

00:12:52.340 --> 00:12:52.820
wrote down,

00:12:52.860 --> 00:12:55.042
which is you said you could visualize

00:12:55.081 --> 00:12:56.062
things in research,

00:12:56.101 --> 00:12:57.043
but it wasn't working out.

00:12:57.783 --> 00:13:00.163
So you recognize you had a skill and

00:13:00.183 --> 00:13:01.745
you tried to use it one place and

00:13:01.784 --> 00:13:02.745
it sort of wasn't working.

00:13:03.285 --> 00:13:04.767
And then you use that sort of same

00:13:04.846 --> 00:13:06.647
skill, a different place.

00:13:07.168 --> 00:13:08.048
And next thing you know,

00:13:08.107 --> 00:13:09.009
it worked really well.

00:13:09.308 --> 00:13:10.068
And the important part,

00:13:10.089 --> 00:13:11.730
you liked it because even if it worked

00:13:11.750 --> 00:13:12.409
and you didn't like it,

00:13:12.429 --> 00:13:13.370
you probably wouldn't have done it as

00:13:13.431 --> 00:13:13.691
much.

00:13:14.230 --> 00:13:15.371
And that goes to-

00:13:16.522 --> 00:13:17.881
And something cool about that, I mean,

00:13:18.082 --> 00:13:19.682
you say it and it's not always as

00:13:19.743 --> 00:13:21.344
linear as like I applied it.

00:13:21.423 --> 00:13:21.984
It didn't work.

00:13:22.384 --> 00:13:23.043
I went somewhere else.

00:13:23.063 --> 00:13:25.125
I mean, this is way down the line.

00:13:25.184 --> 00:13:27.546
One of the things I'm most proud of

00:13:27.586 --> 00:13:29.385
or had some of the most fun doing

00:13:29.405 --> 00:13:32.386
in my career was between twenty,

00:13:32.427 --> 00:13:35.067
twenty two, twenty, twenty three at Ivy.

00:13:35.688 --> 00:13:37.109
And we we got to a level of

00:13:37.249 --> 00:13:39.289
some real scale and we were, you know,

00:13:39.909 --> 00:13:41.390
built into a national engine people

00:13:41.410 --> 00:13:42.610
started to know about us and we had

00:13:42.691 --> 00:13:45.731
a you know a mandate around you know

00:13:45.812 --> 00:13:48.072
in my view when you're at that level

00:13:48.393 --> 00:13:50.134
as a provider group you have a mandate

00:13:50.153 --> 00:13:52.475
to the profession to elevate the game and

00:13:52.534 --> 00:13:55.735
do things the right way and we decided

00:13:55.755 --> 00:13:57.056
that we were going to make a material

00:13:57.096 --> 00:13:59.116
investment in building an outcomes and

00:13:59.157 --> 00:14:00.857
research platform from the ground up

00:14:01.418 --> 00:14:01.999
And, you know,

00:14:02.019 --> 00:14:03.279
not most companies don't have it.

00:14:03.299 --> 00:14:04.100
We didn't use a vendor.

00:14:04.139 --> 00:14:06.022
We built it, you know, from the bolts.

00:14:06.621 --> 00:14:08.563
And that was, you know,

00:14:08.663 --> 00:14:09.605
made me have the opportunity.

00:14:09.625 --> 00:14:11.365
Then I had to leave that initiative and

00:14:11.385 --> 00:14:13.187
bring on a PhD and build the whole

00:14:13.227 --> 00:14:14.948
thing and do our, you know,

00:14:15.309 --> 00:14:16.770
it started with MIPS and became a true

00:14:16.850 --> 00:14:17.510
outcomes program.

00:14:17.530 --> 00:14:19.753
And what I realized is I love research.

00:14:20.033 --> 00:14:20.673
I love data.

00:14:21.053 --> 00:14:21.754
I love all that stuff.

00:14:21.855 --> 00:14:22.836
I'm not a good writer.

00:14:22.875 --> 00:14:23.796
I'm not a good publisher.

00:14:23.816 --> 00:14:27.318
I'm not good at seeing a study through.

00:14:27.399 --> 00:14:28.179
I always make a mistake.

00:14:30.490 --> 00:14:32.630
do it but what i'm good at is

00:14:33.211 --> 00:14:35.172
articulating the vision seeing it and

00:14:35.211 --> 00:14:36.913
working around really smart people who

00:14:36.932 --> 00:14:38.933
have a skill set and expertise there and

00:14:38.974 --> 00:14:40.095
you know look back that was one of

00:14:40.115 --> 00:14:41.696
the things that i'm really most proud of

00:14:41.716 --> 00:14:44.917
was creating this um really high-powered

00:14:45.437 --> 00:14:48.519
uh best-in-class outcomes um predictive

00:14:48.558 --> 00:14:50.320
analytics platform that we could do

00:14:50.399 --> 00:14:52.701
research out of and you can see you

00:14:52.721 --> 00:14:54.861
know people at ivy publishing research out

00:14:54.881 --> 00:14:56.863
of this platform and it's uh my name's

00:14:56.903 --> 00:14:58.443
not on it but it gives me a

00:14:58.484 --> 00:14:59.644
lot of joy to look back on and

00:14:59.664 --> 00:14:59.884
say

00:15:00.264 --> 00:15:02.865
that's something i was good at yeah you

00:15:02.946 --> 00:15:04.826
use your familiar skills in an unfamiliar

00:15:04.846 --> 00:15:06.966
way you thought well i like sort of

00:15:07.307 --> 00:15:10.128
what research does i like the impact it

00:15:10.168 --> 00:15:11.648
has so i'll be a researcher and then

00:15:11.668 --> 00:15:13.428
you got there and you're like oh i'm

00:15:13.448 --> 00:15:15.229
not great at this but i still like

00:15:15.249 --> 00:15:17.190
the way it works but if i can

00:15:17.269 --> 00:15:20.030
fund the engine that can produce research

00:15:20.691 --> 00:15:23.792
that's just as important right i work with

00:15:23.812 --> 00:15:25.692
the foundation for pt research it doesn't

00:15:25.711 --> 00:15:27.113
make any sense to have jimmy mckay on

00:15:27.133 --> 00:15:27.533
your board

00:15:28.452 --> 00:15:30.774
Because I haven't done a lick of research.

00:15:31.293 --> 00:15:32.774
But they don't need another researcher.

00:15:32.794 --> 00:15:33.716
They got oodles of that.

00:15:33.796 --> 00:15:35.035
They need people who understand how to

00:15:35.096 --> 00:15:35.917
create attention.

00:15:36.197 --> 00:15:37.657
Because attention drives marketing.

00:15:37.716 --> 00:15:38.857
Marketing drives business.

00:15:39.138 --> 00:15:39.999
Business drives money.

00:15:40.339 --> 00:15:41.318
Money drives research.

00:15:41.399 --> 00:15:42.500
And then round and round we go.

00:15:43.879 --> 00:15:45.581
How did you get people to follow you?

00:15:45.600 --> 00:15:47.621
There's a lot in that first clinic, right?

00:15:48.402 --> 00:15:50.764
How great... Well, I mean, looking back,

00:15:50.783 --> 00:15:53.625
it's like you got handed something that if

00:15:53.664 --> 00:15:54.184
it failed,

00:15:54.544 --> 00:15:55.625
nobody would have blinked twice.

00:15:56.105 --> 00:15:57.106
But you looked at it as...

00:15:58.250 --> 00:15:59.772
I can do whatever I want and I

00:15:59.792 --> 00:16:01.393
can poke and fail and poke and...

00:16:01.614 --> 00:16:02.274
Hold on a second.

00:16:02.813 --> 00:16:04.154
I pressed this and that happened.

00:16:04.775 --> 00:16:05.076
How did...

00:16:05.876 --> 00:16:07.638
You mentioned how you got external buy-in.

00:16:07.758 --> 00:16:08.839
You put a backpack on.

00:16:08.958 --> 00:16:10.120
You filled it with business cards.

00:16:10.200 --> 00:16:11.360
You didn't come home until the business

00:16:11.380 --> 00:16:12.000
cards were empty.

00:16:12.260 --> 00:16:13.302
You got up at...

00:16:13.322 --> 00:16:14.623
I don't know what hour you were getting

00:16:14.663 --> 00:16:15.442
up to get to HSS.

00:16:15.504 --> 00:16:16.703
It's six o'clock in the morning.

00:16:16.744 --> 00:16:17.365
But in New York,

00:16:17.904 --> 00:16:18.946
you must have been getting up at four.

00:16:18.966 --> 00:16:19.046
Yeah.

00:16:20.326 --> 00:16:22.107
How did you get internal buy-in?

00:16:22.128 --> 00:16:23.288
Because there's no way you did that on

00:16:23.328 --> 00:16:23.990
your own too.

00:16:24.009 --> 00:16:24.049
No.

00:16:24.149 --> 00:16:26.731
You know, they...

00:16:28.667 --> 00:16:33.110
some reason i've always had um a gift

00:16:33.490 --> 00:16:35.491
um i've been blessed with the ability to

00:16:36.272 --> 00:16:39.073
uh build followership i've been told from

00:16:39.114 --> 00:16:40.434
people that will say hey i want to

00:16:40.794 --> 00:16:41.796
jump on that train i've seen it a

00:16:41.816 --> 00:16:43.057
bunch of times in my career and i

00:16:43.076 --> 00:16:46.859
think what it is is um i lead

00:16:46.879 --> 00:16:50.042
with passion i i i'm not i

00:16:51.390 --> 00:16:55.153
I found that negativity is very obviously

00:16:55.173 --> 00:16:57.855
very polarizing and being your choice

00:16:57.894 --> 00:16:59.897
every day to be positive or negative and

00:16:59.996 --> 00:17:02.177
how you look at the world and the

00:17:02.298 --> 00:17:02.597
outlook.

00:17:02.618 --> 00:17:03.798
And sometimes it's really hard.

00:17:03.818 --> 00:17:04.940
Sometimes you wake up and you're

00:17:04.960 --> 00:17:06.121
surrounded by negativity.

00:17:06.800 --> 00:17:08.423
What I do know is that people don't

00:17:08.482 --> 00:17:10.964
follow or get inspired by negativity.

00:17:11.165 --> 00:17:13.268
They will act against it.

00:17:13.288 --> 00:17:16.750
They'll engage in negativity,

00:17:16.810 --> 00:17:18.692
but they're never going to follow that.

00:17:19.074 --> 00:17:22.817
So I've found myself in my most powerful

00:17:23.518 --> 00:17:24.900
capabilities and where I've been at my

00:17:24.960 --> 00:17:28.903
best is when I have a kind of

00:17:28.963 --> 00:17:29.523
a broad

00:17:30.464 --> 00:17:32.707
just a light about the future,

00:17:32.727 --> 00:17:36.410
which is if we come together and leverage

00:17:36.490 --> 00:17:37.730
our respective skill sets,

00:17:37.770 --> 00:17:39.112
and I'm going to give you,

00:17:39.271 --> 00:17:40.553
and this is anybody who would work with

00:17:40.593 --> 00:17:40.752
me,

00:17:41.232 --> 00:17:43.054
license to do what you're passionate

00:17:43.074 --> 00:17:43.355
about,

00:17:43.714 --> 00:17:45.036
and I'm going to help you find the

00:17:45.056 --> 00:17:45.256
way.

00:17:45.455 --> 00:17:48.538
I look at myself as a leader along

00:17:48.577 --> 00:17:53.061
those lines of I'm here to inspire and

00:17:53.082 --> 00:17:55.262
bring out the best of someone and to

00:17:55.303 --> 00:17:57.384
give them the road to go and do

00:17:57.444 --> 00:17:57.505
it.

00:17:57.904 --> 00:17:59.405
So from very early on,

00:18:00.226 --> 00:18:03.426
when I was running a clinic to where

00:18:03.487 --> 00:18:04.166
I am today,

00:18:04.586 --> 00:18:06.708
I've always given people around me who had

00:18:06.728 --> 00:18:10.409
the willingness to jump on a train with

00:18:10.449 --> 00:18:12.930
me the autonomy and the ability to do

00:18:12.950 --> 00:18:14.931
what they're best at and to support them

00:18:14.951 --> 00:18:15.490
in doing it.

00:18:16.131 --> 00:18:19.971
And it really has created a tremendous

00:18:19.991 --> 00:18:21.252
amount of followership that I'm really

00:18:21.292 --> 00:18:21.792
proud of.

00:18:22.353 --> 00:18:23.614
And that I empower,

00:18:23.713 --> 00:18:25.115
I try to empower people to be their

00:18:25.174 --> 00:18:26.675
best and do what they have fun and

00:18:26.715 --> 00:18:28.457
enjoy doing and run with that.

00:18:29.317 --> 00:18:32.378
You're a Hannibal from the eighties,

00:18:32.638 --> 00:18:33.079
a team.

00:18:33.180 --> 00:18:35.201
I do a lot of eighties TV reference.

00:18:35.240 --> 00:18:36.461
You're, you're a Hannibal, right?

00:18:36.481 --> 00:18:38.542
Which is, you know,

00:18:38.563 --> 00:18:40.324
I'm holding a cell phone right now and

00:18:40.364 --> 00:18:46.428
people will give credit or points to

00:18:46.468 --> 00:18:48.229
people who have large followings.

00:18:49.690 --> 00:18:51.632
But what are you actually creating?

00:18:52.893 --> 00:18:53.473
Here's the question.

00:18:53.493 --> 00:18:54.413
You have a lot of followers.

00:18:54.433 --> 00:18:56.516
Where are you leading them?

00:18:56.737 --> 00:18:58.238
What are you leading them to?

00:18:58.637 --> 00:19:00.599
If it's to collect followers,

00:19:01.441 --> 00:19:02.842
I don't understand the value in that.

00:19:03.162 --> 00:19:05.243
If it's to empower people to do the

00:19:05.284 --> 00:19:06.005
most them,

00:19:06.384 --> 00:19:09.627
people will follow you for a long time.

00:19:10.189 --> 00:19:10.709
They will follow.

00:19:10.910 --> 00:19:12.451
People will react to negativity.

00:19:13.432 --> 00:19:15.073
Positivity is slower.

00:19:16.106 --> 00:19:17.268
but more, but more powerful.

00:19:17.367 --> 00:19:18.669
It's just also harder to cook with,

00:19:18.769 --> 00:19:19.209
you know what I mean?

00:19:19.249 --> 00:19:19.568
Like it's.

00:19:19.588 --> 00:19:21.569
Yeah, it is.

00:19:21.630 --> 00:19:23.230
And I find that to be, you know,

00:19:23.451 --> 00:19:23.832
honestly,

00:19:23.852 --> 00:19:25.313
one of the hardest things I do every

00:19:25.333 --> 00:19:27.634
day is, you know, you wake up,

00:19:27.834 --> 00:19:30.236
start your day and you have a choice,

00:19:30.435 --> 00:19:30.675
you know,

00:19:30.695 --> 00:19:31.557
how are you going to see the world

00:19:32.156 --> 00:19:34.278
and, you know, look at the news,

00:19:34.298 --> 00:19:34.999
look at anything else,

00:19:35.019 --> 00:19:35.739
look at your emails.

00:19:35.778 --> 00:19:36.640
And it's very easy.

00:19:37.180 --> 00:19:39.240
to get pulled down into you know what

00:19:39.260 --> 00:19:41.823
was me or you know what was the

00:19:41.863 --> 00:19:44.183
profession um you know we're getting

00:19:44.284 --> 00:19:47.246
clobbered by raids and turnover etc and i

00:19:47.306 --> 00:19:49.006
just for whatever reason throughout the

00:19:49.026 --> 00:19:50.307
course of my life and this certainly

00:19:50.326 --> 00:19:52.347
predates myself professionally have just

00:19:52.448 --> 00:19:55.349
always chosen to say i'm going to take

00:19:55.410 --> 00:19:57.010
the more um

00:19:57.651 --> 00:20:00.432
uh aspirational road because that inspires

00:20:00.472 --> 00:20:01.973
me personally and if i'm inspired

00:20:02.034 --> 00:20:04.194
personally i can then inspire other people

00:20:04.775 --> 00:20:06.655
and i really think that inspiration is

00:20:06.675 --> 00:20:08.436
about and followership is about giving

00:20:08.477 --> 00:20:10.939
people the tools to do what they're best

00:20:10.999 --> 00:20:12.740
at and then giving them the free reign

00:20:12.759 --> 00:20:14.661
the license to go after that without being

00:20:14.840 --> 00:20:17.382
afraid of failure without being afraid of

00:20:17.501 --> 00:20:19.824
you know letting somebody down um and

00:20:19.864 --> 00:20:21.785
supporting them through that failure uh

00:20:21.805 --> 00:20:22.905
that i mean i i

00:20:23.986 --> 00:20:25.445
I'm just astounded by, you know,

00:20:25.465 --> 00:20:26.646
looking back on some of the people I've

00:20:26.666 --> 00:20:28.386
been able to work with and see what

00:20:28.406 --> 00:20:29.307
their careers have done.

00:20:29.988 --> 00:20:31.347
And that's really a cool and very,

00:20:31.407 --> 00:20:35.249
a huge variety of success for people.

00:20:35.269 --> 00:20:36.028
I mean, I've got, you know,

00:20:36.048 --> 00:20:37.190
colleagues that I thought were going to

00:20:37.210 --> 00:20:38.109
be, you know,

00:20:38.150 --> 00:20:39.849
clinical executives because they were so

00:20:39.890 --> 00:20:41.911
good at a certain party.

00:20:41.931 --> 00:20:42.230
You know what,

00:20:42.250 --> 00:20:43.010
that's not what they wanted.

00:20:43.030 --> 00:20:44.531
They wound up, you know,

00:20:44.571 --> 00:20:45.852
circumventing back to another place and

00:20:45.872 --> 00:20:47.751
becoming rockstar physical therapists,

00:20:47.832 --> 00:20:49.573
treating, you know, elite athletes and,

00:20:49.913 --> 00:20:51.413
have an amazing career there it's not

00:20:51.433 --> 00:20:52.773
defined by how much money you make it's

00:20:52.814 --> 00:20:54.914
defined on how i think that's going back

00:20:54.934 --> 00:20:56.855
almost the first question like what like

00:20:56.915 --> 00:20:59.957
what really um matters the most it's

00:20:59.977 --> 00:21:03.098
allowing people to do what they love find

00:21:03.118 --> 00:21:04.239
what they love and do what they love

00:21:04.259 --> 00:21:05.378
and if you let people do what they

00:21:05.419 --> 00:21:07.779
love and build around that they're almost

00:21:07.859 --> 00:21:08.740
always going to be successful

00:21:09.461 --> 00:21:10.741
Yeah, they'll find a way to success.

00:21:10.882 --> 00:21:12.321
Like a lot of times you look at

00:21:12.362 --> 00:21:14.883
someone who is successful, I have anyway.

00:21:15.564 --> 00:21:18.184
And I've seen like it sort of doesn't

00:21:18.244 --> 00:21:18.545
matter.

00:21:18.585 --> 00:21:19.805
But it was like if they really cared

00:21:19.845 --> 00:21:20.164
about it,

00:21:20.244 --> 00:21:21.546
they'd find a way of being the best

00:21:21.605 --> 00:21:23.125
florist in town if they really just

00:21:23.165 --> 00:21:24.707
decided one day it was flowers and not

00:21:24.767 --> 00:21:25.326
rehab.

00:21:26.288 --> 00:21:27.468
So you've been doing this for a couple

00:21:27.508 --> 00:21:28.489
of years.

00:21:28.509 --> 00:21:29.909
Yeah.

00:21:29.949 --> 00:21:31.910
I like similarities and differences.

00:21:32.009 --> 00:21:32.190
Yeah.

00:21:32.659 --> 00:21:33.861
What are the things that have stayed the

00:21:33.921 --> 00:21:34.402
same?

00:21:34.643 --> 00:21:37.007
And what are the things that have changed?

00:21:37.367 --> 00:21:39.932
Macro things in the profession.

00:21:40.597 --> 00:21:42.759
Yeah, so, um, foundationally,

00:21:42.798 --> 00:21:44.000
I kind of laugh when I think about

00:21:44.019 --> 00:21:44.359
this, like,

00:21:44.380 --> 00:21:46.422
what does not change that the human body,

00:21:46.842 --> 00:21:47.982
the patient, you know,

00:21:48.022 --> 00:21:50.765
it's that the end user is the same.

00:21:51.345 --> 00:21:53.906
Um, there's no difference in, you know,

00:21:54.467 --> 00:21:57.169
what people wanted from PT,

00:21:57.189 --> 00:21:59.289
thirty years ago, fifteen years ago.

00:22:00.009 --> 00:22:02.291
Uh, they want to feel better and, um,

00:22:02.531 --> 00:22:03.573
you know, they are there.

00:22:04.232 --> 00:22:06.773
trusting the therapist to take care of

00:22:06.794 --> 00:22:09.214
them, make them feel better, educate them,

00:22:09.275 --> 00:22:09.994
support them.

00:22:11.576 --> 00:22:13.155
I think that's the foundational thing that

00:22:13.175 --> 00:22:13.915
has not changed.

00:22:16.436 --> 00:22:18.897
Everything else, honestly, has changed.

00:22:20.199 --> 00:22:21.199
You think about it from,

00:22:21.219 --> 00:22:22.259
I mentioned this before,

00:22:22.398 --> 00:22:23.480
I came out of PT school,

00:22:23.539 --> 00:22:23.980
there were

00:22:24.559 --> 00:22:26.942
two hundred applicants for the first job I

00:22:26.981 --> 00:22:28.883
got in Kokomo, Indiana.

00:22:29.384 --> 00:22:30.984
I don't know how I got it.

00:22:31.125 --> 00:22:32.846
My starting salary was thirty seven five.

00:22:34.047 --> 00:22:35.708
I had twenty patients a day on my

00:22:35.728 --> 00:22:36.127
schedule.

00:22:36.189 --> 00:22:37.910
There's no question I get to complain

00:22:37.930 --> 00:22:38.809
because there were two hundred other

00:22:38.829 --> 00:22:39.931
people waiting for my job.

00:22:40.432 --> 00:22:42.413
This is in a rural area an hour

00:22:42.472 --> 00:22:43.594
north of Indianapolis that

00:22:44.034 --> 00:22:46.596
nobody would want to go to, but yet,

00:22:46.615 --> 00:22:47.836
two hundred people wanted that job.

00:22:49.298 --> 00:22:50.317
And, you know,

00:22:50.538 --> 00:22:53.200
that environment is obviously completely

00:22:53.259 --> 00:22:53.559
different.

00:22:53.720 --> 00:22:56.301
And I don't go back to the glory

00:22:56.321 --> 00:22:57.482
days where, you know,

00:22:57.502 --> 00:22:59.003
we should be treating twenty visits per

00:22:59.044 --> 00:22:59.463
day.

00:22:59.604 --> 00:23:02.026
You know, I don't celebrate that per se.

00:23:02.586 --> 00:23:04.326
I do think that that's a whole other

00:23:04.366 --> 00:23:06.527
conversation about productivity and what

00:23:06.567 --> 00:23:08.248
can be done and expected and the balance

00:23:08.268 --> 00:23:10.167
between quality and productivity.

00:23:10.888 --> 00:23:12.128
Obviously, that's certainly changed.

00:23:12.769 --> 00:23:15.230
There's no question that requirements

00:23:15.269 --> 00:23:17.830
around documentation, authorization,

00:23:18.971 --> 00:23:20.872
uh etc have become exceedingly more

00:23:20.912 --> 00:23:23.332
difficult but on the other end of that

00:23:23.451 --> 00:23:25.292
the technology and tools to support that

00:23:25.333 --> 00:23:27.093
have become our next generation i mean

00:23:27.113 --> 00:23:29.334
when i came out of pt school i

00:23:29.354 --> 00:23:31.674
was writing notes on paper um and we

00:23:31.714 --> 00:23:33.454
did have authorization you know and

00:23:33.474 --> 00:23:34.875
verification and i was we had to you

00:23:35.316 --> 00:23:37.135
know support our visits people don't think

00:23:37.155 --> 00:23:38.996
that um they think that'll happen in the

00:23:39.036 --> 00:23:40.537
mid to two thousand that's not the case

00:23:40.557 --> 00:23:43.097
it was i remember ortho net coming in

00:23:43.137 --> 00:23:44.538
in the early two thousands and

00:23:44.897 --> 00:23:46.299
making our lives miserable and saying,

00:23:46.319 --> 00:23:47.561
if you don't have, you know,

00:23:48.021 --> 00:23:49.144
if you have four out of ten pain,

00:23:49.163 --> 00:23:49.805
you're discharged.

00:23:49.825 --> 00:23:50.905
If you have seven out of ten pain,

00:23:50.925 --> 00:23:51.707
you haven't gotten better.

00:23:55.307 --> 00:23:55.948
And that was, you know,

00:23:55.968 --> 00:23:56.768
twenty two years ago.

00:23:57.269 --> 00:23:59.029
So I don't think those things have changed

00:23:59.069 --> 00:23:59.369
per se,

00:23:59.390 --> 00:24:03.512
but definitely the demand for validating

00:24:03.553 --> 00:24:04.374
treatment have changed.

00:24:05.434 --> 00:24:05.734
You know,

00:24:05.914 --> 00:24:10.439
the reimbursement climate is different,

00:24:10.739 --> 00:24:11.338
obviously.

00:24:12.039 --> 00:24:14.080
And in some senses, you know,

00:24:14.141 --> 00:24:15.742
you can see that it's

00:24:16.563 --> 00:24:18.104
We have not seen reimbursement keep up

00:24:18.124 --> 00:24:18.784
with inflation,

00:24:19.365 --> 00:24:21.705
but reimbursement at the same time is

00:24:21.746 --> 00:24:23.247
significantly higher than when I started

00:24:23.287 --> 00:24:23.826
practicing.

00:24:24.747 --> 00:24:26.008
And there's a number of reasons for that

00:24:26.028 --> 00:24:26.428
as well.

00:24:26.448 --> 00:24:27.628
And I think people get lost in that

00:24:27.689 --> 00:24:30.951
myth that physical therapy reimbursement

00:24:31.070 --> 00:24:31.810
is in the basements.

00:24:31.990 --> 00:24:32.510
It's not.

00:24:33.731 --> 00:24:34.813
But you got to work for it.

00:24:34.952 --> 00:24:36.733
I mean, there's an equation here.

00:24:36.753 --> 00:24:37.794
You just don't fall out of bed and

00:24:37.814 --> 00:24:39.194
get a hundred dollars a visit.

00:24:39.214 --> 00:24:40.134
You've got to work for it.

00:24:41.883 --> 00:24:44.125
I definitely think the physical therapists

00:24:44.164 --> 00:24:45.266
are obviously very different.

00:24:45.286 --> 00:24:46.286
I mean, when I graduated,

00:24:46.385 --> 00:24:48.788
I was the last bachelor's class of my

00:24:48.867 --> 00:24:50.690
program before they swapped to a DPT.

00:24:51.369 --> 00:24:54.251
And the mindset of a therapist,

00:24:54.692 --> 00:24:56.993
who we were all those years ago,

00:24:57.054 --> 00:24:58.496
I think is definitely different.

00:24:59.395 --> 00:25:00.517
There's a bunch of feeders to that.

00:25:00.537 --> 00:25:03.098
It was massively competitive in PT school

00:25:03.138 --> 00:25:04.140
in the nineties and eighties.

00:25:04.160 --> 00:25:04.799
It was almost,

00:25:04.839 --> 00:25:06.260
it was harder than medical school,

00:25:06.981 --> 00:25:08.702
four or five hundred students applying for

00:25:08.722 --> 00:25:09.423
forty spots.

00:25:09.903 --> 00:25:12.404
So I think we had a lot more.

00:25:13.625 --> 00:25:14.386
Thirty years ago,

00:25:14.507 --> 00:25:16.988
therapists were very intentional about

00:25:17.028 --> 00:25:18.148
going into PT school.

00:25:18.669 --> 00:25:20.109
And it was a decision you made.

00:25:20.150 --> 00:25:21.230
It was really hard to do,

00:25:21.710 --> 00:25:22.651
really hard to get in.

00:25:22.851 --> 00:25:25.613
And I think most of the therapists back

00:25:25.653 --> 00:25:27.473
in that generation, myself included,

00:25:28.173 --> 00:25:29.974
because it was something we were so

00:25:30.654 --> 00:25:33.336
dedicated to becoming and we stuck with

00:25:33.376 --> 00:25:33.517
it.

00:25:34.156 --> 00:25:37.019
And I see a lot more people today

00:25:37.199 --> 00:25:39.079
saying it's hard or do something else.

00:25:39.599 --> 00:25:41.201
I didn't see that in my generation.

00:25:42.163 --> 00:25:43.944
And then one of the last things I

00:25:43.964 --> 00:25:45.086
would call on just from a personal

00:25:45.106 --> 00:25:47.890
standpoint is work-life balance was never

00:25:47.950 --> 00:25:48.711
part of the equation.

00:25:48.750 --> 00:25:49.912
We didn't think about that.

00:25:49.951 --> 00:25:50.792
Words didn't exist.

00:25:50.833 --> 00:25:53.175
We worked and the rest of it kind

00:25:53.195 --> 00:25:53.635
of came.

00:25:54.857 --> 00:25:56.660
And I'm not saying that's a bad thing.

00:25:57.602 --> 00:25:58.842
It's great that we have a better,

00:25:58.962 --> 00:26:01.143
broader view of life than just grinding

00:26:01.163 --> 00:26:01.503
work.

00:26:01.564 --> 00:26:05.184
But it has definitely had its impact on

00:26:05.224 --> 00:26:07.326
the professional advancement opportunities

00:26:07.346 --> 00:26:08.846
in our profession around this work-life

00:26:08.865 --> 00:26:10.846
balance construct that I've never embraced

00:26:10.886 --> 00:26:11.326
personally,

00:26:11.366 --> 00:26:13.347
but I definitely see the value of.

00:26:13.387 --> 00:26:14.868
Well, you work with organizations,

00:26:14.888 --> 00:26:15.828
and we'll get to what you get to

00:26:15.868 --> 00:26:16.890
do now in a second.

00:26:16.910 --> 00:26:18.289
But I feel like, well,

00:26:18.309 --> 00:26:19.631
I'll tip my hand a little bit,

00:26:19.671 --> 00:26:21.451
which is since you've done most of the

00:26:21.491 --> 00:26:23.892
roles at organizations you're probably

00:26:23.912 --> 00:26:24.692
advising, right?

00:26:25.410 --> 00:26:26.931
if a clinician is sitting there saying,

00:26:27.491 --> 00:26:28.152
what do we want?

00:26:28.352 --> 00:26:28.932
More money.

00:26:29.232 --> 00:26:30.354
When do we want it now?

00:26:31.315 --> 00:26:33.356
Are the people who find most success on

00:26:33.376 --> 00:26:35.278
the leadership angle saying, that's great,

00:26:35.337 --> 00:26:36.838
let's figure out how to do it together,

00:26:36.940 --> 00:26:38.240
instead of saying, well,

00:26:38.260 --> 00:26:40.241
these kids today just want to work less

00:26:40.301 --> 00:26:40.903
and make more.

00:26:41.742 --> 00:26:43.644
Are the people most successful the ones

00:26:43.664 --> 00:26:45.686
that are saying, like what you did,

00:26:45.886 --> 00:26:47.548
let's figure out how to do that together,

00:26:47.688 --> 00:26:48.628
because if you get that,

00:26:48.648 --> 00:26:49.809
you're never going to leave me,

00:26:50.351 --> 00:26:51.230
and then I'll be able to hand you

00:26:51.270 --> 00:26:53.333
a clinic in two years, right?

00:26:53.496 --> 00:26:57.176
where it feels like i understand everybody

00:26:57.196 --> 00:26:59.537
nobody's wrong and what they want where i

00:26:59.557 --> 00:27:01.498
think there's a disconnect in is how do

00:27:01.577 --> 00:27:03.738
we get that it's not me not paying

00:27:03.778 --> 00:27:05.979
you or making you work too much and

00:27:06.019 --> 00:27:08.419
me laughing and swimming around scrooge

00:27:08.439 --> 00:27:11.019
mcduck style in my vault that's probably

00:27:11.059 --> 00:27:13.400
not the case it's not the case how

00:27:13.420 --> 00:27:14.641
do we get there together i feel like

00:27:14.661 --> 00:27:16.141
the organizations that figure that out

00:27:17.267 --> 00:27:21.407
Yeah, there's no question.

00:27:22.108 --> 00:27:24.609
You have a choice when you're presented

00:27:24.650 --> 00:27:28.191
with major market shifts over a generation

00:27:28.250 --> 00:27:29.691
and you see this going.

00:27:29.730 --> 00:27:32.751
I recall experiencing this really the

00:27:32.791 --> 00:27:33.413
strongest in

00:27:34.772 --> 00:27:36.874
Um, when the great resignation came,

00:27:36.894 --> 00:27:37.973
it's like, all of a sudden,

00:27:37.993 --> 00:27:39.214
in April of twenty, twenty two,

00:27:39.275 --> 00:27:41.576
everyone decided that their pent up desire

00:27:41.596 --> 00:27:42.696
to leave a job would happen in the

00:27:42.737 --> 00:27:43.237
same day.

00:27:43.576 --> 00:27:43.777
Right?

00:27:43.817 --> 00:27:46.438
Turnover went from normal to just boom,

00:27:46.557 --> 00:27:47.459
like the world.

00:27:48.038 --> 00:27:50.160
And I, this was an experience I had,

00:27:50.319 --> 00:27:51.519
um, I'm really proud of that.

00:27:51.559 --> 00:27:51.660
We,

00:27:51.720 --> 00:27:53.580
as a management team did it when that

00:27:53.621 --> 00:27:54.060
happened.

00:27:54.301 --> 00:27:54.721
Um, we.

00:27:55.442 --> 00:27:57.182
looked around and we didn't blame the

00:27:57.242 --> 00:27:59.804
field we didn't blame the universe around

00:27:59.903 --> 00:28:02.384
us we blamed ourselves and said wait a

00:28:02.444 --> 00:28:03.785
second we're missing something what are we

00:28:03.805 --> 00:28:05.566
going to learn from this experience and we

00:28:06.066 --> 00:28:09.027
immediately you know dug into the ground

00:28:09.326 --> 00:28:11.127
we polled our people we asked the hard

00:28:11.147 --> 00:28:13.548
questions we made ourselves vulnerable uh

00:28:13.568 --> 00:28:15.269
we let them beat us up around what

00:28:15.328 --> 00:28:18.269
it was that was driving to you know

00:28:18.431 --> 00:28:20.391
this significant shift in turnover there's

00:28:20.411 --> 00:28:22.531
obviously a lot of pent-up frustration and

00:28:22.551 --> 00:28:24.012
fatigue coming out of covid it was just

00:28:24.053 --> 00:28:24.992
a resettling of

00:28:25.252 --> 00:28:26.954
you know the way the world was operating

00:28:26.974 --> 00:28:29.156
at that point but we learned a ton

00:28:29.717 --> 00:28:31.419
and you know what we learned is for

00:28:31.479 --> 00:28:33.200
us to be successful and to engage our

00:28:33.220 --> 00:28:35.502
therapists we had to meet them where they

00:28:35.542 --> 00:28:37.724
were and that's providing them the tools

00:28:37.785 --> 00:28:39.946
and the experiences that matter to them

00:28:40.247 --> 00:28:41.067
clinical education

00:28:41.567 --> 00:28:42.867
professional support and development,

00:28:42.948 --> 00:28:44.868
alternative pathways to what success

00:28:44.929 --> 00:28:45.409
actually means,

00:28:45.429 --> 00:28:47.170
a clinical career ladder that allows you

00:28:47.210 --> 00:28:49.730
to celebrate and thrive clinically,

00:28:49.770 --> 00:28:50.510
if that's your direction.

00:28:50.530 --> 00:28:51.811
I think there's far too little of that

00:28:51.832 --> 00:28:53.333
in the profession where we're

00:28:53.393 --> 00:28:54.973
incentivizing and celebrating great

00:28:55.013 --> 00:28:55.594
clinical work.

00:28:56.060 --> 00:28:56.681
on the alternative,

00:28:56.721 --> 00:28:59.801
and we built a very powerful executive

00:28:59.821 --> 00:29:01.142
leadership trajectory to say,

00:29:01.162 --> 00:29:02.163
if you want to go this route,

00:29:02.242 --> 00:29:02.742
we got you.

00:29:02.782 --> 00:29:05.903
And we built internal training that we

00:29:05.963 --> 00:29:08.203
invested in as a management team to help

00:29:08.223 --> 00:29:09.085
them get to that level.

00:29:09.484 --> 00:29:12.325
And we pulled back all the layers of

00:29:12.345 --> 00:29:13.806
the onion that you need to truly

00:29:13.846 --> 00:29:14.806
understand the profession.

00:29:15.266 --> 00:29:16.626
And we shared that with our teams.

00:29:16.767 --> 00:29:17.267
And I think the

00:29:18.027 --> 00:29:19.008
you know you want to understand how to

00:29:19.028 --> 00:29:21.568
make more money here's the equation

00:29:21.588 --> 00:29:24.971
therapist generates x they want to make y

00:29:25.612 --> 00:29:27.173
we need to make a margin to preserve

00:29:27.192 --> 00:29:28.534
the value of this business and more

00:29:28.554 --> 00:29:30.234
importantly because that the value of the

00:29:30.255 --> 00:29:31.675
business doesn't resonate to people what

00:29:31.695 --> 00:29:33.297
they care about is you know what is

00:29:33.317 --> 00:29:34.998
it what are you investing back and we

00:29:35.018 --> 00:29:37.138
were very clear that all of the money

00:29:37.179 --> 00:29:39.140
that we made generally speaking was

00:29:39.180 --> 00:29:41.221
invested in the platform and in the

00:29:41.241 --> 00:29:43.303
development of our teams and we build you

00:29:43.323 --> 00:29:44.804
know nine residency programs

00:29:48.319 --> 00:29:50.101
to bring up our clinicians.

00:29:50.161 --> 00:29:51.300
And I, a hundred percent, as you said,

00:29:51.340 --> 00:29:53.201
that the provider groups that are doing

00:29:53.261 --> 00:29:55.343
that and not sitting back and, you know,

00:29:55.502 --> 00:29:58.505
angrily arguing with the windmills or,

00:29:58.585 --> 00:30:00.185
you know, swinging, you know,

00:30:00.726 --> 00:30:02.527
I'm sure there's some other narratives out

00:30:02.547 --> 00:30:03.728
there that use, but, you know,

00:30:03.768 --> 00:30:05.689
fight with windmills that you're not going

00:30:05.709 --> 00:30:06.388
to win that fight.

00:30:06.769 --> 00:30:07.569
You know, you,

00:30:07.589 --> 00:30:09.029
the world is telling you something,

00:30:09.109 --> 00:30:10.510
you've got to respond,

00:30:10.550 --> 00:30:12.952
react and evolve and the great companies.

00:30:12.992 --> 00:30:14.593
And there's several of them out there are

00:30:14.613 --> 00:30:15.534
doing exactly that.

00:30:15.894 --> 00:30:17.115
And they don't have to be at scale.

00:30:17.154 --> 00:30:19.435
This is not an element of, okay,

00:30:19.516 --> 00:30:20.596
there's the, you know,

00:30:20.636 --> 00:30:22.457
the five or six large companies that are

00:30:22.497 --> 00:30:23.837
out there that are able to do this

00:30:23.877 --> 00:30:25.259
and the rest of the universe can't.

00:30:25.298 --> 00:30:26.219
That's just not true.

00:30:26.920 --> 00:30:29.161
The in-between, the clinics that have,

00:30:29.201 --> 00:30:30.181
you know, two, three, four,

00:30:30.201 --> 00:30:31.021
the companies that have two, three,

00:30:31.041 --> 00:30:33.022
four clinics, fifteen, twenty, a hundred,

00:30:33.542 --> 00:30:34.864
they can do great things too.

00:30:35.263 --> 00:30:36.125
And many of them are.

00:30:36.585 --> 00:30:38.766
It's just about meeting your team and your

00:30:38.885 --> 00:30:40.426
clinicians and not just your clinicians,

00:30:40.446 --> 00:30:42.167
your whole team where they need to be

00:30:42.228 --> 00:30:42.448
met.

00:30:42.867 --> 00:30:44.730
and not arguing with the past and

00:30:44.750 --> 00:30:45.832
complaining about the future,

00:30:45.892 --> 00:30:47.192
but being solutions-oriented.

00:30:47.874 --> 00:30:49.336
Sounds like Chris Voss,

00:30:49.496 --> 00:30:51.538
who was the FBI hostage negotiator,

00:30:51.557 --> 00:30:51.897
would say,

00:30:51.999 --> 00:30:53.721
if someone's speaking logically and you're

00:30:53.760 --> 00:30:54.741
speaking emotionally,

00:30:55.021 --> 00:30:56.903
you're just going to talk past each other.

00:30:58.085 --> 00:30:59.666
But when you can recognize that as a

00:30:59.867 --> 00:31:00.567
real leader...

00:31:01.532 --> 00:31:02.874
you understand if someone's speaking

00:31:02.913 --> 00:31:04.715
emotionally, my job is to listen.

00:31:04.796 --> 00:31:06.376
It sounds like the really fancy thing that

00:31:06.396 --> 00:31:08.558
you did there, Jeremy, was listened.

00:31:09.740 --> 00:31:11.240
And then you evaluated what was said,

00:31:11.381 --> 00:31:13.143
figure out what you could do about it.

00:31:13.682 --> 00:31:15.125
And then you did that.

00:31:15.224 --> 00:31:16.965
Probably not all of it at once because

00:31:16.986 --> 00:31:17.826
that might not be possible,

00:31:18.207 --> 00:31:19.769
but you kept listening and you kept

00:31:19.808 --> 00:31:20.368
evolving.

00:31:20.750 --> 00:31:22.510
And when people feel, Oprah said this,

00:31:23.192 --> 00:31:24.413
people want to be seen, heard,

00:31:24.492 --> 00:31:25.053
and understood.

00:31:25.393 --> 00:31:27.075
If you can show them that,

00:31:27.194 --> 00:31:28.036
not just tell them that,

00:31:28.175 --> 00:31:29.297
you can show them that,

00:31:30.252 --> 00:31:31.734
People tend to not want to leave.

00:31:32.996 --> 00:31:34.297
And it's something I love about

00:31:34.336 --> 00:31:34.817
consulting.

00:31:34.837 --> 00:31:36.759
That's actually the first thing I do with

00:31:36.819 --> 00:31:39.222
any organization that I go into and look

00:31:39.303 --> 00:31:41.404
at as a consultant is,

00:31:41.825 --> 00:31:42.926
what is the state of the org?

00:31:43.287 --> 00:31:45.429
When you're hired as a consultant,

00:31:45.449 --> 00:31:47.270
a lot of times you're viewed as,

00:31:47.632 --> 00:31:48.492
come in here and fix it.

00:31:48.653 --> 00:31:49.973
Get things better tomorrow.

00:31:50.375 --> 00:31:51.435
I've got a problem.

00:31:52.797 --> 00:31:53.878
I need you to be a solution.

00:31:54.058 --> 00:31:55.961
Sometimes I feel like we're like the

00:31:56.020 --> 00:31:58.903
Winston Wolf of from Pulp Fiction.

00:31:59.684 --> 00:32:00.566
That's my generation.

00:32:00.586 --> 00:32:01.227
When you come in,

00:32:01.386 --> 00:32:03.690
I'll leave the movie to the rest of

00:32:03.710 --> 00:32:05.151
the audience to obviously watch.

00:32:05.171 --> 00:32:06.353
I'm amazed by how many people have not

00:32:06.393 --> 00:32:07.213
seen Pulp Fiction,

00:32:07.253 --> 00:32:07.594
but I

00:32:08.340 --> 00:32:09.182
Look what you just did.

00:32:09.362 --> 00:32:10.222
Winston Wolf,

00:32:10.303 --> 00:32:11.463
and if you haven't seen Pulp Fiction,

00:32:11.564 --> 00:32:12.765
turn this episode off right now.

00:32:12.785 --> 00:32:13.425
I don't want to speak to you.

00:32:13.445 --> 00:32:15.126
It's a great film.

00:32:15.208 --> 00:32:17.088
They were in an emotional state.

00:32:17.470 --> 00:32:18.990
Something bad just happened,

00:32:19.090 --> 00:32:20.491
and they were emotional.

00:32:20.792 --> 00:32:22.773
And he walked in and was just like,

00:32:23.154 --> 00:32:24.236
I am speaking logically.

00:32:24.635 --> 00:32:25.217
I am Winston.

00:32:25.576 --> 00:32:26.317
I am in charge.

00:32:26.678 --> 00:32:27.858
You do what I say.

00:32:28.058 --> 00:32:28.940
You will get this.

00:32:29.359 --> 00:32:30.842
And they did everything he said,

00:32:31.362 --> 00:32:32.083
and it happened.

00:32:32.442 --> 00:32:33.963
But he had to put them on the

00:32:34.003 --> 00:32:34.865
logic train.

00:32:34.984 --> 00:32:35.244
He's like,

00:32:35.285 --> 00:32:36.625
I'm not going to speak to you emotionally

00:32:36.767 --> 00:32:37.928
because then we're just going to spiral

00:32:37.948 --> 00:32:38.468
around in circuits.

00:32:38.667 --> 00:32:39.528
Then we all get caught.

00:32:40.769 --> 00:32:42.351
I'm going to bring you into logic mode

00:32:42.411 --> 00:32:42.651
now.

00:32:42.750 --> 00:32:44.353
And I'm going to tell you one thing

00:32:44.393 --> 00:32:45.192
to do at a time.

00:32:45.453 --> 00:32:45.953
Do that.

00:32:46.094 --> 00:32:47.714
We will get that thing I just promised

00:32:47.736 --> 00:32:47.875
you.

00:32:48.929 --> 00:32:50.210
So, you know, leadership,

00:32:50.710 --> 00:32:52.612
leadership lessons from Quentin Tarantino,

00:32:52.692 --> 00:32:53.152
you know,

00:32:53.432 --> 00:32:55.553
it's a bit of a cabaret film, but,

00:32:55.653 --> 00:32:56.433
you know, it does,

00:32:56.574 --> 00:32:58.954
it definitely resonates from, you know,

00:32:58.974 --> 00:32:59.455
where I,

00:32:59.955 --> 00:33:01.057
and what I first do when I go

00:33:01.076 --> 00:33:02.317
into an org is, you know,

00:33:02.397 --> 00:33:04.318
it's let's talk about leadership.

00:33:04.818 --> 00:33:06.299
your team, your culture,

00:33:07.000 --> 00:33:07.980
what are you doing?

00:33:08.300 --> 00:33:09.201
What are your pain points?

00:33:09.221 --> 00:33:10.282
And now, obviously, you know,

00:33:10.303 --> 00:33:11.663
that when you're a consultant,

00:33:11.683 --> 00:33:12.824
the biggest pain points are always,

00:33:12.844 --> 00:33:14.905
I want to grow my revenue or I

00:33:14.945 --> 00:33:16.026
want to build my team.

00:33:16.406 --> 00:33:19.107
You know, I've got a turnover problem.

00:33:19.127 --> 00:33:20.009
I've got a marketing problem.

00:33:20.028 --> 00:33:20.750
I've got a sales problem.

00:33:21.829 --> 00:33:23.090
It's easy just to go right to the

00:33:23.131 --> 00:33:23.471
problem.

00:33:23.550 --> 00:33:24.971
I want to get underneath that and truly

00:33:25.010 --> 00:33:27.873
understand why is that happening and what

00:33:27.913 --> 00:33:28.712
do you want to do about it?

00:33:29.853 --> 00:33:31.574
We listen, we probe,

00:33:32.134 --> 00:33:35.375
and I encourage something we did.

00:33:35.635 --> 00:33:36.415
I mentioned Ivy.

00:33:36.476 --> 00:33:38.836
It was such a great experience.

00:33:39.416 --> 00:33:41.377
We did pulse surveys of our team

00:33:41.798 --> 00:33:42.298
quarterly.

00:33:43.239 --> 00:33:44.598
It's one thing to do a pulse survey.

00:33:44.638 --> 00:33:46.339
If you haven't seen the pulse survey,

00:33:47.099 --> 00:33:48.560
it's a really great tool.

00:33:48.621 --> 00:33:50.842
Twelve questions from

00:33:51.442 --> 00:33:52.701
I can't remember the book.

00:33:52.761 --> 00:33:54.383
It'll probably strike me in a bit and

00:33:54.403 --> 00:33:55.242
we'll figure that out.

00:33:55.282 --> 00:33:59.724
But it's a great way to learn about

00:33:59.785 --> 00:34:00.845
the experience of your team,

00:34:01.505 --> 00:34:02.726
but it's only as good as what you

00:34:02.766 --> 00:34:03.465
actually do with it.

00:34:03.885 --> 00:34:05.806
So I've always said this,

00:34:05.865 --> 00:34:07.807
you don't do a poll survey or a

00:34:07.846 --> 00:34:10.527
survey like that to just hear the answers.

00:34:10.547 --> 00:34:11.927
You do it and then you wrap it

00:34:11.947 --> 00:34:13.849
back and really drill into where we're

00:34:14.108 --> 00:34:15.489
going and have conversations with your

00:34:15.510 --> 00:34:16.070
team to say,

00:34:16.550 --> 00:34:17.090
I recognize

00:34:17.289 --> 00:34:19.132
this and I'm going to fix it with

00:34:19.192 --> 00:34:21.072
you for you to give you a better

00:34:21.132 --> 00:34:21.572
experience.

00:34:21.592 --> 00:34:22.974
And when you do that kind of goes

00:34:22.994 --> 00:34:25.396
back to your saying about Oprah people,

00:34:25.876 --> 00:34:27.277
that's what leads to people trusting you.

00:34:27.297 --> 00:34:28.978
And of course you have to execute.

00:34:29.039 --> 00:34:31.360
And that's the big role of being a

00:34:31.380 --> 00:34:31.740
consultant.

00:34:31.760 --> 00:34:33.521
That's what I really love to do is

00:34:33.541 --> 00:34:34.923
to get in there, to dig in,

00:34:34.943 --> 00:34:35.744
to explore.

00:34:36.143 --> 00:34:37.385
I think it's also why I love doing

00:34:37.485 --> 00:34:37.865
M&A because

00:34:38.585 --> 00:34:39.686
because you're going in and you're

00:34:39.726 --> 00:34:40.085
learning,

00:34:40.126 --> 00:34:41.706
you're peeling back layers and you're

00:34:41.746 --> 00:34:43.706
finding the different pearls and then,

00:34:43.827 --> 00:34:44.047
you know,

00:34:44.067 --> 00:34:45.467
building a plan around those pearls.

00:34:46.027 --> 00:34:47.588
And it just is something that I would

00:34:47.608 --> 00:34:50.309
encourage, you know, every company owner,

00:34:50.349 --> 00:34:51.748
anybody that's got, you know,

00:34:51.949 --> 00:34:54.010
wants to reach this generation,

00:34:54.050 --> 00:34:56.409
grow their business, be successful.

00:34:56.789 --> 00:34:58.650
You've got to go back to your team

00:34:58.670 --> 00:35:01.251
and understand what their motivations,

00:35:01.271 --> 00:35:03.371
what their experiences are and build off

00:35:03.411 --> 00:35:03.672
of those.

00:35:03.711 --> 00:35:04.751
Otherwise you're completely blind.

00:35:06.501 --> 00:35:08.302
I learned a leadership lesson from my dad

00:35:08.342 --> 00:35:09.503
who was not in business.

00:35:09.802 --> 00:35:12.164
He was a New York City firefighter.

00:35:12.184 --> 00:35:14.605
When he got promoted from a firefighter to

00:35:14.625 --> 00:35:15.425
a lieutenant, he was like,

00:35:15.485 --> 00:35:18.286
now I'm in charge of other people.

00:35:18.306 --> 00:35:20.427
The leadership lessons that he got was,

00:35:21.208 --> 00:35:22.309
I work for them.

00:35:23.289 --> 00:35:24.710
I wear a white shirt now.

00:35:25.289 --> 00:35:26.251
I'm in charge,

00:35:26.331 --> 00:35:28.512
but my job is to bring everybody home.

00:35:29.079 --> 00:35:30.760
So my job is I work for them.

00:35:30.900 --> 00:35:32.481
And I when I took over my,

00:35:32.621 --> 00:35:32.800
you know,

00:35:32.860 --> 00:35:34.442
I took over a radio station at like

00:35:34.481 --> 00:35:35.182
twenty four.

00:35:35.682 --> 00:35:37.364
And I remember like being so nervous.

00:35:37.903 --> 00:35:39.364
I had worked under the guy who ran

00:35:39.405 --> 00:35:39.664
the radio.

00:35:39.704 --> 00:35:41.186
I was not starting a radio station.

00:35:41.286 --> 00:35:42.907
I was just like essentially it was like

00:35:42.947 --> 00:35:44.447
I was handed a thing was like a

00:35:44.987 --> 00:35:45.528
B plus.

00:35:45.548 --> 00:35:46.929
It was like, just don't lose.

00:35:46.969 --> 00:35:48.329
If you stay B plus, you're fine.

00:35:48.610 --> 00:35:49.871
But I was sleeping on the couch.

00:35:49.891 --> 00:35:50.692
I was so nervous.

00:35:50.711 --> 00:35:51.711
Like I wouldn't go to bed.

00:35:51.731 --> 00:35:52.572
I was just staying up.

00:35:52.913 --> 00:35:53.713
And my dad was like,

00:35:53.873 --> 00:35:54.934
there were two things he gave me.

00:35:55.375 --> 00:35:55.514
One,

00:35:55.855 --> 00:35:57.677
is anybody going to die tomorrow if you

00:35:57.737 --> 00:35:58.777
screw up at the radio station?

00:35:58.797 --> 00:36:00.599
And I was like, okay, dad, no.

00:36:00.798 --> 00:36:01.239
Got it.

00:36:02.199 --> 00:36:04.322
And then once he got me giggling,

00:36:04.722 --> 00:36:06.282
I left emotion, went back to logic.

00:36:06.322 --> 00:36:06.844
And he was like,

00:36:07.344 --> 00:36:08.824
do your jobs just to listen to them

00:36:08.864 --> 00:36:09.985
and then give them what they need.

00:36:10.005 --> 00:36:10.447
And I was like,

00:36:11.393 --> 00:36:11.494
oh,

00:36:11.534 --> 00:36:13.237
the answer's already gonna be in the room

00:36:13.257 --> 00:36:14.097
if I shut up.

00:36:14.137 --> 00:36:15.239
My job was not to go in there

00:36:15.259 --> 00:36:16.239
and be like, I have all the answers,

00:36:16.280 --> 00:36:16.740
follow me.

00:36:17.181 --> 00:36:18.463
My job was like, what's your,

00:36:18.483 --> 00:36:19.545
give me your biggest problem.

00:36:19.585 --> 00:36:20.545
Give me your biggest three.

00:36:20.666 --> 00:36:22.047
And then which one can I solve?

00:36:22.128 --> 00:36:23.230
And then you trust me a little more.

00:36:23.250 --> 00:36:23.971
And I go,

00:36:23.990 --> 00:36:24.911
now when I tell you I'm working on

00:36:24.931 --> 00:36:25.492
the other two,

00:36:25.893 --> 00:36:27.215
stick around and we'll do that.

00:36:27.614 --> 00:36:28.195
And that was it.

00:36:28.295 --> 00:36:29.177
I did that over and over again.

00:36:29.717 --> 00:36:30.978
You know, as you talk about that,

00:36:30.998 --> 00:36:32.378
I reflect on just some of the lessons

00:36:32.478 --> 00:36:34.199
I've had in leadership and that you speak

00:36:34.239 --> 00:36:35.420
to the, you know,

00:36:35.719 --> 00:36:37.239
we complicate things very often.

00:36:37.280 --> 00:36:38.300
And I like the point you said,

00:36:38.320 --> 00:36:39.740
is anyone going to die if this radio

00:36:39.780 --> 00:36:40.561
station fails?

00:36:40.942 --> 00:36:43.782
Is anyone going to die if the clinic

00:36:43.943 --> 00:36:45.023
I am in fails?

00:36:45.262 --> 00:36:47.804
Hoboken twenty five years ago doesn't make

00:36:47.864 --> 00:36:48.505
it now.

00:36:48.606 --> 00:36:49.045
And, you know,

00:36:49.646 --> 00:36:51.427
I you mentioned your father in law or

00:36:51.447 --> 00:36:53.010
your father is a New York City

00:36:53.070 --> 00:36:53.530
firefighter.

00:36:53.869 --> 00:36:55.592
My father in law, my wife's mother,

00:36:56.032 --> 00:36:57.152
he was a New York City cop for

00:36:57.172 --> 00:36:57.773
forty years.

00:36:57.813 --> 00:36:59.916
And he was ultimately one of the you

00:36:59.936 --> 00:37:01.896
know, he was very high up.

00:37:01.936 --> 00:37:02.318
He was the

00:37:03.802 --> 00:37:05.043
I think one of the top NYPD officers

00:37:05.063 --> 00:37:06.804
on the ground at the World Trade Center

00:37:07.905 --> 00:37:09.266
after the attack.

00:37:10.668 --> 00:37:16.210
And my brother was an infantry combat

00:37:16.811 --> 00:37:19.733
officer in Iraq and Afghanistan and went

00:37:19.753 --> 00:37:23.715
to West Point and was in the hundred

00:37:24.016 --> 00:37:25.697
first airborne in Iraq and then later in

00:37:25.717 --> 00:37:26.297
Afghanistan.

00:37:27.018 --> 00:37:28.778
and you know what i i think in

00:37:28.798 --> 00:37:30.318
that early stage of my career that in

00:37:30.338 --> 00:37:32.039
two thousand one two three four when i

00:37:32.059 --> 00:37:33.581
started to see like i was going in

00:37:33.621 --> 00:37:35.081
somewhere some leadership opportunities

00:37:35.121 --> 00:37:36.961
and i was contrasting and i think it

00:37:37.001 --> 00:37:39.603
really strikes me like it's not that big

00:37:39.623 --> 00:37:40.804
of a deal my daughter would be like

00:37:40.824 --> 00:37:42.364
it's not that deep you know it's like

00:37:42.403 --> 00:37:43.664
this daughter's seventeen i hear that all

00:37:43.684 --> 00:37:44.965
the time and i'll say that like it's

00:37:44.985 --> 00:37:46.885
not that deep bro um it's like the

00:37:46.965 --> 00:37:49.347
language of a seventeen-year-old girl um

00:37:49.387 --> 00:37:51.568
but you know i wasn't saving lives i

00:37:51.608 --> 00:37:53.148
wasn't in danger this was

00:37:53.708 --> 00:37:55.610
you know I'm empowering people to to do

00:37:55.670 --> 00:37:57.072
well in their career the stakes are

00:37:57.172 --> 00:38:00.974
relatively low have fun you know um enjoy

00:38:00.994 --> 00:38:02.735
it a little bit because there are

00:38:03.077 --> 00:38:04.697
professions like you know your father is

00:38:04.737 --> 00:38:06.179
my father-in-law my brother that are

00:38:06.418 --> 00:38:08.501
inherently profoundly dangerous and the

00:38:08.541 --> 00:38:10.603
stakes are significantly higher and you

00:38:10.623 --> 00:38:12.264
can't really have fun in that situation

00:38:12.304 --> 00:38:14.445
but you can enjoy that you know and

00:38:14.465 --> 00:38:16.987
this is not that deep you know you're

00:38:17.007 --> 00:38:17.708
helping people

00:38:18.331 --> 00:38:20.251
get to you're helping to inspire and

00:38:20.291 --> 00:38:21.853
enable and create opportunities for

00:38:21.893 --> 00:38:22.152
people.

00:38:22.213 --> 00:38:24.653
It should be fun and it should be

00:38:24.693 --> 00:38:25.594
wildly rewarding.

00:38:26.054 --> 00:38:27.255
So I think that's a really important

00:38:27.295 --> 00:38:30.096
lesson for people as they explore their

00:38:30.115 --> 00:38:31.217
career, their pathway.

00:38:31.277 --> 00:38:31.797
Have fun.

00:38:31.876 --> 00:38:33.398
Do what you kind of goes back to

00:38:33.418 --> 00:38:34.277
what you mentioned before.

00:38:34.297 --> 00:38:35.717
I'm kind of looping back to the original

00:38:35.759 --> 00:38:36.119
question.

00:38:36.139 --> 00:38:37.119
Like, what is success?

00:38:37.139 --> 00:38:37.298
Like,

00:38:37.719 --> 00:38:39.420
it really should be doing what you love.

00:38:39.800 --> 00:38:41.320
Yes, that should be it.

00:38:41.420 --> 00:38:42.762
Like the definition of success.

00:38:42.802 --> 00:38:43.521
It can't be money.

00:38:44.452 --> 00:38:46.253
it can't be prowess or power that's all

00:38:46.773 --> 00:38:48.472
totally fungible that can be taken away

00:38:48.512 --> 00:38:50.594
tomorrow it doesn't mean anything

00:38:50.914 --> 00:38:52.893
everyone's got their own individual needs

00:38:52.934 --> 00:38:55.014
and that's and i don't begrudge anybody's

00:38:55.195 --> 00:38:56.534
you know going after the needs but at

00:38:56.554 --> 00:38:58.376
the end of the day it has to

00:38:58.416 --> 00:39:00.655
come back to you you're having fun and

00:39:00.695 --> 00:39:02.617
beyond that you're inspired and you're

00:39:02.657 --> 00:39:05.237
passionate i think success truly is

00:39:05.277 --> 00:39:07.677
defined by doing something you love and

00:39:07.697 --> 00:39:09.579
are inspired to do and you want to

00:39:09.599 --> 00:39:11.239
get up every day and do and you

00:39:11.259 --> 00:39:12.639
get the beautiful thing in a career is

00:39:12.659 --> 00:39:13.519
you can recycle that

00:39:13.900 --> 00:39:14.320
You know,

00:39:14.420 --> 00:39:16.101
I once loved doing that as a clinician.

00:39:16.161 --> 00:39:17.282
I love treating patients.

00:39:17.684 --> 00:39:19.304
Then I loved being a senior executive

00:39:19.344 --> 00:39:19.764
operator.

00:39:20.146 --> 00:39:21.646
Then I loved being a development leader.

00:39:22.208 --> 00:39:23.708
And now I love having a consulting

00:39:23.728 --> 00:39:24.068
company.

00:39:24.389 --> 00:39:26.210
It's hard, but that takes me back.

00:39:26.231 --> 00:39:26.331
Like,

00:39:26.351 --> 00:39:28.273
that's what gets me through the hard is

00:39:28.293 --> 00:39:29.253
that I actually love it.

00:39:29.333 --> 00:39:30.635
And I love the people I'm around.

00:39:30.996 --> 00:39:32.297
So I use that word a lot.

00:39:32.677 --> 00:39:33.898
And I think that's one of the most

00:39:33.938 --> 00:39:35.719
critical things is you're inspired by and

00:39:35.739 --> 00:39:36.260
you love.

00:39:36.340 --> 00:39:37.161
And if you have that,

00:39:37.460 --> 00:39:38.222
you can do anything.

00:39:38.943 --> 00:39:40.224
Are you familiar with the ICA guy?

00:39:42.572 --> 00:39:42.672
No.

00:39:42.873 --> 00:39:44.094
Once somebody explained this,

00:39:44.213 --> 00:39:45.394
you just explained it.

00:39:45.434 --> 00:39:46.255
You don't know it,

00:39:46.355 --> 00:39:48.315
but the Japanese put words to it.

00:39:48.376 --> 00:39:49.755
And I don't like, you know,

00:39:49.856 --> 00:39:50.777
and for the people listening,

00:39:50.797 --> 00:39:51.956
I don't really do slides a lot,

00:39:51.976 --> 00:39:54.277
but I keep this sort of one finger

00:39:54.318 --> 00:39:54.717
away.

00:39:55.219 --> 00:39:56.239
And that's the Aika guy.

00:39:56.778 --> 00:39:58.219
So like you need four things.

00:39:58.699 --> 00:39:59.440
You need to love it.

00:39:59.460 --> 00:40:01.260
You need to be good at it.

00:40:01.760 --> 00:40:02.681
You need to be able to get paid

00:40:02.722 --> 00:40:02.961
for it.

00:40:02.981 --> 00:40:04.202
That doesn't mean a million dollars,

00:40:04.242 --> 00:40:05.143
but like you have to be able to

00:40:06.550 --> 00:40:07.929
where that's like worth like balance it's

00:40:07.949 --> 00:40:09.331
like yes yes you need to be able

00:40:09.351 --> 00:40:11.931
to define what above water means to you

00:40:12.150 --> 00:40:13.751
and then be above it or more and

00:40:13.771 --> 00:40:15.552
then the world's got to need it and

00:40:15.592 --> 00:40:17.711
this is one of those examples and if

00:40:17.731 --> 00:40:19.193
you read a book about it they'll go

00:40:19.233 --> 00:40:20.813
into like well three out of four is

00:40:20.873 --> 00:40:23.733
bad but what it feels like you're saying

00:40:23.773 --> 00:40:26.733
is like you can find that the intersection

00:40:26.773 --> 00:40:28.335
of those four that's what aikigai is

00:40:28.414 --> 00:40:30.215
reason for being that's the japanese word

00:40:31.112 --> 00:40:32.614
You can find that in different ways.

00:40:32.733 --> 00:40:33.855
I ran a radio station.

00:40:33.974 --> 00:40:34.615
That was it.

00:40:34.896 --> 00:40:37.599
The only reason I left there was the

00:40:37.659 --> 00:40:39.661
world was changing with smartphones.

00:40:39.681 --> 00:40:40.101
And I was like,

00:40:40.661 --> 00:40:41.762
I'm not going to be able to do

00:40:41.802 --> 00:40:42.483
that here.

00:40:42.864 --> 00:40:44.525
I better go find it somewhere else.

00:40:45.007 --> 00:40:45.927
I changed it.

00:40:46.327 --> 00:40:47.088
Well, wouldn't you know it?

00:40:47.128 --> 00:40:49.291
I accidentally bought a microphone as a PT

00:40:49.311 --> 00:40:50.112
and figured that out.

00:40:50.132 --> 00:40:50.271
But...

00:40:51.447 --> 00:40:53.168
it can be different things and it should

00:40:53.188 --> 00:40:53.530
change.

00:40:53.570 --> 00:40:54.250
It sounds like, I mean,

00:40:54.331 --> 00:40:56.753
you found the middle of that equation

00:40:56.793 --> 00:40:58.614
several times with different roles.

00:40:59.175 --> 00:41:00.297
Success isn't a job.

00:41:00.376 --> 00:41:01.838
It's a combination of those four things.

00:41:03.516 --> 00:41:05.737
And I think that's the beauty of,

00:41:05.818 --> 00:41:06.038
you know,

00:41:06.077 --> 00:41:07.518
if you think about this and explore this,

00:41:07.539 --> 00:41:09.081
if I was talking to a twenty five

00:41:09.121 --> 00:41:09.681
year old therapist,

00:41:09.701 --> 00:41:11.583
come out of school and say, you know,

00:41:13.043 --> 00:41:15.025
be willing to sacrifice and don't expect

00:41:15.045 --> 00:41:16.427
the world to give it to you have

00:41:16.467 --> 00:41:18.088
to be willing to sacrifice.

00:41:18.148 --> 00:41:19.670
And not everything is about getting paid.

00:41:20.130 --> 00:41:21.592
A lot of the best experiences I had

00:41:21.632 --> 00:41:22.992
in my life where I was not paid

00:41:23.012 --> 00:41:24.153
for them, I learned.

00:41:24.574 --> 00:41:26.436
and you are trading the currency that you

00:41:26.456 --> 00:41:29.277
gain is information learning and

00:41:29.318 --> 00:41:31.840
development now i sacrificed a lot too and

00:41:32.000 --> 00:41:33.800
you know in my twenties when everyone was

00:41:33.820 --> 00:41:35.443
having fun and traveling and doing some of

00:41:35.463 --> 00:41:37.143
the cool stuff i wasn't i was working

00:41:37.164 --> 00:41:38.905
and you know i was grinding and trying

00:41:38.925 --> 00:41:41.588
to build a career and you know i

00:41:41.608 --> 00:41:43.829
that that was a trade-off i made uh

00:41:43.969 --> 00:41:46.010
i don't regret it whatsoever i'd rather

00:41:46.391 --> 00:41:47.771
you know do that on the back end

00:41:47.893 --> 00:41:48.233
when i'm

00:41:48.652 --> 00:41:50.114
you know i feel more comfortable and you

00:41:50.134 --> 00:41:51.635
know doing what i want to do but

00:41:51.655 --> 00:41:53.215
that was a deliberate sacrifice and a lot

00:41:53.255 --> 00:41:55.297
of it was i did things that did

00:41:55.336 --> 00:41:57.778
not pay me i went to training camp

00:41:57.798 --> 00:41:59.059
with the new york giants and stayed in

00:41:59.079 --> 00:42:01.300
the dorms for a week it sounds exciting

00:42:01.320 --> 00:42:03.282
but it really wasn't doing sixteen hour

00:42:03.302 --> 00:42:04.844
days i didn't get paid for that you

00:42:04.864 --> 00:42:05.884
know i did not get paid to go

00:42:06.003 --> 00:42:08.385
to hss i went to ten plus con

00:42:08.405 --> 00:42:10.086
ed courses per year for five years i

00:42:10.146 --> 00:42:12.588
didn't get paid for that i was making

00:42:12.869 --> 00:42:14.550
an investment in myself

00:42:14.969 --> 00:42:16.751
So I think I really,

00:42:17.132 --> 00:42:18.333
I would always encourage, you know,

00:42:18.434 --> 00:42:20.817
anybody who wants to be successful to make

00:42:20.836 --> 00:42:23.400
an investment in themselves and see it

00:42:23.420 --> 00:42:26.563
through and be willing to compromise a

00:42:26.583 --> 00:42:28.045
little bit for the long game.

00:42:29.106 --> 00:42:30.809
That to me is another huge part of

00:42:30.849 --> 00:42:32.891
success is being willing to sacrifice and

00:42:32.931 --> 00:42:34.192
go for the long game.

00:42:34.333 --> 00:42:34.492
Yeah.

00:42:35.117 --> 00:42:35.257
Well,

00:42:35.356 --> 00:42:38.749
I think it sounds like you would –

00:42:37.958 --> 00:42:38.759
if you were to give it – so

00:42:38.798 --> 00:42:39.920
I had this question written down.

00:42:39.960 --> 00:42:41.039
If you were going to give advice to

00:42:41.079 --> 00:42:42.840
a twenty-six-year-old who just graduated

00:42:42.860 --> 00:42:43.641
from PT school,

00:42:43.661 --> 00:42:47.384
it sounds like you started answering that.

00:42:47.403 --> 00:42:49.204
But it doesn't need to be the Giants.

00:42:50.224 --> 00:42:51.826
It's the Giants if you want it to

00:42:51.846 --> 00:42:52.346
be the Giants.

00:42:52.385 --> 00:42:54.246
But whatever your version of that is,

00:42:54.626 --> 00:42:55.788
quadruple down on that.

00:42:56.454 --> 00:42:57.914
It could be a youth soccer club,

00:42:57.954 --> 00:42:58.996
could be a hockey club,

00:42:59.036 --> 00:43:01.438
could be a assisted living center.

00:43:01.458 --> 00:43:02.418
You love working with seniors.

00:43:02.878 --> 00:43:05.141
You have a connection with older people

00:43:05.201 --> 00:43:05.981
and you want to help them.

00:43:06.101 --> 00:43:06.842
That's what you should do.

00:43:07.603 --> 00:43:08.764
It doesn't have to be glamorous.

00:43:08.784 --> 00:43:10.025
It doesn't have to be sexy.

00:43:10.065 --> 00:43:11.186
It doesn't have to be at the highest

00:43:11.246 --> 00:43:11.487
level.

00:43:12.507 --> 00:43:13.748
It's just got to be something you love

00:43:13.768 --> 00:43:14.188
and you're interested

00:43:14.248 --> 00:43:16.309
in doing you'll put your all to because

00:43:16.349 --> 00:43:17.690
it's personally rewarding to you and it

00:43:17.710 --> 00:43:19.371
doesn't even have to be in pt it

00:43:19.391 --> 00:43:22.632
can be in any tangential area where you

00:43:22.652 --> 00:43:25.811
can find that passion um i think burnout's

00:43:26.213 --> 00:43:29.434
number one driver of burnout is not being

00:43:29.554 --> 00:43:30.534
oriented around passion

00:43:30.974 --> 00:43:32.034
it's not being oriented around something

00:43:32.275 --> 00:43:33.916
it goes back to that illustration that you

00:43:33.936 --> 00:43:36.297
gave before the solution to burnout to me

00:43:36.317 --> 00:43:37.978
is to start talking very early on in

00:43:38.018 --> 00:43:40.239
careers and plotting around let's stay on

00:43:40.280 --> 00:43:41.900
track with what you truly love to do

00:43:41.920 --> 00:43:44.302
and what you're inspired by and let's also

00:43:44.342 --> 00:43:46.202
look at this in a it's not in

00:43:46.222 --> 00:43:47.583
a vacuum and understand that's going to

00:43:47.603 --> 00:43:50.626
evolve and being willing to allow that to

00:43:50.666 --> 00:43:52.806
evolve and to work with people to help

00:43:52.847 --> 00:43:54.588
to create pathways for them and on your

00:43:54.708 --> 00:43:56.730
own to create your own pathways as that

00:43:56.809 --> 00:43:58.210
does evolve and not be ashamed of the

00:43:58.231 --> 00:43:58.630
evolution

00:43:59.150 --> 00:44:01.132
i went into you know another space for

00:44:01.152 --> 00:44:02.813
a little while i was excited you know

00:44:02.893 --> 00:44:04.614
oral surgery space was excited to do it

00:44:04.635 --> 00:44:06.996
i i left it because of culture it

00:44:07.016 --> 00:44:08.637
wasn't a good fit for me and that's

00:44:08.657 --> 00:44:10.237
what prompted my starting my consulting

00:44:10.257 --> 00:44:14.081
firm you know it it's those experiences

00:44:14.240 --> 00:44:16.442
are what allow you to go to the

00:44:16.461 --> 00:44:19.244
next step so you know do them and

00:44:19.304 --> 00:44:20.704
do them with inspiration and i think you

00:44:20.724 --> 00:44:21.545
can have a great pathway

00:44:22.096 --> 00:44:22.376
Agreed.

00:44:22.755 --> 00:44:25.038
So talk just like a little bit about

00:44:25.737 --> 00:44:27.239
who your firm helps.

00:44:27.259 --> 00:44:29.039
Like what do you get to do now

00:44:29.059 --> 00:44:30.021
and who do you get to do it

00:44:30.061 --> 00:44:30.300
with?

00:44:31.041 --> 00:44:31.300
Yeah.

00:44:31.340 --> 00:44:34.003
So my firm's Equus Growth Advisors.

00:44:34.242 --> 00:44:36.443
And the reason it's named Equus is that's

00:44:36.623 --> 00:44:37.625
Latin for horse.

00:44:37.724 --> 00:44:39.346
And one thing I share about myself,

00:44:39.385 --> 00:44:39.925
my daughter,

00:44:40.025 --> 00:44:40.967
that's the reason I'm in Florida.

00:44:40.987 --> 00:44:43.467
My daughter is a competitive equestrian.

00:44:43.889 --> 00:44:46.550
So I spend a great deal of my

00:44:46.630 --> 00:44:48.210
time and life around horses and

00:44:49.291 --> 00:44:51.454
And I thought as I started my company,

00:44:51.514 --> 00:44:52.755
I'd name it as a tribute to my

00:44:52.795 --> 00:44:54.217
kid because of the work she puts in.

00:44:54.237 --> 00:44:56.699
I thought it was a cool just family

00:44:56.719 --> 00:44:57.219
thing to do.

00:44:57.559 --> 00:45:02.844
So I fashioned my work as a

00:45:03.324 --> 00:45:04.606
strategy-oriented,

00:45:04.967 --> 00:45:08.050
growth-focused strategic advisory firm.

00:45:08.750 --> 00:45:09.670
across all of healthcare.

00:45:09.851 --> 00:45:14.094
And my focus personally is on really

00:45:14.835 --> 00:45:15.335
analyzing,

00:45:15.375 --> 00:45:17.317
assessing businesses and creating

00:45:17.356 --> 00:45:20.938
strategic solutions for them to navigate

00:45:20.978 --> 00:45:21.739
the challenges they have.

00:45:21.780 --> 00:45:21.920
Now,

00:45:22.000 --> 00:45:23.561
largely the challenges that I get most

00:45:23.601 --> 00:45:24.282
excited about

00:45:24.702 --> 00:45:26.282
And I try to work towards our growth

00:45:26.342 --> 00:45:26.742
oriented.

00:45:26.782 --> 00:45:29.443
I've always viewed the world in our

00:45:30.684 --> 00:45:31.485
physical therapy business,

00:45:31.545 --> 00:45:33.485
all healthcare business as a revenue game.

00:45:34.065 --> 00:45:35.505
And I think that's also part of that

00:45:36.146 --> 00:45:38.568
kind of aspirational view or the positive

00:45:38.608 --> 00:45:40.128
view that you can look two choices.

00:45:40.148 --> 00:45:41.088
You can go to the middle of the

00:45:41.108 --> 00:45:42.128
P&L or the top of the P&L.

00:45:42.289 --> 00:45:43.248
I believe in going to the top of

00:45:43.268 --> 00:45:43.670
the P&L.

00:45:43.710 --> 00:45:44.309
That's fun.

00:45:44.670 --> 00:45:45.409
This isn't fun.

00:45:45.449 --> 00:45:47.291
I've never enjoyed managing the middle of

00:45:47.351 --> 00:45:47.811
a P&L.

00:45:47.831 --> 00:45:49.092
That means you have to cut costs and

00:45:49.112 --> 00:45:49.672
that's never fun.

00:45:50.052 --> 00:45:52.313
an enjoyable experience at least for me um

00:45:52.432 --> 00:45:54.253
so i really focus on the top of

00:45:54.273 --> 00:45:57.375
the p l of helping companies build a

00:45:57.394 --> 00:46:00.456
strategic pathway to achieve their growth

00:46:00.496 --> 00:46:03.217
goals i slot in a lot of times

00:46:03.318 --> 00:46:05.798
as a fractional chief strategy officer

00:46:06.179 --> 00:46:08.860
chief revenue officer and bring my

00:46:08.920 --> 00:46:11.121
experience it's not just me it's really

00:46:11.141 --> 00:46:13.181
important we share that equus has you know

00:46:13.202 --> 00:46:13.561
fifteen

00:46:13.981 --> 00:46:16.485
plus advisors and we've got a number of

00:46:16.505 --> 00:46:16.985
clients.

00:46:17.045 --> 00:46:18.987
It's not a PT oriented firm,

00:46:19.027 --> 00:46:20.009
it's a healthcare firm.

00:46:21.050 --> 00:46:22.592
We also have an M&A side of our

00:46:22.632 --> 00:46:25.554
business where I merged in October with an

00:46:25.655 --> 00:46:27.657
M&A advisory firm and they do buy and

00:46:27.697 --> 00:46:28.518
sell side work

00:46:29.179 --> 00:46:30.842
across all of healthcare so we can do

00:46:31.583 --> 00:46:34.045
the M&A work for or with a company.

00:46:34.847 --> 00:46:36.829
If targets you want to go after,

00:46:36.869 --> 00:46:37.831
we do the buy side work.

00:46:37.851 --> 00:46:38.711
If you want to sell your company,

00:46:38.731 --> 00:46:40.695
we do the sell side work and everything

00:46:40.735 --> 00:46:41.255
in between.

00:46:41.896 --> 00:46:45.181
I try to build this as like a

00:46:45.280 --> 00:46:45.561
wheel.

00:46:46.021 --> 00:46:47.782
where we've got all the different elements

00:46:48.063 --> 00:46:50.664
of impact across healthcare from patient

00:46:50.684 --> 00:46:53.284
experience revenue cycle therapeutic

00:46:53.304 --> 00:46:55.365
monitoring which is not again for just pt

00:46:55.405 --> 00:46:58.007
it's across all of healthcare professional

00:46:58.027 --> 00:47:00.028
development sales marketing talent

00:47:00.068 --> 00:47:02.050
acquisition and i also work with a lot

00:47:02.090 --> 00:47:04.050
of outside groups to help support needs

00:47:04.110 --> 00:47:06.170
like data and health informatics will go

00:47:06.251 --> 00:47:09.052
and build those systems for clients um so

00:47:09.092 --> 00:47:11.914
it's a it's a broad but hyper focused

00:47:11.974 --> 00:47:13.675
on strategic revenue growth and x

00:47:15.755 --> 00:47:17.498
but not targeting goals.

00:47:18.420 --> 00:47:20.302
So they get to hire your brain and

00:47:20.342 --> 00:47:21.965
show you what they're either doing too

00:47:22.005 --> 00:47:23.447
much of or not enough of so they

00:47:23.467 --> 00:47:25.070
can continue to do the thing that most

00:47:25.090 --> 00:47:25.851
people want to be doing.

00:47:26.556 --> 00:47:26.835
Yeah,

00:47:26.916 --> 00:47:28.817
and that's I think that's a really good

00:47:28.856 --> 00:47:29.476
way to put it there.

00:47:29.577 --> 00:47:30.518
They're hiring my brain,

00:47:30.557 --> 00:47:33.559
my experience and the team around me that

00:47:33.599 --> 00:47:34.239
collectively,

00:47:34.280 --> 00:47:35.360
if you just think about us from a

00:47:35.420 --> 00:47:36.621
musculoskeletal standpoint,

00:47:36.641 --> 00:47:38.961
we've got two hundred and twenty five plus

00:47:39.001 --> 00:47:41.123
years of experience around the table in

00:47:41.182 --> 00:47:42.264
musculoskeletal care.

00:47:43.043 --> 00:47:44.545
And it also points towards the things I

00:47:44.605 --> 00:47:45.784
really am excited about,

00:47:45.804 --> 00:47:47.186
which are longer horizon.

00:47:48.106 --> 00:47:49.686
opportunities in musculoskeletal care

00:47:49.706 --> 00:47:51.387
beyond traditional PT.

00:47:51.527 --> 00:47:52.807
I love value-based care.

00:47:52.947 --> 00:47:55.469
I love the evolution of hybrid-based

00:47:55.489 --> 00:47:58.550
models and being nimble and thoughtful

00:47:58.590 --> 00:47:59.731
about how to get to the patient.

00:48:00.452 --> 00:48:03.373
I love supporting evolution and innovation

00:48:03.512 --> 00:48:04.213
in healthcare.

00:48:04.233 --> 00:48:08.414
I'm a big proponent of going to meet

00:48:08.434 --> 00:48:10.436
the patient where they need to be met,

00:48:10.456 --> 00:48:11.657
which is where they want to be met.

00:48:12.237 --> 00:48:13.838
whether that's at home, in clinic,

00:48:14.039 --> 00:48:16.260
virtually, any of those different areas.

00:48:16.782 --> 00:48:21.425
And I'm such a true believer in PT

00:48:21.465 --> 00:48:23.568
from the standpoint of bending the

00:48:23.628 --> 00:48:26.030
musculoskeletal cost curve and the impact

00:48:26.050 --> 00:48:28.592
it has on the overall expenses in

00:48:28.612 --> 00:48:29.634
healthcare around the world.

00:48:29.673 --> 00:48:30.255
I mean, we're talking

00:48:30.775 --> 00:48:31.054
Forty,

00:48:31.074 --> 00:48:32.735
fifty percent of healthcare spend is on

00:48:32.795 --> 00:48:34.016
musculoskeletal.

00:48:34.115 --> 00:48:35.456
Physical therapy is just so

00:48:35.516 --> 00:48:37.876
disproportionately underrepresented in

00:48:37.896 --> 00:48:38.476
that equation.

00:48:38.516 --> 00:48:38.697
I mean,

00:48:38.757 --> 00:48:40.757
ten percent of patients who need it access

00:48:40.797 --> 00:48:41.936
it and eighty percent of them don't

00:48:41.956 --> 00:48:43.577
complete a course of care.

00:48:43.597 --> 00:48:44.097
I mean,

00:48:44.117 --> 00:48:46.818
the opportunity is so profound that I

00:48:46.838 --> 00:48:48.918
can't find any way to be negative about

00:48:48.978 --> 00:48:50.998
what's in front of us in the PT

00:48:51.039 --> 00:48:53.039
space because we sit at the,

00:48:53.519 --> 00:48:56.300
literally sit at the dining table of this

00:48:56.619 --> 00:48:58.740
massive opportunity to reduce cost of

00:48:58.760 --> 00:49:00.141
care, improve access,

00:49:00.561 --> 00:49:01.581
improve outcomes,

00:49:02.101 --> 00:49:03.541
work across the entire healthcare

00:49:03.561 --> 00:49:04.161
continuum,

00:49:04.202 --> 00:49:06.463
threading through a number of different

00:49:06.523 --> 00:49:10.704
areas that will impact patients and cost

00:49:10.784 --> 00:49:13.445
and outcomes that I'm really bullish on

00:49:13.465 --> 00:49:14.224
the future of PT.

00:49:14.284 --> 00:49:16.246
I guess sometimes I'm a loud voice in

00:49:16.266 --> 00:49:17.065
the room saying that,

00:49:17.106 --> 00:49:18.427
but I don't think I ever won't be.

00:49:18.907 --> 00:49:19.586
I think patients

00:49:20.197 --> 00:49:21.038
love what we do,

00:49:21.438 --> 00:49:22.500
we just need to get to more of

00:49:22.519 --> 00:49:22.641
them.

00:49:23.302 --> 00:49:25.043
And I think physical therapists are

00:49:25.083 --> 00:49:28.329
amazing at taking care of patients,

00:49:28.349 --> 00:49:29.670
but also they're amazing thinkers.

00:49:31.152 --> 00:49:33.235
I think it's important that I share that

00:49:33.356 --> 00:49:34.516
at Equus with my team,

00:49:34.978 --> 00:49:36.380
so many of the people I work with

00:49:36.460 --> 00:49:37.041
are PTs.

00:49:37.360 --> 00:49:39.061
and i didn't hire them to be pt

00:49:39.081 --> 00:49:40.864
consultants i hired them to be healthcare

00:49:40.884 --> 00:49:44.527
consultants pts are amazing at breaking

00:49:44.586 --> 00:49:47.268
down findings into you know thoughtful

00:49:47.349 --> 00:49:48.891
algorithms and then planning care and then

00:49:48.931 --> 00:49:51.592
going in and effectuating change it's no

00:49:51.652 --> 00:49:53.134
different than what we do with a patient

00:49:53.454 --> 00:49:55.056
it's just doing it with a business

00:49:55.456 --> 00:49:57.797
equation and i found that physical

00:49:57.818 --> 00:49:59.239
therapists are awesome at that so one of

00:49:59.259 --> 00:50:01.240
the messages i would leave to pts is

00:50:02.367 --> 00:50:03.867
understand and leverage that skill set.

00:50:04.349 --> 00:50:06.190
There's so many applications beyond

00:50:06.250 --> 00:50:09.251
treating patients that the way we think,

00:50:09.313 --> 00:50:11.673
the codification of thinking through a

00:50:11.713 --> 00:50:14.356
critical pathway of, okay,

00:50:14.396 --> 00:50:15.717
patient presents to me like this,

00:50:16.237 --> 00:50:17.719
I see this, I'm going to treat this,

00:50:18.159 --> 00:50:21.141
that applies itself so well outside of

00:50:21.322 --> 00:50:23.403
traditional patient care in consulting and

00:50:23.463 --> 00:50:26.246
business operations and all these

00:50:26.266 --> 00:50:26.826
different areas.

00:50:26.885 --> 00:50:27.447
It's really...

00:50:28.027 --> 00:50:29.728
an amazing skill set to leverage and i

00:50:29.748 --> 00:50:31.208
think therapists really need to pull that

00:50:31.268 --> 00:50:33.170
inward and say i've got us i've got

00:50:33.190 --> 00:50:34.992
a skill set i've got a tool that

00:50:35.032 --> 00:50:37.693
can be wielded so many different forms

00:50:38.074 --> 00:50:39.574
it's it's a great skill set to tap

00:50:39.635 --> 00:50:42.197
into all right well we have a tradition

00:50:42.217 --> 00:50:44.237
on the show we always do something called

00:50:44.277 --> 00:50:48.360
the parting shot this is the parting shot

00:50:48.920 --> 00:50:52.503
one last mic drop moment no pressure just

00:50:53.023 --> 00:50:54.344
your legacy on the line

00:50:55.588 --> 00:50:57.050
I mean, you kind of just gave one.

00:50:57.489 --> 00:50:58.710
You kind of just gave one.

00:50:58.809 --> 00:51:00.150
I mean, you've given several,

00:51:00.190 --> 00:51:02.072
but you can reiterate one.

00:51:02.112 --> 00:51:02.851
You can reuse.

00:51:02.891 --> 00:51:04.452
But what would your parting shot around

00:51:04.472 --> 00:51:06.614
the topics we talked today be?

00:51:06.773 --> 00:51:07.894
I'd say my parting shot,

00:51:07.954 --> 00:51:11.416
my mic drop is embrace what you love.

00:51:12.456 --> 00:51:14.717
Build your career around what inspires

00:51:14.737 --> 00:51:14.818
you.

00:51:15.992 --> 00:51:18.534
continually test that at all points of

00:51:18.554 --> 00:51:21.496
your career don't look for people around

00:51:21.536 --> 00:51:23.539
you to give you the solutions find them

00:51:23.559 --> 00:51:26.221
within yourself and it starts with such a

00:51:26.280 --> 00:51:29.083
simple equation what inspires me and when

00:51:29.103 --> 00:51:31.344
you start to find like that you get

00:51:31.405 --> 00:51:33.226
lost in that like i you know i'm

00:51:33.445 --> 00:51:35.246
burnt it's just burnout is the equation

00:51:35.327 --> 00:51:36.768
why burn burnout is

00:51:37.469 --> 00:51:40.672
built off of you know lack of appreciation

00:51:40.731 --> 00:51:41.733
lack of pull through there's all those

00:51:41.753 --> 00:51:43.454
different toggling variables of burnout

00:51:43.894 --> 00:51:45.655
but the center point to me around

00:51:45.896 --> 00:51:48.458
navigating burnout and frustration and

00:51:48.498 --> 00:51:50.340
challenges going right back to that place

00:51:50.460 --> 00:51:52.641
of what do I love doing what inspires

00:51:52.681 --> 00:51:55.123
me what do I define as success for

00:51:55.164 --> 00:51:58.387
myself personally and not be pulled into

00:51:58.887 --> 00:52:01.108
other people's definition of success don't

00:52:01.148 --> 00:52:02.690
worry about what someone else says it's

00:52:02.731 --> 00:52:03.110
exactly

00:52:03.413 --> 00:52:05.074
who cares what I think about what success

00:52:05.135 --> 00:52:05.215
is.

00:52:05.255 --> 00:52:07.038
My pathway is not your pathway.

00:52:07.057 --> 00:52:08.159
It's not someone else's pathway,

00:52:08.719 --> 00:52:11.603
but we can all do incredible things if

00:52:11.644 --> 00:52:12.224
we believe in them.

00:52:12.746 --> 00:52:14.168
And the last parting shot I would give

00:52:14.248 --> 00:52:15.650
is believe in the future of physical

00:52:15.670 --> 00:52:16.030
therapy.

00:52:16.831 --> 00:52:18.213
The narrative that's out there that,

00:52:18.273 --> 00:52:18.894
you know, this is a,

00:52:19.414 --> 00:52:20.576
you know, challenge space.

00:52:20.615 --> 00:52:21.396
Yeah, there's challenges.

00:52:21.436 --> 00:52:23.298
I mean, reimbursement goes down,

00:52:23.338 --> 00:52:23.878
costs go up.

00:52:23.898 --> 00:52:25.159
There's a, you know,

00:52:25.199 --> 00:52:26.681
we're in an evolving state all the time,

00:52:26.702 --> 00:52:28.302
but at the foundational core,

00:52:28.724 --> 00:52:31.146
physical therapy is such a critical part

00:52:31.246 --> 00:52:33.947
of the healthcare continuum.

00:52:33.987 --> 00:52:35.250
And we lose track of that, that,

00:52:35.610 --> 00:52:35.829
you know,

00:52:35.929 --> 00:52:38.112
the opportunity in front of us to build

00:52:38.251 --> 00:52:39.012
a profession and

00:52:39.536 --> 00:52:43.300
that is highly valued by providers,

00:52:43.400 --> 00:52:44.681
payers, you name them,

00:52:45.242 --> 00:52:46.324
is right in our hands.

00:52:46.704 --> 00:52:48.085
We just have to come together as an

00:52:48.146 --> 00:52:49.407
industry, in my view,

00:52:49.867 --> 00:52:52.369
and be positive and look at the outlet

00:52:52.590 --> 00:52:54.112
of it's not, you know,

00:52:54.132 --> 00:52:55.673
CMS isn't doing something, you know,

00:52:55.693 --> 00:52:57.235
to punish us or, you know, we're not,

00:52:57.255 --> 00:52:59.016
our reimbursement rates aren't going down

00:52:59.056 --> 00:53:00.318
because we're devalued.

00:53:00.358 --> 00:53:01.780
We've got to fight against that and

00:53:01.800 --> 00:53:04.121
impress and show the value and never quit

00:53:04.442 --> 00:53:06.043
because if you believe in something it's

00:53:06.103 --> 00:53:08.344
worth the effort and I hope that everybody

00:53:08.365 --> 00:53:10.126
who spends seven years and you know a

00:53:10.166 --> 00:53:11.668
hundred thousand dollars plus to become a

00:53:11.708 --> 00:53:14.070
PT believes in it otherwise why'd you do

00:53:14.150 --> 00:53:16.773
it but tap into that belief um and

00:53:16.873 --> 00:53:19.074
use that belief to carry us forward into

00:53:19.094 --> 00:53:20.615
this next generation which I think is

00:53:21.320 --> 00:53:22.661
I'm really excited about.

00:53:22.740 --> 00:53:24.101
I think the future of PT is bright.

00:53:24.702 --> 00:53:27.485
I think the future of musculoskeletal care

00:53:27.804 --> 00:53:29.425
is massively important,

00:53:29.925 --> 00:53:32.088
and we should be the centerpiece of that

00:53:32.148 --> 00:53:33.588
as a profession, and I love it.

00:53:33.688 --> 00:53:34.530
I can't wait to be a part of

00:53:34.550 --> 00:53:34.650
it.

00:53:35.710 --> 00:53:36.990
I'm ready to run through a brick wall

00:53:37.030 --> 00:53:37.411
here, Jeremy.

00:53:37.431 --> 00:53:38.733
You got me jacked up here at,

00:53:38.793 --> 00:53:40.594
you know, eleven o'clock in the morning.

00:53:40.614 --> 00:53:41.034
I like that.

00:53:41.134 --> 00:53:42.074
I'll jump in the snow.

00:53:42.454 --> 00:53:44.036
Let's go jump in the snow in upstate

00:53:44.056 --> 00:53:44.217
New York.

00:53:44.237 --> 00:53:45.597
I'll show you one of my palm trees

00:53:45.617 --> 00:53:47.179
while you're jumping in the snow.

00:53:48.422 --> 00:53:51.047
I'll put the link for Equus and for

00:53:51.088 --> 00:53:52.471
you on LinkedIn as well in the show

00:53:52.510 --> 00:53:52.731
notes.

00:53:52.791 --> 00:53:54.956
But appreciate this, man.

00:53:55.237 --> 00:53:56.458
And we'll have you back on the show

00:53:56.498 --> 00:53:56.780
pretty soon.

00:53:56.800 --> 00:53:57.862
Great.

00:53:57.922 --> 00:53:58.362
Thanks so much.

00:53:58.382 --> 00:53:58.822
I appreciate it.

00:54:00.952 --> 00:54:02.034
That's it for this one,

00:54:02.293 --> 00:54:03.974
but we're just getting warmed up.

00:54:04.436 --> 00:54:06.356
Smash follow, send it to a friend,

00:54:06.577 --> 00:54:08.217
or crank up the next episode.

00:54:08.759 --> 00:54:09.679
Want to go deeper?

00:54:09.920 --> 00:54:12.262
Hit us at pgpinecast.com.

00:54:13.521 --> 00:54:15.503
Or find us on YouTube and socials at

00:54:15.523 --> 00:54:16.744
pgpinecast.

00:54:17.164 --> 00:54:19.447
And legally, none of this was advice.

00:54:19.527 --> 00:54:21.248
It's for entertainment purposes only.

00:54:21.307 --> 00:54:21.849
Bullshit!

00:54:22.929 --> 00:54:23.530
See, Keith?

00:54:23.730 --> 00:54:24.791
We read the script.

00:54:25.090 --> 00:54:25.731
Happy now?