PTs Aren’t Movement Experts… Yet

WEBVTT

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You're listening to the PT Pinecast,

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where smart people in healthcare come to

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make noise.

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Here's your host, Jimmy McKay.

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Big thanks to Empower EMR.

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If your clinic is stuck in an EMR

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that slows you down,

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Empower gives you speed, clean workflows,

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and features PTs actually asked for.

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Better notes, faster documentation,

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smoother operations,

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all wrapped up in customer support that

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doesn't ghost you because let's face it,

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Something's going to go wrong.

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Nothing's perfect.

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You just want to make sure you're going

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to get help.

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Upgrade your clinic's brain with Empower

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EMR.

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And again, we've said this before,

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transferring over, changing an EMR,

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it's a big deal.

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Kick the tires, see what they have.

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They make transferring easier.

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EmpowerEMR.com.

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Now, most of healthcare runs on numbers.

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Think about it.

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Blood work, numbers, imaging,

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measurements, cardiology,

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data down to the millisecond.

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But when it comes to movement,

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the thing we claim is our domain,

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we still say things like, looks better,

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improving, tolerance increased.

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Today's guest believes it's not good

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enough.

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He runs a referral-based clinical

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biomechanics lab in Vegas that turns

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walking, balance,

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and strength into objective numbers,

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the kind that make clinical skill

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invisible outside the treatment room.

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He says PTs aren't movement experts,

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not yet.

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He's building what he calls the quest

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diagnostics of human movement.

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Our guest today, Chana Wong.

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Chana, welcome to the show.

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We've talked about you before,

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but now you're here.

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Well, thank you for the great intro.

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I really appreciate it.

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I'm

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Happy to be here talking to the one

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and only Jimmy McKay,

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the voice of physical therapy.

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Well, it sure shouldn't be the face,

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but let's dig in.

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I love bold statements.

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And you are a physical therapist.

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I want to make sure the audience

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understands.

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Yes, I am.

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I am a physical therapist.

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This is why you can take shots because

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when you are one of us,

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you can say things, which is good.

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So I love bold statements,

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and I'm going to give you a chance

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to sort of explain what that means.

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You say PTs aren't movement experts yet.

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I love bold statements.

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What do you mean by that?

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Well, to be honest with you,

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we are trained in movements.

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But to be an expert,

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I think the bare minimum requirement is to

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be able to objectively measure, validate,

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and demonstrate movement.

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Oftentimes in clinics,

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physical therapists depend on

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observational data, inferred data,

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or non-standardized data.

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And what I want to push for

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or advocate for is that instead of relying

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on those data,

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we should actually standardize how

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movement is tested so that we use

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standardized data.

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So it sounds like that's a bold statement,

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but what you are and aren't saying,

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you're not saying the problem isn't lack

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of skill, it's lack of objective proof,

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sort of what I said in the intro.

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Infrastructure in physical therapy that,

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you know, clinics are busy.

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Standardizing data is hard.

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That's why it's important to create a

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structure where we can measure movement

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reliably and consistently all the time.

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Okay,

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so we'll get into the model in a

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second, but I like to spoil it.

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Let's get to the end first.

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What actually changes in a clinic when

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movement becomes measured objectively,

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when that becomes easier and simpler and

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more repeatably?

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Yeah, so one of the,

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when I first started Muvik Health,

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I guess that's best way to describe it.

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I spoke with a lot of physical therapists,

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spoke with a lot of medical doctors,

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spoke with a lot of patients and also

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the payers too.

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And the feedback was very unanimous.

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In healthcare,

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credibility and authority is actually

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linked to standard.

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Right now,

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physical therapists are doctorate degree

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professionals that practice without having

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standardized diagnostic infrastructure.

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So when I spoke with physical therapists,

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a lot of them were telling me that

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they were acting like a salesperson.

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In some ways, it's good.

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Some ways,

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it's not what we went to school for.

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We went to school to be the doctors

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of physical therapy.

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So they have to sell to the patients

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that they have to come back for the

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next visit,

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why they need to be in physical therapy

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and how physical therapy helps.

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Professions that use standardized data,

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whether it be outside of health care like

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pilots,

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pilots, forensic scientists, engineers,

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you never question them.

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You get that automatic buy-in that you

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trust them, right?

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So when you flew out to Anaheim past

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weekend,

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you probably never questioned the pilot.

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you just know that they're going to do

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the right thing.

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Same thing with the doctors,

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medical doctors, podiatrists,

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optometrists, dentists,

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they all use standardized data and you

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sort of

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patients or the consumers get automatic

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buy-in that they trust what they're doing.

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In physical therapy,

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it's a little bit different.

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Right now,

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there's about seventy percent of patients

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self-discharge because there's that big

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clarity gap that we don't really address.

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in physical therapy.

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So patients can't see the move,

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can't see the problem or progress

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objectively.

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So they default to,

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I feel better as a finish line.

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So that results in physical therapists

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getting pushed into earning the buy-in

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from the patients.

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So when we start using standardized data,

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it creates a familiar process for the

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patients and it creates,

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it fundamentally changes physical therapy

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from solution led profession to the

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diagnostic first profession.

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And when you do that,

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we have three things that change.

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Patients see their deficits,

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black and white, in detail, using numbers.

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Physical therapists can

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stop pitching and start meeting with

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clinical authority and payers actually

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will see objective data that they need to

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reward rather than just counting visits.

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So it sounds like some things I don't

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want to infer,

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but completion rates and patient buy-in,

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those two things are pretty tight,

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well tied together.

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That might increase.

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Yeah.

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Referrals.

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could also you could infer that it would

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increase documentation.

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Clarity is something that could increase.

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And then you mentioned reduced

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defensiveness with payers because you're

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able to.

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Of course, you know,

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I'm glad you mentioned that because our

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co-founder Akash Patel is also a physical

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therapist.

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He's a he's like a brother to me.

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He's the type of person.

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regardless of any field he went into,

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he would have succeeded.

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Like he could have been,

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if he went into medical field,

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he would have been the best doctor in

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the United States.

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If he went into engineering,

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he would have been the best engineer in

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the United States.

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Uh,

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but I'm glad I'm so happy he chose

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physical therapy, but, um,

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he actually worked with, uh,

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he actually partnered with the clinic

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where he reviewed.

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He partnered with the clinic,

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only made one change to the clinic.

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He reviewed the movement reports with the

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patients the same way the physicians

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review their lab report.

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No new exercises,

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just objective data and clear

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interpretation.

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Within one year,

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the plan of care completion rate for that

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clinic rose from fifty one percent to

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sixty eight percent.

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So, yeah.

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I mean, we know this, right?

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I got a Peloton downstairs.

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And when I can track my progress and

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I can see how things are improving,

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I can look how often I'm doing that.

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When they give me those stupid little

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badges,

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I fall for it every time because we

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want to earn the digital cred.

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But it's a feedback loop, right?

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And now we're able to see that.

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So we've dug into this conversation before

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because we spoke without recording.

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Now that we've gotten the attention of the

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person listening,

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now I want you to walk them through

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the business model of what Movique is

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doing now.

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In the intro I said,

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you started calling yourself

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like the quest diagnostics of human

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movement.

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So if pretend for a second that I

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don't know the model,

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I want you to walk people through,

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not theoretically,

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because you are doing this right now.

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This is not theoretical.

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This is practical.

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So walk people through this,

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walk PTs through what Movique is doing,

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and then we'll talk future state of what

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you're hoping to do.

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OK, yes.

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So we're a clinical biomechanics lab.

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We're not a physical therapy clinic.

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We partner with physical therapy clinics.

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We also partner with medical clinics as

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well in orthopedics, neurology,

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and podiatry.

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So when you identify somebody with

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movement deficits,

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you can refer your patient out to our

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clinic.

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It's as easy as filling out a form

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on our online dashboard.

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And just like Quest Diagnostics,

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we coordinate scheduling and we coordinate

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testing with the patient.

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They come in,

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they get tested using a motion capture,

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force plate, and balance plate.

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Once we get all the data,

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we input it into our dashboard.

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And on your end,

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on the physical therapist's end,

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you can open up that report.

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And you can see different metrics based on

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their gait, running, jumping,

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functional skills on fourth plate,

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and balance plates,

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such as limits of stability,

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weight distribution, et cetera.

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And you can use that report.

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You can speak with the clients.

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Here's the report.

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Each report contains the results.

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the clinical interpretation,

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what that metric means, and the reference,

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and whether it's within reference or out

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of reference.

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So that's like the blood test.

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Yeah.

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Right.

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So you're set up in Vegas and your

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model is,

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and I'm going to say it and you

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correct me where I'm wrong.

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I'll give it a good first draft.

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You're set up in Vegas and your goal

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is to be that blood testing lab.

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Listen,

00:11:39.331 --> 00:11:41.832
if you're a PT clinic for sports or

00:11:41.893 --> 00:11:42.933
outpatient orthopedics,

00:11:43.653 --> 00:11:44.573
it's going to cost you a lot of

00:11:44.594 --> 00:11:46.274
money to do these things and training in

00:11:46.335 --> 00:11:46.615
time.

00:11:47.495 --> 00:11:48.436
So why not?

00:11:49.096 --> 00:11:51.037
It takes space too.

00:11:51.057 --> 00:11:51.236
Sorry.

00:11:51.297 --> 00:11:51.716
Good point.

00:11:51.876 --> 00:11:52.537
Yeah.

00:11:52.557 --> 00:11:54.317
And which is a premium too in a

00:11:54.357 --> 00:11:56.078
larger metro.

00:11:56.119 --> 00:11:59.240
So why not utilize us because we've got

00:11:59.279 --> 00:12:01.640
equipment, space, and staff.

00:12:02.061 --> 00:12:02.260
Mm-hmm.

00:12:04.044 --> 00:12:08.288
You send us a patient pre-eval, post-eval?

00:12:08.347 --> 00:12:09.970
Mostly post-eval.

00:12:10.190 --> 00:12:12.030
I would love to get to pre-eval someday

00:12:12.051 --> 00:12:14.633
so that it's more like, yeah.

00:12:14.653 --> 00:12:15.594
And you send them to,

00:12:16.154 --> 00:12:18.416
they send them to MoVic and then you

00:12:18.456 --> 00:12:21.097
run them through whatever battery of tests

00:12:21.719 --> 00:12:23.841
that you have that the PT feels

00:12:23.880 --> 00:12:24.500
appropriate.

00:12:25.162 --> 00:12:27.243
And then the report goes to the PT.

00:12:27.683 --> 00:12:28.364
Now they're able to,

00:12:28.384 --> 00:12:29.825
the next time they see that patient in

00:12:29.924 --> 00:12:31.486
their clinic, because you're not a clinic,

00:12:31.506 --> 00:12:31.947
you said that.

00:12:32.346 --> 00:12:32.967
We're not a clinic.

00:12:33.533 --> 00:12:34.815
As soon as when they see them in

00:12:34.855 --> 00:12:35.556
their clinic,

00:12:35.676 --> 00:12:38.719
they are now able to have that blood

00:12:38.739 --> 00:12:41.903
panel results in front of them to help

00:12:41.962 --> 00:12:43.085
guide them.

00:12:43.105 --> 00:12:43.424
Yes.

00:12:44.245 --> 00:12:44.927
What did I miss?

00:12:45.047 --> 00:12:45.388
Anything?

00:12:45.947 --> 00:12:46.908
You haven't missed anything.

00:12:46.928 --> 00:12:47.971
That's exactly it.

00:12:48.375 --> 00:12:49.277
Well, you've told me this before,

00:12:49.297 --> 00:12:50.298
so I'm cheating, which is good.

00:12:50.317 --> 00:12:50.557
Okay.

00:12:50.577 --> 00:12:54.140
I don't think that's cheating.

00:12:54.240 --> 00:12:54.921
And then do your homework.

00:12:54.941 --> 00:12:55.442
That's not cheating.

00:12:56.663 --> 00:12:56.923
Okay.

00:12:57.222 --> 00:12:59.985
And then this is done on an annual

00:13:00.024 --> 00:13:01.767
retainer basis right now.

00:13:01.787 --> 00:13:01.907
Yes.

00:13:02.326 --> 00:13:04.067
So we partner with the clinics on an

00:13:04.148 --> 00:13:05.048
annual contract.

00:13:05.909 --> 00:13:07.610
Got it.

00:13:07.630 --> 00:13:08.111
Understood.

00:13:08.572 --> 00:13:10.072
Yeah.

00:13:10.113 --> 00:13:10.373
Well,

00:13:10.734 --> 00:13:13.054
the clinics can travel us out through the

00:13:13.096 --> 00:13:13.875
pilot program, too.

00:13:15.722 --> 00:13:17.543
So it's, there's a low cost effect,

00:13:18.464 --> 00:13:20.125
low cost way to trial moving cows.

00:13:20.144 --> 00:13:20.225
Yeah.

00:13:20.245 --> 00:13:25.788
To see where the right fit.

00:13:25.807 --> 00:13:26.067
Good.

00:13:26.307 --> 00:13:26.528
Okay.

00:13:27.369 --> 00:13:30.710
So why has physical therapy sort of

00:13:30.809 --> 00:13:34.172
tolerated subjective measurement,

00:13:34.412 --> 00:13:35.572
for lack of a better term,

00:13:35.613 --> 00:13:37.474
when we ask people how it feels, right?

00:13:37.734 --> 00:13:38.193
Why have we,

00:13:38.394 --> 00:13:39.835
why has our profession tolerated

00:13:39.875 --> 00:13:41.936
subjective measurement for so long?

00:13:42.035 --> 00:13:42.775
Why is this, how is,

00:13:42.916 --> 00:13:43.275
how are we still,

00:13:43.476 --> 00:13:44.216
how is this still okay?

00:13:44.871 --> 00:13:45.932
Well, to be honest with you,

00:13:45.952 --> 00:13:47.273
it's just my speculation,

00:13:47.953 --> 00:13:51.455
but standardizing data in clinic is very,

00:13:51.475 --> 00:13:52.296
very difficult.

00:13:53.535 --> 00:13:55.998
I think the biggest example that most of

00:13:56.018 --> 00:13:58.698
us use in outpatient clinic is five times

00:13:58.719 --> 00:13:59.339
set to stand.

00:14:00.639 --> 00:14:02.321
The proper way to do five times set

00:14:02.360 --> 00:14:04.942
to stand is to ensure that the chair

00:14:04.981 --> 00:14:06.883
height is between sixteen and seventeen

00:14:06.942 --> 00:14:07.263
inches.

00:14:08.303 --> 00:14:10.565
The chair cannot be anchored to the floor

00:14:12.225 --> 00:14:12.666
or the wall.

00:14:14.605 --> 00:14:16.628
And that's where sort of there's the

00:14:16.668 --> 00:14:17.548
variation of it.

00:14:18.928 --> 00:14:23.812
And when I was working as a clinician,

00:14:24.212 --> 00:14:26.754
I actually met with a retired internal

00:14:27.475 --> 00:14:28.556
medicine physician.

00:14:31.277 --> 00:14:32.717
I was taking a blood pressure,

00:14:33.198 --> 00:14:35.840
and I actually did it the way everyone

00:14:35.860 --> 00:14:38.182
does it, just arm hanging down,

00:14:39.363 --> 00:14:40.964
legs slightly off the floor,

00:14:40.984 --> 00:14:42.105
feet slightly off the floor.

00:14:43.346 --> 00:14:45.628
And she was pointing out to me, Chana,

00:14:46.089 --> 00:14:47.690
the way you're doing it is invalid.

00:14:47.750 --> 00:14:49.311
I won't take your results for it.

00:14:50.131 --> 00:14:51.913
And that's when I sort of learned that

00:14:52.653 --> 00:14:54.995
standardizing how we measure is very,

00:14:55.037 --> 00:14:57.979
very important, not just for patients,

00:14:57.999 --> 00:15:01.142
but also our referral partners who are

00:15:01.182 --> 00:15:02.102
mostly physicians.

00:15:03.466 --> 00:15:03.767
Understood.

00:15:03.787 --> 00:15:03.966
All right.

00:15:05.086 --> 00:15:05.586
Quick break.

00:15:06.368 --> 00:15:06.988
Thanks to U.S.

00:15:07.008 --> 00:15:07.768
Physical Therapy.

00:15:08.687 --> 00:15:09.947
You didn't start your clinic to sell it

00:15:10.048 --> 00:15:10.187
off.

00:15:10.227 --> 00:15:11.428
You built it to last.

00:15:11.548 --> 00:15:11.969
At U.S.

00:15:12.009 --> 00:15:12.649
Physical Therapy,

00:15:12.668 --> 00:15:14.269
they help clinic owners stay local,

00:15:14.769 --> 00:15:17.350
stay in control, and grow with confidence.

00:15:17.950 --> 00:15:19.190
They're not a private equity firm.

00:15:19.210 --> 00:15:21.009
They're physical therapists helping

00:15:21.070 --> 00:15:22.530
physical therapists grow.

00:15:22.890 --> 00:15:24.770
Visit them online at usph.com.

00:15:24.791 --> 00:15:28.371
That's usphpartnerships.com.

00:15:30.071 --> 00:15:31.371
And I do also wanna say thanks.

00:15:32.212 --> 00:15:34.414
This episode brought to you by one of

00:15:34.475 --> 00:15:36.537
our nonprofit partners, Team Gleason,

00:15:36.778 --> 00:15:39.039
supporting people living with ALS with

00:15:39.179 --> 00:15:40.780
access to care, mobility,

00:15:41.322 --> 00:15:42.383
and independence.

00:15:42.423 --> 00:15:43.884
If you wanna support a cause,

00:15:44.823 --> 00:15:46.303
that aligns directly with function and

00:15:46.323 --> 00:15:49.164
dignity, you check out teamgleason.org.

00:15:49.184 --> 00:15:54.365
All right, let me ask this.

00:15:54.605 --> 00:15:55.946
Why is standardized diagnostic

00:15:55.966 --> 00:15:57.405
infrastructure in physical therapy?

00:15:57.446 --> 00:15:58.265
Why is it needed?

00:15:58.886 --> 00:15:59.486
Is it needed?

00:15:59.586 --> 00:16:00.326
Where is it needed?

00:16:00.506 --> 00:16:01.326
Like answer those.

00:16:01.986 --> 00:16:02.886
Yeah, yeah, of course.

00:16:02.966 --> 00:16:05.467
I think that's actually the most common

00:16:05.508 --> 00:16:06.488
question that I get.

00:16:07.947 --> 00:16:08.947
Among physical therapists,

00:16:09.207 --> 00:16:11.589
the biggest pushback is everyone moves

00:16:11.629 --> 00:16:12.048
differently.

00:16:13.692 --> 00:16:15.234
And I agree, everyone moves differently.

00:16:15.394 --> 00:16:17.693
And that isn't actually an argument

00:16:17.774 --> 00:16:19.254
against standardization.

00:16:19.674 --> 00:16:22.394
It is actually the strongest reason for

00:16:22.455 --> 00:16:24.196
standardization.

00:16:24.216 --> 00:16:26.255
We don't say every heart rhythm is

00:16:26.336 --> 00:16:28.456
different, so ECGs are useless.

00:16:28.956 --> 00:16:30.017
We say it the other way.

00:16:30.557 --> 00:16:33.258
Because every heart is different,

00:16:33.717 --> 00:16:36.499
we need a consistent way to measure it

00:16:36.639 --> 00:16:37.418
using ECGs.

00:16:38.254 --> 00:16:41.897
The goal of standardized diagnostic

00:16:41.937 --> 00:16:44.739
infrastructure isn't to standardize the

00:16:44.879 --> 00:16:47.541
output or to make everyone move the same,

00:16:48.101 --> 00:16:50.923
it's to standardize the input the way

00:16:50.984 --> 00:16:53.505
testing is done because standardization

00:16:53.946 --> 00:16:56.908
controls for variability amongst humans

00:16:57.869 --> 00:17:00.672
and it creates a shared baseline that all

00:17:00.731 --> 00:17:02.092
physical therapists can use.

00:17:02.732 --> 00:17:04.755
So right now in physical therapy,

00:17:05.314 --> 00:17:06.334
hypothetically speaking,

00:17:07.095 --> 00:17:08.194
it's not a possibility,

00:17:08.214 --> 00:17:10.355
but it's hypothetical, two people,

00:17:10.655 --> 00:17:12.776
same age, same demographics,

00:17:13.236 --> 00:17:14.237
same left knee pain,

00:17:14.696 --> 00:17:17.176
can go into two different physical therapy

00:17:17.196 --> 00:17:20.778
clinics and walk out with different tests

00:17:20.798 --> 00:17:22.078
being done to them,

00:17:22.578 --> 00:17:24.818
different baselines established,

00:17:25.519 --> 00:17:28.681
and there's a possibility of different

00:17:28.760 --> 00:17:30.060
treatment plan or plan of care.

00:17:31.132 --> 00:17:32.972
For physical therapists like us,

00:17:33.093 --> 00:17:35.634
we like to call that individualized care.

00:17:36.795 --> 00:17:38.015
But at a higher level,

00:17:39.215 --> 00:17:41.297
at like a payer's level,

00:17:42.196 --> 00:17:43.778
they call that variability.

00:17:44.198 --> 00:17:48.940
If two people with the same diagnosis walk

00:17:49.000 --> 00:17:50.300
into physical therapy clinics,

00:17:50.441 --> 00:17:52.021
ideally they should be tested the same

00:17:52.061 --> 00:17:52.201
way.

00:17:53.071 --> 00:17:53.893
But it's not.

00:17:54.113 --> 00:17:58.715
And that creates the noise in whether the

00:17:58.756 --> 00:18:01.278
patient made true improvement or not.

00:18:02.138 --> 00:18:04.560
And the second reason for the importance

00:18:04.681 --> 00:18:08.143
of standardizing diagnostic infrastructure

00:18:08.743 --> 00:18:11.546
is that standardized data is the universal

00:18:11.586 --> 00:18:12.707
language of

00:18:13.472 --> 00:18:16.436
high stake decision making in any

00:18:16.477 --> 00:18:17.076
professions.

00:18:17.738 --> 00:18:19.279
So as I mentioned,

00:18:19.539 --> 00:18:21.561
professions that we trust with our lives,

00:18:22.042 --> 00:18:25.707
pilots, engineers, forensic scientists,

00:18:26.147 --> 00:18:28.631
they rely on objective standardized data

00:18:29.010 --> 00:18:31.554
because the stakes are too high for human

00:18:31.614 --> 00:18:31.814
error.

00:18:32.835 --> 00:18:34.856
Healthcare workers also work the same way.

00:18:35.116 --> 00:18:36.778
The professions that make critical and

00:18:36.798 --> 00:18:38.900
important decisions like, as I mentioned,

00:18:39.220 --> 00:18:42.343
physicians, dentists, eye doctors,

00:18:42.823 --> 00:18:45.184
they rely on standardized data because the

00:18:45.224 --> 00:18:47.866
cost of being wrong is too high.

00:18:48.827 --> 00:18:51.869
So for me, it's just my opinion.

00:18:52.931 --> 00:18:55.432
When we argue that physical therapy

00:18:55.512 --> 00:18:57.694
doesn't need standardized diagnostic

00:18:57.775 --> 00:18:58.474
infrastructure,

00:18:59.155 --> 00:19:01.577
we're making a dangerous claim that

00:19:02.365 --> 00:19:04.686
the consequences of being wrong are so low

00:19:04.707 --> 00:19:06.307
that it's okay to eyeball movements.

00:19:06.946 --> 00:19:08.527
And you and I know that's not true.

00:19:09.227 --> 00:19:10.788
And I know people don't mean it that

00:19:10.807 --> 00:19:11.028
way,

00:19:11.107 --> 00:19:13.748
but it's the way I infer it as

00:19:13.788 --> 00:19:14.048
well.

00:19:15.028 --> 00:19:16.209
Movement is a vital sign.

00:19:16.469 --> 00:19:19.529
It dictates independence, fall risk,

00:19:20.410 --> 00:19:22.490
chronic disease trajectory,

00:19:23.069 --> 00:19:25.671
return to work or activity.

00:19:26.532 --> 00:19:27.574
activities of the living,

00:19:28.273 --> 00:19:30.297
it reflects quality of life as well.

00:19:30.936 --> 00:19:32.459
So for me,

00:19:33.059 --> 00:19:35.201
if physical therapy wants to be seen as

00:19:35.241 --> 00:19:36.544
a high value profession,

00:19:37.785 --> 00:19:40.607
we need to anchor to the same thing

00:19:40.647 --> 00:19:42.990
that the rest of the rest of healthcare

00:19:43.111 --> 00:19:44.071
is anchored to,

00:19:44.472 --> 00:19:46.434
which is objective standardized data.

00:19:47.849 --> 00:19:48.430
If someone said,

00:19:48.470 --> 00:19:50.691
what's the difference between AI video

00:19:50.730 --> 00:19:52.932
analysis and what you're doing,

00:19:52.951 --> 00:19:54.553
like a clinical biomechanics lab,

00:19:54.593 --> 00:19:55.874
how would you explain that?

00:19:56.653 --> 00:19:58.134
Yeah.

00:19:58.174 --> 00:20:01.096
So for me, AI video analysis,

00:20:01.215 --> 00:20:02.916
like the movement analysis that we use

00:20:03.076 --> 00:20:05.557
through our smartphone, iPad,

00:20:05.657 --> 00:20:08.859
or even laptop, it's a powerful tool.

00:20:09.000 --> 00:20:09.660
I love it too.

00:20:10.040 --> 00:20:12.541
I personally use it for myself as well.

00:20:13.182 --> 00:20:15.123
But the core limitation is that it

00:20:15.182 --> 00:20:16.884
produces inferred data.

00:20:18.188 --> 00:20:21.830
So what that means is that the AI

00:20:21.871 --> 00:20:24.554
model doesn't actually directly measure

00:20:24.713 --> 00:20:25.234
movement.

00:20:26.435 --> 00:20:29.438
It estimates movement from the camera

00:20:29.578 --> 00:20:33.923
angle, lens distortion, phone placement.

00:20:35.084 --> 00:20:37.105
So in other words,

00:20:37.925 --> 00:20:39.007
it's not directly measuring it.

00:20:39.067 --> 00:20:42.611
It's measuring based on its previously

00:20:43.030 --> 00:20:43.811
trained models.

00:20:45.123 --> 00:20:46.023
Um, but you know,

00:20:46.044 --> 00:20:48.546
what's what AI video analysis or movement

00:20:48.605 --> 00:20:50.528
analysis is great for is it's great for

00:20:50.587 --> 00:20:51.648
engagement and coaching.

00:20:52.348 --> 00:20:53.390
Um,

00:20:53.470 --> 00:20:56.853
it's great for providing immediate visual

00:20:56.893 --> 00:21:00.296
feedback and it helps patients see the

00:21:00.336 --> 00:21:00.797
movement,

00:21:01.917 --> 00:21:05.361
but the greatest risk shows up in

00:21:05.540 --> 00:21:06.101
healthcare.

00:21:07.001 --> 00:21:09.824
When we use inferred data from movement,

00:21:10.065 --> 00:21:11.526
AI movement analysis,

00:21:12.546 --> 00:21:16.727
like a medical grade standard because

00:21:16.926 --> 00:21:19.948
inferred data can change with protocols or

00:21:20.048 --> 00:21:21.928
setups rather than the patient's

00:21:21.968 --> 00:21:24.288
physiology or their biomechanics.

00:21:24.989 --> 00:21:27.769
So it can create a false baseline and

00:21:27.869 --> 00:21:32.570
it can lead to misleading progress.

00:21:33.330 --> 00:21:36.991
So that's why AI video analysis positioned

00:21:37.031 --> 00:21:39.872
themselves as a wellness, fitness,

00:21:40.153 --> 00:21:41.952
or visualization tool.

00:21:43.289 --> 00:21:45.090
Um, yeah, go for it.

00:21:46.211 --> 00:21:46.391
Yeah.

00:21:46.490 --> 00:21:48.592
Movie tells clinical biomechanics.

00:21:48.612 --> 00:21:50.272
It's it's different.

00:21:50.932 --> 00:21:52.973
It's a completely different tool for

00:21:53.433 --> 00:21:54.914
that's used for different purposes.

00:21:55.115 --> 00:21:58.336
So where, so we produce standardized data,

00:21:59.076 --> 00:21:59.896
you know, uh,

00:21:59.916 --> 00:22:02.278
the sort of testing is completed in a

00:22:02.377 --> 00:22:04.739
controlled condition using the same

00:22:04.778 --> 00:22:07.240
equipment, same instruction,

00:22:07.920 --> 00:22:10.280
same tool on their same scoring system.

00:22:11.198 --> 00:22:14.340
So we remove the noise so that the

00:22:14.461 --> 00:22:18.483
baseline and the follow-up is a true

00:22:18.625 --> 00:22:20.846
apple-to-apple measurement.

00:22:21.686 --> 00:22:25.851
And that difference is really everything.

00:22:25.891 --> 00:22:28.232
And that's what separates AI video

00:22:28.272 --> 00:22:31.375
analysis and movie health or clinical

00:22:31.395 --> 00:22:32.336
biomechanics lab.

00:22:32.817 --> 00:22:34.838
Both can coexist.

00:22:35.358 --> 00:22:36.660
I don't think it's one or the other

00:22:36.721 --> 00:22:36.820
issue.

00:22:36.840 --> 00:22:37.441
Right, right.

00:22:37.500 --> 00:22:37.922
It can't be.

00:22:38.541 --> 00:22:38.721
Yeah,

00:22:38.882 --> 00:22:41.403
the best clinics in Las Vegas actually use

00:22:41.723 --> 00:22:42.124
both.

00:22:42.625 --> 00:22:46.366
So they use us to establish true baseline

00:22:46.547 --> 00:22:48.347
and true progress.

00:22:49.528 --> 00:22:51.730
And they use video analysis for

00:22:53.451 --> 00:22:56.553
in-the-moment coaching.

00:22:56.653 --> 00:23:00.195
So does the profession need...

00:23:01.499 --> 00:23:03.339
comprehensive testing like this?

00:23:03.599 --> 00:23:04.720
I mean, you're in Vegas now.

00:23:04.779 --> 00:23:06.621
I imagine the goal is to spread in

00:23:06.661 --> 00:23:08.261
other major cities and then see how this

00:23:08.301 --> 00:23:08.501
goes.

00:23:08.521 --> 00:23:10.663
But someone asked on our live stream,

00:23:10.722 --> 00:23:13.104
does the profession need comprehensive

00:23:13.144 --> 00:23:14.365
testing like this?

00:23:14.424 --> 00:23:16.806
Where do we need our quest diagnostics of

00:23:16.865 --> 00:23:17.165
movement?

00:23:18.119 --> 00:23:19.740
Well, I'm going to say yes.

00:23:19.760 --> 00:23:21.663
I think it is very important.

00:23:22.962 --> 00:23:25.924
The reason being is that in every other

00:23:26.006 --> 00:23:26.625
healthcare,

00:23:27.165 --> 00:23:28.487
every other branch of healthcare,

00:23:29.127 --> 00:23:31.509
comprehensive diagnostic testing is sort

00:23:31.528 --> 00:23:33.810
of like the non-negotiable bare minimum

00:23:33.971 --> 00:23:34.692
standard of care.

00:23:35.892 --> 00:23:37.192
It explains the mechanism,

00:23:37.693 --> 00:23:40.316
quantifies severity,

00:23:40.615 --> 00:23:43.238
and create a true baseline,

00:23:43.337 --> 00:23:45.159
objective standardized baseline that

00:23:45.953 --> 00:23:47.074
they can track over time.

00:23:47.815 --> 00:23:49.174
In physical therapy clinics,

00:23:50.154 --> 00:23:52.955
most of what we use for evaluation is

00:23:53.096 --> 00:23:54.936
fast, low-cost,

00:23:55.116 --> 00:23:57.657
minimal equipment tests that produce

00:23:58.258 --> 00:24:02.819
binary results or it's graded on a

00:24:02.859 --> 00:24:03.720
subjective scale.

00:24:04.640 --> 00:24:07.201
So the output is mostly observational

00:24:07.240 --> 00:24:08.580
data, inferred data,

00:24:08.801 --> 00:24:09.942
or non-standardized data.

00:24:11.323 --> 00:24:11.682
So,

00:24:12.083 --> 00:24:14.984
and another thing for me is if a

00:24:15.045 --> 00:24:18.366
patient can perform your test at home with

00:24:18.406 --> 00:24:22.489
the chair and a stopwatch, it's a screen,

00:24:22.909 --> 00:24:23.868
not a diagnostic.

00:24:24.088 --> 00:24:28.030
It lacks clinical authority and was never

00:24:28.171 --> 00:24:30.413
meant to carry the weight of clinical

00:24:30.452 --> 00:24:31.012
prescription.

00:24:31.073 --> 00:24:34.934
It was designed to triage more than to

00:24:35.555 --> 00:24:39.217
explain why and why is everything behind

00:24:40.364 --> 00:24:42.403
behind your plan of care.

00:24:44.744 --> 00:24:45.305
For me,

00:24:46.585 --> 00:24:49.865
physical therapy needs standardized

00:24:49.925 --> 00:24:52.965
diagnostic infrastructure or comprehensive

00:24:53.006 --> 00:24:53.506
testing,

00:24:54.426 --> 00:24:56.446
not to replace clinical judgments,

00:24:56.787 --> 00:24:58.307
but to strengthen it.

00:24:58.926 --> 00:25:02.067
We need something that we can anchor that

00:25:02.127 --> 00:25:05.188
we own in physical therapy so that people

00:25:05.667 --> 00:25:08.009
appreciate physical therapists for what

00:25:08.048 --> 00:25:08.269
they do.

00:25:10.176 --> 00:25:10.696
Understood.

00:25:10.817 --> 00:25:11.037
All right.

00:25:11.076 --> 00:25:12.758
So to the clinic owners listening right

00:25:12.798 --> 00:25:12.877
now,

00:25:12.897 --> 00:25:14.058
because that's what you want to talk to,

00:25:14.138 --> 00:25:14.398
right?

00:25:14.439 --> 00:25:16.700
That's the audiences that you're serving

00:25:16.740 --> 00:25:18.161
now and want to continue to serve.

00:25:18.641 --> 00:25:20.162
If you're a clinic owner listening right

00:25:20.201 --> 00:25:25.325
now, what's their first practical step?

00:25:25.625 --> 00:25:27.705
Like what, what would you have people,

00:25:27.726 --> 00:25:28.905
you know, what's, what's the goal?

00:25:28.945 --> 00:25:30.106
Would you want them to do or no?

00:25:31.444 --> 00:25:34.548
Can you rephrase the question again one

00:25:34.608 --> 00:25:35.148
more time?

00:25:35.169 --> 00:25:36.451
I guess if a clinic owner is out

00:25:36.471 --> 00:25:38.593
there and they're in the Vegas area,

00:25:39.294 --> 00:25:41.015
you want them to test drive, right?

00:25:41.035 --> 00:25:42.317
You want them to come in there and

00:25:42.356 --> 00:25:42.977
take a look.

00:25:43.538 --> 00:25:45.519
But if someone isn't in the Las Vegas

00:25:45.579 --> 00:25:49.364
area, what's their first practical step?

00:25:49.463 --> 00:25:52.607
I think they should try to use

00:25:52.647 --> 00:25:53.469
standardized data.

00:25:54.272 --> 00:25:56.394
practice using standardized data as much

00:25:56.434 --> 00:25:57.295
as they can.

00:25:57.494 --> 00:25:58.615
I think most clinics,

00:25:59.175 --> 00:26:01.538
I would love for all clinics to invest

00:26:01.617 --> 00:26:02.417
in technology.

00:26:03.138 --> 00:26:05.359
I think physical therapy should move on

00:26:05.420 --> 00:26:08.582
from visual or manual to more towards

00:26:08.622 --> 00:26:12.263
technology-driven healthcare.

00:26:12.403 --> 00:26:14.885
And really test out the equipment that

00:26:14.905 --> 00:26:15.445
we're using.

00:26:15.987 --> 00:26:18.367
RunDNA, my favorite company.

00:26:19.048 --> 00:26:19.449
Vault,

00:26:19.888 --> 00:26:21.890
probably my second favorite company out

00:26:21.910 --> 00:26:22.089
there.

00:26:24.606 --> 00:26:26.127
Balance tracking system is great for

00:26:26.167 --> 00:26:26.969
tracking balance.

00:26:27.308 --> 00:26:29.089
And I think they should try all these

00:26:30.009 --> 00:26:30.611
companies out,

00:26:30.671 --> 00:26:32.491
reach out to the companies and find out

00:26:32.592 --> 00:26:34.153
more about what they do.

00:26:34.932 --> 00:26:36.713
Yeah.

00:26:36.794 --> 00:26:38.154
All right.

00:26:38.174 --> 00:26:39.596
Is there anything I didn't ask that you

00:26:39.615 --> 00:26:40.936
wanted me to dig into or anything that

00:26:40.977 --> 00:26:42.038
you think that, I mean,

00:26:42.597 --> 00:26:44.459
because you're answering frequently asked

00:26:44.499 --> 00:26:46.299
questions when you're doing outreach to

00:26:46.339 --> 00:26:46.920
clinics, right?

00:26:47.240 --> 00:26:48.560
Is there anything that you typically get

00:26:48.801 --> 00:26:50.342
asked that I didn't give you a chance

00:26:50.682 --> 00:26:51.002
to share?

00:26:52.219 --> 00:26:54.640
They usually ask how difficult this is,

00:26:54.720 --> 00:26:58.281
like in a sense that most physical

00:26:58.321 --> 00:27:01.502
therapists are not trained in biomechanics

00:27:02.022 --> 00:27:04.483
as extensively as we think we are.

00:27:04.723 --> 00:27:05.825
Even when I went to school,

00:27:05.845 --> 00:27:07.365
I had a great professor.

00:27:07.925 --> 00:27:10.626
But for clinical biomechanics,

00:27:10.686 --> 00:27:14.528
we're learning F equals MA and those

00:27:14.568 --> 00:27:15.048
formulas.

00:27:16.634 --> 00:27:19.116
So the biggest concern is that for clinic

00:27:19.176 --> 00:27:20.519
owners that they won't know how to

00:27:20.578 --> 00:27:22.701
interpret these results.

00:27:24.282 --> 00:27:27.807
So it's all in the report.

00:27:28.928 --> 00:27:30.128
That's the easiest way to say it.

00:27:31.990 --> 00:27:32.672
It's pretty much...

00:27:33.886 --> 00:27:35.828
reading through the report and going into

00:27:35.848 --> 00:27:38.849
details with the clients or customers,

00:27:39.010 --> 00:27:41.551
patients, sorry, one-on-one.

00:27:42.073 --> 00:27:44.834
And you can go on our website and

00:27:44.854 --> 00:27:47.175
download the sample report that you get.

00:27:47.816 --> 00:27:49.576
And it gives you a pretty good

00:27:49.636 --> 00:27:50.178
explanation.

00:27:50.238 --> 00:27:52.159
And most physical therapists,

00:27:52.558 --> 00:27:53.420
we're very smart.

00:27:54.019 --> 00:27:56.402
And they really have no issues with it.

00:27:56.642 --> 00:27:57.742
But that's their biggest concern.

00:28:00.082 --> 00:28:00.342
Sure.

00:28:00.823 --> 00:28:04.482
We'll share the website in the show notes,

00:28:04.502 --> 00:28:06.943
but movichealth.com.

00:28:08.203 --> 00:28:09.723
Are you ready for your parting shot?

00:28:10.444 --> 00:28:11.444
Yes, I am.

00:28:11.505 --> 00:28:13.744
Let's do the parting shot.

00:28:14.265 --> 00:28:15.405
This is the parting shot.

00:28:15.965 --> 00:28:17.346
One last mic drop moment.

00:28:18.046 --> 00:28:18.846
No pressure.

00:28:19.287 --> 00:28:21.386
Just your legacy on the line.

00:28:22.898 --> 00:28:24.079
Thanks to Sarah Health,

00:28:24.099 --> 00:28:26.381
the remote care platform helping clinics

00:28:26.421 --> 00:28:28.280
boost revenue without having to add staff.

00:28:28.320 --> 00:28:30.182
Sarah automates daily patient check-ins

00:28:30.682 --> 00:28:33.323
via text, which means no app, no logins,

00:28:33.343 --> 00:28:34.743
just better outcomes.

00:28:34.824 --> 00:28:36.664
A simple way to meet RTM requirements,

00:28:36.704 --> 00:28:37.585
improve follow-through,

00:28:37.605 --> 00:28:40.046
and actually get reimbursed for care

00:28:40.086 --> 00:28:41.227
between visits.

00:28:41.366 --> 00:28:43.307
Easy to set up, simple to use,

00:28:43.347 --> 00:28:44.528
and patients love it.

00:28:44.688 --> 00:28:45.669
SarahHealth.com.

00:28:45.689 --> 00:28:49.170
It's S-A-R-A-Health.com.

00:28:49.230 --> 00:28:50.330
All right, you're parting shot.

00:28:50.351 --> 00:28:51.211
Shana, what do you got for me?

00:28:52.328 --> 00:28:52.749
All right,

00:28:53.750 --> 00:28:57.392
every innovation in a profession does one

00:28:57.412 --> 00:28:58.153
of the two things.

00:28:58.953 --> 00:29:02.115
It either raises the ceiling or it raises

00:29:02.155 --> 00:29:02.635
the floor.

00:29:03.477 --> 00:29:05.417
So raising the ceiling is about

00:29:05.935 --> 00:29:07.116
expanding what's possible.

00:29:07.277 --> 00:29:09.897
It's the new technology, new product.

00:29:10.337 --> 00:29:11.077
It's exciting.

00:29:11.617 --> 00:29:12.398
It's impressive.

00:29:12.919 --> 00:29:16.140
Even I love new technology coming out in

00:29:16.180 --> 00:29:17.820
physical therapy.

00:29:18.901 --> 00:29:20.622
But raising the floor is different.

00:29:21.021 --> 00:29:22.083
When you raise the floor,

00:29:22.282 --> 00:29:24.544
you elevate the minimum standard of care.

00:29:25.163 --> 00:29:27.105
It's about reducing variability and

00:29:27.144 --> 00:29:29.945
ensuring that a patient gets high value

00:29:30.843 --> 00:29:33.243
service regardless of which clinic they're

00:29:33.304 --> 00:29:33.463
in.

00:29:34.164 --> 00:29:35.164
Probably not as fun,

00:29:36.546 --> 00:29:37.886
not as exciting for most people.

00:29:39.146 --> 00:29:41.828
The space between the floor and the

00:29:41.888 --> 00:29:44.250
ceiling is the variability.

00:29:44.710 --> 00:29:46.790
It's how different we are from one or

00:29:46.810 --> 00:29:47.211
the other.

00:29:48.071 --> 00:29:50.593
Every physical therapy or every physical

00:29:50.613 --> 00:29:52.874
therapist starts on the floor,

00:29:53.953 --> 00:29:56.435
but only a elite few will ever reach

00:29:57.511 --> 00:30:00.194
the ceiling and I can think of great

00:30:00.214 --> 00:30:04.381
names, Jimmy McKay, Dave,

00:30:04.901 --> 00:30:06.482
my co-founder Akash Patel.

00:30:06.923 --> 00:30:08.885
They all reached the ceiling already,

00:30:09.027 --> 00:30:11.930
but most of us are unfortunately down here

00:30:11.970 --> 00:30:12.351
at the floor.

00:30:13.722 --> 00:30:16.243
A profession isn't defined by its ceiling.

00:30:16.743 --> 00:30:18.364
It's defined by its floor.

00:30:19.105 --> 00:30:19.904
And right now,

00:30:20.085 --> 00:30:21.845
when I see physical therapy,

00:30:22.306 --> 00:30:24.226
we have a very, very high ceiling.

00:30:25.606 --> 00:30:29.468
So some practice at the level of

00:30:30.008 --> 00:30:30.528
physicians.

00:30:31.607 --> 00:30:34.949
We also have very, very low floor.

00:30:35.528 --> 00:30:39.471
So some people act as more as a

00:30:39.911 --> 00:30:40.671
personal trainer.

00:30:41.488 --> 00:30:43.388
Or glorified personal trainer,

00:30:43.648 --> 00:30:45.670
with quotation, or coaches.

00:30:47.050 --> 00:30:48.892
If we want to build a skyscraper,

00:30:49.231 --> 00:30:51.373
you don't build a skyscraper only by

00:30:51.432 --> 00:30:52.253
raising the ceiling.

00:30:52.953 --> 00:30:54.515
You have to build the floors.

00:30:54.615 --> 00:30:57.036
You have to create the infrastructure that

00:30:57.176 --> 00:30:58.017
everyone stands on.

00:30:59.578 --> 00:31:00.720
And in physical therapy,

00:31:00.859 --> 00:31:03.040
we see leaders doing this quietly.

00:31:03.401 --> 00:31:05.501
They're probably not as vocal as I am,

00:31:06.241 --> 00:31:08.202
but one person I really want to highlight

00:31:08.303 --> 00:31:09.123
is Brian Warner.

00:31:09.462 --> 00:31:11.824
He was a founder of Physical Therapy and

00:31:11.845 --> 00:31:12.265
Balance.

00:31:12.825 --> 00:31:15.746
He's raising the floor in vestibular care,

00:31:15.885 --> 00:31:18.547
creating a standardized benchmark so that

00:31:18.586 --> 00:31:20.367
balance and dissonance treatment in

00:31:20.407 --> 00:31:22.788
physical therapy isn't a guessing game.

00:31:23.710 --> 00:31:24.309
Personally, I'm

00:31:25.105 --> 00:31:26.926
more excited about raising the floor than

00:31:27.307 --> 00:31:28.067
raising the ceiling.

00:31:28.627 --> 00:31:32.470
Because raising the ceiling will only help

00:31:33.230 --> 00:31:34.391
those who are elite few.

00:31:35.491 --> 00:31:36.532
But when you raise the floor,

00:31:37.133 --> 00:31:38.594
you help everyone.

00:31:39.253 --> 00:31:41.174
You move the needle for the entire

00:31:41.295 --> 00:31:44.497
profession within the healthcare system.

00:31:44.636 --> 00:31:47.538
You shift industry towards a profession

00:31:47.558 --> 00:31:51.060
that is valued, respected, defensible,

00:31:51.361 --> 00:31:52.342
and indispensable.

00:31:52.882 --> 00:31:53.862
And that is my parting shot.

00:31:54.001 --> 00:31:54.462
Thank you, Jimmy.

00:31:55.479 --> 00:31:56.299
website again,

00:31:56.460 --> 00:31:57.280
I'll put it in the show notes,

00:31:57.320 --> 00:32:00.242
but it's movichealth.com.

00:32:01.182 --> 00:32:03.085
I'm curious to see where this thing goes.

00:32:03.305 --> 00:32:03.865
I'm interested.

00:32:03.884 --> 00:32:04.705
I like the fact that you're doing it

00:32:04.726 --> 00:32:07.407
in Vegas too, but appreciate your time.

00:32:07.428 --> 00:32:08.528
Thanks for doing this and walking us

00:32:08.548 --> 00:32:08.888
through it.

00:32:10.029 --> 00:32:10.509
You're welcome.

00:32:10.630 --> 00:32:12.692
Thank you for inviting me onto your show.

00:32:14.573 --> 00:32:17.555
Sometimes being in this new field,

00:32:18.016 --> 00:32:20.698
it makes me feel like I'm talking,

00:32:20.857 --> 00:32:22.338
I'm like a chihuahua talking to

00:32:23.306 --> 00:32:25.708
barking at lions right now but i feel

00:32:25.728 --> 00:32:27.689
like i roar today so thank you for

00:32:28.028 --> 00:32:29.789
the platform and thank you for giving

00:32:30.109 --> 00:32:31.070
small people like us

00:32:32.221 --> 00:32:34.102
a platform to talk on.

00:32:34.442 --> 00:32:35.082
Appreciate it, Sean.

00:32:35.102 --> 00:32:36.002
Well, thanks for the time, man.

00:32:36.042 --> 00:32:38.604
You're welcome.

00:32:38.703 --> 00:32:39.804
That's it for this one.

00:32:40.284 --> 00:32:41.724
We're just getting warmed up.

00:32:42.224 --> 00:32:44.145
Smash follow, send it to a friend,

00:32:44.346 --> 00:32:46.007
or crank up the next episode.

00:32:46.527 --> 00:32:47.547
Want to go deeper?

00:32:47.866 --> 00:32:51.949
Hit us at pgpinecast.com or find us on

00:32:51.969 --> 00:32:54.509
YouTube and socials at pgpinecast.

00:32:54.930 --> 00:32:57.191
And legally, none of this was advice.

00:32:57.270 --> 00:32:58.892
It's for entertainment purposes only.

00:33:00.693 --> 00:33:01.336
See, Keith?

00:33:01.476 --> 00:33:02.578
We read the script.

00:33:02.838 --> 00:33:03.480
Happy now?