Should You HIRE or OPTIMIZE?

WEBVTT

00:00:09.496 --> 00:00:10.278
I'm a little disappointed we

00:00:10.298 --> 00:00:11.657
don't have intro music.

00:00:13.619 --> 00:00:14.660
Morning shows have these

00:00:14.720 --> 00:00:16.782
high energy intro songs and

00:00:16.821 --> 00:00:17.301
stuff like that.

00:00:17.321 --> 00:00:17.882
I'm a little disappointed we

00:00:17.902 --> 00:00:18.623
don't have one yet,

00:00:18.682 --> 00:00:20.064
but this is PT Breakfast Club.

00:00:20.083 --> 00:00:20.364
Gentlemen,

00:00:21.524 --> 00:00:22.385
I was going to play Where in the

00:00:22.405 --> 00:00:23.146
World is Jimmy?

00:00:23.806 --> 00:00:26.367
I don't want to make anybody jealous,

00:00:26.408 --> 00:00:27.208
but I am in the conference

00:00:27.228 --> 00:00:28.809
room at a Hampton Inn in Rochester,

00:00:28.829 --> 00:00:29.250
New York.

00:00:30.010 --> 00:00:30.751
I know many of you are

00:00:30.791 --> 00:00:31.972
planning on taking a trip

00:00:32.371 --> 00:00:33.932
to lovely Western Central New York,

00:00:34.293 --> 00:00:34.793
but I've done it.

00:00:36.003 --> 00:00:38.164
There's a guy on TikTok that

00:00:38.225 --> 00:00:39.725
if you send him a video,

00:00:40.085 --> 00:00:41.225
you take your phone,

00:00:41.707 --> 00:00:43.426
you do like a panoramic,

00:00:43.747 --> 00:00:45.008
you do a three-sixty,

00:00:45.067 --> 00:00:46.768
he will figure out where you are.

00:00:46.808 --> 00:00:50.731
But now AI can do it so much easier.

00:00:51.170 --> 00:00:52.231
Like again,

00:00:52.591 --> 00:00:55.133
AI is replacing so many of us

00:00:55.192 --> 00:00:56.152
in so many ways.

00:00:57.194 --> 00:00:58.134
It was awesome.

00:00:58.573 --> 00:00:59.575
This guy's videos were nuts

00:00:59.634 --> 00:01:00.215
and he would like go

00:01:00.234 --> 00:01:01.054
through the process and

00:01:01.094 --> 00:01:01.896
show you how he did it.

00:01:01.915 --> 00:01:02.316
He's like, well,

00:01:02.335 --> 00:01:03.256
I saw the corner of an Ikea

00:01:03.276 --> 00:01:03.957
and there was a tree.

00:01:04.777 --> 00:01:06.798
And that's there's only sixty two Archeas.

00:01:06.837 --> 00:01:09.019
And I was like, this guy's got I mean,

00:01:09.058 --> 00:01:10.299
don't piss this guy off is

00:01:10.340 --> 00:01:11.441
what the message is.

00:01:11.501 --> 00:01:13.962
But also your message is don't piss AI off,

00:01:13.981 --> 00:01:14.962
which is why I always say

00:01:15.042 --> 00:01:16.643
thank you whenever it tells me something,

00:01:16.662 --> 00:01:17.843
because when they take over,

00:01:17.864 --> 00:01:18.343
I want to be like,

00:01:18.683 --> 00:01:19.525
Jimmy was nice and he

00:01:19.545 --> 00:01:20.305
always said thank you.

00:01:21.365 --> 00:01:23.165
So let's kick off the show.

00:01:23.286 --> 00:01:23.947
Dave,

00:01:24.307 --> 00:01:26.947
you had an interesting experience

00:01:27.007 --> 00:01:30.010
with Chad GPT sending you patients.

00:01:31.007 --> 00:01:34.188
Yeah, speaking about AI, this might be,

00:01:34.209 --> 00:01:35.870
I don't know, maybe it's an early signal.

00:01:36.551 --> 00:01:38.171
I think maybe even an

00:01:38.251 --> 00:01:40.153
inflection point with my

00:01:40.394 --> 00:01:41.373
thoughts around AI.

00:01:41.414 --> 00:01:42.875
But nonetheless,

00:01:42.894 --> 00:01:43.555
I do a bunch of the

00:01:43.575 --> 00:01:44.736
callbacks for prospective

00:01:44.757 --> 00:01:45.796
patients calling in for

00:01:45.858 --> 00:01:46.778
concierge pain relief.

00:01:47.599 --> 00:01:49.780
And it was the father of a

00:01:49.840 --> 00:01:51.861
patient calling in.

00:01:52.721 --> 00:01:53.923
So I have an answering

00:01:53.962 --> 00:01:55.004
service that takes down a

00:01:55.043 --> 00:01:55.825
lot of the demographic

00:01:55.844 --> 00:01:56.885
information when they call in.

00:01:56.924 --> 00:01:59.066
And then me or someone on

00:01:59.087 --> 00:02:00.128
the team does the callback.

00:02:00.808 --> 00:02:01.668
typically the answering

00:02:01.709 --> 00:02:02.469
service person is supposed

00:02:02.489 --> 00:02:03.551
to ask how did you hear

00:02:03.570 --> 00:02:04.432
about us or were you

00:02:04.531 --> 00:02:05.632
referred to us so that we

00:02:05.673 --> 00:02:07.493
can send send a handwritten

00:02:07.534 --> 00:02:08.235
thank you letter to a

00:02:08.314 --> 00:02:10.276
physician uh you know build

00:02:10.296 --> 00:02:11.298
that relationship whatever

00:02:12.239 --> 00:02:13.180
they didn't on the

00:02:13.240 --> 00:02:14.420
answering service side so

00:02:15.282 --> 00:02:16.203
in the very beginning after

00:02:16.223 --> 00:02:17.183
introducing myself I always

00:02:17.283 --> 00:02:18.544
ask like you know so so

00:02:18.585 --> 00:02:19.906
hello uh you know mr

00:02:19.945 --> 00:02:21.167
so-and-so you know how did

00:02:21.187 --> 00:02:22.628
you hear about us were you referred by

00:02:23.985 --> 00:02:24.344
whoever,

00:02:24.384 --> 00:02:26.366
physician or some other provider

00:02:26.385 --> 00:02:27.287
or some other professional.

00:02:28.326 --> 00:02:29.747
And this gentleman said that

00:02:30.407 --> 00:02:32.468
he found us through ChachiBT.

00:02:32.609 --> 00:02:35.371
And I was so,

00:02:35.890 --> 00:02:36.912
I was so caught off guard the

00:02:36.951 --> 00:02:37.551
first time ever.

00:02:39.592 --> 00:02:41.514
And I don't know,

00:02:41.593 --> 00:02:42.653
I think I prompted him a little bit,

00:02:42.674 --> 00:02:45.496
but he said, yeah, I was in ChachiBT.

00:02:45.656 --> 00:02:47.137
And this guy, by the way, this guy is,

00:02:48.066 --> 00:02:50.768
Fifty or sixty, which is fascinating.

00:02:50.848 --> 00:02:51.748
Also, it's interesting.

00:02:53.490 --> 00:02:54.670
And he said that he searched

00:02:56.512 --> 00:02:57.231
looking for an in-home

00:02:57.271 --> 00:03:00.754
physical therapist in Bed-Stuy, New York,

00:03:01.014 --> 00:03:02.336
Bed-Stuy, Brooklyn, New York.

00:03:03.544 --> 00:03:03.604
uh,

00:03:03.623 --> 00:03:06.806
in this zip code that treats that has

00:03:06.947 --> 00:03:07.606
physical therapists that

00:03:07.646 --> 00:03:09.528
treat CRPS complex regional

00:03:09.549 --> 00:03:10.049
pain syndrome.

00:03:10.109 --> 00:03:11.270
Now we can get into the

00:03:11.349 --> 00:03:13.231
clinical stuff later, which is, uh,

00:03:13.271 --> 00:03:14.592
we use the STEM pod for that.

00:03:14.633 --> 00:03:16.174
We use Vegas nerve stimulation.

00:03:16.213 --> 00:03:18.955
We'll, we'll do a lot of things, um,

00:03:18.975 --> 00:03:19.597
for chronic pain,

00:03:19.637 --> 00:03:20.997
but that's really on the clinical side.

00:03:21.018 --> 00:03:21.638
Obviously we're going to

00:03:21.677 --> 00:03:22.579
nerd out right now on the

00:03:22.618 --> 00:03:25.640
marketing side and on the AI, uh, side.

00:03:25.901 --> 00:03:28.483
And I have been saying to Tony and Jimmy,

00:03:28.522 --> 00:03:28.924
I don't know,

00:03:28.963 --> 00:03:30.145
probably for the last six to

00:03:30.164 --> 00:03:31.224
twelve months that, uh,

00:03:32.066 --> 00:03:33.546
AI is not replacing Google,

00:03:34.167 --> 00:03:35.367
and people are going to

00:03:35.407 --> 00:03:36.288
search Google forever.

00:03:37.288 --> 00:03:38.550
However, after yesterday,

00:03:38.810 --> 00:03:40.350
and if this trend continues,

00:03:41.512 --> 00:03:44.933
I might have to change that

00:03:45.033 --> 00:03:46.854
thought or at least share

00:03:46.895 --> 00:03:49.415
my belief in the searchability of Google.

00:03:50.276 --> 00:03:51.978
So what are your initial takeaways?

00:03:51.997 --> 00:03:53.079
Do you have any questions for me?

00:03:53.158 --> 00:03:55.520
I mean, I just find it fascinating that,

00:03:56.099 --> 00:03:57.760
yeah, well, let's say you prompted it,

00:03:57.800 --> 00:03:58.401
and what comes up?

00:03:59.062 --> 00:04:00.663
I said uh the original

00:04:00.682 --> 00:04:01.543
problem we find a physical

00:04:01.582 --> 00:04:02.324
therapist in new york city

00:04:02.343 --> 00:04:02.903
they'll come to my

00:04:02.943 --> 00:04:04.724
apartment it brought up

00:04:04.865 --> 00:04:06.846
some usual suspects right

00:04:07.086 --> 00:04:09.467
spear stride stern at home

00:04:09.487 --> 00:04:10.487
pt I'm not sure if any of

00:04:10.508 --> 00:04:12.649
these are rehab on wheels

00:04:12.709 --> 00:04:13.750
then these are familiar

00:04:13.770 --> 00:04:15.270
with these I'm given links

00:04:15.290 --> 00:04:16.230
directions and a phone

00:04:16.250 --> 00:04:18.031
number I'm given reviews

00:04:18.091 --> 00:04:19.153
that I'm guessing come from

00:04:19.213 --> 00:04:20.413
google it's pulling

00:04:20.454 --> 00:04:22.033
google's data and then I

00:04:22.314 --> 00:04:23.295
when you were talking I

00:04:23.314 --> 00:04:24.255
went specific I said

00:04:24.295 --> 00:04:26.117
bedside brooklyn and I have crps

00:04:27.358 --> 00:04:29.358
Luna and then concierge pain

00:04:29.379 --> 00:04:31.540
relief is second on the list.

00:04:31.742 --> 00:04:32.862
Holler at your boy.

00:04:32.963 --> 00:04:34.324
Now what's interesting is

00:04:35.345 --> 00:04:37.266
this gentleman who I'm speaking with,

00:04:39.629 --> 00:04:40.810
my therapist is seeing his

00:04:40.870 --> 00:04:43.312
daughter today for the evaluation.

00:04:44.458 --> 00:04:45.538
And he's like,

00:04:45.620 --> 00:04:47.982
I really liked your website

00:04:48.382 --> 00:04:49.463
and what you described.

00:04:49.584 --> 00:04:51.305
Oh, by the way, I didn't mention this.

00:04:51.906 --> 00:04:53.908
He pulled up a,

00:04:53.949 --> 00:04:56.271
he said that when he prompted ChatGPT,

00:04:56.291 --> 00:04:57.093
he said, yeah,

00:04:57.112 --> 00:04:58.435
it looks like you had

00:04:58.475 --> 00:05:00.137
written several articles

00:05:00.156 --> 00:05:02.519
and blog articles around CRPS.

00:05:03.079 --> 00:05:05.283
And what you guys may or may

00:05:05.302 --> 00:05:06.824
not know is that I use

00:05:07.004 --> 00:05:09.608
ChatGPT to write these blog articles.

00:05:09.668 --> 00:05:12.211
So I don't know if that is the crux of it,

00:05:12.252 --> 00:05:12.432
Tony.

00:05:12.451 --> 00:05:14.415
Do you think that is a major

00:05:14.435 --> 00:05:16.016
consideration or what?

00:05:16.096 --> 00:05:16.398
Or not?

00:05:17.002 --> 00:05:17.403
I don't.

00:05:17.523 --> 00:05:18.363
I don't think that has

00:05:18.403 --> 00:05:19.305
anything to do with it.

00:05:19.365 --> 00:05:22.586
I think now I'm certainly no expert,

00:05:22.666 --> 00:05:25.449
but to my best understanding, you know,

00:05:25.608 --> 00:05:26.509
open AI,

00:05:26.668 --> 00:05:28.451
all of these large language models,

00:05:28.490 --> 00:05:29.511
they've already consumed

00:05:29.610 --> 00:05:30.791
everything on the Internet.

00:05:31.233 --> 00:05:33.653
They have Internet access now, obviously.

00:05:33.774 --> 00:05:36.175
So when I ask a question.

00:05:38.548 --> 00:05:40.569
If I'm asking to look something up,

00:05:40.608 --> 00:05:41.588
it'll go online.

00:05:42.528 --> 00:05:44.069
Now, I don't think it's using Google.

00:05:44.110 --> 00:05:47.571
It's using its own proprietary algorithms,

00:05:47.651 --> 00:05:48.812
but it's going out,

00:05:48.971 --> 00:05:50.451
it's finding those resources,

00:05:50.492 --> 00:05:51.492
it's bringing them back,

00:05:51.632 --> 00:05:53.372
and you're one of those resources.

00:05:53.452 --> 00:05:56.894
This was an insanely specific search.

00:05:57.454 --> 00:05:58.774
I would never imagine a

00:05:58.834 --> 00:05:59.894
person would be searching

00:06:00.055 --> 00:06:01.435
that level of detail.

00:06:02.255 --> 00:06:03.057
But yeah,

00:06:03.476 --> 00:06:05.439
I'm showing up when therapists

00:06:05.480 --> 00:06:06.721
are searching for like

00:06:06.880 --> 00:06:08.141
maintenance therapy covered

00:06:08.182 --> 00:06:11.125
by Medicare or information

00:06:11.165 --> 00:06:12.666
related to billing Medicare.

00:06:13.108 --> 00:06:14.649
Some of my content now is

00:06:14.709 --> 00:06:16.732
being provided through chat GPT.

00:06:16.971 --> 00:06:18.694
I have not had anything show

00:06:18.814 --> 00:06:19.855
up for my total knee

00:06:19.915 --> 00:06:22.257
replacement stuff that I'm aware of.

00:06:23.903 --> 00:06:25.105
Just for the podcast or the

00:06:25.125 --> 00:06:26.367
people listening as they're driving,

00:06:26.466 --> 00:06:28.307
I then prompted ChatGPT,

00:06:28.728 --> 00:06:30.430
which one is the best?

00:06:31.050 --> 00:06:33.432
And keep in mind the suggestions, Dave,

00:06:33.452 --> 00:06:35.093
you came in second,

00:06:35.173 --> 00:06:37.415
right behind Luna in the

00:06:37.596 --> 00:06:38.476
recommendation above.

00:06:38.497 --> 00:06:39.819
And then I pushed ChatGPT a

00:06:39.838 --> 00:06:41.379
little bit and I was like, yeah,

00:06:41.399 --> 00:06:42.521
but which one's the best?

00:06:43.182 --> 00:06:44.562
And it brought Concierge

00:06:44.603 --> 00:06:46.865
Pain Relief to the top and gave me why.

00:06:46.925 --> 00:06:48.466
Specializes in CRPS.

00:06:49.309 --> 00:06:51.471
pain approach, in-home,

00:06:51.511 --> 00:06:52.471
twenty four seven scheduling.

00:06:52.711 --> 00:06:54.593
So I'm blushing.

00:06:54.733 --> 00:06:57.254
I did not pay ChatGPT to show you this.

00:06:57.394 --> 00:07:00.978
I did not pay Jimmy to do it live.

00:07:01.077 --> 00:07:02.319
Yeah, we're going to do this.

00:07:02.338 --> 00:07:03.218
I know.

00:07:03.259 --> 00:07:05.060
Here's here's the here's the thing.

00:07:05.100 --> 00:07:06.100
People will be interacting

00:07:06.120 --> 00:07:08.322
with these with these more and more.

00:07:08.382 --> 00:07:09.343
I think the video, Tony,

00:07:09.363 --> 00:07:10.644
that you shared in our sort

00:07:10.665 --> 00:07:11.745
of collective group chat was

00:07:12.625 --> 00:07:15.187
Chat GPT or AI devices are

00:07:15.326 --> 00:07:16.947
only point three percent of

00:07:17.048 --> 00:07:18.249
search traffic.

00:07:18.668 --> 00:07:20.569
And again, point three of a giant number.

00:07:20.629 --> 00:07:21.329
So it's still a lot,

00:07:21.350 --> 00:07:22.290
but it is point three.

00:07:23.867 --> 00:07:25.389
But what percentage of

00:07:25.488 --> 00:07:27.430
search traffic was yellow

00:07:27.470 --> 00:07:28.910
pages twenty years ago and

00:07:28.930 --> 00:07:30.110
what percentage was Google

00:07:30.651 --> 00:07:31.531
and that shifted?

00:07:32.451 --> 00:07:34.333
I think it'll be a blend in

00:07:34.392 --> 00:07:36.514
terms of it will eventually say, well,

00:07:36.533 --> 00:07:37.293
how do we know?

00:07:37.514 --> 00:07:39.115
Are we constantly consuming

00:07:39.154 --> 00:07:40.636
information into our LLMs

00:07:41.136 --> 00:07:42.377
or are we scrolling or

00:07:42.416 --> 00:07:43.576
crawling as what Google

00:07:43.978 --> 00:07:45.098
sort of has done traditionally?

00:07:45.798 --> 00:07:47.038
This is the way not to quote

00:07:47.079 --> 00:07:48.620
the Mandalorian, but it feels like it.

00:07:49.540 --> 00:07:51.062
So I shared earlier,

00:07:51.122 --> 00:07:52.562
I'm going to bring it up on the screen.

00:07:53.824 --> 00:07:55.266
This, well,

00:07:55.665 --> 00:07:56.927
am I going to bring it up on the screen?

00:07:58.048 --> 00:07:59.310
Thank you, Scott, for the shout out.

00:08:00.911 --> 00:08:01.793
Yeah.

00:08:01.833 --> 00:08:02.192
There it is.

00:08:02.213 --> 00:08:03.053
Yeah, there's that video.

00:08:03.718 --> 00:08:05.497
So I'm not going to play the audio,

00:08:05.538 --> 00:08:07.819
but just this guy, he's amazing.

00:08:07.858 --> 00:08:09.218
He's one of my favorite kind

00:08:09.298 --> 00:08:11.660
of up and coming YouTube channels.

00:08:11.680 --> 00:08:13.040
He's on Facebook, Instagram.

00:08:13.560 --> 00:08:15.021
He's talking about how

00:08:15.100 --> 00:08:17.581
ChatGPT now is offering

00:08:18.081 --> 00:08:19.442
links to products.

00:08:19.482 --> 00:08:21.482
So in this example, he's saying, hey,

00:08:21.541 --> 00:08:22.963
I want an espresso maker

00:08:23.262 --> 00:08:24.723
coming from Italy today.

00:08:25.023 --> 00:08:26.904
And now through ChatGPT,

00:08:27.404 --> 00:08:28.425
you can actually click the

00:08:28.505 --> 00:08:30.307
link and purchase the product.

00:08:30.708 --> 00:08:30.927
I mean,

00:08:31.088 --> 00:08:33.890
we're seeing this move into Google

00:08:33.931 --> 00:08:34.932
space more and more.

00:08:35.211 --> 00:08:36.452
The interviews I'm seeing

00:08:36.494 --> 00:08:38.034
about what Google is doing

00:08:38.054 --> 00:08:39.996
to fight this is talking

00:08:40.037 --> 00:08:41.999
about how obviously Gemini

00:08:42.578 --> 00:08:43.779
is an incredible model.

00:08:44.240 --> 00:08:45.422
They're going to incorporate

00:08:45.442 --> 00:08:46.282
that more effectively.

00:08:47.062 --> 00:08:49.644
I think search, I think buying online,

00:08:49.744 --> 00:08:50.724
I think all of this stuff

00:08:50.764 --> 00:08:52.124
is going to be completely different.

00:08:52.783 --> 00:08:54.063
The most interesting thing

00:08:54.163 --> 00:08:56.544
about Dave's discovery, though, for me,

00:08:57.184 --> 00:08:59.044
is I had completely quit

00:08:59.765 --> 00:09:02.166
writing content for my website.

00:09:02.285 --> 00:09:03.826
I had completely quit

00:09:03.865 --> 00:09:06.527
writing content for other sites.

00:09:07.246 --> 00:09:08.846
Everything was exclusive on

00:09:08.967 --> 00:09:10.788
social media for me over the last year.

00:09:11.673 --> 00:09:11.993
Now,

00:09:12.693 --> 00:09:14.195
I think it shows us we need to get

00:09:14.235 --> 00:09:16.155
back to SEO optimized

00:09:16.176 --> 00:09:19.057
content on our website, on blogs,

00:09:19.239 --> 00:09:20.339
on things like that,

00:09:21.500 --> 00:09:22.600
because these large

00:09:22.640 --> 00:09:24.101
language models are going

00:09:24.142 --> 00:09:24.722
to go out there.

00:09:24.743 --> 00:09:25.623
They're going to consume it.

00:09:25.663 --> 00:09:26.464
They're going to find it.

00:09:26.524 --> 00:09:29.645
And if you're claiming the real estate now,

00:09:29.765 --> 00:09:31.548
the digital real estate now,

00:09:32.087 --> 00:09:33.208
you have a better chance of

00:09:33.269 --> 00:09:34.230
staying on top.

00:09:34.909 --> 00:09:35.931
see that's that's the funny

00:09:35.951 --> 00:09:37.451
part at least I'm not crazy

00:09:37.552 --> 00:09:39.013
which is this guy's video

00:09:39.033 --> 00:09:39.693
the one that we're playing

00:09:39.754 --> 00:09:40.674
here now keep in mind I

00:09:40.774 --> 00:09:41.836
went to that link that he

00:09:41.875 --> 00:09:43.537
shared very quickly by the

00:09:43.557 --> 00:09:44.197
way it wasn't in the

00:09:44.236 --> 00:09:45.518
comments of that video so I

00:09:45.557 --> 00:09:46.698
had to freeze frame it and

00:09:46.739 --> 00:09:48.120
go and then right now it's

00:09:48.140 --> 00:09:50.282
an application for this

00:09:50.341 --> 00:09:51.482
thing that they'll let you

00:09:51.523 --> 00:09:52.543
know when you can do this

00:09:52.624 --> 00:09:53.445
which is fine they're

00:09:53.465 --> 00:09:55.225
rolling it out except the

00:09:55.265 --> 00:09:56.246
funny part is when you do

00:09:56.287 --> 00:09:57.607
play the the audio for that

00:09:57.628 --> 00:09:59.750
video he says seo is dead

00:10:02.397 --> 00:10:04.538
No, I disagree with that.

00:10:04.597 --> 00:10:04.837
Right.

00:10:05.038 --> 00:10:06.340
That's where everybody's saying it's dead.

00:10:06.360 --> 00:10:08.660
And I'm like, no, I think it's yes.

00:10:08.681 --> 00:10:09.621
It's going to pull from that.

00:10:10.182 --> 00:10:12.224
Well, I think it's him just getting,

00:10:12.423 --> 00:10:14.285
you know, getting conversation going.

00:10:14.426 --> 00:10:16.668
It's the way SEO used to be done.

00:10:17.048 --> 00:10:17.668
It's dead.

00:10:18.168 --> 00:10:21.291
A new SEO is on the horizon.

00:10:21.331 --> 00:10:21.731
Correct.

00:10:21.991 --> 00:10:22.152
You know,

00:10:22.172 --> 00:10:23.332
I had a conversation with someone.

00:10:23.352 --> 00:10:24.094
I won't say who it is,

00:10:24.134 --> 00:10:26.154
but they're pretty higher

00:10:26.215 --> 00:10:27.115
up with a large company.

00:10:28.123 --> 00:10:29.984
physical therapy professional organization,

00:10:30.024 --> 00:10:30.524
if you will.

00:10:30.724 --> 00:10:31.904
And the question was,

00:10:31.965 --> 00:10:33.965
because I was playing with AI early,

00:10:34.044 --> 00:10:34.326
again,

00:10:34.505 --> 00:10:36.086
I was batting around a ball of yarn

00:10:36.105 --> 00:10:36.947
like a kid and just trying

00:10:36.966 --> 00:10:37.807
to figure this thing out.

00:10:38.307 --> 00:10:39.307
And the question was, Jimmy,

00:10:39.668 --> 00:10:40.607
when someone searches a

00:10:40.628 --> 00:10:41.649
question about something

00:10:41.668 --> 00:10:43.229
that physical therapists treat,

00:10:43.609 --> 00:10:45.450
how do we make sure we're the answer?

00:10:46.110 --> 00:10:47.051
And my response was,

00:10:47.770 --> 00:10:49.731
you need to actually be the

00:10:49.873 --> 00:10:51.273
answer in terms of, hey,

00:10:51.313 --> 00:10:52.693
if this person has that problem,

00:10:52.955 --> 00:10:53.835
how do I pop up?

00:10:53.855 --> 00:10:56.037
And I was like, you can't game this,

00:10:56.076 --> 00:10:57.037
for lack of a better term,

00:10:57.076 --> 00:10:57.977
like you might have been

00:10:58.018 --> 00:10:59.339
able to in early Google,

00:10:59.499 --> 00:11:01.179
like with SEO and keyword.

00:11:01.200 --> 00:11:02.821
I'm like, you need to be the answer,

00:11:02.880 --> 00:11:03.601
be consistent.

00:11:03.642 --> 00:11:05.523
And I think the message is you still,

00:11:05.582 --> 00:11:07.544
the more frequently and

00:11:07.625 --> 00:11:08.826
better you communicate it,

00:11:09.186 --> 00:11:10.927
the more you rise to the top.

00:11:10.966 --> 00:11:11.287
Dave,

00:11:11.386 --> 00:11:12.488
how long has your practice been

00:11:12.528 --> 00:11:13.369
around in New York City?

00:11:13.389 --> 00:11:15.110
Like six years.

00:11:15.645 --> 00:11:18.076
And at the highest number,

00:11:18.116 --> 00:11:19.181
how many employees or

00:11:19.201 --> 00:11:20.386
people did you have working with you?

00:11:22.264 --> 00:11:22.424
uh,

00:11:22.445 --> 00:11:24.625
eleven independent contractors pre-COVID,

00:11:24.686 --> 00:11:25.645
but they were all different

00:11:25.725 --> 00:11:28.767
levels of patient caseload.

00:11:29.307 --> 00:11:31.248
But you were the answer when

00:11:31.347 --> 00:11:32.508
I asked this thing,

00:11:32.648 --> 00:11:34.328
who would be the best at

00:11:34.389 --> 00:11:35.928
this thing in this place?

00:11:36.548 --> 00:11:37.850
And now we can work

00:11:37.870 --> 00:11:38.730
backwards and reverse

00:11:38.769 --> 00:11:40.009
engineer how Dave popped up.

00:11:40.570 --> 00:11:42.030
But the answer is probably a

00:11:42.071 --> 00:11:43.350
mix of you said it,

00:11:43.390 --> 00:11:44.270
you said it over and over

00:11:44.311 --> 00:11:45.211
again and you shared

00:11:45.231 --> 00:11:46.912
information and we can try

00:11:46.951 --> 00:11:48.092
to game that system all we want.

00:11:48.113 --> 00:11:49.173
But I think that stays true.

00:11:50.431 --> 00:11:51.451
Couple more thoughts on this

00:11:51.491 --> 00:11:53.392
real quick around the, yeah, Craig,

00:11:53.412 --> 00:11:53.932
thank you so much.

00:11:54.293 --> 00:11:56.774
Around this, like Tony said,

00:11:56.813 --> 00:11:58.394
this specific patient,

00:11:58.433 --> 00:12:00.075
this specific search query,

00:12:00.674 --> 00:12:01.816
maybe moving forward,

00:12:02.216 --> 00:12:06.837
like I can unlock the very specific,

00:12:06.918 --> 00:12:07.738
the people that are looking

00:12:07.778 --> 00:12:08.938
for a very specific,

00:12:08.999 --> 00:12:11.940
like targeted solution

00:12:12.100 --> 00:12:13.520
instead of the people that are just like,

00:12:14.301 --> 00:12:15.441
medicare physical therapy

00:12:15.500 --> 00:12:16.701
respectfully or like you

00:12:16.721 --> 00:12:17.522
know any you know

00:12:17.542 --> 00:12:18.581
insurance-based physical

00:12:18.601 --> 00:12:19.682
therapy or physical therapy

00:12:19.702 --> 00:12:21.023
that takes my united

00:12:21.043 --> 00:12:21.884
healthcare in network

00:12:21.923 --> 00:12:23.803
insurance or whatever maybe

00:12:24.203 --> 00:12:24.884
and that's kind of you know

00:12:24.904 --> 00:12:26.524
what that's already the

00:12:26.565 --> 00:12:28.485
type of person who pays out

00:12:28.546 --> 00:12:29.885
of pocket they're already

00:12:30.365 --> 00:12:31.486
that's the type of person who

00:12:32.287 --> 00:12:34.649
is considerate around like communication,

00:12:34.690 --> 00:12:36.471
bedside manner, professionalism.

00:12:36.711 --> 00:12:37.552
Are they clean cut?

00:12:37.572 --> 00:12:38.714
Do they do what they say?

00:12:38.974 --> 00:12:40.576
Are they very prompt with everything?

00:12:40.875 --> 00:12:42.658
Do they have solutions when

00:12:42.738 --> 00:12:43.639
new things pop up?

00:12:44.139 --> 00:12:46.601
Can they be dynamic on their feet when

00:12:47.602 --> 00:12:49.124
So there's one of our

00:12:49.163 --> 00:12:49.784
therapists is seeing

00:12:49.825 --> 00:12:52.346
somebody for back pain and

00:12:52.365 --> 00:12:53.726
then we show up and then like, hey,

00:12:53.826 --> 00:12:54.648
I have like wrist pain

00:12:54.668 --> 00:12:55.948
today or I have ankle pain today.

00:12:56.009 --> 00:12:57.470
And like the therapist is like, hey, well,

00:12:57.690 --> 00:12:58.429
you know, you're self-paced.

00:12:58.450 --> 00:12:59.370
So like, let's screen it.

00:12:59.390 --> 00:13:00.150
Let's evaluate it.

00:13:00.371 --> 00:13:00.892
Let's treat it.

00:13:00.932 --> 00:13:01.491
Let's do that.

00:13:01.932 --> 00:13:03.833
Versus an insurance based practice like,

00:13:03.894 --> 00:13:04.053
oh,

00:13:04.214 --> 00:13:06.375
I must get a new referral and I must

00:13:06.416 --> 00:13:07.515
get it signed.

00:13:07.615 --> 00:13:08.336
And I need you know,

00:13:08.397 --> 00:13:10.238
I don't have a referral on that.

00:13:10.278 --> 00:13:11.019
That's seriously, you know,

00:13:11.038 --> 00:13:11.538
that still happens.

00:13:11.578 --> 00:13:13.360
So to take a step back,

00:13:13.841 --> 00:13:15.341
these types of folks,

00:13:15.881 --> 00:13:16.562
they're looking for.

00:13:17.863 --> 00:13:19.965
a sniper rifle instead of

00:13:20.044 --> 00:13:21.666
like a blowtorch or a

00:13:21.706 --> 00:13:22.846
machine gun or whatever so

00:13:23.466 --> 00:13:24.908
these are the people that

00:13:25.227 --> 00:13:27.789
also would be more willing

00:13:28.431 --> 00:13:31.452
to pay more and so this

00:13:31.592 --> 00:13:32.594
this guy that I spoke with

00:13:32.614 --> 00:13:33.533
he goes yeah I know there's

00:13:33.553 --> 00:13:35.135
fox rehab and there's luna

00:13:35.735 --> 00:13:36.736
and then you know I went

00:13:36.756 --> 00:13:37.657
through the conversation

00:13:37.697 --> 00:13:38.697
and I said you know hey you

00:13:38.717 --> 00:13:39.639
know it's five fifty per

00:13:39.678 --> 00:13:40.658
visit on weekends three

00:13:40.678 --> 00:13:41.460
fifty per visit monday

00:13:41.480 --> 00:13:42.421
through friday and he goes

00:13:43.081 --> 00:13:44.642
oh oh wow yeah okay I mean

00:13:44.662 --> 00:13:45.662
that's you know that's more

00:13:45.682 --> 00:13:46.841
than that's more than we

00:13:46.881 --> 00:13:49.802
thought it would be or um

00:13:49.942 --> 00:13:51.264
that's that's uh that's

00:13:51.303 --> 00:13:52.283
more than the other places

00:13:52.323 --> 00:13:54.424
and I'm like yep yeah I

00:13:54.465 --> 00:13:56.225
mean you know luna is good

00:13:56.265 --> 00:13:58.025
like they just hire and

00:13:58.105 --> 00:13:59.105
almost any therapist with a

00:13:59.166 --> 00:14:00.307
license respectfully and

00:14:00.386 --> 00:14:02.447
fox rehab is geriatrics and

00:14:02.508 --> 00:14:03.307
older folks and your

00:14:03.347 --> 00:14:04.268
daughter's younger so

00:14:04.548 --> 00:14:05.548
that's not the right fit

00:14:06.009 --> 00:14:08.409
you know and um so luna by

00:14:08.450 --> 00:14:10.289
the way is like a hundred

00:14:10.309 --> 00:14:12.030
twenty five bucks per visit self-pay

00:14:12.791 --> 00:14:14.631
and he's paying three fifty

00:14:14.711 --> 00:14:15.932
today starting today like

00:14:15.951 --> 00:14:17.351
who knows who knows if it's

00:14:17.371 --> 00:14:18.232
gonna be fifteen or twenty

00:14:18.253 --> 00:14:19.592
visits or fifty visits or

00:14:20.153 --> 00:14:21.994
three visits who knows but

00:14:22.693 --> 00:14:24.234
the fact that this family

00:14:24.333 --> 00:14:27.174
is like we're gonna pay uh

00:14:27.294 --> 00:14:29.155
what two x or over two x

00:14:29.275 --> 00:14:31.417
almost three x uh what

00:14:31.456 --> 00:14:32.557
another practice will pay

00:14:33.297 --> 00:14:34.256
and it's like how much of

00:14:34.297 --> 00:14:35.197
that we'll never know how

00:14:35.238 --> 00:14:36.937
much of that is because of

00:14:36.957 --> 00:14:38.859
the chat gbt component of

00:14:38.899 --> 00:14:39.418
this I don't know

00:14:40.591 --> 00:14:40.731
Yeah,

00:14:41.032 --> 00:14:43.475
we've always wanted to establish

00:14:43.654 --> 00:14:46.337
authority, establish credibility.

00:14:46.738 --> 00:14:48.198
Clearly, you said, you know,

00:14:48.259 --> 00:14:49.380
he saw your articles,

00:14:49.421 --> 00:14:50.601
he read your articles,

00:14:50.642 --> 00:14:51.462
like you already

00:14:51.523 --> 00:14:53.384
established yourself in his

00:14:53.445 --> 00:14:54.725
head as the expert.

00:14:55.306 --> 00:14:56.346
And to your point...

00:14:57.467 --> 00:14:59.610
We had Will Boyd on not too long ago.

00:14:59.970 --> 00:15:01.650
You can you can shoot with a

00:15:01.691 --> 00:15:04.032
shotgun and like spray wide

00:15:04.173 --> 00:15:05.933
or you could go very specific.

00:15:06.433 --> 00:15:07.514
The fact that this guy is

00:15:07.575 --> 00:15:09.615
looking for this very specific condition,

00:15:09.655 --> 00:15:10.576
the fact that he's looking

00:15:10.616 --> 00:15:11.517
for his daughter,

00:15:12.038 --> 00:15:13.619
like help for his daughter,

00:15:13.639 --> 00:15:15.299
not not even help for him.

00:15:15.799 --> 00:15:16.860
You're checking all the

00:15:16.880 --> 00:15:19.322
boxes to say this is the ideal client.

00:15:19.942 --> 00:15:21.644
And I think therapists get

00:15:21.683 --> 00:15:22.864
frustrated because they're like,

00:15:22.884 --> 00:15:24.024
I'm putting content out and

00:15:24.065 --> 00:15:25.025
I got three views.

00:15:25.881 --> 00:15:26.001
Yeah,

00:15:26.022 --> 00:15:27.422
but those three views might be the

00:15:27.481 --> 00:15:29.003
three people who are

00:15:29.102 --> 00:15:30.263
actually going to pay your

00:15:30.342 --> 00:15:32.364
rates to get what you want.

00:15:32.764 --> 00:15:34.104
You don't need three million

00:15:34.144 --> 00:15:35.604
views of people who are

00:15:35.644 --> 00:15:36.924
never going to pay you to

00:15:36.985 --> 00:15:37.985
do what you do best.

00:15:38.445 --> 00:15:38.605
Right.

00:15:38.684 --> 00:15:39.745
I frame this with a friend.

00:15:40.245 --> 00:15:40.806
I don't know if you guys

00:15:40.826 --> 00:15:41.785
ever met Katie Sutton.

00:15:41.826 --> 00:15:42.966
Katie Sutton is an amazing

00:15:43.025 --> 00:15:44.265
physical therapist assistant.

00:15:44.926 --> 00:15:46.267
I met her through an APTA

00:15:46.307 --> 00:15:47.506
committee years ago,

00:15:47.647 --> 00:15:49.006
and she's just she's an

00:15:49.267 --> 00:15:50.908
outstanding APTA assistant.

00:15:51.488 --> 00:15:52.508
I twisted her arm enough to

00:15:52.548 --> 00:15:53.948
launch a podcast, right?

00:15:53.989 --> 00:15:54.668
She's been doing it for a

00:15:54.688 --> 00:15:55.688
year and a half on and off.

00:15:55.708 --> 00:15:57.089
She hit five thousand

00:15:57.590 --> 00:15:59.129
downloads and she's like, well,

00:15:59.149 --> 00:15:59.990
that's not a million.

00:16:00.070 --> 00:16:00.629
It's not, you know,

00:16:00.690 --> 00:16:01.890
Kim Kardashian numbers.

00:16:01.971 --> 00:16:03.490
Is Kim Kardashian still a thing?

00:16:03.510 --> 00:16:04.770
She's still a thing, right?

00:16:04.831 --> 00:16:06.052
It's not Kardashian numbers.

00:16:06.491 --> 00:16:07.072
But I said,

00:16:07.312 --> 00:16:09.812
if you sat in a conference room

00:16:09.852 --> 00:16:11.653
at a Hampton Inn in Rochester, New York,

00:16:12.092 --> 00:16:13.033
and over the course of a year,

00:16:13.134 --> 00:16:15.453
five thousand PTAs sat with

00:16:15.494 --> 00:16:17.174
you for forty five minutes a pop,

00:16:17.575 --> 00:16:18.294
do that math.

00:16:18.774 --> 00:16:19.716
Five thousand is not that

00:16:19.735 --> 00:16:20.635
much when you compare it to

00:16:21.136 --> 00:16:22.597
the depth and width of the Internet.

00:16:23.038 --> 00:16:23.278
Right.

00:16:23.577 --> 00:16:24.418
But she had forty five

00:16:24.438 --> 00:16:25.139
minute conversations.

00:16:25.198 --> 00:16:26.000
I think she's at twenty

00:16:26.039 --> 00:16:27.780
episodes to five thousand downloads.

00:16:27.980 --> 00:16:29.062
And she's like, wow,

00:16:29.081 --> 00:16:30.403
when you put it that way,

00:16:30.802 --> 00:16:32.024
it's a little bit different.

00:16:32.124 --> 00:16:34.404
So this this thing scales.

00:16:34.465 --> 00:16:34.625
Right.

00:16:34.666 --> 00:16:35.625
Gary Vee's famous for saying

00:16:35.645 --> 00:16:36.527
it's the it's the quickest

00:16:36.547 --> 00:16:37.407
and easiest and cheapest

00:16:37.427 --> 00:16:39.408
way to multiply yourself

00:16:39.509 --> 00:16:40.208
and your insight.

00:16:40.528 --> 00:16:41.250
I still stand by it.

00:16:43.163 --> 00:16:43.982
If we don't have anything

00:16:44.062 --> 00:16:45.082
else on that topic,

00:16:45.243 --> 00:16:47.364
I want to get with Dave and

00:16:47.403 --> 00:16:49.083
talk about an article.

00:16:50.644 --> 00:16:52.205
We went further with ChatGPT.

00:16:52.264 --> 00:16:52.965
I said, hey, listen,

00:16:53.004 --> 00:16:53.904
I'm a physical therapist

00:16:53.924 --> 00:16:55.264
that has a sixty minute commute.

00:16:55.605 --> 00:16:56.544
Who are the best people I

00:16:56.565 --> 00:16:57.466
can listen to learn more

00:16:57.485 --> 00:16:59.186
about my profession as a live stream?

00:16:59.566 --> 00:17:02.866
It mentioned friend of a show, Zach Gabor,

00:17:03.466 --> 00:17:05.767
Level Up Initiative, E-Three Rehab,

00:17:05.866 --> 00:17:07.106
Evidence Based High Quality Rehab.

00:17:07.126 --> 00:17:07.987
They have a YouTube channel.

00:17:08.688 --> 00:17:10.968
And we come in number three.

00:17:11.307 --> 00:17:12.587
How many things have we,

00:17:12.627 --> 00:17:13.988
but how many things have we even,

00:17:14.048 --> 00:17:14.568
we don't even have a

00:17:14.628 --> 00:17:16.469
website for Breakfast Club.

00:17:16.648 --> 00:17:18.689
Like I was nudging it towards live stream,

00:17:18.749 --> 00:17:18.929
right?

00:17:18.969 --> 00:17:19.509
I wanted to see.

00:17:21.089 --> 00:17:23.029
But besides the live stream

00:17:23.049 --> 00:17:24.450
and the YouTube headlines

00:17:24.490 --> 00:17:25.690
and titles and descriptions,

00:17:26.151 --> 00:17:27.351
there's no site.

00:17:27.391 --> 00:17:28.951
We haven't written an article on this.

00:17:29.171 --> 00:17:31.632
So I am terribly curious how

00:17:31.692 --> 00:17:33.192
we came in at all.

00:17:33.311 --> 00:17:34.791
Nevermind being three on this.

00:17:35.231 --> 00:17:36.172
That is interesting because

00:17:36.192 --> 00:17:36.912
I was trying to nudge it

00:17:36.951 --> 00:17:38.353
towards live stream.

00:17:38.393 --> 00:17:40.192
How do you know, figure it out for me?

00:17:41.192 --> 00:17:41.912
I would say,

00:17:41.971 --> 00:17:43.232
and I'd be curious because

00:17:43.252 --> 00:17:44.712
this has got your history

00:17:44.752 --> 00:17:46.874
and now ChatGPT can

00:17:46.913 --> 00:17:48.755
research across previous chats.

00:17:49.414 --> 00:17:51.275
Anybody watching, anybody listening,

00:17:51.996 --> 00:17:52.976
do that prompt.

00:17:52.996 --> 00:17:54.316
Do the same prompt, yes.

00:17:54.395 --> 00:17:56.136
Yeah, ask ChatGPT,

00:17:56.856 --> 00:17:58.417
you're a physical therapist.

00:17:58.958 --> 00:18:00.018
What did you say exactly?

00:18:00.137 --> 00:18:00.298
Yeah,

00:18:00.357 --> 00:18:01.838
I'm going to put it in the comments

00:18:01.858 --> 00:18:02.798
because I would love an

00:18:02.858 --> 00:18:04.480
exact apples to apples.

00:18:05.319 --> 00:18:07.963
Steal this prompt, steal this prompt.

00:18:08.284 --> 00:18:09.266
If you're watching or listening,

00:18:09.306 --> 00:18:11.868
this is your homework or your day work.

00:18:11.909 --> 00:18:13.131
We need you to do this work

00:18:13.151 --> 00:18:14.413
before your actual work today.

00:18:14.864 --> 00:18:16.244
Yeah, this is more important, guys.

00:18:16.345 --> 00:18:17.625
I want to know what ChatGPT

00:18:17.645 --> 00:18:18.365
is saying on this.

00:18:18.385 --> 00:18:20.467
So copy-paste that exact prompt.

00:18:20.907 --> 00:18:21.988
If I'm a physical therapist

00:18:22.008 --> 00:18:23.169
that has a six-minute commute,

00:18:23.489 --> 00:18:24.829
who's the best people?

00:18:24.930 --> 00:18:26.431
I grammatically did that great, sorry.

00:18:26.990 --> 00:18:27.751
Who are the best people I

00:18:27.771 --> 00:18:28.652
can listen to to learn more

00:18:28.692 --> 00:18:29.472
about my profession?

00:18:29.772 --> 00:18:31.134
I specifically didn't say

00:18:31.574 --> 00:18:32.934
clinical practice, business.

00:18:32.974 --> 00:18:33.974
I wanted to be like, hey,

00:18:34.415 --> 00:18:35.375
what do you got for me?

00:18:35.476 --> 00:18:36.757
Kill my boredom for six minutes.

00:18:37.196 --> 00:18:38.557
I'm curious and very,

00:18:38.597 --> 00:18:40.219
very intrigued what it says,

00:18:40.538 --> 00:18:42.660
not through my search history on ChatGPT.

00:18:42.701 --> 00:18:43.441
It's a good point, Tony.

00:18:44.493 --> 00:18:44.794
All right.

00:18:44.854 --> 00:18:47.055
So before we go live,

00:18:47.454 --> 00:18:49.016
I do search research.

00:18:49.115 --> 00:18:50.355
I go to Google.

00:18:50.536 --> 00:18:51.556
I go to chat GPT.

00:18:51.615 --> 00:18:52.596
I'm like physical therapy

00:18:52.656 --> 00:18:54.336
news and I read the headlines.

00:18:54.917 --> 00:18:55.857
Usually there's not a whole

00:18:55.897 --> 00:18:56.958
lot to talk about.

00:18:57.679 --> 00:18:59.398
This article came up.

00:19:00.038 --> 00:19:03.721
And so every now and then we we hear this,

00:19:03.760 --> 00:19:04.121
you know,

00:19:05.580 --> 00:19:06.981
was a Santa Monica physical

00:19:07.001 --> 00:19:08.281
therapist accused of

00:19:08.362 --> 00:19:10.323
sexually assaulting a client.

00:19:11.183 --> 00:19:12.904
Now, I mean, we have no idea.

00:19:12.924 --> 00:19:14.946
It doesn't tell us details in the article.

00:19:15.146 --> 00:19:16.848
It says April seventeenth

00:19:16.868 --> 00:19:19.230
for one count of sexual battery.

00:19:20.152 --> 00:19:21.873
My question is and this

00:19:22.012 --> 00:19:23.515
always kind of comes up.

00:19:24.434 --> 00:19:26.497
So in my physical therapy clinic,

00:19:26.537 --> 00:19:28.038
we would generally never

00:19:28.098 --> 00:19:31.781
have a PT by him or herself

00:19:31.922 --> 00:19:33.564
with a patient and nobody else around.

00:19:34.515 --> 00:19:37.756
But in mobile, outpatient, in home health,

00:19:37.816 --> 00:19:39.596
like we've got this constantly.

00:19:40.215 --> 00:19:41.936
And when I try to wrap my

00:19:41.997 --> 00:19:42.916
brain around this,

00:19:43.517 --> 00:19:44.538
I know so many mobile

00:19:44.557 --> 00:19:45.718
therapists that want to do

00:19:45.758 --> 00:19:46.718
manual therapy.

00:19:47.657 --> 00:19:48.838
You're in the house.

00:19:49.419 --> 00:19:51.179
Some bring treatment tables,

00:19:51.219 --> 00:19:52.318
which blows my mind,

00:19:52.358 --> 00:19:53.779
but you guys are willing to do it.

00:19:54.680 --> 00:19:57.282
How do you manage the risk

00:19:57.823 --> 00:19:59.744
of like touching people,

00:19:59.805 --> 00:20:01.646
getting into these intimate spaces,

00:20:01.727 --> 00:20:04.410
doing these things with, hey,

00:20:04.509 --> 00:20:05.651
I don't want to get accused

00:20:05.730 --> 00:20:07.653
of something that I had no intention of.

00:20:07.732 --> 00:20:10.336
Dave, you're the key to this puzzle.

00:20:10.516 --> 00:20:11.256
What do you do?

00:20:11.576 --> 00:20:12.538
What do your people do?

00:20:14.260 --> 00:20:17.063
I mean, it's a delicate conversation.

00:20:17.143 --> 00:20:18.604
So if I'm speaking to a

00:20:18.663 --> 00:20:19.545
prospective patient,

00:20:20.885 --> 00:20:22.767
I will mention things like, all right,

00:20:22.807 --> 00:20:23.788
well, you know,

00:20:23.807 --> 00:20:24.488
our therapists are in the

00:20:24.508 --> 00:20:25.989
subway most of the time or

00:20:26.048 --> 00:20:27.829
they're on like e-scooters or whatever.

00:20:27.950 --> 00:20:29.090
So like we're not bringing a

00:20:29.111 --> 00:20:30.731
treatment table.

00:20:30.791 --> 00:20:32.153
We do we do share like an

00:20:32.192 --> 00:20:33.554
Amazon link to like a

00:20:33.673 --> 00:20:34.654
Sierra Comfort table.

00:20:34.714 --> 00:20:35.576
If you want to buy one,

00:20:35.596 --> 00:20:36.435
it's like one hundred fifty

00:20:36.455 --> 00:20:36.977
bucks or whatever.

00:20:37.656 --> 00:20:39.637
um or and we literally have

00:20:39.657 --> 00:20:41.019
this conversation it it

00:20:41.038 --> 00:20:42.420
doesn't I think I have a

00:20:42.460 --> 00:20:43.961
conversation on maybe I

00:20:44.040 --> 00:20:44.882
shouldn't maybe I should

00:20:44.902 --> 00:20:45.902
have it pretty much with

00:20:45.942 --> 00:20:47.163
every female and typically

00:20:47.242 --> 00:20:48.584
I typically I think we do

00:20:48.604 --> 00:20:50.265
with females and with dave

00:20:50.305 --> 00:20:51.586
dave david's twenty twenty

00:20:51.625 --> 00:20:55.348
five female male both is

00:20:56.148 --> 00:20:57.170
everything well I'm telling

00:20:57.210 --> 00:20:57.950
you I'm telling you what I

00:20:58.010 --> 00:21:01.012
actually do and and so I we

00:21:01.053 --> 00:21:02.353
definitely this we

00:21:03.594 --> 00:21:05.756
we communicate it more with

00:21:05.776 --> 00:21:06.655
the females because I wanna

00:21:06.675 --> 00:21:07.436
make sure that they're very

00:21:07.477 --> 00:21:08.676
comfortable because right now,

00:21:09.077 --> 00:21:10.178
most of my therapists are

00:21:10.357 --> 00:21:11.138
male therapists.

00:21:11.159 --> 00:21:12.559
I just wanna make sure, hey,

00:21:12.920 --> 00:21:13.901
depending on what you have going on,

00:21:13.941 --> 00:21:15.741
if it's this ankle, low back pain,

00:21:15.781 --> 00:21:16.762
sciatica, whatever it is,

00:21:17.816 --> 00:21:18.316
Here's what we do.

00:21:18.336 --> 00:21:19.376
We don't bring a treatment table.

00:21:19.717 --> 00:21:21.718
We can treat you on your couch,

00:21:21.857 --> 00:21:22.778
your chaise lounge.

00:21:23.278 --> 00:21:25.179
It could be on a yoga mat on

00:21:25.199 --> 00:21:26.240
your carpeted floor.

00:21:26.660 --> 00:21:28.441
If you are able to get down to the floor,

00:21:28.461 --> 00:21:30.020
it depends on the person's situation.

00:21:30.741 --> 00:21:32.781
It could be in your bed or

00:21:32.821 --> 00:21:33.782
guest bed if you're

00:21:33.823 --> 00:21:34.643
comfortable with that.

00:21:34.762 --> 00:21:35.143
Obviously,

00:21:35.222 --> 00:21:36.463
I want you and my therapist to

00:21:36.523 --> 00:21:37.384
speak about that even

00:21:37.423 --> 00:21:38.865
before you guys book the

00:21:38.884 --> 00:21:40.685
visit or before the therapist gets there.

00:21:41.286 --> 00:21:42.928
It always helps if the

00:21:43.127 --> 00:21:44.829
patient or client has a

00:21:44.890 --> 00:21:45.990
spouse or a family member

00:21:46.171 --> 00:21:46.892
or a son or daughter,

00:21:46.951 --> 00:21:47.832
someone else there in the

00:21:47.872 --> 00:21:49.453
apartment just to make sure

00:21:49.473 --> 00:21:50.434
that everyone's comfortable.

00:21:50.454 --> 00:21:52.477
But we absolutely discuss

00:21:52.517 --> 00:21:53.357
this ahead of time.

00:21:54.138 --> 00:21:55.960
I think it comes off to them

00:21:56.760 --> 00:21:57.820
that we're experienced we're

00:21:57.840 --> 00:21:58.862
consummate professionals

00:21:58.961 --> 00:22:00.321
this is a consideration for

00:22:00.402 --> 00:22:01.502
us we know it's a

00:22:01.563 --> 00:22:02.542
consideration for our

00:22:02.583 --> 00:22:03.844
clients we want to make

00:22:03.864 --> 00:22:04.743
sure our clients have a

00:22:04.844 --> 00:22:06.444
great experience but the

00:22:06.484 --> 00:22:07.464
thing is most of the time

00:22:07.505 --> 00:22:08.826
tony is they're already

00:22:09.046 --> 00:22:09.786
like you said before

00:22:09.806 --> 00:22:10.446
they're already kind of

00:22:10.507 --> 00:22:12.047
warmed up because they've

00:22:12.086 --> 00:22:13.327
seen our google reviews or

00:22:13.347 --> 00:22:14.488
they've been on our website

00:22:14.667 --> 00:22:16.429
or they got referred to us

00:22:16.489 --> 00:22:17.469
by a physician that they

00:22:17.509 --> 00:22:18.410
trust or whatever

00:22:19.230 --> 00:22:22.372
So it's luckily it's never

00:22:22.392 --> 00:22:23.873
been an issue because maybe

00:22:23.932 --> 00:22:24.973
we confront it.

00:22:25.034 --> 00:22:27.536
We just we talk about it and

00:22:28.076 --> 00:22:30.317
we will never say, oh, let's you know,

00:22:30.357 --> 00:22:31.659
let's do manual therapy on

00:22:31.699 --> 00:22:33.619
your bed unless we've

00:22:33.740 --> 00:22:35.602
already we've already discussed it.

00:22:36.142 --> 00:22:38.223
And the the patient or client,

00:22:38.263 --> 00:22:39.845
regardless of gender or age or whatever,

00:22:40.565 --> 00:22:41.465
that they've already

00:22:41.925 --> 00:22:43.448
approved it and they're OK with that.

00:22:44.228 --> 00:22:46.710
You know, historically, five,

00:22:46.730 --> 00:22:47.509
six something years ago,

00:22:48.431 --> 00:22:49.551
I had like a younger patient

00:22:49.632 --> 00:22:51.313
and we just put padded

00:22:51.772 --> 00:22:53.074
dining room chairs together.

00:22:53.114 --> 00:22:54.535
Like we just put them together like,

00:22:54.615 --> 00:22:55.455
like three in a row.

00:22:55.536 --> 00:22:56.175
And like the,

00:22:56.736 --> 00:22:58.477
the young female laid on that

00:22:58.497 --> 00:22:59.417
so that I could do manual

00:22:59.458 --> 00:23:00.598
therapy traction on,

00:23:01.038 --> 00:23:02.000
on her cervical spine.

00:23:02.039 --> 00:23:03.980
So there's ways around not

00:23:04.020 --> 00:23:05.162
even entering the bedroom

00:23:05.221 --> 00:23:06.603
or not even using a bed,

00:23:06.643 --> 00:23:09.003
but this is just part of what we do.

00:23:09.044 --> 00:23:10.845
Like we over communicate, like we want to,

00:23:11.224 --> 00:23:11.566
we want to,

00:23:11.586 --> 00:23:13.067
we want to spend as much time

00:23:13.086 --> 00:23:14.307
on the phone as we need to.

00:23:14.988 --> 00:23:16.028
And then that way, all of the,

00:23:17.009 --> 00:23:20.311
visits are smooth and yeah I

00:23:20.352 --> 00:23:21.311
don't know but then also

00:23:21.873 --> 00:23:23.193
with therapists like I

00:23:24.034 --> 00:23:24.875
could have hired a

00:23:24.914 --> 00:23:26.296
therapist in the past that

00:23:26.536 --> 00:23:27.757
could have done this type

00:23:27.777 --> 00:23:28.637
of stuff or had these types

00:23:28.657 --> 00:23:30.878
of allegations we try to

00:23:30.898 --> 00:23:31.660
fight against that as much

00:23:31.700 --> 00:23:32.480
as possible on the front

00:23:32.540 --> 00:23:33.801
end with the rigorous

00:23:33.842 --> 00:23:35.002
interview process and

00:23:35.042 --> 00:23:36.022
checking references and all

00:23:36.042 --> 00:23:38.825
that but uh unfortunately I

00:23:38.845 --> 00:23:40.707
guess it still could happen yeah

00:23:41.788 --> 00:23:42.088
Jimmy,

00:23:42.430 --> 00:23:44.371
do you remember anything from school

00:23:44.550 --> 00:23:46.992
about, like, did you guys discuss?

00:23:48.134 --> 00:23:50.096
Obviously, you remember draping, you know,

00:23:51.416 --> 00:23:53.678
but I know when I have a student,

00:23:53.837 --> 00:23:55.900
if I'm functioning as a CI,

00:23:56.220 --> 00:23:58.622
I try to talk to them about all of this,

00:23:58.721 --> 00:24:00.503
even to the point of,

00:24:01.124 --> 00:24:02.486
If I have a bunch of high

00:24:02.506 --> 00:24:04.228
school kids in here and

00:24:04.307 --> 00:24:06.151
I've got males and females,

00:24:06.631 --> 00:24:09.595
I am like acutely aware of, okay,

00:24:09.736 --> 00:24:10.957
if you're going to do a deadlift,

00:24:10.997 --> 00:24:12.038
which way are you facing?

00:24:12.078 --> 00:24:13.079
Which way are you turning?

00:24:13.140 --> 00:24:13.961
If I'm going to put you on a

00:24:14.000 --> 00:24:14.842
treatment table,

00:24:15.282 --> 00:24:16.384
where are you going to be?

00:24:16.483 --> 00:24:18.207
Which way are your legs pointing like?

00:24:19.866 --> 00:24:21.867
It's all consuming almost to

00:24:21.887 --> 00:24:23.568
the point where I just,

00:24:23.669 --> 00:24:24.588
I am never going to put

00:24:24.648 --> 00:24:27.049
myself in a vulnerable position.

00:24:27.089 --> 00:24:28.671
Do you remember anyone talking about that?

00:24:29.090 --> 00:24:29.250
Well,

00:24:29.270 --> 00:24:30.632
I remember my last clinical setting

00:24:30.652 --> 00:24:31.873
was in pediatrics before I

00:24:31.913 --> 00:24:32.952
left to go non-clinical.

00:24:33.534 --> 00:24:35.054
And I just remembered it was

00:24:35.075 --> 00:24:35.875
a great environment.

00:24:36.569 --> 00:24:37.650
But whenever I needed to do

00:24:37.730 --> 00:24:39.090
anything where maybe maybe

00:24:39.131 --> 00:24:40.612
a patient had their shirt off,

00:24:40.951 --> 00:24:42.211
I didn't want to be in a general room.

00:24:42.432 --> 00:24:43.653
But I always pulled that.

00:24:43.972 --> 00:24:44.413
I lucked out.

00:24:44.432 --> 00:24:46.233
There was always like other PTs around.

00:24:46.413 --> 00:24:47.273
I was the only guy.

00:24:47.354 --> 00:24:48.755
So I was very acutely aware

00:24:48.775 --> 00:24:49.255
of these things.

00:24:49.634 --> 00:24:51.135
And I would always just grab another PT.

00:24:51.155 --> 00:24:52.256
Like, do you mind hanging out in here?

00:24:52.296 --> 00:24:53.636
Because to me,

00:24:54.076 --> 00:24:55.737
it's can be awkward as all

00:24:55.757 --> 00:24:56.417
the situations you

00:24:56.438 --> 00:24:58.018
remembered for me was kids.

00:24:58.097 --> 00:24:59.398
And I was like, I have to be.

00:25:00.318 --> 00:25:02.000
twice as triple diligent for

00:25:02.059 --> 00:25:02.900
any of those things because

00:25:02.940 --> 00:25:03.859
if a kid just says well

00:25:03.900 --> 00:25:05.319
that happened what am I

00:25:05.339 --> 00:25:06.280
supposed to how am I

00:25:06.300 --> 00:25:07.381
supposed to respond so I

00:25:07.540 --> 00:25:09.622
always always had one if

00:25:09.682 --> 00:25:11.721
not two other people um in

00:25:11.741 --> 00:25:13.482
the room plus I was such a

00:25:13.563 --> 00:25:14.923
junior pt compared to the

00:25:14.962 --> 00:25:16.064
females I was working with

00:25:16.403 --> 00:25:17.503
ninety percent of the time I was like

00:25:17.963 --> 00:25:19.365
Am I doing this right?

00:25:19.384 --> 00:25:21.026
Just check what I'm doing

00:25:21.086 --> 00:25:22.186
here or make sure I'm doing

00:25:22.207 --> 00:25:22.946
the best thing possible.

00:25:22.968 --> 00:25:23.728
But yes,

00:25:24.327 --> 00:25:26.109
I remember draping that coming up

00:25:26.150 --> 00:25:27.109
in school and just being like,

00:25:27.391 --> 00:25:28.030
you need to be paying

00:25:28.070 --> 00:25:29.112
attention to these things

00:25:29.132 --> 00:25:29.692
that you might have

00:25:29.751 --> 00:25:30.653
overlooked in the past

00:25:30.692 --> 00:25:31.634
because now you are in

00:25:31.653 --> 00:25:33.575
charge and responsible.

00:25:35.105 --> 00:25:37.307
We shared a image a couple

00:25:37.327 --> 00:25:39.210
of weeks back of physical

00:25:39.250 --> 00:25:42.673
therapy clinics and the prerequisite.

00:25:43.213 --> 00:25:44.414
They all had to look the same.

00:25:44.875 --> 00:25:46.457
I just did a Google image

00:25:46.497 --> 00:25:48.999
search for physical therapy stock images,

00:25:49.019 --> 00:25:50.519
because I knew what was going to come up.

00:25:51.260 --> 00:25:51.862
And of course,

00:25:52.021 --> 00:25:53.563
every single one of these

00:25:53.702 --> 00:25:55.664
images is a physical

00:25:55.704 --> 00:25:58.386
therapist touching another human.

00:25:58.948 --> 00:26:00.028
And Dave knows, like,

00:26:00.189 --> 00:26:01.549
I will do manual therapy.

00:26:01.630 --> 00:26:02.631
I'll rub your back.

00:26:02.691 --> 00:26:03.872
I'll do the things that need

00:26:03.892 --> 00:26:05.913
to be done to bribe you to keep coming,

00:26:05.973 --> 00:26:07.976
just like many physical

00:26:08.016 --> 00:26:09.116
therapists will do.

00:26:10.458 --> 00:26:12.440
But I still think that, you know,

00:26:12.640 --> 00:26:15.722
this is the public's conception of

00:26:16.303 --> 00:26:17.344
And I think there's a lot of

00:26:17.384 --> 00:26:19.443
people who don't want to be touched.

00:26:19.865 --> 00:26:21.265
Don't put your hands on me.

00:26:21.884 --> 00:26:22.945
Show me what to do.

00:26:23.385 --> 00:26:25.007
Let me do what needs to be done.

00:26:25.346 --> 00:26:27.347
But I don't need you to touch my back.

00:26:29.308 --> 00:26:30.048
Ask permission.

00:26:30.409 --> 00:26:31.509
You have to ask the patient

00:26:31.529 --> 00:26:32.410
or client their permission.

00:26:32.730 --> 00:26:33.931
I know it goes...

00:26:34.711 --> 00:26:36.272
it's, it's not that common.

00:26:36.492 --> 00:26:37.834
I feel like maybe we learned

00:26:37.854 --> 00:26:39.015
it in school and then you forget it,

00:26:39.415 --> 00:26:39.935
but it's like,

00:26:40.196 --> 00:26:40.817
even if you're taking some

00:26:40.836 --> 00:26:42.259
of those blood pressures, like, Hey,

00:26:42.298 --> 00:26:43.159
can I put this blood

00:26:43.199 --> 00:26:44.361
pressure cuff on you?

00:26:44.401 --> 00:26:45.240
Can I, Hey,

00:26:45.260 --> 00:26:46.462
can I check your blood pressure?

00:26:46.863 --> 00:26:47.864
Like, like, you know,

00:26:48.124 --> 00:26:49.005
let's check your blood pressure.

00:26:49.025 --> 00:26:49.705
Let's get your number.

00:26:49.986 --> 00:26:51.247
Can I put this cuff on your arm?

00:26:51.267 --> 00:26:52.788
Like it's so,

00:26:53.009 --> 00:26:54.170
I feel like it's so overlooked.

00:26:54.410 --> 00:26:54.691
You just,

00:26:56.711 --> 00:26:57.952
I think legitimately

00:26:58.413 --> 00:26:59.493
therapists are so used to

00:26:59.534 --> 00:27:00.413
touching people.

00:27:00.894 --> 00:27:01.194
You know,

00:27:01.214 --> 00:27:02.516
I have friends that are massage

00:27:02.556 --> 00:27:03.096
therapists,

00:27:03.476 --> 00:27:04.656
like they won't take their

00:27:04.696 --> 00:27:06.337
hands off the people around

00:27:06.357 --> 00:27:07.199
them just because their

00:27:07.239 --> 00:27:09.279
whole day is spent touching people.

00:27:10.520 --> 00:27:11.882
We lose sight of it and we

00:27:11.902 --> 00:27:12.882
don't realize that this

00:27:12.922 --> 00:27:14.163
person in front of us has

00:27:14.182 --> 00:27:14.963
their own history.

00:27:15.003 --> 00:27:17.164
They have their own baggage and trauma and,

00:27:17.664 --> 00:27:17.924
you know,

00:27:17.964 --> 00:27:19.686
experiences and maybe they don't

00:27:19.727 --> 00:27:21.468
want you in their personal space.

00:27:22.948 --> 00:27:24.648
But I think there's value in

00:27:24.689 --> 00:27:25.828
marketing a touchless

00:27:25.868 --> 00:27:27.309
physical therapy experience.

00:27:27.470 --> 00:27:29.191
I think there's value in marketing.

00:27:29.971 --> 00:27:30.891
We won't touch you.

00:27:31.290 --> 00:27:32.991
We won't be in your personal space.

00:27:33.031 --> 00:27:34.412
We respect your boundaries.

00:27:34.432 --> 00:27:35.353
It's not going to be enough

00:27:36.292 --> 00:27:38.634
patience to keep you viable,

00:27:38.693 --> 00:27:39.834
in my opinion.

00:27:39.874 --> 00:27:41.394
Just like the guy who found

00:27:41.454 --> 00:27:44.655
you for that very specific condition.

00:27:45.296 --> 00:27:46.977
If they're out there,

00:27:47.076 --> 00:27:48.257
there's always enough for a

00:27:48.317 --> 00:27:50.077
small single owner operator.

00:27:51.226 --> 00:27:52.445
yeah I think if you if

00:27:52.486 --> 00:27:53.307
you're if you're doing that

00:27:53.346 --> 00:27:54.967
too are you as if I were

00:27:55.027 --> 00:27:56.728
chris doe I'd be talking

00:27:56.748 --> 00:27:57.948
about the outcome he's like

00:27:58.008 --> 00:27:59.528
never he's like never I was

00:27:59.567 --> 00:28:00.449
watching another video and

00:28:00.489 --> 00:28:01.148
I feel like I've watched

00:28:01.368 --> 00:28:02.249
chris doe if you want to

00:28:02.269 --> 00:28:03.230
look him up he's the future

00:28:03.490 --> 00:28:04.269
it doesn't make any sense

00:28:04.289 --> 00:28:05.329
for physical therapists or

00:28:05.349 --> 00:28:06.631
business owners to watch

00:28:06.651 --> 00:28:07.351
his content because they're

00:28:07.371 --> 00:28:09.131
about graphic design and

00:28:09.431 --> 00:28:10.531
website work but it makes

00:28:10.571 --> 00:28:11.551
complete sense because it

00:28:11.571 --> 00:28:12.811
talks about framing and

00:28:12.832 --> 00:28:13.472
he's like I never talk

00:28:13.492 --> 00:28:15.333
about how uh designing this

00:28:15.353 --> 00:28:16.093
website is going to be ten

00:28:16.133 --> 00:28:17.634
thousand dollars why that's the price

00:28:18.334 --> 00:28:19.635
You want the outcome of the website?

00:28:19.776 --> 00:28:21.578
There's a reason you're in

00:28:21.598 --> 00:28:22.599
this meeting is because you

00:28:22.619 --> 00:28:23.862
have a problem and you are

00:28:23.922 --> 00:28:25.284
checking me out to see if I can solve it.

00:28:25.304 --> 00:28:25.903
The answer is yes.

00:28:26.184 --> 00:28:26.766
How do you do it?

00:28:27.006 --> 00:28:27.467
A process.

00:28:28.512 --> 00:28:28.692
Right?

00:28:28.833 --> 00:28:30.453
I want my house painted.

00:28:30.834 --> 00:28:32.355
I honestly don't care what brush you do.

00:28:32.714 --> 00:28:33.255
What do you do?

00:28:33.535 --> 00:28:34.596
How does it make my life better?

00:28:35.016 --> 00:28:36.217
What do I need to do to get it?

00:28:36.277 --> 00:28:36.497
Now,

00:28:36.797 --> 00:28:38.738
if I have an aversion to being touched,

00:28:39.137 --> 00:28:41.098
if there's someone who says I can do that,

00:28:41.878 --> 00:28:42.799
you now are at the top of

00:28:42.819 --> 00:28:44.220
the list or the only thing on the list.

00:28:44.400 --> 00:28:45.881
Or I've got a buddy who says

00:28:46.461 --> 00:28:47.561
he put on his sign

00:28:48.516 --> 00:28:49.896
Hands-on orthopedics.

00:28:50.057 --> 00:28:52.880
Because he's like, that's how I treat.

00:28:53.400 --> 00:28:54.981
And he's like, people call and they say,

00:28:55.321 --> 00:28:56.242
do you do this?

00:28:56.282 --> 00:28:57.624
Because other places don't.

00:28:58.023 --> 00:28:59.705
So I think by the existence

00:28:59.746 --> 00:29:01.007
of hand-on orthopedics- To

00:29:01.027 --> 00:29:03.249
go right against Tony, yes.

00:29:03.608 --> 00:29:04.109
No, no, no.

00:29:04.349 --> 00:29:06.951
This is proof of concepts for framing this,

00:29:07.132 --> 00:29:08.433
if you have it or don't,

00:29:08.854 --> 00:29:10.515
proves the existence of a market for it.

00:29:10.635 --> 00:29:12.396
I do think likely the

00:29:12.436 --> 00:29:13.498
hands-on would probably be

00:29:13.518 --> 00:29:14.239
a larger market.

00:29:14.699 --> 00:29:15.800
Yes, that's my point, yes.

00:29:15.941 --> 00:29:17.983
In terms of saying like, I don't want it.

00:29:18.183 --> 00:29:19.506
But if you're that person who's like,

00:29:19.566 --> 00:29:21.869
I can do it without it, I don't know.

00:29:23.053 --> 00:29:24.974
I'm going to take – so real quick, Will.

00:29:24.994 --> 00:29:25.996
Hands-off massage.

00:29:26.016 --> 00:29:27.676
I'm going to offer hands-off massage.

00:29:28.117 --> 00:29:30.279
The only guy.

00:29:30.299 --> 00:29:31.601
Have you ever heard of Reiki?

00:29:31.740 --> 00:29:31.861
Yes.

00:29:34.042 --> 00:29:34.784
It's rubbish.

00:29:34.864 --> 00:29:36.125
It's rubbish, yes.

00:29:36.164 --> 00:29:37.625
Dave has come on talking

00:29:37.665 --> 00:29:39.607
about virtual massage,

00:29:39.627 --> 00:29:42.932
talking about virtual –

00:29:41.450 --> 00:29:42.550
like there's a market for

00:29:42.671 --> 00:29:43.451
everything out there,

00:29:43.471 --> 00:29:44.792
the craziest stuff you can

00:29:44.952 --> 00:29:45.854
ever even consider.

00:29:45.874 --> 00:29:46.074
There is.

00:29:46.513 --> 00:29:47.555
Will Boyd is here.

00:29:47.615 --> 00:29:48.434
Will, if you missed it,

00:29:48.454 --> 00:29:49.894
we were talking about you earlier.

00:29:49.934 --> 00:29:53.096
We were talking about ChatGPT SEO.

00:29:53.297 --> 00:29:55.597
Dave was getting clients from ChatGPT.

00:29:56.917 --> 00:29:58.419
But my point in this is,

00:29:59.587 --> 00:30:02.608
you have to understand not just, okay,

00:30:02.628 --> 00:30:03.930
there are people who want to be touched.

00:30:03.970 --> 00:30:04.630
Yeah, I get it.

00:30:04.670 --> 00:30:05.691
Those people are out there.

00:30:05.711 --> 00:30:06.490
There's plenty of them.

00:30:07.070 --> 00:30:10.093
But I'm talking about the market of one,

00:30:10.153 --> 00:30:11.393
people who know they don't

00:30:11.432 --> 00:30:12.314
want to be touched.

00:30:12.953 --> 00:30:13.614
And two,

00:30:14.055 --> 00:30:15.355
the people who don't even know

00:30:15.394 --> 00:30:16.736
being touched is an option.

00:30:17.215 --> 00:30:18.698
There are a huge number of

00:30:18.738 --> 00:30:19.679
people that come into my

00:30:19.719 --> 00:30:20.759
clinic every single day.

00:30:20.799 --> 00:30:22.461
They've never been to therapy before.

00:30:22.803 --> 00:30:24.704
They have no idea what to expect.

00:30:25.165 --> 00:30:26.667
I ask every single person,

00:30:27.067 --> 00:30:29.171
what were you expecting me to do today?

00:30:29.490 --> 00:30:30.672
And I promise you,

00:30:31.913 --> 00:30:34.777
not even five percent of them say, well,

00:30:34.817 --> 00:30:36.439
I was expecting you to rub my back.

00:30:37.119 --> 00:30:39.602
So if I rub their back,

00:30:40.103 --> 00:30:42.023
I'm introducing something

00:30:42.404 --> 00:30:44.747
that I don't necessarily need to do,

00:30:45.307 --> 00:30:46.888
you know, and then we can talk about,

00:30:46.929 --> 00:30:47.068
well,

00:30:47.108 --> 00:30:48.809
what's insurance paying me to do or

00:30:48.849 --> 00:30:50.432
is the patient paying me to do?

00:30:50.892 --> 00:30:52.113
I shared a post the other day.

00:30:52.173 --> 00:30:52.532
Hey, man,

00:30:52.593 --> 00:30:54.134
if you want to pay me to rub your back,

00:30:54.315 --> 00:30:55.256
fifty bucks a unit,

00:30:55.435 --> 00:30:56.596
I will rub your back for

00:30:56.636 --> 00:30:57.597
fifty bucks a unit.

00:30:58.057 --> 00:30:59.558
But if insurance is paying

00:30:59.598 --> 00:31:02.220
me twenty dollars to rub your back,

00:31:02.420 --> 00:31:03.380
I am not going to do it

00:31:03.420 --> 00:31:05.300
because it's not medically necessary.

00:31:05.340 --> 00:31:07.041
And most of my referrals,

00:31:07.122 --> 00:31:08.082
most of the people who walk

00:31:08.122 --> 00:31:09.843
into my clinic.

00:31:09.863 --> 00:31:10.383
Could you rub?

00:31:10.462 --> 00:31:11.263
Could you get paid more if

00:31:11.284 --> 00:31:12.304
you rub different parts or

00:31:12.324 --> 00:31:12.804
how does this work?

00:31:12.865 --> 00:31:13.025
No.

00:31:13.105 --> 00:31:14.424
Dan Vapney saying massage

00:31:14.464 --> 00:31:16.846
with your words with your words.

00:31:16.945 --> 00:31:17.487
Beautiful.

00:31:17.507 --> 00:31:19.126
I love it.

00:31:19.586 --> 00:31:19.666
Yeah.

00:31:19.688 --> 00:31:20.667
Hey, since Dan's here,

00:31:21.048 --> 00:31:21.928
you guys want to talk a

00:31:21.969 --> 00:31:24.869
little bit about USPH financial report?

00:31:25.269 --> 00:31:25.470
Yeah.

00:31:25.509 --> 00:31:26.631
You had some of those numbers.

00:31:26.651 --> 00:31:27.451
You want to bring those up?

00:31:28.310 --> 00:31:29.372
I got a screenshot.

00:31:29.471 --> 00:31:30.353
Let me grab it.

00:31:30.713 --> 00:31:34.219
So USPH, US Physical Therapy shared their,

00:31:34.900 --> 00:31:36.961
I think, quarterly numbers, Q one.

00:31:37.583 --> 00:31:38.664
Ooh, we can't see that.

00:31:38.704 --> 00:31:39.526
Can you zoom it in?

00:31:39.546 --> 00:31:41.228
I don't know if I can't zoom it in.

00:31:41.248 --> 00:31:43.612
No, I'll find it.

00:31:43.652 --> 00:31:44.452
I'll put up a better version.

00:31:44.772 --> 00:31:45.993
Yeah, I'll just tell you guys.

00:31:46.054 --> 00:31:49.617
So basically, every year for sure,

00:31:49.998 --> 00:31:51.900
sometimes every quarter, I'll go,

00:31:52.019 --> 00:31:52.759
I'll grab U.S.

00:31:52.779 --> 00:31:53.560
physical therapy.

00:31:53.961 --> 00:31:54.541
I think,

00:31:54.721 --> 00:31:56.143
and Dave can probably correct me

00:31:56.163 --> 00:31:56.644
if I'm wrong,

00:31:57.545 --> 00:31:59.926
in terms of publicly traded companies,

00:32:00.346 --> 00:32:00.988
I think U.S.

00:32:01.008 --> 00:32:02.429
physical therapy is probably

00:32:02.469 --> 00:32:03.650
still doing the best.

00:32:03.829 --> 00:32:04.691
Although if you look at

00:32:04.711 --> 00:32:06.073
their five-year stock chart...

00:32:06.752 --> 00:32:07.753
It's the shits.

00:32:08.193 --> 00:32:09.455
They're doing horrible,

00:32:10.056 --> 00:32:12.038
but it's a steady decline.

00:32:13.098 --> 00:32:14.539
But basically what I love

00:32:14.579 --> 00:32:16.241
about their numbers is they

00:32:16.301 --> 00:32:19.144
run independent private practices,

00:32:19.184 --> 00:32:20.385
very similar to what a lot

00:32:20.425 --> 00:32:21.846
of listeners here are running.

00:32:22.528 --> 00:32:23.689
I feel like it gives us the

00:32:23.729 --> 00:32:25.651
best metric financial benchmark.

00:32:26.270 --> 00:32:28.192
So what they do is they

00:32:28.212 --> 00:32:29.834
share total patient revenue.

00:32:30.555 --> 00:32:32.174
And then they show you how

00:32:32.255 --> 00:32:34.355
much was spent on, quote,

00:32:34.415 --> 00:32:36.096
salaries and related costs.

00:32:36.576 --> 00:32:37.737
So for Q one,

00:32:37.777 --> 00:32:38.957
two thousand twenty five

00:32:39.057 --> 00:32:40.477
total revenue was one

00:32:40.497 --> 00:32:43.478
hundred and eighty three million of that.

00:32:44.498 --> 00:32:45.239
I think one hundred and

00:32:45.259 --> 00:32:47.858
eleven million was salaries

00:32:47.898 --> 00:32:48.959
and related costs.

00:32:48.979 --> 00:32:50.740
That represents sixty percent.

00:32:51.440 --> 00:32:51.619
So,

00:32:51.740 --> 00:32:54.222
sixty percent of revenue went to paying

00:32:54.262 --> 00:32:54.843
salaries.

00:32:55.182 --> 00:32:55.344
Now,

00:32:55.403 --> 00:32:57.105
I don't know if that's just clinical

00:32:57.164 --> 00:32:57.685
salaries.

00:32:57.726 --> 00:32:58.906
I would imagine it includes

00:32:58.946 --> 00:33:00.347
administrative salaries and

00:33:00.387 --> 00:33:00.989
anything else.

00:33:01.970 --> 00:33:03.351
About eighteen and a half

00:33:03.411 --> 00:33:05.553
percent went to covering

00:33:05.653 --> 00:33:08.255
rent supplies and contract labor.

00:33:09.195 --> 00:33:10.297
And then a little bit for

00:33:10.336 --> 00:33:12.958
depreciation and clinic closures.

00:33:13.678 --> 00:33:15.778
But I had shared a post and

00:33:15.818 --> 00:33:16.900
I'm curious to hear what

00:33:16.940 --> 00:33:18.221
you guys see for this.

00:33:19.161 --> 00:33:21.682
If I'm going to risk hiring

00:33:21.741 --> 00:33:24.083
a physical therapist for a

00:33:24.144 --> 00:33:25.544
hundred plus thousand a year,

00:33:25.804 --> 00:33:26.785
that's my out-of-pocket

00:33:26.825 --> 00:33:27.585
risk because I'm pretty

00:33:27.605 --> 00:33:29.105
much committed to probably

00:33:29.145 --> 00:33:30.086
a year's salary.

00:33:31.146 --> 00:33:32.667
What is my potential upside?

00:33:33.248 --> 00:33:37.089
You know, what is the return on that risk?

00:33:37.230 --> 00:33:40.171
Because if it's not double, triple,

00:33:40.230 --> 00:33:40.990
quadruple,

00:33:41.151 --> 00:33:42.192
I don't know that I want to put

00:33:42.231 --> 00:33:43.792
that risk out there.

00:33:43.833 --> 00:33:44.772
What are you guys,

00:33:45.373 --> 00:33:46.814
when you think of hiring a therapist,

00:33:46.874 --> 00:33:48.894
what are you thinking is the return?

00:33:48.914 --> 00:33:50.536
And I'm talking about net profit,

00:33:50.615 --> 00:33:53.477
money in my pocket after all expenses.

00:33:53.957 --> 00:33:54.237
Got it.

00:33:54.257 --> 00:33:55.377
So that's going to depend.

00:33:56.479 --> 00:33:57.559
I get the PT phrase in there,

00:33:57.619 --> 00:33:58.280
the medical phrase.

00:33:58.300 --> 00:33:59.842
Like what we typically see

00:33:59.862 --> 00:34:00.502
or like the quick

00:34:00.522 --> 00:34:01.683
benchmarks I've heard other

00:34:01.703 --> 00:34:03.506
people say is PT is going

00:34:03.526 --> 00:34:05.446
to gross to fifty, right?

00:34:05.548 --> 00:34:07.229
Working fifty weeks a year,

00:34:07.269 --> 00:34:07.970
forty hours a week.

00:34:07.990 --> 00:34:08.630
They're going to gross to

00:34:08.670 --> 00:34:10.132
fifty and a PTA is going to

00:34:10.172 --> 00:34:10.992
gross one fifty.

00:34:11.733 --> 00:34:13.634
Now, you asked me net.

00:34:13.653 --> 00:34:14.634
So now I don't know.

00:34:14.735 --> 00:34:15.235
In New York City,

00:34:15.255 --> 00:34:16.014
it's going to cost more to

00:34:16.074 --> 00:34:18.476
hire and benefits of what

00:34:18.496 --> 00:34:19.097
are you going to offer

00:34:19.157 --> 00:34:21.757
versus – we always rip on Iowa.

00:34:21.838 --> 00:34:22.737
I promise I don't hate Iowa.

00:34:22.757 --> 00:34:23.518
I'm just saying you're the

00:34:23.559 --> 00:34:24.798
opposite of New York City in a good way.

00:34:25.659 --> 00:34:27.940
So it depends, but –

00:34:28.311 --> 00:34:29.972
I did a quick reel the other day,

00:34:29.992 --> 00:34:30.751
a short form video,

00:34:30.791 --> 00:34:31.791
which is adding people

00:34:31.871 --> 00:34:34.512
isn't the solution first, right?

00:34:34.572 --> 00:34:35.693
If you have a great system,

00:34:35.713 --> 00:34:36.213
and that's what we're

00:34:36.233 --> 00:34:37.434
talking about with USPH,

00:34:37.813 --> 00:34:38.753
there's a bunch of clinics

00:34:38.773 --> 00:34:39.534
and brands across the

00:34:39.554 --> 00:34:40.534
country that you'd probably,

00:34:40.715 --> 00:34:42.815
maybe the average person has no idea.

00:34:43.396 --> 00:34:44.936
They are a house of brands.

00:34:45.117 --> 00:34:46.056
There are a bunch of brands

00:34:46.077 --> 00:34:47.378
that you've heard of across the company.

00:34:47.818 --> 00:34:49.539
USPH acquires them,

00:34:49.878 --> 00:34:50.998
streamlines some things you

00:34:51.018 --> 00:34:53.539
don't see in the back offices,

00:34:53.940 --> 00:34:54.920
and then lets those people

00:34:54.960 --> 00:34:55.900
still use their brands in

00:34:55.920 --> 00:34:56.461
their communities.

00:34:56.782 --> 00:34:57.342
So I don't know.

00:34:57.362 --> 00:34:57.601
I mean,

00:34:57.842 --> 00:34:59.262
are those numbers accurate to you guys?

00:34:59.402 --> 00:35:01.463
A PT grossing two-fifty,

00:35:01.503 --> 00:35:02.664
bringing in two-fifty,

00:35:03.045 --> 00:35:04.545
and a PTA adding one-fifty,

00:35:04.585 --> 00:35:05.445
then you have to subtract

00:35:05.505 --> 00:35:06.865
costs from those things as well.

00:35:06.945 --> 00:35:08.306
Dave?

00:35:10.056 --> 00:35:10.516
I mean,

00:35:10.536 --> 00:35:12.277
I feel like it should be at least

00:35:12.318 --> 00:35:12.998
twenty percent.

00:35:13.059 --> 00:35:13.759
Wouldn't it be at least

00:35:13.778 --> 00:35:15.480
fifty K in your pocket,

00:35:15.579 --> 00:35:16.500
in your bank account that

00:35:16.539 --> 00:35:18.900
then you reinvest if you

00:35:19.121 --> 00:35:20.322
you could have a distribution,

00:35:21.161 --> 00:35:23.003
you could you could

00:35:23.043 --> 00:35:24.864
reinvest it with whatever, you know,

00:35:24.903 --> 00:35:26.284
paid marketing, you put it back in,

00:35:26.744 --> 00:35:28.166
you use that to recruit the

00:35:28.186 --> 00:35:29.025
next therapist, whatever.

00:35:29.045 --> 00:35:29.927
And then it becomes like the

00:35:29.967 --> 00:35:30.706
compounding machine.

00:35:31.166 --> 00:35:31.688
Here's another.

00:35:31.728 --> 00:35:32.927
So I know Tony was asking

00:35:32.947 --> 00:35:34.208
about like the actual dollar amount.

00:35:34.228 --> 00:35:35.028
So that's why I was trying

00:35:35.048 --> 00:35:35.789
to just give fifty K.

00:35:36.710 --> 00:35:37.849
But another thing that the

00:35:38.429 --> 00:35:40.050
medium to larger clinics

00:35:40.070 --> 00:35:40.951
probably look at is like,

00:35:41.371 --> 00:35:43.550
let's say we hire this therapist,

00:35:44.271 --> 00:35:47.351
Tom Smith, and let's say, so, you know,

00:35:47.612 --> 00:35:48.552
round numbers, two fifty,

00:35:48.572 --> 00:35:49.192
they're going to generate

00:35:49.211 --> 00:35:50.331
two fifty or you're going

00:35:50.351 --> 00:35:51.253
to pay him one hundred K

00:35:51.393 --> 00:35:53.132
total salary benefits

00:35:53.172 --> 00:35:54.052
compensation package.

00:35:54.693 --> 00:35:57.074
Maybe they the net income in

00:35:57.114 --> 00:35:58.614
your bank account or that

00:35:58.653 --> 00:35:59.773
you could do whatever with

00:35:59.893 --> 00:36:01.414
get taxed on or you reinvest it.

00:36:01.875 --> 00:36:02.875
Let's just say potentially

00:36:02.894 --> 00:36:03.414
if it's fifty K.

00:36:04.195 --> 00:36:05.737
But then also it's that

00:36:05.817 --> 00:36:08.320
therapist is treating like Tony,

00:36:08.360 --> 00:36:09.862
how many in a network practice,

00:36:09.882 --> 00:36:11.304
like how many patient

00:36:11.324 --> 00:36:12.545
encounters per year or

00:36:12.606 --> 00:36:14.869
patients that a therapist is seeing?

00:36:16.030 --> 00:36:17.311
I'm going to say depending

00:36:17.331 --> 00:36:17.952
on the practice.

00:36:18.253 --> 00:36:18.652
Yeah.

00:36:18.773 --> 00:36:20.476
Let's say twelve to fifteen in a day.

00:36:21.775 --> 00:36:25.056
The amount annually that

00:36:25.077 --> 00:36:26.416
that therapist is treating,

00:36:28.297 --> 00:36:29.518
assuming that the therapist

00:36:29.557 --> 00:36:30.478
is great or good,

00:36:31.458 --> 00:36:32.418
they're treating those patients,

00:36:32.438 --> 00:36:33.898
those patients are telling other patients,

00:36:33.918 --> 00:36:34.539
you're getting the word

00:36:34.559 --> 00:36:35.478
about the referrals.

00:36:36.119 --> 00:36:37.940
In a year or two, if that therapist leaves,

00:36:38.340 --> 00:36:39.900
that practice still has the

00:36:39.960 --> 00:36:41.400
benefit of those patient

00:36:41.420 --> 00:36:42.561
encounters being treated by

00:36:42.721 --> 00:36:45.181
at least an adequate physical therapist,

00:36:45.262 --> 00:36:46.981
if not a good physical therapist.

00:36:47.681 --> 00:36:49.003
That therapist leaves the system.

00:36:49.023 --> 00:36:50.402
They go, they move to another state,

00:36:50.422 --> 00:36:50.682
whatever.

00:36:51.202 --> 00:36:52.903
That practice has the

00:36:53.143 --> 00:36:54.503
ongoing goodwill of the

00:36:54.583 --> 00:36:55.563
previous year and the

00:36:55.603 --> 00:36:56.505
previous year of those

00:36:56.545 --> 00:36:58.144
patients that that therapist treated.

00:36:58.824 --> 00:37:00.405
So whether it's warm, you know,

00:37:00.465 --> 00:37:01.045
word of mouth,

00:37:01.865 --> 00:37:02.967
a patient a year or two ago

00:37:03.007 --> 00:37:04.606
wrote a Google review or

00:37:04.646 --> 00:37:06.047
Yelp review because of that therapist,

00:37:06.067 --> 00:37:07.547
that therapist left.

00:37:08.268 --> 00:37:09.288
but you still get some of

00:37:09.307 --> 00:37:10.969
that ongoing annual

00:37:11.028 --> 00:37:12.208
compounding now over time

00:37:12.248 --> 00:37:13.168
maybe there's a long tail

00:37:13.188 --> 00:37:14.148
and maybe it trails off and

00:37:14.168 --> 00:37:14.949
you get less and less of

00:37:14.989 --> 00:37:17.630
that but that's some of the

00:37:18.809 --> 00:37:19.530
like I know you were asking

00:37:19.550 --> 00:37:20.530
for the dollar amount so

00:37:20.550 --> 00:37:21.311
that's why I gave it but

00:37:21.331 --> 00:37:22.630
then these are some of the

00:37:22.650 --> 00:37:23.871
things that you get you get

00:37:24.052 --> 00:37:25.572
ongoing financial benefit

00:37:26.331 --> 00:37:27.251
from a physical therapist

00:37:27.271 --> 00:37:29.353
in terms of like the actual net net

00:37:31.541 --> 00:37:36.146
Now for listeners, Will Boyd is here.

00:37:36.405 --> 00:37:38.887
Will is sharing a tool that

00:37:38.947 --> 00:37:40.068
helps you predict,

00:37:40.809 --> 00:37:42.271
I think it was how much you can pay,

00:37:42.351 --> 00:37:43.931
how profitable they need to be.

00:37:43.992 --> 00:37:45.032
That's kind of what got me

00:37:45.092 --> 00:37:46.755
thinking about this topic again.

00:37:47.195 --> 00:37:48.255
We're not in the market to

00:37:48.275 --> 00:37:49.317
hire a therapist,

00:37:49.777 --> 00:37:50.878
but I still have to look at

00:37:50.918 --> 00:37:52.199
it and I have to say, okay,

00:37:52.519 --> 00:37:53.581
to Dave's point,

00:37:54.221 --> 00:37:55.581
Yeah, there's intangibles.

00:37:56.121 --> 00:37:57.382
You've got the baseline, right?

00:37:57.422 --> 00:37:58.284
Twenty years ago,

00:37:58.563 --> 00:38:00.065
the expectation was if you

00:38:00.105 --> 00:38:01.065
want one hundred thousand,

00:38:01.085 --> 00:38:02.706
you better create four

00:38:02.726 --> 00:38:04.108
hundred to five hundred thousand.

00:38:04.588 --> 00:38:05.228
Today,

00:38:05.650 --> 00:38:08.150
the expectation closer to two

00:38:08.190 --> 00:38:08.931
hundred and fifty.

00:38:08.952 --> 00:38:10.492
I mean, that's the reality of it.

00:38:11.454 --> 00:38:13.195
So the same therapist

00:38:13.235 --> 00:38:14.795
working the same amount is

00:38:14.876 --> 00:38:16.818
generating half of what

00:38:16.858 --> 00:38:17.597
they would have been

00:38:17.657 --> 00:38:20.661
expected to generate two decades ago.

00:38:21.603 --> 00:38:23.804
But then within that, to Dave's point,

00:38:23.945 --> 00:38:25.626
okay, so you get in a good therapist,

00:38:25.686 --> 00:38:25.865
right?

00:38:25.905 --> 00:38:27.726
We assume we do a good hiring process.

00:38:27.746 --> 00:38:28.827
We get in a good therapist.

00:38:28.847 --> 00:38:29.588
They're an asset.

00:38:29.907 --> 00:38:31.349
They're going to help build the practice.

00:38:31.369 --> 00:38:32.728
They're going to build reputation.

00:38:33.148 --> 00:38:34.829
On the flip side, they leave.

00:38:35.010 --> 00:38:36.311
They take a portion of that

00:38:36.351 --> 00:38:38.112
caseload with them because

00:38:38.231 --> 00:38:39.913
those patients want them.

00:38:40.092 --> 00:38:41.974
They don't want total therapy solutions.

00:38:42.313 --> 00:38:43.233
They want Dave Kittle

00:38:43.253 --> 00:38:44.514
because Dave Kittle is what

00:38:44.574 --> 00:38:45.574
helped them feel better.

00:38:46.054 --> 00:38:47.315
So you've got pros and cons.

00:38:47.335 --> 00:38:49.476
You've got risks to weigh on.

00:38:49.817 --> 00:38:50.297
Um, but,

00:38:50.418 --> 00:38:52.239
but I still look at it and I'm like, man,

00:38:52.318 --> 00:38:53.099
I'm pretty much,

00:38:53.179 --> 00:38:54.159
I'm guaranteed an

00:38:54.219 --> 00:38:57.322
investment at risk of a hundred thousand.

00:38:58.101 --> 00:39:00.164
I can lose that full hundred thousand.

00:39:00.443 --> 00:39:01.905
I can lose a portion of it.

00:39:02.085 --> 00:39:03.266
I can have a therapist come in.

00:39:03.286 --> 00:39:04.847
Who's not as good as I was hoping.

00:39:05.427 --> 00:39:07.108
Give me a bad reputation.

00:39:07.608 --> 00:39:08.188
Leave.

00:39:08.648 --> 00:39:10.548
They're no worse for wear.

00:39:10.789 --> 00:39:12.349
I suffer the consequences.

00:39:12.690 --> 00:39:13.750
They do amazing.

00:39:14.090 --> 00:39:14.951
They leave and they take

00:39:14.990 --> 00:39:16.010
half of my caseload.

00:39:16.452 --> 00:39:17.992
I suffer the consequences.

00:39:18.391 --> 00:39:18.972
And then I'm like,

00:39:19.052 --> 00:39:20.833
if I've got a hundred thousand to invest,

00:39:20.952 --> 00:39:22.693
is this the best investment

00:39:22.813 --> 00:39:24.195
I can make with that money?

00:39:24.735 --> 00:39:26.615
Are there other lines of business?

00:39:26.675 --> 00:39:27.916
Are there digital products?

00:39:27.956 --> 00:39:28.936
Are there things that I can

00:39:28.976 --> 00:39:30.878
do that are scalable so

00:39:30.918 --> 00:39:32.717
that my expected return

00:39:32.918 --> 00:39:35.920
isn't fifty thousand on a good outcome?

00:39:36.340 --> 00:39:37.860
But maybe it's two hundred

00:39:37.880 --> 00:39:39.840
and fifty thousand in take

00:39:39.900 --> 00:39:41.382
home because I created

00:39:41.442 --> 00:39:42.362
something that is just

00:39:42.382 --> 00:39:43.523
going to print money for

00:39:43.563 --> 00:39:45.664
the next ten years.

00:39:45.684 --> 00:39:47.063
Good points.

00:39:47.083 --> 00:39:48.405
So you're saying like if

00:39:48.585 --> 00:39:49.605
what would be a better bet

00:39:49.945 --> 00:39:52.586
in terms of ROI instead of hiring,

00:39:52.626 --> 00:39:52.987
because

00:39:54.286 --> 00:39:55.306
it's not it's not a done

00:39:55.327 --> 00:39:56.427
deal right like you said

00:39:56.467 --> 00:39:57.768
years ago it was a five did

00:39:57.789 --> 00:39:58.768
you say five x return

00:39:58.869 --> 00:39:59.630
usually yeah yeah I mean

00:39:59.670 --> 00:40:00.570
that was the standard

00:40:00.710 --> 00:40:01.911
expectation four to five

00:40:01.952 --> 00:40:03.532
times what you cost yeah

00:40:03.693 --> 00:40:05.454
yeah do you so I would say

00:40:05.594 --> 00:40:06.655
and again I did it I just

00:40:06.675 --> 00:40:07.675
did a short form video on

00:40:07.695 --> 00:40:09.416
this which is do you need

00:40:09.496 --> 00:40:11.778
more pts or do you need to

00:40:11.818 --> 00:40:12.639
make sure whatever you're

00:40:12.659 --> 00:40:13.940
doing is optimized now

00:40:14.061 --> 00:40:15.181
before you start adding

00:40:15.221 --> 00:40:16.842
complexity right and this

00:40:16.882 --> 00:40:18.684
came from well more is

00:40:18.724 --> 00:40:19.684
probably better it's like

00:40:19.704 --> 00:40:20.985
well if you put more stress

00:40:21.005 --> 00:40:22.487
this is like this is the bar rescue

00:40:23.126 --> 00:40:23.507
model.

00:40:23.768 --> 00:40:24.889
If you've ever watched that show,

00:40:24.929 --> 00:40:25.971
it's like the stress test

00:40:26.030 --> 00:40:27.972
is put stress through the current system,

00:40:28.373 --> 00:40:29.454
find out where the leaks are,

00:40:29.755 --> 00:40:31.036
fix the leak first,

00:40:31.336 --> 00:40:32.918
then put more things through the system.

00:40:32.938 --> 00:40:34.621
So that would be the John Taffer approach.

00:40:35.913 --> 00:40:37.994
All right, Jimmy, I think you got to go.

00:40:38.235 --> 00:40:38.974
Your time is up.

00:40:39.554 --> 00:40:40.096
I'm going to dip.

00:40:40.115 --> 00:40:41.336
I'll get my parting shots

00:40:41.376 --> 00:40:42.697
for today is try something

00:40:42.737 --> 00:40:43.617
new all the time.

00:40:43.737 --> 00:40:44.679
I'm driving around.

00:40:44.858 --> 00:40:45.920
I'm doing something outside

00:40:45.960 --> 00:40:48.400
of my daily role at Athelas,

00:40:48.420 --> 00:40:50.222
like completely opposite of the spectrum.

00:40:50.842 --> 00:40:51.744
And even if this is

00:40:51.804 --> 00:40:53.405
traditionally not successful,

00:40:53.784 --> 00:40:55.545
I learned a ton and experienced it.

00:40:55.965 --> 00:40:56.786
This goes back to like a

00:40:56.847 --> 00:40:58.487
Jerry Durham statement I

00:40:58.527 --> 00:40:59.688
heard years ago as a student.

00:40:59.708 --> 00:41:00.730
And I'm like, that's insane.

00:41:00.809 --> 00:41:01.750
Jerry used to talk about how

00:41:02.110 --> 00:41:02.990
he would just bring his

00:41:03.050 --> 00:41:04.391
laptop and sit in his

00:41:04.452 --> 00:41:05.632
waiting room in his clinic.

00:41:06.273 --> 00:41:06.992
and just listen.

00:41:07.634 --> 00:41:09.934
Like what is asked first by the patient?

00:41:09.994 --> 00:41:11.014
How do they speak?

00:41:11.054 --> 00:41:12.114
What are they asking about?

00:41:12.536 --> 00:41:14.356
That is likely changed over time.

00:41:14.715 --> 00:41:16.577
And also I'm sure his staff

00:41:16.597 --> 00:41:17.378
knew he was the owner when

00:41:17.398 --> 00:41:18.557
he was sitting there, but like, how is,

00:41:18.737 --> 00:41:20.119
how does your staff respond?

00:41:20.199 --> 00:41:20.418
Right?

00:41:20.438 --> 00:41:21.259
So do you have to sit there

00:41:21.298 --> 00:41:22.480
long enough to get the

00:41:22.519 --> 00:41:23.559
staff to sort of forget

00:41:23.579 --> 00:41:24.239
that you're there?

00:41:24.739 --> 00:41:25.541
The patients are going to

00:41:25.561 --> 00:41:26.201
give you good insight.

00:41:26.240 --> 00:41:26.840
If you're not paying

00:41:26.860 --> 00:41:27.742
attention to those little

00:41:27.762 --> 00:41:29.521
things that you just assume are okay,

00:41:30.202 --> 00:41:31.282
that's a dangerous assumption.

00:41:32.092 --> 00:41:34.373
Gentlemen, I'll see you guys on Tuesday.

00:41:34.393 --> 00:41:34.634
I got to dip.

00:41:34.653 --> 00:41:34.974
All right.

00:41:35.054 --> 00:41:35.954
See you, Jimmy.

00:41:35.974 --> 00:41:36.295
See you, Jimmy.

00:41:36.315 --> 00:41:36.556
So Dave,

00:41:36.735 --> 00:41:38.577
I've got a question about practice

00:41:38.697 --> 00:41:40.958
acquisition and sales,

00:41:41.137 --> 00:41:42.599
and this is your world.

00:41:43.139 --> 00:41:44.139
I don't know that you have

00:41:45.000 --> 00:41:46.541
much to say because these

00:41:46.581 --> 00:41:48.382
are like micro transactions.

00:41:48.681 --> 00:41:50.422
When I sold my practice down in Florida,

00:41:50.762 --> 00:41:53.684
my single location, it was such a tiny,

00:41:54.164 --> 00:41:55.465
it was a handshake deal.

00:41:55.806 --> 00:41:56.867
There was no lawyers,

00:41:56.907 --> 00:41:58.327
like none of the big stuff.

00:41:58.907 --> 00:41:59.869
But there's a lot of

00:41:59.909 --> 00:42:01.150
therapists out there that

00:42:01.190 --> 00:42:02.690
are looking to accelerate.

00:42:02.851 --> 00:42:04.211
They're looking to grow.

00:42:04.291 --> 00:42:05.393
They want to acquire.

00:42:05.452 --> 00:42:06.353
There's a lot of therapists

00:42:06.373 --> 00:42:07.173
that want to get out.

00:42:07.454 --> 00:42:08.474
They want to retire.

00:42:08.775 --> 00:42:09.496
They don't have anything

00:42:09.536 --> 00:42:11.257
that would ever sell to private equity.

00:42:11.918 --> 00:42:14.340
And so I get these questions.

00:42:15.320 --> 00:42:17.641
Two of the big ones that

00:42:17.922 --> 00:42:19.204
therapists are asking me, they're like,

00:42:19.244 --> 00:42:19.724
Tony, you know,

00:42:19.764 --> 00:42:21.985
how do I value the how do I

00:42:22.005 --> 00:42:23.007
come to a price?

00:42:23.266 --> 00:42:24.628
What am I actually buying?

00:42:25.047 --> 00:42:25.648
Yeah.

00:42:26.536 --> 00:42:27.376
I want to share two things

00:42:27.396 --> 00:42:28.757
that therapists don't often

00:42:28.797 --> 00:42:30.378
think about in the transaction,

00:42:30.418 --> 00:42:31.219
but I want you to think

00:42:31.239 --> 00:42:32.501
about a couple of tips you

00:42:32.521 --> 00:42:33.440
can give therapists who

00:42:33.460 --> 00:42:34.282
might be thinking about

00:42:34.322 --> 00:42:35.202
going this direction.

00:42:35.802 --> 00:42:38.445
So one of the topics is the

00:42:38.485 --> 00:42:39.606
accounts receivable.

00:42:40.327 --> 00:42:41.987
When a therapist is buying

00:42:42.148 --> 00:42:43.329
another practice,

00:42:43.708 --> 00:42:45.150
you have to consider like,

00:42:45.349 --> 00:42:46.231
what are you going to do

00:42:46.251 --> 00:42:48.192
with the outstanding accounts receivable?

00:42:48.271 --> 00:42:50.072
If the previous owner is

00:42:50.092 --> 00:42:52.635
seeing patients up to today

00:42:52.775 --> 00:42:54.275
and the transaction happens

00:42:54.556 --> 00:42:57.338
after close of business tonight,

00:42:58.119 --> 00:42:59.338
all of that history,

00:42:59.699 --> 00:43:01.041
there's at least a couple of weeks,

00:43:01.081 --> 00:43:03.141
there's probably more of

00:43:03.222 --> 00:43:04.382
accounts receivable that

00:43:04.402 --> 00:43:05.182
are sitting out there.

00:43:05.744 --> 00:43:06.764
If there's a hundred

00:43:06.824 --> 00:43:08.105
thousand dollars worth of

00:43:08.144 --> 00:43:09.465
accounts receivable and you

00:43:09.545 --> 00:43:10.766
reasonably expect that

00:43:10.786 --> 00:43:11.628
you're going to collect

00:43:13.829 --> 00:43:15.289
then that fifty thousand

00:43:15.309 --> 00:43:16.690
should be calculated in the

00:43:16.750 --> 00:43:18.750
sale price if you're going

00:43:18.769 --> 00:43:20.570
to take over the accounts receivable.

00:43:20.610 --> 00:43:21.590
But if you're going to cut

00:43:21.630 --> 00:43:23.972
ties and allow the old

00:43:24.152 --> 00:43:25.652
previous owner to keep

00:43:25.731 --> 00:43:27.112
their accounts receivable,

00:43:27.152 --> 00:43:27.833
then that's got to be

00:43:27.893 --> 00:43:30.472
reduced from the value of the practice.

00:43:30.512 --> 00:43:31.253
And you're going to have to

00:43:31.293 --> 00:43:33.034
fund the next two or three

00:43:33.054 --> 00:43:34.134
weeks before the new

00:43:34.213 --> 00:43:36.155
accounts start to produce revenue.

00:43:36.775 --> 00:43:38.295
Any advice on something like

00:43:38.315 --> 00:43:40.476
that for somebody in this situation?

00:43:42.056 --> 00:43:43.297
Well, no, I mean,

00:43:43.376 --> 00:43:44.737
what you just described is

00:43:44.797 --> 00:43:46.257
exactly what needs to occur.

00:43:46.978 --> 00:43:48.579
How you just described it is perfect.

00:43:48.818 --> 00:43:51.380
It's either you are going to

00:43:52.121 --> 00:43:53.621
adjust it off the purchase price.

00:43:54.101 --> 00:43:55.782
So if the owner is going to

00:43:55.802 --> 00:43:56.744
be taking the accounts

00:43:56.764 --> 00:43:58.804
receivable from today,

00:43:59.644 --> 00:44:00.766
for the next thirty days or

00:44:00.806 --> 00:44:01.806
sixty days or whatever till

00:44:01.847 --> 00:44:03.106
the actual date you know

00:44:03.588 --> 00:44:06.570
closing date that all needs

00:44:06.590 --> 00:44:07.369
to be discussed ahead of

00:44:07.389 --> 00:44:09.291
time so either I mean it's

00:44:09.331 --> 00:44:10.331
all factored into the deal

00:44:10.632 --> 00:44:11.833
so it's either coming off

00:44:11.873 --> 00:44:14.034
the purchase price or

00:44:14.215 --> 00:44:15.175
you're paying extra but if

00:44:15.235 --> 00:44:16.376
it comes off the purchase

00:44:16.396 --> 00:44:17.496
price then yes then you

00:44:17.536 --> 00:44:18.838
need to have as the owner

00:44:19.338 --> 00:44:20.920
some other cash in a

00:44:20.960 --> 00:44:22.300
separate bank account to

00:44:22.400 --> 00:44:24.202
fund the payroll or the

00:44:24.282 --> 00:44:25.322
rent or whatever it is all

00:44:25.362 --> 00:44:26.724
the other all the other

00:44:26.804 --> 00:44:28.164
utilities or overhead and everything

00:44:29.922 --> 00:44:31.603
to bridge that gap.

00:44:31.844 --> 00:44:35.405
It's very, I think it muddies,

00:44:36.226 --> 00:44:37.507
it's only a muddied water a

00:44:37.547 --> 00:44:39.927
little bit because of the

00:44:40.047 --> 00:44:41.789
delay in healthcare payment

00:44:41.809 --> 00:44:42.570
and reimbursement,

00:44:43.869 --> 00:44:46.130
but it's not a complex topic.

00:44:46.231 --> 00:44:46.851
The way that you just

00:44:46.891 --> 00:44:47.992
described it is perfect.

00:44:48.932 --> 00:44:49.612
And I know you were speaking

00:44:49.632 --> 00:44:50.594
with someone who was having

00:44:50.614 --> 00:44:51.793
some challenges with that recently,

00:44:51.833 --> 00:44:53.434
but that's exactly how it occurs.

00:44:53.454 --> 00:44:54.396
It doesn't matter if it's a

00:44:54.476 --> 00:44:56.597
small practice or a larger practice.

00:44:57.317 --> 00:44:58.737
That's exactly how it occurs.

00:44:59.684 --> 00:44:59.965
Awesome.

00:45:00.164 --> 00:45:00.306
Now,

00:45:00.365 --> 00:45:02.266
another one people don't necessarily

00:45:02.306 --> 00:45:03.927
think about is lease options.

00:45:04.568 --> 00:45:08.030
So when we sold our Florida location,

00:45:08.550 --> 00:45:10.193
we had to make sure, one,

00:45:10.233 --> 00:45:11.773
the landlord was willing to

00:45:12.034 --> 00:45:13.795
switch the lease over to the new owner.

00:45:14.335 --> 00:45:14.876
Two,

00:45:15.036 --> 00:45:16.476
the new owner had to make sure the

00:45:16.536 --> 00:45:17.757
landlord wasn't going to say,

00:45:18.277 --> 00:45:18.478
hey,

00:45:18.518 --> 00:45:20.099
this guy's had a three and a half

00:45:20.139 --> 00:45:22.059
percent annual increase

00:45:22.199 --> 00:45:24.121
that's way below inflation.

00:45:24.601 --> 00:45:26.521
We're going to bump you to a

00:45:26.581 --> 00:45:27.922
hundred percent increase.

00:45:27.943 --> 00:45:29.184
We're going to double your

00:45:29.224 --> 00:45:31.364
rent and sign a new lease with you.

00:45:32.364 --> 00:45:34.005
There's things in that that

00:45:34.045 --> 00:45:35.067
need to be established

00:45:35.086 --> 00:45:36.827
before you purchase,

00:45:36.987 --> 00:45:38.688
if it's a brick and mortar practice.

00:45:39.469 --> 00:45:41.010
And knowing that the

00:45:41.070 --> 00:45:42.731
landlord is even willing to

00:45:43.291 --> 00:45:44.512
let you transition that

00:45:44.552 --> 00:45:45.672
lease or extend the lease?

00:45:45.693 --> 00:45:47.735
Because from the landlord's perspective,

00:45:48.115 --> 00:45:49.757
you're buying an existing business.

00:45:49.836 --> 00:45:52.179
That business has been a tenant for years,

00:45:52.260 --> 00:45:53.581
probably at this point,

00:45:54.161 --> 00:45:55.382
but maybe they want to get

00:45:55.443 --> 00:45:56.684
rid of a healthcare

00:45:56.724 --> 00:45:57.545
business and they want to

00:45:57.585 --> 00:45:58.885
bring something else in.

00:45:59.485 --> 00:46:00.827
Have you seen anything

00:46:01.387 --> 00:46:04.050
related to those kinds of extensions?

00:46:05.572 --> 00:46:06.112
Yes.

00:46:06.132 --> 00:46:07.253
So I...

00:46:08.501 --> 00:46:10.867
when we're looking at potential deals,

00:46:11.407 --> 00:46:13.692
what's wild is every lease is different.

00:46:13.791 --> 00:46:14.894
Like there was a practice

00:46:15.355 --> 00:46:16.197
that we looked at a couple

00:46:16.217 --> 00:46:19.543
of years ago that had something like

00:46:21.117 --> 00:46:23.438
It was like an eighteen year lease.

00:46:23.478 --> 00:46:24.659
It was crazy long,

00:46:24.679 --> 00:46:26.259
like the biggest we've ever seen,

00:46:26.298 --> 00:46:27.820
the longest lease we've ever seen.

00:46:28.679 --> 00:46:31.001
And all the future years

00:46:31.081 --> 00:46:34.561
were already agreed upon, obviously,

00:46:34.581 --> 00:46:35.561
because it was part of the lease.

00:46:36.061 --> 00:46:37.443
And then we look at other

00:46:37.543 --> 00:46:39.182
practices and their leases are, you know,

00:46:39.222 --> 00:46:40.322
three, four or five years.

00:46:42.364 --> 00:46:43.045
Earlier this year we were

00:46:43.065 --> 00:46:43.724
speaking with a practice

00:46:43.804 --> 00:46:46.827
owner that had only like

00:46:47.347 --> 00:46:48.088
two or three years

00:46:48.128 --> 00:46:49.869
remaining on a lease of one

00:46:49.889 --> 00:46:50.750
of their locations.

00:46:50.809 --> 00:46:54.132
So all that is a consideration.

00:46:55.152 --> 00:46:57.313
I actually had a real estate

00:46:57.353 --> 00:47:00.175
broker that works on behalf

00:47:00.235 --> 00:47:02.938
of the practices and the tenants.

00:47:03.934 --> 00:47:05.373
he would get his commission

00:47:05.393 --> 00:47:07.014
from the landlord to fill

00:47:07.275 --> 00:47:08.414
slots right so he's been

00:47:08.434 --> 00:47:09.795
sending me abstracts and

00:47:10.175 --> 00:47:11.235
he's been sending me uh

00:47:12.175 --> 00:47:14.096
square footage options near

00:47:14.257 --> 00:47:14.956
different corners of

00:47:15.016 --> 00:47:16.077
manhattan whatever corner

00:47:16.117 --> 00:47:18.016
or address I send him he's

00:47:18.237 --> 00:47:19.538
pricing out other uh

00:47:19.557 --> 00:47:23.719
options uh in the area and he um

00:47:24.619 --> 00:47:27.480
has he's described like the

00:47:27.500 --> 00:47:29.079
the the differences and

00:47:29.199 --> 00:47:30.500
also the thing they

00:47:31.001 --> 00:47:32.981
consider is that sometimes

00:47:33.021 --> 00:47:33.960
these landlords are like oh

00:47:34.021 --> 00:47:35.081
yeah like you said tony we

00:47:35.101 --> 00:47:36.762
got a new buyer a new

00:47:36.802 --> 00:47:37.842
physical therapy buyer they

00:47:37.862 --> 00:47:38.802
don't know who we are or

00:47:38.902 --> 00:47:40.083
who you are who who's the

00:47:40.103 --> 00:47:42.583
buyer but they could smell

00:47:42.842 --> 00:47:44.344
you know the money and

00:47:44.384 --> 00:47:45.204
think oh well there's

00:47:45.403 --> 00:47:46.324
there's this new buyer so

00:47:46.344 --> 00:47:47.164
you're right maybe they

00:47:47.184 --> 00:47:49.224
want to jack up the um

00:47:50.202 --> 00:47:51.023
the rent on us,

00:47:51.664 --> 00:47:53.646
if we don't do the change

00:47:53.666 --> 00:47:54.507
of ownership properly,

00:47:54.527 --> 00:47:55.188
if we don't have that

00:47:55.228 --> 00:47:58.052
documented in a contract and all that,

00:47:59.733 --> 00:48:00.594
even if the practice has

00:48:00.614 --> 00:48:03.018
five more years on the lease,

00:48:03.039 --> 00:48:03.960
like there needs to be some

00:48:04.000 --> 00:48:05.282
change of ownership clause

00:48:05.302 --> 00:48:06.222
or something that's

00:48:06.322 --> 00:48:07.925
hopefully in the original contract.

00:48:08.925 --> 00:48:10.467
do we want to take uh do we

00:48:10.487 --> 00:48:12.188
need to buy the llc or the

00:48:12.228 --> 00:48:13.829
plc or the business entity

00:48:14.128 --> 00:48:15.510
in order to have the easier

00:48:15.530 --> 00:48:16.409
change of ownership but

00:48:16.449 --> 00:48:17.490
sometimes we want to buy

00:48:17.530 --> 00:48:18.351
the asset we want to have

00:48:18.371 --> 00:48:20.211
an asset sale and not buy a

00:48:20.271 --> 00:48:21.072
stock sale we don't

00:48:21.293 --> 00:48:22.152
sometimes we don't want to

00:48:22.193 --> 00:48:24.693
buy the llc or the plc

00:48:24.713 --> 00:48:25.715
because then we're taking

00:48:26.135 --> 00:48:27.115
we're we're assuming the

00:48:27.135 --> 00:48:28.597
liabilities of that

00:48:28.637 --> 00:48:30.077
practice so if some patient

00:48:30.097 --> 00:48:31.478
was burned by a hot pack

00:48:31.498 --> 00:48:32.958
thirty sixty days ago if

00:48:32.998 --> 00:48:34.460
they file a lawsuit or something

00:48:35.827 --> 00:48:36.728
we might have to deal with

00:48:36.768 --> 00:48:38.271
it as opposed to the seller.

00:48:38.490 --> 00:48:38.690
Anyway,

00:48:38.710 --> 00:48:39.791
so there's all these considerations.

00:48:39.831 --> 00:48:41.653
The cool thing with the real

00:48:41.673 --> 00:48:42.474
estate broker in New York

00:48:42.514 --> 00:48:43.876
City that reached out to me recently

00:48:44.918 --> 00:48:46.599
is he'll send me square

00:48:46.619 --> 00:48:47.900
footage options nearby,

00:48:48.380 --> 00:48:49.902
and he'll say in this building,

00:48:50.041 --> 00:48:50.902
in the current building,

00:48:51.403 --> 00:48:52.525
the current building that

00:48:52.545 --> 00:48:55.666
this practice is in, there's a,

00:48:55.686 --> 00:48:57.449
there's a twenty one percent vacancy.

00:48:57.489 --> 00:48:58.849
There's a sixteen, seventeen,

00:48:58.869 --> 00:49:00.090
whatever percent vacancy.

00:49:00.871 --> 00:49:02.853
So then as the buyers, we could say, well,

00:49:03.574 --> 00:49:05.295
not only is this landlord

00:49:05.536 --> 00:49:06.315
probably not going to raise

00:49:06.356 --> 00:49:07.818
the price on us too much.

00:49:09.059 --> 00:49:10.280
Could we negotiate lower?

00:49:11.659 --> 00:49:12.398
Most people don't even think

00:49:12.418 --> 00:49:13.018
that's an option.

00:49:13.338 --> 00:49:13.739
Now,

00:49:13.780 --> 00:49:14.940
sometimes it's not an option because

00:49:14.960 --> 00:49:15.940
there's bank covenants,

00:49:16.380 --> 00:49:18.601
because the owner of the

00:49:18.681 --> 00:49:20.280
real estate that has

00:49:20.601 --> 00:49:21.561
financing through other

00:49:21.601 --> 00:49:23.402
banks and institutions has

00:49:23.481 --> 00:49:25.161
some covenants where

00:49:25.222 --> 00:49:26.302
sometimes they can't go

00:49:26.342 --> 00:49:27.623
below a certain market rate

00:49:27.842 --> 00:49:30.784
of lease agreements than

00:49:30.804 --> 00:49:31.764
what they already have

00:49:32.403 --> 00:49:33.824
agreed upon in paper.

00:49:33.844 --> 00:49:34.485
Does that make sense?

00:49:35.005 --> 00:49:35.204
Yeah.

00:49:38.773 --> 00:49:39.574
So there's a lot of this

00:49:39.614 --> 00:49:41.518
that there's so many different dynamics.

00:49:41.538 --> 00:49:42.199
There's so many different

00:49:42.219 --> 00:49:42.800
components of it.

00:49:43.438 --> 00:49:44.940
I think there's also value

00:49:45.199 --> 00:49:47.480
in if you have a prime location,

00:49:47.960 --> 00:49:49.780
if you have a longer term lease,

00:49:49.820 --> 00:49:51.081
maybe you originally signed

00:49:51.121 --> 00:49:52.242
a ten year lease and you

00:49:52.262 --> 00:49:54.322
still have five years left on the term.

00:49:54.742 --> 00:49:57.284
You've got a cap, you know,

00:49:57.324 --> 00:49:58.563
three and a half percent

00:49:58.943 --> 00:50:00.184
increase every year.

00:50:00.244 --> 00:50:01.005
But like I said,

00:50:01.364 --> 00:50:03.786
property values around you have gone up.

00:50:04.246 --> 00:50:06.206
If I'm the owner sitting in that clinic,

00:50:06.286 --> 00:50:08.527
that lease has thousands of

00:50:08.567 --> 00:50:10.367
dollars of value still in it.

00:50:10.947 --> 00:50:11.867
If I can make that

00:50:11.907 --> 00:50:13.588
transition to the new owner

00:50:13.608 --> 00:50:15.630
without changing the terms of the lease,

00:50:16.030 --> 00:50:17.269
the new owner couldn't get

00:50:17.309 --> 00:50:18.490
that property for that

00:50:18.530 --> 00:50:19.771
price in that location.

00:50:20.291 --> 00:50:22.351
So these are considerations

00:50:22.371 --> 00:50:23.632
that I don't think enough

00:50:23.672 --> 00:50:25.672
practice owners are thinking about.

00:50:26.293 --> 00:50:30.114
Of course, now you mentioned liability.

00:50:30.735 --> 00:50:32.094
I always explain, I'm like, look,

00:50:32.114 --> 00:50:33.496
there are insurance contracts.

00:50:33.956 --> 00:50:34.956
that you want.

00:50:35.157 --> 00:50:36.918
Those insurance networks are closed.

00:50:36.958 --> 00:50:38.438
They're not accepting new providers.

00:50:38.458 --> 00:50:39.639
You're buying this practice

00:50:39.858 --> 00:50:42.081
maybe for those insurance contracts,

00:50:42.541 --> 00:50:43.621
but there's also insurance

00:50:43.641 --> 00:50:44.722
contracts you don't want.

00:50:45.202 --> 00:50:45.583
So like,

00:50:45.682 --> 00:50:47.023
I don't want your twenty year

00:50:47.043 --> 00:50:48.184
history with Medicare.

00:50:48.905 --> 00:50:50.686
I would start my own LLC.

00:50:51.065 --> 00:50:53.166
I would have my own Medicare PTAN.

00:50:53.266 --> 00:50:55.188
I would start fresh and I

00:50:55.208 --> 00:50:56.768
would get rid of all of

00:50:56.789 --> 00:50:59.351
that history that the previous owner had.

00:51:00.387 --> 00:51:02.168
but I would want you know

00:51:02.248 --> 00:51:04.291
maybe a hard to get into uh

00:51:04.391 --> 00:51:05.331
blue cross blue shield

00:51:05.371 --> 00:51:06.614
contract that they're not

00:51:06.653 --> 00:51:09.115
accepting new providers um

00:51:09.155 --> 00:51:10.918
so when I'm looking at an

00:51:10.998 --> 00:51:12.800
acquisition like this these

00:51:12.840 --> 00:51:13.300
are some of the

00:51:13.360 --> 00:51:14.983
considerations how do you

00:51:15.043 --> 00:51:16.804
mitigate or reduce the risk

00:51:17.304 --> 00:51:18.306
I didn't even think about

00:51:18.585 --> 00:51:20.467
injured patients coming back to sue

00:51:21.068 --> 00:51:23.230
the previous owner, the previous LLC?

00:51:23.289 --> 00:51:25.771
Um, how do I reduce, you know,

00:51:25.791 --> 00:51:27.293
a tenure look back period

00:51:27.373 --> 00:51:29.273
on federal false claims act,

00:51:29.313 --> 00:51:31.795
like all of this baggage of healthcare,

00:51:32.356 --> 00:51:33.717
we want to wipe that stuff out.

00:51:34.677 --> 00:51:35.797
Tony Couture here.

00:51:36.318 --> 00:51:36.978
Love you guys.

00:51:37.039 --> 00:51:38.079
I appreciate it, Tony.

00:51:39.521 --> 00:51:39.701
Um,

00:51:41.400 --> 00:51:44.161
Here, Dan said on the other side,

00:51:44.641 --> 00:51:45.503
Dave Kittle,

00:51:46.242 --> 00:51:47.744
one bad therapist kills that

00:51:47.804 --> 00:51:49.144
momentum and decreases the

00:51:49.204 --> 00:51:50.326
entire clinic's revenue.

00:51:50.385 --> 00:51:52.146
Yeah, that goes back to hiring.

00:51:52.927 --> 00:51:54.527
And Dan, that's exactly what I said.

00:51:54.547 --> 00:51:56.068
I said,

00:51:56.148 --> 00:51:57.489
I think they could do a lot more

00:51:57.550 --> 00:52:00.132
damage than growth.

00:52:00.251 --> 00:52:01.552
And if they do growth,

00:52:01.672 --> 00:52:02.914
they usually want to take

00:52:02.954 --> 00:52:04.074
those patients with them.

00:52:04.894 --> 00:52:05.956
So, you know,

00:52:06.557 --> 00:52:07.981
those are the challenges in

00:52:08.021 --> 00:52:09.222
this environment for

00:52:09.824 --> 00:52:11.407
growing through hiring.

00:52:12.128 --> 00:52:12.268
Well,

00:52:12.688 --> 00:52:15.393
I commented back to Dan Vapney on the

00:52:15.474 --> 00:52:17.556
LinkedIn live video, and I said.

00:52:18.887 --> 00:52:20.409
I said, right, but I said, Dan,

00:52:20.429 --> 00:52:22.869
that's why our, our meaning us,

00:52:22.929 --> 00:52:24.570
and hopefully I'm sure his as well,

00:52:24.690 --> 00:52:25.871
because he's got a great practice.

00:52:26.391 --> 00:52:27.411
That's why our recruiting

00:52:27.431 --> 00:52:28.492
and hiring process needs to

00:52:28.512 --> 00:52:29.751
be dialed in to identify

00:52:29.791 --> 00:52:31.032
great candidates with soft skills,

00:52:31.072 --> 00:52:31.853
clinical skills,

00:52:32.492 --> 00:52:35.574
therapists who are coachable and who's,

00:52:36.514 --> 00:52:37.815
who's the therapist core

00:52:37.856 --> 00:52:39.896
values match our core values.

00:52:39.976 --> 00:52:41.516
And you only find that out

00:52:42.036 --> 00:52:44.318
in the interviewing and hiring process.

00:52:44.338 --> 00:52:45.918
And that's why we have a more

00:52:46.965 --> 00:52:48.065
maybe a more robust or

00:52:48.126 --> 00:52:49.606
exhaustive interview

00:52:49.646 --> 00:52:50.487
process than other

00:52:50.527 --> 00:52:52.407
practices and phone screen

00:52:53.027 --> 00:52:53.728
and a sixty minute

00:52:53.748 --> 00:52:56.009
interview where we're finding out like,

00:52:56.048 --> 00:52:56.509
hey, Tony,

00:52:56.528 --> 00:52:58.510
tell me about a time when and

00:52:58.550 --> 00:52:59.110
that type of stuff.

00:52:59.130 --> 00:53:00.889
So we get to know the person.

00:53:01.690 --> 00:53:04.050
That's the first hour on a

00:53:04.110 --> 00:53:05.331
Zoom or it's in person.

00:53:06.552 --> 00:53:07.853
And then the next hour part

00:53:07.873 --> 00:53:09.913
of the interview is Tony, you know,

00:53:09.932 --> 00:53:11.293
the therapist is evaluating

00:53:11.333 --> 00:53:12.273
me and I'm giving you a

00:53:12.313 --> 00:53:13.173
fake case and you're going

00:53:13.193 --> 00:53:15.215
to evaluate me and treat me and all that.

00:53:15.315 --> 00:53:16.614
And so, of course,

00:53:16.635 --> 00:53:17.355
then we're doing reference

00:53:17.375 --> 00:53:19.536
checks and having to fill

00:53:19.556 --> 00:53:20.856
out a work history form and all that.

00:53:20.896 --> 00:53:23.556
But a couple extra steps go a long way,

00:53:23.577 --> 00:53:24.077
in my opinion,

00:53:24.338 --> 00:53:25.697
for interviewing and hiring.

00:53:26.324 --> 00:53:29.065
Hire slow, fire fast, Dan says.

00:53:29.485 --> 00:53:30.286
Absolutely.

00:53:30.846 --> 00:53:32.626
So before we wrap up the show,

00:53:32.766 --> 00:53:34.686
any other little nuggets of

00:53:34.746 --> 00:53:36.467
advice for smaller

00:53:36.547 --> 00:53:37.967
independent providers who

00:53:37.987 --> 00:53:39.208
are thinking about buying

00:53:39.387 --> 00:53:41.128
out another small,

00:53:41.748 --> 00:53:44.429
longstanding independent provider?

00:53:44.449 --> 00:53:44.710
Yes.

00:53:44.769 --> 00:53:45.530
Thank you for this.

00:53:45.829 --> 00:53:46.670
Thank you for the question.

00:53:47.230 --> 00:53:49.451
Hire an M&A attorney.

00:53:50.418 --> 00:53:51.157
I, the,

00:53:51.197 --> 00:53:52.117
the practice I was telling you

00:53:52.137 --> 00:53:53.639
about a couple of years ago in Brooklyn,

00:53:54.378 --> 00:53:56.679
uh, with the crazy long lease, that was,

00:53:56.860 --> 00:53:57.420
that was like the,

00:53:57.500 --> 00:53:58.219
one of the most appealing

00:53:58.260 --> 00:53:59.280
things from it is that the,

00:53:59.500 --> 00:54:01.101
the lease was a really long lease.

00:54:01.440 --> 00:54:02.400
And I think the lease,

00:54:02.621 --> 00:54:03.800
I think the landlord was a

00:54:03.961 --> 00:54:05.302
nearby orthopedic surgeon.

00:54:05.342 --> 00:54:05.902
So it's kind of like,

00:54:06.061 --> 00:54:08.063
there's multiple good juju, good,

00:54:08.143 --> 00:54:10.643
you know, potential good stuff going on.

00:54:10.663 --> 00:54:12.143
That's all legal and kosher, whatever.

00:54:12.983 --> 00:54:13.063
Um,

00:54:13.664 --> 00:54:15.744
but I spent fifteen thousand

00:54:15.784 --> 00:54:16.684
dollars out of pocket on

00:54:16.724 --> 00:54:17.844
legal fees and the deal

00:54:17.864 --> 00:54:18.965
fell through because we

00:54:19.005 --> 00:54:20.726
found out we found out that

00:54:20.746 --> 00:54:23.606
the practice was not as

00:54:23.646 --> 00:54:24.746
good as we thought it was

00:54:24.947 --> 00:54:27.547
the owner uh leading up to

00:54:27.686 --> 00:54:29.367
as we were uh getting into

00:54:29.407 --> 00:54:30.268
more and more serious due

00:54:30.307 --> 00:54:31.728
diligence and talks the

00:54:31.807 --> 00:54:32.969
owner was funding payroll

00:54:33.009 --> 00:54:34.048
out of his own pocket and

00:54:34.289 --> 00:54:35.708
also decided to not tell us

00:54:35.748 --> 00:54:36.489
that that was actually

00:54:36.530 --> 00:54:37.690
happening as I'm paying

00:54:38.070 --> 00:54:40.250
lawyers uh to draft up you

00:54:40.269 --> 00:54:41.990
know personal agreements and you know

00:54:42.771 --> 00:54:43.972
check if there's any liens

00:54:43.992 --> 00:54:45.612
against him personally or the business,

00:54:45.833 --> 00:54:46.552
all the other stuff.

00:54:46.592 --> 00:54:49.255
So please hire an M&A attorney.

00:54:49.514 --> 00:54:50.255
I don't care if you're going

00:54:50.275 --> 00:54:51.755
to buy a practice for six

00:54:51.856 --> 00:54:53.137
hundred grand or whatever,

00:54:53.217 --> 00:54:55.057
like hire an attorney,

00:54:55.619 --> 00:54:56.958
pay a couple thousand bucks.

00:54:57.039 --> 00:54:59.260
Maybe you can use ChatGPT to draft up

00:55:00.534 --> 00:55:01.695
a bunch of the documents and

00:55:01.735 --> 00:55:02.655
then pay the lawyers to

00:55:02.715 --> 00:55:04.335
have them review them.

00:55:04.396 --> 00:55:06.016
Although many of the lawyers will say,

00:55:06.615 --> 00:55:07.257
we don't want to review

00:55:07.277 --> 00:55:08.516
these because we didn't write them.

00:55:08.597 --> 00:55:09.597
So it's like, you know,

00:55:09.637 --> 00:55:10.597
it depends on the lawyer.

00:55:11.396 --> 00:55:13.318
But please, please hire counsel.

00:55:13.757 --> 00:55:16.418
Do not do one of these deals on your own.

00:55:16.478 --> 00:55:17.679
Do not listen to Tony.

00:55:17.878 --> 00:55:19.619
That was another time in the

00:55:19.659 --> 00:55:20.880
world when Tony was doing a

00:55:20.900 --> 00:55:21.599
handshake deal.

00:55:22.798 --> 00:55:23.179
I don't care.

00:55:23.820 --> 00:55:25.382
I mean, you're rolling the dice.

00:55:25.942 --> 00:55:27.643
Just please hire an attorney

00:55:27.684 --> 00:55:29.726
for all of this to look over the lease,

00:55:29.766 --> 00:55:31.887
the change of ownership, to look over,

00:55:32.748 --> 00:55:32.929
um,

00:55:34.438 --> 00:55:37.378
to actually draft a purchase,

00:55:37.398 --> 00:55:39.059
a sales agreement, purchase sales,

00:55:39.179 --> 00:55:39.858
purchase agreement,

00:55:40.199 --> 00:55:41.739
as well as an employment agreement.

00:55:41.780 --> 00:55:42.420
If that owner is going to

00:55:42.440 --> 00:55:43.239
help with the transition,

00:55:43.260 --> 00:55:44.300
you're going to pay them hourly.

00:55:44.320 --> 00:55:45.521
You're going to pay them salary.

00:55:45.840 --> 00:55:46.780
Are they going to treat patients?

00:55:46.800 --> 00:55:47.860
Are they going to do billing stuff?

00:55:47.880 --> 00:55:48.320
Are they going to,

00:55:49.362 --> 00:55:50.862
are they going to help you do, you know,

00:55:50.882 --> 00:55:53.643
weekly team meetings to kind of, uh,

00:55:53.663 --> 00:55:55.342
you know, ease the transition,

00:55:55.382 --> 00:55:56.563
like whatever they're going to do,

00:55:56.583 --> 00:55:57.864
like that's a separate agreement.

00:55:58.563 --> 00:55:58.764
Um,

00:56:00.289 --> 00:56:01.550
If it's in-network contracts,

00:56:01.630 --> 00:56:03.331
you have the lawyer look

00:56:03.351 --> 00:56:04.472
over the in-network contracts,

00:56:04.492 --> 00:56:06.052
although that sucks because

00:56:06.092 --> 00:56:06.932
the in-network contracts

00:56:06.952 --> 00:56:08.313
sometimes are dozens and

00:56:08.353 --> 00:56:09.414
dozens of ridiculous pages

00:56:09.434 --> 00:56:10.355
that they're going to pay you,

00:56:10.594 --> 00:56:12.096
or they're going to charge

00:56:12.135 --> 00:56:13.817
you to look at these

00:56:13.836 --> 00:56:14.637
ridiculously long

00:56:14.677 --> 00:56:16.157
in-network contracts that

00:56:16.197 --> 00:56:18.739
just are mostly rubbish at this point.

00:56:19.699 --> 00:56:21.981
But please hire an attorney.

00:56:23.362 --> 00:56:24.121
Don't skimp.

00:56:24.302 --> 00:56:25.242
Don't go the cheap route.

00:56:26.407 --> 00:56:26.728
All right.

00:56:26.768 --> 00:56:27.407
That was awesome.

00:56:27.447 --> 00:56:29.128
I want to say that's your parting shot.

00:56:29.708 --> 00:56:30.769
I'm going to share a quote

00:56:30.789 --> 00:56:32.329
from Warren Buffett that I

00:56:32.369 --> 00:56:33.731
heard recently that I love.

00:56:34.130 --> 00:56:36.552
Quote, great businesses are bought,

00:56:37.092 --> 00:56:37.873
not sold.

00:56:38.112 --> 00:56:40.893
Great businesses are bought, not sold.

00:56:41.393 --> 00:56:44.175
So it's a weird,

00:56:44.235 --> 00:56:45.275
it took me a long time to

00:56:45.335 --> 00:56:46.155
think about this,

00:56:46.235 --> 00:56:48.317
but my understanding of that is

00:56:48.856 --> 00:56:50.659
Like nobody is going to sell

00:56:50.878 --> 00:56:51.760
a great business.

00:56:51.860 --> 00:56:52.960
A great business is going to

00:56:52.981 --> 00:56:54.081
stay in your portfolio.

00:56:54.101 --> 00:56:54.902
It's going to put money in

00:56:54.922 --> 00:56:55.563
your bank account.

00:56:55.583 --> 00:56:57.443
It's going to provide financial security.

00:56:58.344 --> 00:57:03.108
But great businesses are bought, not sold.

00:57:03.168 --> 00:57:04.951
If you're going to buy something,

00:57:05.632 --> 00:57:06.652
it's going to be expensive.

00:57:06.692 --> 00:57:07.413
It's going to be hard.

00:57:07.432 --> 00:57:08.494
You have to invest money,

00:57:08.534 --> 00:57:10.215
hire the attorney, do it right.

00:57:10.998 --> 00:57:12.838
All right, guys, Tuesday, Thursday morning,

00:57:12.918 --> 00:57:13.958
eight thirty Eastern.

00:57:14.018 --> 00:57:15.498
Come back and watch us, Dave.

00:57:15.699 --> 00:57:16.199
Next week,

00:57:16.259 --> 00:57:18.139
I want to talk about Cleveland

00:57:18.159 --> 00:57:19.400
Clinic is requiring

00:57:19.440 --> 00:57:21.159
patients to pay their copay

00:57:21.559 --> 00:57:23.601
before they let them schedule.

00:57:24.320 --> 00:57:26.221
I wonder if I already love it.

00:57:26.240 --> 00:57:28.242
I wonder if therapists in

00:57:28.282 --> 00:57:29.521
private practice should be

00:57:29.561 --> 00:57:30.302
doing the same.

00:57:30.362 --> 00:57:31.682
Let's talk about it next week.

00:57:31.722 --> 00:57:33.382
Guys, have an amazing weekend.