Stop Making the EMR Suck Less

WEBVTT

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Broadcasting way too early from three

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separate Wi-Fi connections.

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It's PT Breakfast Club with Tony Meritato,

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Dave Kittle, and Jimmy McKay.

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and we're live uh good morning tony

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maritato good morning jimmy mckay jimmy

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from the office it's so professional it's

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it's so adult do you mean my living

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room isn't nearly as professional as being

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in an office it's pretty dope view maybe

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like you know we got cool like

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skyline over there i took a i took

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a picture actually i mean hoboken like

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again i'm a new yorker and i you

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know the office i work in is in

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new jersey which is you know almost you

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know sacrilege a little bit like working

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in new jersey but but if you think

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about it hoboken has the best views of

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new york like that's the that's the esb

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baby like we're you know it's pretty dope

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wow all right so um this has nothing

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to do with the fact that you are

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at prompt headquarters but it it does you

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know have to do with topics that have

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been floating around the social medias

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And basically, this kind of evolved from,

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you know,

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I have been indirectly involved with EMRs

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since the beginning of time.

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Back in the day, early two thousands,

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I used Microsoft Access and Visual Basic

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to create a ad hoc EMR for my

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clinic.

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I'm not a coder.

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I just looked up, Googled, like,

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how do I do this and how do

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I do that?

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And I made it happen.

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Fast forward now into an AI world,

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and I'm always reliving this experience of

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like, what is the function of an EMR,

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regardless of the brand?

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What should it be doing?

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How does it work?

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Now, I still see a major divide.

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And I don't know,

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because you've had experience with

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multiple companies.

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I still see,

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and you tell me if you see this

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from your side,

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there's a divide between the

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administrative aspect of an EMR and the

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clinical aspect of an EMR.

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And I see it in my clinic.

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My wife, who is a physical therapist,

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runs the administrative aspect of the

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business.

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And so her experience with the EMR that

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we use is completely different.

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then me,

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I never get into the administrative at

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all, the money, none of that.

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I'm all on the clinical side.

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So, like,

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have you seen just that divide first

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before we get into the AI part?

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Oh, a thousand percent.

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I mean,

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my first job or my second job out

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of PT school, we were still on paper,

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but even it was no EMR,

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but you still saw what I did.

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And the woman, bless her soul,

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I can't remember her name.

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She would like call me back when I

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didn't maybe, you know,

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she couldn't read what the hell I wrote

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because we were again on paper.

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And she would walk me through why she

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was asking.

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Like she, God bless her.

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She was so nice and not just come

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here.

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Why are you doing that?

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She was like, hey,

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let me show you what I do.

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And I saw what she was looking at.

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I was like, oh, my God.

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So it did give me a healthy appreciation

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for what I'm doing shows up somewhere

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else.

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She's downstream of me.

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And that's why me writing legibly or being

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clear or all those things.

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are important so i did get to see

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sort of the two halves to the same

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coin this was similar in radio like i'm

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gonna that's all i'm gonna do tony you

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know i'm telling radio stories but there's

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two halves right it was programming we

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played the music we said the jokes we

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did the thing and sales and you'd often

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see these two things at odds right the

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purists would say like

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don't need a commercial and i'm like do

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you like paying rent because otherwise

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it's just a hobby you have to understand

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what happens before or after we do our

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thing and i see the parallel between radio

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programming and sales and clinical and

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administrative or ops whatever you want to

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call it those two are they're not distinct

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thing they're two sides of the same coin

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and you

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do you need to understand them um you

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need to work together i don't know if

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you need to understand everything it

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definitely i think it definitely helps

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people when they see that they go aha

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so we can dig deeper into what should

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this thing be who's the master here does

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do i work for the emr or does

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emr work for me um and i heard

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a great term the other day

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uh there's an author named corey doctorow

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and he's so crazy smart he writes for

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like wired magazine like technology smart

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but he also writes fiction so he can

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put technology the first time i heard

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about a three d printer or glp ones

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was ten fifteen years ago in a book

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and i went cool story that'll never happen

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and as i started seeing the things i

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was like oh my god i read about

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this the two terms were

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Centaur and reverse centaur.

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And then I'll just explain this and stop

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because I think this goes in your

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argument.

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The centaur is it's a man with a

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horse body.

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So you have the thinking ability and the

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reasoning ability of a human and the power

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and efficiency and endurance of a horse.

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Or sometimes we're a reverse centaur.

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where we have the brain of a horse,

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right?

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The brain of a computer with the

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efficiency of a human.

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The reverse centaur is obviously,

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no one wants that.

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That's not efficient, right?

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A horse walking around with a human body.

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And we have to be careful that we're

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not designing processes or things that

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make us reverse centaurs.

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We want to be centaurs.

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We want to do the higher level reasoning

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and then have the thing do the horsepower

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thing, the thing downstream.

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So where do you want to start with

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this?

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Because I think we, I mean,

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this is a big one.

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Yeah,

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so here's my thought process with this.

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And a discussion came up the other day

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about, again, the AI physical therapist.

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Is the AI physical therapist going to

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replace the human physical therapist?

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I shared a post that said,

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what's our obligation

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to contribute to training the ai because i

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said look if we're here to help people

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and i know that there's a technology that

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could reach every single person on the

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globe for virtually zero cost as energy

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comes down

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I should have some obligation to

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contribute my knowledge,

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my experience to making it a better

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service because I can't treat every human

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in the world.

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So why prevent those other humans from

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gaining this experience?

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So, you know, that got me thinking.

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I was like, OK, back to the EMR.

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What does it do now?

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It's a passive part of the business.

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It's a passive part of the clinician.

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At best,

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the AI aspect of ambient listening is

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listening to what I say and turning it

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into clinical documentation.

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But it's not really doing anything else.

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On the administrative side,

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most EMRs today are using AI to help

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post payments and find problems.

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And OK, that's very basic level stuff.

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so so we've talked about humans are

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wearing wearable technology my my apple

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phone tracks steps it can tell the

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authorities when i fall like call nine oh

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one one for me if i have an

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accident it does so much stuff we have

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the pacemaker we have a smart knee we

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have sleep apps that track sleeping i'm

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like the emr should really become kind of

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the the all-encompassing it's capturing

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all of this information

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it integrates with the the person the

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patient's access to information the ai

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aspect of it is look i've got this

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little microcosm of a therapist it's not a

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human therapist it's an ai therapist but

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it's collecting all of this information

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that i'm generating as a patient all day

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long

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Potentially I can put in, you know,

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what did I eat today?

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Snap a picture of it.

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All of this stuff already exists.

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None of it integrates with the EMR.

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So my vision is step one.

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It starts to collect all of that

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information.

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You know that I'm using ChachiPTA as my

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running coach.

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Why do I love ChachiPTA as my running

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coach?

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Any time of day I can put information

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into it.

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I can ask it questions.

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It can ask me questions.

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The AI never gets frustrated.

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It never gets tired.

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It never has a bad day.

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It's never going through a divorce.

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And so it's this like infinite world of

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I can give it information.

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It can sift through and ask me better

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questions.

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And even if the AI thinks I don't

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know what I'm doing,

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it can continue to guide me through the

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process to get the real information.

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Me as a human therapist,

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I have an hour.

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In the best of times,

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I have an hour with the patient.

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I can only ask so many questions.

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I can only collect the information.

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I assume it's truthful.

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It's usually not whether the patients know

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they're lying to me or not.

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They're giving me their subjective

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reports.

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The best tests and measures I have in

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the clinic are

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fairly accurate at best right goniometry

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off by five degrees up or down manual

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muscle testing like give me a break um

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so i'm like i don't have anything to

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go by i am trying to make an

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educated guess through a foggy window at

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best it's like my cousin vinnie you know

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when when they're on the stand asking the

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eyewitness if they see the person in the

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room you know

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So this is what I'm not seeing the

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EMRs and maybe it's happening behind the

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scenes,

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but like this would be my vision for

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the future starting to integrate.

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Let's start there.

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You have two things.

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You just described two things.

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inputting the information.

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We're collecting all this data,

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but because it's everywhere, right?

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What are we gonna do with it?

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By the time Tony was able to sit

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down with his patient and go, okay,

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bring up your Peloton app,

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bring up your Whoop app,

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bring up your Apple Health app,

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and let me sift through all those things,

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I sit down on my Peloton and it's

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like, hey, Jimmy, your last five workouts,

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your average kilojoules per workout or

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watts have gone up ten percent.

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That's great.

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Maybe you should take your FTP test again

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to recalibrate your whatever.

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That's it's able to collect.

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And the second part is synthesize to give

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me something useful.

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Like I asked this question of somebody on

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LinkedIn.

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They're like,

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how come we aren't tripling down on

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wearables?

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I'm like,

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because no one's synthesizing that stuff

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yet.

00:10:37.698 --> 00:10:39.519
And I'm going to oversimplify this because

00:10:39.620 --> 00:10:42.322
I am also not a coder,

00:10:42.361 --> 00:10:44.503
but this information needs to pass through

00:10:44.523 --> 00:10:45.964
a gate and that gate is known as

00:10:45.984 --> 00:10:46.344
an API.

00:10:46.524 --> 00:10:48.225
I don't even know what API stands for.

00:10:48.725 --> 00:10:49.525
I knew at one point,

00:10:49.806 --> 00:10:51.927
but it's a way that two computers talk

00:10:51.966 --> 00:10:52.868
to each other, right?

00:10:53.307 --> 00:10:55.668
We've got all these bits of information.

00:10:56.190 --> 00:10:57.389
Companies like Vault,

00:10:57.971 --> 00:11:00.152
they are very good at the capture.

00:11:00.929 --> 00:11:02.932
But then are we bringing it into the

00:11:03.091 --> 00:11:03.613
EMR?

00:11:03.692 --> 00:11:04.793
I know that prompt is.

00:11:04.933 --> 00:11:06.956
So that's one little nod.

00:11:07.035 --> 00:11:08.116
I'm sure others are as well.

00:11:08.397 --> 00:11:09.778
But that's what it needs to start to

00:11:09.818 --> 00:11:12.421
happen because you need to be given that

00:11:12.461 --> 00:11:14.984
Peloton snapshot because you got what?

00:11:15.703 --> 00:11:18.506
All of six minutes in between patient one

00:11:18.527 --> 00:11:20.749
and patient two to figure out where,

00:11:21.370 --> 00:11:21.909
who are you?

00:11:22.811 --> 00:11:22.971
I mean,

00:11:22.990 --> 00:11:24.251
you asked the question the other day,

00:11:24.753 --> 00:11:27.674
are we even attaching photos in the EMR?

00:11:27.796 --> 00:11:29.677
So Tony and people like Jimmy,

00:11:29.716 --> 00:11:31.379
who I can't remember a name until I've

00:11:31.418 --> 00:11:33.039
seen someone two or three times.

00:11:33.179 --> 00:11:33.440
Oh, yeah,

00:11:33.460 --> 00:11:35.562
that guy with the thing and then the

00:11:35.682 --> 00:11:36.082
facial hair.

00:11:37.369 --> 00:11:38.509
We're still on photos.

00:11:39.149 --> 00:11:40.149
Now we need to understand,

00:11:40.710 --> 00:11:41.909
what was this person coming in for?

00:11:41.929 --> 00:11:43.051
What did they look like a week ago

00:11:43.071 --> 00:11:43.730
when I saw them?

00:11:44.171 --> 00:11:45.711
And then what happened when they escaped

00:11:45.770 --> 00:11:46.250
the clinic?

00:11:46.731 --> 00:11:47.772
We can track that.

00:11:47.912 --> 00:11:49.892
We can, and we are,

00:11:50.172 --> 00:11:51.613
but we're tracking so much.

00:11:51.673 --> 00:11:52.373
The question is,

00:11:52.832 --> 00:11:55.474
are we able to actually leverage it?

00:11:55.634 --> 00:11:57.274
And I don't know that we are at

00:11:57.313 --> 00:11:58.835
scale or you and I wouldn't be asking

00:11:58.875 --> 00:11:59.434
these questions.

00:12:00.089 --> 00:12:00.389
Right.

00:12:00.769 --> 00:12:03.410
And so there is the clinical side of

00:12:03.471 --> 00:12:03.610
it,

00:12:03.671 --> 00:12:06.251
which goes back to the AI is not

00:12:06.272 --> 00:12:07.511
going to replace the therapist.

00:12:07.591 --> 00:12:10.234
It's going to make the therapist better as

00:12:10.274 --> 00:12:12.914
the AI is sifting through all of that

00:12:12.975 --> 00:12:13.554
information.

00:12:13.615 --> 00:12:15.655
I mean, in my mind today,

00:12:15.696 --> 00:12:17.277
which I can only go by what I

00:12:17.317 --> 00:12:17.517
know,

00:12:17.537 --> 00:12:18.738
I have no idea what the future is

00:12:18.758 --> 00:12:19.057
going to be.

00:12:20.018 --> 00:12:21.677
Every patient that walks in this door,

00:12:21.697 --> 00:12:24.458
so we're trying, not we,

00:12:24.798 --> 00:12:25.999
we tried it and it didn't work for

00:12:26.078 --> 00:12:26.879
us, RTM.

00:12:26.918 --> 00:12:28.538
The profession is trying RTM.

00:12:28.558 --> 00:12:31.000
We have this idea about RTM,

00:12:31.039 --> 00:12:32.480
remote therapeutic monitoring.

00:12:32.879 --> 00:12:35.041
The patient still has to be an active

00:12:35.081 --> 00:12:36.120
participant in that.

00:12:37.221 --> 00:12:39.160
We're not at the point where patients want

00:12:39.201 --> 00:12:40.721
to be an active participant.

00:12:40.861 --> 00:12:42.481
I talk to patients all day long.

00:12:42.881 --> 00:12:44.522
They're like, I got this stupid app.

00:12:44.542 --> 00:12:45.381
I have to log in.

00:12:45.402 --> 00:12:46.602
I have to, they hate it.

00:12:46.643 --> 00:12:48.023
They don't want to do that stuff.

00:12:50.003 --> 00:12:53.466
Whereas there are apps that we actively

00:12:53.546 --> 00:12:54.505
want to open.

00:12:54.725 --> 00:12:56.668
I want to open Facebook.

00:12:56.827 --> 00:12:59.129
I want to open Instagram Strava.

00:12:59.690 --> 00:13:00.230
I don't use it,

00:13:00.269 --> 00:13:01.692
but that would be an example.

00:13:01.831 --> 00:13:03.452
So it's one of those things where it's

00:13:03.493 --> 00:13:03.893
like, all right,

00:13:03.932 --> 00:13:05.293
how do we flip the script?

00:13:05.835 --> 00:13:07.375
How does my EMR,

00:13:07.975 --> 00:13:10.357
which AI can code anything.

00:13:10.498 --> 00:13:11.798
Why isn't my EMR.

00:13:12.557 --> 00:13:14.999
coding an app or a component that my

00:13:15.058 --> 00:13:16.779
patient wants to use.

00:13:16.820 --> 00:13:19.503
They're actively engaging by desire,

00:13:19.582 --> 00:13:20.903
not by requirement.

00:13:22.465 --> 00:13:23.905
And then I'm like, OK, well,

00:13:24.025 --> 00:13:25.427
let's go to the therapist side.

00:13:25.466 --> 00:13:26.828
Since we started with this,

00:13:26.869 --> 00:13:27.889
there's two sides to it,

00:13:27.950 --> 00:13:29.750
clinical and administrative or

00:13:29.811 --> 00:13:30.471
operational.

00:13:31.717 --> 00:13:32.418
I said, hey,

00:13:32.817 --> 00:13:34.418
I ran into a situation in the office

00:13:34.438 --> 00:13:35.058
the other day,

00:13:35.198 --> 00:13:36.379
and I've shared this before.

00:13:36.440 --> 00:13:38.480
When I evaluate three or four people the

00:13:38.500 --> 00:13:41.701
same day or I'm doing fifteen evaluations

00:13:41.741 --> 00:13:43.721
in a week and three or four of

00:13:43.782 --> 00:13:46.283
those people hit kind of the same

00:13:46.342 --> 00:13:46.964
paradigm.

00:13:47.423 --> 00:13:49.764
OK, it's Betty, Margaret and Mildred.

00:13:50.184 --> 00:13:52.325
They all have, you know, come out.

00:13:52.365 --> 00:13:54.405
They all are little old ladies in their

00:13:54.505 --> 00:13:56.527
eighties and they all have abnormal gait.

00:13:57.168 --> 00:13:57.408
Man,

00:13:57.428 --> 00:13:59.095
I'm going to have a hard time remembering

00:13:59.154 --> 00:13:59.937
which is which.

00:14:00.418 --> 00:14:00.779
You know?

00:14:01.422 --> 00:14:02.605
So I tell my EMR.

00:14:03.519 --> 00:14:03.719
hey,

00:14:04.178 --> 00:14:06.159
I need you to generate code so that

00:14:06.220 --> 00:14:08.000
I can get a photo of every new

00:14:08.041 --> 00:14:10.201
patient when they come in so that when

00:14:10.261 --> 00:14:11.241
I pull up the account,

00:14:11.643 --> 00:14:13.143
that photo is front and center.

00:14:13.623 --> 00:14:14.203
Right now,

00:14:14.724 --> 00:14:16.705
what I actually do in the real world

00:14:16.804 --> 00:14:18.446
is I open my EMR,

00:14:18.826 --> 00:14:21.067
I go to Documents, I go to IDs,

00:14:21.206 --> 00:14:22.567
I look at their driver's license,

00:14:22.586 --> 00:14:23.148
and I'm like, oh,

00:14:23.607 --> 00:14:24.607
I remember who that is.

00:14:25.269 --> 00:14:26.229
But I don't want to do that.

00:14:26.749 --> 00:14:29.149
I think Planet Fitness has a photo that

00:14:29.210 --> 00:14:31.390
pops up when you scan in.

00:14:31.750 --> 00:14:32.511
That's what I want.

00:14:33.407 --> 00:14:36.868
The EMR company doesn't need to do the

00:14:36.928 --> 00:14:39.289
coding to change the EMR for everybody.

00:14:39.350 --> 00:14:41.750
We're in a day and time where I

00:14:41.791 --> 00:14:44.111
should just be able to run the instance

00:14:44.152 --> 00:14:46.493
where I tell my AI, hey,

00:14:46.533 --> 00:14:47.552
run this code for me.

00:14:48.133 --> 00:14:48.793
Pull up this,

00:14:48.813 --> 00:14:50.494
because this is what I want.

00:14:50.854 --> 00:14:53.254
Don't let me schedule the same person more

00:14:53.274 --> 00:14:54.056
than once in a day.

00:14:55.035 --> 00:14:57.198
And maybe I'm the only clinic that has

00:14:57.239 --> 00:14:58.120
that problem,

00:14:58.580 --> 00:15:00.621
but it's something I should be able to

00:15:00.682 --> 00:15:02.965
generate just like that with a voice

00:15:02.985 --> 00:15:03.446
command.

00:15:03.566 --> 00:15:05.768
And now my EMR takes care of everything

00:15:05.827 --> 00:15:06.008
else.

00:15:06.028 --> 00:15:08.390
Like those are some of the little things

00:15:08.431 --> 00:15:10.852
that it's available right now,

00:15:10.913 --> 00:15:12.715
but we're not seeing it that I think

00:15:13.255 --> 00:15:15.818
improves the experience for me,

00:15:15.859 --> 00:15:16.399
the clinician.

00:15:17.039 --> 00:15:19.740
improves the outcome for the patient maybe

00:15:19.821 --> 00:15:22.623
reduces subjective burnout you know maybe

00:15:22.682 --> 00:15:24.984
makes life a little bit easier and happier

00:15:26.063 --> 00:15:27.804
uh what are you thinking about some of

00:15:27.825 --> 00:15:30.426
that i'd love to i mean we're supposed

00:15:30.446 --> 00:15:33.506
to give you know extreme uh extreme

00:15:33.547 --> 00:15:35.467
thoughts right because otherwise we're if

00:15:35.508 --> 00:15:37.009
we're in the messy middle and we're just

00:15:37.249 --> 00:15:38.970
um mayonnaise flavored ice cream

00:15:40.062 --> 00:15:41.303
I think we keep trying to make a

00:15:41.384 --> 00:15:42.524
better EMR,

00:15:42.745 --> 00:15:44.726
which I think is a race to small

00:15:44.767 --> 00:15:45.849
improvements over time.

00:15:46.149 --> 00:15:46.950
Instead of,

00:15:47.070 --> 00:15:48.331
I wrote a post the other day where

00:15:48.370 --> 00:15:48.630
I said,

00:15:48.671 --> 00:15:50.993
if Peloton let me steer the bike for

00:15:51.133 --> 00:15:51.693
ninety days,

00:15:52.033 --> 00:15:53.735
here's the first three things I do.

00:15:54.115 --> 00:15:56.018
Do you think I stole any ideas from

00:15:56.097 --> 00:15:56.658
health care?

00:15:57.259 --> 00:16:00.041
no i stole one idea from video games

00:16:00.581 --> 00:16:03.982
one idea from hotels and one idea from

00:16:04.123 --> 00:16:06.344
software like number one i've said this

00:16:06.384 --> 00:16:08.485
before we've talked about a gamification

00:16:09.066 --> 00:16:12.447
nowhere in an emr is badges or rewards

00:16:13.067 --> 00:16:14.849
right now it's just do this thing and

00:16:14.928 --> 00:16:17.389
who are you accountable to a pt i

00:16:17.409 --> 00:16:18.211
see once a week

00:16:18.910 --> 00:16:20.592
like i don't know tony do you floss

00:16:20.753 --> 00:16:24.979
i floss sometimes i'm i'm beholden and i'm

00:16:25.019 --> 00:16:27.601
accountable to the woman who knows if i'm

00:16:27.682 --> 00:16:30.024
lying she can see the thing i can't

00:16:30.065 --> 00:16:33.408
see like she knows i don't floss there

00:16:33.448 --> 00:16:35.591
is a study published that said flossing

00:16:35.611 --> 00:16:37.274
doesn't make a difference anyway

00:16:38.315 --> 00:16:41.216
I tell my dental hygienist every time I

00:16:41.275 --> 00:16:43.197
see him twice a year, yeah,

00:16:43.236 --> 00:16:43.996
I've been flossing.

00:16:44.017 --> 00:16:44.476
They're like, oh,

00:16:44.496 --> 00:16:45.937
you can tell it looks so good.

00:16:45.977 --> 00:16:49.139
You've got great dental hygiene.

00:16:49.158 --> 00:16:50.438
That's the equivalent of I can tell you're

00:16:50.458 --> 00:16:51.259
doing your clamshells.

00:16:51.279 --> 00:16:53.120
Yes, a hundred percent.

00:16:53.440 --> 00:16:53.600
Yeah.

00:16:54.041 --> 00:16:55.841
Do you know what my response was to

00:16:56.181 --> 00:16:58.022
you have more tartar buildup on your

00:16:58.042 --> 00:16:58.381
teeth?

00:16:59.302 --> 00:17:00.903
I just go three times a year now.

00:17:02.017 --> 00:17:04.317
I go, okay, I do what I do.

00:17:04.417 --> 00:17:05.417
I'm forty six.

00:17:05.857 --> 00:17:07.838
I'm probably not going to start doing

00:17:07.898 --> 00:17:08.278
more.

00:17:08.699 --> 00:17:10.859
I know I'm a big I call lovingly

00:17:10.900 --> 00:17:13.400
a big, dumb human since I know this.

00:17:13.559 --> 00:17:15.101
But I have build up and I don't

00:17:15.161 --> 00:17:15.980
like that feeling.

00:17:16.020 --> 00:17:17.801
At the end of six months,

00:17:18.122 --> 00:17:20.482
I go three times a year and they

00:17:20.522 --> 00:17:21.242
go, whoa, whoa, whoa.

00:17:21.982 --> 00:17:23.443
your benefits don't cover that third

00:17:23.483 --> 00:17:23.765
visit.

00:17:23.805 --> 00:17:25.445
I go, well, how much is it?

00:17:25.665 --> 00:17:27.567
And they say, it's a hundred dollars.

00:17:27.607 --> 00:17:28.328
And I go, huh?

00:17:28.828 --> 00:17:30.230
Do I like feeling good?

00:17:30.631 --> 00:17:32.451
And is my feeling good worth a hundred

00:17:32.491 --> 00:17:32.932
dollars?

00:17:33.333 --> 00:17:33.833
Yes, it is.

00:17:33.993 --> 00:17:34.173
It is.

00:17:34.334 --> 00:17:35.734
And I feel like I'm doing something good

00:17:35.775 --> 00:17:36.316
for the future.

00:17:36.355 --> 00:17:39.137
Maybe my teeth will last nine years longer

00:17:39.258 --> 00:17:39.719
or whatever.

00:17:39.979 --> 00:17:40.680
So number one,

00:17:41.806 --> 00:17:44.327
video games and gamification two things

00:17:44.928 --> 00:17:47.289
rewards we know we like points i don't

00:17:47.309 --> 00:17:48.931
know how much about teeth we could do

00:17:49.211 --> 00:17:51.413
but i don't know exercise and movement we

00:17:51.512 --> 00:17:53.253
know we do that with the rings and

00:17:53.294 --> 00:17:55.375
the thing in the strava so could you

00:17:55.496 --> 00:17:57.737
steal something from video games the

00:17:57.856 --> 00:18:00.219
second thing would be uh group people

00:18:00.259 --> 00:18:02.200
together and tony's like yeah bro i do

00:18:02.220 --> 00:18:04.481
that already you bring people into groups

00:18:04.821 --> 00:18:06.262
i've told a story about my friend megan

00:18:06.282 --> 00:18:08.704
brown who has not a physical therapy

00:18:08.724 --> 00:18:10.826
clinic it's a pilates and yoga studio

00:18:11.646 --> 00:18:13.528
run by a physical therapist so she's

00:18:13.548 --> 00:18:15.248
giving group physical therapy but people

00:18:15.268 --> 00:18:18.229
are paying for it with um uh cash

00:18:18.409 --> 00:18:20.710
oh my god cash it's all cash guys

00:18:20.730 --> 00:18:22.089
it's just it's is it flowing through your

00:18:22.109 --> 00:18:23.611
insurance company or not flowing through

00:18:23.631 --> 00:18:25.111
your insurance company so that was my

00:18:25.151 --> 00:18:28.633
gamification which is you don't show up to

00:18:28.692 --> 00:18:31.913
play video games or go on your weekend

00:18:31.953 --> 00:18:32.493
bike ride

00:18:33.314 --> 00:18:34.394
Because your PT told you to.

00:18:34.654 --> 00:18:35.836
You do it because if you show up

00:18:35.875 --> 00:18:37.797
at six or eight and the group ride

00:18:37.836 --> 00:18:39.877
leaves at six, people go, where were you,

00:18:39.917 --> 00:18:40.239
bro?

00:18:40.578 --> 00:18:41.799
So there's human accountability.

00:18:41.819 --> 00:18:42.680
We're social animals.

00:18:43.161 --> 00:18:45.481
Video games know this with guilds and

00:18:45.541 --> 00:18:47.242
clans within video games.

00:18:47.303 --> 00:18:49.785
And it matters if you're not there.

00:18:49.805 --> 00:18:50.766
They design the game.

00:18:50.786 --> 00:18:51.405
So you're not there.

00:18:51.826 --> 00:18:53.007
If it matters, if you're not there.

00:18:53.406 --> 00:18:55.588
The second one I stole from software.

00:18:56.169 --> 00:18:57.650
And this, I think, is genius.

00:18:58.211 --> 00:18:59.431
If you're a Peloton,

00:19:00.071 --> 00:19:01.913
you know when someone's about to quiet

00:19:01.952 --> 00:19:02.252
quit.

00:19:02.773 --> 00:19:04.414
You got the data.

00:19:04.494 --> 00:19:06.296
Jimmy used to ride five times a week.

00:19:06.375 --> 00:19:07.616
Now he's riding once a week.

00:19:07.696 --> 00:19:08.397
What's next?

00:19:08.678 --> 00:19:09.258
Canceling.

00:19:10.058 --> 00:19:11.779
Is it tomorrow or three months from now?

00:19:11.819 --> 00:19:13.441
Does not matter.

00:19:14.001 --> 00:19:15.383
What will we do when he cancels?

00:19:15.482 --> 00:19:17.483
We'll send him a coupon to rejoin for

00:19:17.544 --> 00:19:18.365
ten percent off.

00:19:18.825 --> 00:19:20.547
Bro, what's better than that?

00:19:20.987 --> 00:19:22.307
You know when I'm fading.

00:19:23.516 --> 00:19:27.300
imagine Peloton called me like a phone

00:19:27.340 --> 00:19:27.621
call.

00:19:27.721 --> 00:19:28.622
I don't know if you know, Tony,

00:19:28.643 --> 00:19:29.903
these things send more than text me.

00:19:30.223 --> 00:19:31.486
You can talk in this end and someone

00:19:31.506 --> 00:19:32.247
will talk in that end.

00:19:33.008 --> 00:19:34.849
Peloton sent me a t-shirt when I hit

00:19:34.869 --> 00:19:36.172
my, my thousandth ride.

00:19:36.211 --> 00:19:37.113
It said century club.

00:19:37.252 --> 00:19:39.336
They've done nothing since nothing.

00:19:39.695 --> 00:19:40.457
And I've paid them.

00:19:41.666 --> 00:19:43.867
fifty dollars a month for six years.

00:19:44.347 --> 00:19:46.028
I think it doesn't have to be a

00:19:46.087 --> 00:19:47.188
T-shirt again.

00:19:47.667 --> 00:19:49.409
But wouldn't you be more nervous about

00:19:49.489 --> 00:19:51.749
losing me than gaining another client?

00:19:51.769 --> 00:19:54.130
Because you already know all both of the

00:19:54.190 --> 00:19:55.971
elements are in alignment for Peloton.

00:19:56.290 --> 00:19:58.171
So software companies know this and they

00:19:58.230 --> 00:19:59.671
send you a notification when they notice

00:20:00.231 --> 00:20:01.251
usage going down.

00:20:02.403 --> 00:20:03.304
The apps have that,

00:20:03.523 --> 00:20:05.165
but Tony's got no visibility on it.

00:20:05.365 --> 00:20:06.907
So I think that's a big one.

00:20:07.528 --> 00:20:10.813
And then the third one was hospitality.

00:20:11.553 --> 00:20:13.255
And this is smart and I wanna reframe

00:20:13.275 --> 00:20:13.976
it around healthcare.

00:20:14.336 --> 00:20:16.298
Great hotel chains don't define themselves

00:20:16.378 --> 00:20:17.400
by the room.

00:20:18.500 --> 00:20:19.903
Like Hilton's not bragging,

00:20:19.923 --> 00:20:21.585
we've got six hundred and twelve square

00:20:21.625 --> 00:20:21.884
feet.

00:20:21.924 --> 00:20:22.967
Like that's not why you go.

00:20:24.157 --> 00:20:26.558
they build around the experience of why

00:20:26.700 --> 00:20:28.320
you're there and what you need.

00:20:28.540 --> 00:20:28.921
So like,

00:20:29.101 --> 00:20:30.481
I look at this as on ramps.

00:20:30.582 --> 00:20:32.363
I'm surprised Peloton hasn't done it.

00:20:32.403 --> 00:20:34.124
I'm surprised more PT clinics haven't done

00:20:34.144 --> 00:20:34.183
it.

00:20:34.223 --> 00:20:35.845
What I mean by that is why don't

00:20:35.884 --> 00:20:38.826
you have already set up groups for getting

00:20:38.866 --> 00:20:39.547
back into it?

00:20:39.748 --> 00:20:42.429
The six AM club, you know, wanted,

00:20:42.608 --> 00:20:44.390
I used to be a high school football

00:20:44.410 --> 00:20:46.112
player, forty years ago.

00:20:46.311 --> 00:20:48.512
You still have that identity, right?

00:20:48.752 --> 00:20:50.493
And I understand that more people in that

00:20:50.534 --> 00:20:51.615
room will be more like me.

00:20:52.015 --> 00:20:52.576
We keep,

00:20:53.435 --> 00:20:56.676
defining clinical care and our emrs by

00:20:56.737 --> 00:20:59.116
make trying to make a better faster emr

00:20:59.416 --> 00:21:00.936
and i'm trying to tell you it's the

00:21:01.017 --> 00:21:03.637
law of diminishing returns all this money

00:21:03.718 --> 00:21:06.258
is going into making it incrementally suck

00:21:06.357 --> 00:21:08.078
less as rory sutherland would say you're

00:21:08.098 --> 00:21:09.759
not really making it better you're trying

00:21:09.778 --> 00:21:11.618
to make it suck less when i think

00:21:11.638 --> 00:21:13.058
you flip the script and you say how

00:21:13.098 --> 00:21:14.660
does video games get people to not only

00:21:14.700 --> 00:21:16.619
come back but come back in droves pay

00:21:16.660 --> 00:21:18.279
more for the newest version of the game

00:21:18.720 --> 00:21:21.580
in-game purchases i know david rowan

00:21:22.721 --> 00:21:23.761
is probably in there going in-game

00:21:23.801 --> 00:21:24.241
purchases.

00:21:24.301 --> 00:21:25.403
Yeah, that'd be fantastic.

00:21:25.742 --> 00:21:26.864
That's the game that you're in.

00:21:26.903 --> 00:21:28.845
So I think the answer ironically is not

00:21:28.884 --> 00:21:29.644
from inside health.

00:21:29.825 --> 00:21:31.465
The call is not coming from inside the

00:21:31.506 --> 00:21:31.726
room.

00:21:31.786 --> 00:21:32.626
It's from outside,

00:21:32.846 --> 00:21:34.107
but we won't let it in because we're

00:21:34.147 --> 00:21:34.867
prestigious health.

00:21:35.087 --> 00:21:36.288
Tony, we're doctors,

00:21:36.828 --> 00:21:37.849
doctors of physical therapy.

00:21:37.869 --> 00:21:39.170
We don't need help from these video game

00:21:39.190 --> 00:21:39.371
people.

00:21:39.391 --> 00:21:39.931
Those are stupid.

00:21:40.740 --> 00:21:42.101
So then my question is,

00:21:42.381 --> 00:21:44.461
is it even possible, and I don't know,

00:21:45.061 --> 00:21:47.823
for the people that are running the EMRs

00:21:47.863 --> 00:21:51.243
today, because we've talked about this.

00:21:51.743 --> 00:21:56.425
If I sold silverware, right?

00:21:56.465 --> 00:21:57.547
I'm a manufacturer.

00:21:58.027 --> 00:22:00.048
I make forks and knives and spoons.

00:22:00.847 --> 00:22:02.709
and i open a restaurant because i'm like

00:22:02.849 --> 00:22:04.411
a restaurant's going to be the best way

00:22:04.431 --> 00:22:05.510
for me i'm going to open a chain

00:22:05.550 --> 00:22:07.011
of a thousand restaurants because i want

00:22:07.051 --> 00:22:09.594
to sell more silverware but i'm

00:22:09.634 --> 00:22:11.935
approaching the restaurant as somebody who

00:22:11.996 --> 00:22:14.678
is obsessed with silverware i don't care

00:22:14.698 --> 00:22:16.378
what the food is i don't care what

00:22:16.419 --> 00:22:18.621
you know the the experiences and the

00:22:18.641 --> 00:22:20.761
ambiance and that it's it's all about the

00:22:20.801 --> 00:22:21.262
silverware

00:22:22.103 --> 00:22:25.025
Is the mindset and the culture of the

00:22:25.105 --> 00:22:27.807
current companies in the landscape today

00:22:28.528 --> 00:22:30.548
always going to be what it's always been?

00:22:31.369 --> 00:22:33.291
And what we need is we need somebody

00:22:33.332 --> 00:22:36.193
to come out of a different profession to

00:22:36.233 --> 00:22:37.775
come into the EMR and say,

00:22:38.595 --> 00:22:40.457
I'm going to build a new EMR that's

00:22:40.477 --> 00:22:41.257
about this.

00:22:41.297 --> 00:22:42.438
It's not about that.

00:22:42.478 --> 00:22:42.959
Yep.

00:22:44.420 --> 00:22:46.662
Right now, we're sitting around, listen,

00:22:46.942 --> 00:22:49.183
all these organizations pay attention to

00:22:49.223 --> 00:22:49.604
each other.

00:22:49.765 --> 00:22:52.046
I'm not selling secrets, right?

00:22:52.326 --> 00:22:54.248
Big PT chains pay attention to what other

00:22:54.288 --> 00:22:55.148
big PT chains do.

00:22:55.669 --> 00:22:57.131
Universities pay attention to one another.

00:22:57.250 --> 00:22:58.352
Tech companies, tech companies.

00:22:59.011 --> 00:23:01.374
It will change exactly when one person

00:23:01.413 --> 00:23:04.916
does the, as Rory Sutherland would say,

00:23:05.136 --> 00:23:06.558
the unreasonable thing.

00:23:07.098 --> 00:23:09.240
We spent this much money over this much

00:23:09.280 --> 00:23:09.481
time,

00:23:09.521 --> 00:23:10.583
and we did a thing that no one

00:23:10.623 --> 00:23:11.243
else was doing.

00:23:11.624 --> 00:23:12.464
Then they do it,

00:23:12.545 --> 00:23:14.686
and then everyone panics and goes, oh,

00:23:14.707 --> 00:23:15.468
they're doing that.

00:23:15.488 --> 00:23:16.650
They're going to jump ahead of us.

00:23:17.009 --> 00:23:17.150
Well,

00:23:17.170 --> 00:23:18.290
you know what the smarter thing would have

00:23:18.310 --> 00:23:18.632
been done?

00:23:19.792 --> 00:23:20.594
Doing it already.

00:23:20.673 --> 00:23:21.894
You know the answer, right?

00:23:21.974 --> 00:23:22.756
Build the thing.

00:23:23.116 --> 00:23:23.817
Every once in a while,

00:23:23.836 --> 00:23:25.118
you're supposed to do this exercise.

00:23:26.257 --> 00:23:28.076
you go get to run your competitor for

00:23:28.478 --> 00:23:29.617
six months in your brain,

00:23:30.438 --> 00:23:31.738
what would you be pissed off that they

00:23:31.778 --> 00:23:33.278
did if they did it tomorrow?

00:23:33.739 --> 00:23:35.939
I try to use this psychological trick when

00:23:35.979 --> 00:23:37.259
people come to me and they're like,

00:23:37.299 --> 00:23:38.779
I want to start creating content.

00:23:38.819 --> 00:23:40.279
I want to create podcasts,

00:23:41.260 --> 00:23:42.101
but it's a lot of work.

00:23:42.141 --> 00:23:42.421
And I go,

00:23:42.520 --> 00:23:44.641
imagine this idea in your head that is

00:23:44.740 --> 00:23:46.422
absolutely perfect and pure in your brain.

00:23:47.261 --> 00:23:48.963
Tomorrow you wake up and somebody did it.

00:23:49.503 --> 00:23:50.525
How pissed would you be?

00:23:50.545 --> 00:23:52.727
You had the idea first.

00:23:52.767 --> 00:23:53.748
You just didn't execute.

00:23:54.008 --> 00:23:57.192
So my point is this will change exactly

00:23:57.231 --> 00:23:58.752
when someone is bold enough to change it

00:23:58.853 --> 00:24:01.115
and then everyone will follow and not a

00:24:01.295 --> 00:24:03.076
second before that.

00:24:03.597 --> 00:24:07.902
The system is designed to perfectly give a

00:24:07.961 --> 00:24:08.721
result that it gives.

00:24:09.042 --> 00:24:09.762
It's made up that way.

00:24:11.365 --> 00:24:14.708
So that takes me into the next segment.

00:24:14.988 --> 00:24:16.890
You did an awesome interview.

00:24:17.109 --> 00:24:18.971
I don't remember the gentleman's name.

00:24:19.031 --> 00:24:20.512
The company was Active Life.

00:24:21.394 --> 00:24:24.217
Say it again.

00:24:24.750 --> 00:24:25.750
Okay.

00:24:25.770 --> 00:24:27.251
I followed him for a long time.

00:24:27.632 --> 00:24:28.873
You know, for context,

00:24:29.032 --> 00:24:30.493
I came out of personal training.

00:24:30.634 --> 00:24:31.814
I had my CSCS.

00:24:31.953 --> 00:24:33.434
I was a strength coach.

00:24:33.915 --> 00:24:35.856
Then I became a physical therapist.

00:24:36.396 --> 00:24:37.417
I've said it before.

00:24:37.518 --> 00:24:39.078
I'll say it a hundred more times.

00:24:39.219 --> 00:24:40.219
To me,

00:24:40.740 --> 00:24:44.461
the physical therapy license gave me a

00:24:44.561 --> 00:24:46.722
license to bill insurance for what I was

00:24:46.762 --> 00:24:47.364
already doing.

00:24:48.023 --> 00:24:49.766
I was already working with adults.

00:24:49.965 --> 00:24:51.667
I was already working with individuals

00:24:51.728 --> 00:24:54.692
with orthopedic issues that needed

00:24:54.731 --> 00:24:59.096
fitness, needed some pain resolution,

00:24:59.576 --> 00:25:00.278
needed these things.

00:25:02.096 --> 00:25:04.237
The PT license gave me the license to

00:25:04.257 --> 00:25:06.277
bill insurance, period.

00:25:06.477 --> 00:25:08.038
I was going to get the information

00:25:08.198 --> 00:25:08.678
somewhere.

00:25:08.837 --> 00:25:10.558
I didn't need to be in a university

00:25:10.598 --> 00:25:10.959
setting.

00:25:11.739 --> 00:25:14.539
While the PT education experience was

00:25:14.579 --> 00:25:16.599
comprehensive and it was good,

00:25:17.079 --> 00:25:18.401
there was a lot of stuff I'm never

00:25:18.441 --> 00:25:19.000
going to use.

00:25:19.121 --> 00:25:20.921
I'm never going to use pediatric neuro.

00:25:21.021 --> 00:25:22.662
I'm never going to use all of these

00:25:22.781 --> 00:25:23.662
other things.

00:25:24.182 --> 00:25:25.923
I had to go through that to get

00:25:25.982 --> 00:25:26.643
the license.

00:25:26.702 --> 00:25:28.124
I had to get the license to bill

00:25:28.144 --> 00:25:28.683
insurance.

00:25:28.723 --> 00:25:29.203
That's it.

00:25:30.625 --> 00:25:34.909
That being said, I've always said, look,

00:25:35.249 --> 00:25:37.931
if we're stuck in the insurance model,

00:25:38.192 --> 00:25:40.193
the majority of the PT profession,

00:25:41.258 --> 00:25:42.018
But we see,

00:25:42.419 --> 00:25:43.878
just like earlier in the show, I said,

00:25:44.179 --> 00:25:46.641
what's my obligation if I know AI exists?

00:25:47.080 --> 00:25:48.842
I know I can help improve AI with

00:25:48.882 --> 00:25:49.961
my clinical knowledge.

00:25:50.281 --> 00:25:52.542
And AI can deliver services to people who

00:25:52.563 --> 00:25:53.943
will never be my patient.

00:25:54.604 --> 00:25:56.065
I should have some obligation.

00:25:56.144 --> 00:25:57.204
This is the same thing.

00:25:57.306 --> 00:26:01.667
What he's creating, Russon, John Russon,

00:26:01.708 --> 00:26:02.248
I think it is.

00:26:02.807 --> 00:26:04.170
What he is creating,

00:26:04.710 --> 00:26:07.353
they're taking the clinical knowledge of

00:26:07.452 --> 00:26:08.334
physical therapy,

00:26:08.394 --> 00:26:10.256
they're delivering it to personal trainers

00:26:10.276 --> 00:26:12.157
who are unlicensed and free to do what

00:26:12.198 --> 00:26:12.798
they want to do.

00:26:12.818 --> 00:26:17.323
And they're accessing a population that

00:26:17.624 --> 00:26:19.486
either isn't in physical therapy

00:26:20.125 --> 00:26:23.630
won't ever go i i i would never

00:26:23.670 --> 00:26:26.011
go to physical therapy for a shoulder

00:26:26.092 --> 00:26:27.553
problem a knee problem if i had a

00:26:27.613 --> 00:26:29.795
stroke i'm going to physical therapy if i

00:26:29.855 --> 00:26:31.457
had a brain injury if i had an

00:26:31.517 --> 00:26:34.118
amputation i am going to physical therapy

00:26:34.599 --> 00:26:36.361
but like the fitness stuff i'm just not

00:26:36.402 --> 00:26:38.363
going to go you know but i i

00:26:38.403 --> 00:26:40.505
would potentially hire a coach a personal

00:26:40.545 --> 00:26:42.406
trainer or something like that so you

00:26:43.468 --> 00:26:44.851
I thought it was an awesome interview.

00:26:46.031 --> 00:26:48.876
I think he's got a great understanding of

00:26:49.017 --> 00:26:50.759
where he is in the space.

00:26:51.121 --> 00:26:51.560
There it is.

00:26:53.035 --> 00:26:55.696
And I think that he sees that he's

00:26:55.777 --> 00:26:58.479
filling a need that needs to be filled.

00:26:59.398 --> 00:27:01.441
Every person who wants to work with adult

00:27:01.480 --> 00:27:03.561
geriatrics does not need to become a

00:27:03.602 --> 00:27:04.522
physical therapist.

00:27:05.363 --> 00:27:06.784
And it's cost prohibitive,

00:27:06.844 --> 00:27:07.964
and they don't have to put seven,

00:27:08.005 --> 00:27:09.125
eight years into it.

00:27:09.586 --> 00:27:11.007
He's saying, look, in two years,

00:27:11.626 --> 00:27:13.567
you can have all of this information and

00:27:13.607 --> 00:27:14.067
knowledge.

00:27:14.087 --> 00:27:16.730
You can have a body behind you that

00:27:16.769 --> 00:27:19.132
will say, yes, this person is trustworthy.

00:27:20.011 --> 00:27:21.593
and you can help that population who's

00:27:21.613 --> 00:27:22.893
happy to pay out of pocket for it

00:27:22.913 --> 00:27:26.775
yep sean's interesting you said where you

00:27:26.795 --> 00:27:28.675
said a where thing and not a what

00:27:28.756 --> 00:27:31.017
thing because you have physical therapy

00:27:31.376 --> 00:27:33.917
and then you have fitness physical therapy

00:27:33.958 --> 00:27:36.419
does feel like a very established place

00:27:36.818 --> 00:27:39.039
like if i had access to a database

00:27:39.059 --> 00:27:41.260
tony i could tell you exactly how many

00:27:41.361 --> 00:27:43.362
physical therapists there are in the

00:27:43.422 --> 00:27:45.301
united states but i don't know how many

00:27:45.321 --> 00:27:46.262
i don't know if i could ever tell

00:27:46.303 --> 00:27:46.623
you how many

00:27:48.128 --> 00:27:50.190
fitness people there are right because

00:27:50.210 --> 00:27:51.991
there's no i could just wake up tomorrow

00:27:52.031 --> 00:27:54.252
and decide and that feels like very

00:27:54.292 --> 00:27:57.275
ambiguous and unsafe so sean didn't pick a

00:27:57.335 --> 00:28:00.017
place he didn't pick physical therapy or

00:28:00.136 --> 00:28:03.479
fitness he picked the space between and

00:28:03.499 --> 00:28:05.799
that place is wide open and his whole

00:28:05.881 --> 00:28:08.001
his whole i don't want to say argument

00:28:08.021 --> 00:28:09.823
but his whole notice of a pain point

00:28:09.923 --> 00:28:14.826
is when you're discharged from pt when

00:28:14.865 --> 00:28:15.747
you're cleared

00:28:17.289 --> 00:28:19.932
does that mean are you just done and

00:28:19.971 --> 00:28:22.073
most pts know like i've got you to

00:28:22.113 --> 00:28:23.854
the edge of a diving board you can't

00:28:24.634 --> 00:28:25.855
you don't got to go home but you

00:28:25.875 --> 00:28:26.836
got to get you got to get the

00:28:26.875 --> 00:28:28.757
hiccup out of here i don't know where

00:28:28.817 --> 00:28:30.458
home is but good luck right it's the

00:28:30.498 --> 00:28:32.720
bartender being like we're closed and it's

00:28:32.740 --> 00:28:34.079
like where do i go i'm like you

00:28:34.099 --> 00:28:36.382
can go anywhere but just i stop at

00:28:36.422 --> 00:28:38.643
the door at two a.m that's when i

00:28:38.682 --> 00:28:41.424
turn the neon lights off and sean sees

00:28:41.484 --> 00:28:42.306
that and he goes

00:28:43.365 --> 00:28:43.507
Oh,

00:28:43.606 --> 00:28:45.548
if I get one percent of those people,

00:28:45.569 --> 00:28:47.172
if I can teach people how to find

00:28:47.231 --> 00:28:50.296
those people, that is a need.

00:28:52.305 --> 00:28:54.386
that's why it's valuable we see this as

00:28:54.426 --> 00:28:56.808
like scope creep and you if you see

00:28:56.828 --> 00:28:58.450
it as defense if you if you look

00:28:58.490 --> 00:29:00.852
at it defensively you see it as scope

00:29:00.892 --> 00:29:02.212
creep and that's what all of our

00:29:02.252 --> 00:29:04.674
professions do all of us are touching each

00:29:04.714 --> 00:29:06.436
other and in a conference setting on a

00:29:06.517 --> 00:29:08.939
stage in a panel we love each other

00:29:09.098 --> 00:29:10.700
we put our arms around each other and

00:29:10.720 --> 00:29:13.001
then it comes to the facebook groups of

00:29:13.082 --> 00:29:15.023
just our our individual professions

00:29:15.144 --> 00:29:18.425
trainers chiropractors pts pas nurses and

00:29:18.445 --> 00:29:19.047
that's when we're like

00:29:19.326 --> 00:29:22.327
These Kairos are infringing on our

00:29:22.347 --> 00:29:23.087
blabbity blues.

00:29:23.188 --> 00:29:24.327
Are you mad they're doing it?

00:29:24.407 --> 00:29:26.327
Or are you mad they're doing it better

00:29:26.347 --> 00:29:26.749
than you?

00:29:26.989 --> 00:29:27.969
Are you mad they're doing something

00:29:28.009 --> 00:29:29.588
different that you don't agree with or you

00:29:29.608 --> 00:29:30.548
don't believe in?

00:29:31.048 --> 00:29:32.609
Are you mad they're communicating it

00:29:32.630 --> 00:29:34.309
better and people are finding their way to

00:29:34.329 --> 00:29:35.009
them and not you?

00:29:35.029 --> 00:29:36.049
The answer is yes.

00:29:36.329 --> 00:29:37.310
That's what you're mad at.

00:29:37.550 --> 00:29:38.671
You are mad at you.

00:29:38.971 --> 00:29:40.270
So you can play that Taylor Swift song

00:29:40.290 --> 00:29:40.810
all you want.

00:29:41.090 --> 00:29:42.112
Hi, it's me.

00:29:42.491 --> 00:29:43.211
I'm the problem.

00:29:43.531 --> 00:29:43.872
It's me.

00:29:46.303 --> 00:29:49.344
I was pretty interested because also Sean

00:29:49.464 --> 00:29:51.045
from Active Life, who I just interviewed,

00:29:51.105 --> 00:29:51.566
great interview.

00:29:51.605 --> 00:29:52.205
Go listen to him.

00:29:52.246 --> 00:29:52.865
Go read his book.

00:29:53.105 --> 00:29:54.326
I get no nickels from the book.

00:29:54.426 --> 00:29:54.866
Go read it.

00:29:55.347 --> 00:29:56.387
He's on Long Island.

00:29:56.708 --> 00:29:57.888
And Mike Stella,

00:29:58.608 --> 00:29:59.970
who is an athletic trainer,

00:30:00.750 --> 00:30:01.790
is on Long Island.

00:30:02.391 --> 00:30:05.252
I would love to have those guys on

00:30:05.413 --> 00:30:09.634
stage at a PT program on Long Island.

00:30:09.674 --> 00:30:11.496
I did a show live at NYIT.

00:30:11.655 --> 00:30:12.556
So I'm going to reach out to my

00:30:12.596 --> 00:30:13.636
friend, Eric Greenberg,

00:30:14.881 --> 00:30:15.781
and see if I can get there,

00:30:15.801 --> 00:30:19.845
because I'd love to put non-PTs in front

00:30:19.865 --> 00:30:21.166
of a bunch of PT students.

00:30:21.366 --> 00:30:22.728
And I'm not trying to get you to

00:30:22.788 --> 00:30:23.989
think any which way.

00:30:24.169 --> 00:30:25.349
I'm trying to get you to think,

00:30:25.430 --> 00:30:26.111
heart stop,

00:30:26.611 --> 00:30:28.712
about what it is you're actually able to

00:30:28.732 --> 00:30:28.972
do.

00:30:29.233 --> 00:30:30.855
Because I think you and I both agree,

00:30:30.974 --> 00:30:33.317
what we're able to do is much larger

00:30:33.457 --> 00:30:34.778
than what we're thinking about right now.

00:30:34.858 --> 00:30:36.319
Most of our colleagues, I think,

00:30:36.420 --> 00:30:37.540
are thinking about right now.

00:30:38.541 --> 00:30:40.343
I think we're going to be hit with

00:30:40.383 --> 00:30:41.884
the reality that

00:30:42.987 --> 00:30:46.329
where is the scope of physical therapy?

00:30:46.490 --> 00:30:47.750
It's in the diagnosis,

00:30:47.790 --> 00:30:50.073
it's in the evaluation, in the assessment,

00:30:50.113 --> 00:30:51.394
developing the plan of care,

00:30:51.433 --> 00:30:52.855
it's in understanding the why.

00:30:52.974 --> 00:30:54.737
Why am I prescribing this?

00:30:55.498 --> 00:30:58.299
It's not in the how or the doing.

00:30:59.080 --> 00:31:00.201
Anybody can do

00:31:01.869 --> 00:31:02.590
A straight leg raise.

00:31:02.711 --> 00:31:03.871
Anybody can do a lap pull.

00:31:03.911 --> 00:31:05.291
Anybody can do the exercise.

00:31:05.511 --> 00:31:06.712
Once it's been prescribed,

00:31:06.752 --> 00:31:08.413
but you have to understand why are you

00:31:08.453 --> 00:31:09.413
prescribing that?

00:31:09.555 --> 00:31:11.895
Why are you doing this intervention?

00:31:12.516 --> 00:31:15.258
Even at the most complex levels for neuro

00:31:16.077 --> 00:31:18.460
and brain injuries and things like that,

00:31:19.099 --> 00:31:21.781
understanding why is where we should live.

00:31:22.142 --> 00:31:23.782
That's the bread and butter of what we

00:31:23.843 --> 00:31:23.962
do.

00:31:24.747 --> 00:31:26.728
teach other people how to do the how

00:31:27.188 --> 00:31:29.249
that let them take that part of it

00:31:30.029 --> 00:31:32.049
now what's going to make therapists go

00:31:32.090 --> 00:31:34.811
crazy and i don't know with john i've

00:31:34.852 --> 00:31:36.633
followed john for a long time i've never

00:31:36.673 --> 00:31:38.554
met him in person for some reason in

00:31:38.594 --> 00:31:40.554
my mind i feel like he used to

00:31:40.595 --> 00:31:44.375
focus his training on training pts and now

00:31:44.455 --> 00:31:46.958
i feel like his focus is training personal

00:31:46.978 --> 00:31:47.397
trainers

00:31:48.306 --> 00:31:49.307
And so, you know,

00:31:49.547 --> 00:31:50.847
two hundred dollars a session.

00:31:51.328 --> 00:31:53.611
He's talking about increasing from eighty

00:31:53.651 --> 00:31:55.352
dollars a session to one hundred and

00:31:55.412 --> 00:31:55.932
fifty.

00:31:55.972 --> 00:31:58.515
He's talking about moving into price

00:31:58.575 --> 00:32:01.156
points that would be considered comparable

00:32:01.198 --> 00:32:03.118
to a cash based physical therapist.

00:32:03.660 --> 00:32:06.741
He's focusing his his content on

00:32:07.242 --> 00:32:09.805
successful executives who have money,

00:32:10.566 --> 00:32:11.866
more money than time,

00:32:12.426 --> 00:32:13.648
and they just want the solution.

00:32:14.500 --> 00:32:16.843
you know and and so again i think

00:32:16.883 --> 00:32:19.025
he's stepping on toes in a good way

00:32:19.566 --> 00:32:21.989
that's going to force clinicians to figure

00:32:22.068 --> 00:32:24.692
out like why am i not doing that

00:32:24.971 --> 00:32:28.435
but put put that back up uh yeah

00:32:28.455 --> 00:32:30.317
clinicians will see this and they'll get

00:32:30.438 --> 00:32:31.058
so mad

00:32:31.993 --> 00:32:33.674
because we're talking about money and

00:32:33.714 --> 00:32:37.278
they'll go, ah, this is so annoying.

00:32:37.857 --> 00:32:39.338
John isn't saying everybody should do

00:32:39.378 --> 00:32:39.699
this.

00:32:40.180 --> 00:32:41.701
He's saying that this is a way to

00:32:41.721 --> 00:32:42.580
do the thing that you want.

00:32:42.621 --> 00:32:44.382
This is a way to do the thing

00:32:44.402 --> 00:32:46.002
that he's not speaking in absolutes.

00:32:46.844 --> 00:32:48.765
Like again, I pay a woman,

00:32:48.825 --> 00:32:51.626
two hundred bucks to clean my house and

00:32:52.208 --> 00:32:53.669
people are like two hundred hours to see

00:32:53.709 --> 00:32:54.088
a PT.

00:32:54.108 --> 00:32:54.808
That's insane.

00:32:55.190 --> 00:32:56.190
For some of you, it might be,

00:32:56.770 --> 00:32:58.311
but for some people it is not.

00:32:59.161 --> 00:33:00.202
Right?

00:33:00.784 --> 00:33:01.105
Yeah.

00:33:01.244 --> 00:33:01.905
John had one of the...

00:33:02.066 --> 00:33:03.067
I wouldn't say one of the first,

00:33:03.107 --> 00:33:06.153
but had a PT podcast with Gene,

00:33:06.173 --> 00:33:06.875
Chirac abroad.

00:33:07.276 --> 00:33:08.719
They had like a... Oh, he did?

00:33:08.898 --> 00:33:09.640
I knew Gene.

00:33:10.181 --> 00:33:11.202
They launched like...

00:33:12.388 --> 00:33:15.769
Gene and Ben, John, Russin,

00:33:16.170 --> 00:33:18.590
they launched like three or four podcasts

00:33:18.691 --> 00:33:20.551
at the same time, which is a network,

00:33:20.811 --> 00:33:21.771
which is very smart.

00:33:22.132 --> 00:33:23.313
John was one of them.

00:33:25.193 --> 00:33:27.554
I think it was real early in terms

00:33:27.574 --> 00:33:28.775
of like seeing an ROI.

00:33:29.501 --> 00:33:33.826
But figure out what you like doing.

00:33:34.627 --> 00:33:36.230
I say that very much first.

00:33:36.329 --> 00:33:37.490
Figure out what you like doing.

00:33:37.951 --> 00:33:40.034
Then figure out whose problem it solved.

00:33:41.234 --> 00:33:42.215
Don't try the other way,

00:33:42.256 --> 00:33:43.498
which is I want to solve a problem

00:33:43.518 --> 00:33:44.117
for blah, blah, blah.

00:33:44.419 --> 00:33:44.979
Hold on a second.

00:33:45.728 --> 00:33:46.949
What are you doing though?

00:33:47.148 --> 00:33:49.609
Because John likes solving these problems

00:33:49.750 --> 00:33:51.471
and he's, you said he's moved audiences.

00:33:51.852 --> 00:33:52.152
Yeah.

00:33:52.192 --> 00:33:53.413
That's a good way to go about it

00:33:53.432 --> 00:33:54.053
in my opinion.

00:33:54.073 --> 00:33:54.452
Cause he's like,

00:33:54.573 --> 00:33:55.534
I'm not going to change my,

00:33:55.574 --> 00:33:56.354
the thing that I do.

00:33:56.493 --> 00:33:57.394
I'm going to change who I,

00:33:57.575 --> 00:33:58.796
who I offer it to.

00:33:59.155 --> 00:34:00.396
Cause I guess he tried to teach PTs

00:34:00.436 --> 00:34:01.436
and they didn't want to listen or

00:34:01.498 --> 00:34:02.738
whatever, whatever reason he moved.

00:34:02.978 --> 00:34:03.719
And he goes, well,

00:34:03.759 --> 00:34:04.679
I guess this doesn't work.

00:34:04.839 --> 00:34:06.760
No, they don't want to hear it.

00:34:06.820 --> 00:34:07.901
Sell it to someone else.

00:34:09.121 --> 00:34:10.282
So here's the thing.

00:34:10.302 --> 00:34:11.824
You've got John who,

00:34:11.923 --> 00:34:14.224
who tried to do that for PTs and

00:34:14.244 --> 00:34:15.226
then just shipped it away.

00:34:16.454 --> 00:34:17.394
I've shifted away.

00:34:17.715 --> 00:34:19.876
I'm nowhere near as active as I was

00:34:19.916 --> 00:34:22.317
trying to help PTs understand business,

00:34:22.356 --> 00:34:23.936
grow their business, because I'm just,

00:34:24.036 --> 00:34:25.838
I'm yelling into a void.

00:34:26.498 --> 00:34:27.858
And I think this,

00:34:28.079 --> 00:34:29.780
which you shared with me is a great

00:34:29.820 --> 00:34:30.820
example of that.

00:34:31.300 --> 00:34:33.222
So Rob, Rob Jordan, right?

00:34:34.101 --> 00:34:34.322
Yeah.

00:34:34.382 --> 00:34:35.842
Rob Jordan says, Hey,

00:34:35.862 --> 00:34:37.903
he talked to a UHC executive,

00:34:38.403 --> 00:34:40.045
informed them that they want to pull out

00:34:40.085 --> 00:34:40.744
of the network.

00:34:41.065 --> 00:34:43.007
now i don't know how big rob clinic

00:34:43.126 --> 00:34:45.148
is or his operation is but i can

00:34:45.188 --> 00:34:47.670
tell you from personal experience i'll put

00:34:47.690 --> 00:34:49.911
this back up in a second here in

00:34:49.992 --> 00:34:53.295
ohio where i live the hospital the local

00:34:53.394 --> 00:34:58.297
hospital told uhc hey we're not gonna

00:34:58.498 --> 00:35:00.300
we're not gonna negotiate these rates are

00:35:00.340 --> 00:35:02.862
too low we're dropping them and uhc said

00:35:03.402 --> 00:35:06.063
bye bye like we have zero they don't

00:35:06.105 --> 00:35:07.545
care and and

00:35:08.126 --> 00:35:10.827
The thing is, here, for context,

00:35:11.407 --> 00:35:14.268
a huge steel mill that employs thousands

00:35:14.307 --> 00:35:14.887
of people,

00:35:15.347 --> 00:35:19.389
they had UHC as their worker health

00:35:19.429 --> 00:35:20.889
insurance, and they still said,

00:35:20.949 --> 00:35:21.489
we don't care.

00:35:21.548 --> 00:35:22.730
We're not going to negotiate.

00:35:22.750 --> 00:35:23.429
These are the rates.

00:35:23.469 --> 00:35:24.170
Take it or leave it.

00:35:24.690 --> 00:35:26.329
So no individual clinician.

00:35:26.411 --> 00:35:28.030
Now, I've heard stories.

00:35:28.170 --> 00:35:29.710
I've talked to therapists where they've

00:35:29.771 --> 00:35:32.311
negotiated from the sixty dollars.

00:35:33.032 --> 00:35:34.833
But the truth is, like Rob is saying,

00:35:35.152 --> 00:35:35.952
and I'm one of them.

00:35:36.612 --> 00:35:37.755
you know come talk to me if you

00:35:37.795 --> 00:35:39.996
want to i'm one of them i will

00:35:40.036 --> 00:35:42.541
take the sixty dollars i will take sixty

00:35:42.561 --> 00:35:45.204
dollars a visit to deliver a physical

00:35:45.244 --> 00:35:50.110
therapy uh experience that is worth how

00:35:50.150 --> 00:35:50.411
much

00:35:51.806 --> 00:35:52.525
Well, that's the thing.

00:35:52.987 --> 00:35:54.306
So here in Ohio,

00:35:55.086 --> 00:35:57.208
they pay a flat day rate.

00:35:57.869 --> 00:35:59.588
I'm going to say somewhere around fifty or

00:35:59.608 --> 00:36:00.108
fifty five.

00:36:00.168 --> 00:36:01.269
I don't remember exactly.

00:36:01.909 --> 00:36:04.271
So I could do ten minutes of manual

00:36:04.331 --> 00:36:05.672
therapy if I believe that's what the

00:36:05.711 --> 00:36:06.291
patient needs.

00:36:06.331 --> 00:36:07.413
I get paid fifty dollars,

00:36:07.432 --> 00:36:09.452
which is more than twice what Medicare

00:36:09.472 --> 00:36:09.793
pays.

00:36:10.253 --> 00:36:11.873
And then the patient can do other stuff

00:36:11.893 --> 00:36:12.695
that I've prescribed.

00:36:12.715 --> 00:36:14.795
But that does not require my direct one

00:36:14.835 --> 00:36:15.436
on one time.

00:36:16.056 --> 00:36:19.418
I can build an operation around that level

00:36:19.478 --> 00:36:21.599
of reimbursement without losing money and

00:36:21.639 --> 00:36:23.280
it can still be worthwhile.

00:36:23.641 --> 00:36:24.900
The hospital can do it.

00:36:25.121 --> 00:36:25.742
I can do it.

00:36:25.762 --> 00:36:27.483
There's plenty of providers who can do it.

00:36:27.523 --> 00:36:29.264
So you can't do it.

00:36:29.384 --> 00:36:31.204
Rob perhaps can't do it.

00:36:31.545 --> 00:36:34.387
And that's totally fine because, hey,

00:36:34.867 --> 00:36:35.967
give John a call.

00:36:36.168 --> 00:36:37.849
He'll teach you how to earn two hundred

00:36:37.869 --> 00:36:39.710
dollars a session and you don't have to

00:36:39.750 --> 00:36:41.070
worry about sixty dollars.

00:36:41.721 --> 00:36:42.501
Right.

00:36:42.541 --> 00:36:44.023
But what I was getting at there is

00:36:44.083 --> 00:36:45.925
if you understand that UHG is going to

00:36:45.945 --> 00:36:48.967
pay you sixty dollars, Tony goes, OK,

00:36:49.166 --> 00:36:51.108
I'm going to provide forty dollars worth

00:36:51.148 --> 00:36:53.610
of service that you're like you're going

00:36:53.630 --> 00:36:55.313
to provide you're going to provide

00:36:55.373 --> 00:36:56.293
adequate care.

00:36:56.313 --> 00:36:57.614
But you're going to say if I'm being

00:36:57.655 --> 00:36:58.695
paid sixty dollars,

00:36:59.036 --> 00:37:00.697
I can't provide one hundred and twenty

00:37:00.717 --> 00:37:02.579
dollars worth of care because I will be

00:37:02.659 --> 00:37:04.521
in I will be out of business in

00:37:04.581 --> 00:37:05.021
a month.

00:37:05.460 --> 00:37:06.242
You will not support yourself.

00:37:06.262 --> 00:37:07.822
So you're going, OK, I'll take the sixty.

00:37:08.603 --> 00:37:10.686
because uhc you're not going to negotiate

00:37:10.706 --> 00:37:12.487
them with them until you have a long

00:37:12.527 --> 00:37:15.530
enough lever or a sharp enough sword and

00:37:15.690 --> 00:37:17.992
individual clinics just ain't got it i

00:37:18.012 --> 00:37:20.514
will tell you yes it does happen but

00:37:20.534 --> 00:37:22.715
you have to be large enough this is

00:37:23.335 --> 00:37:25.717
this is math at this point like this

00:37:25.757 --> 00:37:27.179
is not hearts and minds you are not

00:37:27.219 --> 00:37:28.780
winning so bring that graphic back up

00:37:29.001 --> 00:37:30.681
because what they said was she pulled up

00:37:30.722 --> 00:37:33.525
some data that indicated that every

00:37:33.565 --> 00:37:35.766
provider in my county was accepting sixty

00:37:35.786 --> 00:37:36.407
dollars a visit

00:37:38.619 --> 00:37:39.760
I'm going to go out here and say

00:37:40.159 --> 00:37:41.942
that that person, she was not lying.

00:37:42.682 --> 00:37:43.583
What more can I say?

00:37:43.963 --> 00:37:44.945
This sounds rhetorical,

00:37:44.965 --> 00:37:46.847
but the answer to Rob is unfortunately,

00:37:46.887 --> 00:37:48.527
and I'm sorry, nothing.

00:37:48.849 --> 00:37:49.528
What more can you say?

00:37:49.548 --> 00:37:50.230
It's nothing.

00:37:50.690 --> 00:37:53.693
You decide to take sixty and provide fifty

00:37:53.733 --> 00:37:54.853
nine dollars worth of.

00:37:55.755 --> 00:37:57.295
invest fifty nine dollars worth of

00:37:57.496 --> 00:38:00.418
therapist time lights electricity all

00:38:00.438 --> 00:38:02.920
those things and make a dollar or not

00:38:03.059 --> 00:38:05.382
those you can have some or none this

00:38:05.422 --> 00:38:07.163
is not a this is not a middle

00:38:07.182 --> 00:38:08.903
ground now bring that back up again

00:38:09.425 --> 00:38:11.726
because then adam said this is a lie

00:38:11.885 --> 00:38:16.809
we negotiated a much higher rate than that

00:38:16.849 --> 00:38:18.690
in that county right

00:38:19.521 --> 00:38:21.525
And then how'd you do that?

00:38:21.545 --> 00:38:23.108
The answer might be if Adam is saying

00:38:23.148 --> 00:38:24.472
they did that and I'm gonna go on

00:38:24.592 --> 00:38:26.054
everything that's being said is true,

00:38:26.536 --> 00:38:27.177
I agree with Adam,

00:38:27.416 --> 00:38:28.498
you did it a certain way.

00:38:30.969 --> 00:38:32.530
I don't, unless I'm wrong, right?

00:38:32.550 --> 00:38:33.789
And there's smarter people who can point

00:38:33.809 --> 00:38:36.751
out the nuances, but that's the breaks,

00:38:36.771 --> 00:38:37.032
kid.

00:38:37.512 --> 00:38:38.012
And it sucks.

00:38:38.251 --> 00:38:39.273
So I go back to,

00:38:39.612 --> 00:38:41.092
if you took the transcript of every

00:38:41.132 --> 00:38:43.233
episode I've ever done over eleven years,

00:38:43.494 --> 00:38:44.594
put it into AI and said,

00:38:44.994 --> 00:38:46.175
what's Jimmy really saying?

00:38:46.255 --> 00:38:48.456
It's understand what game you're playing.

00:38:49.157 --> 00:38:50.436
As soon as you do that, decide,

00:38:50.516 --> 00:38:51.797
do I want to play this game or

00:38:51.858 --> 00:38:52.097
not?

00:38:52.378 --> 00:38:53.878
And playing this game means you can play

00:38:53.918 --> 00:38:54.659
lots of different ways.

00:38:55.458 --> 00:38:57.559
But we hear consistently over and over

00:38:57.579 --> 00:38:57.820
again,

00:38:58.039 --> 00:38:59.221
I'm going to take my ball and go

00:38:59.260 --> 00:38:59.541
home.

00:39:00.041 --> 00:39:01.804
And UHC is going to look at you.

00:39:01.824 --> 00:39:04.626
And before the door closes,

00:39:04.786 --> 00:39:07.128
they forgot about you.

00:39:07.568 --> 00:39:08.750
This is not the way.

00:39:09.030 --> 00:39:09.891
There is a way,

00:39:09.990 --> 00:39:12.152
and other people are doing it.

00:39:12.193 --> 00:39:13.273
So I think this,

00:39:13.894 --> 00:39:15.675
I'm going to put words out there.

00:39:15.976 --> 00:39:18.518
I think the, what does he say?

00:39:19.284 --> 00:39:19.943
Will Boyd said,

00:39:20.003 --> 00:39:20.824
not related to the episode,

00:39:20.844 --> 00:39:22.045
but can you guys do an episode where

00:39:22.085 --> 00:39:23.184
you dress like the other person?

00:39:23.244 --> 00:39:25.005
Tony needs to rock Jimmy's shirt.

00:39:25.804 --> 00:39:27.065
I got flowers on my shirt.

00:39:27.146 --> 00:39:27.945
I'm fashionable.

00:39:29.266 --> 00:39:31.085
I think my kids have shirts like that,

00:39:31.206 --> 00:39:32.646
so I'll go find one.

00:39:32.746 --> 00:39:34.387
I got it from J. Crew Kids, probably,

00:39:34.427 --> 00:39:35.007
is where I got it from.

00:39:35.106 --> 00:39:37.447
It's probably a sale on the internet.

00:39:37.547 --> 00:39:40.047
I think the opposition to my position

00:39:40.088 --> 00:39:40.929
would say, look,

00:39:40.969 --> 00:39:42.588
we have to protect the profession.

00:39:43.009 --> 00:39:44.469
We have to circle the wagons.

00:39:44.829 --> 00:39:47.050
We have to collectively say we are not-

00:39:47.130 --> 00:39:47.590
Where's the union?

00:39:48.456 --> 00:39:49.657
Where's the union?

00:39:49.717 --> 00:39:50.898
And so they're gonna say,

00:39:50.918 --> 00:39:52.840
we need to protect the therapist.

00:39:53.019 --> 00:39:53.681
I'm gonna say,

00:39:54.081 --> 00:39:55.362
who's protecting the consumer?

00:39:55.762 --> 00:39:57.063
Who's protecting the patient?

00:39:57.664 --> 00:39:59.987
If I can deliver the service because I've

00:40:00.047 --> 00:40:01.369
monetized it in other ways,

00:40:01.389 --> 00:40:04.010
the hospital monetizes with surgeries and

00:40:04.170 --> 00:40:04.891
other things.

00:40:05.431 --> 00:40:07.574
I monetize with social media and real

00:40:07.614 --> 00:40:09.096
estate and just the fact that I've been

00:40:09.235 --> 00:40:10.577
at it for twenty five years.

00:40:11.478 --> 00:40:12.898
I talked to somebody the other day.

00:40:12.918 --> 00:40:13.400
I said, look,

00:40:13.940 --> 00:40:15.541
I bought all this equipment about twenty

00:40:15.581 --> 00:40:16.101
years ago.

00:40:16.362 --> 00:40:17.862
It was way cheaper than it would be

00:40:17.902 --> 00:40:18.603
to buy today.

00:40:19.123 --> 00:40:21.565
I have a competitive advantage over every

00:40:21.626 --> 00:40:23.688
other physical therapist who wants to open

00:40:23.708 --> 00:40:25.969
a clinic today simply because I've been

00:40:25.989 --> 00:40:28.630
alive longer and in business longer.

00:40:29.487 --> 00:40:32.170
Does that mean that I shouldn't use my

00:40:32.210 --> 00:40:33.371
competitive advantage,

00:40:33.391 --> 00:40:35.793
that I shouldn't use the resources I have

00:40:36.213 --> 00:40:40.597
to both help my consumer and to still

00:40:40.637 --> 00:40:42.320
be profitable in the process?

00:40:42.340 --> 00:40:43.340
Like, no, that's absurd.

00:40:43.380 --> 00:40:45.001
That's what business is all about.

00:40:45.021 --> 00:40:45.682
Correct.

00:40:46.547 --> 00:40:47.708
Correct.

00:40:47.768 --> 00:40:48.329
I was going to say,

00:40:48.349 --> 00:40:50.369
then people will say, you're the, I can,

00:40:50.449 --> 00:40:51.650
people hear them, right?

00:40:51.911 --> 00:40:52.652
Can you hear them, Tony?

00:40:52.672 --> 00:40:53.913
They're screaming into their speaker.

00:40:54.414 --> 00:40:55.655
You're the reason.

00:40:55.815 --> 00:40:57.235
Tony's the reason.

00:40:57.635 --> 00:40:58.938
You take sixty dollars,

00:40:58.958 --> 00:41:00.038
which means we're never going to make

00:41:00.119 --> 00:41:01.159
seventy dollars.

00:41:01.579 --> 00:41:02.300
And I'm saying, no,

00:41:02.340 --> 00:41:03.561
that that ain't that ain't it.

00:41:04.742 --> 00:41:06.204
I wish it was right.

00:41:06.284 --> 00:41:07.784
And then it's almost cyclical.

00:41:07.844 --> 00:41:09.385
I sound like the old man now.

00:41:10.007 --> 00:41:10.907
Every six months.

00:41:12.007 --> 00:41:14.608
We should pick a day when every PT

00:41:14.628 --> 00:41:17.090
decides we're not gonna treat a patient

00:41:17.130 --> 00:41:17.469
today.

00:41:18.050 --> 00:41:20.331
And that'll show them, that'll show them.

00:41:20.891 --> 00:41:22.391
UHC is gonna see a day where they

00:41:22.411 --> 00:41:24.112
don't spend one single nickel,

00:41:24.472 --> 00:41:26.273
one day where they don't see one nickel,

00:41:26.873 --> 00:41:28.054
fantastic.

00:41:28.074 --> 00:41:29.454
You know what's gonna happen the day two?

00:41:29.755 --> 00:41:31.735
They're gonna spend a hundred and seventy

00:41:31.775 --> 00:41:32.416
percent more.

00:41:32.715 --> 00:41:35.456
Or they're just gonna absorb that day's

00:41:35.516 --> 00:41:37.697
losses and they're never gonna notice it.

00:41:37.998 --> 00:41:39.259
It would be a blip on the radar.

00:41:39.744 --> 00:41:40.284
And then I always,

00:41:40.643 --> 00:41:41.945
my almost stock response is,

00:41:42.324 --> 00:41:44.505
can you get ten people to throw a

00:41:44.545 --> 00:41:45.344
surprise party?

00:41:45.425 --> 00:41:46.885
I need you to organize ten of your

00:41:46.925 --> 00:41:50.186
friends to agree on a time, date, place,

00:41:50.766 --> 00:41:52.367
and theme of a surprise party,

00:41:52.447 --> 00:41:53.686
and let me know how that goes.

00:41:53.867 --> 00:41:55.588
Because that person who says,

00:41:55.807 --> 00:41:56.827
we're going to pick one day,

00:41:56.847 --> 00:41:58.628
it's going to be Black Friday for PT,

00:41:58.708 --> 00:41:59.268
and they're going to see,

00:41:59.289 --> 00:42:00.389
they're going to feel us.

00:42:01.048 --> 00:42:02.128
I agree with your emotion,

00:42:02.228 --> 00:42:03.269
and I wish this were true.

00:42:03.730 --> 00:42:05.690
It's just realistically not going to

00:42:05.730 --> 00:42:06.050
happen,

00:42:06.190 --> 00:42:07.851
or matter even if you have pulled off

00:42:07.891 --> 00:42:08.210
the emotion.

00:42:08.231 --> 00:42:09.331
It's not going to happen.

00:42:10.134 --> 00:42:11.536
Yeah, my response,

00:42:11.576 --> 00:42:14.639
and I have no connection to go sign

00:42:14.679 --> 00:42:15.740
up for this course,

00:42:16.141 --> 00:42:18.063
go make two hundred dollars an hour,

00:42:18.423 --> 00:42:20.286
drop all the insurance companies.

00:42:20.326 --> 00:42:20.585
You know,

00:42:20.806 --> 00:42:22.728
if that's not the business you want to

00:42:22.768 --> 00:42:23.230
be in,

00:42:23.710 --> 00:42:26.273
you can't complain if there are solutions

00:42:26.313 --> 00:42:28.195
available and you just want to ignore

00:42:28.215 --> 00:42:28.295
them.

00:42:28.335 --> 00:42:29.757
Now, I will say, Tony.

00:42:30.637 --> 00:42:34.222
is is john russon speaking in absolutes

00:42:34.322 --> 00:42:35.643
and what i mean by that is is

00:42:35.804 --> 00:42:39.106
he saying you have to treat everybody for

00:42:39.168 --> 00:42:40.628
two hundred dollars an hour is that what

00:42:40.668 --> 00:42:42.391
he's saying because if you want to do

00:42:42.451 --> 00:42:44.032
pro bono and we have said this on

00:42:44.072 --> 00:42:45.635
this show and people do this

00:42:46.581 --> 00:42:48.601
You raise your rates for some people,

00:42:48.782 --> 00:42:49.882
and then you are free.

00:42:49.902 --> 00:42:51.782
I mean, I'm looking outside.

00:42:51.802 --> 00:42:52.922
It still looks like a free country.

00:42:53.282 --> 00:42:55.164
You are free to give stuff away or

00:42:55.244 --> 00:42:57.344
give it away at a reduced rate or

00:42:57.505 --> 00:42:58.784
do whatever the heck you want.

00:42:59.344 --> 00:43:01.405
You cannot do that if you are out

00:43:01.425 --> 00:43:02.286
of business, though.

00:43:02.925 --> 00:43:04.306
So understand what game you're playing.

00:43:04.327 --> 00:43:06.367
So John is saying you can do this.

00:43:06.708 --> 00:43:07.887
This is how things work.

00:43:08.268 --> 00:43:09.447
If you decide not to,

00:43:09.789 --> 00:43:10.809
that is a you problem.

00:43:11.726 --> 00:43:13.206
we're not a political show,

00:43:13.246 --> 00:43:14.768
but you hear the same thing with the

00:43:14.807 --> 00:43:16.668
people who want to raise taxes,

00:43:17.327 --> 00:43:18.608
just pay more in taxes.

00:43:18.648 --> 00:43:20.389
There's nothing stopping me from paying

00:43:20.449 --> 00:43:20.688
more.

00:43:20.768 --> 00:43:22.590
Send the government a bigger check.

00:43:24.289 --> 00:43:26.751
I can monetize my day, my time,

00:43:26.811 --> 00:43:28.570
my patient care with media.

00:43:28.650 --> 00:43:31.291
I let Facebook and YouTube and other

00:43:32.311 --> 00:43:34.532
online platforms pay me the money I need.

00:43:34.972 --> 00:43:35.972
I own the real estate.

00:43:36.373 --> 00:43:37.673
I have the investments.

00:43:38.414 --> 00:43:40.275
I can give stuff away for free.

00:43:40.737 --> 00:43:42.739
I can accept lower reimbursement.

00:43:42.778 --> 00:43:43.860
Like none of that stuff,

00:43:44.460 --> 00:43:46.802
it's not going to move the needle if

00:43:46.842 --> 00:43:48.523
somebody comes in for fifty dollars

00:43:48.623 --> 00:43:50.206
instead of one hundred and fifty dollars.

00:43:50.226 --> 00:43:51.927
It makes no difference in the big scheme

00:43:51.967 --> 00:43:54.670
of things to me because of the business

00:43:54.690 --> 00:43:55.391
that we've built.

00:43:55.731 --> 00:43:57.552
And there's other business models out

00:43:57.592 --> 00:43:57.773
there.

00:43:58.233 --> 00:43:58.693
You know,

00:43:58.773 --> 00:44:01.715
so we don't I know you're at work.

00:44:01.735 --> 00:44:03.496
We don't have to hit the full hour.

00:44:03.697 --> 00:44:05.358
Let's kind of wrap it up now.

00:44:05.438 --> 00:44:06.559
Can I give one good example?

00:44:06.599 --> 00:44:07.259
Just one good example.

00:44:07.900 --> 00:44:09.601
So we talk about these psychological

00:44:09.840 --> 00:44:10.561
theories.

00:44:10.701 --> 00:44:11.382
I love them.

00:44:12.512 --> 00:44:13.853
Some people like listening to me talk

00:44:13.873 --> 00:44:15.434
about them, but they're embedded places.

00:44:15.574 --> 00:44:16.873
And I like to spot them when they're

00:44:16.893 --> 00:44:18.375
in the wild, right?

00:44:18.635 --> 00:44:19.635
And this is one of them.

00:44:19.655 --> 00:44:20.936
And I shared this in our group chat.

00:44:21.297 --> 00:44:23.097
This is a great example of price

00:44:23.557 --> 00:44:24.057
anchoring.

00:44:24.378 --> 00:44:26.860
And that's the psychological theory.

00:44:27.320 --> 00:44:28.481
And the funny part is even when we

00:44:28.541 --> 00:44:29.701
know the trick is happening,

00:44:29.922 --> 00:44:30.661
we still fall for it.

00:44:30.782 --> 00:44:31.641
I still look at this ad and I

00:44:31.661 --> 00:44:33.083
go, those are dope cycles.

00:44:33.103 --> 00:44:35.244
So I'm showing an ad for cycling shoes

00:44:35.284 --> 00:44:36.025
from Pace Bikes.

00:44:36.684 --> 00:44:37.746
And the ad reads,

00:44:38.485 --> 00:44:40.286
why seventy four ninety five?

00:44:40.347 --> 00:44:41.646
Why seventy four dollars and ninety five

00:44:41.686 --> 00:44:42.867
cents and not five hundred?

00:44:43.668 --> 00:44:45.369
What they've done there is they've placed

00:44:45.949 --> 00:44:48.331
an anchor at five hundred because there is

00:44:48.371 --> 00:44:52.351
a picture of six dope looking clean,

00:44:52.532 --> 00:44:54.132
modern cycling shoes.

00:44:54.652 --> 00:44:56.114
So if you are this only applies if

00:44:56.134 --> 00:44:56.793
you're a cyclist.

00:44:56.813 --> 00:44:57.695
If you're not a cyclist, you're like,

00:44:57.875 --> 00:44:59.074
I'm not paying seventy dollars.

00:44:59.094 --> 00:45:00.036
I'm paying seven dollars.

00:45:00.556 --> 00:45:01.956
But this drops an anchor.

00:45:02.976 --> 00:45:04.557
and anchors your brain at worth five

00:45:04.597 --> 00:45:04.818
hundred,

00:45:04.838 --> 00:45:05.878
but w gut is I better hurry up

00:45:05.958 --> 00:45:06.719
that's a steal.

00:45:07.219 --> 00:45:08.400
It would I said on sale for seven

00:45:08.440 --> 00:45:10.702
there's no place to star at five hundred

00:45:10.822 --> 00:45:11.023
and then

00:45:24.452 --> 00:45:26.413
so these this these little psychological

00:45:26.452 --> 00:45:28.554
lessons these little gems i love sharing

00:45:28.574 --> 00:45:29.795
them just as tidbits i don't think we

00:45:29.815 --> 00:45:32.056
need to go deep into it just that's

00:45:32.137 --> 00:45:33.257
how like i literally just want to put

00:45:33.277 --> 00:45:35.418
that that's how it's done people it's not

00:45:35.559 --> 00:45:37.059
complicated you don't need to over explain

00:45:37.079 --> 00:45:38.981
it was one headline i never even read

00:45:39.021 --> 00:45:41.242
beyond that i went headline shoe i didn't

00:45:41.262 --> 00:45:42.202
even read the middle words

00:45:42.603 --> 00:45:45.425
So that is similar to what John did.

00:45:45.605 --> 00:45:47.565
I would redesign John's ad.

00:45:47.987 --> 00:45:48.706
Too many words.

00:45:48.746 --> 00:45:50.068
He's overselling here.

00:45:50.307 --> 00:45:50.788
If he A,

00:45:50.827 --> 00:45:52.630
B tested and changed his ad here.

00:45:53.070 --> 00:45:53.630
And for John,

00:45:53.670 --> 00:45:54.871
if somebody passes this along,

00:45:55.190 --> 00:45:57.293
literally drop this image into chat GPT

00:45:57.373 --> 00:45:59.534
and say, make my ad more like this.

00:45:59.914 --> 00:46:02.596
And I bet you sales conversions go up.

00:46:02.615 --> 00:46:03.416
Yeah.

00:46:03.637 --> 00:46:04.157
Yeah.

00:46:05.967 --> 00:46:06.708
Quick aside,

00:46:08.208 --> 00:46:10.391
we never used to buy anything from Dick's

00:46:10.411 --> 00:46:11.032
Sporting Goods.

00:46:11.932 --> 00:46:13.695
And then lately we had to buy a

00:46:13.735 --> 00:46:15.177
couple of things here and there from

00:46:15.237 --> 00:46:15.496
Dick's,

00:46:15.536 --> 00:46:16.797
but my kids never want to go to

00:46:16.858 --> 00:46:18.820
Dick's and like they'll go begrudgingly

00:46:18.860 --> 00:46:20.561
and get their baseball pants or whatever.

00:46:21.436 --> 00:46:25.039
now the dicks here they re redesign the

00:46:25.099 --> 00:46:27.041
store now they have the simu golf

00:46:27.061 --> 00:46:29.242
simulator now they have the batting cages

00:46:29.322 --> 00:46:30.822
now they've brought in the stuff that

00:46:30.842 --> 00:46:32.784
we've heard about and you and i have

00:46:32.824 --> 00:46:34.905
talked about dicks i think they acquired a

00:46:34.945 --> 00:46:37.327
media company um because they're going to

00:46:37.347 --> 00:46:38.869
start producing a lot of that kind of

00:46:38.909 --> 00:46:42.030
content now literally my kids are like dad

00:46:42.050 --> 00:46:43.211
can we go to dicks i want to

00:46:43.251 --> 00:46:44.592
go to dicks i want to check out

00:46:44.612 --> 00:46:45.534
the new stuff like

00:46:46.414 --> 00:46:48.596
Just because they changed the environment,

00:46:49.195 --> 00:46:50.797
it went from RTM.

00:46:50.836 --> 00:46:53.338
Dix used to be what RTM is today

00:46:53.699 --> 00:46:55.559
to what we want RTM to be.

00:46:55.619 --> 00:46:58.561
We want the patient to want to pull

00:46:58.621 --> 00:47:00.463
up the app and get the information and

00:47:00.523 --> 00:47:02.844
interact with it and have fun with it.

00:47:03.264 --> 00:47:04.166
Let me ask a few questions.

00:47:05.226 --> 00:47:05.766
Number one,

00:47:06.146 --> 00:47:08.009
somebody at Dix Corporate probably saw,

00:47:09.309 --> 00:47:11.871
hey, kids don't care about coming to Dix.

00:47:12.090 --> 00:47:13.132
For me going to Dix when I was

00:47:13.152 --> 00:47:13.391
a kid,

00:47:13.411 --> 00:47:15.733
it was cool to see the next hat.

00:47:16.655 --> 00:47:17.637
And there was probably a drop.

00:47:17.757 --> 00:47:18.918
So what is it like?

00:47:18.958 --> 00:47:21.179
Is it very experiential and gamified?

00:47:21.280 --> 00:47:22.402
Yeah, hands on.

00:47:23.583 --> 00:47:23.943
That's it.

00:47:23.963 --> 00:47:24.684
Hands on.

00:47:24.704 --> 00:47:25.945
You can touch all this stuff.

00:47:26.284 --> 00:47:27.786
You can swing the bat in the batting

00:47:27.806 --> 00:47:28.447
cages.

00:47:28.668 --> 00:47:29.548
You can't.

00:47:30.333 --> 00:47:32.175
yeah so they probably sat there they go

00:47:32.195 --> 00:47:33.916
well what are we competing against they

00:47:33.956 --> 00:47:36.300
did not go to another sporting goods store

00:47:36.360 --> 00:47:37.862
most likely because they're not competing

00:47:38.181 --> 00:47:41.264
they looked at an oculus or a playstation

00:47:41.565 --> 00:47:43.427
or an ipad and they said we're competing

00:47:43.447 --> 00:47:45.469
against that what's our competition for

00:47:45.510 --> 00:47:46.952
that i want that to be the hard

00:47:46.992 --> 00:47:48.893
lesson because if you hear dicks i'm not

00:47:48.914 --> 00:47:50.396
in i'm not competing with dicks

00:47:51.371 --> 00:47:51.992
You aren't,

00:47:52.012 --> 00:47:53.413
but we're all competing for the same

00:47:53.452 --> 00:47:54.673
thing, which is attention.

00:47:55.514 --> 00:47:56.896
Attention leads to trust.

00:47:57.215 --> 00:47:58.336
Trust leads to action.

00:47:58.677 --> 00:48:00.498
This is going to be a theme forever.

00:48:00.699 --> 00:48:01.860
That's the math, right?

00:48:02.420 --> 00:48:04.182
It's not just doing it for the gram.

00:48:04.702 --> 00:48:06.385
It's attention leads to trust.

00:48:07.065 --> 00:48:08.286
You just said that magic phrase.

00:48:08.326 --> 00:48:11.028
Now my kids want to go to a

00:48:11.188 --> 00:48:11.648
store.

00:48:12.269 --> 00:48:13.210
to do that.

00:48:13.690 --> 00:48:15.672
Your clinic could be that.

00:48:16.072 --> 00:48:18.795
Decide what that is that makes people want

00:48:18.815 --> 00:48:19.275
to come.

00:48:19.715 --> 00:48:20.757
And I got news for you.

00:48:21.137 --> 00:48:23.259
Beige painted walls ain't it.

00:48:23.938 --> 00:48:25.519
And a thirty year old, you know,

00:48:26.541 --> 00:48:28.262
assault bike ain't it.

00:48:28.302 --> 00:48:29.864
But it could it does not need to

00:48:29.903 --> 00:48:31.465
be a twenty five thousand dollar golf

00:48:31.485 --> 00:48:34.067
simulator, but it needs to be something.

00:48:34.527 --> 00:48:35.969
And you get to pick and plant your

00:48:36.009 --> 00:48:37.289
flag into what that thing is.

00:48:38.353 --> 00:48:38.974
or don't,

00:48:39.153 --> 00:48:41.094
or wait for UHC to send you sixty

00:48:41.135 --> 00:48:41.594
dollars.

00:48:41.655 --> 00:48:43.235
Like you choose, decide.

00:48:44.596 --> 00:48:44.815
Yeah.

00:48:45.096 --> 00:48:46.856
What do you have coming up this week?

00:48:46.896 --> 00:48:47.556
We'll end with that.

00:48:47.577 --> 00:48:48.717
We're looking forward and then parting

00:48:48.737 --> 00:48:48.838
shots.

00:48:48.858 --> 00:48:49.757
What do you have coming up this week?

00:48:49.797 --> 00:48:50.318
Anything special?

00:48:51.278 --> 00:48:52.139
No, nothing special.

00:48:52.159 --> 00:48:53.619
I've been a hundred percent focused on

00:48:53.659 --> 00:48:54.880
growing the Facebook page.

00:48:54.920 --> 00:48:56.701
We just hit twenty five million views.

00:48:56.981 --> 00:48:57.521
That's wild.

00:48:58.344 --> 00:49:01.266
We're on track to hit five thousand in

00:49:01.326 --> 00:49:03.547
revenue for the month from just from ads.

00:49:04.588 --> 00:49:07.088
I still cannot get myself to create the

00:49:07.108 --> 00:49:09.349
digital product that every single human

00:49:09.530 --> 00:49:11.190
and AI is telling me I need to

00:49:11.231 --> 00:49:11.690
create.

00:49:12.192 --> 00:49:16.494
So pay someone to do it.

00:49:16.514 --> 00:49:18.514
I'm going to get AI to get into

00:49:18.554 --> 00:49:20.556
my psyche and figure out how to make

00:49:20.635 --> 00:49:21.617
me want to do it.

00:49:22.179 --> 00:49:24.000
Okay, all right.

00:49:24.280 --> 00:49:26.001
I've got, Jerry Durham just posted,

00:49:27.362 --> 00:49:28.583
prompt, this is not an ad,

00:49:28.682 --> 00:49:29.403
I'm just saying this.

00:49:29.824 --> 00:49:30.744
Although it's gonna feel like an ad

00:49:30.764 --> 00:49:31.664
whenever you're talking about where you

00:49:31.704 --> 00:49:31.925
work.

00:49:31.965 --> 00:49:33.527
So I'm sorry, this feels icky for me.

00:49:33.726 --> 00:49:34.606
But I do work,

00:49:34.626 --> 00:49:35.568
they're doing something cool,

00:49:35.588 --> 00:49:36.728
which is they're bringing a bunch of

00:49:36.849 --> 00:49:37.849
practice owners in,

00:49:38.990 --> 00:49:40.090
to teach them things,

00:49:40.492 --> 00:49:42.052
but I'll pull the curtain back too,

00:49:42.072 --> 00:49:42.853
because it's pretty obvious.

00:49:42.952 --> 00:49:44.313
They want to learn and be like,

00:49:44.393 --> 00:49:46.114
what are your real frustrations?

00:49:46.494 --> 00:49:48.375
So the dangle is come here and learn,

00:49:48.775 --> 00:49:49.514
grow your practice.

00:49:49.695 --> 00:49:50.956
We've got expertise on that.

00:49:51.556 --> 00:49:52.737
But the magic, I think,

00:49:52.757 --> 00:49:54.797
for Prompt anyway is we're going to listen

00:49:54.856 --> 00:49:55.398
to you.

00:49:55.838 --> 00:49:57.277
Let me go real high tech for you.

00:49:57.518 --> 00:49:58.478
We're going to listen to you.

00:49:59.440 --> 00:50:00.661
And these are some people, you know,

00:50:00.900 --> 00:50:02.161
who've been using the product or don't,

00:50:02.181 --> 00:50:02.501
whatever.

00:50:02.782 --> 00:50:04.224
It's a cross section of practice owners.

00:50:04.503 --> 00:50:05.585
And then they're going to listen.

00:50:06.385 --> 00:50:09.188
Then they're going to do stuff around what

00:50:09.228 --> 00:50:10.509
those practice owners are saying.

00:50:10.748 --> 00:50:12.110
I'm giving away the secret sauce,

00:50:12.130 --> 00:50:13.210
but it's not secret sauce.

00:50:13.590 --> 00:50:15.753
It's quite literally like really smart

00:50:15.873 --> 00:50:16.373
product.

00:50:16.813 --> 00:50:17.414
Not even product,

00:50:17.454 --> 00:50:19.034
it's really smart humanism.

00:50:19.755 --> 00:50:21.757
I heard a great bit of parenting,

00:50:21.777 --> 00:50:24.880
which was be the parent that drives the

00:50:24.900 --> 00:50:25.840
kids to the thing.

00:50:26.760 --> 00:50:29.282
enough that the kids forget that you're in

00:50:29.302 --> 00:50:31.043
the front seat because you're the cool

00:50:31.063 --> 00:50:31.284
mom.

00:50:31.585 --> 00:50:32.804
And then they start talking about the

00:50:32.824 --> 00:50:34.326
stuff that they're actually talking about

00:50:34.606 --> 00:50:36.027
and they forget you're there.

00:50:36.047 --> 00:50:37.027
That's what this is.

00:50:38.289 --> 00:50:40.570
I'll play your music and I get you

00:50:40.610 --> 00:50:41.050
comfortable.

00:50:41.130 --> 00:50:42.251
And then I get to hear you talk

00:50:42.271 --> 00:50:44.873
about, oh, so-and-so is kissing so-and-so.

00:50:45.393 --> 00:50:46.974
You start to hear from the person you're

00:50:47.014 --> 00:50:49.896
trying to influence or help in their

00:50:49.936 --> 00:50:50.398
language.

00:50:50.498 --> 00:50:51.498
This is that version of that.

00:50:51.559 --> 00:50:52.778
Jerry Durham's coming to town.

00:50:52.818 --> 00:50:56.121
So I'm interested to see what Jerry...

00:50:56.621 --> 00:50:58.284
says about this this is my first time

00:50:58.324 --> 00:51:00.186
doing this i've never done it before um

00:51:00.206 --> 00:51:02.929
because that's jerry's whole thing sit in

00:51:02.949 --> 00:51:05.391
your own waiting room long enough that the

00:51:05.431 --> 00:51:07.094
patients in the front desk people forget

00:51:07.114 --> 00:51:09.516
you're there and they continue to act as

00:51:09.536 --> 00:51:11.699
they act when you're not around that's how

00:51:11.719 --> 00:51:13.940
you find your leaks so jerry jerry is

00:51:13.960 --> 00:51:16.163
the originator of secret caller when it

00:51:16.182 --> 00:51:17.405
got in physical therapy

00:51:18.092 --> 00:51:18.893
Yep, he is.

00:51:18.913 --> 00:51:18.952
Oh,

00:51:18.992 --> 00:51:20.635
let's answer this one question real quick.

00:51:20.715 --> 00:51:21.996
Metal Mark asked this at the beginning of

00:51:22.016 --> 00:51:22.817
the show, but we didn't get to it.

00:51:23.496 --> 00:51:24.237
Metal Mark says,

00:51:24.338 --> 00:51:26.360
today's my first day at an independent and

00:51:26.380 --> 00:51:27.822
assisted living facility as a PTA,

00:51:27.842 --> 00:51:29.023
but I have ten years experience in

00:51:29.083 --> 00:51:30.724
outpatient workers' comp setting.

00:51:31.085 --> 00:51:32.525
What advice would you give me to excel?

00:51:33.547 --> 00:51:33.786
Now,

00:51:35.268 --> 00:51:36.608
figure out the game you're playing and

00:51:36.628 --> 00:51:37.307
play it real well.

00:51:38.028 --> 00:51:39.048
Do you like this setting?

00:51:39.088 --> 00:51:39.949
If the answer is yes,

00:51:40.269 --> 00:51:42.230
figure out how to do it.

00:51:42.811 --> 00:51:44.670
Figure out how to do it adequately today

00:51:45.130 --> 00:51:46.791
and then a little bit better tomorrow and

00:51:46.811 --> 00:51:47.612
a little bit better tomorrow.

00:51:47.632 --> 00:51:48.733
And if you like it, keep going.

00:51:48.813 --> 00:51:49.893
And if you don't, switch.

00:51:50.012 --> 00:51:51.713
That's the advice I would give.

00:51:52.353 --> 00:51:53.355
He said skilled nursing?

00:51:54.695 --> 00:51:56.255
First aid at an independent and assisted

00:51:56.295 --> 00:51:56.936
living facility.

00:51:57.951 --> 00:51:59.831
I think you just got to forget everything

00:51:59.891 --> 00:52:02.893
that you learned in the workers' comp

00:52:02.954 --> 00:52:03.494
world.

00:52:03.514 --> 00:52:04.155
Probably.

00:52:04.235 --> 00:52:06.315
Because this is a completely different

00:52:06.335 --> 00:52:07.797
fish tank.

00:52:07.936 --> 00:52:09.938
There are sharks all around you.

00:52:10.117 --> 00:52:11.958
I remember going into those kinds of

00:52:12.039 --> 00:52:12.599
settings.

00:52:12.659 --> 00:52:15.221
You decide.

00:52:15.260 --> 00:52:15.940
He decides.

00:52:15.981 --> 00:52:16.822
She decides.

00:52:17.601 --> 00:52:19.682
Are you there to do the best job

00:52:19.702 --> 00:52:20.222
you can do?

00:52:20.282 --> 00:52:21.483
Are you there to fit in?

00:52:22.103 --> 00:52:24.005
I got in trouble constantly just

00:52:24.025 --> 00:52:24.346
because...

00:52:25.025 --> 00:52:26.206
I was always changing things.

00:52:26.286 --> 00:52:28.307
I was doing what I thought was best

00:52:28.347 --> 00:52:30.028
for the person rather than what's best for

00:52:30.068 --> 00:52:31.048
the organization.

00:52:32.829 --> 00:52:34.931
Well, how does this work?

00:52:34.971 --> 00:52:38.052
Does he work for the assisted living

00:52:38.092 --> 00:52:38.532
facility?

00:52:38.672 --> 00:52:39.652
Like where my dad lives,

00:52:39.693 --> 00:52:40.514
it's a third party.

00:52:42.369 --> 00:52:43.831
Yeah, I have no idea.

00:52:43.851 --> 00:52:44.190
I mean,

00:52:44.351 --> 00:52:47.094
it's either a third party or the facility

00:52:47.153 --> 00:52:47.614
itself.

00:52:47.653 --> 00:52:50.115
Somebody is employing this person.

00:52:51.097 --> 00:52:53.177
And with that, there's other employees.

00:52:53.398 --> 00:52:54.900
And assuming you're not going to be seeing

00:52:54.940 --> 00:52:56.981
the same person every day or throughout

00:52:57.021 --> 00:52:59.123
the plan of care, you know,

00:52:59.163 --> 00:53:01.384
you got to adapt to the environment you're

00:53:01.525 --> 00:53:01.684
in,

00:53:01.724 --> 00:53:03.485
which I guarantee is going to be very

00:53:03.525 --> 00:53:05.947
different than a workers' comp clinic that

00:53:05.987 --> 00:53:07.168
this person's coming out of.

00:53:07.748 --> 00:53:08.789
It's all physics, man.

00:53:08.889 --> 00:53:10.429
Figure out how gravity works here.

00:53:10.528 --> 00:53:13.010
Figure out who the cool colleagues are.

00:53:13.090 --> 00:53:13.891
Learn from them.

00:53:13.990 --> 00:53:15.132
Don't just pretend to learn.

00:53:15.251 --> 00:53:16.371
Actually learn from them.

00:53:16.391 --> 00:53:17.313
That's been my secret,

00:53:17.972 --> 00:53:18.632
using air quotes here,

00:53:18.652 --> 00:53:19.653
my secret at every job.

00:53:19.693 --> 00:53:19.934
I'm like,

00:53:20.934 --> 00:53:23.016
can I do this job as a B-minus

00:53:23.036 --> 00:53:23.856
employee right now?

00:53:24.235 --> 00:53:24.596
Yes.

00:53:25.137 --> 00:53:25.416
Great.

00:53:25.536 --> 00:53:27.757
How can I do an A job but

00:53:27.777 --> 00:53:29.679
still put B-minus effort into it?

00:53:30.199 --> 00:53:31.119
Figure out how to do it better.

00:53:31.500 --> 00:53:32.719
Figure out how to leverage gravity.

00:53:33.260 --> 00:53:35.021
I talked about Centaur and reverse

00:53:35.041 --> 00:53:35.402
Centaur.

00:53:36.632 --> 00:53:38.914
great example is like put a human on

00:53:38.934 --> 00:53:41.536
a bicycle now that's a that's a centaur

00:53:41.657 --> 00:53:42.938
you put the human brain on a thing

00:53:42.958 --> 00:53:44.918
that makes me really efficient so figure

00:53:44.998 --> 00:53:47.641
out how to do adequate and then figure

00:53:47.661 --> 00:53:49.001
out if you like that and then how

00:53:49.041 --> 00:53:50.302
to do that figure out how to jump

00:53:50.342 --> 00:53:52.043
on a bicycle and do that i feel

00:53:52.063 --> 00:53:53.264
like the bicycle in the room is ai

00:53:53.284 --> 00:53:55.146
i feel like for right now like in

00:53:55.166 --> 00:53:57.128
terms of documentation because if that's

00:53:57.148 --> 00:53:59.210
the thing slowing you down and eating

00:53:59.369 --> 00:54:01.672
unnecessary calories how could you remove

00:54:01.711 --> 00:54:03.592
that in in my opinion it's a scrub

00:54:03.652 --> 00:54:04.693
it's a scribe or whatever

00:54:05.706 --> 00:54:07.027
uh, those are our parting shots, right?

00:54:07.047 --> 00:54:07.668
We don't need to react.

00:54:07.849 --> 00:54:08.349
Absolutely.

00:54:08.369 --> 00:54:09.971
You're playing, play it better.

00:54:10.291 --> 00:54:11.353
We'll be back on Thursday.

00:54:11.454 --> 00:54:13.295
Enjoy your enjoy out, put,

00:54:13.596 --> 00:54:14.717
put the digital course together.

00:54:18.306 --> 00:54:18.487
That's it.

00:54:18.507 --> 00:54:18.766
We're out.

00:54:18.806 --> 00:54:20.288
Boys, what the hell are you doing?

00:54:20.327 --> 00:54:23.150
Follow Tony Meritato on YouTube at Total

00:54:23.190 --> 00:54:24.251
Therapy Solution.

00:54:24.291 --> 00:54:25.291
Find Dave Kittle at

00:54:25.311 --> 00:54:28.492
conciergepainrelief.com and on YouTube at

00:54:28.512 --> 00:54:29.713
The Dave Kittle Show.

00:54:29.873 --> 00:54:32.936
And follow Jimmy McKay at PT Podcasts on

00:54:33.056 --> 00:54:34.317
YouTube, the socials,

00:54:34.416 --> 00:54:36.197
and wherever you binge podcasts you

00:54:36.237 --> 00:54:37.878
pretend are for CEUs.

00:54:38.199 --> 00:54:39.641
And hey, just a reminder,

00:54:40.121 --> 00:54:41.422
none of this was for advice.

00:54:41.442 --> 00:54:42.762
This was for entertainment only.

00:54:43.222 --> 00:54:44.603
Our lawyers say that counts.

00:54:44.684 --> 00:54:45.585
Thanks, Keith.