Telehealth vs. In-Person PT: The Future of Physical Therapy

WEBVTT

00:00:08.422 --> 00:00:09.522
Good Tuesday morning to you.

00:00:09.542 --> 00:00:10.563
Breakfast Club PT.

00:00:10.884 --> 00:00:11.903
Coming in a few minutes late

00:00:11.944 --> 00:00:13.685
because I had to refill.

00:00:13.804 --> 00:00:14.125
I'm sorry.

00:00:14.146 --> 00:00:15.846
I don't time my refills very properly.

00:00:16.446 --> 00:00:17.608
He's Tony Meritato.

00:00:17.987 --> 00:00:18.748
That's Dave Kittle.

00:00:18.788 --> 00:00:19.509
I'm Jimmy McKay.

00:00:20.129 --> 00:00:21.690
And we're going to try

00:00:21.710 --> 00:00:22.751
something new today.

00:00:22.911 --> 00:00:23.812
We'll tease that.

00:00:23.871 --> 00:00:24.472
We're going to do something

00:00:24.492 --> 00:00:25.012
a little different.

00:00:25.533 --> 00:00:27.434
We sort of lurk like everybody does.

00:00:27.493 --> 00:00:28.774
You lurk in the comment section.

00:00:29.795 --> 00:00:29.934
Right.

00:00:29.954 --> 00:00:30.556
That's what you do.

00:00:31.416 --> 00:00:33.216
And this one actually came

00:00:33.338 --> 00:00:35.139
in sort of unsolicited.

00:00:35.319 --> 00:00:37.720
Like, hey, I hear you guys talking.

00:00:39.301 --> 00:00:41.203
And they sort of gave us like a Dear Abby,

00:00:41.222 --> 00:00:42.923
like a Dear Breakfast Clubby.

00:00:42.963 --> 00:00:43.744
Should we start with that?

00:00:43.765 --> 00:00:44.704
Do you guys want to go with that?

00:00:45.165 --> 00:00:45.746
Let's do it.

00:00:45.765 --> 00:00:46.347
All right.

00:00:46.387 --> 00:00:47.447
I wonder how many people

00:00:47.487 --> 00:00:49.228
watching remember Dear Abby

00:00:49.368 --> 00:00:49.868
to begin with.

00:00:51.237 --> 00:00:52.659
Yeah, that is a good question.

00:00:53.780 --> 00:00:55.042
I vaguely remember I'm on

00:00:55.063 --> 00:00:55.643
the younger side.

00:00:56.143 --> 00:00:57.265
Yeah, that will date you.

00:00:57.345 --> 00:00:57.845
But essentially,

00:00:57.886 --> 00:00:59.728
Dear Abby was a was a

00:00:59.808 --> 00:01:01.070
column in the newspaper.

00:01:01.130 --> 00:01:02.371
Kids newspaper was when

00:01:02.572 --> 00:01:03.253
people would actually

00:01:03.292 --> 00:01:05.114
deliver emails and paper

00:01:05.155 --> 00:01:05.835
form to your house.

00:01:07.378 --> 00:01:08.158
And people would write in

00:01:08.177 --> 00:01:09.899
with questions and then she

00:01:09.918 --> 00:01:12.078
would sort of give this advice that would,

00:01:12.260 --> 00:01:13.299
you know, in response.

00:01:13.319 --> 00:01:13.840
So we'll do this.

00:01:14.099 --> 00:01:17.180
The dear Jimmy, here's the email or sorry,

00:01:17.200 --> 00:01:18.040
the comment that we got,

00:01:18.081 --> 00:01:19.462
which is I'm a physical

00:01:19.501 --> 00:01:21.042
therapist and a facility

00:01:21.081 --> 00:01:22.121
manager of a large

00:01:22.222 --> 00:01:23.102
orthopedic and sports

00:01:23.143 --> 00:01:25.022
medicine clinic of a big ortho group.

00:01:25.382 --> 00:01:26.664
I had one PT leave about

00:01:26.703 --> 00:01:28.063
three weeks ago and now I

00:01:28.084 --> 00:01:29.685
have another put in there two weeks.

00:01:30.825 --> 00:01:31.885
The reasons are for job

00:01:31.905 --> 00:01:33.105
opportunities closer to home.

00:01:33.906 --> 00:01:35.007
and getting out of corporate

00:01:35.027 --> 00:01:37.067
pt altogether I also let go

00:01:37.108 --> 00:01:37.987
a staff member with a

00:01:38.048 --> 00:01:39.608
managerial role last month

00:01:39.748 --> 00:01:40.790
so if you're keeping track

00:01:40.810 --> 00:01:41.909
that's three down in the

00:01:41.930 --> 00:01:43.191
last month from these

00:01:43.230 --> 00:01:44.311
circumstances the clinic

00:01:44.331 --> 00:01:46.472
feels hectic stressful and

00:01:46.632 --> 00:01:48.192
ever-changing as the

00:01:48.233 --> 00:01:49.213
facility manager of this

00:01:49.254 --> 00:01:50.754
clinic how and what would

00:01:50.775 --> 00:01:51.635
you communicate to your

00:01:51.674 --> 00:01:53.236
staff what things would you

00:01:53.256 --> 00:01:54.156
want them to be reassured

00:01:54.197 --> 00:01:55.156
about what problems do you

00:01:55.177 --> 00:01:56.418
think you need to solve

00:01:56.697 --> 00:01:58.459
first and second I do like that

00:01:59.118 --> 00:02:00.320
forethought, like, okay,

00:02:00.340 --> 00:02:01.481
I can't stop everything at once.

00:02:02.644 --> 00:02:03.545
And why do you think this

00:02:03.564 --> 00:02:04.626
happens so frequently in

00:02:04.786 --> 00:02:06.108
outpatient therapy?

00:02:06.207 --> 00:02:07.590
Any recommendations to me?

00:02:08.311 --> 00:02:11.675
Signed, facility manager.

00:02:11.754 --> 00:02:12.575
A lot of questions.

00:02:13.700 --> 00:02:14.561
yeah where do you want to go

00:02:14.600 --> 00:02:15.801
first I I love the fact

00:02:15.822 --> 00:02:16.822
that this person actually

00:02:16.861 --> 00:02:18.782
put in like the emotions

00:02:18.842 --> 00:02:19.782
like I you know I look at

00:02:19.842 --> 00:02:20.983
words and I see words like

00:02:21.022 --> 00:02:22.122
hectic stressful and

00:02:22.163 --> 00:02:23.663
ever-changing that tells me

00:02:23.704 --> 00:02:25.223
she's paying attention this

00:02:25.424 --> 00:02:26.305
this you know I don't know

00:02:26.324 --> 00:02:27.985
this person but this person

00:02:28.064 --> 00:02:29.466
has empathy or at least has

00:02:29.485 --> 00:02:30.605
the chances empathy is they

00:02:30.626 --> 00:02:31.985
are recognizing what their

00:02:32.026 --> 00:02:33.247
job is their job is to

00:02:33.306 --> 00:02:34.486
recognize that in their staff

00:02:35.026 --> 00:02:36.367
and then do something about it.

00:02:36.407 --> 00:02:38.028
So they at least, in my opinion,

00:02:38.068 --> 00:02:39.308
this person is forward

00:02:39.329 --> 00:02:41.330
thinking enough to say, I see this,

00:02:41.389 --> 00:02:43.371
this is my responsibility, I need to act,

00:02:43.670 --> 00:02:44.570
I don't know what to do.

00:02:44.872 --> 00:02:46.391
So their response was email

00:02:46.412 --> 00:02:47.953
a bunch of nitwits on YouTube.

00:02:47.973 --> 00:02:48.312
No, no,

00:02:48.332 --> 00:02:49.354
they probably asked some other people,

00:02:49.394 --> 00:02:50.354
but they also emailed us.

00:02:50.973 --> 00:02:54.216
So where would you think if

00:02:54.256 --> 00:02:55.336
you were in this person's role,

00:02:55.455 --> 00:02:58.318
where do you think you'd start first?

00:02:58.358 --> 00:02:59.078
Dave, what do you think?

00:03:00.913 --> 00:03:03.536
First thing is rapid action.

00:03:03.817 --> 00:03:05.078
Depending on your state,

00:03:05.217 --> 00:03:06.179
in terms of what you can

00:03:06.199 --> 00:03:07.199
and cannot say to team

00:03:07.219 --> 00:03:08.159
members and employees about

00:03:08.241 --> 00:03:09.762
previous team members and employees,

00:03:10.643 --> 00:03:11.824
that might be a little bit different.

00:03:11.843 --> 00:03:13.966
So my initial response would be,

00:03:14.385 --> 00:03:16.228
you need to schedule an

00:03:16.288 --> 00:03:17.748
in-person meeting with the entire team.

00:03:18.049 --> 00:03:19.069
And depending on your state

00:03:19.651 --> 00:03:21.032
laws and regulations as to

00:03:21.231 --> 00:03:22.252
what I'm able to actually

00:03:22.312 --> 00:03:23.274
say about the previous

00:03:23.394 --> 00:03:24.395
therapists or the previous

00:03:24.435 --> 00:03:25.256
employees who left,

00:03:25.836 --> 00:03:27.317
Depending on that, if you're allowed to,

00:03:27.356 --> 00:03:28.037
if you're able to,

00:03:28.676 --> 00:03:30.018
the team meeting is this.

00:03:30.377 --> 00:03:30.899
Hey, guys.

00:03:31.778 --> 00:03:32.778
So I'm the facility manager.

00:03:32.900 --> 00:03:34.120
I'm the one that sent this question in.

00:03:34.319 --> 00:03:34.719
Hey, guys.

00:03:35.781 --> 00:03:37.882
So we know things have been hectic.

00:03:37.901 --> 00:03:39.862
There's a lot of moving parts.

00:03:39.923 --> 00:03:41.144
There's a lot going on here.

00:03:41.804 --> 00:03:42.623
And I want to just kind of

00:03:42.663 --> 00:03:43.405
communicate everything.

00:03:43.444 --> 00:03:44.125
This is something I think

00:03:44.164 --> 00:03:45.925
Jimmy would obviously agree

00:03:45.945 --> 00:03:46.526
with and appreciate.

00:03:46.806 --> 00:03:48.306
We have to communicate what's going on.

00:03:48.426 --> 00:03:49.568
Obviously, things are changing.

00:03:50.574 --> 00:03:51.415
Folks have been leaving.

00:03:52.316 --> 00:03:53.557
Now we got to pick up the slack.

00:03:54.217 --> 00:03:55.558
I just want to communicate real quick,

00:03:55.598 --> 00:03:57.841
like the current the

00:03:57.881 --> 00:03:58.681
previous two therapists,

00:03:58.722 --> 00:04:00.282
they left because of these reasons.

00:04:00.362 --> 00:04:01.304
Or maybe you can if you're

00:04:01.324 --> 00:04:02.264
not able to say the exact

00:04:02.305 --> 00:04:03.925
reason they left because

00:04:03.945 --> 00:04:05.187
they had to travel or they

00:04:05.227 --> 00:04:06.108
told you guys in public,

00:04:06.388 --> 00:04:07.109
they said it in the clinic.

00:04:07.248 --> 00:04:07.389
Hey,

00:04:07.429 --> 00:04:09.570
I'm traveling or I'm my wife has to

00:04:09.610 --> 00:04:10.592
move or my spouse or my

00:04:10.632 --> 00:04:11.712
husband has to move because

00:04:11.733 --> 00:04:12.734
of their job or we have to

00:04:12.794 --> 00:04:13.533
relocate or whatever.

00:04:14.435 --> 00:04:16.495
So therapist A left for this reason,

00:04:16.536 --> 00:04:17.836
therapist B left for this reason,

00:04:18.137 --> 00:04:20.238
therapist C left because they,

00:04:20.259 --> 00:04:20.658
I don't know,

00:04:20.858 --> 00:04:21.819
like if you're able to say

00:04:23.201 --> 00:04:24.762
because of performance or whatever,

00:04:24.822 --> 00:04:27.064
but basically the team is

00:04:27.124 --> 00:04:28.024
leaving for these reasons.

00:04:28.944 --> 00:04:30.346
If you're able to say some of those things,

00:04:30.565 --> 00:04:31.446
you want to communicate

00:04:31.466 --> 00:04:35.009
like kind of in a professional, nice way.

00:04:35.028 --> 00:04:36.689
Like it's not because this

00:04:36.730 --> 00:04:37.930
place sucks to work at.

00:04:41.293 --> 00:04:42.014
Okay.

00:04:42.033 --> 00:04:42.855
Now it also might.

00:04:42.954 --> 00:04:44.956
So you have to have some awareness,

00:04:45.396 --> 00:04:46.257
you know, but you want to,

00:04:46.357 --> 00:04:46.997
you want to create,

00:04:47.057 --> 00:04:48.139
you want to schedule this

00:04:48.178 --> 00:04:50.360
in-person meeting over communicate.

00:04:50.379 --> 00:04:51.120
You want to get your team

00:04:51.141 --> 00:04:52.180
members talking like, Hey,

00:04:52.261 --> 00:04:54.083
what have you guys, what do you,

00:04:54.103 --> 00:04:54.822
how do you guys feel?

00:04:55.324 --> 00:04:57.045
What have you heard in the trenches?

00:04:57.365 --> 00:04:58.086
Because I just want to

00:04:58.165 --> 00:04:59.786
communicate this because otherwise it's,

00:04:59.807 --> 00:05:00.927
this is like a leaky bucket.

00:05:01.288 --> 00:05:02.588
And if, if three,

00:05:03.288 --> 00:05:04.149
two therapists just got

00:05:04.730 --> 00:05:06.091
relocated or fired or whatever,

00:05:06.370 --> 00:05:07.692
and then one therapist left or,

00:05:07.812 --> 00:05:09.494
or fired or whatever, um,

00:05:10.704 --> 00:05:11.785
this is like potentially a

00:05:11.845 --> 00:05:12.845
mutiny on your hands, right?

00:05:12.865 --> 00:05:14.605
So you need to like patch these holes up.

00:05:14.625 --> 00:05:16.067
You need, this is rapid action.

00:05:16.086 --> 00:05:18.148
This is like SOS, you know,

00:05:18.208 --> 00:05:18.949
send the Coast Guard.

00:05:18.968 --> 00:05:19.968
We need help right now

00:05:20.269 --> 00:05:21.269
because otherwise like we

00:05:21.290 --> 00:05:22.370
have patients coming in and

00:05:22.391 --> 00:05:23.531
we're not gonna have any therapists.

00:05:23.550 --> 00:05:24.851
So I would love to hear what

00:05:24.891 --> 00:05:27.093
Tony would do.

00:05:27.153 --> 00:05:29.214
Yeah, I mean, this is one of those deals.

00:05:29.254 --> 00:05:31.055
You said the word over communicate.

00:05:31.076 --> 00:05:32.956
That's what my wife says all the time.

00:05:32.997 --> 00:05:34.177
Like this would be something

00:05:34.358 --> 00:05:36.178
I would put on my wife's shoulders,

00:05:36.218 --> 00:05:36.978
not my shoulders,

00:05:36.999 --> 00:05:37.838
because I'm terrible with

00:05:37.858 --> 00:05:38.560
this kind of stuff.

00:05:39.194 --> 00:05:39.875
but it's you

00:05:40.076 --> 00:05:41.476
over-communicate to bring

00:05:41.516 --> 00:05:42.918
peace of mind to the crew

00:05:42.937 --> 00:05:43.699
that's still there.

00:05:44.500 --> 00:05:45.821
You'd make the decision,

00:05:45.880 --> 00:05:46.942
is this a problem that

00:05:46.982 --> 00:05:48.283
started ten years ago

00:05:48.322 --> 00:05:49.644
building the team culture

00:05:49.783 --> 00:05:51.185
or is this something new?

00:05:51.565 --> 00:05:52.526
Is it just one of those

00:05:52.586 --> 00:05:53.627
weird things that just

00:05:53.788 --> 00:05:55.369
happened to coincide with

00:05:55.430 --> 00:05:56.630
two therapists leaving for

00:05:56.670 --> 00:05:57.692
better opportunities?

00:05:59.213 --> 00:06:00.134
I've always been,

00:06:00.494 --> 00:06:02.815
and I think you see two kinds of leaders,

00:06:02.956 --> 00:06:03.257
you know,

00:06:03.976 --> 00:06:05.458
I've been the kind of leader that's like,

00:06:06.077 --> 00:06:07.199
everything is amazing.

00:06:07.259 --> 00:06:08.620
This is a great opportunity.

00:06:08.699 --> 00:06:09.000
Look,

00:06:09.040 --> 00:06:10.480
this is going to force us to

00:06:10.880 --> 00:06:12.322
reorganize in a good way.

00:06:12.362 --> 00:06:13.523
It's going to make things better.

00:06:13.583 --> 00:06:15.122
This gives us a chance to

00:06:15.163 --> 00:06:16.184
kind of do a little spring

00:06:16.223 --> 00:06:18.165
cleaning and improve our systems,

00:06:18.644 --> 00:06:20.065
optimize, you know, whatever.

00:06:21.247 --> 00:06:22.848
Other therapy leaders,

00:06:22.867 --> 00:06:25.168
they're going to be like, okay,

00:06:25.189 --> 00:06:25.668
I don't care.

00:06:25.728 --> 00:06:26.269
They're gone.

00:06:26.589 --> 00:06:27.170
Who cares?

00:06:27.290 --> 00:06:29.911
Let them go business as usual.

00:06:30.791 --> 00:06:31.973
But to Dave's point,

00:06:32.656 --> 00:06:34.177
I think this obviously

00:06:34.237 --> 00:06:35.540
starts to spur those

00:06:35.600 --> 00:06:39.002
questions in the other employees' minds.

00:06:39.562 --> 00:06:41.625
And so you talk, you talk, you talk,

00:06:41.665 --> 00:06:42.745
you over-communicate,

00:06:42.786 --> 00:06:44.706
you let them know what's the plan.

00:06:44.827 --> 00:06:46.009
Everything's under control.

00:06:46.249 --> 00:06:46.809
No worries.

00:06:46.829 --> 00:06:47.709
We're going to be fine.

00:06:49.031 --> 00:06:51.052
And you share the strategy

00:06:51.293 --> 00:06:52.494
of how we're going to move

00:06:52.533 --> 00:06:53.295
forward from here.

00:06:54.007 --> 00:06:55.689
How are we going to recruit more people?

00:06:55.889 --> 00:06:57.288
How are we going to offload

00:06:57.930 --> 00:06:59.410
so we don't burn you guys out?

00:07:00.091 --> 00:07:02.591
Probably as my business has

00:07:02.831 --> 00:07:04.932
consolidated and shrunk and

00:07:04.973 --> 00:07:06.213
we've done nothing but

00:07:06.273 --> 00:07:07.514
shrink for a decade.

00:07:08.589 --> 00:07:11.172
Every single conversation, every single,

00:07:11.351 --> 00:07:11.653
you know,

00:07:11.673 --> 00:07:12.733
let's go out to lunch and

00:07:12.774 --> 00:07:14.334
connect again with the team,

00:07:14.915 --> 00:07:16.516
it's always the same message.

00:07:16.576 --> 00:07:19.038
It's, hey, I know we're getting smaller.

00:07:19.178 --> 00:07:20.000
I know we're shrinking.

00:07:20.079 --> 00:07:21.540
I know we're seeing fewer visits,

00:07:21.862 --> 00:07:22.601
but that's okay.

00:07:22.622 --> 00:07:24.463
And this is why that's okay,

00:07:24.504 --> 00:07:25.425
because it gives you guys

00:07:25.444 --> 00:07:27.266
an opportunity to do more

00:07:27.305 --> 00:07:28.326
of what you wanna do.

00:07:28.766 --> 00:07:30.608
We're doing this intentionally.

00:07:30.668 --> 00:07:32.290
This isn't because, you know,

00:07:32.310 --> 00:07:33.411
the company is dying.

00:07:33.851 --> 00:07:35.994
Like it's an intentional move,

00:07:36.514 --> 00:07:37.514
And we're ready for this.

00:07:37.574 --> 00:07:39.115
And I think that kind of

00:07:39.154 --> 00:07:41.735
gives them reassurance and confidence.

00:07:41.915 --> 00:07:42.656
What do you think, Jimmy?

00:07:42.995 --> 00:07:43.375
Yeah, no,

00:07:43.456 --> 00:07:44.795
I agree with with most of what

00:07:44.815 --> 00:07:45.555
you guys have said.

00:07:45.975 --> 00:07:46.937
I don't I think the one

00:07:46.956 --> 00:07:47.956
thing I might change about

00:07:48.016 --> 00:07:49.216
days is I would say we've

00:07:49.237 --> 00:07:49.997
had people leave.

00:07:50.237 --> 00:07:50.478
Right.

00:07:50.598 --> 00:07:51.338
I wouldn't I wouldn't go

00:07:51.377 --> 00:07:52.497
into the specifics about

00:07:52.557 --> 00:07:53.338
why those people left.

00:07:53.358 --> 00:07:54.519
They either talked about or they didn't.

00:07:54.639 --> 00:07:55.858
I'm not even talking about from legality.

00:07:56.579 --> 00:07:58.240
I want to talk to the people in the room.

00:07:58.339 --> 00:07:59.079
And that's when I start to

00:07:59.100 --> 00:07:59.920
agree with both of you,

00:07:59.939 --> 00:08:01.680
which is to go with Chris

00:08:01.740 --> 00:08:02.860
Voss and labeling.

00:08:03.701 --> 00:08:05.141
I would say those things, right?

00:08:05.663 --> 00:08:08.144
This person says like hectic, stressful,

00:08:08.244 --> 00:08:09.084
and ever-changing.

00:08:09.125 --> 00:08:10.286
Like I would address each

00:08:10.386 --> 00:08:11.966
one of those things in terms of saying,

00:08:12.406 --> 00:08:13.668
I've heard from a number of

00:08:13.708 --> 00:08:15.129
you that this is increasing stress.

00:08:15.329 --> 00:08:16.629
I see that, I recognize it,

00:08:16.829 --> 00:08:18.170
and there's a plan in place for that.

00:08:18.230 --> 00:08:19.372
Like people want,

00:08:19.932 --> 00:08:21.052
I think Hemingway said like

00:08:21.093 --> 00:08:21.793
the biggest problem in

00:08:21.814 --> 00:08:22.754
communication is when you

00:08:22.855 --> 00:08:24.475
think it has occurred.

00:08:24.875 --> 00:08:26.778
So making sure you say all these things

00:08:27.767 --> 00:08:28.827
And make sure you understand

00:08:28.867 --> 00:08:31.528
that I learned this from

00:08:32.830 --> 00:08:33.950
Captain John Miller.

00:08:34.690 --> 00:08:35.951
And Captain John Miller was

00:08:35.990 --> 00:08:36.890
in Saving Private Ryan.

00:08:36.910 --> 00:08:37.870
It's Tom Hanks' character.

00:08:37.910 --> 00:08:39.711
And he's like, gripes go up, never down,

00:08:39.851 --> 00:08:40.412
always up.

00:08:40.652 --> 00:08:41.351
You gripe to me,

00:08:41.491 --> 00:08:42.873
I gripe to my commanding officer.

00:08:43.932 --> 00:08:45.214
You can't really say things like,

00:08:45.234 --> 00:08:45.894
I know this sucks,

00:08:45.913 --> 00:08:48.654
but we're going to handle this.

00:08:48.674 --> 00:08:51.274
So I think you just say, I see this.

00:08:51.375 --> 00:08:52.216
We understand this.

00:08:52.275 --> 00:08:53.515
This is being addressed.

00:08:54.015 --> 00:08:55.956
And you be very, very, very, very open.

00:08:56.703 --> 00:08:59.807
Now, I think what should be done,

00:09:00.346 --> 00:09:02.089
like you guys should have

00:09:02.129 --> 00:09:03.970
had a plan in place for this.

00:09:04.510 --> 00:09:04.711
I mean,

00:09:04.750 --> 00:09:07.173
ever since we hired our first employee,

00:09:07.692 --> 00:09:09.154
the whole plan has been

00:09:09.235 --> 00:09:10.755
what happens when this person leaves?

00:09:10.796 --> 00:09:12.297
What happens when everybody quits?

00:09:13.177 --> 00:09:15.081
We need to have these plans

00:09:15.240 --> 00:09:17.283
as part of the structure of the business.

00:09:18.105 --> 00:09:18.926
And that was part of the

00:09:18.966 --> 00:09:20.467
reason why I never kept the

00:09:20.508 --> 00:09:21.269
full caseload.

00:09:21.288 --> 00:09:22.530
As soon as we'd hire somebody,

00:09:22.691 --> 00:09:24.113
I'd delegate my caseload

00:09:24.173 --> 00:09:25.575
out to them because I

00:09:25.654 --> 00:09:26.775
always had to be prepared

00:09:26.796 --> 00:09:27.957
that if somebody left,

00:09:28.097 --> 00:09:29.320
I could take their full caseload.

00:09:29.809 --> 00:09:32.011
Like there was always a place for,

00:09:32.352 --> 00:09:32.592
you know,

00:09:32.633 --> 00:09:34.034
building redundancy in the

00:09:34.095 --> 00:09:38.019
system or else you end up dropping,

00:09:38.318 --> 00:09:38.720
you know,

00:09:38.820 --> 00:09:40.201
what used to be a caseload

00:09:40.240 --> 00:09:41.602
shared among five to a

00:09:41.663 --> 00:09:45.206
caseload shared among two.

00:09:45.326 --> 00:09:46.368
This comes up a lot, Dave.

00:09:46.388 --> 00:09:47.749
I'll let you jump in, but like...

00:09:48.682 --> 00:09:50.164
This is where being a

00:09:50.225 --> 00:09:51.807
physical therapist or any

00:09:51.927 --> 00:09:53.249
employee and then becoming

00:09:53.269 --> 00:09:55.390
the manager is not just the

00:09:55.451 --> 00:09:57.333
most important physical therapist.

00:09:57.653 --> 00:09:58.815
Management is a different job.

00:09:59.576 --> 00:10:02.158
So I've seen people in

00:10:02.219 --> 00:10:03.701
situations where they're like,

00:10:04.001 --> 00:10:05.322
we were not prepared for this.

00:10:06.063 --> 00:10:07.625
That's quite literally your job.

00:10:08.144 --> 00:10:09.485
When three people will never

00:10:09.525 --> 00:10:13.347
call out sick on the same day, yes,

00:10:13.388 --> 00:10:14.427
you have to prepare for that.

00:10:14.447 --> 00:10:15.828
That quite literally is your job.

00:10:15.849 --> 00:10:16.928
And if you're not prepared for that,

00:10:17.350 --> 00:10:18.149
ask your boss.

00:10:18.190 --> 00:10:19.431
That's what their job is to

00:10:19.451 --> 00:10:20.091
help you prepare.

00:10:20.410 --> 00:10:21.672
Gripes go up, never down,

00:10:21.971 --> 00:10:22.932
but information should

00:10:23.052 --> 00:10:23.972
always be coming down.

00:10:25.447 --> 00:10:26.307
And you're right, Jimmy,

00:10:26.327 --> 00:10:26.928
that's the difference

00:10:26.969 --> 00:10:28.970
between even management and ownership,

00:10:29.030 --> 00:10:29.270
right?

00:10:29.291 --> 00:10:30.991
So like if this were to

00:10:31.032 --> 00:10:32.274
happen to me or any of my

00:10:32.293 --> 00:10:33.254
friends and colleagues that

00:10:33.335 --> 00:10:35.155
own practices in the Northeast, right?

00:10:35.716 --> 00:10:37.057
We all have a bench of

00:10:37.118 --> 00:10:37.938
potential candidates.

00:10:37.999 --> 00:10:39.721
We all have a bench of resumes,

00:10:39.841 --> 00:10:40.481
folks that like,

00:10:40.902 --> 00:10:43.042
They kind of dipped their toe in.

00:10:43.062 --> 00:10:44.082
They kind of started to

00:10:44.123 --> 00:10:45.523
interview with us or they

00:10:45.562 --> 00:10:46.883
showed some interest, whatever.

00:10:47.283 --> 00:10:48.224
So if this were to happen at

00:10:48.264 --> 00:10:49.864
my clinic and I'm the owner,

00:10:50.283 --> 00:10:51.504
it's like that same day I'm

00:10:51.563 --> 00:10:52.784
firing out five or ten

00:10:52.865 --> 00:10:54.105
emails or calls or text

00:10:54.125 --> 00:10:55.004
messages or whatever.

00:10:55.345 --> 00:10:56.465
I'm trying to reactivate

00:10:56.504 --> 00:10:57.546
previous candidates that

00:10:57.605 --> 00:10:58.505
showed some interest.

00:10:58.546 --> 00:11:00.625
Maybe they did one or two

00:11:00.826 --> 00:11:01.986
parts of the interview process,

00:11:02.006 --> 00:11:03.067
but they didn't go all the way through.

00:11:03.447 --> 00:11:03.667
Maybe...

00:11:04.326 --> 00:11:05.567
We maybe they went all the

00:11:05.587 --> 00:11:06.548
way through and we kind of

00:11:06.568 --> 00:11:07.570
both agreed like, hey,

00:11:07.629 --> 00:11:08.811
maybe you need to work on A,

00:11:08.850 --> 00:11:10.491
B or C in terms of clinical

00:11:10.511 --> 00:11:12.533
skills or management skills or whatever.

00:11:13.053 --> 00:11:13.815
And then, you know,

00:11:14.014 --> 00:11:15.115
let's talk in a year like

00:11:15.135 --> 00:11:16.057
that happens all the time.

00:11:16.116 --> 00:11:16.297
Right.

00:11:16.336 --> 00:11:18.158
So like this this this

00:11:18.239 --> 00:11:19.740
individual who's a facility manager.

00:11:21.160 --> 00:11:22.081
in my opinion,

00:11:22.282 --> 00:11:24.842
I'm kind of making an assumption here.

00:11:25.363 --> 00:11:26.683
They don't have as much skin

00:11:26.703 --> 00:11:27.884
in the game as an owner, right?

00:11:27.903 --> 00:11:28.625
So they're not going to just,

00:11:28.644 --> 00:11:29.904
they're not going to say in that, in the,

00:11:29.985 --> 00:11:30.706
in the message here,

00:11:31.426 --> 00:11:33.126
if they had skin in the game, they would,

00:11:33.147 --> 00:11:34.148
if they own of the clinic

00:11:34.168 --> 00:11:35.447
or whatever they would have been like,

00:11:35.687 --> 00:11:37.609
and also I already started

00:11:37.828 --> 00:11:38.909
messaging and emailing

00:11:39.289 --> 00:11:40.730
other candidates that in

00:11:40.750 --> 00:11:41.691
the past year showed

00:11:41.730 --> 00:11:43.432
interest and I'm looking at, you know,

00:11:43.471 --> 00:11:44.893
get them interviewed or

00:11:44.952 --> 00:11:45.712
re-interviewed and

00:11:45.832 --> 00:11:46.774
scheduled on the calendar.

00:11:47.173 --> 00:11:48.596
to fill these holes right

00:11:48.855 --> 00:11:49.777
this part the manager

00:11:49.918 --> 00:11:50.899
doesn't didn't even mention

00:11:50.918 --> 00:11:52.080
that which kind of means

00:11:52.120 --> 00:11:53.381
like there is no bench

00:11:53.422 --> 00:11:54.844
there is no there are no

00:11:54.884 --> 00:11:55.865
potential candidates or

00:11:55.884 --> 00:11:56.905
they're going to go up to

00:11:56.946 --> 00:11:57.826
management and be like hey

00:11:58.028 --> 00:11:59.089
hr whatever like do we have

00:11:59.109 --> 00:12:00.431
any candidates any any resumes

00:12:01.567 --> 00:12:02.106
Yeah.

00:12:02.126 --> 00:12:02.748
Dude,

00:12:02.768 --> 00:12:04.388
this is where I think you treat your

00:12:04.447 --> 00:12:05.668
business or your clinic,

00:12:05.729 --> 00:12:06.469
no matter really what it is.

00:12:06.869 --> 00:12:07.889
This is business.

00:12:07.929 --> 00:12:08.690
We could remove everything

00:12:08.730 --> 00:12:09.990
about PT from this and

00:12:10.071 --> 00:12:11.311
still have a valid conversation.

00:12:11.892 --> 00:12:13.292
You have to act like a Major

00:12:13.312 --> 00:12:14.052
League Baseball team.

00:12:14.072 --> 00:12:15.452
You need to act like Moneyball, baby.

00:12:16.234 --> 00:12:17.073
This was in radio.

00:12:17.114 --> 00:12:19.134
This was beaten in my head.

00:12:20.514 --> 00:12:21.515
You've got a great team.

00:12:21.535 --> 00:12:23.216
You've got a morning guy, a midday girl,

00:12:23.236 --> 00:12:24.256
an afternoon person.

00:12:24.736 --> 00:12:25.398
One of them is going to

00:12:25.498 --> 00:12:26.817
leave in the next five years.

00:12:26.898 --> 00:12:27.678
This is where I go into a

00:12:27.698 --> 00:12:29.940
little Gary V. Be thrilled.

00:12:30.720 --> 00:12:31.921
That that person grew at

00:12:31.941 --> 00:12:32.760
your clinic to the point

00:12:32.780 --> 00:12:34.201
when someone else wanted to poach them.

00:12:34.783 --> 00:12:37.365
Or they looked at, they felt so confident,

00:12:37.404 --> 00:12:37.924
they said, you know what,

00:12:37.945 --> 00:12:38.785
I'm going to go somewhere else.

00:12:38.966 --> 00:12:40.046
Be thrilled at that,

00:12:40.407 --> 00:12:41.547
but also be prepared for

00:12:41.586 --> 00:12:42.368
what happens when that

00:12:42.408 --> 00:12:43.629
person grows up and leaves.

00:12:43.928 --> 00:12:45.669
This was not personal, most likely.

00:12:45.690 --> 00:12:47.110
It sounds like none of these

00:12:47.150 --> 00:12:47.631
were personal.

00:12:47.812 --> 00:12:48.552
Except for that third one,

00:12:48.572 --> 00:12:49.572
they had to let somebody go

00:12:50.594 --> 00:12:52.034
as a staff member with a managerial role.

00:12:52.274 --> 00:12:52.514
Good.

00:12:53.315 --> 00:12:54.515
Maybe you made a good decision.

00:12:54.655 --> 00:12:54.976
Definitely.

00:12:55.057 --> 00:12:55.437
I mean,

00:12:55.517 --> 00:12:56.557
I'd rather be short staffed than

00:12:56.577 --> 00:12:57.518
keep someone on who doesn't

00:12:57.557 --> 00:12:58.298
deserve to be there.

00:12:59.292 --> 00:13:00.633
And I would say to your

00:13:00.692 --> 00:13:02.434
credit to everything that

00:13:02.495 --> 00:13:03.716
this person said,

00:13:04.476 --> 00:13:06.177
right on point like this, this,

00:13:06.258 --> 00:13:07.158
the fact that you were

00:13:07.219 --> 00:13:08.539
willing to let somebody go,

00:13:08.679 --> 00:13:09.520
even though two other

00:13:09.561 --> 00:13:10.841
people had just left,

00:13:11.523 --> 00:13:14.625
most managers do whatever

00:13:14.706 --> 00:13:15.746
is easiest for them.

00:13:15.787 --> 00:13:17.168
They don't care about anything else.

00:13:17.607 --> 00:13:18.749
So they would have kept that

00:13:18.789 --> 00:13:20.551
person on even as dead weight,

00:13:20.591 --> 00:13:21.631
just because that's another

00:13:21.672 --> 00:13:23.553
warm body with a license who can build.

00:13:24.697 --> 00:13:26.739
So to this person's credit, you know,

00:13:26.859 --> 00:13:28.120
this is something that

00:13:28.620 --> 00:13:29.740
they're on the right track.

00:13:29.760 --> 00:13:30.681
They probably already know

00:13:30.701 --> 00:13:31.402
the right answer.

00:13:31.422 --> 00:13:32.501
They've thought of all the

00:13:32.522 --> 00:13:33.582
things that we're saying,

00:13:34.082 --> 00:13:35.903
but they just put it out there.

00:13:35.964 --> 00:13:37.544
So we're going to reiterate

00:13:37.585 --> 00:13:38.245
what they're doing.

00:13:38.946 --> 00:13:40.245
And good job being gutsy

00:13:40.285 --> 00:13:41.206
enough to ask the question

00:13:41.246 --> 00:13:42.567
to a bunch of numbnuts on the Internet.

00:13:42.846 --> 00:13:44.488
We have a second one that came in as well,

00:13:44.508 --> 00:13:45.489
because once we got the

00:13:45.528 --> 00:13:47.730
first Dear Breakfast Club question,

00:13:47.932 --> 00:13:48.591
That's when it happens.

00:13:48.611 --> 00:13:49.452
The floodgates open.

00:13:49.472 --> 00:13:50.253
Here's the second one.

00:13:51.933 --> 00:13:52.453
Is this us?

00:13:53.634 --> 00:13:54.596
This was a public post.

00:13:54.615 --> 00:13:56.356
This was not to us, but we're going to,

00:13:56.376 --> 00:13:56.777
that's a good one.

00:13:56.797 --> 00:13:57.616
Let's talk about it.

00:13:57.856 --> 00:13:58.317
Public posts.

00:13:58.337 --> 00:14:02.200
Sorry, Dave.

00:14:02.279 --> 00:14:02.580
All right.

00:14:02.639 --> 00:14:04.760
So this, this was in a Facebook group,

00:14:04.801 --> 00:14:05.802
a physical therapy Facebook group,

00:14:05.861 --> 00:14:06.822
uncaged clinician,

00:14:07.342 --> 00:14:08.962
Joseph Klarberg with fourth.

00:14:09.964 --> 00:14:11.664
What's that?

00:14:11.745 --> 00:14:13.166
I said, yeah, I'm in, I'm in that one too.

00:14:13.206 --> 00:14:13.446
Go ahead.

00:14:14.826 --> 00:14:15.407
Yeah.

00:14:15.427 --> 00:14:16.607
So with the fourth quarter starting,

00:14:16.648 --> 00:14:17.207
we're all thinking about

00:14:17.227 --> 00:14:18.609
the future plans and growth

00:14:18.908 --> 00:14:19.849
with the current Medicare

00:14:19.889 --> 00:14:21.470
proposed cuts for twenty twenty five.

00:14:21.769 --> 00:14:22.769
Where do you realistically

00:14:22.809 --> 00:14:24.191
see the profession in two,

00:14:24.591 --> 00:14:26.072
five and ten years?

00:14:26.471 --> 00:14:27.392
What are you planning to do

00:14:27.412 --> 00:14:28.393
to combat the potential

00:14:28.432 --> 00:14:30.413
cuts and remain profitable?

00:14:30.433 --> 00:14:31.833
Just want to open the

00:14:31.854 --> 00:14:32.754
discussion to let people

00:14:32.774 --> 00:14:34.294
brainstorm together and

00:14:34.335 --> 00:14:35.836
share ideas in public,

00:14:35.875 --> 00:14:37.155
basically in these Facebook groups.

00:14:37.375 --> 00:14:38.256
Right.

00:14:38.277 --> 00:14:39.376
Thank you.

00:14:39.417 --> 00:14:40.557
Now, they're cool.

00:14:40.658 --> 00:14:40.937
I like them.

00:14:43.115 --> 00:14:43.434
Yeah.

00:14:43.475 --> 00:14:44.014
So, I mean,

00:14:44.174 --> 00:14:45.816
I don't take I don't take Medicare.

00:14:45.875 --> 00:14:47.697
So I need Tony Maritato to

00:14:47.817 --> 00:14:49.037
jump in and answer this first.

00:14:49.057 --> 00:14:50.596
And then I can chime in on my thoughts or,

00:14:50.898 --> 00:14:51.778
you know, our approach.

00:14:53.158 --> 00:14:55.839
It's another case where you, the therapist,

00:14:55.879 --> 00:14:56.759
make the decision.

00:14:56.879 --> 00:14:58.000
Are you in business to do

00:14:58.019 --> 00:14:58.720
what you want to do?

00:14:58.799 --> 00:15:00.821
Are you in business to serve the consumer,

00:15:01.341 --> 00:15:02.721
the customer, the client,

00:15:02.760 --> 00:15:03.802
whatever you want to call them?

00:15:04.422 --> 00:15:06.241
If I'm here to serve the

00:15:06.282 --> 00:15:07.163
customer and I'm going to

00:15:07.202 --> 00:15:08.143
have two customers,

00:15:08.182 --> 00:15:09.243
the insurance company and

00:15:09.263 --> 00:15:10.903
the actual patient who's in my clinic.

00:15:11.586 --> 00:15:13.990
then if medicare is gonna do

00:15:14.029 --> 00:15:15.751
something I'm gonna respond

00:15:15.812 --> 00:15:17.313
not react right there

00:15:17.453 --> 00:15:18.576
there's a difference there

00:15:18.635 --> 00:15:21.139
so my response if medicare

00:15:21.158 --> 00:15:22.520
is reducing reimbursement

00:15:22.541 --> 00:15:23.662
I'm going to find ways to

00:15:23.841 --> 00:15:26.445
increase total cart value quote revenue

00:15:27.626 --> 00:15:29.849
I'm going to add RTM into the system.

00:15:29.948 --> 00:15:31.389
I'm going to add other cash

00:15:31.990 --> 00:15:33.511
pay services into the system.

00:15:33.552 --> 00:15:34.633
I'm going to sell products.

00:15:35.153 --> 00:15:36.294
I'm going to do more things

00:15:36.315 --> 00:15:38.576
that my patient wants and

00:15:38.616 --> 00:15:40.398
is willing to pay out of pocket for.

00:15:40.859 --> 00:15:42.480
And I'm not solely going to

00:15:42.539 --> 00:15:44.942
rely on Medicare or any

00:15:45.062 --> 00:15:46.203
other third party payer.

00:15:46.724 --> 00:15:47.666
The other thing is I'm going

00:15:47.686 --> 00:15:48.706
to optimize the system.

00:15:48.746 --> 00:15:49.427
I'm going to grease the

00:15:49.447 --> 00:15:50.610
wheels as long as it works

00:15:50.629 --> 00:15:51.851
to my patient's benefit.

00:15:52.493 --> 00:15:54.275
And I am still an advocate

00:15:54.395 --> 00:15:56.580
and a believer that once

00:15:56.620 --> 00:15:58.743
you get past that first ten,

00:15:58.783 --> 00:16:00.065
fifteen minutes of time,

00:16:01.147 --> 00:16:04.409
Everything else is just it's it's water.

00:16:04.470 --> 00:16:05.792
What is it off a duck's back?

00:16:05.831 --> 00:16:08.474
Like patients do not remember.

00:16:08.573 --> 00:16:09.895
Sixty minutes of education.

00:16:10.395 --> 00:16:12.898
Patients do not remember all

00:16:12.979 --> 00:16:14.419
of this clinical stuff that

00:16:14.440 --> 00:16:15.760
we're trying to drive home

00:16:15.821 --> 00:16:17.222
and trying to impress them

00:16:17.243 --> 00:16:18.583
and trying to do all these things.

00:16:18.964 --> 00:16:20.105
Patients want to feel good.

00:16:20.525 --> 00:16:21.447
They want to be happy.

00:16:21.846 --> 00:16:22.888
They want to leave feeling

00:16:22.927 --> 00:16:24.109
better than they came in.

00:16:24.308 --> 00:16:24.950
You know, that's it.

00:16:24.970 --> 00:16:26.610
And I can deliver that in ten minutes.

00:16:27.152 --> 00:16:28.933
I can still offer a twenty, thirty,

00:16:28.974 --> 00:16:30.355
forty minute experience.

00:16:30.835 --> 00:16:32.596
It's just like going to a restaurant.

00:16:32.616 --> 00:16:33.457
There are times that you

00:16:33.477 --> 00:16:34.599
want to be there longer and

00:16:34.619 --> 00:16:35.399
there are times you want to

00:16:35.479 --> 00:16:36.080
eat and get out.

00:16:37.441 --> 00:16:39.462
If I eliminate four unit

00:16:39.503 --> 00:16:40.724
visits from Medicare and I

00:16:40.744 --> 00:16:42.184
just do single unit visits

00:16:42.225 --> 00:16:44.147
five days a week, I save Medicare money.

00:16:44.366 --> 00:16:45.227
I make more money.

00:16:45.748 --> 00:16:47.590
I showed the numbers on a post recently.

00:16:48.410 --> 00:16:50.131
I think it was a triple the

00:16:50.172 --> 00:16:52.453
profit for single unit

00:16:52.494 --> 00:16:55.057
visits with zero extra work

00:16:55.136 --> 00:16:57.519
because you're still billing for time.

00:16:57.578 --> 00:16:58.639
Sixty minutes is sixty

00:16:58.659 --> 00:16:59.721
minutes spread across four

00:16:59.760 --> 00:17:02.043
patients or one patient or six patients.

00:17:02.722 --> 00:17:03.344
That's what I would do.

00:17:04.642 --> 00:17:05.021
Hold on, hold on.

00:17:05.061 --> 00:17:06.222
You said no extra work.

00:17:06.282 --> 00:17:07.663
You do need extra marketing

00:17:07.703 --> 00:17:08.683
work on the front end to

00:17:08.723 --> 00:17:10.045
get three Medicare patients

00:17:10.065 --> 00:17:10.986
to come in in that same

00:17:11.026 --> 00:17:12.125
hour compared to the one

00:17:12.145 --> 00:17:13.346
Medicare patient at nine a.m.

00:17:13.646 --> 00:17:14.667
You need three Medicare

00:17:14.688 --> 00:17:15.988
patients to come in at nine, nine,

00:17:16.008 --> 00:17:17.990
fifteen, nine, thirty five.

00:17:18.970 --> 00:17:19.670
Right.

00:17:19.790 --> 00:17:21.230
Maybe a lot of the people

00:17:21.250 --> 00:17:22.852
we're talking to have wait lists.

00:17:23.553 --> 00:17:25.134
Why don't we get rid of the wait list?

00:17:25.213 --> 00:17:26.934
Let those people come in.

00:17:26.974 --> 00:17:28.154
They've already spent the money.

00:17:28.174 --> 00:17:29.476
They already did the marketing.

00:17:29.516 --> 00:17:31.176
Those people are ready to come in.

00:17:31.929 --> 00:17:34.390
So some people might have to

00:17:34.470 --> 00:17:35.829
increase their marketing efforts.

00:17:36.971 --> 00:17:38.530
Some people might have to

00:17:38.711 --> 00:17:41.652
increase their new patient admissions,

00:17:41.692 --> 00:17:41.892
right?

00:17:41.912 --> 00:17:43.173
So if I have to admit four

00:17:43.192 --> 00:17:45.013
new patients instead of one,

00:17:45.574 --> 00:17:46.634
but those are logistical

00:17:46.693 --> 00:17:47.835
issues that could be solved

00:17:47.855 --> 00:17:48.875
with better systems.

00:17:48.894 --> 00:17:52.016
I still would say relative

00:17:52.056 --> 00:17:54.076
to tripling your profit,

00:17:55.017 --> 00:17:56.637
a little bit of extra admin work,

00:17:57.038 --> 00:17:57.998
probably worth it.

00:17:58.678 --> 00:18:00.578
And that's where I always fall back on.

00:18:01.337 --> 00:18:05.981
Yeah, I default to this, right?

00:18:06.061 --> 00:18:07.282
So this is the seesaw I talk

00:18:07.303 --> 00:18:08.763
about all the time, this visual.

00:18:09.325 --> 00:18:10.986
So if someone's going to be

00:18:11.066 --> 00:18:12.406
holding down that price,

00:18:12.446 --> 00:18:13.708
if you honestly have no

00:18:13.748 --> 00:18:15.328
control over the cost,

00:18:15.388 --> 00:18:16.369
the price that you can

00:18:16.390 --> 00:18:17.490
charge someone for something,

00:18:17.770 --> 00:18:19.092
then the only thing you can, well,

00:18:19.112 --> 00:18:20.333
you can bitch about it on the internet.

00:18:20.373 --> 00:18:21.314
That is always effective.

00:18:21.334 --> 00:18:22.174
It just doesn't do anything.

00:18:22.595 --> 00:18:23.955
Or you can work on the value

00:18:24.135 --> 00:18:25.596
or you can work on how many different,

00:18:25.616 --> 00:18:26.978
I mean, Tony's changing the game there.

00:18:27.759 --> 00:18:28.680
with saying, well,

00:18:28.700 --> 00:18:29.921
if I can get more people in

00:18:31.001 --> 00:18:32.743
with single unit visits,

00:18:33.263 --> 00:18:35.306
what am I providing while they're there,

00:18:35.586 --> 00:18:36.067
right?

00:18:36.146 --> 00:18:37.268
This goes back to the very,

00:18:37.307 --> 00:18:38.348
very simple question of

00:18:38.769 --> 00:18:39.809
what business are you in?

00:18:40.349 --> 00:18:41.371
What product or service do

00:18:41.411 --> 00:18:42.352
you actually provide?

00:18:42.451 --> 00:18:44.354
And if you provide physical therapy,

00:18:44.534 --> 00:18:45.994
using air quotes on a podcast here,

00:18:46.736 --> 00:18:48.317
you will be beholden to the

00:18:48.396 --> 00:18:49.837
right side of that seesaw

00:18:49.857 --> 00:18:50.618
you're going to be stuck

00:18:50.719 --> 00:18:52.160
someone else is determining

00:18:52.200 --> 00:18:54.280
the maximum you can charge

00:18:54.820 --> 00:18:56.102
for your time in that

00:18:56.142 --> 00:18:57.282
situation and that is a

00:18:57.423 --> 00:18:58.804
sucky place to be in that's

00:18:58.824 --> 00:18:59.523
why you see a lot of

00:18:59.584 --> 00:19:01.465
naysayers online saying

00:19:01.486 --> 00:19:02.425
this is the worst time to

00:19:02.465 --> 00:19:04.548
ever be a pt but if you're

00:19:04.688 --> 00:19:05.627
only focused on the right

00:19:05.667 --> 00:19:06.368
side you're in trouble

00:19:07.045 --> 00:19:09.086
Today's point, though, today's point,

00:19:09.125 --> 00:19:09.846
because you're right,

00:19:09.885 --> 00:19:12.487
like there are therapists in, you know,

00:19:12.886 --> 00:19:13.768
a development of their

00:19:13.788 --> 00:19:15.107
business where they don't

00:19:15.147 --> 00:19:16.689
have enough patients and it

00:19:16.729 --> 00:19:18.690
will cost those therapists more.

00:19:19.029 --> 00:19:19.869
But there are also a lot of

00:19:19.890 --> 00:19:20.810
therapists like me,

00:19:20.851 --> 00:19:22.931
like there's never a time

00:19:22.951 --> 00:19:24.011
where we don't have extra

00:19:24.031 --> 00:19:24.951
people in the clinic.

00:19:25.071 --> 00:19:26.792
I have my my non covered

00:19:26.833 --> 00:19:27.853
maintenance program.

00:19:27.873 --> 00:19:29.374
You can call it a wellness program.

00:19:29.917 --> 00:19:31.318
Those patients are floating around.

00:19:31.358 --> 00:19:32.980
They always have orthopedic issues.

00:19:33.340 --> 00:19:35.082
There isn't a day out of the

00:19:35.122 --> 00:19:36.202
week that I couldn't turn

00:19:36.222 --> 00:19:37.644
them into a legitimate

00:19:37.683 --> 00:19:39.786
physical therapy patient if I wanted.

00:19:40.307 --> 00:19:41.567
But I also recognize the

00:19:41.587 --> 00:19:42.648
value and the benefits of

00:19:42.669 --> 00:19:44.450
them of just coming in and working out,

00:19:44.490 --> 00:19:45.691
coming in and moving a little bit.

00:19:45.911 --> 00:19:48.174
But you decided there what

00:19:48.295 --> 00:19:49.435
value you provided,

00:19:49.476 --> 00:19:50.478
and it wasn't – there

00:19:50.518 --> 00:19:52.601
wasn't just – you're not a train station.

00:19:52.621 --> 00:19:54.022
There's not one track to go

00:19:54.042 --> 00:19:55.003
through Tony's clinic.

00:19:55.565 --> 00:19:56.807
There might be a track or

00:19:56.846 --> 00:19:58.910
lots of tracks that lead to the door,

00:19:59.009 --> 00:20:01.935
but once you're there, you say –

00:20:00.952 --> 00:20:02.115
well, what do you actually need?

00:20:02.575 --> 00:20:04.057
And then Tony was smart enough to know,

00:20:04.577 --> 00:20:05.859
well, can I build a track for that?

00:20:05.900 --> 00:20:06.840
Can I provide that?

00:20:07.142 --> 00:20:09.023
Like this person needs, you know,

00:20:09.084 --> 00:20:09.986
and I'm using air quotes again,

00:20:10.066 --> 00:20:10.767
they're handheld.

00:20:10.967 --> 00:20:11.748
This person needs an

00:20:11.788 --> 00:20:12.970
appointment to stare

00:20:13.029 --> 00:20:13.810
somebody who has the

00:20:13.871 --> 00:20:14.771
personality that matches

00:20:14.791 --> 00:20:15.634
with them every time.

00:20:16.013 --> 00:20:16.914
The way to do that is to

00:20:16.954 --> 00:20:17.736
build them for that.

00:20:18.476 --> 00:20:20.436
But when their benefits are up and you say,

00:20:21.137 --> 00:20:22.077
do you like this?

00:20:22.137 --> 00:20:23.358
Is this of benefit to you?

00:20:23.679 --> 00:20:24.058
Yes.

00:20:24.519 --> 00:20:26.141
Then this is how you pay for that.

00:20:26.621 --> 00:20:27.781
I feel like that's where a

00:20:27.801 --> 00:20:28.882
lot of therapists with the

00:20:28.981 --> 00:20:31.243
Peace Corps gene deep in their gut fail.

00:20:31.263 --> 00:20:32.605
It's like, well, they're done.

00:20:33.204 --> 00:20:35.566
Let me just give it pro bono, which, again,

00:20:35.786 --> 00:20:37.386
I'm for if you can afford

00:20:37.406 --> 00:20:38.208
that or that's a route.

00:20:38.228 --> 00:20:39.828
But someone paying for

00:20:39.868 --> 00:20:41.009
something they find value

00:20:41.089 --> 00:20:44.511
in is called capitalism.

00:20:44.811 --> 00:20:46.272
So where do you go with it, Dave?

00:20:47.065 --> 00:20:48.226
So I do want to come back

00:20:48.287 --> 00:20:49.067
and ask Tony again,

00:20:49.607 --> 00:20:50.249
where do you see the

00:20:50.269 --> 00:20:51.490
profession in two years, five years,

00:20:51.549 --> 00:20:52.791
especially in ten years?

00:20:53.211 --> 00:20:54.032
I want to come back to that.

00:20:54.113 --> 00:20:56.276
But what you're proposing, Tony,

00:20:56.455 --> 00:20:57.457
I think would only work

00:20:57.577 --> 00:20:59.019
maybe in your style of practice,

00:20:59.058 --> 00:21:01.682
your kind of like approach.

00:21:02.604 --> 00:21:02.943
But again,

00:21:02.983 --> 00:21:04.125
I just want to double click on this.

00:21:04.726 --> 00:21:05.487
If you have three or four...

00:21:06.567 --> 00:21:08.971
One unit visit Medicare patients per hour.

00:21:09.471 --> 00:21:11.914
That takes more admin in

00:21:11.954 --> 00:21:13.457
terms of like either calling,

00:21:13.537 --> 00:21:14.378
confirming visits.

00:21:14.778 --> 00:21:15.660
Ten or fifteen percent of

00:21:15.680 --> 00:21:16.662
those folks for outpatient

00:21:16.682 --> 00:21:18.284
are going to no show or cancel anyway.

00:21:18.344 --> 00:21:18.564
Right.

00:21:18.984 --> 00:21:20.246
Compared to like the one

00:21:20.286 --> 00:21:21.307
patient that comes up for nine a.m.,

00:21:21.327 --> 00:21:23.250
you're going to have cancels there.

00:21:24.050 --> 00:21:24.451
Therapy.

00:21:24.471 --> 00:21:25.112
Here's another thing that

00:21:25.152 --> 00:21:25.992
Tony never addresses.

00:21:26.032 --> 00:21:26.353
Tony,

00:21:26.893 --> 00:21:28.334
the therapists are now writing more

00:21:28.374 --> 00:21:30.195
notes per day because they

00:21:30.215 --> 00:21:30.935
have to write three or four

00:21:30.955 --> 00:21:32.196
notes per hour or,

00:21:32.297 --> 00:21:33.518
or they use hippo scribe or whatever,

00:21:33.538 --> 00:21:34.019
but that's still,

00:21:34.038 --> 00:21:34.818
there's still extra work to

00:21:34.838 --> 00:21:35.980
make sure that it gets in.

00:21:36.059 --> 00:21:36.560
No, no.

00:21:36.621 --> 00:21:37.561
How am I wrong?

00:21:37.842 --> 00:21:38.923
Can I answer for Tony?

00:21:39.343 --> 00:21:39.843
Yeah.

00:21:39.863 --> 00:21:40.963
Can I answer for Tony now?

00:21:41.403 --> 00:21:42.365
I might not get the perfect thing,

00:21:42.384 --> 00:21:42.644
but this is,

00:21:42.684 --> 00:21:43.405
this is what you get when you

00:21:43.465 --> 00:21:44.386
listen to Tony enough.

00:21:45.393 --> 00:21:46.972
if you focus on the process

00:21:47.113 --> 00:21:48.594
and make the processes easier,

00:21:49.013 --> 00:21:50.094
those things aren't as much

00:21:50.134 --> 00:21:50.913
of a speed bump.

00:21:51.434 --> 00:21:52.255
Is that something you like

00:21:52.575 --> 00:21:53.515
making sure you understand

00:21:53.535 --> 00:21:54.935
that if you build the process,

00:21:54.955 --> 00:21:56.115
so if you spend the time

00:21:56.135 --> 00:21:57.615
and the effort building the process,

00:21:57.695 --> 00:21:58.215
the front end,

00:21:58.696 --> 00:22:00.096
the effort goes down and

00:22:00.116 --> 00:22:00.717
you're not going to earn

00:22:00.757 --> 00:22:01.477
anything in the beginning

00:22:01.497 --> 00:22:02.096
when you're building,

00:22:02.116 --> 00:22:02.738
but you're going to earn a

00:22:02.778 --> 00:22:03.817
lot more when you go later.

00:22:04.710 --> 00:22:05.069
Yeah, yeah,

00:22:05.109 --> 00:22:06.750
that's a huge part of it for sure.

00:22:08.352 --> 00:22:10.011
So writing more notes,

00:22:10.031 --> 00:22:11.192
that's what everybody says.

00:22:11.893 --> 00:22:13.334
It's like, you know,

00:22:13.433 --> 00:22:16.494
I have great friends and they're like,

00:22:16.535 --> 00:22:17.395
hey, what are you doing today?

00:22:17.415 --> 00:22:18.915
I'm like, I'm going to do some errands.

00:22:19.336 --> 00:22:19.876
What are you doing?

00:22:19.936 --> 00:22:20.196
Well,

00:22:20.336 --> 00:22:21.978
I need to do laundry and I need to

00:22:22.038 --> 00:22:23.137
collect all the clothes and

00:22:23.178 --> 00:22:24.098
I need to sort them into

00:22:24.118 --> 00:22:25.679
whites and darks and I need to do this.

00:22:25.798 --> 00:22:27.059
I need to get the soap and I

00:22:27.079 --> 00:22:28.059
need to put them in and I

00:22:28.099 --> 00:22:28.721
need to switch it.

00:22:29.340 --> 00:22:31.002
You can break a job into

00:22:31.083 --> 00:22:32.364
fifty million pieces.

00:22:32.443 --> 00:22:33.625
The bottom line is if we're

00:22:33.644 --> 00:22:34.846
going to talk documentation,

00:22:34.885 --> 00:22:36.948
we are documenting for time.

00:22:37.067 --> 00:22:38.730
We are documenting for minutes.

00:22:39.230 --> 00:22:41.532
So, yes, for patients.

00:22:41.813 --> 00:22:43.134
But I'm documenting for

00:22:43.193 --> 00:22:45.695
sixty minutes of delivery of service.

00:22:46.517 --> 00:22:48.398
I would argue documenting

00:22:48.419 --> 00:22:49.720
for a fifteen minute unit

00:22:49.799 --> 00:22:51.760
is by far easier than

00:22:51.821 --> 00:22:53.863
documenting for sixty minutes.

00:22:54.503 --> 00:22:55.785
I think there's a lower

00:22:55.924 --> 00:22:57.266
liability there because I'm

00:22:57.385 --> 00:22:58.926
utilizing less services.

00:22:58.946 --> 00:22:59.708
And when you look at how

00:22:59.748 --> 00:23:02.190
Medicare puts you on the radar,

00:23:02.349 --> 00:23:03.671
it's generally based on

00:23:03.830 --> 00:23:05.573
utilization as a component.

00:23:06.032 --> 00:23:07.134
So a therapist who is

00:23:07.233 --> 00:23:08.994
utilizing more units per visit,

00:23:09.055 --> 00:23:10.096
more units per week,

00:23:10.135 --> 00:23:11.317
more units per episode is

00:23:11.356 --> 00:23:11.978
always going to have a

00:23:12.018 --> 00:23:13.138
bigger target on their back.

00:23:14.299 --> 00:23:14.920
But bottom line,

00:23:14.960 --> 00:23:17.540
if I'm going four patients in one hour,

00:23:17.701 --> 00:23:18.421
one unit visit,

00:23:18.582 --> 00:23:20.942
I am documenting four units of care.

00:23:21.061 --> 00:23:22.002
I don't care if it's one

00:23:22.042 --> 00:23:23.123
patient or four patients.

00:23:23.643 --> 00:23:23.903
Yes,

00:23:23.962 --> 00:23:25.824
I'm putting it into different accounts,

00:23:26.263 --> 00:23:27.124
but it's still the same

00:23:27.163 --> 00:23:28.184
documentation burden.

00:23:29.065 --> 00:23:30.424
More clicks, more pages on your EMR.

00:23:30.464 --> 00:23:30.625
Go ahead.

00:23:30.644 --> 00:23:33.105
We're talking one extra click.

00:23:33.145 --> 00:23:34.626
I'm clicking on John instead

00:23:34.686 --> 00:23:35.787
of clicking on Larry.

00:23:36.534 --> 00:23:36.993
That's it.

00:23:37.034 --> 00:23:37.795
It's a one click.

00:23:37.894 --> 00:23:38.875
But OK, you're right.

00:23:39.055 --> 00:23:39.474
You're right.

00:23:40.036 --> 00:23:41.056
And I would say you're right

00:23:41.096 --> 00:23:42.036
in the sense that, yes,

00:23:42.115 --> 00:23:43.517
this works in my practice.

00:23:43.557 --> 00:23:45.097
This works with my personality.

00:23:45.137 --> 00:23:46.597
This works with my team.

00:23:47.179 --> 00:23:48.598
It's not going to work for you.

00:23:48.719 --> 00:23:51.180
But the point in this is if

00:23:51.400 --> 00:23:52.641
I can build something that

00:23:52.701 --> 00:23:54.422
works within my culture,

00:23:54.942 --> 00:23:55.882
you can build something

00:23:55.902 --> 00:23:57.202
that works within your culture.

00:23:57.603 --> 00:23:58.163
And you did.

00:23:58.223 --> 00:24:00.586
Like you said, I can't do that.

00:24:00.685 --> 00:24:01.606
I don't want to do that.

00:24:01.646 --> 00:24:03.188
That's not what I'm great at.

00:24:03.228 --> 00:24:04.709
So I'm going to go self-fay.

00:24:04.769 --> 00:24:05.970
I'm going to go out of network.

00:24:06.029 --> 00:24:07.912
I'm going to stick to where

00:24:08.011 --> 00:24:09.614
I can deliver the greatest value.

00:24:09.854 --> 00:24:11.154
I can deliver the greatest

00:24:11.194 --> 00:24:13.596
value at this end of the bell curve.

00:24:14.198 --> 00:24:15.097
You're delivering the

00:24:15.117 --> 00:24:16.660
greatest value at the other end.

00:24:17.220 --> 00:24:20.042
But don't say that my end

00:24:20.083 --> 00:24:22.365
can't be done or it can't be, you know,

00:24:22.845 --> 00:24:24.167
It absolutely can be.

00:24:24.228 --> 00:24:26.151
And I'm living proof of that.

00:24:26.250 --> 00:24:27.633
I'm here in the clinic today

00:24:28.094 --> 00:24:29.656
because when we finish talking,

00:24:29.797 --> 00:24:30.698
I'm going to get out there

00:24:30.718 --> 00:24:32.121
and I'm going to get my hands dirty.

00:24:34.286 --> 00:24:35.465
I do want to show the

00:24:35.526 --> 00:24:36.567
feedback loop of actually

00:24:36.606 --> 00:24:37.567
hosting a live show.

00:24:37.586 --> 00:24:38.666
The person who wrote in has

00:24:38.807 --> 00:24:40.227
already texted me and said,

00:24:40.788 --> 00:24:41.448
thank you so much.

00:24:41.508 --> 00:24:42.407
Just definitely working on

00:24:42.448 --> 00:24:43.468
high speed communication.

00:24:43.508 --> 00:24:44.827
Got news yesterday of a PT

00:24:44.847 --> 00:24:45.729
starting in a few months.

00:24:46.269 --> 00:24:47.068
So things are on the up.

00:24:47.169 --> 00:24:47.989
I like the point of checking

00:24:48.028 --> 00:24:48.868
in with the current team.

00:24:49.650 --> 00:24:50.190
I just did that.

00:24:50.309 --> 00:24:52.349
But before this second PT resignation,

00:24:52.769 --> 00:24:53.390
always sticky.

00:24:53.430 --> 00:24:54.730
So the fact that that

00:24:54.750 --> 00:24:55.451
person's... Go ahead.

00:24:57.545 --> 00:25:00.467
So that facility manager, first of all,

00:25:00.507 --> 00:25:01.887
thank you for watching live again.

00:25:02.048 --> 00:25:02.669
You're incredible.

00:25:02.689 --> 00:25:03.169
You're awesome.

00:25:03.288 --> 00:25:04.329
And feedback, we love it.

00:25:05.917 --> 00:25:06.897
To the facility manager,

00:25:07.578 --> 00:25:09.118
start texting and emailing

00:25:09.479 --> 00:25:10.979
that candidate stuff.

00:25:11.098 --> 00:25:11.459
I don't know.

00:25:12.079 --> 00:25:13.740
Maybe Tony or Jimmy can give

00:25:13.759 --> 00:25:14.299
you some ideas,

00:25:14.339 --> 00:25:15.660
whether it's events

00:25:15.680 --> 00:25:17.661
happening in the community, pumpkin patch,

00:25:17.701 --> 00:25:19.601
pumpkin picking, apple pickle, whatever.

00:25:20.182 --> 00:25:22.241
Start sending them stuff to build rapport,

00:25:22.261 --> 00:25:23.001
build relationships,

00:25:23.321 --> 00:25:25.123
and make the commitment.

00:25:25.182 --> 00:25:26.063
Because they're starting in

00:25:26.083 --> 00:25:26.643
a couple months.

00:25:27.002 --> 00:25:28.044
Life happens in a couple months.

00:25:28.064 --> 00:25:28.784
You have no idea what's

00:25:28.804 --> 00:25:29.624
going to happen between now and then.

00:25:29.644 --> 00:25:29.983
That's it.

00:25:30.324 --> 00:25:30.663
Why?

00:25:30.703 --> 00:25:33.365
Because yes, yes, on October first,

00:25:34.065 --> 00:25:35.445
Life happens between October

00:25:35.465 --> 00:25:36.566
first and November first.

00:25:36.986 --> 00:25:38.067
And if you're holding your

00:25:38.106 --> 00:25:40.027
breath on that one, again,

00:25:40.067 --> 00:25:41.208
going back to my days in radio,

00:25:41.228 --> 00:25:42.008
it's just where like my,

00:25:42.167 --> 00:25:43.088
my experience comes from.

00:25:43.128 --> 00:25:44.409
If that person is there and

00:25:44.429 --> 00:25:45.108
then they're not.

00:25:45.589 --> 00:25:47.029
And that was the,

00:25:47.049 --> 00:25:47.930
that was the thing you were

00:25:48.050 --> 00:25:50.111
pinning all your success on.

00:25:50.250 --> 00:25:51.432
Hope's not a plan, my man.

00:25:51.491 --> 00:25:53.532
Like, so yes, have a bench,

00:25:53.673 --> 00:25:54.813
be warming that bench.

00:25:55.673 --> 00:25:57.473
Now you can do peer reviewed

00:25:57.493 --> 00:25:58.494
articles to each other,

00:25:58.535 --> 00:26:00.174
like a little journal club over email,

00:26:00.214 --> 00:26:01.816
like literally anything, but guide Tony.

00:26:02.385 --> 00:26:03.446
I was just going to say that

00:26:03.487 --> 00:26:04.867
same principle is why I

00:26:04.907 --> 00:26:07.430
push so hard to get patients in today.

00:26:07.810 --> 00:26:09.352
If you call my clinic this morning,

00:26:09.392 --> 00:26:10.212
you were coming in this

00:26:10.272 --> 00:26:12.295
afternoon because anything

00:26:12.315 --> 00:26:14.737
can happen between today and tomorrow,

00:26:14.797 --> 00:26:15.857
today and next week.

00:26:17.499 --> 00:26:20.761
We complain about, to Dave's point, well,

00:26:20.821 --> 00:26:21.942
I don't have enough patients.

00:26:22.002 --> 00:26:24.045
Well, how quick are you calling them back?

00:26:24.444 --> 00:26:25.645
How quick are you getting

00:26:26.027 --> 00:26:27.347
the evaluation done,

00:26:27.407 --> 00:26:29.589
building that line of communication?

00:26:30.074 --> 00:26:30.273
Dude,

00:26:30.294 --> 00:26:31.275
I don't know anything about this

00:26:31.315 --> 00:26:31.895
business model,

00:26:31.915 --> 00:26:33.416
but I started listening to

00:26:33.436 --> 00:26:34.898
that corner office podcast

00:26:34.939 --> 00:26:35.920
and I mentioned it to you guys.

00:26:35.940 --> 00:26:36.720
And he's just a guy who like

00:26:36.780 --> 00:26:38.241
analyzes businesses really quickly.

00:26:39.010 --> 00:26:40.310
And I had to help somebody

00:26:40.391 --> 00:26:41.270
move really quick.

00:26:41.310 --> 00:26:42.412
So what did I do?

00:26:42.531 --> 00:26:44.152
I Googled moving and in the

00:26:44.172 --> 00:26:45.172
name of my town and I got

00:26:45.211 --> 00:26:46.011
like four or five different

00:26:46.031 --> 00:26:48.012
places and I blew off a

00:26:48.053 --> 00:26:49.413
couple who just wanted me to call.

00:26:49.593 --> 00:26:50.452
I wanted to fill something

00:26:50.573 --> 00:26:52.034
out and like get a quote or

00:26:52.074 --> 00:26:53.273
get a text or something.

00:26:54.134 --> 00:26:56.755
So I found three of those to

00:26:56.775 --> 00:26:58.335
their credit and I got

00:26:58.375 --> 00:27:01.175
calls or texts within five minutes.

00:27:01.256 --> 00:27:02.895
I mean, these people were aggressive.

00:27:02.955 --> 00:27:03.655
And then I thought about it.

00:27:03.675 --> 00:27:04.336
If I was in the moving

00:27:04.375 --> 00:27:05.336
business and I have a truck

00:27:05.376 --> 00:27:06.676
and a bunch of dudes outside,

00:27:07.797 --> 00:27:08.936
I'm not making any money.

00:27:09.277 --> 00:27:11.938
So that one job deciding yes

00:27:11.978 --> 00:27:13.278
or no is binary.

00:27:14.078 --> 00:27:16.038
I think PTs should pay more

00:27:16.078 --> 00:27:17.939
attention and act like moving companies,

00:27:17.979 --> 00:27:20.500
which is get them in today.

00:27:20.599 --> 00:27:23.161
Because if you let them go a day, a week,

00:27:23.580 --> 00:27:24.441
or a couple of weeks,

00:27:24.941 --> 00:27:25.721
that person's going to

00:27:25.740 --> 00:27:26.961
either decide that's not a

00:27:27.001 --> 00:27:29.182
problem anymore or go

00:27:29.261 --> 00:27:30.821
somewhere else to get that solved.

00:27:31.403 --> 00:27:32.722
So act as if.

00:27:34.202 --> 00:27:34.722
I don't know, man.

00:27:34.762 --> 00:27:36.203
I feel like your job as a manager,

00:27:36.223 --> 00:27:37.003
that's part of it.

00:27:38.443 --> 00:27:40.224
So let's pivot just a little

00:27:40.244 --> 00:27:43.106
bit talking about hinge health.

00:27:44.167 --> 00:27:46.108
I had kind of forgotten about that topic,

00:27:46.148 --> 00:27:47.829
but I will say preface this

00:27:48.830 --> 00:27:51.053
about once every month or two,

00:27:51.873 --> 00:27:53.054
somebody in the family

00:27:53.153 --> 00:27:54.894
sends me a screenshot of a

00:27:54.974 --> 00:27:56.476
flyer or an email or

00:27:56.536 --> 00:27:57.436
something they received

00:27:57.477 --> 00:27:59.597
through work saying that

00:27:59.718 --> 00:28:01.920
they could get free physical therapy,

00:28:02.000 --> 00:28:03.320
virtual physical therapy,

00:28:04.701 --> 00:28:05.482
And it kind of brings it

00:28:05.523 --> 00:28:06.263
back on the radar.

00:28:06.644 --> 00:28:08.567
So Dave has a great

00:28:08.667 --> 00:28:10.289
interview with Brian Williams.

00:28:11.211 --> 00:28:13.574
You guys have amazing conversation.

00:28:14.295 --> 00:28:15.596
And I was rewatching it

00:28:15.635 --> 00:28:17.338
again this morning before I came in.

00:28:18.321 --> 00:28:19.501
But Hinge Health came back

00:28:19.541 --> 00:28:20.982
on my radar because

00:28:21.022 --> 00:28:22.923
yesterday I was scrolling

00:28:22.942 --> 00:28:24.403
through LinkedIn and I saw

00:28:24.423 --> 00:28:25.903
a therapist post the job

00:28:25.963 --> 00:28:27.124
opening for Hinge Health.

00:28:27.663 --> 00:28:28.263
And it said, hey,

00:28:28.304 --> 00:28:29.704
come work with me at Hinge Health,

00:28:29.765 --> 00:28:31.365
pelvic floor, women's health.

00:28:31.585 --> 00:28:32.484
I was like, oh,

00:28:32.645 --> 00:28:33.885
I wonder what their job

00:28:34.986 --> 00:28:35.826
posting looks like.

00:28:36.266 --> 00:28:37.527
So I go and I take a look

00:28:38.166 --> 00:28:39.406
and it's awesome.

00:28:39.707 --> 00:28:41.028
I mean, I was blown away.

00:28:41.107 --> 00:28:42.667
I was so impressed by the

00:28:42.708 --> 00:28:44.428
quality of the job listing,

00:28:44.528 --> 00:28:45.848
what they were promoting,

00:28:45.888 --> 00:28:46.749
what they were doing.

00:28:47.751 --> 00:28:49.113
And I know, you know,

00:28:49.313 --> 00:28:50.733
I go back to there was all

00:28:50.753 --> 00:28:53.135
this controversy about them calling it,

00:28:53.536 --> 00:28:55.176
was it virtual physical therapy,

00:28:55.298 --> 00:28:56.498
AI physical therapy?

00:28:56.638 --> 00:28:58.079
Is there a physical therapist?

00:28:58.839 --> 00:29:00.840
So, of course, I shared that post.

00:29:01.001 --> 00:29:02.383
I got another inbound

00:29:02.423 --> 00:29:03.784
message or two from other

00:29:03.824 --> 00:29:05.224
therapists who work at Hinge.

00:29:05.924 --> 00:29:07.685
And I was genuinely impressed.

00:29:07.746 --> 00:29:08.067
Like,

00:29:08.287 --> 00:29:10.288
it sounds like they're doing amazing.

00:29:10.307 --> 00:29:11.229
They're doing a great job.

00:29:11.249 --> 00:29:12.509
They're moving in the right direction.

00:29:12.529 --> 00:29:12.609
Cool.

00:29:13.698 --> 00:29:14.978
I don't think we have an

00:29:15.157 --> 00:29:17.038
accurate depiction because

00:29:17.098 --> 00:29:18.878
I think we and it's the

00:29:18.939 --> 00:29:20.538
royal we as therapists in

00:29:20.579 --> 00:29:22.380
general think either we're

00:29:22.400 --> 00:29:23.339
going to lose our job

00:29:23.380 --> 00:29:24.579
because it's going to be AI

00:29:24.619 --> 00:29:25.740
physical therapy and that's

00:29:25.760 --> 00:29:26.921
not real physical therapy.

00:29:26.961 --> 00:29:29.401
And if I can't touch people and I can't,

00:29:29.621 --> 00:29:30.001
you know,

00:29:30.061 --> 00:29:31.541
connect with people that it's

00:29:31.602 --> 00:29:32.481
not effective.

00:29:32.961 --> 00:29:34.682
But I just I still stand

00:29:34.722 --> 00:29:36.502
true to that perspective that.

00:29:37.605 --> 00:29:39.786
There is a huge demographic, huge,

00:29:40.385 --> 00:29:41.926
that doesn't want to be touched,

00:29:42.267 --> 00:29:44.048
that doesn't want to bother

00:29:44.087 --> 00:29:47.289
with a person that wants a solution,

00:29:47.369 --> 00:29:48.150
wants an answer,

00:29:48.210 --> 00:29:49.391
wants to do it themselves.

00:29:49.691 --> 00:29:50.912
Huge, huge.

00:29:53.853 --> 00:29:55.453
My cousin and me, huge.

00:29:55.574 --> 00:29:57.194
It's a huge demographic.

00:29:58.154 --> 00:30:00.375
And we just don't even know because again,

00:30:00.635 --> 00:30:02.497
we're not talking to those

00:30:02.537 --> 00:30:03.436
people because those people

00:30:03.517 --> 00:30:04.998
aren't even putting us in

00:30:06.558 --> 00:30:07.479
their ecosystem.

00:30:07.739 --> 00:30:09.319
They're not giving us a chance.

00:30:09.420 --> 00:30:11.260
I think this opens a big door for us.

00:30:12.040 --> 00:30:14.301
Dave disagrees.

00:30:14.342 --> 00:30:15.282
We love when that happens.

00:30:15.782 --> 00:30:16.722
You know what?

00:30:16.803 --> 00:30:17.983
I want a virtual roofer to

00:30:18.023 --> 00:30:18.963
come over and I want a

00:30:19.064 --> 00:30:20.525
virtual house painter to come over.

00:30:21.653 --> 00:30:24.574
So what's interesting about that,

00:30:24.814 --> 00:30:25.913
what's interesting about that,

00:30:26.374 --> 00:30:27.473
Jimmy just said,

00:30:27.713 --> 00:30:28.673
I don't want to talk to

00:30:28.713 --> 00:30:30.595
them on the phone for the moving company.

00:30:30.634 --> 00:30:32.115
I just want to fill out a form.

00:30:32.674 --> 00:30:33.835
I want them to tell me, you know,

00:30:33.894 --> 00:30:35.234
I'm putting words in your mouth now,

00:30:35.394 --> 00:30:36.336
how much it costs,

00:30:36.395 --> 00:30:38.455
when it can be done and just get it done.

00:30:39.935 --> 00:30:40.556
So, yeah,

00:30:40.596 --> 00:30:42.217
you're never going to get a

00:30:42.297 --> 00:30:43.876
virtual physical therapist

00:30:44.336 --> 00:30:46.797
unless we get that robot, that's sixty,

00:30:46.856 --> 00:30:47.717
eighty thousand dollar

00:30:47.757 --> 00:30:49.157
robot that does the massage

00:30:49.198 --> 00:30:50.857
for us and we can send it to their house.

00:30:51.601 --> 00:30:52.402
Not going to happen,

00:30:52.902 --> 00:30:54.143
but I would use the robot.

00:30:55.284 --> 00:30:56.605
But that being said,

00:30:57.285 --> 00:30:59.306
that's not the demographic for this.

00:30:59.767 --> 00:31:01.627
The demographic for this is

00:31:02.107 --> 00:31:03.588
the person who's just like,

00:31:03.809 --> 00:31:06.030
I don't even know what my doctor said.

00:31:06.451 --> 00:31:08.992
They're giving me this order for exercise,

00:31:09.032 --> 00:31:10.453
but I'm in too much pain.

00:31:11.974 --> 00:31:13.195
Every single week,

00:31:13.336 --> 00:31:14.416
I have at least two or

00:31:14.436 --> 00:31:15.597
three people who are like,

00:31:16.137 --> 00:31:17.338
I don't know why I'm here.

00:31:17.858 --> 00:31:18.920
I've got back pain.

00:31:18.960 --> 00:31:19.941
I can barely walk.

00:31:19.980 --> 00:31:21.842
My doctor wants me to exercise.

00:31:21.883 --> 00:31:22.643
That's crazy.

00:31:23.022 --> 00:31:25.025
You haven't even gotten an MRI.

00:31:25.365 --> 00:31:27.146
How can you know what to do for me?

00:31:27.346 --> 00:31:28.166
That's what the patients

00:31:28.186 --> 00:31:29.387
tell me every single day.

00:31:29.989 --> 00:31:32.810
And you put that person behind a screen.

00:31:33.490 --> 00:31:33.872
Now,

00:31:33.932 --> 00:31:35.472
at least they have a little sense of

00:31:35.512 --> 00:31:36.113
security.

00:31:37.013 --> 00:31:37.875
They don't trust you.

00:31:37.894 --> 00:31:38.575
They don't like you.

00:31:38.595 --> 00:31:39.375
They don't know you.

00:31:39.875 --> 00:31:41.257
So you give them a little

00:31:41.356 --> 00:31:43.519
space and maybe some of

00:31:43.558 --> 00:31:45.621
them will come so you can rub their back.

00:31:46.394 --> 00:31:47.275
I don't want to do that,

00:31:47.335 --> 00:31:48.895
but there are therapists who do.

00:31:50.076 --> 00:31:51.218
But I think we can have

00:31:51.298 --> 00:31:53.219
access to just so many more people.

00:31:56.288 --> 00:31:57.347
I love the comparison

00:31:57.407 --> 00:32:00.128
between Jimmy McKay finding a mover,

00:32:00.429 --> 00:32:01.869
which Brian Williams and I

00:32:01.910 --> 00:32:02.789
discussed this in the Hinge

00:32:02.809 --> 00:32:03.730
Health is Dead episode on

00:32:03.769 --> 00:32:04.530
the Dave Kittle Show.

00:32:05.351 --> 00:32:08.692
Uber, Lyft, car rides, even moving.

00:32:08.751 --> 00:32:08.892
Now,

00:32:08.932 --> 00:32:11.752
moving is a little more emotional with

00:32:11.873 --> 00:32:14.173
your stuff and all that baggage,

00:32:14.354 --> 00:32:14.953
pun intended.

00:32:15.374 --> 00:32:15.993
I get it.

00:32:16.114 --> 00:32:18.634
But moving someone and their stuff...

00:32:19.375 --> 00:32:20.896
is way more transactional.

00:32:20.936 --> 00:32:21.817
It's closer to,

00:32:22.317 --> 00:32:23.660
I want to ride to the airport.

00:32:23.779 --> 00:32:25.922
I don't care if it's Lyft, Uber, Harbor,

00:32:25.981 --> 00:32:27.584
car service, whatever.

00:32:27.943 --> 00:32:29.286
As long as they have a pulse

00:32:29.625 --> 00:32:31.028
and they kind of drive safely.

00:32:31.107 --> 00:32:32.288
And I don't even ask if they

00:32:32.308 --> 00:32:33.269
have a license or if

00:32:33.289 --> 00:32:34.290
they're insured or whatever.

00:32:34.330 --> 00:32:35.752
Like no one asked that, right?

00:32:36.012 --> 00:32:37.994
So there's things nowadays

00:32:38.015 --> 00:32:39.196
that are more transactional.

00:32:40.184 --> 00:32:41.826
But someone putting their hands on you,

00:32:41.865 --> 00:32:42.665
Tony, I agree.

00:32:43.165 --> 00:32:43.846
Or someone who's a

00:32:43.886 --> 00:32:44.946
healthcare provider that

00:32:45.027 --> 00:32:46.107
now they're gonna ask you

00:32:46.147 --> 00:32:46.847
questions that's gonna

00:32:46.867 --> 00:32:48.249
bring up maybe emotional

00:32:48.288 --> 00:32:49.189
triggers or it's gonna

00:32:49.229 --> 00:32:50.910
bring up previous injuries

00:32:50.950 --> 00:32:52.871
or car accidents or other emotions.

00:32:53.250 --> 00:32:55.011
And you're trying to build a relationship

00:32:55.652 --> 00:32:56.772
That is very different.

00:32:57.074 --> 00:32:59.296
I would say we're closer to, I don't know,

00:32:59.316 --> 00:33:01.438
like what realtors do and

00:33:01.478 --> 00:33:02.239
what people do at like

00:33:02.318 --> 00:33:04.481
Rotary and like the PTA and all that.

00:33:04.501 --> 00:33:05.261
Like it takes time.

00:33:05.482 --> 00:33:06.463
It builds relationships.

00:33:06.824 --> 00:33:08.165
And Brian Williams and I discussed this.

00:33:08.506 --> 00:33:09.126
There is a difference

00:33:09.166 --> 00:33:10.929
between whether it's home

00:33:11.009 --> 00:33:12.410
therapy or outpatient therapy.

00:33:13.270 --> 00:33:14.653
Way more on the relationship

00:33:14.692 --> 00:33:16.715
side and other things that

00:33:16.736 --> 00:33:18.258
are way more on the transactional side.

00:33:18.298 --> 00:33:18.538
Yes.

00:33:18.577 --> 00:33:20.340
Jimmy doesn't care about calling in.

00:33:20.361 --> 00:33:21.602
He just, he wants it.

00:33:21.823 --> 00:33:22.503
He wants speed.

00:33:22.544 --> 00:33:24.767
He wants to get it going and

00:33:24.787 --> 00:33:25.488
he doesn't really care.

00:33:25.528 --> 00:33:26.528
They're not asking him like,

00:33:26.769 --> 00:33:27.711
so why are you moving?

00:33:27.750 --> 00:33:28.731
And tell me how that makes

00:33:28.751 --> 00:33:29.753
you feel and all that.

00:33:30.663 --> 00:33:30.883
Right.

00:33:30.942 --> 00:33:31.963
Brian Williams graduated

00:33:32.044 --> 00:33:32.924
Marymount University.

00:33:33.345 --> 00:33:33.785
Go Saints.

00:33:34.346 --> 00:33:35.666
So I think it all depends.

00:33:35.707 --> 00:33:35.826
Right.

00:33:35.846 --> 00:33:36.426
This is like good.

00:33:36.467 --> 00:33:37.367
Like I'm positioned in the

00:33:37.407 --> 00:33:38.909
middle of Tony and Dave on the video.

00:33:39.990 --> 00:33:41.050
I jotted down some notes.

00:33:41.111 --> 00:33:42.112
There's Home Depot,

00:33:42.152 --> 00:33:43.952
there's handymen and there's contractors.

00:33:44.614 --> 00:33:46.035
I can do some stuff myself.

00:33:46.115 --> 00:33:46.894
I don't know a whole lot.

00:33:46.914 --> 00:33:47.736
When I bought this house,

00:33:47.796 --> 00:33:49.837
I owned a screwdriver and a drill.

00:33:50.258 --> 00:33:50.458
Right.

00:33:50.498 --> 00:33:51.378
So I was going to Home Depot

00:33:51.398 --> 00:33:52.019
for some stuff.

00:33:52.460 --> 00:33:53.681
Some stuff was out of my league.

00:33:54.320 --> 00:33:55.902
I went to a neighbor or a handyman.

00:33:55.922 --> 00:33:56.942
And then sometimes it's like

00:33:57.083 --> 00:33:58.343
full-on contractor, right?

00:33:58.563 --> 00:33:59.963
Some moments I want to drive

00:33:59.983 --> 00:34:00.444
and I want to be in

00:34:00.464 --> 00:34:02.005
complete control because I

00:34:02.025 --> 00:34:02.685
want a road trip.

00:34:02.705 --> 00:34:03.705
I want the experience.

00:34:03.726 --> 00:34:04.527
And sometimes I just want to

00:34:04.567 --> 00:34:05.267
ride to the airport.

00:34:05.666 --> 00:34:06.508
As you mentioned, Dave,

00:34:06.867 --> 00:34:07.808
how many times have we ever

00:34:07.909 --> 00:34:08.648
asked if that person even

00:34:08.668 --> 00:34:09.469
has a life license?

00:34:09.690 --> 00:34:10.309
How many times have you been

00:34:10.329 --> 00:34:11.331
asked if you have a college degree?

00:34:11.590 --> 00:34:12.931
My running count, zero times.

00:34:13.925 --> 00:34:16.204
But it depends, right?

00:34:16.365 --> 00:34:17.606
And I know it's cliche in

00:34:17.626 --> 00:34:18.505
this profession to say like

00:34:18.545 --> 00:34:19.885
everything depends, but it does.

00:34:20.445 --> 00:34:21.306
So I think there's a time

00:34:21.326 --> 00:34:22.347
and there's a place for it.

00:34:22.507 --> 00:34:23.666
I think like an app,

00:34:23.686 --> 00:34:25.467
like a Hinge Health or Virtual Care,

00:34:25.726 --> 00:34:27.047
there's a place for it.

00:34:27.128 --> 00:34:29.407
I don't think either end is gonna go away.

00:34:29.788 --> 00:34:30.947
I think this virtual thing

00:34:30.967 --> 00:34:32.009
is just coming on.

00:34:32.409 --> 00:34:34.048
So we're questioning its viability.

00:34:34.489 --> 00:34:37.929
But the fact that there are apps like that,

00:34:38.210 --> 00:34:39.269
because sometimes I just

00:34:39.289 --> 00:34:40.409
want a little bit of information.

00:34:40.449 --> 00:34:41.871
Sometimes I just want the

00:34:41.911 --> 00:34:43.170
information really quickly.

00:34:44.152 --> 00:34:44.873
I think you can keep

00:34:44.972 --> 00:34:45.873
overhead low and you can

00:34:45.934 --> 00:34:47.954
reach so many people that

00:34:48.014 --> 00:34:49.855
you would only need to charge this much.

00:34:50.574 --> 00:34:52.195
Or what Hinge Health is doing too,

00:34:52.235 --> 00:34:53.195
you go onto Hinge Health's

00:34:53.295 --> 00:34:54.115
app and you type in your

00:34:54.155 --> 00:34:56.436
employer and it figures it out for you,

00:34:56.456 --> 00:34:56.617
right?

00:34:56.637 --> 00:34:58.317
Because there's that big stumbling block.

00:34:58.336 --> 00:34:59.476
I don't need to figure out

00:34:59.496 --> 00:35:00.838
my insurance before I get an Uber.

00:35:01.117 --> 00:35:02.277
I just go onto Hinge and I'm like,

00:35:02.398 --> 00:35:04.219
I don't know, what's our insurance again?

00:35:04.318 --> 00:35:04.898
And I type it in.

00:35:05.378 --> 00:35:05.898
We got it.

00:35:06.099 --> 00:35:06.980
Same as Warby Parker.

00:35:07.000 --> 00:35:07.380
It's like,

00:35:07.400 --> 00:35:08.360
just take a picture of your

00:35:08.380 --> 00:35:09.561
prescription from your eye doctor.

00:35:09.802 --> 00:35:10.302
We got it.

00:35:10.362 --> 00:35:10.862
We got like,

00:35:10.882 --> 00:35:12.023
they understand the biggest

00:35:12.302 --> 00:35:13.503
initial pain point to

00:35:13.543 --> 00:35:15.644
getting that person to begin the process.

00:35:15.864 --> 00:35:16.664
You remove that barrier.

00:35:16.925 --> 00:35:18.065
I just wanted to quote is

00:35:18.126 --> 00:35:19.166
moving a thousand dollars

00:35:19.186 --> 00:35:20.226
or is it ten thousand dollars?

00:35:20.407 --> 00:35:21.407
If it's ten thousand dollars,

00:35:21.608 --> 00:35:22.168
I'm going to go pay my

00:35:22.248 --> 00:35:23.289
friends and rent a truck.

00:35:23.509 --> 00:35:26.451
If it's a thousand bucks, take my money.

00:35:27.010 --> 00:35:28.092
Yeah, I totally agree.

00:35:28.192 --> 00:35:28.692
I love that.

00:35:29.711 --> 00:35:30.291
You're right.

00:35:30.693 --> 00:35:32.853
It's there's people who want transaction.

00:35:32.873 --> 00:35:34.534
There's people who want relationship.

00:35:34.554 --> 00:35:36.695
But I think that we miss the

00:35:36.735 --> 00:35:38.936
people who initially want

00:35:38.976 --> 00:35:40.737
transactional because they

00:35:40.777 --> 00:35:41.697
don't know what it's like.

00:35:41.717 --> 00:35:42.476
They have no idea.

00:35:42.516 --> 00:35:43.637
They come in here and they

00:35:43.657 --> 00:35:45.579
have no idea what to expect.

00:35:46.119 --> 00:35:47.719
And so you can imagine like

00:35:48.280 --> 00:35:49.820
I always say this about massage therapy.

00:35:49.880 --> 00:35:50.380
I'm like, wait,

00:35:50.420 --> 00:35:51.880
you want me to go into a room,

00:35:52.081 --> 00:35:54.481
take off my clothes and lay

00:35:54.521 --> 00:35:55.722
on a table with somebody

00:35:55.762 --> 00:35:57.003
I've never met who I have

00:35:57.143 --> 00:35:58.864
no idea who they are, what you know.

00:35:59.364 --> 00:36:01.405
It's the most bizarre thing

00:36:01.764 --> 00:36:03.985
to most of my geriatric patients.

00:36:04.786 --> 00:36:05.346
Obviously,

00:36:05.405 --> 00:36:07.065
we have cultural sensitivities

00:36:07.106 --> 00:36:08.146
and all this other stuff.

00:36:10.126 --> 00:36:11.208
In physical therapy, I mean,

00:36:11.228 --> 00:36:12.068
there's plenty of physical

00:36:12.088 --> 00:36:13.027
therapists that expect

00:36:13.068 --> 00:36:14.009
patients to take off their

00:36:14.028 --> 00:36:15.969
shirt the first day they meet them.

00:36:16.789 --> 00:36:18.050
There's therapists who think,

00:36:18.130 --> 00:36:19.610
I'm going to touch you the

00:36:19.670 --> 00:36:21.690
first day I meet you.

00:36:21.891 --> 00:36:23.771
It completely skips so many

00:36:23.791 --> 00:36:24.972
steps in the process of

00:36:25.052 --> 00:36:26.413
building trust and building

00:36:26.432 --> 00:36:27.273
a relationship.

00:36:28.333 --> 00:36:29.755
Go ahead, Jimmy.

00:36:29.795 --> 00:36:31.436
You had just commented on a

00:36:31.476 --> 00:36:33.418
comment or a quote from Mark Cardula,

00:36:33.438 --> 00:36:34.518
which is the great question

00:36:34.539 --> 00:36:36.121
to ask at the end of a session, which is,

00:36:36.360 --> 00:36:37.702
have I met your expectations?

00:36:37.722 --> 00:36:40.224
It'd be also great to ask before.

00:36:40.244 --> 00:36:41.565
What are your expectations of today?

00:36:42.224 --> 00:36:43.927
I ask every single one of my patients,

00:36:43.947 --> 00:36:44.166
I'm like,

00:36:44.186 --> 00:36:46.528
so what are you expecting us to do today?

00:36:47.108 --> 00:36:50.152
What do you think we're going to achieve?

00:36:50.192 --> 00:36:51.413
What are you hoping to see?

00:36:51.934 --> 00:36:54.456
And every time it's, oh, I have no idea.

00:36:54.596 --> 00:36:55.896
I have no idea what to expect.

00:36:55.956 --> 00:36:57.659
My doctor just told me to come here.

00:36:58.760 --> 00:37:00.782
I am amazed anybody ever

00:37:01.001 --> 00:37:02.943
goes to physical therapy

00:37:02.963 --> 00:37:03.945
when their doctor tells

00:37:03.965 --> 00:37:05.186
them to go to physical therapy.

00:37:05.646 --> 00:37:07.786
So that's the population

00:37:07.806 --> 00:37:09.887
that I think we need a low barrier entry.

00:37:09.927 --> 00:37:12.188
We need less friction to Jimmy's point.

00:37:12.708 --> 00:37:13.427
It's free.

00:37:13.588 --> 00:37:14.349
It's easy.

00:37:14.429 --> 00:37:15.608
Let's give this a try.

00:37:16.068 --> 00:37:17.250
And then a small portion of

00:37:17.289 --> 00:37:19.289
them might go to the next phase,

00:37:19.349 --> 00:37:21.271
might build a relationship.

00:37:22.351 --> 00:37:24.152
But when we talk about that number,

00:37:24.251 --> 00:37:25.672
seven percent or whatever,

00:37:25.771 --> 00:37:26.873
people with low back pain

00:37:26.992 --> 00:37:28.253
actually go to therapy.

00:37:28.733 --> 00:37:30.313
I'm amazed it's that high.

00:37:30.713 --> 00:37:32.014
And interestingly enough,

00:37:32.054 --> 00:37:32.793
we don't even have enough

00:37:32.833 --> 00:37:34.394
therapists to serve that population.

00:37:34.414 --> 00:37:34.514
Right.

00:37:35.175 --> 00:37:39.280
So we need to offload this huge demand,

00:37:40.201 --> 00:37:42.262
and this is just one tool that can do it.

00:37:43.123 --> 00:37:44.105
I love this comment from Will,

00:37:44.224 --> 00:37:46.748
and it's not about physical therapy.

00:37:46.768 --> 00:37:48.429
It's about business, right?

00:37:49.250 --> 00:37:51.032
Will says what he loves

00:37:51.072 --> 00:37:52.094
about these competing or

00:37:52.153 --> 00:37:53.574
complementary ideas is that

00:37:53.594 --> 00:37:54.615
we can leverage tools for

00:37:54.655 --> 00:37:55.657
mass marketing to see what

00:37:55.717 --> 00:37:56.998
lands with more prospects.

00:37:57.398 --> 00:37:58.679
and see what gets them to take action.

00:37:59.000 --> 00:38:00.360
This is why I was in radio.

00:38:00.661 --> 00:38:01.481
There were three reasons

00:38:01.501 --> 00:38:02.461
people got into radio.

00:38:02.742 --> 00:38:05.224
You wanted to be famous, you loved music,

00:38:05.625 --> 00:38:07.726
or this, the science experiment,

00:38:07.766 --> 00:38:09.367
the social, live,

00:38:09.586 --> 00:38:11.208
real-time science experiment.

00:38:11.487 --> 00:38:12.289
I liked music.

00:38:12.548 --> 00:38:13.969
I didn't mind being in front of people,

00:38:14.010 --> 00:38:15.130
but this is what it was.

00:38:15.951 --> 00:38:17.231
I want therapists or

00:38:17.271 --> 00:38:17.952
everybody listening to

00:38:17.992 --> 00:38:19.534
understand you're in this business.

00:38:20.505 --> 00:38:21.827
You have to be in this business,

00:38:22.206 --> 00:38:23.228
which is sort of changing

00:38:23.248 --> 00:38:25.548
what you do and then using these tools,

00:38:25.608 --> 00:38:25.809
right?

00:38:25.869 --> 00:38:27.010
Hormozy said it the other day,

00:38:27.030 --> 00:38:27.911
I listen to it a lot.

00:38:28.231 --> 00:38:29.152
Whenever I get frustrated

00:38:29.172 --> 00:38:29.931
with anything I'm doing,

00:38:29.952 --> 00:38:31.233
there's three ways to reach people.

00:38:31.253 --> 00:38:33.054
You run ads to get in front of them,

00:38:33.293 --> 00:38:34.574
you create content to get

00:38:34.594 --> 00:38:35.074
in front of them,

00:38:35.215 --> 00:38:36.295
or you meet them one-on-one.

00:38:36.777 --> 00:38:38.257
Tony and I, just to throw in a plug,

00:38:38.277 --> 00:38:38.918
we're gonna be meeting

00:38:38.958 --> 00:38:40.998
people one-on-one at APTA's PPS,

00:38:41.039 --> 00:38:41.900
Private Practice Section

00:38:41.940 --> 00:38:43.061
Conference in a couple of weeks.

00:38:43.621 --> 00:38:44.260
While we're there,

00:38:44.280 --> 00:38:45.641
we're going to be recording

00:38:45.702 --> 00:38:46.523
content with them.

00:38:46.822 --> 00:38:48.503
So we're doing two birds in one stone.

00:38:48.923 --> 00:38:51.786
But I know you are altruistic.

00:38:51.885 --> 00:38:53.007
I know you want to help people.

00:38:53.226 --> 00:38:54.588
I don't even care what business you're in.

00:38:54.768 --> 00:38:55.789
I want you to understand

00:38:55.829 --> 00:38:56.708
what Will just said.

00:38:57.469 --> 00:38:59.331
You can have these ideas.

00:38:59.791 --> 00:39:00.731
This is what attracted me to

00:39:00.791 --> 00:39:02.932
Tony at first online,

00:39:04.034 --> 00:39:04.693
which was you were just

00:39:04.773 --> 00:39:06.155
doing stuff and you were like, hey,

00:39:06.195 --> 00:39:07.096
here's how it's going.

00:39:07.215 --> 00:39:07.755
It sucks.

00:39:07.795 --> 00:39:08.117
And I was like,

00:39:08.137 --> 00:39:09.157
look at somebody else

00:39:09.197 --> 00:39:10.038
showing that they took a

00:39:10.097 --> 00:39:11.639
leap and it didn't work.

00:39:12.693 --> 00:39:13.894
I just learned a lot from that.

00:39:13.994 --> 00:39:14.494
Hey, guess what?

00:39:14.514 --> 00:39:15.855
I'm not going to step in that pothole.

00:39:16.155 --> 00:39:17.155
But what did he learn from it?

00:39:17.215 --> 00:39:17.755
Hey, well, you know,

00:39:17.815 --> 00:39:18.856
ninety percent of it was a fail,

00:39:18.876 --> 00:39:20.016
but here was a happy accident.

00:39:20.356 --> 00:39:21.277
I want people to understand

00:39:21.297 --> 00:39:22.418
that as a therapist,

00:39:22.478 --> 00:39:24.659
you're in this business of trying,

00:39:25.280 --> 00:39:25.880
trying stuff.

00:39:26.019 --> 00:39:28.481
If you don't, when Medicare cuts things,

00:39:28.820 --> 00:39:29.902
you will cease to exist.

00:39:30.242 --> 00:39:31.001
All those clinics that are

00:39:31.021 --> 00:39:32.842
going out of business are not adaptable.

00:39:34.177 --> 00:39:35.478
So two things that came out

00:39:35.498 --> 00:39:37.840
of Dave's interview with Brian Williams.

00:39:37.880 --> 00:39:38.940
If you haven't watched it,

00:39:38.981 --> 00:39:40.262
go to the Dave Kittle show.

00:39:40.282 --> 00:39:40.822
It's a good one.

00:39:40.842 --> 00:39:42.664
Look for Hinge is Dead.

00:39:43.503 --> 00:39:45.105
It's an awesome, awesome interview.

00:39:45.144 --> 00:39:46.385
But two things that came up.

00:39:47.487 --> 00:39:49.827
I was shocked when Brian

00:39:49.867 --> 00:39:53.271
Williams said that if you

00:39:53.311 --> 00:39:54.592
just want exercise,

00:39:54.652 --> 00:39:55.992
go see a personal trainer.

00:39:56.052 --> 00:39:57.653
That blew my mind.

00:39:58.333 --> 00:40:00.076
Because the ultimate irony,

00:40:00.135 --> 00:40:01.637
and I guess this is what

00:40:01.697 --> 00:40:03.981
keeps the dynamic going, to me,

00:40:04.021 --> 00:40:04.961
the easiest thing in the

00:40:04.981 --> 00:40:06.043
world I can do is rub

00:40:06.083 --> 00:40:07.545
someone's back and make them feel better.

00:40:07.985 --> 00:40:09.666
The hardest thing I can do

00:40:10.108 --> 00:40:11.809
is use exercise to make

00:40:11.829 --> 00:40:13.271
them stronger and healthier

00:40:13.331 --> 00:40:14.253
and more resilient.

00:40:14.753 --> 00:40:16.153
And I feel like, you know,

00:40:16.733 --> 00:40:17.855
the difference between us

00:40:17.894 --> 00:40:19.614
and a personal trainer is

00:40:19.675 --> 00:40:22.257
that we absolutely have the

00:40:22.277 --> 00:40:23.177
depth of knowledge and

00:40:23.237 --> 00:40:25.077
understanding of physiology

00:40:25.137 --> 00:40:26.918
and psychology and emotions

00:40:26.978 --> 00:40:28.739
and endocrine system and

00:40:28.780 --> 00:40:30.400
all that stuff to use

00:40:31.081 --> 00:40:32.621
exercise as an effective tool.

00:40:33.382 --> 00:40:34.521
I was just blown away.

00:40:35.362 --> 00:40:36.764
What was your thought on that?

00:40:36.784 --> 00:40:38.463
Because I couldn't tell if you were like,

00:40:38.503 --> 00:40:38.744
yeah,

00:40:38.784 --> 00:40:41.045
personal trainers are better or whatever.

00:40:41.326 --> 00:40:41.826
What do you think?

00:40:44.597 --> 00:40:45.597
I agree with you, Tony.

00:40:46.038 --> 00:40:47.699
I would say like,

00:40:48.179 --> 00:40:49.559
especially our older

00:40:49.599 --> 00:40:51.338
geriatric population clientele,

00:40:51.378 --> 00:40:52.719
like they need mobility.

00:40:52.739 --> 00:40:53.579
They need movement.

00:40:53.599 --> 00:40:54.659
Some of our clientele,

00:40:54.679 --> 00:40:56.800
like they're scheduling us, you know,

00:40:56.940 --> 00:40:57.900
whatever times a week.

00:40:58.000 --> 00:40:58.300
And like,

00:40:58.360 --> 00:40:59.721
that might be like one of the

00:40:59.820 --> 00:41:01.081
only big times that day

00:41:01.101 --> 00:41:01.701
that they're actually

00:41:01.740 --> 00:41:02.981
moving other than to use

00:41:03.001 --> 00:41:04.101
the restroom in their apartment.

00:41:04.681 --> 00:41:06.041
So I agree with you, Tony.

00:41:06.101 --> 00:41:06.842
And I don't,

00:41:07.262 --> 00:41:09.382
I don't completely agree with

00:41:09.782 --> 00:41:12.023
Brian on that about movement exercise.

00:41:12.063 --> 00:41:13.103
And if they just want that,

00:41:13.963 --> 00:41:15.222
I agree with you, Tony,

00:41:15.242 --> 00:41:16.503
that that is a big

00:41:16.543 --> 00:41:18.744
challenge or hurdle for any

00:41:18.764 --> 00:41:20.605
physical therapist and for

00:41:20.664 --> 00:41:22.385
some for some clientele to

00:41:22.425 --> 00:41:23.804
be able to educate them and

00:41:23.945 --> 00:41:24.724
have them do it.

00:41:24.945 --> 00:41:25.746
And you're right.

00:41:25.806 --> 00:41:26.925
It is easier to just kind of

00:41:26.965 --> 00:41:27.965
rub their back and have

00:41:27.985 --> 00:41:28.985
them do something passive.

00:41:29.005 --> 00:41:29.806
So I do agree with that.

00:41:31.226 --> 00:41:31.367
Yeah.

00:41:31.567 --> 00:41:31.726
Yeah.

00:41:32.327 --> 00:41:33.146
Decide if that's a patient

00:41:33.186 --> 00:41:34.268
population you want to work with.

00:41:34.387 --> 00:41:35.768
I don't think I understood how little.

00:41:36.675 --> 00:41:37.996
some older adults move until

00:41:38.036 --> 00:41:39.637
some people close to me got

00:41:39.657 --> 00:41:40.237
a little older.

00:41:40.338 --> 00:41:41.157
I was like, wait a minute.

00:41:41.217 --> 00:41:43.219
Like that's all, you know, not that I ever,

00:41:43.960 --> 00:41:45.780
I always had a soft spot in my heart for,

00:41:46.101 --> 00:41:47.260
for physical therapists who

00:41:47.280 --> 00:41:48.222
work in geriatrics.

00:41:48.822 --> 00:41:50.483
I think my soft spot has

00:41:50.543 --> 00:41:51.623
only grown and my

00:41:52.003 --> 00:41:52.943
understanding of their

00:41:52.983 --> 00:41:55.664
importance has only gone way, way, way,

00:41:55.786 --> 00:41:56.306
way up.

00:41:57.827 --> 00:41:58.668
But it's hard to communicate

00:41:58.688 --> 00:41:59.349
that when you're sitting in

00:41:59.389 --> 00:42:00.349
class in PT school,

00:42:00.730 --> 00:42:01.231
especially when you're

00:42:01.271 --> 00:42:02.311
twenty five and you're

00:42:02.331 --> 00:42:04.213
about to go bang out a CrossFit workout.

00:42:04.253 --> 00:42:05.655
You're like, yeah, old people.

00:42:06.175 --> 00:42:07.117
But understanding what that

00:42:07.177 --> 00:42:10.380
value is and how much how

00:42:10.400 --> 00:42:11.402
much either that person

00:42:11.541 --> 00:42:13.123
would pay for it or I want

00:42:13.143 --> 00:42:13.784
to say pay for it,

00:42:13.804 --> 00:42:14.385
but pay for it in their

00:42:14.425 --> 00:42:15.266
time and their investment

00:42:15.626 --> 00:42:16.807
or how much that family,

00:42:16.907 --> 00:42:18.469
that person's family would be like.

00:42:18.769 --> 00:42:20.190
Yes, get them moving.

00:42:20.251 --> 00:42:21.211
Please, please, please.

00:42:21.532 --> 00:42:23.413
I'm seeing everything decline physically,

00:42:23.893 --> 00:42:25.014
mentally, emotionally.

00:42:25.054 --> 00:42:26.394
These other two decline as

00:42:26.434 --> 00:42:27.516
that person stops moving.

00:42:27.536 --> 00:42:29.317
It's not good.

00:42:29.356 --> 00:42:30.398
The other part of your

00:42:30.458 --> 00:42:31.358
interview that I thought

00:42:31.378 --> 00:42:33.440
was so interesting was you

00:42:33.480 --> 00:42:34.860
guys looked at the move

00:42:34.900 --> 00:42:37.483
that Hinge was making from all digital,

00:42:37.643 --> 00:42:39.963
all online to in person as digital.

00:42:40.918 --> 00:42:42.900
basically as, oh, they're failing,

00:42:42.981 --> 00:42:44.242
this is proof, you know,

00:42:44.282 --> 00:42:45.443
the model doesn't work.

00:42:46.804 --> 00:42:48.565
But I didn't see it that way.

00:42:48.885 --> 00:42:50.186
From my perspective,

00:42:50.786 --> 00:42:52.648
if I was starting a company today,

00:42:52.688 --> 00:42:53.148
I'm like,

00:42:53.530 --> 00:42:55.670
especially at a venture backed size,

00:42:55.731 --> 00:42:57.273
and now that I understand

00:42:57.313 --> 00:42:58.574
that world a little bit better,

00:42:59.152 --> 00:42:59.552
I'm like,

00:42:59.813 --> 00:43:01.793
I can't grow a billion dollar

00:43:01.853 --> 00:43:04.695
company on the back of a human therapist.

00:43:04.835 --> 00:43:06.096
It's never gonna happen.

00:43:06.496 --> 00:43:07.976
It's not scalable enough.

00:43:08.496 --> 00:43:10.137
So what I need to do is I

00:43:10.157 --> 00:43:11.358
would start digital,

00:43:11.978 --> 00:43:15.099
grow as much as I could digital,

00:43:15.739 --> 00:43:17.000
and then I could start to

00:43:17.059 --> 00:43:19.081
roll in the human aspect to

00:43:19.201 --> 00:43:22.061
it because people understand humans,

00:43:22.121 --> 00:43:23.682
people understand services,

00:43:23.722 --> 00:43:24.744
people understand that a

00:43:24.824 --> 00:43:25.623
little bit easier.

00:43:26.280 --> 00:43:27.722
But I think the reason why

00:43:27.762 --> 00:43:29.262
they brought the human side

00:43:29.302 --> 00:43:31.565
to it is because, yeah,

00:43:31.585 --> 00:43:32.847
they want to improve kind

00:43:32.887 --> 00:43:33.628
of their background.

00:43:33.648 --> 00:43:35.090
They want to improve their image.

00:43:36.070 --> 00:43:37.492
People just understand, oh,

00:43:37.512 --> 00:43:38.574
therapy has always been

00:43:38.614 --> 00:43:39.695
delivered by a human.

00:43:40.295 --> 00:43:41.217
But I think it's more to

00:43:41.297 --> 00:43:43.338
support the digital side

00:43:43.418 --> 00:43:44.599
than it is because the

00:43:44.639 --> 00:43:46.583
digital side wasn't profitable enough.

00:43:47.262 --> 00:43:48.802
or wasn't successful enough.

00:43:49.543 --> 00:43:51.824
I just think you can't scale

00:43:51.943 --> 00:43:54.385
human services to a

00:43:54.465 --> 00:43:57.405
multiple billion dollar valuation.

00:43:57.425 --> 00:43:58.686
So you're saying, hold on a second.

00:43:58.726 --> 00:43:59.706
So let me see if I understand.

00:43:59.746 --> 00:44:01.927
So you're saying that this

00:44:02.007 --> 00:44:03.447
might have been in the plan all along,

00:44:03.527 --> 00:44:04.427
but you knew that the way

00:44:04.447 --> 00:44:05.688
to do it to scale is

00:44:05.748 --> 00:44:07.429
digital first and then the other way?

00:44:07.449 --> 00:44:08.409
Because I did, I mean,

00:44:08.489 --> 00:44:09.550
I did look at it like, hey,

00:44:09.570 --> 00:44:10.411
they tried something and

00:44:10.471 --> 00:44:11.090
now they're pivoting.

00:44:12.099 --> 00:44:12.858
Yeah,

00:44:12.938 --> 00:44:14.780
I think it's like Elon Musk and Tesla.

00:44:14.820 --> 00:44:16.581
They went super high end,

00:44:16.721 --> 00:44:17.860
really expensive.

00:44:18.380 --> 00:44:19.362
And then they started to

00:44:19.402 --> 00:44:20.581
bring the price down.

00:44:21.342 --> 00:44:23.063
I think these guys probably

00:44:23.103 --> 00:44:25.684
knew we can't grow to that size.

00:44:26.184 --> 00:44:27.545
We can't access enough

00:44:27.585 --> 00:44:29.726
capacity in human therapists.

00:44:30.346 --> 00:44:31.646
So how can we grow to a

00:44:31.706 --> 00:44:33.126
billion dollars fast?

00:44:33.945 --> 00:44:34.786
Just do it all digital.

00:44:34.947 --> 00:44:35.628
Do it with an app.

00:44:35.728 --> 00:44:36.829
And then work backwards and

00:44:36.849 --> 00:44:38.072
then come backwards to the

00:44:38.092 --> 00:44:39.394
model that you know already works.

00:44:39.454 --> 00:44:40.275
Instead of competing with

00:44:40.297 --> 00:44:42.940
everybody else in a crowded market, Dave,

00:44:42.981 --> 00:44:44.583
you're going to injure your neck.

00:44:44.603 --> 00:44:45.545
You're shaking your head so much.

00:44:48.012 --> 00:44:48.271
Yes.

00:44:48.351 --> 00:44:51.034
So, I mean, I'm against Hinge Health.

00:44:51.974 --> 00:44:53.817
Fine with mentioning it again.

00:44:54.657 --> 00:44:54.836
Okay.

00:44:54.856 --> 00:44:55.358
So real quick,

00:44:55.418 --> 00:44:56.778
if people don't know Hinge Health,

00:44:57.239 --> 00:44:58.539
they sell this benefit,

00:44:58.559 --> 00:45:00.882
this employee benefit to employers.

00:45:01.141 --> 00:45:02.923
So Tony talks about all the time,

00:45:02.963 --> 00:45:03.824
like who's your customer.

00:45:03.864 --> 00:45:04.625
So for Hinge Health,

00:45:04.965 --> 00:45:06.987
their customer is either an

00:45:07.027 --> 00:45:08.788
insurance plan or it's a

00:45:08.847 --> 00:45:10.148
direct to employer plan.

00:45:10.190 --> 00:45:11.349
So they might have insurance

00:45:11.389 --> 00:45:13.012
companies that are the customer.

00:45:13.032 --> 00:45:14.592
They also definitely have insurance.

00:45:14.733 --> 00:45:19.340
The employer funded plans

00:45:20.282 --> 00:45:22.146
and they're talking right to the employer,

00:45:22.646 --> 00:45:22.867
right?

00:45:22.907 --> 00:45:24.128
So then the actual...

00:45:25.123 --> 00:45:25.762
employee,

00:45:26.083 --> 00:45:27.525
the actual quote unquote patient

00:45:27.545 --> 00:45:29.025
or client is then not

00:45:29.065 --> 00:45:29.686
really the customer.

00:45:29.726 --> 00:45:30.166
But anyway,

00:45:30.666 --> 00:45:31.987
the employees get this for free.

00:45:32.027 --> 00:45:32.228
Guys,

00:45:32.248 --> 00:45:33.688
we've talked about it numerous times

00:45:33.708 --> 00:45:34.128
on the show.

00:45:34.148 --> 00:45:36.150
When something is typically for free,

00:45:36.570 --> 00:45:37.530
it's not really,

00:45:38.311 --> 00:45:40.112
it's not really taken all that seriously.

00:45:40.193 --> 00:45:41.713
It doesn't appear valuable.

00:45:42.014 --> 00:45:42.813
It doesn't appear like

00:45:42.853 --> 00:45:46.036
something is all that meaningful.

00:45:46.456 --> 00:45:49.038
So yes, yes, they are VC backed.

00:45:49.438 --> 00:45:51.820
They are, they're a tech company also,

00:45:51.840 --> 00:45:52.219
by the way.

00:45:52.561 --> 00:45:53.981
So Hinch Health is a tech company.

00:45:54.898 --> 00:45:57.360
them pivoting into in-home

00:45:57.719 --> 00:45:59.581
physical therapy visits is

00:45:59.880 --> 00:46:02.563
absolutely a pivot and more

00:46:02.603 --> 00:46:05.585
so probably some grasp at

00:46:05.625 --> 00:46:06.724
some cash and profits

00:46:06.764 --> 00:46:08.547
because I believe their

00:46:08.567 --> 00:46:10.887
core technology does not really work.

00:46:10.947 --> 00:46:12.409
And what I mean by that is

00:46:13.009 --> 00:46:14.389
if these patients or

00:46:14.409 --> 00:46:16.692
clients were no longer employees of

00:46:17.411 --> 00:46:20.876
The Walmarts, the Cargill, the Facebook,

00:46:21.056 --> 00:46:21.996
whatever the big companies

00:46:22.097 --> 00:46:23.579
are where they get this for free.

00:46:24.239 --> 00:46:26.081
If that employee leaves that company,

00:46:26.201 --> 00:46:26.981
now they no longer get

00:46:27.001 --> 00:46:27.782
Hinge Health for free.

00:46:28.403 --> 00:46:30.005
And Hinge Health emails them and says, hey,

00:46:30.025 --> 00:46:31.025
this is ten dollars a month.

00:46:31.045 --> 00:46:31.987
This is twenty dollars a month.

00:46:32.007 --> 00:46:32.907
This is one hundred dollars a month,

00:46:32.927 --> 00:46:34.088
whatever for virtual whatever.

00:46:35.179 --> 00:46:36.780
a significantly small

00:46:36.860 --> 00:46:38.001
percentage of people are

00:46:38.021 --> 00:46:40.181
gonna pay out of pocket for Hinge Health,

00:46:40.221 --> 00:46:40.780
the consumer,

00:46:40.820 --> 00:46:42.161
the actual consumer that is

00:46:42.242 --> 00:46:44.621
paying their own hard earned dollars.

00:46:45.483 --> 00:46:47.083
That is why they pivoted to

00:46:47.422 --> 00:46:49.083
in-person visits,

00:46:49.264 --> 00:46:51.204
in-person physical therapy, house calls,

00:46:52.103 --> 00:46:53.224
because the core technology

00:46:53.425 --> 00:46:54.164
does not really work.

00:46:54.485 --> 00:46:57.085
The end consumer doesn't find value in it,

00:46:57.126 --> 00:46:59.186
that's why.

00:46:59.206 --> 00:47:00.327
Jimmy, you got any thoughts?

00:47:02.898 --> 00:47:03.579
Yeah, I mean,

00:47:03.679 --> 00:47:04.679
I would be nervous about that.

00:47:04.739 --> 00:47:05.239
It's hard.

00:47:05.760 --> 00:47:05.900
Like,

00:47:05.960 --> 00:47:07.422
I see why they went the route they did,

00:47:07.443 --> 00:47:10.284
because it's easier to get, you know,

00:47:10.346 --> 00:47:11.746
fifteen hundred companies

00:47:11.786 --> 00:47:12.947
to say yes to something

00:47:12.967 --> 00:47:13.969
than it is to get fifteen

00:47:14.068 --> 00:47:15.650
million or even fifteen

00:47:15.690 --> 00:47:17.492
thousand individuals to pay

00:47:17.532 --> 00:47:19.153
ten thousand ten dollars a month.

00:47:19.875 --> 00:47:20.835
So I see where like,

00:47:21.356 --> 00:47:22.737
so it's B to B versus B to

00:47:23.057 --> 00:47:24.458
C. B to B is like, hey,

00:47:24.498 --> 00:47:25.719
here's a way to save twenty

00:47:25.739 --> 00:47:28.362
percent on your self insured.

00:47:28.382 --> 00:47:29.222
Here's a way to do this.

00:47:29.262 --> 00:47:30.182
And it's a delivery method.

00:47:30.222 --> 00:47:30.483
And hey,

00:47:30.523 --> 00:47:31.885
we're we're going to do the messy

00:47:31.905 --> 00:47:33.505
work for you if they use it.

00:47:33.646 --> 00:47:34.065
Great.

00:47:34.146 --> 00:47:35.748
And if they don't, also great.

00:47:37.009 --> 00:47:38.148
So I see why that's a value.

00:47:38.469 --> 00:47:39.469
I do think it goes back to

00:47:39.510 --> 00:47:40.130
Will Boyd's point,

00:47:40.150 --> 00:47:41.411
which is like test it and

00:47:41.452 --> 00:47:41.992
see what it works.

00:47:42.052 --> 00:47:43.032
I feel like everybody in our

00:47:43.072 --> 00:47:43.954
profession should be paying

00:47:43.994 --> 00:47:46.775
attention to these models and seeing like,

00:47:47.135 --> 00:47:48.277
hey,

00:47:48.416 --> 00:47:50.338
are we as valuable as we think we are?

00:47:50.358 --> 00:47:50.498
Sorry,

00:47:50.539 --> 00:47:52.460
is the perceived value of what we do

00:47:53.601 --> 00:47:55.722
in this method as valuable

00:47:55.762 --> 00:47:56.463
as we think it is?

00:47:56.523 --> 00:47:56.983
I mean,

00:47:57.003 --> 00:47:58.204
there are practitioners who are

00:47:58.224 --> 00:48:00.106
completely telehealth right now, right?

00:48:00.126 --> 00:48:00.706
But they're able to

00:48:00.766 --> 00:48:03.027
understand like what the process is.

00:48:03.047 --> 00:48:05.150
They're in a marketing department.

00:48:06.501 --> 00:48:07.443
How many can you name that

00:48:07.503 --> 00:48:08.184
are a hundred percent

00:48:08.224 --> 00:48:09.585
telehealth that are a physical therapist?

00:48:09.625 --> 00:48:10.246
How many can you name?

00:48:10.786 --> 00:48:11.487
Oh, I don't know.

00:48:11.547 --> 00:48:13.228
Five.

00:48:13.248 --> 00:48:13.449
That are,

00:48:13.469 --> 00:48:14.951
that are making a full-time living on it.

00:48:14.971 --> 00:48:15.690
I don't know.

00:48:15.711 --> 00:48:16.552
Cause there's not that many.

00:48:17.313 --> 00:48:17.994
There's not that many.

00:48:18.454 --> 00:48:19.635
And now we're, now we're out of COVID.

00:48:19.675 --> 00:48:21.838
I have some, I have some quotes.

00:48:21.958 --> 00:48:22.818
Can I give you guys a quote

00:48:22.838 --> 00:48:23.659
from a colleague that has a

00:48:23.699 --> 00:48:24.340
couple of clinics?

00:48:24.840 --> 00:48:24.981
Yeah.

00:48:25.001 --> 00:48:25.101
Yeah.

00:48:25.161 --> 00:48:25.320
Yeah.

00:48:27.130 --> 00:48:28.911
All right, so Ben Boggy,

00:48:29.371 --> 00:48:30.253
I asked his approval.

00:48:30.313 --> 00:48:30.813
He said yes.

00:48:31.733 --> 00:48:32.293
I could quote him.

00:48:32.755 --> 00:48:34.775
So Ben Boggy, cash practice.

00:48:34.896 --> 00:48:36.518
He's got a practice in San Diego,

00:48:37.217 --> 00:48:39.119
Des Moines, Iowa, and Oakland.

00:48:39.500 --> 00:48:41.240
So two different states.

00:48:41.762 --> 00:48:42.963
This is the same thing with Ron Miller,

00:48:43.003 --> 00:48:44.083
by the way, in Orlando, Florida.

00:48:44.103 --> 00:48:44.884
But Ben Boggy,

00:48:45.103 --> 00:48:45.945
I asked him last night

00:48:45.965 --> 00:48:48.286
because we were going to tee this up.

00:48:48.766 --> 00:48:50.228
So I asked him about telehealth,

00:48:50.268 --> 00:48:51.829
virtual visits, video visits, all that.

00:48:53.277 --> 00:48:55.117
And he says that they still offer it,

00:48:55.619 --> 00:48:57.019
but it's only a handful of

00:48:57.059 --> 00:48:57.880
visits each month.

00:48:57.960 --> 00:48:59.260
And it's usually when someone,

00:48:59.280 --> 00:48:59.981
one of their patients or

00:49:00.001 --> 00:49:01.063
clients is traveling.

00:49:01.782 --> 00:49:03.324
Ben said that they don't advertise it.

00:49:03.344 --> 00:49:04.105
They don't promote it

00:49:04.644 --> 00:49:07.646
because his PTs don't enjoy it.

00:49:07.686 --> 00:49:08.447
They don't enjoy the

00:49:08.467 --> 00:49:10.648
telehealth video visits to deliver them.

00:49:10.949 --> 00:49:11.550
That's what he said.

00:49:11.989 --> 00:49:13.150
And then also it seems to be

00:49:13.190 --> 00:49:14.112
quite a bit of friction

00:49:14.172 --> 00:49:16.353
from patients anyways.

00:49:17.134 --> 00:49:19.155
So, and then Ron Miller and my practice,

00:49:19.617 --> 00:49:20.217
cash practices,

00:49:21.038 --> 00:49:22.780
no one is calling in asking

00:49:22.800 --> 00:49:23.840
for video visits anymore.

00:49:23.981 --> 00:49:25.443
No one's, at least us.

00:49:25.483 --> 00:49:25.603
Now,

00:49:26.023 --> 00:49:27.485
I'm trying to just give some anecdotal,

00:49:28.304 --> 00:49:30.608
you know, points of view, but...

00:49:32.248 --> 00:49:32.568
And again,

00:49:32.967 --> 00:49:35.128
I know my only caveat is

00:49:35.628 --> 00:49:37.329
sometimes I'm like, is Tony right?

00:49:38.349 --> 00:49:40.411
Is there a critical mass of

00:49:40.431 --> 00:49:42.251
people that don't want manual therapy,

00:49:42.492 --> 00:49:43.851
that don't want to have

00:49:43.952 --> 00:49:44.952
in-person anything?

00:49:45.913 --> 00:49:46.552
I think Tony is

00:49:46.652 --> 00:49:48.393
overestimating that population of people.

00:49:48.494 --> 00:49:49.293
I think it's lower.

00:49:49.634 --> 00:49:51.153
Maybe it's somewhere in between.

00:49:51.755 --> 00:49:52.375
But in general...

00:49:54.068 --> 00:49:54.849
There's not many physical

00:49:54.869 --> 00:49:57.492
therapists making eighty, ninety,

00:49:57.512 --> 00:49:59.313
a hundred K a year doing

00:49:59.452 --> 00:50:00.853
all one hundred percent video visits.

00:50:01.474 --> 00:50:02.335
But let me let me let me

00:50:02.394 --> 00:50:03.675
pair these two things together.

00:50:03.916 --> 00:50:04.797
Where do you think this will

00:50:04.817 --> 00:50:06.438
be to five and ten years from now?

00:50:07.157 --> 00:50:07.719
It will not change.

00:50:08.039 --> 00:50:08.599
It will not change.

00:50:08.820 --> 00:50:09.340
You don't think that

00:50:09.380 --> 00:50:10.481
generations and what people

00:50:10.521 --> 00:50:12.601
value changes over time to

00:50:12.702 --> 00:50:14.543
five years is a long time, right?

00:50:14.583 --> 00:50:16.364
Like different generation

00:50:16.425 --> 00:50:17.244
moves into the middle of

00:50:17.266 --> 00:50:20.047
that bell curve over time.

00:50:20.487 --> 00:50:20.748
I don't.

00:50:22.112 --> 00:50:23.052
I think it'll change.

00:50:23.271 --> 00:50:25.034
I think you're asking a fish

00:50:25.134 --> 00:50:26.394
how the air smells.

00:50:27.135 --> 00:50:29.157
I just you cannot take a

00:50:29.237 --> 00:50:31.219
therapist who has been

00:50:31.318 --> 00:50:33.079
raised in a culture of

00:50:33.179 --> 00:50:35.382
being in person and try to

00:50:35.422 --> 00:50:36.603
throw them online.

00:50:37.023 --> 00:50:39.284
Like we have to look outside

00:50:39.304 --> 00:50:39.923
the profession.

00:50:39.943 --> 00:50:41.164
We have to look at examples

00:50:41.184 --> 00:50:43.105
that exist in other industries,

00:50:43.244 --> 00:50:43.945
other things.

00:50:45.364 --> 00:50:46.126
Absolutely.

00:50:46.226 --> 00:50:47.885
I think there is going to be

00:50:48.425 --> 00:50:51.786
a major shift toward, you know,

00:50:52.146 --> 00:50:53.568
accessing this capacity of

00:50:53.708 --> 00:50:55.568
people who do not want to

00:50:55.628 --> 00:50:57.128
go to a therapy clinic,

00:50:57.608 --> 00:50:58.349
don't want to be in person.

00:50:58.748 --> 00:51:00.349
I'm shocked at the people in

00:51:00.389 --> 00:51:02.309
my clinic that are doing

00:51:02.369 --> 00:51:03.590
telehealth visits with

00:51:03.789 --> 00:51:05.070
physician specialists.

00:51:05.831 --> 00:51:06.612
every single day.

00:51:06.831 --> 00:51:08.393
People I would never imagine

00:51:09.032 --> 00:51:09.813
would be comfortable

00:51:09.853 --> 00:51:10.994
getting on a FaceTime or

00:51:11.054 --> 00:51:12.315
Zoom or whatever the doctor

00:51:12.335 --> 00:51:13.215
is doing with them.

00:51:15.117 --> 00:51:16.297
It's blowing my mind and

00:51:16.317 --> 00:51:18.599
it's making me rethink my own biases.

00:51:19.179 --> 00:51:21.460
But I just I think that it

00:51:21.500 --> 00:51:22.940
needs to start from the ground up.

00:51:23.041 --> 00:51:25.161
I think it needs to, you know,

00:51:25.181 --> 00:51:27.824
be something that in the school systems,

00:51:27.864 --> 00:51:29.105
the schools are teaching

00:51:29.664 --> 00:51:30.965
young people who have never

00:51:31.045 --> 00:51:32.847
known what physical therapy is that,

00:51:33.237 --> 00:51:34.737
This is one way to deliver

00:51:34.777 --> 00:51:37.920
these outcomes and these experiences.

00:51:38.340 --> 00:51:40.342
The customer and the healthcare provider,

00:51:40.722 --> 00:51:40.942
right?

00:51:41.021 --> 00:51:41.943
I mean,

00:51:42.003 --> 00:51:44.965
Google Glasses and the new Apple goggles,

00:51:46.385 --> 00:51:47.487
there's a phrase for that.

00:51:47.666 --> 00:51:49.907
The phrase is ahead of its time.

00:51:50.268 --> 00:51:51.648
It's not a bad idea.

00:51:52.130 --> 00:51:53.210
It's ahead of its time.

00:51:53.269 --> 00:51:54.030
It's like, hey, listen,

00:51:54.431 --> 00:51:55.231
we're throwing this out

00:51:55.251 --> 00:51:56.152
there knowing this thing is

00:51:56.251 --> 00:51:57.052
not going to take off,

00:51:57.072 --> 00:51:57.572
but we're going to do it.

00:51:57.592 --> 00:51:59.474
This is market research for

00:51:59.554 --> 00:52:01.115
us in real time.

00:52:01.576 --> 00:52:03.237
across a real audience goes

00:52:03.277 --> 00:52:04.177
back to what will boyd was

00:52:04.197 --> 00:52:05.818
saying it's like you're in

00:52:05.898 --> 00:52:07.179
it for figuring out what

00:52:07.400 --> 00:52:09.021
what parts about it did you

00:52:09.061 --> 00:52:10.161
think people would like and

00:52:10.181 --> 00:52:11.081
what parts about them do

00:52:11.101 --> 00:52:12.003
they actually like or do

00:52:12.023 --> 00:52:13.264
they actually gravitate to

00:52:13.804 --> 00:52:14.744
you can't get to that by

00:52:14.784 --> 00:52:16.025
guessing and thinking I

00:52:16.045 --> 00:52:16.786
think it will change I

00:52:16.806 --> 00:52:17.427
think it'll be a while

00:52:17.947 --> 00:52:19.967
And if you go back again, who,

00:52:20.047 --> 00:52:20.949
fifty years ago,

00:52:20.969 --> 00:52:22.809
would think you would just

00:52:22.889 --> 00:52:24.650
rent a random stranger a

00:52:24.670 --> 00:52:26.032
room in your house or rent

00:52:26.052 --> 00:52:28.813
your whole house or would go, you know,

00:52:28.873 --> 00:52:29.954
and pick somebody up from

00:52:29.994 --> 00:52:31.394
the bars on Friday night

00:52:31.474 --> 00:52:32.996
who you've never met when

00:52:33.016 --> 00:52:34.157
you're not a taxi cab

00:52:34.217 --> 00:52:35.436
driver with a medallion.

00:52:35.978 --> 00:52:37.998
Like, technology is going to change.

00:52:38.099 --> 00:52:39.679
Experiences are going to change.

00:52:39.760 --> 00:52:41.820
People's expectations are going to change.

00:52:43.222 --> 00:52:44.603
I think we're going to see it.

00:52:45.063 --> 00:52:46.266
I don't think it's all or nothing, though.

00:52:46.286 --> 00:52:47.489
I don't think it's people will never,

00:52:47.528 --> 00:52:47.951
right, Dave?

00:52:50.503 --> 00:52:51.764
I was just, yeah, I mean,

00:52:51.784 --> 00:52:52.565
it's not all or nothing.

00:52:52.684 --> 00:52:53.925
Yes, it might shift over time,

00:52:53.945 --> 00:52:56.288
but the example, now one thing, again,

00:52:56.327 --> 00:52:58.588
Tony always provides great rebuttal.

00:52:58.628 --> 00:53:00.271
So the fact that we didn't

00:53:00.291 --> 00:53:02.432
have DPT students learn this,

00:53:02.632 --> 00:53:03.753
it wasn't a track in school,

00:53:04.153 --> 00:53:06.054
it wasn't a class or a course in school.

00:53:06.936 --> 00:53:07.836
That is a great point.

00:53:08.036 --> 00:53:10.018
Like if you install that,

00:53:10.099 --> 00:53:12.621
like then in five, six, seven, ten years,

00:53:12.661 --> 00:53:14.242
whatever, those physical therapists,

00:53:14.262 --> 00:53:14.581
you're right,

00:53:14.661 --> 00:53:15.702
maybe they will be better

00:53:15.742 --> 00:53:17.063
equipped than we are right

00:53:17.103 --> 00:53:18.806
now to deliver a video visit.

00:53:19.445 --> 00:53:20.688
Let's put that aside for a second.

00:53:20.889 --> 00:53:22.393
The example of Dr. Ben Boggy,

00:53:22.432 --> 00:53:23.574
so Prokinetics PT,

00:53:23.594 --> 00:53:24.717
they have three locations.

00:53:25.628 --> 00:53:27.391
All their marketing, their website,

00:53:27.411 --> 00:53:28.210
their communication,

00:53:28.331 --> 00:53:31.373
their ideal clientele, active clientele,

00:53:31.594 --> 00:53:33.576
active patients, active adults,

00:53:34.056 --> 00:53:34.777
and CrossFitters.

00:53:35.297 --> 00:53:35.938
They run ads.

00:53:36.237 --> 00:53:36.878
They say, hey,

00:53:36.918 --> 00:53:38.239
if you're an active adult and CrossFitter,

00:53:38.820 --> 00:53:39.780
and even he just said,

00:53:40.402 --> 00:53:42.583
and I got his approval for that statement,

00:53:43.123 --> 00:53:43.664
even him,

00:53:43.925 --> 00:53:45.085
where they're active adults and

00:53:45.106 --> 00:53:45.706
CrossFitters,

00:53:46.186 --> 00:53:47.447
and he said a small percentage,

00:53:47.648 --> 00:53:50.329
a few visits per month are virtual.

00:53:50.731 --> 00:53:51.952
Now, again, to Tony's point,

00:53:52.652 --> 00:53:54.114
Were all his DPTs trained in

00:53:54.273 --> 00:53:55.375
telehealth visits and how

00:53:55.414 --> 00:53:56.856
to do that during clinical rotations?

00:53:56.916 --> 00:53:57.135
No.

00:53:57.476 --> 00:53:58.797
Was it in the coursework of

00:53:58.838 --> 00:53:59.679
the DPT program?

00:53:59.778 --> 00:53:59.978
No.

00:54:00.099 --> 00:54:00.699
Great point.

00:54:01.119 --> 00:54:01.960
I agree with you, Tony.

00:54:02.782 --> 00:54:04.023
But currently right now,

00:54:05.324 --> 00:54:08.447
he's an active population clientele.

00:54:09.206 --> 00:54:11.409
And even that clientele of patients,

00:54:11.869 --> 00:54:13.070
there's minimal demand.

00:54:13.351 --> 00:54:14.391
No one's coming and saying,

00:54:14.472 --> 00:54:15.032
do you have this?

00:54:15.072 --> 00:54:15.693
Do you offer this?

00:54:16.797 --> 00:54:17.739
Maybe you put on the website,

00:54:17.759 --> 00:54:19.478
maybe a few more people ask about it,

00:54:19.498 --> 00:54:19.858
whatever.

00:54:20.219 --> 00:54:21.699
I just don't think we're there right now.

00:54:22.059 --> 00:54:22.420
You're right.

00:54:22.541 --> 00:54:23.561
Five, ten years down the road,

00:54:24.101 --> 00:54:25.061
a lot of things could change.

00:54:25.461 --> 00:54:26.601
I don't think it's going to change.

00:54:26.681 --> 00:54:28.262
I think physical therapy is

00:54:28.322 --> 00:54:28.983
always going to have some

00:54:29.143 --> 00:54:31.244
physical in-person component.

00:54:32.164 --> 00:54:33.224
But there we go.

00:54:33.244 --> 00:54:35.266
Jeremy Sutton down in Louisiana.

00:54:35.306 --> 00:54:36.367
Hashtag Team Dave.

00:54:36.407 --> 00:54:37.007
Here we go, baby.

00:54:38.413 --> 00:54:38.893
Real quick,

00:54:38.934 --> 00:54:41.556
just going back to a point that

00:54:41.596 --> 00:54:43.297
you made that I also agree with.

00:54:44.139 --> 00:54:45.480
I agree that if you take

00:54:45.519 --> 00:54:47.202
something like Hinge out of

00:54:47.242 --> 00:54:49.965
the employer-funded benefit

00:54:49.985 --> 00:54:52.226
package and you just offer

00:54:52.266 --> 00:54:54.128
it for sale direct to the consumer,

00:54:54.989 --> 00:54:55.831
I don't know how many of

00:54:55.911 --> 00:54:57.411
those people that were

00:54:57.431 --> 00:54:58.514
getting it for free would

00:54:58.574 --> 00:54:59.795
all of a sudden say, yeah,

00:54:59.914 --> 00:55:01.396
I would pay ten bucks a month for that.

00:55:02.099 --> 00:55:02.958
I don't think it would happen.

00:55:03.059 --> 00:55:04.719
But to your point,

00:55:05.460 --> 00:55:07.581
what is the problem that they're solving?

00:55:07.960 --> 00:55:09.802
And I think we get a little

00:55:09.842 --> 00:55:10.762
too short-sighted.

00:55:10.842 --> 00:55:12.402
I hear therapists all the time.

00:55:12.443 --> 00:55:14.043
They're like, yeah, but we save money.

00:55:14.103 --> 00:55:15.543
And if they go to therapy,

00:55:15.583 --> 00:55:16.565
they avoid surgery.

00:55:16.605 --> 00:55:18.045
And I always ask the question, I'm like,

00:55:18.405 --> 00:55:19.025
for how long?

00:55:19.226 --> 00:55:20.985
How long do they avoid surgery?

00:55:21.005 --> 00:55:22.726
Because I get to see a lot

00:55:22.907 --> 00:55:25.547
of people who come to therapy.

00:55:25.847 --> 00:55:27.148
They have back pain.

00:55:27.188 --> 00:55:28.289
They come to therapy.

00:55:28.349 --> 00:55:30.010
We make them feel better for a while.

00:55:30.489 --> 00:55:31.530
They get discharged.

00:55:31.570 --> 00:55:32.731
We think we're the heroes.

00:55:32.791 --> 00:55:33.911
We think we're amazing.

00:55:34.411 --> 00:55:35.690
And then five years later,

00:55:35.731 --> 00:55:37.552
this person comes back and

00:55:37.572 --> 00:55:38.612
they had two surgeries

00:55:38.692 --> 00:55:39.751
between the time that we

00:55:39.791 --> 00:55:41.313
discharged them and I'm

00:55:41.353 --> 00:55:42.333
seeing them today.

00:55:42.873 --> 00:55:44.333
And I'm like, what happened?

00:55:45.092 --> 00:55:46.414
And they were like, oh, it just got,

00:55:46.514 --> 00:55:47.393
you know, I felt better.

00:55:47.414 --> 00:55:48.494
And then I got worse.

00:55:48.514 --> 00:55:49.594
And then I had surgery.

00:55:50.054 --> 00:55:51.715
So from a payer's perspective,

00:55:51.755 --> 00:55:53.394
a third party payer, an insurance company,

00:55:53.414 --> 00:55:55.735
the therapist is short sighted and saying,

00:55:56.135 --> 00:55:56.356
yeah,

00:55:56.376 --> 00:55:58.376
but we help them avoid a fifty

00:55:58.396 --> 00:55:59.496
thousand dollar surgery.

00:56:00.217 --> 00:56:01.057
for a little bit,

00:56:01.498 --> 00:56:02.960
but not over the lifetime

00:56:03.039 --> 00:56:04.340
of that beneficiary for the

00:56:04.420 --> 00:56:05.202
insurance company.

00:56:05.262 --> 00:56:06.483
We have no idea what

00:56:06.523 --> 00:56:07.983
happened after we

00:56:08.023 --> 00:56:09.706
discharged them from our

00:56:09.766 --> 00:56:10.806
therapy services.

00:56:11.226 --> 00:56:12.969
And so I think with the employer,

00:56:13.329 --> 00:56:14.630
like why do insurance

00:56:14.650 --> 00:56:15.771
companies now require

00:56:15.831 --> 00:56:16.992
patients to go to therapy

00:56:17.032 --> 00:56:18.815
for six weeks before getting an MRI?

00:56:19.375 --> 00:56:20.476
Because they know that most

00:56:20.536 --> 00:56:22.559
things are going to resolve in six weeks.

00:56:22.599 --> 00:56:24.021
And then if they don't, okay,

00:56:24.041 --> 00:56:24.943
we'll do the MRI.

00:56:25.264 --> 00:56:26.846
It's not because therapy is

00:56:27.007 --> 00:56:29.210
necessarily helping, quote,

00:56:29.429 --> 00:56:30.492
solve the problem.

00:56:30.891 --> 00:56:32.114
We're giving them peace of mind.

00:56:32.153 --> 00:56:33.335
We're building confidence,

00:56:33.717 --> 00:56:34.858
making them a little healthier.

00:56:36.298 --> 00:56:38.119
I think the employer, it's the same thing.

00:56:38.179 --> 00:56:39.820
The employer is, okay,

00:56:39.880 --> 00:56:41.179
I'm going to bring Hinge in

00:56:41.541 --> 00:56:43.201
because it's going to be a distraction.

00:56:43.360 --> 00:56:44.561
It's going to buy me time.

00:56:44.641 --> 00:56:46.222
It's a less expensive,

00:56:46.322 --> 00:56:48.461
more affordable option to

00:56:48.601 --> 00:56:50.503
lower my overall cost.

00:56:51.143 --> 00:56:52.483
Might not be perfect for one

00:56:52.543 --> 00:56:53.503
individual person,

00:56:53.543 --> 00:56:55.643
but for a community of ten

00:56:55.684 --> 00:56:56.724
thousand employees,

00:56:57.204 --> 00:56:58.224
I'm probably going to save

00:56:58.284 --> 00:56:59.204
more money with Hinge.

00:56:59.639 --> 00:57:00.920
The question you also asked, too,

00:57:00.980 --> 00:57:02.581
is when I see people marketing,

00:57:03.603 --> 00:57:06.465
we help you avoid surgery, knee surgery.

00:57:06.505 --> 00:57:07.588
And knee surgery costs fifty

00:57:07.628 --> 00:57:08.389
thousand dollars.

00:57:09.068 --> 00:57:10.510
Doesn't cost me fifty thousand dollars.

00:57:10.530 --> 00:57:11.010
Yeah,

00:57:11.090 --> 00:57:12.333
you're you're you're highlighting

00:57:12.373 --> 00:57:13.853
what it saves my insurance company.

00:57:14.255 --> 00:57:14.735
No offense.

00:57:16.197 --> 00:57:17.557
I want them to spend fifty thousand.

00:57:17.637 --> 00:57:18.097
You know what?

00:57:18.277 --> 00:57:19.059
Ring them up, baby,

00:57:19.079 --> 00:57:20.000
because I feel like every

00:57:20.019 --> 00:57:21.280
time I look at my paycheck every month,

00:57:21.681 --> 00:57:22.981
there's there's money taken out.

00:57:23.563 --> 00:57:24.684
What you're what you've just

00:57:24.724 --> 00:57:25.523
highlighted is it doesn't

00:57:25.543 --> 00:57:26.764
cost you anything.

00:57:27.025 --> 00:57:28.306
Cost your insurance company something.

00:57:28.666 --> 00:57:29.527
So talking to people about

00:57:29.568 --> 00:57:30.487
what they actually value.

00:57:30.809 --> 00:57:31.469
This is hard.

00:57:31.708 --> 00:57:31.949
You know,

00:57:32.150 --> 00:57:33.090
there was a comment you made the

00:57:33.110 --> 00:57:36.333
other day, which is it, you know,

00:57:36.393 --> 00:57:37.934
the limitations of language.

00:57:38.695 --> 00:57:39.974
of what we actually provide

00:57:40.476 --> 00:57:41.936
is is difficult to convey

00:57:42.215 --> 00:57:43.436
right that's what makes uh

00:57:43.456 --> 00:57:44.277
this is why we have so many

00:57:44.317 --> 00:57:45.817
conversations about why

00:57:45.876 --> 00:57:47.396
maybe different products or

00:57:47.438 --> 00:57:49.737
services or professions do

00:57:49.858 --> 00:57:50.918
better and I'm using their

00:57:50.958 --> 00:57:52.559
quotes but it's difficult

00:57:52.659 --> 00:57:54.739
to actually uh communicate

00:57:54.760 --> 00:57:56.340
the full width and breadth

00:57:56.360 --> 00:57:57.679
because our profession is

00:57:57.719 --> 00:58:01.722
so wide and deep yeah are

00:58:01.742 --> 00:58:03.101
we getting ready for parting shots

00:58:03.498 --> 00:58:03.719
Yeah,

00:58:03.778 --> 00:58:06.460
let's do parting shots after we got Will.

00:58:06.481 --> 00:58:07.242
Will's saying he feels like

00:58:07.262 --> 00:58:09.262
if a small private practice

00:58:09.282 --> 00:58:10.264
tried to sell the commodity

00:58:10.304 --> 00:58:12.025
of PT versus selling the

00:58:12.045 --> 00:58:13.085
experience and status,

00:58:13.105 --> 00:58:14.266
it's going to be a race to the bottom.

00:58:15.027 --> 00:58:17.248
If you sell yourself as a commodity,

00:58:18.148 --> 00:58:18.829
you will lose.

00:58:19.269 --> 00:58:20.289
You're not going to lose tomorrow.

00:58:20.469 --> 00:58:21.510
You're not going to lose next week.

00:58:21.570 --> 00:58:23.072
But over time, when things shrink,

00:58:23.411 --> 00:58:23.913
you will.

00:58:24.293 --> 00:58:27.454
But if you build relations, stories,

00:58:27.494 --> 00:58:28.094
and magic,

00:58:28.195 --> 00:58:29.596
and that's what Seth Godin said, right?

00:58:29.615 --> 00:58:31.257
People don't buy products or services.

00:58:31.277 --> 00:58:33.278
They buy relations, stories, and magic.

00:58:34.159 --> 00:58:35.659
people will want to buy that.

00:58:35.681 --> 00:58:37.121
All right.

00:58:37.181 --> 00:58:37.681
Parting shots.

00:58:37.722 --> 00:58:38.121
What do you got?

00:58:39.623 --> 00:58:40.884
I, I wish party shot.

00:58:41.003 --> 00:58:42.644
I wish we could just be a

00:58:42.664 --> 00:58:43.425
hundred percent virtual.

00:58:43.445 --> 00:58:44.365
It'd be a lot easier on

00:58:44.465 --> 00:58:45.927
myself and my therapist.

00:58:46.527 --> 00:58:46.847
You know,

00:58:47.367 --> 00:58:48.728
no one is going to pay two hundred,

00:58:48.748 --> 00:58:49.670
three hundred, four hundred,

00:58:49.730 --> 00:58:50.429
five hundred dollars a

00:58:50.469 --> 00:58:51.530
visit for a virtual visit.

00:58:51.570 --> 00:58:53.012
Now, of course they might pay once,

00:58:53.833 --> 00:58:55.014
but we have some, you know,

00:58:55.034 --> 00:58:55.914
we have some clients paying

00:58:55.954 --> 00:58:56.655
two grand a week.

00:58:56.795 --> 00:58:58.076
Show me a virtual therapist.

00:58:58.096 --> 00:58:58.896
Let's make it two grand a

00:58:58.936 --> 00:59:00.998
week doing from one client.

00:59:02.298 --> 00:59:03.039
It's not happening.

00:59:03.679 --> 00:59:04.780
I wish it was like talk

00:59:04.800 --> 00:59:06.041
therapy where we could just

00:59:06.081 --> 00:59:06.902
do this virtually.

00:59:07.043 --> 00:59:08.724
I mean, yeah, and get the same outcomes.

00:59:08.764 --> 00:59:11.347
It would be great if we could.

00:59:11.427 --> 00:59:12.067
It's not the way I

00:59:12.126 --> 00:59:13.509
understand consumers right now.

00:59:14.168 --> 00:59:15.050
It is what it is.

00:59:15.570 --> 00:59:16.931
And that's our current business model.

00:59:16.952 --> 00:59:19.773
And yes, there's always room for us to...

00:59:21.012 --> 00:59:22.592
listen to folks like Tony Meritato,

00:59:22.632 --> 00:59:23.673
see what they're posting,

00:59:23.773 --> 00:59:24.934
see some of their insights,

00:59:25.014 --> 00:59:26.353
incorporate some of these insights,

00:59:26.855 --> 00:59:28.034
and maybe add some of this

00:59:28.074 --> 00:59:29.355
on the front end for, you know,

00:59:29.394 --> 00:59:30.456
consult or eval,

00:59:30.596 --> 00:59:31.615
or when they're traveling

00:59:31.655 --> 00:59:32.655
like Ben Boggy's doing,

00:59:32.795 --> 00:59:34.996
or somewhere in the continuum.

00:59:35.737 --> 00:59:37.876
I just, in five, ten years from now,

00:59:38.418 --> 00:59:40.038
virtual physical therapy

00:59:40.117 --> 00:59:41.557
will still be a very,

00:59:41.697 --> 00:59:43.239
very small percentage of

00:59:43.378 --> 00:59:44.378
overall visits or

00:59:44.418 --> 00:59:47.159
encounters between patient and provider.

00:59:48.409 --> 00:59:50.331
The internet never forgets.

00:59:50.371 --> 00:59:51.990
Go to the Dave Kittle show.

00:59:52.070 --> 00:59:53.351
Go watch the video.

00:59:53.452 --> 00:59:55.231
Brian Williams, Dave Kittle.

00:59:55.871 --> 00:59:57.313
We'll come back five years

00:59:57.373 --> 01:00:00.554
from now and we'll see what it says.

01:00:00.974 --> 01:00:01.733
That's your parting shot?

01:00:02.114 --> 01:00:03.213
That's it.

01:00:03.655 --> 01:00:05.715
Yeah.

01:00:06.335 --> 01:00:08.155
I think it's a yes and.

01:00:08.215 --> 01:00:09.536
People want hands on and

01:00:09.576 --> 01:00:11.336
hands off at different parts.

01:00:11.496 --> 01:00:12.817
It's probably not going to be all.

01:00:13.237 --> 01:00:14.978
I understood that hiring a moving company,

01:00:15.018 --> 01:00:15.777
I'm going to have to talk

01:00:15.797 --> 01:00:16.739
to some movers at some

01:00:16.759 --> 01:00:17.579
point and let them in.

01:00:18.458 --> 01:00:19.860
I just didn't want it at the beginning.

01:00:19.981 --> 01:00:21.143
Like I wanted three quotes

01:00:21.184 --> 01:00:22.485
and I wanted it in fifteen minutes.

01:00:22.505 --> 01:00:23.467
So if you give me that.

01:00:23.728 --> 01:00:24.228
But later on,

01:00:24.248 --> 01:00:25.110
maybe I wanted to know where

01:00:25.150 --> 01:00:26.711
my stuff was in transit.

01:00:26.992 --> 01:00:27.873
Do I have to call someone

01:00:27.893 --> 01:00:28.755
and explain my number?

01:00:29.016 --> 01:00:30.318
Or can I just click a link?

01:00:30.637 --> 01:00:31.719
So I think the answer is...

01:00:33.123 --> 01:00:34.603
what problem are you actually solving?

01:00:34.983 --> 01:00:36.224
And then how are you solving it?

01:00:36.244 --> 01:00:37.164
That's later, right?

01:00:37.284 --> 01:00:38.103
What problem?

01:00:38.423 --> 01:00:40.125
Why did I pick you over someone else?

01:00:40.184 --> 01:00:41.184
Not why you do it.

01:00:41.204 --> 01:00:42.425
That's important to you and

01:00:42.445 --> 01:00:43.626
your mission statement.

01:00:43.985 --> 01:00:45.485
But what problem are you actually solving?

01:00:45.505 --> 01:00:46.786
And then can you build

01:00:46.827 --> 01:00:47.987
different ways to solve it?

01:00:48.086 --> 01:00:49.047
If the answer is no,

01:00:49.387 --> 01:00:50.367
I'm going to pick someone else.

01:00:50.827 --> 01:00:51.847
We're back on Thursday.

01:00:52.027 --> 01:00:53.088
We'll start to talk about,

01:00:53.509 --> 01:00:55.168
I want to know who else is coming to PPS.

01:00:55.188 --> 01:00:56.208
I want to know who else is

01:00:56.248 --> 01:00:57.250
going to the actual conference.

01:00:57.269 --> 01:00:58.550
It's not a cheap conference.

01:00:59.110 --> 01:01:00.233
They raise their prices.

01:01:00.695 --> 01:01:01.739
People keep coming.

01:01:01.840 --> 01:01:02.802
So why are you doing that?

01:01:02.902 --> 01:01:03.927
Are you going to PPS?

01:01:04.208 --> 01:01:05.090
We'll see you on Thursday.