The AI Revolution in Physical Therapy Will Machines Outpace Humans?

WEBVTT

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Good morning, everyone.

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Tony Maritato here with Dave Kittle.

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We are missing Jimmy McKay.

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So there's no fancy intro, new music.

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We are jumping straight into it.

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And this is going to be a

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business topic heavy hour.

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So Jimmy or Jimmy, Dave,

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how are you doing?

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Tony, I'm feeling great.

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Good morning.

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Good morning.

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So I got a ton.

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What I did was I went into Google News.

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I just put in physical therapy.

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I started scrolling down

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through the headlines to

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see what I think would be

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interesting for us to talk about.

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Obviously,

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we want to focus on some business topics.

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I sent you a couple topics,

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but the one that kind of stood out to me,

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and I guess this isn't even

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really a business topic,

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but was the topic about residencies.

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So I know this is I'm

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looking for it on my screen.

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I know this is a promo press

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release from UCF,

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University of Central Florida.

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But they were talking about

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record number of DPT

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physical therapy students

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accepted into residencies.

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And I don't really think

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about that all that much,

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but it caught my eye.

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And it got me thinking, you know,

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my perspective, and maybe it is,

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I don't even know if I'm a boomer.

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I think I'm on, I think I'm Gen X. Yeah.

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Why?

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OK, we go for twelve years of, you know,

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school.

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Then we go into college,

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four years bachelor.

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Then we go into grad school,

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another three years.

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I'm like, cut the cord,

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get out of the womb.

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Let these people like be a

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human and gain experience.

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Now they're pushing for them

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to go into residency

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straight out of graduate school.

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I feel like, fine, if you want to do that,

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get ten years of experience.

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Get your hands dirty with real people.

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What do you think?

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Is this the direction we're going?

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Should we go this direction?

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No,

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I think it's just a cash grab from

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either these universities

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or maybe are they also

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other programs that are not universities?

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Like, I don't know, like, like, you know,

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you and I love Jeff more.

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But like,

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is PT on Ice doing a residency or

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or are all the residencies

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through a program,

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an actual school university

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that has a DBT program?

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I don't know.

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That's a good question.

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I don't even know.

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And my understanding was

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these are businesses that

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have developed residencies,

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maybe in partnership with universities.

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So they have some credentials behind it.

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Again,

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I'm not against continued education.

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I love education,

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but I feel like we've gone

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so far away from learning in real life.

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to learning in a classroom,

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learning in a protected environment.

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And the thing that cracked me up the most,

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I'm going to read a quote from this.

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It says, quote,

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residency training for

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physical therapists is the

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crucible where theory meets practice,

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forging experience through

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immersive learning and mentorship.

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No, it's not.

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Go in the clinic, get a job,

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start treating real people,

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go on your own, make mistakes.

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It is OK.

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And the quote goes on to say

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it's the transformative

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journey that hones skills,

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instills confidence,

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shapes compassionate caregivers,

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ensuring excellence in

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every step toward healing.

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I just think it's another crutch.

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I think people are just afraid.

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And I was there like I

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already owned a clinic.

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I was already seeing clients

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as a personal trainer,

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then transitioning to physical therapist.

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I know even at that point,

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I didn't feel like a

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competent therapist when I

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had graduated from the PT program.

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but you just go through it.

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You just learn, you research,

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you study on your own.

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Like you don't have to lean

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on somebody's shoulder for

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every single thing we do.

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What do you think?

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I agree.

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By the way,

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that quote was from who or where?

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Uh, so this is from the university.

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It's one of their representatives.

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Um, like a Catholic university.

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The fact that they said like crucible,

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I mean, it sounded like, you know,

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culty religious almost like, come on.

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And, you know, transformative, uh,

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the best, the best learning, like you said,

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and then you kind of hinted at it.

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If you didn't say directly,

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the best experience is

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experiential learning.

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Right.

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So it's like, that's why we do rotations.

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And I agree, listen, the first year or two,

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maybe even the first three years,

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like I w I didn't fully,

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I didn't fully get, I didn't fully get it,

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you know,

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with like treating patients and

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like you come out, maybe you have an ego.

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I had a DPT and then I had these like

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colleagues and mentors that

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had twenty or thirty years

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of experience over me and I

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know there was a little bit

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of uh kind of like um

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there was some type of mood around like,

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I come out, I have this DPT,

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but they have like decades of experience.

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And I just wanted to put that aside.

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And two of my mentors at that time,

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my first job, they were both CHTs,

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certified hand therapists.

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They were significantly way

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more experienced than I was.

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And I learned from treating

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their patients and looking

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at their exercise and their

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treatment flow sheet.

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Like what did they do with this patient?

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Okay,

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what did they do with the evaluation?

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What have they done since

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the last four or five visits?

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let's model some of that.

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Let's let,

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I'm going to now take this patient,

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their patient through some of this stuff,

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but like in my own kind of way,

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but I'm going to try to

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keep it consistent.

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I want some continuity of care.

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We don't need a residency.

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We don't need a fellowship.

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You're not going to get paid anymore.

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You're not going to get, as far as I know,

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you're probably not going

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to get any student loan

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reduction or relief.

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Scott said salaries don't

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increase and reimbursement

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doesn't change.

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I doubt patients care.

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Patients definitely don't care.

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Is the juice worth the squeeze?

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No, it's not.

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Well,

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and I just don't even think you're

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ready to get the full

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benefit of what a true

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residency would be.

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You know, it's like, again,

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my fifteen year old,

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we're practicing driving in

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the car like he is so green at driving.

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He just needs reps.

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He just needs experience.

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He needs time to see different situations.

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He will do much better in

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the future with experience.

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different kinds of coaching

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and training because now he

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can build on his own experience.

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And I go back to like, well,

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what the heck was the

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clinical internship all about?

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Like,

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why did we do these clinical rotations?

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That was the practical

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experience that gave you a

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chance to get in the mind

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of your CI and understand

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why they made those decisions.

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And one more thing to my understanding,

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when you go into a clinical residency,

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you're accepting a lower salary.

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You are getting paid,

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but you're getting paid less.

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And so it's like,

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when are we going to start

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earning a living?

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When are we going to get out

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there and just be adults?

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Scott also said,

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whatever happened to see one, do one,

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teach one.

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Yeah, I totally agree.

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I think the best learning is in real life.

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Let's hit another topic

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before we get into the ATI financials,

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because I think there is

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some interesting information in there.

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I'm going to put this up on the screen.

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So I saw this,

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which is always interesting.

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Let me see if I can scroll down here.

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So this was a case physical

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therapy clinic owner pleads

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guilty in health care fraud scheme.

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Now, I think it's interesting.

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It says physical therapy

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clinic owner pleads

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But then as I was reading the article,

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so it says, It said in here,

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this is the name of the place.

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I don't even know how you say that.

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Something Spine and Rehab.

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Somewhere in Hawaii.

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Yeah,

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I don't know if this he was a

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physical therapist,

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but he talks about

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submitting a number of claims for doctors,

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nurses and physical therapists.

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So I don't know what kind of

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practice this would have

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been that they were billing

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for doctors and nurses in

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addition to physical therapy.

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Falsely stating the the

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provided services were

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actually provided by

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unlicensed staff members.

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Officials added that the

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unlicensed staff members

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included physical therapists,

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athletic trainers and personal trainers.

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and some who had no

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professional certification whatsoever.

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Under the plea deal, Wells,

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he acknowledged his actions

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caused two hundred and

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fifty to five hundred and

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fifty thousand dollars.

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He agreed to also pay

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restitution of three

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hundred ninety two thousand dollars.

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So a common myth that I hear

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is therapists think they're too small,

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they're not gonna get in trouble.

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We know from generations of

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talking to practice owners that yeah,

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there's plenty of them

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delegating what they're

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billing as PT services to,

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aides and technicians.

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And I love aides and technicians.

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I started as one.

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The best therapists I know

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were aides and technicians

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before they became therapists.

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But you have to understand the rules.

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You have to understand we

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don't even use aides and

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technicians because I don't

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even want the possibility

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of being into that position,

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even though I think it

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delivers a better patient

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care experience.

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What are your thoughts on any of that?

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What's been your experience?

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I mean, we accept and bill some insurances,

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but obviously we're doing

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one-on-one home visits.

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So I don't know.

00:09:43.063 --> 00:09:44.245
What have you seen in real

00:09:44.284 --> 00:09:46.366
life in clinics historically?

00:09:46.427 --> 00:09:47.508
Like when you were a student,

00:09:47.567 --> 00:09:49.230
when you were coming up?

00:09:49.289 --> 00:09:49.470
Yeah.

00:09:49.490 --> 00:09:51.351
So you and I, we commented about this.

00:09:51.751 --> 00:09:52.633
You posted something maybe a

00:09:52.673 --> 00:09:53.313
week or two ago.

00:09:54.554 --> 00:09:55.556
I've seen a lot of fraud.

00:09:57.405 --> 00:09:59.248
I, and it's, it's so commonplace.

00:09:59.548 --> 00:10:00.248
And what I mean by that,

00:10:00.688 --> 00:10:01.389
and I'm not even going to

00:10:01.408 --> 00:10:02.809
say where or whatever, but like,

00:10:03.270 --> 00:10:04.211
I've been obviously through

00:10:04.230 --> 00:10:05.611
rotations and working and all that.

00:10:05.711 --> 00:10:05.932
Like,

00:10:06.778 --> 00:10:07.038
Okay.

00:10:07.538 --> 00:10:10.000
Um, like an aid who's not licensed.

00:10:10.120 --> 00:10:11.241
Typically it's like someone

00:10:11.261 --> 00:10:13.303
who's like a high school

00:10:13.323 --> 00:10:16.866
student who's working between, um,

00:10:16.927 --> 00:10:18.988
you know, like some, like a summer job or,

00:10:19.048 --> 00:10:20.009
or it's some undergrad,

00:10:20.028 --> 00:10:20.769
they're a college student,

00:10:20.789 --> 00:10:21.409
they're undergrad,

00:10:21.429 --> 00:10:22.711
they're working nights and

00:10:22.750 --> 00:10:23.631
weekends or whatever.

00:10:24.312 --> 00:10:25.153
And they're an aid, right?

00:10:25.193 --> 00:10:27.975
So they are, I've seen, um,

00:10:29.116 --> 00:10:30.378
putting hot packs and ice

00:10:30.418 --> 00:10:32.038
packs on a shoulder or a knee.

00:10:33.039 --> 00:10:35.221
Uh, that is not legal, right?

00:10:38.039 --> 00:10:39.400
Why would you say it's not legal?

00:10:40.020 --> 00:10:40.860
Okay.

00:10:40.880 --> 00:10:41.660
What about electrodes?

00:10:42.041 --> 00:10:43.061
Would you agree electrodes,

00:10:43.081 --> 00:10:44.581
they can't put them on and

00:10:44.662 --> 00:10:45.381
even take them off?

00:10:45.422 --> 00:10:46.442
Isn't that part of like,

00:10:47.261 --> 00:10:48.481
that's not kosher either?

00:10:49.623 --> 00:10:52.123
You can't bill for the aid

00:10:52.163 --> 00:10:53.562
or the unlicensed person

00:10:53.864 --> 00:10:55.423
delivering the service.

00:10:56.384 --> 00:10:57.264
Depending on your

00:10:57.303 --> 00:10:58.745
interpretation of specific

00:10:58.784 --> 00:11:00.144
state practice acts,

00:11:00.284 --> 00:11:00.945
you can make the

00:11:00.985 --> 00:11:02.304
determination if what

00:11:02.365 --> 00:11:03.605
you're describing is

00:11:03.644 --> 00:11:04.826
something you can delegate

00:11:04.846 --> 00:11:05.546
to that person.

00:11:06.346 --> 00:11:08.206
I would say hot packs, cold packs.

00:11:08.407 --> 00:11:09.966
From a billing perspective,

00:11:10.086 --> 00:11:11.687
we're not getting reimbursed for those.

00:11:11.727 --> 00:11:13.427
Those are bundled codes anyway.

00:11:14.248 --> 00:11:15.328
A non-licensed person

00:11:15.389 --> 00:11:16.548
absolutely can do that.

00:11:16.908 --> 00:11:17.589
Depending on your

00:11:17.629 --> 00:11:19.669
interpretation of a state practice act,

00:11:19.889 --> 00:11:22.291
applying electrodes, maybe.

00:11:22.791 --> 00:11:24.511
I think once you hit ultrasound,

00:11:24.572 --> 00:11:26.451
now you're probably past the,

00:11:26.611 --> 00:11:27.312
you're not allowed to

00:11:27.351 --> 00:11:28.852
delegate that because there

00:11:28.952 --> 00:11:30.273
is some requirement of

00:11:30.673 --> 00:11:32.114
supervision and attendance.

00:11:33.594 --> 00:11:35.294
But I would say what I

00:11:35.375 --> 00:11:36.515
mainly see and what you

00:11:36.556 --> 00:11:38.395
probably remember is, yeah,

00:11:38.436 --> 00:11:39.157
like when I was an

00:11:39.297 --> 00:11:41.077
unlicensed college kid

00:11:41.138 --> 00:11:42.398
doing an internship,

00:11:42.937 --> 00:11:44.038
I was going through the

00:11:44.078 --> 00:11:46.440
full therapeutic exercise progression.

00:11:46.559 --> 00:11:47.360
I was cuing.

00:11:47.460 --> 00:11:48.360
I was advising.

00:11:48.500 --> 00:11:50.442
I was collecting information.

00:11:50.501 --> 00:11:52.022
And either I was writing the

00:11:52.062 --> 00:11:54.182
documentation or relaying

00:11:54.222 --> 00:11:55.063
the information to the

00:11:55.083 --> 00:11:55.964
therapist who would write

00:11:55.984 --> 00:11:56.943
the documentation.

00:11:57.465 --> 00:11:58.924
And where it really crosses

00:11:58.985 --> 00:12:00.446
the line now is,

00:12:00.645 --> 00:12:02.868
Is when I'm doing that as an

00:12:03.008 --> 00:12:04.328
aide and the therapist is

00:12:04.369 --> 00:12:05.350
doing it for another

00:12:05.409 --> 00:12:07.010
patient and that therapist

00:12:07.130 --> 00:12:09.413
is billing for both of those patients.

00:12:09.874 --> 00:12:10.153
Correct.

00:12:10.173 --> 00:12:12.436
So where I look at it and I'm like, OK,

00:12:13.235 --> 00:12:15.618
we know that this can be a great thing.

00:12:15.918 --> 00:12:17.299
There is no doubt in my mind.

00:12:17.340 --> 00:12:19.501
We we should be able to

00:12:19.562 --> 00:12:22.264
delegate to an unlicensed individual,

00:12:22.764 --> 00:12:24.485
especially one that we've trained.

00:12:24.966 --> 00:12:25.166
Like,

00:12:25.366 --> 00:12:28.009
I don't need you to go to seven years

00:12:28.049 --> 00:12:30.133
of school to understand how

00:12:30.153 --> 00:12:31.455
to carry out my program.

00:12:32.195 --> 00:12:33.177
The person who went to

00:12:33.216 --> 00:12:34.678
school needs to make the decisions,

00:12:34.739 --> 00:12:35.879
but the person carrying out

00:12:35.919 --> 00:12:37.101
the program is simply the

00:12:37.142 --> 00:12:38.903
technician who is literally

00:12:38.923 --> 00:12:40.485
just following the instructions.

00:12:41.787 --> 00:12:42.967
Where we run into problems

00:12:43.048 --> 00:12:44.327
is with billing insurance,

00:12:44.368 --> 00:12:46.389
especially federal payers like Medicare,

00:12:46.469 --> 00:12:47.708
state payers like Medicaid.

00:12:48.389 --> 00:12:49.830
But I always said like, look,

00:12:50.110 --> 00:12:51.530
the biggest opportunity we

00:12:51.551 --> 00:12:52.990
have in PT is the fact that

00:12:53.071 --> 00:12:55.111
patients are paying more out of pocket.

00:12:55.994 --> 00:12:57.176
If you're coming to me with

00:12:57.196 --> 00:12:59.158
a fifty dollar copay for

00:12:59.278 --> 00:13:00.820
every visit and I can make

00:13:00.860 --> 00:13:02.381
the determination that my

00:13:02.442 --> 00:13:04.926
team member can deliver my

00:13:04.966 --> 00:13:06.888
plan of care for twenty

00:13:06.908 --> 00:13:07.969
five dollars a visit

00:13:08.509 --> 00:13:09.871
because it's an LMT or an

00:13:09.912 --> 00:13:11.494
ATC or a personal trainer,

00:13:11.533 --> 00:13:12.916
a high school kid or whatever.

00:13:13.416 --> 00:13:14.357
It's a college hunk.

00:13:14.857 --> 00:13:17.201
You know, the moving companies,

00:13:17.240 --> 00:13:19.682
college hunks, whatever.

00:13:20.783 --> 00:13:22.046
I can save you, the patient,

00:13:22.086 --> 00:13:23.047
twenty five dollars a

00:13:23.106 --> 00:13:24.749
session because your copay is fifty.

00:13:25.509 --> 00:13:26.811
None of those sessions get

00:13:26.850 --> 00:13:27.731
billed to insurance.

00:13:27.772 --> 00:13:28.633
So if you have a twenty

00:13:28.673 --> 00:13:29.754
visit limit for the year,

00:13:29.793 --> 00:13:31.294
we can conserve benefits in

00:13:31.315 --> 00:13:32.517
case you get into a major

00:13:32.976 --> 00:13:34.999
accident or a logical event, whatever.

00:13:36.120 --> 00:13:36.980
You save money.

00:13:37.240 --> 00:13:37.961
I make money.

00:13:38.182 --> 00:13:39.702
I can two, three,

00:13:39.783 --> 00:13:41.365
four people at a time with

00:13:41.424 --> 00:13:42.926
my high school kid because

00:13:42.946 --> 00:13:43.486
I've trained him.

00:13:43.547 --> 00:13:44.147
I've coached him.

00:13:44.167 --> 00:13:45.408
He's got a great personality.

00:13:46.269 --> 00:13:47.389
I have a bigger pool of

00:13:47.470 --> 00:13:49.030
applicants that I can hire from.

00:13:49.072 --> 00:13:51.293
I'm not limited to licensed individuals.

00:13:52.114 --> 00:13:53.735
Everybody comes out on top.

00:13:54.115 --> 00:13:56.256
The kid learns, he gains experience.

00:13:56.297 --> 00:13:57.278
He might go on to become a

00:13:57.317 --> 00:13:58.418
great physical therapist.

00:13:59.058 --> 00:13:59.938
I'm making more money.

00:13:59.999 --> 00:14:01.159
My patient's saving money.

00:14:01.220 --> 00:14:02.841
The insurance is paying less

00:14:02.900 --> 00:14:05.062
because those are non-billable services.

00:14:05.423 --> 00:14:06.803
We're all having a great time.

00:14:07.565 --> 00:14:08.565
I just, you know,

00:14:08.725 --> 00:14:10.667
you have to use a little bit of judgment,

00:14:11.187 --> 00:14:12.908
but this is how we take

00:14:13.008 --> 00:14:14.149
what we're used to doing

00:14:14.188 --> 00:14:15.990
and move it into the

00:14:16.049 --> 00:14:17.630
current two thousand twenty

00:14:17.671 --> 00:14:18.652
four and forward.

00:14:20.157 --> 00:14:20.496
I love it.

00:14:20.537 --> 00:14:20.736
I mean,

00:14:20.756 --> 00:14:22.837
if the patient client customer is

00:14:22.878 --> 00:14:24.437
paying out of pocket and

00:14:24.518 --> 00:14:25.839
they see value in it and

00:14:25.879 --> 00:14:27.058
you can potentially save

00:14:27.078 --> 00:14:27.860
them some money on their

00:14:27.879 --> 00:14:29.080
copay and you're

00:14:29.259 --> 00:14:30.480
communicating with the

00:14:30.580 --> 00:14:31.301
patient or client or the

00:14:31.360 --> 00:14:33.201
family that we're, you know, hey,

00:14:33.221 --> 00:14:33.822
we're not billing your

00:14:33.841 --> 00:14:34.481
insurance for this.

00:14:34.522 --> 00:14:36.302
Like we can have, you know,

00:14:36.501 --> 00:14:38.322
Tom or Jimmy or, you know,

00:14:38.363 --> 00:14:40.124
whoever to help take you

00:14:40.144 --> 00:14:41.083
through this plan of care

00:14:41.124 --> 00:14:42.323
that you developed.

00:14:43.065 --> 00:14:44.024
But these visits won't be

00:14:44.044 --> 00:14:45.985
through insurance and they

00:14:46.025 --> 00:14:46.745
find value in that.

00:14:47.505 --> 00:14:48.567
I love that all day long.

00:14:48.647 --> 00:14:50.107
And then there's no way for

00:14:50.148 --> 00:14:51.288
you to get in trouble with

00:14:51.308 --> 00:14:52.149
some of these payers and

00:14:52.190 --> 00:14:54.871
insurances that do some audit,

00:14:54.912 --> 00:14:56.212
some chart audit or whatever.

00:14:57.193 --> 00:14:57.894
And if you have some

00:14:57.974 --> 00:14:59.596
unlicensed individual doing

00:14:59.615 --> 00:15:00.155
it and they're paying out

00:15:00.196 --> 00:15:00.956
of pocket for it,

00:15:01.677 --> 00:15:02.857
it sounds like it's kosher.

00:15:02.878 --> 00:15:03.538
It sounds like it's fine.

00:15:04.301 --> 00:15:04.801
Yeah.

00:15:04.941 --> 00:15:05.181
Yeah.

00:15:05.240 --> 00:15:06.601
Now that that just took me

00:15:06.701 --> 00:15:07.903
on to a different topic.

00:15:08.003 --> 00:15:09.942
I saw this in my Facebook

00:15:09.982 --> 00:15:12.423
group and I'm going to share it.

00:15:12.884 --> 00:15:14.745
Let me scroll up to the top

00:15:14.764 --> 00:15:16.426
so I can share the original post.

00:15:17.025 --> 00:15:17.986
So this person said,

00:15:18.027 --> 00:15:18.966
just received my out of

00:15:19.027 --> 00:15:20.807
pocket payment for surgery.

00:15:20.908 --> 00:15:22.008
This is in my total knee

00:15:22.048 --> 00:15:23.129
replacement support group.

00:15:23.788 --> 00:15:25.190
For anybody watching,

00:15:25.450 --> 00:15:26.750
so you can kind of see it

00:15:26.850 --> 00:15:27.730
in the background,

00:15:28.431 --> 00:15:29.511
Total Knee Replacement

00:15:29.552 --> 00:15:31.131
Support Group for Kind People.

00:15:31.732 --> 00:15:34.693
I started this, I think back in, in,

00:15:34.714 --> 00:15:36.934
it's got fifteen thousand members.

00:15:38.015 --> 00:15:41.136
Very active group, tons of back and forth.

00:15:41.197 --> 00:15:42.618
I have one other admin

00:15:42.658 --> 00:15:44.438
person who kind of helps me manage it.

00:15:45.099 --> 00:15:46.779
But this, Dave,

00:15:46.820 --> 00:15:47.759
you and I have talked about

00:15:47.820 --> 00:15:49.061
this also before.

00:15:50.116 --> 00:15:51.557
I see therapists trying to

00:15:51.636 --> 00:15:53.857
say physical therapy saves

00:15:53.957 --> 00:15:56.219
you the beneficiary money.

00:15:57.239 --> 00:15:57.359
Um,

00:15:57.599 --> 00:15:59.740
but it's just not true in the eyes of

00:15:59.759 --> 00:16:01.419
the beneficiary, you know?

00:16:01.480 --> 00:16:02.480
So look, okay.

00:16:02.500 --> 00:16:03.721
So this person said my out

00:16:03.760 --> 00:16:04.821
of pocket was three hundred

00:16:04.841 --> 00:16:05.822
and fifty dollars for the

00:16:05.861 --> 00:16:07.501
right knee left me three

00:16:07.522 --> 00:16:08.402
hundred and seventy five

00:16:08.442 --> 00:16:10.602
dollars in this person's mind.

00:16:11.143 --> 00:16:12.364
They paid three hundred and

00:16:12.403 --> 00:16:15.183
fifty dollars for a fifty

00:16:15.224 --> 00:16:16.504
thousand dollar surgery.

00:16:17.485 --> 00:16:19.226
Another person, three hundred and twenty.

00:16:20.267 --> 00:16:21.726
This person said they were

00:16:21.746 --> 00:16:23.028
waiting for Medicare so

00:16:23.048 --> 00:16:23.967
that it's covered.

00:16:24.368 --> 00:16:24.607
You know,

00:16:24.628 --> 00:16:27.089
this person total cost was fifty

00:16:27.129 --> 00:16:28.109
four thousand dollars,

00:16:28.149 --> 00:16:29.730
which I'm sure that's what was billed,

00:16:29.909 --> 00:16:31.090
not what was allowed.

00:16:31.629 --> 00:16:32.591
But they're out of pocket

00:16:32.610 --> 00:16:33.431
was four hundred.

00:16:34.110 --> 00:16:35.572
When was the last time, Dave,

00:16:35.591 --> 00:16:37.312
you're a financially savvy guy.

00:16:37.851 --> 00:16:39.332
When was the last time you

00:16:39.373 --> 00:16:40.793
were able to pay four

00:16:40.832 --> 00:16:42.193
hundred dollars for what

00:16:42.254 --> 00:16:43.894
you understood to be a

00:16:43.974 --> 00:16:45.955
fifty four thousand dollar purchase?

00:16:47.190 --> 00:16:47.429
Never,

00:16:47.610 --> 00:16:49.311
never had a never purchased

00:16:49.350 --> 00:16:51.032
transaction in my life like that.

00:16:51.052 --> 00:16:51.272
Never.

00:16:51.852 --> 00:16:53.754
Now, there are a couple like this person,

00:16:54.053 --> 00:16:56.115
probably not obviously not Medicare.

00:16:56.875 --> 00:16:58.296
Fifty two hundred dollar out

00:16:58.316 --> 00:16:59.176
of pocket costs.

00:16:59.297 --> 00:17:02.097
You know, there was one in a lot of these,

00:17:02.118 --> 00:17:03.198
a ton of these.

00:17:03.578 --> 00:17:05.319
This person paid zero out of pocket.

00:17:05.380 --> 00:17:07.201
This person paid zero out of pocket.

00:17:07.260 --> 00:17:09.142
This person got, quote,

00:17:09.182 --> 00:17:10.903
both of mine were free.

00:17:11.423 --> 00:17:12.663
Yeah, I would.

00:17:12.723 --> 00:17:12.903
I would.

00:17:13.124 --> 00:17:14.184
I would love to.

00:17:14.704 --> 00:17:16.006
I don't know.

00:17:16.266 --> 00:17:17.807
You know how I am with all this.

00:17:17.846 --> 00:17:18.027
Right.

00:17:18.047 --> 00:17:19.428
So like the people who quote

00:17:19.448 --> 00:17:20.347
unquote got it for free,

00:17:20.387 --> 00:17:21.909
like I would love to just

00:17:21.949 --> 00:17:23.750
have them pop on this live

00:17:23.769 --> 00:17:24.451
call right now.

00:17:24.810 --> 00:17:27.071
And I would love to see their function,

00:17:27.492 --> 00:17:29.074
their health and wellness, all that,

00:17:29.094 --> 00:17:31.174
because I bet it would be

00:17:31.315 --> 00:17:32.214
less than the person who

00:17:32.234 --> 00:17:33.336
paid fifty two hundred.

00:17:34.237 --> 00:17:34.916
In my opinion,

00:17:35.257 --> 00:17:36.357
that's just one man's opinion.

00:17:37.065 --> 00:17:37.904
Yeah.

00:17:37.944 --> 00:17:38.025
Yeah.

00:17:38.045 --> 00:17:38.845
You know, this person,

00:17:38.904 --> 00:17:40.026
two hundred and seven.

00:17:41.226 --> 00:17:42.726
But there was one in here.

00:17:42.786 --> 00:17:44.326
So, OK, here's a fourteen hundred.

00:17:44.406 --> 00:17:45.946
Here's a fifty five hundred.

00:17:47.367 --> 00:17:49.528
I share I share a story

00:17:49.567 --> 00:17:52.348
about my mom that I think is interesting.

00:17:52.648 --> 00:17:54.970
If we have a chance, I'll share it here,

00:17:55.049 --> 00:17:56.789
considering it costs ninety

00:17:56.809 --> 00:17:58.390
to one hundred thousand dollars.

00:17:58.450 --> 00:18:00.451
Wasn't surprised by my out of pocket cost.

00:18:00.911 --> 00:18:02.251
So these are people that are

00:18:02.291 --> 00:18:03.852
thinking they're getting, I mean,

00:18:04.231 --> 00:18:05.512
the price of either

00:18:06.553 --> 00:18:09.314
Escalade or a Honda Odyssey

00:18:09.753 --> 00:18:11.634
for free or a couple

00:18:11.654 --> 00:18:13.476
hundred dollars or even a thousand.

00:18:13.895 --> 00:18:14.655
This was the one that

00:18:14.675 --> 00:18:15.557
cracked me up the most.

00:18:15.696 --> 00:18:17.396
Eighty two dollars was the

00:18:17.497 --> 00:18:18.617
out of pocket cost for the

00:18:18.657 --> 00:18:19.518
knee replacement.

00:18:19.877 --> 00:18:21.439
Twenty dollar copay for PT.

00:18:22.278 --> 00:18:24.361
So the physical therapy,

00:18:24.721 --> 00:18:26.903
assuming they want more than four times,

00:18:27.263 --> 00:18:29.925
cost more than the price of surgery.

00:18:32.647 --> 00:18:34.369
This is what consumers are seeing.

00:18:35.090 --> 00:18:36.771
These are the languages and

00:18:36.791 --> 00:18:37.673
the words we need to

00:18:37.692 --> 00:18:39.634
understand if we want to

00:18:39.654 --> 00:18:41.476
improve our marketing.

00:18:41.516 --> 00:18:42.837
We have to move away from

00:18:42.877 --> 00:18:45.359
this crazy idea that we can

00:18:45.400 --> 00:18:46.961
convince these consumers

00:18:46.980 --> 00:18:48.082
that we're saving them money.

00:18:48.871 --> 00:18:50.731
you know, not to mention the time,

00:18:50.771 --> 00:18:51.292
the effort,

00:18:51.333 --> 00:18:53.894
the frustration of like going

00:18:53.933 --> 00:18:54.795
to physical therapy,

00:18:54.894 --> 00:18:55.996
exercising when you're not

00:18:56.096 --> 00:18:58.196
used to exercising, changing lifestyle,

00:18:58.297 --> 00:19:00.278
losing weight, getting healthy,

00:19:00.479 --> 00:19:01.479
all of these things.

00:19:01.499 --> 00:19:02.140
Um, wow.

00:19:02.160 --> 00:19:04.641
There's a ton of comments here.

00:19:05.362 --> 00:19:05.642
Oh yeah.

00:19:06.162 --> 00:19:09.605
I mean, this was, uh, let me see.

00:19:09.644 --> 00:19:09.704
Huh?

00:19:09.724 --> 00:19:09.944
Wow.

00:19:10.065 --> 00:19:10.184
Wow.

00:19:10.265 --> 00:19:14.167
One hundred and forty two

00:19:14.208 --> 00:19:16.429
comments posted thirteen hours ago.

00:19:17.250 --> 00:19:17.450
Um,

00:19:18.569 --> 00:19:18.829
I mean,

00:19:19.210 --> 00:19:20.810
the whole reason why I started that

00:19:20.851 --> 00:19:23.570
group was because I wanted

00:19:23.611 --> 00:19:26.112
to speak the language of

00:19:26.172 --> 00:19:27.632
the people that I was marketing to.

00:19:27.872 --> 00:19:29.153
I wanted to hear what they were saying.

00:19:29.553 --> 00:19:30.633
I wanted to understand their

00:19:30.712 --> 00:19:32.292
real fears and frustrations,

00:19:32.394 --> 00:19:33.433
not what they tell me in

00:19:33.473 --> 00:19:34.193
the clinic because they

00:19:34.213 --> 00:19:35.513
tell me what they think I want to hear.

00:19:36.355 --> 00:19:38.734
I wanted unbiased, you know,

00:19:38.775 --> 00:19:39.775
behind the scenes.

00:19:39.855 --> 00:19:41.556
I wanted to know what was really going on.

00:19:42.375 --> 00:19:43.557
And even though I don't

00:19:43.617 --> 00:19:45.902
monetize that group as much as I should,

00:19:46.002 --> 00:19:47.404
I roll my eyes because I

00:19:47.444 --> 00:19:48.787
know that so much money

00:19:48.826 --> 00:19:49.888
just sitting there,

00:19:51.551 --> 00:19:53.675
it's still such a valuable asset for me.

00:19:54.625 --> 00:19:57.807
Now, to go off that, you helped me.

00:19:58.248 --> 00:19:59.628
I have left those groups,

00:19:59.648 --> 00:20:01.069
but I took your advice.

00:20:01.270 --> 00:20:01.750
I went in.

00:20:02.330 --> 00:20:04.432
I joined a Parkinson's group.

00:20:05.513 --> 00:20:06.214
One of the biggest ones.

00:20:06.755 --> 00:20:08.115
These have tens of thousands,

00:20:08.155 --> 00:20:09.596
if not hundreds of thousands of members.

00:20:10.178 --> 00:20:12.019
I was in a neuropathy group.

00:20:12.078 --> 00:20:12.980
I was in, I think,

00:20:13.019 --> 00:20:14.300
a multiple sclerosis group.

00:20:15.301 --> 00:20:15.923
And people come in.

00:20:16.182 --> 00:20:16.982
They're usually chatting

00:20:17.022 --> 00:20:18.585
about their spouse or their

00:20:18.605 --> 00:20:20.145
family member with Parkinson's.

00:20:20.365 --> 00:20:22.827
And then the neuropathy one is just...

00:20:24.005 --> 00:20:25.145
that's a whole other world.

00:20:25.487 --> 00:20:26.047
People talking about

00:20:26.067 --> 00:20:27.509
neuropathy and the symptoms

00:20:27.568 --> 00:20:28.589
and what they think

00:20:28.630 --> 00:20:29.731
triggers it and makes it

00:20:29.991 --> 00:20:30.873
better and worse.

00:20:30.913 --> 00:20:30.992
And,

00:20:31.973 --> 00:20:33.574
people sharing pictures of

00:20:33.835 --> 00:20:35.454
lotions and potions and things like that.

00:20:35.494 --> 00:20:37.096
I mean, it's, man, it's wild.

00:20:37.135 --> 00:20:37.875
I had to leave all those

00:20:37.895 --> 00:20:41.257
groups because it was just, I did it.

00:20:41.517 --> 00:20:43.336
Like you said, I wanted to hear,

00:20:43.397 --> 00:20:45.458
I wanted to hear like, what are they,

00:20:45.478 --> 00:20:47.019
the neuropathy folks or even,

00:20:47.098 --> 00:20:48.878
or Parkinson's, they talk about, you know,

00:20:49.038 --> 00:20:50.299
tremor and fatigue and

00:20:50.740 --> 00:20:52.140
trouble walking stiffness.

00:20:53.240 --> 00:20:54.000
Some of those words,

00:20:55.000 --> 00:20:56.281
I learned just like you said,

00:20:56.362 --> 00:20:58.102
and then I put that into my website,

00:20:58.182 --> 00:21:01.344
my copy emails, that type of stuff.

00:21:02.084 --> 00:21:05.025
Um, but I don't know, like your, your,

00:21:05.325 --> 00:21:05.805
your group, I,

00:21:06.486 --> 00:21:08.246
I've seen enough where like, it's,

00:21:08.465 --> 00:21:10.166
it's helpful and beneficial.

00:21:10.527 --> 00:21:11.027
Some of these other

00:21:11.067 --> 00:21:12.548
condition groups on Facebook, um,

00:21:13.782 --> 00:21:15.063
know how healthy that is.

00:21:15.123 --> 00:21:16.223
Like the fact that you have

00:21:16.263 --> 00:21:17.844
someone to relate to,

00:21:17.923 --> 00:21:18.904
that is the healthy part.

00:21:18.924 --> 00:21:19.724
That is the good part.

00:21:20.565 --> 00:21:21.244
Um,

00:21:21.285 --> 00:21:23.286
but I just saw a lot of bizarre

00:21:23.346 --> 00:21:25.946
comments and points of view

00:21:26.027 --> 00:21:26.467
and things like,

00:21:26.547 --> 00:21:27.707
and I never really went in there.

00:21:27.787 --> 00:21:28.107
I never,

00:21:28.448 --> 00:21:30.028
I would say things like seek out a

00:21:30.048 --> 00:21:30.867
physical therapist who

00:21:30.907 --> 00:21:32.009
specializes in this.

00:21:32.469 --> 00:21:34.650
I never said, here's my website.

00:21:34.730 --> 00:21:36.029
I'm a physical therapist, whatever.

00:21:36.069 --> 00:21:37.309
So I never even tried to do

00:21:37.430 --> 00:21:38.431
self promotion in there.

00:21:38.451 --> 00:21:39.871
Cause these members are like

00:21:39.951 --> 00:21:41.751
all over the country or the world.

00:21:42.051 --> 00:21:42.092
Um,

00:21:42.732 --> 00:21:44.674
But I had to leave so many

00:21:44.694 --> 00:21:45.276
Facebook groups.

00:21:45.336 --> 00:21:46.037
It's crazy.

00:21:46.076 --> 00:21:48.119
Like I think in general,

00:21:48.240 --> 00:21:49.622
yours is excellent.

00:21:49.962 --> 00:21:50.604
But in general,

00:21:50.703 --> 00:21:52.266
I think Facebook groups are

00:21:52.306 --> 00:21:53.788
becoming more and more toxic.

00:21:53.867 --> 00:21:55.009
But that's just my opinion.

00:21:55.509 --> 00:21:55.828
No,

00:21:55.970 --> 00:21:57.791
I think it depends on who starts the

00:21:57.811 --> 00:21:58.031
group.

00:21:58.092 --> 00:21:59.453
I think that's a huge part of it.

00:21:59.493 --> 00:22:00.494
So I used to be,

00:22:00.615 --> 00:22:02.777
and I still am a huge advocate of saying,

00:22:02.936 --> 00:22:04.499
look at these toxic groups.

00:22:04.920 --> 00:22:07.041
There is like a rheumatoid arthritis group,

00:22:07.082 --> 00:22:08.384
a knee arthritis group,

00:22:08.544 --> 00:22:10.685
any of the back pain, sciatica groups.

00:22:10.746 --> 00:22:11.827
I mean, we know Dean Bull,

00:22:12.307 --> 00:22:15.010
he does an amazing job with his group,

00:22:15.692 --> 00:22:16.353
but it's like,

00:22:16.853 --> 00:22:20.273
PT run groups, really, really good groups.

00:22:20.733 --> 00:22:23.054
You let the individuals who

00:22:23.074 --> 00:22:24.474
are out there experiencing

00:22:24.494 --> 00:22:25.875
and suffering with these conditions,

00:22:25.894 --> 00:22:26.914
start their own groups.

00:22:27.535 --> 00:22:29.056
Usually it devolves into a

00:22:29.135 --> 00:22:31.316
cesspool of disability and

00:22:31.455 --> 00:22:33.257
fear mongering and horrible,

00:22:33.297 --> 00:22:34.076
horrible things.

00:22:35.217 --> 00:22:35.517
Yeah.

00:22:35.557 --> 00:22:37.978
So I, but even within that,

00:22:38.953 --> 00:22:41.134
like you can still learn a lot from that.

00:22:41.194 --> 00:22:42.555
You can see what people are

00:22:42.595 --> 00:22:44.556
thinking and feeling and fearing.

00:22:45.875 --> 00:22:46.717
But yeah,

00:22:46.737 --> 00:22:48.557
I think more therapists need to

00:22:48.596 --> 00:22:50.417
start more groups, but that was a long,

00:22:50.577 --> 00:22:51.337
slow journey.

00:22:51.538 --> 00:22:54.038
Like most things I do.

00:22:54.199 --> 00:22:56.099
Um, if that's when I started,

00:22:56.759 --> 00:22:58.601
I didn't see any growth until like,

00:22:59.060 --> 00:23:00.760
and I would post and I

00:23:00.780 --> 00:23:01.582
would share and I would

00:23:01.602 --> 00:23:02.541
tell people about it.

00:23:02.561 --> 00:23:03.622
And I had the luxury of

00:23:03.662 --> 00:23:05.182
having my YouTube channel that had

00:23:05.603 --> 00:23:06.762
been growing a little bit in

00:23:06.803 --> 00:23:07.983
that time so I could direct

00:23:08.023 --> 00:23:09.344
people from my YouTube to

00:23:09.403 --> 00:23:10.483
the Facebook group.

00:23:11.263 --> 00:23:12.124
And then all of a sudden,

00:23:12.163 --> 00:23:13.845
for whatever reason, it just took off,

00:23:14.105 --> 00:23:14.444
you know,

00:23:14.484 --> 00:23:15.605
and I wish I could say there was

00:23:15.644 --> 00:23:16.704
something I did.

00:23:17.365 --> 00:23:17.925
I didn't.

00:23:18.125 --> 00:23:19.605
It just started growing

00:23:19.665 --> 00:23:21.826
thousands of members and, you know,

00:23:22.286 --> 00:23:23.507
gaining traction.

00:23:23.586 --> 00:23:26.826
And now my person who helps

00:23:26.886 --> 00:23:28.147
me manage the group,

00:23:28.307 --> 00:23:29.928
an administrator in the group,

00:23:31.728 --> 00:23:32.848
she's been known to rub

00:23:32.868 --> 00:23:33.749
people the wrong way.

00:23:34.951 --> 00:23:36.892
she runs other large groups

00:23:36.913 --> 00:23:38.432
she volunteered to help me

00:23:38.692 --> 00:23:39.913
be an administrator for my

00:23:39.952 --> 00:23:40.913
group and I said yeah sure

00:23:40.973 --> 00:23:43.094
I don't I don't care uh she

00:23:43.114 --> 00:23:44.394
will shut down anything

00:23:44.433 --> 00:23:45.515
like she will kick people

00:23:45.575 --> 00:23:46.234
out of the group in a

00:23:46.315 --> 00:23:47.434
heartbeat if they start

00:23:47.474 --> 00:23:48.654
being rude if they start

00:23:48.815 --> 00:23:51.175
talking about drugs so she

00:23:51.215 --> 00:23:52.236
does a great job she's a

00:23:52.276 --> 00:23:54.517
huge asset and there seems

00:23:54.537 --> 00:23:56.317
to be a core you know that

00:23:56.376 --> 00:23:57.718
has been in the community

00:23:57.738 --> 00:23:59.637
for years now and and they

00:23:59.678 --> 00:24:00.758
really do a good job

00:24:00.817 --> 00:24:02.638
managing and controlling the tone

00:24:03.419 --> 00:24:05.682
So I've been super happy with it.

00:24:06.182 --> 00:24:08.545
Let's jump into your area of expertise.

00:24:09.105 --> 00:24:10.126
Let's take a look.

00:24:10.227 --> 00:24:11.488
I'll share it for a little bit,

00:24:11.508 --> 00:24:12.449
but then I pulled some of

00:24:12.469 --> 00:24:13.329
the key highlights.

00:24:14.511 --> 00:24:16.413
So this is the ATI quarterly report.

00:24:16.634 --> 00:24:18.435
You and I have talked about this before.

00:24:18.496 --> 00:24:20.618
We've shared reports like this before.

00:24:20.739 --> 00:24:22.181
I think if you're a practice owner,

00:24:22.221 --> 00:24:22.941
small or big,

00:24:23.501 --> 00:24:24.782
you should be looking at these numbers.

00:24:25.443 --> 00:24:26.664
This is what I would base my

00:24:26.684 --> 00:24:29.247
clinic's performance on as

00:24:29.287 --> 00:24:30.147
just a benchmark.

00:24:30.327 --> 00:24:31.208
Like, am I doing better?

00:24:31.249 --> 00:24:32.189
Am I doing worse?

00:24:32.348 --> 00:24:34.171
Where am I falling on this?

00:24:34.832 --> 00:24:35.991
They have their highlights.

00:24:36.960 --> 00:24:38.161
Couple interesting highlights.

00:24:39.201 --> 00:24:39.442
You know,

00:24:39.501 --> 00:24:41.462
net revenue was one hundred and

00:24:41.482 --> 00:24:42.784
eighty one million compared

00:24:42.824 --> 00:24:44.505
to one hundred and sixty six million.

00:24:44.545 --> 00:24:46.686
So they grew their net net

00:24:46.767 --> 00:24:48.807
revenue by eight point seven percent.

00:24:50.348 --> 00:24:52.750
They talk about net patient revenue.

00:24:53.010 --> 00:24:53.731
There were a couple of the

00:24:53.771 --> 00:24:56.252
numbers rate per visit.

00:24:56.512 --> 00:24:58.214
So their rate per visit was up.

00:24:58.795 --> 00:25:00.296
which we hear everybody talk

00:25:00.316 --> 00:25:02.115
about declining reimbursement,

00:25:02.175 --> 00:25:04.798
yet they have an increase

00:25:04.857 --> 00:25:06.438
of nine point seven percent

00:25:07.019 --> 00:25:08.378
in their revenue per visit.

00:25:08.398 --> 00:25:11.339
And so other revenue they

00:25:11.380 --> 00:25:13.461
talk about little decrease there,

00:25:13.500 --> 00:25:15.442
less than one percent visits per day.

00:25:16.603 --> 00:25:17.202
Again,

00:25:17.542 --> 00:25:19.223
I think therapists are shocked to

00:25:19.324 --> 00:25:22.144
see their visits per day

00:25:22.444 --> 00:25:24.586
for the clinic was twenty

00:25:24.625 --> 00:25:26.586
six point nine compared to twenty five.

00:25:27.429 --> 00:25:30.193
But on a per therapist basis,

00:25:30.513 --> 00:25:33.219
their therapist, based on this statistic,

00:25:33.700 --> 00:25:35.844
they're doing about ten visits per day.

00:25:37.074 --> 00:25:38.674
Every therapist I talk to

00:25:39.036 --> 00:25:40.576
who claims that they know

00:25:40.717 --> 00:25:43.358
ATI will say that's ridiculous.

00:25:43.398 --> 00:25:44.400
They're doing twenty and

00:25:44.440 --> 00:25:45.460
thirty visits a day.

00:25:45.500 --> 00:25:46.361
They're double booking.

00:25:46.381 --> 00:25:47.342
They're doing all this stuff.

00:25:48.142 --> 00:25:48.603
But I mean,

00:25:48.663 --> 00:25:50.483
these these are stats that are

00:25:50.624 --> 00:25:51.904
relatively accurate.

00:25:52.164 --> 00:25:52.685
Obviously,

00:25:52.705 --> 00:25:54.907
we have examples of Enron and

00:25:55.087 --> 00:25:56.167
other publicly traded

00:25:56.208 --> 00:25:57.750
companies that have

00:25:57.809 --> 00:25:59.431
falsified their stats.

00:26:00.299 --> 00:26:01.721
I'm not going to say I

00:26:01.801 --> 00:26:04.305
guarantee these are right.

00:26:04.526 --> 00:26:05.727
But generally speaking, I mean,

00:26:05.747 --> 00:26:07.648
they're audited books and, you know,

00:26:08.529 --> 00:26:09.852
PT salaries and related

00:26:09.892 --> 00:26:12.275
costs were fifty six

00:26:12.474 --> 00:26:13.977
compared to fifty two.

00:26:14.057 --> 00:26:15.598
So those were going up.

00:26:16.400 --> 00:26:18.000
And my guess is this is

00:26:18.039 --> 00:26:20.820
probably like salaries and related costs.

00:26:22.521 --> 00:26:25.982
When USPT shares their numbers,

00:26:27.123 --> 00:26:30.703
they're basing this on per visit.

00:26:30.804 --> 00:26:32.044
Yeah, cost per visit.

00:26:32.903 --> 00:26:34.424
So that's what they're looking at.

00:26:35.884 --> 00:26:38.105
And rate per visit is one

00:26:38.125 --> 00:26:38.965
hundred and eight dollars.

00:26:38.986 --> 00:26:39.826
So they're looking at one

00:26:39.846 --> 00:26:40.645
hundred and eight dollars

00:26:40.685 --> 00:26:42.747
in revenue or rate per visit.

00:26:43.971 --> 00:26:44.051
Uh,

00:26:44.071 --> 00:26:46.713
they're looking at fifty six of those

00:26:46.753 --> 00:26:49.775
dollars being salaries and related costs.

00:26:50.256 --> 00:26:51.635
So, you know,

00:26:51.737 --> 00:26:53.577
used to be down under fifty percent.

00:26:53.678 --> 00:26:55.057
Now it's kind of moving up.

00:26:55.318 --> 00:26:56.179
And when I say used to be,

00:26:56.219 --> 00:26:57.259
I'm talking back in the mid

00:26:57.299 --> 00:27:00.000
two thousands.

00:27:00.020 --> 00:27:01.981
They're using some contract labor,

00:27:02.502 --> 00:27:03.762
doubtful accounts.

00:27:05.924 --> 00:27:06.484
Uh,

00:27:06.505 --> 00:27:09.246
they talk about EBITDA going up six

00:27:09.306 --> 00:27:10.567
point five million compared

00:27:10.606 --> 00:27:11.928
to four point eight million.

00:27:13.874 --> 00:27:15.055
Those are the main numbers.

00:27:16.415 --> 00:27:17.497
Was that like per office,

00:27:17.596 --> 00:27:18.298
the EBITDA number?

00:27:19.038 --> 00:27:21.180
Did it say per clinic or per location?

00:27:21.340 --> 00:27:24.442
Adjusted EBITDA increased.

00:27:26.065 --> 00:27:27.125
It didn't say.

00:27:27.145 --> 00:27:29.788
I don't know.

00:27:30.308 --> 00:27:31.490
Adjusted EBITDA margin was

00:27:31.569 --> 00:27:33.131
three point six compared to

00:27:33.171 --> 00:27:34.592
two point nine percent.

00:27:36.193 --> 00:27:36.513
Wow.

00:27:36.534 --> 00:27:38.256
I mean, that's that's low.

00:27:39.576 --> 00:27:39.896
It is.

00:27:41.815 --> 00:27:42.136
It is.

00:27:42.156 --> 00:27:42.719
But I mean, that's,

00:27:42.818 --> 00:27:43.622
that's what I'm saying.

00:27:43.642 --> 00:27:45.347
Like these guys are barely

00:27:45.388 --> 00:27:46.211
making a profit.

00:27:47.608 --> 00:27:49.890
I know none of us, I mean, truthfully,

00:27:49.950 --> 00:27:51.631
none of us are making a real profit.

00:27:52.131 --> 00:27:53.730
The only reason any of us

00:27:53.770 --> 00:27:54.652
have money in our bank

00:27:54.692 --> 00:27:56.071
accounts is because we're

00:27:56.112 --> 00:27:57.272
willing to do stuff that

00:27:57.393 --> 00:27:58.752
nobody else would be willing to do.

00:27:58.833 --> 00:28:02.255
If we had to hire the marketing department,

00:28:02.295 --> 00:28:03.934
hire the finance department,

00:28:03.954 --> 00:28:05.875
hire the janitorial services,

00:28:05.915 --> 00:28:08.817
hire the purchasing, hire HR,

00:28:08.856 --> 00:28:09.817
hire compliance,

00:28:10.817 --> 00:28:12.699
there would be no money for any of us.

00:28:12.739 --> 00:28:13.558
The only reason...

00:28:14.199 --> 00:28:16.000
anyone at our scale can

00:28:16.101 --> 00:28:18.021
claim profit and have money

00:28:18.041 --> 00:28:18.982
in the bank at home is

00:28:19.002 --> 00:28:20.704
because there's somebody,

00:28:21.085 --> 00:28:21.965
usually the owner,

00:28:22.306 --> 00:28:25.028
who's doing all of that stuff.

00:28:25.628 --> 00:28:26.950
That's the reality of it.

00:28:29.061 --> 00:28:31.643
The these numbers are a

00:28:31.663 --> 00:28:32.442
little interesting.

00:28:33.383 --> 00:28:34.864
The thing about the patient

00:28:35.064 --> 00:28:35.903
visits per day.

00:28:36.003 --> 00:28:36.984
Let's talk about that for a second.

00:28:37.025 --> 00:28:38.845
So every time this gets posted,

00:28:38.865 --> 00:28:39.204
you're right.

00:28:39.224 --> 00:28:40.286
There is always therapists

00:28:40.326 --> 00:28:41.586
that chime in and they're like,

00:28:41.746 --> 00:28:43.507
I used to work for ATI and

00:28:43.886 --> 00:28:45.747
every therapist was seeing like twenty,

00:28:45.767 --> 00:28:47.488
twenty five, twenty eight,

00:28:47.508 --> 00:28:48.688
whatever patients per day.

00:28:49.288 --> 00:28:49.407
Now,

00:28:49.428 --> 00:28:51.128
when you do the when you do that

00:28:51.229 --> 00:28:52.209
average across all their

00:28:52.229 --> 00:28:53.470
clinics and it's what did you say,

00:28:53.490 --> 00:28:56.351
like ten visits per day per

00:28:56.391 --> 00:28:57.510
day per therapist?

00:28:59.428 --> 00:28:59.469
Uh,

00:29:00.737 --> 00:29:01.717
there could be like,

00:29:01.757 --> 00:29:03.698
you look at that average and yeah,

00:29:03.738 --> 00:29:04.357
that's an average.

00:29:04.499 --> 00:29:07.299
They're also a gigantic company, right?

00:29:07.319 --> 00:29:09.160
So let's say ATI is also

00:29:09.240 --> 00:29:10.421
opening up new clinics or

00:29:10.441 --> 00:29:12.382
they're buying other clinics or whatever.

00:29:13.082 --> 00:29:15.323
And those clinics are not

00:29:15.383 --> 00:29:17.943
full or they're half full, half empty,

00:29:17.963 --> 00:29:18.963
however you want to look at it.

00:29:19.825 --> 00:29:21.765
So if you do the average,

00:29:22.506 --> 00:29:25.106
it could come out to that low tally.

00:29:25.626 --> 00:29:27.607
But all of the therapists

00:29:27.627 --> 00:29:28.847
that you and I've ever spoken with,

00:29:29.229 --> 00:29:30.088
we've heard that they're all

00:29:30.797 --> 00:29:31.877
that a ton of their clinics

00:29:32.077 --> 00:29:34.881
and probably a majority of their clinics,

00:29:34.921 --> 00:29:35.740
or maybe it's over

00:29:35.902 --> 00:29:36.622
somewhere around fifty

00:29:36.662 --> 00:29:38.022
percent or more where the

00:29:38.042 --> 00:29:39.084
therapists are seeing two

00:29:39.144 --> 00:29:40.204
or three patients or four

00:29:40.244 --> 00:29:41.385
or whatever per hour.

00:29:41.906 --> 00:29:42.968
And there are double booking

00:29:43.008 --> 00:29:44.088
patients because they have

00:29:44.108 --> 00:29:45.930
to build in the percent of

00:29:46.310 --> 00:29:48.211
canceled visits, late cancels, no shows,

00:29:48.231 --> 00:29:48.492
whatever.

00:29:49.724 --> 00:29:50.805
those therapists then chime

00:29:50.845 --> 00:29:52.885
in on facebook but it has I

00:29:52.945 --> 00:29:53.965
I don't know I I would

00:29:54.006 --> 00:29:54.786
agree I don't know if you

00:29:54.826 --> 00:29:56.165
agree but I think there's

00:29:56.226 --> 00:29:57.126
enough therapists

00:29:57.166 --> 00:29:58.886
commenting on facebook

00:29:59.207 --> 00:30:01.346
specifically about ati's

00:30:01.747 --> 00:30:04.107
scheduling of patients to

00:30:04.407 --> 00:30:05.688
to say that there's some

00:30:05.748 --> 00:30:06.807
truth into what they've

00:30:06.847 --> 00:30:07.909
seen in the trenches

00:30:08.169 --> 00:30:09.689
compared to a press release

00:30:10.088 --> 00:30:11.548
that's saying on average

00:30:12.088 --> 00:30:13.369
it's ten patients per day

00:30:13.410 --> 00:30:14.369
per therapist because

00:30:15.778 --> 00:30:16.357
These clinics,

00:30:16.498 --> 00:30:17.138
some of these clinics might

00:30:17.179 --> 00:30:20.881
not be full and their contract labor.

00:30:21.020 --> 00:30:22.080
So like they have a contract

00:30:22.101 --> 00:30:23.842
labor person come on and

00:30:24.201 --> 00:30:25.103
maybe they're including

00:30:25.143 --> 00:30:27.983
that whole person's full availability,

00:30:28.084 --> 00:30:28.644
but like they're only

00:30:28.683 --> 00:30:29.305
treating a couple of

00:30:29.325 --> 00:30:30.125
patients here or there.

00:30:30.164 --> 00:30:31.705
So I feel like that metric

00:30:31.746 --> 00:30:34.586
probably is juiced to favor ATI.

00:30:34.626 --> 00:30:35.086
I don't know.

00:30:35.126 --> 00:30:35.688
I don't know.

00:30:35.708 --> 00:30:36.087
What do you think?

00:30:36.604 --> 00:30:37.884
I'll tell you my experience,

00:30:37.945 --> 00:30:40.248
and this is just anecdotal

00:30:40.288 --> 00:30:42.230
based on my team, my people.

00:30:42.951 --> 00:30:44.271
And I tell them this when we

00:30:44.311 --> 00:30:45.594
do annual reviews and

00:30:45.614 --> 00:30:47.154
quarterly reviews and stuff like that.

00:30:47.175 --> 00:30:49.337
I'm like, look, you guys.

00:30:50.038 --> 00:30:50.298
First,

00:30:50.378 --> 00:30:52.300
I try to get a sense for how

00:30:52.480 --> 00:30:54.542
overwhelmed they feel if I

00:30:54.563 --> 00:30:55.904
feel like they're getting overwhelmed.

00:30:55.964 --> 00:30:56.164
You know,

00:30:56.184 --> 00:30:57.547
if I see the schedule filling up.

00:30:58.267 --> 00:31:00.249
And I also try to judge my

00:31:00.328 --> 00:31:01.410
like overwhelmed.

00:31:01.450 --> 00:31:02.250
Do I feel busy?

00:31:02.290 --> 00:31:03.092
And I'm like, why?

00:31:03.211 --> 00:31:05.013
Why do I feel busy when I'm

00:31:05.054 --> 00:31:07.155
not even doing twenty visits a week yet?

00:31:07.435 --> 00:31:09.637
I feel like I am doing sixty.

00:31:10.699 --> 00:31:12.140
I think that there are times

00:31:12.200 --> 00:31:14.442
on the schedule where it piles up three,

00:31:14.461 --> 00:31:15.103
four people.

00:31:15.482 --> 00:31:16.463
And then there are times

00:31:16.483 --> 00:31:18.205
where you have an hour of dead space.

00:31:19.012 --> 00:31:19.712
Like you said,

00:31:19.772 --> 00:31:20.313
there are going to be

00:31:20.353 --> 00:31:21.773
clinics in an organization

00:31:21.814 --> 00:31:24.015
like that that are very low production.

00:31:24.974 --> 00:31:25.615
And then there are going to

00:31:25.634 --> 00:31:27.015
be clinics that are super busy.

00:31:27.615 --> 00:31:28.895
And so you're not going to

00:31:28.955 --> 00:31:30.256
hear complaints from the

00:31:30.296 --> 00:31:31.717
clinics and the workers

00:31:31.737 --> 00:31:33.877
that are doing seven visits

00:31:33.938 --> 00:31:35.897
a day because they're loving it.

00:31:35.917 --> 00:31:36.597
They're happy.

00:31:36.637 --> 00:31:37.499
They're getting paid.

00:31:37.538 --> 00:31:38.298
They're hanging out.

00:31:39.058 --> 00:31:39.659
You're going to hear the

00:31:39.699 --> 00:31:40.440
complaint from the

00:31:40.460 --> 00:31:41.480
therapist who's picking up

00:31:41.500 --> 00:31:42.380
the slack for that

00:31:42.440 --> 00:31:44.800
individual doing seven visits a day.

00:31:45.080 --> 00:31:46.500
So I think it's a bias.

00:31:46.601 --> 00:31:47.682
It's a perception.

00:31:48.617 --> 00:31:50.980
that when you get super busy,

00:31:51.019 --> 00:31:52.461
that's what gets stuck in your mind.

00:31:52.942 --> 00:31:54.163
Even though you forgot about

00:31:54.222 --> 00:31:55.103
the slow times,

00:31:55.163 --> 00:31:56.003
even though you forget

00:31:56.044 --> 00:31:56.865
about the fact that,

00:31:56.924 --> 00:31:58.506
and the reality is we've

00:31:58.546 --> 00:31:59.666
talked about these numbers.

00:32:00.027 --> 00:32:01.327
So if you're working a forty

00:32:01.367 --> 00:32:02.189
hour work week,

00:32:02.229 --> 00:32:04.030
let's just say you're doing five days,

00:32:04.090 --> 00:32:05.451
you're doing eight hour days,

00:32:05.832 --> 00:32:07.073
you're probably not

00:32:07.093 --> 00:32:09.214
clocking in right at the

00:32:09.295 --> 00:32:11.276
first billable minute of your day.

00:32:11.296 --> 00:32:12.376
You're probably getting ten,

00:32:12.416 --> 00:32:13.577
fifteen minutes of time

00:32:13.617 --> 00:32:15.299
before the first billable unit.

00:32:15.720 --> 00:32:17.000
You're probably getting ten,

00:32:17.060 --> 00:32:18.201
fifteen minutes of time at

00:32:18.241 --> 00:32:19.182
the end of the day.

00:32:19.202 --> 00:32:20.483
That's already thirty minutes.

00:32:20.904 --> 00:32:21.605
You're probably getting

00:32:21.645 --> 00:32:23.686
thirty minutes of paid time

00:32:23.907 --> 00:32:25.028
during lunch and thirty

00:32:25.048 --> 00:32:26.390
minutes of unpaid time.

00:32:26.769 --> 00:32:28.731
So we're an hour a day into it.

00:32:28.832 --> 00:32:29.732
Five days a week.

00:32:29.752 --> 00:32:32.375
That's five hours of non-productive,

00:32:32.476 --> 00:32:34.096
non-billable time that

00:32:34.136 --> 00:32:34.657
you're not even

00:32:34.698 --> 00:32:35.778
appreciating as the

00:32:35.838 --> 00:32:38.421
employee because maybe you're doing stuff,

00:32:38.661 --> 00:32:40.002
but you're not clocked in.

00:32:40.603 --> 00:32:40.942
You know,

00:32:41.002 --> 00:32:42.304
and so now you're compressing

00:32:42.344 --> 00:32:44.326
forty hours into thirty five hours.

00:32:45.207 --> 00:32:46.146
And then, of course, again,

00:32:46.166 --> 00:32:47.949
you get one cancellation in a day,

00:32:47.989 --> 00:32:49.529
which a clinic like ATI

00:32:49.569 --> 00:32:50.750
wouldn't be unreasonable.

00:32:50.871 --> 00:32:52.451
One cancellation per clinician,

00:32:52.511 --> 00:32:53.373
probably more.

00:32:54.133 --> 00:32:55.673
You start to see how all of

00:32:55.714 --> 00:32:57.195
a sudden you feel like

00:32:57.236 --> 00:32:58.717
those couple hours of high

00:32:58.757 --> 00:33:00.657
production are your whole

00:33:00.698 --> 00:33:02.559
day because you just don't

00:33:02.640 --> 00:33:04.580
realize the inefficiency in

00:33:04.601 --> 00:33:05.582
your day and the other

00:33:05.622 --> 00:33:06.643
stuff that's going on.

00:33:08.336 --> 00:33:09.278
I cannot refute that.

00:33:09.398 --> 00:33:09.759
I agree.

00:33:09.779 --> 00:33:10.582
I know what you're saying.

00:33:11.001 --> 00:33:12.505
Makes sense.

00:33:12.746 --> 00:33:13.667
Let me see.

00:33:13.708 --> 00:33:14.489
There were a couple other

00:33:14.528 --> 00:33:16.452
things that I was looking at here.

00:33:18.300 --> 00:33:19.981
Any thoughts on your side

00:33:20.021 --> 00:33:21.201
about any of the business

00:33:21.221 --> 00:33:22.903
stuff that we've been talking about?

00:33:23.343 --> 00:33:24.544
Oh, this was interesting.

00:33:24.723 --> 00:33:26.664
So there was an article.

00:33:26.684 --> 00:33:29.346
Let me pull this up.

00:33:29.365 --> 00:33:31.567
There are a couple of key facts in this.

00:33:31.646 --> 00:33:34.387
I'm going to share this with you guys.

00:33:35.008 --> 00:33:36.269
Talking about like a

00:33:36.509 --> 00:33:38.369
positive future and growth

00:33:38.430 --> 00:33:42.092
for physical therapy.

00:33:42.112 --> 00:33:44.932
I got to get faster at getting these up.

00:33:45.904 --> 00:33:47.346
All right, here we go.

00:33:47.385 --> 00:33:50.888
So this article, open PR, physical therapy,

00:33:50.929 --> 00:33:53.211
market size, top key players, growth,

00:33:53.250 --> 00:33:54.392
trend analysis,

00:33:54.971 --> 00:33:57.273
and forecast going out to

00:33:57.314 --> 00:33:58.815
two thousand thirty three.

00:34:00.060 --> 00:34:00.662
Um,

00:34:00.682 --> 00:34:02.643
the interesting thing from reports like

00:34:02.682 --> 00:34:05.263
this, you know, is like here,

00:34:05.324 --> 00:34:06.964
you can get a list of the

00:34:07.025 --> 00:34:11.407
top players in the market, uh, here,

00:34:11.467 --> 00:34:13.268
key benefits to stakeholders.

00:34:13.789 --> 00:34:15.590
So they're talking about, you know,

00:34:15.690 --> 00:34:17.951
market insights, stakeholders gain, blah,

00:34:17.971 --> 00:34:18.472
blah, blah.

00:34:19.291 --> 00:34:20.092
Uh, HCA, uh,

00:34:22.679 --> 00:34:23.860
guys, Geisinger.

00:34:24.039 --> 00:34:24.280
Yeah.

00:34:24.420 --> 00:34:27.802
Select medical, you know, Genesis,

00:34:27.943 --> 00:34:30.023
we know these names, but if you notice,

00:34:30.103 --> 00:34:31.025
most of these names are

00:34:31.065 --> 00:34:32.606
really like skilled nursing,

00:34:33.085 --> 00:34:35.248
big facility management companies.

00:34:35.969 --> 00:34:36.108
Um,

00:34:36.289 --> 00:34:39.030
these aren't typically like select has

00:34:39.351 --> 00:34:40.692
some private practices,

00:34:40.751 --> 00:34:43.134
but generally speaking, these are more,

00:34:43.914 --> 00:34:45.175
uh, nursing home.

00:34:45.235 --> 00:34:47.416
Then we've got athletic go down here.

00:34:47.456 --> 00:34:49.117
We've got Nova care down here.

00:34:49.884 --> 00:34:50.985
I always like to know who

00:34:51.025 --> 00:34:52.326
the players in the market are.

00:34:52.666 --> 00:34:54.327
So I have a sense of, you know,

00:34:54.568 --> 00:34:55.829
who I should be looking at

00:34:56.791 --> 00:34:57.952
physical therapy markets

00:34:58.012 --> 00:34:59.472
expected to grow to thirty

00:34:59.512 --> 00:35:01.916
five billion by twenty twenty eight.

00:35:01.996 --> 00:35:03.197
That's compounded growth.

00:35:03.297 --> 00:35:05.119
Six percent increasing

00:35:05.159 --> 00:35:06.760
musculoskeletal disorders

00:35:06.840 --> 00:35:07.802
fuels the growth.

00:35:08.422 --> 00:35:09.943
So MSK,

00:35:10.324 --> 00:35:12.005
there's a lot of opportunity there.

00:35:12.445 --> 00:35:13.347
Increased focus on

00:35:13.447 --> 00:35:15.409
technology-based physical

00:35:15.449 --> 00:35:17.490
therapy to drive revenue.

00:35:18.112 --> 00:35:20.333
Hinge Health, welcome to the party.

00:35:20.675 --> 00:35:20.755
Yeah.

00:35:23.556 --> 00:35:25.998
North America is the largest

00:35:26.077 --> 00:35:28.278
region in the physical therapy market.

00:35:29.380 --> 00:35:30.239
I always think about that.

00:35:30.360 --> 00:35:31.561
I think about my YouTube channel.

00:35:31.581 --> 00:35:33.081
There's a lot of people from India.

00:35:33.661 --> 00:35:34.181
Obviously,

00:35:34.222 --> 00:35:35.782
the Philippines are cranking out

00:35:35.802 --> 00:35:37.164
a lot of therapists.

00:35:37.204 --> 00:35:37.543
You know,

00:35:38.724 --> 00:35:40.465
I think there's a huge opportunity.

00:35:40.945 --> 00:35:43.467
I know there was a therapist.

00:35:43.487 --> 00:35:44.708
Well, Mike Chua, of course,

00:35:44.728 --> 00:35:46.208
but there was another therapist.

00:35:46.829 --> 00:35:48.670
She was helping foreign

00:35:48.710 --> 00:35:49.590
trained therapists get

00:35:49.630 --> 00:35:50.510
licensed in the U.S.,

00:35:51.510 --> 00:35:53.271
And so when I think of some

00:35:53.311 --> 00:35:55.032
of this and I look for the

00:35:55.092 --> 00:35:57.994
opportunities in the profession, I'm like,

00:35:58.815 --> 00:36:01.275
somebody needs to grease those wheels,

00:36:01.715 --> 00:36:03.237
figure out a way to get

00:36:03.416 --> 00:36:05.677
more foreign trained PTs

00:36:05.777 --> 00:36:07.039
licensed in the U.S.

00:36:07.739 --> 00:36:08.619
And I don't even know if

00:36:08.659 --> 00:36:09.440
there is a way that we

00:36:09.460 --> 00:36:10.880
could get foreign trained

00:36:10.920 --> 00:36:12.862
PTs licensed in the U.S.,

00:36:13.081 --> 00:36:14.543
visas to work in the U.S.,

00:36:14.603 --> 00:36:16.463
but not make them come to the U.S.,

00:36:16.844 --> 00:36:17.923
allow them to work as

00:36:18.003 --> 00:36:20.706
telehealth therapists in the U.S.

00:36:21.621 --> 00:36:21.961
I don't know.

00:36:22.021 --> 00:36:24.304
I have no idea, but I feel like, you know,

00:36:24.324 --> 00:36:25.666
the cost of education is so

00:36:25.706 --> 00:36:28.811
much lower once you crack the, I think,

00:36:29.112 --> 00:36:29.172
um,

00:36:30.181 --> 00:36:31.802
the therapist who is doing it,

00:36:32.262 --> 00:36:35.684
her last name is Jing, like Jingle Bells.

00:36:36.364 --> 00:36:38.106
She had a twelve step

00:36:38.146 --> 00:36:39.746
process for everything that

00:36:39.766 --> 00:36:40.827
needs to happen in order

00:36:40.867 --> 00:36:41.608
for a foreign trained

00:36:41.628 --> 00:36:43.128
therapist to work in the US.

00:36:44.128 --> 00:36:46.269
If we could do that through telehealth,

00:36:46.469 --> 00:36:48.570
again, I know you're not a huge fan,

00:36:48.630 --> 00:36:50.291
but it opens up so much

00:36:50.331 --> 00:36:53.052
capacity that for clients

00:36:53.072 --> 00:36:54.634
who don't need hands on,

00:36:54.673 --> 00:36:55.753
for clients who don't need

00:36:55.793 --> 00:36:58.275
a human in their physical space,

00:36:59.016 --> 00:37:00.460
These therapists could

00:37:00.561 --> 00:37:02.166
really help offload some of

00:37:02.568 --> 00:37:04.614
the wait times and wait

00:37:04.635 --> 00:37:05.739
lists that we see going on.

00:37:07.458 --> 00:37:08.579
I got really lucky recently.

00:37:08.599 --> 00:37:09.260
I was telling you guys that

00:37:09.300 --> 00:37:10.922
I hired a new therapist and

00:37:10.961 --> 00:37:11.681
he's doing well.

00:37:11.922 --> 00:37:14.423
He's actually from Mumbai, India.

00:37:14.903 --> 00:37:16.324
He lives here in Brooklyn.

00:37:16.505 --> 00:37:17.505
He was one of the therapists

00:37:17.525 --> 00:37:18.827
who I sent that cold message.

00:37:18.847 --> 00:37:19.847
I shared it with your group

00:37:19.867 --> 00:37:20.668
last night on the call.

00:37:21.168 --> 00:37:21.849
I sent, you know,

00:37:21.869 --> 00:37:22.849
these cold messages out on

00:37:22.909 --> 00:37:25.030
LinkedIn and he replied,

00:37:25.090 --> 00:37:25.871
he was interested.

00:37:25.931 --> 00:37:26.952
Turns out he's in my same

00:37:26.972 --> 00:37:27.853
neighborhood here in

00:37:27.952 --> 00:37:29.153
Brooklyn and in Bay Ridge

00:37:29.733 --> 00:37:31.494
and he's super hungry and

00:37:31.574 --> 00:37:33.396
he was kind of like kind of

00:37:33.416 --> 00:37:34.257
working part-time for

00:37:34.297 --> 00:37:36.639
another similar style home.

00:37:37.338 --> 00:37:38.260
therapy company.

00:37:39.141 --> 00:37:41.682
But he loves the dollar

00:37:41.702 --> 00:37:43.704
amount and compensation that we offer.

00:37:43.804 --> 00:37:45.186
He loves the fact that it's

00:37:45.306 --> 00:37:47.068
ortho and neuro and most

00:37:47.108 --> 00:37:47.989
other places that are doing

00:37:48.028 --> 00:37:48.989
home visits are typically

00:37:49.030 --> 00:37:50.190
like geriatrics only.

00:37:50.851 --> 00:37:53.333
And so he's loving it.

00:37:53.452 --> 00:37:54.233
And I,

00:37:54.715 --> 00:37:56.155
as part of my interview process with

00:37:56.175 --> 00:37:56.856
every therapist,

00:37:57.597 --> 00:37:58.757
The last part of one of the

00:37:58.777 --> 00:38:01.018
last parts of it is they evaluate me.

00:38:01.297 --> 00:38:01.518
Right.

00:38:01.557 --> 00:38:02.719
So he's in my neighborhood.

00:38:02.739 --> 00:38:04.599
So a couple of weeks ago,

00:38:04.619 --> 00:38:05.659
whenever this was a month ago,

00:38:06.320 --> 00:38:07.340
he came over my apartment.

00:38:07.400 --> 00:38:09.541
I popped open my portable treatment table.

00:38:09.601 --> 00:38:12.822
He evaluated me and I was so impressed.

00:38:12.842 --> 00:38:13.563
And that's why I hired him.

00:38:13.583 --> 00:38:14.583
I was so impressed with his

00:38:14.643 --> 00:38:16.003
hands on skills, his

00:38:17.023 --> 00:38:18.264
He had to treat me like a real patient.

00:38:18.344 --> 00:38:21.706
I had fake low back pain sciatica.

00:38:22.746 --> 00:38:24.248
And he took me through an evaluation.

00:38:24.347 --> 00:38:25.509
And then the things where I was like,

00:38:25.528 --> 00:38:25.708
all right,

00:38:25.728 --> 00:38:26.849
let's fast forward through this.

00:38:26.889 --> 00:38:27.670
He was just like, all right,

00:38:27.690 --> 00:38:29.030
so I would do this, this, this, this.

00:38:29.391 --> 00:38:30.490
And his thought process and

00:38:30.530 --> 00:38:31.911
his approach was excellent.

00:38:32.693 --> 00:38:34.393
Checking slump tests,

00:38:34.554 --> 00:38:35.733
all the things that the DBT

00:38:35.773 --> 00:38:37.554
program would cover for a new therapist.

00:38:38.014 --> 00:38:39.516
I was super, super impressed.

00:38:40.137 --> 00:38:41.617
And the one thing I didn't realize,

00:38:41.817 --> 00:38:42.157
he said...

00:38:42.938 --> 00:38:44.378
you know, he said back in Mumbai,

00:38:44.418 --> 00:38:45.280
there is like,

00:38:45.320 --> 00:38:47.041
I forget which area or whatever, but like,

00:38:47.402 --> 00:38:49.344
there's kind of like a New York, New York,

00:38:49.384 --> 00:38:52.146
like Manhattan style area in Mumbai.

00:38:52.206 --> 00:38:53.266
So in terms of like people

00:38:53.608 --> 00:38:56.590
and clientele that have high expectations,

00:38:56.630 --> 00:38:59.132
they're affluent, they have, um, you know,

00:38:59.152 --> 00:39:00.373
discretionary income, all that.

00:39:00.574 --> 00:39:01.315
I didn't realize that.

00:39:01.335 --> 00:39:02.074
So he told me that.

00:39:02.635 --> 00:39:03.295
And I was like,

00:39:03.456 --> 00:39:04.737
you're going to fit in perfectly.

00:39:04.777 --> 00:39:06.239
Like we go in, like,

00:39:06.659 --> 00:39:07.340
of course you want to treat

00:39:07.360 --> 00:39:08.601
everyone respectfully and all that.

00:39:08.621 --> 00:39:09.001
But like,

00:39:10.010 --> 00:39:11.132
being able to deal with that

00:39:11.172 --> 00:39:12.672
clientele is really important for me.

00:39:12.692 --> 00:39:12.891
And it's,

00:39:13.092 --> 00:39:14.072
it's important because that's

00:39:14.293 --> 00:39:15.994
kind of our ideal clientele

00:39:16.253 --> 00:39:17.255
and he's been fitting in great.

00:39:17.295 --> 00:39:19.996
So he was trained in Mumbai.

00:39:20.175 --> 00:39:22.777
And if you didn't know any different,

00:39:22.797 --> 00:39:23.557
like you would think that

00:39:23.597 --> 00:39:25.759
he was trained at some DBT program here.

00:39:25.818 --> 00:39:27.400
So huge fan of that.

00:39:28.159 --> 00:39:30.161
If they're here in person in

00:39:30.201 --> 00:39:33.983
the U S treating in person, not remotely,

00:39:34.523 --> 00:39:36.304
not video visits, not telehealth.

00:39:36.324 --> 00:39:37.925
But again, that's just, that's my bias.

00:39:38.976 --> 00:39:43.204
So I think where we see AI

00:39:43.264 --> 00:39:45.969
technology coming into play here,

00:39:46.231 --> 00:39:49.737
Joey Albritton sent me an audio clip

00:39:50.817 --> 00:39:51.878
I would have a hundred

00:39:51.918 --> 00:39:52.918
percent thought it was him.

00:39:53.139 --> 00:39:54.780
Like there is absolutely no

00:39:54.820 --> 00:39:58.061
doubt in my mind, the cadence of speech,

00:39:58.181 --> 00:39:59.402
the terminology,

00:39:59.643 --> 00:40:01.583
everything that was being said,

00:40:01.764 --> 00:40:02.605
I thought he stripped the

00:40:02.664 --> 00:40:04.206
audio from a video that he

00:40:04.246 --> 00:40:06.427
had recorded and was sharing it with me.

00:40:06.987 --> 00:40:08.909
It was a hundred percent AI generated.

00:40:09.429 --> 00:40:10.831
It was phenomenal.

00:40:11.431 --> 00:40:13.233
And so we see these AI

00:40:13.273 --> 00:40:15.036
companies coming out with

00:40:15.076 --> 00:40:16.978
these video avatars and you

00:40:17.018 --> 00:40:18.521
can't even tell the difference.

00:40:19.722 --> 00:40:21.684
What I'm really curious to see is,

00:40:22.782 --> 00:40:25.523
How quickly it goes from, okay,

00:40:25.563 --> 00:40:27.923
humans in person to humans

00:40:27.943 --> 00:40:29.545
through telehealth to

00:40:29.644 --> 00:40:32.626
virtual AI generated humans

00:40:32.947 --> 00:40:34.327
on a telehealth platform.

00:40:34.907 --> 00:40:36.748
You talked about mock

00:40:36.789 --> 00:40:39.730
evaluations and role play.

00:40:40.230 --> 00:40:40.871
I hate that.

00:40:40.931 --> 00:40:42.210
That drives me insane.

00:40:43.092 --> 00:40:44.371
I would never feel

00:40:44.411 --> 00:40:45.813
comfortable being a fake

00:40:45.873 --> 00:40:46.913
patient and having a

00:40:47.014 --> 00:40:48.914
candidate try to evaluate

00:40:48.954 --> 00:40:49.994
me or do anything to me.

00:40:50.335 --> 00:40:52.155
But that's my weird thing.

00:40:52.235 --> 00:40:52.940
craziness.

00:40:53.181 --> 00:40:53.905
Don't touch Tony.

00:40:56.199 --> 00:40:57.559
Which is hilarious because I

00:40:57.579 --> 00:40:59.981
get so... Okay, anyway.

00:41:00.021 --> 00:41:01.661
I started doing this with

00:41:01.902 --> 00:41:04.481
the new ChatGPT-Foro voice feature.

00:41:05.021 --> 00:41:06.503
So what I did was I got into

00:41:06.563 --> 00:41:09.083
ChatGPT-Foro on the phone.

00:41:09.882 --> 00:41:11.684
I started using the voice feature.

00:41:11.704 --> 00:41:12.224
I said, hey,

00:41:12.983 --> 00:41:14.625
I am teaching physical therapy

00:41:14.684 --> 00:41:16.304
students how to improve

00:41:16.324 --> 00:41:17.724
their evaluation skills.

00:41:18.304 --> 00:41:20.306
I want you to be a patient.

00:41:20.425 --> 00:41:22.306
I want to do a mock evaluation.

00:41:22.967 --> 00:41:24.387
I will give you the condition...

00:41:25.543 --> 00:41:26.784
But then I want you,

00:41:27.123 --> 00:41:28.385
the student is going to ask

00:41:28.405 --> 00:41:30.327
you questions in real time.

00:41:31.407 --> 00:41:32.949
And I want the student to

00:41:32.989 --> 00:41:33.929
figure out what the

00:41:33.969 --> 00:41:36.331
diagnosis is that I'm telling you.

00:41:37.092 --> 00:41:39.213
It was incredible.

00:41:39.333 --> 00:41:41.835
The interactive, the voice back and forth,

00:41:41.875 --> 00:41:43.556
the inflections, like everything.

00:41:43.976 --> 00:41:45.398
And I shared this in the DPT

00:41:45.438 --> 00:41:46.798
student group on Facebook.

00:41:46.818 --> 00:41:49.079
I was like, hey, who's doing this?

00:41:49.161 --> 00:41:50.842
This is so incredible and

00:41:50.882 --> 00:41:52.523
it's so easy and it's so cheap.

00:41:52.543 --> 00:41:53.264
You can turn it into a

00:41:53.324 --> 00:41:54.605
custom GPT if you want.

00:41:55.385 --> 00:41:55.945
Um,

00:41:56.005 --> 00:41:58.166
but have you played around with that at

00:41:58.246 --> 00:41:58.425
all?

00:41:58.606 --> 00:42:00.166
Even from a training perspective,

00:42:00.186 --> 00:42:02.867
like you coach and train your staff,

00:42:02.887 --> 00:42:04.347
your other therapist on how

00:42:04.367 --> 00:42:06.108
to answer the phone, how to handle,

00:42:06.628 --> 00:42:07.469
you know, uh,

00:42:07.929 --> 00:42:09.550
new calls and prospects

00:42:10.369 --> 00:42:11.791
turning GPT four Oh,

00:42:12.110 --> 00:42:14.630
into a training partner is

00:42:14.692 --> 00:42:15.972
incredibly effective.

00:42:17.126 --> 00:42:18.027
I need to look into it and

00:42:18.106 --> 00:42:19.768
use it for onboarding and training.

00:42:19.949 --> 00:42:20.389
I agree.

00:42:21.269 --> 00:42:23.592
The thing with Joey, like that example,

00:42:23.672 --> 00:42:24.592
I have something really quick.

00:42:24.632 --> 00:42:25.614
I know we have like only

00:42:25.653 --> 00:42:26.353
three minutes left.

00:42:26.393 --> 00:42:29.556
So Sturdy McKee posted some

00:42:29.996 --> 00:42:31.077
content piece and I think

00:42:31.097 --> 00:42:31.838
he might've tagged you.

00:42:32.079 --> 00:42:33.360
He tagged me in it on LinkedIn.

00:42:33.699 --> 00:42:34.400
I'll have to send it to you

00:42:34.420 --> 00:42:35.101
if you haven't seen it.

00:42:35.501 --> 00:42:36.643
I clicked on it.

00:42:37.143 --> 00:42:38.565
It was a podcast episode.

00:42:39.550 --> 00:42:40.492
that he took,

00:42:40.934 --> 00:42:43.217
so he's using an app called Notebook LM.

00:42:43.277 --> 00:42:44.059
I'd never even heard of it.

00:42:45.302 --> 00:42:46.023
Have you heard of it?

00:42:46.043 --> 00:42:46.525
Google, yeah.

00:42:46.684 --> 00:42:47.626
Their language model.

00:42:48.483 --> 00:42:48.903
Okay.

00:42:49.063 --> 00:42:49.844
Not Gemini,

00:42:49.884 --> 00:42:50.804
but it's a different one that

00:42:50.824 --> 00:42:51.664
they have available.

00:42:52.204 --> 00:42:53.965
So apparently Sturdy took a

00:42:54.045 --> 00:42:55.865
blog post and I guess he,

00:42:56.206 --> 00:42:57.565
he just copy and pasted the

00:42:57.585 --> 00:42:58.646
blog post into it.

00:42:59.045 --> 00:43:00.367
And the audio is it's,

00:43:00.487 --> 00:43:03.467
it's a podcast of a woman and a man.

00:43:03.507 --> 00:43:06.467
So like two co-hosts of a fake podcast,

00:43:06.827 --> 00:43:07.608
they're talking about

00:43:07.668 --> 00:43:09.128
Sturdy McKee as if it, I mean,

00:43:09.148 --> 00:43:10.489
it sounds like it's from the news.

00:43:10.568 --> 00:43:11.528
It's incredible.

00:43:11.628 --> 00:43:13.869
It sounds like two real humans.

00:43:13.889 --> 00:43:14.349
Like you said,

00:43:14.889 --> 00:43:17.731
Inflection points, pauses, little chuckles,

00:43:18.110 --> 00:43:19.532
the tonality changes,

00:43:20.311 --> 00:43:21.172
and it's completely

00:43:21.351 --> 00:43:22.373
artificial intelligence.

00:43:22.733 --> 00:43:24.474
And I was blown away.

00:43:24.994 --> 00:43:25.434
I'm listening.

00:43:25.653 --> 00:43:27.175
I got like I got like a minute.

00:43:27.434 --> 00:43:28.534
I got two minutes and thirty

00:43:28.574 --> 00:43:29.514
seven seconds into it.

00:43:30.056 --> 00:43:31.275
And then I screenshot it and

00:43:31.436 --> 00:43:32.115
I texted Sturdy.

00:43:32.135 --> 00:43:34.717
I was like, is it like is this for real?

00:43:34.757 --> 00:43:36.478
Both like two minutes.

00:43:36.677 --> 00:43:38.059
People, artificial intelligence.

00:43:38.400 --> 00:43:39.541
They're talking about Sturdy McKee.

00:43:39.561 --> 00:43:41.181
So then they're positioning.

00:43:41.481 --> 00:43:42.623
It's a piece of content for Sturdy.

00:43:42.643 --> 00:43:44.605
It's positioning him in a good light.

00:43:44.844 --> 00:43:46.065
It sounds like he was

00:43:46.126 --> 00:43:47.668
featured on some other podcast.

00:43:47.688 --> 00:43:48.467
That's what it sounds like.

00:43:49.068 --> 00:43:50.931
It's like two real people talking.

00:43:51.811 --> 00:43:52.331
Incredible.

00:43:52.371 --> 00:43:53.472
So I'm assuming the thing

00:43:53.492 --> 00:43:54.293
that Joey sent you is

00:43:54.333 --> 00:43:55.213
probably similar to that

00:43:55.253 --> 00:43:56.835
where you couldn't even

00:43:56.876 --> 00:43:58.898
tell that it was artificial intelligence.

00:43:59.659 --> 00:44:01.280
Yeah, it is.

00:44:01.880 --> 00:44:04.202
There's several large

00:44:04.242 --> 00:44:05.202
language models that are

00:44:05.242 --> 00:44:06.744
capable of doing it right now.

00:44:06.864 --> 00:44:08.746
The Google Notebook is one,

00:44:08.786 --> 00:44:10.246
then there's other

00:44:10.407 --> 00:44:11.347
businesses that have been

00:44:11.387 --> 00:44:13.449
built as wrapper companies around that,

00:44:13.510 --> 00:44:15.271
that also do this stuff.

00:44:18.373 --> 00:44:20.775
I mean, imagine back the original iPhone,

00:44:20.795 --> 00:44:22.297
the first time this came out,

00:44:22.436 --> 00:44:23.978
what it was like, what it could do,

00:44:24.057 --> 00:44:26.099
how revolutionary it was back then,

00:44:26.561 --> 00:44:28.141
and now look at it compared

00:44:28.181 --> 00:44:29.503
to iPhone XVI.

00:44:29.963 --> 00:44:31.744
We are in such an early

00:44:31.804 --> 00:44:34.367
stage of what this technology can do.

00:44:34.907 --> 00:44:35.447
Obviously,

00:44:35.467 --> 00:44:37.309
it could be used for good or bad,

00:44:38.190 --> 00:44:41.652
but we need to embrace and

00:44:42.092 --> 00:44:43.775
start to figure this stuff out.

00:44:44.355 --> 00:44:45.655
So yeah, my fault.

00:44:45.675 --> 00:44:47.916
I need to wrap up a little early today.

00:44:48.177 --> 00:44:49.657
Let's go to parting shots.

00:44:50.478 --> 00:44:51.518
What's your parting shot?

00:44:52.820 --> 00:44:55.262
Parting shot is ten years, twenty years,

00:44:55.322 --> 00:44:57.063
thirty years, fifty years from now,

00:44:57.402 --> 00:44:59.123
there will still never, ever,

00:44:59.284 --> 00:45:02.465
ever be an app or language

00:45:02.525 --> 00:45:05.447
model or fake telehealth, whatever,

00:45:05.487 --> 00:45:08.829
to replace physical therapy.

00:45:08.849 --> 00:45:12.072
The in-person, I have very smart

00:45:13.918 --> 00:45:15.661
clients and patients, their physicians,

00:45:15.702 --> 00:45:16.603
their investors,

00:45:16.643 --> 00:45:19.889
they're very intelligent people.

00:45:19.969 --> 00:45:21.010
And even they

00:45:21.994 --> 00:45:24.376
need the in-person accountability.

00:45:24.416 --> 00:45:26.077
They need something

00:45:26.117 --> 00:45:27.139
scheduled on their calendar.

00:45:27.219 --> 00:45:29.161
If it's an AI, something on your calendar,

00:45:29.181 --> 00:45:30.081
you're just going to cancel it.

00:45:30.101 --> 00:45:30.943
You're just going to no-show it.

00:45:30.963 --> 00:45:31.422
You won't care.

00:45:31.463 --> 00:45:32.864
You won't take it seriously, whatever.

00:45:33.525 --> 00:45:36.367
I truly believe, fifty years from now,

00:45:36.588 --> 00:45:38.248
there will still be humans,

00:45:39.110 --> 00:45:40.331
human physical therapists,

00:45:40.731 --> 00:45:42.713
treating human patients,

00:45:42.994 --> 00:45:44.054
and the human patients are

00:45:44.074 --> 00:45:45.235
paying a premium dollar

00:45:45.255 --> 00:45:45.956
amount out of pocket.

00:45:47.065 --> 00:45:47.284
Okay,

00:45:47.324 --> 00:45:48.706
I'm going to take the other side of

00:45:48.746 --> 00:45:49.445
that bet.

00:45:50.085 --> 00:45:51.266
I'm going to say probably

00:45:51.306 --> 00:45:52.568
within three years,

00:45:53.168 --> 00:45:54.568
we're going to have AI

00:45:54.588 --> 00:45:57.289
that's far better than the

00:45:57.469 --> 00:45:58.730
eighty percent under the

00:45:58.789 --> 00:45:59.990
center of the bell curve.

00:46:01.411 --> 00:46:03.012
Just because, you know,

00:46:03.132 --> 00:46:04.873
we already know AI is more

00:46:04.913 --> 00:46:06.634
empathetic than humans when

00:46:06.673 --> 00:46:07.494
it comes to health care.

00:46:07.514 --> 00:46:08.795
Like that's already been established.

00:46:08.815 --> 00:46:09.835
That's already been researched.

00:46:09.855 --> 00:46:10.815
That's already been proven.

00:46:11.715 --> 00:46:13.976
We see that we can generate

00:46:14.036 --> 00:46:15.958
video content that is

00:46:16.557 --> 00:46:19.599
almost better than human video content.

00:46:20.199 --> 00:46:22.141
You put the empathy with

00:46:22.161 --> 00:46:24.001
that and then you take into account.

00:46:24.362 --> 00:46:25.503
I don't know if you guys remember,

00:46:25.583 --> 00:46:28.284
but I was using HippoScribe

00:46:28.324 --> 00:46:30.764
to process transcripts from

00:46:30.864 --> 00:46:32.226
real patient engagements

00:46:32.766 --> 00:46:35.626
and give me the fears, the anxieties,

00:46:35.706 --> 00:46:36.847
the triggers, the

00:46:37.047 --> 00:46:39.168
that were identified during

00:46:39.228 --> 00:46:40.170
the conversation,

00:46:40.911 --> 00:46:42.472
AI can figure that stuff out.

00:46:42.512 --> 00:46:44.293
So when you want to talk about motivation,

00:46:45.293 --> 00:46:45.974
AI is going to be a

00:46:46.034 --> 00:46:47.775
thousand times better at

00:46:47.855 --> 00:46:48.635
understanding what

00:46:48.675 --> 00:46:49.797
motivates Dave Kittle

00:46:49.836 --> 00:46:51.277
versus what motivates Tony

00:46:51.677 --> 00:46:53.358
Meritato versus anybody else.

00:46:53.878 --> 00:46:54.099
So...

00:46:55.199 --> 00:46:56.442
It's no chance.

00:46:56.822 --> 00:46:58.065
It's going to take fifty years.

00:46:58.125 --> 00:46:59.427
It's not going to take ten years.

00:47:00.369 --> 00:47:02.112
I really think in three years,

00:47:02.713 --> 00:47:04.195
AI is going to replace the

00:47:04.356 --> 00:47:06.980
bulk of what the profession is doing.

00:47:07.481 --> 00:47:08.923
The profession right now.

00:47:10.572 --> 00:47:11.954
Here's a real quick, I know we got to run.

00:47:12.373 --> 00:47:13.556
I have something on my calendar.

00:47:13.615 --> 00:47:15.798
It's called business focused

00:47:15.898 --> 00:47:17.481
hour on my calendar.

00:47:17.501 --> 00:47:18.782
When that pops up on my calendar,

00:47:18.882 --> 00:47:20.103
I am supposed to do one

00:47:20.143 --> 00:47:23.347
hour of business focused something on my,

00:47:23.628 --> 00:47:25.090
for my business, for my practice.

00:47:26.150 --> 00:47:27.632
And it, I'm the only one that sees it.

00:47:28.641 --> 00:47:30.282
So guess what happens sometimes, Tony?

00:47:30.302 --> 00:47:31.581
What?

00:47:31.601 --> 00:47:32.583
Do you think I always do

00:47:32.623 --> 00:47:33.842
business focused activities

00:47:33.862 --> 00:47:34.543
during that time when it

00:47:34.583 --> 00:47:35.364
pops up on my calendar?

00:47:36.204 --> 00:47:36.583
Do you think?

00:47:36.603 --> 00:47:36.963
What do you think?

00:47:36.983 --> 00:47:38.224
I'm guessing no.

00:47:38.784 --> 00:47:39.324
Exactly.

00:47:39.646 --> 00:47:41.326
And as hardworking and as

00:47:41.385 --> 00:47:44.688
motivated and entrepreneurial as I am,

00:47:44.728 --> 00:47:45.128
that's me.

00:47:45.768 --> 00:47:47.150
Now imagine a telehealth visit on,

00:47:47.269 --> 00:47:49.132
you know, John Joseph,

00:47:49.432 --> 00:47:50.193
your next door neighbor,

00:47:50.434 --> 00:47:51.715
telehealth visit on his calendar.

00:47:52.036 --> 00:47:52.737
You think he's gonna take it

00:47:52.777 --> 00:47:54.498
seriously in five, ten, fifteen?

00:47:54.840 --> 00:47:56.161
I don't care about the emotional triggers.

00:47:56.722 --> 00:47:59.385
There is no human onus on it.

00:47:59.425 --> 00:48:00.967
I'm telling you, it's never gonna happen.

00:48:01.527 --> 00:48:01.987
But see,

00:48:02.068 --> 00:48:04.190
you were thinking of it from what

00:48:04.230 --> 00:48:05.510
you understand right now.

00:48:05.570 --> 00:48:07.331
Like what happens when AI

00:48:07.413 --> 00:48:08.592
assistants are tied into

00:48:08.632 --> 00:48:10.215
your bank account and the

00:48:10.695 --> 00:48:12.175
AI knows that you're money

00:48:12.215 --> 00:48:13.456
motivated and says, hey,

00:48:13.597 --> 00:48:15.177
I'm going to donate a

00:48:15.257 --> 00:48:17.719
thousand dollars to the KKK

00:48:17.760 --> 00:48:19.402
because you're not doing

00:48:19.442 --> 00:48:20.322
what you need to do.

00:48:21.302 --> 00:48:23.264
I promise it is going to

00:48:23.385 --> 00:48:24.766
understand how to get you

00:48:24.806 --> 00:48:26.226
to do what you don't want to do.

00:48:26.266 --> 00:48:27.246
That's a whole other model

00:48:27.266 --> 00:48:28.347
without insurance then.

00:48:28.367 --> 00:48:29.028
That's a whole other...

00:48:30.000 --> 00:48:30.561
Real quick,

00:48:30.621 --> 00:48:31.942
Will said we already have

00:48:32.081 --> 00:48:33.764
endless info and people

00:48:33.903 --> 00:48:35.105
still aren't getting better.

00:48:35.125 --> 00:48:36.126
Thank you, Will.

00:48:36.206 --> 00:48:36.927
Implementation.

00:48:37.668 --> 00:48:38.789
There is no AI that's going

00:48:38.809 --> 00:48:39.929
to help with implementation

00:48:39.949 --> 00:48:41.132
that's going to help you

00:48:41.672 --> 00:48:42.972
physically do something

00:48:43.074 --> 00:48:44.255
differently about your

00:48:44.275 --> 00:48:45.556
health and wellness, in my opinion.

00:48:45.936 --> 00:48:46.577
Implementation.

00:48:46.617 --> 00:48:47.717
There's no app that's going to

00:48:48.873 --> 00:48:49.715
Change that.

00:48:49.735 --> 00:48:50.715
Hopefully we're all still

00:48:50.755 --> 00:48:51.675
here in three years.

00:48:51.755 --> 00:48:52.697
We can come back.

00:48:52.737 --> 00:48:53.918
You can prove me wrong.

00:48:54.057 --> 00:48:55.878
I will gladly take my lumps.

00:48:55.978 --> 00:48:58.320
Guys, thank you so much for being here.

00:48:58.380 --> 00:49:00.282
Join us every Tuesday and Thursday,

00:49:00.382 --> 00:49:01.202
eight thirty a.m.

00:49:01.242 --> 00:49:02.744
to talk about PT business.

00:49:03.103 --> 00:49:04.784
Go check out the Dave Kittle show.

00:49:04.864 --> 00:49:07.106
Join the PT podcast

00:49:07.146 --> 00:49:08.246
community and I will see

00:49:08.266 --> 00:49:10.048
you guys next week.

00:49:10.128 --> 00:49:10.389
Thank you.