The Overeducation Dilemma: Are We Training PTs for the Wrong Job?

WEBVTT

00:00:02.141 --> 00:00:03.863
Hey guys, Tony Maritato here.

00:00:04.184 --> 00:00:05.865
Welcome to PT Breakfast Club.

00:00:05.966 --> 00:00:09.430
My silent partner on the left, Jimmy McKay,

00:00:09.711 --> 00:00:11.253
having an amazing morning.

00:00:11.792 --> 00:00:13.074
Dave Kittle will be joining

00:00:13.214 --> 00:00:16.178
us in a couple minutes.

00:00:16.478 --> 00:00:18.361
Let's hit this intro and

00:00:18.420 --> 00:00:19.682
then we'll be ready to go.

00:00:40.588 --> 00:00:42.972
All right, Dave Kittle is back.

00:00:43.493 --> 00:00:44.776
So Jimmy is just going to be

00:00:44.816 --> 00:00:45.618
a pretty face in the

00:00:45.658 --> 00:00:46.880
background today because he

00:00:46.960 --> 00:00:48.201
literally cannot talk.

00:00:49.585 --> 00:00:51.347
Dave, how are you doing this morning?

00:00:53.734 --> 00:00:54.255
I'm feeling great.

00:00:54.295 --> 00:00:55.095
I got some construction

00:00:55.115 --> 00:00:56.996
right outside the old window here.

00:00:57.076 --> 00:00:57.957
So we're gonna see if we can

00:00:57.978 --> 00:00:58.878
make this happen, yeah.

00:00:59.219 --> 00:01:00.198
Yeah, no problem.

00:01:00.719 --> 00:01:01.740
We can't hear anything.

00:01:01.820 --> 00:01:05.302
So I've got a couple of things queued up.

00:01:06.003 --> 00:01:09.206
Let's take today as kind of what's new,

00:01:09.245 --> 00:01:09.945
what's going on,

00:01:09.986 --> 00:01:10.846
what are people talking

00:01:10.906 --> 00:01:12.408
about in physical therapy?

00:01:13.128 --> 00:01:13.948
And Dave,

00:01:14.108 --> 00:01:15.849
I'm gonna start with you because

00:01:16.109 --> 00:01:17.271
you shared a post.

00:01:17.531 --> 00:01:19.052
Let me pull up the screenshot.

00:01:19.632 --> 00:01:21.353
This post was probably from

00:01:21.433 --> 00:01:22.435
one of my favorite people.

00:01:23.094 --> 00:01:24.435
Although I disagree with him,

00:01:25.055 --> 00:01:26.635
he's still one of my favorite people.

00:01:26.676 --> 00:01:29.436
I think this is a great guy.

00:01:29.536 --> 00:01:30.575
Jeff Moore.

00:01:31.215 --> 00:01:32.477
So Jeff said, you know,

00:01:32.557 --> 00:01:33.397
one of the strangest

00:01:33.477 --> 00:01:35.037
hurdles PTs have to

00:01:35.177 --> 00:01:37.578
overcome and in route to

00:01:37.658 --> 00:01:38.477
creating a thriving

00:01:38.518 --> 00:01:39.918
practice is the endless

00:01:40.037 --> 00:01:42.698
shame hurdled upon them by

00:01:42.938 --> 00:01:45.938
other PTs for choosing not to work with,

00:01:46.578 --> 00:01:46.978
quote,

00:01:47.478 --> 00:01:50.040
profit obsessed insurance companies.

00:01:50.760 --> 00:01:52.960
OK, so I totally agree.

00:01:53.081 --> 00:01:55.121
We beat ourselves up more than anything.

00:01:55.162 --> 00:01:56.962
I want to get your perspective in a second,

00:01:57.004 --> 00:01:57.304
Dave.

00:01:58.323 --> 00:01:59.444
But then once we hit the

00:01:59.484 --> 00:02:01.605
propaganda of profit

00:02:01.686 --> 00:02:03.566
obsessed insurance companies,

00:02:04.027 --> 00:02:05.847
that's where I start to disagree here.

00:02:06.509 --> 00:02:08.949
And instead charging a fair quote,

00:02:09.229 --> 00:02:11.891
fair price directly to consumers.

00:02:12.852 --> 00:02:13.953
So, Dave, you shared this.

00:02:14.932 --> 00:02:16.153
You talked about it.

00:02:16.373 --> 00:02:17.574
What's your perspective on that?

00:02:19.502 --> 00:02:21.262
So, yeah, I reshared it on Facebook.

00:02:21.282 --> 00:02:22.802
First of all, I was going to bring this up,

00:02:22.862 --> 00:02:23.603
so I'm glad that you

00:02:23.842 --> 00:02:24.902
immediately brought it up.

00:02:24.923 --> 00:02:25.824
Shout out to Jeff Moore.

00:02:25.843 --> 00:02:26.963
Great guy.

00:02:27.743 --> 00:02:28.883
I believe he's still in Michigan.

00:02:28.903 --> 00:02:30.824
Known him for, I don't know,

00:02:30.865 --> 00:02:31.965
at least 10 years or more.

00:02:34.205 --> 00:02:35.545
So I understand where he's coming from.

00:02:35.566 --> 00:02:37.366
So he's got Onward Health,

00:02:37.486 --> 00:02:38.586
and they basically do

00:02:39.106 --> 00:02:40.706
out-of-pocket or out-of-network billing,

00:02:40.787 --> 00:02:41.848
and they do one-on-one visits.

00:02:41.967 --> 00:02:44.268
So it comes from that lens, right?

00:02:47.593 --> 00:02:47.854
I don't know.

00:02:47.873 --> 00:02:48.054
I mean,

00:02:48.074 --> 00:02:50.534
I think I agree with him more than

00:02:50.615 --> 00:02:51.094
disagree.

00:02:51.514 --> 00:02:53.235
But I re-shared, I said, hey,

00:02:53.294 --> 00:02:54.975
this is why my practice,

00:02:54.996 --> 00:02:55.836
Concierge Pain Relief,

00:02:56.415 --> 00:02:57.395
only accepts five

00:02:57.977 --> 00:02:59.377
out-of-network payers where

00:02:59.417 --> 00:03:00.997
we have a biller who bills

00:03:01.037 --> 00:03:01.956
those insurance companies,

00:03:01.977 --> 00:03:03.038
the out-of-network benefit

00:03:03.478 --> 00:03:04.798
component of the plans.

00:03:05.997 --> 00:03:07.878
Otherwise, overall,

00:03:07.899 --> 00:03:08.979
we're mostly out-of-pocket

00:03:09.158 --> 00:03:10.740
where the consumers are

00:03:10.819 --> 00:03:11.580
basically paying us

00:03:11.639 --> 00:03:12.439
out-of-pocket through their

00:03:12.659 --> 00:03:14.980
credit card or, in some cases, their HSA,

00:03:15.121 --> 00:03:16.040
FSA card, whatever.

00:03:17.330 --> 00:03:19.894
So I think I share enough

00:03:19.933 --> 00:03:21.254
commonality with Jeff in

00:03:21.295 --> 00:03:24.719
this whole situation that I reshared it.

00:03:24.800 --> 00:03:26.562
And I'm assuming it sounds

00:03:26.603 --> 00:03:27.644
like I agree with him way

00:03:27.663 --> 00:03:28.104
more than you do.

00:03:30.161 --> 00:03:33.021
It's just we agree on the fact that, yeah,

00:03:33.081 --> 00:03:35.562
PTs are our own worst enemy.

00:03:35.742 --> 00:03:37.463
Like we beat each other up.

00:03:37.563 --> 00:03:39.384
We argue about interventions.

00:03:39.444 --> 00:03:40.764
We argue about business.

00:03:40.805 --> 00:03:41.805
We argue about everything.

00:03:42.825 --> 00:03:45.306
And ironically, as much as PTs are like,

00:03:45.407 --> 00:03:45.606
hey,

00:03:45.646 --> 00:03:47.026
we're going to help every patient

00:03:47.067 --> 00:03:48.548
achieve every, you know,

00:03:48.728 --> 00:03:49.888
objective and every goal

00:03:49.927 --> 00:03:52.169
they have with ourselves.

00:03:52.789 --> 00:03:53.770
If I want

00:03:54.169 --> 00:03:55.491
somebody to tell me no,

00:03:55.792 --> 00:03:56.573
first person I'm going to

00:03:56.673 --> 00:03:57.854
ask is a physical therapist.

00:03:58.074 --> 00:03:59.695
Because when I post anything

00:03:59.756 --> 00:04:00.657
on social media,

00:04:01.276 --> 00:04:02.318
every physical therapist

00:04:02.358 --> 00:04:04.300
comes on with why I can't do it,

00:04:04.379 --> 00:04:05.401
why I'll never do it,

00:04:05.502 --> 00:04:06.643
why I shouldn't do it.

00:04:06.823 --> 00:04:08.063
It's all negativity,

00:04:08.604 --> 00:04:10.145
which is so disheartening.

00:04:11.067 --> 00:04:11.986
because they would never be

00:04:12.026 --> 00:04:13.147
like that with their patient.

00:04:14.108 --> 00:04:17.509
So that being said, from my perspective,

00:04:17.550 --> 00:04:18.370
and believe me,

00:04:18.410 --> 00:04:19.389
insurance companies don't

00:04:19.449 --> 00:04:20.971
need me to be their advocate.

00:04:22.451 --> 00:04:24.252
But truth be told, they don't care.

00:04:24.271 --> 00:04:26.372
UnitedHealthcare is

00:04:26.552 --> 00:04:28.134
everyone's favorite scapegoat.

00:04:29.093 --> 00:04:30.353
I was teaching last night,

00:04:30.394 --> 00:04:31.995
we were talking about UnitedHealthcare.

00:04:32.035 --> 00:04:34.495
I was showing Medicare Advantage plans and

00:04:34.935 --> 00:04:37.057
Comparing that to traditional Medicare,

00:04:37.137 --> 00:04:38.199
everybody wants to beat up

00:04:38.259 --> 00:04:39.278
on Medicare Advantage,

00:04:39.319 --> 00:04:42.040
but the reality is traditional Medicare,

00:04:42.242 --> 00:04:44.543
if you're a Medicare beneficiary, Part B,

00:04:44.884 --> 00:04:45.124
yes,

00:04:45.223 --> 00:04:47.685
you have an amazing amount of freedom

00:04:48.286 --> 00:04:49.627
and lots of coverage,

00:04:49.666 --> 00:04:50.408
but you pay for that.

00:04:50.887 --> 00:04:52.468
Medicare Part B premiums,

00:04:52.548 --> 00:04:53.788
monthly premiums range

00:04:53.829 --> 00:04:56.490
between like $200 and $500.

00:04:56.490 --> 00:04:57.610
Then your supplemental

00:04:57.670 --> 00:04:58.672
insurance is going to be

00:04:58.732 --> 00:05:01.052
another $200 to $500.

00:05:01.052 --> 00:05:02.533
It's not unreasonable for a

00:05:02.613 --> 00:05:05.134
Medicare Part B beneficiary

00:05:05.175 --> 00:05:07.495
to be paying $500 to $1,000

00:05:07.495 --> 00:05:11.038
a month for primary, secondary insurance.

00:05:11.257 --> 00:05:11.718
Awesome.

00:05:12.237 --> 00:05:13.439
But if you go and look at

00:05:13.499 --> 00:05:14.918
the plans in your area for

00:05:14.939 --> 00:05:15.899
Medicare Advantage,

00:05:16.798 --> 00:05:18.918
Lots of them have zero monthly premium.

00:05:18.978 --> 00:05:20.298
Lots of them have coverage

00:05:20.338 --> 00:05:21.519
that Medicare Part B

00:05:21.540 --> 00:05:23.620
doesn't offer like fitness memberships,

00:05:23.740 --> 00:05:25.781
dental, vision, pharmacy,

00:05:26.461 --> 00:05:27.482
all this other stuff.

00:05:28.062 --> 00:05:30.062
So from the consumer side,

00:05:31.043 --> 00:05:32.064
I'm gonna go with a plan

00:05:32.084 --> 00:05:34.125
like that if I'm not traveling the world,

00:05:34.165 --> 00:05:35.504
if I don't need unlimited

00:05:35.605 --> 00:05:36.946
access to every physician

00:05:37.086 --> 00:05:38.105
in the United States.

00:05:38.625 --> 00:05:40.146
If I have my own doc and I'm

00:05:40.166 --> 00:05:41.447
gonna stick with my own doc

00:05:41.487 --> 00:05:42.427
and I'm gonna stick with my

00:05:42.468 --> 00:05:44.389
own hospital and my own location,

00:05:45.548 --> 00:05:46.649
I'm just going to take the

00:05:46.709 --> 00:05:47.990
most affordable plan,

00:05:48.591 --> 00:05:50.430
but don't vilify it because

00:05:50.591 --> 00:05:52.673
I'm choosing something like that.

00:05:53.333 --> 00:05:54.754
And then to say that

00:05:54.834 --> 00:05:58.716
insurance companies are profit, whatever,

00:05:59.596 --> 00:06:00.396
ironically,

00:06:00.896 --> 00:06:02.177
aren't we the ones complaining

00:06:02.216 --> 00:06:03.158
we don't get paid enough?

00:06:03.278 --> 00:06:04.098
Aren't we the ones

00:06:04.158 --> 00:06:05.499
complaining we need more money?

00:06:05.619 --> 00:06:07.519
Aren't we the ones obsessed

00:06:07.600 --> 00:06:09.180
with profitability because

00:06:09.680 --> 00:06:11.002
we feel like we don't have it?

00:06:11.101 --> 00:06:14.983
And if you look, go on to Yahoo Finance,

00:06:15.870 --> 00:06:17.391
What's the profit margin for

00:06:17.451 --> 00:06:19.074
most of these insurance companies?

00:06:19.293 --> 00:06:20.173
Three, five, 7%.

00:06:21.716 --> 00:06:22.656
I know a lot of therapists

00:06:22.675 --> 00:06:25.057
that are making more than that as profit.

00:06:25.517 --> 00:06:28.880
So we're just as guilty as

00:06:28.961 --> 00:06:30.541
any other business for

00:06:30.562 --> 00:06:32.363
trying to maintain profit margins.

00:06:33.725 --> 00:06:35.706
But what do you say to some of that?

00:06:36.187 --> 00:06:36.427
All right.

00:06:36.487 --> 00:06:36.807
Well,

00:06:36.846 --> 00:06:38.148
there's a whole bunch of folks I'm

00:06:38.208 --> 00:06:39.348
sure live and eventually

00:06:39.369 --> 00:06:40.230
watching this recording

00:06:40.250 --> 00:06:41.451
that's going to be mad at Tony.

00:06:41.490 --> 00:06:43.151
So let me speak for them, Tony,

00:06:43.192 --> 00:06:43.572
real quick.

00:06:45.913 --> 00:06:47.555
First of all, the insurance company, first,

00:06:47.776 --> 00:06:49.156
UnitedHealthcare is like

00:06:49.197 --> 00:06:51.038
the fifth highest revenue

00:06:51.117 --> 00:06:52.158
company in the U.S.

00:06:52.699 --> 00:06:55.141
That arguably is crazy.

00:06:55.221 --> 00:06:56.822
Like you got Facebook, Google,

00:06:57.163 --> 00:07:00.004
I think ExxonMobil, Berkshire Hathaway,

00:07:01.165 --> 00:07:01.665
Walmart.

00:07:01.846 --> 00:07:02.927
And I think UnitedHealthcare

00:07:02.947 --> 00:07:03.827
is somewhere around five or

00:07:03.887 --> 00:07:04.928
six or something at any

00:07:04.968 --> 00:07:06.209
given year over the past several years.

00:07:08.790 --> 00:07:09.872
Is that kosher?

00:07:09.992 --> 00:07:10.752
Does that even make sense?

00:07:10.992 --> 00:07:12.093
That's a talking point.

00:07:12.353 --> 00:07:14.435
Another talking point I

00:07:14.456 --> 00:07:15.817
wanted to bring up is I

00:07:15.857 --> 00:07:17.559
wanted to ask you as a recap, Tony,

00:07:17.999 --> 00:07:18.980
when did you open your practice?

00:07:19.040 --> 00:07:20.581
It was 2000 something.

00:07:20.880 --> 00:07:25.004
What was the year?

00:07:25.024 --> 00:07:25.464
2001 into 2002.

00:07:25.504 --> 00:07:25.946
2001 into 2002.

00:07:26.466 --> 00:07:28.267
Do you recall the dollar

00:07:28.307 --> 00:07:30.309
amount of your average

00:07:30.369 --> 00:07:32.951
payer back then or your top payer?

00:07:33.091 --> 00:07:33.891
Do you remember what the

00:07:33.911 --> 00:07:34.473
dollar amount was?

00:07:35.079 --> 00:07:35.379
Yeah,

00:07:35.420 --> 00:07:38.482
we were averaging about $105 per visit.

00:07:39.702 --> 00:07:40.862
You know, even back then,

00:07:40.963 --> 00:07:42.343
UnitedHealthcare had a

00:07:42.423 --> 00:07:45.064
daily limit of like $70 or $75.

00:07:45.064 --> 00:07:46.966
It's gone down since then.

00:07:48.547 --> 00:07:51.209
But we were on average $105

00:07:51.209 --> 00:07:53.269
per hour of physical therapy delivered.

00:07:56.029 --> 00:07:57.451
Okay, $105 around 2002.

00:07:59.192 --> 00:08:00.072
So everything else has

00:08:00.112 --> 00:08:00.913
increased since then.

00:08:01.192 --> 00:08:02.113
You know where I'm getting at.

00:08:02.593 --> 00:08:03.514
Everything else has increased.

00:08:04.074 --> 00:08:05.235
The clothes that we're wearing,

00:08:05.495 --> 00:08:06.456
the Wi-Fi that we're on

00:08:06.476 --> 00:08:08.377
that we're paying for, the rent,

00:08:08.497 --> 00:08:09.338
the mortgage,

00:08:09.439 --> 00:08:10.660
the interest rates have

00:08:10.699 --> 00:08:12.341
changed obviously and fluctuate,

00:08:12.360 --> 00:08:14.442
but cost of living, rent,

00:08:14.682 --> 00:08:15.903
whatever it might be, utilities,

00:08:17.043 --> 00:08:18.045
all the cost of living has

00:08:18.105 --> 00:08:18.886
increased between 2002 and 2024.

00:08:18.886 --> 00:08:20.047
In some cases has increased dramatically.

00:08:23.903 --> 00:08:25.345
and the third-party payers,

00:08:25.985 --> 00:08:27.286
I want to speak to the

00:08:27.346 --> 00:08:28.668
folks at home getting mad

00:08:28.708 --> 00:08:29.749
right now at Tony Meritato

00:08:29.769 --> 00:08:30.970
that are grabbing their

00:08:31.009 --> 00:08:32.350
pitchforks and they are

00:08:32.410 --> 00:08:33.712
coming to Middletown,

00:08:33.773 --> 00:08:35.815
Ohio to come after Tony Meritato.

00:08:37.355 --> 00:08:39.457
That is what Jeff Moore is getting at.

00:08:39.958 --> 00:08:40.538
That's what he would

00:08:40.558 --> 00:08:41.639
probably say if he were here.

00:08:42.801 --> 00:08:43.461
You and I have watched

00:08:43.501 --> 00:08:44.462
enough of his videos and

00:08:44.503 --> 00:08:46.365
his content and understand

00:08:46.384 --> 00:08:47.186
where he's coming from and

00:08:47.206 --> 00:08:47.985
we know him well enough.

00:08:49.187 --> 00:08:51.229
That is the crux of it.

00:08:51.789 --> 00:08:52.769
The challenge is like we

00:08:52.789 --> 00:08:54.331
have this third party payer

00:08:54.351 --> 00:08:55.513
system and it's different

00:08:55.852 --> 00:08:56.513
compared to any other

00:08:56.552 --> 00:08:58.115
industry where any other place,

00:08:58.174 --> 00:09:00.035
any other industry where the consumer,

00:09:00.056 --> 00:09:02.597
the customer is paying the vendor,

00:09:02.638 --> 00:09:03.639
the supplier, the company,

00:09:03.658 --> 00:09:04.399
whatever directly.

00:09:06.313 --> 00:09:07.554
So this is the challenge of

00:09:07.595 --> 00:09:08.855
this whole third party system.

00:09:08.916 --> 00:09:10.437
But I just wanted to bring up the example.

00:09:10.856 --> 00:09:11.716
You had $105 payer on average,

00:09:11.736 --> 00:09:13.558
or your highest payer in 2002.

00:09:13.558 --> 00:09:14.278
And in 2024, now they're paying 70, 80, 90,

00:09:14.278 --> 00:09:14.918
or somewhere below $105.

00:09:14.918 --> 00:09:15.360
That is a huge issue.

00:09:15.379 --> 00:09:17.100
I know it's not easily fixable, but

00:09:33.484 --> 00:09:33.984
I don't know,

00:09:34.264 --> 00:09:35.445
you just have a different

00:09:35.504 --> 00:09:36.706
approach to it where you

00:09:36.745 --> 00:09:37.725
kind of have a business

00:09:37.765 --> 00:09:39.027
model and have all these

00:09:39.047 --> 00:09:39.947
other things going on where

00:09:39.986 --> 00:09:42.828
you understand at a high

00:09:42.869 --> 00:09:44.149
level how you can adapt,

00:09:44.190 --> 00:09:45.330
how you can be amenable to that,

00:09:45.389 --> 00:09:46.730
how you can do things differently.

00:09:47.610 --> 00:09:48.951
When people are, as you know,

00:09:49.011 --> 00:09:49.613
practice owners are

00:09:50.173 --> 00:09:50.773
practicing in the

00:09:51.072 --> 00:09:52.714
traditional old therapy

00:09:52.754 --> 00:09:54.695
model and each year they're

00:09:54.715 --> 00:09:57.456
having less reimbursement, less payment.

00:09:58.197 --> 00:09:59.437
That's where all this is coming from.

00:09:59.457 --> 00:10:00.577
But fill in some gaps here.

00:10:00.597 --> 00:10:01.977
Let me give me some feedback.

00:10:01.998 --> 00:10:02.418
Give me some.

00:10:02.519 --> 00:10:03.678
Yeah, give me some.

00:10:04.139 --> 00:10:05.480
So I appreciate the intent

00:10:05.879 --> 00:10:07.400
of what Jeff is getting at

00:10:07.581 --> 00:10:09.500
in that we need to innovate.

00:10:09.600 --> 00:10:12.221
We need to support our peers.

00:10:12.282 --> 00:10:14.023
We need to help them kind of

00:10:14.082 --> 00:10:16.423
find profitable ways to deliver services.

00:10:16.823 --> 00:10:17.543
I don't think we need to

00:10:17.583 --> 00:10:19.644
sling mud at the insurance companies.

00:10:19.705 --> 00:10:20.304
And I don't think the

00:10:20.345 --> 00:10:21.365
insurance companies are the

00:10:21.405 --> 00:10:22.505
enemy because they don't

00:10:22.546 --> 00:10:23.466
give a crap about us.

00:10:23.547 --> 00:10:24.366
They don't care about us.

00:10:24.407 --> 00:10:25.346
They're not thinking about us.

00:10:25.366 --> 00:10:26.347
They're not worried about us.

00:10:27.207 --> 00:10:28.408
A couple of things that you said.

00:10:28.467 --> 00:10:30.349
So UHC is one of the highest

00:10:30.408 --> 00:10:31.428
revenue companies.

00:10:31.548 --> 00:10:32.928
Revenue is not profit.

00:10:33.489 --> 00:10:34.289
So, yeah,

00:10:34.330 --> 00:10:36.350
like I know it's pretty much it's

00:10:36.370 --> 00:10:37.830
pretty much mandated that

00:10:37.950 --> 00:10:38.929
everybody in the U.S.

00:10:38.970 --> 00:10:39.990
has health insurance.

00:10:40.030 --> 00:10:41.291
So I would imagine a health

00:10:41.350 --> 00:10:43.130
insurance company is going

00:10:43.150 --> 00:10:44.692
to have high levels of revenue.

00:10:45.231 --> 00:10:46.231
But if we're going to call

00:10:46.272 --> 00:10:49.273
them profit hungry, whatever, greedy,

00:10:50.273 --> 00:10:50.893
we need to look at

00:10:50.952 --> 00:10:52.253
ourselves in the mirror first.

00:10:52.312 --> 00:10:52.572
You know,

00:10:52.653 --> 00:10:54.053
we're looking for bigger profit

00:10:54.073 --> 00:10:55.354
margins than they're looking for.

00:10:55.994 --> 00:10:58.195
The other part of it is locus of control.

00:10:58.695 --> 00:11:00.056
How do we make these decisions?

00:11:00.135 --> 00:11:00.855
I always say, yeah,

00:11:01.735 --> 00:11:02.677
I would like to get paid

00:11:02.736 --> 00:11:04.596
more by insurance companies.

00:11:04.677 --> 00:11:06.337
But what are my opportunities here?

00:11:06.398 --> 00:11:09.239
Well, in 2000, I think it was 2000,

00:11:09.239 --> 00:11:10.700
I was looking at the chart yesterday.

00:11:10.980 --> 00:11:12.080
UnitedHealthcare on an

00:11:12.139 --> 00:11:13.740
adjusted basis was like $6.50 a share.

00:11:13.780 --> 00:11:15.160
Today, it's like $580 a share.

00:11:19.403 --> 00:11:19.962
Well, you know what?

00:11:20.344 --> 00:11:22.684
I could have bought shares back in 2000.

00:11:23.525 --> 00:11:25.086
There is nothing stopping me

00:11:25.147 --> 00:11:27.327
from being an owner of United Healthcare.

00:11:27.347 --> 00:11:28.908
And any therapist that has a

00:11:29.490 --> 00:11:31.370
401k that has exposure to

00:11:31.510 --> 00:11:33.111
the stock market at large,

00:11:33.591 --> 00:11:35.072
they are benefiting on the

00:11:35.114 --> 00:11:36.514
back end from United

00:11:36.595 --> 00:11:37.894
Healthcare's profitability.

00:11:38.336 --> 00:11:40.417
There is no human that's like,

00:11:40.677 --> 00:11:41.837
I am United Healthcare.

00:11:41.878 --> 00:11:42.658
United Healthcare is a

00:11:42.698 --> 00:11:44.058
collection of investors.

00:11:44.179 --> 00:11:46.181
We are among those investors.

00:11:46.280 --> 00:11:48.682
We benefit on the appreciation.

00:11:50.663 --> 00:11:51.104
I see it.

00:11:51.183 --> 00:11:54.447
We benefit as the consumer

00:11:54.486 --> 00:11:55.527
because guess what?

00:11:55.927 --> 00:11:56.947
I have health insurance.

00:11:57.489 --> 00:11:59.409
I had UnitedHealthcare as my

00:11:59.470 --> 00:12:00.850
health insurance for a long time.

00:12:00.910 --> 00:12:02.572
Why did I choose UnitedHealthcare?

00:12:03.013 --> 00:12:03.972
Because they were able to

00:12:04.013 --> 00:12:07.556
negotiate lower fees for the providers.

00:12:07.875 --> 00:12:09.037
So as the consumer,

00:12:09.336 --> 00:12:11.078
my monthly premiums were lower.

00:12:11.739 --> 00:12:12.980
I save money on the monthly

00:12:13.019 --> 00:12:14.081
premium just like Medicare

00:12:14.120 --> 00:12:15.020
Advantage plans.

00:12:15.542 --> 00:12:17.143
They have zero monthly premiums.

00:12:17.743 --> 00:12:19.846
I make money on the stock

00:12:19.905 --> 00:12:20.927
investment because I have

00:12:20.986 --> 00:12:21.969
exposure to the stock

00:12:22.028 --> 00:12:23.890
market and mutual funds and

00:12:23.951 --> 00:12:24.511
potentially

00:12:24.591 --> 00:12:26.254
UnitedHealthcare specifically.

00:12:27.195 --> 00:12:28.817
So I give up a little bit of

00:12:28.856 --> 00:12:30.038
profit on one end,

00:12:30.077 --> 00:12:31.899
but I make up the profit on the other.

00:12:32.839 --> 00:12:33.318
And again,

00:12:33.799 --> 00:12:36.120
nobody is being forced to

00:12:36.260 --> 00:12:38.001
contract with UnitedHealthier.

00:12:38.062 --> 00:12:39.241
So to Jeff's point,

00:12:40.163 --> 00:12:41.482
if you can't afford to

00:12:41.543 --> 00:12:42.783
deliver a profitable

00:12:43.083 --> 00:12:44.445
therapy session for what

00:12:44.504 --> 00:12:45.705
they're offering to pay,

00:12:46.446 --> 00:12:47.525
don't sign the contract.

00:12:48.167 --> 00:12:49.687
There is absolutely nothing

00:12:49.807 --> 00:12:51.248
forcing you to sign the contract.

00:12:51.288 --> 00:12:52.869
We sign those contracts

00:12:53.509 --> 00:12:54.830
either because we want

00:12:54.909 --> 00:12:56.370
access to their beneficiaries

00:12:57.171 --> 00:12:59.312
Or we can do it in a profitable way.

00:12:59.552 --> 00:13:01.254
I can do it in a profitable way.

00:13:01.374 --> 00:13:03.774
I am happy to sign the contract, you know,

00:13:03.815 --> 00:13:04.956
and I don't have the

00:13:04.995 --> 00:13:05.897
problems that you hear

00:13:05.956 --> 00:13:07.177
about from other therapists.

00:13:07.278 --> 00:13:08.418
I don't have take backs.

00:13:08.719 --> 00:13:09.619
I don't have rejections.

00:13:09.678 --> 00:13:10.580
I don't have denials.

00:13:11.139 --> 00:13:13.261
My assumption is when you

00:13:13.302 --> 00:13:14.081
hear a therapist

00:13:14.121 --> 00:13:15.543
complaining about Med or

00:13:15.643 --> 00:13:17.083
United Healthcare taking money back,

00:13:17.104 --> 00:13:18.485
it's because they did something wrong.

00:13:18.865 --> 00:13:19.826
They didn't understand the

00:13:19.865 --> 00:13:21.287
process to submit a claim

00:13:21.326 --> 00:13:23.307
based on the customer

00:13:23.688 --> 00:13:25.590
United Healthcare's guidelines.

00:13:26.049 --> 00:13:26.529
So, of course,

00:13:26.571 --> 00:13:27.530
they're going to refuse to

00:13:27.571 --> 00:13:28.731
pay you if you don't do

00:13:28.831 --> 00:13:30.113
what they're paying you to do.

00:13:31.995 --> 00:13:32.294
All right.

00:13:32.315 --> 00:13:34.336
We got some OMG when you

00:13:34.356 --> 00:13:35.197
look at it that way.

00:13:35.337 --> 00:13:35.857
Thank you.

00:13:35.878 --> 00:13:37.038
I appreciate that.

00:13:37.500 --> 00:13:38.900
There's always a different perspective.

00:13:40.721 --> 00:13:41.342
Well,

00:13:41.383 --> 00:13:42.082
they were talking about my

00:13:42.143 --> 00:13:43.244
perspective or your perspective.

00:13:43.965 --> 00:13:44.365
I don't know.

00:13:44.404 --> 00:13:48.969
I'm going to assume it's my perspective.

00:13:48.989 --> 00:13:49.870
So go ahead.

00:13:51.388 --> 00:13:53.427
so so uh with jeff's point

00:13:53.467 --> 00:13:54.869
like you know fair I don't

00:13:54.889 --> 00:13:55.828
know what I don't know what

00:13:55.849 --> 00:13:57.589
fair is as well but like uh

00:13:57.769 --> 00:13:59.570
a fair amount would be like

00:14:00.830 --> 00:14:02.450
I i suppose like covering

00:14:02.470 --> 00:14:04.191
costs and being able to pay

00:14:04.331 --> 00:14:05.571
you know the labor side the

00:14:05.591 --> 00:14:06.691
physical therapist side all

00:14:06.711 --> 00:14:07.451
right so that she said

00:14:07.490 --> 00:14:08.971
tony's side so she yes

00:14:09.111 --> 00:14:11.091
makes sense uh when you

00:14:11.111 --> 00:14:12.932
look at it tony's way um

00:14:13.273 --> 00:14:14.052
and everyone's look

00:14:14.153 --> 00:14:15.033
everyone's loving tony's

00:14:15.052 --> 00:14:17.293
way so um but that's the

00:14:17.312 --> 00:14:19.134
thing so like you can you can certainly

00:14:20.274 --> 00:14:22.134
have a Tony Meritato style

00:14:22.635 --> 00:14:24.437
adaptability and practice model.

00:14:24.836 --> 00:14:25.677
For us, for example,

00:14:26.518 --> 00:14:27.198
we're in New York City.

00:14:27.359 --> 00:14:28.438
There's absolutely no way

00:14:28.479 --> 00:14:30.620
that we could do any in network plan.

00:14:31.441 --> 00:14:32.201
Arguably,

00:14:32.241 --> 00:14:34.302
Fox Rehab does it with Medicare Part V,

00:14:34.643 --> 00:14:35.283
but they're huge.

00:14:35.303 --> 00:14:36.004
They're at scale.

00:14:37.205 --> 00:14:39.086
they make it work and they have, you know,

00:14:39.447 --> 00:14:40.106
slimmer margins.

00:14:40.147 --> 00:14:42.428
But if I have to pay a therapist,

00:14:42.908 --> 00:14:43.850
if I have to incentivize a

00:14:43.870 --> 00:14:45.370
therapist by paying 80, 90,

00:14:45.370 --> 00:14:46.471
a hundred dollars per visit

00:14:46.772 --> 00:14:48.494
for them to go do a 60 minute home visit,

00:14:50.014 --> 00:14:51.235
that is basically

00:14:51.355 --> 00:14:52.496
everything that Medicare pays.

00:14:52.677 --> 00:14:54.077
And that is more than all

00:14:54.118 --> 00:14:55.318
the in-network contractors

00:14:56.298 --> 00:14:57.961
in network contracts of

00:14:58.000 --> 00:14:59.142
what they pay and they reimburse.

00:14:59.221 --> 00:15:00.602
So for the current

00:15:00.702 --> 00:15:02.144
in-network reimbursement for doing,

00:15:02.203 --> 00:15:03.164
at least for doing

00:15:03.205 --> 00:15:04.666
outpatient physical therapy in the home,

00:15:06.187 --> 00:15:08.769
in most places, especially in most metros,

00:15:08.869 --> 00:15:10.929
it's just not feasible and not possible.

00:15:11.690 --> 00:15:13.370
So sometimes, I mean,

00:15:13.711 --> 00:15:15.371
just not to go up on my soapbox,

00:15:15.392 --> 00:15:16.393
but sometimes we have to

00:15:16.832 --> 00:15:18.014
explain some of this to

00:15:18.274 --> 00:15:19.674
prospective callers on the front end.

00:15:20.914 --> 00:15:21.875
But then again, most of the time,

00:15:21.916 --> 00:15:22.976
if someone's looking to use

00:15:23.017 --> 00:15:25.138
their insurance, we're not the right fit.

00:15:26.217 --> 00:15:27.418
They might call back and say, hey,

00:15:27.458 --> 00:15:27.859
you're right.

00:15:27.899 --> 00:15:28.919
Like we called five other

00:15:28.940 --> 00:15:30.441
places and they have

00:15:31.345 --> 00:15:32.946
a two or three month waiting list,

00:15:33.206 --> 00:15:34.807
or the therapist came for

00:15:34.807 --> 00:15:38.671
12 minutes and said to my spouse, like,

00:15:38.811 --> 00:15:39.491
oh, walk with the cane.

00:15:39.511 --> 00:15:39.932
Yeah, you're good.

00:15:39.951 --> 00:15:40.932
All right, that's it.

00:15:41.052 --> 00:15:42.153
And that's physical therapy.

00:15:42.214 --> 00:15:43.716
So, man,

00:15:44.015 --> 00:15:45.616
the challenge is there's just so

00:15:45.657 --> 00:15:46.577
many different angles or so

00:15:46.597 --> 00:15:47.458
many different perspectives

00:15:47.479 --> 00:15:48.720
and situations for all this,

00:15:48.779 --> 00:15:50.522
for the payment side, the insurance side,

00:15:50.902 --> 00:15:51.802
the labor side.

00:15:53.985 --> 00:15:56.687
And also I would love to get

00:15:56.746 --> 00:15:57.807
Jeff Moore on here.

00:15:57.826 --> 00:15:58.807
Maybe after,

00:15:59.167 --> 00:16:01.388
after Jimmy McKay comes back from the, uh,

00:16:01.488 --> 00:16:03.347
the voice disabled list, the,

00:16:03.488 --> 00:16:05.467
the two to 14 day disabled list,

00:16:05.488 --> 00:16:06.107
whatever it might be.

00:16:06.849 --> 00:16:08.269
Uh, we get Jimmy McKay back on here.

00:16:08.288 --> 00:16:09.089
We get Jeff Moore.

00:16:09.109 --> 00:16:10.688
We go, we go foursies.

00:16:11.129 --> 00:16:13.769
We go two by two and maybe we can, uh,

00:16:14.409 --> 00:16:16.029
have this banter with Jeff

00:16:16.129 --> 00:16:17.490
because he's great on video.

00:16:17.530 --> 00:16:18.071
He's great at, uh,

00:16:20.352 --> 00:16:21.214
putting a little bit more

00:16:21.293 --> 00:16:23.414
juice in his side of things

00:16:23.455 --> 00:16:24.596
from his perspective.

00:16:25.496 --> 00:16:25.996
Yeah,

00:16:26.116 --> 00:16:27.217
one of the things that I remember

00:16:27.238 --> 00:16:28.379
Jeff brought up a long time

00:16:28.418 --> 00:16:30.740
ago was should CIs get paid?

00:16:31.703 --> 00:16:33.546
Should clinical instructors get paid?

00:16:33.566 --> 00:16:35.388
I don't have a screenshot for it,

00:16:35.427 --> 00:16:36.710
but I'd love to touch on

00:16:36.750 --> 00:16:38.652
that topic real quick

00:16:39.913 --> 00:16:42.317
because it's kind of in that same thread.

00:16:42.836 --> 00:16:44.678
What has always been done is

00:16:44.759 --> 00:16:47.121
not what always has to be done.

00:16:47.722 --> 00:16:49.264
So I think there's huge

00:16:49.304 --> 00:16:51.586
value in CIs getting paid.

00:16:52.687 --> 00:16:54.509
I remember when I was a student,

00:16:54.730 --> 00:16:55.629
I already owned a physical

00:16:55.649 --> 00:16:56.350
therapy clinic.

00:16:56.390 --> 00:16:58.192
We already had a thriving business.

00:16:58.231 --> 00:16:59.812
And I was thinking, wait a minute,

00:16:59.893 --> 00:17:02.394
I can't choose who my CI is going to be.

00:17:02.534 --> 00:17:04.236
I can't interview my CI.

00:17:04.415 --> 00:17:06.298
I can't choose the location.

00:17:06.357 --> 00:17:06.998
Like you're just going to

00:17:07.057 --> 00:17:09.700
randomly issue me this place.

00:17:11.861 --> 00:17:14.222
And so that whole model,

00:17:14.663 --> 00:17:16.104
what's been your experience

00:17:16.263 --> 00:17:16.845
in that world?

00:17:16.865 --> 00:17:17.644
Because I don't think you

00:17:17.664 --> 00:17:18.885
guys take students, do you?

00:17:18.905 --> 00:17:18.986
Dave?

00:17:19.906 --> 00:17:20.166
Dave?

00:17:22.551 --> 00:17:22.893
We don't.

00:17:23.173 --> 00:17:23.834
No, we have not.

00:17:25.075 --> 00:17:26.896
But imagine if you did, you know,

00:17:26.958 --> 00:17:27.898
imagine if you had the

00:17:27.939 --> 00:17:29.440
opportunity to bring a student in,

00:17:29.520 --> 00:17:30.961
expose that student to your

00:17:31.001 --> 00:17:32.084
business model,

00:17:32.104 --> 00:17:33.885
to the resources you have available,

00:17:33.965 --> 00:17:35.627
to the kind of patient care

00:17:35.647 --> 00:17:36.909
experience you could deliver.

00:17:36.929 --> 00:17:38.771
And you did it for compensation.

00:17:42.155 --> 00:17:43.857
Because it is taking your time.

00:17:44.018 --> 00:17:45.298
It is taking you away from

00:17:45.400 --> 00:17:46.961
what you would be doing otherwise.

00:17:47.422 --> 00:17:48.442
It is accessing your

00:17:48.482 --> 00:17:49.585
professional knowledge.

00:17:50.546 --> 00:17:52.048
You are delivering a unique

00:17:52.107 --> 00:17:54.170
perspective and value to that student.

00:17:54.190 --> 00:17:55.952
And when we talk about how

00:17:55.992 --> 00:17:57.835
we're going to shape and

00:17:57.875 --> 00:17:59.797
mold the future of physical therapy,

00:18:00.726 --> 00:18:01.967
Nothing against teachers.

00:18:02.146 --> 00:18:03.048
I love teaching.

00:18:03.127 --> 00:18:03.468
You know,

00:18:03.488 --> 00:18:05.670
I would go back to be a professor

00:18:06.290 --> 00:18:07.070
at some point.

00:18:07.471 --> 00:18:11.734
But I do think that if you're in academia,

00:18:11.894 --> 00:18:13.195
you don't quite have the

00:18:13.236 --> 00:18:14.758
same touch points as

00:18:14.798 --> 00:18:15.858
somebody who's in the

00:18:15.898 --> 00:18:16.699
profession treating

00:18:16.739 --> 00:18:18.160
patients on a daily basis.

00:18:18.881 --> 00:18:20.481
If you were offered a stipend,

00:18:20.561 --> 00:18:21.542
if you were offered some

00:18:21.583 --> 00:18:23.224
sort of compensation and

00:18:23.305 --> 00:18:24.645
you could select the

00:18:24.685 --> 00:18:26.686
student that you wanted to accept,

00:18:27.347 --> 00:18:28.548
would you accept the student?

00:18:31.044 --> 00:18:32.285
Of course, of course I would,

00:18:32.305 --> 00:18:34.006
especially because I would

00:18:34.145 --> 00:18:35.826
look at that selfishly.

00:18:35.846 --> 00:18:36.667
I would look at that student

00:18:36.708 --> 00:18:37.827
as saying this could be

00:18:37.868 --> 00:18:39.068
part of my minor league system.

00:18:39.509 --> 00:18:40.589
I can potentially groom this

00:18:40.630 --> 00:18:43.071
person to hire them as

00:18:43.152 --> 00:18:44.192
they're graduating.

00:18:44.792 --> 00:18:45.534
So, yes.

00:18:45.594 --> 00:18:46.054
And by the way,

00:18:46.094 --> 00:18:47.295
that's what a lot of companies do.

00:18:47.355 --> 00:18:48.174
And that's, you know,

00:18:48.515 --> 00:18:49.875
that's part of the whole mix of things.

00:18:50.297 --> 00:18:51.376
But, yeah, absolutely.

00:18:51.738 --> 00:18:53.097
The challenge for us is our.

00:18:53.979 --> 00:18:55.119
Some of our clientele are

00:18:56.279 --> 00:18:57.621
either creatures of habit

00:18:57.701 --> 00:18:59.141
or they want a lot of

00:18:59.181 --> 00:19:00.541
privacy and confidentiality

00:19:00.582 --> 00:19:01.982
because of who they are, their background,

00:19:02.222 --> 00:19:02.563
whatever.

00:19:02.583 --> 00:19:04.503
And that is one of the

00:19:04.544 --> 00:19:05.523
reasons why some people

00:19:05.584 --> 00:19:06.984
want private home visits in

00:19:07.005 --> 00:19:07.845
New York City from us.

00:19:08.925 --> 00:19:10.826
And so the student coming in,

00:19:11.803 --> 00:19:12.942
We've asked this before,

00:19:13.002 --> 00:19:15.084
we've had like therapy candidates,

00:19:15.124 --> 00:19:18.905
we've had other folks ask to shadow,

00:19:19.006 --> 00:19:20.865
or we've had candidates

00:19:20.885 --> 00:19:21.507
that are potentially

00:19:21.527 --> 00:19:22.207
looking to work with us.

00:19:22.227 --> 00:19:22.686
And they're like, hey,

00:19:22.727 --> 00:19:24.488
can I join you for like a

00:19:24.528 --> 00:19:25.367
couple of home visits,

00:19:25.428 --> 00:19:26.328
like to just shadow and

00:19:26.348 --> 00:19:27.009
kind of see how it is,

00:19:27.028 --> 00:19:28.048
like if they had not done

00:19:28.108 --> 00:19:28.890
home visits before.

00:19:30.230 --> 00:19:31.651
And then we'll ask our patients,

00:19:31.770 --> 00:19:32.310
our clients,

00:19:33.479 --> 00:19:34.659
And most of the time they say no.

00:19:35.539 --> 00:19:37.140
So the student,

00:19:37.221 --> 00:19:38.340
because it hasn't been

00:19:38.601 --> 00:19:39.201
introduced already.

00:19:39.240 --> 00:19:39.381
Now,

00:19:39.721 --> 00:19:41.902
if the student was already with me and

00:19:41.942 --> 00:19:43.123
we're starting a new plan of care,

00:19:43.143 --> 00:19:44.983
a new interaction with a new client,

00:19:45.443 --> 00:19:46.223
then it would be like, well,

00:19:46.263 --> 00:19:47.444
that's how it started from day one.

00:19:47.484 --> 00:19:48.484
So like, that's just how it is.

00:19:48.505 --> 00:19:49.184
And that would be fine.

00:19:49.224 --> 00:19:51.125
So I think there would be a

00:19:51.165 --> 00:19:52.527
little work around or some nuance,

00:19:52.626 --> 00:19:53.426
or I would have to say to

00:19:53.487 --> 00:19:54.607
the current patients, like, hey,

00:19:55.607 --> 00:19:56.407
I have a student starting

00:19:56.468 --> 00:19:57.628
in two to four weeks and like,

00:19:57.648 --> 00:19:59.288
they have to come with me no matter what.

00:19:59.409 --> 00:20:02.691
Like we have to have them come as part of,

00:20:04.320 --> 00:20:04.641
But again,

00:20:04.661 --> 00:20:05.701
we're going into people's homes.

00:20:05.781 --> 00:20:06.843
So if someone doesn't want

00:20:06.883 --> 00:20:08.544
it or doesn't want a second

00:20:08.564 --> 00:20:09.865
person standing there like

00:20:09.945 --> 00:20:11.446
awkwardly watching everything,

00:20:12.748 --> 00:20:14.849
that that's just where this

00:20:14.970 --> 00:20:15.510
is what some of the

00:20:15.530 --> 00:20:16.451
patients and clients have said.

00:20:16.490 --> 00:20:18.633
So, like, yeah, I mean,

00:20:19.094 --> 00:20:22.636
we would have to maybe I don't know,

00:20:22.876 --> 00:20:23.597
maybe figure it out,

00:20:23.758 --> 00:20:24.778
but it would be doable.

00:20:24.838 --> 00:20:25.960
And yes, I would be open to it.

00:20:27.109 --> 00:20:28.371
What are the non-financial

00:20:28.431 --> 00:20:30.132
benefits of being a CI?

00:20:30.672 --> 00:20:31.893
So I do think there is a

00:20:31.992 --> 00:20:33.954
level of personal satisfaction.

00:20:34.954 --> 00:20:35.496
By the way,

00:20:35.516 --> 00:20:36.875
I bet you guys are going to

00:20:36.935 --> 00:20:37.636
remember this.

00:20:37.777 --> 00:20:39.097
I just grabbed this image.

00:20:40.459 --> 00:20:42.980
Today, Jimmy is Silent Bob.

00:20:43.500 --> 00:20:47.143
If you guys remember, Jimmy is Silent Bob.

00:20:49.144 --> 00:20:49.726
All right.

00:20:50.066 --> 00:20:50.946
For me, you know,

00:20:50.987 --> 00:20:52.909
now I've disclosed like I

00:20:52.949 --> 00:20:54.190
haven't taken a student in

00:20:54.210 --> 00:20:54.911
a couple of years.

00:20:55.611 --> 00:20:57.452
Once COVID hit and I was

00:20:57.512 --> 00:20:58.594
more out of the clinic,

00:20:58.634 --> 00:20:59.295
I just didn't have the

00:20:59.355 --> 00:21:01.076
resources to take on students.

00:21:01.977 --> 00:21:03.137
I would do it virtually,

00:21:03.479 --> 00:21:04.378
but not in the clinic.

00:21:04.500 --> 00:21:05.961
I just agreed virtually.

00:21:06.240 --> 00:21:07.981
They they they strong armed

00:21:08.001 --> 00:21:10.544
me into it to taking a student,

00:21:10.604 --> 00:21:11.984
making a spot available for

00:21:12.085 --> 00:21:14.707
some time in 2025.

00:21:14.707 --> 00:21:15.667
But that being said, you know,

00:21:15.708 --> 00:21:16.568
it makes you feel good.

00:21:16.669 --> 00:21:17.990
Like you feel like you're

00:21:18.029 --> 00:21:19.790
influencing the future of the profession.

00:21:20.030 --> 00:21:21.653
You feel like you're giving back.

00:21:22.232 --> 00:21:23.273
The student's going to ask

00:21:23.294 --> 00:21:24.375
you questions that make you

00:21:24.414 --> 00:21:25.675
think clinically a little

00:21:25.736 --> 00:21:27.477
more diligently than you

00:21:27.517 --> 00:21:28.798
might have otherwise.

00:21:30.711 --> 00:21:31.931
But like anything my wife

00:21:32.010 --> 00:21:33.291
reminds me all the time,

00:21:33.892 --> 00:21:34.632
there's a difference

00:21:34.692 --> 00:21:35.873
between doing the things

00:21:35.913 --> 00:21:37.733
you enjoy and doing the

00:21:37.773 --> 00:21:38.834
things you need to do.

00:21:38.854 --> 00:21:40.174
I know when I have a student,

00:21:40.214 --> 00:21:41.734
my documentation falls behind.

00:21:41.914 --> 00:21:42.955
When I have a student,

00:21:43.276 --> 00:21:43.955
a lot of other

00:21:44.016 --> 00:21:45.517
responsibilities get pushed

00:21:45.537 --> 00:21:46.416
to the back burner.

00:21:46.977 --> 00:21:49.518
It does cost me money to

00:21:49.637 --> 00:21:51.318
bring a student into my clinic.

00:21:52.338 --> 00:21:52.919
So it's like,

00:21:52.999 --> 00:21:54.759
how much am I willing to pay

00:21:54.859 --> 00:21:56.641
for that student to be here with us?

00:21:57.381 --> 00:21:58.261
I think Jimmy was

00:21:58.301 --> 00:21:59.804
referencing Justin Stiver

00:21:59.824 --> 00:22:00.644
down in Florida.

00:22:00.724 --> 00:22:01.986
Like they do interviews.

00:22:02.006 --> 00:22:03.146
They're very selective about

00:22:03.186 --> 00:22:04.288
the students they bring in,

00:22:04.348 --> 00:22:05.349
but they have housing and

00:22:05.369 --> 00:22:06.330
they have other benefits

00:22:06.371 --> 00:22:07.751
that they could provide the student.

00:22:09.134 --> 00:22:10.255
I just think that we need to

00:22:10.536 --> 00:22:12.617
re-examine the opportunities there.

00:22:13.218 --> 00:22:15.039
And even if the universities

00:22:15.300 --> 00:22:16.821
refuse to pay CIs,

00:22:17.423 --> 00:22:18.942
I bet the student's family,

00:22:18.962 --> 00:22:20.584
if it's possible,

00:22:20.784 --> 00:22:22.564
like I don't know the ethics of it,

00:22:23.003 --> 00:22:24.144
I bet the student's family

00:22:24.223 --> 00:22:27.265
would pay the CI if it was the right CI.

00:22:27.865 --> 00:22:29.164
Because if I already

00:22:29.204 --> 00:22:31.986
invested $150,000 in my education,

00:22:32.665 --> 00:22:33.506
paying $3,000 more,

00:22:33.506 --> 00:22:35.727
$5,000 more for a great

00:22:35.787 --> 00:22:37.027
clinical experience that's

00:22:37.047 --> 00:22:38.727
going to set me up for the future,

00:22:38.747 --> 00:22:42.887
I think it's an investment well worth it.

00:22:44.021 --> 00:22:45.144
Plus you can also learn a

00:22:45.183 --> 00:22:46.527
lot from students given.

00:22:46.547 --> 00:22:46.626
Good.

00:22:50.987 --> 00:22:52.347
Really quick to bring Jeff

00:22:52.367 --> 00:22:53.568
Moore back in that conversation.

00:22:54.308 --> 00:22:55.250
And with clinical

00:22:55.309 --> 00:22:57.070
instruction and clinical education,

00:22:57.432 --> 00:22:59.313
do you remember several years ago,

00:22:59.353 --> 00:23:00.314
this was pre-COVID,

00:23:00.673 --> 00:23:02.935
he used to go live like most mornings.

00:23:02.955 --> 00:23:03.796
Like Monday through Friday,

00:23:03.836 --> 00:23:04.876
he went live at like,

00:23:05.278 --> 00:23:07.939
it was like 6 or 7 a.m., like a maniac.

00:23:08.200 --> 00:23:08.880
God bless you, Jeff.

00:23:08.920 --> 00:23:09.560
You're the man.

00:23:09.621 --> 00:23:10.560
And it was so entertaining.

00:23:10.882 --> 00:23:12.182
He'd go into his clinic.

00:23:12.482 --> 00:23:13.604
It would be really early.

00:23:14.243 --> 00:23:15.144
I don't know why I was up

00:23:15.163 --> 00:23:16.384
that early either on

00:23:16.443 --> 00:23:17.265
Facebook or I was getting

00:23:17.285 --> 00:23:17.904
the notifications.

00:23:17.964 --> 00:23:19.565
And he'd make his cup of coffee, right?

00:23:19.585 --> 00:23:20.545
And he'd be drinking a hot

00:23:20.565 --> 00:23:21.464
cup of coffee and start

00:23:21.484 --> 00:23:22.586
talking about clinical stuff,

00:23:23.006 --> 00:23:24.226
clinical considerations.

00:23:24.685 --> 00:23:26.385
He sometimes would be treating,

00:23:26.425 --> 00:23:27.486
he'd do demonstrations.

00:23:27.826 --> 00:23:30.987
He would be treating one of

00:23:31.027 --> 00:23:31.686
his therapists.

00:23:31.826 --> 00:23:32.586
If he had a student,

00:23:32.606 --> 00:23:33.126
he'd be treating the

00:23:33.166 --> 00:23:33.847
student or they would have

00:23:33.867 --> 00:23:34.567
a conversation.

00:23:35.028 --> 00:23:36.528
He would be treating one of

00:23:36.567 --> 00:23:38.087
his aides or assistants at the time,

00:23:38.127 --> 00:23:38.428
I think.

00:23:38.827 --> 00:23:41.169
So he would be showing hip mobilization.

00:23:42.068 --> 00:23:43.189
or he would be talking right

00:23:43.209 --> 00:23:43.950
into the camera.

00:23:44.329 --> 00:23:45.650
He did that for so long and

00:23:45.710 --> 00:23:46.570
so consistently.

00:23:47.191 --> 00:23:48.391
And I don't know if that was

00:23:48.750 --> 00:23:54.814
part of his way to get Ice Physio,

00:23:54.854 --> 00:23:56.513
his education company, off the ground.

00:23:56.933 --> 00:23:58.434
But it was such a great idea.

00:23:58.454 --> 00:24:00.035
And I don't even know where

00:24:00.075 --> 00:24:01.036
those videos are, Jeff.

00:24:01.056 --> 00:24:03.317
By the way, hopefully they're on YouTube.

00:24:03.436 --> 00:24:04.176
But I think they were just

00:24:04.217 --> 00:24:04.936
all Facebook Lives.

00:24:04.957 --> 00:24:05.877
Did you catch any of those?

00:24:05.897 --> 00:24:06.998
Do you guys remember that?

00:24:07.790 --> 00:24:09.573
I remember Jimmy was saying

00:24:09.633 --> 00:24:10.753
he was on Periscope.

00:24:10.773 --> 00:24:11.715
Periscope, yes.

00:24:11.776 --> 00:24:12.896
So Periscope,

00:24:12.936 --> 00:24:14.018
and then I think Periscope

00:24:14.057 --> 00:24:15.038
was bought by Twitter,

00:24:15.058 --> 00:24:16.160
so then that was Twitter's

00:24:16.260 --> 00:24:18.903
live video account or something.

00:24:19.744 --> 00:24:21.967
And by the way, random fact,

00:24:22.346 --> 00:24:24.028
I used to do cold calls to

00:24:24.068 --> 00:24:24.849
practice owners for

00:24:24.890 --> 00:24:27.153
Vinitial live on Periscope.

00:24:27.772 --> 00:24:28.013
Oh, okay.

00:24:29.832 --> 00:24:30.392
Talk about what do you,

00:24:30.412 --> 00:24:31.932
what do you call like eating,

00:24:31.972 --> 00:24:32.813
swallowing the frog or

00:24:32.853 --> 00:24:33.413
whatever it's called.

00:24:33.992 --> 00:24:35.273
Um, but, uh,

00:24:35.614 --> 00:24:36.453
so you didn't catch any of

00:24:36.473 --> 00:24:37.614
those before with Jeff Moore,

00:24:37.773 --> 00:24:39.094
with the video, the live videos.

00:24:39.775 --> 00:24:40.914
I don't know.

00:24:40.974 --> 00:24:42.095
I remember him.

00:24:42.115 --> 00:24:43.194
I remember some of the

00:24:43.214 --> 00:24:44.435
Facebook lives that I,

00:24:44.455 --> 00:24:47.557
I was never on Periscope, but I mean,

00:24:47.817 --> 00:24:50.136
why everyone isn't doing it still.

00:24:50.596 --> 00:24:51.317
I saw them.

00:24:51.336 --> 00:24:53.938
I was, Jimmy was in PT school at the time.

00:24:54.678 --> 00:24:55.739
He was just a toddler.

00:24:56.439 --> 00:24:57.459
Um, but,

00:24:58.019 --> 00:25:00.021
But yeah, like it's amazing.

00:25:00.041 --> 00:25:01.202
And I will say like,

00:25:01.303 --> 00:25:02.564
imagine the impact that

00:25:02.605 --> 00:25:04.365
Jeff has had on the profession.

00:25:04.547 --> 00:25:06.489
Imagine the influence,

00:25:06.548 --> 00:25:08.270
like he he's brought people

00:25:08.371 --> 00:25:09.632
into private practice.

00:25:09.692 --> 00:25:12.035
He's expanded so many mindsets.

00:25:12.095 --> 00:25:14.357
He's done so much, uh,

00:25:15.038 --> 00:25:16.078
I don't ever want somebody

00:25:16.118 --> 00:25:17.960
to think that I am against

00:25:18.079 --> 00:25:19.119
anything that Jeff is doing.

00:25:19.140 --> 00:25:20.641
I think everything he does is gold.

00:25:20.800 --> 00:25:21.461
I love him.

00:25:21.520 --> 00:25:22.781
I love Zach Long.

00:25:23.261 --> 00:25:25.042
These guys are just innovators.

00:25:25.643 --> 00:25:27.223
But it's just that one

00:25:27.284 --> 00:25:28.765
little aspect of that one

00:25:28.825 --> 00:25:30.365
thing that I think we we

00:25:30.405 --> 00:25:31.566
need at least to hear the

00:25:31.645 --> 00:25:32.626
other side of the story.

00:25:32.967 --> 00:25:33.207
You know,

00:25:33.247 --> 00:25:34.267
and that's what I always hope to

00:25:34.307 --> 00:25:35.488
bring is the other side of

00:25:35.528 --> 00:25:37.148
the story or a different perspective.

00:25:38.730 --> 00:25:39.309
That being said.

00:25:40.759 --> 00:25:43.801
I wanted to talk about how

00:25:43.862 --> 00:25:44.803
you guys are being

00:25:44.883 --> 00:25:46.203
perceived on social media.

00:25:46.864 --> 00:25:49.006
And like, Dave, I didn't do this for yours,

00:25:49.365 --> 00:25:50.405
but I don't know if you've

00:25:50.446 --> 00:25:51.287
done this lately.

00:25:51.307 --> 00:25:53.147
This is a screenshot.

00:25:53.228 --> 00:25:56.711
So I opened a Google incognito browser,

00:25:56.891 --> 00:25:58.832
trying to limit all of my

00:25:58.912 --> 00:25:59.893
search history and stuff.

00:26:00.452 --> 00:26:01.814
I just put my name in quotes

00:26:02.153 --> 00:26:03.515
to see what comes up.

00:26:03.575 --> 00:26:04.655
Like, where do I stand now?

00:26:05.156 --> 00:26:05.997
Interestingly,

00:26:06.076 --> 00:26:06.897
if you would have done this

00:26:06.917 --> 00:26:07.759
a couple of years ago,

00:26:08.239 --> 00:26:09.359
total therapy solutions

00:26:09.400 --> 00:26:11.000
would have been at the top of that list.

00:26:12.142 --> 00:26:14.083
Other more physical therapy

00:26:14.203 --> 00:26:15.785
service delivery things

00:26:15.825 --> 00:26:16.505
would have been there.

00:26:16.965 --> 00:26:17.925
But you could see like my

00:26:17.965 --> 00:26:19.366
top ranking is my LinkedIn.

00:26:20.508 --> 00:26:21.307
which I'm going to talk

00:26:21.327 --> 00:26:22.769
about a LinkedIn post that

00:26:22.808 --> 00:26:25.650
just blew up recently on relative terms.

00:26:26.711 --> 00:26:27.691
My Amazon.

00:26:27.871 --> 00:26:30.511
So that's my Amazon influencer page.

00:26:30.811 --> 00:26:32.653
It's got videos from me

00:26:32.692 --> 00:26:33.894
doing product reviews,

00:26:33.973 --> 00:26:35.034
my Medicare therapy,

00:26:35.054 --> 00:26:37.414
which is a directory website, my Udemy,

00:26:37.795 --> 00:26:38.756
my Thinkific.

00:26:39.635 --> 00:26:41.557
When we talk about personal branding,

00:26:43.955 --> 00:26:46.157
Google looks at all of this

00:26:46.198 --> 00:26:48.380
kind of stuff and tries to

00:26:48.460 --> 00:26:50.342
pull from it to get a sense for,

00:26:50.481 --> 00:26:51.942
is this a real human or is

00:26:51.982 --> 00:26:53.344
this AI generated?

00:26:54.726 --> 00:26:57.567
What is the context around this human?

00:26:57.768 --> 00:27:00.891
How do we rank this human in

00:27:00.951 --> 00:27:02.653
regards to credibility,

00:27:02.752 --> 00:27:03.953
to trustworthiness?

00:27:04.013 --> 00:27:04.894
If you guys remember...

00:27:06.635 --> 00:27:08.037
man, how do I forget this?

00:27:08.936 --> 00:27:11.897
There was an acronym that

00:27:12.238 --> 00:27:13.878
helped you understand what

00:27:13.959 --> 00:27:15.038
Google was looking at.

00:27:16.180 --> 00:27:17.960
Eat, E-E-A-T.

00:27:18.280 --> 00:27:20.882
So it was like expertise, authority,

00:27:20.981 --> 00:27:22.082
trustworthiness,

00:27:22.162 --> 00:27:23.522
and there was another E in there.

00:27:23.542 --> 00:27:26.163
Do you ever look at that stuff?

00:27:26.183 --> 00:27:27.584
Do you ever look at your

00:27:27.824 --> 00:27:29.424
personal brand separate

00:27:29.464 --> 00:27:30.724
maybe even from your

00:27:30.805 --> 00:27:32.566
clinical brand and see

00:27:32.645 --> 00:27:34.547
where you stand in the algorithm?

00:27:36.971 --> 00:27:38.232
I have not in a while,

00:27:38.373 --> 00:27:39.733
but anytime that you post

00:27:39.773 --> 00:27:41.174
this stuff over the past, I don't know,

00:27:41.194 --> 00:27:42.896
a couple of years, I will go and do it.

00:27:42.936 --> 00:27:43.416
And I did,

00:27:43.436 --> 00:27:46.318
I did just Google Dave Kittle in

00:27:46.419 --> 00:27:48.340
quotes and actually a little surprising.

00:27:49.320 --> 00:27:49.922
I want to share it.

00:27:50.342 --> 00:27:51.242
Let me share this real quick.

00:27:51.522 --> 00:27:52.324
If I go present,

00:27:52.364 --> 00:27:53.765
I have not shared on StreamYard yet.

00:27:54.085 --> 00:27:54.625
Share screen?

00:27:55.306 --> 00:27:56.707
Yeah, try to share screen.

00:27:56.926 --> 00:27:57.688
It'll come up.

00:27:58.327 --> 00:28:00.450
Then I can click a window.

00:28:01.109 --> 00:28:01.430
All right.

00:28:02.250 --> 00:28:02.790
Can you see this?

00:28:04.353 --> 00:28:04.692
All right.

00:28:04.792 --> 00:28:05.432
So this is...

00:28:08.048 --> 00:28:08.789
Yeah, go ahead.

00:28:08.809 --> 00:28:09.130
Let me see.

00:28:09.150 --> 00:28:09.670
So we're on this.

00:28:09.869 --> 00:28:10.671
All right, there we go.

00:28:11.611 --> 00:28:13.472
So the first thing interesting is Twitter.

00:28:14.153 --> 00:28:16.034
And then I went down a little bit.

00:28:16.054 --> 00:28:17.234
But by the way, look at this.

00:28:17.955 --> 00:28:19.757
See results about PT Pinecast,

00:28:19.797 --> 00:28:20.457
physical therapy.

00:28:20.477 --> 00:28:22.238
So, you know,

00:28:22.298 --> 00:28:25.421
Jimmy and the whole collab here, you know,

00:28:25.740 --> 00:28:28.021
I guess I'm raising up with

00:28:28.061 --> 00:28:30.483
the high tide of PT Pinecast growth.

00:28:30.523 --> 00:28:31.505
So that's awesome.

00:28:32.265 --> 00:28:33.605
Second is my LinkedIn.

00:28:34.125 --> 00:28:35.727
Then it's my show on YouTube

00:28:35.887 --> 00:28:36.788
and then Instagram.

00:28:39.261 --> 00:28:40.482
Here's my practice website.

00:28:41.183 --> 00:28:42.505
So interesting.

00:28:42.525 --> 00:28:43.045
And then of course,

00:28:43.125 --> 00:28:43.806
it's going to be a bunch of

00:28:43.826 --> 00:28:44.646
videos with Tony and I,

00:28:44.886 --> 00:28:47.028
because Tony has helped me

00:28:47.449 --> 00:28:49.151
with reach as well with the videos,

00:28:49.510 --> 00:28:50.250
Apple podcast.

00:28:50.451 --> 00:28:52.133
So I have not done this in a while.

00:28:52.153 --> 00:28:53.614
Let me just stop share.

00:28:55.395 --> 00:28:55.635
Yeah.

00:28:55.736 --> 00:28:59.940
So you're bringing this up for what?

00:29:00.019 --> 00:29:01.881
For therapists to remember

00:29:01.980 --> 00:29:03.241
and to be considerate of

00:29:03.722 --> 00:29:04.523
what they're putting out,

00:29:05.163 --> 00:29:06.144
how they're being perceived.

00:29:06.164 --> 00:29:07.185
Like why bring this up?

00:29:07.866 --> 00:29:08.626
A couple aspects.

00:29:08.646 --> 00:29:09.087
So yeah,

00:29:09.728 --> 00:29:11.568
we know the value of building a

00:29:11.588 --> 00:29:12.729
personal brand and

00:29:12.788 --> 00:29:13.970
eventually being able to

00:29:14.009 --> 00:29:15.451
monetize and leverage that

00:29:15.510 --> 00:29:16.211
personal brand.

00:29:17.412 --> 00:29:18.731
But what are the opportunities?

00:29:19.232 --> 00:29:20.813
So when we just did this,

00:29:20.873 --> 00:29:21.874
I'll pull mine back up.

00:29:22.554 --> 00:29:24.335
This had no time constraint.

00:29:24.575 --> 00:29:27.215
This was just out of all the history,

00:29:27.797 --> 00:29:28.977
my name, what comes up.

00:29:28.997 --> 00:29:31.097
So if LinkedIn is leveraged

00:29:31.278 --> 00:29:33.799
at the top of that organic search result,

00:29:34.579 --> 00:29:36.201
What I should be doing is

00:29:36.281 --> 00:29:38.124
generating more LinkedIn content.

00:29:38.663 --> 00:29:39.525
LinkedIn gives you the

00:29:39.585 --> 00:29:40.645
opportunity to post.

00:29:40.986 --> 00:29:42.047
We know that they're pushing

00:29:42.086 --> 00:29:42.887
video right now.

00:29:42.928 --> 00:29:43.729
So I'm trying to get more

00:29:43.788 --> 00:29:45.069
LinkedIn video published.

00:29:45.550 --> 00:29:47.613
But LinkedIn also has an article feature.

00:29:48.093 --> 00:29:51.256
And all the articles are

00:29:51.517 --> 00:29:53.719
organically ranking on YouTube.

00:29:54.118 --> 00:29:55.380
I'm sorry, on Google.

00:29:56.538 --> 00:29:58.099
So if I want to get an

00:29:58.200 --> 00:30:00.421
article out there about dry needling,

00:30:00.441 --> 00:30:02.382
I will write an article,

00:30:02.541 --> 00:30:05.344
put it on LinkedIn, optimize it for SEO,

00:30:05.523 --> 00:30:07.243
and Google will start to

00:30:07.305 --> 00:30:08.305
present that article.

00:30:08.325 --> 00:30:09.705
And then of course, from that article,

00:30:09.786 --> 00:30:11.125
I can link into my business,

00:30:11.567 --> 00:30:14.407
I can link into my other resources,

00:30:14.488 --> 00:30:15.209
whatever I wanna do.

00:30:16.249 --> 00:30:16.849
But to me,

00:30:16.970 --> 00:30:18.570
what that gives us is it gives

00:30:18.631 --> 00:30:20.333
us a sense to know where is

00:30:20.393 --> 00:30:21.413
the attention going?

00:30:22.054 --> 00:30:23.715
What is Google prioritizing?

00:30:23.756 --> 00:30:25.416
Because Google still gets a ton of search.

00:30:25.958 --> 00:30:27.398
And where should I put my

00:30:27.459 --> 00:30:28.319
time and efforts?

00:30:28.420 --> 00:30:29.901
Because if we're just

00:30:30.221 --> 00:30:31.843
throwing stuff out and not

00:30:31.903 --> 00:30:33.223
knowing where it should go,

00:30:33.243 --> 00:30:35.086
I think we're losing some

00:30:35.105 --> 00:30:36.487
of that time and value.

00:30:36.547 --> 00:30:38.048
And for you, same thing.

00:30:38.088 --> 00:30:39.950
Like you're treating professionals,

00:30:39.990 --> 00:30:40.631
you're treating experts.

00:30:41.070 --> 00:30:43.272
CEOs or retired individuals.

00:30:44.394 --> 00:30:45.695
If Twitter is up there at

00:30:45.736 --> 00:30:47.817
the top of your organic search results,

00:30:47.897 --> 00:30:48.137
man,

00:30:48.218 --> 00:30:51.079
I would be leveraging Twitter above

00:30:51.140 --> 00:30:52.582
some of the other platforms

00:30:53.102 --> 00:30:54.063
because that's probably

00:30:54.103 --> 00:30:55.064
going to get that message

00:30:55.144 --> 00:30:56.384
out in front of the right people.

00:30:56.684 --> 00:30:57.865
I just wanted to share that

00:30:57.906 --> 00:30:58.826
for other therapists.

00:30:58.988 --> 00:31:00.048
And the funny thing with that.

00:31:02.391 --> 00:31:03.111
Oh, you froze.

00:31:04.112 --> 00:31:04.392
Go ahead.

00:31:04.432 --> 00:31:04.913
Say that again.

00:31:04.932 --> 00:31:06.453
I'm here.

00:31:06.614 --> 00:31:06.875
I'm here.

00:31:07.075 --> 00:31:07.275
I'm here.

00:31:08.426 --> 00:31:09.166
The funny thing when I

00:31:09.207 --> 00:31:10.448
shared and I can pull it back up,

00:31:10.468 --> 00:31:16.710
but when I shared my Google query here,

00:31:17.309 --> 00:31:18.650
the first thing with the Twitter,

00:31:18.670 --> 00:31:19.911
I guess like the sub

00:31:20.070 --> 00:31:23.332
headline is my popular

00:31:23.392 --> 00:31:25.551
tweet that had whatever 96

00:31:25.551 --> 00:31:26.251
or whatever thousand

00:31:26.311 --> 00:31:27.873
impressions that a physical

00:31:27.893 --> 00:31:28.472
therapist should be

00:31:28.492 --> 00:31:29.232
physically fit if they want

00:31:29.252 --> 00:31:31.153
to charge $250 to $400 per

00:31:31.193 --> 00:31:32.653
visit and get patients to

00:31:32.733 --> 00:31:33.855
invest in their health and wellness,

00:31:33.914 --> 00:31:34.595
agree or disagree.

00:31:35.296 --> 00:31:36.156
Not all of that was shown,

00:31:36.198 --> 00:31:38.260
but like most of it was shown as like the,

00:31:38.280 --> 00:31:38.962
what do you call it?

00:31:38.982 --> 00:31:40.526
Like the preview or whatever,

00:31:40.645 --> 00:31:42.388
like the sub headline of

00:31:42.409 --> 00:31:44.733
the first search result for Twitter.

00:31:44.794 --> 00:31:45.194
So anyway.

00:31:45.928 --> 00:31:46.788
The other thing you guys

00:31:46.808 --> 00:31:48.189
could be doing is limit the

00:31:48.210 --> 00:31:50.411
search criteria to specific

00:31:50.451 --> 00:31:51.111
amount of time.

00:31:51.171 --> 00:31:52.511
So you can do your search,

00:31:52.571 --> 00:31:53.653
go into the options,

00:31:54.032 --> 00:31:55.294
limit it to the past week,

00:31:55.374 --> 00:31:56.634
limit it to the past month,

00:31:57.035 --> 00:32:00.396
see what the most current content is.

00:32:01.038 --> 00:32:02.419
And that's what I do a lot

00:32:02.538 --> 00:32:03.679
when I wanna just see,

00:32:03.778 --> 00:32:04.900
am I getting backlinks?

00:32:05.000 --> 00:32:06.461
Am I getting citations?

00:32:06.520 --> 00:32:08.762
Like who is talking about me

00:32:08.942 --> 00:32:10.503
or where are the links coming from?

00:32:11.104 --> 00:32:13.766
I just limit it to the most recent week

00:32:14.286 --> 00:32:15.906
And I try to do that once a

00:32:15.967 --> 00:32:17.188
week to just get a sense

00:32:17.268 --> 00:32:18.548
for what's going on.

00:32:19.970 --> 00:32:23.451
That being said, do you have a topic,

00:32:23.471 --> 00:32:23.652
Dave?

00:32:23.672 --> 00:32:24.332
Because I don't want to

00:32:24.413 --> 00:32:25.792
bogart the whole episode.

00:32:27.213 --> 00:32:29.195
Yeah, so in the private chat here,

00:32:29.276 --> 00:32:30.977
Jimmy put in his poll of

00:32:30.997 --> 00:32:31.856
the week from LinkedIn.

00:32:32.637 --> 00:32:34.199
And so Jimmy asked,

00:32:34.858 --> 00:32:35.759
which of these stings the

00:32:35.799 --> 00:32:37.121
most about your DPT degree?

00:32:37.141 --> 00:32:37.901
The price tag,

00:32:37.941 --> 00:32:39.201
the cost of your degree that

00:32:39.241 --> 00:32:41.262
puts a dent in your wallet, the ROI,

00:32:41.303 --> 00:32:42.384
the value of your degree in

00:32:42.403 --> 00:32:43.924
terms of what it's brought

00:32:44.284 --> 00:32:45.144
to your career.

00:32:45.625 --> 00:32:48.127
So here on the screen right now,

00:32:48.728 --> 00:32:51.711
this was posted by Jimmy 15 hours ago.

00:32:52.551 --> 00:32:54.272
Degree dilemma, what frustrates you more?

00:32:54.653 --> 00:32:55.374
As professionals,

00:32:55.835 --> 00:32:56.816
we've all invested time and

00:32:56.836 --> 00:32:57.896
money into our education,

00:32:57.936 --> 00:32:59.117
but the question remains,

00:33:00.078 --> 00:33:01.680
which of these stings the most?

00:33:01.740 --> 00:33:04.261
The price tag, the ROI,

00:33:05.970 --> 00:33:06.711
or show results.

00:33:06.750 --> 00:33:07.511
So the price tag,

00:33:07.531 --> 00:33:08.311
the cost of your degree

00:33:08.332 --> 00:33:10.773
that puts it in your wallet or the ROI,

00:33:10.814 --> 00:33:11.795
the value of your degree in

00:33:11.835 --> 00:33:13.056
terms of what it's brought

00:33:13.076 --> 00:33:13.696
to your career.

00:33:14.376 --> 00:33:19.101
And this poll is getting popular already.

00:33:19.121 --> 00:33:20.162
So far, the price tag, 47%.

00:33:20.481 --> 00:33:24.705
The ROI was at 40% and then show results.

00:33:25.385 --> 00:33:27.007
I have it covered on my screen now.

00:33:29.189 --> 00:33:29.690
Show results, 13%.

00:33:32.172 --> 00:33:33.452
So Tony, what do you think so far?

00:33:34.448 --> 00:33:35.949
Well, like Jimmy's saying, ironically,

00:33:35.969 --> 00:33:38.568
more people are mad about the price,

00:33:38.648 --> 00:33:39.650
but they knew the price

00:33:39.750 --> 00:33:40.549
before they bought it.

00:33:42.131 --> 00:33:43.030
I would probably say they

00:33:43.111 --> 00:33:44.070
didn't know the price.

00:33:44.471 --> 00:33:44.811
I don't know.

00:33:44.852 --> 00:33:45.811
I'm trying to go back.

00:33:46.031 --> 00:33:47.051
It's a lifetime ago.

00:33:48.113 --> 00:33:51.054
Did I really understand what I was paying,

00:33:51.173 --> 00:33:53.294
the price I was paying in dollars,

00:33:53.454 --> 00:33:54.275
absolute dollars?

00:33:54.954 --> 00:33:55.796
I don't know that I did.

00:33:55.816 --> 00:33:56.836
And I don't know that a lot

00:33:57.316 --> 00:33:58.757
of young adults going into

00:33:58.817 --> 00:34:00.838
college really understand the impact,

00:34:00.878 --> 00:34:02.078
the price that they're paying.

00:34:02.680 --> 00:34:04.520
Forget about the financing

00:34:04.601 --> 00:34:05.381
and the interest

00:34:05.441 --> 00:34:06.981
accumulation and all of that.

00:34:08.242 --> 00:34:10.824
But then also it's their responsibility.

00:34:11.764 --> 00:34:12.166
It is.

00:34:12.425 --> 00:34:13.106
But you know what?

00:34:13.527 --> 00:34:14.809
If you're a patient and you

00:34:14.869 --> 00:34:15.809
have health insurance,

00:34:15.889 --> 00:34:17.811
how many of them fully

00:34:17.891 --> 00:34:19.793
understand the price going in?

00:34:19.813 --> 00:34:22.016
I don't think a lot of them do,

00:34:22.096 --> 00:34:23.358
but it's their responsibility.

00:34:23.757 --> 00:34:24.958
How many of us understand

00:34:24.998 --> 00:34:27.422
the actual cost we pay in taxes,

00:34:27.521 --> 00:34:28.742
the amount of dollars,

00:34:28.822 --> 00:34:29.884
absolute dollars that come

00:34:29.925 --> 00:34:31.306
out of our paycheck every week,

00:34:31.646 --> 00:34:33.588
every month for taxes?

00:34:34.268 --> 00:34:35.349
I don't think a lot of us do.

00:34:35.389 --> 00:34:36.369
I think a lot of us just

00:34:36.409 --> 00:34:38.931
make decisions based on the emotion.

00:34:38.951 --> 00:34:40.871
I want to help people.

00:34:41.192 --> 00:34:42.833
Physical therapists help people.

00:34:42.853 --> 00:34:44.152
I want a job.

00:34:44.514 --> 00:34:45.454
There's a need for more

00:34:45.514 --> 00:34:46.414
physical therapists.

00:34:46.793 --> 00:34:48.275
I'm going to become a physical therapist.

00:34:49.335 --> 00:34:50.215
New business idea,

00:34:50.275 --> 00:34:51.115
find models where the

00:34:51.155 --> 00:34:52.396
customer doesn't know the

00:34:52.456 --> 00:34:54.518
cost and double down on that.

00:34:55.764 --> 00:34:57.206
I think that's an old business idea.

00:34:57.246 --> 00:34:58.967
I think it's been around a long time.

00:34:59.027 --> 00:34:59.927
I think that's what a lot of

00:34:59.967 --> 00:35:03.090
people like lay their bets on.

00:35:04.411 --> 00:35:07.253
What do you think about price versus ROI?

00:35:09.614 --> 00:35:09.813
Dave?

00:35:10.215 --> 00:35:12.295
So really quick, really quick.

00:35:12.315 --> 00:35:16.898
So like I chose a direct entry program.

00:35:16.978 --> 00:35:17.920
So it was like the three and

00:35:17.940 --> 00:35:18.800
three program instead of

00:35:18.840 --> 00:35:19.940
like a four-year undergrad,

00:35:19.960 --> 00:35:20.722
get a bachelor's,

00:35:20.802 --> 00:35:21.702
transfer to some other

00:35:21.762 --> 00:35:22.882
school to get a three-year

00:35:22.922 --> 00:35:24.403
DPT where you're going to

00:35:24.423 --> 00:35:25.585
school basically all year round.

00:35:25.945 --> 00:35:26.684
and do seven years.

00:35:26.764 --> 00:35:28.945
So I chose as a whatever,

00:35:28.945 --> 00:35:30.967
18 year old or 19 or whatever,

00:35:31.387 --> 00:35:32.007
from high school,

00:35:32.447 --> 00:35:34.208
that I'm going to go to this school.

00:35:35.489 --> 00:35:37.188
Luckily, I was playing D2 baseball,

00:35:37.208 --> 00:35:38.969
got some baseball scholarship money,

00:35:39.110 --> 00:35:40.309
but I knew that it was

00:35:40.329 --> 00:35:42.791
going to be a six year program.

00:35:43.150 --> 00:35:43.911
And then at the end of that,

00:35:43.992 --> 00:35:45.012
I get a bachelor's and the

00:35:45.072 --> 00:35:46.413
doctor of physical therapy degree.

00:35:47.413 --> 00:35:47.552
And

00:35:48.998 --> 00:35:50.079
from my perspective,

00:35:50.139 --> 00:35:50.980
anyone that's out there

00:35:51.300 --> 00:35:53.882
complaining about the ROI

00:35:53.902 --> 00:35:55.083
of our degree and this and that,

00:35:55.422 --> 00:35:56.264
I wish there was video

00:35:56.304 --> 00:35:58.385
camera footage of those families,

00:35:58.425 --> 00:36:00.146
of those therapists back

00:36:00.166 --> 00:36:01.266
when they were 18 or 19 or

00:36:01.286 --> 00:36:01.967
whenever they made the

00:36:02.027 --> 00:36:03.288
decision to go to physical therapy.

00:36:03.688 --> 00:36:04.509
Because what they did is

00:36:04.568 --> 00:36:05.188
probably what I did,

00:36:05.469 --> 00:36:06.409
which is you got all these

00:36:06.449 --> 00:36:08.550
college envelopes across the table.

00:36:08.570 --> 00:36:09.211
You're looking at where

00:36:09.331 --> 00:36:10.251
you're going to go tour and

00:36:10.271 --> 00:36:11.833
look around and you're going to compare

00:36:13.586 --> 00:36:15.547
athletic training to physical therapy,

00:36:15.768 --> 00:36:16.387
or I don't know,

00:36:16.447 --> 00:36:17.847
like what other things that

00:36:17.887 --> 00:36:18.487
people compare?

00:36:18.668 --> 00:36:19.989
Nursing school, maybe PA,

00:36:20.028 --> 00:36:22.230
they're comparing where they're gonna go,

00:36:22.269 --> 00:36:23.210
like what track they're

00:36:23.230 --> 00:36:25.391
gonna do and start on.

00:36:27.331 --> 00:36:28.711
And the folks that eventually,

00:36:28.851 --> 00:36:29.612
all the folks that we're

00:36:29.632 --> 00:36:30.132
talking about that

00:36:30.172 --> 00:36:31.231
eventually ended up going

00:36:31.251 --> 00:36:32.213
into physical therapy school,

00:36:32.233 --> 00:36:33.273
getting a DPT degree.

00:36:33.652 --> 00:36:34.713
If we had video of them and

00:36:34.733 --> 00:36:35.873
their families making this

00:36:35.914 --> 00:36:36.813
decision at that time,

00:36:37.233 --> 00:36:39.074
they had concluded at that time,

00:36:39.474 --> 00:36:40.434
this is going to be the

00:36:40.494 --> 00:36:41.614
best track for you.

00:36:41.635 --> 00:36:42.916
This is a track that,

00:36:43.516 --> 00:36:46.818
fits your skill set, fits your interests.

00:36:48.059 --> 00:36:49.699
Meaning at that time, Tony,

00:36:49.920 --> 00:36:51.059
like my family and other families,

00:36:51.079 --> 00:36:52.960
like when the student is 18

00:36:52.960 --> 00:36:53.661
or 19 years old,

00:36:53.961 --> 00:36:55.302
they're selling themselves like this.

00:36:55.402 --> 00:36:56.543
They're saying physical therapy,

00:36:56.784 --> 00:36:57.744
it's always going to be in demand.

00:36:58.405 --> 00:36:59.065
It's always a need.

00:36:59.105 --> 00:36:59.885
You get to help people.

00:36:59.945 --> 00:37:00.646
It's rewarding.

00:37:00.706 --> 00:37:01.405
It's fulfilling.

00:37:01.425 --> 00:37:03.427
They're basically selling themselves.

00:37:03.768 --> 00:37:06.028
Whenever you all listening or watching,

00:37:06.469 --> 00:37:07.869
whenever you made the

00:37:07.909 --> 00:37:08.851
decision to go to physical

00:37:08.891 --> 00:37:09.431
therapy school,

00:37:09.570 --> 00:37:11.452
You chose that because you

00:37:11.532 --> 00:37:12.353
saw that there was some

00:37:12.413 --> 00:37:13.873
amount of autonomy and freedom,

00:37:13.914 --> 00:37:14.713
and maybe you could open up

00:37:14.735 --> 00:37:15.335
your own practice,

00:37:15.434 --> 00:37:16.295
or you're always gonna have

00:37:16.335 --> 00:37:18.257
a job at the hospital or

00:37:18.297 --> 00:37:19.737
the skilled nursing facility or whatever,

00:37:19.777 --> 00:37:20.918
which all those things are

00:37:21.518 --> 00:37:22.039
pretty much true.

00:37:22.059 --> 00:37:22.820
You could start a practice

00:37:22.840 --> 00:37:23.440
anytime you want.

00:37:23.880 --> 00:37:25.001
You could start a mobile

00:37:25.021 --> 00:37:25.742
Medicare practice.

00:37:25.762 --> 00:37:26.581
You could go work for,

00:37:27.543 --> 00:37:28.824
Any place that's every place

00:37:28.864 --> 00:37:30.423
is hiring skilled nursing facilities,

00:37:30.864 --> 00:37:32.525
all that hospitals, et cetera.

00:37:33.005 --> 00:37:34.806
So that's the thing that we

00:37:34.826 --> 00:37:36.726
don't have is is the the

00:37:36.786 --> 00:37:38.487
video of footage of these

00:37:38.547 --> 00:37:39.728
families making that decision,

00:37:39.768 --> 00:37:41.228
the students making this decision.

00:37:41.248 --> 00:37:42.329
You know,

00:37:42.389 --> 00:37:43.769
Jimmy McKay and the folks like

00:37:43.789 --> 00:37:44.769
that making the decision

00:37:44.809 --> 00:37:46.050
when he was leaving radio

00:37:46.090 --> 00:37:47.731
and he was saying, like,

00:37:47.851 --> 00:37:48.851
I want to go with this path.

00:37:48.871 --> 00:37:50.032
This is what's going to be

00:37:50.052 --> 00:37:51.152
best for me and my future.

00:37:53.047 --> 00:37:54.128
What happened there when

00:37:54.528 --> 00:37:56.612
they were looking at the

00:37:56.793 --> 00:37:58.295
trends and the growth of

00:37:58.335 --> 00:37:59.677
the industry and the job

00:37:59.717 --> 00:38:00.538
prospects and all that?

00:38:00.878 --> 00:38:01.659
Where did all that go?

00:38:03.222 --> 00:38:04.123
Right, right.

00:38:06.045 --> 00:38:07.304
The other part of that that

00:38:07.445 --> 00:38:10.427
I struggle with is the duration.

00:38:10.507 --> 00:38:12.007
You're making a decision

00:38:12.688 --> 00:38:15.070
seven years before the

00:38:15.110 --> 00:38:17.371
reality of the outcome of that decision.

00:38:17.490 --> 00:38:19.373
Imagine how much has changed

00:38:19.413 --> 00:38:20.432
in the last seven years.

00:38:20.492 --> 00:38:22.034
Imagine how much more is

00:38:22.054 --> 00:38:23.715
going to change in the next seven years.

00:38:25.780 --> 00:38:26.940
Decision or best guess.

00:38:26.960 --> 00:38:28.521
Yeah, it's absolutely a best guess.

00:38:28.541 --> 00:38:31.664
So rather than looking at this as, okay,

00:38:31.744 --> 00:38:32.585
I'm going to get this

00:38:32.644 --> 00:38:33.865
degree and I'm going to be

00:38:33.885 --> 00:38:36.027
this professional in seven years.

00:38:36.047 --> 00:38:36.887
Uh,

00:38:37.068 --> 00:38:39.329
I wish there was more of the

00:38:39.570 --> 00:38:40.730
integration involved.

00:38:40.769 --> 00:38:43.012
So, okay, I think I want to go this route.

00:38:43.092 --> 00:38:44.273
I'm going to start working.

00:38:44.512 --> 00:38:46.094
We've talked about exercise

00:38:46.134 --> 00:38:48.315
techs or aides that go into

00:38:48.335 --> 00:38:49.615
the physical therapy

00:38:49.655 --> 00:38:50.817
profession and then down

00:38:50.856 --> 00:38:52.597
the road become physical therapists.

00:38:53.358 --> 00:38:53.398
Um,

00:38:54.059 --> 00:38:56.240
I think you don't want it.

00:38:56.260 --> 00:38:57.561
I don't know.

00:38:57.581 --> 00:38:59.043
I think there's so much

00:38:59.103 --> 00:39:01.744
advantage to being in the

00:39:01.764 --> 00:39:04.206
workforce while getting educated,

00:39:04.985 --> 00:39:05.387
you know,

00:39:05.507 --> 00:39:07.148
and trying to combine those two.

00:39:08.248 --> 00:39:10.550
Growing or building on this idea,

00:39:11.210 --> 00:39:12.411
let me share the last topic

00:39:12.451 --> 00:39:15.393
that I had because this kind of ties in.

00:39:15.413 --> 00:39:19.635
New data, live YouTube viewers,

00:39:20.516 --> 00:39:22.777
much higher when Jimmy doesn't talk.

00:39:24.331 --> 00:39:24.592
All right,

00:39:24.652 --> 00:39:27.653
so I asked this question on LinkedIn.

00:39:28.875 --> 00:39:32.637
Did we over-educate PTs for

00:39:32.657 --> 00:39:33.978
the job they actually want?

00:39:34.418 --> 00:39:35.559
Now, believe me,

00:39:35.599 --> 00:39:37.599
I have no deep thoughts

00:39:37.679 --> 00:39:38.880
behind these questions.

00:39:38.920 --> 00:39:39.762
I'm trying to figure this

00:39:39.782 --> 00:39:40.762
stuff out for myself.

00:39:40.802 --> 00:39:42.923
That's why I share this on social media.

00:39:42.943 --> 00:39:43.643
In my experience,

00:39:44.184 --> 00:39:46.565
most PTs wanna treat patients, right?

00:39:46.646 --> 00:39:49.186
They don't want to only do evaluations.

00:39:49.807 --> 00:39:51.108
What's interesting about that

00:39:52.159 --> 00:39:52.780
I know a couple of

00:39:52.800 --> 00:39:53.659
therapists that are in the

00:39:53.679 --> 00:39:55.481
skilled nursing world and

00:39:55.782 --> 00:39:57.083
they don't even mention,

00:39:57.123 --> 00:39:58.945
they don't call them physical therapists.

00:39:59.025 --> 00:40:01.666
They call them evaluators and treaters.

00:40:02.327 --> 00:40:03.728
The treaters are the PTAs,

00:40:03.768 --> 00:40:05.269
the evaluators are the PTs.

00:40:05.369 --> 00:40:07.791
The PTs only do evaluations.

00:40:07.811 --> 00:40:08.893
They don't touch a patient.

00:40:08.913 --> 00:40:09.914
They don't go near a patient.

00:40:10.233 --> 00:40:11.235
And truthfully now with

00:40:11.255 --> 00:40:12.715
skilled nursing being the way it is,

00:40:12.876 --> 00:40:13.817
most of the quote

00:40:13.936 --> 00:40:16.239
evaluators aren't even on site.

00:40:16.619 --> 00:40:18.260
They're doing it through telehealth.

00:40:18.681 --> 00:40:20.242
And they're just doing it as

00:40:20.262 --> 00:40:22.186
a way to rubber stamp the

00:40:22.226 --> 00:40:23.387
plan of care and get that

00:40:23.427 --> 00:40:26.813
person to see the the PTA.

00:40:27.393 --> 00:40:28.675
So it's it's OK.

00:40:28.715 --> 00:40:29.556
They want to treat

00:40:30.672 --> 00:40:32.213
the skills to be a great

00:40:32.233 --> 00:40:33.994
evaluator are not the same

00:40:34.074 --> 00:40:35.215
as the skills to be a great

00:40:35.315 --> 00:40:36.355
treating clinician.

00:40:37.235 --> 00:40:38.916
I said a neurosurgeon could

00:40:38.976 --> 00:40:40.938
kiss a boo-boo and stitch a laceration,

00:40:41.077 --> 00:40:42.378
but if that's what they

00:40:42.418 --> 00:40:44.278
wanna do most of the time,

00:40:44.820 --> 00:40:45.980
why did they spend all that

00:40:46.019 --> 00:40:48.242
time becoming a neurosurgeon?

00:40:49.222 --> 00:40:49.362
Um,

00:40:49.942 --> 00:40:53.202
now we have stacks of DPTs who want to

00:40:53.222 --> 00:40:54.342
spend most of their time

00:40:54.443 --> 00:40:55.563
treating patients rather

00:40:55.623 --> 00:40:56.623
than evaluating and

00:40:56.663 --> 00:40:59.463
starting a plan of care.

00:40:59.483 --> 00:41:01.224
65% agreed, 35% disagreed.

00:41:01.264 --> 00:41:02.764
I got 84 votes on it.

00:41:03.244 --> 00:41:04.784
This particular post was

00:41:04.824 --> 00:41:07.065
kind of sitting dormant for

00:41:07.105 --> 00:41:08.804
a while and then all of a sudden spiked.

00:41:08.885 --> 00:41:10.746
I think I'm at like 34,000

00:41:10.746 --> 00:41:12.746
impressions right now, um,

00:41:13.085 --> 00:41:14.166
over the last seven days.

00:41:14.626 --> 00:41:16.347
So pretty interesting from

00:41:16.447 --> 00:41:18.327
that perspective, but yeah.

00:41:18.527 --> 00:41:19.007
I don't know.

00:41:19.347 --> 00:41:19.547
Like,

00:41:20.628 --> 00:41:23.088
should we be more a vocation in a

00:41:23.190 --> 00:41:26.090
technical school or should we be more of,

00:41:26.170 --> 00:41:26.431
you know,

00:41:26.471 --> 00:41:29.932
an elevated profession in a DPT program?

00:41:29.952 --> 00:41:33.775
And it's not a argument over the DPT.

00:41:33.835 --> 00:41:35.315
I don't care about the DPT.

00:41:35.436 --> 00:41:36.956
It's a discussion around.

00:41:37.851 --> 00:41:40.192
What do we actually want to do?

00:41:40.293 --> 00:41:42.434
Why did we become physical therapists?

00:41:42.934 --> 00:41:44.414
What is the actual service

00:41:44.474 --> 00:41:45.235
we want to deliver?

00:41:45.275 --> 00:41:45.896
In the beginning,

00:41:46.315 --> 00:41:48.436
my first decade of being a therapist,

00:41:48.637 --> 00:41:49.637
I wanted a treat.

00:41:50.177 --> 00:41:51.918
I wanted to engage and interact.

00:41:52.260 --> 00:41:53.900
I was more like a personal trainer.

00:41:53.940 --> 00:41:56.181
I wanted to motivate and

00:41:56.222 --> 00:41:58.282
encourage and figure out

00:41:58.362 --> 00:41:59.903
new and innovative ways to

00:42:00.143 --> 00:42:01.545
deliver an exercise

00:42:01.585 --> 00:42:02.666
intervention that made my

00:42:02.726 --> 00:42:04.166
patient who hates exercise

00:42:04.266 --> 00:42:05.927
love what they were doing.

00:42:06.507 --> 00:42:07.489
That was the stuff that I

00:42:07.528 --> 00:42:08.588
wanted to do at that point.

00:42:09.150 --> 00:42:10.510
But there's not a lot of money in that.

00:42:11.070 --> 00:42:12.512
There are personal trainers

00:42:12.552 --> 00:42:13.132
with a weekend

00:42:13.152 --> 00:42:14.452
certification who could do

00:42:14.512 --> 00:42:16.273
it just as well as I could do it.

00:42:16.914 --> 00:42:20.615
So this goes back to the how

00:42:20.655 --> 00:42:22.858
do we afford to be a physical therapist?

00:42:22.898 --> 00:42:23.398
Go ahead, Dave.

00:42:25.599 --> 00:42:28.661
So I clicked agree on your post here.

00:42:28.722 --> 00:42:29.541
Who was your customer?

00:42:30.041 --> 00:42:32.123
What's funny is I voted when

00:42:32.143 --> 00:42:33.143
there were only nine votes

00:42:34.425 --> 00:42:38.447
and it was 33% for agree, 67% disagree.

00:42:38.487 --> 00:42:39.407
Then when you shared it,

00:42:39.467 --> 00:42:40.688
because I must have voted

00:42:41.148 --> 00:42:42.188
like when it first came out

00:42:42.449 --> 00:42:43.188
and now you said you have

00:42:43.208 --> 00:42:44.429
like 60 or 80 or whatever

00:42:45.150 --> 00:42:45.971
folks that voted on it.

00:42:46.411 --> 00:42:47.791
Now it flipped the other way.

00:42:47.831 --> 00:42:49.972
So it's majority agree to,

00:42:50.092 --> 00:42:51.994
they agree with your post, right?

00:42:52.014 --> 00:42:53.434
Yeah.

00:42:54.713 --> 00:42:57.835
To my understanding, there it is.

00:42:58.195 --> 00:42:59.856
They agree that we've

00:43:00.157 --> 00:43:02.197
overeducated individuals

00:43:02.797 --> 00:43:04.938
for what they actually want to do.

00:43:06.179 --> 00:43:07.701
We've overeducated them for

00:43:07.760 --> 00:43:08.800
what they actually want to do.

00:43:09.882 --> 00:43:10.782
And that has nothing to do

00:43:10.802 --> 00:43:12.963
with value or anything like that.

00:43:13.063 --> 00:43:13.384
Go ahead.

00:43:15.405 --> 00:43:16.445
I was looking at a different

00:43:16.505 --> 00:43:17.985
agree or disagree post of yours,

00:43:18.025 --> 00:43:19.646
the who is your customer one,

00:43:19.686 --> 00:43:21.847
which will be another topic of the day.

00:43:23.123 --> 00:43:25.543
Yeah, no, this one's about the education.

00:43:25.744 --> 00:43:26.864
And it goes back to, look,

00:43:27.864 --> 00:43:29.226
out of all the things that I can do,

00:43:30.045 --> 00:43:32.086
I believe this is my personal opinion.

00:43:32.126 --> 00:43:33.367
The highest value,

00:43:33.387 --> 00:43:35.728
the highest ROI back to

00:43:35.768 --> 00:43:39.170
Jimmy's post is I am going

00:43:39.230 --> 00:43:40.951
to evaluate the situation.

00:43:41.030 --> 00:43:41.331
Right.

00:43:41.630 --> 00:43:42.711
And I try to compare it to

00:43:42.731 --> 00:43:44.793
like the architect versus

00:43:44.992 --> 00:43:46.914
the person who actually builds the house.

00:43:48.215 --> 00:43:50.456
The highest value on a per

00:43:50.496 --> 00:43:51.677
minute basis is the

00:43:51.777 --> 00:43:53.420
architect who designed the house,

00:43:53.780 --> 00:43:54.960
who ensured safety,

00:43:55.041 --> 00:43:56.963
the engineer who made sure

00:43:56.983 --> 00:43:58.164
that it's not going to collapse.

00:43:59.204 --> 00:44:00.286
So as the therapist,

00:44:00.326 --> 00:44:02.007
like my highest value that

00:44:02.068 --> 00:44:03.789
I could deliver is let me

00:44:03.829 --> 00:44:04.811
evaluate the human.

00:44:05.719 --> 00:44:07.501
Let me look at all the factors in play.

00:44:07.541 --> 00:44:09.382
Let me look at the differential diagnosis.

00:44:09.402 --> 00:44:10.824
Let me do the clinical exam.

00:44:11.224 --> 00:44:12.706
Let me talk to the person.

00:44:12.806 --> 00:44:14.367
What is your true objective?

00:44:14.407 --> 00:44:16.690
You say this might be your goal,

00:44:16.710 --> 00:44:17.630
but I have a feeling the

00:44:17.690 --> 00:44:19.893
underlying issues, the insecurities,

00:44:20.012 --> 00:44:20.672
the other things,

00:44:21.094 --> 00:44:22.594
probably really the plan

00:44:22.635 --> 00:44:24.237
that will help you achieve

00:44:24.257 --> 00:44:26.117
your outcome is this.

00:44:26.177 --> 00:44:27.378
And I create the plan and I

00:44:27.418 --> 00:44:28.940
create the patient-centered goals.

00:44:29.527 --> 00:44:32.655
man, that is like $1,000 an hour value.

00:44:33.336 --> 00:44:34.940
And I think people who have

00:44:34.960 --> 00:44:36.644
the income understand that.

00:44:36.664 --> 00:44:37.385
That's why, Dave,

00:44:37.746 --> 00:44:39.210
your business is what it is.

00:44:40.097 --> 00:44:42.836
But then the other level of that is, okay,

00:44:42.858 --> 00:44:45.358
does it take me to actually

00:44:45.418 --> 00:44:46.918
deliver the intervention?

00:44:47.538 --> 00:44:50.219
Does it take me to actually

00:44:50.418 --> 00:44:51.878
carry out the program?

00:44:51.978 --> 00:44:53.179
I don't think it does.

00:44:53.659 --> 00:44:54.639
Because I think I could take

00:44:54.659 --> 00:44:57.820
an uneducated individual and say, look,

00:44:58.119 --> 00:44:59.219
these are the five things I

00:44:59.260 --> 00:45:00.081
want you to do with this

00:45:00.121 --> 00:45:01.280
person in the next hour.

00:45:02.360 --> 00:45:03.661
They're not thinking,

00:45:03.981 --> 00:45:05.222
is this the right thing to do?

00:45:05.242 --> 00:45:07.202
They're simply following the blueprint.

00:45:08.371 --> 00:45:11.014
But the therapist wants to do that.

00:45:11.134 --> 00:45:13.235
So it's like in a business,

00:45:13.255 --> 00:45:15.217
and I'll make this correlation,

00:45:16.237 --> 00:45:17.557
I'm paying a therapist to

00:45:18.179 --> 00:45:19.539
do the highest value thing.

00:45:20.059 --> 00:45:21.101
I probably don't want to pay

00:45:21.141 --> 00:45:22.340
my therapist a therapist's

00:45:22.400 --> 00:45:23.782
wage to sweep the floor.

00:45:24.222 --> 00:45:25.242
I probably don't want to pay

00:45:25.302 --> 00:45:26.563
my therapist a therapist's

00:45:26.643 --> 00:45:28.405
wage to organize the

00:45:28.465 --> 00:45:30.786
shelves and to wipe down the tables,

00:45:30.867 --> 00:45:31.146
right?

00:45:31.666 --> 00:45:31.867
But

00:45:33.007 --> 00:45:34.148
In a certain respect,

00:45:34.208 --> 00:45:36.590
that's what a lot of us wanted to do.

00:45:36.650 --> 00:45:38.710
We want to be there with the patient,

00:45:38.771 --> 00:45:39.731
treating the patient,

00:45:40.231 --> 00:45:42.492
but that could be delivered by anyone.

00:45:42.532 --> 00:45:43.414
It doesn't have to be

00:45:43.454 --> 00:45:44.554
delivered by a therapist.

00:45:44.914 --> 00:45:45.675
So what do you say?

00:45:49.237 --> 00:45:49.476
Dave.

00:45:50.463 --> 00:45:52.884
I have to disagree the past, yeah,

00:45:53.224 --> 00:45:54.143
a couple of minutes ago

00:45:54.164 --> 00:45:55.384
when you said a trainer can

00:45:55.423 --> 00:45:56.324
just take a weekend course

00:45:56.364 --> 00:45:57.525
and do about the same as you.

00:45:58.184 --> 00:45:58.864
I disagree.

00:45:58.945 --> 00:46:00.244
Tony, Rob Vining and I,

00:46:00.304 --> 00:46:01.364
we highlighted some of your

00:46:01.465 --> 00:46:05.385
clever MacGyver type videos using, I mean,

00:46:05.425 --> 00:46:06.985
like monster bands and all

00:46:07.025 --> 00:46:07.686
these other things that

00:46:07.726 --> 00:46:09.626
you've used to help your

00:46:09.686 --> 00:46:11.086
patients and clients over the years.

00:46:11.887 --> 00:46:14.788
And I think you are so

00:46:14.947 --> 00:46:16.507
advanced with your ability

00:46:16.588 --> 00:46:17.829
to maybe evaluate and treat

00:46:18.009 --> 00:46:18.809
patients and clients

00:46:19.409 --> 00:46:21.650
I think you almost like it's

00:46:21.771 --> 00:46:23.371
almost come so easy to you

00:46:23.472 --> 00:46:24.652
that maybe it's like so

00:46:24.773 --> 00:46:26.255
simplified that you think a

00:46:26.275 --> 00:46:27.456
personal trainer could go

00:46:28.215 --> 00:46:29.137
learn a weekend course and

00:46:29.177 --> 00:46:31.798
then do the things that a lot of us do.

00:46:32.018 --> 00:46:33.440
So I definitely have to say

00:46:33.501 --> 00:46:34.240
I disagree with that.

00:46:34.942 --> 00:46:35.882
So let me clarify,

00:46:36.103 --> 00:46:37.543
because I don't think I

00:46:37.603 --> 00:46:38.545
explained it quite right.

00:46:39.664 --> 00:46:40.746
Yeah, I agree.

00:46:40.786 --> 00:46:41.726
Like there are clinicians

00:46:41.806 --> 00:46:43.188
out there that have amazing

00:46:43.507 --> 00:46:44.849
brains inside their skulls

00:46:44.889 --> 00:46:45.690
and they're incredibly

00:46:45.750 --> 00:46:47.130
creative and they have all that stuff.

00:46:47.771 --> 00:46:49.452
But what I'm saying is,

00:46:49.693 --> 00:46:50.914
do you think I could take a

00:46:50.954 --> 00:46:53.175
person who doesn't have the skills,

00:46:53.255 --> 00:46:54.396
knowledge and education of

00:46:54.436 --> 00:46:55.458
a therapist and say,

00:46:56.277 --> 00:46:58.219
I want you to do this, this thing,

00:46:58.559 --> 00:46:59.420
whatever that thing is.

00:47:00.677 --> 00:47:02.657
that person could probably carry it out.

00:47:02.717 --> 00:47:03.657
I'm not saying that person

00:47:03.717 --> 00:47:04.798
is thinking of the thing.

00:47:04.838 --> 00:47:06.099
They're not creating the thing.

00:47:06.119 --> 00:47:07.820
They're not choosing the intervention.

00:47:08.201 --> 00:47:10.101
They are simply delivering

00:47:10.161 --> 00:47:10.961
the intervention.

00:47:11.702 --> 00:47:13.322
I think anybody could do that.

00:47:13.822 --> 00:47:15.744
So you pay the therapist for

00:47:15.903 --> 00:47:17.025
all the creative and the

00:47:17.085 --> 00:47:18.505
wisdom and the experience,

00:47:19.365 --> 00:47:20.186
but you shouldn't

00:47:20.266 --> 00:47:21.487
necessarily be paying the

00:47:21.527 --> 00:47:24.228
therapist to deliver the intervention.

00:47:24.809 --> 00:47:24.949
Now,

00:47:24.989 --> 00:47:26.650
there are interventions that require

00:47:26.690 --> 00:47:28.552
your expertise during the delivery,

00:47:28.632 --> 00:47:28.871
right?

00:47:29.431 --> 00:47:30.773
And Medicare has a great example.

00:47:30.833 --> 00:47:31.914
If you have a patient with a

00:47:31.974 --> 00:47:33.074
humeral fracture that's

00:47:33.235 --> 00:47:35.016
unhealed and that patient

00:47:35.056 --> 00:47:36.717
requires passive range of motion,

00:47:36.836 --> 00:47:39.338
I am not going to tell an untrained,

00:47:39.398 --> 00:47:41.239
unlicensed individual to

00:47:41.360 --> 00:47:42.641
mobilize that shoulder,

00:47:42.800 --> 00:47:44.382
even though from the outside,

00:47:44.422 --> 00:47:45.161
it just looks like you're

00:47:45.181 --> 00:47:45.762
moving their arm.

00:47:46.621 --> 00:47:49.342
But for a lot of the stuff that we do,

00:47:50.503 --> 00:47:52.523
I can tell somebody what to do.

00:47:52.543 --> 00:47:53.644
They don't need to know why

00:47:53.704 --> 00:47:54.244
they're doing it.

00:47:54.284 --> 00:47:55.766
They don't need to know the

00:47:55.905 --> 00:47:56.885
background behind it.

00:47:56.965 --> 00:47:57.867
I see what you're saying.

00:47:58.648 --> 00:47:58.889
Yeah.

00:47:59.750 --> 00:48:01.851
And so if I'm a therapist

00:48:01.871 --> 00:48:04.112
who wants to maximize my income,

00:48:04.652 --> 00:48:05.733
I need to deliver,

00:48:05.813 --> 00:48:07.034
I need to solve the highest

00:48:07.074 --> 00:48:07.996
value problems.

00:48:08.876 --> 00:48:10.478
And that is not sitting

00:48:10.518 --> 00:48:11.478
there with your patient,

00:48:11.539 --> 00:48:12.579
no matter how much you love it,

00:48:13.679 --> 00:48:14.420
socializing,

00:48:14.541 --> 00:48:16.963
connecting and doing all those things.

00:48:17.023 --> 00:48:18.443
You can pay somebody who has

00:48:18.483 --> 00:48:20.204
a great personality and a

00:48:20.244 --> 00:48:22.106
good disposition to do that

00:48:22.186 --> 00:48:22.726
stuff for you.

00:48:24.681 --> 00:48:26.764
All right, so fine, I agree with that.

00:48:27.224 --> 00:48:28.925
And then also this kind of

00:48:28.945 --> 00:48:30.786
supports kind of what you usually say,

00:48:30.885 --> 00:48:32.007
which is a comment here

00:48:32.086 --> 00:48:34.128
live from the Myofascial Clinic.

00:48:34.148 --> 00:48:35.088
Thank you for your live comment.

00:48:35.510 --> 00:48:36.070
They said,

00:48:36.409 --> 00:48:38.391
because the right evaluation is

00:48:38.411 --> 00:48:40.913
the magic to the entire plan of care.

00:48:41.454 --> 00:48:42.795
And that's kind of what Tony

00:48:42.835 --> 00:48:44.215
has been saying today and

00:48:44.635 --> 00:48:47.438
recently about the value of

00:48:47.757 --> 00:48:48.978
the licensed physical

00:48:48.998 --> 00:48:49.940
therapist and the ability

00:48:49.980 --> 00:48:52.681
to evaluate or re-eval or reassess

00:48:53.501 --> 00:48:54.663
Um, and I agree.

00:48:54.722 --> 00:48:56.222
So that sets up the whole plan of care.

00:48:56.262 --> 00:48:58.864
And then depending on your practice model,

00:48:58.905 --> 00:48:59.505
you can have the,

00:48:59.744 --> 00:49:01.025
some of the plan of care or

00:49:01.045 --> 00:49:01.925
a lot of the plan of care

00:49:01.945 --> 00:49:02.927
be carried out by a

00:49:03.487 --> 00:49:04.067
physical therapist

00:49:04.106 --> 00:49:06.047
assistant or whatever it might be.

00:49:07.809 --> 00:49:08.088
Yeah.

00:49:08.128 --> 00:49:11.090
Jimmy, um, like driver's license,

00:49:11.231 --> 00:49:13.751
you can go where you want on road career.

00:49:14.371 --> 00:49:14.652
Yeah.

00:49:14.771 --> 00:49:16.952
And, and like Dave's model, you know, I,

00:49:17.213 --> 00:49:18.914
I come from a fine arts background,

00:49:18.934 --> 00:49:19.775
so I'm going to talk about, um,

00:49:20.494 --> 00:49:21.476
Pablo Picasso, um,

00:49:22.492 --> 00:49:23.713
I can spend millions of

00:49:23.793 --> 00:49:25.413
dollars buying a unique

00:49:25.494 --> 00:49:27.074
Pablo Picasso painting.

00:49:28.594 --> 00:49:30.456
I can hire Pablo Picasso,

00:49:30.476 --> 00:49:31.235
because he's a painter,

00:49:31.976 --> 00:49:32.916
to paint my bathroom.

00:49:33.876 --> 00:49:34.297
Paint it blue.

00:49:34.318 --> 00:49:35.018
I think he passed away.

00:49:35.038 --> 00:49:35.117
What?

00:49:38.331 --> 00:49:38.630
Anyway,

00:49:39.452 --> 00:49:41.072
Pablo went through his blue period.

00:49:41.213 --> 00:49:43.635
I can pay him to paint my bathroom blue.

00:49:44.655 --> 00:49:47.038
Dave, you have people that say,

00:49:47.057 --> 00:49:48.840
I don't care if a lower

00:49:48.900 --> 00:49:49.920
trained individual can

00:49:49.960 --> 00:49:51.081
deliver this intervention

00:49:51.661 --> 00:49:53.943
because the therapist prescribed it.

00:49:54.344 --> 00:49:55.664
I want to pay the therapist

00:49:55.684 --> 00:49:56.945
to deliver that intervention.

00:49:57.347 --> 00:49:58.367
You're in that world.

00:49:58.487 --> 00:49:59.327
And that's amazing.

00:49:59.748 --> 00:50:01.230
But that's not the insurance based world.

00:50:01.670 --> 00:50:03.030
So this is where we need to say,

00:50:03.070 --> 00:50:04.572
what about the people that

00:50:04.672 --> 00:50:06.253
don't want to pay Pablo

00:50:06.295 --> 00:50:08.335
Picasso to paint their bathroom?

00:50:08.797 --> 00:50:09.697
Maybe they want to paint it

00:50:09.757 --> 00:50:10.938
themselves or they want to

00:50:10.978 --> 00:50:12.139
paint a kid down the street

00:50:12.139 --> 00:50:13.862
$100 to paint it.

00:50:14.202 --> 00:50:14.382
Like,

00:50:14.442 --> 00:50:16.523
how can we open up those opportunities?

00:50:16.543 --> 00:50:19.527
I think that's what we need

00:50:19.547 --> 00:50:20.568
to put our efforts into.

00:50:23.170 --> 00:50:23.771
Absolutely.

00:50:24.110 --> 00:50:24.811
Great artists.

00:50:27.847 --> 00:50:29.907
I don't wanna go longer than we need to.

00:50:30.369 --> 00:50:31.969
What are your parting shots?

00:50:32.050 --> 00:50:33.070
What are you thinking about?

00:50:35.972 --> 00:50:36.592
Parting shots,

00:50:36.652 --> 00:50:39.655
we'll go back to the whole

00:50:39.675 --> 00:50:41.416
Jeff Moore post and what we

00:50:41.436 --> 00:50:42.077
were talking about at the

00:50:42.097 --> 00:50:42.677
top of the show.

00:50:42.697 --> 00:50:43.858
I think it's just, again,

00:50:43.898 --> 00:50:46.179
it's important to know your

00:50:46.239 --> 00:50:47.740
practice model, your business model,

00:50:47.820 --> 00:50:48.742
know your team,

00:50:49.663 --> 00:50:51.204
the value that you deliver

00:50:51.304 --> 00:50:52.505
to whoever your ideal

00:50:52.545 --> 00:50:53.485
client or patient is.

00:50:53.905 --> 00:50:55.186
My ideal patient or client is,

00:50:56.106 --> 00:50:57.088
very different than Tony

00:50:57.108 --> 00:50:59.329
Meritato's ideal patient or client.

00:50:59.849 --> 00:51:01.190
Yes, we're in two different states.

00:51:01.632 --> 00:51:03.313
Yes, maybe, Tony,

00:51:03.333 --> 00:51:05.213
you're more in a suburban area.

00:51:05.293 --> 00:51:08.697
I'm in a metropolitan, busy city area.

00:51:10.822 --> 00:51:13.342
If you know yourself, your practice,

00:51:13.362 --> 00:51:14.003
what you deliver,

00:51:14.342 --> 00:51:15.704
whatever you believe that

00:51:15.724 --> 00:51:17.885
you're either what you

00:51:17.945 --> 00:51:20.005
value or what your patients

00:51:20.126 --> 00:51:21.766
or clients are valuing in

00:51:22.146 --> 00:51:23.047
what they're searching for

00:51:23.306 --> 00:51:25.467
or what they value in your practice model,

00:51:26.327 --> 00:51:27.489
you have to know that.

00:51:27.548 --> 00:51:30.469
Maybe it takes some time to figure it out.

00:51:30.789 --> 00:51:31.329
And it's okay.

00:51:31.489 --> 00:51:32.670
And it's okay for both of

00:51:33.190 --> 00:51:34.692
Tony and my practice to

00:51:34.871 --> 00:51:37.452
coexist in our great United

00:51:37.472 --> 00:51:38.253
States of America.

00:51:40.235 --> 00:51:40.436
You know,

00:51:40.456 --> 00:51:41.856
we just we have two different models.

00:51:42.217 --> 00:51:44.059
And Tony has the network

00:51:44.259 --> 00:51:46.081
insurance model and has a

00:51:46.121 --> 00:51:46.860
brick and mortar office.

00:51:47.661 --> 00:51:49.663
And we are mostly out of

00:51:49.682 --> 00:51:50.443
network or out of pocket.

00:51:50.503 --> 00:51:51.284
And we go to our patients,

00:51:51.324 --> 00:51:52.085
our clients homes.

00:51:52.985 --> 00:51:54.646
And we're at the end of the day,

00:51:54.686 --> 00:51:56.307
we're probably doing fairly

00:51:56.748 --> 00:51:58.130
similar interventions and

00:51:58.190 --> 00:51:59.210
we're just delivering it or

00:51:59.251 --> 00:52:00.512
packaging it in two different ways.

00:52:01.559 --> 00:52:02.079
Absolutely.

00:52:02.320 --> 00:52:02.800
That's the thing.

00:52:02.840 --> 00:52:04.041
There is no wrong answer.

00:52:04.061 --> 00:52:05.422
I would say there's probably

00:52:05.461 --> 00:52:06.523
no right answer either.

00:52:06.543 --> 00:52:09.103
It's whatever is specific

00:52:09.264 --> 00:52:11.626
and appropriate to your situation.

00:52:11.646 --> 00:52:14.047
And at the end of the day, I mean,

00:52:14.068 --> 00:52:15.389
we have a finite amount of

00:52:15.449 --> 00:52:16.690
time on this planet.

00:52:17.369 --> 00:52:19.311
We want to enjoy that time.

00:52:19.331 --> 00:52:21.153
We want to enjoy that experience.

00:52:21.293 --> 00:52:22.434
I will do things that cost

00:52:22.474 --> 00:52:23.956
me money because I enjoy

00:52:24.016 --> 00:52:25.077
the way it makes me feel.

00:52:25.557 --> 00:52:26.418
But on the flip side,

00:52:26.478 --> 00:52:27.659
I have responsibilities I

00:52:27.719 --> 00:52:28.860
need to take care of that

00:52:28.920 --> 00:52:30.463
require I have enough money

00:52:30.503 --> 00:52:31.163
to pay the bills.

00:52:31.684 --> 00:52:33.666
So you guys just lead and

00:52:33.786 --> 00:52:34.867
cut your own path.

00:52:35.126 --> 00:52:36.708
You will find the happiness

00:52:36.748 --> 00:52:37.628
that you're looking for.

00:52:38.170 --> 00:52:39.610
Jimmy, just smile and wave.

00:52:40.231 --> 00:52:41.172
Just smile and wave.

00:52:43.295 --> 00:52:44.036
All right, guys.

00:52:44.097 --> 00:52:44.998
Jimmy's parting shot.

00:52:45.039 --> 00:52:46.461
You have two ears, one mouth.

00:52:47.003 --> 00:52:48.706
Use them proportionately.

00:52:49.246 --> 00:52:50.548
We will see you guys coming

00:52:50.628 --> 00:52:52.813
up this next Tuesday and Thursday,

00:52:52.813 --> 00:52:54.175
8.30 a.m.

00:52:54.275 --> 00:52:55.458
Thanks so much for joining us.