The Systems That Burn Out Physical Therapists

WEBVTT

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You're listening to the PT Pinecast,

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where smart people in healthcare come to

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make noise.

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Here's your host, Jimmy McKay.

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All right.

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Some people in physical therapy chase

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efficiency.

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Others chase compliance.

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And most clinics are stuck somewhere in

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the middle, just going around in circles,

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chasing something,

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trying to treat patients well while

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surviving productivity expectations,

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documentation pressure,

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and reimbursement changes that seem to

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shift every year or every, I don't know,

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What if the systems inside healthcare

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actually protected the clinicians instead

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of burning them out?

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What if compliance wasn't something

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therapists feared,

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but something that gave them confidence

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What if business strategy didn't dilute

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clinical care at all,

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but actually strengthened it?

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Today's guest has built a career right at

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that intersection that I just described.

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She's helped organizations translate

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clinical excellence into systems that

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work.

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turning compliance into clarity,

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education into something people actually

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use.

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Who would have thought?

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And how about turning strategy into tools

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that help therapists survive modern

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healthcare?

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She believes it's something simple but

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powerful.

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Clinical decisions should guide financial

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decisions, not the other way around.

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And if you do what's right for the

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patient, the money will follow.

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Let's bring in Katie Holterman.

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How'd we do on the intro, Katie?

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I think pretty good.

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I think pretty good.

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I like to wear a lot of hats.

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So as you can see,

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they kind of go on and off and

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depending on the lens that I'm looking at

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and things like that.

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But that's good, right?

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Because I don't think I talked about silos

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more in my life until I became a

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physical therapy student and then

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graduated.

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I don't know that there were silos in

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my previous life,

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but I definitely recognize them.

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And you're talking about...

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being able to sit atop the silos and

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see what's going on in each and saying,

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Hey, you're over here trying to fix this,

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but you're doing it this way.

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If you just changed it,

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it would solve your problem in this

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problem.

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And that feels like actual efficiency.

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Exactly.

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Exactly.

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And being able to kind of look at

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through different lens lenses and jump

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around without jumping in,

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but jumping around and,

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and

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pulling what is needed out of each bucket,

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so to speak.

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Yeah.

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Right now,

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it might feel like in healthcare and

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probably warranted that clinicians are

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where the rubber meets the road.

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I mean, we have to be, right?

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We are a service.

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We provide a service, right?

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That is what we do in healthcare.

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We provide care.

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Care is a service.

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And it often feels like where the rubber

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meets the road or where the brake pads

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are, right?

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That's where the most friction is.

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Unfortunately, that's where our

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our humans are who want to give the

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most.

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So you talk a lot about building systems

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that actually protect clinicians instead

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of burning them out.

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What does that look like or what could

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that look like in reality in a clinic?

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How can you give me examples of situations

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where we're actually able to protect those

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people instead of using them as the thing

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that we stop the car with?

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Exactly.

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Well,

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I think the first thing that you said

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was really important is that

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we have a service right but it's our

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product correct clinicians don't want to

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think that they have a product clinicians

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are touchy-feely and loving and want to do

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the great thing and a product is stingy

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and tangible and not um not something that

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people want to grab onto but when you

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start to realize that your service is a

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product

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That's kind of the first system that you

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put into place is that understanding

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piece.

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That in and itself is a system that

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works,

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just having that clarity of everything.

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That to me is strategy number one.

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Then when we go forward and say, okay,

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now what systems can we put into place

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to protect the clinician as far as from

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a compliance perspective,

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making sure that we are doing something

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that is compliant and doing it well

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without having to jump through seventeen

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hoops to do it.

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That's a slam dunk if we can do

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that,

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where we just put something in place and

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have checks and balances that are already

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in the workflow for the clinician.

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Why don't we do this?

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Let's start with there.

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I'll give an example.

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I bought a bike off eBay because one

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day I was going to be a triathlete

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and I was riding on that bike.

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That was my bike.

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And eventually after two or three years,

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someone looked at me riding that bike.

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It was one of those bikes where you

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sort of like lay down like you're super

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fast, you know,

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the hands in front of you.

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And someone said, hey,

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why do you sort of curl your wrists

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in?

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And I'm like, well,

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the handlebars are this long and my arms

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are longer.

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And they go, you know,

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there's a screw right there.

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You loosen that,

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those things telescope out.

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You could have them go longer.

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I adapted to the bike instead of,

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because I didn't know,

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I didn't know any better.

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I could have the bike adapt to me

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and I wouldn't have cocked my wrists for

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two and a half years.

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Now that's the only way I can ride,

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by the way.

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So let's start with why doesn't that

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happen?

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Like,

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why do we build systems that actually we

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ask the clinician to adapt to instead

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of...

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making more sense the other way around?

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I think there's a number of reasons.

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I think our EMR systems are failing us,

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but it's not the system itself.

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It's how we exactly what you're saying,

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how we aren't using the tools within the

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EMR systems to help

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them adapt to what we need.

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Now,

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I'll put the EMR companies aside because

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there's so many of them.

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They all have their limitations.

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They all have their benefits.

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One is not better than the other.

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I take that back.

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There are some that are better than the

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other.

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But I guess they're different tools and

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some of them are better in this situation

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versus that.

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Exactly.

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Exactly.

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I mean, here's an example.

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So I my I'm an SLP by trade.

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I just play a really good PT on

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TV.

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So that's, you know, but that being said,

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so many of the EMR systems are built

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for PT and OT.

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So being an SLP in that world where

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you're, you know,

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if you're an SLP in a rehab clinic

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or something like that,

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you have to fit your exactly a circle

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into a square anyway on daily life because

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clinics are set up for PT.

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Clinics are just that's, you know,

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SLP is the odd man out anyway.

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Then you have a documentation system

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that's either built for PT

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or built for skilled nursing or built for,

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you know, this place.

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And so you're already two or three steps

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behind in trying to make your

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documentation effective, efficient,

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compliant,

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you're working against that.

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So the more that you can work with

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the EMR systems to make sure that,

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you know,

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if there is any flexibility in what you

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can do to not have clinicians working

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against that day after day and minute

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after minute, that's going to be key.

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And then the other piece is sometimes,

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you know,

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clinicians get into their

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patterns of treatment that are great

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clinically,

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but then make it ten times harder for

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them to document or for them to audit

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their own documentation rather than,

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again, like you were saying,

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adapt to the bike or have the bike

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adapt to you.

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Sometimes you need to kind of give a

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little to get a little.

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Understood.

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And it seems like,

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because we should follow the money,

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and you said,

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make it good and the money will follow.

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It seems like,

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and I don't have a number to this,

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but if my day felt better or easier,

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or if I wanted to,

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if I was spending more time doing the

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thing,

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being the SLP or the PT or the

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OT, the clinic, the hospital,

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anything would probably have happier,

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more productive therapists who stuck

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around longer.

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And we know those things cost money.

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Absolutely.

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The money for hiring and rehiring and

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training, it is bananas.

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It is so expensive.

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It's an entire industrial complex.

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Yes, completely.

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And the problem is,

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if you look at just a general evaluation

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that you have to write,

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There are sometimes seventeen steps,

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clicks, buttons,

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boxes that you need to fill in.

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And if you click this and then you

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make an error,

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you have to go back three times.

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If we can save clinicians three steps,

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five steps, that's a huge difference, too.

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But clinicians sometimes don't like to

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think outside the box.

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And so if we can use education to

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help them problem solve in the moment,

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that's going to help them in the long

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run anyway.

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And again, to your point,

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save the burnout,

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save the frustration that they're feeling

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and keep the clinician and keep them

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happy.

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A lot of therapists might hear the word

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efficiency and immediately think it means

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cutting corners or I'm sure a lot of

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things and emotions jump into someone's

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head when they hear efficiency.

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How can clinics become more efficient

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without compromising clinical standards,

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without cutting those corners,

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without putting the team in?

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So how can they do that?

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I think a couple of different ways.

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It's not a bad word.

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And people do think I always say the

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word productivity.

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Oh my gosh,

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you say that word in front of a

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bunch of clinicians and you think that I

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just had the mouth of a sailor,

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which I do,

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but I don't use it on a daily

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basis at work.

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But it has become this terrible word.

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I think taking that terribleness out of it

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is step one.

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Before you even put into practice any tips

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or tricks or things like that,

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you need to

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to get on the same page with a

00:10:38.609 --> 00:10:41.089
clinician and understand why efficiency,

00:10:41.129 --> 00:10:41.629
productivity,

00:10:41.668 --> 00:10:43.090
whatever word you want to use,

00:10:44.049 --> 00:10:45.309
isn't a terrible thing.

00:10:45.671 --> 00:10:48.010
It is a thing that the rest of

00:10:48.071 --> 00:10:52.292
the world uses as they measure success.

00:10:52.631 --> 00:10:54.352
It may not be called productivity,

00:10:55.827 --> 00:10:57.609
but yeah, there's a hundred words for it.

00:10:57.629 --> 00:10:57.808
Right.

00:10:57.970 --> 00:10:58.590
Exactly.

00:10:58.710 --> 00:11:00.431
It's, it's your, your product,

00:11:00.451 --> 00:11:03.013
your service, your, your efficiency, your,

00:11:03.452 --> 00:11:05.355
your success.

00:11:05.414 --> 00:11:05.615
I mean,

00:11:05.634 --> 00:11:07.375
some industries just call it your measure

00:11:07.416 --> 00:11:07.996
of success.

00:11:08.397 --> 00:11:09.557
That is what it is.

00:11:10.097 --> 00:11:12.200
So I think that's number one is kind

00:11:12.240 --> 00:11:14.000
of having laying that groundwork for,

00:11:14.221 --> 00:11:15.942
for clinicians to say, you know,

00:11:15.981 --> 00:11:16.962
this is the expectation.

00:11:17.023 --> 00:11:17.764
It's not all bad.

00:11:17.823 --> 00:11:19.024
Let's get on the same page on how

00:11:19.043 --> 00:11:19.945
we can make that work.

00:11:21.125 --> 00:11:22.427
It's not cutting corners.

00:11:22.787 --> 00:11:24.788
And here's why it's not cutting corners

00:11:24.869 --> 00:11:25.349
because you,

00:11:26.027 --> 00:11:32.870
If you are doing a session and making

00:11:33.431 --> 00:11:35.231
the patient at the center of it,

00:11:36.692 --> 00:11:39.414
if you are consistently talking to them

00:11:39.434 --> 00:11:40.134
about their goals,

00:11:40.174 --> 00:11:41.696
consistently talking to them about what's

00:11:41.716 --> 00:11:42.756
going to work the best,

00:11:43.476 --> 00:11:46.519
consistently asking their feedback,

00:11:47.599 --> 00:11:49.880
that is going to make the session run

00:11:49.941 --> 00:11:51.961
more efficiently already.

00:11:52.315 --> 00:11:53.475
because you're already putting the patient

00:11:53.514 --> 00:11:54.596
at the center of it and you're not

00:11:54.635 --> 00:11:56.255
putting a lot of fluff in that you

00:11:56.296 --> 00:11:58.517
feel as a clinician is better than what

00:11:58.537 --> 00:11:59.476
the patient feels.

00:12:00.456 --> 00:12:02.158
So I think by starting with the patient's

00:12:02.398 --> 00:12:02.898
ears,

00:12:03.697 --> 00:12:05.719
that's the first step in becoming an

00:12:05.739 --> 00:12:07.419
efficient clinician.

00:12:07.860 --> 00:12:10.701
I have observed tens of thousands of

00:12:10.760 --> 00:12:12.880
sessions, maybe an exaggeration,

00:12:13.120 --> 00:12:16.442
but a lot of sessions where I've watched

00:12:16.481 --> 00:12:18.302
clinicians go.

00:12:19.183 --> 00:12:25.350
Talk, do, put patients doing X, Y, Z.

00:12:25.571 --> 00:12:27.472
Not once asking the patient,

00:12:28.494 --> 00:12:29.495
does this work for you?

00:12:30.797 --> 00:12:32.238
How is this going to help you in

00:12:32.258 --> 00:12:33.078
your daily life?

00:12:33.539 --> 00:12:35.261
And if they would have started with those

00:12:35.322 --> 00:12:36.663
questions from the get-go,

00:12:37.203 --> 00:12:38.485
their sessions would have been ten times

00:12:38.544 --> 00:12:39.046
more efficient.

00:12:40.370 --> 00:12:43.652
efficiency and quality are not enemies.

00:12:43.731 --> 00:12:44.893
That is something that I took away from

00:12:44.913 --> 00:12:45.832
a lot of things that I read that

00:12:45.852 --> 00:12:45.993
you,

00:12:46.153 --> 00:12:47.293
that you had said that those things are

00:12:47.413 --> 00:12:48.514
not enemies.

00:12:48.735 --> 00:12:50.936
And if you understand that and we can

00:12:50.975 --> 00:12:54.038
adapt the system to work towards that,

00:12:54.918 --> 00:12:56.399
everybody sort of wins.

00:12:56.418 --> 00:12:57.299
The clinician has a better,

00:12:57.919 --> 00:12:59.500
has a better feeling when they walk out

00:12:59.520 --> 00:13:00.782
at five o'clock or whatever time they're

00:13:00.802 --> 00:13:02.202
leaving and the patient has a better

00:13:02.243 --> 00:13:03.984
experience and they want to come back and

00:13:05.287 --> 00:13:06.287
Efficiency and quality,

00:13:06.947 --> 00:13:08.028
they're not enemies.

00:13:08.087 --> 00:13:09.187
You've also said something that might

00:13:09.207 --> 00:13:09.927
surprise people.

00:13:10.469 --> 00:13:12.408
Compliance is also not the enemy.

00:13:12.428 --> 00:13:12.928
I mean, geez,

00:13:13.269 --> 00:13:14.590
if you see a meeting with compliance

00:13:14.610 --> 00:13:15.889
department on your schedule pop up,

00:13:15.929 --> 00:13:17.791
I'm sure heart rates generally rise.

00:13:17.811 --> 00:13:20.351
But why do so many clinicians see it

00:13:20.392 --> 00:13:20.751
that way,

00:13:20.772 --> 00:13:22.292
that compliance might be the enemy?

00:13:22.572 --> 00:13:23.993
And what are they getting wrong?

00:13:25.253 --> 00:13:27.833
I think that the word compliance stirs up

00:13:29.654 --> 00:13:32.275
scary images out of compliance.

00:13:33.659 --> 00:13:35.600
I mean, you can hear you're in compliance,

00:13:35.620 --> 00:13:37.062
but most of the time... Yeah,

00:13:37.101 --> 00:13:38.403
no one calls a meeting to tell you

00:13:38.643 --> 00:13:39.203
you're in compliance.

00:13:39.224 --> 00:13:40.423
You're in compliance, exactly.

00:13:41.024 --> 00:13:43.385
No one will say to you...

00:13:44.947 --> 00:13:45.567
A perfect example,

00:13:45.587 --> 00:13:46.868
I just had this this morning.

00:13:47.708 --> 00:13:49.009
I'm never going to tell my son,

00:13:49.549 --> 00:13:51.571
you're making your bed correctly.

00:13:51.591 --> 00:13:52.491
Right.

00:13:52.511 --> 00:13:53.513
I'm going to yell at him that he's

00:13:53.552 --> 00:13:55.614
making his bed incorrectly because he's

00:13:55.653 --> 00:13:57.095
throwing the sheets on and it's driving me

00:13:57.134 --> 00:13:57.855
crazy and he's got...

00:13:59.238 --> 00:14:02.841
We never say you're in compliance,

00:14:02.900 --> 00:14:04.041
you're doing a great job.

00:14:04.361 --> 00:14:06.163
We say you're out of compliance and here's

00:14:06.202 --> 00:14:06.623
why.

00:14:08.244 --> 00:14:10.105
We say that to help,

00:14:10.505 --> 00:14:12.966
but people hear I'm out of compliance and

00:14:12.986 --> 00:14:13.927
this is a scary thing.

00:14:14.008 --> 00:14:14.187
Now,

00:14:14.408 --> 00:14:15.609
it is a scary thing because if you're

00:14:15.629 --> 00:14:17.210
out of compliance, it costs money.

00:14:18.130 --> 00:14:19.251
And we don't want that.

00:14:20.893 --> 00:14:22.913
But I think that if people understood that

00:14:22.974 --> 00:14:25.375
compliance is a support system,

00:14:26.096 --> 00:14:28.357
that we can, you know, by...

00:14:28.927 --> 00:14:31.149
a compliance department or making sure

00:14:31.168 --> 00:14:33.889
that you're in compliance, again,

00:14:33.948 --> 00:14:35.769
it's making your job a little bit easier

00:14:35.809 --> 00:14:37.330
in the end because you don't have to

00:14:37.370 --> 00:14:39.870
do any rework.

00:14:40.250 --> 00:14:41.951
That's a supportive nature that every

00:14:41.971 --> 00:14:43.912
compliance department wants to hold true.

00:14:43.951 --> 00:14:44.091
Yeah.

00:14:45.653 --> 00:14:47.673
It's a tool that protects you and the

00:14:47.692 --> 00:14:48.873
clinics and the care.

00:14:49.734 --> 00:14:50.494
Use it as such.

00:14:50.634 --> 00:14:51.614
I used to have a meeting once a

00:14:51.653 --> 00:14:53.075
week in radio with my boss where we

00:14:53.174 --> 00:14:54.034
literally mean this

00:14:54.912 --> 00:14:56.552
this went down like nails,

00:14:56.591 --> 00:14:59.352
which was we listened to a tape of

00:14:59.513 --> 00:15:01.253
me.

00:15:01.293 --> 00:15:02.453
Fast forward and play,

00:15:02.514 --> 00:15:04.134
and we'd sit there in silence and listen

00:15:04.173 --> 00:15:04.573
to me.

00:15:05.153 --> 00:15:06.554
And I'm a pretty extroverted guy,

00:15:07.174 --> 00:15:08.235
but I started sweating.

00:15:08.674 --> 00:15:09.955
And that was a knot in your stomach

00:15:10.134 --> 00:15:12.216
until my boss eventually, I think,

00:15:12.275 --> 00:15:13.975
saw me squirming in the seat and said,

00:15:14.556 --> 00:15:15.236
hey, just so you know,

00:15:15.616 --> 00:15:18.537
this is to work on, not penalize.

00:15:19.378 --> 00:15:20.577
And the minute I started looking at it

00:15:20.597 --> 00:15:21.018
like that,

00:15:22.003 --> 00:15:23.384
I actually looked forward to it and it's

00:15:23.423 --> 00:15:25.004
probably where I got the best ROI in

00:15:25.065 --> 00:15:28.245
terms of improvement,

00:15:28.947 --> 00:15:30.506
but it needs to be framed that way.

00:15:30.868 --> 00:15:33.408
Or myself included, if you see compliance,

00:15:34.428 --> 00:15:36.590
your heart rate goes up and now you're

00:15:36.649 --> 00:15:37.890
automatically playing defense,

00:15:37.931 --> 00:15:39.032
I guess is what I'm getting at.

00:15:39.371 --> 00:15:40.692
Yes, exactly.

00:15:40.893 --> 00:15:44.794
And the thing is that you do have

00:15:44.855 --> 00:15:47.216
to kind of play defense all the time

00:15:47.336 --> 00:15:49.116
to be in compliance

00:15:50.030 --> 00:15:51.152
Because you have to be thinking

00:15:51.192 --> 00:15:51.932
defensively.

00:15:52.693 --> 00:15:52.813
Sure.

00:15:52.833 --> 00:15:54.095
Understanding what game you're playing.

00:15:54.655 --> 00:15:55.456
Exactly.

00:15:55.697 --> 00:15:57.278
And it doesn't have to be that you

00:15:57.418 --> 00:15:57.698
are.

00:15:58.080 --> 00:15:58.860
There's a difference between.

00:16:00.621 --> 00:16:04.486
Between kind of being on the defense and

00:16:04.807 --> 00:16:06.969
being in defense of what you're doing.

00:16:07.269 --> 00:16:07.990
Yeah.

00:16:08.070 --> 00:16:10.212
And I think that that's something that

00:16:10.253 --> 00:16:11.914
people need to to kind of.

00:16:12.736 --> 00:16:14.017
recognize within themselves.

00:16:14.457 --> 00:16:16.577
I have everybody ask three questions of

00:16:16.597 --> 00:16:20.639
their documentation whenever they're

00:16:20.678 --> 00:16:22.399
trying to assess their documentation or

00:16:22.419 --> 00:16:24.740
when I'm trying to get them in practice

00:16:24.961 --> 00:16:25.961
as they're documenting.

00:16:26.020 --> 00:16:26.780
Three questions.

00:16:27.441 --> 00:16:28.701
Would I defend this in court?

00:16:30.101 --> 00:16:30.721
How easily?

00:16:31.523 --> 00:16:33.523
Would another clinician know exactly what

00:16:33.543 --> 00:16:34.783
to do next?

00:16:35.283 --> 00:16:35.663
Clarity.

00:16:36.144 --> 00:16:38.264
And then did I clearly connect treatment

00:16:38.304 --> 00:16:38.725
to function?

00:16:39.864 --> 00:16:40.965
And if people are going to answer those

00:16:41.004 --> 00:16:42.346
three questions, I always say,

00:16:42.767 --> 00:16:44.008
you don't have to worry about compliance.

00:16:44.408 --> 00:16:44.607
I mean,

00:16:45.149 --> 00:16:46.610
obviously from technical sides and things

00:16:46.649 --> 00:16:47.190
like that you do,

00:16:47.230 --> 00:16:48.772
but from a documentation perspective,

00:16:49.192 --> 00:16:50.893
you can answer those three questions you

00:16:50.932 --> 00:16:51.394
haven't made.

00:16:52.134 --> 00:16:53.956
And if you can simplify it like that,

00:16:54.135 --> 00:16:55.397
I think people feel like, okay,

00:16:55.417 --> 00:16:56.238
those are three questions.

00:16:56.337 --> 00:16:56.938
I can do that.

00:16:56.958 --> 00:16:58.539
I can make sure that happens.

00:16:59.760 --> 00:17:03.144
Very, very rarely is the answer,

00:17:03.224 --> 00:17:04.545
make it more complicated, right?

00:17:05.213 --> 00:17:05.753
Exactly.

00:17:05.773 --> 00:17:06.934
So I think what you're saying there is,

00:17:07.415 --> 00:17:08.316
I need to see,

00:17:08.355 --> 00:17:09.757
can you answer these three?

00:17:09.957 --> 00:17:11.077
Let's simplify it.

00:17:11.178 --> 00:17:12.318
Now you can do that a hundred different

00:17:12.358 --> 00:17:12.838
ways.

00:17:13.200 --> 00:17:14.140
Right.

00:17:14.319 --> 00:17:15.681
I forget where the study was,

00:17:15.721 --> 00:17:17.722
but someone ran an analysis on thousands

00:17:17.742 --> 00:17:18.522
of treatment notes.

00:17:19.483 --> 00:17:20.964
And we'll say that insurance,

00:17:20.984 --> 00:17:21.746
I'm using air quotes here,

00:17:21.806 --> 00:17:23.646
insurance requires too much documentation.

00:17:23.727 --> 00:17:25.407
And the analysis showed that we actually

00:17:25.548 --> 00:17:26.489
over-documented.

00:17:27.320 --> 00:17:28.301
I could see that.

00:17:28.321 --> 00:17:30.683
Because we probably weren't focused on

00:17:30.703 --> 00:17:32.184
what the actual goal was.

00:17:32.244 --> 00:17:34.487
We hear documentation and some people,

00:17:34.507 --> 00:17:35.228
myself included,

00:17:35.448 --> 00:17:38.451
heard write down as much as you can.

00:17:39.673 --> 00:17:40.673
And if you want to talk to a

00:17:40.733 --> 00:17:41.114
lawyer,

00:17:41.213 --> 00:17:42.494
the lawyer will tell you if you're ever

00:17:42.535 --> 00:17:43.115
on the stand,

00:17:43.135 --> 00:17:44.517
you answer the question asked,

00:17:44.896 --> 00:17:47.660
not a word more.

00:17:47.700 --> 00:17:48.680
More is not better.

00:17:48.800 --> 00:17:49.621
Better is better.

00:17:49.861 --> 00:17:52.083
And simpler is the goal.

00:17:52.182 --> 00:17:53.243
The goal should be those three.

00:17:53.304 --> 00:17:54.164
Do those three things again.

00:17:54.565 --> 00:17:55.226
Let me see if I can do it.

00:17:56.346 --> 00:17:57.186
Can you answer this?

00:17:57.207 --> 00:17:58.387
Would you feel comfortable answering this

00:17:58.407 --> 00:17:58.749
in court?

00:17:59.229 --> 00:17:59.628
Correct.

00:17:59.849 --> 00:18:02.451
If another therapist read your note cold,

00:18:03.011 --> 00:18:04.493
could they understand it is clear.

00:18:04.933 --> 00:18:05.575
Yeah.

00:18:05.674 --> 00:18:06.275
And then the third one,

00:18:06.315 --> 00:18:08.517
can you connect what you're doing to a

00:18:08.557 --> 00:18:08.777
goal?

00:18:09.278 --> 00:18:09.738
Exactly.

00:18:10.219 --> 00:18:11.279
Is there a purpose for this?

00:18:11.759 --> 00:18:12.760
Why the heck are you doing it?

00:18:12.840 --> 00:18:13.961
Because if you can't do that,

00:18:14.001 --> 00:18:14.843
then you shouldn't have done it.

00:18:15.222 --> 00:18:18.326
And I think that where people get into

00:18:18.365 --> 00:18:18.586
this

00:18:20.928 --> 00:18:22.950
doing too much or doing more than they

00:18:22.990 --> 00:18:25.471
need to or feeling like it's complicated

00:18:25.811 --> 00:18:28.074
is because we do state the phrase of,

00:18:28.173 --> 00:18:29.234
if you didn't document it,

00:18:29.255 --> 00:18:31.857
you didn't do it, which is true,

00:18:32.498 --> 00:18:35.441
but there's a way to document it to

00:18:35.701 --> 00:18:36.981
answer those three questions and be done.

00:18:37.442 --> 00:18:38.022
Efficiently.

00:18:38.563 --> 00:18:39.284
Exactly.

00:18:39.403 --> 00:18:40.944
See, I came to PT again,

00:18:41.025 --> 00:18:41.806
a second career.

00:18:42.346 --> 00:18:43.287
Yes, I worked in radio.

00:18:44.300 --> 00:18:45.741
before that i had a degree in journalism

00:18:46.502 --> 00:18:48.003
and it was so weird going through

00:18:48.463 --> 00:18:50.164
undergrad because i took my journalism

00:18:50.204 --> 00:18:52.826
classes and i took my core classes english

00:18:53.067 --> 00:18:55.308
science whatever and there in those

00:18:55.348 --> 00:18:58.290
courses the general classes i had to write

00:18:58.310 --> 00:19:01.854
an eight-page paper the goal was length

00:19:02.493 --> 00:19:04.836
where in my journalism classes my goal was

00:19:05.016 --> 00:19:06.857
clarity and the best

00:19:07.946 --> 00:19:09.647
was can you get the most information

00:19:09.688 --> 00:19:13.250
transmitted through words or sounds in the

00:19:13.351 --> 00:19:15.413
fewest amount of words?

00:19:15.472 --> 00:19:17.554
So it was very funny to jump back

00:19:17.574 --> 00:19:19.655
and forth between those classes because in

00:19:19.915 --> 00:19:21.076
one, I was playing one game,

00:19:21.096 --> 00:19:23.739
which was answer the question in eight

00:19:23.759 --> 00:19:24.638
pages or more.

00:19:25.460 --> 00:19:26.980
And the other was you have a thousand

00:19:27.020 --> 00:19:27.961
words, no more.

00:19:28.021 --> 00:19:29.942
You cannot use a thousand and one.

00:19:30.483 --> 00:19:33.086
So my brain did not brain very well.

00:19:33.465 --> 00:19:35.587
So I come to PT where when I'm

00:19:35.627 --> 00:19:37.209
learning documentation, I'm saying, well,

00:19:38.330 --> 00:19:40.332
I remember having a CI just walking by

00:19:40.352 --> 00:19:42.011
my computer, not reading,

00:19:42.372 --> 00:19:44.292
seeing physically how many words were

00:19:44.313 --> 00:19:45.432
there and being like, it needs more.

00:19:45.913 --> 00:19:46.692
And I'm like, why?

00:19:46.792 --> 00:19:47.512
And she's like, just,

00:19:47.633 --> 00:19:48.473
I can tell from here.

00:19:48.493 --> 00:19:49.153
And I'm like,

00:19:49.193 --> 00:19:50.354
but you don't know the words.

00:19:50.413 --> 00:19:51.914
What if I picked better words?

00:19:52.335 --> 00:19:54.095
What if they answered Katie's three,

00:19:54.375 --> 00:19:55.295
Katie's big three?

00:19:56.635 --> 00:19:57.816
I feel like I feel,

00:19:57.855 --> 00:19:58.516
and the answer was always,

00:19:58.635 --> 00:20:01.317
I feel I don't want to have this.

00:20:01.356 --> 00:20:02.457
Not when I hit submit,

00:20:02.557 --> 00:20:04.337
I feel like the more is better.

00:20:04.417 --> 00:20:05.317
And I understand that.

00:20:05.753 --> 00:20:06.013
Yeah.

00:20:06.334 --> 00:20:06.575
Yeah.

00:20:06.894 --> 00:20:08.155
And then take it a step further.

00:20:08.195 --> 00:20:08.476
Right.

00:20:08.675 --> 00:20:09.737
Think about your settings.

00:20:09.936 --> 00:20:12.417
So I've started in acute care, acute care.

00:20:12.498 --> 00:20:14.219
You write and I'm old.

00:20:14.318 --> 00:20:16.140
So I started, you know, way back when,

00:20:16.160 --> 00:20:17.520
when we still had paper charts and all

00:20:17.540 --> 00:20:17.801
that.

00:20:20.182 --> 00:20:22.503
You wrote four sentences and that was it.

00:20:22.523 --> 00:20:25.906
I mean, your note was simple, but.

00:20:27.342 --> 00:20:29.403
You switch to a different setting.

00:20:29.423 --> 00:20:30.762
And if you're not writing a book,

00:20:31.503 --> 00:20:33.564
that wasn't acceptable in that setting.

00:20:33.963 --> 00:20:35.724
So to me,

00:20:36.025 --> 00:20:39.185
those three questions kind of came out of,

00:20:39.645 --> 00:20:41.487
I need to find that happy medium for

00:20:41.527 --> 00:20:43.248
myself as a documenter.

00:20:43.268 --> 00:20:43.968
Yeah.

00:20:44.750 --> 00:20:46.491
And then when I got into more of,

00:20:46.531 --> 00:20:46.872
you know,

00:20:48.054 --> 00:20:49.836
overseeing clinical services and making

00:20:49.875 --> 00:20:51.356
sure that the clinical product was good

00:20:51.376 --> 00:20:52.397
and it was compliant,

00:20:52.719 --> 00:20:54.980
then those three questions really helped

00:20:55.020 --> 00:20:57.743
serve in an educational framework when I'm

00:20:57.824 --> 00:20:58.904
educating clinicians.

00:20:59.486 --> 00:21:01.127
It's just when you can simplify it there.

00:21:01.147 --> 00:21:02.088
I remember learning research,

00:21:02.128 --> 00:21:02.689
my professor.

00:21:03.815 --> 00:21:04.935
oversimplified it.

00:21:05.016 --> 00:21:06.576
He was like, Jimmy, just what?

00:21:06.896 --> 00:21:07.336
So what?

00:21:07.416 --> 00:21:07.837
Now what?

00:21:08.057 --> 00:21:11.019
I'm like, oh, I can do that.

00:21:11.339 --> 00:21:13.800
My brain can't brain holding ten different

00:21:13.820 --> 00:21:15.201
things while I'm reading something.

00:21:15.603 --> 00:21:15.982
But if it's like,

00:21:16.042 --> 00:21:16.782
what are we talking about?

00:21:16.803 --> 00:21:17.304
Can you explain?

00:21:17.344 --> 00:21:18.044
And when you're done reading this,

00:21:18.064 --> 00:21:19.025
can you explain what happened?

00:21:19.184 --> 00:21:19.384
Yeah.

00:21:20.005 --> 00:21:21.185
Can you explain why it mattered?

00:21:21.226 --> 00:21:21.586
So what?

00:21:21.726 --> 00:21:21.946
Yeah.

00:21:22.446 --> 00:21:23.448
Can you explain now what?

00:21:23.548 --> 00:21:24.028
Now where should we go?

00:21:24.048 --> 00:21:24.127
Okay.

00:21:24.147 --> 00:21:25.068
What are you going to do with this?

00:21:25.229 --> 00:21:25.509
Oh, yeah.

00:21:25.808 --> 00:21:26.009
Great.

00:21:26.048 --> 00:21:26.288
Do that.

00:21:26.670 --> 00:21:28.750
And then research became fun after that.

00:21:30.167 --> 00:21:30.828
A hundred percent.

00:21:30.848 --> 00:21:31.750
A hundred percent.

00:21:31.950 --> 00:21:34.353
You simplify it down and you think it's

00:21:34.432 --> 00:21:37.837
not that hard if I just think of

00:21:37.897 --> 00:21:38.618
the end goal.

00:21:38.939 --> 00:21:39.259
Yeah.

00:21:39.358 --> 00:21:39.539
Yeah.

00:21:40.099 --> 00:21:41.241
Do you want to say thanks to U.S.

00:21:41.281 --> 00:21:43.344
Physical Therapy, USPH,

00:21:43.464 --> 00:21:44.986
a national network of clinics focused on

00:21:45.006 --> 00:21:45.846
developing clinicians?

00:21:46.548 --> 00:21:47.108
Not burning them out.

00:21:47.528 --> 00:21:49.049
They offer leadership tracks, mentorship,

00:21:49.089 --> 00:21:51.092
and the stability PTs need to build long

00:21:51.112 --> 00:21:53.294
careers in the profession while still

00:21:53.354 --> 00:21:54.315
practicing locally.

00:21:54.454 --> 00:21:56.737
USPH.com, that's USPH.com.

00:21:56.876 --> 00:21:58.479
And our friends at Empower EMR,

00:21:58.939 --> 00:22:00.721
built specifically for physical therapists

00:22:00.740 --> 00:22:01.521
who are tired of...

00:22:02.102 --> 00:22:03.061
doing everything we're talking about.

00:22:03.261 --> 00:22:04.883
Documentation, slowing them down.

00:22:05.242 --> 00:22:07.223
Empower focuses on speed, clean workflows,

00:22:07.243 --> 00:22:09.364
and documentation tools PTs actually ask

00:22:09.384 --> 00:22:09.584
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00:22:09.884 --> 00:22:10.444
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00:22:10.464 --> 00:22:11.545
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00:22:11.944 --> 00:22:13.726
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00:22:13.746 --> 00:22:14.185
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00:22:14.226 --> 00:22:16.185
Find them online at Empower, E-M-R.

00:22:16.506 --> 00:22:20.387
That is Empower, E-M-R.com.

00:22:20.428 --> 00:22:20.587
Katie,

00:22:20.607 --> 00:22:22.087
your hot take is that most continuing

00:22:22.127 --> 00:22:24.328
education is a waste of time.

00:22:24.409 --> 00:22:25.409
I love hot takes.

00:22:25.888 --> 00:22:26.848
That's gonna make some people

00:22:26.969 --> 00:22:30.770
uncomfortable because going with this more

00:22:30.931 --> 00:22:31.431
is better.

00:22:32.568 --> 00:22:34.651
More continuation is better than less in

00:22:34.750 --> 00:22:35.411
continuation.

00:22:35.671 --> 00:22:38.232
So what's broken about continuation right

00:22:38.313 --> 00:22:40.255
now in your view?

00:22:40.315 --> 00:22:42.797
So continuing education to me,

00:22:42.876 --> 00:22:45.699
and I am a nerd that loves to

00:22:45.939 --> 00:22:48.421
have continuing education more and more

00:22:48.441 --> 00:22:48.780
and more.

00:22:49.721 --> 00:22:51.063
In American Speech and Hearing

00:22:51.083 --> 00:22:51.544
Association,

00:22:51.564 --> 00:22:52.924
we have something called the ACE Award,

00:22:52.944 --> 00:22:55.826
which is the achievement for continuing

00:22:55.846 --> 00:22:56.386
education.

00:22:56.626 --> 00:22:58.368
So it's clinicians who get

00:22:59.602 --> 00:23:00.942
X number of CEUs per year.

00:23:01.143 --> 00:23:02.502
I have like eighteen of these things.

00:23:03.824 --> 00:23:04.243
Yeah, I love it.

00:23:04.263 --> 00:23:05.023
I love it.

00:23:05.104 --> 00:23:07.125
All of it's a waste of time because

00:23:09.865 --> 00:23:11.105
because at the end of the day,

00:23:11.747 --> 00:23:13.346
I'm going to say ninety five percent of

00:23:13.386 --> 00:23:15.887
the continuing education courses that you

00:23:15.907 --> 00:23:17.969
sit through, you sit through them,

00:23:18.608 --> 00:23:21.630
you think you learn something and you

00:23:21.670 --> 00:23:23.050
cannot apply it the next day.

00:23:24.438 --> 00:23:28.138
And if we're going to make true continuing

00:23:28.219 --> 00:23:30.440
education worthwhile for our clinicians,

00:23:30.480 --> 00:23:33.079
because every clinician discipline has a

00:23:33.160 --> 00:23:35.240
certain number that they need to adhere

00:23:35.280 --> 00:23:35.621
to,

00:23:36.641 --> 00:23:38.701
make it something that's going to be

00:23:38.961 --> 00:23:41.823
applicable the minute you walk out that

00:23:41.863 --> 00:23:42.123
door.

00:23:42.222 --> 00:23:44.202
And I think ninety five percent of our

00:23:44.282 --> 00:23:46.364
CEU courses missed the mark on this.

00:23:46.673 --> 00:23:48.193
So how do you spot a good one

00:23:48.275 --> 00:23:50.436
before you plunk down money and give up

00:23:50.457 --> 00:23:50.876
a weekend?

00:23:50.916 --> 00:23:51.778
How do you, what do you,

00:23:51.837 --> 00:23:52.659
what's your big, you know,

00:23:52.679 --> 00:23:54.019
you've got a big three or a litmus

00:23:54.039 --> 00:23:55.060
test or a, you know,

00:23:55.381 --> 00:23:56.923
how do you spot those ones that the

00:23:56.962 --> 00:23:57.824
juice is going to be worth?

00:23:58.384 --> 00:23:59.164
Yeah.

00:23:59.224 --> 00:23:59.724
Yeah.

00:24:00.006 --> 00:24:00.125
Um,

00:24:00.385 --> 00:24:02.347
it's a great question and I wish I

00:24:02.367 --> 00:24:03.989
had the direct answer to it because I

00:24:04.029 --> 00:24:04.910
haven't figured that out.

00:24:04.930 --> 00:24:06.652
Let's put it this way.

00:24:06.932 --> 00:24:08.192
What besides like, you know,

00:24:08.253 --> 00:24:09.074
people love that phrase, right?

00:24:09.134 --> 00:24:10.115
Monday morning applicable.

00:24:10.154 --> 00:24:10.776
Can I use this?

00:24:11.576 --> 00:24:11.737
Um,

00:24:12.958 --> 00:24:14.618
don't have to name it you can but

00:24:14.699 --> 00:24:16.098
what's one that you took that you were

00:24:16.118 --> 00:24:18.460
like gosh this was great like for every

00:24:18.500 --> 00:24:21.040
minute i was in class i got value

00:24:21.521 --> 00:24:23.821
and then why like what about it was

00:24:23.862 --> 00:24:28.064
so great so i i don't know that

00:24:28.104 --> 00:24:29.785
i'm going to answer that question exactly

00:24:29.825 --> 00:24:32.365
just because of the way that i think

00:24:32.405 --> 00:24:35.146
it depends on what your interest is or

00:24:35.186 --> 00:24:36.827
what you're you know what you are doing

00:24:36.867 --> 00:24:37.448
on a day-to-day

00:24:37.946 --> 00:24:40.627
But I think the thing that gets me

00:24:41.248 --> 00:24:47.189
about the continuing ed pieces are each

00:24:47.229 --> 00:24:49.509
discipline has certain requirements for

00:24:49.689 --> 00:24:52.069
topics or certain hours or things like

00:24:52.109 --> 00:24:52.390
that.

00:24:53.170 --> 00:24:55.711
And I don't even necessarily subscribe to

00:24:55.730 --> 00:24:57.391
the Monday morning applicable.

00:24:58.250 --> 00:24:59.990
I want it something that you're going to

00:25:00.030 --> 00:25:02.652
walk away and say, I got it.

00:25:03.251 --> 00:25:04.573
and it's going to stick with me.

00:25:04.633 --> 00:25:06.094
Maybe I won't use it Monday morning,

00:25:06.134 --> 00:25:07.914
but I can use it two weeks from

00:25:07.954 --> 00:25:10.636
now because I remember it so much.

00:25:10.917 --> 00:25:14.880
The problem is we have these instructors

00:25:14.920 --> 00:25:18.323
who either are talking research

00:25:18.863 --> 00:25:21.243
and aren't able to kind of apply this

00:25:21.463 --> 00:25:23.404
or we we have data that's not really

00:25:23.444 --> 00:25:25.666
telling a story or you're just not

00:25:25.707 --> 00:25:27.207
connecting with the audience so as an

00:25:27.366 --> 00:25:30.709
educator my my big thing is i need

00:25:31.288 --> 00:25:32.930
to to come with a presentation i need

00:25:32.950 --> 00:25:36.092
to come with a slide deck great but

00:25:36.132 --> 00:25:38.732
if my audience and i'm looking out and

00:25:38.833 --> 00:25:41.954
half of them are at a different spot

00:25:41.994 --> 00:25:44.256
in their career or a different wanting a

00:25:44.296 --> 00:25:46.676
different thing than i've originally had

00:25:47.978 --> 00:25:48.458
prepared

00:25:49.423 --> 00:25:50.423
I got to be ready to throw that

00:25:50.463 --> 00:25:51.744
PowerPoint out the window and say,

00:25:51.765 --> 00:25:54.326
let's just have a chat, you know?

00:25:54.666 --> 00:25:56.647
And I think that's where most of these

00:25:57.249 --> 00:25:57.828
courses,

00:25:57.868 --> 00:25:59.750
because they are such strict guidelines

00:25:59.851 --> 00:26:00.872
on, you know, what,

00:26:01.971 --> 00:26:04.193
what the course has to meet and the

00:26:04.233 --> 00:26:07.016
objectives people are held to their

00:26:07.056 --> 00:26:07.777
PowerPoints.

00:26:09.243 --> 00:26:10.044
But at the end of the day,

00:26:10.064 --> 00:26:12.444
if you just have to have a conversation

00:26:12.484 --> 00:26:14.006
or pivot and tell a story,

00:26:14.685 --> 00:26:16.386
that's going to actually help the

00:26:16.446 --> 00:26:17.886
participant.

00:26:18.567 --> 00:26:19.407
Know your audience.

00:26:20.387 --> 00:26:21.008
Recognize.

00:26:21.048 --> 00:26:21.888
I've said this before.

00:26:22.088 --> 00:26:24.890
I could be the world's greatest third

00:26:24.910 --> 00:26:25.470
grade teacher.

00:26:25.529 --> 00:26:27.191
I could rip through a third grade syllabus

00:26:27.230 --> 00:26:28.111
in like three weeks.

00:26:28.131 --> 00:26:28.730
We'd be done.

00:26:29.511 --> 00:26:29.951
Move along.

00:26:29.971 --> 00:26:30.432
Now,

00:26:30.471 --> 00:26:31.893
the third graders would have no idea what

00:26:31.932 --> 00:26:32.492
I just said.

00:26:32.932 --> 00:26:34.634
And one percent of them would have learned

00:26:34.953 --> 00:26:35.354
any of it.

00:26:36.380 --> 00:26:38.420
The goal isn't to have communicated.

00:26:38.500 --> 00:26:40.300
The goal is to have achieved

00:26:40.480 --> 00:26:41.240
understanding.

00:26:41.740 --> 00:26:44.381
And I always use a third grade analogy

00:26:44.401 --> 00:26:45.161
because it's so odd.

00:26:45.221 --> 00:26:45.942
Of course,

00:26:45.981 --> 00:26:47.221
you're going to get third graders and you

00:26:47.241 --> 00:26:48.301
get at thirty of them and they're going

00:26:48.321 --> 00:26:50.582
to be there for every topic.

00:26:50.981 --> 00:26:52.163
Some are going to be more or less

00:26:52.202 --> 00:26:54.663
knowledgeable or more or less excited

00:26:54.682 --> 00:26:56.002
about learning or, you know.

00:26:56.702 --> 00:26:58.344
And then when we have adults, we like,

00:26:58.463 --> 00:26:59.463
well, no, you're all adults.

00:26:59.483 --> 00:27:01.344
You need your you should all be exactly

00:27:01.364 --> 00:27:02.324
the same and you should.

00:27:02.763 --> 00:27:04.125
No, no, no, no.

00:27:04.144 --> 00:27:05.125
That's I'm sorry.

00:27:05.164 --> 00:27:06.045
That's not how it works.

00:27:06.505 --> 00:27:07.886
Exactly, exactly.

00:27:08.067 --> 00:27:09.667
And everyone's at different points in

00:27:09.688 --> 00:27:10.409
their career,

00:27:10.788 --> 00:27:12.711
different points in their interests.

00:27:12.750 --> 00:27:13.011
You know,

00:27:13.071 --> 00:27:14.653
some people are going to sit through an

00:27:14.772 --> 00:27:17.836
ethics class that's required by the

00:27:17.856 --> 00:27:18.436
discipline.

00:27:19.018 --> 00:27:21.559
And you have maybe three who are actually

00:27:21.619 --> 00:27:23.942
factually interested in ethics.

00:27:24.971 --> 00:27:29.199
or have an ethical dilemma that they may

00:27:29.219 --> 00:27:31.442
have had that they can pull from the

00:27:31.501 --> 00:27:33.925
experience that the instructor is talking

00:27:33.945 --> 00:27:36.229
about and the others are sitting in the

00:27:36.249 --> 00:27:36.690
room going,

00:27:36.829 --> 00:27:38.291
I just need to get this continuing

00:27:38.352 --> 00:27:39.673
education credit.

00:27:39.713 --> 00:27:40.414
There's different reasons.

00:27:40.935 --> 00:27:41.256
Yeah.

00:27:41.336 --> 00:27:43.157
And so you need to be able to

00:27:43.998 --> 00:27:46.500
manage to the listener and change what

00:27:46.519 --> 00:27:48.520
you're talking about based on what they

00:27:48.621 --> 00:27:49.761
need in that moment.

00:27:50.501 --> 00:27:51.282
And I think a lot of that,

00:27:51.742 --> 00:27:53.584
the continuing ed is just, you know,

00:27:53.663 --> 00:27:55.325
unfortunately can be a waste of time if

00:27:55.345 --> 00:27:57.307
you're not able to pivot as an instructor.

00:27:57.826 --> 00:27:58.567
Well, you mentioned pivot.

00:27:58.647 --> 00:28:00.429
Healthcare used to reward volume.

00:28:00.669 --> 00:28:00.848
I mean,

00:28:00.868 --> 00:28:02.210
a lot of places it still does.

00:28:02.529 --> 00:28:04.651
But things now are shifting towards value,

00:28:04.671 --> 00:28:05.551
which is good value.

00:28:07.102 --> 00:28:08.702
But if there's a theme that I think

00:28:08.742 --> 00:28:10.244
I've picked up from our conversation right

00:28:10.285 --> 00:28:10.464
now,

00:28:10.605 --> 00:28:12.987
it's understand what game you're playing.

00:28:13.047 --> 00:28:14.928
Understand what tools you have and what

00:28:15.048 --> 00:28:16.869
good is for this situation.

00:28:17.430 --> 00:28:19.652
So what does that actually mean for the

00:28:19.672 --> 00:28:21.834
way that therapists, PTs, OTs,

00:28:22.153 --> 00:28:23.115
we're all sort of cousins,

00:28:23.414 --> 00:28:24.316
practice day to day?

00:28:24.395 --> 00:28:27.298
This shift away from volume and towards

00:28:27.417 --> 00:28:27.898
value.

00:28:28.019 --> 00:28:31.260
A lot of conversations with this VBC

00:28:31.300 --> 00:28:31.801
coming up.

00:28:32.261 --> 00:28:32.642
Right.

00:28:32.721 --> 00:28:34.203
What will that change?

00:28:34.344 --> 00:28:34.624
Right.

00:28:34.683 --> 00:28:36.565
So how does that actually play out for

00:28:36.825 --> 00:28:38.707
for for everybody?

00:28:38.886 --> 00:28:39.267
Yeah.

00:28:39.366 --> 00:28:42.910
So I think the I think people need

00:28:42.930 --> 00:28:45.711
to understand that outcomes,

00:28:46.512 --> 00:28:47.773
which used to be just kind of like

00:28:47.814 --> 00:28:50.015
this word that we heard in the background.

00:28:50.154 --> 00:28:50.435
Right.

00:28:51.661 --> 00:28:53.001
outcomes are going to be the driver.

00:28:53.262 --> 00:28:55.064
If they aren't already in your clinic,

00:28:55.265 --> 00:28:56.986
they are going to be your driver.

00:28:57.205 --> 00:28:59.788
It is how well did you see that

00:28:59.828 --> 00:29:00.169
patient?

00:29:00.229 --> 00:29:02.211
How well did you get that patient back

00:29:02.250 --> 00:29:03.271
to their goal?

00:29:04.854 --> 00:29:06.454
How quickly did you do it?

00:29:06.715 --> 00:29:08.376
How efficiently did you do it?

00:29:09.919 --> 00:29:11.319
And how did you do it at the

00:29:11.339 --> 00:29:11.700
end of the day?

00:29:11.820 --> 00:29:12.340
What worked?

00:29:12.500 --> 00:29:13.241
What didn't work?

00:29:13.923 --> 00:29:14.823
And I think

00:29:15.723 --> 00:29:17.365
that going back to what we were talking

00:29:17.385 --> 00:29:18.326
about originally, you know,

00:29:18.667 --> 00:29:19.788
listening to the patients,

00:29:20.048 --> 00:29:24.654
stopping everything and stopping what you

00:29:24.694 --> 00:29:27.478
think your what's the word,

00:29:27.557 --> 00:29:28.398
what you think your

00:29:30.717 --> 00:29:32.478
goal is going to be or your treatment

00:29:32.498 --> 00:29:34.259
plan or your idea in your head when

00:29:34.278 --> 00:29:37.181
you walk into that session put that aside

00:29:37.641 --> 00:29:39.741
listen to the patient and ask you know

00:29:39.862 --> 00:29:42.304
ask the questions that's going to help

00:29:42.324 --> 00:29:44.704
with value-based care but it is the

00:29:44.805 --> 00:29:46.266
outcomes are really what's going to drive

00:29:46.306 --> 00:29:48.847
it and clinicians need to understand that

00:29:49.228 --> 00:29:51.469
i don't think they do yeah it's it's

00:29:51.749 --> 00:29:53.450
it's playing a slightly different uh well

00:29:53.829 --> 00:29:55.070
playing the same game but now the

00:29:55.290 --> 00:29:57.712
scoreboard is a little bit it might be

00:29:57.752 --> 00:29:58.133
different

00:29:58.472 --> 00:30:00.394
yeah i had i had a great former

00:30:00.434 --> 00:30:04.178
sales director who would start like these

00:30:04.258 --> 00:30:05.878
meetings with clients or whatever and he

00:30:05.898 --> 00:30:07.000
would start the certain way i remember

00:30:07.019 --> 00:30:09.040
like after ten times hearing him just

00:30:09.060 --> 00:30:10.502
being like why are you saying that and

00:30:10.522 --> 00:30:11.963
he and he sat me down he said

00:30:12.644 --> 00:30:13.825
i want to understand what their version of

00:30:13.865 --> 00:30:14.244
good is

00:30:14.986 --> 00:30:18.307
Because if I'm playing ice hockey,

00:30:18.828 --> 00:30:21.130
but I'm being judged on figure skating,

00:30:21.769 --> 00:30:23.151
I'm never going to win.

00:30:23.330 --> 00:30:25.472
I just scored nine goals, right?

00:30:25.492 --> 00:30:27.034
But you didn't do any triple lutzes.

00:30:29.315 --> 00:30:31.436
And so it's just speaking two different

00:30:31.477 --> 00:30:31.977
languages.

00:30:32.217 --> 00:30:34.097
So when I start with clients or companies,

00:30:34.578 --> 00:30:35.419
or even if someone just says,

00:30:35.538 --> 00:30:36.400
I want to pick your brain.

00:30:36.460 --> 00:30:37.259
And I'm, you know,

00:30:37.401 --> 00:30:38.760
what are we solving for here?

00:30:38.922 --> 00:30:40.843
Like, what does good look like?

00:30:41.242 --> 00:30:42.263
Yeah.

00:30:42.344 --> 00:30:43.846
And it makes them often,

00:30:43.865 --> 00:30:45.487
it makes them stop and think they don't

00:30:45.507 --> 00:30:46.448
have a clear answer right away.

00:30:46.627 --> 00:30:47.328
That's good.

00:30:48.390 --> 00:30:49.651
They know the answer,

00:30:49.671 --> 00:30:52.153
but they haven't maybe asked or they don't

00:30:52.173 --> 00:30:53.255
know how to put it in a sentence.

00:30:53.734 --> 00:30:54.695
That's step one.

00:30:55.217 --> 00:30:55.376
Right.

00:30:55.757 --> 00:30:56.958
What does good look like?

00:30:58.058 --> 00:30:59.560
And scale this for me.

00:30:59.760 --> 00:31:02.042
Is this a five hundred dollar problem,

00:31:02.423 --> 00:31:04.265
a fifty thousand dollar problem or a half

00:31:04.285 --> 00:31:05.405
a million dollar problem?

00:31:06.262 --> 00:31:07.625
Cause I don't like asking like in what

00:31:07.785 --> 00:31:07.944
I do,

00:31:07.964 --> 00:31:10.709
I don't like asking what's your budget.

00:31:11.049 --> 00:31:12.490
That's an objective question.

00:31:12.951 --> 00:31:13.952
What I'll do is like, what,

00:31:15.663 --> 00:31:17.704
What changes for your organization if we

00:31:17.765 --> 00:31:18.305
fix this?

00:31:18.664 --> 00:31:19.786
If we fix this right?

00:31:20.227 --> 00:31:21.508
And I'm purpose and like,

00:31:21.827 --> 00:31:23.088
I haven't told you what we're going to

00:31:23.108 --> 00:31:24.329
fix because I don't know what the problem

00:31:24.349 --> 00:31:24.490
is yet.

00:31:24.670 --> 00:31:26.332
But if we do, what changes?

00:31:26.852 --> 00:31:28.693
And that shows me the level of intensity.

00:31:29.273 --> 00:31:29.394
Like,

00:31:29.413 --> 00:31:31.215
is this a one phone call and done?

00:31:31.516 --> 00:31:32.497
What do you think it is?

00:31:33.076 --> 00:31:34.298
I want you to fix our entire social

00:31:34.337 --> 00:31:35.538
media strategy in the next hour.

00:31:35.818 --> 00:31:39.142
My man, that's not going to happen.

00:31:39.521 --> 00:31:40.123
Let's get on.

00:31:40.663 --> 00:31:41.144
I was taught.

00:31:41.183 --> 00:31:42.545
Have you ever heard of the arc triangle?

00:31:43.323 --> 00:31:43.864
Yeah.

00:31:43.884 --> 00:31:45.625
Affinity, reality, communication,

00:31:45.724 --> 00:31:47.605
and then that's the goal.

00:31:47.826 --> 00:31:48.946
You have to have those three things to

00:31:48.987 --> 00:31:51.169
achieve understanding, right?

00:31:52.750 --> 00:31:53.990
We are not in the same reality.

00:31:54.030 --> 00:31:55.451
If you think I'm going to overhaul an

00:31:55.471 --> 00:31:56.972
entire system in the next forty eight

00:31:57.032 --> 00:31:58.114
minutes, not going to happen.

00:31:58.394 --> 00:32:00.016
So let's get on the same page there.

00:32:00.076 --> 00:32:01.297
Right.

00:32:02.451 --> 00:32:04.354
But these types of conversations need to

00:32:04.374 --> 00:32:04.634
be had.

00:32:04.755 --> 00:32:06.596
A lot of times I feel like productivity

00:32:06.656 --> 00:32:08.199
or efficiency or standards are,

00:32:09.180 --> 00:32:10.561
this is the number you need to hit.

00:32:11.303 --> 00:32:12.384
Without telling clinicians,

00:32:12.904 --> 00:32:14.646
how do I affect that number?

00:32:15.968 --> 00:32:16.949
How do I do better?

00:32:16.989 --> 00:32:18.611
What are the runs or goals or triple

00:32:18.631 --> 00:32:18.991
let'ses?

00:32:19.383 --> 00:32:20.163
Well, and here's the thing.

00:32:20.263 --> 00:32:22.984
I think also it's not just the,

00:32:23.005 --> 00:32:24.026
you know, how do I do it?

00:32:24.266 --> 00:32:24.965
I always say, you know,

00:32:24.986 --> 00:32:27.426
teach the why before the what.

00:32:27.607 --> 00:32:29.608
Ask the why before the what.

00:32:29.628 --> 00:32:31.609
Don't ask what the end result's going to

00:32:31.630 --> 00:32:31.750
be.

00:32:31.910 --> 00:32:34.530
Ask, you know, why are we doing it?

00:32:34.711 --> 00:32:35.912
Then you get to the how,

00:32:35.932 --> 00:32:36.853
then you get to the what.

00:32:36.932 --> 00:32:38.834
But if you don't have the why and

00:32:38.854 --> 00:32:40.434
the clinician doesn't understand the why,

00:32:42.891 --> 00:32:45.073
then you're losing before you've even

00:32:45.093 --> 00:32:45.252
started.

00:32:45.272 --> 00:32:47.134
You're creating mini MacGyvers though.

00:32:47.295 --> 00:32:48.855
Otherwise, it's just following SOP.

00:32:48.875 --> 00:32:50.557
If I understand the why and then I

00:32:50.596 --> 00:32:51.877
get something unusual,

00:32:52.038 --> 00:32:53.339
I can figure out a way to make

00:32:53.380 --> 00:32:54.559
this work because I understand where

00:32:54.580 --> 00:32:55.421
the... Just listen,

00:32:55.461 --> 00:32:57.222
tell me to get to Times Square.

00:32:57.242 --> 00:32:58.903
You don't have to tell me what route

00:32:58.923 --> 00:32:59.364
to take.

00:32:59.625 --> 00:33:00.806
But if the goal is get to Times

00:33:00.846 --> 00:33:03.007
Square by noon, I'll figure it out.

00:33:03.047 --> 00:33:03.807
Don't worry about it.

00:33:04.147 --> 00:33:05.930
But if it's follow these steps,

00:33:06.009 --> 00:33:07.151
as soon as I get to five and

00:33:07.171 --> 00:33:08.050
there's a traffic jam,

00:33:08.392 --> 00:33:10.053
I don't know what to do.

00:33:10.133 --> 00:33:11.134
I'm not empowered...

00:33:12.188 --> 00:33:13.648
with a goal to know why,

00:33:14.269 --> 00:33:16.592
or I don't know what kind of tools

00:33:16.612 --> 00:33:17.272
I'm allowed to do.

00:33:17.313 --> 00:33:18.874
There's a story that's pretty famous.

00:33:19.493 --> 00:33:22.537
The Zappos.com, the online shoe retailer,

00:33:23.258 --> 00:33:25.339
the guy who launched it realized they kept

00:33:25.880 --> 00:33:28.182
being a bottleneck in customer service.

00:33:29.123 --> 00:33:31.005
And he realizes because every customer

00:33:31.045 --> 00:33:32.486
service problem went through him as the

00:33:32.526 --> 00:33:33.006
CEO.

00:33:33.267 --> 00:33:34.007
So finally, he just said,

00:33:34.146 --> 00:33:36.368
if the problem requires a solution that's

00:33:36.388 --> 00:33:38.010
a thousand dollars or less,

00:33:39.713 --> 00:33:41.595
whatever action you think is best take it

00:33:42.115 --> 00:33:44.257
up to a thousand dollars and just explain

00:33:44.477 --> 00:33:46.538
what i did this because this and this

00:33:46.878 --> 00:33:47.818
and then i'll look at it and go

00:33:47.858 --> 00:33:49.299
yeah you got it and if there's one

00:33:49.319 --> 00:33:50.800
that's like hey man that didn't let's

00:33:50.840 --> 00:33:52.863
let's review this case and their amount of

00:33:52.923 --> 00:33:54.864
complaints went down and their time to

00:33:54.923 --> 00:33:57.346
solve uh problems went down and their

00:33:57.405 --> 00:34:00.948
costs went down of course they did you

00:34:00.968 --> 00:34:02.548
understood the why the goal was to make

00:34:02.568 --> 00:34:05.371
happy people yep understood got it less

00:34:05.391 --> 00:34:06.951
than a thousand dollars most of the time

00:34:06.991 --> 00:34:08.092
it was probably like a twenty eight dollar

00:34:08.112 --> 00:34:08.293
fix

00:34:09.425 --> 00:34:09.905
Exactly.

00:34:10.186 --> 00:34:11.226
And they were empowered.

00:34:11.527 --> 00:34:12.547
So they did it.

00:34:12.567 --> 00:34:13.327
They did it better.

00:34:13.527 --> 00:34:14.547
They did it more efficiently.

00:34:14.847 --> 00:34:15.329
Correct.

00:34:16.369 --> 00:34:18.210
And that's exactly how we have to treat

00:34:18.269 --> 00:34:20.791
our clinicians and ensure that our

00:34:20.811 --> 00:34:22.092
clinicians understand that,

00:34:22.652 --> 00:34:24.393
the empowerment, the why,

00:34:25.552 --> 00:34:26.813
and the simplicity of it all.

00:34:27.193 --> 00:34:29.375
Yeah, I agree.

00:34:29.394 --> 00:34:31.856
We'll bring you back for an episode that's

00:34:31.896 --> 00:34:33.396
really on a six-step playbook, right?

00:34:33.436 --> 00:34:34.416
So how about we'll tease,

00:34:34.436 --> 00:34:35.697
let's call it front tease, everybody.

00:34:36.737 --> 00:34:38.458
We'll bring you back for the six-step

00:34:38.478 --> 00:34:38.798
playbook.

00:34:38.818 --> 00:34:40.460
If a clinic owner or rehab director wanted

00:34:40.480 --> 00:34:42.882
to create systems that protect clinicians,

00:34:43.842 --> 00:34:45.103
we'll bring you back for a full episode

00:34:45.123 --> 00:34:46.523
on six because I feel like asking you

00:34:46.543 --> 00:34:49.686
that, it's two episodes in one.

00:34:50.387 --> 00:34:51.427
So we'll separate that.

00:34:51.467 --> 00:34:52.268
So that'll be the second one.

00:34:52.588 --> 00:34:55.130
So we'll skip to the parting shot right

00:34:55.170 --> 00:34:57.371
now.

00:34:57.431 --> 00:34:58.532
This is the parting shot.

00:34:59.092 --> 00:35:00.472
One last mic drop moment.

00:35:01.173 --> 00:35:01.974
No pressure.

00:35:02.414 --> 00:35:04.516
Just your legacy on the line.

00:35:05.878 --> 00:35:06.099
All right,

00:35:06.119 --> 00:35:07.139
there's your parting shot brought to you

00:35:07.159 --> 00:35:08.480
by our friends at Sarah Health.

00:35:08.940 --> 00:35:10.300
They help clinics stay connected with

00:35:10.360 --> 00:35:12.862
patients between visits using automated

00:35:13.043 --> 00:35:14.903
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00:35:15.224 --> 00:35:19.485
Text message that support RTM codes.

00:35:19.666 --> 00:35:20.186
Text message.

00:35:20.387 --> 00:35:22.387
That means there's no app or login or

00:35:22.427 --> 00:35:24.548
thing to forget or password to re-op every

00:35:25.248 --> 00:35:25.889
text messages.

00:35:26.650 --> 00:35:28.070
It's one of the easiest ways clinics can

00:35:28.090 --> 00:35:29.492
improve outcomes while unlocking new

00:35:29.532 --> 00:35:31.313
reimbursable care outside the clinic.

00:35:31.474 --> 00:35:35.336
Visit sarahhealth.com, S-A-R-A health.com.

00:35:35.817 --> 00:35:36.717
So you have two choices.

00:35:37.137 --> 00:35:38.699
You can pick your own parting shot and

00:35:38.719 --> 00:35:39.239
just do it,

00:35:39.780 --> 00:35:41.282
or I can give you a prompt.

00:35:42.061 --> 00:35:44.664
Which one do you want?

00:35:44.704 --> 00:35:45.985
I'm feeling spicy today.

00:35:46.005 --> 00:35:47.367
Let's do a prompt because I...

00:35:48.525 --> 00:35:48.907
All right.

00:35:48.947 --> 00:35:51.190
So if therapists feel like efficiency

00:35:51.309 --> 00:35:53.052
always means cutting corners,

00:35:53.733 --> 00:35:54.793
you say that's wrong.

00:35:55.235 --> 00:35:56.757
What would you have them do?

00:35:56.777 --> 00:35:58.659
What's the first step,

00:35:59.219 --> 00:36:00.842
like an action that they should take?

00:36:00.862 --> 00:36:02.182
If a clinician's listening, like, okay,

00:36:02.222 --> 00:36:02.664
I agree with her.

00:36:02.704 --> 00:36:03.605
I'd love that to happen.

00:36:03.905 --> 00:36:05.246
But what do I do about it here

00:36:05.266 --> 00:36:07.610
in my clinic where Katie's not my boss?

00:36:08.971 --> 00:36:10.411
Hmm.

00:36:10.893 --> 00:36:12.273
And they're feeling like they have to cut

00:36:12.313 --> 00:36:12.755
corners.

00:36:13.114 --> 00:36:13.956
Or they're just feeling like,

00:36:14.255 --> 00:36:16.257
here I have this metric that I'm measured

00:36:16.297 --> 00:36:16.639
to.

00:36:17.500 --> 00:36:18.079
What do I do?

00:36:18.099 --> 00:36:20.001
Do I talk to my boss and ask

00:36:20.021 --> 00:36:21.043
them to walk me through it?

00:36:21.222 --> 00:36:22.644
I feel like the answer is always people,

00:36:22.704 --> 00:36:23.005
right?

00:36:23.925 --> 00:36:24.346
Yes.

00:36:24.706 --> 00:36:27.650
I would say if they don't even know

00:36:27.670 --> 00:36:30.492
where to start, first step to do is...

00:36:31.833 --> 00:36:33.554
is ask the question.

00:36:34.916 --> 00:36:35.177
Ask,

00:36:36.358 --> 00:36:38.380
what is the main goal for me to

00:36:38.420 --> 00:36:38.599
meet?

00:36:38.920 --> 00:36:41.782
Is it more visits per week?

00:36:42.282 --> 00:36:44.625
Is it better use of my time?

00:36:44.744 --> 00:36:45.905
Is it better outcomes?

00:36:46.085 --> 00:36:47.367
Is it better documentation?

00:36:47.467 --> 00:36:52.711
What is it that's going to make me

00:36:52.911 --> 00:36:56.594
a next level clinician or make me able

00:36:56.655 --> 00:36:59.418
to meet that goal in a more efficient

00:36:59.458 --> 00:36:59.617
way?

00:36:59.922 --> 00:37:01.284
Because you can do a lot of them,

00:37:01.364 --> 00:37:02.063
but I would say like,

00:37:02.184 --> 00:37:04.945
which lever has the most leverage?

00:37:05.306 --> 00:37:05.885
Right.

00:37:05.945 --> 00:37:07.067
I have twenty choices.

00:37:08.248 --> 00:37:09.108
I can't pull all twenty,

00:37:09.307 --> 00:37:11.068
but which one should I pull first or

00:37:11.108 --> 00:37:16.032
most often or sooner to get that number

00:37:16.072 --> 00:37:16.853
to move?

00:37:18.393 --> 00:37:20.574
And to what it just sounds like you're

00:37:20.594 --> 00:37:20.795
saying,

00:37:20.835 --> 00:37:21.936
understand what the North Star really

00:37:21.976 --> 00:37:22.155
means,

00:37:22.215 --> 00:37:24.336
what is good in this situation look like?

00:37:24.641 --> 00:37:26.563
A hundred percent because it could look a

00:37:26.603 --> 00:37:28.385
million different ways for different

00:37:28.425 --> 00:37:28.784
people,

00:37:29.306 --> 00:37:32.947
but every person has the first lever to

00:37:33.068 --> 00:37:35.190
try and then they may need to try

00:37:35.230 --> 00:37:35.851
different ones.

00:37:36.170 --> 00:37:36.490
Yeah.

00:37:36.570 --> 00:37:37.791
Or the first one works perfectly.

00:37:38.052 --> 00:37:38.952
Yeah.

00:37:38.972 --> 00:37:39.152
Katie,

00:37:39.172 --> 00:37:40.193
if someone was going to reach out to

00:37:40.213 --> 00:37:41.175
you, what's the best place?

00:37:41.195 --> 00:37:42.596
Is it the old LinkedIn?

00:37:42.675 --> 00:37:45.418
LinkedIn is the best place to reach me.

00:37:45.438 --> 00:37:48.760
I get messages all the time and I'll

00:37:49.460 --> 00:37:50.282
be sure to respond.

00:37:50.302 --> 00:37:50.762
All right.

00:37:50.782 --> 00:37:51.563
We'll bring you back.

00:37:51.702 --> 00:37:52.724
Katie, appreciate the time.

00:37:52.744 --> 00:37:53.583
Thanks for talking with us.

00:37:53.824 --> 00:37:54.204
Thank you.

00:37:56.465 --> 00:37:57.545
That's it for this one.

00:37:58.005 --> 00:37:59.505
We're just getting warmed up.

00:37:59.945 --> 00:38:01.847
Smash follow, send it to a friend,

00:38:02.067 --> 00:38:03.726
or crank up the next episode.

00:38:04.246 --> 00:38:05.208
Want to go deeper?

00:38:05.628 --> 00:38:07.768
Hit us at pgpinecast.com.

00:38:08.989 --> 00:38:11.010
Or find us on YouTube and socials at

00:38:11.030 --> 00:38:12.250
pgpinecast.

00:38:12.670 --> 00:38:14.951
And legally, none of this was advice.

00:38:15.010 --> 00:38:16.670
It's for entertainment purposes only.

00:38:16.690 --> 00:38:18.391
Bullshit!

00:38:18.431 --> 00:38:19.012
See, Keith?

00:38:19.231 --> 00:38:20.293
We read the script.

00:38:20.592 --> 00:38:21.233
Happy now?