Dec. 5, 2024
This PT Practice is Transforming Patient Care and Building Networks
In this episode of PT Business Blueprint, we sit down with Dan, co-owner of Advantage Physical Therapy in Long Island, NY, to explore the challenges and opportunities in growing a PT practice.
Chapter Timestamps:
[0:00] Welcome & Vision: A Thousand Conversations with PT Owners
[4:10] Taking Over a Legacy Practice: From Paper Charts to Digital Transformation
[9:25] Growing a Practice: Scaling Staff and Shifting Demographics
[13:35] Challenges of Modernization: Employee Buy-In & Operational Changes
[17:50] Expanding Patient Care: In-Home Therapy and Access Barriers
[22:00] Communication Over Fancy Marketing: Why Basics Matter
[27:15] Introducing an IPA: Collaboration Without Losing Independence
[34:30] Lessons Learned: Simplifying Complex Collaborations
[39:45] The Call to Action: PT Advocacy and Policy Engagement in 2024
Dan shares his journey from taking over a legacy clinic rooted in tradition to transforming it into a thriving, modern practice that embraces innovative approaches.
We delve into:
Moving from paper charts to digital EMRs and the lessons learned along the way.
Shifting patient demographics and expanding care models to include in-home therapy and broader specialties.
The formation of a groundbreaking Independent Practice Association (IPA) for PTs in New York and its impact on collaboration, payer negotiations, and patient access.
Simple yet effective communication and marketing strategies for growing a practice.
Why PTs need to engage with policy and advocacy to drive real change for the profession.
Key Takeaway: Innovation doesn’t have to be fancy—sometimes the basics, like strong communication and collaboration, are the most transformative tools.
WEBVTT
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Dan, welcome to the podcast, man.
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PT Business Blueprint.
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The goal, I've said this before,
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I'm going to say it
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probably for the first hundred episodes.
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Because if I keep saying it,
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then eventually I'll do it.
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Which is,
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what if I could have a thousand
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conversations with practice
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owners over the next five years?
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Which is still pretty ambitious.
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That's two hundred conversations a year.
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Although...
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I talk a lot.
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And with the goal,
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really just being able to
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highlight the different
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ways that we all address similar problems,
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which is how do we deliver care?
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How do we make that financially viable?
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How do we make sure we have
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a steady stream of patients?
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All those different things.
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So Dan, tell us about your practice.
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Where is it?
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What's the name?
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Who do you see the whole night?
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Sure.
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So I'm one of the co-owners
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of Advantage Physical Therapy.
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It's in Long Island,
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Nassau County in Woodmere, New York.
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This private practice has
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been around since nineteen ninety two.
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I'm just one of the newest owners.
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I was also born in nineteen ninety two.
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So it's like a little full
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circle moment type of thing.
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Like I was born in it.
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The practice was also born.
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And historically,
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it's been an anchor in this community.
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So it had a really good reputation.
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People love going here.
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Before we took over, we had
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two full-time therapists and
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two part-time.
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Now we have five full-time
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therapists and two part-time.
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We're adding in our
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occupational therapist in January.
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So that's a whole different topic,
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but that's very complicated to do legally,
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but we found a way to do it.
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And so we are growing and
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we're getting our second
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location in twenty twenty five also.
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So it's
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Yeah,
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so I took over a year and a half ago
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with my friend and it's just been growth.
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And prior to us taking over,
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they were paper charting.
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It was like- Wow, really?
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In twenty twenty four?
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Yeah, it was hard.
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So and so I was just like,
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I can't do this my whole career.
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I wasn't paper charting.
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I did a clinical out in
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Peconic Bay once and I was doing that.
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And I was just like,
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I will never do this again.
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And going through that
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process where you bring in an EMR,
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shout out prompt for being
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my EMR and helping us get
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to the twenty first century.
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Right.
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But it was it was a struggle.
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Right.
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So we did that in six months.
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And now we're over a year later.
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of being in in on an emr and
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that has allowed us to to
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grow in a lot of ways let
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me ask you this um what was
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the what was the hardest
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part like adding so you're
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a little different because
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I think most organizations
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might make a switch from
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emr one to emr two but you
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were you were doing this um
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but this this is just an
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example of adoption and
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like everybody wants to be
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innovative but nobody wants
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to innovate because
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innovating is hard like
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there's friction hard
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What were like one or two of
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the hardest parts?
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Was it employee buy-in?
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Was it like just logistic?
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Yeah.
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Okay.
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Yeah.
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Imagine teaching.
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So we have a great
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demographic lineup of like
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a physical therapist.
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We have the thirty-two-year-old men.
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So there's three
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thirty-two-year-old guys
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that went to PT school together and
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And then the previous generation,
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which is a sixty and older
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physical therapist that
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have been doing things
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basically the same way for
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like twenty years.
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And so we have young men and
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grandmas and it's awesome.
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Patients love it.
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We have fun in the clinic.
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It's great.
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But like,
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how can we get everyone on the same page,
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especially like the front office that was
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wanting to do things a
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certain way right so you're
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taking co-pays differently
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you're tracking payment
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posting differently you're
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you're doing everything and
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it's overall more efficient
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but changing practice
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patterns that you've done a
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certain thing for like eighteen years
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twenty years is very
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challenging and so uh it
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was a slow process it took
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us about like three to four
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months to really like get
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into the groove with it but
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really going and sending
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all these plans of cares to
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doctors all over again
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right coming from the new
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emr versus what we used to
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do that like that was crazy
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like changing fax lines and
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everything like
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So much was done and there's so much to do,
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but we're finally in like a
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better groove of things, right?
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That's cool.
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So tell me about the practice.
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Who do you treat?
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You know, who comes through the door?
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You said it was sort of a
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staple in the community.
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So I'm starting to guess, you know,
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do you niche down a little
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bit or are you sort of, you know,
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we'll figure out how to help?
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Right.
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So historically,
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they were Medicare Part B.
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So it was basically a geriatric practice.
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Since I came in,
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and you can probably see
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from our social media,
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now we're treating like
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little babies that are
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learning how to walk or
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have torticollis or are a
00:05:07.839 --> 00:05:09.762
little bit developmentally delayed.
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We have people that are
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coming in for more like vertigo.
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uh bppv and more of your
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like recreational athletes
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as well too so like since I
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came in our percentage of
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medicare part b went from
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like ninety percent to like
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sixty right and which is
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hard to do in uh in a
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practice that has been
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around for thirty years is
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that change that like niche
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but like I came in from uh
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a private practice like
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I've opened up in my career
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two clinics, um, one in Atlanta,
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one in New Jersey.
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And like,
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it was all about how can I
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actually grow it?
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And at first I took everyone right here.
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We have the opposite problem.
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We can take everyone.
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It's just like, how do we best take them?
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Do we take them in the
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office all the time?
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Now we can also see them at their home.
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And,
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and also can we try to get them to
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have more access because we
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have a lot of snowbirds here, right?
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It's,
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It's New York.
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A lot of them go to Florida or overseas.
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How can we make sure that
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they're doing their best
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and everything we've worked
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so hard with here that they
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can have access outside of here?
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So in a year and a half,
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we're trying to change the
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experience to not only be in the clinic,
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but also in the home, in the gym,
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at work and abroad.
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When you're saying in the home,
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are you doing telehealth or
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is this physically house calls?
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Physical household.
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So some people like they've
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been coming on and off for like years.
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But what happens when
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there's barriers to that?
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Maybe there's cog, cog, cog,
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cog to barriers where they
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can't drive a car,
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but you don't want them to desaturate.
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You don't want their
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functional status to go down.
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And this is very common in
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the Medicaid population
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where a lot of these people
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have trouble to get to an office.
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It might take them a whole day.
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And I don't understand why
00:07:05.141 --> 00:07:06.663
Medicaid doesn't pay the
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providers more to just go
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to them because it would
00:07:10.024 --> 00:07:11.324
actually decrease the total
00:07:11.365 --> 00:07:13.925
cost and the time save and
00:07:13.946 --> 00:07:16.127
the resources across the entire board.
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I think that's a huge
00:07:17.788 --> 00:07:19.389
opportunity and I'm trying
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to figure that out.
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You've got the perfect...
00:07:22.815 --> 00:07:23.797
candidate for physical
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therapy is the people who
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have so much trouble even
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getting to a clinic that's
00:07:28.319 --> 00:07:30.060
that's your jam and then
00:07:30.081 --> 00:07:31.281
there's that gap right so
00:07:31.302 --> 00:07:32.362
some practices are saying
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you know I mean that you
00:07:33.223 --> 00:07:34.204
know notably I worked for a
00:07:34.244 --> 00:07:35.144
couple practices that were
00:07:35.165 --> 00:07:36.466
like we do house calls like
00:07:36.485 --> 00:07:37.487
what doctors used to do
00:07:37.526 --> 00:07:39.387
doctors if you're sick you
00:07:39.427 --> 00:07:40.228
don't come to an office
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full of other sick people
00:07:41.509 --> 00:07:42.290
we come to you because
00:07:42.310 --> 00:07:43.031
you're already sick at your
00:07:43.071 --> 00:07:45.973
house exactly in terms of that
00:07:46.572 --> 00:07:47.293
You talked about a couple of
00:07:47.312 --> 00:07:48.192
different behavior change,
00:07:48.353 --> 00:07:49.213
one being an EMR,
00:07:49.254 --> 00:07:50.834
the second being your patient population.
00:07:51.274 --> 00:07:53.074
How did you change communicating that?
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Because if you're still
00:07:54.855 --> 00:07:56.394
operating this practice
00:07:56.415 --> 00:07:57.035
that's been around since
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nineteen ninety two,
00:07:58.336 --> 00:07:59.855
people thought of you a certain way.
00:07:59.875 --> 00:08:00.956
You need to change culture.
00:08:01.276 --> 00:08:01.956
How did you go about
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marketing and communicating
00:08:03.297 --> 00:08:04.637
differently to let people
00:08:04.656 --> 00:08:06.617
know we're still this,
00:08:06.737 --> 00:08:07.997
but now we're also this?
00:08:08.077 --> 00:08:09.497
We've sort of expanded.
00:08:10.531 --> 00:08:10.831
Yeah,
00:08:10.932 --> 00:08:14.254
so a lot of it was me just contacting
00:08:14.274 --> 00:08:15.636
our current referral
00:08:15.696 --> 00:08:17.418
sources to let them know like, hey,
00:08:17.858 --> 00:08:19.119
you might see a little
00:08:19.158 --> 00:08:21.281
different plans of cares come in, right?
00:08:21.341 --> 00:08:23.461
And that was an opportunity
00:08:23.603 --> 00:08:25.024
to me to coordinate and
00:08:25.064 --> 00:08:26.345
collaborate with the people
00:08:26.365 --> 00:08:27.386
already sending, right?
00:08:27.425 --> 00:08:28.726
Just like showing like, hey,
00:08:29.007 --> 00:08:30.208
we're trying to optimize.
00:08:30.427 --> 00:08:32.330
We're trying to be cutting edge.
00:08:32.649 --> 00:08:34.230
This is how we're doing this
00:08:34.471 --> 00:08:35.672
on the operation side.
00:08:35.913 --> 00:08:37.214
But I'd really like your
00:08:37.354 --> 00:08:39.635
help to make this even better, right?
00:08:40.524 --> 00:08:41.164
They like,
00:08:41.304 --> 00:08:43.408
they allowed me to call them and say like,
00:08:43.447 --> 00:08:43.847
all right,
00:08:44.408 --> 00:08:46.230
I need a new script for this person,
00:08:46.250 --> 00:08:47.972
this person, this person, you might see,
00:08:48.052 --> 00:08:49.916
see, see this, like it helps.
00:08:50.595 --> 00:08:52.135
the administrative burden if
00:08:52.176 --> 00:08:53.596
you know it's coming in and
00:08:53.738 --> 00:08:55.958
how it comes in is easier to tackle.
00:08:56.159 --> 00:08:58.140
So the doctor knows, hey,
00:08:58.181 --> 00:08:59.182
I'm going to be sending
00:08:59.302 --> 00:09:00.783
thirty plans of cares over.
00:09:01.423 --> 00:09:02.284
Don't kill me.
00:09:02.745 --> 00:09:03.586
But they're all going to
00:09:03.625 --> 00:09:04.686
come in all at once.
00:09:04.725 --> 00:09:05.667
If you can just knock this
00:09:05.767 --> 00:09:07.568
out in like twenty or thirty minutes,
00:09:07.609 --> 00:09:08.950
like ideally,
00:09:09.590 --> 00:09:11.451
what day would you like them to come in?
00:09:11.491 --> 00:09:11.652
Right.
00:09:11.711 --> 00:09:14.333
That communication is crucial,
00:09:14.695 --> 00:09:15.835
especially as like a newer
00:09:15.956 --> 00:09:17.197
owner that wasn't there.
00:09:17.317 --> 00:09:17.476
Right.
00:09:17.517 --> 00:09:19.599
We still have the previous ownership here,
00:09:19.639 --> 00:09:19.818
too.
00:09:20.278 --> 00:09:22.400
But just making sure like
00:09:22.541 --> 00:09:23.902
everyone's on the same page
00:09:23.961 --> 00:09:26.023
and growing that with new
00:09:26.303 --> 00:09:27.303
referral sources that
00:09:27.384 --> 00:09:28.745
didn't historically send
00:09:28.785 --> 00:09:29.865
here because we weren't
00:09:29.926 --> 00:09:31.347
cutting edge where it was
00:09:31.388 --> 00:09:33.828
harder to communicate with us digitally.
00:09:33.948 --> 00:09:34.190
Right.
00:09:34.250 --> 00:09:36.871
So now they know what we can do.
00:09:36.912 --> 00:09:37.552
They've heard a lot,
00:09:37.572 --> 00:09:39.514
a lot of great things over the years,
00:09:39.614 --> 00:09:41.174
but now it's easier to have
00:09:41.215 --> 00:09:43.557
that two way communication.
00:09:44.706 --> 00:09:46.327
I think a lot of people will
00:09:46.408 --> 00:09:48.990
skip to the big fancy thing,
00:09:49.110 --> 00:09:49.770
myself included.
00:09:49.791 --> 00:09:51.153
This is why it's easy for me to spot.
00:09:51.552 --> 00:09:52.274
So I love the fact that I
00:09:52.333 --> 00:09:53.335
asked you a communications
00:09:53.355 --> 00:09:54.676
and marketing question and
00:09:54.696 --> 00:09:56.616
your answer was talking to people,
00:09:56.998 --> 00:09:58.058
which is actually the goal
00:09:58.538 --> 00:09:59.799
of running ads or doing
00:09:59.840 --> 00:10:00.841
webinars or workshops.
00:10:01.081 --> 00:10:01.961
That's actually the goal.
00:10:01.981 --> 00:10:02.423
So you were like,
00:10:02.663 --> 00:10:03.703
we didn't do anything fancy
00:10:04.104 --> 00:10:04.705
and it worked.
00:10:04.784 --> 00:10:06.066
It sounds like we didn't do anything.
00:10:06.525 --> 00:10:07.486
And that's what you hear
00:10:07.527 --> 00:10:10.089
people who are experts will often refer.
00:10:11.029 --> 00:10:12.630
whether in PT or communications,
00:10:12.951 --> 00:10:15.113
which is do the basics.
00:10:15.253 --> 00:10:17.153
I know you want to get fancy,
00:10:17.634 --> 00:10:19.176
but fancy is complicated
00:10:19.375 --> 00:10:20.116
and expensive and
00:10:20.157 --> 00:10:23.038
time-consuming and it could work.
00:10:23.798 --> 00:10:26.240
A lot of times you're more consistent.
00:10:26.280 --> 00:10:28.302
The basics work more frequently.
00:10:28.903 --> 00:10:29.423
So much.
00:10:29.562 --> 00:10:30.663
And like the easiest thing
00:10:30.744 --> 00:10:32.284
to do is a practice that
00:10:32.384 --> 00:10:33.826
has been around for years
00:10:33.865 --> 00:10:35.508
has touched a lot of lives.
00:10:35.528 --> 00:10:36.528
There's a lot of value there.
00:10:36.849 --> 00:10:37.328
If you can just
00:10:37.977 --> 00:10:39.239
call them like if you can
00:10:39.278 --> 00:10:40.659
have that touch point that
00:10:40.740 --> 00:10:42.120
has saw that have
00:10:42.240 --> 00:10:43.481
historically seen them like
00:10:43.682 --> 00:10:44.964
once every two years or
00:10:45.104 --> 00:10:47.666
once a year call them even
00:10:47.725 --> 00:10:48.826
if they don't reactivate
00:10:48.886 --> 00:10:50.467
and become a patient right
00:10:50.748 --> 00:10:51.609
they're going to tell their
00:10:51.649 --> 00:10:52.970
friends like hey my
00:10:53.009 --> 00:10:54.051
physical therapist just
00:10:54.071 --> 00:10:55.471
called me and because it
00:10:55.491 --> 00:10:56.673
was my birthday and because
00:10:56.712 --> 00:10:58.634
we had such good records
00:10:59.034 --> 00:11:00.176
like it was easy to plug
00:11:00.336 --> 00:11:01.897
everything in and our emr
00:11:01.917 --> 00:11:03.357
kind of told us and we just
00:11:03.378 --> 00:11:04.499
called patients because
00:11:04.898 --> 00:11:05.999
It's their birthday, right?
00:11:06.078 --> 00:11:07.399
Or an anniversary.
00:11:07.419 --> 00:11:09.140
And we have that on file now.
00:11:09.581 --> 00:11:11.162
And they're going to tell
00:11:11.542 --> 00:11:12.523
five of their friends that
00:11:12.543 --> 00:11:14.384
they play Mahjong with or this or that.
00:11:14.683 --> 00:11:16.065
And then one of their friends,
00:11:16.245 --> 00:11:17.785
a family member might need it.
00:11:17.885 --> 00:11:19.486
And just because you're in their head,
00:11:19.827 --> 00:11:20.028
right?
00:11:20.048 --> 00:11:21.828
Because you have that warm touch point.
00:11:22.149 --> 00:11:23.129
That's the best marketing
00:11:23.169 --> 00:11:24.309
that you can even do.
00:11:25.010 --> 00:11:27.613
That doesn't cost you any money.
00:11:27.712 --> 00:11:28.052
Nothing.
00:11:28.072 --> 00:11:28.192
Yeah.
00:11:28.575 --> 00:11:28.955
It's smart.
00:11:29.034 --> 00:11:29.676
It's communication.
00:11:29.855 --> 00:11:30.476
It's the basics.
00:11:30.557 --> 00:11:31.317
Most of the time when I do
00:11:31.336 --> 00:11:32.499
communications presentations,
00:11:32.538 --> 00:11:34.220
my first slide is two tin
00:11:34.259 --> 00:11:35.061
cans and a string.
00:11:35.520 --> 00:11:35.822
That's it.
00:11:36.121 --> 00:11:36.601
It's you're,
00:11:36.621 --> 00:11:37.082
you're trying to get
00:11:37.102 --> 00:11:38.644
information from one place to the other.
00:11:38.984 --> 00:11:40.706
Don't over complicate it.
00:11:41.265 --> 00:11:43.788
Um, when someone walks into your clinic,
00:11:43.828 --> 00:11:44.568
what's it look like?
00:11:44.629 --> 00:11:45.750
We often talk about, Hey,
00:11:45.831 --> 00:11:47.812
we can add bells and whistles.
00:11:48.393 --> 00:11:49.774
Adding everything is usually
00:11:49.813 --> 00:11:50.674
never a good idea,
00:11:51.014 --> 00:11:52.155
but what do you have that
00:11:52.176 --> 00:11:53.977
you find useful in your clinic?
00:11:55.051 --> 00:11:55.871
Yeah,
00:11:55.892 --> 00:11:58.456
the most useful thing we do have is
00:11:58.696 --> 00:11:59.798
our people in the front.
00:12:00.599 --> 00:12:03.883
So we have it evolved.
00:12:04.504 --> 00:12:06.647
And I don't think we are a
00:12:06.687 --> 00:12:08.149
good candidate to evolve to
00:12:08.190 --> 00:12:10.312
where we have a screen there.
00:12:12.019 --> 00:12:13.780
maybe one day, um,
00:12:13.880 --> 00:12:14.981
when my front office
00:12:15.042 --> 00:12:16.403
retires to like Florida and
00:12:16.423 --> 00:12:18.563
she can pop up on a screen on the beach,
00:12:18.624 --> 00:12:20.525
like people would love that
00:12:20.546 --> 00:12:21.706
because it's the same person.
00:12:21.767 --> 00:12:23.628
She's just in her next phase,
00:12:23.668 --> 00:12:25.428
but she has been a bit
00:12:25.469 --> 00:12:26.830
around here for like years.
00:12:27.169 --> 00:12:29.091
Um, hopefully we can do that,
00:12:29.131 --> 00:12:32.033
but like we have people, um, and, uh,
00:12:32.072 --> 00:12:32.974
we have the same setup.
00:12:32.994 --> 00:12:34.195
We have chairs there, this and that,
00:12:34.215 --> 00:12:36.436
but my pet peeve is waiting
00:12:36.515 --> 00:12:37.817
at a doctor's office.
00:12:37.836 --> 00:12:40.759
So I try for us not to use those chairs.
00:12:40.778 --> 00:12:41.720
That's only for like
00:12:42.503 --> 00:12:44.365
people's aides or their
00:12:44.404 --> 00:12:45.586
family members that feel
00:12:45.625 --> 00:12:46.605
like they're like in the
00:12:46.645 --> 00:12:48.268
way or their drivers, right?
00:12:48.668 --> 00:12:50.450
Like when a person checks in,
00:12:50.730 --> 00:12:51.330
I don't want them to
00:12:51.350 --> 00:12:52.630
waiting in the chair unless
00:12:52.650 --> 00:12:53.993
they're like an hour early.
00:12:54.052 --> 00:12:55.052
And even then I'll try to
00:12:55.092 --> 00:12:57.034
like squeeze them in early if I can.
00:12:57.655 --> 00:12:59.417
Um, but, uh, but, uh,
00:12:59.437 --> 00:13:01.138
I want them to come right on it.
00:13:01.639 --> 00:13:02.139
Um,
00:13:02.639 --> 00:13:04.321
because that just helps the patient
00:13:04.421 --> 00:13:06.643
experience time is the like
00:13:06.923 --> 00:13:07.744
greatest asset.
00:13:08.486 --> 00:13:09.587
I don't want anyone waiting.
00:13:09.707 --> 00:13:10.508
I want them moving.
00:13:10.648 --> 00:13:11.729
I want them engaging.
00:13:11.889 --> 00:13:13.730
I want them to have that experience.
00:13:13.769 --> 00:13:15.171
I want them seeing their
00:13:15.211 --> 00:13:16.792
neighbors and I want that
00:13:16.851 --> 00:13:17.851
community feeling.
00:13:17.951 --> 00:13:19.633
I want us to be a busy
00:13:19.773 --> 00:13:22.975
Starbucks that people are just, you know,
00:13:23.075 --> 00:13:24.495
talking, engaging, moving,
00:13:24.535 --> 00:13:27.456
getting like their metabolism going.
00:13:27.777 --> 00:13:29.398
I want all of that and I
00:13:29.418 --> 00:13:30.599
want it to be fun.
00:13:30.839 --> 00:13:31.679
And so I,
00:13:32.480 --> 00:13:34.360
I ideally don't even want a waiting room,
00:13:34.900 --> 00:13:37.263
but I have to have one for everyone else.
00:13:37.342 --> 00:13:37.602
Right.
00:13:37.623 --> 00:13:37.783
Yeah.
00:13:38.711 --> 00:13:38.932
All right.
00:13:38.971 --> 00:13:39.972
You did something or you're
00:13:40.013 --> 00:13:41.374
doing something a little bit different.
00:13:41.413 --> 00:13:42.933
Let's talk about private practice network.
00:13:42.994 --> 00:13:44.615
Now this is an IPA,
00:13:44.634 --> 00:13:46.375
which talks to me because I
00:13:46.395 --> 00:13:47.197
do like craft beer.
00:13:47.216 --> 00:13:51.359
It's an E like, so help me understand what,
00:13:51.499 --> 00:13:52.259
what is it?
00:13:52.720 --> 00:13:53.860
Why'd you formulate it?
00:13:53.980 --> 00:13:55.322
What's it allowed you and
00:13:55.562 --> 00:13:56.182
seven to nine other
00:13:56.201 --> 00:13:57.822
practices to do in the state of New York?
00:13:57.863 --> 00:13:59.163
This is new and this is innovative.
00:13:59.183 --> 00:14:00.423
And I like talking about stuff like this.
00:14:00.485 --> 00:14:01.225
Yeah.
00:14:01.284 --> 00:14:04.346
So re re recently myself and, uh, I think,
00:14:04.626 --> 00:14:04.687
uh,
00:14:05.193 --> 00:14:07.557
eight to ten other private practice owner,
00:14:07.596 --> 00:14:09.359
we've created a steering
00:14:09.418 --> 00:14:10.580
committee for the first
00:14:10.659 --> 00:14:12.743
private practice network IPA.
00:14:13.563 --> 00:14:15.525
And IPA is an independent
00:14:15.586 --> 00:14:17.388
physician association or
00:14:18.109 --> 00:14:19.971
independent practice association.
00:14:20.946 --> 00:14:22.905
um and uh what it does it
00:14:23.125 --> 00:14:25.226
allows you to collaborate
00:14:25.326 --> 00:14:26.667
as a group for like
00:14:27.126 --> 00:14:29.427
contracting and billing and
00:14:29.488 --> 00:14:31.548
credentialing and operation
00:14:31.827 --> 00:14:33.207
but you still will have
00:14:33.288 --> 00:14:34.908
your own entity being your
00:14:35.109 --> 00:14:36.769
own private private
00:14:36.808 --> 00:14:38.168
practice historically this
00:14:38.208 --> 00:14:39.769
was done with your uh
00:14:39.828 --> 00:14:41.389
primary care physicians
00:14:41.409 --> 00:14:42.970
maybe a few specialists but
00:14:43.029 --> 00:14:44.230
it hasn't trickled down to
00:14:44.429 --> 00:14:46.331
us in the pt space a lot of
00:14:46.370 --> 00:14:48.431
it is just because like it's hard to
00:14:50.654 --> 00:14:52.695
So is it a way to group
00:14:52.735 --> 00:14:54.056
yourselves together without
00:14:54.096 --> 00:14:55.336
having to become a
00:14:55.397 --> 00:14:57.576
franchise or having to
00:14:57.658 --> 00:14:59.477
business-wise sign and join?
00:14:59.498 --> 00:15:00.418
So it's a way to sort of
00:15:01.058 --> 00:15:03.860
group together formally,
00:15:03.960 --> 00:15:07.782
but you're not now one business entity.
00:15:08.282 --> 00:15:08.481
Right.
00:15:08.741 --> 00:15:10.403
Everyone is a shareholder
00:15:10.783 --> 00:15:12.703
and they are all together
00:15:12.844 --> 00:15:13.724
in this one thing.
00:15:13.764 --> 00:15:15.085
So you have an equal say in
00:15:16.692 --> 00:15:18.114
in this group and doesn't
00:15:18.153 --> 00:15:19.274
matter if you have five
00:15:19.335 --> 00:15:20.876
offices or one office,
00:15:21.157 --> 00:15:23.639
but at least you can pull
00:15:23.678 --> 00:15:25.301
together your resources in
00:15:25.360 --> 00:15:27.942
order to get like maybe better EMR costs,
00:15:28.102 --> 00:15:30.524
maybe better software as a
00:15:30.566 --> 00:15:33.868
service costs for like these AI scribes,
00:15:34.568 --> 00:15:35.929
but also negotiate with
00:15:35.990 --> 00:15:37.731
payers and just show, hey,
00:15:37.831 --> 00:15:40.894
we're seeing this many visits per month
00:15:41.414 --> 00:15:42.215
All together,
00:15:42.355 --> 00:15:43.336
this is a lot of claimed
00:15:43.375 --> 00:15:45.135
volume over several zip codes.
00:15:45.395 --> 00:15:47.037
This is how many providers
00:15:47.096 --> 00:15:48.116
we have and all their
00:15:48.197 --> 00:15:49.876
specialties and demographics.
00:15:49.956 --> 00:15:51.758
And some of us do visits at
00:15:51.798 --> 00:15:52.658
the home and this and that.
00:15:52.697 --> 00:15:54.359
So it allows to provide more
00:15:54.558 --> 00:15:57.499
access more and to help
00:15:57.559 --> 00:16:00.059
more lives with different types of people,
00:16:00.080 --> 00:16:01.360
which we know New York has
00:16:01.380 --> 00:16:02.760
a lot of different types of people.
00:16:03.386 --> 00:16:03.466
Well,
00:16:03.486 --> 00:16:05.008
it's got to help you negotiate better too,
00:16:05.067 --> 00:16:05.249
right?
00:16:05.308 --> 00:16:06.809
And there's the strength in
00:16:06.870 --> 00:16:08.370
numbers in terms of paying attention.
00:16:08.530 --> 00:16:10.173
Now you get paid attention to,
00:16:11.274 --> 00:16:13.034
we hate to say it, but now you're,
00:16:13.455 --> 00:16:14.495
instead of being eight
00:16:14.576 --> 00:16:16.557
individual squeaky wheels, right?
00:16:16.577 --> 00:16:18.178
Which can be ignored sometimes.
00:16:18.259 --> 00:16:19.200
It's just how things are.
00:16:19.559 --> 00:16:21.422
You're one pretty large
00:16:21.461 --> 00:16:22.763
squeaky wheel if you're all
00:16:22.802 --> 00:16:24.024
squeaking in the same direction.
00:16:24.825 --> 00:16:25.365
You got it.
00:16:25.686 --> 00:16:26.046
And-
00:16:26.726 --> 00:16:28.008
the payers don't have enough
00:16:28.148 --> 00:16:30.509
resources in order to hit
00:16:30.609 --> 00:16:31.870
all those eighty different
00:16:31.950 --> 00:16:33.051
squeaky wheels.
00:16:33.071 --> 00:16:34.572
They want one really good,
00:16:34.672 --> 00:16:36.873
nice wheel that operates really well,
00:16:36.932 --> 00:16:38.894
like they will reward that
00:16:39.495 --> 00:16:41.076
entity that operates more
00:16:41.196 --> 00:16:44.118
efficiently and timely and compliantly.
00:16:44.298 --> 00:16:44.638
Right.
00:16:44.658 --> 00:16:46.759
So it's nicer to be one
00:16:46.798 --> 00:16:49.081
entity and they want to do
00:16:49.120 --> 00:16:50.620
that and they want to incentivize that.
00:16:50.660 --> 00:16:52.403
So they'll raise it up.
00:16:52.602 --> 00:16:52.863
Right.
00:16:52.883 --> 00:16:53.003
So
00:16:53.706 --> 00:16:55.368
An IPA is one way of doing that,
00:16:55.467 --> 00:16:56.389
but there's another way,
00:16:57.288 --> 00:16:59.091
and that's with an MSO,
00:16:59.110 --> 00:17:01.552
which is a managing service organization,
00:17:01.652 --> 00:17:01.851
right?
00:17:01.912 --> 00:17:04.193
So this is a service or an
00:17:04.253 --> 00:17:07.776
entity that will handle those needs.
00:17:07.796 --> 00:17:09.076
They might help you with
00:17:09.136 --> 00:17:10.357
administrative burden by
00:17:10.417 --> 00:17:12.078
like checking your eligibility,
00:17:12.239 --> 00:17:16.060
authorizations, billing compliance.
00:17:16.101 --> 00:17:17.261
So this is another thing,
00:17:17.301 --> 00:17:19.683
but you don't have a say there,
00:17:20.044 --> 00:17:21.904
but they operate
00:17:22.309 --> 00:17:23.570
very efficiently and they
00:17:23.590 --> 00:17:24.711
can help you and you pay
00:17:24.730 --> 00:17:27.152
them a percent or a fee
00:17:27.192 --> 00:17:28.833
like every year and they'll
00:17:28.853 --> 00:17:30.273
help you with the pair
00:17:30.993 --> 00:17:32.075
relationship piece where
00:17:32.115 --> 00:17:33.335
like they have a legal team
00:17:33.355 --> 00:17:34.096
that will like to look
00:17:34.115 --> 00:17:35.195
through the contracts and
00:17:35.256 --> 00:17:36.757
everything and be like we
00:17:36.797 --> 00:17:38.278
don't want this no prior
00:17:38.317 --> 00:17:40.098
authorizations right uh we
00:17:40.138 --> 00:17:42.319
need a higher fee um so all
00:17:42.380 --> 00:17:44.300
of that so um that's
00:17:44.500 --> 00:17:46.361
another vehicle to
00:17:46.642 --> 00:17:48.522
negotiate with uh payers
00:17:48.563 --> 00:17:49.883
that you can do as a small
00:17:50.462 --> 00:17:51.503
mom and pop because
00:17:52.098 --> 00:17:53.900
You have to because I tried
00:17:53.960 --> 00:17:55.760
for six months to get them on the phone.
00:17:56.260 --> 00:17:57.821
They didn't want to talk to me.
00:17:57.942 --> 00:17:59.202
The network was closed.
00:17:59.282 --> 00:18:02.765
I wasn't allowed to see those patients,
00:18:02.825 --> 00:18:05.165
but it was a lot easier to
00:18:05.205 --> 00:18:06.446
go through them.
00:18:06.567 --> 00:18:10.169
I got credentialed in thirty days.
00:18:10.209 --> 00:18:10.469
Got it.
00:18:11.980 --> 00:18:14.201
So this is available.
00:18:14.321 --> 00:18:16.083
This is a thing.
00:18:16.222 --> 00:18:18.605
So, I mean, you and I are, you know,
00:18:18.644 --> 00:18:19.505
we were on LinkedIn and
00:18:19.525 --> 00:18:20.506
you're in Facebook groups
00:18:20.526 --> 00:18:21.067
and you see people
00:18:21.106 --> 00:18:22.047
complaining about things.
00:18:22.067 --> 00:18:24.709
And listen, I love me some complaining,
00:18:25.490 --> 00:18:27.290
but you're actually being
00:18:27.330 --> 00:18:28.511
able to execute and say,
00:18:28.612 --> 00:18:29.673
what are the strengths if
00:18:30.153 --> 00:18:30.873
we pool together,
00:18:30.913 --> 00:18:32.595
if we come together and be able to say,
00:18:32.815 --> 00:18:34.455
now we can affect change.
00:18:34.516 --> 00:18:35.497
Right, right.
00:18:35.737 --> 00:18:37.198
I think the worst thing we
00:18:37.238 --> 00:18:38.578
can do is try to compete.
00:18:38.699 --> 00:18:39.660
Like this time...
00:18:40.615 --> 00:18:40.815
Right.
00:18:40.935 --> 00:18:42.237
Like that's not good for our
00:18:42.317 --> 00:18:43.518
profession as a whole.
00:18:43.919 --> 00:18:45.039
And we have a shortage.
00:18:45.099 --> 00:18:46.382
Like we know there's a
00:18:46.442 --> 00:18:48.904
shortage of pro providers.
00:18:48.924 --> 00:18:49.905
Like this is our time to
00:18:49.986 --> 00:18:53.490
strike because we have supply demand,
00:18:53.670 --> 00:18:53.849
right?
00:18:54.109 --> 00:18:55.392
We're all super busy.
00:18:55.882 --> 00:18:58.104
We're just, our X isn't high enough.
00:18:58.183 --> 00:18:59.385
What we're getting paid per
00:18:59.465 --> 00:19:01.488
visit is not enough to keep
00:19:01.587 --> 00:19:02.288
our lights on.
00:19:02.729 --> 00:19:04.269
And that's not good for
00:19:04.349 --> 00:19:05.351
business because if there's
00:19:05.412 --> 00:19:07.834
only one option, it's never a good thing.
00:19:07.894 --> 00:19:09.154
You need a competitive
00:19:09.214 --> 00:19:11.458
landscape to innovate, to push.
00:19:11.758 --> 00:19:14.740
And I'd rather us compete on our people,
00:19:14.861 --> 00:19:15.761
like the, like,
00:19:16.142 --> 00:19:17.462
having the best specialists
00:19:17.482 --> 00:19:19.384
in the clinic that we pour
00:19:19.464 --> 00:19:20.685
resources into and we have
00:19:20.705 --> 00:19:22.166
a good culture with and how
00:19:22.207 --> 00:19:24.088
we operate as businesses.
00:19:24.108 --> 00:19:24.288
Like,
00:19:24.689 --> 00:19:26.651
do you get people in within twenty
00:19:26.691 --> 00:19:27.951
four to forty forty eight hours?
00:19:28.031 --> 00:19:28.992
Do you communicate?
00:19:29.012 --> 00:19:29.252
Well,
00:19:29.573 --> 00:19:31.153
I would rather us compete on that
00:19:31.474 --> 00:19:32.454
rather than try to just
00:19:32.494 --> 00:19:33.817
compete to have the most business,
00:19:33.836 --> 00:19:34.096
because
00:19:34.537 --> 00:19:35.857
there's not enough physical
00:19:35.917 --> 00:19:37.458
therapists and we know this
00:19:37.657 --> 00:19:39.019
and what I'm trying to do
00:19:39.459 --> 00:19:41.180
is we need legislation and
00:19:41.559 --> 00:19:43.059
policy that says hey you
00:19:43.160 --> 00:19:44.520
need a certain amount of
00:19:44.560 --> 00:19:46.561
pts this for ten thousand
00:19:46.602 --> 00:19:48.001
lives or a hundred thousand
00:19:48.041 --> 00:19:50.343
lives because that exists
00:19:50.363 --> 00:19:52.084
for primary care exists for
00:19:52.104 --> 00:19:53.644
you your dentist but it
00:19:53.664 --> 00:19:55.244
doesn't exist for us and
00:19:55.285 --> 00:19:56.665
that's a problem because
00:19:56.726 --> 00:19:58.266
there has to be some sort
00:19:58.346 --> 00:19:59.567
of what is enough
00:19:59.982 --> 00:20:00.903
and what is too much,
00:20:01.363 --> 00:20:04.644
and we have to be able to regulate that.
00:20:04.663 --> 00:20:05.304
Kudos to you.
00:20:05.484 --> 00:20:07.065
Eighty organizations,
00:20:07.505 --> 00:20:08.765
we said this before I hit record,
00:20:08.825 --> 00:20:09.806
like getting eight people
00:20:09.846 --> 00:20:11.885
to agree on something is not easy.
00:20:12.246 --> 00:20:14.067
Never mind eighty business owners,
00:20:14.086 --> 00:20:15.586
who this is their livelihood, who say,
00:20:15.946 --> 00:20:16.207
okay,
00:20:16.326 --> 00:20:18.508
I'll invest time and money and
00:20:18.548 --> 00:20:19.448
resources into coming
00:20:19.468 --> 00:20:20.328
together and doing this.
00:20:20.769 --> 00:20:21.449
That's not easy.
00:20:21.528 --> 00:20:23.028
So kudos for you and the
00:20:23.608 --> 00:20:24.410
rest of the board on that
00:20:24.450 --> 00:20:25.710
organization for going
00:20:25.730 --> 00:20:27.911
ahead and organizing.
00:20:27.951 --> 00:20:28.631
Yeah, we have...
00:20:29.901 --> 00:20:31.501
eight to ten people on the
00:20:31.541 --> 00:20:33.964
board that have been
00:20:34.025 --> 00:20:35.165
private practice owners for
00:20:36.226 --> 00:20:37.448
way longer than me.
00:20:37.607 --> 00:20:39.930
I'm learning so much from all of them,
00:20:40.329 --> 00:20:43.512
but we have eighty types of
00:20:43.593 --> 00:20:44.894
practices across New York
00:20:44.993 --> 00:20:47.615
State that have pledged to even join.
00:20:47.635 --> 00:20:49.278
That's great.
00:20:49.337 --> 00:20:50.479
Biggest lesson in putting
00:20:50.499 --> 00:20:51.559
something like that together?
00:20:51.640 --> 00:20:52.259
Biggest thing that you've
00:20:52.279 --> 00:20:53.862
taken away or learned that
00:20:53.882 --> 00:20:55.303
wasn't expected when you went in?
00:21:00.473 --> 00:21:03.777
Make sure there's one mission, one voice.
00:21:04.538 --> 00:21:09.541
And having someone with
00:21:09.622 --> 00:21:12.565
legal background is so crucial.
00:21:12.625 --> 00:21:16.048
It's so crucial to simplify things, right?
00:21:18.292 --> 00:21:18.853
Yeah, it's funny.
00:21:18.993 --> 00:21:20.934
We look at these things and
00:21:20.954 --> 00:21:22.376
they say they shouldn't be that hard,
00:21:22.416 --> 00:21:23.897
but there's some things
00:21:23.917 --> 00:21:25.118
that you just can't go around.
00:21:25.598 --> 00:21:26.640
Legal is typically one of
00:21:26.660 --> 00:21:27.882
those things where it's like, well,
00:21:28.122 --> 00:21:29.383
and it's also one of those things,
00:21:29.423 --> 00:21:29.962
it's a landmine,
00:21:29.982 --> 00:21:31.124
you step on it or it could
00:21:31.144 --> 00:21:31.825
really sting you.
00:21:32.164 --> 00:21:33.066
You want to make sure you
00:21:33.086 --> 00:21:33.886
don't get stung there.
00:21:34.607 --> 00:21:36.088
Last thing we do on these short episodes,
00:21:36.368 --> 00:21:37.049
parting shot.
00:21:37.509 --> 00:21:38.310
What's something you'd want
00:21:38.330 --> 00:21:39.432
to leave with the audience?
00:21:40.192 --> 00:21:42.434
A mic drop moment, a soapbox statement,
00:21:42.454 --> 00:21:43.154
something you want to leave
00:21:43.174 --> 00:21:43.675
as we wrap up.
00:21:44.473 --> 00:21:48.257
Yeah, so especially in twenty twenty four,
00:21:48.517 --> 00:21:50.479
I think all of us as
00:21:50.558 --> 00:21:51.940
physical therapists need to
00:21:51.960 --> 00:21:54.461
be more involved with with policy.
00:21:55.281 --> 00:21:57.183
We have to collaborate more,
00:21:57.423 --> 00:21:58.964
especially with our peers
00:21:59.184 --> 00:22:01.426
in in government,
00:22:01.928 --> 00:22:03.588
our peers in private practice.
00:22:04.133 --> 00:22:04.973
in hospitals,
00:22:05.013 --> 00:22:07.256
like our biggest enemy is ourselves.
00:22:07.635 --> 00:22:09.038
If we can all pull our
00:22:09.077 --> 00:22:10.839
resources and time together,
00:22:10.880 --> 00:22:13.642
whether it's five minutes or one hour, um,
00:22:13.863 --> 00:22:15.564
every month where we can
00:22:15.683 --> 00:22:17.385
actually just write to a
00:22:17.526 --> 00:22:19.528
rep or a representative or
00:22:19.587 --> 00:22:21.450
get them to visit us in the
00:22:21.470 --> 00:22:22.691
clinic or get them to be a
00:22:22.750 --> 00:22:23.791
patient of ours, right.
00:22:24.112 --> 00:22:25.874
To demonstrate our value and
00:22:26.654 --> 00:22:27.655
our biggest barriers.
00:22:28.240 --> 00:22:30.020
That's all it takes to get
00:22:30.060 --> 00:22:32.643
that ball rolling in the right direction.
00:22:32.863 --> 00:22:34.364
And we're starting to see
00:22:34.384 --> 00:22:35.924
that in the past three years.
00:22:35.944 --> 00:22:36.605
There's been Health
00:22:36.984 --> 00:22:38.665
Transparency Act where we
00:22:38.707 --> 00:22:40.186
know what everyone's getting paid.
00:22:41.607 --> 00:22:44.210
We're seeing better access points,
00:22:44.269 --> 00:22:45.631
less administrative burden.
00:22:45.951 --> 00:22:47.011
You go APTA.
00:22:47.031 --> 00:22:48.692
You've been crushing it for three years.
00:22:49.053 --> 00:22:50.614
Let's try to get that
00:22:51.114 --> 00:22:52.494
economic shift where the
00:22:52.515 --> 00:22:53.316
fee schedule is going the
00:22:53.455 --> 00:22:54.615
opposite direction.
00:22:54.675 --> 00:22:55.297
And I'm seeing...
00:22:56.017 --> 00:22:57.998
Potentially, it might go up this year,
00:22:58.038 --> 00:22:59.519
but it's requiring all of
00:22:59.598 --> 00:23:02.080
us to get involved politically,
00:23:02.500 --> 00:23:03.801
just send letters out.
00:23:04.162 --> 00:23:08.464
And if we have enough, if, you know,
00:23:08.505 --> 00:23:11.606
twenty therapists in every zip code,
00:23:12.307 --> 00:23:16.029
you know, just messages it, that's huge.
00:23:16.170 --> 00:23:16.309
Yeah.
00:23:16.903 --> 00:23:17.304
Understood.
00:23:18.023 --> 00:23:18.865
Make your voice heard.
00:23:19.205 --> 00:23:20.326
That's how decisions are made.
00:23:21.127 --> 00:23:21.307
Dan,
00:23:21.327 --> 00:23:22.430
appreciate you doing this for the
00:23:22.450 --> 00:23:22.910
profession.
00:23:23.069 --> 00:23:23.891
Maybe it'll catch on.
00:23:24.010 --> 00:23:24.592
Maybe other people will
00:23:24.632 --> 00:23:25.373
start paying attention to
00:23:25.393 --> 00:23:26.094
these different ways that
00:23:26.114 --> 00:23:28.016
we can connect and make
00:23:28.036 --> 00:23:28.916
your collective voice heard.
00:23:29.196 --> 00:23:30.097
Appreciate you coming on the
00:23:30.118 --> 00:23:30.838
show and doing this for us.
00:23:30.858 --> 00:23:32.221
You got it, man.
00:00:09.598 --> 00:00:10.958
Dan, welcome to the podcast, man.
00:00:10.999 --> 00:00:12.640
PT Business Blueprint.
00:00:12.660 --> 00:00:14.320
The goal, I've said this before,
00:00:14.339 --> 00:00:14.781
I'm going to say it
00:00:14.801 --> 00:00:16.221
probably for the first hundred episodes.
00:00:16.661 --> 00:00:17.582
Because if I keep saying it,
00:00:17.602 --> 00:00:18.461
then eventually I'll do it.
00:00:18.803 --> 00:00:19.103
Which is,
00:00:19.182 --> 00:00:20.263
what if I could have a thousand
00:00:20.303 --> 00:00:21.283
conversations with practice
00:00:21.344 --> 00:00:22.423
owners over the next five years?
00:00:22.643 --> 00:00:23.605
Which is still pretty ambitious.
00:00:23.625 --> 00:00:24.964
That's two hundred conversations a year.
00:00:25.205 --> 00:00:25.525
Although...
00:00:26.306 --> 00:00:26.867
I talk a lot.
00:00:27.946 --> 00:00:28.588
And with the goal,
00:00:28.628 --> 00:00:29.649
really just being able to
00:00:29.689 --> 00:00:30.568
highlight the different
00:00:30.629 --> 00:00:32.771
ways that we all address similar problems,
00:00:32.790 --> 00:00:34.411
which is how do we deliver care?
00:00:34.752 --> 00:00:36.152
How do we make that financially viable?
00:00:36.554 --> 00:00:37.433
How do we make sure we have
00:00:37.454 --> 00:00:38.594
a steady stream of patients?
00:00:38.755 --> 00:00:39.676
All those different things.
00:00:40.276 --> 00:00:42.798
So Dan, tell us about your practice.
00:00:43.097 --> 00:00:43.899
Where is it?
00:00:44.659 --> 00:00:45.299
What's the name?
00:00:45.399 --> 00:00:46.460
Who do you see the whole night?
00:00:47.021 --> 00:00:47.262
Sure.
00:00:47.362 --> 00:00:49.082
So I'm one of the co-owners
00:00:49.143 --> 00:00:50.484
of Advantage Physical Therapy.
00:00:50.743 --> 00:00:52.185
It's in Long Island,
00:00:52.524 --> 00:00:54.587
Nassau County in Woodmere, New York.
00:00:55.030 --> 00:00:55.990
This private practice has
00:00:56.011 --> 00:00:57.692
been around since nineteen ninety two.
00:00:57.752 --> 00:00:59.872
I'm just one of the newest owners.
00:01:00.533 --> 00:01:03.253
I was also born in nineteen ninety two.
00:01:03.314 --> 00:01:04.534
So it's like a little full
00:01:04.594 --> 00:01:06.995
circle moment type of thing.
00:01:07.036 --> 00:01:08.736
Like I was born in it.
00:01:08.757 --> 00:01:10.596
The practice was also born.
00:01:10.736 --> 00:01:11.537
And historically,
00:01:11.558 --> 00:01:16.099
it's been an anchor in this community.
00:01:16.799 --> 00:01:20.301
So it had a really good reputation.
00:01:20.381 --> 00:01:22.682
People love going here.
00:01:22.721 --> 00:01:24.222
Before we took over, we had
00:01:25.337 --> 00:01:27.519
two full-time therapists and
00:01:27.560 --> 00:01:28.260
two part-time.
00:01:28.721 --> 00:01:30.543
Now we have five full-time
00:01:30.582 --> 00:01:33.025
therapists and two part-time.
00:01:33.665 --> 00:01:34.587
We're adding in our
00:01:34.807 --> 00:01:37.769
occupational therapist in January.
00:01:37.868 --> 00:01:40.031
So that's a whole different topic,
00:01:40.051 --> 00:01:42.272
but that's very complicated to do legally,
00:01:42.352 --> 00:01:43.954
but we found a way to do it.
00:01:44.956 --> 00:01:47.498
And so we are growing and
00:01:47.537 --> 00:01:48.918
we're getting our second
00:01:48.959 --> 00:01:51.021
location in twenty twenty five also.
00:01:51.120 --> 00:01:52.102
So it's
00:01:52.498 --> 00:01:52.757
Yeah,
00:01:52.837 --> 00:01:55.140
so I took over a year and a half ago
00:01:55.159 --> 00:01:57.703
with my friend and it's just been growth.
00:01:58.302 --> 00:02:00.584
And prior to us taking over,
00:02:00.745 --> 00:02:01.786
they were paper charting.
00:02:02.227 --> 00:02:03.447
It was like- Wow, really?
00:02:03.548 --> 00:02:04.569
In twenty twenty four?
00:02:05.510 --> 00:02:06.549
Yeah, it was hard.
00:02:06.631 --> 00:02:10.114
So and so I was just like,
00:02:10.394 --> 00:02:11.955
I can't do this my whole career.
00:02:12.134 --> 00:02:13.437
I wasn't paper charting.
00:02:13.616 --> 00:02:15.818
I did a clinical out in
00:02:15.878 --> 00:02:18.461
Peconic Bay once and I was doing that.
00:02:18.873 --> 00:02:19.335
And I was just like,
00:02:19.395 --> 00:02:20.515
I will never do this again.
00:02:21.276 --> 00:02:22.578
And going through that
00:02:22.617 --> 00:02:25.161
process where you bring in an EMR,
00:02:25.300 --> 00:02:27.864
shout out prompt for being
00:02:28.443 --> 00:02:30.265
my EMR and helping us get
00:02:30.406 --> 00:02:33.109
to the twenty first century.
00:02:33.229 --> 00:02:33.550
Right.
00:02:34.631 --> 00:02:36.913
But it was it was a struggle.
00:02:36.973 --> 00:02:37.193
Right.
00:02:37.233 --> 00:02:38.854
So we did that in six months.
00:02:39.094 --> 00:02:41.418
And now we're over a year later.
00:02:42.122 --> 00:02:44.343
of being in in on an emr and
00:02:44.364 --> 00:02:45.965
that has allowed us to to
00:02:46.025 --> 00:02:47.526
grow in a lot of ways let
00:02:47.545 --> 00:02:49.127
me ask you this um what was
00:02:49.167 --> 00:02:50.187
the what was the hardest
00:02:50.227 --> 00:02:52.127
part like adding so you're
00:02:52.147 --> 00:02:52.848
a little different because
00:02:52.868 --> 00:02:53.929
I think most organizations
00:02:53.968 --> 00:02:54.990
might make a switch from
00:02:55.150 --> 00:02:57.151
emr one to emr two but you
00:02:57.170 --> 00:02:58.951
were you were doing this um
00:02:58.972 --> 00:03:00.133
but this this is just an
00:03:00.173 --> 00:03:01.573
example of adoption and
00:03:01.612 --> 00:03:02.394
like everybody wants to be
00:03:02.433 --> 00:03:03.433
innovative but nobody wants
00:03:03.454 --> 00:03:04.055
to innovate because
00:03:04.094 --> 00:03:05.235
innovating is hard like
00:03:05.254 --> 00:03:06.135
there's friction hard
00:03:06.855 --> 00:03:07.877
What were like one or two of
00:03:07.896 --> 00:03:09.277
the hardest parts?
00:03:09.318 --> 00:03:11.419
Was it employee buy-in?
00:03:11.479 --> 00:03:13.381
Was it like just logistic?
00:03:13.502 --> 00:03:13.681
Yeah.
00:03:13.741 --> 00:03:13.961
Okay.
00:03:13.981 --> 00:03:14.401
Yeah.
00:03:15.203 --> 00:03:16.623
Imagine teaching.
00:03:16.804 --> 00:03:18.305
So we have a great
00:03:18.466 --> 00:03:20.366
demographic lineup of like
00:03:20.887 --> 00:03:21.828
a physical therapist.
00:03:21.867 --> 00:03:24.330
We have the thirty-two-year-old men.
00:03:24.669 --> 00:03:25.711
So there's three
00:03:25.770 --> 00:03:27.492
thirty-two-year-old guys
00:03:27.513 --> 00:03:30.395
that went to PT school together and
00:03:30.838 --> 00:03:32.838
And then the previous generation,
00:03:32.878 --> 00:03:34.919
which is a sixty and older
00:03:35.280 --> 00:03:36.360
physical therapist that
00:03:36.379 --> 00:03:37.221
have been doing things
00:03:37.381 --> 00:03:38.881
basically the same way for
00:03:38.920 --> 00:03:39.600
like twenty years.
00:03:39.841 --> 00:03:42.842
And so we have young men and
00:03:42.961 --> 00:03:44.822
grandmas and it's awesome.
00:03:44.861 --> 00:03:45.681
Patients love it.
00:03:45.923 --> 00:03:47.242
We have fun in the clinic.
00:03:47.483 --> 00:03:47.862
It's great.
00:03:47.902 --> 00:03:48.302
But like,
00:03:48.362 --> 00:03:50.243
how can we get everyone on the same page,
00:03:50.383 --> 00:03:52.123
especially like the front office that was
00:03:52.718 --> 00:03:53.740
wanting to do things a
00:03:53.819 --> 00:03:55.442
certain way right so you're
00:03:55.462 --> 00:03:56.924
taking co-pays differently
00:03:57.224 --> 00:03:58.466
you're tracking payment
00:03:58.485 --> 00:03:59.927
posting differently you're
00:04:00.127 --> 00:04:00.908
you're doing everything and
00:04:01.650 --> 00:04:03.192
it's overall more efficient
00:04:03.491 --> 00:04:04.993
but changing practice
00:04:05.014 --> 00:04:05.996
patterns that you've done a
00:04:06.075 --> 00:04:07.837
certain thing for like eighteen years
00:04:08.311 --> 00:04:10.211
twenty years is very
00:04:10.252 --> 00:04:12.633
challenging and so uh it
00:04:12.653 --> 00:04:14.155
was a slow process it took
00:04:14.215 --> 00:04:15.575
us about like three to four
00:04:15.616 --> 00:04:16.637
months to really like get
00:04:16.677 --> 00:04:17.896
into the groove with it but
00:04:17.956 --> 00:04:19.418
really going and sending
00:04:19.437 --> 00:04:20.399
all these plans of cares to
00:04:20.439 --> 00:04:21.819
doctors all over again
00:04:21.879 --> 00:04:23.141
right coming from the new
00:04:23.261 --> 00:04:25.521
emr versus what we used to
00:04:25.562 --> 00:04:27.182
do that like that was crazy
00:04:27.223 --> 00:04:28.684
like changing fax lines and
00:04:28.723 --> 00:04:29.524
everything like
00:04:30.295 --> 00:04:33.779
So much was done and there's so much to do,
00:04:33.800 --> 00:04:34.800
but we're finally in like a
00:04:34.860 --> 00:04:36.822
better groove of things, right?
00:04:36.843 --> 00:04:38.504
That's cool.
00:04:38.524 --> 00:04:39.305
So tell me about the practice.
00:04:39.326 --> 00:04:39.966
Who do you treat?
00:04:40.146 --> 00:04:42.249
You know, who comes through the door?
00:04:42.269 --> 00:04:43.009
You said it was sort of a
00:04:43.050 --> 00:04:44.011
staple in the community.
00:04:44.031 --> 00:04:45.752
So I'm starting to guess, you know,
00:04:45.812 --> 00:04:46.673
do you niche down a little
00:04:46.694 --> 00:04:48.896
bit or are you sort of, you know,
00:04:48.956 --> 00:04:49.836
we'll figure out how to help?
00:04:50.620 --> 00:04:50.901
Right.
00:04:50.942 --> 00:04:52.603
So historically,
00:04:52.702 --> 00:04:55.026
they were Medicare Part B.
00:04:55.125 --> 00:04:57.247
So it was basically a geriatric practice.
00:04:57.709 --> 00:04:58.810
Since I came in,
00:04:58.850 --> 00:04:59.850
and you can probably see
00:04:59.891 --> 00:05:00.971
from our social media,
00:05:02.014 --> 00:05:02.853
now we're treating like
00:05:02.995 --> 00:05:04.495
little babies that are
00:05:04.596 --> 00:05:06.017
learning how to walk or
00:05:06.057 --> 00:05:07.800
have torticollis or are a
00:05:07.839 --> 00:05:09.762
little bit developmentally delayed.
00:05:09.822 --> 00:05:10.862
We have people that are
00:05:10.963 --> 00:05:12.345
coming in for more like vertigo.
00:05:13.120 --> 00:05:15.122
uh bppv and more of your
00:05:15.161 --> 00:05:16.442
like recreational athletes
00:05:16.482 --> 00:05:18.382
as well too so like since I
00:05:18.583 --> 00:05:20.903
came in our percentage of
00:05:21.223 --> 00:05:22.684
medicare part b went from
00:05:22.723 --> 00:05:24.305
like ninety percent to like
00:05:24.444 --> 00:05:25.925
sixty right and which is
00:05:25.966 --> 00:05:28.607
hard to do in uh in a
00:05:28.646 --> 00:05:29.627
practice that has been
00:05:29.646 --> 00:05:30.706
around for thirty years is
00:05:30.726 --> 00:05:32.187
that change that like niche
00:05:32.288 --> 00:05:35.189
but like I came in from uh
00:05:35.288 --> 00:05:36.309
a private practice like
00:05:36.728 --> 00:05:38.110
I've opened up in my career
00:05:38.654 --> 00:05:41.776
two clinics, um, one in Atlanta,
00:05:41.937 --> 00:05:43.076
one in New Jersey.
00:05:43.658 --> 00:05:44.257
And like,
00:05:44.338 --> 00:05:45.478
it was all about how can I
00:05:45.538 --> 00:05:46.819
actually grow it?
00:05:46.939 --> 00:05:50.201
And at first I took everyone right here.
00:05:50.502 --> 00:05:51.521
We have the opposite problem.
00:05:51.661 --> 00:05:52.783
We can take everyone.
00:05:53.122 --> 00:05:55.624
It's just like, how do we best take them?
00:05:55.824 --> 00:05:56.785
Do we take them in the
00:05:56.845 --> 00:05:58.026
office all the time?
00:05:58.565 --> 00:06:01.026
Now we can also see them at their home.
00:06:01.687 --> 00:06:01.947
And,
00:06:02.187 --> 00:06:04.468
and also can we try to get them to
00:06:04.488 --> 00:06:05.610
have more access because we
00:06:05.629 --> 00:06:07.370
have a lot of snowbirds here, right?
00:06:07.451 --> 00:06:07.591
It's,
00:06:07.975 --> 00:06:08.415
It's New York.
00:06:08.435 --> 00:06:10.617
A lot of them go to Florida or overseas.
00:06:10.896 --> 00:06:11.997
How can we make sure that
00:06:12.377 --> 00:06:13.658
they're doing their best
00:06:13.718 --> 00:06:14.778
and everything we've worked
00:06:14.819 --> 00:06:17.060
so hard with here that they
00:06:17.081 --> 00:06:18.541
can have access outside of here?
00:06:18.862 --> 00:06:20.723
So in a year and a half,
00:06:20.802 --> 00:06:22.925
we're trying to change the
00:06:23.084 --> 00:06:25.685
experience to not only be in the clinic,
00:06:25.745 --> 00:06:27.827
but also in the home, in the gym,
00:06:27.987 --> 00:06:30.529
at work and abroad.
00:06:31.470 --> 00:06:32.531
When you're saying in the home,
00:06:32.591 --> 00:06:34.012
are you doing telehealth or
00:06:34.031 --> 00:06:35.512
is this physically house calls?
00:06:36.279 --> 00:06:37.180
Physical household.
00:06:37.201 --> 00:06:38.882
So some people like they've
00:06:38.901 --> 00:06:41.603
been coming on and off for like years.
00:06:42.144 --> 00:06:43.266
But what happens when
00:06:43.545 --> 00:06:44.766
there's barriers to that?
00:06:44.867 --> 00:06:46.468
Maybe there's cog, cog, cog,
00:06:46.507 --> 00:06:48.350
cog to barriers where they
00:06:48.370 --> 00:06:49.329
can't drive a car,
00:06:49.550 --> 00:06:51.572
but you don't want them to desaturate.
00:06:51.591 --> 00:06:52.153
You don't want their
00:06:52.192 --> 00:06:53.593
functional status to go down.
00:06:54.115 --> 00:06:55.297
And this is very common in
00:06:55.317 --> 00:06:57.218
the Medicaid population
00:06:57.377 --> 00:06:59.338
where a lot of these people
00:06:59.418 --> 00:07:01.339
have trouble to get to an office.
00:07:01.379 --> 00:07:03.060
It might take them a whole day.
00:07:03.521 --> 00:07:05.041
And I don't understand why
00:07:05.141 --> 00:07:06.663
Medicaid doesn't pay the
00:07:06.702 --> 00:07:07.983
providers more to just go
00:07:08.262 --> 00:07:09.783
to them because it would
00:07:10.024 --> 00:07:11.324
actually decrease the total
00:07:11.365 --> 00:07:13.925
cost and the time save and
00:07:13.946 --> 00:07:16.127
the resources across the entire board.
00:07:16.507 --> 00:07:17.728
I think that's a huge
00:07:17.788 --> 00:07:19.389
opportunity and I'm trying
00:07:19.408 --> 00:07:20.310
to figure that out.
00:07:20.810 --> 00:07:21.870
You've got the perfect...
00:07:22.815 --> 00:07:23.797
candidate for physical
00:07:23.836 --> 00:07:24.677
therapy is the people who
00:07:24.716 --> 00:07:26.678
have so much trouble even
00:07:26.738 --> 00:07:28.300
getting to a clinic that's
00:07:28.319 --> 00:07:30.060
that's your jam and then
00:07:30.081 --> 00:07:31.281
there's that gap right so
00:07:31.302 --> 00:07:32.362
some practices are saying
00:07:32.403 --> 00:07:33.182
you know I mean that you
00:07:33.223 --> 00:07:34.204
know notably I worked for a
00:07:34.244 --> 00:07:35.144
couple practices that were
00:07:35.165 --> 00:07:36.466
like we do house calls like
00:07:36.485 --> 00:07:37.487
what doctors used to do
00:07:37.526 --> 00:07:39.387
doctors if you're sick you
00:07:39.427 --> 00:07:40.228
don't come to an office
00:07:40.249 --> 00:07:41.149
full of other sick people
00:07:41.509 --> 00:07:42.290
we come to you because
00:07:42.310 --> 00:07:43.031
you're already sick at your
00:07:43.071 --> 00:07:45.973
house exactly in terms of that
00:07:46.572 --> 00:07:47.293
You talked about a couple of
00:07:47.312 --> 00:07:48.192
different behavior change,
00:07:48.353 --> 00:07:49.213
one being an EMR,
00:07:49.254 --> 00:07:50.834
the second being your patient population.
00:07:51.274 --> 00:07:53.074
How did you change communicating that?
00:07:53.134 --> 00:07:54.754
Because if you're still
00:07:54.855 --> 00:07:56.394
operating this practice
00:07:56.415 --> 00:07:57.035
that's been around since
00:07:57.055 --> 00:07:57.915
nineteen ninety two,
00:07:58.336 --> 00:07:59.855
people thought of you a certain way.
00:07:59.875 --> 00:08:00.956
You need to change culture.
00:08:01.276 --> 00:08:01.956
How did you go about
00:08:02.055 --> 00:08:03.177
marketing and communicating
00:08:03.297 --> 00:08:04.637
differently to let people
00:08:04.656 --> 00:08:06.617
know we're still this,
00:08:06.737 --> 00:08:07.997
but now we're also this?
00:08:08.077 --> 00:08:09.497
We've sort of expanded.
00:08:10.531 --> 00:08:10.831
Yeah,
00:08:10.932 --> 00:08:14.254
so a lot of it was me just contacting
00:08:14.274 --> 00:08:15.636
our current referral
00:08:15.696 --> 00:08:17.418
sources to let them know like, hey,
00:08:17.858 --> 00:08:19.119
you might see a little
00:08:19.158 --> 00:08:21.281
different plans of cares come in, right?
00:08:21.341 --> 00:08:23.461
And that was an opportunity
00:08:23.603 --> 00:08:25.024
to me to coordinate and
00:08:25.064 --> 00:08:26.345
collaborate with the people
00:08:26.365 --> 00:08:27.386
already sending, right?
00:08:27.425 --> 00:08:28.726
Just like showing like, hey,
00:08:29.007 --> 00:08:30.208
we're trying to optimize.
00:08:30.427 --> 00:08:32.330
We're trying to be cutting edge.
00:08:32.649 --> 00:08:34.230
This is how we're doing this
00:08:34.471 --> 00:08:35.672
on the operation side.
00:08:35.913 --> 00:08:37.214
But I'd really like your
00:08:37.354 --> 00:08:39.635
help to make this even better, right?
00:08:40.524 --> 00:08:41.164
They like,
00:08:41.304 --> 00:08:43.408
they allowed me to call them and say like,
00:08:43.447 --> 00:08:43.847
all right,
00:08:44.408 --> 00:08:46.230
I need a new script for this person,
00:08:46.250 --> 00:08:47.972
this person, this person, you might see,
00:08:48.052 --> 00:08:49.916
see, see this, like it helps.
00:08:50.595 --> 00:08:52.135
the administrative burden if
00:08:52.176 --> 00:08:53.596
you know it's coming in and
00:08:53.738 --> 00:08:55.958
how it comes in is easier to tackle.
00:08:56.159 --> 00:08:58.140
So the doctor knows, hey,
00:08:58.181 --> 00:08:59.182
I'm going to be sending
00:08:59.302 --> 00:09:00.783
thirty plans of cares over.
00:09:01.423 --> 00:09:02.284
Don't kill me.
00:09:02.745 --> 00:09:03.586
But they're all going to
00:09:03.625 --> 00:09:04.686
come in all at once.
00:09:04.725 --> 00:09:05.667
If you can just knock this
00:09:05.767 --> 00:09:07.568
out in like twenty or thirty minutes,
00:09:07.609 --> 00:09:08.950
like ideally,
00:09:09.590 --> 00:09:11.451
what day would you like them to come in?
00:09:11.491 --> 00:09:11.652
Right.
00:09:11.711 --> 00:09:14.333
That communication is crucial,
00:09:14.695 --> 00:09:15.835
especially as like a newer
00:09:15.956 --> 00:09:17.197
owner that wasn't there.
00:09:17.317 --> 00:09:17.476
Right.
00:09:17.517 --> 00:09:19.599
We still have the previous ownership here,
00:09:19.639 --> 00:09:19.818
too.
00:09:20.278 --> 00:09:22.400
But just making sure like
00:09:22.541 --> 00:09:23.902
everyone's on the same page
00:09:23.961 --> 00:09:26.023
and growing that with new
00:09:26.303 --> 00:09:27.303
referral sources that
00:09:27.384 --> 00:09:28.745
didn't historically send
00:09:28.785 --> 00:09:29.865
here because we weren't
00:09:29.926 --> 00:09:31.347
cutting edge where it was
00:09:31.388 --> 00:09:33.828
harder to communicate with us digitally.
00:09:33.948 --> 00:09:34.190
Right.
00:09:34.250 --> 00:09:36.871
So now they know what we can do.
00:09:36.912 --> 00:09:37.552
They've heard a lot,
00:09:37.572 --> 00:09:39.514
a lot of great things over the years,
00:09:39.614 --> 00:09:41.174
but now it's easier to have
00:09:41.215 --> 00:09:43.557
that two way communication.
00:09:44.706 --> 00:09:46.327
I think a lot of people will
00:09:46.408 --> 00:09:48.990
skip to the big fancy thing,
00:09:49.110 --> 00:09:49.770
myself included.
00:09:49.791 --> 00:09:51.153
This is why it's easy for me to spot.
00:09:51.552 --> 00:09:52.274
So I love the fact that I
00:09:52.333 --> 00:09:53.335
asked you a communications
00:09:53.355 --> 00:09:54.676
and marketing question and
00:09:54.696 --> 00:09:56.616
your answer was talking to people,
00:09:56.998 --> 00:09:58.058
which is actually the goal
00:09:58.538 --> 00:09:59.799
of running ads or doing
00:09:59.840 --> 00:10:00.841
webinars or workshops.
00:10:01.081 --> 00:10:01.961
That's actually the goal.
00:10:01.981 --> 00:10:02.423
So you were like,
00:10:02.663 --> 00:10:03.703
we didn't do anything fancy
00:10:04.104 --> 00:10:04.705
and it worked.
00:10:04.784 --> 00:10:06.066
It sounds like we didn't do anything.
00:10:06.525 --> 00:10:07.486
And that's what you hear
00:10:07.527 --> 00:10:10.089
people who are experts will often refer.
00:10:11.029 --> 00:10:12.630
whether in PT or communications,
00:10:12.951 --> 00:10:15.113
which is do the basics.
00:10:15.253 --> 00:10:17.153
I know you want to get fancy,
00:10:17.634 --> 00:10:19.176
but fancy is complicated
00:10:19.375 --> 00:10:20.116
and expensive and
00:10:20.157 --> 00:10:23.038
time-consuming and it could work.
00:10:23.798 --> 00:10:26.240
A lot of times you're more consistent.
00:10:26.280 --> 00:10:28.302
The basics work more frequently.
00:10:28.903 --> 00:10:29.423
So much.
00:10:29.562 --> 00:10:30.663
And like the easiest thing
00:10:30.744 --> 00:10:32.284
to do is a practice that
00:10:32.384 --> 00:10:33.826
has been around for years
00:10:33.865 --> 00:10:35.508
has touched a lot of lives.
00:10:35.528 --> 00:10:36.528
There's a lot of value there.
00:10:36.849 --> 00:10:37.328
If you can just
00:10:37.977 --> 00:10:39.239
call them like if you can
00:10:39.278 --> 00:10:40.659
have that touch point that
00:10:40.740 --> 00:10:42.120
has saw that have
00:10:42.240 --> 00:10:43.481
historically seen them like
00:10:43.682 --> 00:10:44.964
once every two years or
00:10:45.104 --> 00:10:47.666
once a year call them even
00:10:47.725 --> 00:10:48.826
if they don't reactivate
00:10:48.886 --> 00:10:50.467
and become a patient right
00:10:50.748 --> 00:10:51.609
they're going to tell their
00:10:51.649 --> 00:10:52.970
friends like hey my
00:10:53.009 --> 00:10:54.051
physical therapist just
00:10:54.071 --> 00:10:55.471
called me and because it
00:10:55.491 --> 00:10:56.673
was my birthday and because
00:10:56.712 --> 00:10:58.634
we had such good records
00:10:59.034 --> 00:11:00.176
like it was easy to plug
00:11:00.336 --> 00:11:01.897
everything in and our emr
00:11:01.917 --> 00:11:03.357
kind of told us and we just
00:11:03.378 --> 00:11:04.499
called patients because
00:11:04.898 --> 00:11:05.999
It's their birthday, right?
00:11:06.078 --> 00:11:07.399
Or an anniversary.
00:11:07.419 --> 00:11:09.140
And we have that on file now.
00:11:09.581 --> 00:11:11.162
And they're going to tell
00:11:11.542 --> 00:11:12.523
five of their friends that
00:11:12.543 --> 00:11:14.384
they play Mahjong with or this or that.
00:11:14.683 --> 00:11:16.065
And then one of their friends,
00:11:16.245 --> 00:11:17.785
a family member might need it.
00:11:17.885 --> 00:11:19.486
And just because you're in their head,
00:11:19.827 --> 00:11:20.028
right?
00:11:20.048 --> 00:11:21.828
Because you have that warm touch point.
00:11:22.149 --> 00:11:23.129
That's the best marketing
00:11:23.169 --> 00:11:24.309
that you can even do.
00:11:25.010 --> 00:11:27.613
That doesn't cost you any money.
00:11:27.712 --> 00:11:28.052
Nothing.
00:11:28.072 --> 00:11:28.192
Yeah.
00:11:28.575 --> 00:11:28.955
It's smart.
00:11:29.034 --> 00:11:29.676
It's communication.
00:11:29.855 --> 00:11:30.476
It's the basics.
00:11:30.557 --> 00:11:31.317
Most of the time when I do
00:11:31.336 --> 00:11:32.499
communications presentations,
00:11:32.538 --> 00:11:34.220
my first slide is two tin
00:11:34.259 --> 00:11:35.061
cans and a string.
00:11:35.520 --> 00:11:35.822
That's it.
00:11:36.121 --> 00:11:36.601
It's you're,
00:11:36.621 --> 00:11:37.082
you're trying to get
00:11:37.102 --> 00:11:38.644
information from one place to the other.
00:11:38.984 --> 00:11:40.706
Don't over complicate it.
00:11:41.265 --> 00:11:43.788
Um, when someone walks into your clinic,
00:11:43.828 --> 00:11:44.568
what's it look like?
00:11:44.629 --> 00:11:45.750
We often talk about, Hey,
00:11:45.831 --> 00:11:47.812
we can add bells and whistles.
00:11:48.393 --> 00:11:49.774
Adding everything is usually
00:11:49.813 --> 00:11:50.674
never a good idea,
00:11:51.014 --> 00:11:52.155
but what do you have that
00:11:52.176 --> 00:11:53.977
you find useful in your clinic?
00:11:55.051 --> 00:11:55.871
Yeah,
00:11:55.892 --> 00:11:58.456
the most useful thing we do have is
00:11:58.696 --> 00:11:59.798
our people in the front.
00:12:00.599 --> 00:12:03.883
So we have it evolved.
00:12:04.504 --> 00:12:06.647
And I don't think we are a
00:12:06.687 --> 00:12:08.149
good candidate to evolve to
00:12:08.190 --> 00:12:10.312
where we have a screen there.
00:12:12.019 --> 00:12:13.780
maybe one day, um,
00:12:13.880 --> 00:12:14.981
when my front office
00:12:15.042 --> 00:12:16.403
retires to like Florida and
00:12:16.423 --> 00:12:18.563
she can pop up on a screen on the beach,
00:12:18.624 --> 00:12:20.525
like people would love that
00:12:20.546 --> 00:12:21.706
because it's the same person.
00:12:21.767 --> 00:12:23.628
She's just in her next phase,
00:12:23.668 --> 00:12:25.428
but she has been a bit
00:12:25.469 --> 00:12:26.830
around here for like years.
00:12:27.169 --> 00:12:29.091
Um, hopefully we can do that,
00:12:29.131 --> 00:12:32.033
but like we have people, um, and, uh,
00:12:32.072 --> 00:12:32.974
we have the same setup.
00:12:32.994 --> 00:12:34.195
We have chairs there, this and that,
00:12:34.215 --> 00:12:36.436
but my pet peeve is waiting
00:12:36.515 --> 00:12:37.817
at a doctor's office.
00:12:37.836 --> 00:12:40.759
So I try for us not to use those chairs.
00:12:40.778 --> 00:12:41.720
That's only for like
00:12:42.503 --> 00:12:44.365
people's aides or their
00:12:44.404 --> 00:12:45.586
family members that feel
00:12:45.625 --> 00:12:46.605
like they're like in the
00:12:46.645 --> 00:12:48.268
way or their drivers, right?
00:12:48.668 --> 00:12:50.450
Like when a person checks in,
00:12:50.730 --> 00:12:51.330
I don't want them to
00:12:51.350 --> 00:12:52.630
waiting in the chair unless
00:12:52.650 --> 00:12:53.993
they're like an hour early.
00:12:54.052 --> 00:12:55.052
And even then I'll try to
00:12:55.092 --> 00:12:57.034
like squeeze them in early if I can.
00:12:57.655 --> 00:12:59.417
Um, but, uh, but, uh,
00:12:59.437 --> 00:13:01.138
I want them to come right on it.
00:13:01.639 --> 00:13:02.139
Um,
00:13:02.639 --> 00:13:04.321
because that just helps the patient
00:13:04.421 --> 00:13:06.643
experience time is the like
00:13:06.923 --> 00:13:07.744
greatest asset.
00:13:08.486 --> 00:13:09.587
I don't want anyone waiting.
00:13:09.707 --> 00:13:10.508
I want them moving.
00:13:10.648 --> 00:13:11.729
I want them engaging.
00:13:11.889 --> 00:13:13.730
I want them to have that experience.
00:13:13.769 --> 00:13:15.171
I want them seeing their
00:13:15.211 --> 00:13:16.792
neighbors and I want that
00:13:16.851 --> 00:13:17.851
community feeling.
00:13:17.951 --> 00:13:19.633
I want us to be a busy
00:13:19.773 --> 00:13:22.975
Starbucks that people are just, you know,
00:13:23.075 --> 00:13:24.495
talking, engaging, moving,
00:13:24.535 --> 00:13:27.456
getting like their metabolism going.
00:13:27.777 --> 00:13:29.398
I want all of that and I
00:13:29.418 --> 00:13:30.599
want it to be fun.
00:13:30.839 --> 00:13:31.679
And so I,
00:13:32.480 --> 00:13:34.360
I ideally don't even want a waiting room,
00:13:34.900 --> 00:13:37.263
but I have to have one for everyone else.
00:13:37.342 --> 00:13:37.602
Right.
00:13:37.623 --> 00:13:37.783
Yeah.
00:13:38.711 --> 00:13:38.932
All right.
00:13:38.971 --> 00:13:39.972
You did something or you're
00:13:40.013 --> 00:13:41.374
doing something a little bit different.
00:13:41.413 --> 00:13:42.933
Let's talk about private practice network.
00:13:42.994 --> 00:13:44.615
Now this is an IPA,
00:13:44.634 --> 00:13:46.375
which talks to me because I
00:13:46.395 --> 00:13:47.197
do like craft beer.
00:13:47.216 --> 00:13:51.359
It's an E like, so help me understand what,
00:13:51.499 --> 00:13:52.259
what is it?
00:13:52.720 --> 00:13:53.860
Why'd you formulate it?
00:13:53.980 --> 00:13:55.322
What's it allowed you and
00:13:55.562 --> 00:13:56.182
seven to nine other
00:13:56.201 --> 00:13:57.822
practices to do in the state of New York?
00:13:57.863 --> 00:13:59.163
This is new and this is innovative.
00:13:59.183 --> 00:14:00.423
And I like talking about stuff like this.
00:14:00.485 --> 00:14:01.225
Yeah.
00:14:01.284 --> 00:14:04.346
So re re recently myself and, uh, I think,
00:14:04.626 --> 00:14:04.687
uh,
00:14:05.193 --> 00:14:07.557
eight to ten other private practice owner,
00:14:07.596 --> 00:14:09.359
we've created a steering
00:14:09.418 --> 00:14:10.580
committee for the first
00:14:10.659 --> 00:14:12.743
private practice network IPA.
00:14:13.563 --> 00:14:15.525
And IPA is an independent
00:14:15.586 --> 00:14:17.388
physician association or
00:14:18.109 --> 00:14:19.971
independent practice association.
00:14:20.946 --> 00:14:22.905
um and uh what it does it
00:14:23.125 --> 00:14:25.226
allows you to collaborate
00:14:25.326 --> 00:14:26.667
as a group for like
00:14:27.126 --> 00:14:29.427
contracting and billing and
00:14:29.488 --> 00:14:31.548
credentialing and operation
00:14:31.827 --> 00:14:33.207
but you still will have
00:14:33.288 --> 00:14:34.908
your own entity being your
00:14:35.109 --> 00:14:36.769
own private private
00:14:36.808 --> 00:14:38.168
practice historically this
00:14:38.208 --> 00:14:39.769
was done with your uh
00:14:39.828 --> 00:14:41.389
primary care physicians
00:14:41.409 --> 00:14:42.970
maybe a few specialists but
00:14:43.029 --> 00:14:44.230
it hasn't trickled down to
00:14:44.429 --> 00:14:46.331
us in the pt space a lot of
00:14:46.370 --> 00:14:48.431
it is just because like it's hard to
00:14:50.654 --> 00:14:52.695
So is it a way to group
00:14:52.735 --> 00:14:54.056
yourselves together without
00:14:54.096 --> 00:14:55.336
having to become a
00:14:55.397 --> 00:14:57.576
franchise or having to
00:14:57.658 --> 00:14:59.477
business-wise sign and join?
00:14:59.498 --> 00:15:00.418
So it's a way to sort of
00:15:01.058 --> 00:15:03.860
group together formally,
00:15:03.960 --> 00:15:07.782
but you're not now one business entity.
00:15:08.282 --> 00:15:08.481
Right.
00:15:08.741 --> 00:15:10.403
Everyone is a shareholder
00:15:10.783 --> 00:15:12.703
and they are all together
00:15:12.844 --> 00:15:13.724
in this one thing.
00:15:13.764 --> 00:15:15.085
So you have an equal say in
00:15:16.692 --> 00:15:18.114
in this group and doesn't
00:15:18.153 --> 00:15:19.274
matter if you have five
00:15:19.335 --> 00:15:20.876
offices or one office,
00:15:21.157 --> 00:15:23.639
but at least you can pull
00:15:23.678 --> 00:15:25.301
together your resources in
00:15:25.360 --> 00:15:27.942
order to get like maybe better EMR costs,
00:15:28.102 --> 00:15:30.524
maybe better software as a
00:15:30.566 --> 00:15:33.868
service costs for like these AI scribes,
00:15:34.568 --> 00:15:35.929
but also negotiate with
00:15:35.990 --> 00:15:37.731
payers and just show, hey,
00:15:37.831 --> 00:15:40.894
we're seeing this many visits per month
00:15:41.414 --> 00:15:42.215
All together,
00:15:42.355 --> 00:15:43.336
this is a lot of claimed
00:15:43.375 --> 00:15:45.135
volume over several zip codes.
00:15:45.395 --> 00:15:47.037
This is how many providers
00:15:47.096 --> 00:15:48.116
we have and all their
00:15:48.197 --> 00:15:49.876
specialties and demographics.
00:15:49.956 --> 00:15:51.758
And some of us do visits at
00:15:51.798 --> 00:15:52.658
the home and this and that.
00:15:52.697 --> 00:15:54.359
So it allows to provide more
00:15:54.558 --> 00:15:57.499
access more and to help
00:15:57.559 --> 00:16:00.059
more lives with different types of people,
00:16:00.080 --> 00:16:01.360
which we know New York has
00:16:01.380 --> 00:16:02.760
a lot of different types of people.
00:16:03.386 --> 00:16:03.466
Well,
00:16:03.486 --> 00:16:05.008
it's got to help you negotiate better too,
00:16:05.067 --> 00:16:05.249
right?
00:16:05.308 --> 00:16:06.809
And there's the strength in
00:16:06.870 --> 00:16:08.370
numbers in terms of paying attention.
00:16:08.530 --> 00:16:10.173
Now you get paid attention to,
00:16:11.274 --> 00:16:13.034
we hate to say it, but now you're,
00:16:13.455 --> 00:16:14.495
instead of being eight
00:16:14.576 --> 00:16:16.557
individual squeaky wheels, right?
00:16:16.577 --> 00:16:18.178
Which can be ignored sometimes.
00:16:18.259 --> 00:16:19.200
It's just how things are.
00:16:19.559 --> 00:16:21.422
You're one pretty large
00:16:21.461 --> 00:16:22.763
squeaky wheel if you're all
00:16:22.802 --> 00:16:24.024
squeaking in the same direction.
00:16:24.825 --> 00:16:25.365
You got it.
00:16:25.686 --> 00:16:26.046
And-
00:16:26.726 --> 00:16:28.008
the payers don't have enough
00:16:28.148 --> 00:16:30.509
resources in order to hit
00:16:30.609 --> 00:16:31.870
all those eighty different
00:16:31.950 --> 00:16:33.051
squeaky wheels.
00:16:33.071 --> 00:16:34.572
They want one really good,
00:16:34.672 --> 00:16:36.873
nice wheel that operates really well,
00:16:36.932 --> 00:16:38.894
like they will reward that
00:16:39.495 --> 00:16:41.076
entity that operates more
00:16:41.196 --> 00:16:44.118
efficiently and timely and compliantly.
00:16:44.298 --> 00:16:44.638
Right.
00:16:44.658 --> 00:16:46.759
So it's nicer to be one
00:16:46.798 --> 00:16:49.081
entity and they want to do
00:16:49.120 --> 00:16:50.620
that and they want to incentivize that.
00:16:50.660 --> 00:16:52.403
So they'll raise it up.
00:16:52.602 --> 00:16:52.863
Right.
00:16:52.883 --> 00:16:53.003
So
00:16:53.706 --> 00:16:55.368
An IPA is one way of doing that,
00:16:55.467 --> 00:16:56.389
but there's another way,
00:16:57.288 --> 00:16:59.091
and that's with an MSO,
00:16:59.110 --> 00:17:01.552
which is a managing service organization,
00:17:01.652 --> 00:17:01.851
right?
00:17:01.912 --> 00:17:04.193
So this is a service or an
00:17:04.253 --> 00:17:07.776
entity that will handle those needs.
00:17:07.796 --> 00:17:09.076
They might help you with
00:17:09.136 --> 00:17:10.357
administrative burden by
00:17:10.417 --> 00:17:12.078
like checking your eligibility,
00:17:12.239 --> 00:17:16.060
authorizations, billing compliance.
00:17:16.101 --> 00:17:17.261
So this is another thing,
00:17:17.301 --> 00:17:19.683
but you don't have a say there,
00:17:20.044 --> 00:17:21.904
but they operate
00:17:22.309 --> 00:17:23.570
very efficiently and they
00:17:23.590 --> 00:17:24.711
can help you and you pay
00:17:24.730 --> 00:17:27.152
them a percent or a fee
00:17:27.192 --> 00:17:28.833
like every year and they'll
00:17:28.853 --> 00:17:30.273
help you with the pair
00:17:30.993 --> 00:17:32.075
relationship piece where
00:17:32.115 --> 00:17:33.335
like they have a legal team
00:17:33.355 --> 00:17:34.096
that will like to look
00:17:34.115 --> 00:17:35.195
through the contracts and
00:17:35.256 --> 00:17:36.757
everything and be like we
00:17:36.797 --> 00:17:38.278
don't want this no prior
00:17:38.317 --> 00:17:40.098
authorizations right uh we
00:17:40.138 --> 00:17:42.319
need a higher fee um so all
00:17:42.380 --> 00:17:44.300
of that so um that's
00:17:44.500 --> 00:17:46.361
another vehicle to
00:17:46.642 --> 00:17:48.522
negotiate with uh payers
00:17:48.563 --> 00:17:49.883
that you can do as a small
00:17:50.462 --> 00:17:51.503
mom and pop because
00:17:52.098 --> 00:17:53.900
You have to because I tried
00:17:53.960 --> 00:17:55.760
for six months to get them on the phone.
00:17:56.260 --> 00:17:57.821
They didn't want to talk to me.
00:17:57.942 --> 00:17:59.202
The network was closed.
00:17:59.282 --> 00:18:02.765
I wasn't allowed to see those patients,
00:18:02.825 --> 00:18:05.165
but it was a lot easier to
00:18:05.205 --> 00:18:06.446
go through them.
00:18:06.567 --> 00:18:10.169
I got credentialed in thirty days.
00:18:10.209 --> 00:18:10.469
Got it.
00:18:11.980 --> 00:18:14.201
So this is available.
00:18:14.321 --> 00:18:16.083
This is a thing.
00:18:16.222 --> 00:18:18.605
So, I mean, you and I are, you know,
00:18:18.644 --> 00:18:19.505
we were on LinkedIn and
00:18:19.525 --> 00:18:20.506
you're in Facebook groups
00:18:20.526 --> 00:18:21.067
and you see people
00:18:21.106 --> 00:18:22.047
complaining about things.
00:18:22.067 --> 00:18:24.709
And listen, I love me some complaining,
00:18:25.490 --> 00:18:27.290
but you're actually being
00:18:27.330 --> 00:18:28.511
able to execute and say,
00:18:28.612 --> 00:18:29.673
what are the strengths if
00:18:30.153 --> 00:18:30.873
we pool together,
00:18:30.913 --> 00:18:32.595
if we come together and be able to say,
00:18:32.815 --> 00:18:34.455
now we can affect change.
00:18:34.516 --> 00:18:35.497
Right, right.
00:18:35.737 --> 00:18:37.198
I think the worst thing we
00:18:37.238 --> 00:18:38.578
can do is try to compete.
00:18:38.699 --> 00:18:39.660
Like this time...
00:18:40.615 --> 00:18:40.815
Right.
00:18:40.935 --> 00:18:42.237
Like that's not good for our
00:18:42.317 --> 00:18:43.518
profession as a whole.
00:18:43.919 --> 00:18:45.039
And we have a shortage.
00:18:45.099 --> 00:18:46.382
Like we know there's a
00:18:46.442 --> 00:18:48.904
shortage of pro providers.
00:18:48.924 --> 00:18:49.905
Like this is our time to
00:18:49.986 --> 00:18:53.490
strike because we have supply demand,
00:18:53.670 --> 00:18:53.849
right?
00:18:54.109 --> 00:18:55.392
We're all super busy.
00:18:55.882 --> 00:18:58.104
We're just, our X isn't high enough.
00:18:58.183 --> 00:18:59.385
What we're getting paid per
00:18:59.465 --> 00:19:01.488
visit is not enough to keep
00:19:01.587 --> 00:19:02.288
our lights on.
00:19:02.729 --> 00:19:04.269
And that's not good for
00:19:04.349 --> 00:19:05.351
business because if there's
00:19:05.412 --> 00:19:07.834
only one option, it's never a good thing.
00:19:07.894 --> 00:19:09.154
You need a competitive
00:19:09.214 --> 00:19:11.458
landscape to innovate, to push.
00:19:11.758 --> 00:19:14.740
And I'd rather us compete on our people,
00:19:14.861 --> 00:19:15.761
like the, like,
00:19:16.142 --> 00:19:17.462
having the best specialists
00:19:17.482 --> 00:19:19.384
in the clinic that we pour
00:19:19.464 --> 00:19:20.685
resources into and we have
00:19:20.705 --> 00:19:22.166
a good culture with and how
00:19:22.207 --> 00:19:24.088
we operate as businesses.
00:19:24.108 --> 00:19:24.288
Like,
00:19:24.689 --> 00:19:26.651
do you get people in within twenty
00:19:26.691 --> 00:19:27.951
four to forty forty eight hours?
00:19:28.031 --> 00:19:28.992
Do you communicate?
00:19:29.012 --> 00:19:29.252
Well,
00:19:29.573 --> 00:19:31.153
I would rather us compete on that
00:19:31.474 --> 00:19:32.454
rather than try to just
00:19:32.494 --> 00:19:33.817
compete to have the most business,
00:19:33.836 --> 00:19:34.096
because
00:19:34.537 --> 00:19:35.857
there's not enough physical
00:19:35.917 --> 00:19:37.458
therapists and we know this
00:19:37.657 --> 00:19:39.019
and what I'm trying to do
00:19:39.459 --> 00:19:41.180
is we need legislation and
00:19:41.559 --> 00:19:43.059
policy that says hey you
00:19:43.160 --> 00:19:44.520
need a certain amount of
00:19:44.560 --> 00:19:46.561
pts this for ten thousand
00:19:46.602 --> 00:19:48.001
lives or a hundred thousand
00:19:48.041 --> 00:19:50.343
lives because that exists
00:19:50.363 --> 00:19:52.084
for primary care exists for
00:19:52.104 --> 00:19:53.644
you your dentist but it
00:19:53.664 --> 00:19:55.244
doesn't exist for us and
00:19:55.285 --> 00:19:56.665
that's a problem because
00:19:56.726 --> 00:19:58.266
there has to be some sort
00:19:58.346 --> 00:19:59.567
of what is enough
00:19:59.982 --> 00:20:00.903
and what is too much,
00:20:01.363 --> 00:20:04.644
and we have to be able to regulate that.
00:20:04.663 --> 00:20:05.304
Kudos to you.
00:20:05.484 --> 00:20:07.065
Eighty organizations,
00:20:07.505 --> 00:20:08.765
we said this before I hit record,
00:20:08.825 --> 00:20:09.806
like getting eight people
00:20:09.846 --> 00:20:11.885
to agree on something is not easy.
00:20:12.246 --> 00:20:14.067
Never mind eighty business owners,
00:20:14.086 --> 00:20:15.586
who this is their livelihood, who say,
00:20:15.946 --> 00:20:16.207
okay,
00:20:16.326 --> 00:20:18.508
I'll invest time and money and
00:20:18.548 --> 00:20:19.448
resources into coming
00:20:19.468 --> 00:20:20.328
together and doing this.
00:20:20.769 --> 00:20:21.449
That's not easy.
00:20:21.528 --> 00:20:23.028
So kudos for you and the
00:20:23.608 --> 00:20:24.410
rest of the board on that
00:20:24.450 --> 00:20:25.710
organization for going
00:20:25.730 --> 00:20:27.911
ahead and organizing.
00:20:27.951 --> 00:20:28.631
Yeah, we have...
00:20:29.901 --> 00:20:31.501
eight to ten people on the
00:20:31.541 --> 00:20:33.964
board that have been
00:20:34.025 --> 00:20:35.165
private practice owners for
00:20:36.226 --> 00:20:37.448
way longer than me.
00:20:37.607 --> 00:20:39.930
I'm learning so much from all of them,
00:20:40.329 --> 00:20:43.512
but we have eighty types of
00:20:43.593 --> 00:20:44.894
practices across New York
00:20:44.993 --> 00:20:47.615
State that have pledged to even join.
00:20:47.635 --> 00:20:49.278
That's great.
00:20:49.337 --> 00:20:50.479
Biggest lesson in putting
00:20:50.499 --> 00:20:51.559
something like that together?
00:20:51.640 --> 00:20:52.259
Biggest thing that you've
00:20:52.279 --> 00:20:53.862
taken away or learned that
00:20:53.882 --> 00:20:55.303
wasn't expected when you went in?
00:21:00.473 --> 00:21:03.777
Make sure there's one mission, one voice.
00:21:04.538 --> 00:21:09.541
And having someone with
00:21:09.622 --> 00:21:12.565
legal background is so crucial.
00:21:12.625 --> 00:21:16.048
It's so crucial to simplify things, right?
00:21:18.292 --> 00:21:18.853
Yeah, it's funny.
00:21:18.993 --> 00:21:20.934
We look at these things and
00:21:20.954 --> 00:21:22.376
they say they shouldn't be that hard,
00:21:22.416 --> 00:21:23.897
but there's some things
00:21:23.917 --> 00:21:25.118
that you just can't go around.
00:21:25.598 --> 00:21:26.640
Legal is typically one of
00:21:26.660 --> 00:21:27.882
those things where it's like, well,
00:21:28.122 --> 00:21:29.383
and it's also one of those things,
00:21:29.423 --> 00:21:29.962
it's a landmine,
00:21:29.982 --> 00:21:31.124
you step on it or it could
00:21:31.144 --> 00:21:31.825
really sting you.
00:21:32.164 --> 00:21:33.066
You want to make sure you
00:21:33.086 --> 00:21:33.886
don't get stung there.
00:21:34.607 --> 00:21:36.088
Last thing we do on these short episodes,
00:21:36.368 --> 00:21:37.049
parting shot.
00:21:37.509 --> 00:21:38.310
What's something you'd want
00:21:38.330 --> 00:21:39.432
to leave with the audience?
00:21:40.192 --> 00:21:42.434
A mic drop moment, a soapbox statement,
00:21:42.454 --> 00:21:43.154
something you want to leave
00:21:43.174 --> 00:21:43.675
as we wrap up.
00:21:44.473 --> 00:21:48.257
Yeah, so especially in twenty twenty four,
00:21:48.517 --> 00:21:50.479
I think all of us as
00:21:50.558 --> 00:21:51.940
physical therapists need to
00:21:51.960 --> 00:21:54.461
be more involved with with policy.
00:21:55.281 --> 00:21:57.183
We have to collaborate more,
00:21:57.423 --> 00:21:58.964
especially with our peers
00:21:59.184 --> 00:22:01.426
in in government,
00:22:01.928 --> 00:22:03.588
our peers in private practice.
00:22:04.133 --> 00:22:04.973
in hospitals,
00:22:05.013 --> 00:22:07.256
like our biggest enemy is ourselves.
00:22:07.635 --> 00:22:09.038
If we can all pull our
00:22:09.077 --> 00:22:10.839
resources and time together,
00:22:10.880 --> 00:22:13.642
whether it's five minutes or one hour, um,
00:22:13.863 --> 00:22:15.564
every month where we can
00:22:15.683 --> 00:22:17.385
actually just write to a
00:22:17.526 --> 00:22:19.528
rep or a representative or
00:22:19.587 --> 00:22:21.450
get them to visit us in the
00:22:21.470 --> 00:22:22.691
clinic or get them to be a
00:22:22.750 --> 00:22:23.791
patient of ours, right.
00:22:24.112 --> 00:22:25.874
To demonstrate our value and
00:22:26.654 --> 00:22:27.655
our biggest barriers.
00:22:28.240 --> 00:22:30.020
That's all it takes to get
00:22:30.060 --> 00:22:32.643
that ball rolling in the right direction.
00:22:32.863 --> 00:22:34.364
And we're starting to see
00:22:34.384 --> 00:22:35.924
that in the past three years.
00:22:35.944 --> 00:22:36.605
There's been Health
00:22:36.984 --> 00:22:38.665
Transparency Act where we
00:22:38.707 --> 00:22:40.186
know what everyone's getting paid.
00:22:41.607 --> 00:22:44.210
We're seeing better access points,
00:22:44.269 --> 00:22:45.631
less administrative burden.
00:22:45.951 --> 00:22:47.011
You go APTA.
00:22:47.031 --> 00:22:48.692
You've been crushing it for three years.
00:22:49.053 --> 00:22:50.614
Let's try to get that
00:22:51.114 --> 00:22:52.494
economic shift where the
00:22:52.515 --> 00:22:53.316
fee schedule is going the
00:22:53.455 --> 00:22:54.615
opposite direction.
00:22:54.675 --> 00:22:55.297
And I'm seeing...
00:22:56.017 --> 00:22:57.998
Potentially, it might go up this year,
00:22:58.038 --> 00:22:59.519
but it's requiring all of
00:22:59.598 --> 00:23:02.080
us to get involved politically,
00:23:02.500 --> 00:23:03.801
just send letters out.
00:23:04.162 --> 00:23:08.464
And if we have enough, if, you know,
00:23:08.505 --> 00:23:11.606
twenty therapists in every zip code,
00:23:12.307 --> 00:23:16.029
you know, just messages it, that's huge.
00:23:16.170 --> 00:23:16.309
Yeah.
00:23:16.903 --> 00:23:17.304
Understood.
00:23:18.023 --> 00:23:18.865
Make your voice heard.
00:23:19.205 --> 00:23:20.326
That's how decisions are made.
00:23:21.127 --> 00:23:21.307
Dan,
00:23:21.327 --> 00:23:22.430
appreciate you doing this for the
00:23:22.450 --> 00:23:22.910
profession.
00:23:23.069 --> 00:23:23.891
Maybe it'll catch on.
00:23:24.010 --> 00:23:24.592
Maybe other people will
00:23:24.632 --> 00:23:25.373
start paying attention to
00:23:25.393 --> 00:23:26.094
these different ways that
00:23:26.114 --> 00:23:28.016
we can connect and make
00:23:28.036 --> 00:23:28.916
your collective voice heard.
00:23:29.196 --> 00:23:30.097
Appreciate you coming on the
00:23:30.118 --> 00:23:30.838
show and doing this for us.
00:23:30.858 --> 00:23:32.221
You got it, man.