Understand What Game You’re Playing: Barnes & Noble, AI and the Future of PT

WEBVTT

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Broadcasting way too early from three

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separate Wi-Fi connections.

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It's PT Breakfast Club with Tony Meritato,

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Dave Kittle, and Jimmy McKay.

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Good Tuesday morning to you.

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It feels like a Monday.

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Does it feel like a Monday to you?

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It's a Tuesday.

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Every day feels like a weird day.

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I don't even keep track anymore.

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Tony Meritato, I'm Jimmy McKay.

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Dave Kittle's coming in hot at some point.

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I was on the road.

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I was at the Breakthrough Market.

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Chad Madden.

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Chad Madden's event.

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They did, they call it Titans Live.

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Again, why were none of, neither,

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none of us,

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none of the three of us,

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that doesn't sound grammatically correct.

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How did we not have a seat at

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that table?

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I do not understand.

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They put a hundred and one people in

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the book.

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I filled out the thing.

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We were a hundred and two.

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I filled out the thing and was like,

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okay,

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they asked me to fill out a thing.

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I guess I'm in the book.

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I opened the book.

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Uh,

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Didn't make cutting room floor,

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Tony cutting the floor.

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That's all right.

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We can take it.

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It's all right.

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Yeah.

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So I mean, like, good idea, right?

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Good premise.

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Have you are you a big reader?

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I don't know if this has ever come

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up before.

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You read some stuff, right?

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I mean, I read every day.

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I haven't read a book in a long

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time, but ironically,

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I'm reading less books,

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but

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And I've got two of them.

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Tim Ferriss did Tools of Titans and Tribe

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of Mentors.

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Best way to write a book, guys,

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here's how you do it.

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You get a Google sheet.

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You pick thirteen or fourteen questions.

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You send those questions to a hundred

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people.

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They answer them.

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You publish the results,

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put your name on the cover,

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and you wrote a book.

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Tim Ferriss did it twice.

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Landed himself on the bestseller list.

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That's what this was.

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And it was a brick, man.

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It's a brick.

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It's a Bible.

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How have you not done that for physical

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therapy?

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So five years ago, six years ago,

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and I've got people that worked with me,

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Bridget and Juliet, I saw that and went,

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let's do it.

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And you know me,

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I'm onto the next thing.

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And now you're not writing a book,

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now you're herding cats.

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Now you're like, can you fill this out?

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Or that, you know,

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that answer's too short.

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So I went to do that idea.

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And then by the time I ran into

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like all the parts about that idea that

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I don't like, I went, this idea, whatever,

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I'm onto the next thing.

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I wonder the new format would be,

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you have the questions, Dave's here,

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you have the questions,

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you give them a number,

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they call and answer the questions by

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voice, transcribe AI,

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turn it into the Kindle version.

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would have no problem doing doing the work

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be like okay we're going to do an

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episode and your responses are going to be

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the book yeah and then you get a

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video out of it you get the audio

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out of it you get the transcription of

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it so maybe we do a hundred and

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two people tony maybe we do a hundred

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and three people because have you heard

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about six minute abs

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And that joke will land with some people.

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Go Google.

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I get it.

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I remember.

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Eight-minute abs, seven-minute abs,

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six-minute abs.

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Yeah, I mean,

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there was a lot of people that you

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know from LinkedIn at this event.

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It was in Nashville.

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I got to be honest,

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by the time I traveled there and traveled

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back, everybody's like,

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you're going to Nashville.

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I was in bed by ten o'clock.

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I was like, I'm done, man.

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Because when you're standing there talking

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to people all day, you're exhausted.

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so but good to see a lot of

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faces that i've people have some people

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i've never even met before but i feel

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like i've interacted with for years uh on

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linkedin and whatnot but i don't know man

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i think events i'm i'm into events like

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that but i know not everybody is

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All right,

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so a lot going on in the group

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chat while I was gone too.

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There was a lot of stuff.

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Where do we want to start?

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If anything,

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if you shared something and you want to

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get into it,

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there's a lot of funny things that were

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floating around in our group chat for

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this.

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Dave,

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why don't you kick it off since you

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just jumped in?

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What was funny?

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What do you call that?

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There was a video, hot yoga.

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That was the one that made me go,

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what the hell?

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I was like reading it on my phone.

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I was like, what is this?

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That was the hot yoga.

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All right,

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so I shared that with these guys just

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because, you know,

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there are definitely people who were made,

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what is it, a voice?

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Face for radio, voice for newspaper.

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So this woman, I mean,

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I don't know if you guys see this.

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I'm one of those sickos.

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I get all these, like,

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Kensington Street live videos of junkies

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on the side of the road.

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I don't know what your algorithm is

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saying.

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I don't know what your algorithm is

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saying.

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Okay, fast forward.

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This woman is like promoting.

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I think it's real promoting her yoga

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studio,

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hot body yoga or hot something yoga.

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And I mean, the woman is scary.

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The woman is full on scary.

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And I'm like,

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you're not the person to be promoting this

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if it's a real yoga studio and you

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want real customers to come to this yoga

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studio.

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Was it a gag?

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Like,

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I watched it and it was over the

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top.

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It reminded me of Wanda from In Living

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Color when Jamie Foxx would do Wanda.

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And he would do like this and it

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was over the top, right?

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That was a lifetime ago.

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That is not something that you would

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create today.

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I guarantee there isn't anyone on popular

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media that would create that character

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today and not get canceled,

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not get run out of the city, whatever.

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So anyway, I go back to.

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Even if you feel like, like for me,

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still hate my voice,

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can't stand watching my own videos,

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still feel self-conscious.

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We talked about this the other day.

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it's a great it's a great voice and

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everyone knows it but when i saw that

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video i had to share it with you

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guys because i was like all right maybe

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she's not the best one to be on

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video i don't i can't find my link

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right now just because my computer's being

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weird but like what were the what was

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the attention on there what were the are

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they doing it to gain attention are they

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doing it to be an outlier so weird

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that people like us go check this check

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this crazy lady out like now we have

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to stack weird on top of anything else

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to get any attention

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it might be like there are tons of

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accounts on tick tock that i think are

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just you know rage bait accounts they're

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they're not real accounts they're saying

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things to just inflame the viewer so the

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viewer keeps watching right i fall for it

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a ton um and i think you know

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they make plenty of money with it they

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monetize it whether it's ai or a real

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person i can't even tell that anymore like

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the technology has gotten so good

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but let's let's briefly talk about

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something else that i share that i think

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is a better topic i i saw the

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article from barnes and noble this is an

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interesting evolution and i want to hear

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what you guys think about it so before

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amazon you know you wanted a book

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you go to the bookstore you browse the

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shelves there were times where you go to

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the library imagine that going so there

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were times where i remember like going to

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barnes noble i was always that person who

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would fall asleep in the comfy chair like

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think that i was going to read a

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book or something rarely bought anything

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but you know it was the experience but

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there was no other choice if you needed

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a book

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then amazon comes along they get every

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book title ever you know imaginable it's

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available now we're at the point where i

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can get a book in two hours barnes

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noble languished for like a decade i

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didn't realize i did tell you guys i

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don't know if you remember the only reason

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why barnes noble stayed in business where

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books a million went out of business

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walden books went out of business all of

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these other bookstores borders went out of

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business

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Barnes & Noble stuck around because of the

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real estate.

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They owned most of the real estate.

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And as real estate appreciated and

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interest rates were so low,

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they were able to manage their balance

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sheet.

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Now,

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Barnes & Noble is back on the scene.

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They've reemerged.

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They've opened more new bookstores.

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I think it was in the year of

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twenty twenty four than they did in the

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entire decade of two thousand nine to two

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thousand nineteen.

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They are booming now.

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They're different bookstores.

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They're smaller bookstores,

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smaller footprint.

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It's not the superstore that it used to

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be the new CEO.

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is trying to bring books local.

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So if my Barnes & Noble here in

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Cincinnati is going to have a different

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selection than where Jimmy is or where

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Dave is,

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And when you look at that evolution,

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you know, Amazon started selling books.

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Now,

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books is probably one of the smallest

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money makers that Amazon has,

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like their their ad business,

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their server business, like storage,

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all that.

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There's so many other ways that Amazon

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makes money today than they did when they

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started.

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Barnes & Noble is a completely different

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business.

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If I want Catcher in the Rye,

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I go to Amazon.

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If I wanna find a new book to

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read, I go to Barnes & Noble.

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So the question is,

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how do we bring that evolution into PT?

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I've been surviving like Barnes & Noble,

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not because the PT business is so great,

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but I had real estate,

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I have social media,

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I have other ways to make money.

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I think a lot of practices have been

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in that boat.

00:09:36.397 --> 00:09:38.938
Now, do they follow Dave's lead?

00:09:39.379 --> 00:09:40.940
Do they go all self-pay?

00:09:40.980 --> 00:09:43.020
Do they go high-end concierge?

00:09:43.081 --> 00:09:47.625
Do they sell the experience like Barnes &

00:09:45.942 --> 00:09:48.845
Noble now is selling the experience of

00:09:48.985 --> 00:09:50.024
being a bookstore?

00:09:51.505 --> 00:09:53.307
Or do they just continue to languish and

00:09:53.366 --> 00:09:55.548
continue to battle for pennies on the

00:09:55.589 --> 00:09:55.889
dollar?

00:09:57.452 --> 00:09:58.913
I have to comment locally because I did

00:09:58.953 --> 00:10:01.436
send you guys something brick and mortar

00:10:01.716 --> 00:10:03.636
that's near me that closed down,

00:10:03.716 --> 00:10:05.918
which is unrelated to the bookstore.

00:10:05.937 --> 00:10:08.080
But it was a this place called Soul

00:10:08.120 --> 00:10:08.519
Detox.

00:10:08.539 --> 00:10:10.780
They did like cupping and massage and

00:10:11.501 --> 00:10:13.123
stretch and whatever.

00:10:13.383 --> 00:10:15.203
And long story short, it's closed down.

00:10:15.464 --> 00:10:17.125
It used to be around and now it's

00:10:17.164 --> 00:10:17.625
not anymore.

00:10:18.493 --> 00:10:22.056
Whereas the bookmark shop bookstore in my

00:10:22.096 --> 00:10:23.998
neighborhood has been there forever.

00:10:24.317 --> 00:10:26.759
They have authors come and do readings and

00:10:27.159 --> 00:10:27.760
kids books.

00:10:29.741 --> 00:10:31.504
There's always a section of any market,

00:10:31.543 --> 00:10:31.783
I think,

00:10:31.823 --> 00:10:34.145
that will always thrive no matter what.

00:10:34.166 --> 00:10:34.725
I mean,

00:10:35.006 --> 00:10:36.107
my son's two and a half years old.

00:10:36.148 --> 00:10:38.730
We have like two hundred books.

00:10:39.429 --> 00:10:41.451
And any time that any other family has

00:10:41.471 --> 00:10:42.472
a kid moving forward,

00:10:42.793 --> 00:10:43.894
a child moving forward,

00:10:44.494 --> 00:10:47.616
they will always mostly buy books.

00:10:47.756 --> 00:10:50.378
physical books so all the bookstores will

00:10:50.437 --> 00:10:52.359
never be obliterated there will always be

00:10:52.399 --> 00:10:56.480
paperback books um but in terms of in

00:10:56.520 --> 00:10:57.841
terms of going up market down market

00:10:57.860 --> 00:10:59.981
that's obviously another conversation i'm

00:11:00.022 --> 00:11:01.802
curious for you what are some of the

00:11:01.842 --> 00:11:04.823
book or book titles that you read you've

00:11:04.844 --> 00:11:06.725
probably read a hundred times to your son

00:11:08.825 --> 00:11:11.149
Well, there's three that Sturdy McKee,

00:11:11.250 --> 00:11:12.673
my partner business coach,

00:11:12.732 --> 00:11:14.977
told me to get that actually help manage

00:11:15.038 --> 00:11:16.341
people, manage employees,

00:11:16.380 --> 00:11:17.523
but they're actually kids' books.

00:11:18.605 --> 00:11:21.687
Like who, not who moved my cheese.

00:11:22.129 --> 00:11:23.089
If you give a mouse a cookie,

00:11:23.349 --> 00:11:25.551
there's like the little red hen.

00:11:26.071 --> 00:11:27.631
If you give a mouse a cookie and

00:11:27.652 --> 00:11:28.472
there's like a third one.

00:11:28.893 --> 00:11:30.975
And Sturdy used to give these books to

00:11:31.034 --> 00:11:33.056
his therapist when they came to him and

00:11:33.076 --> 00:11:34.417
said, hey, I want to make more money.

00:11:34.657 --> 00:11:35.677
I want to be a manager.

00:11:35.717 --> 00:11:36.638
I want to be a clinic director.

00:11:36.958 --> 00:11:39.379
And he would give them three kids books.

00:11:39.659 --> 00:11:42.062
He would have dozens on hand and he

00:11:42.081 --> 00:11:43.043
would give these.

00:11:43.062 --> 00:11:44.663
So those are a few books.

00:11:45.323 --> 00:11:46.205
My son, I mean,

00:11:46.304 --> 00:11:47.905
he's reading anything about Dora.

00:11:48.446 --> 00:11:51.027
or Sesame Street.

00:11:51.447 --> 00:11:53.106
But those are some of the titles that,

00:11:53.386 --> 00:11:53.567
you know,

00:11:53.626 --> 00:11:55.086
pop into the top of my head.

00:11:55.147 --> 00:11:55.287
Yeah.

00:11:55.307 --> 00:11:56.368
Some of the things that make me what

00:11:56.388 --> 00:11:56.888
you're talking about,

00:11:56.908 --> 00:11:58.768
Barnes and Noble is I mean,

00:11:58.788 --> 00:11:59.768
if there was going to be a theme

00:11:59.788 --> 00:12:01.489
among all these live streams that I

00:12:01.589 --> 00:12:03.328
typically feel like I say because I like

00:12:03.369 --> 00:12:04.788
to look at this is like understand what

00:12:04.808 --> 00:12:05.429
game you're playing.

00:12:06.029 --> 00:12:07.409
So like Barnes and Noble,

00:12:07.429 --> 00:12:08.730
was it going to out book or out

00:12:08.789 --> 00:12:09.230
selection?

00:12:09.289 --> 00:12:10.630
Amazon wasn't going to be able to do

00:12:10.671 --> 00:12:12.171
that as hard as it would try.

00:12:12.230 --> 00:12:12.471
Right.

00:12:13.030 --> 00:12:14.811
So it under it now is understanding that

00:12:15.692 --> 00:12:16.552
I would love to see their

00:12:17.412 --> 00:12:18.472
Balance sheet.

00:12:18.592 --> 00:12:20.313
Are they public?

00:12:20.374 --> 00:12:21.215
Can we see them?

00:12:21.715 --> 00:12:23.836
I would love to see puzzles and games

00:12:23.876 --> 00:12:24.758
and calendars.

00:12:25.559 --> 00:12:26.600
Like what percentage?

00:12:28.482 --> 00:12:29.744
That's where they can out experience

00:12:29.823 --> 00:12:30.163
Amazon,

00:12:30.203 --> 00:12:33.086
which is the tactile touch in person with

00:12:33.106 --> 00:12:34.727
the cafe, with the smell of coffee,

00:12:34.748 --> 00:12:37.429
grab a book.

00:12:37.570 --> 00:12:39.131
There's a Starbucks in every one.

00:12:39.192 --> 00:12:39.751
So like, all right,

00:12:39.812 --> 00:12:41.134
what doesn't Amazon have?

00:12:41.173 --> 00:12:45.517
It's like people, experience, vibe, right?

00:12:45.817 --> 00:12:47.778
I'm actually, you know, I mean,

00:12:47.818 --> 00:12:49.000
if you work in New York,

00:12:49.019 --> 00:12:49.921
you live in New York and you go

00:12:49.941 --> 00:12:50.662
to a coffee shop,

00:12:52.072 --> 00:12:53.254
Twenty percent of the people are there to

00:12:53.274 --> 00:12:54.634
buy a coffee and leave.

00:12:54.695 --> 00:12:55.696
And the other eighty percent are there

00:12:55.716 --> 00:12:57.256
with a laptop looking for an outlet to

00:12:57.317 --> 00:12:57.756
hang out.

00:12:57.797 --> 00:12:58.618
But as long I mean,

00:12:58.677 --> 00:13:00.418
my first my I was just taught, like,

00:13:00.620 --> 00:13:01.519
go buy a coffee.

00:13:02.421 --> 00:13:03.422
And if you're there for more than an

00:13:03.461 --> 00:13:03.741
hour,

00:13:03.861 --> 00:13:05.423
you buy another thing because you're

00:13:05.503 --> 00:13:06.423
sucking off the Wi-Fi,

00:13:06.443 --> 00:13:08.044
but you're there for other things.

00:13:08.085 --> 00:13:09.125
And I feel like Barnes and Noble

00:13:10.326 --> 00:13:12.408
understands that in terms of local

00:13:12.448 --> 00:13:12.969
bookshops.

00:13:13.009 --> 00:13:13.269
Dave,

00:13:13.288 --> 00:13:16.110
you made me think authors and local

00:13:16.150 --> 00:13:17.451
bookshops were the.

00:13:18.552 --> 00:13:21.293
original micro influencers with micro

00:13:21.333 --> 00:13:23.894
niches like I saw this great like like

00:13:23.934 --> 00:13:27.096
Twitter thread or threads thread who said

00:13:27.157 --> 00:13:28.697
like you know I did a book signing

00:13:29.157 --> 00:13:31.457
and you know thirty eight people showed up

00:13:31.518 --> 00:13:33.119
and they're like yeah but those thirty

00:13:33.158 --> 00:13:35.879
eight people are like raving fans and

00:13:35.899 --> 00:13:37.760
they're just in person like they came in

00:13:37.821 --> 00:13:39.481
person and they're going to tell five

00:13:39.522 --> 00:13:41.503
people each and is that a way to

00:13:41.543 --> 00:13:41.842
do it

00:13:42.623 --> 00:13:44.043
Yeah, I've used this term before.

00:13:44.083 --> 00:13:45.624
I think we've over we've been over

00:13:45.683 --> 00:13:46.625
Kardashian,

00:13:46.845 --> 00:13:48.385
even though I think Kardashians are out of

00:13:48.405 --> 00:13:49.206
the zeitgeist.

00:13:49.225 --> 00:13:50.067
I haven't seen them in a while,

00:13:50.386 --> 00:13:51.767
but like we got a little jaded on

00:13:51.787 --> 00:13:54.268
like a million this and a million shares

00:13:54.288 --> 00:13:56.249
and a million likes where it's like, well,

00:13:56.288 --> 00:13:57.190
it's just thirty eight.

00:13:57.210 --> 00:13:57.850
I'm like, my man,

00:13:57.909 --> 00:14:00.150
thirty eight people doing something in

00:14:00.211 --> 00:14:02.572
person at the same time in the same

00:14:02.611 --> 00:14:03.692
place in a random town.

00:14:04.253 --> 00:14:05.996
It's kind of a big deal,

00:14:06.116 --> 00:14:08.461
especially when you understand your total

00:14:08.481 --> 00:14:09.945
addressable market and who's ever gonna

00:14:09.965 --> 00:14:10.505
buy your book.

00:14:10.966 --> 00:14:12.811
So I think Barnes & Noble understood what

00:14:12.850 --> 00:14:14.354
game they were playing and they're playing

00:14:14.413 --> 00:14:14.474
it.

00:14:15.575 --> 00:14:17.355
Well, I think they changed the game.

00:14:17.956 --> 00:14:18.817
They've adapted.

00:14:18.876 --> 00:14:20.077
Now, the question is,

00:14:20.118 --> 00:14:21.398
so like in Davestown,

00:14:21.437 --> 00:14:22.538
that little bookstore.

00:14:23.139 --> 00:14:23.418
Yeah,

00:14:23.479 --> 00:14:25.681
like Amazon can't bring in an author to

00:14:25.760 --> 00:14:28.501
sit down across the aisle from you.

00:14:28.562 --> 00:14:28.902
You know,

00:14:29.403 --> 00:14:31.984
Amazon or Barnes & Noble used to bring

00:14:32.024 --> 00:14:33.904
in authors to do book signings and things

00:14:33.945 --> 00:14:34.445
like that.

00:14:34.505 --> 00:14:35.466
You'd go meet them.

00:14:35.946 --> 00:14:38.248
But the question is, just like us.

00:14:39.148 --> 00:14:40.489
How scalable is it?

00:14:40.629 --> 00:14:41.869
Maybe it doesn't need to be.

00:14:42.428 --> 00:14:44.929
How is that local bookstore still making

00:14:44.990 --> 00:14:45.309
money?

00:14:45.769 --> 00:14:47.311
How am I still making money?

00:14:47.350 --> 00:14:51.552
Twenty five years into business because I

00:14:51.592 --> 00:14:52.493
had the real estate.

00:14:53.192 --> 00:14:54.813
I have equipment that I'm not having to

00:14:54.854 --> 00:14:55.514
buy again.

00:14:55.573 --> 00:14:56.955
I'm not buying new equipment.

00:14:57.014 --> 00:14:58.875
I haven't bought new equipment in twenty

00:14:58.894 --> 00:14:59.235
years.

00:14:59.775 --> 00:15:02.096
You know, like is that bookstore?

00:15:02.115 --> 00:15:04.557
And I'm genuinely asking Dave based on,

00:15:04.677 --> 00:15:05.798
you know, your best guess.

00:15:06.778 --> 00:15:08.879
How is that bookstore affording to say in

00:15:08.899 --> 00:15:09.380
business?

00:15:09.780 --> 00:15:11.221
Or is it just because the owners are

00:15:11.241 --> 00:15:11.903
like, you know what?

00:15:12.283 --> 00:15:13.104
I've got enough.

00:15:13.323 --> 00:15:14.125
I don't need more.

00:15:14.225 --> 00:15:15.265
I love what I'm doing.

00:15:15.706 --> 00:15:19.450
I'm willing to sacrifice and lose because

00:15:19.509 --> 00:15:20.551
I would be sitting at home.

00:15:20.610 --> 00:15:21.491
So I'm just going to sit in my

00:15:21.511 --> 00:15:21.932
bookstore.

00:15:22.884 --> 00:15:24.865
Like, what do you think?

00:15:24.946 --> 00:15:26.327
There's no way for me to know.

00:15:26.408 --> 00:15:28.470
But this this bookmark shop that's near me

00:15:28.629 --> 00:15:30.251
has been there for, I would say,

00:15:30.292 --> 00:15:31.854
at least ten or more years.

00:15:32.214 --> 00:15:33.576
I've been I've been coming to this

00:15:33.615 --> 00:15:34.897
neighborhood in Bay Ridge since two

00:15:34.937 --> 00:15:36.359
thousand summer, two thousand nine.

00:15:36.818 --> 00:15:39.182
So fifteen, twenty years, the book,

00:15:39.221 --> 00:15:40.363
the bookstore has been there.

00:15:41.215 --> 00:15:43.577
it's covered from floor to ceiling with

00:15:43.618 --> 00:15:46.841
books and tables for other books or

00:15:47.542 --> 00:15:48.182
child's toys,

00:15:48.222 --> 00:15:50.804
which I think probably have pretty good

00:15:50.845 --> 00:15:51.785
margins, some of the stuff.

00:15:51.865 --> 00:15:53.087
And when we, by the way,

00:15:53.307 --> 00:15:55.110
this is timely because when we just went

00:15:55.350 --> 00:15:57.932
to this bookshop two weekends ago,

00:15:58.312 --> 00:15:59.234
there was a local author

00:15:59.955 --> 00:16:02.515
who read one of his books and did

00:16:02.556 --> 00:16:04.177
some drawing,

00:16:04.376 --> 00:16:06.496
coloring on an easel with some of the

00:16:06.517 --> 00:16:08.437
kids that were there watching and allowed

00:16:08.477 --> 00:16:10.879
the kids to engage and participate.

00:16:10.899 --> 00:16:13.059
So that allows the parents to take the

00:16:13.080 --> 00:16:15.259
kids to somewhere, like a play date,

00:16:15.279 --> 00:16:15.760
basically.

00:16:16.860 --> 00:16:18.221
We can kind of turn our brains off.

00:16:19.522 --> 00:16:21.042
The kid gets to interact with the author.

00:16:21.562 --> 00:16:23.082
Then the author, obviously,

00:16:23.123 --> 00:16:25.024
we feel compelled to buy the guy's book.

00:16:26.365 --> 00:16:27.186
Twenty dollars.

00:16:27.586 --> 00:16:27.765
I mean,

00:16:27.785 --> 00:16:29.767
it's a great book and it's designed well

00:16:29.927 --> 00:16:30.488
and all that.

00:16:30.508 --> 00:16:32.068
But it's like a twenty dollar.

00:16:32.708 --> 00:16:32.989
By the way,

00:16:33.009 --> 00:16:34.090
it's CDs used to be twenty.

00:16:34.210 --> 00:16:34.549
I don't know.

00:16:34.690 --> 00:16:35.931
I don't know how we used to be

00:16:35.990 --> 00:16:37.851
OK buying CDs for twenty dollars back in

00:16:38.412 --> 00:16:39.312
nineteen ninety nine.

00:16:40.313 --> 00:16:41.553
Some of those CDs were twenty to twenty

00:16:41.573 --> 00:16:42.495
five bucks then,

00:16:42.575 --> 00:16:43.755
which is crazy to think about.

00:16:44.956 --> 00:16:46.397
So to Tony's point,

00:16:46.957 --> 00:16:48.219
there's a lot of toys there.

00:16:48.239 --> 00:16:49.919
So it's not just it's not just a.

00:16:51.004 --> 00:16:51.543
Books only.

00:16:52.065 --> 00:16:52.725
And which is funny, right?

00:16:52.745 --> 00:16:54.025
Because it's like is a bookstore.

00:16:54.287 --> 00:16:56.587
But then there's like complimentary toys

00:16:56.628 --> 00:16:58.950
for these kids and obviously adult books

00:16:58.990 --> 00:16:59.370
as well.

00:16:59.730 --> 00:17:01.371
Like just just normal like fiction,

00:17:01.392 --> 00:17:03.854
nonfiction novels and stuff.

00:17:03.894 --> 00:17:05.315
So I don't know the answer, Tony.

00:17:05.355 --> 00:17:06.536
Could it be that they're just staying in

00:17:06.556 --> 00:17:08.218
business because they're so obsessed with

00:17:08.258 --> 00:17:09.939
books and the smell of books and flipping

00:17:09.979 --> 00:17:11.619
through a book and reading and the hobby

00:17:11.660 --> 00:17:12.101
of reading?

00:17:12.721 --> 00:17:13.402
Totally could be.

00:17:14.194 --> 00:17:14.615
However,

00:17:14.955 --> 00:17:16.696
they bring in authors in all the time.

00:17:16.757 --> 00:17:18.498
Those authors bring in customers and foot

00:17:18.538 --> 00:17:19.018
traffic.

00:17:19.558 --> 00:17:21.000
They promote it on their Instagram.

00:17:21.019 --> 00:17:23.060
The authors promote it on their social

00:17:23.101 --> 00:17:23.382
media.

00:17:23.981 --> 00:17:25.202
It seems like,

00:17:25.222 --> 00:17:26.483
I'm not saying it's a great business,

00:17:26.943 --> 00:17:28.565
but I always judge to go back to

00:17:28.904 --> 00:17:30.906
the place locally where I sent you guys

00:17:30.967 --> 00:17:32.048
the screenshots yesterday.

00:17:32.728 --> 00:17:33.969
place that closed down that was doing

00:17:34.009 --> 00:17:35.890
massage and cupping and stretching and all

00:17:35.910 --> 00:17:37.871
that type of stuff and they were only

00:17:37.911 --> 00:17:39.731
there for four or five years probably one

00:17:40.291 --> 00:17:42.452
one lease only another another gone and

00:17:42.492 --> 00:17:44.374
the whole website url is gone meaning

00:17:44.534 --> 00:17:45.835
they're they didn't downsize or change

00:17:45.875 --> 00:17:47.996
locations like they're done but this

00:17:48.016 --> 00:17:50.498
bookshop is still there so i feel like

00:17:51.137 --> 00:17:52.919
you cannot tony tony you can only bleed

00:17:52.959 --> 00:17:54.579
money for so long you're not going to

00:17:54.619 --> 00:17:56.280
have multiple multiple leases

00:17:57.599 --> 00:17:58.381
Unless you're crazy,

00:17:58.401 --> 00:17:59.321
which as a business owner,

00:17:59.362 --> 00:18:02.184
you could be where you are going into

00:18:02.224 --> 00:18:02.746
more leases,

00:18:02.786 --> 00:18:04.347
but you're paying out of pocket for the

00:18:04.428 --> 00:18:06.170
lease or the payroll and the labor and

00:18:06.190 --> 00:18:07.391
all that, which is possible.

00:18:07.490 --> 00:18:07.991
I've seen it.

00:18:09.232 --> 00:18:09.973
But I don't know.

00:18:10.034 --> 00:18:10.994
Any other thoughts there from that?

00:18:12.480 --> 00:18:14.201
I would say the best day of owning

00:18:14.261 --> 00:18:15.742
a boat is the day you buy it

00:18:15.782 --> 00:18:17.163
and the day you sell it, right?

00:18:18.265 --> 00:18:20.266
You just lose money the entire time.

00:18:22.347 --> 00:18:23.929
I do think there are enough of us

00:18:23.989 --> 00:18:25.970
around that stay in the small business

00:18:26.009 --> 00:18:28.310
world, especially after ten years,

00:18:28.852 --> 00:18:30.492
who are willing to sacrifice.

00:18:30.613 --> 00:18:31.933
Now, even for me,

00:18:32.054 --> 00:18:34.035
as many clinics as we've owned over the

00:18:34.075 --> 00:18:34.455
years,

00:18:35.355 --> 00:18:37.798
i've never closed my clinic the clinic

00:18:37.817 --> 00:18:40.800
that i work at because i am willing

00:18:41.121 --> 00:18:44.624
to do the job of ten people um

00:18:44.743 --> 00:18:46.045
i'm willing to do the marketing i'm

00:18:46.085 --> 00:18:47.586
willing to do the admin i'm willing to

00:18:47.625 --> 00:18:48.967
do the billing i'm willing to do the

00:18:48.987 --> 00:18:51.288
janitorial and clean the toilet like i am

00:18:51.328 --> 00:18:53.049
willing to do all of those things for

00:18:53.069 --> 00:18:56.553
the salary of a therapist other people

00:18:56.633 --> 00:18:58.734
aren't going to do that every every clinic

00:18:58.755 --> 00:19:00.876
that i i have closed over the years

00:19:00.916 --> 00:19:01.777
and i've closed many

00:19:02.518 --> 00:19:04.138
It's because it just wasn't financially

00:19:04.179 --> 00:19:06.180
viable anymore and it wasn't worth it.

00:19:06.279 --> 00:19:09.101
So I think a lot of us in

00:19:09.181 --> 00:19:12.343
health care, the Peace Corps gene,

00:19:12.702 --> 00:19:15.984
we're willing to sacrifice as long as we

00:19:16.025 --> 00:19:18.746
can, as cut as deeply as we can,

00:19:19.486 --> 00:19:22.307
just because we love what we're doing and

00:19:22.367 --> 00:19:24.269
it fulfills us in other ways.

00:19:24.308 --> 00:19:24.828
Yep.

00:19:25.148 --> 00:19:27.010
Of course, at some point, yeah,

00:19:27.050 --> 00:19:29.571
the reality, you know, strikes and hey,

00:19:29.613 --> 00:19:31.134
I got to pay my kids tuition.

00:19:31.193 --> 00:19:33.075
I got to put food on the table.

00:19:33.115 --> 00:19:34.135
I got to do something.

00:19:34.675 --> 00:19:36.758
That's when you see somebody close the

00:19:36.857 --> 00:19:38.199
last door.

00:19:38.239 --> 00:19:39.140
Jimmy, what are you going to say?

00:19:39.444 --> 00:19:40.265
I was going to share,

00:19:40.486 --> 00:19:41.365
I found the statistics,

00:19:41.385 --> 00:19:42.906
the latest statistics where Barnes and

00:19:42.946 --> 00:19:44.887
Noble books are a fifty eight percent

00:19:44.948 --> 00:19:46.729
toys, eleven, a cafe,

00:19:46.808 --> 00:19:48.529
nine and then gifts and others,

00:19:48.609 --> 00:19:49.390
twelve percent.

00:19:49.430 --> 00:19:50.790
So that's what makes up Barnes and Noble.

00:19:50.830 --> 00:19:52.051
But if it was just books,

00:19:52.791 --> 00:19:54.472
you're not going to outbook Amazon.

00:19:54.492 --> 00:19:55.373
So, I mean, of course,

00:19:55.953 --> 00:19:57.815
we're doing exactly what everybody should

00:19:57.835 --> 00:19:58.654
be doing, which is like,

00:19:58.734 --> 00:19:59.836
what's my version of that?

00:20:00.713 --> 00:20:03.497
You know, is it offering cash services,

00:20:03.656 --> 00:20:05.317
which is almost like, oh, man,

00:20:05.358 --> 00:20:06.539
let me wipe that off my tongue,

00:20:06.880 --> 00:20:07.560
that bad word.

00:20:07.580 --> 00:20:08.040
It's like, guys,

00:20:08.060 --> 00:20:09.382
it's all money on the way down.

00:20:09.402 --> 00:20:11.203
It's just you hand money to another

00:20:11.243 --> 00:20:12.586
company, then they decide.

00:20:12.885 --> 00:20:14.907
That's the crazier version, right?

00:20:14.968 --> 00:20:15.268
Like,

00:20:15.688 --> 00:20:17.851
if you honestly can make someone's dollar

00:20:17.871 --> 00:20:18.411
go further,

00:20:19.132 --> 00:20:20.553
help them get better and stay better,

00:20:21.473 --> 00:20:22.714
isn't that a better ROI?

00:20:23.685 --> 00:20:26.127
on their dollar is them giving it directly

00:20:26.188 --> 00:20:26.607
to you.

00:20:26.688 --> 00:20:27.288
And that feels, Oh,

00:20:27.308 --> 00:20:28.348
I don't want to touch that dollar.

00:20:28.368 --> 00:20:28.750
It's icky.

00:20:28.869 --> 00:20:29.289
That's okay.

00:20:29.309 --> 00:20:29.891
Dave will touch it.

00:20:29.990 --> 00:20:30.851
He'll he hasn't been great.

00:20:30.911 --> 00:20:31.271
No problem.

00:20:31.332 --> 00:20:32.372
He'll watch that dollar off.

00:20:32.491 --> 00:20:33.192
Like they'll take that.

00:20:33.772 --> 00:20:33.973
And I,

00:20:34.074 --> 00:20:35.233
and I think I keep hearing this.

00:20:36.234 --> 00:20:37.836
The, the gifts break down there with,

00:20:38.016 --> 00:20:38.737
with Barnes and Noble.

00:20:38.836 --> 00:20:39.897
Do you think that's gift cards?

00:20:39.917 --> 00:20:42.700
Because toys toy.

00:20:42.819 --> 00:20:42.900
Okay.

00:20:43.160 --> 00:20:45.201
So toys would be obviously kids items.

00:20:45.261 --> 00:20:47.123
Gifts would be any adult,

00:20:47.222 --> 00:20:48.344
any adult product that's there.

00:20:48.364 --> 00:20:50.665
So, so the, so I'm like,

00:20:51.405 --> 00:20:52.446
not just kids stuff.

00:20:52.467 --> 00:20:54.048
They have like really expensive,

00:20:54.087 --> 00:20:57.250
like adult, like high Lego boxes,

00:20:57.791 --> 00:20:58.952
really expensive, a hundred,

00:20:58.972 --> 00:21:00.814
a hundred and fifty dollar Lego things and

00:21:00.953 --> 00:21:01.875
really expensive.

00:21:01.894 --> 00:21:03.195
High, high margin.

00:21:03.256 --> 00:21:03.977
Those are going to be high.

00:21:03.997 --> 00:21:04.436
Correct.

00:21:05.137 --> 00:21:07.460
Really expensive board games, adult games.

00:21:07.519 --> 00:21:09.461
So I think the gifts is probably just

00:21:09.500 --> 00:21:09.662
like,

00:21:10.241 --> 00:21:12.644
It could even be impulse buys at the

00:21:12.683 --> 00:21:13.463
front desk, right?

00:21:13.503 --> 00:21:15.025
A pen, a bookmark.

00:21:15.204 --> 00:21:16.865
What do you think the margin on a

00:21:16.945 --> 00:21:18.126
bookmark is?

00:21:18.166 --> 00:21:19.748
Like, seven thousand percent?

00:21:20.107 --> 00:21:22.670
Costs me four tenths of a schmeckle and

00:21:22.750 --> 00:21:24.371
I sell it for seven dollars because it's

00:21:24.391 --> 00:21:25.991
got an inspirational quote from Maya

00:21:26.112 --> 00:21:26.711
Angelou on it.

00:21:26.731 --> 00:21:29.153
It's like, that thing's a markup machine,

00:21:29.193 --> 00:21:29.374
right?

00:21:29.594 --> 00:21:30.694
And it's that impulse buy.

00:21:31.095 --> 00:21:32.375
But if they've got you,

00:21:32.576 --> 00:21:34.997
they're doing similar to what Amazon does.

00:21:35.396 --> 00:21:36.657
I actually don't think Amazon does this

00:21:36.698 --> 00:21:38.740
well enough, which is, if I'm buying this,

00:21:39.599 --> 00:21:41.601
before you check out what do other people

00:21:41.641 --> 00:21:43.502
buy i know amazon does it i'm just

00:21:43.522 --> 00:21:45.243
surprised it's not more prominent it's a

00:21:45.284 --> 00:21:47.224
little bit lower if you're buying this

00:21:47.325 --> 00:21:50.007
other people who buy this also buy this

00:21:50.047 --> 00:21:51.607
i'm surprised they're not doing that a

00:21:51.627 --> 00:21:52.108
little more

00:21:54.041 --> 00:21:56.123
That actually was something that came up

00:21:56.182 --> 00:21:58.364
in one of the articles I read where

00:21:58.403 --> 00:22:01.065
they were talking about upsells and you

00:22:01.105 --> 00:22:02.445
get to the counter and you're like, oh,

00:22:02.506 --> 00:22:03.926
I need this or I need that.

00:22:05.086 --> 00:22:07.748
For some reason, I can't say for certain,

00:22:07.827 --> 00:22:11.750
I thought they were saying that Barnes &

00:22:09.249 --> 00:22:11.410
Noble basically does a better job at that

00:22:12.130 --> 00:22:13.590
than Amazon does.

00:22:13.990 --> 00:22:14.391
I think so.

00:22:14.451 --> 00:22:15.771
Yeah, Will Boyd chiming in saying, yeah,

00:22:15.791 --> 00:22:17.032
but then you'd have to sell, Jimmy,

00:22:17.133 --> 00:22:19.275
which is a curse word in PT.

00:22:19.775 --> 00:22:20.915
You know, I agree with Will.

00:22:20.935 --> 00:22:21.997
I'm not disagreeing with him.

00:22:22.037 --> 00:22:23.178
But this is how I would say this

00:22:23.218 --> 00:22:24.499
to someone who said that to me.

00:22:24.538 --> 00:22:25.318
I don't like selling.

00:22:25.720 --> 00:22:27.080
My dad was a New York City fireman.

00:22:28.490 --> 00:22:30.151
They didn't have to sell stop, drop,

00:22:30.191 --> 00:22:30.570
and roll.

00:22:30.750 --> 00:22:32.813
They repeated it over and over and over

00:22:32.833 --> 00:22:33.432
and over again.

00:22:33.553 --> 00:22:34.134
I got to be honest,

00:22:34.153 --> 00:22:35.394
the amount of times I heard stop, drop,

00:22:35.413 --> 00:22:35.654
and roll,

00:22:35.694 --> 00:22:36.954
I thought I would be on fire more

00:22:36.994 --> 00:22:37.516
as an adult,

00:22:37.556 --> 00:22:38.936
but I've been on fire zero times.

00:22:39.656 --> 00:22:41.157
They didn't have to sell call nine one

00:22:41.357 --> 00:22:43.660
one, but they sure as hell repeated it.

00:22:43.720 --> 00:22:45.221
So the fire department didn't sell that

00:22:45.260 --> 00:22:45.580
stuff.

00:22:46.060 --> 00:22:46.842
They repeated it.

00:22:46.882 --> 00:22:48.522
They got a line and they repeated it.

00:22:48.903 --> 00:22:49.923
So no one, you know,

00:22:50.263 --> 00:22:51.224
I think Will's right,

00:22:51.265 --> 00:22:51.964
but I don't think you had,

00:22:52.244 --> 00:22:53.405
it's not this dirty thing.

00:22:53.685 --> 00:22:55.166
If you honestly and truly believe it,

00:22:55.386 --> 00:22:56.327
as Kevin Hart would say,

00:22:56.688 --> 00:22:57.769
say it with your chest.

00:22:59.864 --> 00:23:01.223
So later today,

00:23:01.564 --> 00:23:02.845
I'm talking to Hinge Health.

00:23:03.164 --> 00:23:05.964
We're talking about the future of PT.

00:23:06.045 --> 00:23:07.184
And, you know,

00:23:08.125 --> 00:23:10.385
I share some experiences with them and

00:23:10.465 --> 00:23:12.945
talk about social media and just the

00:23:13.027 --> 00:23:14.186
impact that it's had.

00:23:15.666 --> 00:23:16.626
But it got me thinking,

00:23:16.727 --> 00:23:18.567
putting these two things together,

00:23:19.508 --> 00:23:22.688
do you guys know what this is a

00:23:22.748 --> 00:23:23.508
picture of?

00:23:24.828 --> 00:23:25.769
That is...

00:23:26.883 --> 00:23:28.546
Something in a typewriter.

00:23:28.625 --> 00:23:29.627
Is that a typewriter on the right?

00:23:29.748 --> 00:23:31.631
And on the left, a magnifying glass?

00:23:32.152 --> 00:23:33.614
Microfiche?

00:23:33.753 --> 00:23:35.576
What's looking into the magnifying glass?

00:23:35.738 --> 00:23:36.238
A woman.

00:23:37.059 --> 00:23:38.281
Close.

00:23:38.342 --> 00:23:38.701
Close.

00:23:38.742 --> 00:23:40.005
That's actually a computer.

00:23:41.266 --> 00:23:42.386
She's looking into a computer.

00:23:42.907 --> 00:23:45.230
No, the woman is a computer.

00:23:45.569 --> 00:23:48.413
If you go back and I look this

00:23:48.472 --> 00:23:49.034
up this morning,

00:23:49.094 --> 00:23:50.674
nineteen thirty to nineteen seventy,

00:23:50.734 --> 00:23:53.337
NASA Langley called women.

00:23:53.357 --> 00:23:54.618
Oh, yeah, yeah, yeah.

00:23:55.160 --> 00:23:56.161
That was a computer.

00:23:56.201 --> 00:23:59.284
That woman, that human was a computer.

00:24:00.084 --> 00:24:02.326
And so they would sit around and compute.

00:24:02.366 --> 00:24:04.087
They'd calculate numbers and do all this

00:24:04.107 --> 00:24:04.628
kind of stuff.

00:24:05.726 --> 00:24:08.008
Um, fast forward to today, you know,

00:24:08.067 --> 00:24:08.949
what is a computer?

00:24:09.128 --> 00:24:10.430
Well, it's not a woman, right?

00:24:10.470 --> 00:24:11.170
It's not a human.

00:24:12.211 --> 00:24:15.973
And so names, words, terminology, lexicon,

00:24:16.034 --> 00:24:17.075
it all changes.

00:24:17.134 --> 00:24:18.596
It evolves over time.

00:24:19.296 --> 00:24:20.676
And this is one of the things that

00:24:20.696 --> 00:24:22.298
I'm going to kind of discuss a little

00:24:22.337 --> 00:24:22.699
bit.

00:24:22.719 --> 00:24:25.580
And we've talked about this before we came

00:24:25.681 --> 00:24:28.442
out of, was it reconstruction age AIDS?

00:24:28.962 --> 00:24:30.944
Then we became physical therapists.

00:24:31.045 --> 00:24:33.727
The physical therapists of a hundred years

00:24:33.747 --> 00:24:36.388
ago are not the physical therapists of

00:24:36.509 --> 00:24:36.989
today.

00:24:38.269 --> 00:24:41.112
As things are accelerating and changing so

00:24:41.152 --> 00:24:41.692
quickly,

00:24:41.913 --> 00:24:44.174
what is a physical therapist ten years

00:24:44.214 --> 00:24:45.015
from now going to be?

00:24:45.035 --> 00:24:46.276
Great question.

00:24:46.536 --> 00:24:47.856
My expectation,

00:24:48.278 --> 00:24:50.179
it's going to be a significant,

00:24:50.960 --> 00:24:53.240
most of what we do is digital in

00:24:53.320 --> 00:24:53.761
ten years.

00:24:55.164 --> 00:24:58.486
The people who still want to touch humans,

00:24:59.027 --> 00:25:01.528
they may not be physical therapists.

00:25:01.567 --> 00:25:03.688
That might not be physical therapy

00:25:03.769 --> 00:25:04.709
anymore, but that's fine.

00:25:04.749 --> 00:25:06.048
It doesn't mean they don't exist.

00:25:06.589 --> 00:25:08.450
That just means they find a new name,

00:25:08.470 --> 00:25:10.730
a new terminology, a new classification.

00:25:11.271 --> 00:25:11.872
Because again,

00:25:12.846 --> 00:25:14.508
As we continue to see reimbursement

00:25:14.548 --> 00:25:14.988
decline,

00:25:15.067 --> 00:25:18.109
why am I continuing to fight to preserve

00:25:18.470 --> 00:25:21.231
language that doesn't help me and doesn't

00:25:21.271 --> 00:25:22.491
help my patient anymore?

00:25:22.531 --> 00:25:22.632
Yeah,

00:25:23.073 --> 00:25:25.814
it's funny to watch other people walk into

00:25:25.834 --> 00:25:28.435
an idea that we've been talking about.

00:25:28.496 --> 00:25:30.196
I'm not even saying we're the first people

00:25:30.797 --> 00:25:32.337
to talk about this or realize that,

00:25:32.718 --> 00:25:34.499
but I forget what Facebook group I was

00:25:34.558 --> 00:25:36.119
in and watch someone in the comments

00:25:36.180 --> 00:25:37.121
section go.

00:25:38.121 --> 00:25:39.743
Why don't I just give up my license

00:25:39.763 --> 00:25:41.626
and then I'd have less restrictions?

00:25:41.767 --> 00:25:43.671
And I just sort of commented, Yeah,

00:25:43.730 --> 00:25:45.232
feels like it's actually not helping you.

00:25:45.292 --> 00:25:47.056
It's preventing you from doing what you

00:25:47.096 --> 00:25:49.140
want or being able to even keep the

00:25:49.160 --> 00:25:50.321
doors open.

00:25:50.342 --> 00:25:51.463
And this was not me being

00:25:52.394 --> 00:25:53.056
overdramatic.

00:25:53.076 --> 00:25:54.435
This person was saying like, I can't,

00:25:54.717 --> 00:25:55.696
I can't keep the doors open.

00:25:55.717 --> 00:25:58.378
Like I'm losing ten dollars a visit on

00:25:58.398 --> 00:25:59.819
these certain insurances in these certain

00:25:59.880 --> 00:26:00.180
areas.

00:26:00.460 --> 00:26:02.162
But if I gave up my if I

00:26:03.082 --> 00:26:04.002
dropped my license,

00:26:04.542 --> 00:26:07.305
I would be not beholden to those rules.

00:26:07.365 --> 00:26:09.426
There are there are positives and

00:26:09.467 --> 00:26:11.107
negatives to most situations.

00:26:11.347 --> 00:26:12.568
And if the negatives outweigh the

00:26:12.608 --> 00:26:14.529
positives, don't do that game.

00:26:15.391 --> 00:26:17.192
Let's revisit this with Dave.

00:26:17.372 --> 00:26:18.112
I want to bring you in.

00:26:18.172 --> 00:26:18.512
Hang on.

00:26:19.715 --> 00:26:20.797
I've asked you before.

00:26:20.957 --> 00:26:23.119
It's time to ask you again.

00:26:25.442 --> 00:26:27.064
I understand there are times where you do

00:26:27.104 --> 00:26:29.106
bill out of network for certain third

00:26:29.146 --> 00:26:30.847
party payers or you submit claims on

00:26:30.868 --> 00:26:31.689
behalf of the patient.

00:26:31.729 --> 00:26:34.593
But if you have somebody who is not

00:26:34.633 --> 00:26:36.074
going through insurance,

00:26:36.974 --> 00:26:40.016
What is the value of calling yourself or

00:26:40.056 --> 00:26:43.198
your service physical therapy and

00:26:43.238 --> 00:26:44.998
constraining it to that?

00:26:45.479 --> 00:26:47.219
You can't hire anyone you want.

00:26:47.278 --> 00:26:49.420
You have to hire a physical therapist.

00:26:49.940 --> 00:26:51.800
Eliminate that title and you can hire

00:26:52.020 --> 00:26:54.162
anyone who is available with the skills

00:26:54.221 --> 00:26:55.722
and the expertise that you want.

00:26:56.482 --> 00:26:58.663
you're not getting reimbursement so you

00:26:58.683 --> 00:27:00.766
don't have to worry about that it opens

00:27:00.826 --> 00:27:02.787
the door to doing so much more even

00:27:02.846 --> 00:27:05.169
beyond the the confines of the state of

00:27:05.229 --> 00:27:09.330
new york like i just don't see in

00:27:09.590 --> 00:27:13.673
more cases for you why the benefit of

00:27:13.753 --> 00:27:15.615
still being called a physical therapist

00:27:15.994 --> 00:27:16.855
and physical therapy

00:27:19.387 --> 00:27:19.729
I don't know.

00:27:20.028 --> 00:27:22.109
I don't know if there is a benefit.

00:27:22.250 --> 00:27:23.490
I think on the front end,

00:27:23.631 --> 00:27:26.393
if we're saying or conveying Dr.

00:27:26.452 --> 00:27:27.914
So-and-so, Dr. Ethan, Dr. Chris,

00:27:27.934 --> 00:27:28.315
or whatever,

00:27:28.954 --> 00:27:31.737
maybe I am assuming that it will help

00:27:31.777 --> 00:27:33.298
with authority or credibility or whatever,

00:27:33.358 --> 00:27:33.538
which...

00:27:34.019 --> 00:27:35.740
uh once in a while over the years

00:27:35.759 --> 00:27:37.701
like if we had a uh we had

00:27:37.721 --> 00:27:39.462
a pta that we kind of tested with

00:27:39.502 --> 00:27:41.724
we had a a physical therapist that was

00:27:41.785 --> 00:27:43.685
from another country where they did not

00:27:43.705 --> 00:27:46.208
have the dpt and some patients did say

00:27:46.288 --> 00:27:47.388
they didn't say they didn't care about the

00:27:47.469 --> 00:27:48.410
they didn't care about the physical

00:27:48.430 --> 00:27:51.071
therapist part but they did say like oh

00:27:51.152 --> 00:27:52.893
well i see that this person is not

00:27:52.913 --> 00:27:54.974
a doctor like they don't have their their

00:27:55.015 --> 00:27:57.636
doctor degree or whatever and you know dr

00:27:57.656 --> 00:27:59.397
crystal does or dr ethan does or whatever

00:27:59.798 --> 00:27:59.919
so you

00:28:01.075 --> 00:28:02.536
some of our clients did say that,

00:28:02.836 --> 00:28:03.737
but I agree with you, Tony,

00:28:03.777 --> 00:28:07.699
none of them ever cared if they were

00:28:07.719 --> 00:28:08.680
a physical therapist or not.

00:28:08.720 --> 00:28:10.101
But, but then again, we were not,

00:28:10.181 --> 00:28:13.262
we were not saying here's a, uh,

00:28:13.482 --> 00:28:13.824
I don't know,

00:28:14.023 --> 00:28:16.265
rehab personal trainer or someone that

00:28:16.444 --> 00:28:17.125
like, we, we never,

00:28:17.405 --> 00:28:18.666
we never had someone else with a different

00:28:18.707 --> 00:28:21.288
title or a different designation where

00:28:21.328 --> 00:28:23.230
then the client was like, yeah, okay,

00:28:23.309 --> 00:28:23.849
fine, whatever.

00:28:24.150 --> 00:28:27.071
So, um, I don't know if we've,

00:28:27.413 --> 00:28:29.334
you know, gone down that route enough.

00:28:29.986 --> 00:28:31.727
I would say, like, name recognition,

00:28:32.268 --> 00:28:32.607
right?

00:28:32.647 --> 00:28:33.448
Sounds legit.

00:28:33.468 --> 00:28:34.568
That's why people want to get the letters

00:28:34.628 --> 00:28:35.349
after the name, right?

00:28:35.390 --> 00:28:38.632
Like, that feels like the legitness of it.

00:28:38.971 --> 00:28:39.211
You know,

00:28:39.292 --> 00:28:43.535
physical therapist has some understanding

00:28:43.576 --> 00:28:43.855
to it.

00:28:43.915 --> 00:28:45.997
As much as people say,

00:28:46.396 --> 00:28:48.759
people have no idea what we do.

00:28:48.818 --> 00:28:50.961
And I go, no idea at all.

00:28:51.080 --> 00:28:51.780
If you said,

00:28:52.461 --> 00:28:54.163
go to chat GPT and generate...

00:28:54.182 --> 00:28:55.403
They have some idea.

00:28:55.423 --> 00:28:58.125
They would go, I don't know, a human...

00:28:58.746 --> 00:29:01.009
standing maybe with clothes like okay

00:29:01.048 --> 00:29:03.432
where does this person work like no idea

00:29:03.751 --> 00:29:05.134
and i just think it's a giant cop

00:29:05.253 --> 00:29:06.816
out you know i sort of went back

00:29:06.855 --> 00:29:08.738
and held someone accountable when they

00:29:08.778 --> 00:29:11.540
said it's the apta's job to do a

00:29:11.601 --> 00:29:14.865
marketing campaign um to make sure people

00:29:14.884 --> 00:29:16.386
know what we do and i go no

00:29:16.926 --> 00:29:17.067
no

00:29:17.627 --> 00:29:19.109
They're a professional association.

00:29:19.150 --> 00:29:20.553
They're where professionals associate.

00:29:20.893 --> 00:29:22.536
No, they're not good at public.

00:29:22.776 --> 00:29:23.778
That's not what they're built for.

00:29:24.258 --> 00:29:25.519
And then I brought this in in front

00:29:25.539 --> 00:29:27.222
of a room full of PTs who were

00:29:27.303 --> 00:29:27.824
wagging there.

00:29:27.864 --> 00:29:29.125
It's always someone else's fault.

00:29:29.326 --> 00:29:31.068
Well, we're this, but they should do that.

00:29:31.549 --> 00:29:32.030
And I said,

00:29:32.892 --> 00:29:33.472
Do you remember that?

00:29:33.532 --> 00:29:34.713
Remember Aaron Burr?

00:29:34.773 --> 00:29:35.755
Why do you think a lot of us

00:29:35.815 --> 00:29:37.115
know who Aaron Burr and the fact that

00:29:37.135 --> 00:29:38.817
he got into a duel, right?

00:29:39.038 --> 00:29:39.719
A shooting duel.

00:29:40.078 --> 00:29:41.440
Hamilton, the show.

00:29:41.520 --> 00:29:42.902
It was because of Got Milk.

00:29:42.981 --> 00:29:44.503
It was the Got Milk ad,

00:29:44.884 --> 00:29:46.566
brilliantly done campaign,

00:29:46.885 --> 00:29:48.307
and it was paid for by the American

00:29:48.346 --> 00:29:49.788
Dairy Farmers Association.

00:29:50.088 --> 00:29:50.750
And I don't even know.

00:29:50.829 --> 00:29:52.371
I could go to Wikipedia and see how

00:29:52.411 --> 00:29:52.550
long,

00:29:52.571 --> 00:29:54.212
but I feel like that ad campaign ran

00:29:54.272 --> 00:29:54.432
for...

00:29:55.233 --> 00:29:57.494
a bajillion years it was a bunch of

00:29:57.535 --> 00:29:59.395
different ones but it started with a radio

00:29:59.836 --> 00:30:01.415
they were asking a question and the guy

00:30:01.435 --> 00:30:02.997
was like i'm an aaron burr expert but

00:30:03.017 --> 00:30:04.718
he had eaten some cookies and he was

00:30:04.738 --> 00:30:06.938
like on the phone he couldn't get it

00:30:07.138 --> 00:30:08.638
if he'd only had some milk to wash

00:30:08.659 --> 00:30:11.180
down the cookies right so they paid

00:30:11.259 --> 00:30:13.740
millions of dollars to do the creative to

00:30:13.800 --> 00:30:16.102
put the ads everywhere it became almost

00:30:16.142 --> 00:30:17.843
like it was it was a campaign on

00:30:17.942 --> 00:30:20.963
billboards got milk it was a question

00:30:21.836 --> 00:30:22.998
And then someone brought this up,

00:30:23.337 --> 00:30:26.539
how much milk consumption went up during

00:30:26.640 --> 00:30:27.861
or after that campaign?

00:30:28.181 --> 00:30:30.162
And the answer was zero percent.

00:30:31.083 --> 00:30:33.064
Do you think we had a milk awareness

00:30:33.104 --> 00:30:33.604
problem?

00:30:34.064 --> 00:30:36.566
No, but it felt good because look,

00:30:36.705 --> 00:30:39.667
I see, there's me, I milk cows, yay.

00:30:40.067 --> 00:30:40.788
So I'm out here.

00:30:42.910 --> 00:30:45.651
You were solving a problem that wasn't an

00:30:45.810 --> 00:30:46.152
issue.

00:30:47.415 --> 00:30:48.977
I say, okay, great,

00:30:49.396 --> 00:30:50.998
you do this big campaign and everyone's

00:30:51.198 --> 00:30:52.798
aware of physical therapists,

00:30:52.878 --> 00:30:54.839
except if you want a private practice that

00:30:54.859 --> 00:30:55.621
does this niche,

00:30:56.080 --> 00:30:58.342
is that campaign going to do anything for

00:30:58.382 --> 00:30:59.063
your business?

00:30:59.542 --> 00:31:00.303
I don't think it is.

00:31:00.763 --> 00:31:02.003
So I think if you want a private

00:31:02.044 --> 00:31:04.286
practice, you spend a dollar, Dave,

00:31:04.306 --> 00:31:05.405
correct me if I'm wrong, Tony,

00:31:05.425 --> 00:31:05.967
correct me if I'm wrong,

00:31:06.267 --> 00:31:07.587
you spend a dollar, you're in your brain,

00:31:07.607 --> 00:31:07.887
you're like,

00:31:08.208 --> 00:31:09.328
this has got to bring me a buck

00:31:09.348 --> 00:31:10.930
fifty or else I'm not going to keep

00:31:10.970 --> 00:31:11.450
doing it.

00:31:11.950 --> 00:31:13.431
And I don't think that it will.

00:31:13.550 --> 00:31:15.332
I do not think PT has an awareness

00:31:15.372 --> 00:31:15.751
problem.

00:31:15.771 --> 00:31:16.492
And if it does,

00:31:17.173 --> 00:31:18.534
It's on the individual.

00:31:18.614 --> 00:31:19.994
Now, a final thing,

00:31:20.214 --> 00:31:22.016
where I think the APTA or its state

00:31:22.036 --> 00:31:24.258
chapters or academies could go ROI

00:31:24.317 --> 00:31:27.680
positive is they bring Dave, Tony,

00:31:27.779 --> 00:31:29.181
and Jimmy to their conference.

00:31:29.461 --> 00:31:30.922
They give us a two-hour session,

00:31:31.343 --> 00:31:33.023
pay the hell out of us to do

00:31:33.084 --> 00:31:33.183
it,

00:31:33.463 --> 00:31:36.286
and we teach them how to create content.

00:31:36.326 --> 00:31:37.287
Not going for free.

00:31:37.307 --> 00:31:37.707
Not going for free.

00:31:38.327 --> 00:31:39.849
And we'll teach a hundred of your people

00:31:40.029 --> 00:31:42.032
how to create a hundred pieces a month.

00:31:42.333 --> 00:31:44.876
And now suddenly your awareness problem

00:31:45.196 --> 00:31:46.117
goes away,

00:31:46.398 --> 00:31:48.101
but it's not going to be APTA state

00:31:48.121 --> 00:31:50.384
chapters or academies or APTA national.

00:31:50.724 --> 00:31:51.746
It just ain't.

00:31:53.467 --> 00:31:55.067
I didn't see Aaron Burr on the bingo

00:31:55.087 --> 00:31:55.788
card for today.

00:31:55.888 --> 00:31:56.628
Random fact,

00:31:56.729 --> 00:31:58.910
after we got married in a church in

00:31:58.950 --> 00:31:59.450
Manhattan,

00:31:59.530 --> 00:32:02.412
we had our celebration at One If By

00:32:02.471 --> 00:32:02.751
Land,

00:32:02.791 --> 00:32:04.732
which was actually Aaron Burr's old

00:32:04.752 --> 00:32:06.213
carriage house in Manhattan.

00:32:07.134 --> 00:32:08.295
Didn't think we were going to ever come

00:32:08.315 --> 00:32:08.454
there,

00:32:08.494 --> 00:32:10.016
but I have to drop it real quick.

00:32:10.435 --> 00:32:11.416
Now, in terms of the...

00:32:12.201 --> 00:32:13.663
In terms of the designation, Tony,

00:32:15.282 --> 00:32:17.684
there's a lot of physicians going into

00:32:17.744 --> 00:32:19.085
concierge who are out of pocket.

00:32:19.105 --> 00:32:21.006
There's a lot of nurses or PAs,

00:32:21.306 --> 00:32:22.626
some of them going into like the med

00:32:22.666 --> 00:32:24.567
spas or the injectables or whatever,

00:32:24.587 --> 00:32:25.827
and they're keeping their licenses.

00:32:26.469 --> 00:32:29.930
Have you noticed any of those other

00:32:29.970 --> 00:32:32.131
providers or professionals changing their

00:32:32.171 --> 00:32:33.872
names, changing their designations,

00:32:34.491 --> 00:32:36.573
the way that you're proposing in ten years

00:32:36.633 --> 00:32:39.555
physical therapists might be a different

00:32:39.595 --> 00:32:40.295
title or a different name?

00:32:42.295 --> 00:32:43.256
Jimmy.

00:32:43.296 --> 00:32:44.897
And I don't like bashing other

00:32:44.959 --> 00:32:46.701
professions, but you asked the question,

00:32:46.740 --> 00:32:47.662
so I'll give the answer.

00:32:48.462 --> 00:32:49.605
And maybe we're guilty,

00:32:49.644 --> 00:32:51.907
so I'm throwing a lot of asterisks before

00:32:51.948 --> 00:32:52.868
I start throwing shade.

00:32:53.549 --> 00:32:56.874
I see a lot of chiropractors using words

00:32:57.174 --> 00:32:58.316
that are not their words.

00:32:58.957 --> 00:33:01.260
I'm a functional neurologist.

00:33:01.340 --> 00:33:05.626
And I'm like, what is that?

00:33:05.646 --> 00:33:07.269
That is where I draw the line where

00:33:07.349 --> 00:33:08.471
I say, no, no, no,

00:33:08.632 --> 00:33:09.732
you don't get to call yourself a

00:33:09.752 --> 00:33:12.436
neurologist unless you are a neurologist.

00:33:13.077 --> 00:33:14.019
That is where I can say,

00:33:15.060 --> 00:33:16.821
Say whatever you want, but that's my line.

00:33:17.261 --> 00:33:18.842
And I forget the doctor's name.

00:33:18.862 --> 00:33:21.663
He does a great job on Instagram calling

00:33:21.702 --> 00:33:22.563
people out.

00:33:22.702 --> 00:33:23.242
And I will say,

00:33:23.403 --> 00:33:25.564
he should call PTs out if we do

00:33:25.683 --> 00:33:26.824
anything egregious like this.

00:33:27.064 --> 00:33:28.404
But calling yourself a functional

00:33:28.424 --> 00:33:28.924
neurologist,

00:33:29.224 --> 00:33:31.785
and God forbid you have someone who needs

00:33:31.825 --> 00:33:32.405
a neurologist,

00:33:32.605 --> 00:33:33.925
and they wind up in your office,

00:33:34.286 --> 00:33:36.747
no offense, not the right place for you,

00:33:37.166 --> 00:33:38.767
and disrespectful that way.

00:33:38.826 --> 00:33:40.528
So I see people doing it in a

00:33:40.607 --> 00:33:41.288
shady way

00:33:42.067 --> 00:33:43.108
But Dave, good question.

00:33:43.148 --> 00:33:44.849
Is anybody doing it?

00:33:45.530 --> 00:33:46.191
Let me rephrase it.

00:33:46.211 --> 00:33:46.971
Let me ask Tony again.

00:33:47.011 --> 00:33:48.772
So Tony's saying in ten years,

00:33:48.893 --> 00:33:49.753
physical therapists,

00:33:49.814 --> 00:33:51.795
they can drop the physical therapist title

00:33:51.855 --> 00:33:53.736
and be a different title.

00:33:53.776 --> 00:33:55.116
Before I even weigh in on that,

00:33:55.278 --> 00:33:56.038
I'm saying, Tony,

00:33:56.057 --> 00:33:58.039
you've seen a lot of concierge physicians

00:33:58.440 --> 00:33:59.160
leave insurance.

00:33:59.180 --> 00:34:01.382
There are concierge memberships or monthly

00:34:01.461 --> 00:34:02.702
or yearly or annual, whatever.

00:34:04.163 --> 00:34:07.566
And as well as the PAs or NPs

00:34:07.707 --> 00:34:09.628
or any of these other allied

00:34:10.027 --> 00:34:10.688
professionals.

00:34:11.983 --> 00:34:13.126
starting their own practices.

00:34:13.666 --> 00:34:14.789
Are they changing their names?

00:34:15.010 --> 00:34:17.737
Have you seen that they're changing their

00:34:17.797 --> 00:34:20.143
title or how they're calling themselves on

00:34:20.202 --> 00:34:20.623
social media?

00:34:21.302 --> 00:34:24.543
So if, and we've shared this before, no,

00:34:24.664 --> 00:34:26.684
I have not seen it in physical therapy.

00:34:27.306 --> 00:34:28.365
Well, yes, we just did.

00:34:28.405 --> 00:34:29.246
You just told me we started as

00:34:29.326 --> 00:34:30.206
reconstruction aids.

00:34:30.327 --> 00:34:32.208
So maybe it's a hundred year cycle,

00:34:32.228 --> 00:34:32.527
but yeah.

00:34:32.588 --> 00:34:33.827
Yeah, but no, but, but, but no,

00:34:33.867 --> 00:34:35.228
but recently you're not seeing.

00:34:35.248 --> 00:34:37.090
What I have seen and we've said it

00:34:37.210 --> 00:34:37.809
finance.

00:34:38.110 --> 00:34:40.010
So a lot of the finance guys,

00:34:40.110 --> 00:34:41.911
especially the ones on social media and

00:34:41.931 --> 00:34:43.452
Will Boyd can chime in on this.

00:34:43.492 --> 00:34:44.092
He's watching.

00:34:45.554 --> 00:34:48.655
They gave up their finance licensing or

00:34:48.695 --> 00:34:51.197
whatever you call it so that they can

00:34:51.257 --> 00:34:53.780
produce more social media content.

00:34:54.221 --> 00:34:57.083
There is so much regulation in finance,

00:34:57.523 --> 00:34:59.905
they couldn't produce the content they're

00:34:59.945 --> 00:35:02.907
producing and keep their licenses in

00:35:02.947 --> 00:35:03.327
finance.

00:35:03.347 --> 00:35:04.628
So I've seen it in finance.

00:35:06.494 --> 00:35:08.016
I've seen a little bit in medicine,

00:35:08.056 --> 00:35:09.797
but what's really interesting is there are

00:35:09.838 --> 00:35:12.541
politicians out there right now today who

00:35:12.621 --> 00:35:14.744
are calling themselves a medical doctor,

00:35:14.784 --> 00:35:15.503
an MD.

00:35:15.804 --> 00:35:17.226
They never passed the boards.

00:35:17.547 --> 00:35:18.989
They went through medical school.

00:35:19.048 --> 00:35:20.731
They've never practiced as a medical

00:35:20.771 --> 00:35:21.150
doctor.

00:35:21.210 --> 00:35:21.512
They don't.

00:35:22.192 --> 00:35:24.813
they they never got whatever license as a

00:35:24.873 --> 00:35:26.635
medical doctor but they call themselves a

00:35:26.675 --> 00:35:29.356
doctor and they use that for their

00:35:29.416 --> 00:35:31.878
political benefit i think your people

00:35:31.918 --> 00:35:35.161
could still be they are they graduated as

00:35:35.181 --> 00:35:37.202
a doctor of physical therapy yeah you

00:35:37.222 --> 00:35:40.043
could still leverage that education

00:35:40.664 --> 00:35:42.766
without the licensure and without the

00:35:42.826 --> 00:35:43.766
restrictions

00:35:44.789 --> 00:35:46.512
There's five letters that you get when you

00:35:46.552 --> 00:35:48.414
graduate today or tomorrow.

00:35:48.434 --> 00:35:50.936
It's PT, DPT, and it sounds redundant,

00:35:51.478 --> 00:35:52.900
and it kind of is, but you're right.

00:35:53.800 --> 00:35:56.003
PT is the license.

00:35:56.063 --> 00:35:57.485
DPT is the degree.

00:35:57.826 --> 00:35:59.788
So yes, I mean, there are people who...

00:36:00.409 --> 00:36:01.690
Let me figure out how you'd have to

00:36:01.730 --> 00:36:02.030
do this.

00:36:02.791 --> 00:36:03.192
If you...

00:36:04.213 --> 00:36:05.034
If you passed,

00:36:05.373 --> 00:36:06.876
if you graduated from school but didn't

00:36:06.896 --> 00:36:09.478
pass the boards, you'd be a DPT,

00:36:09.518 --> 00:36:10.079
no PT.

00:36:10.760 --> 00:36:12.101
So there's a way to be a DPT

00:36:12.141 --> 00:36:12.942
without PT.

00:36:13.262 --> 00:36:13.943
Someone check me on this,

00:36:13.963 --> 00:36:14.884
but I think I'm doing the math right.

00:36:15.143 --> 00:36:16.525
You can be a DPT without a PT,

00:36:16.545 --> 00:36:18.387
but you can't be a PT without the

00:36:18.427 --> 00:36:19.827
DPT.

00:36:19.867 --> 00:36:20.628
Right now, yes.

00:36:20.849 --> 00:36:21.710
Right now, correct.

00:36:21.949 --> 00:36:23.311
But yes, yeah, I mean,

00:36:23.351 --> 00:36:25.293
so technically that person's correct,

00:36:26.114 --> 00:36:27.275
but correct and clear,

00:36:27.576 --> 00:36:28.516
those are two different words.

00:36:29.710 --> 00:36:32.012
Now, the other one more thing real quick.

00:36:32.032 --> 00:36:33.655
The other part I would bring into this

00:36:33.775 --> 00:36:35.336
is, you know,

00:36:35.577 --> 00:36:39.340
our state organizations or boards, I mean,

00:36:39.360 --> 00:36:42.344
they're not super effective or aggressive,

00:36:42.465 --> 00:36:42.784
right?

00:36:42.844 --> 00:36:46.268
So we have non-DPTs using the credentials

00:36:46.309 --> 00:36:46.690
DPT.

00:36:47.731 --> 00:36:48.190
i.e.

00:36:48.251 --> 00:36:50.032
lifetime family fitness.

00:36:50.572 --> 00:36:52.673
We've got chiropractors and all sorts of

00:36:52.693 --> 00:36:54.655
people doing all sorts of crazy stuff with

00:36:54.675 --> 00:36:57.438
the terminology, physiotherapy,

00:36:57.518 --> 00:36:58.518
physical therapy.

00:36:58.597 --> 00:36:59.659
What is it exactly?

00:37:00.500 --> 00:37:03.302
So it's like even going across state

00:37:03.322 --> 00:37:03.842
lines,

00:37:03.902 --> 00:37:06.884
like I don't think we should be limited

00:37:06.903 --> 00:37:09.244
by state boundaries and what we could do.

00:37:09.806 --> 00:37:11.666
But I know lots of PTs who are

00:37:11.706 --> 00:37:14.528
doing PT across state lines without the

00:37:14.568 --> 00:37:16.811
compact or without licensure in other

00:37:16.851 --> 00:37:17.251
states.

00:37:17.891 --> 00:37:18.070
So,

00:37:18.170 --> 00:37:19.472
it's like if you're going to make a

00:37:19.512 --> 00:37:21.052
law and then not enforce the law,

00:37:21.112 --> 00:37:22.333
how effective is the law?

00:37:22.393 --> 00:37:24.996
What is the purpose of the law?

00:37:25.056 --> 00:37:25.817
So, that too,

00:37:26.197 --> 00:37:28.057
I think when you look at the lack

00:37:28.097 --> 00:37:31.519
of enforcement with other factors,

00:37:32.260 --> 00:37:34.141
I think most of us are still fearful,

00:37:34.222 --> 00:37:34.943
me included.

00:37:35.222 --> 00:37:38.824
I'm pointing at myself to give up what

00:37:39.025 --> 00:37:41.447
little bit of equity we still have in

00:37:41.487 --> 00:37:42.188
the license.

00:37:42.688 --> 00:37:44.849
I still have a license to bill insurance.

00:37:45.389 --> 00:37:47.731
I still have a license to bill Medicare.

00:37:48.112 --> 00:37:50.994
Like there's still some shred of value in

00:37:51.054 --> 00:37:53.876
that that I can build other things upon.

00:37:54.335 --> 00:37:54.675
Hence,

00:37:54.856 --> 00:37:56.898
that's why I have not chosen to give

00:37:56.918 --> 00:37:57.677
it up.

00:37:58.838 --> 00:38:02.041
Ten years is it's kind of far away,

00:38:02.061 --> 00:38:02.981
but it's not that far away.

00:38:03.021 --> 00:38:05.764
So I have to nicely say that I

00:38:05.804 --> 00:38:07.525
strongly disagree with Tony because in ten

00:38:07.545 --> 00:38:08.045
years from now,

00:38:09.010 --> 00:38:10.733
Physical therapists will still be with the

00:38:10.773 --> 00:38:12.034
doctor of physical therapy degree.

00:38:12.054 --> 00:38:13.416
We will still call each other physical

00:38:13.456 --> 00:38:14.396
therapists.

00:38:14.858 --> 00:38:16.780
There's a little pocket that say I'm a

00:38:16.820 --> 00:38:18.481
physio or I'm a physiotherapist because

00:38:18.501 --> 00:38:20.244
that's what is used in Europe and all

00:38:20.284 --> 00:38:21.385
these other countries except for the

00:38:21.405 --> 00:38:21.985
United States.

00:38:23.306 --> 00:38:24.427
Maybe fifty years, Tony.

00:38:24.728 --> 00:38:26.170
Maybe I can agree with fifty years,

00:38:26.210 --> 00:38:27.532
but ten years is...

00:38:28.510 --> 00:38:29.150
Far enough away,

00:38:29.471 --> 00:38:31.192
but close enough where I don't think

00:38:31.211 --> 00:38:32.574
there's going to be a major change in

00:38:32.614 --> 00:38:33.474
our actual title.

00:38:33.974 --> 00:38:36.597
Maybe we'll see more therapists dropping

00:38:36.617 --> 00:38:38.539
their license and just being like self-pay

00:38:38.639 --> 00:38:41.501
and having less restrictions so that they

00:38:41.541 --> 00:38:44.023
don't have to write notes, right?

00:38:44.063 --> 00:38:45.385
I guess that would be one benefit.

00:38:45.405 --> 00:38:45.666
I don't know.

00:38:45.686 --> 00:38:46.005
What else?

00:38:50.514 --> 00:38:51.835
I wonder how long it took,

00:38:52.275 --> 00:38:53.416
and I was just trying to look it

00:38:53.496 --> 00:38:53.677
up,

00:38:54.137 --> 00:38:57.099
how long it took horse-drawn carriages in

00:38:57.139 --> 00:39:00.023
New York to disappear, mostly,

00:39:00.043 --> 00:39:01.284
because there are still horse-drawn

00:39:01.304 --> 00:39:02.204
carriages today.

00:39:02.626 --> 00:39:02.925
There's a few.

00:39:02.945 --> 00:39:04.887
How long did it take for the transition

00:39:04.907 --> 00:39:07.449
to happen from a hundred percent

00:39:07.971 --> 00:39:11.313
horse-drawn carriage in New York to mostly

00:39:11.333 --> 00:39:12.655
cars, Henry Ford?

00:39:12.675 --> 00:39:13.815
A hundred years.

00:39:13.856 --> 00:39:14.237
How long?

00:39:15.528 --> 00:39:16.429
Fifty to one hundred years.

00:39:16.449 --> 00:39:18.190
I don't think so.

00:39:18.251 --> 00:39:18.451
No.

00:39:18.550 --> 00:39:19.351
And I'll tell you why.

00:39:19.371 --> 00:39:20.112
I'll tell you why.

00:39:20.311 --> 00:39:21.612
I'll tell you why it wasn't that long.

00:39:22.653 --> 00:39:24.875
Horseshit.

00:39:24.894 --> 00:39:26.255
The Industrial Revolution,

00:39:27.536 --> 00:39:29.398
the Industrial Revolution brought so many

00:39:29.458 --> 00:39:30.298
people to the city.

00:39:31.420 --> 00:39:33.961
And with city and people came horses and

00:39:33.981 --> 00:39:35.161
with horses came manure.

00:39:35.682 --> 00:39:37.764
They said in ten years,

00:39:38.625 --> 00:39:40.405
horseshit will be nine feet deep.

00:39:41.641 --> 00:39:43.503
then they had to pivot hard to cars

00:39:43.563 --> 00:39:44.844
because otherwise you were going to have

00:39:44.905 --> 00:39:45.445
disease.

00:39:45.786 --> 00:39:47.226
So they pivoted fast.

00:39:47.628 --> 00:39:49.068
This is like saying, like,

00:39:49.289 --> 00:39:50.710
how long did it take us to go

00:39:50.771 --> 00:39:51.311
from, like,

00:39:51.492 --> 00:39:55.635
bicycle commuting to city bus or car

00:39:55.655 --> 00:39:56.016
commuting?

00:39:56.237 --> 00:39:56.356
Like,

00:39:56.376 --> 00:39:57.918
there's still people commuting on bikes

00:39:58.079 --> 00:40:01.422
and walking to work because they got a

00:40:01.442 --> 00:40:02.684
DUI or whatever.

00:40:03.184 --> 00:40:03.864
There is,

00:40:03.945 --> 00:40:05.666
and they're still horse-drawn carriages.

00:40:05.706 --> 00:40:06.786
So ChatGPT said,

00:40:06.826 --> 00:40:10.228
twenty-five to thirty-five years to go

00:40:10.248 --> 00:40:13.210
from all horses to predominantly cars.

00:40:14.190 --> 00:40:16.411
How long has AI been around?

00:40:16.472 --> 00:40:16.672
Like,

00:40:16.733 --> 00:40:20.494
we have to acknowledge the impact of AI

00:40:20.574 --> 00:40:23.936
relative to the impact of cars to replace

00:40:23.976 --> 00:40:26.217
the majority, not a hundred percent,

00:40:26.277 --> 00:40:28.139
but the majority of what we are doing

00:40:28.179 --> 00:40:29.820
right now as PTs.

00:40:30.820 --> 00:40:33.123
um and i just i think what's going

00:40:33.143 --> 00:40:35.425
to happen is it creates the vacuum that

00:40:35.965 --> 00:40:37.967
sucks out all of the bottom of the

00:40:38.007 --> 00:40:40.949
market i'm not saying a pt a human

00:40:41.010 --> 00:40:43.753
pt isn't going to be there for the

00:40:43.793 --> 00:40:46.094
more complicated more complex more

00:40:46.135 --> 00:40:48.597
involved individual who's going to take

00:40:48.617 --> 00:40:50.878
into account the psychosocial and and the

00:40:51.018 --> 00:40:53.862
economic and you know the history of the

00:40:53.902 --> 00:40:55.784
family and all of these other things

00:40:56.264 --> 00:40:59.125
But I'm saying the majority of simple

00:40:59.204 --> 00:41:00.505
outpatient orthopedics,

00:41:00.706 --> 00:41:02.407
the majority of simple neuro,

00:41:02.726 --> 00:41:04.708
the majority of simple pediatric,

00:41:04.728 --> 00:41:08.528
the majority of these simple things that I

00:41:08.568 --> 00:41:10.510
know you always say this and I love

00:41:10.550 --> 00:41:11.431
it and I respect it.

00:41:11.490 --> 00:41:13.492
But this is the this is the people

00:41:13.512 --> 00:41:15.331
that already cancel no show and stop

00:41:15.351 --> 00:41:16.472
coming to physical therapy anyway.

00:41:17.969 --> 00:41:20.811
So you agree with that?

00:41:20.831 --> 00:41:22.393
So they're already sucked out of the

00:41:22.432 --> 00:41:22.952
market, Tony,

00:41:22.972 --> 00:41:24.253
because they come for one or two or

00:41:24.273 --> 00:41:25.974
three visits and they're like, this,

00:41:26.014 --> 00:41:27.056
my thing is not that bad,

00:41:27.275 --> 00:41:29.197
or I don't have the money or I'm

00:41:29.237 --> 00:41:30.498
not that, uh,

00:41:30.518 --> 00:41:31.840
I don't want to invest that much in

00:41:31.960 --> 00:41:34.280
my health time or money.

00:41:34.581 --> 00:41:37.204
So they already don't go to physical

00:41:37.224 --> 00:41:37.423
therapy.

00:41:37.483 --> 00:41:39.164
They come, they dabble and they're like,

00:41:39.224 --> 00:41:41.126
I'm out because they don't want to do

00:41:41.166 --> 00:41:42.166
it or they, whatever.

00:41:42.186 --> 00:41:42.987
There's so many reasons.

00:41:43.512 --> 00:41:45.375
I would love to see how much that

00:41:45.494 --> 00:41:47.376
exactly what you said, that dabble,

00:41:47.416 --> 00:41:50.780
that I've got patients right now that'll

00:41:50.820 --> 00:41:53.302
schedule three and four evaluations,

00:41:53.422 --> 00:41:54.403
keep canceling,

00:41:54.443 --> 00:41:55.905
keep no showing three and four times.

00:41:55.945 --> 00:41:57.887
Because they're not serious and nothing

00:41:57.907 --> 00:41:59.449
with AI will change that.

00:42:00.048 --> 00:42:03.809
The impact of that on the profession at

00:42:03.889 --> 00:42:07.451
large is so massive that is what will

00:42:07.490 --> 00:42:08.030
disappear.

00:42:08.451 --> 00:42:09.311
Just like right now,

00:42:09.411 --> 00:42:11.811
I probably have four patients on caseload

00:42:12.152 --> 00:42:14.791
who are doing four to six physical therapy

00:42:14.831 --> 00:42:17.413
visits just so they can get an MRI,

00:42:17.853 --> 00:42:19.592
just so they can get a surgery.

00:42:20.273 --> 00:42:21.512
And it's nothing against them.

00:42:21.532 --> 00:42:22.954
That's what they need to do to get

00:42:22.994 --> 00:42:23.974
what they think that they need.

00:42:25.000 --> 00:42:26.119
that is gonna be gone.

00:42:26.539 --> 00:42:28.400
The cancellations, the no-shows,

00:42:28.460 --> 00:42:29.360
the repeat offenders,

00:42:29.440 --> 00:42:30.661
those are all gonna be gone.

00:42:31.222 --> 00:42:32.981
It is gonna clean all of that out.

00:42:33.041 --> 00:42:33.963
That is still there.

00:42:34.003 --> 00:42:34.663
If it wasn't there,

00:42:34.702 --> 00:42:36.222
you wouldn't be telling me about it.

00:42:37.224 --> 00:42:39.503
And that has a bigger negative impact on

00:42:39.704 --> 00:42:41.625
my schedule, my profitability,

00:42:41.744 --> 00:42:43.945
my ability to operate a business.

00:42:43.985 --> 00:42:46.065
If I ran a business in the conventional

00:42:46.126 --> 00:42:46.505
way,

00:42:47.206 --> 00:42:48.567
I would be out of business twenty years

00:42:48.606 --> 00:42:48.786
ago.

00:42:50.077 --> 00:42:51.958
But these same people that we're talking

00:42:51.978 --> 00:42:52.239
about,

00:42:52.898 --> 00:42:55.001
they might also sign up for Hinge Health

00:42:55.041 --> 00:42:56.963
or Sword Health and never log into the

00:42:57.043 --> 00:42:58.384
app because that type of person,

00:42:58.423 --> 00:42:59.724
in my opinion,

00:43:00.266 --> 00:43:01.507
is not serious about their health and

00:43:01.527 --> 00:43:01.907
wellness.

00:43:02.188 --> 00:43:03.489
They're not going to invest the time or

00:43:03.528 --> 00:43:03.809
the money.

00:43:03.909 --> 00:43:05.269
Or if it's Hinge Health and Sword Health,

00:43:05.349 --> 00:43:06.851
I mean, it's basically free, right?

00:43:07.251 --> 00:43:08.353
You see these ads, it's free.

00:43:08.853 --> 00:43:10.295
So there's no barrier to entry.

00:43:10.335 --> 00:43:11.675
They just download an app and they've

00:43:11.835 --> 00:43:13.617
downloaded twenty five or fifty other apps

00:43:13.637 --> 00:43:14.097
on their phone.

00:43:14.117 --> 00:43:15.179
So they know how to do that process.

00:43:15.199 --> 00:43:15.760
They sign up.

00:43:16.320 --> 00:43:18.101
And then they don't log in ever to

00:43:18.201 --> 00:43:20.661
even do it because the person is not

00:43:20.740 --> 00:43:21.202
serious.

00:43:21.262 --> 00:43:23.262
So it doesn't even matter about is a

00:43:23.302 --> 00:43:24.362
concierge out of pocket?

00:43:24.563 --> 00:43:25.202
Is it a network?

00:43:25.242 --> 00:43:27.224
Is it only a twenty dollar copay or

00:43:27.324 --> 00:43:30.123
is it free for my employer or however

00:43:30.143 --> 00:43:31.364
they access one of these AI?

00:43:32.085 --> 00:43:34.206
I don't think AI changes these people at

00:43:34.266 --> 00:43:34.766
all, ever.

00:43:37.438 --> 00:43:39.298
Yeah, it was this decision to change,

00:43:39.599 --> 00:43:39.759
right?

00:43:39.798 --> 00:43:41.219
It was not lack of information.

00:43:41.699 --> 00:43:43.219
We've not had a lack of information

00:43:43.280 --> 00:43:45.541
problem in a long, long time.

00:43:46.922 --> 00:43:48.621
The pain isn't great enough to overcome

00:43:48.641 --> 00:43:49.842
the effort required to change.

00:43:50.315 --> 00:43:52.097
Before we hit Dana's comment,

00:43:52.818 --> 00:43:55.280
I agree with Dave, a hundred percent.

00:43:55.340 --> 00:43:58.344
The difference is now the individual that

00:43:58.384 --> 00:44:01.646
would have cost me unreasonable amounts of

00:44:01.686 --> 00:44:04.449
resources and still dropped off,

00:44:04.929 --> 00:44:07.932
that person goes to a digital platform

00:44:07.992 --> 00:44:10.275
where it costs virtually nothing.

00:44:10.755 --> 00:44:12.597
It doesn't matter if they drop off.

00:44:12.958 --> 00:44:14.500
Now, I'm not going to blame them.

00:44:14.559 --> 00:44:15.722
I'm not going to say they don't care

00:44:15.742 --> 00:44:16.382
about their health.

00:44:16.402 --> 00:44:16.922
They do.

00:44:17.364 --> 00:44:18.885
I'm not going to say they're not serious.

00:44:18.925 --> 00:44:19.447
They are.

00:44:19.847 --> 00:44:22.110
It's just this isn't the solution for

00:44:22.170 --> 00:44:22.530
them.

00:44:22.992 --> 00:44:23.932
And totally fine.

00:44:24.393 --> 00:44:24.614
You know,

00:44:24.634 --> 00:44:26.135
but the idea is when the doctor says

00:44:26.175 --> 00:44:27.458
go to therapy and they don't want to

00:44:27.498 --> 00:44:28.259
go to therapy,

00:44:28.798 --> 00:44:31.940
Now they have an option to still do

00:44:31.960 --> 00:44:33.139
what they would have done,

00:44:33.619 --> 00:44:36.481
but not take away from my resources.

00:44:36.840 --> 00:44:39.561
They could go digital and not do therapy.

00:44:39.641 --> 00:44:40.842
They don't have to come to me and

00:44:40.882 --> 00:44:41.762
not do therapy.

00:44:42.262 --> 00:44:43.802
I think it's a huge benefit.

00:44:44.163 --> 00:44:45.742
And I do think just like Dana,

00:44:45.762 --> 00:44:46.983
if you want to put that back up,

00:44:47.443 --> 00:44:47.884
you know,

00:44:47.903 --> 00:44:50.164
we're going to see this just like graphic

00:44:50.204 --> 00:44:50.764
design.

00:44:51.405 --> 00:44:53.264
I don't use a graphic designer because the

00:44:53.344 --> 00:44:55.666
simple stuff has been wiped out by

00:44:55.965 --> 00:44:57.126
artificial intelligence.

00:45:00.043 --> 00:45:00.503
Thank you, Will.

00:45:00.643 --> 00:45:00.985
Love you.

00:45:01.005 --> 00:45:02.726
When Dave brings the Philly out of him,

00:45:02.746 --> 00:45:03.927
he gets all fired up.

00:45:03.947 --> 00:45:05.007
But Dana,

00:45:05.088 --> 00:45:07.891
always a great voice of not even just

00:45:07.971 --> 00:45:08.331
reason.

00:45:08.452 --> 00:45:10.032
I feel like she sees around corners,

00:45:10.052 --> 00:45:10.152
right?

00:45:10.172 --> 00:45:11.275
Because this is what she does.

00:45:11.315 --> 00:45:11.594
She says,

00:45:11.635 --> 00:45:13.416
the same is predicted for primary care

00:45:13.456 --> 00:45:13.956
physicians.

00:45:14.518 --> 00:45:16.298
AI will take over the simple to moderate

00:45:16.440 --> 00:45:17.099
primary care.

00:45:18.088 --> 00:45:19.148
And I'd love to hear what Dana has

00:45:19.188 --> 00:45:19.528
to think.

00:45:19.748 --> 00:45:22.369
I've heard some other smart people say

00:45:22.949 --> 00:45:25.971
that's actually going to be difficult for

00:45:26.010 --> 00:45:27.090
the people in healthcare.

00:45:27.291 --> 00:45:28.492
And this was their explanation.

00:45:28.972 --> 00:45:29.911
Every once in a while,

00:45:29.952 --> 00:45:30.992
if I can sort of turn my brain

00:45:31.032 --> 00:45:31.172
off,

00:45:31.192 --> 00:45:33.092
like someone walks in and when Tony sees

00:45:33.132 --> 00:45:34.253
a total knee replacement patient,

00:45:34.273 --> 00:45:36.092
he's like, great, I've run this play.

00:45:36.634 --> 00:45:37.594
This is a bootleg, right?

00:45:37.653 --> 00:45:39.434
I've run this play for ten thousand times,

00:45:39.793 --> 00:45:39.934
right?

00:45:40.434 --> 00:45:41.894
I can sort of predict and he can

00:45:41.914 --> 00:45:43.074
sort of turn his brain off,

00:45:43.215 --> 00:45:44.536
which for humans,

00:45:45.076 --> 00:45:45.996
we sort of need to do that.

00:45:46.576 --> 00:45:48.478
So what these people were predicting is

00:45:48.518 --> 00:45:50.300
just what Dana is saying is, A,

00:45:50.360 --> 00:45:51.780
I will take over the simple to moderate

00:45:51.820 --> 00:45:52.382
primary care.

00:45:52.722 --> 00:45:55.724
If all you're seeing are the zebras,

00:45:56.284 --> 00:45:57.827
what does that do to you?

00:45:58.347 --> 00:46:00.489
And what does that do to a profession

00:46:00.590 --> 00:46:02.692
or people just entering the profession or

00:46:02.731 --> 00:46:03.873
people who've been in the profession?

00:46:04.172 --> 00:46:05.514
If you're not seeing any horses,

00:46:05.735 --> 00:46:06.956
you're only seeing zebras.

00:46:09.023 --> 00:46:09.722
I just, by the way,

00:46:09.822 --> 00:46:10.943
I already pay for insurance.

00:46:10.963 --> 00:46:12.224
We're paying like,

00:46:12.684 --> 00:46:13.724
I think it's like eighteen hundred a

00:46:13.784 --> 00:46:13.943
month,

00:46:13.963 --> 00:46:16.105
which is kind of ridiculous for no value,

00:46:16.585 --> 00:46:17.445
minimal to no value.

00:46:17.485 --> 00:46:19.925
And then premium increases and they say,

00:46:20.085 --> 00:46:21.206
oh, we're going to increase your premiums.

00:46:21.626 --> 00:46:22.726
And we and we get no value.

00:46:22.746 --> 00:46:24.027
We get no additional value.

00:46:24.047 --> 00:46:24.507
We get nothing.

00:46:24.567 --> 00:46:24.788
Right.

00:46:25.168 --> 00:46:27.168
So two weeks ago or three weeks ago,

00:46:27.208 --> 00:46:29.349
I just signed up to pay a primary

00:46:29.389 --> 00:46:30.668
care physician in person.

00:46:31.108 --> 00:46:32.789
He also does telehealth and all that type

00:46:32.869 --> 00:46:33.389
of stuff.

00:46:33.809 --> 00:46:35.331
Two hundred fifty bucks a month to join

00:46:35.351 --> 00:46:37.052
his primary care membership.

00:46:37.112 --> 00:46:39.454
And we have nothing emergent.

00:46:39.594 --> 00:46:40.655
We have nothing serious.

00:46:41.195 --> 00:46:43.976
And so I also am going to disagree

00:46:43.996 --> 00:46:44.356
with that.

00:46:44.797 --> 00:46:46.438
I'm not saying I'm not disagreeing with

00:46:46.458 --> 00:46:46.677
Dana,

00:46:46.697 --> 00:46:48.539
but I'm saying she's saying the prediction

00:46:48.619 --> 00:46:51.161
is primary care physicians that I will

00:46:51.181 --> 00:46:53.822
help take over the simple to moderate.

00:46:54.543 --> 00:46:56.905
I think that that could in some

00:46:56.965 --> 00:46:58.045
situations, but also.

00:46:58.786 --> 00:46:59.827
there's certain I don't know what

00:46:59.867 --> 00:47:01.369
percentage of consumers are like me in the

00:47:01.389 --> 00:47:01.728
market.

00:47:02.009 --> 00:47:04.431
But there's people that want a physician

00:47:04.512 --> 00:47:05.733
in person or telehealth.

00:47:06.052 --> 00:47:07.335
And maybe we'll say, Hey,

00:47:07.675 --> 00:47:08.536
maybe we could agree on this,

00:47:08.775 --> 00:47:12.360
a physician nowadays, who utilizes AI,

00:47:13.019 --> 00:47:15.302
but still the the humanistic

00:47:15.842 --> 00:47:16.543
It could be in person,

00:47:16.583 --> 00:47:18.043
it could be telehealth, whatever.

00:47:18.523 --> 00:47:20.105
I want a physician who uses AI,

00:47:20.144 --> 00:47:21.905
maybe for differential diagnosis or

00:47:22.306 --> 00:47:22.786
whatever,

00:47:23.925 --> 00:47:25.947
but I still want a human interaction.

00:47:26.286 --> 00:47:28.208
I don't want just like a,

00:47:28.427 --> 00:47:30.489
whatever the AI physician version is of

00:47:30.548 --> 00:47:31.608
Hinge Health or Sword Health.

00:47:31.949 --> 00:47:32.449
I don't want that.

00:47:32.710 --> 00:47:34.269
I could just chat you BT at Gemini,

00:47:34.289 --> 00:47:34.931
Claude, whatever.

00:47:35.751 --> 00:47:37.514
What benefit does that give me?

00:47:37.554 --> 00:47:41.300
What certainty or belief does that give me

00:47:41.400 --> 00:47:43.302
as a consumer or a patient who has

00:47:43.342 --> 00:47:45.085
something moderate to,

00:47:45.967 --> 00:47:47.009
maybe it's a little more moderate,

00:47:47.289 --> 00:47:48.090
maybe it's above moderate?

00:47:50.179 --> 00:47:51.780
Yeah, I think that's consensus.

00:47:52.420 --> 00:47:53.822
At some point here,

00:47:54.001 --> 00:47:56.902
the physician who refuses to use AI,

00:47:56.922 --> 00:47:59.603
the health care provider who refuses to

00:47:59.744 --> 00:48:03.085
use AI now becomes negligent,

00:48:03.226 --> 00:48:05.067
now becomes liable.

00:48:05.106 --> 00:48:07.728
How could you possibly refuse to use this

00:48:07.788 --> 00:48:10.728
technology to support your own clinical

00:48:10.768 --> 00:48:11.530
decision making?

00:48:12.369 --> 00:48:13.670
I told my kids the other day,

00:48:13.891 --> 00:48:15.532
my twins are fifteen and a half.

00:48:15.572 --> 00:48:17.514
They're driving every day with me.

00:48:18.114 --> 00:48:18.434
I'm like,

00:48:18.894 --> 00:48:21.217
you guys are probably on the cusp pretty

00:48:21.257 --> 00:48:21.536
soon.

00:48:21.677 --> 00:48:24.458
It's insurance is going to be tenfold more

00:48:24.518 --> 00:48:26.521
expensive if you want to drive the car

00:48:26.561 --> 00:48:30.003
yourself because the car should drive

00:48:30.063 --> 00:48:32.045
itself, which will reduce the cost,

00:48:32.125 --> 00:48:33.405
reduce the liability,

00:48:33.465 --> 00:48:34.726
reduce the accident rates,

00:48:34.786 --> 00:48:35.708
all of these things.

00:48:37.753 --> 00:48:38.193
Which again,

00:48:38.233 --> 00:48:40.335
we're moving into such a different world.

00:48:41.076 --> 00:48:43.777
Even if the person watching this doesn't

00:48:43.836 --> 00:48:44.117
agree,

00:48:44.137 --> 00:48:45.838
because I did hear a really good case

00:48:46.139 --> 00:48:50.800
to support why true AGI will never happen

00:48:50.981 --> 00:48:54.663
and the amount of technology needed for

00:48:54.864 --> 00:48:57.885
true artificial intelligence at the

00:48:57.925 --> 00:49:00.306
highest level is never going to arrive.

00:49:01.351 --> 00:49:02.911
Just where we are today,

00:49:02.972 --> 00:49:04.293
just where we are right now,

00:49:04.472 --> 00:49:05.853
even with the hallucinations,

00:49:05.914 --> 00:49:07.014
even with the mistakes,

00:49:07.355 --> 00:49:09.096
Jimmy and I were joking the other day,

00:49:09.155 --> 00:49:10.996
like we talk,

00:49:11.016 --> 00:49:13.778
the person who says AI makes mistakes has

00:49:13.858 --> 00:49:14.900
never met a human,

00:49:15.440 --> 00:49:18.581
has never met somebody who is up late

00:49:18.621 --> 00:49:20.824
the night before, went out drinking.

00:49:21.224 --> 00:49:22.565
didn't have their coffee.

00:49:22.625 --> 00:49:23.865
Like, are you kidding me?

00:49:23.925 --> 00:49:24.626
Seriously?

00:49:24.987 --> 00:49:25.947
And if you're not sure,

00:49:26.068 --> 00:49:27.548
just go across social media.

00:49:27.989 --> 00:49:31.791
There is so much craziness all across

00:49:31.831 --> 00:49:34.273
social media of people doing crazy stuff

00:49:34.293 --> 00:49:37.255
far beyond any hallucination AI could ever

00:49:37.295 --> 00:49:37.677
have.

00:49:39.378 --> 00:49:41.059
Yeah, like we're already at that point.

00:49:42.019 --> 00:49:43.860
I do think Dave, Jimmy,

00:49:43.900 --> 00:49:45.001
the three of us agree,

00:49:45.762 --> 00:49:48.905
AI plus the human is the perfect scenario,

00:49:48.925 --> 00:49:49.905
at least for right now.

00:49:50.222 --> 00:49:51.081
Yeah, there's a great book.

00:49:51.121 --> 00:49:52.922
I just started it because I was flying

00:49:52.963 --> 00:49:53.224
back,

00:49:53.264 --> 00:49:54.664
and I usually buy books when I'm in

00:49:54.684 --> 00:49:55.164
the airport.

00:49:55.184 --> 00:49:56.344
That's when I actually buy books.

00:49:57.105 --> 00:49:58.365
There's a guy by the name of Cory

00:49:58.405 --> 00:50:00.507
Doctorow, who's a super smart dude.

00:50:00.666 --> 00:50:02.228
He's written for Wired Magazine, boing,

00:50:02.268 --> 00:50:02.547
boing.

00:50:02.568 --> 00:50:03.809
He writes fiction and nonfiction,

00:50:04.188 --> 00:50:05.409
and he's got this book now.

00:50:05.710 --> 00:50:05.809
Well,

00:50:05.829 --> 00:50:07.891
his last book is called In Shitification.

00:50:07.951 --> 00:50:10.132
I figure if I'm gonna drop S bombs

00:50:10.172 --> 00:50:10.452
and stuff,

00:50:10.472 --> 00:50:11.233
I might as well do a couple in

00:50:11.253 --> 00:50:11.612
an episode.

00:50:12.632 --> 00:50:13.432
I'm not reading that one.

00:50:13.532 --> 00:50:16.313
I'm reading The Reverse Centaur's Guide to

00:50:16.373 --> 00:50:17.434
Life After AI.

00:50:17.755 --> 00:50:19.614
And you guys know what a centaur is,

00:50:19.675 --> 00:50:19.934
right?

00:50:20.414 --> 00:50:22.556
So a centaur is a good use of

00:50:22.596 --> 00:50:23.335
technology.

00:50:23.795 --> 00:50:25.936
It's the human brain on top of a

00:50:25.996 --> 00:50:26.777
horse's body.

00:50:26.856 --> 00:50:29.898
Horse, very strong, super efficient, yada,

00:50:29.918 --> 00:50:30.217
yada.

00:50:30.978 --> 00:50:34.239
He's saying, and again, I'm a chapter in,

00:50:34.739 --> 00:50:36.920
but my vibe is make sure you're not

00:50:36.960 --> 00:50:37.960
a reverse centaur.

00:50:38.340 --> 00:50:41.300
Make sure you're not a horse's brain

00:50:41.340 --> 00:50:41.541
centaur.

00:50:42.550 --> 00:50:44.472
strapped to a human body, right?

00:50:44.492 --> 00:50:46.112
So make sure you're not just an idiot

00:50:46.211 --> 00:50:49.152
following as fast as a human can go,

00:50:49.172 --> 00:50:50.072
which is less than a horse.

00:50:50.713 --> 00:50:52.054
I said this to students yesterday at the

00:50:52.094 --> 00:50:53.094
College of Staten Island.

00:50:54.094 --> 00:50:54.335
Listen,

00:50:54.855 --> 00:50:56.335
because some students are pushing back

00:50:56.655 --> 00:50:57.315
about AI.

00:50:57.436 --> 00:50:58.195
And that's great.

00:50:58.416 --> 00:51:00.697
Question lots of things, right?

00:51:01.016 --> 00:51:02.938
And I said, you have a choice.

00:51:03.657 --> 00:51:04.378
You can say,

00:51:04.717 --> 00:51:06.179
I decide I don't want to work in

00:51:06.199 --> 00:51:08.239
a practice who uses AI documentation.

00:51:08.518 --> 00:51:09.880
That is your choice.

00:51:10.639 --> 00:51:11.340
It is a tool.

00:51:11.561 --> 00:51:13.422
But then understand what that tool

00:51:13.481 --> 00:51:14.003
requires.

00:51:14.282 --> 00:51:16.804
If we're a tree company and I say,

00:51:17.244 --> 00:51:18.827
your job is to work for eight hours

00:51:18.927 --> 00:51:20.347
and you'll be paid commiserate to how many

00:51:20.407 --> 00:51:21.389
trees you knock down,

00:51:21.528 --> 00:51:23.070
and I don't want to use gas power

00:51:23.110 --> 00:51:25.592
because carbon monoxide, that's okay.

00:51:25.972 --> 00:51:27.853
Sharpen that ax and get to work.

00:51:28.153 --> 00:51:29.916
But understand we're in the number of

00:51:29.996 --> 00:51:31.297
trees cut down game.

00:51:31.637 --> 00:51:33.057
Understand what game you're playing.

00:51:33.318 --> 00:51:36.900
So you can live however you want, but...

00:51:37.722 --> 00:51:39.463
the universe and the world is moving in

00:51:39.503 --> 00:51:41.184
a different direction and if you're not on

00:51:41.264 --> 00:51:43.284
it i'm just worried that you're going to

00:51:43.304 --> 00:51:45.085
be left behind and that if you're okay

00:51:45.106 --> 00:51:47.927
with that that's okay because as my dad

00:51:47.967 --> 00:51:49.487
always said one day we're all going to

00:51:49.507 --> 00:51:51.548
be dirt so make a decision what do

00:51:51.568 --> 00:51:57.070
you want to be doing i'll let you

00:51:57.090 --> 00:52:01.313
guys know tony you're muted we'll do

00:52:01.353 --> 00:52:04.594
parting shots yeah yeah go ahead let's do

00:52:04.614 --> 00:52:05.275
parting shots

00:52:07.719 --> 00:52:09.559
I'll go first.

00:52:09.679 --> 00:52:09.860
Go ahead.

00:52:09.880 --> 00:52:10.239
I was going to say,

00:52:10.300 --> 00:52:11.340
understand what game you're playing.

00:52:11.360 --> 00:52:12.579
We started with Barnes and Noble.

00:52:12.659 --> 00:52:15.460
We shifted that to what, of course,

00:52:15.501 --> 00:52:17.400
what our audience of PT, clinic owners,

00:52:17.440 --> 00:52:17.981
clinicians,

00:52:18.101 --> 00:52:20.001
anything is going to be doing with it.

00:52:20.461 --> 00:52:22.501
Just try to zoom out and see what

00:52:22.541 --> 00:52:23.242
the game is.

00:52:23.382 --> 00:52:24.682
And then I would say, zoom in,

00:52:24.983 --> 00:52:26.923
not even on the game, on yourself.

00:52:27.164 --> 00:52:28.543
This is where that stuff that we had

00:52:28.563 --> 00:52:29.923
to do in PT school that I hated,

00:52:30.184 --> 00:52:30.824
reflection.

00:52:31.123 --> 00:52:31.164
Oh,

00:52:31.184 --> 00:52:32.304
I hated it when I was in PT

00:52:32.324 --> 00:52:32.545
school.

00:52:33.364 --> 00:52:34.346
But I do it a lot more now

00:52:34.385 --> 00:52:36.606
and I find out I make better decisions

00:52:36.626 --> 00:52:38.088
when I stop for a half a second

00:52:38.288 --> 00:52:38.967
and actually think,

00:52:39.588 --> 00:52:40.588
what am I going to fit in well

00:52:40.608 --> 00:52:40.869
with?

00:52:41.048 --> 00:52:42.030
What's going to work for me?

00:52:42.329 --> 00:52:43.431
Not next Tuesday,

00:52:43.650 --> 00:52:45.112
but fifteen Tuesdays from now.

00:52:45.371 --> 00:52:46.913
So understand what game you're playing and

00:52:46.932 --> 00:52:48.532
what game you like to play and are

00:52:48.552 --> 00:52:50.213
equipped to play and want to be playing

00:52:50.253 --> 00:52:51.315
fifteen Tuesdays from now.

00:52:52.556 --> 00:52:54.257
All right, parting shot real quick, Dave,

00:52:54.336 --> 00:52:55.396
my two favorites.

00:52:55.918 --> 00:52:57.978
I'll teach my dog one hundred words.

00:52:59.929 --> 00:53:01.753
And then The Napping House.

00:53:02.233 --> 00:53:04.418
I don't know either one.

00:53:04.458 --> 00:53:04.858
I got to get them.

00:53:05.498 --> 00:53:06.760
Oh, man, you got to do it.

00:53:07.061 --> 00:53:08.184
They're still on my head.

00:53:10.882 --> 00:53:13.465
Parting shots for us in this conversation,

00:53:13.505 --> 00:53:14.786
like it doesn't really matter.

00:53:15.027 --> 00:53:16.228
The only thing that matters is serving

00:53:16.268 --> 00:53:17.489
your customer, right?

00:53:17.510 --> 00:53:18.630
So your client, your patient,

00:53:19.072 --> 00:53:20.594
talk about Barnes and Noble and the split

00:53:20.673 --> 00:53:23.155
of how much books they sell versus the

00:53:23.175 --> 00:53:25.418
cafe versus the gift cards versus toys or

00:53:25.438 --> 00:53:25.778
whatever,

00:53:26.179 --> 00:53:27.541
or the bookshop that I was talking about,

00:53:27.581 --> 00:53:29.583
how much they sell books versus toys or

00:53:29.603 --> 00:53:29.882
whatever.

00:53:30.443 --> 00:53:32.025
As long as you just stay in business,

00:53:32.726 --> 00:53:34.568
And if you have problems staying in

00:53:34.588 --> 00:53:34.867
business,

00:53:34.887 --> 00:53:36.989
you got to contact Will Boyd who is

00:53:37.028 --> 00:53:37.429
here live.

00:53:37.469 --> 00:53:38.871
If you have some issues with finances and

00:53:38.911 --> 00:53:40.492
cashflow, check out Will Boyd.

00:53:40.532 --> 00:53:42.253
But the most important thing is your team

00:53:42.333 --> 00:53:43.713
and your customer and your client.

00:53:43.733 --> 00:53:44.514
So it doesn't matter.

00:53:44.894 --> 00:53:46.695
All that matters is serving that client

00:53:46.715 --> 00:53:47.336
and that customer.

00:53:47.356 --> 00:53:48.697
It doesn't matter what your title is.

00:53:48.938 --> 00:53:50.838
It doesn't matter what's the split between

00:53:52.139 --> 00:53:54.021
home visits versus clinic visits or

00:53:54.081 --> 00:53:54.961
telehealth or whatever.

00:53:55.001 --> 00:53:56.402
Like all that matters is serving your

00:53:56.443 --> 00:53:57.923
client and keeping your team.

00:53:58.563 --> 00:54:00.206
And if you do that, then you can,

00:54:00.905 --> 00:54:01.626
you know, you could...

00:54:03.599 --> 00:54:05.340
sail through your, you know,

00:54:05.900 --> 00:54:06.960
your duration of business,

00:54:07.000 --> 00:54:09.021
however long that might be without having

00:54:09.041 --> 00:54:09.842
to pay out of pocket for it.

00:54:10.021 --> 00:54:11.762
The business of business is business,

00:54:12.123 --> 00:54:12.382
right?

00:54:12.402 --> 00:54:13.284
Stay in business.

00:54:13.443 --> 00:54:15.585
If you don't pivot, you're in trouble.

00:54:15.744 --> 00:54:16.164
All right, gentlemen,

00:54:16.184 --> 00:54:17.146
we'll see you guys on Thursday.

00:54:19.862 --> 00:54:20.043
That's it.

00:54:20.063 --> 00:54:20.302
We're out.

00:54:20.322 --> 00:54:21.844
Boys, what the hell are you doing?

00:54:21.884 --> 00:54:24.706
Follow Tony Meritato on YouTube at Total

00:54:24.746 --> 00:54:25.786
Therapy Solution.

00:54:25.847 --> 00:54:26.827
Find Dave Kittle at

00:54:26.867 --> 00:54:30.050
conciergepainrelief.com and on YouTube at

00:54:30.070 --> 00:54:31.251
The Dave Kittle Show.

00:54:31.572 --> 00:54:34.494
And follow Jimmy McKay at PT Podcasts on

00:54:34.614 --> 00:54:35.875
YouTube, the socials,

00:54:35.974 --> 00:54:37.755
and wherever you binge podcasts you

00:54:37.775 --> 00:54:39.438
pretend are for CEUs.

00:54:39.757 --> 00:54:41.199
And hey, just a reminder,

00:54:41.679 --> 00:54:42.980
none of this was for advice.

00:54:43.019 --> 00:54:44.460
This was for entertainment only.

00:54:44.762 --> 00:54:46.182
Our lawyers say that counts.

00:54:46.242 --> 00:54:47.143
Thanks, Keith.