Volume vs Value: The Future of PT Clinics

WEBVTT

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And we are live.

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Welcome back, Dave Kittle.

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How's your day going?

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Good morning.

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Good morning.

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I'm feeling great.

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I mean, let's go.

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Nothing bad happens before eight thirty

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a.m.

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I'm going to do the best I can.

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We've got some crummy weather and crummy

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Internet conditions.

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So, all right.

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Jimmy McKay is out for the day.

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He is South Carolina.

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Is that where he is?

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I didn't catch it.

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He's with Danny Mata or Mate.

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I forget how you say it,

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but I'm looking forward to hearing how

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things go when he comes back.

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Uh,

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you shared something kind of interesting.

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Let's talk about the deal where you had

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a client that found you starting with a

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Google search.

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Yes.

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Um,

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So this is a sister of a prospective

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client in Manhattan.

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So sometimes,

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you know how sometimes it happens where

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there's like a family member that's

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searching for healthcare providers.

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I don't know if it's common near you,

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but for us it's like,

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I don't know if the,

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if the person is like a busy professional

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and maybe they're not taking their health

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seriously,

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then sometimes like a family member steps

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in.

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So this family member found us on Google

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for in-home physical therapy in Manhattan

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for their brother.

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And,

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I always, before I call,

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because if it's me calling,

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I'll usually call from my personal cell

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phone number,

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not even like the go high level number.

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Because when I text them first,

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I want them to make sure that the

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phone gets answered.

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And if it's iMessage,

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then it's a blue text message,

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not a green text message.

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So a little bit of logistics up front.

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So I'll text, you know, hi, so-and-so,

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this is Dr. Kittle,

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Concierge Pain Relief PT.

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You called in regards to,

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and I'll call you back personally in a

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few minutes.

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How did you hear about us?

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Were you referred by?

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a physician, Google, or best of NYC list.

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And this person wrote,

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truly started with a Google search and

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went from there.

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After finding your website,

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I went on to look at reviews on

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other sites, comma, your Instagram,

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et cetera,

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and thought that you and your team could

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be a great fit, exclamation point.

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I'm like, there's some emotion here.

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They saw our Instagram.

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Now, what's amazing is,

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i pitched you know five fifty a visit

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for weekends three fifty visit monday

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through friday or normal self-pay rates

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and they didn't balk at all they were

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they they were like totally warmed up and

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so i want to stop and say thank

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you to tony maritato thank you to jimmy

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mckay for nudging me and uh urging me

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to build up my instagram for concierge

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pain relief because

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This is just validation.

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This person has not followed my account.

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They haven't looked at our stories.

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They haven't liked anything or commented.

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It's like they're invisible and they're

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completely in the ether until you get some

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type of feedback like this.

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Either they follow your account or they

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mention it like this.

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And I had to dig for it.

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They didn't voluntarily say it up front.

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So thank you, first of all.

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And any feedback, any response to that?

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Yeah,

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that's an interesting situation because I

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used to say that it was horrible to

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ask how you found out about us.

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How did you hear of us?

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Before you built a relationship,

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you just said it's the first thing you

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say before you even talk to the person.

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Yes,

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because once you get into the

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relationship, Tony, people forget.

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They're like, oh, I don't know.

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One of the websites online or somebody

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mentioned.

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People forget, at least in my experience.

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People don't recall.

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So I want to ask it before there's

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any relationship.

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That is literally typically the first

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question.

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Usually if someone calls in,

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the answering service is answering our

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phones right now.

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They're supposed to ask it.

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They don't always do because I'm paying a

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thousand dollars a month for an answering

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service.

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So it's kind of like they're humans.

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They read through a script,

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but they don't always ask every aspect of

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the script or the questions of the of

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the script.

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So, you know,

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they're good enough until the AI bots take

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over.

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So we ask that up front because I've

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learned that if I ask it later,

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people forget they have they don't recall.

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I want to for information.

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is it chat gpt is it google is

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is it a friend is it a physician

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because if it's a physician if it's a

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friend word of mouth i say to them

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well can you was it tony or jimmy

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or who was it on a podcast that

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mentioned you know because we like to send

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a handwritten thank you note to whoever

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referred you to us so i want to

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ask it right away when it's fresh in

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their memory

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Right.

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Makes sense.

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I mean, it makes total sense.

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And the reality is we are getting most

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of our referrals through physician

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referrals.

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So it doesn't even, you know,

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it's not as relevant for us.

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But typically, you know,

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my standard advice would be

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Don't come out with guns blazing,

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trying to figure out how you're going to

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get your next patient from this patient,

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chill out first day,

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give them a little space,

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let them breathe,

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like get to know them a little bit.

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And then two,

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three sessions in and be like, Hey,

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you know, I meant to ask you,

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how did you find out about us?

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Like,

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You know,

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especially when we'll usually ask, like,

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have you been to therapy somewhere else?

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I always say,

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what did you like about it when you

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went there?

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What did you not like?

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I had an interesting call the other day,

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younger female patient.

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calling, looking for self-pay rates.

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And this person was like,

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basically had been in a car accident and

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had some back pain.

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I don't know how the conversation came

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this way, but I said, oh,

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so they were like, well,

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I was going to this other therapy clinic,

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but it was too expensive.

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Looking to see what else is in the

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area.

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And I was like, oh, okay, well,

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what'd they do that you liked?

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What'd they do that you didn't like?

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Did they do any manual therapy?

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Because we're

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We are so conditioned to think everybody

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wants to be touched.

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Oh, no, I hate manual therapy.

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I've got fibromyalgia.

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I don't want anybody to touch me.

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I just I did best when we did

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core exercises.

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I was like, holy ass.

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This is my kind of person.

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Let's go bring it in here.

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We can take good care of you.

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So.

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Interesting, interesting story.

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I found a website.

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I saw this.

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We're going to switch topics just a little

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bit,

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but I want to get your take on

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it.

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A guy came in actually yesterday.

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He was an investor in a new startup.

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It is a neuro rehab,

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but he is not a physical therapist.

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They do have a physical therapist on site,

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but it is not physical therapy.

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It's designed for individuals who have

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Parkinson's, stroke,

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Traumatic brain injury.

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It is not insurance-based.

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It's self-pay.

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They have basically games and equipment

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that you get on with virtual reality and

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the goggles and all the stuff that we've

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heard about.

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They're brand new to the area.

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I think they have five other locations

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around the United States.

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They're trying to build a footprint.

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And the guy was nice enough.

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He said,

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we got to talking and he was in

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sales for other things, got into this.

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I'm like,

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who's handling your social media?

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He was like, you're looking at him.

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We started talking about it a little bit,

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but immediately after he left,

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an ad popped up on Facebook.

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Tell me they're not listening.

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for something very similar.

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So I'm going to pull it up on

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the screen.

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For those of you listening,

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it's called stroke.fitness.

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This particular one,

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it's different from the guy who came in

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yesterday, but there's some similarities.

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This is down in Tampa, Florida.

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And basically what this is, it's self pay.

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It's not therapy.

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It's for individuals who have had a stroke

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who want to get into fitness.

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They have a series of machines.

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I'll see they have a bunch of video

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testimonials.

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I'll see if I can find some of

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the pictures of the equipment they have.

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Pricing plans,

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one hundred and seventy nine dollars a

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month for remote membership, which,

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you know,

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that doesn't seem like it'd be effective,

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but three hundred and seventy nine a

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month.

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For on-site membership.

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For context,

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we charge a hundred a month for patients

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to come in and just kind of work

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out thirty to forty minutes,

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usually twice a week.

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So, you know,

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they're they're almost four times the

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price.

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But I don't understand why a great

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neurotherapist wouldn't do something like

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this.

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Any thoughts on your end?

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I love it.

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Struck out fitness.

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um, neuro, this could be,

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you just use the equipment by yourself or

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is it like you have a coach trainer

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person or is it group?

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There's a coach on site.

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Uh, there's guided, you know, workouts.

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They don't have a great website.

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I've seen actually on their Facebook.

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Let me see if I can pull up

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their Facebook.

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Um, some videos of, of their,

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of their clients, um,

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Yeah, they have videos and testimonials,

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but really like as somebody looking into

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this, I want to see what they're doing.

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OK,

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so here you should be able to see

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that, you know,

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here's the video of somebody walking into

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the facility.

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These are the machines they have.

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I think we're going to see a lot

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more of this happening.

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where physical therapists,

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occupational therapists,

00:09:55.844 --> 00:09:57.764
we're not satisfying the need.

00:09:58.745 --> 00:10:00.586
We're not providing access.

00:10:00.626 --> 00:10:02.168
We're not getting to enough people.

00:10:03.009 --> 00:10:05.409
And you're going to see entrepreneurial,

00:10:05.450 --> 00:10:08.832
business-minded, non-clinicians say, hey,

00:10:08.852 --> 00:10:10.234
there is a gap in the market.

00:10:10.833 --> 00:10:11.774
We could do it cheaper.

00:10:12.034 --> 00:10:13.296
We could probably do it better.

00:10:13.775 --> 00:10:16.437
We could do it with more accessibility to

00:10:16.518 --> 00:10:17.138
more people.

00:10:17.899 --> 00:10:20.480
And this is what's going to make up

00:10:20.519 --> 00:10:21.400
the difference for

00:10:22.078 --> 00:10:24.399
Fewer therapists going into school,

00:10:24.880 --> 00:10:26.822
fewer therapists paying the money to get,

00:10:27.282 --> 00:10:29.403
which we'll talk about the longevity of a

00:10:29.462 --> 00:10:30.244
career in a minute.

00:10:31.964 --> 00:10:33.926
I think this is going to be what

00:10:33.985 --> 00:10:34.586
happens.

00:10:34.885 --> 00:10:36.606
And just last thing before you go,

00:10:37.047 --> 00:10:37.807
before you talk,

00:10:38.567 --> 00:10:40.028
I went into chat GPT and I was

00:10:40.048 --> 00:10:40.229
like,

00:10:40.428 --> 00:10:42.049
how many licensed therapists are in the

00:10:42.110 --> 00:10:43.051
United States right now?

00:10:44.024 --> 00:10:45.385
And it was like almost three hundred

00:10:45.426 --> 00:10:45.785
thousand.

00:10:46.307 --> 00:10:47.788
How many licensed physical therapist

00:10:47.947 --> 00:10:50.328
assistants are in the United States right

00:10:50.349 --> 00:10:50.489
now?

00:10:50.528 --> 00:10:51.990
And it was under one hundred thousand,

00:10:52.009 --> 00:10:52.770
which I was surprised.

00:10:52.811 --> 00:10:53.611
I thought it would be more.

00:10:54.746 --> 00:10:55.488
And then I said,

00:10:55.768 --> 00:10:57.809
if you took all of these licensed

00:10:57.850 --> 00:10:58.691
therapists,

00:10:59.311 --> 00:11:01.393
assume they work forty hours a week,

00:11:01.933 --> 00:11:04.096
assume they see one patient an hour.

00:11:04.897 --> 00:11:07.339
How many total with the capacity,

00:11:07.379 --> 00:11:09.721
how many total visits could be delivered?

00:11:10.422 --> 00:11:12.104
And then I said,

00:11:12.144 --> 00:11:14.206
are there any objective numbers out there

00:11:14.225 --> 00:11:16.307
for how many people in the United States

00:11:16.368 --> 00:11:18.190
actually need or would benefit from

00:11:18.250 --> 00:11:18.990
physical therapy?

00:11:19.711 --> 00:11:22.172
And Chachi PT was like, conservatively,

00:11:22.192 --> 00:11:24.072
a hundred million people would benefit

00:11:24.113 --> 00:11:25.052
from PT.

00:11:26.734 --> 00:11:29.335
PTs right now, if everybody was working,

00:11:29.556 --> 00:11:31.015
everybody did one an hour,

00:11:31.115 --> 00:11:34.398
you'd be looking at something like it was

00:11:34.437 --> 00:11:36.778
like a one fifth.

00:11:37.019 --> 00:11:39.559
We can handle one fifth of the capacity

00:11:39.720 --> 00:11:41.561
of what actually needs to be served.

00:11:43.952 --> 00:11:44.594
Well, I mean,

00:11:44.614 --> 00:11:46.034
there's a lot there because there's always

00:11:46.054 --> 00:11:48.196
going to be some patients and clients out

00:11:48.235 --> 00:11:49.596
there that don't want treatment.

00:11:50.918 --> 00:11:51.158
I mean,

00:11:51.239 --> 00:11:52.659
there's patients and clients out there

00:11:52.679 --> 00:11:54.081
that don't want to go to their primary

00:11:54.181 --> 00:11:55.481
or haven't seen their primary in ten or

00:11:55.522 --> 00:11:56.121
twenty years, right?

00:11:56.142 --> 00:11:58.283
So I think there's similar numbers,

00:11:58.524 --> 00:11:59.945
you included.

00:12:00.164 --> 00:12:03.148
There's similar numbers for I think any of

00:12:03.187 --> 00:12:05.730
the health care providers out there.

00:12:06.210 --> 00:12:06.629
So, of course,

00:12:06.649 --> 00:12:07.510
we're not going to be able to serve

00:12:07.551 --> 00:12:07.971
everyone.

00:12:08.051 --> 00:12:09.832
And then there's the combination of like

00:12:10.133 --> 00:12:12.595
cost or travel to an office or

00:12:13.464 --> 00:12:15.926
If it's home visits, it's more convenient,

00:12:15.985 --> 00:12:18.147
but that's through their insurance maybe.

00:12:18.346 --> 00:12:19.548
Or if it's self-paced,

00:12:19.788 --> 00:12:21.428
that might price out certain people,

00:12:21.509 --> 00:12:21.690
right?

00:12:21.769 --> 00:12:22.610
Even in New York City,

00:12:22.629 --> 00:12:23.610
there's some people that don't want to pay

00:12:23.650 --> 00:12:25.972
out of pocket for the convenience or for

00:12:25.993 --> 00:12:27.052
like a different experience.

00:12:27.754 --> 00:12:29.855
There's some people that just don't want

00:12:30.294 --> 00:12:32.517
to do the effort that would be required

00:12:32.576 --> 00:12:34.477
for this type of stroke fitness or stroke

00:12:34.518 --> 00:12:37.900
rehab or whatever the treatment might be.

00:12:40.600 --> 00:12:41.961
Let me ask you a question in terms

00:12:42.020 --> 00:12:44.662
of the licensed health care providers for

00:12:44.942 --> 00:12:46.443
like physical therapists that can help

00:12:47.063 --> 00:12:48.644
folks with stroke or any other movement

00:12:48.684 --> 00:12:48.985
issues.

00:12:50.025 --> 00:12:51.527
What would be the ideal number?

00:12:51.586 --> 00:12:51.726
Like,

00:12:51.767 --> 00:12:56.089
should we have one to one from should

00:12:56.109 --> 00:12:57.429
we should we have one hundred million

00:12:58.091 --> 00:12:58.870
physical therapists?

00:12:58.890 --> 00:13:01.832
Should we have PTs and OTs or anyone

00:13:01.852 --> 00:13:03.573
that can help with stroke or movement

00:13:03.594 --> 00:13:04.934
issues or even if it's back pain or

00:13:04.975 --> 00:13:05.375
everything?

00:13:05.965 --> 00:13:08.506
Should it be one to two?

00:13:09.388 --> 00:13:09.928
What's the number?

00:13:09.948 --> 00:13:11.129
You're saying one to five?

00:13:11.769 --> 00:13:12.130
I don't know.

00:13:12.311 --> 00:13:14.131
I don't know if there's any research on

00:13:14.192 --> 00:13:14.613
even that.

00:13:14.993 --> 00:13:15.573
Is that good enough?

00:13:15.614 --> 00:13:20.457
Does that supply the demand based off of

00:13:20.597 --> 00:13:23.519
what the market yearns for, desires,

00:13:23.581 --> 00:13:25.322
wants, is already utilizing?

00:13:25.501 --> 00:13:28.245
That's kind of like a big question that

00:13:28.284 --> 00:13:30.025
maybe has never been answered or maybe

00:13:30.046 --> 00:13:30.647
can't be answered.

00:13:30.687 --> 00:13:30.807
Yeah.

00:13:31.311 --> 00:13:31.870
Yeah, well,

00:13:32.011 --> 00:13:34.854
this is what I've been thinking about so

00:13:34.894 --> 00:13:35.153
much.

00:13:35.214 --> 00:13:35.673
I'm like,

00:13:36.315 --> 00:13:40.076
I've been vocally kind of saying PT is

00:13:40.116 --> 00:13:41.798
probably not going to exist in another

00:13:41.839 --> 00:13:42.678
decade, right?

00:13:42.759 --> 00:13:44.980
The physical therapy profession,

00:13:45.000 --> 00:13:45.942
physical therapist.

00:13:46.501 --> 00:13:47.322
So I'm like, well, why?

00:13:47.403 --> 00:13:49.004
What are the threats to the profession?

00:13:49.083 --> 00:13:49.965
What's going on?

00:13:50.684 --> 00:13:51.806
When I research it,

00:13:51.865 --> 00:13:54.368
it says enrollment is up.

00:13:54.528 --> 00:13:56.708
That's not my impression based on what I

00:13:56.769 --> 00:13:58.610
see within my echo chamber, right?

00:13:59.129 --> 00:14:01.912
So we know that PTs are complaining about

00:14:01.991 --> 00:14:02.971
not getting paid enough.

00:14:03.552 --> 00:14:05.453
We know that PTs are complaining about

00:14:06.073 --> 00:14:07.294
treating too many patients.

00:14:07.916 --> 00:14:10.756
Everywhere I look, most of the PTs,

00:14:11.138 --> 00:14:13.658
OTs and SLPs are all saying the same

00:14:13.698 --> 00:14:13.879
thing.

00:14:13.918 --> 00:14:15.120
I mean, I just listened to this.

00:14:15.639 --> 00:14:18.121
This woman on TikTok drives me crazy,

00:14:18.982 --> 00:14:20.984
but I can't stop listening because it's so

00:14:21.083 --> 00:14:22.565
stupid and absurd.

00:14:22.945 --> 00:14:24.586
But then the algorithm thinks that I like

00:14:24.645 --> 00:14:24.725
it.

00:14:24.765 --> 00:14:25.826
So it gives me more of it.

00:14:27.559 --> 00:14:29.461
And this person wants to be an advocate

00:14:29.480 --> 00:14:30.581
for the OT profession.

00:14:30.600 --> 00:14:31.121
And I'm like,

00:14:31.282 --> 00:14:33.743
she has no knowledge or no understanding

00:14:33.883 --> 00:14:36.224
of all the other stuff that goes into

00:14:36.264 --> 00:14:37.764
the business of OT.

00:14:38.124 --> 00:14:38.945
Not just, yeah,

00:14:39.004 --> 00:14:40.725
you can be an amazing OT,

00:14:41.046 --> 00:14:43.046
but like you need a foundation and

00:14:43.105 --> 00:14:44.547
understanding the rest of it anyway.

00:14:45.745 --> 00:14:46.826
There are so many, I think,

00:14:47.025 --> 00:14:49.508
existential threats to the professions.

00:14:50.028 --> 00:14:51.989
One of which is, yes,

00:14:52.089 --> 00:14:54.010
we are beneficial to the population.

00:14:54.071 --> 00:14:55.532
Yes, we help a lot of people.

00:14:55.591 --> 00:14:56.913
We reduce healthcare costs.

00:14:56.952 --> 00:14:57.653
We can change,

00:14:57.692 --> 00:14:59.695
fundamentally change a patient's life.

00:15:00.014 --> 00:15:01.775
We can keep them in the home longer.

00:15:01.816 --> 00:15:03.618
We can do so many amazing things.

00:15:04.357 --> 00:15:07.701
But if we don't get the numbers up,

00:15:07.883 --> 00:15:09.945
if we don't increase access,

00:15:10.004 --> 00:15:11.706
we become so small.

00:15:12.347 --> 00:15:14.331
When I talk to docs and the doc

00:15:14.370 --> 00:15:16.153
is like, yeah, I would refer to PT,

00:15:16.173 --> 00:15:17.735
but they can't get in for six weeks.

00:15:17.855 --> 00:15:18.895
I'm not going to bother.

00:15:19.636 --> 00:15:19.836
Right.

00:15:19.876 --> 00:15:21.339
We become irrelevant.

00:15:22.216 --> 00:15:24.197
Because we can't serve enough people.

00:15:24.798 --> 00:15:26.818
It's just like a family restaurant that's

00:15:26.899 --> 00:15:28.139
local in the community.

00:15:28.519 --> 00:15:29.900
The line is out the door.

00:15:30.301 --> 00:15:32.263
It doesn't matter how many more people

00:15:32.302 --> 00:15:33.263
want to come to them.

00:15:33.302 --> 00:15:34.864
They can't serve more food.

00:15:34.945 --> 00:15:35.924
There's a limit.

00:15:35.945 --> 00:15:37.025
There's a bottleneck there.

00:15:37.426 --> 00:15:38.787
I think that's what's going to really,

00:15:39.086 --> 00:15:39.587
in the end,

00:15:39.628 --> 00:15:40.928
that's what's going to destroy the

00:15:40.969 --> 00:15:43.269
profession is the therapists who are

00:15:43.309 --> 00:15:45.250
existing right now don't want to see more

00:15:45.291 --> 00:15:45.731
patients.

00:15:45.991 --> 00:15:47.552
They don't take pride in seeing more

00:15:47.613 --> 00:15:47.972
patients.

00:15:48.013 --> 00:15:50.034
They're not excited to see more patients.

00:15:50.514 --> 00:15:51.895
They want to see fewer patients.

00:15:52.316 --> 00:15:53.017
which is fine.

00:15:53.456 --> 00:15:55.077
But at some point you become irrelevant

00:15:55.097 --> 00:15:57.078
because if you can't help more people,

00:15:57.139 --> 00:15:59.539
you eventually can't help anybody.

00:15:59.580 --> 00:16:02.302
And the people sending patients to us

00:16:02.461 --> 00:16:04.023
won't send to us anymore.

00:16:04.403 --> 00:16:05.644
They will send other places.

00:16:05.663 --> 00:16:07.105
They will find other solutions.

00:16:07.725 --> 00:16:10.386
So that's what got me thinking about this

00:16:10.447 --> 00:16:10.966
originally.

00:16:12.148 --> 00:16:13.249
Let me double click on that.

00:16:13.308 --> 00:16:15.350
I heard something from Ben Boggy on a

00:16:15.470 --> 00:16:16.370
video recently.

00:16:16.410 --> 00:16:17.731
So he owns Prokinetics.

00:16:17.772 --> 00:16:19.472
He does a clinical marketer with Jordan

00:16:19.493 --> 00:16:19.812
Mather.

00:16:20.332 --> 00:16:21.774
So Ben said something like,

00:16:23.388 --> 00:16:26.009
uh, he'll listen to calls, uh, from,

00:16:26.029 --> 00:16:26.669
for his practice.

00:16:26.730 --> 00:16:28.711
And someone will say like, Oh,

00:16:28.750 --> 00:16:30.511
like I called these other in network

00:16:30.552 --> 00:16:31.452
offices and it's like,

00:16:31.692 --> 00:16:32.972
it takes four to six weeks to like

00:16:32.993 --> 00:16:33.352
get in.

00:16:33.693 --> 00:16:34.673
And you're saying you can get me in

00:16:34.693 --> 00:16:35.254
like this week.

00:16:35.274 --> 00:16:37.416
Like, are you guys like not great?

00:16:37.456 --> 00:16:38.015
Like, are you not,

00:16:38.035 --> 00:16:40.057
cause you're not busy or like they were

00:16:40.076 --> 00:16:40.356
kind of,

00:16:40.636 --> 00:16:42.077
it was almost like the ability to get

00:16:42.138 --> 00:16:45.099
in sooner was almost like a drawback or

00:16:45.119 --> 00:16:46.080
like, why is that?

00:16:46.779 --> 00:16:47.921
How come you guys have availability,

00:16:47.961 --> 00:16:48.821
but these other places don't.

00:16:49.782 --> 00:16:49.902
So,

00:16:50.827 --> 00:16:52.327
Ben's team member or whoever is kind of

00:16:52.368 --> 00:16:54.769
like, well, those other places,

00:16:56.528 --> 00:16:59.590
they're so busy because they accept every

00:16:59.629 --> 00:17:00.649
insurance under the sun.

00:17:01.669 --> 00:17:04.171
And they have historically, not always,

00:17:04.191 --> 00:17:06.590
but historically had to have their

00:17:06.631 --> 00:17:09.892
therapist treat fifteen to twenty five or

00:17:09.951 --> 00:17:12.492
thirty or whatever patient a day when they

00:17:12.532 --> 00:17:13.232
may not want to.

00:17:14.877 --> 00:17:16.498
And it's resulted in apparently some of

00:17:16.518 --> 00:17:18.179
these therapists across the country in

00:17:18.259 --> 00:17:18.618
general,

00:17:18.659 --> 00:17:19.759
like there's a little bit of a trend,

00:17:19.798 --> 00:17:20.798
maybe you can push back on it,

00:17:21.179 --> 00:17:22.858
of therapists not wanting to be in those

00:17:22.919 --> 00:17:24.000
models anymore, right?

00:17:24.059 --> 00:17:26.000
Not wanting to be treating twenty or

00:17:26.220 --> 00:17:28.400
thirty patients a day.

00:17:28.440 --> 00:17:30.280
So they'll leave some of those bigger in

00:17:30.320 --> 00:17:32.060
network corporate companies.

00:17:32.480 --> 00:17:33.721
And so now when they leave,

00:17:33.740 --> 00:17:35.642
they're not those companies are not always

00:17:35.701 --> 00:17:38.221
able to hire the next physical therapist

00:17:38.261 --> 00:17:41.583
to supply the inflow demand of new in

00:17:41.623 --> 00:17:42.942
network insurance patients.

00:17:43.959 --> 00:17:46.200
And so therefore that also creates a

00:17:46.240 --> 00:17:46.759
waiting list.

00:17:46.779 --> 00:17:47.039
So there's,

00:17:47.240 --> 00:17:48.520
there's a waiting list because they accept

00:17:48.560 --> 00:17:49.280
all insurances.

00:17:49.340 --> 00:17:51.201
So it's just volume as you know,

00:17:51.541 --> 00:17:53.803
but then also therapists are not wanting

00:17:53.843 --> 00:17:56.325
to go there, work there,

00:17:56.424 --> 00:17:59.645
stay there longer because of more

00:17:59.665 --> 00:18:00.886
patients, more notes,

00:18:01.346 --> 00:18:02.906
the quote unquote burnout type stuff.

00:18:03.768 --> 00:18:04.887
When he said that, I was like, Oh,

00:18:05.008 --> 00:18:05.929
actually that makes sense.

00:18:05.949 --> 00:18:08.130
So like Ben and his team member on

00:18:08.150 --> 00:18:09.589
the phone is basically saying like,

00:18:10.171 --> 00:18:10.951
we have, you know,

00:18:11.070 --> 00:18:12.311
eight or nine therapists here that are

00:18:12.352 --> 00:18:12.811
full time.

00:18:13.682 --> 00:18:15.223
But we do all one-on-one visits.

00:18:15.324 --> 00:18:18.405
And so we are able to hire more

00:18:18.445 --> 00:18:18.826
therapists.

00:18:19.006 --> 00:18:21.067
The places that you just called have one

00:18:21.107 --> 00:18:23.829
or two or three therapists only because

00:18:23.849 --> 00:18:25.190
they take your insurance and because the

00:18:25.210 --> 00:18:27.172
therapists have to see fifteen or thirty

00:18:27.192 --> 00:18:28.932
or whatever patients a day and they're not

00:18:28.972 --> 00:18:30.493
able to retain physical therapists.

00:18:31.530 --> 00:18:32.290
Any thoughts on that?

00:18:32.351 --> 00:18:33.571
I mean, I heard, I was like, wow,

00:18:33.632 --> 00:18:34.551
that was like a light bulb moment.

00:18:34.592 --> 00:18:35.811
I was like, that makes sense.

00:18:35.832 --> 00:18:36.711
Of course, that makes some sense.

00:18:36.731 --> 00:18:37.092
Now, of course,

00:18:37.112 --> 00:18:38.012
that's not going to be every,

00:18:38.653 --> 00:18:40.272
that's not every in-network office across

00:18:40.292 --> 00:18:40.833
the country.

00:18:40.932 --> 00:18:42.233
We don't have to name all the corporates

00:18:42.273 --> 00:18:43.973
or the big, you know, the big team,

00:18:44.173 --> 00:18:46.414
the big companies that are like that.

00:18:46.454 --> 00:18:46.755
However,

00:18:46.835 --> 00:18:48.355
I think there is some truth to that,

00:18:49.076 --> 00:18:50.996
that would result in them having more

00:18:51.076 --> 00:18:54.156
waiting lists because of the lower

00:18:54.196 --> 00:18:54.876
reimbursement,

00:18:55.458 --> 00:18:56.838
which results in having to see more

00:18:56.878 --> 00:18:57.398
volume,

00:18:57.739 --> 00:18:59.400
which results in therapists not wanting to

00:18:59.420 --> 00:19:00.621
stay in that model in general.

00:19:00.721 --> 00:19:02.361
Some will, but some don't like it.

00:19:02.961 --> 00:19:03.821
Any pushback on that?

00:19:03.902 --> 00:19:04.923
Is there any truth in that?

00:19:05.002 --> 00:19:08.344
Is it like half truth, half assumption?

00:19:08.364 --> 00:19:08.664
I don't know.

00:19:08.684 --> 00:19:09.144
What do you think?

00:19:09.813 --> 00:19:11.374
Yeah, I think about that a lot.

00:19:11.413 --> 00:19:13.315
So yesterday I was on the phone with

00:19:13.335 --> 00:19:14.875
a couple of new patients who were calling

00:19:14.914 --> 00:19:15.635
to get scheduled.

00:19:16.355 --> 00:19:19.376
And every single time I answer the phone

00:19:19.416 --> 00:19:20.678
and it's a new patient wanting to

00:19:20.718 --> 00:19:21.538
schedule, I'm like,

00:19:21.557 --> 00:19:22.519
I can get you in today.

00:19:22.538 --> 00:19:24.058
How about you come in this afternoon?

00:19:24.078 --> 00:19:25.380
How about you come in tomorrow morning?

00:19:26.000 --> 00:19:27.240
And in the back of my mind,

00:19:27.441 --> 00:19:28.300
I am thinking,

00:19:28.881 --> 00:19:30.362
this person should be thinking,

00:19:30.582 --> 00:19:32.383
why can you get me in so quick

00:19:32.403 --> 00:19:34.203
when the hospital has a six-week wait

00:19:34.243 --> 00:19:34.544
list?

00:19:35.884 --> 00:19:38.385
Now, very, very, very infrequently,

00:19:39.528 --> 00:19:43.490
you might hit a consumer who's that

00:19:43.549 --> 00:19:45.730
knowledgeable and understands and is

00:19:45.770 --> 00:19:46.351
thinking that.

00:19:46.531 --> 00:19:49.173
Most consumers are like, okay, let's go.

00:19:49.393 --> 00:19:51.513
We'll get it going.

00:19:51.653 --> 00:19:55.016
I don't think it's because they're

00:19:55.076 --> 00:19:57.257
overworked and underpaid and a lot of the

00:19:57.356 --> 00:19:59.738
typical stuff you hear about PTs working

00:19:59.758 --> 00:20:00.338
at hospital.

00:20:00.378 --> 00:20:01.959
Hospitals are notorious for just

00:20:02.098 --> 00:20:02.619
one-on-one

00:20:03.579 --> 00:20:04.240
Around here,

00:20:04.300 --> 00:20:06.281
hospitals are not pushing production.

00:20:06.342 --> 00:20:08.763
Hospitals are not getting like thirty

00:20:08.804 --> 00:20:09.604
patients a day.

00:20:09.663 --> 00:20:12.385
Hospitals are like, no, we just need PTs.

00:20:12.425 --> 00:20:13.527
We're going to lose money anyway.

00:20:13.567 --> 00:20:14.688
You can see one an hour.

00:20:14.728 --> 00:20:16.288
You can see him as long as you

00:20:16.328 --> 00:20:16.608
want.

00:20:18.646 --> 00:20:21.388
I just, I remember, and this goes back,

00:20:21.409 --> 00:20:22.348
maybe it's just me.

00:20:22.429 --> 00:20:24.230
I know there is a competitive streak in

00:20:24.289 --> 00:20:24.609
you.

00:20:25.790 --> 00:20:29.373
I remember like, I want to do more.

00:20:29.633 --> 00:20:31.074
I want to produce more.

00:20:31.213 --> 00:20:32.734
How many more can I see?

00:20:33.275 --> 00:20:34.115
I handled twenty.

00:20:34.155 --> 00:20:35.476
Can I handle twenty five?

00:20:35.856 --> 00:20:36.916
I handle twenty five.

00:20:36.957 --> 00:20:38.198
Can I handle twenty seven?

00:20:38.218 --> 00:20:41.559
Like that was innate in my culture growing

00:20:41.660 --> 00:20:41.819
up.

00:20:41.859 --> 00:20:42.900
That was innate in me.

00:20:42.960 --> 00:20:45.142
Now I always want to outperform.

00:20:46.082 --> 00:20:48.483
I don't see that in today's market.

00:20:48.845 --> 00:20:49.164
Hence,

00:20:49.625 --> 00:20:51.207
I don't hire any physical therapists.

00:20:51.307 --> 00:20:53.028
I don't hire any new clinicians.

00:20:53.648 --> 00:20:55.191
I can't afford to pay them what they

00:20:55.230 --> 00:20:56.432
want.

00:20:56.551 --> 00:20:58.273
I'm not comfortable with the production

00:20:58.534 --> 00:21:01.056
that they want to produce.

00:21:01.215 --> 00:21:03.238
It's a culture that doesn't mix.

00:21:03.278 --> 00:21:04.259
So I just say I'm not going to

00:21:04.278 --> 00:21:04.499
do it.

00:21:05.428 --> 00:21:06.548
Um, but I don't know,

00:21:06.647 --> 00:21:07.749
I don't know if that comes out of

00:21:07.769 --> 00:21:09.209
the school, out of the,

00:21:09.288 --> 00:21:11.328
the educational process, you know,

00:21:11.990 --> 00:21:13.930
I don't know where that happens, but like,

00:21:13.990 --> 00:21:14.890
if you're in sports,

00:21:14.930 --> 00:21:16.111
you want to score points.

00:21:16.711 --> 00:21:18.631
If you're doing something you want to

00:21:18.730 --> 00:21:19.651
overachieve,

00:21:20.270 --> 00:21:22.112
why does it all of a sudden change

00:21:22.172 --> 00:21:23.771
when we look at patient care?

00:21:23.811 --> 00:21:24.231
Like, no,

00:21:24.672 --> 00:21:26.373
I don't want to sacrifice outcomes.

00:21:27.113 --> 00:21:28.294
But to me,

00:21:28.733 --> 00:21:30.976
the better therapist can get better

00:21:31.076 --> 00:21:33.077
outcomes and higher volume.

00:21:33.458 --> 00:21:35.338
It's not a one or the other.

00:21:35.799 --> 00:21:38.402
But we've talked everybody into like, no,

00:21:38.461 --> 00:21:40.282
if you see more than one an hour,

00:21:40.303 --> 00:21:41.483
you're going to get bad outcomes.

00:21:41.904 --> 00:21:43.165
I get good outcomes.

00:21:43.246 --> 00:21:44.205
I get great outcomes.

00:21:44.626 --> 00:21:45.827
And I see more than one an hour.

00:21:46.488 --> 00:21:50.111
And it makes me feel fulfilled to know

00:21:50.131 --> 00:21:51.332
that I can help more people,

00:21:51.392 --> 00:21:52.673
to know that I can get people in

00:21:52.712 --> 00:21:54.855
within an hour sometimes.

00:21:56.969 --> 00:21:58.471
So I understand what Ben's saying.

00:21:58.971 --> 00:21:59.791
Totally get it.

00:22:00.633 --> 00:22:03.214
I don't think it really applies broadly

00:22:03.256 --> 00:22:05.037
because I don't think the consumer is

00:22:05.076 --> 00:22:06.239
thinking about it that much.

00:22:06.798 --> 00:22:08.059
In general, the consumer,

00:22:08.079 --> 00:22:09.020
the patient is like,

00:22:09.321 --> 00:22:10.942
my doctor told me to go to therapy.

00:22:11.503 --> 00:22:11.983
What do I do?

00:22:12.744 --> 00:22:14.625
And they're just playing a very passive

00:22:14.665 --> 00:22:14.945
role.

00:22:15.526 --> 00:22:17.667
So I get them in within twenty four

00:22:17.688 --> 00:22:18.028
hours.

00:22:18.067 --> 00:22:19.147
That's our objective.

00:22:19.488 --> 00:22:20.368
Minute you call,

00:22:20.628 --> 00:22:22.069
I want you in the clinic within twenty

00:22:22.089 --> 00:22:22.569
four hours.

00:22:22.609 --> 00:22:24.711
I want the evaluation done and I want

00:22:24.750 --> 00:22:26.571
follow up scheduled the same week,

00:22:26.672 --> 00:22:27.672
the same day, you know.

00:22:29.272 --> 00:22:30.834
But that's always been our metric.

00:22:31.773 --> 00:22:32.894
I don't think the consumer is going to

00:22:32.914 --> 00:22:34.215
be like, oh, this place must suck.

00:22:34.276 --> 00:22:35.596
Nobody wants to go here and they have

00:22:35.675 --> 00:22:36.517
openings, you know.

00:22:38.298 --> 00:22:40.719
Yeah, I mean, the consumer wants

00:22:41.308 --> 00:22:41.828
access.

00:22:41.868 --> 00:22:43.891
They want typically to use their

00:22:43.931 --> 00:22:44.431
insurance.

00:22:44.451 --> 00:22:45.692
They want to get scheduled.

00:22:47.593 --> 00:22:48.713
They don't want a big waiting list

00:22:48.733 --> 00:22:49.193
typically.

00:22:50.694 --> 00:22:51.596
They want to get it done.

00:22:52.336 --> 00:22:53.037
That's it.

00:22:53.277 --> 00:22:54.798
I just had a person in here last

00:22:54.857 --> 00:22:55.117
night.

00:22:56.298 --> 00:22:58.941
I generated an eight team visit plan of

00:22:58.980 --> 00:23:00.121
care.

00:23:00.361 --> 00:23:02.143
I didn't realize the person wanted to get

00:23:02.222 --> 00:23:03.784
four visits and go get an MRI.

00:23:04.433 --> 00:23:04.913
You know,

00:23:04.973 --> 00:23:07.515
so like that's why the person was here.

00:23:07.555 --> 00:23:09.155
They were here to get their four visits

00:23:09.195 --> 00:23:10.156
and go get their MRI.

00:23:10.196 --> 00:23:12.218
They were not here to get better,

00:23:12.317 --> 00:23:14.459
even though they were getting better.

00:23:14.479 --> 00:23:15.578
They were doing amazing.

00:23:15.979 --> 00:23:18.780
I was blown away by how well this

00:23:18.840 --> 00:23:21.061
person had responded to therapeutic

00:23:21.122 --> 00:23:21.862
exercise.

00:23:22.482 --> 00:23:23.002
Didn't matter.

00:23:23.442 --> 00:23:24.624
I'm here for four visits.

00:23:24.644 --> 00:23:25.844
I'm going to get my MRI.

00:23:26.003 --> 00:23:27.404
I'll tell you what the doctor says.

00:23:28.011 --> 00:23:29.313
I was like, okay, that's fine.

00:23:29.512 --> 00:23:31.234
You know, your coinsurance is blank.

00:23:32.076 --> 00:23:34.758
We collect cash or credit and we let

00:23:34.778 --> 00:23:35.019
them go.

00:23:37.182 --> 00:23:38.981
I always have biases.

00:23:39.001 --> 00:23:39.782
I think we all do.

00:23:40.242 --> 00:23:41.143
Is it possible?

00:23:41.262 --> 00:23:42.202
Cause I want to, I want to,

00:23:42.282 --> 00:23:43.743
I want to mention that I have biases

00:23:43.804 --> 00:23:45.544
first, but now I'm going to say, Tony,

00:23:45.723 --> 00:23:46.723
you might have a bias.

00:23:47.183 --> 00:23:48.065
Let me push back on it.

00:23:48.285 --> 00:23:48.484
Right.

00:23:48.625 --> 00:23:49.525
So, okay.

00:23:50.325 --> 00:23:51.105
Is it possible?

00:23:51.404 --> 00:23:52.365
Because for us, we,

00:23:52.486 --> 00:23:54.425
we get some physician referrals,

00:23:54.465 --> 00:23:56.386
but like we're mostly word of mouth or,

00:23:56.547 --> 00:23:56.967
or Google.

00:23:57.007 --> 00:24:00.048
So either Google organic listing or Google

00:24:00.127 --> 00:24:00.347
ads.

00:24:00.387 --> 00:24:00.528
Right.

00:24:00.548 --> 00:24:01.268
So at any given time,

00:24:01.307 --> 00:24:02.448
I'm spending a lot of money on Google

00:24:02.508 --> 00:24:02.647
ads.

00:24:02.667 --> 00:24:04.548
And sometimes I turn everything down to a

00:24:04.588 --> 00:24:05.429
dollar a day budget.

00:24:05.588 --> 00:24:06.128
So it's like,

00:24:06.855 --> 00:24:07.555
Zero, basically.

00:24:09.376 --> 00:24:10.616
So most of our patients are either from

00:24:10.656 --> 00:24:11.557
word of mouth or Google.

00:24:12.637 --> 00:24:14.358
And some physician referrals,

00:24:14.378 --> 00:24:15.839
but not that many compared to you,

00:24:15.880 --> 00:24:17.780
compared to historically how you build up

00:24:17.800 --> 00:24:18.321
your practice.

00:24:18.402 --> 00:24:21.604
So my pushback would be the people that

00:24:21.624 --> 00:24:23.565
are finding us on Google or word of

00:24:23.605 --> 00:24:23.964
mouth,

00:24:24.945 --> 00:24:28.247
they are maybe putting in more effort or

00:24:28.288 --> 00:24:29.907
it's a different approach because they're

00:24:30.009 --> 00:24:32.690
seeking in-home physical therapy or

00:24:32.789 --> 00:24:34.471
one-on-one therapy in our brick and mortar

00:24:34.550 --> 00:24:35.030
office.

00:24:35.451 --> 00:24:35.991
They want it.

00:24:36.721 --> 00:24:38.540
And or just like the thing I mentioned

00:24:38.560 --> 00:24:39.121
at the top of the show,

00:24:39.382 --> 00:24:40.481
if the family members calling in,

00:24:40.541 --> 00:24:41.922
we have to ask, Hey,

00:24:42.182 --> 00:24:43.182
I know you're calling in for so and

00:24:43.221 --> 00:24:45.563
so are they motivated to do this?

00:24:45.903 --> 00:24:47.522
Or are they going to be pushing back?

00:24:47.643 --> 00:24:48.923
And are we going to have, you know,

00:24:48.942 --> 00:24:49.542
some issues here?

00:24:51.703 --> 00:24:54.743
Our clientele typically is seeking a

00:24:54.804 --> 00:24:56.865
solution, they want to walk better,

00:24:56.904 --> 00:24:58.684
they want to decrease their back pain,

00:24:58.704 --> 00:24:59.365
their neck pain,

00:24:59.384 --> 00:25:01.546
they want to get back to sports or

00:25:01.605 --> 00:25:02.865
walking in Central Park or whatever.

00:25:04.218 --> 00:25:06.920
So they want what we have to offer

00:25:07.079 --> 00:25:08.480
and they, not always,

00:25:08.500 --> 00:25:11.703
but they're typically ready to focus on

00:25:11.723 --> 00:25:13.424
that and put in the effort and follow

00:25:13.444 --> 00:25:14.066
a treatment plan.

00:25:14.865 --> 00:25:18.068
Whereas what you're talking about is their

00:25:18.108 --> 00:25:19.650
physician told them to go to physical

00:25:19.690 --> 00:25:20.109
therapy.

00:25:20.590 --> 00:25:22.873
Is it possible that that's your bias

00:25:22.913 --> 00:25:24.032
because that's where a lot of your

00:25:24.073 --> 00:25:27.455
patients come from as opposed to half of

00:25:27.476 --> 00:25:29.617
your patients saying that they found you

00:25:29.698 --> 00:25:31.179
on Google and they're seeking it out

00:25:31.199 --> 00:25:32.220
because they want to do it?

00:25:32.934 --> 00:25:33.976
Yeah, a hundred percent.

00:25:34.557 --> 00:25:36.759
You and I are fundamentally different

00:25:36.798 --> 00:25:37.559
businesses.

00:25:37.700 --> 00:25:40.102
I hate that you and I are even

00:25:40.162 --> 00:25:42.585
called physical therapy because we are

00:25:42.704 --> 00:25:44.247
such a different business,

00:25:44.287 --> 00:25:45.807
such a different business model.

00:25:46.929 --> 00:25:48.651
It goes back to Rory Sutherland.

00:25:48.851 --> 00:25:49.071
You know,

00:25:49.092 --> 00:25:50.752
I was listening to the clip last night

00:25:50.792 --> 00:25:51.153
again,

00:25:51.193 --> 00:25:53.276
where he talks about McDonald's versus a

00:25:53.355 --> 00:25:54.836
Michelin star restaurant.

00:25:55.917 --> 00:25:57.838
The thing with McDonald's is it's never

00:25:57.898 --> 00:26:00.239
going to be as good as a Michelin

00:26:00.259 --> 00:26:01.159
star restaurant,

00:26:01.679 --> 00:26:02.900
but you're never going to get sick.

00:26:03.319 --> 00:26:05.180
You're going to get consistent results.

00:26:05.220 --> 00:26:06.881
You know exactly what's happening.

00:26:06.941 --> 00:26:09.161
You are satisfying the hunger problem.

00:26:09.621 --> 00:26:12.461
You are not delivering a food dining

00:26:12.541 --> 00:26:13.301
experience.

00:26:13.882 --> 00:26:16.343
You go to a five-star Michelin restaurant.

00:26:17.403 --> 00:26:19.829
I can go to, not saying you,

00:26:19.849 --> 00:26:22.915
but I can go to an amazing physical

00:26:22.957 --> 00:26:26.344
therapist who most of the time can deliver

00:26:26.463 --> 00:26:27.948
an amazing experience.

00:26:28.643 --> 00:26:29.663
but there are gonna be times where they

00:26:29.682 --> 00:26:29.903
don't.

00:26:30.364 --> 00:26:32.943
There are gonna be times where the patient

00:26:32.983 --> 00:26:34.224
has a negative outcome.

00:26:34.285 --> 00:26:35.884
The therapist did too much.

00:26:35.924 --> 00:26:38.865
Like I get the stories of the therapist

00:26:38.905 --> 00:26:40.686
did dry needling, the therapist did this,

00:26:40.747 --> 00:26:41.767
the therapist did that,

00:26:41.807 --> 00:26:44.228
and the patient now in their own mind,

00:26:44.288 --> 00:26:45.367
it's all fabricated,

00:26:45.407 --> 00:26:47.548
but they're disabled and they've got,

00:26:47.749 --> 00:26:47.969
you know,

00:26:48.009 --> 00:26:50.730
twenty years of dysfunction because of

00:26:50.789 --> 00:26:52.410
something that a therapist did that they

00:26:52.450 --> 00:26:54.790
were trying to use to help them get

00:26:54.830 --> 00:26:55.090
better.

00:26:55.691 --> 00:26:57.192
So you're going to have amazing results a

00:26:57.211 --> 00:26:57.892
lot of the times,

00:26:57.932 --> 00:26:58.972
but you're going to get a few that

00:26:58.992 --> 00:27:00.554
are going to go south really quick,

00:27:00.634 --> 00:27:01.375
really badly.

00:27:02.115 --> 00:27:02.976
On my side,

00:27:03.316 --> 00:27:04.676
you're never going to get an amazing

00:27:04.737 --> 00:27:05.637
result, right?

00:27:05.657 --> 00:27:06.837
You're going to get what you get.

00:27:06.857 --> 00:27:07.759
You're going to feel better.

00:27:07.778 --> 00:27:08.960
You're going to leave feeling better than

00:27:08.980 --> 00:27:09.519
you come in.

00:27:09.539 --> 00:27:10.601
You're going to get a little stronger.

00:27:10.621 --> 00:27:11.922
You're going to get a little healthier,

00:27:11.981 --> 00:27:12.301
maybe.

00:27:13.863 --> 00:27:15.243
But you're never going to get worse.

00:27:15.263 --> 00:27:16.865
You're never going to get a negative

00:27:16.964 --> 00:27:17.266
outcome.

00:27:17.326 --> 00:27:19.207
I am never going to take a chance

00:27:19.326 --> 00:27:22.288
on an intervention that has a chance to

00:27:22.328 --> 00:27:24.171
make you incredibly better,

00:27:24.770 --> 00:27:26.172
but also has a chance to make you

00:27:26.251 --> 00:27:26.652
worse.

00:27:26.732 --> 00:27:28.273
Like that is that is not what we

00:27:28.314 --> 00:27:28.493
do.

00:27:28.574 --> 00:27:28.993
So, yes,

00:27:29.034 --> 00:27:31.076
the people who come to us largely,

00:27:31.895 --> 00:27:33.597
they don't want to get worse.

00:27:33.637 --> 00:27:35.479
They don't want a negative experience.

00:27:35.519 --> 00:27:36.579
And I will deliver that.

00:27:37.127 --> 00:27:38.489
The people who find you,

00:27:39.068 --> 00:27:40.529
they want improvement.

00:27:40.869 --> 00:27:43.270
They're willing to do what needs to be

00:27:43.310 --> 00:27:47.192
done and take that risk of having a

00:27:47.272 --> 00:27:48.833
better than expected outcome,

00:27:48.913 --> 00:27:52.515
knowing that there could possibly be a

00:27:52.595 --> 00:27:54.076
negative experience in there too.

00:27:57.681 --> 00:27:58.561
How do we wrap that?

00:27:58.602 --> 00:27:59.282
How do we,

00:27:59.423 --> 00:28:00.644
or put a pin in it until Jimmy

00:28:00.663 --> 00:28:02.025
comes back?

00:28:02.384 --> 00:28:03.726
It's not an easy scenario.

00:28:03.786 --> 00:28:04.707
It's two different, like you said,

00:28:04.727 --> 00:28:05.587
it's two different businesses.

00:28:05.928 --> 00:28:07.970
Maybe we can have Jimmy on another time

00:28:08.029 --> 00:28:09.751
when he comes back and we can joke

00:28:09.771 --> 00:28:11.833
around about what should your business be

00:28:11.853 --> 00:28:12.094
called?

00:28:12.114 --> 00:28:13.355
What should my business be called?

00:28:13.375 --> 00:28:16.517
Because it is different.

00:28:16.576 --> 00:28:18.318
It's different populations,

00:28:18.338 --> 00:28:19.200
different clientele,

00:28:19.240 --> 00:28:20.740
different mindsets of folks.

00:28:20.820 --> 00:28:21.701
So there's a lot there.

00:28:22.236 --> 00:28:24.457
He shared a post that showed like a

00:28:24.517 --> 00:28:27.856
technician compared to a,

00:28:27.957 --> 00:28:28.978
I forget what the other word.

00:28:29.258 --> 00:28:31.157
I didn't like the other comparison.

00:28:31.557 --> 00:28:33.199
I like the idea of the technician and

00:28:33.219 --> 00:28:33.858
the expert.

00:28:34.259 --> 00:28:36.358
This comes from E-Myth Revisited.

00:28:36.939 --> 00:28:38.200
I'm the technician still.

00:28:38.440 --> 00:28:39.779
I'm out there doing the stuff.

00:28:39.819 --> 00:28:40.779
I'm making the pies.

00:28:40.839 --> 00:28:42.300
You know, like that's what I do best.

00:28:42.681 --> 00:28:44.060
You come in, I'll rub your back.

00:28:44.161 --> 00:28:45.221
I'll exercise you.

00:28:45.260 --> 00:28:46.442
You'll leave feeling better than you

00:28:46.481 --> 00:28:46.761
started.

00:28:46.781 --> 00:28:48.182
That's it.

00:28:48.461 --> 00:28:49.541
You, I would say,

00:28:49.582 --> 00:28:51.363
is more on the expert side.

00:28:51.942 --> 00:28:53.303
deep diagnosis,

00:28:53.383 --> 00:28:54.723
looking at the case history,

00:28:54.763 --> 00:28:56.644
like diving into all of these details.

00:28:56.683 --> 00:28:58.644
You establish yourself as the expert.

00:28:59.505 --> 00:29:02.105
People are coming to you already sold on

00:29:02.144 --> 00:29:03.224
your expertise,

00:29:03.345 --> 00:29:05.086
knowing that I can't get something this

00:29:05.105 --> 00:29:06.486
good without paying for it.

00:29:07.105 --> 00:29:09.686
So that's where I think we'll bring Jimmy

00:29:09.826 --> 00:29:11.747
in and we'll take a look at that

00:29:11.807 --> 00:29:13.886
comparison of, you know,

00:29:14.488 --> 00:29:15.887
I'm fine being the builder.

00:29:16.587 --> 00:29:17.847
You're more the architect.

00:29:18.468 --> 00:29:20.368
Like I'm fine being the line cook.

00:29:20.409 --> 00:29:21.489
You're more the head chef.

00:29:22.479 --> 00:29:24.761
It's just we understand our role.

00:29:24.781 --> 00:29:27.045
McDonald's doesn't try to be a five-star

00:29:27.144 --> 00:29:28.205
Michelin restaurant.

00:29:28.625 --> 00:29:30.167
They're happy being McDonald's and they

00:29:30.188 --> 00:29:33.412
make billions of dollars doing it.

00:29:33.432 --> 00:29:35.354
They are happy being transactional.

00:29:36.234 --> 00:29:36.474
So...

00:29:37.494 --> 00:29:39.777
Up on the screen right now, this was,

00:29:39.936 --> 00:29:41.857
you shared it and then I also saw

00:29:41.978 --> 00:29:42.098
it.

00:29:43.278 --> 00:29:43.900
Matt Gregory,

00:29:44.339 --> 00:29:45.661
I don't think I have any connection to

00:29:45.701 --> 00:29:45.881
him,

00:29:45.921 --> 00:29:48.022
but he posted that he came across an

00:29:48.403 --> 00:29:49.304
interesting stat.

00:29:49.763 --> 00:29:51.586
Seems the average length of a career in

00:29:51.685 --> 00:29:53.487
physical therapy is only about seven

00:29:53.527 --> 00:29:53.847
years.

00:29:54.528 --> 00:29:55.429
He couldn't believe it.

00:29:55.489 --> 00:29:56.429
He researched it.

00:29:56.509 --> 00:29:58.089
Turns out that he believes it to be

00:29:58.150 --> 00:29:58.569
true.

00:29:59.230 --> 00:30:00.750
This could mean that careers would

00:30:00.911 --> 00:30:02.731
obviously be less than that.

00:30:03.051 --> 00:30:04.452
So like some people are getting in for

00:30:04.472 --> 00:30:04.972
a year,

00:30:05.032 --> 00:30:06.513
some people are getting in for a couple

00:30:06.534 --> 00:30:06.953
of months.

00:30:08.434 --> 00:30:09.016
Then he said,

00:30:09.096 --> 00:30:11.076
who's going to school all those years and

00:30:11.116 --> 00:30:13.897
running up huge debt for a career of

00:30:13.917 --> 00:30:14.718
a couple of years,

00:30:14.758 --> 00:30:18.000
looking at medical doctor career and it's

00:30:18.059 --> 00:30:19.401
thirty to thirty five years.

00:30:20.494 --> 00:30:23.417
So, you know, that's another good example.

00:30:23.458 --> 00:30:26.279
And that's that's been around forever.

00:30:26.319 --> 00:30:28.122
I was in school in the mid two

00:30:28.162 --> 00:30:30.344
thousands and that was a stat that was

00:30:30.384 --> 00:30:30.903
still there.

00:30:31.924 --> 00:30:33.086
When I get a student,

00:30:33.287 --> 00:30:35.087
when I get somebody who is like, hey,

00:30:35.167 --> 00:30:36.869
I need ten observation hours.

00:30:37.150 --> 00:30:38.570
One of the things we talk about is

00:30:38.611 --> 00:30:39.051
like, look.

00:30:39.965 --> 00:30:41.646
If you're female and you want to have

00:30:41.686 --> 00:30:42.267
kids,

00:30:42.827 --> 00:30:45.009
is it worth putting all this money in

00:30:45.348 --> 00:30:47.549
for a couple of years and then getting

00:30:47.770 --> 00:30:50.311
out and starting your family?

00:30:50.451 --> 00:30:52.272
If you're a male and you want to

00:30:52.393 --> 00:30:53.413
own a practice,

00:30:54.114 --> 00:30:56.375
is it worth putting all this money in

00:30:56.855 --> 00:30:58.277
when you want to get out of patient

00:30:58.297 --> 00:30:58.977
care anyway?

00:31:00.790 --> 00:31:01.191
Yes,

00:31:01.270 --> 00:31:05.051
there is the archetype of I can afford

00:31:05.132 --> 00:31:05.271
it.

00:31:05.912 --> 00:31:06.893
I want to do this.

00:31:07.532 --> 00:31:09.553
I'm not I don't care about the money.

00:31:09.692 --> 00:31:11.814
I don't care if this earns me a

00:31:11.874 --> 00:31:12.394
living.

00:31:13.153 --> 00:31:14.213
This is what I want to do,

00:31:14.775 --> 00:31:15.134
you know,

00:31:15.174 --> 00:31:17.174
and I think that's the ideal candidate.

00:31:17.974 --> 00:31:20.355
But what are your thoughts on seven years

00:31:20.496 --> 00:31:22.616
as the average?

00:31:22.636 --> 00:31:25.116
I mean, that sounds crazy to me.

00:31:25.176 --> 00:31:27.077
I can't even I can't even hear that

00:31:27.097 --> 00:31:27.458
before.

00:31:28.334 --> 00:31:28.913
I don't think so.

00:31:29.173 --> 00:31:29.654
I don't think so.

00:31:30.134 --> 00:31:31.674
I can't, I can't even fathom.

00:31:32.635 --> 00:31:34.817
It doesn't even register.

00:31:34.876 --> 00:31:35.396
Now, of course,

00:31:35.457 --> 00:31:37.778
and I went off and I did the

00:31:38.178 --> 00:31:38.498
initial,

00:31:38.518 --> 00:31:40.038
the tech app and then came back and

00:31:40.719 --> 00:31:41.239
you know, that,

00:31:41.259 --> 00:31:45.300
that failed and then open up a practice.

00:31:45.340 --> 00:31:46.922
It doesn't even make sense to me.

00:31:47.082 --> 00:31:47.521
I don't get it.

00:31:47.602 --> 00:31:50.442
Like, I think there candidly,

00:31:50.762 --> 00:31:54.384
there are some people that like I've heard

00:31:54.424 --> 00:31:57.205
of or knew of through school or other

00:31:57.266 --> 00:31:57.885
schools where,

00:31:59.517 --> 00:32:01.557
their family had money and they didn't

00:32:01.577 --> 00:32:03.318
have to take out any student loan debt

00:32:03.358 --> 00:32:04.558
and they bounced around to different

00:32:04.598 --> 00:32:05.799
colleges and different programs.

00:32:05.819 --> 00:32:06.500
And they,

00:32:06.519 --> 00:32:07.960
they might've gotten different degrees and

00:32:07.980 --> 00:32:10.141
then they come out and they,

00:32:10.320 --> 00:32:11.582
I joked about this on the show before,

00:32:11.602 --> 00:32:13.282
like they never got punched in the face

00:32:13.323 --> 00:32:14.202
by life before.

00:32:14.222 --> 00:32:15.663
Like they never had any real adversity.

00:32:16.403 --> 00:32:20.265
And so they eventually maybe have some

00:32:20.305 --> 00:32:20.806
adversity,

00:32:21.026 --> 00:32:22.806
like a challenging patient and they're

00:32:22.986 --> 00:32:25.307
treating patients a day and they have to

00:32:25.346 --> 00:32:26.147
do notes a day.

00:32:26.788 --> 00:32:27.488
And they had,

00:32:27.508 --> 00:32:29.169
they had some challenging patients that,

00:32:30.617 --> 00:32:31.919
didn't like them or whatever.

00:32:31.999 --> 00:32:32.739
And they're just like,

00:32:33.058 --> 00:32:34.159
they get jaded over time.

00:32:34.660 --> 00:32:34.980
I don't know.

00:32:35.220 --> 00:32:37.000
Like for me, like you said, uh,

00:32:37.019 --> 00:32:39.161
already I liked I'm competitive.

00:32:39.300 --> 00:32:40.301
I like to do more.

00:32:40.342 --> 00:32:42.422
I like to strive, uh, for more.

00:32:42.461 --> 00:32:44.323
So whether it's better patient results or

00:32:44.363 --> 00:32:45.503
back when I was in, in network,

00:32:45.544 --> 00:32:47.743
there were times where I had multiple pay,

00:32:47.943 --> 00:32:48.305
multiple,

00:32:48.345 --> 00:32:49.865
multiple patients at the same time that I

00:32:49.884 --> 00:32:50.325
was treating.

00:32:50.826 --> 00:32:52.965
And they all seem to have gotten what

00:32:52.986 --> 00:32:54.646
they wanted and like that experience and

00:32:54.666 --> 00:32:54.967
all that.

00:32:55.047 --> 00:32:57.387
So this, I don't know.

00:32:57.748 --> 00:32:58.627
I think I got to bounce the ball

00:32:58.709 --> 00:32:59.709
back to you because it doesn't even,

00:33:00.807 --> 00:33:02.288
It doesn't even make sense because I don't

00:33:02.368 --> 00:33:04.590
think maybe part of it is they're

00:33:04.631 --> 00:33:06.971
seventeen and eighteen and maybe they made

00:33:06.991 --> 00:33:07.632
the wrong decision.

00:33:08.192 --> 00:33:08.333
Right.

00:33:08.353 --> 00:33:09.374
When they when they made the decision.

00:33:09.433 --> 00:33:09.713
I don't know.

00:33:10.321 --> 00:33:12.242
I've never heard anyone discuss this,

00:33:12.303 --> 00:33:14.843
but I searched a couple months ago the

00:33:14.883 --> 00:33:18.105
gender distribution in PT-OTSLP.

00:33:19.244 --> 00:33:20.605
I'll just read it from my side of

00:33:20.625 --> 00:33:21.885
the screen, but basically,

00:33:22.605 --> 00:33:23.925
and these are AI numbers,

00:33:23.965 --> 00:33:25.547
so I can't guarantee accuracy.

00:33:26.287 --> 00:33:27.326
It said, uh,

00:33:27.446 --> 00:33:31.328
sixty-five percent of the PT population is

00:33:31.568 --> 00:33:32.009
female.

00:33:33.145 --> 00:33:34.386
Eighty nine percent.

00:33:34.567 --> 00:33:37.009
Eighty nine percent of the OT population

00:33:37.069 --> 00:33:39.892
is female and ninety five percent of

00:33:39.971 --> 00:33:42.013
speech language pathologists are female.

00:33:42.575 --> 00:33:43.194
Compare that.

00:33:43.756 --> 00:33:44.076
Wow.

00:33:44.477 --> 00:33:45.738
Yeah, it's massive.

00:33:45.758 --> 00:33:47.159
Compare that to physicians.

00:33:47.740 --> 00:33:48.740
Thirty nine percent.

00:33:48.780 --> 00:33:49.320
Mostly male.

00:33:49.520 --> 00:33:49.922
Mostly male.

00:33:50.986 --> 00:33:51.207
You know,

00:33:51.227 --> 00:33:52.587
and I bet if you go into like

00:33:52.688 --> 00:33:54.628
orthopedics or you go into specialties,

00:33:54.669 --> 00:33:57.592
it's even a higher percentage of males.

00:33:57.652 --> 00:34:00.253
Now, again, I go back to,

00:34:00.974 --> 00:34:02.355
I don't know if this is sexist or

00:34:02.395 --> 00:34:02.615
not.

00:34:02.695 --> 00:34:04.518
I don't understand that stuff these days,

00:34:04.577 --> 00:34:07.500
but the bottom line is I'm not having

00:34:07.519 --> 00:34:08.061
a baby.

00:34:08.661 --> 00:34:10.362
I'm not coming out of the profession to

00:34:10.443 --> 00:34:12.244
have a baby to raise my kids.

00:34:12.344 --> 00:34:14.146
Yes, I spent time with my kids.

00:34:14.186 --> 00:34:15.206
I want them to be there when they

00:34:15.226 --> 00:34:16.748
were young and I was fortunate enough to,

00:34:16.788 --> 00:34:16.869
but

00:34:17.744 --> 00:34:20.606
But if I'm the person who's birthing the

00:34:20.666 --> 00:34:23.769
human, I'm not working during that time.

00:34:23.849 --> 00:34:24.150
Right.

00:34:24.269 --> 00:34:27.072
And it's really hard to go back after

00:34:27.092 --> 00:34:28.273
you had that child.

00:34:29.253 --> 00:34:29.853
We're in it.

00:34:29.873 --> 00:34:30.474
I told you, I get it.

00:34:30.494 --> 00:34:32.315
I get it.

00:34:32.396 --> 00:34:33.797
I think that is a huge,

00:34:34.057 --> 00:34:35.559
huge aspect of this.

00:34:35.958 --> 00:34:38.201
You've got a huge population of females

00:34:38.240 --> 00:34:39.260
within the profession.

00:34:39.702 --> 00:34:41.123
They're getting pulled out to start

00:34:41.143 --> 00:34:42.403
families, which is amazing.

00:34:42.543 --> 00:34:43.684
I wish more would, but,

00:34:45.085 --> 00:34:46.847
And a lot of them either aren't going

00:34:46.867 --> 00:34:48.608
back at all or going back in some

00:34:48.648 --> 00:34:50.630
capacity, going back part-time,

00:34:50.670 --> 00:34:51.791
going back to do something.

00:34:52.632 --> 00:34:54.952
So I think the numbers are a bit

00:34:55.032 --> 00:34:57.494
skewed just because the gender

00:34:57.534 --> 00:34:59.277
distribution is so different.

00:34:59.297 --> 00:35:00.898
It's not a fifty-fifty deal.

00:35:03.038 --> 00:35:03.818
But that being said,

00:35:03.838 --> 00:35:05.760
you still have to be reasonable and say,

00:35:05.800 --> 00:35:05.900
hey,

00:35:05.920 --> 00:35:07.541
they're not charging women less than

00:35:07.561 --> 00:35:10.161
they're charging men going into PT school,

00:35:10.603 --> 00:35:10.802
right?

00:35:10.842 --> 00:35:12.344
The degree costs just as much.

00:35:12.643 --> 00:35:14.905
The degree cost takes just as much time.

00:35:15.204 --> 00:35:16.545
The women are getting paid the same

00:35:16.585 --> 00:35:17.646
salaries as the men.

00:35:18.106 --> 00:35:20.248
So I think this is one of those

00:35:20.288 --> 00:35:22.728
deals where probably these other factors

00:35:22.789 --> 00:35:23.809
are contributing to it.

00:35:23.849 --> 00:35:25.431
But if you're making that decision,

00:35:25.990 --> 00:35:26.851
you want to be a PT.

00:35:29.940 --> 00:35:30.860
Back in my day,

00:35:31.380 --> 00:35:33.242
I paid like five thousand dollars a year

00:35:33.282 --> 00:35:34.061
to be a PT.

00:35:34.782 --> 00:35:36.784
You can do that and throw it away.

00:35:37.164 --> 00:35:39.144
You can't pay two hundred thousand dollars

00:35:39.364 --> 00:35:42.927
and just throw it away.

00:35:42.987 --> 00:35:43.327
Now,

00:35:43.407 --> 00:35:46.068
the seven years makes a lot more sense.

00:35:46.309 --> 00:35:47.670
That makes a lot more sense in terms

00:35:47.710 --> 00:35:49.690
of the timeline of my friends and folks

00:35:49.710 --> 00:35:50.391
that I've known.

00:35:51.300 --> 00:35:52.960
between leaving school and then getting

00:35:53.001 --> 00:35:54.101
married or starting a family,

00:35:54.320 --> 00:35:56.282
that timeline based off the gender

00:35:56.862 --> 00:35:58.382
percentages in the therapies,

00:35:58.663 --> 00:36:00.443
that makes a ton of sense.

00:36:00.503 --> 00:36:00.804
Yeah.

00:36:01.284 --> 00:36:02.244
Yeah.

00:36:02.684 --> 00:36:04.724
So we're coming to the close.

00:36:06.226 --> 00:36:08.626
Anything that's been on your radar lately,

00:36:08.786 --> 00:36:10.668
anything that's interesting from a

00:36:10.728 --> 00:36:12.288
business perspective that you've been

00:36:12.307 --> 00:36:13.449
looking at or thinking about?

00:36:15.349 --> 00:36:16.311
there might've been something that I

00:36:16.351 --> 00:36:16.831
recently shared.

00:36:16.851 --> 00:36:18.331
I'm trying to remember screenshots.

00:36:18.411 --> 00:36:21.733
We covered that big one about therapists

00:36:21.753 --> 00:36:22.534
leaving the profession.

00:36:23.295 --> 00:36:23.795
I want to go back.

00:36:23.815 --> 00:36:24.315
I want to go back.

00:36:24.396 --> 00:36:25.117
I got, I got something.

00:36:25.157 --> 00:36:25.797
I want to go back to what you

00:36:25.817 --> 00:36:26.137
said earlier.

00:36:26.257 --> 00:36:29.039
I think you are completely wrong about the

00:36:29.199 --> 00:36:31.820
physical therapy world basically being

00:36:31.880 --> 00:36:32.922
non-existent in ten years.

00:36:33.302 --> 00:36:33.862
Yeah.

00:36:34.143 --> 00:36:37.585
These big companies that have fifty or

00:36:37.625 --> 00:36:40.347
more locations,

00:36:40.367 --> 00:36:41.007
you think they're

00:36:41.672 --> 00:36:42.913
You think they're just going to dry up?

00:36:42.952 --> 00:36:44.074
You just think they're going to start

00:36:44.114 --> 00:36:45.954
closing locations and all that?

00:36:47.275 --> 00:36:47.894
There's no way.

00:36:49.094 --> 00:36:50.416
Will they have to figure out a way

00:36:50.456 --> 00:36:52.396
to pay and keep up with cost of

00:36:52.436 --> 00:36:53.077
inflation and all that?

00:36:53.277 --> 00:36:53.416
Well,

00:36:53.936 --> 00:36:55.336
I know some insider baseball here in New

00:36:55.356 --> 00:36:55.657
York City.

00:36:55.677 --> 00:36:58.617
There's a big corporate that I know

00:36:58.657 --> 00:36:59.838
therapists that used to work there,

00:37:00.498 --> 00:37:06.781
and they describe these –

00:37:03.952 --> 00:37:06.675
corporates as places where all they do

00:37:06.755 --> 00:37:08.237
it's kind of churning nowadays they're

00:37:08.277 --> 00:37:09.737
kind of churning through new grads like

00:37:09.838 --> 00:37:11.599
every office has like a clinic director or

00:37:11.619 --> 00:37:14.762
a regional director that's seven or ten or

00:37:14.782 --> 00:37:17.143
whatever years of experience but all the

00:37:17.164 --> 00:37:21.527
treating therapists are new grads and so

00:37:21.626 --> 00:37:24.250
i'm not saying that's great i you know

00:37:24.389 --> 00:37:26.451
if if the the new grads are getting

00:37:26.510 --> 00:37:27.811
patients better and the patients like the

00:37:27.831 --> 00:37:29.373
experience and all that then that's fine

00:37:29.693 --> 00:37:31.795
that's that's fine but the

00:37:32.869 --> 00:37:34.150
Because of the cap of payment

00:37:34.190 --> 00:37:36.373
reimbursement across all the payers,

00:37:37.755 --> 00:37:38.615
these places can't,

00:37:39.135 --> 00:37:41.538
they can't increase salaries every year by

00:37:41.599 --> 00:37:43.360
three or five or ten percent every year

00:37:43.420 --> 00:37:45.461
for therapists that stay in the practice

00:37:45.481 --> 00:37:46.762
for ten, fifteen, twenty years.

00:37:47.384 --> 00:37:50.306
So they just continually hire new grads

00:37:50.387 --> 00:37:52.168
and then the new grads stay there for

00:37:52.648 --> 00:37:55.532
one to three to five years and then

00:37:55.552 --> 00:37:56.492
they leave, they move on.

00:37:58.338 --> 00:38:00.159
That in itself is not great.

00:38:00.960 --> 00:38:01.820
That's why we're different,

00:38:01.862 --> 00:38:05.204
why we can pay therapists way higher.

00:38:06.523 --> 00:38:08.324
But even with that,

00:38:09.186 --> 00:38:11.387
I can't imagine how the physical therapy

00:38:11.407 --> 00:38:12.307
profession is going to be

00:38:12.972 --> 00:38:14.534
way different or non-existent in ten

00:38:14.574 --> 00:38:14.914
years.

00:38:15.396 --> 00:38:17.217
I think you'll still have new grads coming

00:38:17.237 --> 00:38:17.697
out of school.

00:38:18.177 --> 00:38:19.438
They signed up for the DPT.

00:38:19.478 --> 00:38:20.539
They went through the boards.

00:38:21.420 --> 00:38:23.342
They don't fully understand the financial

00:38:23.382 --> 00:38:26.987
decision or the environment of capped

00:38:27.027 --> 00:38:29.509
reimbursement, basically capped salaries,

00:38:30.911 --> 00:38:32.032
and what they're signing up for.

00:38:32.871 --> 00:38:34.873
And these DPT programs also have been

00:38:34.934 --> 00:38:36.396
historically making a ton of money.

00:38:37.375 --> 00:38:39.317
having you know going from bachelors to

00:38:39.356 --> 00:38:41.597
masters and from back masters to doctorate

00:38:42.179 --> 00:38:43.420
and you know if they could if they

00:38:43.440 --> 00:38:44.721
could add a double doctorate tony they

00:38:44.740 --> 00:38:46.242
would do it they would hey you want

00:38:46.262 --> 00:38:47.623
to you want a double d you want

00:38:47.643 --> 00:38:49.664
a double d dpt like if they can

00:38:49.704 --> 00:38:51.465
do it they would they would absolutely you

00:38:51.485 --> 00:38:52.646
want to you want a double big mac

00:38:52.666 --> 00:38:54.509
with that dpt like they would they would

00:38:54.588 --> 00:38:55.829
upsell you oh you want some fries with

00:38:55.849 --> 00:38:57.871
that dpt let's let's like you want a

00:38:57.911 --> 00:38:59.592
dbt plus a plus an ot or something

00:38:59.612 --> 00:39:01.454
you know like if they could do that

00:39:01.474 --> 00:39:03.635
they would and they're

00:39:05.228 --> 00:39:07.130
You know this, I know you understand this,

00:39:07.150 --> 00:39:08.650
which is like wherever the financial

00:39:08.670 --> 00:39:09.331
incentives lie,

00:39:09.371 --> 00:39:10.432
that's where you're going to find a lot

00:39:10.452 --> 00:39:10.972
of the behavior.

00:39:11.032 --> 00:39:13.135
So I can't imagine these big corporates

00:39:13.195 --> 00:39:14.715
are going to change much in ten years

00:39:15.757 --> 00:39:17.458
other than their compensation is going to

00:39:17.498 --> 00:39:18.478
be a little bit more compressed,

00:39:18.498 --> 00:39:19.458
their margins are going to be a little

00:39:19.478 --> 00:39:21.300
bit more compressed unless they figure out

00:39:21.320 --> 00:39:22.262
some self-pay stuff.

00:39:23.242 --> 00:39:24.824
But I don't really care because we're

00:39:24.844 --> 00:39:27.565
going to operate in a busy market where

00:39:27.646 --> 00:39:29.646
we can charge a premium rate and I

00:39:29.666 --> 00:39:30.568
can pay therapists

00:39:31.597 --> 00:39:32.097
hundred, you know,

00:39:32.137 --> 00:39:33.840
hundred and twenty six thousand dollars,

00:39:33.860 --> 00:39:36.161
one hundred and seventy thousand dollars

00:39:36.501 --> 00:39:37.101
over time, you know,

00:39:37.242 --> 00:39:38.782
base pay plus performance pay.

00:39:39.403 --> 00:39:40.744
And I'm going to start advertising this

00:39:42.945 --> 00:39:43.467
selfishly.

00:39:43.527 --> 00:39:44.807
I'm going to I'm going to stand on

00:39:44.827 --> 00:39:46.007
the soapbox right now and say I'm going

00:39:46.027 --> 00:39:47.409
to start advertising this on social media

00:39:47.429 --> 00:39:51.793
and saying that we pay therapists the

00:39:51.833 --> 00:39:52.152
most.

00:39:52.773 --> 00:39:53.873
I got to figure out the wording,

00:39:54.233 --> 00:39:56.155
but we're going to be the only show

00:39:56.175 --> 00:39:56.715
in town,

00:39:57.096 --> 00:39:58.818
one of the only shows in town that

00:39:58.838 --> 00:40:00.498
can do that because of our model.

00:40:01.577 --> 00:40:03.257
and we'll see how that goes but i

00:40:03.277 --> 00:40:04.918
threw a lot at you i i do

00:40:04.938 --> 00:40:06.518
think that that profession is going to be

00:40:06.958 --> 00:40:09.838
basically the same as right now in ten

00:40:09.878 --> 00:40:10.918
years i think i think it's gonna be

00:40:10.938 --> 00:40:13.400
the same the network is compressed out of

00:40:13.420 --> 00:40:14.659
network self-pay is gonna get more and

00:40:14.679 --> 00:40:16.900
more popular with online video and more

00:40:16.920 --> 00:40:19.101
discretionary income and every everything

00:40:19.141 --> 00:40:20.521
else is increasing in price and more

00:40:20.561 --> 00:40:21.641
consumers are just gonna be like all right

00:40:21.661 --> 00:40:23.322
i guess i gotta i guess i gotta

00:40:23.342 --> 00:40:25.362
be a wise consumer and find a

00:40:26.346 --> 00:40:27.947
PT or a chiro or someone to go

00:40:28.047 --> 00:40:29.369
see and they charge out of pocket,

00:40:29.688 --> 00:40:31.851
it's going to continue to become more and

00:40:31.871 --> 00:40:35.673
more normal and appropriate to pay out of

00:40:35.693 --> 00:40:37.556
pocket for physical therapy and health and

00:40:37.576 --> 00:40:39.358
wellness services more every single year,

00:40:39.398 --> 00:40:40.219
which benefits us.

00:40:41.539 --> 00:40:42.420
So I don't know.

00:40:42.481 --> 00:40:43.882
What do you think?

00:40:44.081 --> 00:40:47.264
I intentionally said ten years to try and

00:40:47.485 --> 00:40:50.327
overshoot the expectation that I actually

00:40:50.367 --> 00:40:50.628
have.

00:40:51.273 --> 00:40:52.173
You think it's five?

00:40:54.114 --> 00:40:54.815
This is what I see.

00:40:54.976 --> 00:40:56.436
I see hinge and sword.

00:40:57.217 --> 00:40:59.498
I see these two companies coming out and

00:40:59.557 --> 00:41:02.878
blazing a path to how do we get

00:41:03.199 --> 00:41:05.360
one therapist to manage a thousand

00:41:05.400 --> 00:41:08.382
patients as opposed to one therapist

00:41:08.461 --> 00:41:10.023
managing eight patients.

00:41:11.838 --> 00:41:12.978
I think what you're going to see and

00:41:12.998 --> 00:41:14.079
you're going to see pressures from

00:41:14.139 --> 00:41:14.798
multiple areas,

00:41:14.818 --> 00:41:16.440
you're going to see these two companies

00:41:16.940 --> 00:41:17.900
make all the mistakes,

00:41:17.960 --> 00:41:20.880
but then figure out the solutions and take

00:41:21.081 --> 00:41:24.822
AI to a place where one human therapist

00:41:24.842 --> 00:41:26.822
can manage a thousand or more patients.

00:41:27.663 --> 00:41:28.543
I think you're going to see,

00:41:29.224 --> 00:41:31.945
you said DPT programs are profitable.

00:41:32.284 --> 00:41:32.846
I don't know.

00:41:33.365 --> 00:41:36.047
But on a university level,

00:41:36.588 --> 00:41:38.889
when you look at where the university

00:41:38.929 --> 00:41:39.869
makes its money,

00:41:40.590 --> 00:41:42.670
I don't think they're profitable on the

00:41:42.791 --> 00:41:45.612
university-like ecosystem.

00:41:45.672 --> 00:41:47.753
So I think it's just a nuisance.

00:41:47.793 --> 00:41:48.534
They're so small.

00:41:48.594 --> 00:41:49.853
There's so few students.

00:41:50.313 --> 00:41:51.295
Who really cares?

00:41:51.755 --> 00:41:53.795
I just heard about one of the bigger

00:41:53.835 --> 00:41:56.117
public universities cutting a whole huge

00:41:56.177 --> 00:41:56.998
department off.

00:41:57.378 --> 00:41:58.338
of linguistics.

00:41:59.079 --> 00:42:00.579
And I'm like, okay,

00:42:01.039 --> 00:42:03.601
why wouldn't they cut all these all little

00:42:03.681 --> 00:42:06.342
tiny departments of PTO, TSOP,

00:42:06.402 --> 00:42:08.483
all this stuff that really doesn't make,

00:42:09.224 --> 00:42:10.483
it doesn't move the needle for them.

00:42:11.824 --> 00:42:14.405
So I see departments cutting programs.

00:42:14.766 --> 00:42:16.927
I see fewer students deciding to take on

00:42:16.947 --> 00:42:18.327
the financial obligation.

00:42:19.579 --> 00:42:21.601
I see it easier to get the education,

00:42:21.621 --> 00:42:22.382
the information.

00:42:22.422 --> 00:42:24.762
Like, I really think my kid,

00:42:24.802 --> 00:42:27.545
my thirteen year old asked me the other

00:42:27.605 --> 00:42:28.666
day, Dad,

00:42:28.706 --> 00:42:31.168
do you think I could do everything a

00:42:31.208 --> 00:42:32.909
physical therapist could do?

00:42:33.449 --> 00:42:34.969
How long do you think it would take

00:42:35.010 --> 00:42:36.530
me to learn that stuff?

00:42:36.590 --> 00:42:37.291
I said, you know what?

00:42:37.572 --> 00:42:37.972
Really?

00:42:38.773 --> 00:42:40.153
Other than the evaluation.

00:42:40.972 --> 00:42:42.534
You could do it all in a month.

00:42:43.054 --> 00:42:44.954
You could learn how to count to ten

00:42:45.335 --> 00:42:45.916
in a month.

00:42:46.416 --> 00:42:50.518
You could learn how to pull that handle

00:42:50.719 --> 00:42:53.940
thirty times like you could do that stuff

00:42:53.981 --> 00:42:54.681
pretty quick.

00:42:55.481 --> 00:42:57.242
What's going to take you time is learning

00:42:57.282 --> 00:42:59.003
how to differentiate when it's a.

00:42:59.503 --> 00:42:59.764
You know,

00:42:59.824 --> 00:43:02.909
rotator cuff tear versus some other,

00:43:03.110 --> 00:43:05.514
you know, issue with the shoulder,

00:43:06.456 --> 00:43:08.398
the diagnostics, the case history,

00:43:08.438 --> 00:43:09.579
learning how to build trust,

00:43:09.621 --> 00:43:11.063
learning how to relate to your patients

00:43:11.083 --> 00:43:11.463
like that.

00:43:11.623 --> 00:43:12.846
That takes some time.

00:43:13.516 --> 00:43:14.376
Years, years.

00:43:14.817 --> 00:43:17.518
But there isn't a single person,

00:43:17.918 --> 00:43:21.081
an adult today who can't get on AI

00:43:21.501 --> 00:43:23.422
and probably learn all that stuff right

00:43:23.463 --> 00:43:24.903
now without the college degree.

00:43:25.364 --> 00:43:25.644
You know,

00:43:25.804 --> 00:43:27.346
we're still in a situation where the

00:43:27.385 --> 00:43:29.166
college degree, those three letters,

00:43:29.467 --> 00:43:32.148
sometimes two after your name gives you

00:43:32.188 --> 00:43:34.150
the license to bill insurance.

00:43:35.164 --> 00:43:36.586
That's hardly worth it anymore.

00:43:36.987 --> 00:43:38.670
There's no money in that anymore.

00:43:38.730 --> 00:43:40.393
So why am I going to spend seven

00:43:40.432 --> 00:43:42.094
years and two hundred thousand dollars so

00:43:42.135 --> 00:43:44.418
I can bill insurance to get paid fifteen

00:43:44.458 --> 00:43:46.161
bucks to get paid a dollar a minute?

00:43:47.222 --> 00:43:47.981
I don't need that.

00:43:48.623 --> 00:43:48.983
You know,

00:43:49.083 --> 00:43:50.443
so so I think we're going to see

00:43:50.463 --> 00:43:50.943
all these things.

00:43:50.963 --> 00:43:52.585
We're going to see schools dropping the

00:43:52.605 --> 00:43:54.626
programs because they're not making enough

00:43:54.706 --> 00:43:57.007
money generally to support it.

00:43:57.487 --> 00:44:00.268
We're going to see therapists with AI

00:44:00.489 --> 00:44:02.289
treating thousands of patients a day

00:44:02.789 --> 00:44:03.610
because they can do it.

00:44:03.731 --> 00:44:05.751
They have the capacity now to do it.

00:44:06.581 --> 00:44:07.501
They're going to replace me.

00:44:07.521 --> 00:44:08.543
They're not going to replace you.

00:44:09.744 --> 00:44:11.364
That's an important aspect here.

00:44:13.166 --> 00:44:13.527
Agreed.

00:44:13.806 --> 00:44:15.889
We're going to see fewer people interested

00:44:15.929 --> 00:44:17.490
in taking on the debt to become a

00:44:17.550 --> 00:44:18.130
therapist,

00:44:18.291 --> 00:44:20.112
but learning all the information on their

00:44:20.273 --> 00:44:20.452
own.

00:44:21.494 --> 00:44:22.675
And effectively, I mean,

00:44:22.695 --> 00:44:24.797
you're going to have at some point in

00:44:24.956 --> 00:44:27.518
AI that better and more knowledgeable than

00:44:27.739 --> 00:44:29.740
any physical therapist on the world to

00:44:29.880 --> 00:44:30.862
answer your questions.

00:44:30.902 --> 00:44:31.943
They can't rub your butt,

00:44:32.344 --> 00:44:33.525
but they can answer your questions.

00:44:34.385 --> 00:44:35.585
They can tell you what's wrong.

00:44:35.606 --> 00:44:37.746
They can help you go through a twenty

00:44:37.786 --> 00:44:40.389
question game and figure out what your

00:44:40.449 --> 00:44:41.429
diagnosis is.

00:44:41.509 --> 00:44:44.210
Probably better than the human who might

00:44:44.251 --> 00:44:45.391
not have had their coffee,

00:44:45.411 --> 00:44:46.952
who might have woken up on the wrong

00:44:46.992 --> 00:44:47.693
side of the bed.

00:44:47.793 --> 00:44:49.653
I mean, I listen to them on TikTok.

00:44:50.213 --> 00:44:50.454
You know,

00:44:50.494 --> 00:44:52.014
they break up with their boyfriend or

00:44:52.034 --> 00:44:54.655
their girlfriend and they're a mental

00:44:54.695 --> 00:44:55.054
wreck.

00:44:55.594 --> 00:44:58.556
Like we have licensed professionals going

00:44:58.635 --> 00:45:01.496
on TikTok today that are screaming because

00:45:01.516 --> 00:45:02.757
they're upset about something.

00:45:02.876 --> 00:45:04.956
I've never screamed in my life because I'm

00:45:04.996 --> 00:45:06.077
upset about something.

00:45:06.637 --> 00:45:08.157
That's not a stable human.

00:45:08.637 --> 00:45:11.579
That is the profession as it shows to

00:45:11.619 --> 00:45:13.338
the consumer right now across social

00:45:13.358 --> 00:45:14.818
media.

00:45:15.239 --> 00:45:17.119
I don't see it happening ten years from

00:45:17.179 --> 00:45:17.300
now.

00:45:20.143 --> 00:45:23.563
But your service will still be needed ten

00:45:23.583 --> 00:45:24.184
years from now.

00:45:24.503 --> 00:45:25.804
It just won't be physical therapy.

00:45:26.143 --> 00:45:27.043
It won't have the name.

00:45:27.164 --> 00:45:28.824
It won't have the title.

00:45:31.025 --> 00:45:32.144
You threw a lot at me.

00:45:32.184 --> 00:45:32.585
Two things.

00:45:32.846 --> 00:45:33.025
One,

00:45:33.646 --> 00:45:37.766
when we can share multiple universities

00:45:38.206 --> 00:45:42.668
dropping the DPT programs on an article

00:45:42.768 --> 00:45:44.927
online, show me that.

00:45:45.692 --> 00:45:47.172
show me a trend of that show me

00:45:47.233 --> 00:45:49.293
multiple schools dropping a dpt program

00:45:49.793 --> 00:45:51.715
then what then i'll say i was wrong

00:45:51.956 --> 00:45:53.737
tony i believe you jimmy you're refereeing

00:45:53.876 --> 00:45:56.038
again put put your jimmy's in the middle

00:45:56.438 --> 00:45:57.838
we're on either side and we can duke

00:45:57.878 --> 00:46:01.581
it out if i see universities dropping dpt

00:46:01.621 --> 00:46:03.001
programs which i haven't heard of it if

00:46:03.081 --> 00:46:04.583
it if it happens please let us know

00:46:04.603 --> 00:46:06.403
in the comments comment on yeah on the

00:46:06.423 --> 00:46:09.065
youtube or wherever on facebook wherever

00:46:09.085 --> 00:46:11.527
let us know if that if that starts

00:46:11.547 --> 00:46:12.407
happening then

00:46:13.233 --> 00:46:15.293
absolutely then of course you're right and

00:46:15.333 --> 00:46:19.695
then also if sword health or hinge health

00:46:19.815 --> 00:46:24.715
gets acquired by usph or select medical or

00:46:24.795 --> 00:46:26.657
those are the two select medical i think

00:46:26.677 --> 00:46:28.737
went private recently larry ben said but

00:46:28.797 --> 00:46:32.318
yeah us usph is public if if one

00:46:32.358 --> 00:46:35.259
of the big conglomerates that own or or

00:46:35.498 --> 00:46:37.978
not concentra um what's the one that larry

00:46:37.998 --> 00:46:39.519
used to be a part of confluent if

00:46:39.559 --> 00:46:41.519
confluent or one of these big groups

00:46:42.614 --> 00:46:45.795
acquire or invest in Sword Health or Hinch

00:46:45.815 --> 00:46:46.094
Health,

00:46:47.534 --> 00:46:48.875
then I will also come on here and

00:46:48.914 --> 00:46:51.896
say Tony was right, I was wrong,

00:46:52.315 --> 00:46:54.456
and that they are the only way that

00:46:54.496 --> 00:46:57.177
they can get out of the in-network squeeze

00:46:57.577 --> 00:46:58.536
of having all these brick and mortar

00:46:58.556 --> 00:47:00.516
offices across the country would be

00:47:00.556 --> 00:47:03.617
acquiring or partnering with Sword Health

00:47:03.657 --> 00:47:05.137
or Hinch Health so that they can go

00:47:05.177 --> 00:47:07.358
from one therapist to eight patients to

00:47:07.378 --> 00:47:07.838
what you said,

00:47:07.978 --> 00:47:10.179
one therapist to a thousand patients or

00:47:10.199 --> 00:47:10.458
whatever.

00:47:12.019 --> 00:47:13.181
This stuff might happen.

00:47:13.780 --> 00:47:15.942
But I believe in every in every,

00:47:16.322 --> 00:47:18.543
not just every city, but in every,

00:47:19.123 --> 00:47:21.324
not even metro, in every zip code,

00:47:21.784 --> 00:47:23.545
there will still be a demand for the

00:47:23.764 --> 00:47:26.646
one on one out of pocket physical

00:47:26.666 --> 00:47:29.887
therapist who's going to charge one or two

00:47:29.907 --> 00:47:34.429
hundred dollars plus per visit in podunk

00:47:34.469 --> 00:47:37.469
little towns that have populations of ten,

00:47:37.530 --> 00:47:38.731
twenty, fifty thousand people.

00:47:39.773 --> 00:47:41.875
and you can get your dpt degree you're

00:47:41.894 --> 00:47:42.856
going to know all your differential

00:47:42.896 --> 00:47:44.036
diagnosis you're going to know when to

00:47:44.097 --> 00:47:45.699
refer people out you're going to know you

00:47:45.719 --> 00:47:48.342
plus you can use some of the ai

00:47:48.422 --> 00:47:51.885
and other stuff to keep up with research

00:47:52.025 --> 00:47:53.047
and your techniques and all that

00:47:54.146 --> 00:47:54.927
So that's two things.

00:47:54.967 --> 00:47:55.708
And then the other thing I want to

00:47:55.728 --> 00:47:57.708
push back on is how come personal trainers

00:47:57.728 --> 00:48:00.351
are not already using Claude, ChatGPT,

00:48:00.411 --> 00:48:02.512
Gemini, all that to replace us?

00:48:02.552 --> 00:48:04.873
How come they're not using these

00:48:04.893 --> 00:48:05.353
technologies?

00:48:05.373 --> 00:48:06.434
They've been around long enough.

00:48:07.795 --> 00:48:09.556
Or even just basic Google that's been

00:48:09.576 --> 00:48:11.858
around for the last fifteen or twenty

00:48:11.878 --> 00:48:12.318
years or whatever.

00:48:12.637 --> 00:48:14.378
How come personal trainers are not already

00:48:14.398 --> 00:48:15.059
doing what you're saying,

00:48:15.079 --> 00:48:15.420
which is

00:48:16.934 --> 00:48:17.675
Getting smarter,

00:48:17.835 --> 00:48:19.958
using technology to understand

00:48:19.978 --> 00:48:22.101
differential diagnosis based off of where

00:48:22.141 --> 00:48:23.782
the pain is and where the pain travels.

00:48:23.802 --> 00:48:24.985
They could be doing all this already,

00:48:25.025 --> 00:48:25.244
Tony.

00:48:25.284 --> 00:48:26.346
They could be saying, oh,

00:48:26.365 --> 00:48:27.827
you have pain that travels this way.

00:48:27.887 --> 00:48:29.010
So that's, that's okay.

00:48:29.030 --> 00:48:29.329
Let me see.

00:48:29.349 --> 00:48:30.711
That's a long, this dermatome.

00:48:30.751 --> 00:48:31.773
Let's pull up this script.

00:48:31.793 --> 00:48:33.235
A personal trainer could be doing that

00:48:33.275 --> 00:48:33.655
right now.

00:48:33.916 --> 00:48:34.257
They're not.

00:48:35.626 --> 00:48:36.487
I would disagree.

00:48:36.728 --> 00:48:38.668
I would say they've been doing it for

00:48:38.688 --> 00:48:39.208
years.

00:48:39.248 --> 00:48:41.088
There's been corrective exercise

00:48:41.108 --> 00:48:42.630
certifications for years.

00:48:42.690 --> 00:48:46.771
You go on ACE or NASM or any

00:48:46.811 --> 00:48:48.452
of the personal training certification

00:48:48.472 --> 00:48:48.932
websites,

00:48:48.952 --> 00:48:51.793
you're going to see personal trainers with

00:48:51.853 --> 00:48:53.775
certifications for carpal tunnel,

00:48:53.815 --> 00:48:54.795
for shoulder pain,

00:48:54.835 --> 00:48:58.817
for all of these things that historically

00:48:58.856 --> 00:49:01.318
physical therapists used to own the market

00:49:01.378 --> 00:49:01.458
on.

00:49:02.289 --> 00:49:02.750
We don't.

00:49:03.070 --> 00:49:04.311
We can't protect the letters.

00:49:04.351 --> 00:49:05.630
We can't protect licensure.

00:49:05.670 --> 00:49:08.711
We can't even get lifetime to stop using

00:49:08.751 --> 00:49:09.532
DPT,

00:49:10.012 --> 00:49:13.693
which in every state should be protected

00:49:14.934 --> 00:49:16.213
under the State Practice Act.

00:49:16.373 --> 00:49:18.275
We lose that lawsuit every single time.

00:49:19.329 --> 00:49:21.710
The Hinge Health, I just went online.

00:49:21.909 --> 00:49:24.331
It's a three billion dollar market cap.

00:49:24.532 --> 00:49:27.672
USPH is a one billion dollar market cap.

00:49:28.052 --> 00:49:29.673
But we're talking about atoms.

00:49:29.954 --> 00:49:31.534
We're talking about atoms and bits,

00:49:31.594 --> 00:49:34.577
you know, like if anything ever happened,

00:49:34.956 --> 00:49:37.898
Hinge would say, I'm going to acquire ATI.

00:49:38.398 --> 00:49:40.719
I'm going to acquire USPH.

00:49:41.300 --> 00:49:42.380
But then they're going to look at

00:49:42.420 --> 00:49:43.442
themselves and be like,

00:49:43.561 --> 00:49:45.063
why would we ever do that?

00:49:45.483 --> 00:49:47.746
We have software that's scalable to

00:49:47.826 --> 00:49:48.405
infinity.

00:49:48.786 --> 00:49:51.889
We have virtually zero labor cost.

00:49:52.409 --> 00:49:54.572
Why would we go pay for humans?

00:49:54.632 --> 00:49:56.112
Why would we get into the world of

00:49:56.293 --> 00:49:59.456
atoms when there's nothing good that comes

00:49:59.576 --> 00:49:59.996
out of it?

00:50:00.036 --> 00:50:01.197
And these other companies have been

00:50:01.257 --> 00:50:03.059
suffering and floundering for years.

00:50:04.460 --> 00:50:05.422
I really think...

00:50:06.550 --> 00:50:08.373
agree with you i'd be interested to see

00:50:08.432 --> 00:50:10.235
when the universities start making those

00:50:10.275 --> 00:50:13.617
cuts um but i i really do think

00:50:13.677 --> 00:50:17.262
that they are going to perfect the

00:50:17.302 --> 00:50:20.485
technology that's going to increase access

00:50:20.885 --> 00:50:23.128
that's going to wipe out the commoditized

00:50:23.168 --> 00:50:26.090
service i deliver a commoditized service

00:50:26.996 --> 00:50:29.918
we will be removed from the equation

00:50:30.418 --> 00:50:31.960
because we bring the cost of care down

00:50:32.019 --> 00:50:34.701
to virtually zero when we do that for

00:50:34.762 --> 00:50:37.702
insurance companies i would imagine uhc

00:50:37.722 --> 00:50:39.804
would buy hinge like that's that's the

00:50:39.864 --> 00:50:42.945
acquisition that i would see um or build

00:50:42.985 --> 00:50:46.427
their own in-house but yeah it'll be

00:50:46.487 --> 00:50:49.070
exciting times bottom bottom line is if

00:50:49.130 --> 00:50:51.690
you understand how to talk to humans if

00:50:51.751 --> 00:50:52.612
people like you

00:50:53.211 --> 00:50:55.032
If you're generally a happy person,

00:50:55.813 --> 00:50:57.295
you're going to be successful the rest of

00:50:57.315 --> 00:50:57.715
your life.

00:50:57.775 --> 00:51:00.115
It doesn't matter whether you call it

00:51:00.195 --> 00:51:02.557
physical therapy or you just say, hey,

00:51:02.978 --> 00:51:04.038
I just help you feel better.

00:51:04.559 --> 00:51:04.838
You know,

00:51:04.898 --> 00:51:06.619
come hang out for an hour twice a

00:51:06.659 --> 00:51:06.940
week.

00:51:07.099 --> 00:51:08.340
I will help you feel better.

00:51:08.701 --> 00:51:09.561
You'll live longer.

00:51:09.742 --> 00:51:10.621
You'll move better.

00:51:10.862 --> 00:51:13.443
You'll get off the chair without grunting

00:51:14.224 --> 00:51:15.184
like an old person.

00:51:15.244 --> 00:51:16.965
Like that's what I sell.

00:51:17.666 --> 00:51:19.387
And it's not called physical therapy.

00:51:20.108 --> 00:51:21.148
That was my parting shot.

00:51:21.188 --> 00:51:21.608
What you got?

00:51:22.085 --> 00:51:24.867
Yeah, well, I'll say my parting shot is,

00:51:26.469 --> 00:51:28.451
well, you also have the cheers effect,

00:51:28.510 --> 00:51:29.251
right, in your office.

00:51:29.291 --> 00:51:29.992
So it's not,

00:51:30.693 --> 00:51:32.894
you say that you are transactional and

00:51:32.914 --> 00:51:35.056
you're the lowest cost and, you know,

00:51:35.097 --> 00:51:37.117
the whatever, the lowest denominator.

00:51:37.137 --> 00:51:37.418
But no,

00:51:37.498 --> 00:51:39.400
you have people paying out of pocket for

00:51:39.440 --> 00:51:41.161
the gym access.

00:51:41.222 --> 00:51:42.382
They have access to you.

00:51:42.443 --> 00:51:43.384
People want that.

00:51:44.023 --> 00:51:45.766
I think even with all this technology

00:51:45.786 --> 00:51:46.907
stuff and AI and all this,

00:51:47.708 --> 00:51:49.168
there's still going to be people that want

00:51:49.873 --> 00:51:52.735
the, the specialist, the expert,

00:51:52.755 --> 00:51:54.077
the person that they can ask.

00:51:55.057 --> 00:51:55.717
And they know,

00:51:55.757 --> 00:51:57.539
like there's going to be some different

00:51:57.659 --> 00:51:59.001
style of trust where they're going to

00:51:59.021 --> 00:52:00.141
continue to trust you, Tony,

00:52:00.181 --> 00:52:03.304
because they know that you've seen a ton

00:52:03.344 --> 00:52:06.007
of people in person for years and you've

00:52:06.047 --> 00:52:08.208
had to kind of navigate like the pros

00:52:08.228 --> 00:52:09.990
and cons of that and successes.

00:52:10.030 --> 00:52:12.753
And then some where it treatments didn't

00:52:12.793 --> 00:52:15.235
work or something had like a bad response

00:52:15.255 --> 00:52:15.556
or whatever.

00:52:15.576 --> 00:52:15.675
Um,

00:52:16.507 --> 00:52:17.927
And it's that human connection that I

00:52:17.967 --> 00:52:18.929
think people will always want.

00:52:19.028 --> 00:52:21.608
I think they'll always want what you have.

00:52:21.889 --> 00:52:23.509
They like that it's lower cost that you

00:52:23.548 --> 00:52:25.289
take a lot of the insurances and that

00:52:25.329 --> 00:52:26.210
you take their Medicare.

00:52:26.769 --> 00:52:27.530
So they like that,

00:52:27.610 --> 00:52:29.630
but then they'll also pay out of pocket

00:52:29.670 --> 00:52:31.831
for the gym experience or the next thing

00:52:31.851 --> 00:52:32.610
that you might offer,

00:52:32.630 --> 00:52:33.490
whatever that might be.

00:52:34.231 --> 00:52:35.711
The commoditized practices that are

00:52:35.831 --> 00:52:37.172
strictly transactional,

00:52:37.251 --> 00:52:40.753
like the McDonald's version and

00:52:42.184 --> 00:52:44.286
it's eight patients per one therapist.

00:52:44.706 --> 00:52:45.206
Yeah,

00:52:45.226 --> 00:52:47.007
I think those are gonna get swallowed up

00:52:47.086 --> 00:52:48.547
and have to close and their margins are

00:52:48.567 --> 00:52:51.588
gonna be continually tight.

00:52:51.668 --> 00:52:53.248
Anyway, so that's it for me.

00:52:53.289 --> 00:52:53.969
That's my parting shot.

00:52:54.708 --> 00:52:56.829
All right, guys, come back and follow us,

00:52:56.929 --> 00:52:59.110
join us, hang out with us Tuesday,

00:52:59.150 --> 00:52:59.990
Thursday mornings,

00:53:00.090 --> 00:53:01.851
eight thirty Eastern a.m.

00:53:02.692 --> 00:53:04.452
Jimmy will be back next week and I'm

00:53:04.472 --> 00:53:06.253
sure we'll get lots of stories about the

00:53:06.313 --> 00:53:07.574
event he's at right now.

00:53:07.673 --> 00:53:09.074
Dave, you enjoy your weekend.

00:53:09.454 --> 00:53:10.755
Spend some time with your little boy.

00:53:11.782 --> 00:53:12.050
Thank you.