What PTs Are Really Talking About: Burnout, AI, and Getting Paid

WEBVTT

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Broadcasting way too early from three

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separate Wi-Fi connections.

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It's PT Breakfast Club with Tony Meritato,

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Dave Kittle, and Jimmy McKay.

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Good morning,

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physical therapy and anybody else

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listening because your clinic Wi-Fi

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auto-connected by accident.

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Today,

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we're talking about three things that

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should be unrelated but are not.

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An AI company just bought another AI

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company.

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They're just eating each other.

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for a modest,

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two hundred eighty five million dollars in

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the grand scheme of things.

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It's not a billion clinics are growing

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while clinicians are well,

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they've got one foot out the door.

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We'll give you the numbers on it.

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Plus,

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Dave wants to put a fifty percent money

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back guarantee on patient care.

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And if that made you uncomfortable,

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Good,

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because today's show is about who actually

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has leverage in rehab right now and who

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doesn't.

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Let's get into it.

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Tony,

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step one on having leverage is number one.

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You got to have confidence.

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because confidence isn't learned,

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it's applied in a spray.

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Dave's jumping in there as well.

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There we go.

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Morning.

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I got my confidence spray on.

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It has nothing to do with billing, man.

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I just... I don't know.

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It's...

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It's like ax spray.

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You just a little armpits,

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a little on the chest,

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and then we're ready to roll.

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Nothing wrong with it.

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All right.

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We got to go with the big idea.

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I just did a little video yesterday.

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AI didn't kill PT.

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It just bought the front door.

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The news broke yesterday.

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It was everywhere.

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Sword Health acquires Kaya Health for two

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hundred eighty five million dollars.

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We said this.

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We were like, Sword's going to buy Hinge.

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Hinge is going to buy this.

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This is going to buy all these things.

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We're just going to buy each other till

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there's, you know,

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this is the this is the Highlander.

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There can only be one.

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it's consolidation, right?

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This is about access, correct?

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This is not about exercises or apps.

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This is about access to people who's got

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the best Kung Fu,

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who's got the biggest bank account,

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and now they're working together.

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And I mean,

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thank God all the CEOs probably got paid,

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right?

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I mean, that's the bottom line.

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So what does this actually mean?

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What does this matter to the average

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clinic owner?

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Does it?

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Is it a signal?

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Is it a harbinger?

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What is it?

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You seem more excited than anybody about

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this.

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I didn't think anything of it.

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I saw the headline.

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I was like, OK,

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but you seem to feel like this has

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a bigger impact.

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Well, I mean,

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we knew this was going to happen.

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Well, here's why.

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Here's why.

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I hear so much of this or see

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something with sword or hinge or kai or

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whatever.

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And then people are like,

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they use words they tell us never to

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use in PT school,

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which is never and always.

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Well,

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it doesn't matter what that's happening

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because AI will never be able to do

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what I can do.

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And we're always going to be.

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And people who use never and always,

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they typically don't have jobs anymore.

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So that's what I'm looking at,

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which is I don't think this is the

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thing.

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I think this is the thing on the

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way to whatever the big thing is.

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Okay, so before I hear from Dave,

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I asked ChatGPT and it said the big

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impact is market consolidation and digital

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MSK care.

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That is an interesting keyword.

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We were talking about primary care,

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primary physical therapy care.

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Digital MSK care is something that

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probably we should do some SEO

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optimization for.

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Yeah.

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Significant expansion of reach,

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Germany and European market access,

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broader clinical and product portfolio,

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strategic growth signals and digital

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health,

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meaning it's looking good for digital

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health.

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Dave, what do you think?

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You know,

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I used to be more interested in the

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tech spaces, obviously.

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And I don't know.

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I just I don't think it's a big

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deal there.

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Like Jimmy said, it's yeah,

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you're just capturing more accounts and

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then they can try to cross sell the

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the either the consumers and or the

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decision makers of those consumers.

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So the employee funded plans or whoever is

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offering Hinge Health.

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So if I'm sorry,

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this was this was Sword who made the

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deal.

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It was Sword that acquired Kaya.

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Yeah.

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whatever hinge hinge store whatever like

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yeah they're just they're just buying more

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users that they can kind of try to

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cross-pollinate with their core product

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and then they'll try to you know put

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it in front of the users they'll try

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to put it in front of the other

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decision makers at the other companies

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where kaya health was already ingrained in

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the companies using it uh i'm sorry what

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did uh dan batman say dan thank you

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for commenting live and being here

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Dan's saying it's about investors and

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debt.

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Same reason why Hinch help went public.

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It's about money.

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Sure.

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Right.

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I mean,

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you only have so long if you've got

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whatever you've got.

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Right.

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And then if you know you're not going

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to be around two years from now,

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this is me making my best estimate.

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And someone offers you something and

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you're saying, well,

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it's the best offer we're going to get

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in the next three years.

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And if we keep going,

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we might be here in three years.

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You take the deal.

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You sell what you have while it still

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has value.

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That's my estimate.

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And I am by no means a big

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picture thinker like Dan and other people.

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Just I'm just that's not my thing,

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but I'm trying to understand it because I

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want to know what's happening for a clinic

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because here's what I see.

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I looked at,

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I don't know where the hell my phone

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is, which is for the first time ever.

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It's not more.

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I don't,

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I don't think this affects brick and

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mortar or mobile or concierge clinics at

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all.

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Literally.

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I don't think that's my question

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completely.

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I don't think it'll ever affect how,

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how will it affect us?

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I don't, I have, I have,

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I have people that want the in-person

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experience,

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enough people in New York city that have

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enough discretionary income and I can pay

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my therapist competitively.

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And the people that pay us, uh,

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will laugh at this type of a platform

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then there's other people that maybe

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somehow they come they comment on hinge

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health and sword health's facebook ads and

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they're like this is cool and this is

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you know i get this through my employer

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and it's awesome like that's amazing like

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cool where are you where where are you

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where are you this is a bell curve

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where are you are you in the middle

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where is my practice or what do you

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mean what do you

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Where are you?

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Are you in the middle?

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Yeah, your practice.

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In terms of average,

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if this is beige walls.

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Average of what?

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Of using tech?

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In terms of usage.

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Like, where are you?

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In terms of if this is an innovativeness

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bell curve.

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So I think I was telling you guys

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about the AI recording sales apps and that

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type of stuff.

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So I'm always an early adopter in testing

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things out.

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But in terms of our offering of our

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practice, we're on the opposite side.

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We're on the small end.

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Let me ask this a different way.

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Are there more PT clinics in strip malls

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or more clinics like Dave is doing in

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New York City?

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There's more clinics in strip malls.

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Right.

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You're over here.

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I'm asking what this is going to do

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for them.

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Nothing.

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Nothing.

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I don't know, man.

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I don't think it's going to do anything.

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All right.

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I saw this.

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I disagree.

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I agree with Dave in the sense that

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it's not going to affect him.

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It's not going to affect me.

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But to me,

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the middle of that bell curve that Jimmy

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is showing is Athletico, ATI.

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It's the large, multi...

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It's something like Kaiser Permanente.

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It's these big groups.

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I do think they will see an impact.

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I do think it will draw out a

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lot of the excess in referrals just

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because it's a cheaper, easier solution.

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Back to what I said, I think,

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the other day.

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I don't know.

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If I'm going to waste money,

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I would rather waste less money than waste

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more money.

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If I'm going to pay for somebody to

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go get useless therapy,

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I would rather pay less for them to

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get useless therapy.

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That's what I'm saying.

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And those are the referrals that I think

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we're going to see sucked out of the

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market.

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It's not going to affect you or me,

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but it's going to affect those large

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organizations that are dealing with

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thousands and tens of thousands of CPT

00:08:38.668 --> 00:08:39.788
generating machines.

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Ben thinks it looks like a mustache from

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a guy in the eighteen hundreds.

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Come on.

00:08:45.875 --> 00:08:47.056
Ben's smart enough to know he knows the

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bell curve.

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He's just joking around.

00:08:48.616 --> 00:08:50.238
He knows.

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Dan says it won't affect us yet.

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The longer these doors exist,

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the more it will change behavior.

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That's what I'm saying.

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I saw this in two thousand and eight.

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And I started walking towards the door out

00:09:03.188 --> 00:09:03.690
of radio.

00:09:03.970 --> 00:09:06.051
I understood that it's crap.

00:09:06.110 --> 00:09:07.851
Do you guys remember the term buffering?

00:09:08.472 --> 00:09:09.572
It's not even said anymore.

00:09:10.453 --> 00:09:11.495
Like there was a thing, kids,

00:09:11.514 --> 00:09:12.934
there was a thing called real player.

00:09:12.975 --> 00:09:14.677
That's how you listen to anything on the

00:09:14.716 --> 00:09:15.116
internet.

00:09:15.937 --> 00:09:17.918
I listened to my first live stream in

00:09:17.938 --> 00:09:19.960
a car with my phone plugged into an

00:09:20.080 --> 00:09:22.942
aux cord, driving home from work.

00:09:23.562 --> 00:09:25.302
And I was like, this sucks.

00:09:25.443 --> 00:09:26.264
But in six months,

00:09:26.303 --> 00:09:27.304
it's going to suck less.

00:09:28.711 --> 00:09:31.033
I could not have convinced anybody to

00:09:31.072 --> 00:09:32.933
listen to a crappy live stream on a

00:09:32.974 --> 00:09:36.436
flip phone in two thousand and eight.

00:09:36.475 --> 00:09:37.655
I'm saying in ten years,

00:09:37.696 --> 00:09:38.216
what will this do?

00:09:38.256 --> 00:09:38.836
I don't know.

00:09:39.057 --> 00:09:39.996
That's what I'm worried about.

00:09:40.437 --> 00:09:41.717
This is probably going to affect a middle

00:09:41.738 --> 00:09:42.519
schooler right now.

00:09:43.038 --> 00:09:43.778
That's what I'm saying.

00:09:43.999 --> 00:09:45.279
The middle schooler who's like,

00:09:45.399 --> 00:09:46.139
I'll be a PT,

00:09:46.340 --> 00:09:48.140
the middle schooler who just tore her ACL,

00:09:48.160 --> 00:09:48.520
who's like,

00:09:48.662 --> 00:09:49.761
I'm going to go to be a PT.

00:09:50.461 --> 00:09:51.543
I'm questioning that.

00:09:53.080 --> 00:09:54.440
That's also going to sound smart, too,

00:09:54.460 --> 00:09:55.480
is just say your idea is going to

00:09:55.519 --> 00:09:56.740
be thirty years in the future and then

00:09:56.760 --> 00:09:57.301
you're not around.

00:09:57.321 --> 00:09:59.980
You're not around to defend it.

00:10:00.581 --> 00:10:03.101
A couple of things that my GPT said

00:10:03.121 --> 00:10:04.341
that I thought was interesting.

00:10:05.142 --> 00:10:08.023
It it's saying that Hinge Health still is

00:10:08.082 --> 00:10:11.143
by far the market dominating company.

00:10:11.923 --> 00:10:15.163
It said that Hinge is more positioned for

00:10:15.244 --> 00:10:15.903
wearables,

00:10:16.163 --> 00:10:17.485
which I didn't really even think.

00:10:17.664 --> 00:10:18.445
I don't know the difference.

00:10:19.184 --> 00:10:20.265
Yeah,

00:10:20.326 --> 00:10:22.147
basically it's saying Hinge is more about

00:10:22.246 --> 00:10:22.947
wearables.

00:10:23.027 --> 00:10:24.347
It's got a larger U.S.

00:10:24.388 --> 00:10:25.067
member base,

00:10:25.128 --> 00:10:27.509
larger investors with the IPO that's

00:10:28.929 --> 00:10:29.509
happened.

00:10:30.451 --> 00:10:32.812
Sword is just trying to kind of gain

00:10:32.871 --> 00:10:33.532
market share,

00:10:33.552 --> 00:10:35.673
but it's not even close to what Hinge

00:10:35.712 --> 00:10:37.033
is capable of right now.

00:10:37.594 --> 00:10:39.455
Hinge has the connections with the

00:10:39.495 --> 00:10:41.575
employer base and the payer base.

00:10:42.735 --> 00:10:44.875
But it keeps bringing back this thing

00:10:44.895 --> 00:10:48.657
about Hinge being connected with wearables

00:10:48.697 --> 00:10:50.677
that Sword doesn't really do.

00:10:52.118 --> 00:10:54.399
And Sword has apparently more of an

00:10:54.438 --> 00:10:57.479
emphasis on live clinician interaction

00:10:57.719 --> 00:10:59.659
that Hinge doesn't necessarily do.

00:11:02.368 --> 00:11:03.948
We briefly talked about this a while ago

00:11:04.089 --> 00:11:06.892
about some of these companies sending like

00:11:07.032 --> 00:11:08.732
a wearable device to someone's home so

00:11:08.753 --> 00:11:10.794
that it can track their repetitions,

00:11:10.815 --> 00:11:11.955
the range of motion, whatever.

00:11:12.755 --> 00:11:15.138
My stance on this was that's ridiculous.

00:11:15.258 --> 00:11:16.499
And in general,

00:11:16.639 --> 00:11:18.480
over time and across the country,

00:11:19.201 --> 00:11:20.903
People are not going to just like there's

00:11:21.164 --> 00:11:22.046
these EMS suits.

00:11:22.066 --> 00:11:24.311
Have you seen these EMS full body suits

00:11:24.370 --> 00:11:26.413
with electric EMS electro simulation?

00:11:27.096 --> 00:11:29.399
And I talked about it.

00:11:29.500 --> 00:11:30.903
There are personal training companies

00:11:30.942 --> 00:11:31.443
doing it.

00:11:32.239 --> 00:11:33.259
Yeah.

00:11:33.639 --> 00:11:35.539
It's people get sore afterwards.

00:11:35.600 --> 00:11:37.561
People say it's a great workout and that's

00:11:37.600 --> 00:11:40.241
fine, but there's so much to put on.

00:11:40.422 --> 00:11:40.682
It's like,

00:11:40.863 --> 00:11:42.342
it's literally like you're going to have a

00:11:42.403 --> 00:11:42.883
wetsuit on.

00:11:42.923 --> 00:11:43.604
Like you're going to go,

00:11:43.624 --> 00:11:44.703
you're going to go,

00:11:44.783 --> 00:11:46.445
you're going to go surfing right now in,

00:11:46.705 --> 00:11:47.524
you know,

00:11:47.565 --> 00:11:50.025
it's like a wetsuit with EMS and all

00:11:50.046 --> 00:11:51.966
these electrodes and it activates your

00:11:52.006 --> 00:11:52.726
muscles or whatever.

00:11:52.787 --> 00:11:54.908
So it's like this big new, you know,

00:11:54.967 --> 00:11:56.168
trend in personal training.

00:11:57.164 --> 00:11:58.485
But that's just too much.

00:11:58.524 --> 00:11:59.446
You're sweating into it.

00:11:59.485 --> 00:12:00.446
Now it's got to be hard to get

00:12:00.566 --> 00:12:03.067
off because it's wet and tight.

00:12:03.126 --> 00:12:04.826
It sounds like a horrible...

00:12:06.168 --> 00:12:09.087
Sounds like a good Friday night to me.

00:12:09.107 --> 00:12:10.749
We had one client that has tried it.

00:12:10.808 --> 00:12:12.389
One of our physical therapy patient

00:12:12.428 --> 00:12:14.870
clients has tried that, and they liked it.

00:12:15.190 --> 00:12:17.990
But in general, it's just too much of,

00:12:18.191 --> 00:12:18.910
I think, a new thing,

00:12:18.931 --> 00:12:20.611
too much stuff to do,

00:12:20.711 --> 00:12:21.692
and even a wearable...

00:12:22.412 --> 00:12:24.354
like it's just it's just not the right

00:12:24.374 --> 00:12:25.995
thing i remember i poo-pooed the wearable

00:12:26.014 --> 00:12:28.917
thing and i got tony's approval he you

00:12:28.976 --> 00:12:32.100
agreed with that that's like not the no

00:12:32.139 --> 00:12:33.561
like just like a wearable like a i

00:12:33.581 --> 00:12:34.981
don't know like a wrist thing or a

00:12:35.081 --> 00:12:36.823
leg thing or something like if hinge

00:12:36.844 --> 00:12:38.524
health or sword health were to send yeah

00:12:39.005 --> 00:12:41.246
to every knee pain patient or whatever

00:12:41.827 --> 00:12:43.068
yeah if it's not a thing i'll just

00:12:43.129 --> 00:12:44.649
normally like a watch like if it's not

00:12:44.669 --> 00:12:46.272
going to do another thing i don't think

00:12:46.312 --> 00:12:48.052
people will do well i don't know there

00:12:48.072 --> 00:12:49.313
will be the edge people i mean because

00:12:49.333 --> 00:12:50.294
people are wearing whoops

00:12:51.563 --> 00:12:53.245
the rings,

00:12:53.625 --> 00:12:55.466
there's also a little psychological signal

00:12:55.505 --> 00:12:55.745
there.

00:12:56.405 --> 00:12:57.746
You know what I mean?

00:12:58.326 --> 00:13:00.989
This is why I get the Iron Man

00:13:01.028 --> 00:13:01.489
tattoo.

00:13:01.629 --> 00:13:02.009
It's like,

00:13:02.730 --> 00:13:03.830
I want other people to see it.

00:13:04.331 --> 00:13:04.951
You know what I mean?

00:13:04.971 --> 00:13:05.910
It's a little bit of that.

00:13:07.192 --> 00:13:08.893
If you're at home doing your knee

00:13:09.113 --> 00:13:11.354
exercises with a wearable through hinge or

00:13:11.374 --> 00:13:12.495
sword or whatever in the future,

00:13:13.034 --> 00:13:13.875
no one else is seeing that.

00:13:14.014 --> 00:13:15.775
Yeah, if you take some social media video,

00:13:15.836 --> 00:13:16.817
you take a video of it and you

00:13:16.856 --> 00:13:17.356
post it online.

00:13:19.057 --> 00:13:20.658
If you're a true patient that's

00:13:21.340 --> 00:13:24.625
like, it's a different wearable.

00:13:24.684 --> 00:13:26.248
It's outside of your normal things.

00:13:26.268 --> 00:13:26.908
Like you're saying, Jimmy,

00:13:26.928 --> 00:13:27.509
it's not a watch.

00:13:27.529 --> 00:13:29.592
It's not a normal thing.

00:13:29.673 --> 00:13:31.115
And so I don't think there's going to

00:13:31.135 --> 00:13:32.958
be long life of those wearables

00:13:33.119 --> 00:13:33.580
regardless.

00:13:34.133 --> 00:13:36.053
Ryan Eder, I had him on the show,

00:13:36.094 --> 00:13:36.433
I think,

00:13:37.254 --> 00:13:38.654
and I'm going to have him either just

00:13:38.815 --> 00:13:39.395
out soon.

00:13:39.995 --> 00:13:41.197
He's big into computer vision.

00:13:41.216 --> 00:13:42.596
You're not going to have to wear anything.

00:13:43.258 --> 00:13:44.398
Like you're going to wear a watch for

00:13:44.418 --> 00:13:45.318
like the biometrics,

00:13:45.359 --> 00:13:46.779
but like in terms of range of motion

00:13:46.820 --> 00:13:47.919
or like all those things,

00:13:48.299 --> 00:13:49.620
it'll be a camera that you won't even

00:13:49.640 --> 00:13:51.782
have to think about looking at you to

00:13:51.822 --> 00:13:52.682
measure all those things.

00:13:52.942 --> 00:13:55.104
Like we're not, it's there, we're here.

00:13:57.258 --> 00:13:57.597
Hey,

00:13:57.658 --> 00:14:00.339
if regular exercises fixed all orthopedic

00:14:00.359 --> 00:14:02.178
and musculoskeletal pains,

00:14:02.719 --> 00:14:04.600
then we would never get referrals from

00:14:04.639 --> 00:14:05.299
personal trainers.

00:14:05.340 --> 00:14:06.900
Personal trainers would be just fixing

00:14:07.260 --> 00:14:09.041
aches and pains and chronic pains and all

00:14:09.061 --> 00:14:09.780
this forever.

00:14:10.240 --> 00:14:12.562
So again, I will stand on this,

00:14:13.042 --> 00:14:16.423
that this hinge sword health stuff is

00:14:16.842 --> 00:14:19.043
short while it's here.

00:14:19.203 --> 00:14:20.464
It's not going to be long lasting.

00:14:21.846 --> 00:14:22.706
We talked about it before,

00:14:22.787 --> 00:14:25.568
but for people that benefit from it,

00:14:25.609 --> 00:14:26.288
that's amazing.

00:14:26.428 --> 00:14:27.009
That's awesome.

00:14:27.309 --> 00:14:28.510
And if you don't need to pay out

00:14:28.530 --> 00:14:29.532
of pocket or you don't need to do

00:14:29.552 --> 00:14:31.894
a copay and go to Tony's office, whatever,

00:14:32.033 --> 00:14:32.514
that's great.

00:14:32.533 --> 00:14:33.033
That's fine.

00:14:33.654 --> 00:14:34.975
But then you're going to have questions

00:14:35.015 --> 00:14:36.517
and you want to speak to a specialist

00:14:36.537 --> 00:14:37.658
like Tony that has experience.

00:14:37.697 --> 00:14:38.839
And you want, again,

00:14:38.879 --> 00:14:40.200
then you get sucked into the environment

00:14:40.259 --> 00:14:42.041
and the cheers experience and the office

00:14:42.061 --> 00:14:42.480
and all that.

00:14:42.881 --> 00:14:43.942
That forever,

00:14:44.003 --> 00:14:45.283
I don't care what technology...

00:14:46.399 --> 00:14:48.003
improves and changes over time the

00:14:48.043 --> 00:14:50.407
experience of either the one-on-one what

00:14:50.427 --> 00:14:53.172
we do or the one-to-many in tony's office

00:14:53.211 --> 00:14:56.238
with that environment is what people will

00:14:56.278 --> 00:14:58.140
want for millennia in my opinion

00:14:58.181 --> 00:14:59.543
regardless of any technology

00:15:00.902 --> 00:15:01.962
You know, I think it's interesting.

00:15:02.123 --> 00:15:04.985
In my clinic, I would basically say,

00:15:05.004 --> 00:15:07.966
and this is like Midwestern steel town,

00:15:08.548 --> 00:15:11.669
you know, it's not where Dave is.

00:15:12.890 --> 00:15:14.711
Most of my geriatric patients have a

00:15:14.772 --> 00:15:15.373
smartwatch.

00:15:15.452 --> 00:15:18.154
Most of them get alerts and messages,

00:15:18.215 --> 00:15:19.995
texts and all that stuff on their

00:15:20.035 --> 00:15:20.736
smartwatch.

00:15:21.397 --> 00:15:22.577
I was just looking at some numbers.

00:15:22.597 --> 00:15:23.219
So Apple,

00:15:23.519 --> 00:15:25.000
obviously the biggest smartwatch

00:15:25.220 --> 00:15:26.541
distributor, Hollywood.

00:15:26.880 --> 00:15:27.000
uh,

00:15:27.020 --> 00:15:28.802
two hundred and eighty one million million

00:15:28.961 --> 00:15:31.442
units sold as of two thousand twenty four.

00:15:31.501 --> 00:15:32.201
However,

00:15:32.822 --> 00:15:35.182
Apple Watch shipments declined nineteen

00:15:35.222 --> 00:15:37.123
percent year over year in two thousand

00:15:37.163 --> 00:15:37.764
twenty four.

00:15:38.884 --> 00:15:39.443
Personally,

00:15:39.683 --> 00:15:41.825
I don't think the market is in wearables.

00:15:42.085 --> 00:15:44.245
I think the market is implantables.

00:15:45.404 --> 00:15:47.125
We have patients getting total knee

00:15:47.166 --> 00:15:49.365
replacements where they're they have the

00:15:49.405 --> 00:15:51.986
technology in the implant so that they can

00:15:52.027 --> 00:15:53.027
measure range of motion,

00:15:53.047 --> 00:15:54.307
they can measure step counts,

00:15:54.687 --> 00:15:55.827
they can measure that stuff.

00:15:56.768 --> 00:15:58.808
We have patients with the watchman

00:15:59.009 --> 00:16:00.049
implant, you know,

00:16:00.129 --> 00:16:03.230
pacemakers like smart devices that are in

00:16:03.270 --> 00:16:04.051
your body.

00:16:04.731 --> 00:16:06.652
I really like this is now getting to

00:16:06.672 --> 00:16:08.472
the point where it's not like you forget

00:16:08.513 --> 00:16:09.693
to put your smartwatch on.

00:16:09.894 --> 00:16:10.994
I never wear a watch.

00:16:11.114 --> 00:16:11.955
I hate watches.

00:16:12.054 --> 00:16:13.054
I don't wear jewelry.

00:16:13.174 --> 00:16:14.135
I don't have a necklace.

00:16:14.196 --> 00:16:16.376
I barely I wear my ring.

00:16:16.397 --> 00:16:17.116
That's about it.

00:16:17.909 --> 00:16:19.711
But putting it in your body,

00:16:21.153 --> 00:16:22.937
I think that's where this is going to

00:16:22.976 --> 00:16:23.136
go.

00:16:23.616 --> 00:16:23.937
Yeah.

00:16:24.177 --> 00:16:25.639
I mean, guys, look,

00:16:26.301 --> 00:16:28.923
X-Files and those sci-fi shows from back

00:16:28.964 --> 00:16:30.306
in the day, it's amazing.

00:16:30.886 --> 00:16:31.587
There was an episode...

00:16:31.607 --> 00:16:32.769
Were you guys X-Files or am I the

00:16:32.828 --> 00:16:33.009
only...

00:16:34.711 --> 00:16:35.270
Well, let's go back.

00:16:35.691 --> 00:16:36.731
We'll come back to that for one second.

00:16:37.493 --> 00:16:38.994
No one's going to get implantables for

00:16:39.073 --> 00:16:41.615
normal physical therapy though, Tony for,

00:16:41.815 --> 00:16:42.936
for a surgical procedure.

00:16:43.035 --> 00:16:43.296
Sure.

00:16:43.495 --> 00:16:43.677
Okay.

00:16:43.697 --> 00:16:44.496
Let's say in the future,

00:16:44.576 --> 00:16:45.538
every surgical procedure,

00:16:45.817 --> 00:16:47.239
you implant something that's going to then

00:16:47.278 --> 00:16:48.720
track their range of motion or their

00:16:49.039 --> 00:16:49.440
cadence.

00:16:49.460 --> 00:16:50.000
They're walking,

00:16:50.020 --> 00:16:51.581
they're standing versus sitting rate,

00:16:51.601 --> 00:16:51.942
whatever.

00:16:52.302 --> 00:16:53.462
That sounds super cool.

00:16:53.503 --> 00:16:54.783
Like that makes a ton of sense,

00:16:55.344 --> 00:16:56.644
but how many knee replacements are done in

00:16:56.664 --> 00:16:57.404
the country per year?

00:16:57.424 --> 00:16:58.365
Like a couple hundred thousand.

00:16:59.534 --> 00:17:01.316
Over eight hundred thousand, I believe,

00:17:01.735 --> 00:17:02.615
in the US,

00:17:03.697 --> 00:17:05.557
most of which is which is which is

00:17:05.596 --> 00:17:06.317
typically overdone,

00:17:06.377 --> 00:17:07.458
like in other countries.

00:17:08.698 --> 00:17:09.398
But that's the thing.

00:17:09.419 --> 00:17:09.578
Like,

00:17:09.638 --> 00:17:11.179
I don't think I've seen a patient come

00:17:11.259 --> 00:17:13.339
in after their first knee replacement who

00:17:13.400 --> 00:17:15.401
didn't book their second knee replacement

00:17:15.800 --> 00:17:17.020
six weeks in the future.

00:17:17.301 --> 00:17:20.303
Every single one of them is coming in.

00:17:20.843 --> 00:17:21.663
I'm bone on bone.

00:17:21.682 --> 00:17:23.743
You just walked across the room fine.

00:17:24.263 --> 00:17:25.585
But yet in their mind,

00:17:25.625 --> 00:17:27.924
they're bone on bone and can't function

00:17:27.984 --> 00:17:29.526
without a second knee replacement.

00:17:30.605 --> 00:17:31.807
But that being said, like,

00:17:32.007 --> 00:17:34.587
take this through the next logical step.

00:17:35.048 --> 00:17:35.307
OK,

00:17:35.367 --> 00:17:37.729
so we've got smart devices being implanted

00:17:37.769 --> 00:17:38.148
right now.

00:17:38.489 --> 00:17:40.210
Why wouldn't there be a knee replacement

00:17:40.250 --> 00:17:41.971
that does the exercise for me?

00:17:42.590 --> 00:17:45.332
We had a passive range of motion.

00:17:45.771 --> 00:17:47.333
Like now we're going to be at the

00:17:47.452 --> 00:17:49.173
point where we put a knee replacement in

00:17:49.213 --> 00:17:51.233
that does the range of motion for you.

00:17:51.374 --> 00:17:52.414
You just measure it.

00:17:52.974 --> 00:17:53.736
You skipped ahead.

00:17:53.855 --> 00:17:56.417
I thought you were going to say implant

00:17:56.699 --> 00:18:00.102
the knee that can measure use and range

00:18:00.122 --> 00:18:00.622
of motion.

00:18:00.662 --> 00:18:01.583
That's already there.

00:18:01.702 --> 00:18:03.644
The knees are already there that measure

00:18:03.664 --> 00:18:06.047
step count, that measure range of motion.

00:18:06.067 --> 00:18:06.708
I didn't know that.

00:18:06.728 --> 00:18:08.490
We've got that in the clinic right now.

00:18:08.529 --> 00:18:10.852
They have the app on their phone next

00:18:10.872 --> 00:18:11.772
to their electronic knee.

00:18:12.432 --> 00:18:14.976
Why not have the knee that walks for

00:18:15.016 --> 00:18:16.838
you, that does your range of motion,

00:18:16.878 --> 00:18:19.301
that stimulates the muscles,

00:18:19.342 --> 00:18:20.583
that has EMS in it,

00:18:20.623 --> 00:18:22.566
that makes you whether you want to or

00:18:22.586 --> 00:18:22.665
not.

00:18:22.685 --> 00:18:25.229
It's going to need some really big chips

00:18:25.249 --> 00:18:25.990
from NVIDIA,

00:18:26.089 --> 00:18:27.672
and they're probably too big right now to

00:18:27.692 --> 00:18:28.913
fit inside this knee replacement.

00:18:29.513 --> 00:18:30.894
For all the stuff you're talking about,

00:18:30.914 --> 00:18:31.974
for EMS.

00:18:32.655 --> 00:18:33.836
Yeah, but those are smaller.

00:18:33.875 --> 00:18:35.757
But in terms of like an EMS and

00:18:35.836 --> 00:18:37.198
to make someone get up and move.

00:18:37.218 --> 00:18:39.798
And can you imagine a patient that's like

00:18:40.400 --> 00:18:42.101
sixty eight years old and they're like,

00:18:42.121 --> 00:18:42.701
I don't want to move.

00:18:42.780 --> 00:18:44.321
And their knees like making a move and

00:18:44.342 --> 00:18:45.442
they're like having to stand up.

00:18:46.502 --> 00:18:47.222
I don't want to move,

00:18:47.242 --> 00:18:48.344
but the knees moving anyway.

00:18:48.959 --> 00:18:50.960
What are you going in for for surgery?

00:18:51.160 --> 00:18:51.259
Ah,

00:18:51.279 --> 00:18:53.240
they got to replace my knee replacement.

00:18:53.260 --> 00:18:55.862
They got to update my iOS on my

00:18:55.882 --> 00:18:56.603
knee replacement.

00:18:56.623 --> 00:18:57.502
And that's, you know, they got to do,

00:18:57.522 --> 00:18:58.523
that's a hard replace.

00:18:58.544 --> 00:18:59.144
They got to plug,

00:18:59.223 --> 00:19:00.344
they actually got to plug in.

00:19:01.244 --> 00:19:03.105
Ben said, there's a company doing this.

00:19:03.165 --> 00:19:04.686
And frankly, the data you get,

00:19:04.967 --> 00:19:07.307
it's not worth the cost yet.

00:19:07.347 --> 00:19:07.928
There we go.

00:19:07.948 --> 00:19:08.008
Ben,

00:19:08.067 --> 00:19:10.388
I'm going to say yet after all of

00:19:10.449 --> 00:19:10.848
that,

00:19:11.970 --> 00:19:14.371
you can get most of the same info.

00:19:15.271 --> 00:19:15.551
Yeah.

00:19:15.612 --> 00:19:17.231
Unintended consequences.

00:19:17.633 --> 00:19:18.212
Absolutely.

00:19:19.436 --> 00:19:20.438
Yeah.

00:19:20.478 --> 00:19:21.038
Well, I mean,

00:19:21.097 --> 00:19:22.578
somebody in the comment section below,

00:19:22.638 --> 00:19:22.839
right?

00:19:22.880 --> 00:19:24.401
Whenever you start talking about this

00:19:24.441 --> 00:19:24.780
stuff,

00:19:26.962 --> 00:19:29.785
you start talking in logic and people

00:19:29.845 --> 00:19:31.346
respond with emotion.

00:19:31.546 --> 00:19:32.227
It's human nature.

00:19:32.267 --> 00:19:33.827
I'm guilty of this ten times a day.

00:19:34.888 --> 00:19:36.930
People will never, AI will never,

00:19:36.990 --> 00:19:37.871
robots will never

00:19:40.463 --> 00:19:41.523
And I just say, yeah,

00:19:41.723 --> 00:19:43.144
like it will never replace.

00:19:43.164 --> 00:19:44.325
This is where like now you go the

00:19:44.384 --> 00:19:45.285
other side of the pendulum,

00:19:45.305 --> 00:19:46.986
which is like it will never replace our

00:19:47.046 --> 00:19:48.326
hands or our minds.

00:19:48.365 --> 00:19:49.826
And I'm like, I don't know.

00:19:49.905 --> 00:19:51.747
The AI robot has entered the chat.

00:19:51.846 --> 00:19:53.666
The AI massage thing has entered the chat.

00:19:54.406 --> 00:19:55.748
I don't think it will replace things.

00:19:56.167 --> 00:19:57.147
All of those things.

00:19:57.528 --> 00:19:59.929
I'm asking how much of the mustache.

00:20:00.669 --> 00:20:02.830
will it will it capture it always affects

00:20:02.871 --> 00:20:04.811
the middle first that's the financially

00:20:04.832 --> 00:20:06.753
the best place to go for and it's

00:20:06.773 --> 00:20:09.236
the easiest place because beige painted no

00:20:09.276 --> 00:20:11.376
no it's the it's the it's the innovators

00:20:11.396 --> 00:20:13.318
first which is the smaller one side and

00:20:13.338 --> 00:20:15.780
then the middle is like uh mass and

00:20:15.800 --> 00:20:17.301
then the other side would be the laggards

00:20:17.781 --> 00:20:21.184
what i'm saying is the the early doctors

00:20:21.204 --> 00:20:22.625
innovators and then the middle is the mask

00:20:22.645 --> 00:20:22.905
go ahead

00:20:23.294 --> 00:20:23.513
Right.

00:20:23.914 --> 00:20:26.636
I'm saying any innovation in terms of

00:20:26.717 --> 00:20:29.519
population, who's most susceptible?

00:20:29.579 --> 00:20:31.721
It's not Dave or Tony who have innovative

00:20:31.821 --> 00:20:32.201
anything.

00:20:32.942 --> 00:20:34.584
Who's most susceptible to innovation?

00:20:36.276 --> 00:20:38.257
The PT clinic who's got beige painted

00:20:38.297 --> 00:20:40.259
walls in a strip mall who hasn't innovated

00:20:40.278 --> 00:20:40.880
in twenty years,

00:20:41.220 --> 00:20:43.321
they will feel this punch first.

00:20:43.461 --> 00:20:45.784
We're going to talk about prompts report.

00:20:46.023 --> 00:20:49.286
The clinic that's about to die will be

00:20:49.307 --> 00:20:50.968
affected by a two percent change in

00:20:51.008 --> 00:20:53.069
something like this in three years.

00:20:53.829 --> 00:20:54.550
You guys won't.

00:20:55.531 --> 00:20:56.471
It's not even a speed bump.

00:20:56.491 --> 00:20:57.913
This is a gnat on your windshield.

00:20:58.273 --> 00:20:59.934
This could cripple the ones that are

00:21:00.015 --> 00:21:01.256
already circling the drain.

00:21:02.116 --> 00:21:03.397
They're the most susceptible.

00:21:03.817 --> 00:21:05.660
The ones that either have... Yeah,

00:21:05.980 --> 00:21:06.421
it could be.

00:21:06.441 --> 00:21:09.042
The ones that have slim profit margins and

00:21:09.202 --> 00:21:11.064
or lower perceived value from their

00:21:11.124 --> 00:21:12.144
average professional client.

00:21:12.345 --> 00:21:13.486
That's what I'm saying.

00:21:14.346 --> 00:21:15.468
But what I was saying a second ago

00:21:15.508 --> 00:21:18.490
is people will say, well,

00:21:18.549 --> 00:21:19.971
it'll never be able to do this.

00:21:19.990 --> 00:21:21.271
It'll never be able to do that.

00:21:21.311 --> 00:21:22.333
And I understand that.

00:21:22.973 --> 00:21:24.454
Except all it takes is...

00:21:25.575 --> 00:21:27.895
two percent of anything and that ram the

00:21:27.935 --> 00:21:30.215
ramifications that math maps why are we

00:21:30.236 --> 00:21:32.497
looking at what is that wally wally i

00:21:32.537 --> 00:21:36.018
mean for for decades i assume the future

00:21:36.238 --> 00:21:40.138
of humanity was this but for the first

00:21:40.180 --> 00:21:41.140
time ever

00:21:41.960 --> 00:21:44.320
I'm realizing like we've got the weight

00:21:44.340 --> 00:21:45.121
loss drugs.

00:21:45.320 --> 00:21:47.922
We've got the technology to force people

00:21:47.961 --> 00:21:50.143
to exercise whether they want to or not.

00:21:50.962 --> 00:21:52.583
We've got implantables,

00:21:52.663 --> 00:21:53.903
not just wearables.

00:21:54.423 --> 00:21:56.785
I really think we could be at a

00:21:56.845 --> 00:21:59.904
tipping point here where whether somebody

00:22:00.025 --> 00:22:00.786
wants to.

00:22:00.806 --> 00:22:02.526
I was just listening to an interview where

00:22:02.546 --> 00:22:04.747
they talked about removing memories from

00:22:04.807 --> 00:22:05.446
your head.

00:22:06.047 --> 00:22:08.167
So if you wanted to take a memory

00:22:08.327 --> 00:22:09.508
out, they could find it.

00:22:09.627 --> 00:22:11.288
They could zap it and it's gone.

00:22:11.929 --> 00:22:14.631
Eternal Sunshine.

00:22:14.651 --> 00:22:15.750
It's a scary time.

00:22:16.071 --> 00:22:17.071
It's a scary time.

00:22:17.192 --> 00:22:17.992
I'm not denying it.

00:22:18.012 --> 00:22:19.433
That could fix some mental health.

00:22:19.834 --> 00:22:21.315
There might be some good use cases there.

00:22:21.335 --> 00:22:22.015
That's a movie.

00:22:22.115 --> 00:22:23.016
That's what I was going to say ten

00:22:23.036 --> 00:22:23.536
minutes ago.

00:22:24.135 --> 00:22:25.757
There's an X-Files episode.

00:22:26.157 --> 00:22:28.298
The entire episode is shot in a sushi

00:22:28.338 --> 00:22:30.941
restaurant with Dana Scully and Fox

00:22:30.980 --> 00:22:31.300
Mulder.

00:22:31.840 --> 00:22:32.642
No humans...

00:22:33.602 --> 00:22:36.343
are involved you order with an app it's

00:22:36.383 --> 00:22:37.863
a sushi right you order with an app

00:22:38.542 --> 00:22:40.703
and then there's machines in the back and

00:22:40.723 --> 00:22:42.464
there's a problem of course with with

00:22:42.585 --> 00:22:45.265
molder's order and then it's it even keyed

00:22:45.345 --> 00:22:46.986
on the tipping how much do you want

00:22:47.006 --> 00:22:49.326
to tip and molder was like no tip

00:22:49.446 --> 00:22:51.406
and the app was giving him crap all

00:22:51.426 --> 00:22:52.907
that was ridiculous ten years ago when

00:22:52.928 --> 00:22:55.407
that thing came out it's not ridiculous

00:22:55.448 --> 00:22:57.568
anymore do you guys have this

00:22:58.577 --> 00:23:01.861
The shopping cart at my supermarket right

00:23:01.921 --> 00:23:03.321
now, I'm not even that edgy.

00:23:03.842 --> 00:23:05.523
I'm not in a big city, right?

00:23:05.663 --> 00:23:07.305
I'm an hour from New York.

00:23:08.465 --> 00:23:10.607
Dave, have you seen this?

00:23:10.647 --> 00:23:11.367
Shopping cart.

00:23:11.969 --> 00:23:14.211
I log in with my price plus number.

00:23:14.990 --> 00:23:16.451
And then as I put things into the

00:23:16.491 --> 00:23:16.853
cart,

00:23:17.752 --> 00:23:19.173
I just swing it by the scanner and

00:23:19.255 --> 00:23:19.954
boop in there.

00:23:20.035 --> 00:23:20.836
And when I check out,

00:23:20.935 --> 00:23:22.057
it already knows what's in the cart.

00:23:22.297 --> 00:23:23.038
Here's the kicker.

00:23:24.078 --> 00:23:25.839
If I put something in the cart and

00:23:25.880 --> 00:23:26.599
didn't scan it,

00:23:26.660 --> 00:23:28.381
it's like we have a camera.

00:23:28.641 --> 00:23:30.541
We watch something go in that didn't scan.

00:23:30.761 --> 00:23:31.221
There's an error.

00:23:31.241 --> 00:23:32.542
We're going to have an associate come over

00:23:32.563 --> 00:23:33.182
and check that.

00:23:33.643 --> 00:23:34.123
We're there.

00:23:34.182 --> 00:23:37.184
This is in upstate New York.

00:23:37.265 --> 00:23:39.125
This is not the edge.

00:23:39.705 --> 00:23:40.026
Guys,

00:23:40.865 --> 00:23:42.626
are we going to be beaming people up?

00:23:42.686 --> 00:23:42.886
I mean,

00:23:42.987 --> 00:23:45.468
everything in Star Trek has happened.

00:23:46.368 --> 00:23:48.210
That was Nextel, right?

00:23:48.609 --> 00:23:49.369
Laser beams.

00:23:49.410 --> 00:23:50.510
We've got those things.

00:23:51.151 --> 00:23:52.490
It's just time.

00:23:52.751 --> 00:23:53.491
It's time.

00:23:54.980 --> 00:23:59.162
So to Ben's point, yes, meat sacks.

00:23:59.803 --> 00:24:01.963
We've used that terminology before.

00:24:02.503 --> 00:24:04.805
I just want to be a muscly meat

00:24:04.825 --> 00:24:04.904
sack.

00:24:04.924 --> 00:24:07.586
I want muscle, not fat.

00:24:07.606 --> 00:24:09.027
I love the one line in The Matrix,

00:24:09.047 --> 00:24:09.208
though,

00:24:09.228 --> 00:24:10.807
where they're like zinging each other and

00:24:10.867 --> 00:24:12.348
called them copper top.

00:24:12.950 --> 00:24:14.190
And I think that went over my head

00:24:14.230 --> 00:24:16.250
the first eighty six times I watched it.

00:24:16.270 --> 00:24:17.852
And I was like, oh, it's a battery.

00:24:17.872 --> 00:24:19.252
That's an Energizer battery.

00:24:19.292 --> 00:24:20.012
Copper top.

00:24:20.232 --> 00:24:20.814
Oh, Duracell.

00:24:20.834 --> 00:24:21.213
Duracell.

00:24:23.375 --> 00:24:25.237
Yeah, I don't imagine.

00:24:25.317 --> 00:24:25.596
I mean,

00:24:25.636 --> 00:24:27.596
this has probably been one of my biggest

00:24:27.616 --> 00:24:28.396
friction points.

00:24:28.436 --> 00:24:29.157
So Ben says,

00:24:29.538 --> 00:24:31.317
even setting up your phone for computer

00:24:31.357 --> 00:24:33.159
vision can be a friction point.

00:24:33.278 --> 00:24:33.638
I agree.

00:24:34.999 --> 00:24:37.279
Thinking that somebody is going to set up

00:24:37.319 --> 00:24:39.721
a phone and record them doing videos and

00:24:39.740 --> 00:24:42.661
the AI is going to analyze your hip

00:24:42.741 --> 00:24:43.882
hinge and is it proper?

00:24:44.602 --> 00:24:46.723
I think that's a total waste of time.

00:24:46.824 --> 00:24:49.125
I don't see any reasonable person doing

00:24:49.185 --> 00:24:49.526
that.

00:24:49.846 --> 00:24:50.946
Oh, no, no, no.

00:24:51.086 --> 00:24:52.989
The first people will be not reasonable.

00:24:53.068 --> 00:24:54.390
These are the people who already own

00:24:54.450 --> 00:24:55.671
tonals in their house.

00:24:55.931 --> 00:24:58.853
I was talking with someone who I love

00:24:58.893 --> 00:24:59.114
her.

00:24:59.134 --> 00:25:00.914
It was like, I think people should just,

00:25:01.055 --> 00:25:01.996
I mean, wouldn't it be great?

00:25:02.016 --> 00:25:02.816
You'd save a lot of money,

00:25:02.836 --> 00:25:03.757
just buy a tonal.

00:25:03.777 --> 00:25:06.398
And I'm like, what does a tonal cost?

00:25:06.439 --> 00:25:07.480
And I can't remember what it costs,

00:25:07.519 --> 00:25:09.902
but I remember thinking, are you insane?

00:25:10.061 --> 00:25:10.583
What does it cost?

00:25:11.416 --> 00:25:12.218
I mean, at least hundreds,

00:25:12.238 --> 00:25:16.201
if not a thousand.

00:25:16.361 --> 00:25:18.061
This person had money and they were like,

00:25:18.102 --> 00:25:19.083
just buy tonals.

00:25:19.123 --> 00:25:20.904
If everybody got a tonal and then a

00:25:20.944 --> 00:25:21.944
PT could zoom in.

00:25:21.984 --> 00:25:22.865
And I'm like, lady,

00:25:23.365 --> 00:25:25.188
you are so far away from reality.

00:25:25.248 --> 00:25:27.169
We're not all, we don't have tonal money.

00:25:27.670 --> 00:25:31.093
But as that goes on,

00:25:31.692 --> 00:25:32.913
that's going to get cheaper.

00:25:32.933 --> 00:25:34.255
So I think the people who have that

00:25:34.335 --> 00:25:36.396
might be, wouldn't that be a great model?

00:25:37.742 --> 00:25:39.364
Instead of just doing telehealth with a

00:25:39.423 --> 00:25:39.845
phone,

00:25:40.164 --> 00:25:41.865
you zoom in on a tonal and you're

00:25:41.885 --> 00:25:43.906
staring at them and you can know, okay,

00:25:44.346 --> 00:25:45.488
do this exercise, boop.

00:25:45.728 --> 00:25:47.009
And then just like the matrix,

00:25:47.249 --> 00:25:48.369
do you know how to fly a helicopter?

00:25:49.309 --> 00:25:49.730
Now I do.

00:25:50.411 --> 00:25:51.412
Okay, do this exercise.

00:25:51.451 --> 00:25:52.952
And the tonal changes to the thing and

00:25:52.972 --> 00:25:54.012
gives the proper resistance.

00:25:54.053 --> 00:25:56.214
That's the merging that I'm waiting for.

00:25:56.694 --> 00:25:58.096
We're not there yet because tonals cost

00:25:58.135 --> 00:26:00.096
ten grand.

00:26:00.136 --> 00:26:03.298
So, Jimmy, you had two other topics.

00:26:03.358 --> 00:26:04.720
Let's get to topic number two.

00:26:05.461 --> 00:26:05.682
Yeah,

00:26:05.701 --> 00:26:07.625
we have to get to topic number two,

00:26:08.105 --> 00:26:10.470
but we also have to talk about another

00:26:10.529 --> 00:26:10.891
sponsor.

00:26:10.971 --> 00:26:11.432
This one...

00:26:12.269 --> 00:26:13.330
This one could be a thing.

00:26:13.351 --> 00:26:14.330
This one's already a thing.

00:26:14.631 --> 00:26:15.471
I would do this one.

00:26:16.352 --> 00:26:17.133
Students love it.

00:26:17.792 --> 00:26:18.634
Clinicians love it.

00:26:18.953 --> 00:26:20.355
The clipboard of authority.

00:26:20.755 --> 00:26:22.296
This segment is sponsored by the clipboard

00:26:22.316 --> 00:26:22.855
of authority.

00:26:22.875 --> 00:26:24.156
The heavier the clipboard,

00:26:24.196 --> 00:26:25.377
the more correct you are.

00:26:25.458 --> 00:26:27.618
Perfect for nodding silently,

00:26:27.919 --> 00:26:29.380
pretending to observe movement,

00:26:29.720 --> 00:26:32.122
and ending conversations without speaking.

00:26:32.301 --> 00:26:33.323
Just look at your clipboard.

00:26:33.643 --> 00:26:35.203
Now featuring extra weight for difficult

00:26:35.243 --> 00:26:38.005
patients and premium leather grip that

00:26:38.045 --> 00:26:38.665
says, look...

00:26:39.266 --> 00:26:40.386
I've been doing this for a while.

00:26:40.626 --> 00:26:41.988
The clipboard of authority.

00:26:42.048 --> 00:26:42.929
You don't need answers.

00:26:43.269 --> 00:26:45.411
You just need something to hold on to.

00:26:45.730 --> 00:26:46.351
That's all you do.

00:26:46.872 --> 00:26:47.132
All right.

00:26:47.172 --> 00:26:48.772
So very low, very low, very low tech,

00:26:48.893 --> 00:26:50.294
very low tech, very low tech.

00:26:50.453 --> 00:26:52.375
Like it carries a little cachet in it.

00:26:52.395 --> 00:26:52.615
You know,

00:26:53.576 --> 00:26:54.778
I was what I want to brag.

00:26:55.563 --> 00:26:56.364
I was a VIP.

00:26:56.544 --> 00:26:57.403
Did you guys get this?

00:26:57.664 --> 00:26:57.984
I don't know.

00:26:58.105 --> 00:26:58.724
I'm a VIP.

00:26:58.765 --> 00:27:00.186
I got something very exclusive.

00:27:00.247 --> 00:27:01.688
Probably only fifty people in the country

00:27:01.728 --> 00:27:02.067
got this.

00:27:02.327 --> 00:27:02.808
I'm only kidding.

00:27:03.148 --> 00:27:04.269
I'm on the prompt mailing list or

00:27:04.289 --> 00:27:04.529
whatever.

00:27:04.890 --> 00:27:06.671
I got this in my inbox and I

00:27:06.692 --> 00:27:08.813
was like, what's this?

00:27:11.330 --> 00:27:12.872
WebPT has done this for years.

00:27:13.011 --> 00:27:13.932
It's a state of the union.

00:27:14.092 --> 00:27:15.813
Because if you're an EMR company and you

00:27:15.833 --> 00:27:17.673
have access to hundreds or thousands of

00:27:17.713 --> 00:27:18.013
clinics,

00:27:18.354 --> 00:27:19.835
why wouldn't you ask all of them for

00:27:19.875 --> 00:27:21.234
a survey and tell them,

00:27:21.255 --> 00:27:22.455
we're going to put all your answers with

00:27:22.476 --> 00:27:23.556
other people's answers and we're going to

00:27:23.576 --> 00:27:24.717
get answered answers.

00:27:25.297 --> 00:27:26.457
So Prompt Health,

00:27:26.497 --> 00:27:28.317
twenty twenty six rehab therapy report.

00:27:28.417 --> 00:27:29.038
I got to be honest,

00:27:29.358 --> 00:27:30.318
I just started calling it the state of

00:27:30.338 --> 00:27:31.880
the union because rehab therapy reports

00:27:31.920 --> 00:27:32.920
didn't have any pop for me.

00:27:34.181 --> 00:27:35.681
Eight and ten clinics are growing year

00:27:35.721 --> 00:27:36.141
over year.

00:27:37.481 --> 00:27:38.863
Seventy percent of clinicians are thinking

00:27:38.903 --> 00:27:39.383
about leaving.

00:27:40.269 --> 00:27:40.990
I don't understand that.

00:27:41.871 --> 00:27:43.772
Eight in ten clinics are growing year over

00:27:43.792 --> 00:27:43.992
year.

00:27:45.173 --> 00:27:47.295
Seventy percent of clinicians are thinking

00:27:47.315 --> 00:27:49.096
about leaving that clinic.

00:27:50.076 --> 00:27:51.617
Burnout highest in clinics with

00:27:51.657 --> 00:27:53.098
disconnected manual systems.

00:27:54.279 --> 00:27:55.961
Younger PTs less than thirty are most

00:27:56.020 --> 00:27:56.401
burned out.

00:27:56.582 --> 00:27:57.741
I'm just throwing out statistics.

00:27:59.202 --> 00:27:59.963
What are these things?

00:28:01.025 --> 00:28:03.046
Do the data ever shock you guys from

00:28:03.086 --> 00:28:04.287
these things or just like, yeah,

00:28:04.366 --> 00:28:05.508
we knew that?

00:28:05.528 --> 00:28:06.709
Before we talk about the data,

00:28:06.729 --> 00:28:07.869
before we talk about the topic,

00:28:08.905 --> 00:28:10.386
For the folks at home watching on YouTube,

00:28:10.747 --> 00:28:13.950
Jimmy wore a tie to make this video

00:28:14.450 --> 00:28:15.411
on PT Pinecast.

00:28:15.871 --> 00:28:18.532
And I just want to reflect on the

00:28:18.593 --> 00:28:24.396
power of Jimmy's diverse attire.

00:28:24.457 --> 00:28:25.617
Sometimes it might be a hoodie.

00:28:25.678 --> 00:28:26.919
Sometimes it might be a beanie.

00:28:27.499 --> 00:28:28.079
Some days...

00:28:28.759 --> 00:28:29.799
He's got the hair done.

00:28:30.121 --> 00:28:31.601
Some days he's shaved.

00:28:31.641 --> 00:28:32.340
Some days he's not.

00:28:32.381 --> 00:28:34.122
Some days he's got a tie on with

00:28:34.182 --> 00:28:35.123
a white button up.

00:28:35.482 --> 00:28:36.202
I couldn't believe it.

00:28:36.663 --> 00:28:38.124
And I was never sure, like,

00:28:38.183 --> 00:28:39.884
who would wear a tie on a podcast

00:28:39.903 --> 00:28:40.104
first.

00:28:40.144 --> 00:28:40.704
I mean,

00:28:40.884 --> 00:28:42.265
you know I'm close enough some days.

00:28:42.726 --> 00:28:43.965
But I thought, you know,

00:28:44.026 --> 00:28:44.685
would it be Jimmy?

00:28:44.766 --> 00:28:45.426
Would it be Tony?

00:28:45.507 --> 00:28:46.366
No, definitely Jimmy.

00:28:46.747 --> 00:28:48.426
If we're on Kalashi or whatever that app

00:28:48.487 --> 00:28:49.548
is where you can bet on anything,

00:28:50.008 --> 00:28:51.807
the number for which one of us three

00:28:51.827 --> 00:28:52.488
to wear a tie.

00:28:52.708 --> 00:28:54.709
I was the, I was the long shot,

00:28:54.769 --> 00:28:55.788
but you paid out if you,

00:28:55.909 --> 00:28:56.669
if you voted on that.

00:28:58.509 --> 00:28:59.569
Cause I wanted to do like,

00:28:59.609 --> 00:29:00.869
I was trying to find like serious,

00:29:00.910 --> 00:29:01.509
like I totally get it.

00:29:01.549 --> 00:29:03.570
It made sense.

00:29:04.270 --> 00:29:05.030
Music or whatever.

00:29:06.192 --> 00:29:07.471
So when you guys look at these things,

00:29:08.092 --> 00:29:08.372
You know what?

00:29:08.852 --> 00:29:10.053
Do you look at these things?

00:29:10.353 --> 00:29:11.053
If you do,

00:29:11.173 --> 00:29:12.874
does it surprise any of you?

00:29:13.453 --> 00:29:14.694
Or are you like, yeah, okay,

00:29:14.954 --> 00:29:15.474
I figured that.

00:29:15.654 --> 00:29:17.935
Or is it ever like there's one statistic

00:29:17.976 --> 00:29:18.717
in there that goes, huh,

00:29:18.856 --> 00:29:19.537
didn't think of that.

00:29:20.797 --> 00:29:23.479
I was surprised when APTA said we were

00:29:23.519 --> 00:29:25.019
going to have too many physical

00:29:25.058 --> 00:29:25.700
therapists.

00:29:25.940 --> 00:29:26.839
I remember that.

00:29:26.859 --> 00:29:27.861
That was a while ago, right?

00:29:28.060 --> 00:29:30.040
Seriously?

00:29:30.060 --> 00:29:30.961
That was a while ago, right?

00:29:31.342 --> 00:29:31.821
Yeah, yeah.

00:29:31.842 --> 00:29:33.282
That was an old report.

00:29:33.363 --> 00:29:33.482
Right.

00:29:34.654 --> 00:29:36.776
I haven't really been looking at these

00:29:37.155 --> 00:29:37.717
market reports.

00:29:37.757 --> 00:29:39.676
I think at this point, the past,

00:29:39.696 --> 00:29:40.238
I don't know,

00:29:40.258 --> 00:29:41.557
before and even before and after COVID,

00:29:41.577 --> 00:29:43.739
they're kind of approximately the same.

00:29:45.359 --> 00:29:46.440
I think still one of the best ones

00:29:46.460 --> 00:29:48.800
is that the WebPT one about the drop-offs,

00:29:48.820 --> 00:29:50.442
which was like, I don't know,

00:29:50.461 --> 00:29:52.303
whatever it was, like, uh,

00:29:52.343 --> 00:29:54.124
ninety percent of patients drop off or

00:29:54.163 --> 00:29:56.704
something, something insane that don't,

00:29:56.865 --> 00:29:57.085
you know,

00:29:57.164 --> 00:29:58.286
don't complete their plan of care.

00:29:58.365 --> 00:29:59.726
I think that was probably one of the

00:29:59.746 --> 00:30:00.426
best ones from, like,

00:30:00.446 --> 00:30:00.926
the past

00:30:01.663 --> 00:30:02.904
I don't know, ten years or whatever.

00:30:03.305 --> 00:30:05.346
But everything else, I mean,

00:30:05.385 --> 00:30:07.507
prompts is obviously going to be most of

00:30:07.527 --> 00:30:08.666
this data is going to be from in-network

00:30:08.686 --> 00:30:08.988
clinics.

00:30:09.008 --> 00:30:10.929
So that's fine because that's like where

00:30:10.949 --> 00:30:11.648
the volume is.

00:30:12.249 --> 00:30:13.769
But most of what you covered,

00:30:13.789 --> 00:30:15.451
like I watched a little bit or I

00:30:15.691 --> 00:30:16.451
listened to a little bit.

00:30:16.570 --> 00:30:19.393
So I wasn't surprised at all.

00:30:20.012 --> 00:30:20.712
Yeah.

00:30:20.752 --> 00:30:20.854
Well,

00:30:20.874 --> 00:30:22.713
the things that the contradiction is

00:30:22.753 --> 00:30:23.335
confusing me.

00:30:23.474 --> 00:30:25.355
Eight out of ten clinics are growing year

00:30:25.395 --> 00:30:25.736
over year.

00:30:27.173 --> 00:30:29.374
except seventy percent of clinicians are

00:30:29.394 --> 00:30:31.255
thinking about leaving which means the

00:30:31.275 --> 00:30:33.215
clinics are doing well but they're just

00:30:33.276 --> 00:30:35.656
shuffling and reshuffling the deck they

00:30:35.696 --> 00:30:37.297
could be i don't know couldn't wouldn't

00:30:37.317 --> 00:30:38.498
that say a clinic could do a lot

00:30:38.518 --> 00:30:39.877
better if you if you stopped having to

00:30:39.917 --> 00:30:44.039
try to attract and hire people sure yeah

00:30:44.059 --> 00:30:45.320
you would have more focus on

00:30:46.317 --> 00:30:49.640
know marketing or growth or stability and

00:30:49.920 --> 00:30:52.261
less focus on recruiting and hiring i mean

00:30:52.301 --> 00:30:54.403
you always need you always need to focus

00:30:54.443 --> 00:30:56.105
on both but if seventy percent of your

00:30:56.125 --> 00:30:58.606
workforce is whatever it was unsatisfied

00:30:58.686 --> 00:31:00.828
or looking to potentially leave the leave

00:31:00.868 --> 00:31:02.951
their job or leave the industry like yeah

00:31:02.971 --> 00:31:04.132
that's quite significant

00:31:05.795 --> 00:31:09.417
I liked Jared Hall's recent post where he

00:31:09.438 --> 00:31:10.317
was talking about,

00:31:10.377 --> 00:31:12.859
and I forget the law or the rule,

00:31:13.359 --> 00:31:14.601
but basically as you make things more

00:31:14.621 --> 00:31:17.222
efficient, you increase utilization.

00:31:17.643 --> 00:31:19.084
And I think that's what we're seeing here.

00:31:19.124 --> 00:31:21.105
Clinics are operating more efficiently.

00:31:21.605 --> 00:31:23.887
They're getting more done with less staff.

00:31:24.867 --> 00:31:26.068
I just that's it.

00:31:26.109 --> 00:31:28.050
That's there's no other like secret

00:31:28.090 --> 00:31:28.632
recipe.

00:31:29.031 --> 00:31:29.392
Yes.

00:31:29.492 --> 00:31:30.733
More therapists are leaving.

00:31:31.094 --> 00:31:31.354
Yes.

00:31:31.394 --> 00:31:33.615
Fewer therapists are joining.

00:31:34.696 --> 00:31:36.999
We have to develop business models that

00:31:37.078 --> 00:31:38.961
don't look like the business models of the

00:31:39.000 --> 00:31:39.340
past.

00:31:39.442 --> 00:31:42.683
Why are we in the insurance based market?

00:31:43.365 --> 00:31:45.385
trying to do what Dave is doing in

00:31:45.405 --> 00:31:46.346
the self-pay market.

00:31:46.425 --> 00:31:48.346
Why are we still trying to do hour-long

00:31:48.405 --> 00:31:48.826
sessions?

00:31:48.886 --> 00:31:52.106
Why are we still selling relationships and

00:31:52.508 --> 00:31:54.907
listening to stories when that's not what

00:31:54.948 --> 00:31:56.189
we're being paid for?

00:31:56.749 --> 00:31:58.528
Everybody across the board goes to

00:31:58.568 --> 00:31:59.608
single-unit visits.

00:32:00.309 --> 00:32:00.970
Immediately,

00:32:01.069 --> 00:32:04.611
we quadruple our access to clinicians

00:32:05.030 --> 00:32:07.230
because one clinician can do the work of

00:32:07.311 --> 00:32:09.711
four if we reduce the duration of the

00:32:09.751 --> 00:32:10.051
visit,

00:32:10.132 --> 00:32:11.772
and I would argue the patient gets a

00:32:11.813 --> 00:32:12.553
better outcome.

00:32:14.343 --> 00:32:16.306
The patient gets a faster outcome.

00:32:16.546 --> 00:32:17.727
How would you define a better outcome?

00:32:18.507 --> 00:32:20.627
if it was all single unit visits?

00:32:20.647 --> 00:32:22.329
I don't know that I would say faster.

00:32:23.089 --> 00:32:25.310
In other words, my shoulder hurts,

00:32:25.531 --> 00:32:26.832
now my shoulder doesn't hurt.

00:32:26.873 --> 00:32:30.035
Do I get to that end game faster?

00:32:30.154 --> 00:32:30.634
Probably not,

00:32:30.654 --> 00:32:31.756
because we're talking about healing

00:32:31.796 --> 00:32:34.257
tissues, we're talking about physiology.

00:32:34.718 --> 00:32:37.940
But I would say better because the fifteen

00:32:37.960 --> 00:32:38.299
minutes,

00:32:38.460 --> 00:32:40.361
ten minutes we spend with each patient is

00:32:40.421 --> 00:32:41.201
more impactful.

00:32:41.582 --> 00:32:43.824
They actually remember something we taught

00:32:43.864 --> 00:32:45.265
them when they go home.

00:32:46.285 --> 00:32:48.526
We increase compliance if we increase

00:32:48.566 --> 00:32:49.247
frequency.

00:32:49.787 --> 00:32:52.387
We reduce total utilization per case,

00:32:52.428 --> 00:32:54.328
but we increase the number of cases.

00:32:54.709 --> 00:32:57.130
Like every metric goes up in a positive

00:32:57.170 --> 00:32:59.771
direction if we treat this in the way

00:32:59.811 --> 00:33:01.291
that I believe it's intended to be

00:33:01.352 --> 00:33:01.692
treated.

00:33:02.113 --> 00:33:02.512
Meaning...

00:33:02.992 --> 00:33:03.834
What's your problem?

00:33:04.173 --> 00:33:05.674
This is the solution to solve your

00:33:05.714 --> 00:33:06.095
problem.

00:33:06.154 --> 00:33:07.736
Let's start working on that solution.

00:33:07.915 --> 00:33:10.176
Doesn't have to be what's your problem.

00:33:10.196 --> 00:33:11.258
Let's get to know each other.

00:33:11.298 --> 00:33:13.619
Let's spend sixty minutes of uninterrupted

00:33:13.660 --> 00:33:15.200
time in a private room.

00:33:15.520 --> 00:33:17.521
Tell me about your deepest, darkest fears.

00:33:18.894 --> 00:33:19.534
I like to know.

00:33:19.614 --> 00:33:21.595
If you, if you, if you had a,

00:33:21.674 --> 00:33:23.075
if you had an orthopedic issue, right,

00:33:23.096 --> 00:33:25.455
you had the friends PT clinic nearby down

00:33:25.476 --> 00:33:27.096
the street, which, which,

00:33:27.217 --> 00:33:28.436
which one just for you, like,

00:33:28.457 --> 00:33:29.317
which one would you prefer?

00:33:29.417 --> 00:33:32.459
Like you go to his practice two times

00:33:32.499 --> 00:33:34.078
a week and each time is an hour

00:33:34.640 --> 00:33:36.920
or Tony's saying you go in for,

00:33:37.220 --> 00:33:39.520
you go into Tony's version of the clinic

00:33:39.540 --> 00:33:41.781
that is also in your neighborhood or in

00:33:41.801 --> 00:33:42.201
your town.

00:33:43.163 --> 00:33:43.682
And Tony's off.

00:33:43.843 --> 00:33:45.563
Tony's offering what?

00:33:45.623 --> 00:33:46.703
Fifteen minute visits.

00:33:47.304 --> 00:33:48.984
But he's saying come more often.

00:33:49.444 --> 00:33:49.605
Yeah.

00:33:49.865 --> 00:33:51.665
So I'm saying I like both of those.

00:33:51.685 --> 00:33:52.547
I'm going to smush them together.

00:33:52.626 --> 00:33:53.467
Here's what I would want.

00:33:54.087 --> 00:33:56.568
I would want the initial eval to feel

00:33:56.608 --> 00:33:59.310
like you're measuring me to be an NFL

00:33:59.330 --> 00:34:00.010
wide receiver.

00:34:00.510 --> 00:34:02.192
Like I'd want the eval to be like,

00:34:02.491 --> 00:34:03.333
let's check everything.

00:34:03.353 --> 00:34:04.433
Let's really get to know you.

00:34:04.554 --> 00:34:07.095
I want to find out follow up visits.

00:34:07.454 --> 00:34:08.815
What I would prefer and I think people

00:34:08.856 --> 00:34:10.137
would follow would be.

00:34:11.175 --> 00:34:12.396
Hey, buddy, let's check it out.

00:34:12.436 --> 00:34:14.335
Let's chop it up for ten minutes.

00:34:14.356 --> 00:34:15.376
Let's do all those things.

00:34:15.797 --> 00:34:17.737
And then here's your thing.

00:34:18.277 --> 00:34:19.177
You've got access.

00:34:20.018 --> 00:34:22.219
You can leave now or go do the

00:34:22.260 --> 00:34:22.539
things.

00:34:22.559 --> 00:34:24.061
I'll give you six things to do.

00:34:24.181 --> 00:34:25.041
Do them or not.

00:34:25.300 --> 00:34:27.722
But that's not one-on-one with the

00:34:27.762 --> 00:34:28.623
therapist anymore.

00:34:29.043 --> 00:34:30.503
So I would say the eval would make

00:34:30.543 --> 00:34:33.003
me feel like a full diagnostic for one

00:34:33.043 --> 00:34:33.324
hour.

00:34:33.804 --> 00:34:35.545
And then follow-ups would be,

00:34:35.706 --> 00:34:38.007
let's see what we did between last time

00:34:38.027 --> 00:34:38.347
and now.

00:34:39.226 --> 00:34:40.766
Good, based on that information,

00:34:41.407 --> 00:34:42.248
do these things.

00:34:43.088 --> 00:34:44.248
Steve over here is going to help you.

00:34:44.570 --> 00:34:47.612
And then it's a one unit visit plus

00:34:48.251 --> 00:34:49.652
access, use it or not.

00:34:49.952 --> 00:34:51.434
I make suggestions, you make decisions.

00:34:51.675 --> 00:34:52.554
Wait, so you were saying,

00:34:52.574 --> 00:34:54.036
so Steve would be, what's the example?

00:34:54.076 --> 00:34:55.456
So the therapist is with the patient for

00:34:55.476 --> 00:34:55.896
fifteen minutes.

00:34:55.916 --> 00:34:57.639
You said go over to do whatever with

00:34:57.719 --> 00:34:57.938
Steve.

00:34:57.998 --> 00:35:00.561
Right.

00:35:03.951 --> 00:35:04.132
Yep.

00:35:04.152 --> 00:35:04.532
Attack or whatever.

00:35:04.552 --> 00:35:05.052
Right over here.

00:35:05.112 --> 00:35:05.492
Here's the thing.

00:35:05.913 --> 00:35:07.773
While I'm talking, look at Ben's comments.

00:35:08.134 --> 00:35:09.134
Which one?

00:35:09.235 --> 00:35:09.514
Yeah.

00:35:09.775 --> 00:35:11.876
So Jimmy wants to feel important.

00:35:12.315 --> 00:35:13.317
The evaluation.

00:35:13.376 --> 00:35:14.378
He wants to be measured.

00:35:14.418 --> 00:35:16.099
He wants all these fancy devices.

00:35:16.818 --> 00:35:17.719
And I totally agree.

00:35:18.059 --> 00:35:19.179
When I go to Chipotle,

00:35:19.481 --> 00:35:22.481
I want filet mignon instead of cheap flank

00:35:22.521 --> 00:35:22.842
steak.

00:35:23.262 --> 00:35:24.684
But when they show me the price of

00:35:24.744 --> 00:35:25.943
paying for filet mignon,

00:35:26.105 --> 00:35:27.565
I choose the cheap flank steak.

00:35:27.985 --> 00:35:28.206
Right.

00:35:29.146 --> 00:35:29.586
Have that available.

00:35:29.606 --> 00:35:31.768
And that's why you will never go away,

00:35:31.827 --> 00:35:34.829
Dave, because you offer the highest level.

00:35:35.289 --> 00:35:36.311
It is available,

00:35:36.590 --> 00:35:37.952
but you're not trying to do it for

00:35:38.012 --> 00:35:39.393
insurance reimbursement rates.

00:35:39.753 --> 00:35:41.614
So give the consumer the choice.

00:35:41.954 --> 00:35:43.956
Hey, look, I can fix your shoulder pain.

00:35:43.996 --> 00:35:45.577
Dave can fix your shoulder pain.

00:35:46.077 --> 00:35:47.797
Mine is going to be covered by insurance.

00:35:47.838 --> 00:35:48.759
Dave's not.

00:35:48.878 --> 00:35:50.139
Dave will have more fun.

00:35:50.179 --> 00:35:51.501
Dave will have a better experience.

00:35:51.541 --> 00:35:52.740
Dave will have better products.

00:35:53.362 --> 00:35:53.882
I will not.

00:35:54.382 --> 00:35:56.344
But both of us will get you there.

00:35:56.364 --> 00:35:57.585
It just depends on how much money you

00:35:57.625 --> 00:35:58.085
want to spend.

00:35:59.472 --> 00:36:00.733
How do they want to get there?

00:36:00.773 --> 00:36:01.954
How do you want to achieve your goals?

00:36:03.295 --> 00:36:03.695
Yeah.

00:36:03.735 --> 00:36:05.217
What I would say is to keep the

00:36:05.277 --> 00:36:09.001
feeling high or mid, you know, six, seven,

00:36:09.882 --> 00:36:12.103
I would do the one-on-one bougie eval,

00:36:12.264 --> 00:36:12.483
right?

00:36:12.764 --> 00:36:13.764
But we do that now and we can

00:36:13.804 --> 00:36:14.445
charge for it.

00:36:15.186 --> 00:36:16.987
Even insurance companies will say, yeah,

00:36:17.027 --> 00:36:18.349
the eval is more work,

00:36:18.389 --> 00:36:20.311
so we're going to pay X. And then...

00:36:21.331 --> 00:36:23.012
Subsequent visits and all the different

00:36:23.052 --> 00:36:23.952
policies are lower.

00:36:24.153 --> 00:36:26.434
I would say to keep the same perceived

00:36:26.474 --> 00:36:28.235
value because all value is perceived

00:36:28.255 --> 00:36:28.376
value.

00:36:28.775 --> 00:36:29.876
Keep the one on one.

00:36:30.217 --> 00:36:31.416
Everything's about you.

00:36:31.737 --> 00:36:33.338
Let me look deep into your soul and

00:36:33.358 --> 00:36:34.239
learn everything about you.

00:36:34.298 --> 00:36:35.159
That's the eval.

00:36:35.239 --> 00:36:37.820
And follow ups are a one unit plus,

00:36:37.860 --> 00:36:39.541
though, instead of one unit.

00:36:39.581 --> 00:36:40.882
And then, all right, here's your code.

00:36:40.942 --> 00:36:41.302
Get out.

00:36:42.003 --> 00:36:42.782
Let's do the thing.

00:36:42.822 --> 00:36:44.222
You know how this is going to change.

00:36:44.304 --> 00:36:45.284
Not me touching you.

00:36:45.643 --> 00:36:46.423
I did the thing.

00:36:46.543 --> 00:36:47.963
I did the rubbies and I did the

00:36:47.983 --> 00:36:48.423
tuggies.

00:36:49.085 --> 00:36:49.644
Rubs and tugs.

00:36:50.804 --> 00:36:52.364
And now go over there and get sweaty.

00:36:52.465 --> 00:36:53.744
What do you want me to do?

00:36:53.985 --> 00:36:56.905
And then have access to the cryo pool

00:36:56.985 --> 00:36:59.666
and the infrared spa and the light you'd

00:36:59.706 --> 00:37:00.327
stick somewhere.

00:37:00.527 --> 00:37:01.226
Do whatever you want,

00:37:01.467 --> 00:37:03.007
but it's access and you don't nickel and

00:37:03.047 --> 00:37:03.847
dime them for that.

00:37:04.507 --> 00:37:05.847
I think that's how you keep your perceived

00:37:05.867 --> 00:37:09.028
value high while keeping your costs low

00:37:09.289 --> 00:37:10.369
and go more on volume.

00:37:12.056 --> 00:37:13.617
I'm going to pull this up.

00:37:14.356 --> 00:37:14.976
Sorry, I'll do it.

00:37:15.777 --> 00:37:15.998
All right.

00:37:16.018 --> 00:37:17.278
So Ben said, let's pause there.

00:37:17.478 --> 00:37:18.798
And this was a little earlier in the

00:37:18.838 --> 00:37:19.539
conversation.

00:37:19.679 --> 00:37:21.159
If drop-off is so high,

00:37:21.219 --> 00:37:22.501
reimbursement is so low,

00:37:22.981 --> 00:37:24.742
where are the companies like Ash who

00:37:24.782 --> 00:37:27.103
regulate PT visit utilization when the

00:37:27.123 --> 00:37:30.644
reality is PT is a rounding error?

00:37:31.144 --> 00:37:32.246
Agreed.

00:37:32.306 --> 00:37:33.766
Does that mean you know it all as

00:37:33.786 --> 00:37:34.206
a whole?

00:37:34.847 --> 00:37:36.588
The cost and pain of utilization

00:37:36.608 --> 00:37:39.610
management is not needed as most patients

00:37:39.650 --> 00:37:42.391
drop off before even hitting the seven

00:37:42.431 --> 00:37:43.672
hundred dollars in billing.

00:37:45.192 --> 00:37:46.992
Why does this still exist?

00:37:47.534 --> 00:37:48.094
What does that mean?

00:37:48.153 --> 00:37:48.893
It's a rounding error.

00:37:48.914 --> 00:37:49.414
You said you agree.

00:37:49.434 --> 00:37:50.195
I don't understand that means.

00:37:50.514 --> 00:37:51.315
Yeah,

00:37:51.335 --> 00:37:53.016
it's very it's very small in the whole

00:37:53.036 --> 00:37:53.597
scheme of things.

00:37:53.958 --> 00:37:55.621
You look at the total cost of health

00:37:55.641 --> 00:37:55.900
care,

00:37:55.940 --> 00:37:57.503
you look at what we actually I mean,

00:37:57.523 --> 00:38:00.146
a thousand dollars is like ten visits

00:38:00.586 --> 00:38:01.688
compared to, you know,

00:38:01.728 --> 00:38:04.070
surgeries and anesthesia and ORs and all

00:38:04.110 --> 00:38:04.931
this other stuff.

00:38:06.112 --> 00:38:07.755
The only thing I can imagine now I'm

00:38:07.795 --> 00:38:10.117
speaking completely out of speculation and

00:38:10.257 --> 00:38:11.219
Ben can correct me.

00:38:12.059 --> 00:38:13.760
I would imagine these companies are coming

00:38:13.780 --> 00:38:14.802
to the payer and saying, look,

00:38:14.822 --> 00:38:16.163
it's not going to cost you anything.

00:38:16.262 --> 00:38:18.304
We'll take a percentage of what we save.

00:38:18.905 --> 00:38:21.106
And so even though it is such a

00:38:21.166 --> 00:38:22.047
tiny amount,

00:38:22.646 --> 00:38:24.427
if they come in and run their algorithms

00:38:24.469 --> 00:38:26.829
to say this patient needs four visits,

00:38:26.909 --> 00:38:28.291
not thirty six visits,

00:38:28.791 --> 00:38:30.512
they save the insurance company,

00:38:30.733 --> 00:38:31.974
they're going to get a portion of what

00:38:32.014 --> 00:38:32.594
they save.

00:38:32.713 --> 00:38:35.255
Why wouldn't you do that?

00:38:35.275 --> 00:38:36.757
That's why I think they still exist.

00:38:38.632 --> 00:38:40.135
And then Ben said, in fact,

00:38:40.255 --> 00:38:43.664
if PT was better utilized without friction

00:38:44.126 --> 00:38:46.652
and reduction in TCOC,

00:38:48.293 --> 00:38:52.898
Total cost of care and musculoskeletal as

00:38:52.938 --> 00:38:53.978
a whole goes down,

00:38:54.418 --> 00:38:55.840
putting friction in the wrong spots.

00:38:56.320 --> 00:38:58.262
And that's where a couple of weeks ago

00:38:58.442 --> 00:38:59.123
I shared it.

00:38:59.202 --> 00:39:00.143
I asked chat GPT.

00:39:00.164 --> 00:39:00.463
I'm like,

00:39:00.864 --> 00:39:02.865
if there's all this research that says we

00:39:02.905 --> 00:39:04.706
save insurance companies money,

00:39:05.228 --> 00:39:07.148
why are we not seeing the benefit of

00:39:07.188 --> 00:39:07.409
that?

00:39:07.429 --> 00:39:10.032
And it's because most likely the insurance

00:39:10.052 --> 00:39:12.454
company business model does not benefit

00:39:12.873 --> 00:39:13.815
from what we do.

00:39:14.775 --> 00:39:16.496
If we maybe and I don't think we

00:39:16.556 --> 00:39:18.336
actually do save the insurance company

00:39:18.396 --> 00:39:20.137
money, but if we did,

00:39:20.476 --> 00:39:22.077
they're making money in other ways.

00:39:22.117 --> 00:39:23.918
They need to spend more money,

00:39:24.139 --> 00:39:24.878
my understanding,

00:39:24.918 --> 00:39:27.519
in order to make more profit because

00:39:27.539 --> 00:39:30.121
they're limited to a percentage of like

00:39:30.141 --> 00:39:31.822
the money they spend is how much they

00:39:31.862 --> 00:39:33.382
can take as profit.

00:39:33.902 --> 00:39:35.764
So it doesn't help them to spend less.

00:39:35.824 --> 00:39:38.224
It's better for them to spend more because

00:39:38.264 --> 00:39:39.864
then they can charge more than they can

00:39:39.925 --> 00:39:40.585
profit more.

00:39:40.726 --> 00:39:41.666
That's that's the model.

00:39:42.594 --> 00:39:43.014
Yeah, I mean,

00:39:43.675 --> 00:39:45.257
this is where I love people who do

00:39:45.336 --> 00:39:45.797
advocacy,

00:39:45.838 --> 00:39:47.099
but that's not going to change it.

00:39:47.119 --> 00:39:48.380
I mean, guys, let's be realistic.

00:39:49.581 --> 00:39:50.963
It's not like insurance companies don't do

00:39:51.043 --> 00:39:51.364
math.

00:39:51.384 --> 00:39:52.565
They're a math company.

00:39:53.164 --> 00:39:54.226
It's all they do is math.

00:39:54.686 --> 00:39:56.128
And if we had a big enough math,

00:39:57.010 --> 00:39:57.990
they would math with us.

00:39:58.090 --> 00:39:59.192
And they would go, here's more math.

00:39:59.913 --> 00:40:01.373
I'm using math as a verb and a

00:40:01.414 --> 00:40:02.255
noun.

00:40:02.295 --> 00:40:02.835
That's not it.

00:40:03.016 --> 00:40:03.697
I'm very sorry.

00:40:03.936 --> 00:40:04.398
They don't under...

00:40:05.666 --> 00:40:07.126
What's that line I just used like seven

00:40:07.166 --> 00:40:07.427
times?

00:40:07.447 --> 00:40:08.387
The Upton Sinclair line.

00:40:09.106 --> 00:40:10.967
It's hard to get someone to understand

00:40:11.007 --> 00:40:12.489
something when their salary is dependent

00:40:12.528 --> 00:40:13.568
on them not understanding it.

00:40:14.268 --> 00:40:15.110
It's not even that.

00:40:15.510 --> 00:40:16.389
We're so small.

00:40:16.469 --> 00:40:18.130
It's like, oh, are you still here?

00:40:18.471 --> 00:40:18.731
Did we?

00:40:19.490 --> 00:40:19.771
Yeah.

00:40:19.931 --> 00:40:20.231
Okay.

00:40:20.331 --> 00:40:20.871
Yeah, sure.

00:40:20.931 --> 00:40:22.132
We'll give you a nickel.

00:40:22.152 --> 00:40:23.193
This will go down.

00:40:24.532 --> 00:40:25.773
Reimbursement will go down.

00:40:26.809 --> 00:40:27.670
year over year.

00:40:27.849 --> 00:40:28.369
Act as if.

00:40:28.429 --> 00:40:30.331
Decide if you want to be in this.

00:40:31.052 --> 00:40:32.612
Since I released that video when I went

00:40:32.632 --> 00:40:33.873
to Graham Sessions last weekend,

00:40:34.353 --> 00:40:34.873
people were like,

00:40:35.054 --> 00:40:36.536
I loved it because I just sit here.

00:40:36.596 --> 00:40:37.335
They're like, well,

00:40:37.356 --> 00:40:38.336
what are you going to do about it?

00:40:38.356 --> 00:40:39.617
What's APTA going to do about it?

00:40:39.637 --> 00:40:40.137
I'm like, guys,

00:40:40.338 --> 00:40:41.699
I'm a dude in my living room.

00:40:41.778 --> 00:40:44.440
Sometimes I wear a tie.

00:40:45.081 --> 00:40:45.882
What am I going to do about it?

00:40:45.961 --> 00:40:47.202
I'm asking you questions.

00:40:48.153 --> 00:40:49.815
The people who want complete control are

00:40:49.856 --> 00:40:51.317
also looking for people to solve it for

00:40:51.336 --> 00:40:51.476
them.

00:40:51.496 --> 00:40:51.836
And I'm like,

00:40:52.538 --> 00:40:53.539
you still have to solve it.

00:40:53.559 --> 00:40:54.480
What were you going to do yesterday?

00:40:54.579 --> 00:40:54.980
Nothing.

00:40:55.581 --> 00:40:57.362
I just held up a mirror and you're

00:40:57.402 --> 00:40:58.423
shocked at the result.

00:40:59.164 --> 00:41:00.045
I'm very sorry.

00:41:00.204 --> 00:41:04.369
That ain't it.

00:41:04.389 --> 00:41:04.710
Go ahead.

00:41:04.730 --> 00:41:05.791
Keep the conversation going.

00:41:05.831 --> 00:41:06.391
I'll be right back.

00:41:06.690 --> 00:41:08.333
Ben Galen saying population health

00:41:08.373 --> 00:41:11.034
principles deliver the solution cost that

00:41:11.076 --> 00:41:12.416
matches the severity and need.

00:41:13.085 --> 00:41:13.266
Yeah,

00:41:13.306 --> 00:41:14.967
not all patients need the filet mignon.

00:41:15.007 --> 00:41:16.447
They don't and they won't buy it.

00:41:16.487 --> 00:41:18.670
That's why it's a pyramid.

00:41:20.070 --> 00:41:21.552
What I mean by that is what Dave

00:41:21.592 --> 00:41:23.052
does is higher end,

00:41:23.112 --> 00:41:24.914
quite literally up on the pyramid.

00:41:24.954 --> 00:41:25.655
But the pyramid,

00:41:25.835 --> 00:41:27.096
we know how pyramids are shaped.

00:41:27.596 --> 00:41:28.436
It's thinner up there.

00:41:28.817 --> 00:41:29.438
You're not looking.

00:41:29.498 --> 00:41:31.838
You don't need twenty thousand people.

00:41:31.938 --> 00:41:33.561
You need two thousand people or a

00:41:33.601 --> 00:41:33.940
thousand.

00:41:33.960 --> 00:41:34.320
I don't know.

00:41:34.902 --> 00:41:37.402
So you're like, I'm going to solve this,

00:41:37.422 --> 00:41:38.063
which is funny.

00:41:40.454 --> 00:41:42.275
when Dave talks about what he does and

00:41:42.315 --> 00:41:44.576
people respond, Dave says, emotional,

00:41:44.755 --> 00:41:45.655
sorry, logically,

00:41:46.197 --> 00:41:49.617
I do this for this cost for these

00:41:49.657 --> 00:41:50.018
people.

00:41:50.637 --> 00:41:52.097
And then I've seen this happen in Dave's

00:41:52.117 --> 00:41:52.797
comment section.

00:41:52.818 --> 00:41:53.297
People are like,

00:41:53.318 --> 00:41:54.858
but what about people who can't afford it?

00:41:54.898 --> 00:41:55.679
And like, I don't know.

00:41:55.739 --> 00:41:57.199
It sounds like you want to take care

00:41:57.219 --> 00:41:57.739
of those people.

00:41:58.219 --> 00:41:58.719
I think Pete,

00:41:59.039 --> 00:42:00.860
all people should have access to care.

00:42:00.880 --> 00:42:03.360
I agree,

00:42:03.380 --> 00:42:04.561
but it's not going to be the same.

00:42:04.800 --> 00:42:05.601
I understand that.

00:42:05.681 --> 00:42:06.161
Exactly.

00:42:06.362 --> 00:42:06.782
Exactly.

00:42:07.320 --> 00:42:09.222
Why not cake for breakfast and lunch and

00:42:09.262 --> 00:42:09.521
dinner?

00:42:09.621 --> 00:42:12.362
Then we'll want cake with triple frosting.

00:42:13.402 --> 00:42:14.364
This is a choice.

00:42:15.664 --> 00:42:16.724
I don't know how else to explain.

00:42:16.784 --> 00:42:18.264
This is not me deciding this is the

00:42:18.284 --> 00:42:18.704
way it is.

00:42:18.844 --> 00:42:19.846
This is the way it is.

00:42:20.186 --> 00:42:21.326
I'm just the one explaining it.

00:42:21.925 --> 00:42:22.947
Don't kill the messenger.

00:42:23.146 --> 00:42:23.927
But if you want to drop it in

00:42:23.947 --> 00:42:25.907
my comment section and increase the reach,

00:42:26.188 --> 00:42:28.188
by all means, I'll poke the bear.

00:42:28.688 --> 00:42:29.168
I will do that.

00:42:30.342 --> 00:42:30.802
Yeah, I mean,

00:42:31.003 --> 00:42:32.945
there's a bunch of practices that accept

00:42:33.286 --> 00:42:35.208
Medicaid and Medicare and all the

00:42:35.228 --> 00:42:36.670
different payers and insurances.

00:42:38.614 --> 00:42:42.056
But if those patients wanted a more

00:42:42.235 --> 00:42:43.695
one-on-one experience,

00:42:43.896 --> 00:42:46.076
that clinic cannot offer that, right?

00:42:46.295 --> 00:42:47.135
But we can,

00:42:47.896 --> 00:42:49.856
but therefore we can't accept those

00:42:49.916 --> 00:42:50.836
low-paying insurances, right?

00:42:50.856 --> 00:42:54.617
So no clinic can offer everything to all

00:42:54.657 --> 00:42:56.617
consumers in terms of like each little

00:42:56.637 --> 00:42:56.938
subset,

00:42:56.958 --> 00:42:59.259
like physical therapy or whatever the

00:42:59.539 --> 00:43:01.119
other industries are.

00:43:01.159 --> 00:43:02.378
So Mark, I don't know,

00:43:02.579 --> 00:43:04.800
Mark and his comment is APTA has to

00:43:04.840 --> 00:43:05.860
cover all PTs.

00:43:06.239 --> 00:43:06.539
Stop.

00:43:06.860 --> 00:43:07.280
What does that mean?

00:43:09.126 --> 00:43:09.666
Cover what?

00:43:10.487 --> 00:43:11.027
Cover what?

00:43:11.969 --> 00:43:13.849
They're a professional association.

00:43:14.710 --> 00:43:16.833
They drive across a bridge and talk to

00:43:16.853 --> 00:43:17.873
people in Washington.

00:43:18.273 --> 00:43:19.896
What does cover all PTs mean?

00:43:19.956 --> 00:43:20.615
Cover them how?

00:43:20.876 --> 00:43:22.157
They don't dictate rates.

00:43:22.717 --> 00:43:24.980
They don't dictate educational

00:43:25.019 --> 00:43:25.639
requirements.

00:43:25.659 --> 00:43:26.521
That's CAPD.

00:43:26.721 --> 00:43:28.523
They don't set tuition prices.

00:43:28.543 --> 00:43:28.623
Yeah.

00:43:28.961 --> 00:43:29.782
So I know Mark,

00:43:29.802 --> 00:43:30.704
he's been on my podcast.

00:43:30.724 --> 00:43:32.646
He's got a practice on the West Coast.

00:43:33.067 --> 00:43:35.389
I think maybe he's saying that ABTA is

00:43:35.449 --> 00:43:38.494
like representing all PTs and it's hard to

00:43:38.873 --> 00:43:41.717
represent all PTs when there's different

00:43:41.757 --> 00:43:43.460
sections of PTs that like want different

00:43:43.480 --> 00:43:44.541
things and all that, right?

00:43:44.880 --> 00:43:45.280
Agreed.

00:43:45.521 --> 00:43:45.802
Agreed.

00:43:45.922 --> 00:43:46.521
Here's the thing.

00:43:46.961 --> 00:43:48.222
None of those things are going to happen.

00:43:48.583 --> 00:43:49.023
They're not.

00:43:49.643 --> 00:43:51.344
It's a professional association.

00:43:51.664 --> 00:43:53.065
This is a place to hang out with

00:43:53.106 --> 00:43:54.646
people who do the same thing as you

00:43:54.987 --> 00:43:56.487
and learn what's working and what's not.

00:43:56.827 --> 00:43:58.289
Don't look at it as big brother.

00:43:58.409 --> 00:43:58.989
It's not.

00:43:59.188 --> 00:44:00.010
It's not big brother.

00:44:00.929 --> 00:44:02.590
They don't sell themselves as big brother.

00:44:02.911 --> 00:44:03.672
I wish they were.

00:44:03.992 --> 00:44:04.952
I wish we could just throw a bucket

00:44:04.972 --> 00:44:06.213
of money and they'd go across the river

00:44:06.253 --> 00:44:06.753
and solve things.

00:44:06.773 --> 00:44:07.574
They can't.

00:44:08.635 --> 00:44:10.356
If they lowered the reimbursement for us,

00:44:10.396 --> 00:44:11.916
that would hurt another set of PTs.

00:44:12.777 --> 00:44:13.498
Who is they?

00:44:14.306 --> 00:44:15.186
Insurance companies,

00:44:16.067 --> 00:44:18.387
if they lowered the reimbursement for us,

00:44:19.429 --> 00:44:20.690
I'm guessing inpatient PTs,

00:44:20.730 --> 00:44:21.630
is he an inpatient PT?

00:44:22.811 --> 00:44:24.172
No, he's got an outpatient practice.

00:44:24.692 --> 00:44:28.673
So Mark, thank you for joining us live.

00:44:30.074 --> 00:44:31.275
Give us another comment or two, Mark,

00:44:31.295 --> 00:44:32.936
if you want to just help clarify a

00:44:32.956 --> 00:44:34.478
little bit and we can keep rolling.

00:44:36.835 --> 00:44:38.177
John thinks we should get Ben Galen on

00:44:38.197 --> 00:44:39.518
the show because for a deeper...

00:44:40.000 --> 00:44:40.760
I've threatened that.

00:44:40.880 --> 00:44:41.601
I've said Ben.

00:44:42.161 --> 00:44:43.844
I think Ben... Yeah,

00:44:43.923 --> 00:44:44.603
he's been on my show.

00:44:44.664 --> 00:44:45.664
He's super smart.

00:44:46.186 --> 00:44:47.527
This is when you know someone has

00:44:47.547 --> 00:44:47.907
something.

00:44:47.947 --> 00:44:49.528
Because I think I DMed Ben,

00:44:49.610 --> 00:44:50.369
or maybe I did in my head,

00:44:50.389 --> 00:44:51.110
and I was like, hey,

00:44:51.552 --> 00:44:52.512
I think it was one day when one

00:44:52.532 --> 00:44:53.393
of you guys was going to be out.

00:44:53.413 --> 00:44:54.353
I was like, hey, do you want to...

00:44:54.434 --> 00:44:55.295
And he was like, oh,

00:44:55.315 --> 00:44:56.315
I don't really have anything to add.

00:44:56.376 --> 00:44:56.916
I'm like, really?

00:44:56.936 --> 00:44:57.197
Because...

00:44:58.429 --> 00:45:00.251
you add a lot like maybe just add

00:45:00.291 --> 00:45:02.072
it without text without your thumbs doing

00:45:02.092 --> 00:45:05.074
the talking um i want to understand what

00:45:05.114 --> 00:45:06.615
mark is saying because i hear this a

00:45:06.695 --> 00:45:06.996
lot

00:45:08.885 --> 00:45:09.985
But I'm a words guy.

00:45:10.266 --> 00:45:12.606
So when people start throwing they or

00:45:12.666 --> 00:45:14.168
cover, I'm like, cover what?

00:45:14.268 --> 00:45:14.907
Cover how?

00:45:15.268 --> 00:45:15.748
Cover who?

00:45:15.788 --> 00:45:16.429
What does that mean?

00:45:16.568 --> 00:45:17.329
I want to understand.

00:45:18.110 --> 00:45:21.030
Because I think this is an expectation and

00:45:21.070 --> 00:45:21.992
reality problem.

00:45:22.311 --> 00:45:22.711
People are like,

00:45:22.731 --> 00:45:24.313
I paid five hundred dollars for my APTA

00:45:24.333 --> 00:45:26.693
membership for a decade and I didn't get

00:45:26.733 --> 00:45:27.333
anything for it.

00:45:27.634 --> 00:45:30.516
What did you expect to get?

00:45:30.556 --> 00:45:31.536
What was on the menu?

00:45:32.016 --> 00:45:32.836
They didn't offer that.

00:45:32.876 --> 00:45:33.998
You felt like they did,

00:45:34.038 --> 00:45:34.858
but you didn't read it.

00:45:35.478 --> 00:45:36.679
I don't think you should be an APTA

00:45:36.699 --> 00:45:38.079
member unless you understand what you're

00:45:38.099 --> 00:45:38.480
buying.

00:45:39.351 --> 00:45:41.492
And then if you don't like that,

00:45:41.532 --> 00:45:42.114
don't buy.

00:45:44.635 --> 00:45:46.135
People think I'm the biggest APTA

00:45:46.215 --> 00:45:46.596
whatever.

00:45:47.255 --> 00:45:48.856
I'm just here explaining stuff because I

00:45:48.896 --> 00:45:50.277
hear these people saying the same

00:45:50.918 --> 00:45:51.858
complaints and I'm like,

00:45:51.918 --> 00:45:53.519
what did you expect was going to be

00:45:53.559 --> 00:45:54.380
in the box?

00:45:56.501 --> 00:45:57.641
I don't agree with Jimmy working on my

00:45:57.661 --> 00:45:57.922
statement.

00:45:58.021 --> 00:45:58.842
Okay.

00:45:58.862 --> 00:45:59.822
This is where a guy like Mark,

00:45:59.983 --> 00:46:01.623
I want to hear his words because most

00:46:01.643 --> 00:46:02.684
of the time when I see that,

00:46:02.985 --> 00:46:04.106
we wind up, we're agreeing,

00:46:04.126 --> 00:46:04.965
we're just using different words.

00:46:04.985 --> 00:46:06.786
Yeah, he does.

00:46:06.806 --> 00:46:07.648
I'm not taking shots.

00:46:09.094 --> 00:46:09.755
What do you mean by that?

00:46:09.775 --> 00:46:10.795
We're on the same page.

00:46:12.858 --> 00:46:13.918
Ben's got the face for radio.

00:46:14.259 --> 00:46:15.139
Keep talking, my friend.

00:46:15.179 --> 00:46:16.081
I got the face for radio, too.

00:46:17.161 --> 00:46:18.782
Let's get to this.

00:46:18.842 --> 00:46:19.463
Hold on a second.

00:46:19.483 --> 00:46:20.184
Oh, gosh.

00:46:20.324 --> 00:46:21.826
These guys paid triple the rate.

00:46:21.846 --> 00:46:23.067
Uh-oh.

00:46:23.206 --> 00:46:24.027
There's a big spender.

00:46:24.088 --> 00:46:24.969
A big sponsor.

00:46:25.764 --> 00:46:26.585
This is Triple the Rate.

00:46:27.427 --> 00:46:28.226
Clinical Vibes,

00:46:28.568 --> 00:46:30.429
this section brought to you by Clinical

00:46:30.449 --> 00:46:30.889
Vibes.

00:46:31.311 --> 00:46:32.210
Brought to you by Clinical Vibes,

00:46:32.231 --> 00:46:34.594
the treatment philosophy based entirely on

00:46:34.693 --> 00:46:36.416
how it feels.

00:46:36.456 --> 00:46:37.856
By the way, all the visuals today,

00:46:37.896 --> 00:46:38.898
I used Tony's prompt.

00:46:39.398 --> 00:46:42.141
No protocols, no guidelines, just vibes.

00:46:42.181 --> 00:46:43.121
Simply ask yourself...

00:46:43.822 --> 00:46:45.664
Does this feel right?

00:46:46.264 --> 00:46:46.744
If yes,

00:46:47.065 --> 00:46:48.485
document confidently from then on out.

00:46:48.706 --> 00:46:50.507
Clinical vibes, not evidence-based,

00:46:50.987 --> 00:46:53.148
but emotionally compelling.

00:46:53.228 --> 00:46:53.507
All right.

00:46:54.047 --> 00:46:54.708
They paid triple,

00:46:54.728 --> 00:46:57.250
but did they pay in cash or vibes?

00:46:57.309 --> 00:46:58.010
They paid in vibes.

00:46:58.311 --> 00:46:59.670
They paid triple the vibes.

00:46:59.771 --> 00:47:01.431
It felt like a good deal when I

00:47:01.472 --> 00:47:01.811
signed it.

00:47:03.833 --> 00:47:04.974
I like the,

00:47:05.414 --> 00:47:06.894
like when Jimmy reads through like the

00:47:06.934 --> 00:47:08.096
little, like the real advertising.

00:47:08.115 --> 00:47:08.396
Oh, he froze.

00:47:08.416 --> 00:47:09.175
What are you going to give me a

00:47:09.195 --> 00:47:09.556
compliment?

00:47:09.577 --> 00:47:09.936
What happened?

00:47:09.956 --> 00:47:10.496
I'm here.

00:47:11.697 --> 00:47:12.197
You don't hear me.

00:47:13.170 --> 00:47:15.172
yeah yeah i'm here you're good you hear

00:47:15.211 --> 00:47:17.271
me yep i'm good now we're here go

00:47:17.311 --> 00:47:18.873
so when you read when you when you

00:47:18.913 --> 00:47:19.813
read through kind of like the bullet

00:47:19.853 --> 00:47:22.253
points of the advertisement like from chat

00:47:22.273 --> 00:47:24.755
gbt or wherever you got it um it's

00:47:24.934 --> 00:47:26.956
it's perfect i love it i think though

00:47:26.996 --> 00:47:29.737
in the future we should consider you put

00:47:29.777 --> 00:47:32.318
an ad up and tony or i have

00:47:32.338 --> 00:47:34.418
to do the ad read completely i like

00:47:34.438 --> 00:47:35.559
that idea

00:47:36.672 --> 00:47:37.695
Cause we never know what's coming.

00:47:37.755 --> 00:47:37.934
I don't,

00:47:37.974 --> 00:47:38.976
I don't know if the audience knows,

00:47:39.016 --> 00:47:40.057
but so you do these,

00:47:40.077 --> 00:47:40.759
you put them up.

00:47:40.980 --> 00:47:42.282
We have no idea what's going on on

00:47:42.302 --> 00:47:42.682
the screen.

00:47:42.902 --> 00:47:43.083
No.

00:47:43.603 --> 00:47:43.764
Yeah.

00:47:43.784 --> 00:47:44.224
What I want.

00:47:44.264 --> 00:47:45.146
It's not going to be,

00:47:45.827 --> 00:47:47.048
the ad read will not be as good

00:47:47.108 --> 00:47:48.751
as whatever you usually read.

00:47:49.333 --> 00:47:50.474
So you know what I want to do?

00:47:50.534 --> 00:47:51.717
It could be a fun exercise.

00:47:52.246 --> 00:47:53.246
The worst part of this,

00:47:53.266 --> 00:47:54.068
and I need to adapt,

00:47:54.168 --> 00:47:55.188
the worst part is when I put the

00:47:55.347 --> 00:47:55.909
ad up,

00:47:56.568 --> 00:47:58.610
I can see your faces in the monitors,

00:47:58.650 --> 00:47:59.610
but the audience can't.

00:48:00.070 --> 00:48:01.351
And I see you reacting.

00:48:01.590 --> 00:48:03.512
So the funny thing is I'm looking at

00:48:03.552 --> 00:48:05.492
you guys, but the audience can't see you.

00:48:05.793 --> 00:48:07.213
And when I see one of you giggle

00:48:07.293 --> 00:48:08.974
or do this, I go even harder.

00:48:09.813 --> 00:48:12.155
Like I go full Phil Hartman on the

00:48:12.195 --> 00:48:12.775
next line.

00:48:13.295 --> 00:48:14.317
And if I look at you guys and

00:48:14.336 --> 00:48:15.157
you guys are like, eh,

00:48:15.177 --> 00:48:16.199
I sort of just speed through it.

00:48:16.259 --> 00:48:16.579
I'm like,

00:48:16.599 --> 00:48:17.380
I don't give a shit about this.

00:48:17.400 --> 00:48:17.940
Well, let's keep moving.

00:48:19.541 --> 00:48:20.101
All right.

00:48:20.422 --> 00:48:21.722
Anyway, Dave's going to sell certainty,

00:48:21.784 --> 00:48:22.543
not sessions.

00:48:22.643 --> 00:48:23.885
We're going to call this the fifty percent

00:48:23.925 --> 00:48:24.985
guarantee experiment.

00:48:25.527 --> 00:48:27.728
Dave, you run with run with us.

00:48:28.757 --> 00:48:29.157
Okay.

00:48:29.177 --> 00:48:29.277
Yeah.

00:48:29.396 --> 00:48:30.277
So I want your feedback.

00:48:30.297 --> 00:48:30.998
We're doing this live.

00:48:31.358 --> 00:48:32.458
This is what I would usually do with

00:48:32.478 --> 00:48:34.541
like my friends or business coaches or

00:48:34.561 --> 00:48:34.981
whatever.

00:48:35.061 --> 00:48:38.362
So we're kind of like five fifty a

00:48:38.402 --> 00:48:39.963
visit for Saturday, Sunday,

00:48:39.983 --> 00:48:40.925
three fifty per visit,

00:48:40.965 --> 00:48:41.744
Monday through Friday.

00:48:41.784 --> 00:48:42.985
That's kind of like our pricing.

00:48:43.025 --> 00:48:45.246
We do take some insurances and all that

00:48:45.266 --> 00:48:45.688
type of stuff.

00:48:45.708 --> 00:48:45.907
But

00:48:47.222 --> 00:48:48.643
Um, I've been reading more.

00:48:48.724 --> 00:48:50.746
I had the a hundred million dollar model,

00:48:51.025 --> 00:48:52.807
whatever money models from Alex Ramosi.

00:48:52.827 --> 00:48:54.369
I got a bunch of,

00:48:54.409 --> 00:48:55.371
I got a bunch of stuff from Alex

00:48:55.411 --> 00:48:55.710
Ramosi.

00:48:55.751 --> 00:48:56.692
And one of the things is a,

00:48:57.893 --> 00:48:58.094
you know,

00:48:58.114 --> 00:48:59.695
there's money back guarantees or there's

00:48:59.735 --> 00:49:00.797
conditional guarantees.

00:49:01.416 --> 00:49:02.539
I want to pitch this live.

00:49:02.719 --> 00:49:04.199
So just, let's just say, um,

00:49:05.085 --> 00:49:06.067
Say Jimmy's got back pain.

00:49:06.467 --> 00:49:07.989
Jimmy's got seven out of ten back pain.

00:49:08.048 --> 00:49:11.851
He's got pain when he squats and Jimmy

00:49:11.871 --> 00:49:12.413
wants to get back.

00:49:12.472 --> 00:49:13.373
I'm just making all this up.

00:49:13.793 --> 00:49:15.856
He wants to get back to Orange Theory

00:49:15.896 --> 00:49:16.396
Fitness.

00:49:16.476 --> 00:49:17.878
He's going three times a week,

00:49:18.478 --> 00:49:20.159
but now he's got back pain with squatting.

00:49:20.219 --> 00:49:21.141
So Jimmy comes in.

00:49:21.960 --> 00:49:24.083
He does an evaluation with my physical

00:49:24.123 --> 00:49:25.164
therapist, Dr. Andrew.

00:49:25.664 --> 00:49:27.286
In that visit, in the first visit,

00:49:27.326 --> 00:49:28.567
he goes through the whole one hour

00:49:28.646 --> 00:49:30.548
comprehensive evaluation, pre post test,

00:49:30.588 --> 00:49:30.909
all that.

00:49:32.025 --> 00:49:33.545
The pain goes from seven out of ten

00:49:33.565 --> 00:49:36.088
to five out of ten with your deep

00:49:36.108 --> 00:49:36.389
squat.

00:49:36.409 --> 00:49:37.909
So, OK, let me see a squat.

00:49:37.949 --> 00:49:39.030
And you're like, oh, yeah, right there.

00:49:39.090 --> 00:49:40.012
It's seven out of ten.

00:49:40.032 --> 00:49:40.952
And then we do some treatment,

00:49:40.972 --> 00:49:41.934
whatever the treatment is.

00:49:42.494 --> 00:49:43.635
Then, OK, let's stand back up.

00:49:43.675 --> 00:49:44.516
Let's squat again.

00:49:45.097 --> 00:49:46.197
Five out of ten low back pain.

00:49:46.217 --> 00:49:47.958
So you're already having a treatment

00:49:47.998 --> 00:49:49.780
preview in a short period of time,

00:49:50.400 --> 00:49:53.184
which will then help the therapist then

00:49:53.423 --> 00:49:55.806
present financing and cost and investment,

00:49:55.826 --> 00:49:56.507
all that type of stuff.

00:49:56.567 --> 00:49:58.387
So then the therapist says, all right,

00:49:58.407 --> 00:49:58.648
Jimmy,

00:49:58.688 --> 00:49:58.829
so

00:50:01.402 --> 00:50:03.164
based off of this and how you're feeling,

00:50:04.003 --> 00:50:05.304
I believe that I can get this better

00:50:05.385 --> 00:50:06.164
in twelve visits.

00:50:06.585 --> 00:50:08.126
I think there's a good chance that I

00:50:08.146 --> 00:50:10.166
can help you completely overcome this.

00:50:10.668 --> 00:50:11.927
And in twelve visits from now,

00:50:12.007 --> 00:50:13.208
we'll talk about whether we're going to do

00:50:13.309 --> 00:50:14.409
once a week or twice a week or

00:50:14.429 --> 00:50:14.710
whatever.

00:50:15.523 --> 00:50:16.724
But with twelve visits,

00:50:17.043 --> 00:50:18.425
as well as some things for you to

00:50:18.445 --> 00:50:18.925
do at home,

00:50:19.485 --> 00:50:20.768
I'm going to get you back to Orange

00:50:20.788 --> 00:50:21.108
Theory.

00:50:21.128 --> 00:50:22.748
So I'm selling your goal.

00:50:22.809 --> 00:50:24.871
I'm selling the outcome,

00:50:24.911 --> 00:50:26.032
the transformation,

00:50:26.132 --> 00:50:27.713
the result of what you want,

00:50:28.373 --> 00:50:29.695
which is getting back to Orange Theory.

00:50:30.536 --> 00:50:33.938
And what we're going to do is to

00:50:33.998 --> 00:50:34.639
get you there.

00:50:35.480 --> 00:50:37.402
What it's going to cost is forty two

00:50:37.422 --> 00:50:40.543
hundred dollars.

00:50:40.644 --> 00:50:41.005
And so

00:50:42.815 --> 00:50:44.577
I meant just multiplying.

00:50:44.936 --> 00:50:47.237
So three fifty times twelve is forty two

00:50:47.257 --> 00:50:47.737
hundred dollars.

00:50:48.038 --> 00:50:48.777
And you're going to be like, oh,

00:50:48.818 --> 00:50:49.597
my gosh, that's a lot.

00:50:49.617 --> 00:50:50.978
And I wanted to use my insurance and

00:50:51.259 --> 00:50:52.860
all the normal objections that we hear.

00:50:53.000 --> 00:50:54.619
And that's more than I thought it would

00:50:54.659 --> 00:50:54.820
be.

00:50:54.880 --> 00:50:56.101
And I got to speak with my spouse

00:50:56.161 --> 00:50:57.181
and I got to think about it and

00:50:57.240 --> 00:50:57.501
sleep,

00:50:57.900 --> 00:50:59.461
sleep overnight on it and get back to

00:50:59.481 --> 00:51:00.661
you and let me think about it and

00:51:00.702 --> 00:51:01.882
all that type of stuff.

00:51:02.606 --> 00:51:05.070
and then we would say okay well we

00:51:05.090 --> 00:51:06.492
want to nail down is it just price

00:51:06.512 --> 00:51:07.594
and let's just say if it is just

00:51:07.634 --> 00:51:09.317
price it's literally like you're fearful

00:51:09.456 --> 00:51:11.661
of paying something and not getting the

00:51:11.721 --> 00:51:13.364
outcome you're you're afraid of paying for

00:51:13.423 --> 00:51:15.788
something and it not working right so then

00:51:15.827 --> 00:51:16.588
you feel like

00:51:17.594 --> 00:51:19.155
You know, you feel bad about yourself.

00:51:19.175 --> 00:51:21.117
You feel like you made the wrong decision.

00:51:21.697 --> 00:51:23.097
So then we say, hey, Jimmy,

00:51:23.577 --> 00:51:24.978
if we do not get you back to

00:51:25.059 --> 00:51:27.661
Orange Theory in these twelve visits and

00:51:27.701 --> 00:51:28.942
we could do video and we're going to

00:51:28.961 --> 00:51:30.782
make it objective and measurable as much

00:51:30.802 --> 00:51:32.684
as possible in terms of like squat depth

00:51:33.425 --> 00:51:34.666
or we want to just try to make

00:51:34.686 --> 00:51:36.827
it as objective as possible.

00:51:37.027 --> 00:51:38.329
And you have to do some check ins

00:51:38.369 --> 00:51:40.990
along the way in terms of showing us

00:51:41.030 --> 00:51:42.891
some exercises that you've done or

00:51:43.192 --> 00:51:44.333
whatever it is along the way.

00:51:44.373 --> 00:51:45.934
So you have to hit some checkpoints along

00:51:45.974 --> 00:51:47.074
this twelve visit process.

00:51:48.043 --> 00:51:49.704
you're not paying free by the twelfth

00:51:49.724 --> 00:51:52.887
visit you get half your money back or

00:51:53.806 --> 00:51:55.407
you continue to we'll continue to work

00:51:55.427 --> 00:51:58.630
with you until we get you back to

00:51:58.730 --> 00:52:00.490
orange theory and then there'll be some

00:52:00.530 --> 00:52:02.050
terms and a little bit of fine print

00:52:02.070 --> 00:52:03.231
about what that would be is it going

00:52:03.251 --> 00:52:04.793
to be like full normal visits or is

00:52:04.873 --> 00:52:07.454
it also remote coaching remote programming

00:52:07.474 --> 00:52:09.114
whatever but there's a little thing a

00:52:09.135 --> 00:52:10.635
couple things for me to iron out there

00:52:11.215 --> 00:52:12.237
but it would basically be like

00:52:13.498 --> 00:52:13.579
Now,

00:52:13.599 --> 00:52:14.659
it's not a hundred percent money back

00:52:14.679 --> 00:52:15.320
guarantee, Jimmy,

00:52:15.340 --> 00:52:16.960
because we're going to do our side.

00:52:17.001 --> 00:52:18.342
Like we're bringing our A gain every

00:52:18.382 --> 00:52:20.202
single day and we need to make sure.

00:52:20.382 --> 00:52:22.063
So like we can't refund that because it's

00:52:22.083 --> 00:52:23.045
like a service based business.

00:52:23.065 --> 00:52:24.304
So I can't refund a hundred percent of

00:52:24.324 --> 00:52:26.427
your money, but it would be fifty percent.

00:52:26.447 --> 00:52:28.027
So meaning if you if if it didn't

00:52:28.047 --> 00:52:29.748
work for you because you didn't trust

00:52:29.768 --> 00:52:31.349
yourself or whatever,

00:52:31.869 --> 00:52:33.090
we'll refund half your money.

00:52:33.150 --> 00:52:34.331
So you get to the twelfth visit.

00:52:34.731 --> 00:52:35.931
You let us know, hey,

00:52:35.952 --> 00:52:37.172
I want half my money back and we

00:52:37.213 --> 00:52:39.434
send you two thousand one hundred dollars

00:52:39.474 --> 00:52:40.275
back or whatever.

00:52:41.420 --> 00:52:43.081
continue to work with us in whatever the

00:52:43.181 --> 00:52:46.364
defined capacity is moving forward and i

00:52:46.384 --> 00:52:48.385
think that the issue or the challenge of

00:52:48.425 --> 00:52:49.666
this for me to wrap my head around

00:52:49.726 --> 00:52:52.608
is like would some people like refunding

00:52:52.648 --> 00:52:54.528
half the money is fine but tony what

00:52:54.568 --> 00:52:56.731
if someone was like no i'm not a

00:52:56.751 --> 00:52:58.032
hundred percent but they like wanted to

00:52:58.132 --> 00:52:59.713
stay working with us like almost

00:52:59.793 --> 00:53:01.753
indefinitely i think that's like my only

00:53:02.675 --> 00:53:04.516
my only thought of like how this could

00:53:04.596 --> 00:53:06.336
ever go wrong like someone who

00:53:07.438 --> 00:53:08.880
wants to work with us for another twelve

00:53:08.900 --> 00:53:09.239
visits.

00:53:09.380 --> 00:53:10.221
And then like they say,

00:53:10.240 --> 00:53:11.081
they're still not better.

00:53:11.141 --> 00:53:11.882
And then they're like, actually,

00:53:11.922 --> 00:53:12.903
just refund half my money.

00:53:12.923 --> 00:53:14.666
So now they got twenty four visits and

00:53:14.726 --> 00:53:15.947
now asking for money back.

00:53:15.967 --> 00:53:17.449
So there's some things around there that

00:53:17.469 --> 00:53:18.250
need to be tightened up.

00:53:18.289 --> 00:53:19.411
And this is what I would like your

00:53:19.431 --> 00:53:20.512
help for or help on.

00:53:20.572 --> 00:53:20.753
Tony,

00:53:20.773 --> 00:53:21.753
you want to go first or me to

00:53:21.773 --> 00:53:22.155
go first?

00:53:22.315 --> 00:53:22.795
I don't know.

00:53:23.376 --> 00:53:24.096
I hate it.

00:53:24.115 --> 00:53:26.016
I just don't like it.

00:53:27.036 --> 00:53:27.297
You know,

00:53:27.358 --> 00:53:28.777
I think about so many professional

00:53:28.818 --> 00:53:29.579
services.

00:53:29.679 --> 00:53:32.099
I think about like attorneys.

00:53:32.139 --> 00:53:34.581
You're you're indicted for something,

00:53:34.621 --> 00:53:35.141
whatever.

00:53:35.202 --> 00:53:36.501
Like the attorney is not going to give

00:53:36.541 --> 00:53:38.302
you fifty percent back if they don't.

00:53:38.764 --> 00:53:39.583
If you go to jail,

00:53:40.463 --> 00:53:42.125
there's just so many things like that.

00:53:42.465 --> 00:53:43.846
I feel like this makes it too much

00:53:43.865 --> 00:53:44.487
about the money.

00:53:45.567 --> 00:53:47.746
And if we're coming down to,

00:53:47.766 --> 00:53:51.208
and I shared the risk reversal definition,

00:53:51.407 --> 00:53:54.068
I just think we're focused on the wrong

00:53:54.108 --> 00:53:54.509
thing.

00:53:54.708 --> 00:53:57.009
And for you and what you do and

00:53:57.048 --> 00:53:57.728
how you do it,

00:53:57.789 --> 00:54:00.090
I'm just not a fan of this kind

00:54:00.170 --> 00:54:01.010
of interaction.

00:54:01.750 --> 00:54:02.869
Yeah, I like it.

00:54:03.489 --> 00:54:03.969
Here's why.

00:54:04.429 --> 00:54:06.831
But there's going to be an asterisk

00:54:07.130 --> 00:54:07.510
everywhere.

00:54:07.530 --> 00:54:09.851
There needs to be specific and asterisks.

00:54:09.971 --> 00:54:10.630
Here's what I mean.

00:54:10.791 --> 00:54:12.391
Number one, this is not for everybody.

00:54:12.811 --> 00:54:13.931
You tell your staff,

00:54:15.851 --> 00:54:17.152
define who this is for.

00:54:17.233 --> 00:54:18.994
This is for the person who that's their

00:54:19.054 --> 00:54:20.235
primary objection.

00:54:20.777 --> 00:54:22.018
Like what are you afraid of?

00:54:22.378 --> 00:54:23.639
I'm afraid of if I do it and

00:54:23.659 --> 00:54:24.661
I spend this money and I don't get

00:54:24.722 --> 00:54:24.802
it.

00:54:25.161 --> 00:54:25.483
Okay.

00:54:25.902 --> 00:54:26.844
Then you pull this out.

00:54:26.923 --> 00:54:27.704
It's holstered.

00:54:27.744 --> 00:54:28.867
It's not on your website.

00:54:28.887 --> 00:54:30.688
This is not, listen, this is,

00:54:30.768 --> 00:54:31.889
this is where I call the look around.

00:54:32.744 --> 00:54:33.525
When you pitch this,

00:54:33.824 --> 00:54:34.885
when your clinician pitches this,

00:54:34.905 --> 00:54:35.306
they do this.

00:54:35.425 --> 00:54:37.666
Listen, I'm not supposed to do this,

00:54:38.487 --> 00:54:39.927
but I'm pretty confident.

00:54:40.166 --> 00:54:40.646
Don't say pretty.

00:54:41.027 --> 00:54:42.128
I'm confident we can do this.

00:54:42.807 --> 00:54:43.628
Here's what it looks like.

00:54:44.128 --> 00:54:46.429
What I don't like is pain-free because you

00:54:46.449 --> 00:54:48.148
can't see or that is a symptom,

00:54:48.188 --> 00:54:48.869
not a sign.

00:54:49.289 --> 00:54:50.230
I would go with signs.

00:54:50.829 --> 00:54:52.951
Can you show me that you've done this?

00:54:52.971 --> 00:54:54.371
Because they're going to go, yeah,

00:54:54.391 --> 00:54:55.070
I'm not a hundred percent.

00:54:55.150 --> 00:54:55.210
I'm

00:54:57.992 --> 00:55:00.394
So just be specific along the way.

00:55:00.775 --> 00:55:03.077
If then, now act like a lawyer.

00:55:03.637 --> 00:55:05.018
So what we're saying is, listen,

00:55:05.099 --> 00:55:06.059
if you do all these things and it

00:55:06.079 --> 00:55:10.583
doesn't happen, then my plan failed.

00:55:10.643 --> 00:55:11.784
But are you the part that failed?

00:55:11.804 --> 00:55:12.606
Did you not do it?

00:55:12.726 --> 00:55:13.887
Then how is that my fault?

00:55:14.688 --> 00:55:15.728
This is where when I first heard of

00:55:15.768 --> 00:55:18.271
value-based care, I was like, dude,

00:55:18.311 --> 00:55:19.672
that sounds like a huge risk.

00:55:19.773 --> 00:55:19.972
Like,

00:55:21.103 --> 00:55:21.844
We signed on,

00:55:21.864 --> 00:55:23.286
but you didn't do it and I lost

00:55:23.346 --> 00:55:24.487
money, but I did my thing.

00:55:24.527 --> 00:55:26.608
This is where I will never do affiliate

00:55:26.628 --> 00:55:28.829
deals for podcast sponsors.

00:55:29.110 --> 00:55:30.851
So I definitely talked about your product

00:55:30.871 --> 00:55:33.253
for a hundred days and you might pay

00:55:33.273 --> 00:55:34.253
me for some of that.

00:55:34.393 --> 00:55:36.675
I definitely build a show every day and

00:55:36.715 --> 00:55:37.536
you might pay me.

00:55:38.237 --> 00:55:39.458
My job is to get them to know

00:55:39.478 --> 00:55:41.480
about your product,

00:55:41.639 --> 00:55:42.500
not to make them buy it.

00:55:42.880 --> 00:55:43.641
That's a human thing.

00:55:43.960 --> 00:55:45.443
Your job is to give them the plan.

00:55:45.842 --> 00:55:47.023
Their job is to do it.

00:55:47.704 --> 00:55:49.266
So I like this.

00:55:50.193 --> 00:55:51.434
I think you're ninety eight percent of the

00:55:51.454 --> 00:55:51.735
way there.

00:55:52.135 --> 00:55:53.335
I actually think you need less.

00:55:53.976 --> 00:55:55.257
I don't think you need to add to

00:55:55.277 --> 00:55:55.376
that.

00:55:55.416 --> 00:55:58.038
I usually like put the put the specifics.

00:55:59.659 --> 00:56:01.119
Yeah.

00:56:01.179 --> 00:56:01.699
Yeah.

00:56:02.320 --> 00:56:02.719
All of health.

00:56:02.860 --> 00:56:03.920
Ben is saying all of health care should

00:56:03.940 --> 00:56:04.521
be like this.

00:56:05.320 --> 00:56:07.141
You can't put a cap on the time

00:56:07.161 --> 00:56:08.842
duration if going to the out.

00:56:08.882 --> 00:56:09.664
This is what we need you in the

00:56:09.684 --> 00:56:10.903
room, Ben, because I'm reading.

00:56:11.704 --> 00:56:13.985
I thought he just said six months,

00:56:14.005 --> 00:56:15.326
but then he said you can't put a

00:56:15.365 --> 00:56:16.266
cap on time.

00:56:17.452 --> 00:56:18.012
Give like a rate.

00:56:18.132 --> 00:56:19.813
Oh, I think what he's saying.

00:56:19.873 --> 00:56:21.132
I'm channeling Ben.

00:56:21.172 --> 00:56:22.032
Like, hey, listen,

00:56:22.233 --> 00:56:23.793
then I'll give you the money back or

00:56:25.253 --> 00:56:25.833
you can continue.

00:56:25.914 --> 00:56:27.534
Is your goal still to get to Orange

00:56:27.574 --> 00:56:27.934
Theory?

00:56:28.275 --> 00:56:28.554
Yeah.

00:56:28.875 --> 00:56:29.135
All right.

00:56:29.155 --> 00:56:30.934
Then we'll continue to work together until

00:56:30.974 --> 00:56:31.436
you get there.

00:56:31.476 --> 00:56:32.896
Maybe we're just eighty five percent of

00:56:32.916 --> 00:56:33.315
the way there.

00:56:33.655 --> 00:56:34.596
So let's work together.

00:56:34.976 --> 00:56:36.416
I'll continue to work together with you.

00:56:36.856 --> 00:56:37.577
I'll give you the money back.

00:56:37.637 --> 00:56:40.097
Now we walk away or we continue to

00:56:40.137 --> 00:56:43.278
work together for six months to get you

00:56:43.298 --> 00:56:44.619
there at no additional cost.

00:56:45.362 --> 00:56:45.501
Yeah,

00:56:45.702 --> 00:56:46.722
this is what I was going to say.

00:56:46.742 --> 00:56:48.143
This is a risk contract.

00:56:48.463 --> 00:56:50.806
You agree to the KPI that are realistic

00:56:50.846 --> 00:56:53.007
to show you have done your part.

00:56:54.268 --> 00:56:56.028
But in case the patient hasn't done

00:56:56.048 --> 00:56:56.208
theirs,

00:56:56.889 --> 00:56:58.210
there needs to be a way to track

00:56:58.271 --> 00:56:58.351
it.

00:56:58.411 --> 00:56:59.331
It doesn't need to be like a thing

00:56:59.351 --> 00:57:00.271
that you do in the courtroom.

00:57:00.331 --> 00:57:01.552
And here's my comment.

00:57:01.592 --> 00:57:03.074
They'd have to – I don't know.

00:57:03.094 --> 00:57:04.394
It could be like they have to video

00:57:04.454 --> 00:57:05.755
record them doing their HEP.

00:57:06.175 --> 00:57:06.996
Yeah, I don't know.

00:57:07.056 --> 00:57:08.117
Like three days a week or something,

00:57:08.418 --> 00:57:10.938
which would cause more –

00:57:10.378 --> 00:57:12.239
It would be more work for the patient.

00:57:12.260 --> 00:57:14.021
But if you could document those videos and

00:57:14.041 --> 00:57:15.280
then you look back when they go and

00:57:15.300 --> 00:57:15.701
you're like, well,

00:57:16.342 --> 00:57:17.961
you only did four minutes each time.

00:57:18.623 --> 00:57:20.043
This is where I don't like it with

00:57:20.103 --> 00:57:21.463
Tony, which is not for everybody.

00:57:21.543 --> 00:57:23.284
And now you guys are like splitting hairs

00:57:23.304 --> 00:57:24.545
and you're arguing with the person you're

00:57:24.565 --> 00:57:25.306
supposed to be helping.

00:57:25.706 --> 00:57:26.365
This is where I don't like it.

00:57:26.606 --> 00:57:29.387
But I will say lawyers do do this.

00:57:30.288 --> 00:57:32.750
lawyers do take on cases like in

00:57:32.809 --> 00:57:34.731
disability claims and they say i will work

00:57:34.751 --> 00:57:37.293
for you for free if we win because

00:57:37.313 --> 00:57:38.994
they know the case is huge though that's

00:57:39.014 --> 00:57:41.077
the difference yeah and if i win i

00:57:41.117 --> 00:57:43.659
get thirty percent and you're like thirty

00:57:43.699 --> 00:57:45.539
percent that'll be hundreds of you and

00:57:45.559 --> 00:57:47.521
you're like or you could just pay me

00:57:47.561 --> 00:57:49.884
along the way which do you want that's

00:57:49.903 --> 00:57:51.565
where i don't like this on your website

00:57:51.865 --> 00:57:53.025
but i would like it if you're like

00:57:53.746 --> 00:57:55.208
first you gotta decide who is this right

00:57:55.248 --> 00:57:55.447
for

00:57:56.309 --> 00:57:57.289
And then do that.

00:57:57.510 --> 00:57:58.250
Do it as a test.

00:57:58.289 --> 00:57:58.929
But first,

00:57:58.969 --> 00:58:00.690
the hard part is defining who it's right

00:58:00.710 --> 00:58:02.092
for, who it's not.

00:58:02.572 --> 00:58:03.733
I think it's more important to decide who

00:58:03.753 --> 00:58:04.253
it's not for.

00:58:04.634 --> 00:58:05.733
And then what does it look like?

00:58:06.454 --> 00:58:07.215
That's realistic.

00:58:07.394 --> 00:58:08.835
Videotaping my workouts,

00:58:08.956 --> 00:58:09.755
I would never do that.

00:58:09.896 --> 00:58:11.976
I would just be like, okay,

00:58:12.036 --> 00:58:13.338
this is like if you don't like the

00:58:13.438 --> 00:58:13.878
food,

00:58:14.619 --> 00:58:16.760
but you ate eighty percent of it and

00:58:16.780 --> 00:58:17.500
you sent it back.

00:58:17.599 --> 00:58:19.061
It's like, I looked like you like it,

00:58:19.081 --> 00:58:19.360
chief.

00:58:19.420 --> 00:58:20.382
Like, I don't know.

00:58:20.481 --> 00:58:21.181
You didn't like it.

00:58:21.202 --> 00:58:22.302
You ate most of it.

00:58:22.322 --> 00:58:22.922
What do you want me to do with

00:58:22.963 --> 00:58:23.043
it?

00:58:23.143 --> 00:58:23.903
I made the food.

00:58:24.769 --> 00:58:26.231
You looked at the menu, you ordered it.

00:58:26.650 --> 00:58:27.612
I like this idea.

00:58:28.652 --> 00:58:29.972
This is a psychological thing.

00:58:30.112 --> 00:58:31.233
I think the amount of people that will

00:58:31.273 --> 00:58:32.735
actually push back on you or ever ask

00:58:32.755 --> 00:58:36.737
for their money back is terribly low.

00:58:36.797 --> 00:58:37.378
Right.

00:58:37.418 --> 00:58:38.778
It would help with conversions on the

00:58:38.818 --> 00:58:39.438
front end, which is,

00:58:39.518 --> 00:58:40.300
that's the whole point.

00:58:42.119 --> 00:58:42.619
I don't know.

00:58:43.179 --> 00:58:45.282
I think the advantage to being a small

00:58:45.342 --> 00:58:47.804
business like this is we don't need large

00:58:47.844 --> 00:58:48.543
volumes.

00:58:48.563 --> 00:58:50.646
I don't disagree either.

00:58:50.666 --> 00:58:53.588
I feel like this is a hard road

00:58:53.648 --> 00:58:56.751
to try and convert a couple of potential

00:58:56.771 --> 00:58:59.713
clients that with sales and all the other

00:58:59.753 --> 00:59:00.534
stuff you understand,

00:59:00.574 --> 00:59:01.594
you could do it a different way.

00:59:02.175 --> 00:59:03.677
How many do you think you have?

00:59:03.737 --> 00:59:05.018
Let's say you have a hundred patients.

00:59:05.458 --> 00:59:08.800
How many would you need to give this

00:59:09.101 --> 00:59:10.442
to push them over the edge to jump

00:59:10.501 --> 00:59:11.103
in and go with you?

00:59:13.996 --> 00:59:15.277
Is this the exception or the rule?

00:59:15.418 --> 00:59:16.699
It's not the rule because you wouldn't be

00:59:16.739 --> 00:59:18.103
in business if this was the rule.

00:59:18.322 --> 00:59:18.804
Well, no.

00:59:19.103 --> 00:59:21.206
So because right now we're predominantly

00:59:21.248 --> 00:59:21.909
visit by visit.

00:59:21.929 --> 00:59:23.550
Now, I have sold some packages.

00:59:23.610 --> 00:59:24.291
Oh, I see what you mean.

00:59:25.083 --> 00:59:26.503
have sold some you know we've done some

00:59:26.543 --> 00:59:29.686
packages but this would be like here's the

00:59:29.706 --> 00:59:32.867
thing like this also this whole idea came

00:59:32.887 --> 00:59:35.349
from alex ramosi because he was doing this

00:59:35.389 --> 00:59:36.869
type of a style for brick and mortar

00:59:36.889 --> 00:59:38.331
businesses and gyms and all that and what

00:59:38.731 --> 00:59:40.311
what it does in terms of helping the

00:59:40.353 --> 00:59:42.434
whole flywheel of the business is if

00:59:42.454 --> 00:59:44.255
you're selling this amount of money up

00:59:44.295 --> 00:59:46.775
front one thousand three thousand four

00:59:46.795 --> 00:59:48.277
thousand whatever dollars up front per

00:59:48.336 --> 00:59:48.717
person

00:59:49.297 --> 00:59:49.637
Understood.

00:59:49.657 --> 00:59:50.199
That's like,

00:59:50.239 --> 00:59:52.219
that's the return on ad spend, the ROAS,

00:59:52.239 --> 00:59:54.400
like when you're paying for Facebook ads

00:59:54.422 --> 00:59:55.822
and Google ads and Instagram ads,

00:59:55.842 --> 00:59:57.063
you know, meet meta ads.

00:59:57.103 --> 00:59:59.244
So you get that money and you're using

00:59:59.364 --> 01:00:02.387
the profit of that new customer and you're

01:00:02.407 --> 01:00:03.887
getting more new patients and you know,

01:00:03.987 --> 01:00:05.548
each month and you're,

01:00:05.628 --> 01:00:07.210
and you're using the cash of those

01:00:07.250 --> 01:00:09.391
packages to pay for the ad spend and

01:00:09.411 --> 01:00:11.112
to get more patients and customers.

01:00:11.932 --> 01:00:12.454
I don't think,

01:00:12.673 --> 01:00:14.014
I don't think you would lose doing this.

01:00:16.027 --> 01:00:16.887
I don't know if you need to do...

01:00:17.289 --> 01:00:18.210
Yeah, I would do this.

01:00:18.291 --> 01:00:18.851
I would try it.

01:00:18.871 --> 01:00:20.813
All right, we're almost at time.

01:00:20.833 --> 01:00:21.594
We got to do parting shots.

01:00:21.614 --> 01:00:22.255
But before we do,

01:00:22.297 --> 01:00:23.077
I want to make sure we don't lose

01:00:23.117 --> 01:00:23.518
money here.

01:00:24.760 --> 01:00:25.400
Our sponsor,

01:00:25.460 --> 01:00:26.583
what do you guys think this is?

01:00:27.063 --> 01:00:28.385
What do you think they sell?

01:00:30.722 --> 01:00:32.443
Up next is progress notes.

01:00:32.543 --> 01:00:34.684
If it exists, it probably happened.

01:00:35.144 --> 01:00:36.284
You can do things better.

01:00:36.625 --> 01:00:40.266
Write it in paper and pen or like

01:00:40.286 --> 01:00:41.327
the old Ten Commandments.

01:00:41.347 --> 01:00:42.668
You could chisel it as well,

01:00:42.728 --> 01:00:44.947
but progress notes,

01:00:45.568 --> 01:00:48.510
just write it and do it better.

01:00:49.210 --> 01:00:49.550
Yes.

01:00:50.349 --> 01:00:51.110
Progress, close.

01:00:51.190 --> 01:00:53.090
It's a regular notebook that somehow

01:00:53.130 --> 01:00:54.291
counts as documentation.

01:00:54.331 --> 01:00:55.672
You write whatever you want,

01:00:56.052 --> 01:00:57.193
whatever you remember.

01:00:57.833 --> 01:00:59.534
In handwriting, no one can read.

01:01:01.760 --> 01:01:03.862
Now it comes with coffee stains for

01:01:03.942 --> 01:01:05.742
authenticity and random page that just

01:01:05.782 --> 01:01:06.382
says better.

01:01:06.682 --> 01:01:06.983
Yeah,

01:01:07.063 --> 01:01:08.764
I got to dig into the details better.

01:01:09.184 --> 01:01:10.164
Progress notes.

01:01:10.384 --> 01:01:12.324
If it exists, it probably happened.

01:01:12.344 --> 01:01:13.425
This just backs you up.

01:01:13.465 --> 01:01:15.146
This is a record of nothing.

01:01:15.246 --> 01:01:16.626
That's what progress notes is.

01:01:16.726 --> 01:01:17.666
All right, parting shots.

01:01:18.206 --> 01:01:18.967
Parting shots.

01:01:19.128 --> 01:01:20.728
Implantable, not wearable.

01:01:20.768 --> 01:01:22.088
That's the future of PT.

01:01:22.748 --> 01:01:24.510
Tony wants to be inside you.

01:01:24.550 --> 01:01:25.090
Keep going.

01:01:25.130 --> 01:01:26.090
Dave, parting shot.

01:01:26.110 --> 01:01:28.391
How do I follow that?

01:01:28.431 --> 01:01:30.351
Quickly.

01:01:31.300 --> 01:01:32.001
It's not.

01:01:32.121 --> 01:01:32.601
It's not.

01:01:32.681 --> 01:01:35.023
Implantables will not be the future of

01:01:35.063 --> 01:01:35.663
physical therapy.

01:01:35.702 --> 01:01:38.724
What's your parting shot then?

01:01:38.744 --> 01:01:39.905
My parting shot is the future will

01:01:39.925 --> 01:01:41.487
continue to be this bifurcation,

01:01:41.507 --> 01:01:43.949
this split of the low cost,

01:01:44.708 --> 01:01:47.170
extremely thin margin of physical therapy

01:01:47.210 --> 01:01:49.932
practices or out of network self-pay that

01:01:49.972 --> 01:01:50.972
have higher margins.

01:01:51.092 --> 01:01:52.634
And yes, there's more of the sales hurdle,

01:01:52.653 --> 01:01:53.934
which we're just talking about.

01:01:55.536 --> 01:01:57.458
But those are the two options moving

01:01:57.478 --> 01:01:57.717
forward.

01:01:58.452 --> 01:02:00.454
My parting shot will piggyback on both of

01:02:00.494 --> 01:02:00.753
yours.

01:02:01.134 --> 01:02:03.916
The future will be better for the people

01:02:04.155 --> 01:02:06.757
who pay attention.

01:02:06.978 --> 01:02:08.057
I think the people who are paying

01:02:08.077 --> 01:02:08.498
attention.

01:02:08.838 --> 01:02:09.998
None of what we just said is going

01:02:10.018 --> 01:02:10.920
to come true on this show.

01:02:11.500 --> 01:02:12.579
Some of it kind of will.

01:02:13.420 --> 01:02:14.702
And we're all going to be Nostradamus

01:02:14.742 --> 01:02:16.543
because we're geniuses when we look in

01:02:16.583 --> 01:02:16.902
reverse.

01:02:16.922 --> 01:02:17.983
We're back on Tuesday.

01:02:18.563 --> 01:02:19.184
Have a good weekend.

01:02:23.186 --> 01:02:26.067
Tony Maritano on YouTube at Total Therapy

01:02:26.086 --> 01:02:26.646
Solution.

01:02:26.706 --> 01:02:27.686
Find Dave Kittle at

01:02:27.726 --> 01:02:30.907
conciergepainrelief.com and on YouTube at

01:02:30.947 --> 01:02:32.108
The Dave Kittle Show.

01:02:32.427 --> 01:02:35.268
And follow Jimmy McKay at PT Podcast on

01:02:35.467 --> 01:02:36.728
YouTube, the socials,

01:02:36.829 --> 01:02:38.608
and wherever you binge podcasts you

01:02:38.628 --> 01:02:40.289
pretend are for CEUs.

01:02:40.608 --> 01:02:42.050
And hey, just a reminder,

01:02:42.530 --> 01:02:43.829
none of this was for advice.

01:02:43.869 --> 01:02:45.190
This was for entertainment only.

01:02:45.610 --> 01:02:47.010
Our lawyers say that counts.

01:02:47.090 --> 01:02:47.990
Thanks, Keith.