Why Neuro PTs Need to Start Charging What They're Worth

WEBVTT

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Thanks, Voice Guy.

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First,

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I want to say thanks to Brooks IHL.

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If you're thinking residency, fellowship,

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or just want deeper clinical mastery,

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at least kick the tires.

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Brooks IHL has programs that actually

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shape better clinicians,

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not just give you letters.

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Everybody likes letters.

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Letters are great.

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But really, you want the other stuff.

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I know what you want.

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Brooksihl.org.

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That's brooksihl.org.

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Orthopedics, neuro, geriatrics,

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pediatrics.

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There's more.

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I just don't have a list in front

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of me.

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And do,

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in this tenth anniversary year of the

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podcast,

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who knew this would go more than ten

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weeks?

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Never mind a decade.

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Brooks has been here for a couple years

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supporting the show.

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So thanks, Brooks.

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Brooksihl.org.

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Today's guest...

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spent nearly a decade, also a decade,

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a decade, a decade,

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working with patients who challenged the

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norms of recovery and rehabilitation.

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But somewhere along the way,

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she realized it wasn't just the patients

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who needed new ways to move.

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It was the profession itself.

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It was us.

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The call was coming from inside the house.

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Now she's on a mission to flip the

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script in neurologic physical therapy,

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building a movement, a business,

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and a mindset that says we don't have

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to wait for someone else to fix it.

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Spoiler alert.

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No one's going to fix it.

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We either fix it or it falls apart.

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We all know that.

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She's changing the game for clinicians who

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want more than burnout and low-ball

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paychecks.

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I love this.

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Let's get into the studio.

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Lauren Young,

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you mentioned spicy and salty before we

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got started.

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I was like, yeah,

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and we could tell with that intro.

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We're bringing a little salt.

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Yeah, we're here.

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Jimmy,

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it's funny that you say it's been ten

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years because I'm pretty sure I've been

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listening to your podcast from the

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origins.

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Really?

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Well, when did you, all right,

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so I always love this.

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This is not scripted, nothing scripted.

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How did you,

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do you remember how you found the show

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and where were you in school?

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Like where were you in your life?

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I was early,

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early career clinician whenever I found

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out.

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When did you graduate?

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I was twenty sixteen.

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Me too.

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Yeah.

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So I was working and I don't it

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had to be something that like the APTA

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put out.

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And if you were a part of it,

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I don't remember.

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And I've been trying to remember.

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But I remember very vividly listening to

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your podcast.

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And I can tell you,

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I don't know what episode,

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I don't know where, but you said,

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the problem is we are salespeople,

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but we are not doing a good job

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selling.

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And in that moment, I was like,

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light on.

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So I will tell you,

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I thought all these years of listening to

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your podcast was like, man,

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if I make it on that podcast,

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I will have made it.

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And here I am.

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And here we are the pioneer of

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I mean,

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you were really the first one in this

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space talking about the things that people

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didn't want to talk about.

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And I whispered them.

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They whispered them or said them without

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putting their name on them at happy hours.

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This is why I'll podcast like, you know,

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I don't drink a beer in every episode

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anymore.

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I did at one point drink a beer

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in every episode.

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You know,

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my waistline would appreciate that.

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We'll do it in person.

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But what I kept seeing was there was

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two reasons.

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I think I started this.

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I sat in a room full of a

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thousand people watching a person give a

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presentation that I was like,

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this is cool,

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but I don't get all of it and

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met the person after in the bar and

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it was a totally different person and the

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words and the vibe was different.

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And I was like,

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you're just as brilliant here

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but I didn't understand you on stage.

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Why did you do that?

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Do this there.

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And then the other thing was that,

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which is like, we all complain.

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Like I'm going to Graham sessions in a

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couple of weeks.

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Do you know what Graham sessions are?

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A lot of people don't.

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I didn't know.

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It's like an invite only thing.

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It's only one hundred fifty people and

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it's meant to be.

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And I'm not knocking the reasoning behind

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it.

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But it's meant to like, well,

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we talk about it and we can talk

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about whatever we want,

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but nobody pays repercussions.

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And I'm like, but then there's no stakes.

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There's no tension.

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If there's no tension, I start off.

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I didn't expect this to go this way,

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but we'll keep going.

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Whenever I'm working with someone,

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doesn't matter what.

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If it's a company, right?

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I'm sitting in front of three people and

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they're like,

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maybe we want to work together,

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do a project.

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I go, one of my go-to questions,

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which is great for clinical care,

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what happens if we do nothing in six

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months?

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And people are like, what do you mean?

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Well, you've done nothing for a while.

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What happens if we do nothing for six

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more months?

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What I'm doing is I want them to

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envision the stakes.

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What fails?

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What doesn't grow?

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What does that feel like?

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Are we still pissed?

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What happens if I don't do my dishes

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for another day because I live alone?

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I have to walk by them and they

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smell and then I feel even worse.

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And then there's more dishes because I

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have to keep eating.

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And that's the only way to get me

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to do anything.

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The other good question I like is,

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if this doesn't get fixed,

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or if we proceed with option A, B,

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or C, and it fails, who's in trouble?

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And I don't say that to be like,

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let's point blame.

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That doesn't help.

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What I mean is like,

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who's going to own this and champion this

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with me?

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Not fight me, but it's like,

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who gets in trouble?

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Because if five people... First of all,

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if you can't answer that, and you're like,

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well, us and this and it's not...

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No one owns it,

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so they won't get in trouble.

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And if five people own it, same thing.

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won't change.

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And what's the trouble, right?

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Like, I see identify the trouble PT world,

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we all think,

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like the highest stake is like losing the

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license,

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I'm in a clinic where I just opened,

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you know,

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I have this setup that I'm okay,

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if it fails,

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I don't think it's going to fail.

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I'm not intending for it to fail,

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but like,

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I'm not going to lose my license if

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it fails.

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Like, what do I actually lose?

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And I think people don't delve into that

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question enough.

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And so they are just paralyzed by fear

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because they don't realize what it is that

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I'm losing.

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Really,

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it might be six months of my life

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and I've learned a lot doing this.

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So have I really lost even if it

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doesn't work out?

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No,

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I've learned a ton that I would take

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back into a different clinic with me.

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This is a sports analogy,

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but it still works,

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which is there's a difference between

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playing to win and playing not to lose.

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Did you play sports?

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Were you an athlete, former athlete?

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High school, but yeah.

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But what sports?

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I can use that analogy.

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What sport?

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Yeah, it's softball.

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Yeah, like it's funny.

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I played baseball and softball and all of

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a sudden you're up by six and one

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run goes in and you're like, well,

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we're up by five.

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So let's just get this.

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Like,

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let's just be safe and keep the ball.

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It's like next thing you know,

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you're down by two and you're like,

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what happened?

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Where did it go?

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That's playing not to lose instead of

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like, I need to win now.

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Pretend like it's tied.

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Pretend like we're down one.

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You know,

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I play old man beer league hockey now

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and we'll be sitting on the bench.

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And I just quote, like,

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I don't even know where it came from.

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Probably watching some game on TV.

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And they were like, oh,

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we're up to two goal lead.

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Worst lead in hockey.

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Why?

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Because you're comfortable.

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Because you're comfortable and you're

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like, well, I just, I won't push.

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It's like,

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you have to act as if it matters.

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Not act as if I got to throw

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ten Hail Marys and risk losing everything,

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but act as if what I'm doing is

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going to affect what happens three, six,

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nine, twelve months from now.

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And I think that's part of the

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I don't want to say issue,

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but issue with our profession is

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everyone's comfortable.

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We're all comfortable.

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We have a system.

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It sort of works depending on who you

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talk to.

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I don't think it works great,

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but it does what it's intended to do,

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but then that's the baseline.

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And I think we have the ability to

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do so much more,

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but so many people come out of school.

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You've got debt, all of these things.

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We go into a clinic,

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we start the nine to five,

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we see twenty four patients a day.

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And by year five,

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we're burned out because we were

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comfortable.

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Did you see the movie?

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It was George Clooney up in the air

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where he's the guy who flies around and

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fires people.

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So his job is you,

00:07:50.752 --> 00:07:53.432
a company hires him to go around the

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country and like do layoffs.

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He's the guy who sits in the room.

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You get called into his office.

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He's the grim reaper.

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And who's the guy from Whiplash?

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Remember the movie about the drummer?

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I'm a terrible movie person.

00:08:05.322 --> 00:08:06.223
But it's that guy.

00:08:06.644 --> 00:08:07.704
The guy is getting fired.

00:08:07.744 --> 00:08:08.983
So George Clooney is sitting across.

00:08:09.004 --> 00:08:10.845
Someone's yelling it right now at the

00:08:10.884 --> 00:08:11.245
speakers.

00:08:11.264 --> 00:08:11.944
Like, how come you don't know this?

00:08:12.944 --> 00:08:14.644
And he's sitting across and he's looking

00:08:14.725 --> 00:08:15.605
and he's firing this guy.

00:08:15.646 --> 00:08:18.946
And the guy's like in his sixties.

00:08:19.026 --> 00:08:20.307
And he's looking at this guy's resume and

00:08:20.326 --> 00:08:20.927
he goes, hey man,

00:08:21.026 --> 00:08:21.887
I saw on your resume,

00:08:21.927 --> 00:08:23.846
like you went to the Culinary Institute

00:08:23.947 --> 00:08:26.788
and now you work here at XYZ Cubicle.

00:08:27.819 --> 00:08:29.680
And then George Clooney said,

00:08:30.379 --> 00:08:31.401
because this guy's pissed.

00:08:31.480 --> 00:08:32.601
He's like, you guys are firing me?

00:08:32.922 --> 00:08:34.222
I've worked here for twenty five years.

00:08:34.322 --> 00:08:35.503
And Clooney's like, it's not me.

00:08:36.264 --> 00:08:37.224
But he looks at him and he goes,

00:08:37.804 --> 00:08:39.105
how much did they pay you to first?

00:08:39.225 --> 00:08:40.186
How much did they pay to give up

00:08:40.206 --> 00:08:40.625
your dream?

00:08:41.506 --> 00:08:43.488
And then the guy stops and he takes

00:08:43.548 --> 00:08:44.587
a breath and he said,

00:08:44.908 --> 00:08:46.489
like twenty three thousand dollars,

00:08:46.548 --> 00:08:48.009
twenty three thousand five hundred dollars

00:08:48.070 --> 00:08:48.811
in health insurance.

00:08:49.451 --> 00:08:50.711
And that was twenty five years ago.

00:08:51.572 --> 00:08:53.514
And it's like, you came,

00:08:54.054 --> 00:08:55.475
you didn't come this far to come this

00:08:55.515 --> 00:08:55.855
far.

00:08:55.956 --> 00:08:56.155
Like,

00:08:56.775 --> 00:08:59.077
and I'm not saying cash out your four

00:08:59.097 --> 00:09:00.599
Oh one K and just throw,

00:09:00.938 --> 00:09:01.558
just wing it.

00:09:01.619 --> 00:09:02.320
That's not what I'm saying.

00:09:02.480 --> 00:09:04.221
What I'm saying is like what you do

00:09:04.280 --> 00:09:07.163
now will come about three, six, nine,

00:09:07.202 --> 00:09:08.102
twelve from now.

00:09:08.243 --> 00:09:09.303
If you do something now,

00:09:09.403 --> 00:09:10.825
we say this to patients all the time

00:09:10.904 --> 00:09:11.826
and then we don't do it.

00:09:13.172 --> 00:09:15.532
So you said PTs need to stop being

00:09:15.552 --> 00:09:16.173
bleeding hearts.

00:09:16.452 --> 00:09:17.952
I say Peace Corps gene.

00:09:17.972 --> 00:09:18.712
You say bleeding hearts.

00:09:18.793 --> 00:09:19.432
Pretty much same thing.

00:09:20.033 --> 00:09:21.114
What do you mean by that?

00:09:21.193 --> 00:09:21.994
And then what do we need to do

00:09:22.533 --> 00:09:24.094
instead?

00:09:24.374 --> 00:09:26.934
I think that in school,

00:09:26.975 --> 00:09:28.934
because I've done a lot of thinking about

00:09:28.975 --> 00:09:30.375
this, because I've run,

00:09:30.534 --> 00:09:34.735
I just in October put my application in

00:09:34.755 --> 00:09:36.556
to be only Medicare.

00:09:36.635 --> 00:09:38.197
Like I'm only accepting Medicare as an

00:09:38.297 --> 00:09:38.716
insurance.

00:09:38.736 --> 00:09:39.636
And that's a lot of.

00:09:40.273 --> 00:09:41.053
Maybe before we get into this,

00:09:41.134 --> 00:09:42.755
give people the setup so they understand

00:09:42.775 --> 00:09:43.918
where you're coming from and where you

00:09:43.957 --> 00:09:44.057
are.

00:09:44.544 --> 00:09:44.764
Yeah,

00:09:44.804 --> 00:09:48.626
so I worked in clinic-based settings

00:09:49.327 --> 00:09:53.169
across the continuum of care for seven-ish

00:09:53.669 --> 00:09:55.230
years, full-time.

00:09:55.291 --> 00:09:57.871
I'm in academia now while running.

00:09:59.033 --> 00:10:00.212
It was a cash-based clinic,

00:10:00.553 --> 00:10:02.394
now starting in network with Medicare.

00:10:02.475 --> 00:10:03.695
A lot of that is because of the

00:10:03.715 --> 00:10:05.115
rules that we have that we can't,

00:10:05.176 --> 00:10:06.096
as physical therapists,

00:10:06.177 --> 00:10:07.057
opt out of Medicare.

00:10:07.177 --> 00:10:08.837
So you really don't have a choice if

00:10:08.857 --> 00:10:10.458
you want to see that patient population.

00:10:11.078 --> 00:10:13.100
um and a lot of neuro folks that

00:10:13.181 --> 00:10:14.743
i'm a neuro clinical specialist i should

00:10:14.783 --> 00:10:16.484
probably say that too um a lot of

00:10:16.524 --> 00:10:18.865
neuro folks are medicare beneficiaries so

00:10:19.366 --> 00:10:21.048
um you know it's kind of from a

00:10:21.087 --> 00:10:23.650
business perspective you i had to i didn't

00:10:23.671 --> 00:10:26.312
really have a choice um so now i've

00:10:26.352 --> 00:10:28.815
got i was doing mobile um out of

00:10:28.855 --> 00:10:32.337
network and i opened up a clinic and

00:10:32.437 --> 00:10:35.140
so essentially looking at all of this

00:10:36.408 --> 00:10:40.671
You say I've heard the conversation that

00:10:40.711 --> 00:10:42.633
trying to charge cash for something that

00:10:42.692 --> 00:10:45.315
Medicare or that insurance covers is

00:10:45.514 --> 00:10:46.134
unethical.

00:10:47.096 --> 00:10:48.336
We shouldn't do this.

00:10:48.456 --> 00:10:49.957
Like, where is the tipping point?

00:10:50.437 --> 00:10:53.620
But then I look and see massage

00:10:53.640 --> 00:10:55.381
therapists, chiropractors,

00:10:55.481 --> 00:10:58.484
personal trainers, exercise physiologists,

00:10:58.524 --> 00:10:59.245
you name it.

00:11:00.264 --> 00:11:03.985
they're charging cash for their service

00:11:04.066 --> 00:11:04.905
that, you know,

00:11:04.985 --> 00:11:06.326
I'm not going to say is exactly the

00:11:06.366 --> 00:11:07.027
same as ours,

00:11:07.067 --> 00:11:09.106
but there is some overlap at some points

00:11:09.486 --> 00:11:11.668
where we're all doing very similar things.

00:11:12.107 --> 00:11:14.089
And so if people are willing to pay

00:11:14.129 --> 00:11:15.149
those practitioners,

00:11:16.089 --> 00:11:18.370
I think that we are doing the profession

00:11:18.429 --> 00:11:20.210
and ourselves a disservice as physical

00:11:20.250 --> 00:11:22.270
therapists by being a bleeding heart and

00:11:22.331 --> 00:11:23.510
saying, well, no, no, no,

00:11:23.971 --> 00:11:26.292
let me figure out a way so you

00:11:26.312 --> 00:11:27.451
can use your insurance.

00:11:27.491 --> 00:11:29.513
When these people are coming to you and

00:11:29.613 --> 00:11:30.072
saying,

00:11:30.572 --> 00:11:32.274
I'm happy to pay you out of pocket.

00:11:32.695 --> 00:11:36.217
So that's what I mean by bleeding heart.

00:11:36.378 --> 00:11:39.640
I think we need a little more business

00:11:39.681 --> 00:11:40.961
knowledge, not a little,

00:11:41.101 --> 00:11:43.583
a lot more business knowledge in our PT

00:11:43.624 --> 00:11:44.225
schools.

00:11:44.825 --> 00:11:46.285
Even if you're going to go work for

00:11:46.346 --> 00:11:47.027
someone else,

00:11:47.167 --> 00:11:50.909
understanding this is how you can maximize

00:11:51.009 --> 00:11:51.490
billing.

00:11:51.750 --> 00:11:53.471
I can tell you for seven years of

00:11:53.491 --> 00:11:54.072
my career,

00:11:54.472 --> 00:11:57.316
I charged an eval and that's it.

00:11:58.399 --> 00:11:59.298
That's crazy.

00:11:59.798 --> 00:12:01.580
I should have been charging therapeutic

00:12:01.620 --> 00:12:03.779
activity because I spent fifteen minutes

00:12:04.120 --> 00:12:06.541
explaining a home exercise program or

00:12:06.681 --> 00:12:09.981
teaching how the proper way to move them

00:12:10.042 --> 00:12:12.121
from the bed to wherever.

00:12:13.482 --> 00:12:15.623
But it was never presented to me in

00:12:15.682 --> 00:12:18.004
a business manner of here's what you're

00:12:18.024 --> 00:12:18.344
doing.

00:12:18.384 --> 00:12:19.423
Here's how you do it.

00:12:20.943 --> 00:12:22.664
In a way to to make revenue,

00:12:22.725 --> 00:12:25.686
because that's where this all goes is I

00:12:25.806 --> 00:12:26.725
feel like we are.

00:12:27.677 --> 00:12:30.938
pushing the profession to a point where

00:12:31.818 --> 00:12:33.200
it's not gonna be sustainable.

00:12:33.379 --> 00:12:35.260
Because we are such bleeding hearts,

00:12:36.442 --> 00:12:38.462
patients aren't gonna have a place to go

00:12:38.543 --> 00:12:40.423
because there's not going to be a business

00:12:40.443 --> 00:12:41.345
to sustain that.

00:12:41.950 --> 00:12:43.251
I've used this before and I can't remember

00:12:43.272 --> 00:12:43.972
who I stole it from,

00:12:43.993 --> 00:12:45.474
which was like the lifeboat analogy.

00:12:45.835 --> 00:12:47.336
If you have a lifeboat and it says

00:12:47.636 --> 00:12:50.000
this lifeboat will hold one thousand

00:12:50.039 --> 00:12:53.283
pounds and you've got ten people that are

00:12:53.322 --> 00:12:54.063
all one hundred pounds.

00:12:54.083 --> 00:12:55.065
I don't know who these people are.

00:12:55.085 --> 00:12:55.806
They're all one hundred pounds,

00:12:55.826 --> 00:12:56.626
but I'm not good with math.

00:12:57.048 --> 00:12:58.568
And there's one more person in the water

00:12:59.029 --> 00:12:59.931
and you pull them in.

00:13:00.291 --> 00:13:01.253
You all sink.

00:13:02.192 --> 00:13:04.494
I nobody wants to leave most people.

00:13:04.573 --> 00:13:05.794
Most people don't want to leave an extra

00:13:05.815 --> 00:13:06.534
person in the water.

00:13:06.554 --> 00:13:07.375
Right.

00:13:07.434 --> 00:13:09.655
Ninety nine percent of all PTs would opt

00:13:09.735 --> 00:13:11.576
to bring that person in the water or

00:13:11.596 --> 00:13:12.157
sorry, in the boat.

00:13:13.057 --> 00:13:14.817
But then we like if the clinic goes

00:13:14.878 --> 00:13:17.359
down, we help no one.

00:13:18.419 --> 00:13:21.400
So we need how do we scrub this

00:13:21.421 --> 00:13:22.321
from our DNA?

00:13:22.400 --> 00:13:23.662
How do we get the Peace Corps gene

00:13:23.741 --> 00:13:25.482
out of it without losing the heart?

00:13:26.043 --> 00:13:26.802
Yeah.

00:13:26.863 --> 00:13:28.124
Which is and again,

00:13:29.692 --> 00:13:30.933
Lauren, myself,

00:13:31.153 --> 00:13:32.835
most people are not asking you or telling

00:13:32.855 --> 00:13:33.855
you to do anything unethical.

00:13:34.134 --> 00:13:38.356
We're asking you to understand how gravity

00:13:38.376 --> 00:13:40.839
works and sunlight and physics and

00:13:41.158 --> 00:13:42.580
understand the physics of what you're

00:13:42.600 --> 00:13:43.159
talking about.

00:13:43.879 --> 00:13:45.880
But here's a question,

00:13:45.900 --> 00:13:47.182
but it's almost rhetorical, but like,

00:13:47.461 --> 00:13:48.903
where do you put this in PT school?

00:13:48.962 --> 00:13:51.063
Is this a hot topic?

00:13:51.649 --> 00:13:52.211
weekend?

00:13:52.431 --> 00:13:53.251
Is this a day?

00:13:53.753 --> 00:13:55.054
Is this sprinkled throughout?

00:13:55.634 --> 00:13:56.537
We've got, I mean,

00:13:56.557 --> 00:13:57.317
what do you take out?

00:13:57.337 --> 00:13:57.958
We've got, you know,

00:13:57.979 --> 00:13:59.419
you getting hit with a fire hose.

00:14:00.341 --> 00:14:01.663
I don't know the answer because I'm not

00:14:01.703 --> 00:14:02.063
an academic.

00:14:02.083 --> 00:14:03.525
I'm going to stop talking about academic

00:14:03.546 --> 00:14:04.827
things because I haven't been in it.

00:14:04.868 --> 00:14:06.330
So I can't speak on that behalf.

00:14:06.716 --> 00:14:08.096
No, I think that you're right, though.

00:14:08.336 --> 00:14:08.537
I mean,

00:14:09.037 --> 00:14:10.357
the program that I teach in is

00:14:10.418 --> 00:14:10.998
accelerated.

00:14:11.359 --> 00:14:12.619
Our students are getting their doctorate

00:14:12.658 --> 00:14:13.340
in two years.

00:14:13.360 --> 00:14:16.301
So you talk about firehose of traditional

00:14:16.341 --> 00:14:18.623
PT program and now you've accelerated it.

00:14:19.062 --> 00:14:20.023
And I think, you know,

00:14:20.244 --> 00:14:21.844
even in PT school,

00:14:21.884 --> 00:14:24.745
would I have been receptive to this?

00:14:24.785 --> 00:14:26.726
Would I have had the context to then

00:14:26.866 --> 00:14:27.908
understand?

00:14:28.648 --> 00:14:31.250
what is trying to be said to me

00:14:31.289 --> 00:14:33.351
when I haven't gone out and build.

00:14:33.392 --> 00:14:34.152
I mean, like I said,

00:14:34.532 --> 00:14:36.573
I was seven years in and I was

00:14:36.774 --> 00:14:38.414
angry when my clinic was like,

00:14:38.735 --> 00:14:41.017
we're gonna stop buying in the really good

00:14:41.157 --> 00:14:43.077
E-Stim pads and we're gonna buy the E-Stim

00:14:43.118 --> 00:14:44.219
pads that work,

00:14:44.720 --> 00:14:46.480
but they're not top of the line.

00:14:46.581 --> 00:14:48.182
I was like, this is ridiculous.

00:14:48.501 --> 00:14:51.083
And now looking back, I'm like, oh,

00:14:51.583 --> 00:14:53.085
I see, I understand.

00:14:53.525 --> 00:14:54.706
So I think for me,

00:14:56.696 --> 00:14:59.822
my clinic giving me that information and

00:14:59.863 --> 00:15:00.283
saying,

00:15:00.644 --> 00:15:04.273
because I'm looking at hiring someone to

00:15:04.312 --> 00:15:05.456
come in and help me.

00:15:08.077 --> 00:15:10.158
what I said is if we understand this

00:15:10.220 --> 00:15:11.921
to the point where we can maximize our

00:15:11.961 --> 00:15:13.100
billing, again, like you said,

00:15:13.120 --> 00:15:14.162
without being unethical,

00:15:14.422 --> 00:15:16.943
without totally being soulless,

00:15:16.964 --> 00:15:17.985
because I'm not,

00:15:18.264 --> 00:15:19.706
I got in this to help people,

00:15:20.105 --> 00:15:21.927
but I also see, again,

00:15:22.047 --> 00:15:24.448
we have to make this sustainable to be

00:15:24.509 --> 00:15:25.970
able to continue to help people.

00:15:26.850 --> 00:15:29.753
If we can maximize our billing and

00:15:29.793 --> 00:15:32.433
maximize our time and maybe pick up other

00:15:32.514 --> 00:15:34.216
sources of revenue,

00:15:35.255 --> 00:15:35.496
then

00:15:36.498 --> 00:15:37.500
I can pay you more.

00:15:38.140 --> 00:15:39.804
But we have these students who are coming

00:15:39.845 --> 00:15:40.846
out of school and they want a hundred

00:15:40.886 --> 00:15:41.749
thousand dollars.

00:15:42.884 --> 00:15:44.445
your clinic's not making a hundred

00:15:44.465 --> 00:15:45.346
thousand dollars.

00:15:46.187 --> 00:15:48.248
How do you expect them to pay you

00:15:48.268 --> 00:15:48.528
that?

00:15:48.649 --> 00:15:48.928
You know,

00:15:49.009 --> 00:15:50.690
if you're willing to come in and say,

00:15:50.809 --> 00:15:53.072
I have these six ideas that I think

00:15:53.111 --> 00:15:55.994
we could maximize billing in this way,

00:15:56.293 --> 00:15:57.875
and we could be a hybrid and I'll

00:15:57.916 --> 00:16:00.317
run this extra class three days a week

00:16:00.498 --> 00:16:02.619
after hours or whatever,

00:16:02.940 --> 00:16:04.260
now pay me more money.

00:16:04.640 --> 00:16:05.562
Okay.

00:16:05.601 --> 00:16:06.261
Let's talk.

00:16:07.102 --> 00:16:07.984
But I think that

00:16:09.065 --> 00:16:10.727
it's clinic owners too.

00:16:10.748 --> 00:16:13.672
And I'm really talking because you look at

00:16:13.711 --> 00:16:16.255
some of these big private equity groups,

00:16:17.289 --> 00:16:18.529
it's volume, right?

00:16:18.590 --> 00:16:20.971
They can take that low contract because

00:16:20.990 --> 00:16:23.052
they're willing to put their therapist

00:16:23.451 --> 00:16:25.653
seeing twenty, thirty people a day,

00:16:25.913 --> 00:16:27.013
which is crazy to me.

00:16:27.094 --> 00:16:29.234
I've only worked in places that I see

00:16:29.333 --> 00:16:30.174
one patient an hour,

00:16:30.215 --> 00:16:31.914
but it is a little different in neuro.

00:16:33.556 --> 00:16:33.956
But, you know,

00:16:34.535 --> 00:16:36.417
it's these smaller clinics that are

00:16:36.897 --> 00:16:39.138
getting taken out of

00:16:40.432 --> 00:16:42.695
essentially our economic chain because

00:16:42.715 --> 00:16:46.076
they can't keep up with the low contract

00:16:46.136 --> 00:16:48.638
rates that other larger companies are

00:16:48.717 --> 00:16:51.139
acquiring because they have the volume to

00:16:51.179 --> 00:16:51.659
do so.

00:16:52.480 --> 00:16:53.581
But then we're losing.

00:16:53.701 --> 00:16:56.023
We're losing wonderful clinicians because

00:16:56.062 --> 00:16:56.923
they're tired.

00:16:57.663 --> 00:17:00.046
In what other profession does someone go

00:17:00.066 --> 00:17:02.027
get a doctorate degree and within five

00:17:02.067 --> 00:17:04.749
years is burned out and leaves the

00:17:04.788 --> 00:17:05.249
profession?

00:17:05.680 --> 00:17:05.960
Yeah, I mean,

00:17:05.980 --> 00:17:07.241
I was listening to a talk on burnout

00:17:07.281 --> 00:17:09.144
every day and I don't disagree that it's

00:17:09.163 --> 00:17:09.364
there.

00:17:09.424 --> 00:17:09.884
I felt it.

00:17:11.707 --> 00:17:12.708
Why does it come about?

00:17:13.108 --> 00:17:14.631
This could be its own series.

00:17:14.651 --> 00:17:16.353
I could do an entire week of things

00:17:16.373 --> 00:17:16.993
like this, right?

00:17:17.034 --> 00:17:20.218
But if I feel like I'm getting taken

00:17:20.258 --> 00:17:20.798
advantage of,

00:17:21.788 --> 00:17:23.171
That is like a rock in my...

00:17:23.750 --> 00:17:25.933
A pebble in my shoe every step.

00:17:26.815 --> 00:17:28.237
So burnout doesn't come like a...

00:17:28.856 --> 00:17:30.318
I touch the hot stove and there's a

00:17:30.398 --> 00:17:30.740
scar.

00:17:30.779 --> 00:17:34.103
It's like it's small and a pebble in

00:17:34.183 --> 00:17:35.724
every step until it's this thing that

00:17:35.744 --> 00:17:36.326
won't heal.

00:17:38.067 --> 00:17:38.929
You mentioned somewhere...

00:17:39.877 --> 00:17:41.398
That feels like it's opposite.

00:17:41.439 --> 00:17:43.942
It feels like when someone says cash-based

00:17:44.182 --> 00:17:45.482
something, it's orthopedics.

00:17:46.284 --> 00:17:47.305
Why do you think cash...

00:17:47.384 --> 00:17:50.027
These two terms feel like they don't

00:17:50.067 --> 00:17:51.268
puzzle piece together ever.

00:17:51.607 --> 00:17:53.269
Cash-based neuro.

00:17:53.589 --> 00:17:55.412
This goes like soulless.

00:17:55.912 --> 00:17:56.792
I'm using air quotes here.

00:17:56.813 --> 00:17:57.313
Cash.

00:17:57.733 --> 00:17:59.775
And then all of the hearts and feels,

00:18:00.056 --> 00:18:00.895
neuro.

00:18:00.935 --> 00:18:02.278
It feels like those two things don't go

00:18:02.317 --> 00:18:02.718
together.

00:18:03.178 --> 00:18:03.338
But...

00:18:04.239 --> 00:18:05.461
They did, obviously.

00:18:05.480 --> 00:18:06.201
You put them together.

00:18:06.462 --> 00:18:07.743
Why do you feel like those two things

00:18:07.763 --> 00:18:09.105
together get so much pushback,

00:18:09.968 --> 00:18:11.410
especially from inside the profession?

00:18:12.135 --> 00:18:12.375
up.

00:18:12.395 --> 00:18:13.876
I think there's a lot of reasons.

00:18:14.137 --> 00:18:17.339
I think one big reason that PTs feel

00:18:17.359 --> 00:18:18.921
this way is because,

00:18:19.602 --> 00:18:21.002
and I do think that there is a

00:18:21.063 --> 00:18:21.383
shift.

00:18:21.403 --> 00:18:23.964
I've talked to people on social media and,

00:18:24.244 --> 00:18:25.445
you know, kind of across the country.

00:18:25.506 --> 00:18:27.248
I do think there's a shift people are

00:18:27.288 --> 00:18:27.607
seeing.

00:18:28.028 --> 00:18:29.588
I think the big piece is, you know,

00:18:29.628 --> 00:18:31.570
a neurologic injury, spinal cord injury,

00:18:31.590 --> 00:18:34.353
brain injury, stroke, they're not cheap.

00:18:34.833 --> 00:18:38.036
And so there are so many other medical

00:18:38.395 --> 00:18:41.479
factors that are coming into play.

00:18:41.659 --> 00:18:41.798
The

00:18:43.523 --> 00:18:47.286
Other thing that I think why it works,

00:18:47.645 --> 00:18:48.826
what I'm doing, and again,

00:18:49.166 --> 00:18:50.528
I like to be very transparent.

00:18:50.587 --> 00:18:51.848
I'm a low volume clinic.

00:18:53.613 --> 00:18:56.076
want forty patients per week because I

00:18:56.115 --> 00:18:58.817
can't give everything that I need to give.

00:18:58.897 --> 00:18:59.098
You know,

00:18:59.179 --> 00:19:02.442
I'll leave a patient's house and I might

00:19:02.461 --> 00:19:04.463
make two hours of phone calls getting

00:19:04.584 --> 00:19:07.727
wheelchairs ready, getting DME splints,

00:19:08.048 --> 00:19:11.230
getting bath equipment coordinated with

00:19:11.351 --> 00:19:13.133
other departments in the state.

00:19:13.873 --> 00:19:14.094
You know,

00:19:15.349 --> 00:19:16.550
doing that forty hours a week,

00:19:16.611 --> 00:19:18.913
then I'm back to where I was seven

00:19:18.952 --> 00:19:19.413
years ago.

00:19:19.432 --> 00:19:20.433
And I was like, I'm done.

00:19:20.773 --> 00:19:22.234
I will go work at Lululemon.

00:19:22.694 --> 00:19:24.375
I'm finished being a PT.

00:19:25.376 --> 00:19:26.377
And so I think

00:19:27.750 --> 00:19:31.053
where my clinic's vision initially was is

00:19:31.113 --> 00:19:33.173
that there is a subset of people who

00:19:33.213 --> 00:19:35.674
get discharged from insurance,

00:19:35.714 --> 00:19:37.756
from physical therapy, sorry,

00:19:37.855 --> 00:19:39.896
from physical therapy because of insurance

00:19:39.916 --> 00:19:43.057
limitations, you know, lack of progress,

00:19:43.118 --> 00:19:43.979
whatever it may be,

00:19:44.019 --> 00:19:47.320
who still want care because it's twelve

00:19:47.381 --> 00:19:51.082
weeks of neurologic specific physical

00:19:51.122 --> 00:19:51.583
therapy

00:19:52.583 --> 00:19:54.463
isn't getting most people back to where

00:19:54.483 --> 00:19:57.226
they want to be so what we're seeing

00:19:57.266 --> 00:19:58.987
is a lot of people coming into that

00:19:59.067 --> 00:20:02.269
space what mine has evolved into is people

00:20:02.308 --> 00:20:05.269
who want more frequency so i'll have

00:20:05.410 --> 00:20:08.092
people who see their you know

00:20:08.192 --> 00:20:11.114
insurance-based therapist two or three

00:20:11.134 --> 00:20:12.753
days a week and then they see me

00:20:12.795 --> 00:20:14.675
the other one or two days a week

00:20:15.875 --> 00:20:17.376
and then they're getting four to five days

00:20:17.396 --> 00:20:18.778
a week of therapy and we know what

00:20:18.798 --> 00:20:20.398
that means for neuroplasticity

00:20:21.163 --> 00:20:22.944
But they don't have the bill that comes

00:20:22.984 --> 00:20:24.766
along with an out of network therapist for

00:20:24.826 --> 00:20:25.506
five days a week.

00:20:25.865 --> 00:20:28.347
So again, it's creating a model.

00:20:28.488 --> 00:20:29.929
And what I try and tell people is

00:20:29.949 --> 00:20:31.950
like, what is your quality of life worth?

00:20:32.569 --> 00:20:35.111
You know, if your quality of life is,

00:20:35.371 --> 00:20:38.113
is worth what insurance is going to pay.

00:20:39.246 --> 00:20:40.586
then that's fine.

00:20:41.166 --> 00:20:42.147
That's your choice.

00:20:42.347 --> 00:20:43.769
But if you want more,

00:20:44.549 --> 00:20:46.730
insurance isn't going to cover everything

00:20:46.750 --> 00:20:49.292
that you need, nor, you know,

00:20:49.413 --> 00:20:51.114
does it always.

00:20:51.974 --> 00:20:53.776
We always have, and too,

00:20:53.796 --> 00:20:55.797
we can get into a lot of these

00:20:55.856 --> 00:20:56.738
places, you know,

00:20:56.778 --> 00:20:58.659
it might take an hour to get this

00:20:58.679 --> 00:21:01.520
person out of bed, dressed, ready to go.

00:21:01.681 --> 00:21:02.381
Then you've got a

00:21:09.486 --> 00:21:09.726
You know,

00:21:09.746 --> 00:21:11.288
an out of network therapist is going to

00:21:11.327 --> 00:21:11.667
cost.

00:21:11.728 --> 00:21:13.589
And for me, I come to your home.

00:21:13.650 --> 00:21:15.771
So now all that travel and everything

00:21:15.892 --> 00:21:17.373
isn't isn't there anymore.

00:21:17.452 --> 00:21:19.575
So I think you're right.

00:21:19.674 --> 00:21:20.476
It's not done.

00:21:20.496 --> 00:21:21.176
And there's a few.

00:21:21.416 --> 00:21:23.878
So so part of the bleeding heart issue

00:21:24.058 --> 00:21:24.720
is part of it.

00:21:24.960 --> 00:21:26.721
The other part is the Medicare issue.

00:21:27.382 --> 00:21:27.642
You know,

00:21:27.662 --> 00:21:30.505
we can't opt out of Medicare if I

00:21:30.545 --> 00:21:31.326
go in and say.

00:21:31.885 --> 00:21:33.287
you're a Medicare beneficiary,

00:21:33.366 --> 00:21:34.887
I'm going to do an evaluation on you

00:21:34.928 --> 00:21:36.009
and it's two hundred dollars.

00:21:36.088 --> 00:21:40.311
I've just committed fraud and I have legal

00:21:40.372 --> 00:21:40.731
risks.

00:21:40.852 --> 00:21:42.374
So you can't do it.

00:21:42.933 --> 00:21:46.056
And that's a whole nother conversation

00:21:46.115 --> 00:21:48.758
that could take up more time.

00:21:48.958 --> 00:21:50.659
But that being said,

00:21:51.259 --> 00:21:53.842
I think that those are two big reasons

00:21:53.902 --> 00:21:57.483
of why you're not seeing this as much.

00:21:57.523 --> 00:21:58.184
But it's coming.

00:21:58.605 --> 00:21:59.865
I really think that it's coming.

00:22:00.336 --> 00:22:01.977
Have you ever heard of next step,

00:22:02.717 --> 00:22:03.576
next step fitness?

00:22:04.897 --> 00:22:06.939
So I met Yanni Corey who founded that,

00:22:07.338 --> 00:22:08.578
you know, and I, you know,

00:22:08.598 --> 00:22:09.319
I was just thinking, I was like,

00:22:09.420 --> 00:22:10.720
I haven't had Yanni on the show in

00:22:10.740 --> 00:22:11.300
a couple of years.

00:22:12.361 --> 00:22:14.442
He hates the system, but loves PTs.

00:22:15.082 --> 00:22:15.761
And then he's like,

00:22:15.862 --> 00:22:18.864
I've taken heat from PTs because he sets

00:22:18.923 --> 00:22:20.544
up essentially next step fitness is like

00:22:21.065 --> 00:22:21.744
Yanni got injured.

00:22:23.595 --> 00:22:24.476
went through PT.

00:22:25.135 --> 00:22:26.698
It wasn't enough, right?

00:22:27.077 --> 00:22:29.099
The insurance didn't cover what he needed.

00:22:29.819 --> 00:22:31.961
He was at least financially able to go

00:22:32.021 --> 00:22:32.461
get that.

00:22:32.602 --> 00:22:33.903
He's like, dude,

00:22:33.963 --> 00:22:36.806
I was in the point one percent who

00:22:36.826 --> 00:22:38.487
was able to fly to Kentucky and live

00:22:38.527 --> 00:22:41.369
there and work with this really advanced

00:22:41.430 --> 00:22:43.211
neuro PT for months.

00:22:43.991 --> 00:22:45.373
Who can do that?

00:22:45.413 --> 00:22:47.375
So his next step is essentially he wants

00:22:47.394 --> 00:22:48.275
to set up gyms

00:22:49.686 --> 00:22:51.769
that have the right equipment that people

00:22:51.809 --> 00:22:53.191
pay membership to be at.

00:22:53.551 --> 00:22:53.912
But he's like,

00:22:54.011 --> 00:22:55.294
I have to leave PTs out of the

00:22:55.334 --> 00:22:57.416
equation because they're too expensive.

00:22:57.717 --> 00:22:59.700
But he's like, I want their brain,

00:22:59.720 --> 00:23:01.801
but I can't pay for this.

00:23:01.862 --> 00:23:03.324
And he's right that math doesn't math.

00:23:03.785 --> 00:23:05.046
So what he does is he brings PTs

00:23:05.066 --> 00:23:05.968
into train trainers.

00:23:07.147 --> 00:23:08.087
to make sure that they're,

00:23:08.188 --> 00:23:09.188
they're understanding.

00:23:09.528 --> 00:23:11.588
And like, I'm like, but here's the point.

00:23:12.328 --> 00:23:13.429
If PTs don't like that,

00:23:13.489 --> 00:23:14.789
it's like people are still getting great

00:23:14.809 --> 00:23:18.170
care and a PT touched them one degree

00:23:18.210 --> 00:23:18.790
removed.

00:23:19.351 --> 00:23:20.790
So it's like Yanni was like,

00:23:20.830 --> 00:23:21.871
I'm not going to stand here yelling at

00:23:21.911 --> 00:23:22.351
clouds.

00:23:22.371 --> 00:23:23.070
I'm just going to fix,

00:23:23.090 --> 00:23:23.912
I'm going to create something.

00:23:24.071 --> 00:23:24.132
I,

00:23:24.152 --> 00:23:25.311
he had to create his own solution and

00:23:25.352 --> 00:23:25.711
he did.

00:23:25.731 --> 00:23:27.092
You can't fault someone for that.

00:23:27.731 --> 00:23:27.971
No.

00:23:28.113 --> 00:23:29.992
And is he based out of Kansas city?

00:23:31.148 --> 00:23:33.171
He is based at a, he probably,

00:23:33.510 --> 00:23:34.593
his goal is to have one of these

00:23:34.613 --> 00:23:35.554
at least in every state.

00:23:35.594 --> 00:23:36.934
So he's out of California.

00:23:36.954 --> 00:23:37.315
I know that,

00:23:37.335 --> 00:23:39.017
but I think he has one in Kansas.

00:23:39.257 --> 00:23:40.018
Yeah, here it is.

00:23:40.038 --> 00:23:42.240
LA, Atlanta, Kansas City, Orlando,

00:23:42.299 --> 00:23:44.021
Raleigh, Vegas, Pittsburgh, New Zealand,

00:23:44.102 --> 00:23:44.482
Ukraine.

00:23:44.702 --> 00:23:45.703
So those are all the locations.

00:23:45.723 --> 00:23:45.943
Wow.

00:23:46.297 --> 00:23:47.698
I've got, so I've got two,

00:23:48.377 --> 00:23:49.417
I've lived in Kansas City.

00:23:49.438 --> 00:23:52.098
I've got two former patients who go there

00:23:52.179 --> 00:23:52.578
and they love it.

00:23:52.598 --> 00:23:54.079
They've been going there for, I mean,

00:23:54.559 --> 00:23:56.181
I've been gone from Kansas City for almost

00:23:56.381 --> 00:23:57.240
four or five years.

00:23:57.280 --> 00:23:58.541
They've been going there that long.

00:23:58.942 --> 00:24:00.321
And, you know, like you said,

00:24:00.362 --> 00:24:02.383
I think that's the big piece of it

00:24:02.442 --> 00:24:04.463
is they have the equipment.

00:24:04.903 --> 00:24:07.786
Yes, that's the FBS bike.

00:24:07.806 --> 00:24:09.906
They've got the arc X that's now come

00:24:10.027 --> 00:24:12.647
out standing frames, the excite.

00:24:12.748 --> 00:24:12.948
I mean,

00:24:13.188 --> 00:24:15.970
every piece of equipment and at least the

00:24:16.009 --> 00:24:18.070
one in Kansas City is it does all

00:24:18.111 --> 00:24:18.691
diagnoses,

00:24:18.730 --> 00:24:20.972
but it's really specialized to spinal cord

00:24:21.012 --> 00:24:21.313
injury.

00:24:22.032 --> 00:24:24.214
um and so it's like you know these

00:24:24.295 --> 00:24:26.277
things are pieces of equipment i mean the

00:24:26.356 --> 00:24:29.940
arcx is forty thousand dollars like you

00:24:29.960 --> 00:24:32.481
know but they have it and again it's

00:24:32.582 --> 00:24:35.984
it's based on a cash pay rate it's

00:24:36.105 --> 00:24:40.808
someone else who found people will pay you

00:24:41.469 --> 00:24:44.892
if you show up so you know at

00:24:44.912 --> 00:24:45.593
that point

00:24:47.412 --> 00:24:48.991
Why aren't we doing more of this?

00:24:49.192 --> 00:24:50.772
And I totally agree.

00:24:50.913 --> 00:24:53.053
I think people are much more willing to

00:24:53.093 --> 00:24:54.074
pay a trainer,

00:24:54.374 --> 00:24:56.374
fifty to seventy dollars an hour than they

00:24:56.413 --> 00:24:57.554
are to pay a PT,

00:24:57.693 --> 00:24:59.075
one hundred and twenty five,

00:24:59.535 --> 00:25:02.654
whether you're going to get better or

00:25:02.734 --> 00:25:05.715
different care from either one.

00:25:05.855 --> 00:25:08.037
At some point, the cost is the problem.

00:25:08.076 --> 00:25:09.076
So how do we fix that?

00:25:10.542 --> 00:25:13.444
Well, we now hire those personal trainers.

00:25:13.644 --> 00:25:15.945
We oversee what's happening.

00:25:16.026 --> 00:25:18.426
I mean, eventually in my mind,

00:25:18.487 --> 00:25:21.368
that's where I want this to head is

00:25:21.429 --> 00:25:24.809
that I want to oversee personal trainers

00:25:24.871 --> 00:25:26.510
who are willing to work with this

00:25:26.550 --> 00:25:28.551
population because it's a very niche

00:25:28.592 --> 00:25:29.192
population.

00:25:29.972 --> 00:25:31.513
Personal trainers can go out and work with

00:25:31.554 --> 00:25:33.596
anyone who is an able-bodied individual.

00:25:34.016 --> 00:25:36.238
You bring in someone who's swinging at you

00:25:36.278 --> 00:25:41.020
mid-session or crying mid-session or has

00:25:41.401 --> 00:25:43.663
bones that are super brittle because they

00:25:43.722 --> 00:25:47.244
haven't stood or walked in years.

00:25:48.006 --> 00:25:50.887
It could be a recipe for disaster if

00:25:50.948 --> 00:25:52.749
it's not properly supervised.

00:25:52.888 --> 00:25:55.050
So I do think that...

00:25:56.088 --> 00:25:57.352
There's got to be a way that we

00:25:57.372 --> 00:25:59.977
can all play nice in the sandbox,

00:26:00.076 --> 00:26:02.981
but there's just a very big divide between

00:26:03.644 --> 00:26:04.464
that model right now.

00:26:04.986 --> 00:26:06.128
I said you could be mad.

00:26:06.189 --> 00:26:07.391
You could be as mad as you want.

00:26:08.549 --> 00:26:09.490
at the situation,

00:26:09.570 --> 00:26:11.592
but don't be mad at someone else for

00:26:11.692 --> 00:26:13.432
solving the problem that they're stuck in.

00:26:13.492 --> 00:26:14.653
Yanni's in a chair, man.

00:26:15.333 --> 00:26:16.933
And so the only way to get better

00:26:17.775 --> 00:26:20.796
was to quite literally chart his own

00:26:20.836 --> 00:26:21.236
course.

00:26:21.977 --> 00:26:23.877
He's nice enough to not, I mean,

00:26:23.897 --> 00:26:25.018
he could have just bought all this stuff

00:26:25.699 --> 00:26:27.299
himself or just solved his own problem.

00:26:27.720 --> 00:26:29.500
He now takes his time, his effort, his,

00:26:29.520 --> 00:26:30.441
you know, his energy,

00:26:30.540 --> 00:26:31.461
and he tries to solve it.

00:26:31.481 --> 00:26:33.103
And again, ambitious goal.

00:26:33.202 --> 00:26:33.482
He's like,

00:26:33.522 --> 00:26:34.702
I want one of these in every state,

00:26:34.803 --> 00:26:35.644
in every major city.

00:26:37.292 --> 00:26:38.413
And the fact that he's the only one

00:26:38.452 --> 00:26:40.034
should, you know, anger people.

00:26:40.473 --> 00:26:40.693
Right.

00:26:40.713 --> 00:26:41.374
So look him up.

00:26:41.473 --> 00:26:43.394
I'll give the next step fitness.org.

00:26:43.434 --> 00:26:44.075
Just look into it.

00:26:44.154 --> 00:26:45.336
If it's in the city, go tour it.

00:26:46.576 --> 00:26:46.695
Yeah.

00:26:46.715 --> 00:26:47.776
Yanni's the first guy who go come in

00:26:47.816 --> 00:26:48.016
here,

00:26:48.336 --> 00:26:50.356
steal everything I'm doing and go do it

00:26:50.396 --> 00:26:50.896
somewhere else.

00:26:50.936 --> 00:26:51.857
He's the first guy.

00:26:51.877 --> 00:26:52.837
He'll show you how to do it.

00:26:52.897 --> 00:26:53.218
I bet.

00:26:54.038 --> 00:26:54.498
You mentioned,

00:26:54.657 --> 00:26:55.919
you mentioned being in academics.

00:26:56.759 --> 00:26:58.859
You've called out or mentioned how,

00:26:58.900 --> 00:27:00.880
how does PT education misses its Mark?

00:27:01.259 --> 00:27:02.340
If you were building a,

00:27:03.125 --> 00:27:07.048
a PT program, dry erase board, blank,

00:27:07.807 --> 00:27:08.769
what would you change?

00:27:09.888 --> 00:27:10.409
Oh, man.

00:27:10.849 --> 00:27:11.849
Stop, start, continue.

00:27:11.890 --> 00:27:12.851
What would you stop doing?

00:27:12.931 --> 00:27:14.211
Start doing, continue.

00:27:14.490 --> 00:27:15.372
What does it look like?

00:27:15.392 --> 00:27:17.512
Or what's your one or two suggestions if

00:27:17.532 --> 00:27:18.593
you had a magic wand?

00:27:19.493 --> 00:27:20.594
If I had a magic wand,

00:27:20.854 --> 00:27:23.634
I would put everyone who is in academia

00:27:23.674 --> 00:27:26.817
back in the clinic and learning about

00:27:27.895 --> 00:27:28.915
what the billing is,

00:27:28.997 --> 00:27:30.977
what the AI is doing right now,

00:27:31.277 --> 00:27:33.397
what does a typical day for a physical

00:27:33.438 --> 00:27:35.759
therapist look like in your average PT

00:27:35.778 --> 00:27:36.079
clinic?

00:27:36.099 --> 00:27:38.840
That would be thing number one.

00:27:38.901 --> 00:27:41.241
Not just our four hours or our eight

00:27:41.261 --> 00:27:43.482
hours that are given to us in our

00:27:43.522 --> 00:27:44.163
contract.

00:27:44.663 --> 00:27:45.604
The other thing is,

00:27:46.124 --> 00:27:48.184
and I think it kind of rolls off

00:27:48.224 --> 00:27:48.565
of that,

00:27:48.684 --> 00:27:51.425
is things are changing and PT school

00:27:51.506 --> 00:27:53.126
education just isn't keeping up.

00:27:54.027 --> 00:27:55.607
So I think...

00:27:56.521 --> 00:27:58.884
The hands of time moves slowly in

00:27:59.025 --> 00:27:59.665
academia,

00:28:00.066 --> 00:28:03.210
and I think that just and I work

00:28:03.230 --> 00:28:04.951
for a very progressive program.

00:28:05.112 --> 00:28:06.794
That's the kind of crazy thing,

00:28:06.834 --> 00:28:07.694
but there's other.

00:28:10.247 --> 00:28:12.749
factors at play that you really have to

00:28:12.788 --> 00:28:15.009
stay within the constraints of the

00:28:15.130 --> 00:28:16.070
academic system.

00:28:16.211 --> 00:28:18.471
So even though you might be as progressive

00:28:18.511 --> 00:28:20.394
as you want to be, I mean,

00:28:20.594 --> 00:28:22.095
they're a two-year program and they

00:28:22.134 --> 00:28:23.476
started this ten years ago.

00:28:24.375 --> 00:28:26.758
You know, when you start this,

00:28:27.377 --> 00:28:28.338
you can be progressive,

00:28:28.358 --> 00:28:30.400
but you still have constraints that you

00:28:30.440 --> 00:28:31.280
have to monitor.

00:28:31.340 --> 00:28:32.981
So I think putting people in the clinic,

00:28:33.221 --> 00:28:35.604
one thing that comes to mind is like

00:28:35.624 --> 00:28:37.003
documentation.

00:28:37.384 --> 00:28:39.165
We spend time, you know,

00:28:39.715 --> 00:28:41.396
grading, soap notes,

00:28:41.518 --> 00:28:43.259
and all of these things.

00:28:43.398 --> 00:28:44.319
And I'm like, man,

00:28:44.880 --> 00:28:46.942
AI is doing most of this now.

00:28:47.342 --> 00:28:49.644
And then I took Tony Meritato's course,

00:28:50.664 --> 00:28:51.365
Zero to Paid.

00:28:52.307 --> 00:28:53.827
And he's like,

00:28:54.167 --> 00:28:56.069
you know what Medicare requires for a

00:28:56.130 --> 00:28:57.351
certified plan of care?

00:28:57.371 --> 00:28:58.511
Here's your three things.

00:28:58.571 --> 00:28:58.991
And I'm like,

00:28:59.132 --> 00:29:02.434
why are we in school teaching students

00:29:02.474 --> 00:29:04.436
that they have to write this novel

00:29:05.717 --> 00:29:07.657
when one AI will do it for you,

00:29:07.958 --> 00:29:08.478
which granted,

00:29:08.557 --> 00:29:10.278
I'm not saying like you have to go

00:29:10.378 --> 00:29:12.059
and you have to check it, right?

00:29:12.099 --> 00:29:14.000
I'm not saying we use AI unchecked,

00:29:14.560 --> 00:29:19.522
but we're using AI and Medicare doesn't

00:29:19.563 --> 00:29:21.044
require this novel.

00:29:21.104 --> 00:29:22.484
So why are we writing one?

00:29:23.345 --> 00:29:25.645
Somebody did an analysis years ago by

00:29:25.705 --> 00:29:26.246
APTA.

00:29:26.326 --> 00:29:28.946
We were over-documenting by a crazy double

00:29:28.967 --> 00:29:31.067
digit percentage and under-billing by a

00:29:31.107 --> 00:29:32.949
crazy double digit percentage and then

00:29:33.028 --> 00:29:34.490
saying we're overworked and underpaid.

00:29:36.921 --> 00:29:38.615
the calls coming from inside the house.

00:29:39.159 --> 00:29:40.440
The writing is on the wall.

00:29:41.920 --> 00:29:44.701
Yeah, and that's the thing is like again,

00:29:44.780 --> 00:29:46.701
it all goes back to we have to

00:29:46.721 --> 00:29:50.123
have educators who are educated in what's

00:29:50.163 --> 00:29:52.463
coming next and what's what's happening.

00:29:52.544 --> 00:29:53.765
And then we have to have a system

00:29:53.805 --> 00:29:55.566
who's willing to make these changes.

00:29:55.665 --> 00:29:58.727
And it's not just like this cool feature

00:29:58.807 --> 00:29:59.527
in a course.

00:29:59.626 --> 00:30:02.127
It's like this is how PT is is

00:30:02.228 --> 00:30:04.429
evolving and how it's going.

00:30:05.390 --> 00:30:06.390
You know, I've talked.

00:30:06.930 --> 00:30:09.771
Generally, with a friend, they own like,

00:30:09.791 --> 00:30:11.472
fifteen PT clinics and he's always

00:30:11.492 --> 00:30:11.833
approached me.

00:30:11.853 --> 00:30:13.414
He's like, let's start our own PT school.

00:30:13.454 --> 00:30:14.055
I'm like, no, no, no,

00:30:14.095 --> 00:30:14.895
we don't need to do that.

00:30:15.215 --> 00:30:18.877
But what we've talked about is how do

00:30:18.897 --> 00:30:21.180
you make something that's specialized to

00:30:21.240 --> 00:30:23.540
where if you're ready to run,

00:30:23.661 --> 00:30:24.961
if you know you're going to open a

00:30:25.001 --> 00:30:26.242
clinic, you start.

00:30:27.044 --> 00:30:27.983
It's a dual program.

00:30:28.023 --> 00:30:30.625
It's an MBA or a master's in health

00:30:30.645 --> 00:30:31.286
administration,

00:30:31.326 --> 00:30:34.388
something dual enrolling with PT and you

00:30:34.429 --> 00:30:36.410
come out and you're ready to go because.

00:30:37.590 --> 00:30:40.471
this journey of opening a clinic and just

00:30:40.612 --> 00:30:42.472
figuring out what are the rules,

00:30:42.553 --> 00:30:43.933
what can you do, what can't you do,

00:30:44.574 --> 00:30:47.076
has been just completely eye-opening.

00:30:47.115 --> 00:30:48.136
At some points I'm like,

00:30:48.737 --> 00:30:51.238
where do you even learn this?

00:30:51.278 --> 00:30:52.398
I've called people,

00:30:52.499 --> 00:30:56.921
I've had to use resources because it's

00:30:56.941 --> 00:30:57.761
like a secret club.

00:30:57.801 --> 00:30:59.603
It's like the Graham session sometimes.

00:30:59.623 --> 00:31:00.462
That's how I feel.

00:31:02.964 --> 00:31:04.026
If you don't know a mentor in the

00:31:04.046 --> 00:31:04.385
field,

00:31:05.287 --> 00:31:08.150
that's already done this who can help you?

00:31:11.153 --> 00:31:11.753
Where do you go?

00:31:11.814 --> 00:31:13.955
Where is the magic bullet of information

00:31:13.976 --> 00:31:15.917
that says, here's how you open a clinic?

00:31:16.378 --> 00:31:17.480
It's everywhere and nowhere.

00:31:17.539 --> 00:31:19.142
It's like you don't need permission,

00:31:19.182 --> 00:31:20.522
but you also need guide rails,

00:31:20.563 --> 00:31:21.584
but you could figure it out.

00:31:21.624 --> 00:31:23.086
But not everybody has the money, the time,

00:31:23.125 --> 00:31:24.487
or the risk tolerance.

00:31:25.711 --> 00:31:26.990
We need more people to do it,

00:31:27.030 --> 00:31:29.211
but whose job is it to help?

00:31:29.412 --> 00:31:30.251
It's everybody's job,

00:31:30.271 --> 00:31:31.173
but it's nobody's job.

00:31:31.252 --> 00:31:33.393
Who gets in trouble if we don't do

00:31:33.413 --> 00:31:35.394
this, and who's going to help us?

00:31:37.534 --> 00:31:38.094
Before I forget,

00:31:38.114 --> 00:31:39.555
I'll say thanks to Empower EMR,

00:31:39.595 --> 00:31:41.934
the platform helping clinics simplify

00:31:41.955 --> 00:31:43.855
documentation, improve patient engagement,

00:31:43.915 --> 00:31:44.655
and get their time back.

00:31:44.776 --> 00:31:45.977
EMR doesn't have to be painful.

00:31:46.497 --> 00:31:47.116
That's a choice,

00:31:47.777 --> 00:31:48.777
as long as you pick the right one.

00:31:48.916 --> 00:31:50.877
And who knows if Empower EMR is the

00:31:50.917 --> 00:31:51.498
right one for you?

00:31:51.837 --> 00:31:53.659
They understand there's a cost involved in

00:31:53.719 --> 00:31:54.078
change.

00:31:55.138 --> 00:31:57.446
So go just talk to Sharif there.

00:31:57.909 --> 00:31:59.233
EmpowerEMR.com.

00:31:59.273 --> 00:32:00.377
It's EmpowerEMR.

00:32:02.836 --> 00:32:05.675
You've mentioned being considered a

00:32:05.756 --> 00:32:07.696
graduate degree versus a professional

00:32:07.737 --> 00:32:08.416
degree before.

00:32:08.477 --> 00:32:08.856
I think that's,

00:32:08.896 --> 00:32:09.958
we started talking about that.

00:32:09.978 --> 00:32:12.018
That's the thing that was all the rage

00:32:12.038 --> 00:32:14.038
and we were signing petitions and we were

00:32:14.058 --> 00:32:15.318
going to March,

00:32:15.538 --> 00:32:16.900
March in Washington on this.

00:32:16.960 --> 00:32:17.720
How dare you?

00:32:17.759 --> 00:32:18.840
And I was like, you know,

00:32:18.861 --> 00:32:19.921
this is where I liked hanging out with

00:32:19.961 --> 00:32:20.240
Tony.

00:32:20.260 --> 00:32:20.621
He's a lot.

00:32:20.641 --> 00:32:20.881
He's like,

00:32:21.141 --> 00:32:23.402
did anything change besides a word in a

00:32:23.461 --> 00:32:23.781
book?

00:32:24.001 --> 00:32:24.961
It didn't matter anyway.

00:32:25.241 --> 00:32:25.442
Yeah.

00:32:26.962 --> 00:32:28.002
To begin with?

00:32:28.022 --> 00:32:28.523
Correct.

00:32:28.584 --> 00:32:29.044
That was the thing.

00:32:29.064 --> 00:32:29.884
When someone pointed that out,

00:32:29.923 --> 00:32:30.223
I didn't know.

00:32:30.243 --> 00:32:30.505
They're like,

00:32:30.525 --> 00:32:31.444
we didn't have the designation.

00:32:31.484 --> 00:32:33.006
It was sort of like we were on

00:32:33.086 --> 00:32:34.145
double secret probation.

00:32:34.165 --> 00:32:35.626
We were like allowed to, but weren't.

00:32:35.686 --> 00:32:36.626
And then it was taken away.

00:32:36.646 --> 00:32:37.027
I was like,

00:32:37.607 --> 00:32:38.827
this is like when you're in sales and

00:32:38.847 --> 00:32:40.048
you're like, I lost the sale.

00:32:40.148 --> 00:32:41.308
It's like, did you have the sale?

00:32:41.489 --> 00:32:42.190
How'd you lose it?

00:32:42.549 --> 00:32:43.190
You didn't have it.

00:32:43.210 --> 00:32:43.990
It was never yours.

00:32:44.330 --> 00:32:45.010
Don't feel bad.

00:32:45.691 --> 00:32:47.071
So why was that?

00:32:47.392 --> 00:32:47.832
I feel like,

00:32:47.991 --> 00:32:50.973
why was that a distraction important for

00:32:51.013 --> 00:32:51.513
the future?

00:32:51.534 --> 00:32:52.314
Maybe, I guess,

00:32:52.334 --> 00:32:53.934
maybe it got our attention at least.

00:32:55.342 --> 00:32:57.723
that was it was nuts because it was

00:32:57.763 --> 00:33:00.027
like okay there were rumblings and then it

00:33:00.047 --> 00:33:01.688
got a little louder so you saw a

00:33:01.768 --> 00:33:03.829
few people start talking about it and then

00:33:04.050 --> 00:33:06.653
all of a sudden all of social media

00:33:06.692 --> 00:33:08.694
was doing the well if i'm not considered

00:33:08.755 --> 00:33:11.718
professional anymore like whatever and i'm

00:33:11.758 --> 00:33:12.198
like wait

00:33:13.044 --> 00:33:13.544
to be clear,

00:33:13.564 --> 00:33:15.246
we were never considered professional.

00:33:15.266 --> 00:33:16.807
We didn't get anything taken from us.

00:33:16.846 --> 00:33:18.488
We just didn't get added to the list.

00:33:18.868 --> 00:33:21.070
But I think this is a really important

00:33:21.471 --> 00:33:22.571
because, you know,

00:33:22.672 --> 00:33:24.313
I have my own I have my own

00:33:24.353 --> 00:33:24.814
thoughts.

00:33:24.973 --> 00:33:27.316
I don't know that I have a strong

00:33:27.355 --> 00:33:29.257
opinion either way,

00:33:29.376 --> 00:33:31.679
which I think is kind of shocking for

00:33:31.739 --> 00:33:32.219
some people,

00:33:32.278 --> 00:33:34.381
because I can be very passionate about

00:33:34.480 --> 00:33:35.261
things when I'm ready.

00:33:35.662 --> 00:33:38.203
But I think the cost of tuition,

00:33:38.825 --> 00:33:41.267
when you look at our return on investment,

00:33:42.348 --> 00:33:43.169
is terrible.

00:33:43.609 --> 00:33:46.391
So something needs to change so we can,

00:33:47.030 --> 00:33:48.951
you know, have a better quality of life,

00:33:48.991 --> 00:33:49.432
essentially.

00:33:49.491 --> 00:33:50.012
I mean,

00:33:50.032 --> 00:33:51.653
there's people who are working three jobs

00:33:51.692 --> 00:33:53.134
to pay their student loans off.

00:33:53.173 --> 00:33:56.295
And that's, again, why are we burned out?

00:33:56.976 --> 00:33:59.636
Because you're working nine to five,

00:34:00.376 --> 00:34:02.877
five to nine, and then on the weekends,

00:34:03.018 --> 00:34:03.979
like you have no life.

00:34:04.858 --> 00:34:07.980
So I think like that's part of the

00:34:08.041 --> 00:34:08.501
equation.

00:34:08.581 --> 00:34:10.442
But again, I don't

00:34:11.409 --> 00:34:12.329
I think it could be good.

00:34:12.389 --> 00:34:14.211
I think it could be really bad where

00:34:14.431 --> 00:34:18.315
nothing changes and there's no more PTs

00:34:18.355 --> 00:34:21.177
because they can't afford to go to school.

00:34:21.257 --> 00:34:24.440
Obviously, that scenario is not great.

00:34:25.481 --> 00:34:26.621
We're seeing it in education.

00:34:27.043 --> 00:34:28.043
I don't know about where you live,

00:34:28.063 --> 00:34:28.744
but where I live,

00:34:29.304 --> 00:34:31.186
a lot of my friends were teachers, right?

00:34:31.527 --> 00:34:33.949
And I remember when people my age,

00:34:33.969 --> 00:34:36.530
so people born in the late seventies,

00:34:36.650 --> 00:34:36.990
eighties,

00:34:38.032 --> 00:34:40.353
to get a job in education in where

00:34:40.434 --> 00:34:42.016
i live in new york or long island

00:34:42.655 --> 00:34:45.918
you had to know someone to know someone

00:34:45.978 --> 00:34:48.221
my grandma's neighbor is the school super

00:34:48.240 --> 00:34:50.523
like you had to to get any job

00:34:50.842 --> 00:34:52.925
never mind the subject or the age you

00:34:52.945 --> 00:34:54.927
wanted to teach didn't matter now

00:34:55.978 --> 00:34:58.021
I think they're just driving around

00:34:58.101 --> 00:34:59.561
handing out teaching positions.

00:34:59.882 --> 00:35:00.222
Why?

00:35:00.762 --> 00:35:02.684
Because they made it a horrible thing.

00:35:02.985 --> 00:35:04.326
And now no one...

00:35:04.425 --> 00:35:05.726
And I mentioned this to someone else.

00:35:05.867 --> 00:35:07.628
Even if you made it great tomorrow,

00:35:07.648 --> 00:35:08.889
you're going to have to wait a few

00:35:08.909 --> 00:35:10.990
years for those high school kids to

00:35:11.030 --> 00:35:11.572
graduate,

00:35:11.612 --> 00:35:12.773
go through a couple years of school and

00:35:12.813 --> 00:35:13.893
come out and then start.

00:35:14.795 --> 00:35:15.635
We're not seeing...

00:35:15.715 --> 00:35:17.456
I feel like we're waiting for... We heard,

00:35:17.536 --> 00:35:18.358
we saw the lightning.

00:35:18.858 --> 00:35:20.018
We haven't felt the thunder yet.

00:35:20.503 --> 00:35:20.782
Yep.

00:35:21.023 --> 00:35:21.184
Yep.

00:35:21.264 --> 00:35:23.385
And that's what I feel like only time's

00:35:23.405 --> 00:35:25.407
going to tell with this decision, right?

00:35:25.507 --> 00:35:25.807
Is like,

00:35:26.327 --> 00:35:27.548
is it going to be a good thing?

00:35:27.708 --> 00:35:28.829
Is it going to be a bad thing?

00:35:28.869 --> 00:35:31.431
Because it's going to happen either way.

00:35:31.833 --> 00:35:33.373
So what do we do?

00:35:33.414 --> 00:35:35.195
And I think, you know, like I said,

00:35:35.315 --> 00:35:36.836
it was all the rage and then it

00:35:36.856 --> 00:35:38.898
kind of fizzled out.

00:35:39.099 --> 00:35:40.039
And again,

00:35:40.300 --> 00:35:43.543
it'll come back around when we start to

00:35:43.583 --> 00:35:44.784
see changes or things change.

00:35:46.092 --> 00:35:48.293
in this nature, but I don't, again,

00:35:48.313 --> 00:35:48.713
like I said,

00:35:48.974 --> 00:35:50.253
I don't know how I personally feel.

00:35:50.293 --> 00:35:51.434
And I put a lot of stuff out

00:35:51.474 --> 00:35:52.675
on my social media and I'm like,

00:35:52.976 --> 00:35:53.195
you know,

00:35:53.235 --> 00:35:54.757
if you're called and you feel like you

00:35:54.797 --> 00:35:55.496
wanna petition,

00:35:55.516 --> 00:35:57.898
the APTA has very strongly said, you know,

00:35:57.938 --> 00:35:59.739
that they're against this,

00:35:59.798 --> 00:36:03.240
which makes sense because there could be

00:36:03.340 --> 00:36:07.143
potential really not great impacts in the

00:36:07.182 --> 00:36:07.623
profession.

00:36:08.684 --> 00:36:09.184
And I see that.

00:36:09.204 --> 00:36:10.264
I'm gonna have to rewind.

00:36:10.485 --> 00:36:12.206
Did I just say we heard lightning?

00:36:12.981 --> 00:36:13.260
Did you?

00:36:14.402 --> 00:36:14.782
Probably.

00:36:15.322 --> 00:36:16.083
So someone's probably going,

00:36:16.123 --> 00:36:16.844
who is this guy?

00:36:18.306 --> 00:36:18.947
Sure you can.

00:36:19.568 --> 00:36:20.088
All right.

00:36:20.128 --> 00:36:22.670
So you're clearly passionate about

00:36:22.710 --> 00:36:25.273
changing stuff that you're passionate

00:36:25.293 --> 00:36:25.474
about.

00:36:25.574 --> 00:36:27.615
What's one step for a PT in your

00:36:27.655 --> 00:36:30.039
mind who feels stuck in the old model?

00:36:30.239 --> 00:36:31.340
Not not fifteen.

00:36:31.380 --> 00:36:32.081
Fifteen is too many.

00:36:32.420 --> 00:36:33.661
We know this with exercises,

00:36:33.963 --> 00:36:34.864
but we should also know this with

00:36:34.903 --> 00:36:35.724
professional steps.

00:36:36.471 --> 00:36:37.672
Give them one and you got a chance.

00:36:37.692 --> 00:36:38.813
Give them ten and you got no chance.

00:36:38.873 --> 00:36:40.813
What's one step for a PT who feels

00:36:40.853 --> 00:36:43.135
stuck in the old model and wants to

00:36:43.175 --> 00:36:43.675
break free?

00:36:44.376 --> 00:36:45.478
What advice would you give them?

00:36:46.597 --> 00:36:48.760
I would say go start an LLC.

00:36:49.900 --> 00:36:52.902
It takes, in most states, a hundred bucks.

00:36:53.463 --> 00:36:54.704
Go start your LLC.

00:36:55.965 --> 00:36:58.106
And I'm a big believer when I started

00:36:58.126 --> 00:36:58.567
this.

00:36:58.666 --> 00:36:58.927
I mean,

00:36:58.987 --> 00:37:00.208
some days I still don't know what I'm

00:37:00.228 --> 00:37:00.487
doing.

00:37:00.849 --> 00:37:01.869
But when I started this,

00:37:01.989 --> 00:37:03.971
I really didn't know what I was doing.

00:37:04.751 --> 00:37:04.911
I'm a...

00:37:05.663 --> 00:37:05.862
big,

00:37:05.902 --> 00:37:07.804
big believer in feel the fear and do

00:37:07.824 --> 00:37:08.425
it anyways.

00:37:08.644 --> 00:37:10.385
And so I was terrified.

00:37:10.545 --> 00:37:11.927
I'm like, I don't know what I'm doing,

00:37:12.206 --> 00:37:14.128
but I started by saying,

00:37:14.507 --> 00:37:15.628
this is my business name.

00:37:16.188 --> 00:37:19.050
And from there I had somebody,

00:37:19.130 --> 00:37:21.672
I was here, well, I started my business.

00:37:21.731 --> 00:37:22.932
I maybe had had it for a month

00:37:23.032 --> 00:37:24.494
and I had a PT clinic reach out

00:37:24.534 --> 00:37:25.134
to me and they were like,

00:37:25.173 --> 00:37:26.514
we want you to come work for us

00:37:26.855 --> 00:37:29.695
and do this cash-based stuff out of our

00:37:29.876 --> 00:37:30.356
clinic.

00:37:31.572 --> 00:37:33.414
And like I got this feeling inside of

00:37:33.434 --> 00:37:34.634
me and I was like, oh, no,

00:37:35.074 --> 00:37:37.094
this is like my my brand.

00:37:37.114 --> 00:37:37.856
This is my thing.

00:37:37.936 --> 00:37:39.476
I'm really proud of it.

00:37:40.237 --> 00:37:41.936
And it was very easy to be like,

00:37:42.117 --> 00:37:42.237
oh,

00:37:42.717 --> 00:37:44.117
I know you're offering me more money than

00:37:44.338 --> 00:37:45.199
what this is going to make,

00:37:45.259 --> 00:37:46.458
but I'm not interested.

00:37:47.239 --> 00:37:48.139
And in that moment,

00:37:48.239 --> 00:37:50.681
I realized like how much this meant to

00:37:50.721 --> 00:37:50.900
me.

00:37:50.981 --> 00:37:52.601
And so I think if you start your

00:37:52.742 --> 00:37:53.302
LLC.

00:37:56.402 --> 00:37:58.423
And you're kind of.

00:37:59.952 --> 00:38:03.014
like protective of it and then from there

00:38:03.054 --> 00:38:05.536
you take steps when you have something

00:38:05.597 --> 00:38:07.338
legal that protects you you have your

00:38:07.679 --> 00:38:10.342
insurance in place now when that patient

00:38:10.362 --> 00:38:12.204
says hey do you see people on the

00:38:12.244 --> 00:38:14.846
side you can say yeah i sure do

00:38:15.507 --> 00:38:18.009
um i'm actually working uh with someone

00:38:18.108 --> 00:38:18.570
and we're

00:38:19.170 --> 00:38:22.130
We're hoping to start a cohort in April

00:38:22.610 --> 00:38:25.211
that talks you through how do you create

00:38:25.271 --> 00:38:26.092
a side hustle?

00:38:26.253 --> 00:38:27.853
Because for a lot of people,

00:38:28.094 --> 00:38:30.193
they don't want out of their nine to

00:38:30.233 --> 00:38:30.954
five job.

00:38:31.355 --> 00:38:33.735
But if you can slowly make that transition

00:38:33.835 --> 00:38:36.257
into seeing three or four extra patients a

00:38:36.297 --> 00:38:36.536
week,

00:38:36.936 --> 00:38:38.436
Maybe you don't have to go work that

00:38:38.476 --> 00:38:41.177
PRN job eight hours a day on Saturday

00:38:41.217 --> 00:38:44.077
or Sunday or go to the nursing home

00:38:44.597 --> 00:38:47.059
for three hours every evening after work.

00:38:47.438 --> 00:38:50.259
And now it becomes you making the full

00:38:50.318 --> 00:38:52.480
amount of money instead of giving part of

00:38:52.500 --> 00:38:53.559
it to someone else.

00:38:54.340 --> 00:38:56.521
So that's my advice is like,

00:38:56.561 --> 00:38:57.760
just do it.

00:38:57.860 --> 00:38:58.521
Do the thing.

00:38:58.621 --> 00:39:01.302
If it sits there for two years, whatever.

00:39:02.181 --> 00:39:02.742
You did it.

00:39:02.802 --> 00:39:03.561
You took a step.

00:39:04.166 --> 00:39:04.347
Good.

00:39:04.927 --> 00:39:05.188
Okay.

00:39:05.288 --> 00:39:06.947
Are you ready to play a game?

00:39:06.987 --> 00:39:07.528
I've got a game.

00:39:07.548 --> 00:39:08.289
You ready to play a game?

00:39:10.110 --> 00:39:12.911
It must be my internet.

00:39:14.452 --> 00:39:15.572
We're going to play a quick game.

00:39:15.592 --> 00:39:16.552
You ready for a quick game?

00:39:16.913 --> 00:39:17.773
Ready for a quick game.

00:39:21.041 --> 00:39:21.280
Okay.

00:39:21.300 --> 00:39:22.882
We're going to do clinical rebel or

00:39:22.963 --> 00:39:23.864
business boss.

00:39:23.884 --> 00:39:25.646
I'm going to throw a few situations your

00:39:25.686 --> 00:39:25.846
way.

00:39:25.865 --> 00:39:26.306
You tell me,

00:39:26.365 --> 00:39:29.309
does this make you a clinical rebel or

00:39:29.329 --> 00:39:30.630
a business boss or both?

00:39:30.811 --> 00:39:31.851
And then just give me like a half

00:39:31.871 --> 00:39:32.192
a sentence.

00:39:32.231 --> 00:39:32.472
Why?

00:39:32.932 --> 00:39:33.592
Um,

00:39:33.653 --> 00:39:36.335
you charge out of pocket for high value

00:39:36.376 --> 00:39:37.297
neuroservices.

00:39:37.597 --> 00:39:39.119
Are you a clinical rebel or a business

00:39:39.159 --> 00:39:40.199
boss or both?

00:39:41.121 --> 00:39:41.280
Yeah.

00:39:41.340 --> 00:39:42.501
Why?

00:39:42.601 --> 00:39:44.684
I think that you have to value your

00:39:44.704 --> 00:39:45.025
skills.

00:39:47.420 --> 00:39:48.581
It doesn't value your skills.

00:39:48.922 --> 00:39:49.103
Yeah.

00:39:49.422 --> 00:39:51.125
You create an online course for PTs that

00:39:51.304 --> 00:39:52.666
isn't CEU approved.

00:39:54.012 --> 00:39:54.813
but it's still valuable.

00:39:55.193 --> 00:39:55.574
Business boss.

00:39:55.594 --> 00:39:55.675
Yeah.

00:39:55.695 --> 00:39:57.056
A hundred percent.

00:39:57.175 --> 00:39:58.277
I, I, when I started,

00:39:58.478 --> 00:39:59.719
I've done a couple of courses and I

00:39:59.759 --> 00:40:00.840
thought that you had to do it.

00:40:00.860 --> 00:40:01.740
And then I was like, you know what?

00:40:02.201 --> 00:40:03.362
You're going to get that for three hundred

00:40:03.382 --> 00:40:04.302
bucks from Medbridge anyway.

00:40:04.342 --> 00:40:04.503
Like,

00:40:04.963 --> 00:40:06.505
so you're here to learn stuff or for

00:40:06.525 --> 00:40:08.007
the little number at the end, whatever.

00:40:09.909 --> 00:40:10.710
Send it into your state.

00:40:10.730 --> 00:40:11.550
You can get it.

00:40:11.831 --> 00:40:12.110
Yeah.

00:40:12.831 --> 00:40:15.074
You say no to an insurance contract that

00:40:15.094 --> 00:40:15.735
underpays.

00:40:15.855 --> 00:40:17.135
Are you a clinical rebel or a business

00:40:17.155 --> 00:40:17.737
boss or both?

00:40:19.418 --> 00:40:20.297
Business boss.

00:40:20.838 --> 00:40:22.018
Listen, as soon as you sign,

00:40:22.039 --> 00:40:22.938
you can't complain.

00:40:23.219 --> 00:40:25.119
You have waived your right to complain

00:40:25.139 --> 00:40:27.380
because you signed the contract.

00:40:28.742 --> 00:40:31.182
You bring on a student intern but have

00:40:31.202 --> 00:40:33.284
them help with your social media strategy.

00:40:33.423 --> 00:40:34.884
Are you a clinical rebel or business boss

00:40:34.903 --> 00:40:37.746
or both?

00:40:37.865 --> 00:40:41.067
I would say maybe business boss.

00:40:41.086 --> 00:40:43.847
Could be both because it could be clinical

00:40:43.889 --> 00:40:44.568
content too.

00:40:45.657 --> 00:40:47.998
could be and it's i guess what's the

00:40:48.038 --> 00:40:49.577
purpose is your purpose to build your

00:40:49.657 --> 00:40:51.358
brand if the purpose is to build your

00:40:51.378 --> 00:40:53.778
brand business boss is your purpose is for

00:40:53.858 --> 00:40:57.679
education clinical there's a both uh final

00:40:57.719 --> 00:41:00.000
question you tell a patient you need more

00:41:00.019 --> 00:41:02.221
than what insurance will cover and i can

00:41:02.280 --> 00:41:05.641
help you outside of it oh i think

00:41:05.681 --> 00:41:07.961
clinical rebel and business boss love it

00:41:08.021 --> 00:41:09.762
all right you're off the hot seat last

00:41:09.782 --> 00:41:11.242
thing we do on the episode is called

00:41:11.302 --> 00:41:12.822
the parting shot

00:41:13.786 --> 00:41:15.831
This is the parting shot.

00:41:16.353 --> 00:41:17.757
One last mic drop moment.

00:41:18.438 --> 00:41:19.242
No pressure.

00:41:19.682 --> 00:41:21.809
Just your legacy on the line.

00:41:23.085 --> 00:41:24.547
pressure just your legacy i'm aligned uh

00:41:24.606 --> 00:41:26.168
but it's brought to you by u.s physical

00:41:26.208 --> 00:41:28.429
therapy building great pt clinics and

00:41:28.469 --> 00:41:30.710
great pt careers across the country

00:41:30.809 --> 00:41:33.552
usph.com they've got a lot of them you'll

00:41:33.572 --> 00:41:35.172
be hearing from them on this show in

00:41:35.213 --> 00:41:37.934
twenty twenty six and beyond usph.com so

00:41:37.974 --> 00:41:40.695
parting shot lauren waiting for a decade

00:41:40.735 --> 00:41:43.878
for this no pressure whatsoever what are

00:41:43.898 --> 00:41:45.217
you gonna leave with the audience leave

00:41:45.239 --> 00:41:48.559
the audience with today um you have to

00:41:48.599 --> 00:41:50.681
be the pt that you would want treating

00:41:50.702 --> 00:41:51.242
your parents

00:41:53.581 --> 00:41:56.443
whether that's in business in clinical in

00:41:56.603 --> 00:41:58.364
all of the things you have to want

00:41:58.684 --> 00:42:00.365
what is best for the person in front

00:42:00.405 --> 00:42:03.027
of you and that is and sometimes you

00:42:03.047 --> 00:42:04.367
need to make a business decision so you

00:42:04.387 --> 00:42:06.050
can exist long enough to help the person

00:42:06.090 --> 00:42:07.530
three five seven years in advance

00:42:07.590 --> 00:42:09.952
otherwise your heart can bleed all you

00:42:09.992 --> 00:42:11.172
want but if you ain't in business you

00:42:11.233 --> 00:42:13.193
ain't helping anybody if you're not a pt

00:42:13.213 --> 00:42:14.954
anymore because you got burned out by the

00:42:14.994 --> 00:42:17.777
system then all of that help and love

00:42:17.817 --> 00:42:19.577
that you have is gone

00:42:20.161 --> 00:42:21.184
No margin, no mission.

00:42:22.527 --> 00:42:23.949
Lauren, where can people find you?

00:42:24.010 --> 00:42:24.751
Where, what's the,

00:42:24.911 --> 00:42:25.753
I'll put it in the show notes and

00:42:25.773 --> 00:42:25.974
everything,

00:42:25.994 --> 00:42:26.715
but where would you want people?

00:42:26.735 --> 00:42:27.938
What's like the one or two places you

00:42:27.958 --> 00:42:28.800
want people to go if they were like,

00:42:28.840 --> 00:42:29.722
yeah, I want to learn more.

00:42:30.224 --> 00:42:32.045
Yeah, go follow me on Instagram.

00:42:32.105 --> 00:42:34.306
It's at neuro elite PT.

00:42:35.206 --> 00:42:36.846
That's going to be the best place to

00:42:36.885 --> 00:42:37.246
find me.

00:42:37.405 --> 00:42:40.487
I'm happy to answer messages, questions.

00:42:40.726 --> 00:42:42.708
I think the biggest thing about PT is

00:42:42.728 --> 00:42:44.467
we have to be a community and help

00:42:44.507 --> 00:42:46.327
each other and lift each other up because

00:42:46.347 --> 00:42:47.208
we're all struggling.

00:42:47.449 --> 00:42:48.929
We all feel very similarly.

00:42:49.048 --> 00:42:51.168
So that's the place to do it.

00:42:51.929 --> 00:42:52.208
Love it.

00:42:52.228 --> 00:42:53.110
Lauren, appreciate the time.

00:42:53.130 --> 00:42:54.110
Thank you for doing this.

00:42:54.130 --> 00:42:54.590
Thanks, Jimmy.

00:42:56.434 --> 00:42:57.494
That's it for this one,

00:42:57.775 --> 00:42:59.456
but we're just getting warmed up.

00:42:59.916 --> 00:43:01.818
Smash follow, send it to a friend,

00:43:02.039 --> 00:43:03.699
or crank up the next episode.

00:43:04.221 --> 00:43:05.121
Want to go deeper?

00:43:05.402 --> 00:43:07.724
Hit us at pgpinecast.com.

00:43:08.985 --> 00:43:10.987
Or find us on YouTube and socials at

00:43:11.186 --> 00:43:12.228
pgpinecast.

00:43:12.648 --> 00:43:14.929
And legally, none of this was advice.

00:43:15.010 --> 00:43:17.311
It's for entertainment purposes only.

00:43:18.413 --> 00:43:18.994
See, Keith?

00:43:19.193 --> 00:43:20.255
We read the script.

00:43:20.574 --> 00:43:21.235
Happy now?