Jan. 26, 2026

Why PT Needs Boldness, Not Burnout | Patrick Graham

Why PT Needs Boldness, Not Burnout | Patrick Graham

Jimmy chats with Patrick Graham — one of the three co-founders and namesake of the Graham Sessions — about the evolution of the event, the ideas that have shaped physical therapy, and what the future holds as the 20th anniversary approaches.


From confidentiality to boldness, Patrick unpacks what makes the Graham Sessions unlike any other gathering in healthcare.


KEY DISCUSSIONS INCLUDE:

  • The purpose and rules of the Graham Sessions
  • Why some ideas last and others fade
  • What PTs can learn from dentistry
  • How education and tech are reshaping the profession
  • The importance of asking the right question


QUOTABLE:

“Ask the question. That's where every big idea starts.”

Transcript
WEBVTT

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You're listening to the P.T.

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Pinecast,

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where smart people in healthcare come to

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make noise.

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Here's your host, Jimmy McKay.

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All right,

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the ingredients of a good talk or a

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good session or a good meeting,

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I would say most likely, well,

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you've got to have chocolate,

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you've got to have marshmallows,

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you've

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And you can't forget Graham.

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Graham crackers.

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Graham crackers.

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I went to the supermarket the other day

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just for you, just for this.

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Oh, someone's getting phone calls here.

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Patrick Graham here.

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What year is this?

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Nineteen.

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This is nineteen.

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Wow.

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Good for you.

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Is it still weird coming to a meeting

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with literally your name on it?

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Because now it's not even like I bet

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you ninety percent of people in this room.

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No, maybe not this room,

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but most people who hear about the Graham

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sessions,

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they don't know like you're still at the

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Graham sessions.

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You're still there.

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Well, yeah, it's it's very humbling.

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Yeah.

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Yeah.

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So let's go back before we go forward.

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I was there ten years ago.

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when we did the founders interview,

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it was in Florida.

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Correct.

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And we talked about where things had

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started and where they had gone.

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And each year,

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or I imagine there are some cycles where

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a topic comes up and it stays around

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for a couple of years and maybe it's

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solved or we move on.

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But what are the things that stay the

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same,

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even nineteen years into doing the Graham

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sessions?

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You know,

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I think the big thing that doesn't change

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is

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the broadness of ideas and the broadness

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of thoughts.

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And I think the more we focus on

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those,

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the more we're moving our profession

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forward.

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And that was the whole genesis of the

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whole idea is

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We want to get these ideas.

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We want to flush them out.

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We want to debate them.

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And then from there,

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people can take them back.

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Do something with them.

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Do something with them.

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Exactly.

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First rule of Fight Club is you don't

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talk about Fight Club.

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Second rule of Fight Club is you don't

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talk about Fight Club.

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What's the first rule of Graham Sessions?

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Everything's confidential.

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Yeah.

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You can talk about ideas but not attach

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them to people.

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Correct.

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This way people aren't.

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afraid apprehensive to say something

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because they might have repercussions

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everything's off the record yeah but we

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want the ideas to leave the room

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absolutely but we can just put a not

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it's said by anonymous or we'll leave that

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part out all right so i've been asking

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everybody today been doing a bunch of live

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uh streams ten minutes quick fast to the

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point what's something on the docket this

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year either you know we're at three

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o'clock in the afternoon

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something that's already been covered or

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we're going to cover this afternoon that

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you're like, yeah, I want to,

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I'm excited to hear about this.

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This is a topic that you're sitting there,

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you know, all right, let's dig in.

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What's exciting you?

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So I love the panel that related to

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some of the lessons with their learning

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from dentistry as well as some of the

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network opportunities that out of the box

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thinking that occurred with the model they

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discussed and how they've executed it.

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beautiful yeah good artists borrow great

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artists steal Picasso said that which is

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hey listen if we keep trying to solve

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the problem with what we've got in the

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room we're gonna run out of solutions if

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it doesn't work let's look outside so look

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at a dentistry looking at different

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options and that's a great start how about

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something that's not on the docket that

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you're like man where where's this I'm met

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where's this

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You know,

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I think we discussed a little bit about

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education and we just heard a great what

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I believe speech.

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But we can't tell by who what he

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said.

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No, I know.

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I know.

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I'm just kidding.

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But he brought up the point of someone

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in our profession who challenged the

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status quo,

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created something different that's

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changing waves.

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That excites me,

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to have people in a room

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Okay, they're doing this,

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they're doing this.

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How could we do that?

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What do I do?

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Correct.

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How do I do that?

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What's my version of that?

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Yeah, it's exciting.

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What needs to be on three hundred and

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sixty five days from now?

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What what would you put on the docket?

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You've you've prepared this meeting a

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bunch of times.

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That can't be easy, right?

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Because you can't have everything covered.

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No.

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But what would you put on the on

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the horizon for the twentieth anniversary?

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Wow.

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You know, I think boldness.

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Okay.

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What does that mean?

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So we've heard a bunch today,

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but what energizes me about this meeting

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is the freshness ideas,

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the boldness of our colleagues and taking

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that out into the real world to see

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where we're going to go and what we

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can do.

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We can wallow in our pity,

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how poorly we're reimbursed,

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We have the best opportunity we've ever

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had because people know who a physical

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therapist is and the highest demand out

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there.

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What are we going to spend our effort

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and our time on?

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And diamonds are formed under pressure.

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That's the theme this time.

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You've been part of putting these

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together, but in the beginning and now,

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how did you figure out who to put

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in the room?

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What was the...

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I imagine if a chef is making a

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soup or whatever, you're like, okay,

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it's got to have a little bit of

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this and a little bit of that,

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not too much this and not enough that.

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How did you figure out what was a

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good mix?

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It wasn't me.

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Steve Anderson has led this thing for

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nineteen years and now Keaton's doing a

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beautiful job.

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The first year we literally,

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we kind of invited,

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we thought were thought leaders in the

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profession and a bunch of them came and

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it was productive.

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Second year,

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it started getting a little stale and

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Steve really started putting some effort

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and planning into.

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kind of an agenda and specific topics and

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got a committee structure.

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He just really elevated it.

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Yeah.

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I mean, he's, he's,

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it's incredible what he did.

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And that to me has been what has

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kept us alive.

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Yeah.

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Looking back, did,

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did it achieve its goal each year?

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Oh yeah.

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Yeah.

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Yeah.

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I don't know.

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I don't know if you remember last year,

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but they kind of recapped some ton of

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things that have happened in our

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profession and,

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And a lot of the ideas were fleshed

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out and derived out of the Graham

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sessions.

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And that was the whole desire of this

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crazy idea.

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All right.

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Well,

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Keaton will be sixty and twenty more year.

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I don't know.

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But in twenty years, what do you hope?

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How do you hope things have progressed?

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What would you what would your hope be

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for the next twenty being next year's

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twentieth anniversary?

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I hope that our younger generation.

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is as bold and as passionate as we

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are.

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And I really believe they are.

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Um,

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I think the new therapists coming out have

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more confidence and, uh,

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tools at their disposal than any we've

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ever had in our profession and their ideas

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and technology and the use of technology.

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I mean, I can't even fathom it.

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I'm sixty and I look at where we've

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come and I think it's just going to

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get exponentially faster.

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Yeah, I don't disagree.

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And it's the people who lean into them

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or at least curious about those tools.

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Yeah.

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You don't do a master on day one,

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but pretend it doesn't exist.

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That's how you get run over.

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No, I do.

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I think a lot of.

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what some people would term as

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traditional,

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that's supposedly what got us here,

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will be obsolete.

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Yeah.

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It's crazy how fast these things are

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going.

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Yeah.

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I mean, look at you, man.

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You're the first guy I've ever known in

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our profession with your talent.

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And I remember when you first came and

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I was like,

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This is a great idea.

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Weird, right?

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My mom was very confused, too.

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And you're fantastic.

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Well, thank you.

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I appreciate that.

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I mean, you really are.

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Thank you.

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I appreciate that.

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I look at it as I get to

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sit next to super smart people and either

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ask great questions and try to find the

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answer out there or a person has solved

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a problem.

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Great.

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Reframe that problem.

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Tell me how you solved it.

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And we send it out there.

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You know, I brought something up earlier.

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We were talking about primary care.

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That's great.

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It was a great victory specifically in

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Utah,

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but there's different ways to access PT as

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primary care.

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And my push, of course,

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I wanted to be spicy, which was,

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this is a great idea.

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Don't screw it up.

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Well,

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how are you going to screw it up?

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And I made everybody look outside the

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windows here on the seventh floor of APTA.

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And I said,

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all those people out there have no idea

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what this means.

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They have no idea how it could help

00:08:58.014 --> 00:08:58.355
them.

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And if we fail there,

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it doesn't matter how great our services

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are.

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It doesn't matter how great our skills

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are.

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We've got to make sure we don't fumble

00:09:06.524 --> 00:09:06.745
that.

00:09:06.865 --> 00:09:07.846
Now, here's the best part.

00:09:07.927 --> 00:09:08.807
You don't do it yourself.

00:09:09.448 --> 00:09:10.471
There are professionals who can help you

00:09:10.490 --> 00:09:10.831
do that.

00:09:10.890 --> 00:09:12.633
But don't try to do it yourself if

00:09:12.653 --> 00:09:14.014
you can't actually execute it

00:09:14.716 --> 00:09:15.836
Cause I wouldn't want you to fail there

00:09:15.856 --> 00:09:17.297
and be confused five years from now.

00:09:17.336 --> 00:09:18.378
We had primary care.

00:09:18.898 --> 00:09:19.618
What happened?

00:09:20.158 --> 00:09:22.779
You'd failed this one simple thing.

00:09:23.039 --> 00:09:24.260
Yeah, I agree.

00:09:24.500 --> 00:09:26.120
Yeah, I agree.

00:09:26.140 --> 00:09:27.902
We've got another talk going on soon,

00:09:28.142 --> 00:09:29.482
but I wanted to make sure we have

00:09:29.682 --> 00:09:30.903
a, we have a tradition on the show.

00:09:31.024 --> 00:09:32.604
Every episode we do something called the

00:09:32.683 --> 00:09:33.424
parting shot.

00:09:33.445 --> 00:09:36.245
This is the parting shot.

00:09:36.806 --> 00:09:38.187
One last mic drop moment.

00:09:38.866 --> 00:09:39.668
No pressure.

00:09:40.128 --> 00:09:42.229
Just your legacy on the line.

00:09:43.458 --> 00:09:44.841
No pressure whatsoever, Patrick,

00:09:44.860 --> 00:09:46.062
just your entire legacy.

00:09:46.101 --> 00:09:48.384
Now, what's just an idea, a concept,

00:09:48.625 --> 00:09:49.785
words of hope for the future,

00:09:49.846 --> 00:09:50.966
something you want to leave with the

00:09:51.006 --> 00:09:52.268
audience as we wrap up and go back

00:09:52.288 --> 00:09:52.548
inside?

00:09:52.948 --> 00:09:53.188
You know,

00:09:53.269 --> 00:09:55.331
my whole career has been on not being

00:09:55.351 --> 00:09:56.472
afraid to ask the questions.

00:09:58.011 --> 00:09:59.653
And I would just encourage people,

00:10:00.475 --> 00:10:01.216
ask the question.

00:10:01.416 --> 00:10:02.456
Yeah, ask the question.

00:10:02.476 --> 00:10:05.821
I just referenced Terry Gross is a NPR

00:10:05.860 --> 00:10:06.280
host,

00:10:06.902 --> 00:10:08.224
and she's done more than twenty thousand

00:10:08.244 --> 00:10:09.424
interviews over her career.

00:10:09.485 --> 00:10:10.625
And she wrote a book and the title

00:10:10.645 --> 00:10:11.547
of the book I thought was great.

00:10:11.647 --> 00:10:12.548
All I did was ask.

00:10:12.928 --> 00:10:13.850
All I did was ask.

00:10:14.070 --> 00:10:14.330
Right.

00:10:14.409 --> 00:10:15.751
And questions can be powerful because

00:10:15.772 --> 00:10:16.952
hopefully eventually if you ask enough of

00:10:16.972 --> 00:10:17.114
them.

00:10:17.793 --> 00:10:18.695
uh, they lead to answers.

00:10:18.715 --> 00:10:19.115
Absolutely.

00:10:19.154 --> 00:10:20.875
And that's what I think grand sessions is.

00:10:21.116 --> 00:10:22.898
So it's a little, little pressure cooker,

00:10:22.937 --> 00:10:23.118
right?

00:10:23.138 --> 00:10:24.558
Bring them in, get a little fun.

00:10:25.259 --> 00:10:26.080
Uh,

00:10:26.100 --> 00:10:27.841
we've got a couple more sessions going on

00:10:27.900 --> 00:10:28.802
as we live stream,

00:10:29.763 --> 00:10:31.323
but we know where the real conversations

00:10:31.344 --> 00:10:32.524
are going to happen tonight.

00:10:32.565 --> 00:10:33.985
About five thirty.

00:10:34.005 --> 00:10:34.306
Yep.

00:10:34.346 --> 00:10:35.106
When we walked up there,

00:10:35.126 --> 00:10:37.028
that's how do we get more of that

00:10:37.087 --> 00:10:37.928
and facilitate it?

00:10:37.948 --> 00:10:38.808
Because that's where the real

00:10:38.849 --> 00:10:39.590
conversations and,

00:10:40.232 --> 00:10:41.214
The back of the napkin.

00:10:41.234 --> 00:10:42.455
The reason they say it's the back of

00:10:42.475 --> 00:10:44.677
the napkin idea is because napkins are

00:10:44.697 --> 00:10:45.999
over a drink or a meal or a

00:10:46.198 --> 00:10:46.799
cup of coffee.

00:10:46.840 --> 00:10:49.582
So looking forward to sharing some more

00:10:49.643 --> 00:10:52.206
ideas after the agenda is over this

00:10:52.285 --> 00:10:52.546
evening.

00:10:52.826 --> 00:10:53.366
Awesome.

00:10:53.407 --> 00:10:54.227
Patrick, appreciate the time, man.

00:10:54.248 --> 00:10:55.089
Yeah, thanks.

00:10:56.147 --> 00:10:57.207
That's it for this one,

00:10:57.508 --> 00:10:59.188
but we're just getting warmed up.

00:10:59.629 --> 00:11:01.551
Smash follow, send it to a friend,

00:11:01.770 --> 00:11:03.432
or crank up the next episode.

00:11:03.952 --> 00:11:04.552
Want to go deeper?

00:11:04.592 --> 00:11:09.355
Hit us at pgpiecast.com or find us on

00:11:09.397 --> 00:11:11.937
YouTube and socials at pgpiecast.

00:11:12.359 --> 00:11:14.659
And legally, none of this was advice.

00:11:14.720 --> 00:11:16.442
It's for entertainment purposes only.

00:11:17.062 --> 00:11:18.102
Bullshit!

00:11:18.123 --> 00:11:18.702
See, Keith?

00:11:18.923 --> 00:11:19.984
We read the script.

00:11:20.283 --> 00:11:20.924
Happy now?