Aug. 23, 2024

Why Stretch Labs Are Changing the Game for Physical Therapists

Show Notes
Transcript

Dive into the rise of stretch labs and their impact on the physical therapy industry. Are stretch labs a threat or an opportunity for PTs? We explore the business model behind these popular fitness boutiques, their appeal to consumers, and how physical therapists can adapt or even capitalize on this trend. We also discuss the ethical implications and how PTs can position themselves in a market increasingly driven by consumer demand for wellness services.

Key Points Discussed:

The rise of stretch labs and their impact on traditional physical therapy practices.

How stretch labs are attracting clients with a focus on perceived value rather than clinical outcomes.

The importance of adapting to market demands and the potential for PTs to integrate similar services.

The ethical considerations of offering wellness services outside traditional PT practice.

Practical advice for PTs looking to compete with or collaborate with these new business models.

WEBVTT

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All right, good morning.

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It is Breakfast Club PT.

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We are live on all the social platforms.

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I'm trying to go live.

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I don't know if you guys have done this.

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I'm trying to go live on Instagram,

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and now it looks like we're doing it.

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All right, good morning to you guys.

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Today,

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we are going to discuss some

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business and marketing,

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but we're gonna start out

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with a discussion about value.

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I love when we pay attention.

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I think Dave and I realized

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on Tuesday when Tony wasn't here,

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this show is all gripes.

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This show is all complaints,

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but we try to spin it.

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And hopefully you do too,

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which is what can we learn

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from this gripe?

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What can we learn from this complaint?

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How do we take a W out of an L?

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And that's what we're going

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to discuss today.

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We're going to get really specific.

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Do you want to point out live questions?

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live comments.

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This is not like class in

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third grade where save your

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questions or comments for the end.

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I was always that kid that

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wanted to shout it out.

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So feel free to shout it out

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either live or while you're

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watching the replay.

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We'll get back to you on

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what you want answered.

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So without further ado, let's start.

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There we go.

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All right, Breakfast Club PT.

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I got myself lined up.

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Tony's back.

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Dave is back.

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I got nervous, Dave.

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I was like, on Tuesday, I'm like,

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I don't know if we're going

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to be able to get just two

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of us to go an hour.

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And then I was looking at the clock.

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I'm like, we got to cut it.

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Because we're getting close to an hour.

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Kept it rolling.

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That was good.

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I liked that.

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Um,

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let me tell you guys real quick for

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anybody listening.

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I think this is relatable.

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Um, I am back in the driver's seat.

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It's, it's mixed emotion.

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So here's the deal.

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You guys know, I started, you know,

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small 800 square foot Sarasota,

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Florida on CS to key.

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I wasn't a physical therapist.

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I hired a physical therapist,

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grew to five locations, three in Florida,

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two in Ohio, full admin team,

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marketing team, billing team, everything.

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Now,

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We're just whittling away.

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I am down to legitimately probably two,

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three full-time positions,

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two part-time positions.

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I'm losing one more to

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maternity leave in about six weeks.

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I lost one to babysitting grandchildren.

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Amazing stuff.

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But I am literally the one

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back in the driver's seat answering calls,

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booking new appointments, scheduling,

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billing.

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I don't post payments.

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That's automatic.

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But I feel like Jerry Durham.

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I am reinventing the

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administrative process and

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I'm trying to figure out

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the technology to make this

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happen for people who don't have admin.

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What's up, Jimmy?

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Nice and smooth.

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You're trying to make it

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smooth now is what it looks like.

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Absolutely.

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But you know what?

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I love it.

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It is so like it's so

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fulfilling to take a

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process that looks terrible,

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is inefficient and make it

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efficient again.

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You know, that that to me is exciting.

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Um, this reminds me of, I forget the quote,

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I don't know if it was

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Confucius or whatever, who said like,

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you're never this,

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you never walk through the

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same stream twice or whatever, you know,

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the,

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the adage is the stream is always

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changing and you never

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really read the same book

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twice because you're a different person.

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So you're going through like

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similar processes that you

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might've gone through before.

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Um,

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but you're doing it as a different person.

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So you're coming at it.

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This is where like people, I like, look,

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look,

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I didn't know there was going to be

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a theme here, but here it is already.

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I said, you know,

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you try to turn a complaint

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into something else.

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You try to, you try to convert it.

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People, people usually use the term,

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go back to square one,

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square one is a negative.

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And I look at it as like,

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but you're not going back

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to square one as the same person.

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You're going back as a

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different person with

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different experiences.

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That's why when you hear all

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these people who have unicorn companies,

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that's really their first rodeo.

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They have been to several rodeos.

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And they've taken some bits...

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Um, because they can,

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they recognize patterns and

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they've tried things and they've failed.

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And hopefully those people have said,

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why'd this thing fail?

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All right, well,

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I'm not going to get caught

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on that again.

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So are there any things

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you're seeing again for the

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first time again that you're like, oh,

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okay, I'm going to do this differently.

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Yeah, you know, just like originally,

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just like 2001.

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And Dave,

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I'm curious to hear your

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perspective as a business owner.

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I step back into the role of

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answering the phone.

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And I'm like,

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there's got to be a better

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way to do this.

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You know, what's the ultimate outcome?

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What do I want this

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telephone conversation to be?

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end in, for me,

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I want that person to

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complete an evaluation,

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like ASAP within 24 hours,

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preferably within an hour.

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If I can transition this

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person from voice telephone

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call to a telehealth video

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call that I could bill for

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that interaction,

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That's what I want to try to

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figure out how to do.

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And what I do is I think of

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the psychology of the

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person behind the telephone.

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I'm like,

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is this an 82 year old geriatric

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or is this a 28 year old tech savvy kid?

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Can I integrate the RTM

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platform right now?

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Can I start doing RTM right

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with this interaction?

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How can I optimize the minutes of my life,

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my time to get this person

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on the phone the best

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possible experience while

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still monetizing those minutes?

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And now we have a whole new

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batch of technology.

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One of the ones I keep talking about,

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and I share this on social media,

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like we're getting 12 and

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15 page faxes that are

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coming in for new referrals.

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We didn't used to get that before.

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But when you look at that fax information,

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it's practically the whole

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medical record.

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I've got the physician

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report with impressions and case history.

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I've got information about insurance.

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I've got information about demographics,

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a face sheet.

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Why is a human taking that

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PDF off the electronic fax,

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retyping it back into the EMR?

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When the technology exists

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to just snap a picture or

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process that with OCR and

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turn it into text and put

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it into the system.

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The problem is there's no

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HIPAA compliant technology available.

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Yeah, so this brings up a thing I just saw,

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like a similar gripe on Reddit,

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and I've just started to

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dive into Reddit recently, and it's wild.

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But somebody was complaining about photo.

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You guys are familiar with photo, right?

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Physical therapy outcomes.

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And they were saying just

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what Tony was talking about similarly,

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where some people don't

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Um,

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a lot of the questions they were asking,

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it wasn't, it wasn't, um,

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configured for the,

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for the person that they were looking at.

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So like, for example,

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I'm doing an evaluation.

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I put the person's birth

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date in the computer should

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know how old they are and

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not to get ageist,

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but they were saying the

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question was always the

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first question or one of them was, uh,

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what's, what's it like when you jump.

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or run and they were like

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this person's always like I

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haven't jumped around in 10

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years so then they have to

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put a zero in that and that

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totally skews their score

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it's like that thing needs

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to adapt the other problem

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they were having goes to

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more of tony's point was

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Some people aren't tech savvy.

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So you hand them an iPad

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because that's what photo

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is allowing at the front desk.

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And they're like,

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I don't know what I'm doing with this.

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So they have two options.

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The receptionist has to stop

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and spend 15 minutes doing

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that and not what else they

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could be doing.

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Or they print out a paper copy,

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but that actually leads to more tasks,

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which is reentering that

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paper copy into the iPad or the EMR.

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It's like you have to

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understand what the problem was.

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The problem was.

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and solve it better.

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Or you're just going to be

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putting duct taping

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solutions onto problems forever.

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And then it's turtles all the way down.

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Dave, what do you do?

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Do you go back and optimize systems?

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Do you review processes?

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Like how do you handle that?

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Yeah.

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Well, so real quick, a couple of things.

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One is we're going to

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potentially talk about the

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stretch lab phenomenon.

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And I was going to kind of

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set up and ask Tony, like,

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are you guys going to add this?

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Like, could you add this?

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But at the top of the show,

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when you're talking about

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doing these other roles and

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you're stepping back into

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like insurance and front desk and calls.

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it kind of says you're not

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going to be able to add

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that because you're doing

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all this other stuff.

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So we'll put that aside for a second.

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The thing about photo,

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one of my rotations in

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Philly was at Moss Rehab on

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Market Street.

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It was a cool location.

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They had a big computer

00:08:28.564 --> 00:08:32.466
terminal that the patients

00:08:32.547 --> 00:08:33.746
would go on and do photo.

00:08:33.868 --> 00:08:35.869
And my recollection was that

00:08:37.426 --> 00:08:39.346
It took significantly too long.

00:08:40.126 --> 00:08:41.687
Of course, if someone was not tech savvy,

00:08:42.207 --> 00:08:43.149
we would help them or whatever.

00:08:43.188 --> 00:08:45.250
But even if people were tech savvy,

00:08:45.350 --> 00:08:47.071
it just killed so much time.

00:08:47.091 --> 00:08:48.230
And then it printed out this

00:08:48.350 --> 00:08:49.491
multi-page report.

00:08:49.831 --> 00:08:51.052
And it's like, I got to page through this.

00:08:51.072 --> 00:08:51.673
But then I'm going to sit

00:08:51.712 --> 00:08:53.153
down with this human, this patient,

00:08:53.594 --> 00:08:54.173
this client,

00:08:54.254 --> 00:08:56.134
and ask them questions anyway.

00:08:56.154 --> 00:08:57.855
So I still...

00:08:58.535 --> 00:08:59.277
That was like my only

00:08:59.376 --> 00:09:00.197
experience with photo.

00:09:00.337 --> 00:09:01.538
I understand that it can

00:09:01.599 --> 00:09:02.679
help with outcomes and then

00:09:02.720 --> 00:09:04.062
tracking changes and

00:09:04.101 --> 00:09:04.802
progress and all that.

00:09:04.881 --> 00:09:06.323
But I've always had a bad

00:09:06.344 --> 00:09:07.424
taste in my mouth for photo.

00:09:07.565 --> 00:09:09.466
And, you know, one outcome measure,

00:09:09.486 --> 00:09:10.008
that's one thing.

00:09:10.028 --> 00:09:11.908
Like one page, the lefts or, you know,

00:09:11.928 --> 00:09:12.690
Oswestry or whatever.

00:09:12.730 --> 00:09:14.131
Like one outcome measure, okay,

00:09:14.152 --> 00:09:14.552
that's fine.

00:09:14.871 --> 00:09:17.434
But photo is beyond excessive.

00:09:17.754 --> 00:09:19.856
And I would never – I don't

00:09:19.876 --> 00:09:20.937
even know how much it costs, Tony,

00:09:20.957 --> 00:09:22.539
but I would never –

00:09:22.539 --> 00:09:23.080
pay for it.

00:09:23.139 --> 00:09:23.400
I don't know.

00:09:23.441 --> 00:09:24.600
We wouldn't even use it if it was free.

00:09:24.821 --> 00:09:25.642
Maybe we would use it if we

00:09:25.682 --> 00:09:26.422
got paid to use it.

00:09:26.461 --> 00:09:26.621
Like,

00:09:26.642 --> 00:09:27.682
I don't know if we're sponsored or

00:09:27.722 --> 00:09:27.962
something,

00:09:27.982 --> 00:09:29.504
but like it was just so much

00:09:29.604 --> 00:09:31.065
time away from the patient

00:09:31.085 --> 00:09:33.725
experience when they're

00:09:33.765 --> 00:09:36.048
asking like multiple page of questions.

00:09:36.788 --> 00:09:38.989
Um, so that's the second thing.

00:09:39.009 --> 00:09:40.951
And then Tony asked me how

00:09:40.990 --> 00:09:42.150
we do so we can kind of get into it,

00:09:42.171 --> 00:09:42.350
I guess.

00:09:44.472 --> 00:09:45.472
Go ahead, get into it.

00:09:45.552 --> 00:09:46.374
Let's hear it.

00:09:46.974 --> 00:09:47.735
So you were asking about

00:09:47.774 --> 00:09:48.575
like on the front end with

00:09:48.615 --> 00:09:50.135
like the admin paperwork side of things.

00:09:50.688 --> 00:09:51.549
Do you ever go back?

00:09:51.570 --> 00:09:54.072
Do you review the systems you created,

00:09:54.131 --> 00:09:55.572
the processes you created?

00:09:55.592 --> 00:09:56.394
Do you improve them?

00:09:56.413 --> 00:09:57.195
Do you modify them?

00:09:57.215 --> 00:09:58.556
Because I went like a decade.

00:09:58.576 --> 00:10:00.177
I wasn't changing anything.

00:10:00.278 --> 00:10:01.359
I wasn't going to electronic

00:10:01.418 --> 00:10:02.139
medical record.

00:10:02.239 --> 00:10:04.640
I wasn't changing the phone process.

00:10:05.322 --> 00:10:06.923
I did not want to rock the boat.

00:10:07.003 --> 00:10:09.686
The boat was rocking well enough.

00:10:10.970 --> 00:10:11.690
Yeah, of course.

00:10:11.750 --> 00:10:13.731
I mean, when we start,

00:10:13.812 --> 00:10:15.653
we use whatever tools or

00:10:15.692 --> 00:10:16.913
systems or processes that

00:10:17.013 --> 00:10:18.533
are either common to us,

00:10:18.573 --> 00:10:19.475
common to colleagues that

00:10:19.514 --> 00:10:20.615
are close and easy to us.

00:10:21.916 --> 00:10:22.275
Of course,

00:10:22.296 --> 00:10:23.596
it is a little more challenging

00:10:23.636 --> 00:10:25.357
to change things later down the road.

00:10:25.378 --> 00:10:26.057
Like, for example,

00:10:26.097 --> 00:10:27.379
I have an answering service

00:10:27.879 --> 00:10:29.480
and I use the 646 New York

00:10:29.879 --> 00:10:31.640
City area code phone number

00:10:31.760 --> 00:10:32.881
through that answering service.

00:10:32.902 --> 00:10:33.802
So if I cancel them,

00:10:33.861 --> 00:10:34.482
I'm actually kind of

00:10:34.523 --> 00:10:35.903
screwed because I'm tied or

00:10:35.923 --> 00:10:36.823
I got to buy the phone

00:10:36.844 --> 00:10:38.205
number from this answering service.

00:10:42.027 --> 00:10:42.488
We'll go back.

00:10:42.528 --> 00:10:45.089
I'll look at the paperwork things.

00:10:45.549 --> 00:10:46.429
I've had to edit

00:10:46.730 --> 00:10:49.152
specifically the informed consent,

00:10:49.172 --> 00:10:50.332
the financial policy.

00:10:50.533 --> 00:10:51.453
We've had some

00:10:51.514 --> 00:10:52.313
out-of-network insurance

00:10:52.354 --> 00:10:55.115
patients where their visits get denied,

00:10:55.336 --> 00:10:57.177
and then months later, it's like, hey,

00:10:57.278 --> 00:10:58.138
we resubmitted.

00:10:59.467 --> 00:11:00.788
all the stuff,

00:11:00.970 --> 00:11:02.772
and you sign this financial

00:11:02.831 --> 00:11:03.611
agreement that said,

00:11:04.173 --> 00:11:04.953
if any of these visits get

00:11:04.994 --> 00:11:06.095
denied for this, this, this,

00:11:06.134 --> 00:11:06.775
and this reason,

00:11:07.616 --> 00:11:09.197
then the out-of-pocket cost

00:11:09.278 --> 00:11:10.259
is $250 per visit.

00:11:10.659 --> 00:11:12.001
So I actually have to chase

00:11:12.062 --> 00:11:13.143
a couple patients right now,

00:11:13.743 --> 00:11:14.924
one that owes $12,000 and

00:11:14.985 --> 00:11:15.445
one that owes...

00:11:16.485 --> 00:11:22.774
$4,200.

00:11:16.505 --> 00:11:19.269
So in terms of accounts receivable,

00:11:19.330 --> 00:11:20.610
sometimes it happens with

00:11:20.791 --> 00:11:21.572
out-of-pocket or

00:11:21.672 --> 00:11:22.774
out-of-network practices.

00:11:22.833 --> 00:11:24.095
So yeah, but I mean,

00:11:25.056 --> 00:11:28.000
with changing or with going

00:11:28.159 --> 00:11:29.341
forward into time, of course,

00:11:29.381 --> 00:11:30.863
there's certain processes to change.

00:11:31.403 --> 00:11:31.823
Of course,

00:11:32.024 --> 00:11:33.186
we know physical therapists very

00:11:33.206 --> 00:11:35.928
well and most business owners.

00:11:36.590 --> 00:11:38.091
A lot of things are set it and forget it.

00:11:38.633 --> 00:11:39.734
And that is the challenge is

00:11:39.934 --> 00:11:40.554
going back in.

00:11:40.596 --> 00:11:40.956
Right, Tony?

00:11:40.975 --> 00:11:42.958
Like going back in and like seeing like,

00:11:42.979 --> 00:11:43.860
can we optimize this?

00:11:43.879 --> 00:11:44.660
Can we get rid of some of

00:11:44.681 --> 00:11:46.683
the stuff that's redundant or excessive?

00:11:47.104 --> 00:11:47.924
How can we make the patient

00:11:47.946 --> 00:11:49.147
experience smoother and better?

00:11:49.287 --> 00:11:49.947
What's the information?

00:11:49.967 --> 00:11:50.629
What are the things that

00:11:50.649 --> 00:11:51.350
we're collecting that we

00:11:51.389 --> 00:11:53.153
actually we don't need or we never used?

00:11:54.397 --> 00:11:55.778
That's the killer right there.

00:11:56.177 --> 00:11:57.317
As you grow,

00:11:57.557 --> 00:11:59.678
either in size or just in duration,

00:12:00.259 --> 00:12:01.879
you develop systems and

00:12:01.899 --> 00:12:04.500
policies that used to work back in 1982.

00:12:04.500 --> 00:12:05.461
They don't work today.

00:12:05.481 --> 00:12:06.182
You don't need them.

00:12:06.881 --> 00:12:09.403
And it's so hard to break those habits.

00:12:09.442 --> 00:12:10.303
So right now,

00:12:10.364 --> 00:12:11.923
my primary admin person is

00:12:12.063 --> 00:12:13.465
out of the office every single day.

00:12:14.585 --> 00:12:15.765
So I don't have any admin

00:12:15.806 --> 00:12:16.785
person in the office.

00:12:17.366 --> 00:12:19.567
And when I look at the stuff

00:12:19.587 --> 00:12:20.707
that's being done, I'm like,

00:12:21.107 --> 00:12:22.688
why are we collecting this information?

00:12:22.749 --> 00:12:24.669
I am never going to use this information,

00:12:24.710 --> 00:12:26.171
but somebody spent two

00:12:26.230 --> 00:12:29.091
minutes collecting this information.

00:12:29.572 --> 00:12:30.852
I've taken address.

00:12:31.173 --> 00:12:32.933
I've got a copy of your driver's license.

00:12:33.033 --> 00:12:35.855
Now with the new EMR we're using,

00:12:35.955 --> 00:12:37.076
they'll send me a picture

00:12:37.096 --> 00:12:38.235
of their driver's license

00:12:38.316 --> 00:12:39.456
and insurance card through

00:12:39.476 --> 00:12:40.857
a HIPAA compliant platform.

00:12:42.118 --> 00:12:43.318
I never have to ask for

00:12:43.479 --> 00:12:44.458
address information.

00:12:44.499 --> 00:12:45.099
It's right there.

00:12:45.178 --> 00:12:47.259
But yet my team is so used

00:12:47.299 --> 00:12:49.480
to always asking for address information.

00:12:50.041 --> 00:12:50.681
And so I'm like,

00:12:51.280 --> 00:12:53.241
we can free up so much time.

00:12:53.302 --> 00:12:54.642
Time is so valuable.

00:12:55.123 --> 00:12:56.163
So these are the kinds of

00:12:56.202 --> 00:12:57.623
things that I do think it

00:12:57.683 --> 00:12:59.703
takes a certain brain type,

00:13:00.183 --> 00:13:02.245
personality type to look at this and say,

00:13:02.264 --> 00:13:02.465
look,

00:13:02.504 --> 00:13:03.946
we don't have to do it the way it's

00:13:03.985 --> 00:13:04.525
always been done.

00:13:05.025 --> 00:13:06.307
We can do this better.

00:13:07.187 --> 00:13:08.849
And it's the most simple fixes.

00:13:08.889 --> 00:13:10.149
And then once you push those

00:13:10.270 --> 00:13:11.971
out there and they get adopted,

00:13:11.991 --> 00:13:12.873
you're like, oh, my gosh,

00:13:12.893 --> 00:13:14.153
I can't believe I used to do that.

00:13:14.234 --> 00:13:15.754
I was wasting so much time,

00:13:15.815 --> 00:13:16.875
so much inefficiency.

00:13:17.235 --> 00:13:18.477
That whole why are we doing this?

00:13:18.518 --> 00:13:19.719
It's because we've always done it.

00:13:19.778 --> 00:13:20.658
So we're going to keep doing

00:13:20.759 --> 00:13:22.160
it because no one has been

00:13:22.221 --> 00:13:23.100
bold enough to say we're

00:13:23.120 --> 00:13:24.722
not doing this anymore or

00:13:24.743 --> 00:13:25.884
we're going to do something different.

00:13:27.044 --> 00:13:29.528
Talking about why we do what

00:13:29.548 --> 00:13:30.349
we've always done.

00:13:30.469 --> 00:13:32.552
Jimmy, let's talk about going to school,

00:13:32.631 --> 00:13:33.332
paying the money,

00:13:33.432 --> 00:13:35.596
investing in the degree of

00:13:35.676 --> 00:13:36.817
being a physical therapist.

00:13:37.018 --> 00:13:38.099
So this was a poll that I

00:13:38.139 --> 00:13:39.581
put up on Twitter, Facebook,

00:13:39.640 --> 00:13:40.162
and LinkedIn.

00:13:40.461 --> 00:13:41.764
I'll share the results of one of them.

00:13:41.803 --> 00:13:42.705
But I wanted to understand

00:13:42.725 --> 00:13:43.346
because there's a lot of

00:13:43.426 --> 00:13:44.386
bitching and complaining.

00:13:45.307 --> 00:13:46.950
around, number one,

00:13:46.990 --> 00:13:47.890
like the move from a

00:13:47.951 --> 00:13:50.134
master's degree to a DPT,

00:13:50.193 --> 00:13:51.895
which is one thing, right?

00:13:51.995 --> 00:13:53.337
Somebody had a comment like,

00:13:53.398 --> 00:13:55.299
I'm so angry at the cost of my degree.

00:13:55.320 --> 00:13:55.961
So I'm like,

00:13:56.000 --> 00:13:57.722
are you angry at the cost of your degree?

00:13:57.743 --> 00:13:59.365
Or are you angry with the

00:13:59.384 --> 00:14:00.687
return on investment?

00:14:00.966 --> 00:14:01.548
And here's the trap.

00:14:03.794 --> 00:14:04.615
both of those things you're

00:14:04.654 --> 00:14:05.456
responsible for.

00:14:05.475 --> 00:14:06.796
Now I know there's some

00:14:06.836 --> 00:14:08.076
convolution in terms of like, well,

00:14:08.116 --> 00:14:09.596
how much does a degree actually cost?

00:14:09.636 --> 00:14:11.597
But like you signed, you were an adult,

00:14:12.438 --> 00:14:12.918
you owe that.

00:14:13.099 --> 00:14:14.799
I think degrees should cost less money.

00:14:14.820 --> 00:14:15.879
Let's be very, very clear.

00:14:16.360 --> 00:14:17.441
But I think that's a process.

00:14:17.941 --> 00:14:18.620
And I don't think that we

00:14:18.660 --> 00:14:19.341
can control that.

00:14:19.601 --> 00:14:20.721
So here was the poll that I put up.

00:14:20.802 --> 00:14:21.861
What frustrates you more?

00:14:22.403 --> 00:14:23.043
As professionals,

00:14:23.082 --> 00:14:24.683
we're all invested time and

00:14:24.744 --> 00:14:25.844
money into our education,

00:14:26.144 --> 00:14:27.065
but the question remains,

00:14:27.245 --> 00:14:28.825
which of those stings the most?

00:14:28.884 --> 00:14:30.206
I wanted to know emotionally

00:14:30.245 --> 00:14:32.226
what they thought stings the most.

00:14:32.866 --> 00:14:34.388
And I said, was it the price tag,

00:14:35.307 --> 00:14:36.448
the cost of your degree

00:14:36.489 --> 00:14:37.229
that puts a dent in your

00:14:37.269 --> 00:14:38.809
wallet every month, you gotta pay that,

00:14:39.730 --> 00:14:40.570
or the ROI,

00:14:40.610 --> 00:14:43.091
the value your degree returns

00:14:43.272 --> 00:14:44.192
in terms of what's brought

00:14:44.231 --> 00:14:45.272
into your career?

00:14:45.351 --> 00:14:46.852
And it's not just money there, right?

00:14:47.513 --> 00:14:48.374
And the results,

00:14:48.413 --> 00:14:50.014
I think I had about 200

00:14:50.014 --> 00:14:51.095
responses on LinkedIn,

00:14:51.115 --> 00:14:51.955
a couple hundred on Twitter,

00:14:51.975 --> 00:14:52.875
a couple hundred on Facebook.

00:14:53.556 --> 00:14:57.638
And here it was 47% said the price tag,

00:14:57.697 --> 00:14:59.298
the cost of the degree,

00:15:00.318 --> 00:15:02.260
was the thing that stung the most.

00:15:02.541 --> 00:15:03.621
You're responsible for that.

00:15:04.201 --> 00:15:05.342
The return on investment was

00:15:05.342 --> 00:15:07.325
40% and then 13% with that

00:15:07.384 --> 00:15:08.785
cop out answer of show results.

00:15:09.225 --> 00:15:10.047
This is on LinkedIn.

00:15:10.267 --> 00:15:11.548
The Twitter results were

00:15:11.587 --> 00:15:13.528
actually flip flopped a little bit.

00:15:13.649 --> 00:15:14.710
It was the ROI.

00:15:14.750 --> 00:15:15.811
So people anger what they

00:15:15.831 --> 00:15:16.772
can get out of it.

00:15:16.912 --> 00:15:17.631
Here's the trap.

00:15:18.493 --> 00:15:19.254
number one you're on the

00:15:19.293 --> 00:15:20.394
hook for it you sign them a

00:15:20.434 --> 00:15:21.095
dotted line that's your

00:15:21.115 --> 00:15:22.876
fault buyer beware you

00:15:22.897 --> 00:15:24.859
signed for it that was that

00:15:25.038 --> 00:15:27.400
was in your control you're

00:15:27.520 --> 00:15:28.802
so mad at that thing in the

00:15:28.881 --> 00:15:30.864
past the price tag it's out

00:15:30.884 --> 00:15:31.924
of your control now but

00:15:31.965 --> 00:15:33.285
you're responsible here's

00:15:33.326 --> 00:15:35.268
the thing everybody's

00:15:35.288 --> 00:15:36.408
saying 40 saying the roi

00:15:36.889 --> 00:15:37.870
that's the only damn thing

00:15:37.909 --> 00:15:39.711
you can control so if you

00:15:39.772 --> 00:15:41.312
are if you sign them a dotted line

00:15:42.153 --> 00:15:43.697
sat on a conveyor belt and

00:15:43.758 --> 00:15:45.020
went through PT school and

00:15:45.041 --> 00:15:46.865
came out and had a bill and

00:15:46.904 --> 00:15:49.070
then sat on a different conveyor belt.

00:15:50.068 --> 00:15:52.751
which is a job at someone else's business,

00:15:52.932 --> 00:15:54.572
and you're upset with what's coming,

00:15:54.592 --> 00:15:55.693
that's your fault.

00:15:56.355 --> 00:15:57.635
The thing that you can do is,

00:15:57.676 --> 00:15:59.116
and we'll get into other options,

00:15:59.638 --> 00:16:00.238
you can get off that

00:16:00.298 --> 00:16:01.759
conveyor belt and do something different.

00:16:01.779 --> 00:16:02.801
You can leave the profession.

00:16:02.821 --> 00:16:04.361
A lot of people threaten to

00:16:04.402 --> 00:16:06.303
leave the profession every day,

00:16:06.323 --> 00:16:07.365
and we're seeing people do that.

00:16:07.384 --> 00:16:08.285
It kind of feels like every

00:16:08.326 --> 00:16:09.047
four years when people

00:16:09.086 --> 00:16:10.408
threaten to move to Canada,

00:16:10.768 --> 00:16:11.589
if a certain political

00:16:11.629 --> 00:16:12.409
candidate that they don't

00:16:12.429 --> 00:16:13.331
like gets elected,

00:16:13.350 --> 00:16:14.230
there's the saber rattling.

00:16:15.952 --> 00:16:17.234
But I find this interesting

00:16:17.274 --> 00:16:18.315
because one of those things

00:16:18.355 --> 00:16:19.976
you currently have,

00:16:20.878 --> 00:16:22.778
I want to say complete control over,

00:16:22.818 --> 00:16:23.879
which is the ROI.

00:16:23.921 --> 00:16:25.701
So that was the thing I'm like, okay,

00:16:25.741 --> 00:16:26.302
you can bitch,

00:16:26.602 --> 00:16:28.043
but what are we going to do about it?

00:16:28.245 --> 00:16:30.506
Did the results surprise you guys at all?

00:16:30.547 --> 00:16:31.727
I mean, it was a trap answer.

00:16:31.827 --> 00:16:33.009
It was a trap question.

00:16:33.149 --> 00:16:34.090
What do you think, Dave?

00:16:34.190 --> 00:16:35.831
I'm surprised by that, truthfully.

00:16:37.436 --> 00:16:38.417
I'm not surprised.

00:16:39.258 --> 00:16:39.619
Obviously,

00:16:39.678 --> 00:16:41.179
Jimmy puts out the poll

00:16:41.220 --> 00:16:42.721
responses in a way that

00:16:42.761 --> 00:16:44.423
those are typically the

00:16:44.644 --> 00:16:46.365
biggest areas that people

00:16:46.446 --> 00:16:48.347
will talk about or complain

00:16:48.388 --> 00:16:50.450
about or mention in terms

00:16:50.509 --> 00:16:53.432
of any negative sentiment

00:16:53.614 --> 00:16:55.095
around their degree.

00:16:55.995 --> 00:16:57.538
um but I love like you know

00:16:57.557 --> 00:16:58.859
we we're all here with with

00:16:58.899 --> 00:17:00.461
jimmy right like jimmy is

00:17:00.500 --> 00:17:01.581
doing something right now

00:17:01.761 --> 00:17:03.063
like just like working from

00:17:03.104 --> 00:17:04.164
home you've worked for

00:17:04.204 --> 00:17:05.487
other companies you're

00:17:05.507 --> 00:17:06.508
doing this like in the we

00:17:06.528 --> 00:17:07.769
talked about last episode

00:17:07.808 --> 00:17:08.309
nine we don't have to

00:17:08.349 --> 00:17:09.671
rehash it but like the last

00:17:09.711 --> 00:17:10.991
episode of like therapists

00:17:11.333 --> 00:17:12.513
trying to find non-clinical

00:17:12.894 --> 00:17:16.557
jobs but but being a ptot slp um you know

00:17:17.199 --> 00:17:18.740
jimmy arguably I mean you

00:17:18.759 --> 00:17:20.161
know I can't speak for him

00:17:20.181 --> 00:17:21.382
but he's living you know

00:17:21.863 --> 00:17:22.742
pretty well in terms of

00:17:22.782 --> 00:17:23.564
like doing the things

00:17:23.604 --> 00:17:24.284
people want to do which is

00:17:24.304 --> 00:17:25.305
like work from home like

00:17:25.585 --> 00:17:26.486
kind of make their own

00:17:26.506 --> 00:17:27.727
schedule do you know

00:17:27.787 --> 00:17:28.768
different tasks whatever

00:17:28.847 --> 00:17:29.868
like you know different

00:17:29.909 --> 00:17:30.648
initiatives different

00:17:30.669 --> 00:17:32.530
projects whatever but and

00:17:32.550 --> 00:17:34.051
so jimmy you went you got a

00:17:34.092 --> 00:17:35.833
dpt uh you did some

00:17:35.873 --> 00:17:37.114
rotations I forget if you

00:17:37.134 --> 00:17:38.355
even had a first job or you

00:17:38.375 --> 00:17:39.256
did fox rehab I can't

00:17:39.296 --> 00:17:40.537
remember if you treated two

00:17:40.576 --> 00:17:41.877
years for two and a half years

00:17:42.537 --> 00:17:43.377
Okay, that's long enough.

00:17:44.138 --> 00:17:44.558
You treat it.

00:17:44.818 --> 00:17:46.220
And now you're doing this.

00:17:46.980 --> 00:17:48.962
You created it though, right?

00:17:49.683 --> 00:17:50.825
And I know I mentioned it before,

00:17:50.964 --> 00:17:53.867
but I like to also mention it.

00:17:54.667 --> 00:17:55.709
It never gets talked about

00:17:56.450 --> 00:17:57.830
of the cost of being able

00:17:57.851 --> 00:17:58.592
to help your friends and

00:17:58.632 --> 00:18:00.394
family or yourself with the

00:18:00.453 --> 00:18:02.154
knowledge that we've got about...

00:18:02.855 --> 00:18:04.037
Differential diagnoses,

00:18:04.417 --> 00:18:06.539
mechanism of injury, healing,

00:18:06.599 --> 00:18:09.061
recovery time, sleep, nutrition, diet,

00:18:09.201 --> 00:18:10.564
exercise, mobility, whatever.

00:18:11.284 --> 00:18:11.523
I mean,

00:18:11.825 --> 00:18:13.046
I think over the course of your

00:18:13.086 --> 00:18:14.606
life that $250,000 for that

00:18:18.696 --> 00:18:19.257
I think it's worth it.

00:18:19.396 --> 00:18:22.238
But again, you know, the folks out there,

00:18:22.258 --> 00:18:23.478
the PTs in the Facebook

00:18:23.498 --> 00:18:24.198
groups are the judge and

00:18:24.218 --> 00:18:25.098
the jury at the same time.

00:18:25.818 --> 00:18:28.660
You can give people a

00:18:28.759 --> 00:18:30.700
toolbox and materials and

00:18:30.779 --> 00:18:33.320
people will make a boat or excuses.

00:18:34.080 --> 00:18:35.682
You know, I mean, you could you know,

00:18:35.741 --> 00:18:36.622
I mean, that's the thing.

00:18:36.642 --> 00:18:38.201
It really is what you do with it.

00:18:38.301 --> 00:18:39.843
So here's the funny part.

00:18:40.303 --> 00:18:42.363
The people who are doing the most with it,

00:18:42.502 --> 00:18:44.084
we don't see them bitching on Twitter.

00:18:44.912 --> 00:18:46.153
We don't see them complaining on Reddit.

00:18:46.192 --> 00:18:46.593
We don't see.

00:18:46.873 --> 00:18:48.354
So there is another side to it.

00:18:48.453 --> 00:18:49.454
So when I saw that post

00:18:49.474 --> 00:18:51.796
yesterday about the person

00:18:51.816 --> 00:18:52.576
essentially describing,

00:18:52.636 --> 00:18:53.557
I would like to do what I

00:18:53.617 --> 00:18:56.599
want when I want around

00:18:56.619 --> 00:18:57.599
complete flexibility.

00:18:57.619 --> 00:18:58.500
And my question is great.

00:18:58.641 --> 00:19:00.261
What, what value are you providing?

00:19:00.301 --> 00:19:01.803
Because if you're asking for a dollar,

00:19:01.883 --> 00:19:02.864
I need you to bring two and

00:19:02.884 --> 00:19:04.845
a half worth of value value.

00:19:05.204 --> 00:19:05.404
Right.

00:19:05.684 --> 00:19:06.846
And that person was essentially saying,

00:19:06.865 --> 00:19:07.286
where are the,

00:19:07.547 --> 00:19:08.406
and I feel like clinicians

00:19:08.446 --> 00:19:09.248
just default to this

00:19:09.347 --> 00:19:11.868
utilization reviewer job, which doesn't,

00:19:12.148 --> 00:19:12.930
which isn't that the person

00:19:12.970 --> 00:19:14.070
we complain about all the time.

00:19:15.407 --> 00:19:16.528
The person that's denying care.

00:19:16.548 --> 00:19:17.669
So people are like, oh,

00:19:17.689 --> 00:19:19.450
these utilization reviewers denying care.

00:19:19.490 --> 00:19:20.250
These guys are idiots.

00:19:20.451 --> 00:19:21.151
Hey, are they hiring?

00:19:21.211 --> 00:19:22.751
Because I heard the job pays pretty well.

00:19:22.791 --> 00:19:23.712
It's like, hold on a second.

00:19:24.133 --> 00:19:25.473
That's like Luke deciding to

00:19:25.513 --> 00:19:26.693
be a stormtrooper for the

00:19:26.753 --> 00:19:27.855
benefits and the paycheck.

00:19:27.934 --> 00:19:29.215
It's like, what are you doing here?

00:19:29.556 --> 00:19:30.776
Because they just want to

00:19:30.796 --> 00:19:31.477
work from home from a

00:19:31.497 --> 00:19:33.178
laptop and not go anywhere

00:19:33.238 --> 00:19:34.377
and not go travel to an

00:19:34.417 --> 00:19:35.278
office or travel to a

00:19:35.298 --> 00:19:36.519
patient's home and treat patients.

00:19:36.579 --> 00:19:37.200
That's what they want to do.

00:19:37.359 --> 00:19:38.701
I will say the job that I created,

00:19:38.740 --> 00:19:40.842
I wound up working from like 6 a.m.

00:19:40.862 --> 00:19:42.603
to 6 p.m., but I still like it.

00:19:43.143 --> 00:19:44.003
And I still think I bring

00:19:44.064 --> 00:19:44.903
value because the people

00:19:44.923 --> 00:19:46.345
that I work for keep paying me.

00:19:46.665 --> 00:19:48.007
And if I didn't, I'd get fired.

00:19:48.527 --> 00:19:49.788
But you can take my story,

00:19:50.067 --> 00:19:52.470
which I do all the time, to PT schools.

00:19:52.529 --> 00:19:52.849
And I'm like,

00:19:53.069 --> 00:19:53.871
I'm not expecting any of you

00:19:53.891 --> 00:19:54.672
to run out and start a

00:19:54.711 --> 00:19:55.833
podcast or do anything that

00:19:55.873 --> 00:19:56.573
I do on the side.

00:19:56.873 --> 00:19:58.714
But what's your thing plus PT?

00:20:00.079 --> 00:20:00.259
You know,

00:20:00.279 --> 00:20:01.820
when I pitched myself to Fox Rehab,

00:20:01.881 --> 00:20:03.201
I emailed the CEO and I was like,

00:20:03.682 --> 00:20:04.402
I'm guessing you have a

00:20:04.461 --> 00:20:05.321
recruitment problem.

00:20:05.682 --> 00:20:06.363
What if we launched a

00:20:06.403 --> 00:20:08.564
podcast that educated, inspired,

00:20:08.624 --> 00:20:11.285
and informed geriatric PTs?

00:20:11.305 --> 00:20:12.605
And then the close of every episode was,

00:20:12.625 --> 00:20:13.046
by the way,

00:20:13.145 --> 00:20:14.625
we have practice in these

00:20:14.645 --> 00:20:15.987
30-something states.

00:20:16.586 --> 00:20:17.227
That was my pitch.

00:20:17.247 --> 00:20:17.867
And he was like,

00:20:18.268 --> 00:20:19.647
we do have a recruiting problem.

00:20:19.868 --> 00:20:19.989
Now,

00:20:20.009 --> 00:20:21.189
I could have tried to get a job in the

00:20:21.229 --> 00:20:22.269
recruiting department of Fox,

00:20:22.289 --> 00:20:23.309
but that's not what I wanted to do.

00:20:23.950 --> 00:20:25.050
I built a side avenue.

00:20:25.770 --> 00:20:27.191
So don't go do that.

00:20:27.211 --> 00:20:28.051
I mean, you can if you want,

00:20:28.071 --> 00:20:30.132
but what's your yes and is

00:20:30.172 --> 00:20:31.073
the real message.

00:20:31.133 --> 00:20:31.732
I think that is.

00:20:32.913 --> 00:20:33.252
Yeah,

00:20:33.413 --> 00:20:35.114
it's internal versus external locus

00:20:35.153 --> 00:20:37.595
of control, you know, external locus.

00:20:37.954 --> 00:20:39.174
I can't control the price.

00:20:39.234 --> 00:20:40.596
I'm going to get mad at the price.

00:20:41.635 --> 00:20:43.636
The price is I'm genuinely

00:20:43.696 --> 00:20:44.596
shocked that therapists

00:20:44.636 --> 00:20:46.817
would be complaining about the price.

00:20:46.857 --> 00:20:48.278
The price does not matter.

00:20:48.337 --> 00:20:49.558
What matters is the return

00:20:49.618 --> 00:20:50.358
on the investment.

00:20:51.199 --> 00:20:51.659
And so,

00:20:51.940 --> 00:20:54.000
but return on investment is under

00:20:54.101 --> 00:20:54.760
my control.

00:20:54.840 --> 00:20:56.241
What do I do with that degree?

00:20:56.301 --> 00:20:57.923
What do I do with those three letters?

00:20:59.022 --> 00:21:00.344
So obviously it doesn't feel

00:21:00.384 --> 00:21:01.763
good to look at myself in

00:21:01.804 --> 00:21:03.464
the mirror and blame myself

00:21:03.625 --> 00:21:06.247
for the lack of return on investment.

00:21:06.747 --> 00:21:06.866
Yeah.

00:21:06.886 --> 00:21:07.606
When you, the whole thing,

00:21:07.626 --> 00:21:08.548
when you point at people,

00:21:08.847 --> 00:21:10.628
how many fingers are pointed back at you?

00:21:10.669 --> 00:21:11.729
It's like you, my dude,

00:21:12.029 --> 00:21:12.789
there was somebody in a

00:21:12.890 --> 00:21:13.911
LinkedIn discussion and

00:21:13.931 --> 00:21:15.250
I'll find it because he

00:21:15.270 --> 00:21:16.412
wound up accusing me of being

00:21:17.691 --> 00:21:19.292
like unprofessional or whatever.

00:21:19.732 --> 00:21:20.213
But he was like,

00:21:20.713 --> 00:21:22.976
APTA was directly

00:21:23.056 --> 00:21:25.598
responsible for the cost of my degree.

00:21:26.140 --> 00:21:27.019
And I'm a word guy.

00:21:27.080 --> 00:21:28.721
I was like, directly responsible?

00:21:29.282 --> 00:21:30.223
They didn't set the price.

00:21:30.723 --> 00:21:30.983
Also,

00:21:31.045 --> 00:21:32.026
they didn't send him a dotted line

00:21:32.046 --> 00:21:32.865
and show up to PT school.

00:21:33.586 --> 00:21:35.568
The price didn't change, right?

00:21:35.608 --> 00:21:36.509
There's rules around.

00:21:36.529 --> 00:21:37.471
You can't change the price

00:21:37.510 --> 00:21:39.173
in the middle of a degree, right?

00:21:39.192 --> 00:21:40.534
Like, I'm pretty sure you can't do that.

00:21:40.574 --> 00:21:42.375
Like, if you're in year two, you can't say,

00:21:42.395 --> 00:21:42.935
hey, by the way,

00:21:43.195 --> 00:21:44.076
the price is going to go up.

00:21:44.837 --> 00:21:46.960
When you sat down day one, year one,

00:21:47.019 --> 00:21:49.442
you knew what the cost was going to be.

00:21:49.843 --> 00:21:51.884
You thought you knew what the value was.

00:21:51.944 --> 00:21:52.905
And then when you got out,

00:21:53.707 --> 00:21:54.307
but here's the thing.

00:21:54.887 --> 00:21:55.788
Value is changeable.

00:21:57.115 --> 00:21:59.196
Values completely, it's up to you, right?

00:21:59.676 --> 00:22:01.417
People, what's that line?

00:22:01.478 --> 00:22:03.598
People bitch about needs, but not wants.

00:22:03.959 --> 00:22:04.960
I'll complain about the cost

00:22:04.980 --> 00:22:05.880
of gas and milk,

00:22:06.300 --> 00:22:09.321
but not the cost of my Bose

00:22:09.362 --> 00:22:10.782
headphones or my MacBook.

00:22:11.123 --> 00:22:13.163
I'll find a way to get those

00:22:13.203 --> 00:22:14.144
things that I want,

00:22:14.163 --> 00:22:15.244
but the things that I need,

00:22:15.285 --> 00:22:16.265
I'm gonna complain about it.

00:22:16.285 --> 00:22:16.865
Well, apparently,

00:22:17.526 --> 00:22:19.606
Being a PT is a need if you

00:22:19.626 --> 00:22:21.087
want to provide physical therapy,

00:22:21.368 --> 00:22:23.349
but it's not the only way you can do it.

00:22:23.369 --> 00:22:24.170
So do you want to talk about

00:22:24.250 --> 00:22:25.290
stretch lab or do you want

00:22:25.310 --> 00:22:26.652
to go with the example of

00:22:26.672 --> 00:22:29.273
the chiropractor that stirred the pot?

00:22:29.614 --> 00:22:30.914
Let me grab the example.

00:22:30.994 --> 00:22:32.895
So this was shared in my

00:22:32.935 --> 00:22:34.037
Facebook group the other day.

00:22:34.336 --> 00:22:35.518
I'm not going to read the whole thing.

00:22:35.817 --> 00:22:37.439
It's a ton of information.

00:22:37.499 --> 00:22:38.579
I know there are people listening,

00:22:38.619 --> 00:22:39.260
not watching.

00:22:39.861 --> 00:22:41.982
But the gist of it is, Anthony,

00:22:42.343 --> 00:22:43.544
I know a while back you

00:22:43.564 --> 00:22:44.305
were talking about

00:22:44.404 --> 00:22:45.665
hypothetically scheduling

00:22:45.705 --> 00:22:48.367
Medicare patients every 8 to 10 minutes,

00:22:48.528 --> 00:22:49.989
only billing a single unit,

00:22:50.048 --> 00:22:51.250
and then having patients

00:22:51.289 --> 00:22:52.310
work with a tech or a

00:22:52.351 --> 00:22:53.711
trainer for a cash price.

00:22:54.732 --> 00:22:55.773
And then they go through

00:22:55.794 --> 00:22:57.894
this breakdown of a chiropractor.

00:22:57.914 --> 00:22:58.695
Chiropractor.

00:22:59.056 --> 00:23:03.038
who is generating about 960,000 a year.

00:23:03.058 --> 00:23:04.839
I don't know if these are

00:23:04.880 --> 00:23:06.520
real numbers or theoretical numbers,

00:23:06.601 --> 00:23:08.501
but I will say I know

00:23:08.541 --> 00:23:09.682
chiropractors doing this.

00:23:10.703 --> 00:23:12.025
I know a handful of them.

00:23:12.204 --> 00:23:13.105
I've worked with them.

00:23:13.125 --> 00:23:14.526
I know them personally.

00:23:15.166 --> 00:23:17.048
And so it goes back to

00:23:17.167 --> 00:23:18.808
return on the investment, right?

00:23:18.909 --> 00:23:20.871
But what's most interesting about this,

00:23:21.411 --> 00:23:23.092
so the guys that I know doing it,

00:23:23.612 --> 00:23:25.374
they're doing it 100% compliant.

00:23:25.453 --> 00:23:26.755
They're not breaking any rules.

00:23:26.775 --> 00:23:28.316
They're not violating any laws.

00:23:28.996 --> 00:23:30.416
But think about that.

00:23:30.557 --> 00:23:32.478
So in this example,

00:23:33.077 --> 00:23:34.878
this person is saying 40 to

00:23:34.878 --> 00:23:38.861
80 patients a day, five days a week,

00:23:38.861 --> 00:23:39.921
40 to 80 patients a day,

00:23:40.000 --> 00:23:40.661
five days a week.

00:23:41.182 --> 00:23:42.602
This is a chiropractic office.

00:23:43.702 --> 00:23:44.762
What do you guys think?

00:23:44.803 --> 00:23:45.763
And I know you probably saw

00:23:45.824 --> 00:23:46.824
some of the replies.

00:23:47.505 --> 00:23:49.305
What do you think are the

00:23:49.444 --> 00:23:50.885
gist of the replies that

00:23:50.925 --> 00:23:52.487
other therapists are sharing about this?

00:23:53.553 --> 00:23:53.873
ethics?

00:23:54.814 --> 00:23:55.834
I didn't, yeah, I didn't see that.

00:23:55.933 --> 00:23:56.874
I didn't see this at all.

00:23:56.894 --> 00:23:58.015
So this is the first time I'm seeing it.

00:23:58.275 --> 00:23:59.115
Um, yeah, I,

00:23:59.215 --> 00:24:00.395
I'm assuming there's going to be some,

00:24:00.836 --> 00:24:01.916
some hatred just because it

00:24:02.576 --> 00:24:03.798
is a couple of things,

00:24:03.917 --> 00:24:04.837
a Cairo and it's a

00:24:04.877 --> 00:24:07.558
different model that we all kind of do.

00:24:07.659 --> 00:24:08.519
And most of the,

00:24:08.619 --> 00:24:10.019
most of the therapists in this group are,

00:24:10.079 --> 00:24:10.961
are going to be delivering

00:24:11.080 --> 00:24:12.760
every unit of care or every

00:24:12.861 --> 00:24:13.961
minute of care or whatever.

00:24:14.021 --> 00:24:14.221
Right.

00:24:14.281 --> 00:24:16.803
So I'm sure it is negative

00:24:16.843 --> 00:24:18.104
and people are saying fraud

00:24:18.144 --> 00:24:19.523
and call your state department and,

00:24:19.564 --> 00:24:20.525
you know, call, uh,

00:24:20.984 --> 00:24:23.586
Call the secretary of, I don't know,

00:24:23.665 --> 00:24:24.267
a fraud, whatever.

00:24:24.287 --> 00:24:24.866
You nailed it.

00:24:24.987 --> 00:24:25.626
You nailed it.

00:24:25.686 --> 00:24:27.647
It was, when does he do documentation?

00:24:28.148 --> 00:24:31.269
Does he have to have an ABN signed?

00:24:31.390 --> 00:24:32.451
Such fraud.

00:24:33.711 --> 00:24:34.892
Pre-typed templates.

00:24:35.311 --> 00:24:36.613
Pre-typed phrases.

00:24:37.252 --> 00:24:38.693
What terrible treatment.

00:24:38.753 --> 00:24:40.194
Quote, what terrible treatment.

00:24:40.255 --> 00:24:41.434
How do they know?

00:24:41.454 --> 00:24:41.976
They don't know.

00:24:42.135 --> 00:24:42.516
They don't know.

00:24:43.151 --> 00:24:43.590
What's that?

00:24:45.874 --> 00:24:47.315
That's a gigantic assumption.

00:24:47.915 --> 00:24:51.058
So I'm a believer that if I

00:24:51.138 --> 00:24:53.741
want to truly see what the

00:24:53.781 --> 00:24:54.982
consumer values,

00:24:55.163 --> 00:24:56.845
I look at what the consumer does.

00:24:56.884 --> 00:24:58.606
Do you think you can have a

00:24:58.666 --> 00:25:00.249
practice running 40 to 80

00:25:00.249 --> 00:25:02.330
patients a day and those

00:25:02.411 --> 00:25:04.492
patients aren't receiving what they want?

00:25:05.054 --> 00:25:06.315
Like it'd be impossible.

00:25:06.414 --> 00:25:06.914
And again,

00:25:06.934 --> 00:25:08.696
I know the chiropractors that

00:25:08.737 --> 00:25:09.737
are doing this and I know

00:25:09.777 --> 00:25:11.317
the patients that are going to it.

00:25:11.397 --> 00:25:12.459
I've got a perfect example.

00:25:12.499 --> 00:25:14.059
I've got a patient in my clinic right now.

00:25:14.621 --> 00:25:15.881
I'm treating for a condition.

00:25:16.521 --> 00:25:18.022
The spouse of the patient

00:25:18.623 --> 00:25:19.663
drops the patient off

00:25:19.683 --> 00:25:20.765
because the patient can't drive,

00:25:21.484 --> 00:25:23.467
goes half a mile up the road.

00:25:24.307 --> 00:25:26.929
gets a crack, comes half a mile back,

00:25:27.388 --> 00:25:28.410
and then sits and rides on

00:25:28.450 --> 00:25:29.790
my bike for about 20

00:25:29.790 --> 00:25:31.192
minutes while I'm finishing

00:25:31.311 --> 00:25:34.334
the patient visit that I'm delivering.

00:25:34.354 --> 00:25:36.335
He goes to that chiropractor

00:25:36.494 --> 00:25:37.355
every single day,

00:25:37.395 --> 00:25:38.336
three days a week when the

00:25:38.356 --> 00:25:39.978
patient's in my clinic to get a crack.

00:25:40.238 --> 00:25:40.877
He loves it.

00:25:41.178 --> 00:25:42.298
He pays out of pocket.

00:25:42.638 --> 00:25:44.621
He would never dream of quitting.

00:25:45.020 --> 00:25:46.342
He gets everything that he

00:25:46.382 --> 00:25:48.042
wants for the time invested.

00:25:48.702 --> 00:25:49.384
And I've talked to

00:25:49.403 --> 00:25:50.424
chiropractors that'll

00:25:50.585 --> 00:25:52.266
effectively have 10

00:25:52.266 --> 00:25:53.626
treatment rooms set up.

00:25:54.426 --> 00:25:55.768
Patients will be prepped and

00:25:55.867 --> 00:25:58.729
ready and laying on 10 adjustment tables,

00:25:59.170 --> 00:26:00.230
pop, pop, pop, pop, pop.

00:26:00.589 --> 00:26:02.951
And then as they leave one room,

00:26:02.990 --> 00:26:03.852
that patient's leaving,

00:26:03.872 --> 00:26:04.892
the new one's coming in.

00:26:04.912 --> 00:26:07.653
And it is absolutely a conveyor belt.

00:26:07.733 --> 00:26:10.095
But again, these are adults,

00:26:10.394 --> 00:26:11.516
back to Jimmy's point,

00:26:11.816 --> 00:26:13.356
making a conscious decision

00:26:13.696 --> 00:26:14.896
to get what they want.

00:26:14.957 --> 00:26:16.117
They are buying what they want.

00:26:16.198 --> 00:26:17.679
As much as we hate McDonald's,

00:26:18.038 --> 00:26:19.720
there is never a shortage

00:26:19.900 --> 00:26:21.181
of individuals buying

00:26:21.240 --> 00:26:22.381
McDonald's cheeseburgers

00:26:22.421 --> 00:26:23.521
and hamburgers and shakes.

00:26:24.631 --> 00:26:26.711
So it just drives me crazy

00:26:26.751 --> 00:26:28.272
that therapists put all of

00:26:28.333 --> 00:26:29.772
their biases on this.

00:26:30.212 --> 00:26:31.534
Then they complain that they

00:26:31.554 --> 00:26:32.513
don't make enough money.

00:26:32.534 --> 00:26:33.914
And, you know,

00:26:33.954 --> 00:26:35.234
there are models out there

00:26:35.275 --> 00:26:36.695
that work that satisfy the

00:26:36.715 --> 00:26:37.776
patient that are compliant

00:26:37.816 --> 00:26:38.797
with third party payers.

00:26:38.896 --> 00:26:40.717
And they just simply refuse

00:26:40.957 --> 00:26:42.097
to even investigate it.

00:26:42.557 --> 00:26:42.877
Hold on.

00:26:42.897 --> 00:26:44.598
So throw that graphic back back up.

00:26:44.679 --> 00:26:45.659
So let me let me just make

00:26:45.699 --> 00:26:47.359
sure the audience didn't go too fast.

00:26:47.380 --> 00:26:48.539
I think you guys are really smart.

00:26:48.599 --> 00:26:49.661
I'm a little slower.

00:26:49.701 --> 00:26:50.601
So what this person is

00:26:50.661 --> 00:26:52.142
saying and correct me if I'm wrong.

00:26:53.557 --> 00:26:54.979
Let's say he's seeing 40 to

00:26:54.979 --> 00:26:55.719
80 patients a day.

00:26:55.979 --> 00:27:00.083
He's billing one code for Medicare,

00:27:00.864 --> 00:27:01.884
and that's sort of like his

00:27:01.963 --> 00:27:03.945
Costco rotisserie chicken.

00:27:04.626 --> 00:27:09.451
He knows he's getting one unit of Medicare,

00:27:09.891 --> 00:27:11.692
and then everything after

00:27:11.732 --> 00:27:14.035
that is an upsell, and it's an a la carte,

00:27:14.134 --> 00:27:14.976
and it's a decision.

00:27:15.155 --> 00:27:16.317
While I've got you here,

00:27:16.517 --> 00:27:18.018
what else can I serve you with?

00:27:18.057 --> 00:27:18.818
Do I have that right?

00:27:19.400 --> 00:27:19.579
Yeah.

00:27:19.619 --> 00:27:21.280
So he's billing an adjustment code.

00:27:21.320 --> 00:27:22.461
And basically for

00:27:22.560 --> 00:27:23.681
chiropractic care to be

00:27:23.721 --> 00:27:24.701
covered by Medicare,

00:27:24.740 --> 00:27:26.082
Medicare only covers the

00:27:26.122 --> 00:27:27.821
adjustment code and only in

00:27:27.862 --> 00:27:29.502
an acute situation.

00:27:29.982 --> 00:27:30.182
Right.

00:27:30.242 --> 00:27:31.923
So the adjustment code based

00:27:31.962 --> 00:27:32.943
on this email for North

00:27:32.983 --> 00:27:34.104
Carolina is thirty eight

00:27:34.144 --> 00:27:35.263
dollars and three cents.

00:27:35.403 --> 00:27:38.724
Then he charges fifty five dollars for,

00:27:38.825 --> 00:27:39.105
quote,

00:27:39.286 --> 00:27:41.465
a buffet of other stuff like that

00:27:41.486 --> 00:27:42.987
is not covered for medication,

00:27:43.227 --> 00:27:44.067
massage gun.

00:27:45.567 --> 00:27:46.588
And then they go through

00:27:46.648 --> 00:27:48.509
doing the math for 40 units at $38 a unit,

00:27:48.529 --> 00:27:49.611
plus another 40 cash pay at $55 a session,

00:27:49.611 --> 00:27:50.571
$3,721 five days a week.

00:27:50.612 --> 00:27:50.771
That's $18,600.

00:28:00.200 --> 00:28:01.380
And does all of the math

00:28:01.519 --> 00:28:03.401
leading to $80,000 a month,

00:28:03.401 --> 00:28:05.001
$960,000 a year.

00:28:05.102 --> 00:28:07.221
So hold on a second.

00:28:07.261 --> 00:28:08.002
So all right,

00:28:08.143 --> 00:28:09.603
let me play devil's advocate or whatever.

00:28:10.083 --> 00:28:11.824
So if he has someone who

00:28:11.864 --> 00:28:12.903
comes in and gets an

00:28:12.923 --> 00:28:14.964
adjustment and that one unit of Medicare,

00:28:14.984 --> 00:28:15.464
they could leave.

00:28:16.259 --> 00:28:16.420
Yeah.

00:28:16.799 --> 00:28:17.760
They can walk out the door

00:28:18.201 --> 00:28:19.621
to buy the other stuff.

00:28:20.040 --> 00:28:20.260
Okay.

00:28:20.701 --> 00:28:21.942
Or so you're like, Hey, you're done.

00:28:22.382 --> 00:28:22.801
FYI.

00:28:22.902 --> 00:28:24.343
If you'd like this, this is,

00:28:24.482 --> 00:28:25.482
this is what this costs.

00:28:25.542 --> 00:28:27.084
He's told that person in a

00:28:27.163 --> 00:28:28.743
language that they speak in

00:28:28.844 --> 00:28:30.025
words that they understand.

00:28:30.585 --> 00:28:31.325
If you do this,

00:28:31.365 --> 00:28:33.945
this is $55 or you can leave.

00:28:35.066 --> 00:28:35.787
Do I have that right?

00:28:36.126 --> 00:28:36.406
Correct.

00:28:37.865 --> 00:28:38.826
I don't know where the

00:28:38.925 --> 00:28:39.906
unethicalness comes.

00:28:39.946 --> 00:28:41.429
Now, you might not like that,

00:28:42.230 --> 00:28:43.550
but that's not unethical.

00:28:44.011 --> 00:28:45.894
That's your feeling, thought,

00:28:45.933 --> 00:28:47.955
and emotion that you are projecting.

00:28:48.536 --> 00:28:49.376
I'm not saying you need to

00:28:49.416 --> 00:28:50.178
flip your model.

00:28:50.438 --> 00:28:50.979
I'm saying,

00:28:51.900 --> 00:28:52.621
and this goes back to a

00:28:52.641 --> 00:28:54.162
discussion we had last week, which is,

00:28:54.803 --> 00:28:57.905
are PTs overeducated or underpaid, right?

00:28:58.646 --> 00:29:00.409
So you're educated to

00:29:00.469 --> 00:29:02.030
provide a really high value

00:29:02.191 --> 00:29:03.553
service and what they value

00:29:03.613 --> 00:29:05.835
is the evaluation and what they value,

00:29:06.015 --> 00:29:06.996
what they insurance

00:29:07.036 --> 00:29:08.979
companies or Medicare value

00:29:09.019 --> 00:29:09.920
less is the treatment.

00:29:10.180 --> 00:29:11.401
So maybe you should be doing

00:29:11.441 --> 00:29:12.682
more of the high value thing.

00:29:12.782 --> 00:29:13.903
It sounds like this person

00:29:14.424 --> 00:29:16.787
understood the understood

00:29:16.826 --> 00:29:18.809
the how many points each thing was.

00:29:18.829 --> 00:29:19.490
Yeah.

00:29:20.682 --> 00:29:22.124
and decided to score more points.

00:29:22.164 --> 00:29:23.566
He's like, well, I could kick field goals.

00:29:23.605 --> 00:29:24.366
That's three points.

00:29:24.967 --> 00:29:26.749
Or I could score touchdowns at six points.

00:29:26.808 --> 00:29:28.269
So I'm just going to get a

00:29:28.351 --> 00:29:29.491
lot of balls on the five

00:29:29.531 --> 00:29:30.352
yard line and score a lot

00:29:30.372 --> 00:29:31.453
of touchdowns and,

00:29:31.673 --> 00:29:33.556
and then let other people

00:29:33.596 --> 00:29:35.156
on the team kick field

00:29:35.196 --> 00:29:36.357
goals while I'm scoring a

00:29:36.397 --> 00:29:37.499
touchdown at the other end of the field.

00:29:38.140 --> 00:29:39.681
That's how you run up the score,

00:29:40.141 --> 00:29:41.481
which sounds unethical,

00:29:41.922 --> 00:29:44.023
except everybody in the room likes it.

00:29:44.423 --> 00:29:46.265
Or look at this guy's marketing machine.

00:29:46.684 --> 00:29:47.766
How is he seeing 40 days?

00:29:48.105 --> 00:29:49.787
Do you think new people are

00:29:49.866 --> 00:29:50.988
falling off of trees?

00:29:52.648 --> 00:29:53.429
Here's the one bit of

00:29:53.469 --> 00:29:54.369
information I would love.

00:29:54.930 --> 00:29:56.111
What's the repeat customer?

00:29:56.570 --> 00:29:57.592
What's the person coming back,

00:29:57.632 --> 00:29:59.833
like you said, three times a week?

00:29:59.873 --> 00:30:01.173
It has to be close to all of them, right?

00:30:01.733 --> 00:30:03.015
So I would love to hear from

00:30:03.055 --> 00:30:03.694
someone in the audience

00:30:03.734 --> 00:30:05.715
telling me where the unethicalness lies.

00:30:05.736 --> 00:30:06.876
Because that person who's

00:30:06.916 --> 00:30:08.317
doing that figured out the

00:30:08.377 --> 00:30:09.317
game and is playing it well.

00:30:10.159 --> 00:30:11.619
So physical therapists

00:30:11.799 --> 00:30:12.799
probably that commented,

00:30:12.859 --> 00:30:13.840
and I don't know because I

00:30:13.881 --> 00:30:14.540
didn't see this post,

00:30:14.560 --> 00:30:15.662
but most likely because we

00:30:15.741 --> 00:30:18.063
all want to do therapeutic

00:30:18.123 --> 00:30:19.864
exercise and therapeutic intervention,

00:30:19.884 --> 00:30:21.125
neuromuscular re-ed, right?

00:30:21.144 --> 00:30:23.046
So we're kind of geared to

00:30:24.106 --> 00:30:26.627
get someone independent and empowered,

00:30:26.667 --> 00:30:26.867
right?

00:30:27.347 --> 00:30:28.489
This model is just different.

00:30:28.509 --> 00:30:29.549
This is just a different model.

00:30:30.450 --> 00:30:31.810
uh we're you want to go

00:30:31.851 --> 00:30:32.830
teach someone how to do you

00:30:32.851 --> 00:30:33.971
know prone press-ups and

00:30:34.010 --> 00:30:34.731
you know I don't know like

00:30:34.771 --> 00:30:35.751
a hip stretch or whatever

00:30:35.872 --> 00:30:37.251
and treat them for two to

00:30:37.291 --> 00:30:38.492
six visits or 12 visits or

00:30:38.532 --> 00:30:39.573
whatever and then discharge

00:30:39.593 --> 00:30:40.733
them and say bye like I

00:30:40.773 --> 00:30:41.594
hope you have a nice life

00:30:41.673 --> 00:30:42.773
and hopefully I never have

00:30:42.794 --> 00:30:43.615
to see you again whatever

00:30:43.654 --> 00:30:44.595
which by the way is

00:30:44.634 --> 00:30:46.355
terrible for business and

00:30:46.455 --> 00:30:47.516
it's just it's a totally

00:30:47.556 --> 00:30:50.096
different model and I want

00:30:50.116 --> 00:30:52.298
to tip my cat I want to tip my cat to

00:30:54.002 --> 00:30:54.563
This is me.

00:30:54.624 --> 00:30:56.384
This is not Tony or Jimmy,

00:30:56.424 --> 00:30:57.484
but I want to tip my cap to

00:30:57.525 --> 00:30:58.306
the practice owner of this

00:30:58.346 --> 00:30:59.506
Cairo because this,

00:30:59.606 --> 00:31:01.027
like Tony said about McDonald's,

00:31:01.106 --> 00:31:02.909
this takes operational excellence.

00:31:02.929 --> 00:31:04.108
You have to have, like Jimmy said,

00:31:04.470 --> 00:31:05.829
the marketing machine on the front end,

00:31:06.391 --> 00:31:07.530
but then the value and the

00:31:07.611 --> 00:31:09.251
actual deliverable that the

00:31:09.372 --> 00:31:10.272
patient and the client is

00:31:10.292 --> 00:31:11.534
getting for this repeat

00:31:11.554 --> 00:31:12.755
business to actually occur

00:31:12.875 --> 00:31:14.134
and to potentially be

00:31:14.615 --> 00:31:15.415
generating 960 grand a year.

00:31:16.957 --> 00:31:18.137
It has to be a great environment,

00:31:18.218 --> 00:31:19.097
a great experience.

00:31:19.419 --> 00:31:20.839
No one's getting burned with hot packs.

00:31:20.920 --> 00:31:23.161
No one is getting cursed out.

00:31:23.401 --> 00:31:24.821
It must be a great environment.

00:31:25.201 --> 00:31:26.942
That local community values this.

00:31:26.982 --> 00:31:28.003
They continue to come back.

00:31:28.044 --> 00:31:28.924
They tell their friends and

00:31:28.944 --> 00:31:29.664
neighbors about it.

00:31:30.085 --> 00:31:31.046
And then apparently they're

00:31:31.066 --> 00:31:33.186
doing 40 to 80 patients a day.

00:31:33.548 --> 00:31:35.128
That takes a great team.

00:31:35.169 --> 00:31:36.388
It takes operational excellence.

00:31:36.509 --> 00:31:37.470
Everyone's dialed in.

00:31:37.910 --> 00:31:40.172
And the actual paying clients,

00:31:40.192 --> 00:31:41.472
so the Medicare beneficiary

00:31:41.532 --> 00:31:43.733
slash paying out of pocket

00:31:43.753 --> 00:31:46.036
for the non-covered services,

00:31:47.065 --> 00:31:49.007
They see or feel value.

00:31:49.086 --> 00:31:50.528
And just because you don't

00:31:50.568 --> 00:31:51.789
see or feel the value does

00:31:51.829 --> 00:31:52.391
not mean that those

00:31:52.411 --> 00:31:53.372
patients or clients are wrong.

00:31:55.182 --> 00:31:56.583
Yeah, yeah.

00:31:56.643 --> 00:31:58.383
And so if we want to take

00:31:58.442 --> 00:32:00.785
this and just kind of borrow from it,

00:32:02.065 --> 00:32:03.405
this is where I go back to, you know,

00:32:03.645 --> 00:32:04.786
I've got a lot of amazing

00:32:04.826 --> 00:32:07.406
therapists in my Medicare group and they,

00:32:07.426 --> 00:32:09.688
I tell them in my course, I'm like, look,

00:32:09.769 --> 00:32:10.828
I am teaching you guys how

00:32:10.848 --> 00:32:12.509
to bill Medicare, how to create claims,

00:32:12.549 --> 00:32:13.410
how to do all this stuff.

00:32:13.450 --> 00:32:14.230
But at the same time,

00:32:14.270 --> 00:32:15.270
I need you to understand

00:32:15.851 --> 00:32:17.271
you have a big target on

00:32:17.291 --> 00:32:18.432
your back because of the

00:32:18.853 --> 00:32:20.153
direction you chose to take

00:32:20.173 --> 00:32:20.792
your practice.

00:32:20.993 --> 00:32:22.034
These are therapists that

00:32:22.094 --> 00:32:23.795
chose to be lymphedema therapists.

00:32:24.315 --> 00:32:26.417
pelvic floor therapists, you know,

00:32:26.518 --> 00:32:29.382
complex neuro cases, complex amputees.

00:32:29.982 --> 00:32:30.964
We need you like,

00:32:31.085 --> 00:32:32.747
please don't ever leave the profession.

00:32:32.767 --> 00:32:34.409
These are amazing clinicians, but

00:32:35.458 --> 00:32:36.838
they have a giant target on

00:32:36.878 --> 00:32:38.720
their back because by the

00:32:38.780 --> 00:32:40.122
nature of their business,

00:32:40.162 --> 00:32:40.781
they are gonna be

00:32:40.821 --> 00:32:42.663
delivering more services,

00:32:43.263 --> 00:32:45.085
billable units than anybody else.

00:32:45.965 --> 00:32:47.727
And so one of the things we

00:32:47.747 --> 00:32:49.709
need to look at is they're so ingrained.

00:32:49.749 --> 00:32:51.210
So somebody had posted in my group,

00:32:51.289 --> 00:32:51.930
great question.

00:32:52.310 --> 00:32:54.712
Hey, I typically do a two hour evaluation.

00:32:55.472 --> 00:32:57.034
I could see Dave doing a

00:32:57.074 --> 00:32:58.375
two-hour evaluation when

00:32:58.394 --> 00:33:00.536
somebody is paying $500, $600, right?

00:33:00.556 --> 00:33:02.217
Because they're buying all the stuff.

00:33:02.616 --> 00:33:03.798
But he wants to do a

00:33:03.857 --> 00:33:05.239
two-hour evaluation for a

00:33:05.298 --> 00:33:06.500
Medicare beneficiary.

00:33:07.200 --> 00:33:07.980
And he said, you know,

00:33:08.000 --> 00:33:10.642
I really value the education,

00:33:10.701 --> 00:33:11.542
building rapport.

00:33:11.603 --> 00:33:13.304
We go through all of the case history.

00:33:13.364 --> 00:33:14.704
We do all of this testing.

00:33:14.744 --> 00:33:15.744
We do all of this stuff.

00:33:16.645 --> 00:33:18.207
And I'm like, that's cool.

00:33:18.767 --> 00:33:19.887
But more than anything,

00:33:19.928 --> 00:33:21.189
let me ask you two questions.

00:33:22.068 --> 00:33:23.890
He was focusing on patient buy-in.

00:33:23.910 --> 00:33:24.570
Okay.

00:33:25.640 --> 00:33:26.780
Do you think if you're going

00:33:26.800 --> 00:33:27.461
through Medicare,

00:33:28.281 --> 00:33:29.423
obviously you're not getting paid.

00:33:29.462 --> 00:33:30.423
It's an untimed code.

00:33:30.483 --> 00:33:31.644
You can do a two hour eval.

00:33:31.684 --> 00:33:32.965
I can do a 10 minute eval.

00:33:33.006 --> 00:33:33.686
I'm going to get paid the

00:33:33.707 --> 00:33:34.528
same amount as you.

00:33:34.847 --> 00:33:36.209
But that's not what we're talking about.

00:33:36.630 --> 00:33:37.670
It's the patient buy in.

00:33:37.690 --> 00:33:39.051
Do you really think if you

00:33:39.112 --> 00:33:41.173
did an hour versus two hour,

00:33:41.574 --> 00:33:43.255
the patient's not going to buy in?

00:33:43.295 --> 00:33:44.836
They're not going to hire

00:33:44.876 --> 00:33:46.617
you when Medicare is paying the bill.

00:33:47.118 --> 00:33:48.038
They probably are.

00:33:48.779 --> 00:33:50.101
But in my practice,

00:33:50.121 --> 00:33:52.141
and I've tested it over 22 years,

00:33:52.622 --> 00:33:55.182
like I can do 10 minutes

00:33:55.982 --> 00:33:58.743
and that patient feels so valued.

00:33:58.763 --> 00:34:01.545
And the word is feels, feels so valued,

00:34:01.644 --> 00:34:04.205
feels so listened to, feels so heard,

00:34:04.605 --> 00:34:05.767
feels like they understand

00:34:05.787 --> 00:34:07.007
that I am on their side.

00:34:07.027 --> 00:34:08.248
I am here for them.

00:34:08.827 --> 00:34:10.208
I can do that in about 10

00:34:10.208 --> 00:34:11.228
minutes most of the time.

00:34:12.170 --> 00:34:15.172
why do I need to invest 60 minutes,

00:34:15.172 --> 00:34:17.052
90 minutes, you know, whatever,

00:34:17.052 --> 00:34:18.052
110 minutes,

00:34:18.632 --> 00:34:19.672
when I can achieve the same

00:34:19.733 --> 00:34:21.233
outcome in 10?

00:34:21.233 --> 00:34:22.934
And I honestly think,

00:34:22.974 --> 00:34:24.394
and you guys I think will agree,

00:34:24.795 --> 00:34:25.996
patients don't remember two

00:34:26.036 --> 00:34:27.275
hours of information,

00:34:27.315 --> 00:34:28.056
no matter how much

00:34:28.135 --> 00:34:29.916
education you're giving them.

00:34:30.016 --> 00:34:31.797
It's like three minutes they'll remember.

00:34:32.097 --> 00:34:33.277
They don't even remember my name.

00:34:33.637 --> 00:34:35.159
They don't remember my company name.

00:34:35.518 --> 00:34:37.559
I tell them one thing, they remember that.

00:34:37.639 --> 00:34:38.920
So from my perspective,

00:34:39.420 --> 00:34:41.402
a single unit visit five

00:34:41.461 --> 00:34:43.503
days a week is far more impactful,

00:34:43.603 --> 00:34:44.704
far more beneficial,

00:34:44.824 --> 00:34:46.244
far better patient outcome,

00:34:46.284 --> 00:34:47.105
better patient care

00:34:47.125 --> 00:34:49.186
experience than doing two,

00:34:49.806 --> 00:34:51.327
two hour sessions a week

00:34:51.467 --> 00:34:54.309
because 90% of that two hours is wasted.

00:34:55.010 --> 00:34:55.650
What do you guys think?

00:34:55.909 --> 00:34:56.630
That is a lot.

00:34:57.831 --> 00:34:58.612
That is too much.

00:34:59.411 --> 00:35:00.552
That is not what the person

00:35:00.652 --> 00:35:01.172
is looking for.

00:35:01.193 --> 00:35:02.313
They're looking for a solution.

00:35:03.271 --> 00:35:04.570
They're focused on the how,

00:35:04.692 --> 00:35:05.811
like two hours.

00:35:05.871 --> 00:35:07.992
Like I would love to see the,

00:35:10.793 --> 00:35:12.514
it's the law of diminishing returns.

00:35:12.594 --> 00:35:14.715
Like after a certain timeframe,

00:35:15.394 --> 00:35:17.135
it doesn't work, right?

00:35:17.235 --> 00:35:17.615
It's not,

00:35:18.356 --> 00:35:20.876
you're losing and not gaining two hours.

00:35:20.936 --> 00:35:22.057
If I went somewhere for two hours,

00:35:22.478 --> 00:35:23.498
I'd be like, I'm not going back.

00:35:23.518 --> 00:35:24.398
That guy doesn't know what he's doing.

00:35:24.438 --> 00:35:25.579
It took him two hours to do

00:35:25.599 --> 00:35:26.418
what another person could

00:35:26.438 --> 00:35:27.260
do in 20 minutes.

00:35:29.704 --> 00:35:30.905
But what happens is we have

00:35:30.965 --> 00:35:32.045
confirmation bias.

00:35:32.465 --> 00:35:34.266
The patients who stay are

00:35:34.306 --> 00:35:35.126
the ones who love it.

00:35:35.646 --> 00:35:36.927
The ones who are really

00:35:36.987 --> 00:35:39.568
staying for the personal attention.

00:35:39.628 --> 00:35:40.608
Like, yeah,

00:35:40.648 --> 00:35:42.090
there are people out there who

00:35:42.130 --> 00:35:43.570
would love to absorb two

00:35:43.610 --> 00:35:44.610
hours of your attention.

00:35:45.110 --> 00:35:45.952
And it doesn't matter what

00:35:45.972 --> 00:35:46.452
you're telling them.

00:35:46.472 --> 00:35:47.172
They have no idea what

00:35:47.192 --> 00:35:47.751
you're telling them.

00:35:47.771 --> 00:35:49.152
They just like that they are

00:35:49.193 --> 00:35:50.753
the center of attention for two hours.

00:35:51.293 --> 00:35:52.335
But that's not what Medicare

00:35:52.355 --> 00:35:53.335
is paying us to do.

00:35:53.454 --> 00:35:54.376
I don't think it improves

00:35:54.396 --> 00:35:56.737
the patient outcome or anything else.

00:35:57.398 --> 00:35:58.838
And so it goes back to what

00:35:58.878 --> 00:36:00.478
are we optimizing for?

00:36:01.260 --> 00:36:03.081
You don't have to see 80 patients a day.

00:36:03.601 --> 00:36:04.740
But I do think there is

00:36:04.822 --> 00:36:06.782
tremendous value to be delivered.

00:36:07.302 --> 00:36:08.382
Single unit visits.

00:36:08.923 --> 00:36:10.905
I work on one functional task.

00:36:11.485 --> 00:36:11.744
Right.

00:36:11.804 --> 00:36:13.887
Patient comes in post-op knee replacement.

00:36:14.246 --> 00:36:14.467
OK,

00:36:14.507 --> 00:36:16.568
we've got 20 things that we can work on

00:36:16.608 --> 00:36:17.510
in this plan of care.

00:36:17.889 --> 00:36:18.130
Today,

00:36:18.150 --> 00:36:19.391
we're going to work on independent

00:36:19.411 --> 00:36:19.972
sit to stand.

00:36:20.351 --> 00:36:21.112
And for 10 minutes,

00:36:21.253 --> 00:36:24.414
we do dedicated independent sit to stand.

00:36:25.074 --> 00:36:26.175
You can ride the bike and

00:36:26.215 --> 00:36:27.416
you can do the other stuff

00:36:27.456 --> 00:36:27.998
and you can do your

00:36:28.038 --> 00:36:29.338
stretches and socialize and

00:36:29.358 --> 00:36:30.480
hang out with the other six

00:36:30.579 --> 00:36:31.800
to 10 people that are here.

00:36:32.521 --> 00:36:33.581
but you don't need my

00:36:33.722 --> 00:36:35.722
billable medicare time for

00:36:35.802 --> 00:36:37.063
more than those 10 minutes

00:36:37.443 --> 00:36:38.344
but I do need you to come

00:36:38.384 --> 00:36:39.664
back tomorrow and the next

00:36:39.704 --> 00:36:40.405
day and the next day and

00:36:40.425 --> 00:36:41.945
what happens is most

00:36:42.005 --> 00:36:42.967
clinics are doing two

00:36:43.007 --> 00:36:44.387
visits a week four unit

00:36:44.407 --> 00:36:45.887
visits that's eight units a

00:36:45.949 --> 00:36:47.969
week I get better outcomes

00:36:48.030 --> 00:36:49.590
with five days a week one

00:36:49.690 --> 00:36:51.090
unit that's five billable

00:36:51.190 --> 00:36:53.512
units a week I'm saving medicare money

00:36:54.132 --> 00:36:55.675
I'm getting better outcomes.

00:36:56.074 --> 00:36:57.356
My patients are enjoying it

00:36:57.396 --> 00:36:58.998
more and they're building compliance.

00:36:59.038 --> 00:37:01.681
They're building that that muscle to,

00:37:02.081 --> 00:37:03.483
you know, I do this every day.

00:37:03.842 --> 00:37:04.804
I'm just going to therapy.

00:37:04.824 --> 00:37:06.226
This is part of my daily routine.

00:37:07.186 --> 00:37:07.726
Like, gosh,

00:37:07.887 --> 00:37:10.090
I just I check so many of the good boxes.

00:37:11.467 --> 00:37:13.630
And I'm surprised that Tony

00:37:13.650 --> 00:37:14.429
hasn't mentioned this yet.

00:37:14.951 --> 00:37:18.092
This Cairo model is probably

00:37:18.413 --> 00:37:19.753
using the Medicare as the

00:37:19.793 --> 00:37:20.514
lead generation.

00:37:20.554 --> 00:37:21.956
Someone calls in, do you take Medicare?

00:37:21.996 --> 00:37:22.777
Yes, we take it.

00:37:22.817 --> 00:37:23.817
Let's get you booked, whatever.

00:37:24.458 --> 00:37:26.920
And then at some point at the eval,

00:37:26.960 --> 00:37:27.800
or probably not over the phone,

00:37:27.820 --> 00:37:29.581
but probably in the in-person evaluation,

00:37:29.601 --> 00:37:30.222
the first visit,

00:37:30.242 --> 00:37:31.242
because I think that post,

00:37:31.282 --> 00:37:32.643
did the post say something

00:37:32.684 --> 00:37:34.625
about $350 for the evaluation?

00:37:35.266 --> 00:37:35.666
Did you see that?

00:37:35.686 --> 00:37:36.527
Yeah, I pulled it back up.

00:37:37.067 --> 00:37:38.969
No, so that would have to be out of pocket,

00:37:39.009 --> 00:37:39.128
right?

00:37:41.048 --> 00:37:44.534
Um, no, $350 with imaging.

00:37:45.235 --> 00:37:45.416
Yeah.

00:37:45.436 --> 00:37:47.139
So Medicare doesn't cover imaging,

00:37:47.260 --> 00:37:48.202
the cost of imaging.

00:37:48.222 --> 00:37:49.523
So if they're doing x-rays,

00:37:49.585 --> 00:37:51.126
that's going to be an out of pocket cost.

00:37:52.492 --> 00:37:54.313
Okay, so anyway, never mind.

00:37:54.653 --> 00:37:57.056
So this Cairo,

00:37:57.356 --> 00:37:58.998
this model is basically

00:37:59.079 --> 00:38:01.061
using Medicare as a lead gen,

00:38:01.101 --> 00:38:02.483
which Tony has talked about

00:38:03.123 --> 00:38:03.884
intermittently over the

00:38:03.903 --> 00:38:04.605
past several years,

00:38:04.644 --> 00:38:06.126
like get these patients in

00:38:06.146 --> 00:38:07.929
your practice and then say, oh,

00:38:07.969 --> 00:38:08.509
by the way, oh,

00:38:08.548 --> 00:38:10.190
you want to hit the golf

00:38:10.231 --> 00:38:11.952
ball another 50 or 100 yards?

00:38:12.594 --> 00:38:13.514
Medicare is not paying for that.

00:38:13.594 --> 00:38:14.155
Oh, you want to walk...

00:38:14.675 --> 00:38:15.775
You can walk two blocks,

00:38:15.795 --> 00:38:16.456
but you want to be able to

00:38:16.496 --> 00:38:17.336
walk 10 blocks.

00:38:17.396 --> 00:38:18.416
Medicare is not going to pay for that.

00:38:18.456 --> 00:38:19.038
Or you want to go on your

00:38:19.077 --> 00:38:20.117
vacation in six weeks.

00:38:20.538 --> 00:38:21.478
Medicare is not going to pay for that.

00:38:21.498 --> 00:38:22.798
That's not medically necessary.

00:38:22.878 --> 00:38:25.699
So the one visit or the one

00:38:25.780 --> 00:38:27.019
unit code and then the rest

00:38:27.039 --> 00:38:27.740
is out of pocket.

00:38:28.681 --> 00:38:29.780
The out of pocket expenditures,

00:38:29.820 --> 00:38:30.802
as long as those patients

00:38:31.342 --> 00:38:32.001
like the service,

00:38:32.041 --> 00:38:32.802
they're not going to call

00:38:32.822 --> 00:38:33.862
their credit card company

00:38:33.882 --> 00:38:34.802
and do a chargeback.

00:38:34.862 --> 00:38:35.003
Right.

00:38:35.043 --> 00:38:35.802
So there's never going to be

00:38:35.822 --> 00:38:37.463
a retroactive payment taken

00:38:37.503 --> 00:38:38.844
back by the patients on the

00:38:39.023 --> 00:38:40.144
private pay cash side.

00:38:40.784 --> 00:38:41.726
Like it can happen on the

00:38:41.746 --> 00:38:42.606
Medicare side if you don't

00:38:42.646 --> 00:38:44.206
have great documentation, you get audited,

00:38:44.266 --> 00:38:44.586
whatever.

00:38:45.068 --> 00:38:47.668
So this model, guys and gals,

00:38:47.708 --> 00:38:49.389
like why wouldn't you want

00:38:49.409 --> 00:38:50.550
to model this model,

00:38:50.670 --> 00:38:51.711
model this structure

00:38:52.592 --> 00:38:53.913
instead of having four units?

00:38:54.693 --> 00:38:56.193
The answer of why people

00:38:56.295 --> 00:38:58.036
will not take this exact model,

00:38:58.335 --> 00:38:59.295
screenshot this,

00:38:59.416 --> 00:39:00.117
and put it into play

00:39:00.157 --> 00:39:02.338
tomorrow is the same reason – well,

00:39:02.358 --> 00:39:02.577
sorry.

00:39:02.938 --> 00:39:03.659
Some people will,

00:39:03.818 --> 00:39:04.739
and you'll never hear from

00:39:04.760 --> 00:39:05.659
them in a Facebook group

00:39:05.719 --> 00:39:07.101
because they're out there succeeding.

00:39:07.141 --> 00:39:08.061
They're too busy winning.

00:39:09.416 --> 00:39:10.539
And the reason that the

00:39:10.579 --> 00:39:11.360
people who are bitching

00:39:11.400 --> 00:39:13.244
about it won't do it is the same thing.

00:39:13.465 --> 00:39:15.130
And it's emotional because I

00:39:15.349 --> 00:39:17.074
feel like I shouldn't be doing this.

00:39:17.134 --> 00:39:18.476
Or I feel like the people

00:39:18.516 --> 00:39:19.699
who said this is bad care.

00:39:21.353 --> 00:39:22.855
I would say the best – don't

00:39:22.875 --> 00:39:23.894
people say what's the best

00:39:24.014 --> 00:39:25.295
KPI if you can only measure

00:39:25.376 --> 00:39:26.496
one KPI in your practice?

00:39:26.936 --> 00:39:28.518
It's completed plans of care

00:39:28.757 --> 00:39:32.400
or return visits or referring a friend.

00:39:32.900 --> 00:39:34.420
You don't get to 80 a day

00:39:34.940 --> 00:39:35.780
without those things.

00:39:36.041 --> 00:39:37.402
You do not mathematically.

00:39:37.501 --> 00:39:38.583
I would love to know a couple things.

00:39:38.603 --> 00:39:39.182
I would love to know

00:39:39.302 --> 00:39:41.284
percentage of returns –

00:39:41.284 --> 00:39:42.744
I would love to know where, oh,

00:39:42.844 --> 00:39:43.125
there it is.

00:39:43.485 --> 00:39:44.686
He said it's North Carolina.

00:39:44.846 --> 00:39:46.586
Doesn't tell me like, is it a rural area?

00:39:46.608 --> 00:39:47.228
Is it suburban?

00:39:47.268 --> 00:39:47.708
Is it urban?

00:39:48.128 --> 00:39:48.849
I would love to know that.

00:39:48.869 --> 00:39:49.588
I'm going to guess it's

00:39:49.608 --> 00:39:51.570
closer to urban because 80 a day,

00:39:51.610 --> 00:39:53.092
it's a large patient population.

00:39:54.112 --> 00:39:55.012
But that's the reason that

00:39:55.052 --> 00:39:55.572
no one's going to steal

00:39:55.612 --> 00:39:56.813
this model is because it's

00:39:56.873 --> 00:39:58.775
emotionally doesn't feel good.

00:39:58.855 --> 00:39:59.615
So you won't do it.

00:39:59.916 --> 00:40:01.077
What you'll do in six months,

00:40:01.356 --> 00:40:02.478
we'll do the same episode.

00:40:02.617 --> 00:40:04.239
Are you mad at the cost of your education?

00:40:04.259 --> 00:40:05.398
Or are you mad at the return

00:40:05.438 --> 00:40:05.980
on investment?

00:40:06.239 --> 00:40:07.039
And that the same people

00:40:07.079 --> 00:40:08.360
will bitch about the cost

00:40:08.661 --> 00:40:09.302
of their education.

00:40:10.284 --> 00:40:11.565
But to support them before

00:40:11.606 --> 00:40:12.646
we hit Stretch Lab,

00:40:13.268 --> 00:40:15.730
I will say that I bet most

00:40:15.769 --> 00:40:17.572
of the people who are commenting there,

00:40:17.771 --> 00:40:18.612
if I said,

00:40:18.632 --> 00:40:20.914
I will guarantee you a million

00:40:20.954 --> 00:40:22.936
dollars if you do this kind of thing,

00:40:23.157 --> 00:40:23.717
they wouldn't do it.

00:40:23.737 --> 00:40:25.298
Because they would rather

00:40:25.318 --> 00:40:27.960
not have the money than do that,

00:40:28.021 --> 00:40:29.121
which is totally fine.

00:40:29.641 --> 00:40:31.483
I make those decisions every single day.

00:40:31.523 --> 00:40:32.385
You guys have heard me say

00:40:32.425 --> 00:40:33.106
it a hundred times.

00:40:33.226 --> 00:40:34.347
I don't need a nicer house.

00:40:34.447 --> 00:40:35.487
I don't need a newer car.

00:40:36.027 --> 00:40:37.509
All I want is time with my kids.

00:40:37.568 --> 00:40:39.170
If I'm doing 80 visits in the clinic,

00:40:39.271 --> 00:40:40.992
I can't have the time with my kids.

00:40:41.032 --> 00:40:42.972
So I will always sacrifice

00:40:43.414 --> 00:40:45.936
additional income for the

00:40:45.976 --> 00:40:47.697
time that I can spend with my family.

00:40:47.737 --> 00:40:48.838
That is a conscious choice,

00:40:48.878 --> 00:40:49.677
but I'm never going to

00:40:49.717 --> 00:40:51.400
complain about somebody else doing it.

00:40:52.059 --> 00:40:52.239
Nope.

00:40:52.940 --> 00:40:54.221
But you can't do both.

00:40:54.300 --> 00:40:55.521
You can't complain about not

00:40:56.182 --> 00:40:58.764
getting paid what you think you're worth.

00:40:58.804 --> 00:40:59.905
Here's my next poll question

00:40:59.925 --> 00:41:00.606
if you want to follow on

00:41:00.646 --> 00:41:01.427
socials and chime in.

00:41:01.688 --> 00:41:02.708
This is an open-ended.

00:41:02.809 --> 00:41:03.389
I said, hey,

00:41:03.449 --> 00:41:04.951
if you think PTs are underpaid,

00:41:05.351 --> 00:41:06.452
what is appropriately paid?

00:41:06.753 --> 00:41:07.914
I need an objective answer.

00:41:08.393 --> 00:41:09.554
How much money do you need?

00:41:09.594 --> 00:41:10.655
And then my follow-up question is,

00:41:11.036 --> 00:41:11.898
how much have you brought in?

00:41:12.909 --> 00:41:13.990
Because you eat what you kill.

00:41:14.692 --> 00:41:16.112
Whether you're a one-person show,

00:41:16.472 --> 00:41:17.795
you only eat what you kill,

00:41:17.894 --> 00:41:19.416
minus expenses.

00:41:19.876 --> 00:41:22.318
Or from a business owner's perspective,

00:41:22.818 --> 00:41:23.920
you can only have a portion

00:41:23.940 --> 00:41:24.581
of what the entire

00:41:24.621 --> 00:41:25.661
organization brings in.

00:41:25.981 --> 00:41:26.842
That's just math.

00:41:27.423 --> 00:41:28.784
So I don't know if you skipped that part,

00:41:28.804 --> 00:41:30.567
but we did take statistics

00:41:30.626 --> 00:41:31.568
as a prereq for PT.

00:41:31.588 --> 00:41:32.288
That's some math.

00:41:33.208 --> 00:41:34.028
scott saying a patient's

00:41:34.048 --> 00:41:35.070
last impression is their

00:41:35.110 --> 00:41:36.929
lasting impression yup and

00:41:36.989 --> 00:41:38.210
if it was bad and you felt

00:41:38.371 --> 00:41:39.550
flim flammed or scammed

00:41:39.871 --> 00:41:40.871
those 80 people a day

00:41:40.911 --> 00:41:42.211
wouldn't be coming back and

00:41:42.251 --> 00:41:43.152
according to that thing if

00:41:43.172 --> 00:41:45.434
that's true they are and

00:41:45.474 --> 00:41:46.673
they are they have no

00:41:46.733 --> 00:41:48.014
problem eating a big mac

00:41:48.074 --> 00:41:50.155
the big mac version and

00:41:50.536 --> 00:41:51.456
there's mcdonald's all over

00:41:51.476 --> 00:41:52.976
the world the only thing

00:41:52.996 --> 00:41:53.817
I'll close on this is

00:41:54.724 --> 00:41:55.943
the advice of when a PT

00:41:55.963 --> 00:41:57.724
student takes the NPTE is

00:41:57.804 --> 00:41:58.764
make sure you're answering

00:41:58.804 --> 00:42:00.085
the question that's being asked.

00:42:00.826 --> 00:42:01.967
Make sure you're delivering

00:42:02.007 --> 00:42:03.166
the thing that's being looked for.

00:42:03.527 --> 00:42:06.128
A two-hour evaluation may be it sometimes,

00:42:06.708 --> 00:42:06.987
right?

00:42:07.849 --> 00:42:08.489
But it might not.

00:42:08.849 --> 00:42:09.588
But if you're delivering a

00:42:09.628 --> 00:42:10.610
two-hour evaluation,

00:42:11.030 --> 00:42:12.690
when I wanted a solution

00:42:12.710 --> 00:42:14.630
because my back pain is one

00:42:14.751 --> 00:42:16.472
one-hundredth of my problem set,

00:42:17.192 --> 00:42:19.193
get it to me how I want to do it.

00:42:19.313 --> 00:42:19.793
Ask someone,

00:42:19.813 --> 00:42:20.532
do you want the two-hour

00:42:20.592 --> 00:42:21.934
evaluation or the 30-minute?

00:42:23.257 --> 00:42:24.376
And if I want the two hour,

00:42:25.177 --> 00:42:26.378
give me the option to pay for it.

00:42:27.137 --> 00:42:29.217
So that's exactly what stretch lab did.

00:42:29.617 --> 00:42:30.197
They said,

00:42:30.557 --> 00:42:32.458
what can we pluck out of

00:42:32.858 --> 00:42:34.438
physical therapy that

00:42:34.679 --> 00:42:35.719
individuals are willing to

00:42:35.759 --> 00:42:37.460
pay for that potentially

00:42:37.519 --> 00:42:39.039
insurance is not covering

00:42:39.559 --> 00:42:40.800
that has the highest

00:42:40.880 --> 00:42:42.679
perceived value to the patient.

00:42:42.719 --> 00:42:44.621
Now I I've got to share this quickly.

00:42:45.380 --> 00:42:45.501
Um,

00:42:45.701 --> 00:42:48.360
I was sitting at my son's cross country

00:42:48.460 --> 00:42:50.802
parent meeting yesterday and, you know, a

00:42:51.581 --> 00:42:53.463
I have great gratitude to

00:42:53.643 --> 00:42:55.644
all of the coaches, all of the volunteers,

00:42:55.724 --> 00:42:56.905
everything they put into it.

00:42:57.505 --> 00:42:59.306
But I did have to bite my

00:42:59.367 --> 00:43:01.528
tongue when the coach was

00:43:01.568 --> 00:43:03.510
saying we stretch before we run,

00:43:03.550 --> 00:43:05.371
we stretch after we run.

00:43:05.411 --> 00:43:07.152
And I tell the students to

00:43:07.331 --> 00:43:08.753
even try and get stretching

00:43:08.813 --> 00:43:09.474
during the day.

00:43:11.467 --> 00:43:12.407
I thought my son was gonna

00:43:12.447 --> 00:43:14.088
knock me out because it just,

00:43:14.748 --> 00:43:16.010
it came out and I didn't

00:43:16.050 --> 00:43:16.829
want it to come out.

00:43:16.889 --> 00:43:17.090
Now,

00:43:17.911 --> 00:43:20.731
I tend to not be a huge advocate of

00:43:20.831 --> 00:43:23.373
stretching unless there's a real reason.

00:43:23.693 --> 00:43:25.494
We're stretching a contracture,

00:43:25.514 --> 00:43:26.653
we're stretching a targeted

00:43:26.693 --> 00:43:27.614
tissue because there was

00:43:27.675 --> 00:43:29.514
some sort of direct injury

00:43:29.554 --> 00:43:30.195
to that tissue.

00:43:30.876 --> 00:43:31.956
General stretching for

00:43:32.077 --> 00:43:33.137
general perceived

00:43:33.237 --> 00:43:34.277
performance improvement

00:43:34.297 --> 00:43:35.498
makes no sense to me.

00:43:36.918 --> 00:43:38.559
But anyway, it doesn't matter.

00:43:38.719 --> 00:43:40.119
It doesn't matter what I think of it.

00:43:40.739 --> 00:43:42.360
I have patients in my clinic

00:43:42.400 --> 00:43:44.702
today that go to stretch lab.

00:43:44.742 --> 00:43:46.242
They don't want to pay for

00:43:46.282 --> 00:43:47.083
physical therapy,

00:43:47.163 --> 00:43:48.282
but they will pay for

00:43:48.342 --> 00:43:51.364
stretch lab to get a 55 minute stretch.

00:43:51.864 --> 00:43:53.625
I had the owner of three

00:43:53.644 --> 00:43:55.445
stretch lab locations who

00:43:55.766 --> 00:43:56.826
came to me for therapy.

00:43:56.865 --> 00:43:57.246
And of course,

00:43:57.286 --> 00:43:58.206
I got a chance to pick her

00:43:58.226 --> 00:43:59.007
brains a little bit.

00:44:00.827 --> 00:44:01.349
But yeah,

00:44:01.429 --> 00:44:02.949
they just plucked out what is

00:44:02.989 --> 00:44:04.030
something that the

00:44:04.271 --> 00:44:06.253
population perceives as valuable.

00:44:06.293 --> 00:44:07.474
What are they willing to pay for?

00:44:07.855 --> 00:44:08.815
Let's do more of that.

00:44:09.556 --> 00:44:11.458
And it's been raging success.

00:44:11.818 --> 00:44:14.242
There are stories of this everywhere.

00:44:14.362 --> 00:44:15.443
Like I think the story of,

00:44:15.463 --> 00:44:17.505
you guys know the app Slack, right?

00:44:17.525 --> 00:44:19.347
The messaging and file sharing app.

00:44:19.407 --> 00:44:20.367
You don't know Slack, Tony?

00:44:20.407 --> 00:44:20.588
Really?

00:44:20.608 --> 00:44:21.108
Yeah.

00:44:21.289 --> 00:44:22.130
With a slap?

00:44:22.190 --> 00:44:23.411
With a P or slack?

00:44:23.851 --> 00:44:24.192
Slack.

00:44:24.371 --> 00:44:25.012
S-L-A-C-K.

00:44:25.233 --> 00:44:25.552
Yeah, yeah.

00:44:25.653 --> 00:44:25.994
I know that.

00:44:26.054 --> 00:44:27.454
So it's an app, file sharing,

00:44:27.574 --> 00:44:28.556
DMing and everything like that.

00:44:28.576 --> 00:44:30.057
That's not what it was intended to do,

00:44:30.117 --> 00:44:30.778
though, at first.

00:44:30.818 --> 00:44:31.980
This is like serendipity.

00:44:32.039 --> 00:44:34.501
But they put something in

00:44:34.561 --> 00:44:36.204
front of people and watched

00:44:36.324 --> 00:44:38.106
which parts they –

00:44:38.106 --> 00:44:40.027
you know, poked around and liked using.

00:44:40.068 --> 00:44:40.349
And then they,

00:44:40.449 --> 00:44:41.168
instead of saying you're

00:44:41.269 --> 00:44:42.251
using the tool wrong,

00:44:42.291 --> 00:44:43.192
you're doing it wrong.

00:44:43.211 --> 00:44:43.972
They said, Oh,

00:44:44.353 --> 00:44:45.253
well we put this thing in

00:44:45.293 --> 00:44:46.094
front of you thinking you'd

00:44:46.155 --> 00:44:46.815
use it this way.

00:44:47.235 --> 00:44:49.539
Turns out people actually use it this way.

00:44:49.838 --> 00:44:51.240
The story of TheraBand.

00:44:52.262 --> 00:44:52.581
Did you know,

00:44:52.601 --> 00:44:53.842
do you know the background of TheraBand?

00:44:53.882 --> 00:44:54.864
It was a dental dam.

00:44:56.018 --> 00:44:57.478
That's what the material was.

00:44:58.219 --> 00:44:59.820
And then some PTs got their hands on it.

00:44:59.840 --> 00:45:00.400
I was like, well,

00:45:00.420 --> 00:45:01.661
this is stretchy in this direction,

00:45:01.681 --> 00:45:02.882
and I can do this, and I can do this.

00:45:03.384 --> 00:45:03.884
And then you go the

00:45:03.903 --> 00:45:05.405
progression of dental dam

00:45:05.425 --> 00:45:07.146
to TheraBand to someone

00:45:07.286 --> 00:45:09.969
like Scott Dickinson,

00:45:10.028 --> 00:45:11.730
who looks at TheraBand and goes,

00:45:11.971 --> 00:45:12.731
but it's doing it wrong,

00:45:12.771 --> 00:45:14.632
and he creates Next Level.

00:45:14.693 --> 00:45:15.413
And we'll have an episode

00:45:15.733 --> 00:45:16.594
with Scott coming out.

00:45:16.634 --> 00:45:17.934
But it's like they paid

00:45:17.974 --> 00:45:19.717
attention to the thing everybody liked.

00:45:21.195 --> 00:45:22.014
not what you like,

00:45:22.275 --> 00:45:23.456
because you're not buying your service,

00:45:23.476 --> 00:45:24.255
you're providing it.

00:45:24.836 --> 00:45:26.476
And so what they saw was, well,

00:45:26.556 --> 00:45:28.217
people like that feeling of stretch.

00:45:28.737 --> 00:45:29.257
So they said,

00:45:29.679 --> 00:45:30.778
we're going to offer it to you.

00:45:30.798 --> 00:45:32.300
We're going to make that a seamless,

00:45:32.420 --> 00:45:35.061
frictionless process.

00:45:35.161 --> 00:45:37.382
So I thought we'd do like a dive session

00:45:37.702 --> 00:45:39.384
a deep, a quick, a shallow dive.

00:45:39.403 --> 00:45:40.465
We're going to dive in the shallow end.

00:45:40.485 --> 00:45:41.045
We're going to dive in the

00:45:41.085 --> 00:45:42.688
three foot end stretch lab

00:45:42.869 --> 00:45:44.130
boutique fitness franchise.

00:45:44.170 --> 00:45:45.010
I've got it on the screen

00:45:45.311 --> 00:45:46.833
specializes in assisted

00:45:46.914 --> 00:45:47.894
stretching services.

00:45:48.034 --> 00:45:49.277
I can already hear the PTs

00:45:49.297 --> 00:45:50.918
of the world rolling their eyes.

00:45:50.978 --> 00:45:51.900
Well, that's not this.

00:45:51.960 --> 00:45:53.722
And that's not, you know, best practice.

00:45:54.503 --> 00:45:55.844
Founded in 2015 by two

00:45:56.003 --> 00:45:57.304
fitness industry people who

00:45:57.364 --> 00:45:58.585
paid attention to something.

00:45:59.166 --> 00:46:00.427
And the idea is you go into

00:46:00.467 --> 00:46:01.606
these boutiques and someone

00:46:01.626 --> 00:46:02.608
just like they're on the screen.

00:46:03.288 --> 00:46:06.070
This is similar to a massage, right?

00:46:06.210 --> 00:46:07.110
Is there, you know,

00:46:07.130 --> 00:46:08.492
how much evidence is the

00:46:08.552 --> 00:46:09.371
value of massage?

00:46:09.391 --> 00:46:10.092
But I'll tell you why I get

00:46:10.112 --> 00:46:11.432
a massage because I like

00:46:11.512 --> 00:46:12.634
the way it feels.

00:46:13.333 --> 00:46:14.335
I like how I feel when I

00:46:14.375 --> 00:46:14.954
walk out of there.

00:46:14.974 --> 00:46:16.516
And is it worth 60 or 90 bucks?

00:46:16.996 --> 00:46:17.757
The answer is yes.

00:46:18.277 --> 00:46:19.157
So now you can start your

00:46:19.217 --> 00:46:20.998
own stretch lab franchise.

00:46:21.239 --> 00:46:23.621
I mean, people can be angry about it.

00:46:24.320 --> 00:46:25.342
Because of their own emotion,

00:46:25.561 --> 00:46:26.222
they're projecting.

00:46:26.262 --> 00:46:27.003
That's not good.

00:46:27.043 --> 00:46:28.063
And they're wagging their finger.

00:46:29.143 --> 00:46:30.125
But they're giving people

00:46:30.144 --> 00:46:31.766
what they want in a way they want.

00:46:31.905 --> 00:46:32.945
Where's the problem?

00:46:32.985 --> 00:46:33.987
Someone explain it to me.

00:46:35.268 --> 00:46:37.088
Dave, what's your perspective?

00:46:37.748 --> 00:46:38.409
So, I mean,

00:46:38.769 --> 00:46:40.231
I've had initially when this

00:46:40.271 --> 00:46:41.231
first came out years ago,

00:46:41.251 --> 00:46:42.211
I had a little negative

00:46:42.231 --> 00:46:43.432
sentiment because they were

00:46:43.452 --> 00:46:46.434
calling their people the actual,

00:46:46.614 --> 00:46:47.494
not even personal trainers.

00:46:47.594 --> 00:46:48.496
They're not calling them

00:46:48.516 --> 00:46:49.076
personal trainers.

00:46:49.536 --> 00:46:50.936
They call them stretchologists.

00:46:51.177 --> 00:46:52.038
Lexologists.

00:46:52.519 --> 00:46:54.501
Plexologist or posturologist,

00:46:54.521 --> 00:46:56.443
which is basically, I mean,

00:46:56.463 --> 00:46:57.925
it sounds like proctologist.

00:46:57.945 --> 00:46:59.186
I mean, they're just making up words.

00:46:59.206 --> 00:47:01.907
I mean, it's just crazy, but, um, yes, the,

00:47:02.387 --> 00:47:03.389
or just like mixologist.

00:47:03.429 --> 00:47:03.849
Exactly.

00:47:04.289 --> 00:47:06.711
So shaken drinks and a bar.

00:47:07.452 --> 00:47:07.552
Um,

00:47:09.501 --> 00:47:11.503
The model is good because

00:47:11.702 --> 00:47:14.264
the labor is low and that's

00:47:14.284 --> 00:47:15.565
why the price point is low

00:47:15.784 --> 00:47:16.625
and the labor is low.

00:47:16.844 --> 00:47:17.525
So it works out.

00:47:17.565 --> 00:47:18.186
They're going to be a little

00:47:18.206 --> 00:47:19.365
bit more volume based than

00:47:19.967 --> 00:47:20.686
probably a lot of physical

00:47:20.706 --> 00:47:21.427
therapy offices.

00:47:22.208 --> 00:47:22.947
I have, by the way,

00:47:23.708 --> 00:47:24.969
my observation is I've seen

00:47:25.048 --> 00:47:26.429
one or two of these clothes already.

00:47:27.369 --> 00:47:28.210
There was one in Brooklyn.

00:47:28.230 --> 00:47:29.990
I mean, they're all kind of the same.

00:47:30.070 --> 00:47:31.632
It's a different brand name, Stretch Lab.

00:47:31.652 --> 00:47:34.032
There's a million different stretch names.

00:47:34.913 --> 00:47:35.813
I think at the end of the day,

00:47:36.574 --> 00:47:37.414
physical therapists and

00:47:37.454 --> 00:47:39.255
practice owners can do a couple things,

00:47:39.275 --> 00:47:39.896
a couple options.

00:47:39.996 --> 00:47:40.737
One is do nothing,

00:47:40.976 --> 00:47:42.237
like just continue to see

00:47:42.257 --> 00:47:43.438
them pop up and do that.

00:47:43.458 --> 00:47:46.021
They're going to continue to maybe expand.

00:47:46.081 --> 00:47:47.402
And there's other ones here

00:47:47.422 --> 00:47:48.702
in New York City called Stretched.

00:47:49.463 --> 00:47:50.804
And I can't remember the other.

00:47:50.824 --> 00:47:51.664
There's other ones out there.

00:47:52.648 --> 00:47:53.369
So you could do nothing.

00:47:54.409 --> 00:47:55.990
You could add it as a

00:47:56.030 --> 00:47:56.891
service in your practice,

00:47:56.911 --> 00:47:57.731
which is what we've done.

00:47:57.771 --> 00:47:59.213
So on my website,

00:47:59.233 --> 00:48:00.954
we have whatever I call it.

00:48:01.275 --> 00:48:01.914
What do you call it?

00:48:03.416 --> 00:48:05.458
I think I have it as fascial

00:48:05.498 --> 00:48:07.760
stretch therapy, which I know PTs hate,

00:48:07.780 --> 00:48:08.460
but that's what the

00:48:08.481 --> 00:48:09.360
consumer is searching.

00:48:09.380 --> 00:48:11.103
That's the word that they're looking for.

00:48:12.164 --> 00:48:13.385
You know, I'm Google-based, baby.

00:48:14.405 --> 00:48:15.425
I know the Google queries,

00:48:15.525 --> 00:48:17.467
so I'm using the consumer's line.

00:48:17.507 --> 00:48:18.047
You know why?

00:48:18.469 --> 00:48:19.909
Because those consumers pay us,

00:48:20.309 --> 00:48:21.811
and the PTs out there don't pay us.

00:48:22.371 --> 00:48:24.914
So my patients and clients pay our bills,

00:48:24.994 --> 00:48:26.135
so we use those search

00:48:26.175 --> 00:48:27.235
queries that those

00:48:27.596 --> 00:48:28.376
consumers are going to

00:48:28.396 --> 00:48:31.159
potentially find us through.

00:48:31.179 --> 00:48:34.920
So you can add it, or really quick,

00:48:35.021 --> 00:48:35.842
if I could share my screen

00:48:35.862 --> 00:48:36.543
for two seconds,

00:48:37.222 --> 00:48:39.164
there's a practice owner in Delaware

00:48:40.862 --> 00:48:42.182
uh this is stephen rapacelli

00:48:42.242 --> 00:48:43.943
he's a pt he's been in

00:48:44.043 --> 00:48:46.344
practice for decades uh

00:48:46.405 --> 00:48:47.786
since 1992 he's had

00:48:47.846 --> 00:48:48.545
performance physical

00:48:48.585 --> 00:48:50.586
therapy down in uh delaware

00:48:50.606 --> 00:48:51.807
he's got multiple locations

00:48:52.487 --> 00:48:54.389
and he's also the ceo of

00:48:54.510 --> 00:48:55.989
stretchplex from three

00:48:56.010 --> 00:48:57.891
years ago so let me jump

00:48:57.990 --> 00:48:59.172
over can you guys now see

00:48:59.211 --> 00:49:01.353
their website stretchplex I

00:49:01.373 --> 00:49:02.014
still see linkedin

00:49:02.960 --> 00:49:03.420
All right, hold on.

00:49:03.440 --> 00:49:05.282
Let me share this tab instead.

00:49:05.922 --> 00:49:07.403
While you're doing that, I want to say,

00:49:07.503 --> 00:49:08.764
as long as you are not

00:49:08.804 --> 00:49:10.826
making claims that you are

00:49:10.965 --> 00:49:12.786
selling something or doing something,

00:49:13.146 --> 00:49:15.467
that just doesn't actually do.

00:49:15.648 --> 00:49:17.068
I don't want people to think, well,

00:49:17.088 --> 00:49:18.409
these guys are advocating

00:49:18.429 --> 00:49:19.170
to sell snake oil.

00:49:19.610 --> 00:49:20.690
As long as you are open and

00:49:20.731 --> 00:49:21.952
honest about what you're providing,

00:49:23.492 --> 00:49:24.793
you cannot throw an ethical

00:49:24.853 --> 00:49:25.414
argument at me.

00:49:25.594 --> 00:49:26.434
That holds water.

00:49:28.396 --> 00:49:28.576
Right.

00:49:28.596 --> 00:49:29.577
So do you see this now?

00:49:30.077 --> 00:49:30.217
Yep.

00:49:30.498 --> 00:49:32.900
Stretchplex, stretchplexnow.com.

00:49:33.280 --> 00:49:35.221
So they have two, four,

00:49:35.240 --> 00:49:36.623
they have four locations.

00:49:37.003 --> 00:49:37.782
I think he's got three or

00:49:37.824 --> 00:49:40.244
four PT practices and now he's got a,

00:49:40.746 --> 00:49:42.126
this is a separate brick

00:49:42.166 --> 00:49:44.849
and mortar business, separate locations,

00:49:44.889 --> 00:49:45.809
separate branding.

00:49:46.289 --> 00:49:48.411
Now I think it's absolutely genius.

00:49:48.452 --> 00:49:49.532
I've heard Steven on,

00:49:49.572 --> 00:49:50.373
I think Chad Madden's

00:49:50.414 --> 00:49:51.835
podcast and a couple other podcasts.

00:49:52.858 --> 00:49:54.219
I'm assuming, I don't know if they do this,

00:49:54.239 --> 00:49:54.800
but they should,

00:49:54.900 --> 00:49:56.260
which is referring the

00:49:56.300 --> 00:49:57.460
patients and clients to and

00:49:57.521 --> 00:49:58.802
from each service, right?

00:49:58.822 --> 00:49:59.922
So like the consumer who

00:49:59.963 --> 00:50:01.083
only wants the stretch plex,

00:50:01.483 --> 00:50:03.684
and then when the patient

00:50:04.324 --> 00:50:06.346
has too much pain or too much issues,

00:50:06.445 --> 00:50:08.106
or they need some

00:50:08.146 --> 00:50:09.467
differential diagnosis figured out,

00:50:09.507 --> 00:50:11.047
whatever, or they ask like, hey,

00:50:11.449 --> 00:50:12.588
should I see a doctor about

00:50:12.608 --> 00:50:13.550
this or a therapist?

00:50:13.570 --> 00:50:14.570
What should I do?

00:50:14.710 --> 00:50:15.510
Or should I see a

00:50:15.530 --> 00:50:16.371
chiropractor or whatever?

00:50:18.438 --> 00:50:19.500
stretchologist or whatever

00:50:19.619 --> 00:50:20.960
at stretchplex should say

00:50:21.000 --> 00:50:22.521
oh you know what we have a

00:50:22.561 --> 00:50:23.681
partnership or we have a

00:50:23.782 --> 00:50:24.822
you know whatever with

00:50:24.882 --> 00:50:25.563
performance physical

00:50:25.603 --> 00:50:26.523
therapy down the street why

00:50:26.543 --> 00:50:28.023
don't I connect you or

00:50:28.063 --> 00:50:29.103
here's a referral or here's

00:50:29.123 --> 00:50:30.364
a business card or how

00:50:30.385 --> 00:50:31.664
about I you know we get you

00:50:31.686 --> 00:50:32.465
in there we try to fit you

00:50:32.485 --> 00:50:33.706
in there whatever and do a

00:50:33.746 --> 00:50:35.206
little cross promotion

00:50:35.306 --> 00:50:37.108
cross uh referral between

00:50:37.128 --> 00:50:38.048
the two businesses there

00:50:38.068 --> 00:50:38.648
are two different

00:50:38.668 --> 00:50:39.789
businesses two different

00:50:39.809 --> 00:50:41.409
brick and mortar offices so

00:50:41.730 --> 00:50:43.871
at the end of the day um I

00:50:43.911 --> 00:50:44.831
think physical therapists

00:50:44.851 --> 00:50:46.572
and practice owners do nothing

00:50:47.621 --> 00:50:48.063
do nothing,

00:50:48.443 --> 00:50:49.565
add it to your current practice

00:50:49.945 --> 00:50:52.128
as one of your services, or like Steven,

00:50:52.447 --> 00:50:53.570
completely different business,

00:50:54.231 --> 00:50:55.932
probably a different LLC entity,

00:50:56.273 --> 00:50:57.855
different brick and mortar location,

00:50:57.875 --> 00:50:59.858
and refer patients to

00:50:59.878 --> 00:51:01.420
clients between those two.

00:51:01.460 --> 00:51:02.521
So what are the pros and cons of that?

00:51:02.541 --> 00:51:02.722
Go ahead.

00:51:02.922 --> 00:51:04.284
There's a fourth option though, Dave,

00:51:04.344 --> 00:51:05.045
which is you could bitch

00:51:05.065 --> 00:51:05.784
about it on Facebook.

00:51:06.512 --> 00:51:07.833
Right, right.

00:51:08.014 --> 00:51:08.994
That is a viable option.

00:51:09.514 --> 00:51:10.894
One of the options, look,

00:51:11.054 --> 00:51:11.996
me five years ago,

00:51:12.016 --> 00:51:13.297
especially me in PT school,

00:51:13.416 --> 00:51:15.998
I would have raged against this, right?

00:51:16.057 --> 00:51:16.878
I would have looked at this like,

00:51:16.918 --> 00:51:18.478
this isn't this and this and this.

00:51:18.980 --> 00:51:20.280
Then look at it for what it is.

00:51:20.300 --> 00:51:21.820
They're being very clear, open,

00:51:21.860 --> 00:51:22.782
and honest of what it is.

00:51:23.561 --> 00:51:24.822
And this is another adult

00:51:24.882 --> 00:51:26.202
making a decision with

00:51:26.242 --> 00:51:27.623
their own monies and

00:51:27.664 --> 00:51:28.643
they're giving monies to

00:51:28.684 --> 00:51:29.505
people to do a thing.

00:51:29.565 --> 00:51:30.184
And when they leave,

00:51:30.744 --> 00:51:31.706
they're either happy about

00:51:31.726 --> 00:51:33.425
it or they're not happy about it, right?

00:51:33.947 --> 00:51:34.646
You did mention like a

00:51:34.686 --> 00:51:35.527
couple of those closing.

00:51:36.047 --> 00:51:36.847
That doesn't mean the thing

00:51:36.867 --> 00:51:37.768
that they're providing isn't good.

00:51:37.788 --> 00:51:38.228
That could have been a

00:51:38.248 --> 00:51:39.208
crappy business owner or a

00:51:39.268 --> 00:51:40.789
bad market or any of those things.

00:51:41.190 --> 00:51:41.809
True, true.

00:51:43.251 --> 00:51:43.771
Tony, what do you think?

00:51:44.952 --> 00:51:45.393
I love it.

00:51:45.532 --> 00:51:46.293
I think it's awesome.

00:51:46.333 --> 00:51:47.875
I think any of these things that come out,

00:51:47.914 --> 00:51:49.436
I think we can learn lessons from.

00:51:49.876 --> 00:51:50.416
Dave and I,

00:51:50.456 --> 00:51:51.719
I think we even looked at some

00:51:51.739 --> 00:51:54.001
of these on Biz by Cell one time,

00:51:54.061 --> 00:51:55.742
looking at that as a business model,

00:51:55.822 --> 00:51:57.563
if we went in as a therapist.

00:51:58.407 --> 00:51:59.847
bought a stretch lab

00:51:59.887 --> 00:52:01.728
location and then brought

00:52:01.768 --> 00:52:03.269
physical therapy into it,

00:52:03.351 --> 00:52:05.231
made billable services out of it.

00:52:05.731 --> 00:52:06.012
I mean,

00:52:06.052 --> 00:52:07.673
you just took something to the next

00:52:07.773 --> 00:52:09.034
level because you opened

00:52:09.054 --> 00:52:11.016
the doors of insurance reimbursement,

00:52:11.757 --> 00:52:12.137
you know?

00:52:12.197 --> 00:52:14.057
So there are so many ways

00:52:14.097 --> 00:52:15.199
that we could leverage

00:52:15.458 --> 00:52:17.340
what's already proven successful.

00:52:17.920 --> 00:52:18.782
I think that that's a

00:52:18.822 --> 00:52:20.302
mistake that we make as

00:52:20.402 --> 00:52:21.684
therapists is we're like, well,

00:52:21.704 --> 00:52:22.324
we're therapists.

00:52:22.384 --> 00:52:23.284
We do therapy.

00:52:23.304 --> 00:52:23.885
Yeah.

00:52:25.126 --> 00:52:26.427
But let's look at the market.

00:52:26.586 --> 00:52:27.867
Where is the money flowing?

00:52:28.487 --> 00:52:30.309
What can we do on top of

00:52:30.329 --> 00:52:32.110
that to add value to that?

00:52:32.291 --> 00:52:33.590
And then how can we bring

00:52:33.630 --> 00:52:34.831
that into organizations?

00:52:34.891 --> 00:52:37.233
And we see so many people that are saying,

00:52:37.253 --> 00:52:39.275
I am buying businesses.

00:52:39.355 --> 00:52:42.657
I'm building a little portfolio.

00:52:43.237 --> 00:52:44.498
So that, you know,

00:52:44.518 --> 00:52:46.340
I don't have to be the one

00:52:46.860 --> 00:52:48.840
literally stretching every hamstring,

00:52:48.860 --> 00:52:49.882
massaging every neck.

00:52:50.612 --> 00:52:50.731
Now,

00:52:50.851 --> 00:52:52.972
here's the thing to go back to the PT

00:52:52.992 --> 00:52:55.434
degree versus cost versus ROI.

00:52:55.594 --> 00:52:56.574
And this was in a similar

00:52:56.655 --> 00:52:57.635
thread that I think Dave

00:52:57.675 --> 00:52:58.556
was getting hammered on in

00:52:58.596 --> 00:52:59.456
a Facebook group that I

00:52:59.476 --> 00:53:00.436
keep poking the bear on,

00:53:01.396 --> 00:53:02.777
which is someone pointed

00:53:02.918 --> 00:53:07.300
out that calling yourself a DPT,

00:53:08.139 --> 00:53:09.380
if you don't have a doctor

00:53:09.400 --> 00:53:10.840
of physical therapy, is against,

00:53:10.961 --> 00:53:11.902
and they use an example of

00:53:11.942 --> 00:53:12.922
the State of Indiana

00:53:13.262 --> 00:53:14.722
Physical Therapy Practice Act.

00:53:15.123 --> 00:53:16.324
Now, Tony, quick review.

00:53:17.123 --> 00:53:18.844
Who does the State Physical

00:53:18.905 --> 00:53:20.045
Therapy Practice Act...

00:53:21.052 --> 00:53:22.092
Who does that govern?

00:53:23.855 --> 00:53:24.516
Physical therapist.

00:53:25.036 --> 00:53:26.117
Who does it not govern?

00:53:26.777 --> 00:53:28.559
Everybody who isn't a physical therapist.

00:53:28.880 --> 00:53:31.342
So someone is just a little bit skewed.

00:53:31.362 --> 00:53:31.764
And again,

00:53:31.824 --> 00:53:33.264
correct me if I'm wrong in the comments,

00:53:33.306 --> 00:53:33.445
but...

00:53:34.963 --> 00:53:35.983
Your physical therapy

00:53:36.023 --> 00:53:41.108
practice act or your state

00:53:41.369 --> 00:53:42.231
occupational therapy

00:53:42.251 --> 00:53:43.652
practice act doesn't mean

00:53:43.711 --> 00:53:45.114
anything to me because I'm not an OT.

00:53:45.773 --> 00:53:46.996
So keep that in mind.

00:53:47.155 --> 00:53:48.898
It governs this, right?

00:53:49.637 --> 00:53:50.559
So you can be mad at

00:53:50.639 --> 00:53:51.661
stretchologists or

00:53:51.740 --> 00:53:53.762
posturologists or

00:53:53.963 --> 00:53:56.646
fasciologists all you want, right?

00:53:57.025 --> 00:53:58.387
They're not in your arena.

00:53:58.427 --> 00:53:59.349
This is where it's almost

00:53:59.389 --> 00:54:01.210
like your DPT handcuffs you.

00:54:01.670 --> 00:54:03.733
If you keep trying to do DPT things,

00:54:04.434 --> 00:54:04.693
right?

00:54:05.494 --> 00:54:06.556
So that's why when someone says,

00:54:06.615 --> 00:54:07.177
what do you do?

00:54:07.297 --> 00:54:08.338
I'm a physical therapist.

00:54:08.378 --> 00:54:09.318
I'm going to say, that's your degree.

00:54:09.358 --> 00:54:10.079
That ain't what you do.

00:54:10.519 --> 00:54:12.422
Ask a smart real estate

00:54:12.461 --> 00:54:13.182
agent what they do.

00:54:13.242 --> 00:54:13.704
And they say,

00:54:14.043 --> 00:54:16.206
I help people find their

00:54:16.226 --> 00:54:17.206
dream homes every day.

00:54:17.648 --> 00:54:18.288
How do I do that?

00:54:18.409 --> 00:54:19.409
I have a real estate practice.

00:54:19.909 --> 00:54:20.911
It might seem like Jimmy's

00:54:20.951 --> 00:54:22.251
trying to be a marketing

00:54:22.291 --> 00:54:23.434
guy and change the headline,

00:54:23.733 --> 00:54:24.635
but that's a different

00:54:24.715 --> 00:54:26.255
thing because one makes me

00:54:26.356 --> 00:54:27.958
ask you a question about

00:54:28.018 --> 00:54:28.639
how you could do that.

00:54:28.699 --> 00:54:29.298
So what do you think?

00:54:29.318 --> 00:54:32.001
Like a stretchologist might say,

00:54:32.041 --> 00:54:34.143
I help people feel better

00:54:34.864 --> 00:54:36.585
and feel refreshed.

00:54:37.047 --> 00:54:38.748
I help you move better throughout the day.

00:54:39.349 --> 00:54:40.009
How do you do that?

00:54:40.168 --> 00:54:41.369
Oh, I have this thing called Stretch Lab.

00:54:41.389 --> 00:54:42.809
You come in and for 50 minutes,

00:54:43.469 --> 00:54:44.291
I do some things.

00:54:44.871 --> 00:54:46.251
Stop telling people about

00:54:46.271 --> 00:54:47.931
the tools that you use or your degree.

00:54:48.331 --> 00:54:49.672
Start telling them about the outcome.

00:54:50.052 --> 00:54:51.213
That's what Stretch Lab does.

00:54:51.512 --> 00:54:53.114
They show you the outcome, right?

00:54:54.014 --> 00:54:55.715
So you could be mad about it

00:54:55.855 --> 00:54:56.514
or you could bitch about it

00:54:56.534 --> 00:54:58.235
on Facebook or you could

00:54:58.295 --> 00:54:59.635
join them and offer them that.

00:54:59.695 --> 00:55:01.376
Now, this is all your decision too,

00:55:01.717 --> 00:55:02.856
but you can't complain

00:55:02.916 --> 00:55:03.737
about it when the market

00:55:03.757 --> 00:55:04.577
doesn't want to pay for

00:55:04.757 --> 00:55:05.478
what you're providing.

00:55:06.760 --> 00:55:07.601
I love the idea.

00:55:07.621 --> 00:55:10.525
Your physical therapy is

00:55:10.625 --> 00:55:11.786
part of your education.

00:55:11.847 --> 00:55:13.027
You have that knowledge,

00:55:13.188 --> 00:55:15.650
but you do so much more.

00:55:15.670 --> 00:55:16.811
That's just an element.

00:55:17.813 --> 00:55:19.956
Seb C is asking for

00:55:19.996 --> 00:55:21.056
information that I said,

00:55:21.177 --> 00:55:22.117
come back Tuesday.

00:55:22.478 --> 00:55:23.900
I want to spend some serious

00:55:23.920 --> 00:55:25.001
time talking about this.

00:55:25.061 --> 00:55:25.922
I think OT is...

00:55:26.643 --> 00:55:29.945
is so undercapitalized, underappreciated.

00:55:29.985 --> 00:55:30.505
There are so many

00:55:30.565 --> 00:55:31.706
opportunities for OTs

00:55:31.786 --> 00:55:32.527
moving into private

00:55:32.568 --> 00:55:34.648
practice that we need more

00:55:34.688 --> 00:55:35.769
than two or three minutes

00:55:35.829 --> 00:55:36.670
to discuss this.

00:55:37.190 --> 00:55:38.211
But it's the same thing.

00:55:38.512 --> 00:55:39.713
Just because you have OT

00:55:39.793 --> 00:55:41.733
after your name doesn't mean anything.

00:55:42.235 --> 00:55:43.916
You capture the knowledge, the value,

00:55:43.956 --> 00:55:45.297
the experience that you've had,

00:55:45.737 --> 00:55:46.818
and you turn that into

00:55:46.898 --> 00:55:48.099
something the market wants

00:55:48.259 --> 00:55:50.240
and something you want to deliver.

00:55:50.260 --> 00:55:52.702
And that's where the magic happens.

00:55:53.512 --> 00:55:55.755
Can I give it a specific example?

00:55:55.835 --> 00:55:56.695
And then we can work on

00:55:57.195 --> 00:55:58.596
Seb's question because OTs,

00:55:58.976 --> 00:56:01.318
I like it because it's not what we do.

00:56:01.378 --> 00:56:02.778
So we need to actually think

00:56:02.818 --> 00:56:04.400
about this from a different perspective.

00:56:04.960 --> 00:56:06.302
And we can bring her on the show.

00:56:06.742 --> 00:56:08.003
And this is my friend, Megan Brown.

00:56:08.583 --> 00:56:10.503
Megan Brown is a complete,

00:56:10.864 --> 00:56:11.985
her business in one of the

00:56:13.445 --> 00:56:14.706
most expensive real estate

00:56:15.807 --> 00:56:17.028
areas in the country, Alexandria,

00:56:17.068 --> 00:56:17.489
Virginia.

00:56:18.230 --> 00:56:19.710
Her physical therapy practice,

00:56:19.731 --> 00:56:20.690
I'm using air quotes,

00:56:20.851 --> 00:56:22.092
isn't a physical therapy practice.

00:56:22.132 --> 00:56:23.092
It's a Pilates studio.

00:56:24.112 --> 00:56:25.492
but Megan doesn't sell PT

00:56:25.572 --> 00:56:26.733
and she doesn't sell Pilates either.

00:56:26.773 --> 00:56:27.653
She sells community.

00:56:28.054 --> 00:56:29.434
She sells the ability to,

00:56:29.534 --> 00:56:30.893
for you to become a better person.

00:56:31.534 --> 00:56:32.375
She actually goes out of her

00:56:32.414 --> 00:56:34.054
way to not provide PT.

00:56:34.235 --> 00:56:34.514
Why?

00:56:34.574 --> 00:56:35.574
Because Megan's like,

00:56:35.655 --> 00:56:36.675
I'm worth more than this.

00:56:37.496 --> 00:56:38.456
But do you think she uses

00:56:38.496 --> 00:56:40.735
her PT knowledge every single day?

00:56:41.077 --> 00:56:41.317
Yup.

00:56:41.677 --> 00:56:42.496
She uses that thing that

00:56:42.536 --> 00:56:44.456
Dave's talking about in a different way.

00:56:45.097 --> 00:56:46.918
She, and I know this is like a bad term.

00:56:46.958 --> 00:56:48.338
She repackages what she's

00:56:48.378 --> 00:56:50.378
able to deliver and delivers it.

00:56:50.458 --> 00:56:51.278
And when it comes out the

00:56:51.318 --> 00:56:53.159
other side of her packaging, she,

00:56:55.550 --> 00:56:57.570
it has a higher perceived value.

00:56:57.650 --> 00:56:59.452
Keep in mind, all value is perceived.

00:57:00.012 --> 00:57:01.333
Value is perceived value.

00:57:01.673 --> 00:57:03.054
What I perceive is different

00:57:03.074 --> 00:57:03.775
than what you perceive.

00:57:04.096 --> 00:57:05.195
But Megan's able to build a

00:57:05.215 --> 00:57:06.757
thriving business as a

00:57:06.836 --> 00:57:08.237
physical therapist without

00:57:08.297 --> 00:57:09.438
the words physical therapy

00:57:09.478 --> 00:57:10.099
on the outside of the

00:57:10.119 --> 00:57:11.561
building or the website or

00:57:11.581 --> 00:57:12.320
her business card.

00:57:12.601 --> 00:57:13.681
But trust me, my friends,

00:57:13.942 --> 00:57:16.043
she is 1000% a physical therapist.

00:57:16.903 --> 00:57:18.545
Instead of parting shots today,

00:57:18.965 --> 00:57:20.286
let's close with a special

00:57:20.347 --> 00:57:21.126
acknowledgement.

00:57:21.407 --> 00:57:22.427
Jimmy, you're up.

00:57:23.376 --> 00:57:24.556
Yeah, so this was a video.

00:57:24.956 --> 00:57:26.498
We are very active on social media,

00:57:26.579 --> 00:57:27.940
and all three of us missed

00:57:28.000 --> 00:57:29.420
this video that was shared.

00:57:29.981 --> 00:57:31.123
And so I'll do it just a quick.

00:57:31.202 --> 00:57:33.324
This is Tom Fletcher, right?

00:57:33.364 --> 00:57:33.844
That's his name.

00:57:34.686 --> 00:57:36.007
And I won't play the video.

00:57:36.146 --> 00:57:37.248
He did share it publicly,

00:57:37.407 --> 00:57:38.568
but it's a long video.

00:57:39.449 --> 00:57:42.353
And I wanted Tom's video to be a story,

00:57:42.932 --> 00:57:44.253
at least to share the idea

00:57:44.474 --> 00:57:46.275
of when you do something,

00:57:46.675 --> 00:57:47.577
and that's like spend an

00:57:47.617 --> 00:57:49.018
extra 10 minutes with a patient,

00:57:49.639 --> 00:57:50.659
maybe not an extra two hours,

00:57:50.699 --> 00:57:51.440
but an extra 10 minutes

00:57:51.460 --> 00:57:53.179
with the patient or go the extra mile,

00:57:54.061 --> 00:57:56.521
call an old friend, do a live stream.

00:57:56.902 --> 00:57:58.242
It sort of has those ripple effects,

00:57:58.722 --> 00:57:58.922
right?

00:57:59.103 --> 00:57:59.782
Some people might call it

00:57:59.802 --> 00:58:00.663
the butterfly effect.

00:58:01.282 --> 00:58:01.963
And the reason I'm bringing

00:58:01.983 --> 00:58:03.184
this up is Tom shared a

00:58:03.204 --> 00:58:04.505
video in a Facebook group

00:58:05.425 --> 00:58:06.465
Tom's a physical therapist

00:58:07.326 --> 00:58:09.288
and share a two minute video about, Hey,

00:58:09.347 --> 00:58:10.929
like you're, you know,

00:58:11.009 --> 00:58:12.068
stupid little live streams

00:58:12.088 --> 00:58:13.030
that you guys do, you know,

00:58:13.070 --> 00:58:14.391
two or two twice a week.

00:58:15.150 --> 00:58:15.231
Um,

00:58:15.351 --> 00:58:16.751
he was traveling back and forth to the

00:58:16.811 --> 00:58:17.273
hospital.

00:58:17.612 --> 00:58:18.713
His wife was very ill.

00:58:19.213 --> 00:58:20.695
It was a really bad time in his life.

00:58:20.755 --> 00:58:21.155
Essentially.

00:58:21.175 --> 00:58:22.016
It was what he was setting

00:58:22.056 --> 00:58:24.456
us up with and being able

00:58:24.496 --> 00:58:25.597
to sort of zone out and

00:58:25.657 --> 00:58:26.978
listen to something that he

00:58:27.018 --> 00:58:28.199
sort of wanted to get better at,

00:58:28.239 --> 00:58:29.500
or just kind of tune into,

00:58:29.519 --> 00:58:31.621
which was us talking about PT, marketing,

00:58:31.661 --> 00:58:33.063
business, technology, whatever.

00:58:33.083 --> 00:58:33.123
Um,

00:58:34.422 --> 00:58:35.724
Helped him get through some times.

00:58:36.103 --> 00:58:37.903
That's not why we did this, right?

00:58:37.963 --> 00:58:39.063
We didn't turn on our

00:58:39.083 --> 00:58:40.644
cameras every Tuesday and

00:58:40.704 --> 00:58:44.206
Thursday to make people feel better.

00:58:44.666 --> 00:58:45.826
We did it because we like to

00:58:45.865 --> 00:58:46.405
talk about it.

00:58:46.646 --> 00:58:47.706
And oh, by the way,

00:58:47.806 --> 00:58:49.347
these things ripple out into the world.

00:58:49.427 --> 00:58:51.367
So we didn't do it because of that.

00:58:52.047 --> 00:58:53.009
But that's the closing of

00:58:53.028 --> 00:58:56.012
the loop is Tom told us he got value.

00:58:56.092 --> 00:58:58.795
He didn't feel alone for 20

00:58:58.795 --> 00:59:00.856
minutes a day on his drive.

00:59:00.896 --> 00:59:02.960
And to me, dude, that's more than enough,

00:59:03.559 --> 00:59:03.820
right?

00:59:03.940 --> 00:59:06.063
So I thought this was a really – I mean,

00:59:06.463 --> 00:59:06.864
number one,

00:59:06.903 --> 00:59:07.804
thanks for being vulnerable

00:59:07.885 --> 00:59:08.686
and sharing that.

00:59:08.746 --> 00:59:10.166
I mean, the video, I mean,

00:59:10.608 --> 00:59:11.327
I couldn't even watch it

00:59:11.367 --> 00:59:12.829
twice because it was like –

00:59:12.829 --> 00:59:13.510
It was killing me.

00:59:13.690 --> 00:59:14.411
But trust me,

00:59:14.431 --> 00:59:15.291
I thought about it multiple

00:59:15.311 --> 00:59:16.291
times after I saw that.

00:59:16.331 --> 00:59:18.233
So what you put out into the world,

00:59:18.273 --> 00:59:19.034
it feels like you're

00:59:19.074 --> 00:59:20.074
talking to your phone and

00:59:20.094 --> 00:59:21.114
it just goes somewhere.

00:59:21.474 --> 00:59:22.496
And then you pay attention

00:59:22.516 --> 00:59:23.396
to the likes and the

00:59:23.496 --> 00:59:24.536
follows and the shares.

00:59:25.077 --> 00:59:26.297
Maybe that's the wrong metric,

00:59:26.418 --> 00:59:27.358
but maybe the real metric

00:59:27.418 --> 00:59:29.019
is a little harder to calculate.

00:59:29.039 --> 00:59:30.740
But trust me, it's there.

00:59:32.110 --> 00:59:32.289
Yeah.

00:59:32.309 --> 00:59:33.650
And we just want to say, thanks, Tom.

00:59:33.690 --> 00:59:34.771
We appreciate that.

00:59:34.951 --> 00:59:36.710
It touched all of us deeply.

00:59:37.391 --> 00:59:39.751
And you know, if we dedicated any episode,

00:59:39.891 --> 00:59:41.612
we would dedicate this episode to you.

00:59:41.632 --> 00:59:42.432
So thanks so much.

00:59:42.472 --> 00:59:42.713
Yeah.

00:59:43.052 --> 00:59:43.552
All right.

00:59:43.592 --> 00:59:44.833
We're going to come back on Tuesday.

00:59:44.873 --> 00:59:47.213
So I can't say it any better.

00:59:47.293 --> 00:59:48.273
It was an absolute honor.

00:59:48.293 --> 00:59:50.855
Um, other than my son being born this year,

00:59:51.054 --> 00:59:53.795
Tom, that video was made my year, man.

00:59:53.856 --> 00:59:56.275
Like I can't even believe that.

00:59:56.335 --> 00:59:58.496
And I shared it with you guys and, um,

01:00:00.061 --> 01:00:01.505
If we can help or assist in any way,

01:00:01.686 --> 01:00:03.050
please reach out, send us a message,

01:00:03.110 --> 01:00:03.612
let us know.

01:00:04.333 --> 01:00:05.778
And yeah, you guys said it well,

01:00:05.818 --> 01:00:06.280
so well put.

01:00:07.021 --> 01:00:08.302
All right, so subscribe,

01:00:08.362 --> 01:00:09.342
do all the things that live

01:00:09.382 --> 01:00:10.864
streamers are supposed to say, follow,

01:00:10.943 --> 01:00:11.164
like.

01:00:11.625 --> 01:00:12.625
I do like the feedback.

01:00:12.786 --> 01:00:14.226
Like a video like that from Tom,

01:00:14.706 --> 01:00:16.088
it's not going to go away anytime soon.

01:00:16.268 --> 01:00:16.708
I'll be thinking,

01:00:16.728 --> 01:00:17.668
that'll be keeping me warm

01:00:17.688 --> 01:00:18.329
throughout the winter.

01:00:18.849 --> 01:00:19.849
And I hope you're doing well, Tom.

01:00:20.590 --> 01:00:21.471
But letting us know what you

01:00:21.490 --> 01:00:21.971
get out of it.

01:00:22.291 --> 01:00:22.532
Hey,

01:00:22.632 --> 01:00:23.751
give us an idea for what you want to

01:00:23.791 --> 01:00:24.393
talk about next.

01:00:24.492 --> 01:00:26.134
Just like Seb will be back on Tuesday.

01:00:26.974 --> 01:00:28.474
Listen to it via the podcast

01:00:28.494 --> 01:00:29.496
or the live stream everywhere.

01:00:29.655 --> 01:00:30.856
And we'll dive into that

01:00:30.896 --> 01:00:33.117
question from the OT, Seb.

01:00:33.177 --> 01:00:33.938
Gentlemen, have a great day.

01:00:33.958 --> 01:00:34.398
We'll see you soon.

Why Stretch Labs Are Changing the Game for Physical Therapists

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