May 17, 2025
Why You Should Drop Your PT License! (And Why It Matters)

Dave Kittle and Tony Maritato go all in on the real issues PTs face in 2025: burnout, bureaucracy, and whether your license is actually worth it anymore. This is a raw, transparent conversation for clinicians fed up with “check-the-box” education and broken billing expectations.
WEBVTT
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All right, we are live.
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I am back.
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I'm here with Dave Kittle, Tony Maritato.
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Jimmy may or may not jump on.
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He's got another meeting this morning.
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But I was just asking Dave
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before we started about
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Mother's Day in New York.
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So, you know, down here, down here,
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out here, southwest Ohio area.
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The tradition is always we mulch,
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we mulch the flower beds,
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we mulch the yard, we cut the grass,
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we edge, we clean it up,
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make it look pretty for mom.
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Tell me again what you guys did for,
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is this her first Mother's
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Day as a mother?
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No, second,
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because the baby was born last
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March twenty ninth.
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So the first Mother's Day
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was pretty quick last year,
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like in terms of like, you know,
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got on us quick.
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So this year,
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probably a little bit more
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time for her to soak it up and all that.
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And yeah, it was great.
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We just went out for an
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early dinner in the
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neighborhood here in
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Brooklyn and had a good time.
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Awesome.
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With the baby, of course.
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Yeah, of course.
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So lots to talk about.
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I was in D.C.
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last week.
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It was awesome.
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But you shared this
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screenshot and I think it
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resonates probably with
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every small private practice owner.
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So I've got it up on the screen.
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This comes from the physical
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therapy billing group.
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It's an awesome group.
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Shelly, Heidi,
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if you guys are PT practice owners,
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OT practice owners,
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go check out the group on Facebook.
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But it says, love some help.
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My husband, who's the owner,
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has been doing his own billing,
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a five therapist office.
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That's a boatload.
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That's a ton.
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Staying up until two a.m.
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every night,
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seeing eighteen patients a day himself,
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including Saturdays when
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things went kind of bad two years ago.
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So had some negative
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outcomes from a previous billing company.
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It sounds like says now with
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my aggressive scheduling,
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it's just getting to be too much for him.
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No time to deal with issues.
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Ideally,
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he'd love a full time person in
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the office.
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They're in South California, I think.
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But, like,
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maybe we look for a virtual
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company or in person.
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Any input or suggestions?
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So, Dave, you shared that with me.
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What are your thoughts about that?
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Yeah, so, I mean...
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You have to do something.
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You have to figure out something.
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And it's either going to be
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outsource it or you hire a
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billing person in-house.
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It depends on the total
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volume of claims and visits
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per week and per month and all that.
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But as an aside,
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This practice,
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you got to treat it like a business.
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I just did a solo episode
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screen share of Joe Lowe's
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post on LinkedIn about the
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physical therapy M&A market
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for twenty twenty five.
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And you commented on that.
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And I screen share that as
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part of my episode.
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And one of your comments, Tony, was,
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you know,
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basically like this will work or X, Y, Z,
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like with that market report,
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like the improvement or the
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ability for practices to
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grow or maintain
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profitability and all that.
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Your your comment said,
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basically like it'll work or
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this is possible if you
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treat the therapy practice
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like a business.
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And this screen share is no different.
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I think it's, respectfully, respectfully,
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I think it's crazy for a practice owner,
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a physical therapist
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practice owner that has
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five physical therapists
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to be treating eighteen
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patients per day and doing the billing.
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You need an intervention, respectfully.
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You need an intervention.
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You need Sturdy McKee, Jamie Schrier.
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You need a coach to help you
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delegate stuff.
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The first thing I'm thinking
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of is you need to just get out.
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I can't believe that there
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are small business owners
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that want to do all the stuff
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It's crazy.
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And then how do you have time to work out,
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go to the gym, go for a jog, I don't know,
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do leisurely stuff, mow the lawn,
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mulching,
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like Tony was just talking about.
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How do you have time to do any of that?
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You don't.
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And your head's spinning all the time.
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And then if you do some of these things,
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if you outsource it,
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or if you hire one or two
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billion people for the practice, yes,
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some of your income money
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goes to their salaries.
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but you have more time for
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clarity to think about self pay options,
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to think about hiring and
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recruiting other therapists
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to replace yourself.
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So I have a lot of thoughts
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obviously about this and I just,
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I don't know, like Tony, like how,
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how does this happen?
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Is this something that you
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see a lot or you've heard a
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lot with practice owners
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that like they want to do
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all this stuff and then the
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practice kind of gets
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bigger over time and they
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never get out of those initial jobs,
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roles or responsibilities?
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Yeah,
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I think it's one of those things where,
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like I said,
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the comment said two years
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ago they had a negative experience.
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So, you know, I always share this story.
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When we started, we hired a biller.
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We thought a biller was a biller.
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Like we didn't realize, well,
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there's physical therapy
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billers and non-physical therapy billers.
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So we hire this random biller.
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We we never get any of our claims paid.
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Thankfully,
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we still we started as a cash
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based business.
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So we had tons of income coming in.
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We fired that bill or hired
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a second bill or still no results.
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We lost about sixty thousand
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dollars back in two thousand one,
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two thousand two until we
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hired the third biller.
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Now, the third biller was awesome.
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He specialized in physical
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therapy billing.
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He reminds me actually now
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that I think of it of Heidi
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and Shelly and some of the
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billers that are in that Facebook group.
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It was just him and a partner.
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They were a small, you know,
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service provider.
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And he dug us out of a major hole there.
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But we still had such a
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negative experience.
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Now, I think for us,
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what made the difference
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because we were in the same boat.
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We were seeing tons of patients.
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We were busy.
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We didn't have five clinicians.
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We probably had two like myself,
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my my wife, another two other therapists.
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So let's say four in total.
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But we were treating a full
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caseload and running the
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business and doing everything.
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And I think you're just on
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that hamster wheel.
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It's going so fast.
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You don't have time to take
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a breath and step off.
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And as clinicians,
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we tend to think nobody can
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do it better than us, whatever it is.
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So we want to do it all.
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We're not approaching this
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like a business.
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We're approaching this like patient care.
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I will see more patients.
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I will build more units.
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I will do more stuff.
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And so you just can't do it anymore.
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For us, we read E-Myth, revisited it.
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We made the decision that
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we're going to treat this
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like a business and not a job.
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We took our self-worth and
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value away from having to
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do everything and being the
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best at everything.
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We went through some education,
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some consulting,
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and we actually learned how
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to structure a business and
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bring people in to put them
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into those roles that we had defined.
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And for the next, I don't know,
00:07:18.627 --> 00:07:19.649
probably three years,
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we outsourced as we continued to grow,
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outsourced our billing.
00:07:23.901 --> 00:07:24.482
But even there,
00:07:24.641 --> 00:07:25.882
we got to the point where like,
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why are we paying, you know,
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seven percent on a million
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in revenue when really we
00:07:31.225 --> 00:07:32.125
could just bring it in
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house and probably do it better.
00:07:33.665 --> 00:07:34.766
But at that point,
00:07:35.466 --> 00:07:38.187
we had replaced ourselves as clinicians.
00:07:38.307 --> 00:07:39.668
We were no longer treating
00:07:39.887 --> 00:07:41.329
every patient every day.
00:07:42.209 --> 00:07:43.629
So we had the capacity,
00:07:43.689 --> 00:07:45.709
the bandwidth to build a
00:07:45.771 --> 00:07:46.630
billing business.
00:07:46.670 --> 00:07:47.911
And we've actually spun off
00:07:48.411 --> 00:07:50.291
billing businesses as
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completely separate entities because
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Because we had the ability
00:07:54.357 --> 00:07:56.379
to not spend eight to ten
00:07:56.420 --> 00:07:57.663
hours treating patients and
00:07:57.682 --> 00:07:59.125
then try to work on the
00:07:59.165 --> 00:07:59.987
business afterward.
00:08:01.761 --> 00:08:02.922
Yeah, makes a ton of sense.
00:08:02.961 --> 00:08:06.024
I feel like for the small business owner,
00:08:06.064 --> 00:08:08.567
the practice owners out there, it's just,
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I think, a shame to not... Respectfully,
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we're not saying it's not a
00:08:15.132 --> 00:08:15.952
serious business.
00:08:16.014 --> 00:08:16.574
Obviously, it is.
00:08:16.593 --> 00:08:18.636
You have five physical
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therapists outside of the owner.
00:08:20.357 --> 00:08:20.817
Like you said,
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that's a meaningful practice,
00:08:23.639 --> 00:08:24.500
even if they're in network.
00:08:24.740 --> 00:08:25.141
And so...
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it's just a shame that I
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don't know like is it is it
00:08:30.125 --> 00:08:31.726
some you know small
00:08:31.786 --> 00:08:34.489
business like uh dna or
00:08:34.609 --> 00:08:36.571
ethos or something where
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it's like my generation and
00:08:39.852 --> 00:08:42.215
and older uh and I like to
00:08:42.235 --> 00:08:43.336
include myself in in the
00:08:43.416 --> 00:08:44.677
you know put your head down
00:08:44.716 --> 00:08:46.399
like just grind it out like
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it might have stopped a
00:08:47.399 --> 00:08:48.740
little bit after my age but
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like kind of like you know
00:08:50.581 --> 00:08:52.263
your colleagues and your
00:08:52.302 --> 00:08:54.044
friends and small business owners like
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Is it just easy for practice owners,
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business owners that are
00:08:58.128 --> 00:08:59.548
independent to kind of put
00:08:59.568 --> 00:09:02.412
their head down, just grind it out until,
00:09:02.932 --> 00:09:03.152
you know,
00:09:03.172 --> 00:09:04.173
your wife goes on a Facebook
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group and says like, hey,
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we need some help with this or that.
00:09:06.754 --> 00:09:07.576
And it's not even it's not
00:09:07.596 --> 00:09:08.317
even that individual.
00:09:08.336 --> 00:09:09.957
It's not even that the practice owner,
00:09:10.057 --> 00:09:10.599
that's the physical
00:09:10.639 --> 00:09:12.139
therapist asking for help.
00:09:12.399 --> 00:09:13.581
So who knows if he or she
00:09:13.640 --> 00:09:14.302
even wants to help?
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Yeah.
00:09:15.437 --> 00:09:15.638
Yeah.
00:09:15.778 --> 00:09:16.077
Yeah.
00:09:16.177 --> 00:09:16.817
I think it is.
00:09:16.999 --> 00:09:19.219
I think it's within our DNA,
00:09:19.599 --> 00:09:20.739
but then I think there's
00:09:20.818 --> 00:09:22.539
also a lot of baggage that
00:09:22.580 --> 00:09:23.580
we bring with us.
00:09:23.620 --> 00:09:25.299
You know, what did your parents do?
00:09:25.360 --> 00:09:26.400
What were your parents'
00:09:26.900 --> 00:09:28.280
mindsets around money?
00:09:29.682 --> 00:09:30.782
I know I've still got tons
00:09:30.802 --> 00:09:32.341
of baggage from mom and dad
00:09:32.381 --> 00:09:33.662
and how they addressed money,
00:09:33.721 --> 00:09:35.302
how your spouse addresses money,
00:09:35.383 --> 00:09:36.383
what money is.
00:09:37.023 --> 00:09:38.344
We were just, I mean,
00:09:38.504 --> 00:09:41.443
every chance I get with my four boys,
00:09:41.943 --> 00:09:43.924
I always try to instill in them
00:09:44.485 --> 00:09:45.025
Who cares?
00:09:45.145 --> 00:09:45.806
It's just money.
00:09:46.567 --> 00:09:49.109
It has zero value unless you spend it.
00:09:49.629 --> 00:09:51.410
You decide how you want to spend it.
00:09:51.451 --> 00:09:52.631
Spend it could be investing
00:09:52.711 --> 00:09:54.673
it or it could be just wasteful spending.
00:09:54.714 --> 00:09:55.475
It doesn't matter.
00:09:56.014 --> 00:09:56.936
But the point is,
00:09:57.476 --> 00:09:59.158
I want them to understand
00:09:59.677 --> 00:10:01.320
money can always be created.
00:10:01.399 --> 00:10:02.841
It can always be generated.
00:10:03.101 --> 00:10:05.484
There's no scarcity around money ever.
00:10:06.063 --> 00:10:07.765
You could have zero money
00:10:08.265 --> 00:10:09.547
and be completely happy.
00:10:09.707 --> 00:10:10.948
You could have millions of
00:10:11.009 --> 00:10:13.051
dollars and be completely miserable.
00:10:13.591 --> 00:10:15.153
So those are the lessons
00:10:15.192 --> 00:10:17.274
that I try to instill in my kids.
00:10:18.384 --> 00:10:20.684
But I recognize that I still
00:10:20.725 --> 00:10:22.846
have a ton of bad money
00:10:22.926 --> 00:10:25.265
habits from my parents who
00:10:25.285 --> 00:10:26.966
were successful in their own right.
00:10:27.047 --> 00:10:27.307
I mean,
00:10:27.346 --> 00:10:29.027
I'm not taking anything away from them.
00:10:29.586 --> 00:10:32.807
I'm just saying it's work to
00:10:32.888 --> 00:10:34.307
change the way we look at it.
00:10:34.347 --> 00:10:34.807
Plus,
00:10:35.408 --> 00:10:37.568
going back to I think a lot of
00:10:37.609 --> 00:10:39.708
therapists just tie their value,
00:10:39.769 --> 00:10:42.710
their identity to I'm a hard worker.
00:10:42.830 --> 00:10:44.669
I was successful in school.
00:10:44.730 --> 00:10:46.010
I checked all the boxes and
00:10:46.071 --> 00:10:46.990
I did the homework.
00:10:48.010 --> 00:10:49.751
I never saw value in any of that.
00:10:49.971 --> 00:10:51.952
So I came to therapy from
00:10:52.013 --> 00:10:53.474
kind of a different perspective.
00:10:54.933 --> 00:10:56.154
But there's a lot of
00:10:56.254 --> 00:10:58.755
identity tied to doing what
00:10:58.796 --> 00:11:00.657
you think you're supposed to do.
00:11:01.317 --> 00:11:03.438
So and a lot of people still think, well,
00:11:03.458 --> 00:11:04.178
I got to work hard.
00:11:04.399 --> 00:11:06.659
If I'm not working hard, I'm being lazy.
00:11:07.259 --> 00:11:08.321
It's just not true at all.
00:11:10.304 --> 00:11:10.924
Yeah, I love it.
00:11:11.385 --> 00:11:13.006
Um, so what are, what are some,
00:11:13.106 --> 00:11:14.067
I know there's a bunch of comments.
00:11:14.086 --> 00:11:15.427
I know Joey Albritton commented,
00:11:15.447 --> 00:11:17.408
a bunch of folks commented, what would be,
00:11:18.049 --> 00:11:18.750
uh, you know, not,
00:11:18.970 --> 00:11:20.530
not that they're asking for
00:11:20.671 --> 00:11:22.152
our unsolicited advice.
00:11:22.172 --> 00:11:23.472
They're asking that whole
00:11:23.513 --> 00:11:24.354
Facebook group or whatever.
00:11:24.913 --> 00:11:26.355
What would be like,
00:11:26.634 --> 00:11:28.296
what would be an idea or like,
00:11:28.475 --> 00:11:29.756
what would you do if you were that owner?
00:11:29.836 --> 00:11:30.236
And you know,
00:11:30.277 --> 00:11:31.217
your wife is going on the
00:11:31.238 --> 00:11:34.460
Facebook group and, uh, or what's,
00:11:34.559 --> 00:11:36.740
what suggestion would you have for, uh,
00:11:36.780 --> 00:11:37.562
for this practice owner?
00:11:38.143 --> 00:11:39.063
I think this is where you
00:11:39.124 --> 00:11:41.386
have to bring in a new set of eyes.
00:11:41.486 --> 00:11:42.567
This is where you have to
00:11:42.607 --> 00:11:44.230
bring in an outside consultant.
00:11:44.529 --> 00:11:45.931
And you have to step back
00:11:46.471 --> 00:11:48.474
and use the logical brain.
00:11:48.514 --> 00:11:49.696
You have a clinical brain.
00:11:49.735 --> 00:11:51.037
There's logic in that.
00:11:51.517 --> 00:11:52.477
It's like, well, wait a minute.
00:11:52.719 --> 00:11:53.879
If this person is doing
00:11:53.940 --> 00:11:55.000
eighteen visits a day.
00:11:55.922 --> 00:11:57.864
So let's say close to two
00:11:57.884 --> 00:11:59.505
thousand dollars in revenue
00:11:59.546 --> 00:12:02.207
generation a day, just this person.
00:12:02.889 --> 00:12:03.909
And then there's five,
00:12:04.269 --> 00:12:05.370
potentially five other
00:12:05.410 --> 00:12:07.072
people doing comparable.
00:12:07.592 --> 00:12:07.952
You know,
00:12:08.293 --> 00:12:09.835
this practice is doing a
00:12:09.894 --> 00:12:13.038
significant amount of revenue within this,
00:12:13.379 --> 00:12:14.639
probably upwards, you know,
00:12:14.720 --> 00:12:15.961
well over half.
00:12:16.341 --> 00:12:17.802
a five hundred thousand plus
00:12:17.841 --> 00:12:19.482
close to a million in revenue,
00:12:20.124 --> 00:12:21.585
you have to sit there and be like,
00:12:21.664 --> 00:12:24.167
wait a minute, something doesn't add up.
00:12:24.427 --> 00:12:25.967
We're generating, let's say,
00:12:26.008 --> 00:12:26.849
seven hundred and fifty
00:12:26.889 --> 00:12:28.210
thousand a year in revenue.
00:12:28.889 --> 00:12:31.231
And I'm I'm killing myself
00:12:31.392 --> 00:12:32.952
doing all this stuff like
00:12:33.753 --> 00:12:35.534
you have to acknowledge
00:12:35.554 --> 00:12:36.394
there's a problem.
00:12:36.916 --> 00:12:38.277
The wife acknowledges it.
00:12:38.356 --> 00:12:39.878
Other people around you see it.
00:12:40.717 --> 00:12:42.097
You have to acknowledge it
00:12:42.118 --> 00:12:42.859
and then you have to get a
00:12:42.899 --> 00:12:43.739
fresh set of eyes.
00:12:43.778 --> 00:12:43.999
You know,
00:12:44.038 --> 00:12:45.658
somebody to come in and look at this,
00:12:45.879 --> 00:12:48.600
give you their perspective
00:12:49.039 --> 00:12:50.240
from the outside looking in.
00:12:50.320 --> 00:12:51.921
And then you can decide like, all right,
00:12:52.301 --> 00:12:54.000
do I agree with their perspective?
00:12:54.160 --> 00:12:54.480
You know,
00:12:54.821 --> 00:12:56.542
we get patients and I tie
00:12:56.581 --> 00:12:57.841
everything back to patient care.
00:12:58.322 --> 00:12:59.522
Patient walks in the door.
00:12:59.961 --> 00:13:01.003
He loves smoking.
00:13:01.123 --> 00:13:02.163
He loves drinking.
00:13:02.302 --> 00:13:03.903
He loves eating whatever he wants,
00:13:03.982 --> 00:13:06.104
but his back pain doesn't get better.
00:13:06.844 --> 00:13:08.125
I can tell them, look,
00:13:08.144 --> 00:13:09.825
this isn't a mechanical problem.
00:13:09.965 --> 00:13:11.066
It's a chemical problem.
00:13:11.485 --> 00:13:14.267
Your body is dealing with chemical issues.
00:13:14.687 --> 00:13:16.288
If you really want to address this,
00:13:16.347 --> 00:13:17.808
we need lifestyle change.
00:13:18.308 --> 00:13:19.649
And then that that patient
00:13:19.688 --> 00:13:20.750
can make the decision.
00:13:21.190 --> 00:13:22.190
Yeah, I want to do this.
00:13:22.250 --> 00:13:22.671
I'm ready.
00:13:22.730 --> 00:13:24.051
I'm ready to make the change.
00:13:24.071 --> 00:13:25.292
I'm going to change my diet,
00:13:25.331 --> 00:13:26.331
change my lifestyle.
00:13:26.351 --> 00:13:27.712
I'm going to start to exercise.
00:13:28.493 --> 00:13:29.373
Or they're going to say, no,
00:13:29.432 --> 00:13:30.094
I don't want that.
00:13:30.394 --> 00:13:31.254
And they're going to they
00:13:31.274 --> 00:13:32.514
would rather deal with the
00:13:32.553 --> 00:13:34.475
pain of back back pain.
00:13:35.235 --> 00:13:36.375
This guy would rather deal
00:13:36.394 --> 00:13:37.775
with the pain of burnout
00:13:38.235 --> 00:13:40.196
than make these changes
00:13:40.216 --> 00:13:41.797
because they're so fearful
00:13:42.277 --> 00:13:44.378
of what those changes involve.
00:13:44.418 --> 00:13:45.658
And a lot of times those
00:13:45.697 --> 00:13:46.998
changes are more painful.
00:13:47.639 --> 00:13:49.379
Exercising daily and eating
00:13:49.438 --> 00:13:50.698
a different diet is more
00:13:50.739 --> 00:13:52.320
painful than the nuisance
00:13:52.340 --> 00:13:53.480
back pain he's dealing with.
00:13:53.519 --> 00:13:54.461
He'd rather just deal with
00:13:54.500 --> 00:13:55.341
the nuisance back pain.
00:13:56.124 --> 00:13:58.065
But you need an outside set of eyes,
00:13:58.105 --> 00:13:59.945
somebody like you or other
00:13:59.985 --> 00:14:01.145
people that are out there
00:14:01.206 --> 00:14:02.285
that have been down that
00:14:02.346 --> 00:14:04.267
road and have seen a
00:14:04.326 --> 00:14:06.168
hundred other business models.
00:14:06.748 --> 00:14:08.508
That's somebody that I would say, hey,
00:14:08.548 --> 00:14:09.389
take a look at this and
00:14:09.428 --> 00:14:10.168
tell me what you see.
00:14:11.673 --> 00:14:12.855
I love what you mentioned
00:14:12.934 --> 00:14:15.056
maybe ten or so minutes ago.
00:14:15.076 --> 00:14:15.996
I don't know how long we had
00:14:16.037 --> 00:14:16.717
a lot of five or ten
00:14:16.738 --> 00:14:17.697
minutes ago when you
00:14:17.758 --> 00:14:18.698
mentioned that you had
00:14:18.798 --> 00:14:20.639
tried several different billers.
00:14:21.240 --> 00:14:22.000
And this goes back to
00:14:22.081 --> 00:14:23.481
remember when we were searching,
00:14:23.522 --> 00:14:24.363
we were interviewing folks
00:14:24.442 --> 00:14:25.623
to do home cleaning.
00:14:26.203 --> 00:14:28.164
And I don't know if I mentioned this,
00:14:28.205 --> 00:14:29.245
but like the first person
00:14:29.865 --> 00:14:31.447
like we had her come twice
00:14:31.506 --> 00:14:33.568
and like it just she was super nice,
00:14:33.609 --> 00:14:34.870
but it just like took forever.
00:14:34.889 --> 00:14:36.350
It was like eight hours.
00:14:36.370 --> 00:14:36.971
Like our place,
00:14:37.831 --> 00:14:39.972
it's a condo apartment in Brooklyn.
00:14:41.614 --> 00:14:42.474
place for three hours.
00:14:42.494 --> 00:14:42.594
Now,
00:14:42.634 --> 00:14:44.394
were you paying by the hour or by the
00:14:44.455 --> 00:14:44.815
job?
00:14:45.195 --> 00:14:46.316
No, by the job.
00:14:46.375 --> 00:14:46.696
It's like,
00:14:47.515 --> 00:14:49.417
why would you not hustle to get
00:14:49.576 --> 00:14:51.138
out of here sooner?
00:14:51.177 --> 00:14:53.778
It was a flat rate for the whole job.
00:14:53.798 --> 00:14:56.179
And by the way, that was her idea.
00:14:56.960 --> 00:14:57.620
The reason I'm bringing this
00:14:57.679 --> 00:14:59.020
up is because we tried her
00:14:59.041 --> 00:15:01.061
a couple of times and we're like, yeah,
00:15:01.081 --> 00:15:04.363
we're going to pause and
00:15:04.722 --> 00:15:05.763
then we continue the search.
00:15:09.133 --> 00:15:10.313
I think certain business
00:15:10.374 --> 00:15:14.018
owners can get in the rut of like, well,
00:15:14.057 --> 00:15:15.519
we tried that, so that didn't work.
00:15:15.918 --> 00:15:17.821
It's like what you said and what I did,
00:15:17.860 --> 00:15:19.623
then we look for another cleaner.
00:15:19.643 --> 00:15:20.123
If that didn't work,
00:15:20.143 --> 00:15:20.663
we're going to look for
00:15:20.683 --> 00:15:21.585
another and another.
00:15:22.264 --> 00:15:23.066
It's the same thing with
00:15:23.125 --> 00:15:24.427
recruiting for therapists.
00:15:24.888 --> 00:15:26.469
Some are just not going to
00:15:26.489 --> 00:15:27.009
be the right fit.
00:15:27.110 --> 00:15:29.272
They're going to be too experienced,
00:15:29.331 --> 00:15:30.232
too inexperienced.
00:15:30.253 --> 00:15:31.394
They're just not going to be
00:15:31.413 --> 00:15:31.854
the right fit.
00:15:33.134 --> 00:15:34.336
um regardless of the
00:15:34.355 --> 00:15:35.056
challenges that this
00:15:35.096 --> 00:15:36.135
practice had with uh
00:15:36.176 --> 00:15:37.197
billing folks or billing
00:15:37.236 --> 00:15:38.657
companies or whatever like
00:15:38.996 --> 00:15:40.477
there absolutely is a great
00:15:40.498 --> 00:15:41.518
fit out there like you said
00:15:41.738 --> 00:15:42.798
you might need a coach or a
00:15:42.859 --> 00:15:44.599
consultant or some practice
00:15:44.658 --> 00:15:46.100
owner that has been there before
00:15:47.065 --> 00:15:48.505
that hired five or ten
00:15:48.546 --> 00:15:49.907
different billing companies
00:15:49.966 --> 00:15:50.506
over the years,
00:15:50.888 --> 00:15:52.808
they actually could give
00:15:52.828 --> 00:15:54.070
you maybe like a cheat
00:15:54.090 --> 00:15:55.190
sheet or a handout of like,
00:15:55.630 --> 00:15:57.331
here's the proper questions to ask.
00:15:57.371 --> 00:15:57.511
Like,
00:15:57.572 --> 00:16:00.553
here's the savvy questions to ask
00:16:00.634 --> 00:16:01.455
when you're interviewing
00:16:01.514 --> 00:16:02.916
business or when you're
00:16:02.956 --> 00:16:04.517
interviewing billing companies.
00:16:05.177 --> 00:16:05.817
Like, you know,
00:16:06.177 --> 00:16:07.157
those types of asking for
00:16:07.216 --> 00:16:08.457
referrals or asking for
00:16:09.817 --> 00:16:11.197
references and asking to
00:16:11.238 --> 00:16:11.899
speak with other business
00:16:11.958 --> 00:16:12.778
owners that they're already
00:16:12.798 --> 00:16:14.318
helping on the billing side.
00:16:14.379 --> 00:16:16.460
So I love that.
00:16:16.700 --> 00:16:18.759
I always want to echo that,
00:16:18.799 --> 00:16:20.220
which is like there's just
00:16:20.299 --> 00:16:21.900
always more to assess and
00:16:21.921 --> 00:16:23.140
check out and never think
00:16:23.160 --> 00:16:24.441
that just because the first
00:16:24.561 --> 00:16:26.922
option or two didn't work out,
00:16:26.961 --> 00:16:28.621
that that's like the whole
00:16:29.081 --> 00:16:29.942
route doesn't work.
00:16:30.023 --> 00:16:31.623
Obviously, billing companies work.
00:16:32.614 --> 00:16:33.554
And you would think this is
00:16:33.595 --> 00:16:35.775
a lesson we already understand.
00:16:35.796 --> 00:16:37.158
The patient who comes in and
00:16:37.177 --> 00:16:38.778
says physical therapy
00:16:38.798 --> 00:16:39.879
doesn't work because they
00:16:39.919 --> 00:16:41.900
went down the street and they didn't do,
00:16:42.221 --> 00:16:44.403
you know, well with that.
00:16:44.523 --> 00:16:45.663
And that same physical
00:16:45.703 --> 00:16:46.565
therapist will then go on
00:16:46.585 --> 00:16:47.164
Facebook and say,
00:16:47.345 --> 00:16:48.785
I can't believe these patients say,
00:16:48.806 --> 00:16:50.187
you know, physical therapy won't work.
00:16:50.267 --> 00:16:50.947
And, you know,
00:16:51.128 --> 00:16:52.589
get physical therapy first
00:16:52.629 --> 00:16:55.150
and get PT first or, you know, PT.
00:16:55.591 --> 00:16:57.952
What was your choose PT first?
00:16:59.394 --> 00:17:00.215
It's hilarious.
00:17:00.235 --> 00:17:00.475
Yes.
00:17:00.754 --> 00:17:01.336
What a conundrum.
00:17:02.168 --> 00:17:03.089
What's interesting about
00:17:03.229 --> 00:17:04.390
what you shared with the
00:17:04.410 --> 00:17:07.211
cleaning person is you,
00:17:07.330 --> 00:17:10.012
and correct me if I'm wrong,
00:17:10.153 --> 00:17:11.153
you were just at least a
00:17:11.213 --> 00:17:14.816
little bit more concerned
00:17:14.855 --> 00:17:16.277
with the amount of time it
00:17:16.317 --> 00:17:18.358
took than the quality of the job.
00:17:18.439 --> 00:17:20.961
Now, a lot of people will say- No, no, no.
00:17:21.020 --> 00:17:21.641
I'm sorry.
00:17:21.681 --> 00:17:24.403
It was like missing dusty,
00:17:25.222 --> 00:17:26.284
dirty spots or whatever.
00:17:26.304 --> 00:17:27.525
So it was both.
00:17:27.605 --> 00:17:29.806
It was low quality and it took too long.
00:17:29.866 --> 00:17:31.788
So it's like, how did that happen?
00:17:32.833 --> 00:17:34.634
Yeah.
00:17:34.653 --> 00:17:36.654
Okay, let's pivot a little bit.
00:17:36.835 --> 00:17:37.996
You've shared a ton of
00:17:38.056 --> 00:17:38.936
information about
00:17:39.096 --> 00:17:40.938
recruitment and hiring and
00:17:41.077 --> 00:17:42.378
ads that you're running and
00:17:42.778 --> 00:17:43.980
how to bring in staff.
00:17:45.460 --> 00:17:48.102
I was listening to Dan Ariely.
00:17:48.342 --> 00:17:49.542
Are you familiar with him at all?
00:17:51.269 --> 00:17:51.788
Love him.
00:17:52.369 --> 00:17:54.211
What is he like a behavioral economics?
00:17:54.452 --> 00:17:56.194
Yeah, behavioral economics.
00:17:56.674 --> 00:17:57.476
At Duke or something.
00:17:57.496 --> 00:17:58.317
He's an author.
00:17:58.498 --> 00:17:59.219
Excellent books.
00:17:59.519 --> 00:18:01.060
Predictably Irrational is
00:18:01.741 --> 00:18:03.784
probably in my top five of
00:18:03.845 --> 00:18:04.885
like favorite books of all time.
00:18:05.358 --> 00:18:06.559
So the last time I shared
00:18:06.599 --> 00:18:07.840
some of his content,
00:18:08.301 --> 00:18:09.942
maybe it was Joey Rossi or
00:18:10.163 --> 00:18:12.105
somebody had shared he had
00:18:12.164 --> 00:18:14.527
some questionable research
00:18:14.686 --> 00:18:16.387
ethic violations and people
00:18:16.409 --> 00:18:17.548
were investigating him
00:18:17.589 --> 00:18:18.509
because maybe he didn't
00:18:18.529 --> 00:18:19.431
really carry out the
00:18:19.471 --> 00:18:20.652
research or his findings
00:18:20.731 --> 00:18:22.273
were manipulated.
00:18:22.453 --> 00:18:22.814
I don't know.
00:18:24.234 --> 00:18:25.596
I read those opinions.
00:18:25.856 --> 00:18:26.576
Nonetheless,
00:18:26.797 --> 00:18:28.239
the idea behind the
00:18:28.298 --> 00:18:30.319
information is still valuable.
00:18:30.339 --> 00:18:30.560
Right.
00:18:31.121 --> 00:18:34.443
So one of the, the like, fifteen year ago,
00:18:34.523 --> 00:18:37.046
YouTube Ted Talks was why
00:18:37.125 --> 00:18:39.468
we enjoy the work that we do.
00:18:40.087 --> 00:18:41.348
And it got me thinking about
00:18:41.568 --> 00:18:42.630
your situation.
00:18:43.411 --> 00:18:45.613
So I'm going to share my chat GPT.
00:18:47.233 --> 00:18:48.454
And what I did.
00:18:48.835 --> 00:18:49.836
Folks, you got to jump over.
00:18:49.915 --> 00:18:51.156
You got to jump over to the YouTube.
00:18:51.176 --> 00:18:52.758
Jump over to Learn Medicare
00:18:52.778 --> 00:18:54.159
Billing or PT podcast or
00:18:54.180 --> 00:18:55.279
the Dave Kittle show on YouTube.
00:18:55.319 --> 00:18:56.500
If you're listening right
00:18:56.520 --> 00:18:58.323
now on iTunes or Spotify or
00:18:58.403 --> 00:18:59.644
LinkedIn or wherever you're watching.
00:19:00.252 --> 00:19:00.593
Yeah.
00:19:00.633 --> 00:19:02.233
So if you guys don't already do this,
00:19:02.273 --> 00:19:03.575
this is a cool little hack,
00:19:03.875 --> 00:19:05.455
but then we'll get into the main content.
00:19:05.836 --> 00:19:06.957
Let me get up here at the top.
00:19:07.278 --> 00:19:07.938
So basically,
00:19:08.939 --> 00:19:10.819
let's say you hear a YouTube
00:19:11.420 --> 00:19:12.540
interview and you're like, yeah,
00:19:12.560 --> 00:19:13.221
I love that idea.
00:19:13.261 --> 00:19:14.422
How can I apply that idea to
00:19:14.461 --> 00:19:15.242
physical therapy?
00:19:15.942 --> 00:19:17.324
So I put in a simple prompt.
00:19:17.423 --> 00:19:18.065
I just say, hey,
00:19:18.105 --> 00:19:19.486
Dan Ariely talks about the
00:19:19.506 --> 00:19:21.186
importance of meaningful work.
00:19:21.686 --> 00:19:24.367
This is coming from a TED Talk transcript.
00:19:24.807 --> 00:19:26.288
I want you to process this
00:19:26.388 --> 00:19:27.548
and then tell me how this
00:19:27.608 --> 00:19:28.949
applies to the physical
00:19:28.989 --> 00:19:30.210
therapy private practice.
00:19:30.890 --> 00:19:32.790
And on YouTube, you can copy and paste,
00:19:32.830 --> 00:19:33.951
if you're on a desktop,
00:19:34.431 --> 00:19:36.592
the full transcript of the interview.
00:19:37.451 --> 00:19:40.655
So I put it in and then chat GPT, you know,
00:19:40.715 --> 00:19:42.959
says, OK, here's the framework,
00:19:43.140 --> 00:19:45.281
the meaningful work magnet.
00:19:45.962 --> 00:19:46.483
The goal,
00:19:46.503 --> 00:19:48.465
create a job ad that's emotion
00:19:48.567 --> 00:19:49.748
that emotionally resonates
00:19:49.768 --> 00:19:51.269
with clinicians who crave
00:19:51.349 --> 00:19:52.551
more than just a paycheck.
00:19:53.132 --> 00:19:55.174
Therapists want their work to matter.
00:19:56.076 --> 00:19:57.977
And I'll just give you the headlines,
00:19:57.997 --> 00:20:00.398
you know, stop, start with the mission,
00:20:00.679 --> 00:20:01.440
not the money.
00:20:01.680 --> 00:20:02.700
So instead of saying we're
00:20:02.880 --> 00:20:05.402
hiring five thousand dollar sign on bonus,
00:20:05.442 --> 00:20:06.482
which we see everywhere,
00:20:07.022 --> 00:20:08.104
start with something like
00:20:08.183 --> 00:20:09.825
your work should mean something.
00:20:10.085 --> 00:20:12.727
Ours does every visit, every patient,
00:20:12.846 --> 00:20:13.988
every life we touch.
00:20:14.708 --> 00:20:16.348
And I was thinking about you
00:20:16.388 --> 00:20:17.609
because one of your main
00:20:17.730 --> 00:20:19.431
ads is talking about how
00:20:19.490 --> 00:20:21.251
much a therapist could make
00:20:21.751 --> 00:20:23.634
relative to how few visits
00:20:23.673 --> 00:20:25.054
they need to do to make that money.
00:20:25.074 --> 00:20:28.836
But anyway, tell a micro story of impact,
00:20:28.997 --> 00:20:31.438
acknowledge the trade-off transparently.
00:20:31.979 --> 00:20:32.618
I do that.
00:20:33.159 --> 00:20:33.900
I'm like, look, guys,
00:20:33.920 --> 00:20:34.840
you're not going to make as
00:20:34.901 --> 00:20:36.040
much money working for me
00:20:36.080 --> 00:20:37.241
as you would make working
00:20:37.422 --> 00:20:39.784
in home health or a skilled nursing.
00:20:40.443 --> 00:20:41.724
But it's because...
00:20:42.305 --> 00:20:45.128
The difference in the population we treat,
00:20:45.388 --> 00:20:47.371
you know, nothing will burn you out,
00:20:47.411 --> 00:20:48.051
chew you up,
00:20:48.112 --> 00:20:50.474
spit you out more than seeing
00:20:50.515 --> 00:20:52.156
the same person in a
00:20:52.196 --> 00:20:54.159
different body every single
00:20:54.199 --> 00:20:55.540
day and knowing that you're
00:20:55.601 --> 00:20:56.981
not really helping anybody.
00:20:57.563 --> 00:20:57.803
You know,
00:20:57.823 --> 00:21:00.984
somebody shared a post about a I
00:21:01.025 --> 00:21:02.125
don't know if this is the right word,
00:21:02.165 --> 00:21:04.208
a catatonic person on
00:21:04.268 --> 00:21:06.469
hospice who a physical
00:21:06.489 --> 00:21:08.691
therapist is supposed to be helping.
00:21:08.750 --> 00:21:10.551
Like there's just there's no
00:21:10.612 --> 00:21:12.153
meaning in that kind of work.
00:21:12.173 --> 00:21:14.474
A lot of times describe the
00:21:14.494 --> 00:21:16.715
challenge as a source of pride.
00:21:17.135 --> 00:21:17.376
Right.
00:21:17.436 --> 00:21:18.596
Why do we climb a mountain?
00:21:18.636 --> 00:21:20.999
Because it feels good to get to the top,
00:21:21.078 --> 00:21:21.940
even though it's hard.
00:21:22.826 --> 00:21:24.647
Give them ownership language,
00:21:25.269 --> 00:21:26.609
not ownership equity,
00:21:26.710 --> 00:21:28.310
just ownership language.
00:21:29.632 --> 00:21:32.093
Show that their work will be seen.
00:21:32.354 --> 00:21:34.855
Use emotional, resonant call to action.
00:21:34.994 --> 00:21:36.576
And then it gives a little sample ad.
00:21:37.257 --> 00:21:37.997
So first,
00:21:38.057 --> 00:21:39.999
what are some of your thoughts on this?
00:21:41.548 --> 00:21:42.990
Just a joke because I burst
00:21:43.049 --> 00:21:43.630
out in laughter.
00:21:44.210 --> 00:21:45.230
Give them ownership.
00:21:45.750 --> 00:21:46.711
Not of equity, though.
00:21:46.770 --> 00:21:47.510
Definitely not.
00:21:47.530 --> 00:21:49.411
That's so funny.
00:21:49.531 --> 00:21:51.392
It's the feeling of ownership,
00:21:51.412 --> 00:21:52.672
not actual ownership.
00:21:52.772 --> 00:21:55.073
Hey, I need to do better at that, man.
00:21:55.212 --> 00:21:57.673
If I can best or better
00:21:57.713 --> 00:22:00.615
convey the staff role
00:22:01.194 --> 00:22:02.895
that they get to take ownership of.
00:22:02.955 --> 00:22:03.215
Well, I,
00:22:03.316 --> 00:22:04.955
and my therapist somewhat do like
00:22:04.976 --> 00:22:06.576
they get to make their own schedule.
00:22:06.596 --> 00:22:07.376
They get to,
00:22:08.198 --> 00:22:08.938
they get to make like what
00:22:08.958 --> 00:22:11.019
time they're going to start and end, uh,
00:22:11.038 --> 00:22:11.499
per day.
00:22:12.199 --> 00:22:13.720
They get to fit in people, you know,
00:22:13.740 --> 00:22:14.680
clients, whatever they want,
00:22:14.960 --> 00:22:16.681
they can work weekends or not.
00:22:17.300 --> 00:22:17.580
Um,
00:22:17.921 --> 00:22:18.060
I mean,
00:22:18.141 --> 00:22:19.301
I have one therapist that's
00:22:19.383 --> 00:22:20.564
averaging like two point
00:22:20.844 --> 00:22:22.305
eight patients per day and
00:22:22.325 --> 00:22:24.247
he's making just two point eight.
00:22:24.267 --> 00:22:24.667
Now, of course,
00:22:24.807 --> 00:22:25.548
I know you got to travel in
00:22:25.588 --> 00:22:27.390
between the patients and all that.
00:22:27.410 --> 00:22:28.250
And you got to travel to the
00:22:28.270 --> 00:22:28.731
first patient.
00:22:28.751 --> 00:22:30.073
You got to travel to home
00:22:30.093 --> 00:22:30.834
from the last patient.
00:22:30.874 --> 00:22:32.375
So sometimes it might come
00:22:32.414 --> 00:22:35.097
out to like a more of a workday,
00:22:35.117 --> 00:22:37.440
but two point eight patients on average.
00:22:38.040 --> 00:22:39.362
And they're making like.
00:22:40.143 --> 00:22:41.443
They're on pace for like
00:22:41.483 --> 00:22:43.666
ninety K by treating two
00:22:43.707 --> 00:22:44.807
point eight patients per day.
00:22:44.968 --> 00:22:45.729
So it's pretty good deal.
00:22:46.088 --> 00:22:48.330
But I need to give them ownership of.
00:22:49.071 --> 00:22:50.133
Yeah, like like I don't know,
00:22:50.252 --> 00:22:51.173
like more of the is that
00:22:51.193 --> 00:22:52.295
like the touchy feely stuff?
00:22:52.315 --> 00:22:52.955
Would you say, Tony,
00:22:52.976 --> 00:22:55.337
like more ownership around that or what?
00:22:55.801 --> 00:22:56.082
Yeah.
00:22:56.462 --> 00:22:57.323
Own your schedule.
00:22:57.643 --> 00:22:59.404
You know, you, you have control.
00:23:00.005 --> 00:23:00.465
Autonomy.
00:23:00.586 --> 00:23:00.945
Yeah.
00:23:01.006 --> 00:23:01.926
Who you can treat,
00:23:02.007 --> 00:23:03.327
how you want to treat them.
00:23:03.387 --> 00:23:05.429
Like we all went to school
00:23:05.489 --> 00:23:06.910
to be professionals.
00:23:07.371 --> 00:23:08.270
I want to come into a
00:23:08.330 --> 00:23:10.212
position where I'm a professional.
00:23:10.813 --> 00:23:12.375
I think too many of us as
00:23:12.454 --> 00:23:14.476
business owners think, well,
00:23:14.516 --> 00:23:16.557
they want equity in the business.
00:23:16.698 --> 00:23:17.679
I don't think they want it.
00:23:17.759 --> 00:23:18.519
I don't think they care.
00:23:18.959 --> 00:23:20.500
Even me as an example of,
00:23:21.221 --> 00:23:22.480
I wouldn't want to come in
00:23:22.641 --> 00:23:23.942
as an equity partner
00:23:24.001 --> 00:23:25.382
because I don't want the
00:23:25.402 --> 00:23:27.762
liability associated with your problems,
00:23:28.083 --> 00:23:29.742
your baggage, you know,
00:23:29.843 --> 00:23:31.462
and we are as a profession
00:23:31.542 --> 00:23:32.923
so risk averse.
00:23:33.604 --> 00:23:34.784
I think of a therapist.
00:23:35.124 --> 00:23:36.085
It thinks that they're on
00:23:36.125 --> 00:23:37.505
the hook for mistakes that
00:23:37.565 --> 00:23:40.526
the bigger entity makes
00:23:40.945 --> 00:23:41.786
that freaks them out.
00:23:42.425 --> 00:23:44.907
So it's like as business owners, we think,
00:23:45.028 --> 00:23:47.390
oh, they want ownership in that respect.
00:23:47.490 --> 00:23:48.210
I don't think they do.
00:23:48.330 --> 00:23:49.351
I think they just they want
00:23:49.391 --> 00:23:50.832
the independency, autonomy.
00:23:51.252 --> 00:23:52.334
They want to feel good about
00:23:52.374 --> 00:23:53.453
the work that they're doing.
00:23:53.634 --> 00:23:55.476
And yours is a great example.
00:23:55.976 --> 00:23:57.738
Like you are working with a
00:23:57.778 --> 00:23:59.959
clientele that you can make
00:24:00.098 --> 00:24:01.319
real impact with.
00:24:01.740 --> 00:24:03.221
You can change that person's
00:24:03.281 --> 00:24:04.542
life fundamentally.
00:24:04.583 --> 00:24:05.743
You can keep them in their
00:24:05.784 --> 00:24:07.325
home or their apartment longer.
00:24:07.384 --> 00:24:08.685
You can improve their
00:24:08.726 --> 00:24:10.807
quality of life versus others.
00:24:11.815 --> 00:24:12.875
some of the other places
00:24:12.895 --> 00:24:17.259
that it's just that treadmill of CPT code,
00:24:17.298 --> 00:24:18.920
CPT code, CPT code.
00:24:19.240 --> 00:24:20.780
Nobody is going to get better anyway.
00:24:21.101 --> 00:24:22.041
If they do get better,
00:24:22.102 --> 00:24:22.541
you're going to get
00:24:22.602 --> 00:24:23.583
penalized because they're
00:24:23.603 --> 00:24:25.144
going to want to discharge early.
00:24:26.065 --> 00:24:28.266
The conventional system is
00:24:28.365 --> 00:24:32.548
designed to reward the most
00:24:32.709 --> 00:24:35.171
basic mediocre outcome.
00:24:35.931 --> 00:24:37.031
Don't get better quicker.
00:24:37.432 --> 00:24:38.833
Don't invest in innovation.
00:24:39.252 --> 00:24:40.874
Don't improve your education.
00:24:41.674 --> 00:24:42.855
That is what the system
00:24:42.894 --> 00:24:45.196
right now is designed to encourage.
00:24:45.737 --> 00:24:46.478
And so, yeah,
00:24:46.518 --> 00:24:48.298
you give them the opportunity
00:24:48.358 --> 00:24:50.720
to step out of that negative cycle.
00:24:51.280 --> 00:24:53.961
And I do think like those
00:24:54.021 --> 00:24:58.404
emotional triggers resonate deeply.
00:24:58.484 --> 00:24:59.365
Anything else for this topic
00:24:59.385 --> 00:25:00.046
or you want to move on?
00:25:00.605 --> 00:25:01.346
No, we can move on.
00:25:03.541 --> 00:25:04.563
I sent you a link for
00:25:04.623 --> 00:25:07.444
Instagram in Facebook Messenger,
00:25:07.545 --> 00:25:08.787
unless you have some other topics.
00:25:08.866 --> 00:25:10.847
I know Jimmy's not here,
00:25:10.867 --> 00:25:11.888
but we were joking last
00:25:11.949 --> 00:25:14.411
week that I know you were at your DC,
00:25:15.132 --> 00:25:16.993
your son's class trip,
00:25:17.334 --> 00:25:18.214
but you sent us a picture.
00:25:18.394 --> 00:25:19.435
I don't have it right now,
00:25:19.796 --> 00:25:21.436
but it did look like you
00:25:21.457 --> 00:25:22.097
were at the Vatican.
00:25:23.018 --> 00:25:23.397
Jimmy,
00:25:24.499 --> 00:25:25.499
he'll mention this the next time he
00:25:25.519 --> 00:25:25.959
comes back,
00:25:25.979 --> 00:25:27.480
but we had a good laugh as if
00:25:27.920 --> 00:25:29.700
you were at the Vatican and
00:25:29.720 --> 00:25:30.520
that you were actually
00:25:30.580 --> 00:25:32.320
becoming the next Pope.
00:25:32.520 --> 00:25:34.122
And you know what?
00:25:34.402 --> 00:25:35.281
You and the new Pope,
00:25:35.622 --> 00:25:36.942
you don't look that different.
00:25:37.202 --> 00:25:39.463
You got the same haircut and
00:25:39.723 --> 00:25:40.903
there's some similarities there.
00:25:40.943 --> 00:25:41.763
So we had a good laugh.
00:25:41.784 --> 00:25:42.884
All right,
00:25:42.944 --> 00:25:44.525
let me see if I can get this one
00:25:44.644 --> 00:25:45.685
up on the screen.
00:25:48.046 --> 00:25:49.666
Tell me what's going on with this.
00:25:49.707 --> 00:25:50.227
Okay.
00:25:50.583 --> 00:25:50.883
Okay.
00:25:50.903 --> 00:25:51.304
All right.
00:25:51.324 --> 00:25:53.525
So Jimmy McKay is not here.
00:25:53.625 --> 00:25:54.405
He's got an awesome new
00:25:54.486 --> 00:25:55.346
segment here on the show
00:25:55.405 --> 00:25:56.807
called steal the strategy.
00:25:57.288 --> 00:25:57.587
Jimmy,
00:25:57.827 --> 00:25:59.910
I hope I don't want to steal your
00:25:59.930 --> 00:26:00.769
strategy because you're not here.
00:26:00.789 --> 00:26:02.230
I just want to highlight this.
00:26:02.431 --> 00:26:03.652
I came up with this.
00:26:03.992 --> 00:26:05.394
I came across this guy's
00:26:05.453 --> 00:26:06.394
Instagram a couple of weeks ago,
00:26:06.433 --> 00:26:07.095
maybe a month ago.
00:26:07.394 --> 00:26:09.455
He had like fifteen thousand followers.
00:26:09.516 --> 00:26:10.416
Now he's got, I don't know,
00:26:10.436 --> 00:26:12.157
like twenty or thirty thousand followers.
00:26:12.499 --> 00:26:13.538
Thirty eight thousand.
00:26:13.778 --> 00:26:14.059
Thirty.
00:26:14.279 --> 00:26:15.240
This guy is.
00:26:16.181 --> 00:26:17.221
it's kind of weird he's
00:26:17.381 --> 00:26:19.142
adding like five thousand
00:26:19.182 --> 00:26:21.422
followers per week here's
00:26:21.481 --> 00:26:23.261
this so this guy does a
00:26:23.321 --> 00:26:24.803
joke right he he holds up
00:26:24.843 --> 00:26:26.022
his phone it's him and his
00:26:26.063 --> 00:26:27.863
wife shopping at walmart or
00:26:27.942 --> 00:26:28.962
they're getting pedicures
00:26:29.002 --> 00:26:30.743
at the nail salon wherever
00:26:30.784 --> 00:26:31.584
they're at at a restaurant
00:26:31.604 --> 00:26:32.624
nice restaurant he holds up
00:26:32.644 --> 00:26:33.864
his phone and he goes what
00:26:33.903 --> 00:26:35.684
up gang hey what's going on
00:26:35.744 --> 00:26:37.045
I'm here with tina we're
00:26:37.105 --> 00:26:37.944
checking out the deals
00:26:37.984 --> 00:26:39.625
today at walmart so he acts
00:26:39.644 --> 00:26:41.965
like a fake social media influencer
00:26:42.526 --> 00:26:44.247
And obviously his wife gets embarrassed.
00:26:44.267 --> 00:26:44.467
So like,
00:26:44.487 --> 00:26:46.086
that's the funny part is she gets like,
00:26:46.307 --> 00:26:46.988
she's like, no.
00:26:47.067 --> 00:26:48.347
And like, she like runs away.
00:26:48.667 --> 00:26:49.749
And then you could see like, yeah,
00:26:49.769 --> 00:26:50.588
like there, right there,
00:26:50.868 --> 00:26:53.329
that clip of him at the nail salon.
00:26:53.450 --> 00:26:55.190
And like the wife puts her
00:26:55.230 --> 00:26:56.131
hand in front of her face
00:26:56.171 --> 00:26:57.230
and all the women that are,
00:26:57.631 --> 00:26:58.352
that are working there,
00:26:58.612 --> 00:26:59.872
all the women that are in the nail salon,
00:26:59.892 --> 00:27:01.113
they're all covering their face.
00:27:01.772 --> 00:27:02.232
It's funny.
00:27:02.333 --> 00:27:02.732
It's funny.
00:27:03.032 --> 00:27:03.653
Here's the thing.
00:27:04.273 --> 00:27:05.693
This guy owns one or two
00:27:05.733 --> 00:27:07.375
different restaurants in Chicago.
00:27:07.934 --> 00:27:10.496
He links to the, the, uh,
00:27:11.597 --> 00:27:13.138
the restaurant on his profile.
00:27:13.179 --> 00:27:15.161
And I think the, the URL in the Instagram,
00:27:15.401 --> 00:27:18.383
the entire Instagram is a joke.
00:27:18.762 --> 00:27:20.003
He does, he just does jokes.
00:27:20.064 --> 00:27:21.766
He just, he just is a funny guy.
00:27:21.826 --> 00:27:23.067
He likes to do jokes.
00:27:23.326 --> 00:27:26.209
He goes up to the Starbucks line and he,
00:27:26.608 --> 00:27:26.828
you know,
00:27:27.250 --> 00:27:28.411
he does fake voices from
00:27:28.490 --> 00:27:29.290
different movies.
00:27:29.330 --> 00:27:30.392
Like when he goes up to the
00:27:30.412 --> 00:27:31.472
Starbucks line in the
00:27:31.492 --> 00:27:32.894
drive-through and he's like, you know,
00:27:32.973 --> 00:27:34.894
yeah, can I get a, can I get a large,
00:27:35.095 --> 00:27:35.336
you know,
00:27:35.855 --> 00:27:37.718
can I get a medium pike in a
00:27:37.837 --> 00:27:38.818
large venti cup?
00:27:39.259 --> 00:27:40.140
And then they asked for his
00:27:40.200 --> 00:27:41.461
name and he does like, you know,
00:27:41.520 --> 00:27:42.883
like an Al Pacino voice or
00:27:42.903 --> 00:27:45.525
he just does stupid, like, right.
00:27:45.545 --> 00:27:47.426
The point of sharing this is
00:27:47.467 --> 00:27:49.128
that he's adding like five
00:27:49.169 --> 00:27:51.130
thousand followers per week.
00:27:51.170 --> 00:27:51.611
Now, of course,
00:27:52.131 --> 00:27:53.752
many of them are not in the Chicago area,
00:27:53.833 --> 00:27:56.315
but he's got Johnny's
00:27:56.355 --> 00:27:58.136
heroes and subs or whatever
00:27:58.176 --> 00:27:59.878
his like restaurant is.
00:28:01.683 --> 00:28:02.905
And he's getting more
00:28:03.006 --> 00:28:06.030
eyeballs for his restaurant
00:28:06.732 --> 00:28:08.335
that is linked here in his bio.
00:28:09.156 --> 00:28:11.539
None of his posts are about the restaurant,
00:28:11.681 --> 00:28:12.762
about his business.
00:28:14.517 --> 00:28:16.398
And so that was part that was part one.
00:28:16.459 --> 00:28:17.619
And then part two was one of
00:28:17.640 --> 00:28:18.881
the recent posts while I
00:28:18.901 --> 00:28:20.682
was following him is he was
00:28:20.702 --> 00:28:22.884
featured on the news in Chicago.
00:28:23.464 --> 00:28:26.188
And then the news anchor is mentioning,
00:28:26.208 --> 00:28:26.607
you know, oh,
00:28:26.728 --> 00:28:29.250
Johnny Anastopoulos has this
00:28:29.290 --> 00:28:31.051
funny Instagram account and
00:28:31.092 --> 00:28:32.673
he's the owner of whatever it is,
00:28:32.693 --> 00:28:33.575
whatever the restaurant is.
00:28:34.576 --> 00:28:35.236
We don't we don't know.
00:28:35.276 --> 00:28:37.878
Johnny's beef, Johnny's gyros.
00:28:38.898 --> 00:28:41.619
Beef and Gyros in, you know, Lincoln Park,
00:28:42.480 --> 00:28:43.661
Chicago or whatever it is.
00:28:44.240 --> 00:28:45.701
So the local news anchors
00:28:46.201 --> 00:28:47.741
have featured him and his
00:28:47.801 --> 00:28:49.521
Instagram account a couple times,
00:28:49.862 --> 00:28:53.202
which then gets more exposure locally.
00:28:54.163 --> 00:28:56.324
And they even had him in the news,
00:28:56.364 --> 00:28:57.463
like a week or two ago,
00:28:57.564 --> 00:28:58.164
they brought him and
00:28:58.184 --> 00:28:59.085
invited him and his wife
00:28:59.184 --> 00:29:00.565
into the news station.
00:29:00.944 --> 00:29:02.746
And he was like on the live news.
00:29:03.430 --> 00:29:03.869
Yeah.
00:29:04.069 --> 00:29:04.349
Okay.
00:29:04.369 --> 00:29:05.611
This was, this is long winded.
00:29:05.651 --> 00:29:06.550
I'm going to cut to the chase.
00:29:06.951 --> 00:29:07.750
The question for Tony
00:29:07.770 --> 00:29:09.912
Meritato is could physical
00:29:09.951 --> 00:29:11.071
therapists steal the strategy?
00:29:11.112 --> 00:29:11.873
Could private practice
00:29:11.913 --> 00:29:12.873
owners steal the strategy
00:29:12.932 --> 00:29:13.732
where they make a,
00:29:14.113 --> 00:29:15.153
whether it's a personal account,
00:29:15.513 --> 00:29:16.574
a different account, whatever.
00:29:17.094 --> 00:29:17.354
And they,
00:29:17.714 --> 00:29:19.295
you do an amazing strategy of
00:29:19.355 --> 00:29:20.414
video inside your clinic.
00:29:20.835 --> 00:29:21.736
And maybe some therapists
00:29:21.756 --> 00:29:22.675
don't want to do that or
00:29:22.695 --> 00:29:23.915
they can't do it or they're
00:29:23.935 --> 00:29:24.777
afraid to do it or whatever.
00:29:25.997 --> 00:29:27.096
You also have to be kind of
00:29:27.357 --> 00:29:28.438
outgoing to even do this.
00:29:28.478 --> 00:29:29.698
I think to do like the selfie video,
00:29:29.718 --> 00:29:30.479
the way he's doing it,
00:29:30.499 --> 00:29:31.679
but maybe there's other ways to do it.
00:29:32.741 --> 00:29:34.202
Could or should physical
00:29:34.242 --> 00:29:35.182
therapy practice owners
00:29:35.243 --> 00:29:36.304
steal this strategy,
00:29:36.865 --> 00:29:37.585
create kind of like a
00:29:37.664 --> 00:29:41.386
humorous account that they capture funny,
00:29:41.727 --> 00:29:42.127
stupid,
00:29:42.188 --> 00:29:43.989
laughable things in their local area,
00:29:45.215 --> 00:29:45.936
then just link to their
00:29:45.957 --> 00:29:47.659
physical therapy profile at
00:29:47.679 --> 00:29:49.961
the top of the profile.
00:29:50.362 --> 00:29:51.784
But all the content has
00:29:51.903 --> 00:29:53.526
nothing to do with the actual business.
00:29:53.546 --> 00:29:54.125
What are your thoughts?
00:29:54.227 --> 00:29:55.268
Good, bad, indifferent?
00:29:55.768 --> 00:29:56.769
Yes, a hundred percent.
00:29:56.829 --> 00:29:57.631
Yes, you can do it.
00:29:57.671 --> 00:29:58.551
Yes, you should do it.
00:29:59.132 --> 00:30:00.253
What I think is interesting
00:30:00.294 --> 00:30:01.915
about that scenario though,
00:30:02.096 --> 00:30:03.416
and I don't know anything
00:30:03.597 --> 00:30:05.159
besides what you just shared,
00:30:05.720 --> 00:30:07.221
His personal profile on
00:30:07.301 --> 00:30:08.403
Instagram has thirty eight
00:30:08.423 --> 00:30:09.523
thousand followers.
00:30:09.604 --> 00:30:11.365
His business profile only
00:30:11.526 --> 00:30:14.028
has like thirty six hundred followers.
00:30:15.449 --> 00:30:17.471
The personal and that's what I do.
00:30:17.510 --> 00:30:17.771
You know,
00:30:17.832 --> 00:30:20.013
I grow my personal way more than
00:30:20.094 --> 00:30:23.656
I grow like branded business profiles.
00:30:25.474 --> 00:30:26.855
But the whole idea here is
00:30:27.476 --> 00:30:29.978
looking past just is this
00:30:30.018 --> 00:30:31.199
going to put more patients
00:30:31.338 --> 00:30:33.420
in my my physical therapy clinic?
00:30:33.460 --> 00:30:35.721
Because with a thirty eight
00:30:35.741 --> 00:30:37.323
thousand follower account,
00:30:37.702 --> 00:30:39.944
he can move into true influencing.
00:30:40.005 --> 00:30:41.246
He can get brand deals.
00:30:41.286 --> 00:30:42.767
He can do product endorsements.
00:30:42.807 --> 00:30:45.147
He can do so much more with that account,
00:30:45.709 --> 00:30:47.009
even if he never sells an
00:30:47.069 --> 00:30:48.471
extra sandwich because of it.
00:30:49.030 --> 00:30:50.431
So there's huge value in
00:30:50.471 --> 00:30:51.511
capturing attention.
00:30:51.751 --> 00:30:52.531
We know we're in an
00:30:52.731 --> 00:30:54.393
attention based economy.
00:30:55.512 --> 00:30:57.452
I still get pretty much two
00:30:57.472 --> 00:30:59.614
to three emails a week of
00:30:59.713 --> 00:31:00.973
product companies that want
00:31:01.013 --> 00:31:02.214
me to do videos and
00:31:02.275 --> 00:31:03.335
endorsements for them.
00:31:04.035 --> 00:31:05.036
I don't have to do them for
00:31:05.076 --> 00:31:06.076
free anymore unless I
00:31:06.256 --> 00:31:07.576
really want the product and
00:31:07.615 --> 00:31:08.596
it's a high ticket product.
00:31:10.509 --> 00:31:15.133
But a therapist who wants to build a brand,
00:31:15.153 --> 00:31:17.536
a personal brand, absolutely,
00:31:17.576 --> 00:31:18.896
this is a great strategy.
00:31:19.317 --> 00:31:20.538
And if you want to monetize
00:31:20.577 --> 00:31:21.638
that with patient care,
00:31:21.659 --> 00:31:22.720
you probably could.
00:31:23.080 --> 00:31:24.241
You could put out a product
00:31:24.301 --> 00:31:26.703
like Kelly Starrett has
00:31:26.864 --> 00:31:28.766
digital products for people
00:31:28.806 --> 00:31:31.008
that have physical conditions.
00:31:31.048 --> 00:31:31.949
He's never going to treat
00:31:31.969 --> 00:31:33.589
them as a physical therapy patient,
00:31:33.630 --> 00:31:34.912
but he sells these products.
00:31:35.531 --> 00:31:37.153
You could do product endorsements like,
00:31:37.433 --> 00:31:39.215
man, there's just so much you can do.
00:31:39.936 --> 00:31:41.999
And you don't have to be outgoing.
00:31:42.159 --> 00:31:43.319
Like, that's the funniest part.
00:31:43.759 --> 00:31:46.123
I hate I am an introvert
00:31:46.163 --> 00:31:46.863
through and through.
00:31:47.443 --> 00:31:48.704
I hate socializing.
00:31:48.885 --> 00:31:50.307
I love being silent.
00:31:50.426 --> 00:31:51.848
I love being by myself.
00:31:52.409 --> 00:31:54.009
But if I'm in front of the
00:31:54.049 --> 00:31:55.829
camera and I've got a job to do,
00:31:56.009 --> 00:31:57.070
I will do the job.
00:31:57.550 --> 00:31:57.891
You know,
00:31:57.931 --> 00:31:59.571
it's it's a different and I hear
00:31:59.612 --> 00:32:02.032
this a lot from a lot of influencers.
00:32:02.212 --> 00:32:03.932
It's like a switch that flips.
00:32:04.473 --> 00:32:06.973
You're a different person on
00:32:07.034 --> 00:32:09.035
camera than you are off camera.
00:32:10.135 --> 00:32:11.796
So it's something that we
00:32:11.875 --> 00:32:13.497
should be building for all of us.
00:32:15.171 --> 00:32:16.050
And we'll have to get
00:32:16.070 --> 00:32:17.551
Jimmy's feedback on this
00:32:17.571 --> 00:32:18.373
because I did want to share
00:32:18.393 --> 00:32:20.173
this at a time when both of
00:32:20.273 --> 00:32:21.294
you were here on the show.
00:32:21.334 --> 00:32:22.875
But yeah,
00:32:22.934 --> 00:32:24.615
so that's why I wanted to show it.
00:32:25.496 --> 00:32:25.836
Hopefully,
00:32:25.855 --> 00:32:27.217
Jimmy doesn't get upset that I'm
00:32:27.297 --> 00:32:29.137
stealing his segment on
00:32:29.238 --> 00:32:30.679
steal this strategy.
00:32:30.759 --> 00:32:32.079
I think his segment was
00:32:32.099 --> 00:32:32.759
steal the strategy.
00:32:32.819 --> 00:32:35.020
So I just wanted to share that.
00:32:35.080 --> 00:32:35.441
And you're right.
00:32:35.882 --> 00:32:36.122
Also,
00:32:37.021 --> 00:32:38.123
people want to follow more of the
00:32:38.143 --> 00:32:38.742
personal accounts.
00:32:38.762 --> 00:32:39.423
They don't want to follow
00:32:39.462 --> 00:32:40.824
like corporate and business accounts.
00:32:40.864 --> 00:32:41.023
Right.
00:32:41.044 --> 00:32:41.344
So that's,
00:32:41.544 --> 00:32:43.324
that's another reason why his
00:32:43.423 --> 00:32:45.365
personal one also it's, it's funny,
00:32:45.704 --> 00:32:45.825
right?
00:32:45.845 --> 00:32:46.845
Like it's, it's funny.
00:32:46.904 --> 00:32:47.506
Like you don't know what's
00:32:47.526 --> 00:32:48.046
going to happen.
00:32:48.086 --> 00:32:49.566
So you watch more and then
00:32:49.586 --> 00:32:50.346
you're more likely to like
00:32:50.365 --> 00:32:51.527
watch a second and a third video.
00:32:51.567 --> 00:32:52.326
Cause you don't know,
00:32:52.646 --> 00:32:53.606
like when he drives up to
00:32:53.646 --> 00:32:55.188
the drive-through at Starbucks or he,
00:32:55.708 --> 00:32:57.749
he walked into Starbucks and he ordered,
00:32:58.328 --> 00:32:58.489
um,
00:32:59.469 --> 00:33:01.029
With some Brad Pitt
00:33:01.069 --> 00:33:02.690
character from some movie, you know,
00:33:03.690 --> 00:33:05.050
any any order with the
00:33:05.070 --> 00:33:05.951
character's name and the
00:33:06.030 --> 00:33:06.770
accent or whatever.
00:33:07.192 --> 00:33:08.372
So you don't know what he's going to do.
00:33:08.491 --> 00:33:08.771
But yeah,
00:33:08.811 --> 00:33:09.751
more people want to follow the
00:33:09.791 --> 00:33:10.853
personal accounts and they
00:33:10.873 --> 00:33:12.512
don't want to follow like the corporate,
00:33:12.873 --> 00:33:13.854
you know, business accounts.
00:33:13.894 --> 00:33:15.673
And I guess, you know, I guess that's OK.
00:33:15.693 --> 00:33:16.615
That's just the way the
00:33:16.835 --> 00:33:17.694
attention economy is.
00:33:18.604 --> 00:33:19.064
There is a,
00:33:19.864 --> 00:33:21.765
I can't say the name because Jim,
00:33:21.785 --> 00:33:23.244
Jimmy's doing this interview.
00:33:23.305 --> 00:33:24.125
I don't know if he's done it
00:33:24.164 --> 00:33:25.566
already or it's on the books.
00:33:26.086 --> 00:33:28.266
It's part of the PT pint cast series,
00:33:28.846 --> 00:33:31.207
but I think this is a,
00:33:31.666 --> 00:33:32.307
it's a home health
00:33:32.346 --> 00:33:35.208
therapist who's doing funny videos.
00:33:35.647 --> 00:33:37.067
He is on par.
00:33:37.489 --> 00:33:38.628
He's on par with
00:33:39.449 --> 00:33:41.050
So medical doctors that are
00:33:41.131 --> 00:33:42.771
out there that have, you know,
00:33:42.892 --> 00:33:44.333
million subscriber accounts.
00:33:44.374 --> 00:33:44.614
Like,
00:33:44.854 --> 00:33:46.515
I think it's just a matter of time
00:33:46.535 --> 00:33:48.237
before this account blows up.
00:33:48.396 --> 00:33:49.978
If he doesn't quit before he
00:33:49.998 --> 00:33:52.019
hits that inflection point.
00:33:53.080 --> 00:33:53.701
He is awesome.
00:33:53.801 --> 00:33:54.722
I can't wait for that,
00:33:54.843 --> 00:33:57.484
that interview to go live and go public.
00:33:57.505 --> 00:33:58.144
And so.
00:34:00.181 --> 00:34:01.162
I wanted to talk about
00:34:01.682 --> 00:34:02.923
pivoting just a little bit.
00:34:03.784 --> 00:34:05.785
I shared a post that gains
00:34:05.845 --> 00:34:07.546
traction is gaining traction.
00:34:08.427 --> 00:34:09.867
You're not in this world,
00:34:10.288 --> 00:34:11.829
but in case you didn't know,
00:34:12.128 --> 00:34:14.911
so as a Medicare contractor provider,
00:34:15.291 --> 00:34:17.231
when I treat a Medicare beneficiary,
00:34:17.873 --> 00:34:20.753
my plan of care has to be certified.
00:34:20.793 --> 00:34:23.115
That means signed by the
00:34:23.175 --> 00:34:25.476
physician or non-physician practitioner.
00:34:25.516 --> 00:34:26.918
So it could be a physician assistant.
00:34:26.958 --> 00:34:28.159
It could be a nurse practitioner.
00:34:28.179 --> 00:34:29.420
There's a couple other options.
00:34:30.179 --> 00:34:32.161
providers who can certify a plan of care.
00:34:33.081 --> 00:34:34.360
In two thousand twenty five,
00:34:34.942 --> 00:34:37.282
Congress or whoever updated
00:34:37.342 --> 00:34:39.103
the laws made some changes
00:34:39.143 --> 00:34:41.603
that said as long as I have
00:34:41.643 --> 00:34:44.443
a referral and I have proof
00:34:44.603 --> 00:34:46.164
that I sent the plan of
00:34:46.224 --> 00:34:47.465
care for signature,
00:34:48.204 --> 00:34:49.826
I don't need a signature on
00:34:49.846 --> 00:34:51.485
the initial plan of care.
00:34:51.606 --> 00:34:53.226
But if I extend the plan of care,
00:34:53.266 --> 00:34:55.007
change the plan of care, do anything,
00:34:55.487 --> 00:34:56.847
then I do need a signature.
00:34:59.246 --> 00:35:02.068
I can't believe the comments
00:35:02.088 --> 00:35:03.148
that I'm seeing from
00:35:03.268 --> 00:35:05.289
physical therapists who
00:35:05.409 --> 00:35:09.112
think a physician should be
00:35:09.331 --> 00:35:11.432
obligated to sign my plan of care.
00:35:11.572 --> 00:35:12.833
I've said it repeatedly.
00:35:12.873 --> 00:35:14.074
I'm like, if I'm a doctor,
00:35:14.353 --> 00:35:15.835
if I have MD after my name,
00:35:16.635 --> 00:35:18.315
I am not referring patients
00:35:18.335 --> 00:35:20.637
to physical therapy simply because...
00:35:21.416 --> 00:35:24.179
I'm expected to sign plans of care.
00:35:24.541 --> 00:35:25.762
I don't have the time for it.
00:35:26.081 --> 00:35:27.543
I don't have the desire for it.
00:35:27.864 --> 00:35:29.126
I don't have the interest in it.
00:35:29.525 --> 00:35:31.809
Like, I'm sorry, but there is no way.
00:35:31.889 --> 00:35:33.951
Now, these docs aren't getting paid extra.
00:35:34.552 --> 00:35:36.454
There is no like benefit or
00:35:36.534 --> 00:35:37.875
bonus system for them.
00:35:39.016 --> 00:35:40.777
And think about how many
00:35:40.817 --> 00:35:42.536
patients in a day a doctor sees,
00:35:42.577 --> 00:35:44.157
how many patients on
00:35:44.237 --> 00:35:46.137
caseload a doctor manages,
00:35:46.518 --> 00:35:47.898
thousands of patients.
00:35:48.298 --> 00:35:50.659
That's hundreds of plans of care.
00:35:51.898 --> 00:35:53.440
When you sign that plan of care,
00:35:53.480 --> 00:35:55.320
you're saying effectively, yes,
00:35:55.480 --> 00:35:56.840
I agree with this plan of care.
00:35:56.860 --> 00:35:58.561
When they've never met me,
00:35:58.601 --> 00:35:59.862
they have no idea who I am.
00:35:59.902 --> 00:36:01.362
They have no idea what I'm doing.
00:36:01.402 --> 00:36:01.961
Most of the time,
00:36:01.981 --> 00:36:02.922
they don't understand what
00:36:02.961 --> 00:36:04.822
the plan of care even entails.
00:36:05.722 --> 00:36:06.684
I think this is a major
00:36:06.744 --> 00:36:08.164
issue that I've never seen
00:36:08.224 --> 00:36:09.545
discussed or addressed.
00:36:10.965 --> 00:36:13.706
And it's absurd that actual
00:36:13.746 --> 00:36:15.188
licensed therapists think
00:36:15.367 --> 00:36:16.788
doctors should be obligated
00:36:16.827 --> 00:36:18.188
to sign plans of care.
00:36:18.608 --> 00:36:19.929
What are your thoughts on this?
00:36:20.646 --> 00:36:21.106
Well,
00:36:21.126 --> 00:36:22.967
the one comment I saw from Joey Rossi
00:36:23.027 --> 00:36:25.088
was he said there's some
00:36:25.128 --> 00:36:26.250
physicians he's spoken with
00:36:26.309 --> 00:36:27.471
that are no longer
00:36:27.510 --> 00:36:28.911
referring to physical
00:36:28.952 --> 00:36:30.713
therapy because of this specifically.
00:36:31.333 --> 00:36:32.474
That's crazy.
00:36:33.876 --> 00:36:34.976
I think so.
00:36:34.996 --> 00:36:36.557
We're licensed physical therapists.
00:36:36.597 --> 00:36:38.920
We have to have, you know, licensure.
00:36:38.960 --> 00:36:41.882
We have to do continuing education.
00:36:42.242 --> 00:36:43.784
We're CPR certified.
00:36:44.344 --> 00:36:45.644
The fact that this is still
00:36:45.844 --> 00:36:48.728
even a part of CMS is ridiculous.
00:36:48.867 --> 00:36:49.309
I don't know.
00:36:50.048 --> 00:36:51.371
You might think it's a good, I don't know.
00:36:51.530 --> 00:36:51.951
I don't know.
00:36:51.971 --> 00:36:52.972
But I think, Tony,
00:36:53.072 --> 00:36:54.112
I think it's absolutely
00:36:54.152 --> 00:36:55.534
ridiculous that a plan of
00:36:55.554 --> 00:36:56.695
care even needs to be signed.
00:36:57.036 --> 00:36:58.896
So you're saying the first initial,
00:36:58.916 --> 00:36:59.577
so the first, what,
00:36:59.617 --> 00:37:00.679
nine days or what is it?
00:37:00.759 --> 00:37:01.659
Thirty days or what's the?
00:37:02.222 --> 00:37:04.704
So the way the law was developed,
00:37:05.664 --> 00:37:06.706
if you have a referral,
00:37:06.726 --> 00:37:08.266
because a lot of us have direct access.
00:37:08.286 --> 00:37:09.728
So I've got a guy coming in today.
00:37:10.748 --> 00:37:13.251
He's been a patient of mine for a decade.
00:37:13.351 --> 00:37:15.413
He travels back and forth to Florida.
00:37:15.512 --> 00:37:16.994
He just texted me this morning.
00:37:17.454 --> 00:37:18.755
He's like, hey, I got a muscle issue.
00:37:18.815 --> 00:37:19.836
I want to come in and see you.
00:37:20.757 --> 00:37:22.139
He's a Medicare beneficiary.
00:37:22.898 --> 00:37:24.340
He doesn't he's not coming
00:37:24.400 --> 00:37:25.460
in with a referral.
00:37:25.800 --> 00:37:27.021
Now I can see him.
00:37:27.081 --> 00:37:28.300
Medicare doesn't require a
00:37:28.360 --> 00:37:29.862
referral and my state
00:37:29.882 --> 00:37:31.302
allows direct access.
00:37:31.842 --> 00:37:34.583
But because I don't have a referral,
00:37:34.824 --> 00:37:36.425
I would still need even in
00:37:36.445 --> 00:37:37.505
twenty twenty five a
00:37:37.605 --> 00:37:38.726
signature on the plan of
00:37:38.766 --> 00:37:39.945
care if this is going to be
00:37:39.985 --> 00:37:41.047
paid for by Medicare.
00:37:41.806 --> 00:37:43.108
If I have a referral,
00:37:43.648 --> 00:37:45.048
I don't need a signature,
00:37:45.088 --> 00:37:47.110
but I do have to prove that
00:37:47.170 --> 00:37:48.791
I at least sent the plan of
00:37:48.851 --> 00:37:49.972
care to the physician.
00:37:50.012 --> 00:37:51.152
That's the new change.
00:37:51.333 --> 00:37:52.293
I don't need the signature,
00:37:52.333 --> 00:37:53.175
but I need proof that I
00:37:53.215 --> 00:37:56.317
sent it for the initial plan of care.
00:37:57.797 --> 00:38:00.380
If I make a plan of care for three weeks,
00:38:00.440 --> 00:38:01.981
two times a week, six visits,
00:38:02.481 --> 00:38:04.021
that's the initial plan of care.
00:38:04.061 --> 00:38:05.963
If I decide to extend it...
00:38:06.623 --> 00:38:08.344
then I need a signature.
00:38:08.965 --> 00:38:11.027
It can be the duration you
00:38:11.067 --> 00:38:13.628
prescribe or up to ninety days.
00:38:14.047 --> 00:38:16.210
So if I prescribe a six month plan of care,
00:38:16.809 --> 00:38:19.092
my initial is limited to ninety days.
00:38:19.572 --> 00:38:21.492
But if I do it shorter than ninety days,
00:38:21.873 --> 00:38:22.934
then that's my initial.
00:38:24.650 --> 00:38:25.110
And, you know,
00:38:26.431 --> 00:38:27.431
we joked about this across
00:38:27.452 --> 00:38:29.293
the country that most
00:38:29.313 --> 00:38:30.655
physical therapists are going to say,
00:38:30.715 --> 00:38:32.956
you know, three times a week for,
00:38:33.697 --> 00:38:35.900
you know, sixteen weeks or whatever.
00:38:36.179 --> 00:38:36.661
I'm joking.
00:38:36.701 --> 00:38:38.202
But like I oftentimes it's
00:38:38.222 --> 00:38:39.222
going to be like a really
00:38:39.302 --> 00:38:40.523
it's never going to be three weeks.
00:38:41.085 --> 00:38:42.045
It's going to be a bigger number.
00:38:43.106 --> 00:38:45.347
So, OK, so maximum ninety days.
00:38:45.668 --> 00:38:46.588
And at that point.
00:38:47.369 --> 00:38:49.672
What is a therapist's option?
00:38:49.931 --> 00:38:50.572
They have to send that
00:38:50.612 --> 00:38:51.492
patient to a different
00:38:51.512 --> 00:38:52.833
physician to get it signed.
00:38:53.634 --> 00:38:54.074
Say, hey,
00:38:54.114 --> 00:38:56.916
do you have your primary won't sign it,
00:38:56.936 --> 00:38:58.398
so I have to send you to a specialist.
00:38:58.438 --> 00:39:00.099
Or can they, through Medicare,
00:39:00.119 --> 00:39:01.860
can they then go visit an
00:39:01.920 --> 00:39:03.221
urgent care or some other
00:39:03.320 --> 00:39:04.282
primary care physician
00:39:04.302 --> 00:39:06.342
that's not their PCP on record?
00:39:06.762 --> 00:39:07.623
What are you going to do?
00:39:08.356 --> 00:39:12.159
If the main doctor refuses, then yeah,
00:39:12.219 --> 00:39:13.300
you start playing the game.
00:39:13.541 --> 00:39:14.541
You start saying, okay,
00:39:14.902 --> 00:39:16.123
do you have an oncologist?
00:39:16.143 --> 00:39:17.623
Do you have a nephrologist?
00:39:17.643 --> 00:39:20.105
Do you have a orthopedic that, you know,
00:39:20.144 --> 00:39:21.505
can I sneak it through
00:39:21.967 --> 00:39:23.288
someone else and try it?
00:39:23.327 --> 00:39:24.208
Someone that's not going to
00:39:24.228 --> 00:39:25.489
read it and just sign it.
00:39:25.509 --> 00:39:27.570
And this is where my
00:39:27.610 --> 00:39:30.472
frustration comes back in where I'm like,
00:39:30.853 --> 00:39:32.373
what's the whole intent of
00:39:32.414 --> 00:39:33.275
the law anyway?
00:39:33.355 --> 00:39:34.715
When was the law generated?
00:39:34.775 --> 00:39:36.376
When was the guideline created?
00:39:36.916 --> 00:39:38.677
it was probably created before we were,
00:39:39.119 --> 00:39:41.661
I'm not, but others were DPTs.
00:39:42.161 --> 00:39:43.621
It was created back when
00:39:43.722 --> 00:39:45.164
therapists were really
00:39:45.864 --> 00:39:48.186
glorified AIDS technicians.
00:39:48.585 --> 00:39:50.268
The doctor used to say,
00:39:50.688 --> 00:39:52.208
get this patient out of bed,
00:39:52.289 --> 00:39:53.530
walk this patient, you know,
00:39:53.710 --> 00:39:57.213
and ironically in the Medicare guideline,
00:39:57.373 --> 00:39:59.795
it specifically says if the referral is,
00:40:00.275 --> 00:40:01.835
contains all of the required
00:40:01.916 --> 00:40:03.576
elements for the plan of care.
00:40:04.036 --> 00:40:05.197
You don't need a separate
00:40:05.237 --> 00:40:06.717
plan of care and you don't
00:40:06.757 --> 00:40:07.898
need a separate signature.
00:40:08.318 --> 00:40:10.559
So back in the day when the doctor said,
00:40:10.778 --> 00:40:12.659
I want this patient to get a three,
00:40:13.059 --> 00:40:14.300
is it megahertz, whatever,
00:40:14.400 --> 00:40:16.400
ultrasound for seven
00:40:16.460 --> 00:40:20.302
minutes on left elbow, you know,
00:40:20.402 --> 00:40:22.384
we come from technicians.
00:40:22.804 --> 00:40:23.643
Like, guys,
00:40:23.724 --> 00:40:25.764
we are not the same therapists
00:40:26.485 --> 00:40:28.166
that we were thirty years ago.
00:40:29.141 --> 00:40:30.782
but the laws never change.
00:40:30.802 --> 00:40:31.963
The laws don't keep up.
00:40:32.003 --> 00:40:33.384
The laws don't advance as
00:40:33.443 --> 00:40:36.487
quickly as we believe we're advancing.
00:40:37.067 --> 00:40:38.628
That goes back to my argument.
00:40:39.108 --> 00:40:40.929
I think most of us have left
00:40:40.989 --> 00:40:42.331
physical therapy behind.
00:40:42.391 --> 00:40:44.193
We are no longer operating
00:40:44.773 --> 00:40:46.074
as the way the world
00:40:46.134 --> 00:40:47.635
perceives a physical therapist.
00:40:48.036 --> 00:40:49.376
We are no longer operating
00:40:49.396 --> 00:40:50.338
in that capacity.
00:40:50.818 --> 00:40:52.980
So you can fight to drag the
00:40:53.019 --> 00:40:54.221
credential with you
00:40:54.760 --> 00:40:56.342
Or you can just let the credential go.
00:40:56.684 --> 00:40:57.925
The letters are meaningless.
00:40:57.985 --> 00:40:59.588
They don't help us in
00:40:59.648 --> 00:41:01.351
virtually any way because
00:41:01.811 --> 00:41:03.052
we don't get compensation
00:41:03.072 --> 00:41:04.534
for the letters that are
00:41:04.596 --> 00:41:05.998
worth what we're doing.
00:41:06.438 --> 00:41:07.360
Just let them go.
00:41:07.599 --> 00:41:08.762
Like, forget it.
00:41:09.382 --> 00:41:10.184
What are your thoughts?
00:41:12.030 --> 00:41:13.751
Man, I always like to push back with this,
00:41:13.932 --> 00:41:16.074
because you're not letting them go,
00:41:16.153 --> 00:41:16.353
right?
00:41:16.373 --> 00:41:18.556
So a listener, a follower,
00:41:18.675 --> 00:41:19.356
someone who's watching or
00:41:19.396 --> 00:41:20.518
listening now or on the replay,
00:41:20.538 --> 00:41:21.739
they're going to say, well, Tony,
00:41:21.778 --> 00:41:22.458
are you doing that?
00:41:23.079 --> 00:41:23.900
And you're going to say no,
00:41:23.920 --> 00:41:24.621
because you guys are still
00:41:24.641 --> 00:41:25.601
licensing credential and
00:41:25.621 --> 00:41:26.442
billing Medicare and
00:41:26.481 --> 00:41:27.782
billing all the network insurances,
00:41:27.963 --> 00:41:28.304
right?
00:41:29.590 --> 00:41:31.391
So I had one guy and I can't
00:41:31.431 --> 00:41:32.112
remember his name.
00:41:32.152 --> 00:41:33.532
I wish I could give him credit.
00:41:34.492 --> 00:41:35.914
He gave me a great response.
00:41:36.713 --> 00:41:38.715
He said I was basically he
00:41:38.735 --> 00:41:39.556
said I was crazy,
00:41:39.596 --> 00:41:40.795
that I was completely wrong.
00:41:41.297 --> 00:41:42.456
He said that, you know,
00:41:42.496 --> 00:41:43.717
the credentialing allows
00:41:43.737 --> 00:41:45.498
them to do dry needling legally.
00:41:45.878 --> 00:41:48.019
The credentialing allows
00:41:48.039 --> 00:41:49.119
them to do all of these
00:41:49.159 --> 00:41:51.621
services within the law
00:41:51.681 --> 00:41:52.702
that he wouldn't be able to
00:41:52.742 --> 00:41:54.422
do if he let his license go.
00:41:55.538 --> 00:41:57.059
It dawned on me.
00:41:57.300 --> 00:41:58.842
I was like, yeah, you're right.
00:41:58.862 --> 00:41:59.985
He's a hundred percent right.
00:42:00.164 --> 00:42:01.306
I'm a hundred percent wrong
00:42:01.427 --> 00:42:03.128
relative to his situation.
00:42:03.650 --> 00:42:05.152
He wants to do those things.
00:42:05.452 --> 00:42:06.434
I don't want to do those things.
00:42:06.454 --> 00:42:08.896
I have zero interest in dry needling.
00:42:08.958 --> 00:42:10.079
I have zero interest in
00:42:10.940 --> 00:42:11.800
Pretty much any of the
00:42:11.820 --> 00:42:13.762
things that require my licensure.
00:42:14.302 --> 00:42:16.284
So to your point, Dave, well,
00:42:16.344 --> 00:42:17.565
why haven't I let it go?
00:42:17.846 --> 00:42:20.367
Why haven't I followed my own advice?
00:42:20.829 --> 00:42:20.949
Well,
00:42:20.989 --> 00:42:22.349
it's because I still have a
00:42:22.389 --> 00:42:23.710
successful business that
00:42:23.791 --> 00:42:26.273
runs on a thirty year old model.
00:42:27.894 --> 00:42:29.416
A new therapist coming into
00:42:29.456 --> 00:42:31.396
business today doesn't have
00:42:31.436 --> 00:42:32.898
the advantages that I have.
00:42:33.338 --> 00:42:34.878
And you hear this stuff in
00:42:34.938 --> 00:42:36.019
popular media when they
00:42:36.059 --> 00:42:37.721
talk about boomers versus
00:42:38.081 --> 00:42:39.161
younger generations.
00:42:39.942 --> 00:42:40.882
It's true, guys.
00:42:40.943 --> 00:42:45.025
I have zero, zero debt to any university.
00:42:46.085 --> 00:42:47.106
I have, you know,
00:42:47.306 --> 00:42:49.309
the history with the referral sources.
00:42:49.349 --> 00:42:51.269
So I have zero marketing expense.
00:42:51.851 --> 00:42:54.233
I have the history with my systems.
00:42:54.652 --> 00:42:56.454
I can operationally deliver
00:42:56.514 --> 00:42:57.954
services for a fraction of
00:42:57.994 --> 00:43:00.757
the cost of somebody new
00:43:00.797 --> 00:43:01.697
coming in and trying to
00:43:01.737 --> 00:43:03.059
build the business that I have.
00:43:03.699 --> 00:43:05.360
I have legacy experience.
00:43:05.574 --> 00:43:07.175
that nobody else in my area has.
00:43:07.255 --> 00:43:09.356
I have low overhead because
00:43:09.815 --> 00:43:10.835
I signed a lease and I've
00:43:10.876 --> 00:43:12.056
got a lease that hasn't
00:43:12.096 --> 00:43:14.516
gone up in monthly rate for
00:43:14.637 --> 00:43:15.597
like ten years.
00:43:16.737 --> 00:43:18.657
You can't do what I do.
00:43:19.018 --> 00:43:20.057
So I'm not going to.
00:43:20.137 --> 00:43:21.557
It's like the guy, me,
00:43:22.097 --> 00:43:23.239
who has a thirty year
00:43:23.278 --> 00:43:24.998
mortgage at a three percent
00:43:25.059 --> 00:43:25.559
interest rate.
00:43:25.619 --> 00:43:26.518
I'm not going to sell my
00:43:26.579 --> 00:43:28.559
house because of the
00:43:28.639 --> 00:43:29.880
interest rate on my mortgage.
00:43:29.920 --> 00:43:30.940
I'm not going to get rid of
00:43:30.960 --> 00:43:31.940
those credentials because
00:43:31.980 --> 00:43:33.081
those credentials are still
00:43:33.121 --> 00:43:34.340
profitable for me in the
00:43:34.360 --> 00:43:35.221
model that I have.
00:43:36.152 --> 00:43:38.353
But if I was a big time influencer,
00:43:38.414 --> 00:43:39.355
if I had hundreds of
00:43:39.394 --> 00:43:40.775
thousands of subscribers,
00:43:41.175 --> 00:43:42.036
that's where the original
00:43:42.097 --> 00:43:43.137
context came from.
00:43:43.617 --> 00:43:46.000
If I wanted to treat and I
00:43:46.039 --> 00:43:48.623
wanted to treat across state lines, man,
00:43:48.663 --> 00:43:49.543
the first thing I'd do is
00:43:49.603 --> 00:43:51.364
I'd get rid of the letters
00:43:51.425 --> 00:43:52.865
after my name and I would
00:43:52.885 --> 00:43:54.748
just go independence for true,
00:43:54.788 --> 00:43:55.728
full autonomy.
00:43:56.766 --> 00:43:58.606
That if you're doing virtual
00:43:58.806 --> 00:44:00.288
and you're doing, you know,
00:44:00.327 --> 00:44:01.228
the triaging we talked
00:44:01.248 --> 00:44:02.528
about before or the, you know,
00:44:02.889 --> 00:44:03.969
remote programming or
00:44:04.009 --> 00:44:05.150
you're kind of doing some
00:44:05.190 --> 00:44:06.030
telehealth or whatever
00:44:06.389 --> 00:44:07.150
across state lines.
00:44:07.951 --> 00:44:09.692
That is that that is I have
00:44:09.711 --> 00:44:10.391
to agree with you there.
00:44:10.431 --> 00:44:11.373
That is the easiest way to
00:44:11.432 --> 00:44:13.012
go because of the whole compact thing.
00:44:13.052 --> 00:44:14.094
And you got to, you know,
00:44:14.134 --> 00:44:15.574
get licensure in all these
00:44:15.954 --> 00:44:16.574
different states.
00:44:16.614 --> 00:44:17.916
And there's some states now
00:44:17.956 --> 00:44:18.556
that are what is it,
00:44:18.775 --> 00:44:20.976
fifteen or maybe twenty at the most.
00:44:21.016 --> 00:44:22.478
That's a compact you get.
00:44:22.958 --> 00:44:23.918
licensed in one of those
00:44:23.958 --> 00:44:25.219
states and now you have uh
00:44:25.438 --> 00:44:26.679
licensed reciprocity or
00:44:26.699 --> 00:44:27.880
whatever in the compact
00:44:27.900 --> 00:44:28.760
across all those states but
00:44:28.800 --> 00:44:30.681
not every state and if
00:44:30.740 --> 00:44:31.920
you're yeah if you have a
00:44:31.960 --> 00:44:32.860
social media following and
00:44:32.880 --> 00:44:33.460
you're going to be doing
00:44:33.481 --> 00:44:34.661
some of the triaging and
00:44:34.802 --> 00:44:35.961
some of the borderline
00:44:36.021 --> 00:44:37.922
therapy medical type
00:44:38.003 --> 00:44:39.483
questions and you know
00:44:39.884 --> 00:44:40.923
coaching or treatment or
00:44:40.943 --> 00:44:41.623
whatever you want to call
00:44:41.684 --> 00:44:44.264
it virtual care then yeah
00:44:44.284 --> 00:44:45.644
it does make sense to drop
00:44:45.684 --> 00:44:46.445
the license I a hundred
00:44:46.465 --> 00:44:47.146
percent agree with that
00:44:48.231 --> 00:44:49.311
And I think we've seen
00:44:49.391 --> 00:44:50.693
proven models from
00:44:51.873 --> 00:44:53.634
non-licensed PTs or
00:44:53.673 --> 00:44:54.894
clinicians that are working.
00:44:56.016 --> 00:44:57.297
In the finance world,
00:44:58.597 --> 00:45:00.579
we should get Will Butler back on.
00:45:00.619 --> 00:45:02.320
It's been forever since I've
00:45:02.360 --> 00:45:02.900
talked to him.
00:45:02.920 --> 00:45:03.820
Definitely.
00:45:04.371 --> 00:45:05.994
But every time I've pushed
00:45:06.034 --> 00:45:07.356
him to get on social media,
00:45:07.396 --> 00:45:08.597
he always says he can't
00:45:08.637 --> 00:45:10.059
because there's so much
00:45:10.099 --> 00:45:11.420
restriction on what he can
00:45:11.460 --> 00:45:12.501
say and what he can share.
00:45:13.041 --> 00:45:14.324
And when you look at Dave
00:45:14.364 --> 00:45:15.605
Ramsey and you look at the
00:45:15.724 --> 00:45:17.166
big social media
00:45:18.088 --> 00:45:20.230
influencers in the finance space,
00:45:20.670 --> 00:45:22.233
they've all let go of their
00:45:22.413 --> 00:45:23.833
their licensing.
00:45:24.335 --> 00:45:25.576
because they can't say the
00:45:25.596 --> 00:45:26.496
things that they want to
00:45:26.556 --> 00:45:28.878
say and still be compliant
00:45:28.918 --> 00:45:29.918
with the regulations.
00:45:30.318 --> 00:45:32.019
And I think the same applies
00:45:32.059 --> 00:45:32.860
to healthcare.
00:45:33.661 --> 00:45:34.681
There's a bunch of medical
00:45:34.742 --> 00:45:35.983
doctors and healthcare
00:45:36.023 --> 00:45:37.664
influencers that had to let
00:45:37.704 --> 00:45:38.864
go of their licensure
00:45:39.644 --> 00:45:41.545
But they're making ten
00:45:41.606 --> 00:45:44.206
million a year because of
00:45:44.286 --> 00:45:46.807
the social media reach that
00:45:46.827 --> 00:45:48.208
they've built and the
00:45:48.248 --> 00:45:50.289
businesses and the tools around that.
00:45:51.070 --> 00:45:53.972
So I just â With Dave Ramsey,
00:45:54.012 --> 00:45:56.032
was he a CPA or was he like
00:45:56.052 --> 00:45:59.346
a financial â what do you call it â
00:46:01.054 --> 00:46:01.855
CFA or whatever.
00:46:01.875 --> 00:46:03.617
Or yeah.
00:46:03.978 --> 00:46:04.097
Yeah.
00:46:05.318 --> 00:46:08.083
I think he had all of those licenses.
00:46:08.923 --> 00:46:11.186
He, I don't even know that world,
00:46:11.246 --> 00:46:13.469
but I had read interviews
00:46:13.509 --> 00:46:15.351
and looked into it.
00:46:16.132 --> 00:46:18.052
But a lot of the newer ones, too,
00:46:18.393 --> 00:46:18.853
same thing.
00:46:18.893 --> 00:46:20.394
They're attorneys, you know,
00:46:20.434 --> 00:46:22.376
attorneys that had their
00:46:22.817 --> 00:46:23.717
they passed the bar.
00:46:23.777 --> 00:46:25.318
They were licensed and then
00:46:25.619 --> 00:46:27.019
they let it go so they can
00:46:27.059 --> 00:46:28.360
go on to social media
00:46:28.920 --> 00:46:29.681
because that was the
00:46:29.702 --> 00:46:31.063
direction that they wanted to go.
00:46:31.123 --> 00:46:32.403
And they couldn't do it,
00:46:32.443 --> 00:46:33.985
but they still had their knowledge.
00:46:34.005 --> 00:46:35.666
And that's the same thing with us.
00:46:35.706 --> 00:46:35.867
Like,
00:46:35.887 --> 00:46:37.188
you're never going to take away my
00:46:37.288 --> 00:46:38.648
knowledge of physical therapy.
00:46:39.548 --> 00:46:42.632
I just I can't deliver one
00:46:42.713 --> 00:46:44.956
on one physical therapy advice,
00:46:45.516 --> 00:46:47.960
but I can basically provide education,
00:46:48.000 --> 00:46:49.842
information, influence, you know,
00:46:49.902 --> 00:46:51.565
all of those kinds of things,
00:46:52.025 --> 00:46:53.788
not practicing physical therapy.
00:46:55.416 --> 00:46:56.516
not having liability
00:46:56.577 --> 00:46:57.938
insurance for physical therapy,
00:46:58.018 --> 00:46:59.480
not having to do ridiculous
00:46:59.920 --> 00:47:01.302
waste of time continuing
00:47:01.402 --> 00:47:03.364
education for the twenty
00:47:03.385 --> 00:47:05.286
four hour credit hours that
00:47:05.806 --> 00:47:07.449
are virtually meaningless.
00:47:07.909 --> 00:47:09.231
Because, you know,
00:47:09.351 --> 00:47:13.235
we know so many people that just go there,
00:47:13.295 --> 00:47:14.836
check the box and they get the credit.
00:47:14.896 --> 00:47:17.278
Like none of this stuff has any impact.
00:47:17.298 --> 00:47:17.438
Agreed.
00:47:17.458 --> 00:47:17.599
Agreed.
00:47:18.219 --> 00:47:20.860
yeah I uh there's a there's
00:47:20.900 --> 00:47:21.641
a ton of therapists that
00:47:21.661 --> 00:47:22.521
just what is there's
00:47:22.541 --> 00:47:23.360
different websites that are
00:47:23.380 --> 00:47:24.902
like ninety nine dollars a
00:47:24.942 --> 00:47:26.081
year or something and you
00:47:26.101 --> 00:47:27.963
just the physical therapist
00:47:28.822 --> 00:47:29.643
I won't mention any names
00:47:29.762 --> 00:47:30.563
but go on there like the
00:47:30.603 --> 00:47:33.003
day before their ceus or uh
00:47:33.043 --> 00:47:34.384
you know your your license
00:47:34.423 --> 00:47:35.204
is about to be renewed or
00:47:35.224 --> 00:47:35.945
whatever they go on like
00:47:35.965 --> 00:47:37.204
the night before and they
00:47:37.244 --> 00:47:38.284
you know do a bunch of like
00:47:38.784 --> 00:47:40.126
whatever courses and just
00:47:40.146 --> 00:47:41.045
to just to get the
00:47:41.885 --> 00:47:42.947
amount of courses done for
00:47:43.007 --> 00:47:43.788
license renewal.
00:47:43.867 --> 00:47:44.768
And then I think I don't
00:47:44.789 --> 00:47:45.429
know about your state,
00:47:45.449 --> 00:47:46.269
but like our license
00:47:46.309 --> 00:47:48.431
renewal is like it's like
00:47:48.452 --> 00:47:49.211
the honor system.
00:47:49.391 --> 00:47:51.173
It's like, yes, I just click a box like,
00:47:51.233 --> 00:47:51.514
yes,
00:47:51.813 --> 00:47:53.735
I certify or I don't even know if it
00:47:53.755 --> 00:47:54.297
says certify.
00:47:54.416 --> 00:47:56.297
I agree or yes, I
00:47:57.159 --> 00:47:58.340
I don't know if it is.
00:47:58.360 --> 00:47:59.739
It doesn't say a test like I
00:47:59.760 --> 00:48:00.880
attest that I have or
00:48:00.920 --> 00:48:02.181
whatever that I have
00:48:02.442 --> 00:48:03.121
completed all the
00:48:03.202 --> 00:48:04.422
continuing education courses.
00:48:04.483 --> 00:48:06.623
And maybe if there's a random audit,
00:48:06.704 --> 00:48:07.585
I guess you have to show
00:48:07.625 --> 00:48:09.346
your content certificates
00:48:09.385 --> 00:48:10.827
or whatever to the board or
00:48:10.867 --> 00:48:12.228
the licensing body or
00:48:12.268 --> 00:48:13.148
whatever of your state.
00:48:14.608 --> 00:48:14.929
But yeah,
00:48:15.108 --> 00:48:16.389
I agree that whole thing is a joke too.
00:48:18.197 --> 00:48:21.838
Yeah, I mean, I use physicaltherapy.com.
00:48:21.898 --> 00:48:23.358
It's ninety nine dollars for
00:48:23.398 --> 00:48:24.199
twelve months.
00:48:24.719 --> 00:48:26.081
But if you do it, you know,
00:48:26.121 --> 00:48:28.561
like four months before they're due,
00:48:29.043 --> 00:48:30.123
you can get your twenty
00:48:30.163 --> 00:48:31.784
four credit hours and then
00:48:31.804 --> 00:48:33.184
you can do another twenty
00:48:33.204 --> 00:48:34.284
four credit hours in the
00:48:34.324 --> 00:48:36.025
next calendar year for the
00:48:36.065 --> 00:48:37.887
next two year period.
00:48:38.347 --> 00:48:39.507
So theoretically,
00:48:39.588 --> 00:48:41.188
it's forty nine dollars or
00:48:41.208 --> 00:48:43.851
whatever for each one.
00:48:45.070 --> 00:48:46.972
Now, look, I'm not against education.
00:48:47.112 --> 00:48:48.954
I work every single day to
00:48:49.034 --> 00:48:51.076
learn new stuff and I want
00:48:51.096 --> 00:48:52.056
to learn new stuff.
00:48:52.155 --> 00:48:53.998
My point in this is the
00:48:54.038 --> 00:48:55.137
person who doesn't care
00:48:55.177 --> 00:48:56.278
about learning new stuff
00:48:56.418 --> 00:48:57.599
isn't going to learn new stuff.
00:48:57.639 --> 00:48:58.701
You can't mandate it.
00:48:58.740 --> 00:48:59.681
You can't force it.
00:49:00.362 --> 00:49:02.304
And there's nothing worse
00:49:02.344 --> 00:49:05.068
than a law that has no real
00:49:05.248 --> 00:49:06.889
impact and no real effect.
00:49:07.331 --> 00:49:08.791
And the law just burdens the
00:49:08.811 --> 00:49:09.873
people who want to do a
00:49:09.893 --> 00:49:11.576
good job more because the
00:49:11.615 --> 00:49:12.436
people who don't care,
00:49:12.777 --> 00:49:14.478
they're not following the laws anyway.
00:49:15.601 --> 00:49:18.224
So it's just a waste of time, money,
00:49:18.364 --> 00:49:19.686
effort, compliance.
00:49:21.186 --> 00:49:22.626
Uh, that was great.
00:49:23.047 --> 00:49:24.108
I know we're a little bit early,
00:49:24.128 --> 00:49:25.728
but let's wrap up the episode.
00:49:25.809 --> 00:49:27.969
So what do you think?
00:49:28.050 --> 00:49:28.590
I want your,
00:49:28.670 --> 00:49:30.452
I'm going to give you your parting shot.
00:49:31.253 --> 00:49:33.094
What do you think is the
00:49:33.173 --> 00:49:36.295
most like emotional impact
00:49:36.755 --> 00:49:38.637
of finding a new therapist
00:49:38.657 --> 00:49:40.117
to join your organization?
00:49:40.679 --> 00:49:40.998
What is,
00:49:41.139 --> 00:49:42.400
what is the thing that's the most
00:49:42.500 --> 00:49:43.019
rewarding?
00:49:43.039 --> 00:49:46.262
That is the most meaningful in what you do,
00:49:46.302 --> 00:49:47.163
the way you do it.
00:49:49.869 --> 00:49:50.409
And I don't know if I'm
00:49:50.429 --> 00:49:51.070
going to get this right.
00:49:51.110 --> 00:49:52.269
I mean,
00:49:52.351 --> 00:49:54.211
it's not even for anybody else for you.
00:49:54.492 --> 00:49:54.632
Okay.
00:49:55.652 --> 00:49:57.173
No, I thought you were saying, Oh, for me,
00:49:57.193 --> 00:49:58.114
the emotional part of me
00:49:58.295 --> 00:49:59.876
finding a new staff, physical therapist.
00:50:00.516 --> 00:50:00.856
What?
00:50:00.916 --> 00:50:02.177
No, in your business,
00:50:02.418 --> 00:50:04.199
you as a therapist in your business,
00:50:04.239 --> 00:50:05.440
what's the most meaningful
00:50:05.460 --> 00:50:08.242
part of you doing your job for you?
00:50:08.262 --> 00:50:08.362
Uh,
00:50:11.586 --> 00:50:13.387
having the patient or client
00:50:14.028 --> 00:50:16.030
voice that they were able
00:50:16.050 --> 00:50:17.990
to do XYZ emotional thing
00:50:18.010 --> 00:50:20.632
like travel to their son's college in St.
00:50:20.672 --> 00:50:23.954
Louis or being able to walk
00:50:24.434 --> 00:50:27.137
confidently in public with
00:50:27.197 --> 00:50:28.498
less of a tremor or with
00:50:28.538 --> 00:50:30.458
better balance so that they
00:50:30.858 --> 00:50:32.380
are able to walk their dog
00:50:32.400 --> 00:50:33.860
in the park so that they
00:50:33.880 --> 00:50:37.423
can do something in the world better
00:50:38.675 --> 00:50:40.615
than they could without me,
00:50:40.635 --> 00:50:41.737
like before they met me.
00:50:41.797 --> 00:50:43.637
I think, I mean, that's one for sure.
00:50:44.398 --> 00:50:45.938
And I think you would say
00:50:46.679 --> 00:50:48.021
you would take a little
00:50:48.061 --> 00:50:51.202
less money a year to have
00:50:51.242 --> 00:50:52.824
that kind of meaningful
00:50:52.923 --> 00:50:54.585
impact on somebody's life
00:50:55.425 --> 00:50:57.485
versus maybe making a
00:50:57.525 --> 00:50:59.186
thousand or two more a year,
00:50:59.967 --> 00:51:02.009
but knowing that nothing
00:51:02.028 --> 00:51:03.929
you did all year had any
00:51:03.969 --> 00:51:05.630
benefit or any real impact
00:51:05.731 --> 00:51:07.192
on the patients you were working with.
00:51:07.652 --> 00:51:08.213
Don't you agree?
00:51:09.717 --> 00:51:10.777
I agree.
00:51:10.798 --> 00:51:11.199
Yeah.
00:51:11.239 --> 00:51:11.679
Same for me.
00:51:12.119 --> 00:51:14.280
Like my at this stage of my life,
00:51:14.320 --> 00:51:16.380
especially fifty years old,
00:51:16.400 --> 00:51:18.722
I am I am working for the
00:51:18.782 --> 00:51:20.483
meaningful impact more than
00:51:20.563 --> 00:51:22.844
I am working for the money, you know,
00:51:22.943 --> 00:51:25.304
and so I will do hard things.
00:51:25.806 --> 00:51:28.266
I will sacrifice more if I
00:51:28.306 --> 00:51:29.907
know the sacrifice has
00:51:30.007 --> 00:51:31.527
meaning on the other side,
00:51:32.148 --> 00:51:34.690
as opposed to just working harder daily.
00:51:35.429 --> 00:51:37.273
doing meaningless jobs,
00:51:37.432 --> 00:51:39.335
meaningless tasks for a
00:51:39.376 --> 00:51:40.177
little extra money.
00:51:40.418 --> 00:51:42.039
The extra money just isn't
00:51:42.079 --> 00:51:44.603
worth sacrificing the
00:51:44.643 --> 00:51:46.626
importance of having an
00:51:46.666 --> 00:51:47.527
impact on someone.
00:51:48.188 --> 00:51:48.989
So guys, we're done.
00:51:50.014 --> 00:51:51.255
And I think today is Tuesday.
00:51:51.436 --> 00:51:54.400
It is Tuesday, May thirteenth.
00:51:54.860 --> 00:51:55.880
Come back Thursday.
00:51:56.442 --> 00:51:58.164
Jimmy McKay will be back with us.
00:51:58.304 --> 00:51:59.186
Eight thirty a.m.
00:51:59.246 --> 00:52:00.387
Tuesday, Thursday morning.
00:52:00.447 --> 00:52:01.387
Dave Kittle show.
00:52:01.427 --> 00:52:04.411
Go check it out on iTunes and YouTube.
00:52:04.873 --> 00:52:06.474
And we will catch you guys next time.
00:52:06.514 --> 00:52:07.076
Thanks, Dave.
00:52:07.115 --> 00:52:08.137
Thanks, Tony.
00:00:01.423 --> 00:00:02.904
All right, we are live.
00:00:03.145 --> 00:00:03.926
I am back.
00:00:04.325 --> 00:00:06.569
I'm here with Dave Kittle, Tony Maritato.
00:00:06.628 --> 00:00:08.471
Jimmy may or may not jump on.
00:00:08.531 --> 00:00:10.132
He's got another meeting this morning.
00:00:10.833 --> 00:00:12.455
But I was just asking Dave
00:00:12.474 --> 00:00:13.897
before we started about
00:00:14.016 --> 00:00:15.579
Mother's Day in New York.
00:00:16.059 --> 00:00:18.461
So, you know, down here, down here,
00:00:18.542 --> 00:00:21.446
out here, southwest Ohio area.
00:00:21.966 --> 00:00:24.329
The tradition is always we mulch,
00:00:24.370 --> 00:00:25.812
we mulch the flower beds,
00:00:25.832 --> 00:00:27.614
we mulch the yard, we cut the grass,
00:00:27.635 --> 00:00:28.896
we edge, we clean it up,
00:00:28.937 --> 00:00:30.338
make it look pretty for mom.
00:00:31.541 --> 00:00:33.704
Tell me again what you guys did for,
00:00:34.064 --> 00:00:35.506
is this her first Mother's
00:00:35.527 --> 00:00:36.408
Day as a mother?
00:00:37.417 --> 00:00:38.097
No, second,
00:00:38.118 --> 00:00:39.878
because the baby was born last
00:00:40.020 --> 00:00:40.899
March twenty ninth.
00:00:40.960 --> 00:00:42.301
So the first Mother's Day
00:00:42.341 --> 00:00:43.441
was pretty quick last year,
00:00:43.481 --> 00:00:44.661
like in terms of like, you know,
00:00:44.701 --> 00:00:45.503
got on us quick.
00:00:45.923 --> 00:00:46.823
So this year,
00:00:46.862 --> 00:00:47.564
probably a little bit more
00:00:47.584 --> 00:00:49.284
time for her to soak it up and all that.
00:00:49.365 --> 00:00:50.905
And yeah, it was great.
00:00:50.926 --> 00:00:52.365
We just went out for an
00:00:52.405 --> 00:00:53.246
early dinner in the
00:00:53.267 --> 00:00:53.847
neighborhood here in
00:00:53.866 --> 00:00:55.987
Brooklyn and had a good time.
00:00:56.008 --> 00:00:57.728
Awesome.
00:00:57.768 --> 00:00:58.609
With the baby, of course.
00:00:59.305 --> 00:01:00.246
Yeah, of course.
00:01:01.027 --> 00:01:02.347
So lots to talk about.
00:01:03.689 --> 00:01:04.629
I was in D.C.
00:01:04.670 --> 00:01:05.329
last week.
00:01:06.230 --> 00:01:07.031
It was awesome.
00:01:07.852 --> 00:01:09.492
But you shared this
00:01:09.552 --> 00:01:11.873
screenshot and I think it
00:01:11.974 --> 00:01:13.454
resonates probably with
00:01:13.555 --> 00:01:15.757
every small private practice owner.
00:01:16.456 --> 00:01:17.757
So I've got it up on the screen.
00:01:17.796 --> 00:01:20.518
This comes from the physical
00:01:20.537 --> 00:01:21.677
therapy billing group.
00:01:21.737 --> 00:01:22.998
It's an awesome group.
00:01:23.039 --> 00:01:23.998
Shelly, Heidi,
00:01:24.498 --> 00:01:26.700
if you guys are PT practice owners,
00:01:26.780 --> 00:01:28.019
OT practice owners,
00:01:28.200 --> 00:01:29.941
go check out the group on Facebook.
00:01:30.700 --> 00:01:32.320
But it says, love some help.
00:01:32.600 --> 00:01:34.102
My husband, who's the owner,
00:01:34.581 --> 00:01:36.402
has been doing his own billing,
00:01:36.621 --> 00:01:38.462
a five therapist office.
00:01:38.703 --> 00:01:39.924
That's a boatload.
00:01:39.944 --> 00:01:40.963
That's a ton.
00:01:42.125 --> 00:01:43.325
Staying up until two a.m.
00:01:43.385 --> 00:01:44.025
every night,
00:01:44.085 --> 00:01:46.507
seeing eighteen patients a day himself,
00:01:46.567 --> 00:01:48.528
including Saturdays when
00:01:48.588 --> 00:01:50.771
things went kind of bad two years ago.
00:01:51.450 --> 00:01:53.272
So had some negative
00:01:53.352 --> 00:01:55.254
outcomes from a previous billing company.
00:01:55.313 --> 00:01:57.754
It sounds like says now with
00:01:57.814 --> 00:01:59.596
my aggressive scheduling,
00:01:59.956 --> 00:02:02.158
it's just getting to be too much for him.
00:02:02.858 --> 00:02:04.599
No time to deal with issues.
00:02:04.760 --> 00:02:05.260
Ideally,
00:02:05.299 --> 00:02:07.081
he'd love a full time person in
00:02:07.100 --> 00:02:07.822
the office.
00:02:08.842 --> 00:02:11.622
They're in South California, I think.
00:02:12.682 --> 00:02:13.943
But, like,
00:02:14.364 --> 00:02:16.145
maybe we look for a virtual
00:02:16.185 --> 00:02:17.504
company or in person.
00:02:18.085 --> 00:02:20.086
Any input or suggestions?
00:02:20.725 --> 00:02:22.646
So, Dave, you shared that with me.
00:02:23.146 --> 00:02:25.867
What are your thoughts about that?
00:02:26.087 --> 00:02:27.949
Yeah, so, I mean...
00:02:29.537 --> 00:02:30.437
You have to do something.
00:02:30.657 --> 00:02:31.998
You have to figure out something.
00:02:32.098 --> 00:02:33.259
And it's either going to be
00:02:33.460 --> 00:02:34.621
outsource it or you hire a
00:02:34.661 --> 00:02:35.540
billing person in-house.
00:02:35.580 --> 00:02:36.442
It depends on the total
00:02:37.043 --> 00:02:39.144
volume of claims and visits
00:02:39.183 --> 00:02:40.664
per week and per month and all that.
00:02:40.705 --> 00:02:43.687
But as an aside,
00:02:44.888 --> 00:02:45.508
This practice,
00:02:45.829 --> 00:02:46.849
you got to treat it like a business.
00:02:46.949 --> 00:02:48.790
I just did a solo episode
00:02:49.132 --> 00:02:51.272
screen share of Joe Lowe's
00:02:51.332 --> 00:02:52.834
post on LinkedIn about the
00:02:52.973 --> 00:02:55.015
physical therapy M&A market
00:02:55.036 --> 00:02:55.937
for twenty twenty five.
00:02:55.977 --> 00:02:57.157
And you commented on that.
00:02:57.177 --> 00:02:58.438
And I screen share that as
00:02:58.459 --> 00:02:59.058
part of my episode.
00:02:59.079 --> 00:03:01.320
And one of your comments, Tony, was,
00:03:01.341 --> 00:03:02.301
you know,
00:03:02.842 --> 00:03:04.483
basically like this will work or X, Y, Z,
00:03:04.502 --> 00:03:06.324
like with that market report,
00:03:06.365 --> 00:03:08.645
like the improvement or the
00:03:09.067 --> 00:03:10.288
ability for practices to
00:03:10.307 --> 00:03:11.489
grow or maintain
00:03:11.508 --> 00:03:12.288
profitability and all that.
00:03:12.568 --> 00:03:14.070
Your your comment said,
00:03:15.403 --> 00:03:16.866
basically like it'll work or
00:03:17.026 --> 00:03:18.407
this is possible if you
00:03:18.448 --> 00:03:19.588
treat the therapy practice
00:03:19.609 --> 00:03:20.210
like a business.
00:03:20.289 --> 00:03:22.532
And this screen share is no different.
00:03:22.752 --> 00:03:27.058
I think it's, respectfully, respectfully,
00:03:27.139 --> 00:03:30.282
I think it's crazy for a practice owner,
00:03:30.342 --> 00:03:31.063
a physical therapist
00:03:31.104 --> 00:03:31.944
practice owner that has
00:03:32.044 --> 00:03:33.227
five physical therapists
00:03:34.471 --> 00:03:35.931
to be treating eighteen
00:03:35.972 --> 00:03:37.992
patients per day and doing the billing.
00:03:39.372 --> 00:03:40.954
You need an intervention, respectfully.
00:03:40.973 --> 00:03:41.814
You need an intervention.
00:03:43.155 --> 00:03:45.216
You need Sturdy McKee, Jamie Schrier.
00:03:45.256 --> 00:03:48.076
You need a coach to help you
00:03:48.117 --> 00:03:49.057
delegate stuff.
00:03:49.717 --> 00:03:50.498
The first thing I'm thinking
00:03:50.538 --> 00:03:52.599
of is you need to just get out.
00:03:52.939 --> 00:03:54.400
I can't believe that there
00:03:54.419 --> 00:03:55.221
are small business owners
00:03:55.260 --> 00:03:57.342
that want to do all the stuff
00:03:59.139 --> 00:03:59.579
It's crazy.
00:03:59.658 --> 00:04:02.161
And then how do you have time to work out,
00:04:02.461 --> 00:04:06.302
go to the gym, go for a jog, I don't know,
00:04:06.522 --> 00:04:08.243
do leisurely stuff, mow the lawn,
00:04:08.663 --> 00:04:09.085
mulching,
00:04:09.104 --> 00:04:10.145
like Tony was just talking about.
00:04:10.344 --> 00:04:11.566
How do you have time to do any of that?
00:04:11.586 --> 00:04:12.006
You don't.
00:04:12.606 --> 00:04:13.747
And your head's spinning all the time.
00:04:15.068 --> 00:04:16.408
And then if you do some of these things,
00:04:16.428 --> 00:04:17.389
if you outsource it,
00:04:17.769 --> 00:04:19.009
or if you hire one or two
00:04:19.050 --> 00:04:22.411
billion people for the practice, yes,
00:04:22.471 --> 00:04:23.932
some of your income money
00:04:23.973 --> 00:04:25.213
goes to their salaries.
00:04:26.194 --> 00:04:28.055
but you have more time for
00:04:28.136 --> 00:04:30.877
clarity to think about self pay options,
00:04:30.898 --> 00:04:32.019
to think about hiring and
00:04:32.059 --> 00:04:33.259
recruiting other therapists
00:04:33.278 --> 00:04:34.379
to replace yourself.
00:04:34.399 --> 00:04:36.860
So I have a lot of thoughts
00:04:36.922 --> 00:04:38.843
obviously about this and I just,
00:04:38.923 --> 00:04:39.923
I don't know, like Tony, like how,
00:04:40.043 --> 00:04:40.744
how does this happen?
00:04:40.783 --> 00:04:42.845
Is this something that you
00:04:42.884 --> 00:04:43.826
see a lot or you've heard a
00:04:43.846 --> 00:04:44.685
lot with practice owners
00:04:44.706 --> 00:04:45.406
that like they want to do
00:04:45.427 --> 00:04:46.666
all this stuff and then the
00:04:46.687 --> 00:04:47.387
practice kind of gets
00:04:47.427 --> 00:04:48.788
bigger over time and they
00:04:48.889 --> 00:04:51.310
never get out of those initial jobs,
00:04:51.410 --> 00:04:52.370
roles or responsibilities?
00:04:53.185 --> 00:04:53.485
Yeah,
00:04:53.505 --> 00:04:55.266
I think it's one of those things where,
00:04:55.547 --> 00:04:56.067
like I said,
00:04:56.487 --> 00:04:58.288
the comment said two years
00:04:58.329 --> 00:05:00.329
ago they had a negative experience.
00:05:00.370 --> 00:05:02.572
So, you know, I always share this story.
00:05:02.612 --> 00:05:05.774
When we started, we hired a biller.
00:05:06.033 --> 00:05:07.714
We thought a biller was a biller.
00:05:07.894 --> 00:05:09.276
Like we didn't realize, well,
00:05:09.295 --> 00:05:10.516
there's physical therapy
00:05:10.557 --> 00:05:12.637
billers and non-physical therapy billers.
00:05:12.677 --> 00:05:14.218
So we hire this random biller.
00:05:14.999 --> 00:05:17.579
We we never get any of our claims paid.
00:05:17.620 --> 00:05:18.141
Thankfully,
00:05:18.180 --> 00:05:19.740
we still we started as a cash
00:05:19.781 --> 00:05:20.622
based business.
00:05:20.641 --> 00:05:22.702
So we had tons of income coming in.
00:05:23.442 --> 00:05:25.004
We fired that bill or hired
00:05:25.043 --> 00:05:27.904
a second bill or still no results.
00:05:28.004 --> 00:05:30.105
We lost about sixty thousand
00:05:30.146 --> 00:05:32.187
dollars back in two thousand one,
00:05:32.226 --> 00:05:34.307
two thousand two until we
00:05:34.327 --> 00:05:35.528
hired the third biller.
00:05:36.434 --> 00:05:37.735
Now, the third biller was awesome.
00:05:38.214 --> 00:05:39.755
He specialized in physical
00:05:39.795 --> 00:05:40.555
therapy billing.
00:05:41.016 --> 00:05:42.437
He reminds me actually now
00:05:42.456 --> 00:05:43.978
that I think of it of Heidi
00:05:44.017 --> 00:05:45.079
and Shelly and some of the
00:05:45.478 --> 00:05:47.519
billers that are in that Facebook group.
00:05:48.701 --> 00:05:50.221
It was just him and a partner.
00:05:50.302 --> 00:05:51.862
They were a small, you know,
00:05:51.983 --> 00:05:53.002
service provider.
00:05:53.884 --> 00:05:56.264
And he dug us out of a major hole there.
00:05:56.365 --> 00:05:57.927
But we still had such a
00:05:58.007 --> 00:05:59.228
negative experience.
00:05:59.307 --> 00:06:00.389
Now, I think for us,
00:06:00.449 --> 00:06:01.449
what made the difference
00:06:01.810 --> 00:06:03.192
because we were in the same boat.
00:06:03.552 --> 00:06:05.314
We were seeing tons of patients.
00:06:05.454 --> 00:06:06.235
We were busy.
00:06:06.254 --> 00:06:07.576
We didn't have five clinicians.
00:06:07.617 --> 00:06:10.579
We probably had two like myself,
00:06:10.939 --> 00:06:13.762
my my wife, another two other therapists.
00:06:13.783 --> 00:06:15.324
So let's say four in total.
00:06:15.925 --> 00:06:16.966
But we were treating a full
00:06:16.985 --> 00:06:18.387
caseload and running the
00:06:18.406 --> 00:06:20.189
business and doing everything.
00:06:21.449 --> 00:06:22.531
And I think you're just on
00:06:22.550 --> 00:06:23.732
that hamster wheel.
00:06:23.771 --> 00:06:25.072
It's going so fast.
00:06:25.093 --> 00:06:26.353
You don't have time to take
00:06:26.394 --> 00:06:27.634
a breath and step off.
00:06:28.315 --> 00:06:29.776
And as clinicians,
00:06:30.216 --> 00:06:32.238
we tend to think nobody can
00:06:32.259 --> 00:06:34.321
do it better than us, whatever it is.
00:06:34.880 --> 00:06:36.461
So we want to do it all.
00:06:36.482 --> 00:06:37.641
We're not approaching this
00:06:37.682 --> 00:06:38.502
like a business.
00:06:38.543 --> 00:06:40.684
We're approaching this like patient care.
00:06:41.223 --> 00:06:42.444
I will see more patients.
00:06:42.485 --> 00:06:44.305
I will build more units.
00:06:44.386 --> 00:06:45.666
I will do more stuff.
00:06:46.326 --> 00:06:48.067
And so you just can't do it anymore.
00:06:48.887 --> 00:06:52.009
For us, we read E-Myth, revisited it.
00:06:52.850 --> 00:06:53.891
We made the decision that
00:06:53.911 --> 00:06:54.591
we're going to treat this
00:06:54.630 --> 00:06:56.312
like a business and not a job.
00:06:57.773 --> 00:06:59.694
We took our self-worth and
00:06:59.754 --> 00:07:02.134
value away from having to
00:07:02.175 --> 00:07:03.336
do everything and being the
00:07:03.375 --> 00:07:04.396
best at everything.
00:07:05.377 --> 00:07:06.858
We went through some education,
00:07:06.898 --> 00:07:07.978
some consulting,
00:07:08.117 --> 00:07:09.418
and we actually learned how
00:07:09.439 --> 00:07:11.199
to structure a business and
00:07:11.240 --> 00:07:13.721
bring people in to put them
00:07:13.920 --> 00:07:16.382
into those roles that we had defined.
00:07:17.062 --> 00:07:18.586
And for the next, I don't know,
00:07:18.627 --> 00:07:19.649
probably three years,
00:07:19.990 --> 00:07:22.076
we outsourced as we continued to grow,
00:07:22.156 --> 00:07:23.057
outsourced our billing.
00:07:23.901 --> 00:07:24.482
But even there,
00:07:24.641 --> 00:07:25.882
we got to the point where like,
00:07:25.983 --> 00:07:27.362
why are we paying, you know,
00:07:27.423 --> 00:07:28.863
seven percent on a million
00:07:28.903 --> 00:07:31.204
in revenue when really we
00:07:31.225 --> 00:07:32.125
could just bring it in
00:07:32.165 --> 00:07:33.605
house and probably do it better.
00:07:33.665 --> 00:07:34.766
But at that point,
00:07:35.466 --> 00:07:38.187
we had replaced ourselves as clinicians.
00:07:38.307 --> 00:07:39.668
We were no longer treating
00:07:39.887 --> 00:07:41.329
every patient every day.
00:07:42.209 --> 00:07:43.629
So we had the capacity,
00:07:43.689 --> 00:07:45.709
the bandwidth to build a
00:07:45.771 --> 00:07:46.630
billing business.
00:07:46.670 --> 00:07:47.911
And we've actually spun off
00:07:48.411 --> 00:07:50.291
billing businesses as
00:07:50.331 --> 00:07:51.773
completely separate entities because
00:07:52.353 --> 00:07:54.297
Because we had the ability
00:07:54.357 --> 00:07:56.379
to not spend eight to ten
00:07:56.420 --> 00:07:57.663
hours treating patients and
00:07:57.682 --> 00:07:59.125
then try to work on the
00:07:59.165 --> 00:07:59.987
business afterward.
00:08:01.761 --> 00:08:02.922
Yeah, makes a ton of sense.
00:08:02.961 --> 00:08:06.024
I feel like for the small business owner,
00:08:06.064 --> 00:08:08.567
the practice owners out there, it's just,
00:08:08.687 --> 00:08:13.130
I think, a shame to not... Respectfully,
00:08:13.151 --> 00:08:15.072
we're not saying it's not a
00:08:15.132 --> 00:08:15.952
serious business.
00:08:16.014 --> 00:08:16.574
Obviously, it is.
00:08:16.593 --> 00:08:18.636
You have five physical
00:08:18.656 --> 00:08:19.937
therapists outside of the owner.
00:08:20.357 --> 00:08:20.817
Like you said,
00:08:20.858 --> 00:08:22.980
that's a meaningful practice,
00:08:23.639 --> 00:08:24.500
even if they're in network.
00:08:24.740 --> 00:08:25.141
And so...
00:08:27.083 --> 00:08:28.644
it's just a shame that I
00:08:28.684 --> 00:08:30.004
don't know like is it is it
00:08:30.125 --> 00:08:31.726
some you know small
00:08:31.786 --> 00:08:34.489
business like uh dna or
00:08:34.609 --> 00:08:36.571
ethos or something where
00:08:37.010 --> 00:08:39.633
it's like my generation and
00:08:39.852 --> 00:08:42.215
and older uh and I like to
00:08:42.235 --> 00:08:43.336
include myself in in the
00:08:43.416 --> 00:08:44.677
you know put your head down
00:08:44.716 --> 00:08:46.399
like just grind it out like
00:08:46.719 --> 00:08:47.359
it might have stopped a
00:08:47.399 --> 00:08:48.740
little bit after my age but
00:08:48.779 --> 00:08:50.241
like kind of like you know
00:08:50.581 --> 00:08:52.263
your colleagues and your
00:08:52.302 --> 00:08:54.044
friends and small business owners like
00:08:54.644 --> 00:08:56.427
Is it just easy for practice owners,
00:08:56.447 --> 00:08:57.567
business owners that are
00:08:58.128 --> 00:08:59.548
independent to kind of put
00:08:59.568 --> 00:09:02.412
their head down, just grind it out until,
00:09:02.932 --> 00:09:03.152
you know,
00:09:03.172 --> 00:09:04.173
your wife goes on a Facebook
00:09:04.212 --> 00:09:05.134
group and says like, hey,
00:09:05.173 --> 00:09:06.434
we need some help with this or that.
00:09:06.754 --> 00:09:07.576
And it's not even it's not
00:09:07.596 --> 00:09:08.317
even that individual.
00:09:08.336 --> 00:09:09.957
It's not even that the practice owner,
00:09:10.057 --> 00:09:10.599
that's the physical
00:09:10.639 --> 00:09:12.139
therapist asking for help.
00:09:12.399 --> 00:09:13.581
So who knows if he or she
00:09:13.640 --> 00:09:14.302
even wants to help?
00:09:14.817 --> 00:09:15.097
Yeah.
00:09:15.437 --> 00:09:15.638
Yeah.
00:09:15.778 --> 00:09:16.077
Yeah.
00:09:16.177 --> 00:09:16.817
I think it is.
00:09:16.999 --> 00:09:19.219
I think it's within our DNA,
00:09:19.599 --> 00:09:20.739
but then I think there's
00:09:20.818 --> 00:09:22.539
also a lot of baggage that
00:09:22.580 --> 00:09:23.580
we bring with us.
00:09:23.620 --> 00:09:25.299
You know, what did your parents do?
00:09:25.360 --> 00:09:26.400
What were your parents'
00:09:26.900 --> 00:09:28.280
mindsets around money?
00:09:29.682 --> 00:09:30.782
I know I've still got tons
00:09:30.802 --> 00:09:32.341
of baggage from mom and dad
00:09:32.381 --> 00:09:33.662
and how they addressed money,
00:09:33.721 --> 00:09:35.302
how your spouse addresses money,
00:09:35.383 --> 00:09:36.383
what money is.
00:09:37.023 --> 00:09:38.344
We were just, I mean,
00:09:38.504 --> 00:09:41.443
every chance I get with my four boys,
00:09:41.943 --> 00:09:43.924
I always try to instill in them
00:09:44.485 --> 00:09:45.025
Who cares?
00:09:45.145 --> 00:09:45.806
It's just money.
00:09:46.567 --> 00:09:49.109
It has zero value unless you spend it.
00:09:49.629 --> 00:09:51.410
You decide how you want to spend it.
00:09:51.451 --> 00:09:52.631
Spend it could be investing
00:09:52.711 --> 00:09:54.673
it or it could be just wasteful spending.
00:09:54.714 --> 00:09:55.475
It doesn't matter.
00:09:56.014 --> 00:09:56.936
But the point is,
00:09:57.476 --> 00:09:59.158
I want them to understand
00:09:59.677 --> 00:10:01.320
money can always be created.
00:10:01.399 --> 00:10:02.841
It can always be generated.
00:10:03.101 --> 00:10:05.484
There's no scarcity around money ever.
00:10:06.063 --> 00:10:07.765
You could have zero money
00:10:08.265 --> 00:10:09.547
and be completely happy.
00:10:09.707 --> 00:10:10.948
You could have millions of
00:10:11.009 --> 00:10:13.051
dollars and be completely miserable.
00:10:13.591 --> 00:10:15.153
So those are the lessons
00:10:15.192 --> 00:10:17.274
that I try to instill in my kids.
00:10:18.384 --> 00:10:20.684
But I recognize that I still
00:10:20.725 --> 00:10:22.846
have a ton of bad money
00:10:22.926 --> 00:10:25.265
habits from my parents who
00:10:25.285 --> 00:10:26.966
were successful in their own right.
00:10:27.047 --> 00:10:27.307
I mean,
00:10:27.346 --> 00:10:29.027
I'm not taking anything away from them.
00:10:29.586 --> 00:10:32.807
I'm just saying it's work to
00:10:32.888 --> 00:10:34.307
change the way we look at it.
00:10:34.347 --> 00:10:34.807
Plus,
00:10:35.408 --> 00:10:37.568
going back to I think a lot of
00:10:37.609 --> 00:10:39.708
therapists just tie their value,
00:10:39.769 --> 00:10:42.710
their identity to I'm a hard worker.
00:10:42.830 --> 00:10:44.669
I was successful in school.
00:10:44.730 --> 00:10:46.010
I checked all the boxes and
00:10:46.071 --> 00:10:46.990
I did the homework.
00:10:48.010 --> 00:10:49.751
I never saw value in any of that.
00:10:49.971 --> 00:10:51.952
So I came to therapy from
00:10:52.013 --> 00:10:53.474
kind of a different perspective.
00:10:54.933 --> 00:10:56.154
But there's a lot of
00:10:56.254 --> 00:10:58.755
identity tied to doing what
00:10:58.796 --> 00:11:00.657
you think you're supposed to do.
00:11:01.317 --> 00:11:03.438
So and a lot of people still think, well,
00:11:03.458 --> 00:11:04.178
I got to work hard.
00:11:04.399 --> 00:11:06.659
If I'm not working hard, I'm being lazy.
00:11:07.259 --> 00:11:08.321
It's just not true at all.
00:11:10.304 --> 00:11:10.924
Yeah, I love it.
00:11:11.385 --> 00:11:13.006
Um, so what are, what are some,
00:11:13.106 --> 00:11:14.067
I know there's a bunch of comments.
00:11:14.086 --> 00:11:15.427
I know Joey Albritton commented,
00:11:15.447 --> 00:11:17.408
a bunch of folks commented, what would be,
00:11:18.049 --> 00:11:18.750
uh, you know, not,
00:11:18.970 --> 00:11:20.530
not that they're asking for
00:11:20.671 --> 00:11:22.152
our unsolicited advice.
00:11:22.172 --> 00:11:23.472
They're asking that whole
00:11:23.513 --> 00:11:24.354
Facebook group or whatever.
00:11:24.913 --> 00:11:26.355
What would be like,
00:11:26.634 --> 00:11:28.296
what would be an idea or like,
00:11:28.475 --> 00:11:29.756
what would you do if you were that owner?
00:11:29.836 --> 00:11:30.236
And you know,
00:11:30.277 --> 00:11:31.217
your wife is going on the
00:11:31.238 --> 00:11:34.460
Facebook group and, uh, or what's,
00:11:34.559 --> 00:11:36.740
what suggestion would you have for, uh,
00:11:36.780 --> 00:11:37.562
for this practice owner?
00:11:38.143 --> 00:11:39.063
I think this is where you
00:11:39.124 --> 00:11:41.386
have to bring in a new set of eyes.
00:11:41.486 --> 00:11:42.567
This is where you have to
00:11:42.607 --> 00:11:44.230
bring in an outside consultant.
00:11:44.529 --> 00:11:45.931
And you have to step back
00:11:46.471 --> 00:11:48.474
and use the logical brain.
00:11:48.514 --> 00:11:49.696
You have a clinical brain.
00:11:49.735 --> 00:11:51.037
There's logic in that.
00:11:51.517 --> 00:11:52.477
It's like, well, wait a minute.
00:11:52.719 --> 00:11:53.879
If this person is doing
00:11:53.940 --> 00:11:55.000
eighteen visits a day.
00:11:55.922 --> 00:11:57.864
So let's say close to two
00:11:57.884 --> 00:11:59.505
thousand dollars in revenue
00:11:59.546 --> 00:12:02.207
generation a day, just this person.
00:12:02.889 --> 00:12:03.909
And then there's five,
00:12:04.269 --> 00:12:05.370
potentially five other
00:12:05.410 --> 00:12:07.072
people doing comparable.
00:12:07.592 --> 00:12:07.952
You know,
00:12:08.293 --> 00:12:09.835
this practice is doing a
00:12:09.894 --> 00:12:13.038
significant amount of revenue within this,
00:12:13.379 --> 00:12:14.639
probably upwards, you know,
00:12:14.720 --> 00:12:15.961
well over half.
00:12:16.341 --> 00:12:17.802
a five hundred thousand plus
00:12:17.841 --> 00:12:19.482
close to a million in revenue,
00:12:20.124 --> 00:12:21.585
you have to sit there and be like,
00:12:21.664 --> 00:12:24.167
wait a minute, something doesn't add up.
00:12:24.427 --> 00:12:25.967
We're generating, let's say,
00:12:26.008 --> 00:12:26.849
seven hundred and fifty
00:12:26.889 --> 00:12:28.210
thousand a year in revenue.
00:12:28.889 --> 00:12:31.231
And I'm I'm killing myself
00:12:31.392 --> 00:12:32.952
doing all this stuff like
00:12:33.753 --> 00:12:35.534
you have to acknowledge
00:12:35.554 --> 00:12:36.394
there's a problem.
00:12:36.916 --> 00:12:38.277
The wife acknowledges it.
00:12:38.356 --> 00:12:39.878
Other people around you see it.
00:12:40.717 --> 00:12:42.097
You have to acknowledge it
00:12:42.118 --> 00:12:42.859
and then you have to get a
00:12:42.899 --> 00:12:43.739
fresh set of eyes.
00:12:43.778 --> 00:12:43.999
You know,
00:12:44.038 --> 00:12:45.658
somebody to come in and look at this,
00:12:45.879 --> 00:12:48.600
give you their perspective
00:12:49.039 --> 00:12:50.240
from the outside looking in.
00:12:50.320 --> 00:12:51.921
And then you can decide like, all right,
00:12:52.301 --> 00:12:54.000
do I agree with their perspective?
00:12:54.160 --> 00:12:54.480
You know,
00:12:54.821 --> 00:12:56.542
we get patients and I tie
00:12:56.581 --> 00:12:57.841
everything back to patient care.
00:12:58.322 --> 00:12:59.522
Patient walks in the door.
00:12:59.961 --> 00:13:01.003
He loves smoking.
00:13:01.123 --> 00:13:02.163
He loves drinking.
00:13:02.302 --> 00:13:03.903
He loves eating whatever he wants,
00:13:03.982 --> 00:13:06.104
but his back pain doesn't get better.
00:13:06.844 --> 00:13:08.125
I can tell them, look,
00:13:08.144 --> 00:13:09.825
this isn't a mechanical problem.
00:13:09.965 --> 00:13:11.066
It's a chemical problem.
00:13:11.485 --> 00:13:14.267
Your body is dealing with chemical issues.
00:13:14.687 --> 00:13:16.288
If you really want to address this,
00:13:16.347 --> 00:13:17.808
we need lifestyle change.
00:13:18.308 --> 00:13:19.649
And then that that patient
00:13:19.688 --> 00:13:20.750
can make the decision.
00:13:21.190 --> 00:13:22.190
Yeah, I want to do this.
00:13:22.250 --> 00:13:22.671
I'm ready.
00:13:22.730 --> 00:13:24.051
I'm ready to make the change.
00:13:24.071 --> 00:13:25.292
I'm going to change my diet,
00:13:25.331 --> 00:13:26.331
change my lifestyle.
00:13:26.351 --> 00:13:27.712
I'm going to start to exercise.
00:13:28.493 --> 00:13:29.373
Or they're going to say, no,
00:13:29.432 --> 00:13:30.094
I don't want that.
00:13:30.394 --> 00:13:31.254
And they're going to they
00:13:31.274 --> 00:13:32.514
would rather deal with the
00:13:32.553 --> 00:13:34.475
pain of back back pain.
00:13:35.235 --> 00:13:36.375
This guy would rather deal
00:13:36.394 --> 00:13:37.775
with the pain of burnout
00:13:38.235 --> 00:13:40.196
than make these changes
00:13:40.216 --> 00:13:41.797
because they're so fearful
00:13:42.277 --> 00:13:44.378
of what those changes involve.
00:13:44.418 --> 00:13:45.658
And a lot of times those
00:13:45.697 --> 00:13:46.998
changes are more painful.
00:13:47.639 --> 00:13:49.379
Exercising daily and eating
00:13:49.438 --> 00:13:50.698
a different diet is more
00:13:50.739 --> 00:13:52.320
painful than the nuisance
00:13:52.340 --> 00:13:53.480
back pain he's dealing with.
00:13:53.519 --> 00:13:54.461
He'd rather just deal with
00:13:54.500 --> 00:13:55.341
the nuisance back pain.
00:13:56.124 --> 00:13:58.065
But you need an outside set of eyes,
00:13:58.105 --> 00:13:59.945
somebody like you or other
00:13:59.985 --> 00:14:01.145
people that are out there
00:14:01.206 --> 00:14:02.285
that have been down that
00:14:02.346 --> 00:14:04.267
road and have seen a
00:14:04.326 --> 00:14:06.168
hundred other business models.
00:14:06.748 --> 00:14:08.508
That's somebody that I would say, hey,
00:14:08.548 --> 00:14:09.389
take a look at this and
00:14:09.428 --> 00:14:10.168
tell me what you see.
00:14:11.673 --> 00:14:12.855
I love what you mentioned
00:14:12.934 --> 00:14:15.056
maybe ten or so minutes ago.
00:14:15.076 --> 00:14:15.996
I don't know how long we had
00:14:16.037 --> 00:14:16.717
a lot of five or ten
00:14:16.738 --> 00:14:17.697
minutes ago when you
00:14:17.758 --> 00:14:18.698
mentioned that you had
00:14:18.798 --> 00:14:20.639
tried several different billers.
00:14:21.240 --> 00:14:22.000
And this goes back to
00:14:22.081 --> 00:14:23.481
remember when we were searching,
00:14:23.522 --> 00:14:24.363
we were interviewing folks
00:14:24.442 --> 00:14:25.623
to do home cleaning.
00:14:26.203 --> 00:14:28.164
And I don't know if I mentioned this,
00:14:28.205 --> 00:14:29.245
but like the first person
00:14:29.865 --> 00:14:31.447
like we had her come twice
00:14:31.506 --> 00:14:33.568
and like it just she was super nice,
00:14:33.609 --> 00:14:34.870
but it just like took forever.
00:14:34.889 --> 00:14:36.350
It was like eight hours.
00:14:36.370 --> 00:14:36.971
Like our place,
00:14:37.831 --> 00:14:39.972
it's a condo apartment in Brooklyn.
00:14:41.614 --> 00:14:42.474
place for three hours.
00:14:42.494 --> 00:14:42.594
Now,
00:14:42.634 --> 00:14:44.394
were you paying by the hour or by the
00:14:44.455 --> 00:14:44.815
job?
00:14:45.195 --> 00:14:46.316
No, by the job.
00:14:46.375 --> 00:14:46.696
It's like,
00:14:47.515 --> 00:14:49.417
why would you not hustle to get
00:14:49.576 --> 00:14:51.138
out of here sooner?
00:14:51.177 --> 00:14:53.778
It was a flat rate for the whole job.
00:14:53.798 --> 00:14:56.179
And by the way, that was her idea.
00:14:56.960 --> 00:14:57.620
The reason I'm bringing this
00:14:57.679 --> 00:14:59.020
up is because we tried her
00:14:59.041 --> 00:15:01.061
a couple of times and we're like, yeah,
00:15:01.081 --> 00:15:04.363
we're going to pause and
00:15:04.722 --> 00:15:05.763
then we continue the search.
00:15:09.133 --> 00:15:10.313
I think certain business
00:15:10.374 --> 00:15:14.018
owners can get in the rut of like, well,
00:15:14.057 --> 00:15:15.519
we tried that, so that didn't work.
00:15:15.918 --> 00:15:17.821
It's like what you said and what I did,
00:15:17.860 --> 00:15:19.623
then we look for another cleaner.
00:15:19.643 --> 00:15:20.123
If that didn't work,
00:15:20.143 --> 00:15:20.663
we're going to look for
00:15:20.683 --> 00:15:21.585
another and another.
00:15:22.264 --> 00:15:23.066
It's the same thing with
00:15:23.125 --> 00:15:24.427
recruiting for therapists.
00:15:24.888 --> 00:15:26.469
Some are just not going to
00:15:26.489 --> 00:15:27.009
be the right fit.
00:15:27.110 --> 00:15:29.272
They're going to be too experienced,
00:15:29.331 --> 00:15:30.232
too inexperienced.
00:15:30.253 --> 00:15:31.394
They're just not going to be
00:15:31.413 --> 00:15:31.854
the right fit.
00:15:33.134 --> 00:15:34.336
um regardless of the
00:15:34.355 --> 00:15:35.056
challenges that this
00:15:35.096 --> 00:15:36.135
practice had with uh
00:15:36.176 --> 00:15:37.197
billing folks or billing
00:15:37.236 --> 00:15:38.657
companies or whatever like
00:15:38.996 --> 00:15:40.477
there absolutely is a great
00:15:40.498 --> 00:15:41.518
fit out there like you said
00:15:41.738 --> 00:15:42.798
you might need a coach or a
00:15:42.859 --> 00:15:44.599
consultant or some practice
00:15:44.658 --> 00:15:46.100
owner that has been there before
00:15:47.065 --> 00:15:48.505
that hired five or ten
00:15:48.546 --> 00:15:49.907
different billing companies
00:15:49.966 --> 00:15:50.506
over the years,
00:15:50.888 --> 00:15:52.808
they actually could give
00:15:52.828 --> 00:15:54.070
you maybe like a cheat
00:15:54.090 --> 00:15:55.190
sheet or a handout of like,
00:15:55.630 --> 00:15:57.331
here's the proper questions to ask.
00:15:57.371 --> 00:15:57.511
Like,
00:15:57.572 --> 00:16:00.553
here's the savvy questions to ask
00:16:00.634 --> 00:16:01.455
when you're interviewing
00:16:01.514 --> 00:16:02.916
business or when you're
00:16:02.956 --> 00:16:04.517
interviewing billing companies.
00:16:05.177 --> 00:16:05.817
Like, you know,
00:16:06.177 --> 00:16:07.157
those types of asking for
00:16:07.216 --> 00:16:08.457
referrals or asking for
00:16:09.817 --> 00:16:11.197
references and asking to
00:16:11.238 --> 00:16:11.899
speak with other business
00:16:11.958 --> 00:16:12.778
owners that they're already
00:16:12.798 --> 00:16:14.318
helping on the billing side.
00:16:14.379 --> 00:16:16.460
So I love that.
00:16:16.700 --> 00:16:18.759
I always want to echo that,
00:16:18.799 --> 00:16:20.220
which is like there's just
00:16:20.299 --> 00:16:21.900
always more to assess and
00:16:21.921 --> 00:16:23.140
check out and never think
00:16:23.160 --> 00:16:24.441
that just because the first
00:16:24.561 --> 00:16:26.922
option or two didn't work out,
00:16:26.961 --> 00:16:28.621
that that's like the whole
00:16:29.081 --> 00:16:29.942
route doesn't work.
00:16:30.023 --> 00:16:31.623
Obviously, billing companies work.
00:16:32.614 --> 00:16:33.554
And you would think this is
00:16:33.595 --> 00:16:35.775
a lesson we already understand.
00:16:35.796 --> 00:16:37.158
The patient who comes in and
00:16:37.177 --> 00:16:38.778
says physical therapy
00:16:38.798 --> 00:16:39.879
doesn't work because they
00:16:39.919 --> 00:16:41.900
went down the street and they didn't do,
00:16:42.221 --> 00:16:44.403
you know, well with that.
00:16:44.523 --> 00:16:45.663
And that same physical
00:16:45.703 --> 00:16:46.565
therapist will then go on
00:16:46.585 --> 00:16:47.164
Facebook and say,
00:16:47.345 --> 00:16:48.785
I can't believe these patients say,
00:16:48.806 --> 00:16:50.187
you know, physical therapy won't work.
00:16:50.267 --> 00:16:50.947
And, you know,
00:16:51.128 --> 00:16:52.589
get physical therapy first
00:16:52.629 --> 00:16:55.150
and get PT first or, you know, PT.
00:16:55.591 --> 00:16:57.952
What was your choose PT first?
00:16:59.394 --> 00:17:00.215
It's hilarious.
00:17:00.235 --> 00:17:00.475
Yes.
00:17:00.754 --> 00:17:01.336
What a conundrum.
00:17:02.168 --> 00:17:03.089
What's interesting about
00:17:03.229 --> 00:17:04.390
what you shared with the
00:17:04.410 --> 00:17:07.211
cleaning person is you,
00:17:07.330 --> 00:17:10.012
and correct me if I'm wrong,
00:17:10.153 --> 00:17:11.153
you were just at least a
00:17:11.213 --> 00:17:14.816
little bit more concerned
00:17:14.855 --> 00:17:16.277
with the amount of time it
00:17:16.317 --> 00:17:18.358
took than the quality of the job.
00:17:18.439 --> 00:17:20.961
Now, a lot of people will say- No, no, no.
00:17:21.020 --> 00:17:21.641
I'm sorry.
00:17:21.681 --> 00:17:24.403
It was like missing dusty,
00:17:25.222 --> 00:17:26.284
dirty spots or whatever.
00:17:26.304 --> 00:17:27.525
So it was both.
00:17:27.605 --> 00:17:29.806
It was low quality and it took too long.
00:17:29.866 --> 00:17:31.788
So it's like, how did that happen?
00:17:32.833 --> 00:17:34.634
Yeah.
00:17:34.653 --> 00:17:36.654
Okay, let's pivot a little bit.
00:17:36.835 --> 00:17:37.996
You've shared a ton of
00:17:38.056 --> 00:17:38.936
information about
00:17:39.096 --> 00:17:40.938
recruitment and hiring and
00:17:41.077 --> 00:17:42.378
ads that you're running and
00:17:42.778 --> 00:17:43.980
how to bring in staff.
00:17:45.460 --> 00:17:48.102
I was listening to Dan Ariely.
00:17:48.342 --> 00:17:49.542
Are you familiar with him at all?
00:17:51.269 --> 00:17:51.788
Love him.
00:17:52.369 --> 00:17:54.211
What is he like a behavioral economics?
00:17:54.452 --> 00:17:56.194
Yeah, behavioral economics.
00:17:56.674 --> 00:17:57.476
At Duke or something.
00:17:57.496 --> 00:17:58.317
He's an author.
00:17:58.498 --> 00:17:59.219
Excellent books.
00:17:59.519 --> 00:18:01.060
Predictably Irrational is
00:18:01.741 --> 00:18:03.784
probably in my top five of
00:18:03.845 --> 00:18:04.885
like favorite books of all time.
00:18:05.358 --> 00:18:06.559
So the last time I shared
00:18:06.599 --> 00:18:07.840
some of his content,
00:18:08.301 --> 00:18:09.942
maybe it was Joey Rossi or
00:18:10.163 --> 00:18:12.105
somebody had shared he had
00:18:12.164 --> 00:18:14.527
some questionable research
00:18:14.686 --> 00:18:16.387
ethic violations and people
00:18:16.409 --> 00:18:17.548
were investigating him
00:18:17.589 --> 00:18:18.509
because maybe he didn't
00:18:18.529 --> 00:18:19.431
really carry out the
00:18:19.471 --> 00:18:20.652
research or his findings
00:18:20.731 --> 00:18:22.273
were manipulated.
00:18:22.453 --> 00:18:22.814
I don't know.
00:18:24.234 --> 00:18:25.596
I read those opinions.
00:18:25.856 --> 00:18:26.576
Nonetheless,
00:18:26.797 --> 00:18:28.239
the idea behind the
00:18:28.298 --> 00:18:30.319
information is still valuable.
00:18:30.339 --> 00:18:30.560
Right.
00:18:31.121 --> 00:18:34.443
So one of the, the like, fifteen year ago,
00:18:34.523 --> 00:18:37.046
YouTube Ted Talks was why
00:18:37.125 --> 00:18:39.468
we enjoy the work that we do.
00:18:40.087 --> 00:18:41.348
And it got me thinking about
00:18:41.568 --> 00:18:42.630
your situation.
00:18:43.411 --> 00:18:45.613
So I'm going to share my chat GPT.
00:18:47.233 --> 00:18:48.454
And what I did.
00:18:48.835 --> 00:18:49.836
Folks, you got to jump over.
00:18:49.915 --> 00:18:51.156
You got to jump over to the YouTube.
00:18:51.176 --> 00:18:52.758
Jump over to Learn Medicare
00:18:52.778 --> 00:18:54.159
Billing or PT podcast or
00:18:54.180 --> 00:18:55.279
the Dave Kittle show on YouTube.
00:18:55.319 --> 00:18:56.500
If you're listening right
00:18:56.520 --> 00:18:58.323
now on iTunes or Spotify or
00:18:58.403 --> 00:18:59.644
LinkedIn or wherever you're watching.
00:19:00.252 --> 00:19:00.593
Yeah.
00:19:00.633 --> 00:19:02.233
So if you guys don't already do this,
00:19:02.273 --> 00:19:03.575
this is a cool little hack,
00:19:03.875 --> 00:19:05.455
but then we'll get into the main content.
00:19:05.836 --> 00:19:06.957
Let me get up here at the top.
00:19:07.278 --> 00:19:07.938
So basically,
00:19:08.939 --> 00:19:10.819
let's say you hear a YouTube
00:19:11.420 --> 00:19:12.540
interview and you're like, yeah,
00:19:12.560 --> 00:19:13.221
I love that idea.
00:19:13.261 --> 00:19:14.422
How can I apply that idea to
00:19:14.461 --> 00:19:15.242
physical therapy?
00:19:15.942 --> 00:19:17.324
So I put in a simple prompt.
00:19:17.423 --> 00:19:18.065
I just say, hey,
00:19:18.105 --> 00:19:19.486
Dan Ariely talks about the
00:19:19.506 --> 00:19:21.186
importance of meaningful work.
00:19:21.686 --> 00:19:24.367
This is coming from a TED Talk transcript.
00:19:24.807 --> 00:19:26.288
I want you to process this
00:19:26.388 --> 00:19:27.548
and then tell me how this
00:19:27.608 --> 00:19:28.949
applies to the physical
00:19:28.989 --> 00:19:30.210
therapy private practice.
00:19:30.890 --> 00:19:32.790
And on YouTube, you can copy and paste,
00:19:32.830 --> 00:19:33.951
if you're on a desktop,
00:19:34.431 --> 00:19:36.592
the full transcript of the interview.
00:19:37.451 --> 00:19:40.655
So I put it in and then chat GPT, you know,
00:19:40.715 --> 00:19:42.959
says, OK, here's the framework,
00:19:43.140 --> 00:19:45.281
the meaningful work magnet.
00:19:45.962 --> 00:19:46.483
The goal,
00:19:46.503 --> 00:19:48.465
create a job ad that's emotion
00:19:48.567 --> 00:19:49.748
that emotionally resonates
00:19:49.768 --> 00:19:51.269
with clinicians who crave
00:19:51.349 --> 00:19:52.551
more than just a paycheck.
00:19:53.132 --> 00:19:55.174
Therapists want their work to matter.
00:19:56.076 --> 00:19:57.977
And I'll just give you the headlines,
00:19:57.997 --> 00:20:00.398
you know, stop, start with the mission,
00:20:00.679 --> 00:20:01.440
not the money.
00:20:01.680 --> 00:20:02.700
So instead of saying we're
00:20:02.880 --> 00:20:05.402
hiring five thousand dollar sign on bonus,
00:20:05.442 --> 00:20:06.482
which we see everywhere,
00:20:07.022 --> 00:20:08.104
start with something like
00:20:08.183 --> 00:20:09.825
your work should mean something.
00:20:10.085 --> 00:20:12.727
Ours does every visit, every patient,
00:20:12.846 --> 00:20:13.988
every life we touch.
00:20:14.708 --> 00:20:16.348
And I was thinking about you
00:20:16.388 --> 00:20:17.609
because one of your main
00:20:17.730 --> 00:20:19.431
ads is talking about how
00:20:19.490 --> 00:20:21.251
much a therapist could make
00:20:21.751 --> 00:20:23.634
relative to how few visits
00:20:23.673 --> 00:20:25.054
they need to do to make that money.
00:20:25.074 --> 00:20:28.836
But anyway, tell a micro story of impact,
00:20:28.997 --> 00:20:31.438
acknowledge the trade-off transparently.
00:20:31.979 --> 00:20:32.618
I do that.
00:20:33.159 --> 00:20:33.900
I'm like, look, guys,
00:20:33.920 --> 00:20:34.840
you're not going to make as
00:20:34.901 --> 00:20:36.040
much money working for me
00:20:36.080 --> 00:20:37.241
as you would make working
00:20:37.422 --> 00:20:39.784
in home health or a skilled nursing.
00:20:40.443 --> 00:20:41.724
But it's because...
00:20:42.305 --> 00:20:45.128
The difference in the population we treat,
00:20:45.388 --> 00:20:47.371
you know, nothing will burn you out,
00:20:47.411 --> 00:20:48.051
chew you up,
00:20:48.112 --> 00:20:50.474
spit you out more than seeing
00:20:50.515 --> 00:20:52.156
the same person in a
00:20:52.196 --> 00:20:54.159
different body every single
00:20:54.199 --> 00:20:55.540
day and knowing that you're
00:20:55.601 --> 00:20:56.981
not really helping anybody.
00:20:57.563 --> 00:20:57.803
You know,
00:20:57.823 --> 00:21:00.984
somebody shared a post about a I
00:21:01.025 --> 00:21:02.125
don't know if this is the right word,
00:21:02.165 --> 00:21:04.208
a catatonic person on
00:21:04.268 --> 00:21:06.469
hospice who a physical
00:21:06.489 --> 00:21:08.691
therapist is supposed to be helping.
00:21:08.750 --> 00:21:10.551
Like there's just there's no
00:21:10.612 --> 00:21:12.153
meaning in that kind of work.
00:21:12.173 --> 00:21:14.474
A lot of times describe the
00:21:14.494 --> 00:21:16.715
challenge as a source of pride.
00:21:17.135 --> 00:21:17.376
Right.
00:21:17.436 --> 00:21:18.596
Why do we climb a mountain?
00:21:18.636 --> 00:21:20.999
Because it feels good to get to the top,
00:21:21.078 --> 00:21:21.940
even though it's hard.
00:21:22.826 --> 00:21:24.647
Give them ownership language,
00:21:25.269 --> 00:21:26.609
not ownership equity,
00:21:26.710 --> 00:21:28.310
just ownership language.
00:21:29.632 --> 00:21:32.093
Show that their work will be seen.
00:21:32.354 --> 00:21:34.855
Use emotional, resonant call to action.
00:21:34.994 --> 00:21:36.576
And then it gives a little sample ad.
00:21:37.257 --> 00:21:37.997
So first,
00:21:38.057 --> 00:21:39.999
what are some of your thoughts on this?
00:21:41.548 --> 00:21:42.990
Just a joke because I burst
00:21:43.049 --> 00:21:43.630
out in laughter.
00:21:44.210 --> 00:21:45.230
Give them ownership.
00:21:45.750 --> 00:21:46.711
Not of equity, though.
00:21:46.770 --> 00:21:47.510
Definitely not.
00:21:47.530 --> 00:21:49.411
That's so funny.
00:21:49.531 --> 00:21:51.392
It's the feeling of ownership,
00:21:51.412 --> 00:21:52.672
not actual ownership.
00:21:52.772 --> 00:21:55.073
Hey, I need to do better at that, man.
00:21:55.212 --> 00:21:57.673
If I can best or better
00:21:57.713 --> 00:22:00.615
convey the staff role
00:22:01.194 --> 00:22:02.895
that they get to take ownership of.
00:22:02.955 --> 00:22:03.215
Well, I,
00:22:03.316 --> 00:22:04.955
and my therapist somewhat do like
00:22:04.976 --> 00:22:06.576
they get to make their own schedule.
00:22:06.596 --> 00:22:07.376
They get to,
00:22:08.198 --> 00:22:08.938
they get to make like what
00:22:08.958 --> 00:22:11.019
time they're going to start and end, uh,
00:22:11.038 --> 00:22:11.499
per day.
00:22:12.199 --> 00:22:13.720
They get to fit in people, you know,
00:22:13.740 --> 00:22:14.680
clients, whatever they want,
00:22:14.960 --> 00:22:16.681
they can work weekends or not.
00:22:17.300 --> 00:22:17.580
Um,
00:22:17.921 --> 00:22:18.060
I mean,
00:22:18.141 --> 00:22:19.301
I have one therapist that's
00:22:19.383 --> 00:22:20.564
averaging like two point
00:22:20.844 --> 00:22:22.305
eight patients per day and
00:22:22.325 --> 00:22:24.247
he's making just two point eight.
00:22:24.267 --> 00:22:24.667
Now, of course,
00:22:24.807 --> 00:22:25.548
I know you got to travel in
00:22:25.588 --> 00:22:27.390
between the patients and all that.
00:22:27.410 --> 00:22:28.250
And you got to travel to the
00:22:28.270 --> 00:22:28.731
first patient.
00:22:28.751 --> 00:22:30.073
You got to travel to home
00:22:30.093 --> 00:22:30.834
from the last patient.
00:22:30.874 --> 00:22:32.375
So sometimes it might come
00:22:32.414 --> 00:22:35.097
out to like a more of a workday,
00:22:35.117 --> 00:22:37.440
but two point eight patients on average.
00:22:38.040 --> 00:22:39.362
And they're making like.
00:22:40.143 --> 00:22:41.443
They're on pace for like
00:22:41.483 --> 00:22:43.666
ninety K by treating two
00:22:43.707 --> 00:22:44.807
point eight patients per day.
00:22:44.968 --> 00:22:45.729
So it's pretty good deal.
00:22:46.088 --> 00:22:48.330
But I need to give them ownership of.
00:22:49.071 --> 00:22:50.133
Yeah, like like I don't know,
00:22:50.252 --> 00:22:51.173
like more of the is that
00:22:51.193 --> 00:22:52.295
like the touchy feely stuff?
00:22:52.315 --> 00:22:52.955
Would you say, Tony,
00:22:52.976 --> 00:22:55.337
like more ownership around that or what?
00:22:55.801 --> 00:22:56.082
Yeah.
00:22:56.462 --> 00:22:57.323
Own your schedule.
00:22:57.643 --> 00:22:59.404
You know, you, you have control.
00:23:00.005 --> 00:23:00.465
Autonomy.
00:23:00.586 --> 00:23:00.945
Yeah.
00:23:01.006 --> 00:23:01.926
Who you can treat,
00:23:02.007 --> 00:23:03.327
how you want to treat them.
00:23:03.387 --> 00:23:05.429
Like we all went to school
00:23:05.489 --> 00:23:06.910
to be professionals.
00:23:07.371 --> 00:23:08.270
I want to come into a
00:23:08.330 --> 00:23:10.212
position where I'm a professional.
00:23:10.813 --> 00:23:12.375
I think too many of us as
00:23:12.454 --> 00:23:14.476
business owners think, well,
00:23:14.516 --> 00:23:16.557
they want equity in the business.
00:23:16.698 --> 00:23:17.679
I don't think they want it.
00:23:17.759 --> 00:23:18.519
I don't think they care.
00:23:18.959 --> 00:23:20.500
Even me as an example of,
00:23:21.221 --> 00:23:22.480
I wouldn't want to come in
00:23:22.641 --> 00:23:23.942
as an equity partner
00:23:24.001 --> 00:23:25.382
because I don't want the
00:23:25.402 --> 00:23:27.762
liability associated with your problems,
00:23:28.083 --> 00:23:29.742
your baggage, you know,
00:23:29.843 --> 00:23:31.462
and we are as a profession
00:23:31.542 --> 00:23:32.923
so risk averse.
00:23:33.604 --> 00:23:34.784
I think of a therapist.
00:23:35.124 --> 00:23:36.085
It thinks that they're on
00:23:36.125 --> 00:23:37.505
the hook for mistakes that
00:23:37.565 --> 00:23:40.526
the bigger entity makes
00:23:40.945 --> 00:23:41.786
that freaks them out.
00:23:42.425 --> 00:23:44.907
So it's like as business owners, we think,
00:23:45.028 --> 00:23:47.390
oh, they want ownership in that respect.
00:23:47.490 --> 00:23:48.210
I don't think they do.
00:23:48.330 --> 00:23:49.351
I think they just they want
00:23:49.391 --> 00:23:50.832
the independency, autonomy.
00:23:51.252 --> 00:23:52.334
They want to feel good about
00:23:52.374 --> 00:23:53.453
the work that they're doing.
00:23:53.634 --> 00:23:55.476
And yours is a great example.
00:23:55.976 --> 00:23:57.738
Like you are working with a
00:23:57.778 --> 00:23:59.959
clientele that you can make
00:24:00.098 --> 00:24:01.319
real impact with.
00:24:01.740 --> 00:24:03.221
You can change that person's
00:24:03.281 --> 00:24:04.542
life fundamentally.
00:24:04.583 --> 00:24:05.743
You can keep them in their
00:24:05.784 --> 00:24:07.325
home or their apartment longer.
00:24:07.384 --> 00:24:08.685
You can improve their
00:24:08.726 --> 00:24:10.807
quality of life versus others.
00:24:11.815 --> 00:24:12.875
some of the other places
00:24:12.895 --> 00:24:17.259
that it's just that treadmill of CPT code,
00:24:17.298 --> 00:24:18.920
CPT code, CPT code.
00:24:19.240 --> 00:24:20.780
Nobody is going to get better anyway.
00:24:21.101 --> 00:24:22.041
If they do get better,
00:24:22.102 --> 00:24:22.541
you're going to get
00:24:22.602 --> 00:24:23.583
penalized because they're
00:24:23.603 --> 00:24:25.144
going to want to discharge early.
00:24:26.065 --> 00:24:28.266
The conventional system is
00:24:28.365 --> 00:24:32.548
designed to reward the most
00:24:32.709 --> 00:24:35.171
basic mediocre outcome.
00:24:35.931 --> 00:24:37.031
Don't get better quicker.
00:24:37.432 --> 00:24:38.833
Don't invest in innovation.
00:24:39.252 --> 00:24:40.874
Don't improve your education.
00:24:41.674 --> 00:24:42.855
That is what the system
00:24:42.894 --> 00:24:45.196
right now is designed to encourage.
00:24:45.737 --> 00:24:46.478
And so, yeah,
00:24:46.518 --> 00:24:48.298
you give them the opportunity
00:24:48.358 --> 00:24:50.720
to step out of that negative cycle.
00:24:51.280 --> 00:24:53.961
And I do think like those
00:24:54.021 --> 00:24:58.404
emotional triggers resonate deeply.
00:24:58.484 --> 00:24:59.365
Anything else for this topic
00:24:59.385 --> 00:25:00.046
or you want to move on?
00:25:00.605 --> 00:25:01.346
No, we can move on.
00:25:03.541 --> 00:25:04.563
I sent you a link for
00:25:04.623 --> 00:25:07.444
Instagram in Facebook Messenger,
00:25:07.545 --> 00:25:08.787
unless you have some other topics.
00:25:08.866 --> 00:25:10.847
I know Jimmy's not here,
00:25:10.867 --> 00:25:11.888
but we were joking last
00:25:11.949 --> 00:25:14.411
week that I know you were at your DC,
00:25:15.132 --> 00:25:16.993
your son's class trip,
00:25:17.334 --> 00:25:18.214
but you sent us a picture.
00:25:18.394 --> 00:25:19.435
I don't have it right now,
00:25:19.796 --> 00:25:21.436
but it did look like you
00:25:21.457 --> 00:25:22.097
were at the Vatican.
00:25:23.018 --> 00:25:23.397
Jimmy,
00:25:24.499 --> 00:25:25.499
he'll mention this the next time he
00:25:25.519 --> 00:25:25.959
comes back,
00:25:25.979 --> 00:25:27.480
but we had a good laugh as if
00:25:27.920 --> 00:25:29.700
you were at the Vatican and
00:25:29.720 --> 00:25:30.520
that you were actually
00:25:30.580 --> 00:25:32.320
becoming the next Pope.
00:25:32.520 --> 00:25:34.122
And you know what?
00:25:34.402 --> 00:25:35.281
You and the new Pope,
00:25:35.622 --> 00:25:36.942
you don't look that different.
00:25:37.202 --> 00:25:39.463
You got the same haircut and
00:25:39.723 --> 00:25:40.903
there's some similarities there.
00:25:40.943 --> 00:25:41.763
So we had a good laugh.
00:25:41.784 --> 00:25:42.884
All right,
00:25:42.944 --> 00:25:44.525
let me see if I can get this one
00:25:44.644 --> 00:25:45.685
up on the screen.
00:25:48.046 --> 00:25:49.666
Tell me what's going on with this.
00:25:49.707 --> 00:25:50.227
Okay.
00:25:50.583 --> 00:25:50.883
Okay.
00:25:50.903 --> 00:25:51.304
All right.
00:25:51.324 --> 00:25:53.525
So Jimmy McKay is not here.
00:25:53.625 --> 00:25:54.405
He's got an awesome new
00:25:54.486 --> 00:25:55.346
segment here on the show
00:25:55.405 --> 00:25:56.807
called steal the strategy.
00:25:57.288 --> 00:25:57.587
Jimmy,
00:25:57.827 --> 00:25:59.910
I hope I don't want to steal your
00:25:59.930 --> 00:26:00.769
strategy because you're not here.
00:26:00.789 --> 00:26:02.230
I just want to highlight this.
00:26:02.431 --> 00:26:03.652
I came up with this.
00:26:03.992 --> 00:26:05.394
I came across this guy's
00:26:05.453 --> 00:26:06.394
Instagram a couple of weeks ago,
00:26:06.433 --> 00:26:07.095
maybe a month ago.
00:26:07.394 --> 00:26:09.455
He had like fifteen thousand followers.
00:26:09.516 --> 00:26:10.416
Now he's got, I don't know,
00:26:10.436 --> 00:26:12.157
like twenty or thirty thousand followers.
00:26:12.499 --> 00:26:13.538
Thirty eight thousand.
00:26:13.778 --> 00:26:14.059
Thirty.
00:26:14.279 --> 00:26:15.240
This guy is.
00:26:16.181 --> 00:26:17.221
it's kind of weird he's
00:26:17.381 --> 00:26:19.142
adding like five thousand
00:26:19.182 --> 00:26:21.422
followers per week here's
00:26:21.481 --> 00:26:23.261
this so this guy does a
00:26:23.321 --> 00:26:24.803
joke right he he holds up
00:26:24.843 --> 00:26:26.022
his phone it's him and his
00:26:26.063 --> 00:26:27.863
wife shopping at walmart or
00:26:27.942 --> 00:26:28.962
they're getting pedicures
00:26:29.002 --> 00:26:30.743
at the nail salon wherever
00:26:30.784 --> 00:26:31.584
they're at at a restaurant
00:26:31.604 --> 00:26:32.624
nice restaurant he holds up
00:26:32.644 --> 00:26:33.864
his phone and he goes what
00:26:33.903 --> 00:26:35.684
up gang hey what's going on
00:26:35.744 --> 00:26:37.045
I'm here with tina we're
00:26:37.105 --> 00:26:37.944
checking out the deals
00:26:37.984 --> 00:26:39.625
today at walmart so he acts
00:26:39.644 --> 00:26:41.965
like a fake social media influencer
00:26:42.526 --> 00:26:44.247
And obviously his wife gets embarrassed.
00:26:44.267 --> 00:26:44.467
So like,
00:26:44.487 --> 00:26:46.086
that's the funny part is she gets like,
00:26:46.307 --> 00:26:46.988
she's like, no.
00:26:47.067 --> 00:26:48.347
And like, she like runs away.
00:26:48.667 --> 00:26:49.749
And then you could see like, yeah,
00:26:49.769 --> 00:26:50.588
like there, right there,
00:26:50.868 --> 00:26:53.329
that clip of him at the nail salon.
00:26:53.450 --> 00:26:55.190
And like the wife puts her
00:26:55.230 --> 00:26:56.131
hand in front of her face
00:26:56.171 --> 00:26:57.230
and all the women that are,
00:26:57.631 --> 00:26:58.352
that are working there,
00:26:58.612 --> 00:26:59.872
all the women that are in the nail salon,
00:26:59.892 --> 00:27:01.113
they're all covering their face.
00:27:01.772 --> 00:27:02.232
It's funny.
00:27:02.333 --> 00:27:02.732
It's funny.
00:27:03.032 --> 00:27:03.653
Here's the thing.
00:27:04.273 --> 00:27:05.693
This guy owns one or two
00:27:05.733 --> 00:27:07.375
different restaurants in Chicago.
00:27:07.934 --> 00:27:10.496
He links to the, the, uh,
00:27:11.597 --> 00:27:13.138
the restaurant on his profile.
00:27:13.179 --> 00:27:15.161
And I think the, the URL in the Instagram,
00:27:15.401 --> 00:27:18.383
the entire Instagram is a joke.
00:27:18.762 --> 00:27:20.003
He does, he just does jokes.
00:27:20.064 --> 00:27:21.766
He just, he just is a funny guy.
00:27:21.826 --> 00:27:23.067
He likes to do jokes.
00:27:23.326 --> 00:27:26.209
He goes up to the Starbucks line and he,
00:27:26.608 --> 00:27:26.828
you know,
00:27:27.250 --> 00:27:28.411
he does fake voices from
00:27:28.490 --> 00:27:29.290
different movies.
00:27:29.330 --> 00:27:30.392
Like when he goes up to the
00:27:30.412 --> 00:27:31.472
Starbucks line in the
00:27:31.492 --> 00:27:32.894
drive-through and he's like, you know,
00:27:32.973 --> 00:27:34.894
yeah, can I get a, can I get a large,
00:27:35.095 --> 00:27:35.336
you know,
00:27:35.855 --> 00:27:37.718
can I get a medium pike in a
00:27:37.837 --> 00:27:38.818
large venti cup?
00:27:39.259 --> 00:27:40.140
And then they asked for his
00:27:40.200 --> 00:27:41.461
name and he does like, you know,
00:27:41.520 --> 00:27:42.883
like an Al Pacino voice or
00:27:42.903 --> 00:27:45.525
he just does stupid, like, right.
00:27:45.545 --> 00:27:47.426
The point of sharing this is
00:27:47.467 --> 00:27:49.128
that he's adding like five
00:27:49.169 --> 00:27:51.130
thousand followers per week.
00:27:51.170 --> 00:27:51.611
Now, of course,
00:27:52.131 --> 00:27:53.752
many of them are not in the Chicago area,
00:27:53.833 --> 00:27:56.315
but he's got Johnny's
00:27:56.355 --> 00:27:58.136
heroes and subs or whatever
00:27:58.176 --> 00:27:59.878
his like restaurant is.
00:28:01.683 --> 00:28:02.905
And he's getting more
00:28:03.006 --> 00:28:06.030
eyeballs for his restaurant
00:28:06.732 --> 00:28:08.335
that is linked here in his bio.
00:28:09.156 --> 00:28:11.539
None of his posts are about the restaurant,
00:28:11.681 --> 00:28:12.762
about his business.
00:28:14.517 --> 00:28:16.398
And so that was part that was part one.
00:28:16.459 --> 00:28:17.619
And then part two was one of
00:28:17.640 --> 00:28:18.881
the recent posts while I
00:28:18.901 --> 00:28:20.682
was following him is he was
00:28:20.702 --> 00:28:22.884
featured on the news in Chicago.
00:28:23.464 --> 00:28:26.188
And then the news anchor is mentioning,
00:28:26.208 --> 00:28:26.607
you know, oh,
00:28:26.728 --> 00:28:29.250
Johnny Anastopoulos has this
00:28:29.290 --> 00:28:31.051
funny Instagram account and
00:28:31.092 --> 00:28:32.673
he's the owner of whatever it is,
00:28:32.693 --> 00:28:33.575
whatever the restaurant is.
00:28:34.576 --> 00:28:35.236
We don't we don't know.
00:28:35.276 --> 00:28:37.878
Johnny's beef, Johnny's gyros.
00:28:38.898 --> 00:28:41.619
Beef and Gyros in, you know, Lincoln Park,
00:28:42.480 --> 00:28:43.661
Chicago or whatever it is.
00:28:44.240 --> 00:28:45.701
So the local news anchors
00:28:46.201 --> 00:28:47.741
have featured him and his
00:28:47.801 --> 00:28:49.521
Instagram account a couple times,
00:28:49.862 --> 00:28:53.202
which then gets more exposure locally.
00:28:54.163 --> 00:28:56.324
And they even had him in the news,
00:28:56.364 --> 00:28:57.463
like a week or two ago,
00:28:57.564 --> 00:28:58.164
they brought him and
00:28:58.184 --> 00:28:59.085
invited him and his wife
00:28:59.184 --> 00:29:00.565
into the news station.
00:29:00.944 --> 00:29:02.746
And he was like on the live news.
00:29:03.430 --> 00:29:03.869
Yeah.
00:29:04.069 --> 00:29:04.349
Okay.
00:29:04.369 --> 00:29:05.611
This was, this is long winded.
00:29:05.651 --> 00:29:06.550
I'm going to cut to the chase.
00:29:06.951 --> 00:29:07.750
The question for Tony
00:29:07.770 --> 00:29:09.912
Meritato is could physical
00:29:09.951 --> 00:29:11.071
therapists steal the strategy?
00:29:11.112 --> 00:29:11.873
Could private practice
00:29:11.913 --> 00:29:12.873
owners steal the strategy
00:29:12.932 --> 00:29:13.732
where they make a,
00:29:14.113 --> 00:29:15.153
whether it's a personal account,
00:29:15.513 --> 00:29:16.574
a different account, whatever.
00:29:17.094 --> 00:29:17.354
And they,
00:29:17.714 --> 00:29:19.295
you do an amazing strategy of
00:29:19.355 --> 00:29:20.414
video inside your clinic.
00:29:20.835 --> 00:29:21.736
And maybe some therapists
00:29:21.756 --> 00:29:22.675
don't want to do that or
00:29:22.695 --> 00:29:23.915
they can't do it or they're
00:29:23.935 --> 00:29:24.777
afraid to do it or whatever.
00:29:25.997 --> 00:29:27.096
You also have to be kind of
00:29:27.357 --> 00:29:28.438
outgoing to even do this.
00:29:28.478 --> 00:29:29.698
I think to do like the selfie video,
00:29:29.718 --> 00:29:30.479
the way he's doing it,
00:29:30.499 --> 00:29:31.679
but maybe there's other ways to do it.
00:29:32.741 --> 00:29:34.202
Could or should physical
00:29:34.242 --> 00:29:35.182
therapy practice owners
00:29:35.243 --> 00:29:36.304
steal this strategy,
00:29:36.865 --> 00:29:37.585
create kind of like a
00:29:37.664 --> 00:29:41.386
humorous account that they capture funny,
00:29:41.727 --> 00:29:42.127
stupid,
00:29:42.188 --> 00:29:43.989
laughable things in their local area,
00:29:45.215 --> 00:29:45.936
then just link to their
00:29:45.957 --> 00:29:47.659
physical therapy profile at
00:29:47.679 --> 00:29:49.961
the top of the profile.
00:29:50.362 --> 00:29:51.784
But all the content has
00:29:51.903 --> 00:29:53.526
nothing to do with the actual business.
00:29:53.546 --> 00:29:54.125
What are your thoughts?
00:29:54.227 --> 00:29:55.268
Good, bad, indifferent?
00:29:55.768 --> 00:29:56.769
Yes, a hundred percent.
00:29:56.829 --> 00:29:57.631
Yes, you can do it.
00:29:57.671 --> 00:29:58.551
Yes, you should do it.
00:29:59.132 --> 00:30:00.253
What I think is interesting
00:30:00.294 --> 00:30:01.915
about that scenario though,
00:30:02.096 --> 00:30:03.416
and I don't know anything
00:30:03.597 --> 00:30:05.159
besides what you just shared,
00:30:05.720 --> 00:30:07.221
His personal profile on
00:30:07.301 --> 00:30:08.403
Instagram has thirty eight
00:30:08.423 --> 00:30:09.523
thousand followers.
00:30:09.604 --> 00:30:11.365
His business profile only
00:30:11.526 --> 00:30:14.028
has like thirty six hundred followers.
00:30:15.449 --> 00:30:17.471
The personal and that's what I do.
00:30:17.510 --> 00:30:17.771
You know,
00:30:17.832 --> 00:30:20.013
I grow my personal way more than
00:30:20.094 --> 00:30:23.656
I grow like branded business profiles.
00:30:25.474 --> 00:30:26.855
But the whole idea here is
00:30:27.476 --> 00:30:29.978
looking past just is this
00:30:30.018 --> 00:30:31.199
going to put more patients
00:30:31.338 --> 00:30:33.420
in my my physical therapy clinic?
00:30:33.460 --> 00:30:35.721
Because with a thirty eight
00:30:35.741 --> 00:30:37.323
thousand follower account,
00:30:37.702 --> 00:30:39.944
he can move into true influencing.
00:30:40.005 --> 00:30:41.246
He can get brand deals.
00:30:41.286 --> 00:30:42.767
He can do product endorsements.
00:30:42.807 --> 00:30:45.147
He can do so much more with that account,
00:30:45.709 --> 00:30:47.009
even if he never sells an
00:30:47.069 --> 00:30:48.471
extra sandwich because of it.
00:30:49.030 --> 00:30:50.431
So there's huge value in
00:30:50.471 --> 00:30:51.511
capturing attention.
00:30:51.751 --> 00:30:52.531
We know we're in an
00:30:52.731 --> 00:30:54.393
attention based economy.
00:30:55.512 --> 00:30:57.452
I still get pretty much two
00:30:57.472 --> 00:30:59.614
to three emails a week of
00:30:59.713 --> 00:31:00.973
product companies that want
00:31:01.013 --> 00:31:02.214
me to do videos and
00:31:02.275 --> 00:31:03.335
endorsements for them.
00:31:04.035 --> 00:31:05.036
I don't have to do them for
00:31:05.076 --> 00:31:06.076
free anymore unless I
00:31:06.256 --> 00:31:07.576
really want the product and
00:31:07.615 --> 00:31:08.596
it's a high ticket product.
00:31:10.509 --> 00:31:15.133
But a therapist who wants to build a brand,
00:31:15.153 --> 00:31:17.536
a personal brand, absolutely,
00:31:17.576 --> 00:31:18.896
this is a great strategy.
00:31:19.317 --> 00:31:20.538
And if you want to monetize
00:31:20.577 --> 00:31:21.638
that with patient care,
00:31:21.659 --> 00:31:22.720
you probably could.
00:31:23.080 --> 00:31:24.241
You could put out a product
00:31:24.301 --> 00:31:26.703
like Kelly Starrett has
00:31:26.864 --> 00:31:28.766
digital products for people
00:31:28.806 --> 00:31:31.008
that have physical conditions.
00:31:31.048 --> 00:31:31.949
He's never going to treat
00:31:31.969 --> 00:31:33.589
them as a physical therapy patient,
00:31:33.630 --> 00:31:34.912
but he sells these products.
00:31:35.531 --> 00:31:37.153
You could do product endorsements like,
00:31:37.433 --> 00:31:39.215
man, there's just so much you can do.
00:31:39.936 --> 00:31:41.999
And you don't have to be outgoing.
00:31:42.159 --> 00:31:43.319
Like, that's the funniest part.
00:31:43.759 --> 00:31:46.123
I hate I am an introvert
00:31:46.163 --> 00:31:46.863
through and through.
00:31:47.443 --> 00:31:48.704
I hate socializing.
00:31:48.885 --> 00:31:50.307
I love being silent.
00:31:50.426 --> 00:31:51.848
I love being by myself.
00:31:52.409 --> 00:31:54.009
But if I'm in front of the
00:31:54.049 --> 00:31:55.829
camera and I've got a job to do,
00:31:56.009 --> 00:31:57.070
I will do the job.
00:31:57.550 --> 00:31:57.891
You know,
00:31:57.931 --> 00:31:59.571
it's it's a different and I hear
00:31:59.612 --> 00:32:02.032
this a lot from a lot of influencers.
00:32:02.212 --> 00:32:03.932
It's like a switch that flips.
00:32:04.473 --> 00:32:06.973
You're a different person on
00:32:07.034 --> 00:32:09.035
camera than you are off camera.
00:32:10.135 --> 00:32:11.796
So it's something that we
00:32:11.875 --> 00:32:13.497
should be building for all of us.
00:32:15.171 --> 00:32:16.050
And we'll have to get
00:32:16.070 --> 00:32:17.551
Jimmy's feedback on this
00:32:17.571 --> 00:32:18.373
because I did want to share
00:32:18.393 --> 00:32:20.173
this at a time when both of
00:32:20.273 --> 00:32:21.294
you were here on the show.
00:32:21.334 --> 00:32:22.875
But yeah,
00:32:22.934 --> 00:32:24.615
so that's why I wanted to show it.
00:32:25.496 --> 00:32:25.836
Hopefully,
00:32:25.855 --> 00:32:27.217
Jimmy doesn't get upset that I'm
00:32:27.297 --> 00:32:29.137
stealing his segment on
00:32:29.238 --> 00:32:30.679
steal this strategy.
00:32:30.759 --> 00:32:32.079
I think his segment was
00:32:32.099 --> 00:32:32.759
steal the strategy.
00:32:32.819 --> 00:32:35.020
So I just wanted to share that.
00:32:35.080 --> 00:32:35.441
And you're right.
00:32:35.882 --> 00:32:36.122
Also,
00:32:37.021 --> 00:32:38.123
people want to follow more of the
00:32:38.143 --> 00:32:38.742
personal accounts.
00:32:38.762 --> 00:32:39.423
They don't want to follow
00:32:39.462 --> 00:32:40.824
like corporate and business accounts.
00:32:40.864 --> 00:32:41.023
Right.
00:32:41.044 --> 00:32:41.344
So that's,
00:32:41.544 --> 00:32:43.324
that's another reason why his
00:32:43.423 --> 00:32:45.365
personal one also it's, it's funny,
00:32:45.704 --> 00:32:45.825
right?
00:32:45.845 --> 00:32:46.845
Like it's, it's funny.
00:32:46.904 --> 00:32:47.506
Like you don't know what's
00:32:47.526 --> 00:32:48.046
going to happen.
00:32:48.086 --> 00:32:49.566
So you watch more and then
00:32:49.586 --> 00:32:50.346
you're more likely to like
00:32:50.365 --> 00:32:51.527
watch a second and a third video.
00:32:51.567 --> 00:32:52.326
Cause you don't know,
00:32:52.646 --> 00:32:53.606
like when he drives up to
00:32:53.646 --> 00:32:55.188
the drive-through at Starbucks or he,
00:32:55.708 --> 00:32:57.749
he walked into Starbucks and he ordered,
00:32:58.328 --> 00:32:58.489
um,
00:32:59.469 --> 00:33:01.029
With some Brad Pitt
00:33:01.069 --> 00:33:02.690
character from some movie, you know,
00:33:03.690 --> 00:33:05.050
any any order with the
00:33:05.070 --> 00:33:05.951
character's name and the
00:33:06.030 --> 00:33:06.770
accent or whatever.
00:33:07.192 --> 00:33:08.372
So you don't know what he's going to do.
00:33:08.491 --> 00:33:08.771
But yeah,
00:33:08.811 --> 00:33:09.751
more people want to follow the
00:33:09.791 --> 00:33:10.853
personal accounts and they
00:33:10.873 --> 00:33:12.512
don't want to follow like the corporate,
00:33:12.873 --> 00:33:13.854
you know, business accounts.
00:33:13.894 --> 00:33:15.673
And I guess, you know, I guess that's OK.
00:33:15.693 --> 00:33:16.615
That's just the way the
00:33:16.835 --> 00:33:17.694
attention economy is.
00:33:18.604 --> 00:33:19.064
There is a,
00:33:19.864 --> 00:33:21.765
I can't say the name because Jim,
00:33:21.785 --> 00:33:23.244
Jimmy's doing this interview.
00:33:23.305 --> 00:33:24.125
I don't know if he's done it
00:33:24.164 --> 00:33:25.566
already or it's on the books.
00:33:26.086 --> 00:33:28.266
It's part of the PT pint cast series,
00:33:28.846 --> 00:33:31.207
but I think this is a,
00:33:31.666 --> 00:33:32.307
it's a home health
00:33:32.346 --> 00:33:35.208
therapist who's doing funny videos.
00:33:35.647 --> 00:33:37.067
He is on par.
00:33:37.489 --> 00:33:38.628
He's on par with
00:33:39.449 --> 00:33:41.050
So medical doctors that are
00:33:41.131 --> 00:33:42.771
out there that have, you know,
00:33:42.892 --> 00:33:44.333
million subscriber accounts.
00:33:44.374 --> 00:33:44.614
Like,
00:33:44.854 --> 00:33:46.515
I think it's just a matter of time
00:33:46.535 --> 00:33:48.237
before this account blows up.
00:33:48.396 --> 00:33:49.978
If he doesn't quit before he
00:33:49.998 --> 00:33:52.019
hits that inflection point.
00:33:53.080 --> 00:33:53.701
He is awesome.
00:33:53.801 --> 00:33:54.722
I can't wait for that,
00:33:54.843 --> 00:33:57.484
that interview to go live and go public.
00:33:57.505 --> 00:33:58.144
And so.
00:34:00.181 --> 00:34:01.162
I wanted to talk about
00:34:01.682 --> 00:34:02.923
pivoting just a little bit.
00:34:03.784 --> 00:34:05.785
I shared a post that gains
00:34:05.845 --> 00:34:07.546
traction is gaining traction.
00:34:08.427 --> 00:34:09.867
You're not in this world,
00:34:10.288 --> 00:34:11.829
but in case you didn't know,
00:34:12.128 --> 00:34:14.911
so as a Medicare contractor provider,
00:34:15.291 --> 00:34:17.231
when I treat a Medicare beneficiary,
00:34:17.873 --> 00:34:20.753
my plan of care has to be certified.
00:34:20.793 --> 00:34:23.115
That means signed by the
00:34:23.175 --> 00:34:25.476
physician or non-physician practitioner.
00:34:25.516 --> 00:34:26.918
So it could be a physician assistant.
00:34:26.958 --> 00:34:28.159
It could be a nurse practitioner.
00:34:28.179 --> 00:34:29.420
There's a couple other options.
00:34:30.179 --> 00:34:32.161
providers who can certify a plan of care.
00:34:33.081 --> 00:34:34.360
In two thousand twenty five,
00:34:34.942 --> 00:34:37.282
Congress or whoever updated
00:34:37.342 --> 00:34:39.103
the laws made some changes
00:34:39.143 --> 00:34:41.603
that said as long as I have
00:34:41.643 --> 00:34:44.443
a referral and I have proof
00:34:44.603 --> 00:34:46.164
that I sent the plan of
00:34:46.224 --> 00:34:47.465
care for signature,
00:34:48.204 --> 00:34:49.826
I don't need a signature on
00:34:49.846 --> 00:34:51.485
the initial plan of care.
00:34:51.606 --> 00:34:53.226
But if I extend the plan of care,
00:34:53.266 --> 00:34:55.007
change the plan of care, do anything,
00:34:55.487 --> 00:34:56.847
then I do need a signature.
00:34:59.246 --> 00:35:02.068
I can't believe the comments
00:35:02.088 --> 00:35:03.148
that I'm seeing from
00:35:03.268 --> 00:35:05.289
physical therapists who
00:35:05.409 --> 00:35:09.112
think a physician should be
00:35:09.331 --> 00:35:11.432
obligated to sign my plan of care.
00:35:11.572 --> 00:35:12.833
I've said it repeatedly.
00:35:12.873 --> 00:35:14.074
I'm like, if I'm a doctor,
00:35:14.353 --> 00:35:15.835
if I have MD after my name,
00:35:16.635 --> 00:35:18.315
I am not referring patients
00:35:18.335 --> 00:35:20.637
to physical therapy simply because...
00:35:21.416 --> 00:35:24.179
I'm expected to sign plans of care.
00:35:24.541 --> 00:35:25.762
I don't have the time for it.
00:35:26.081 --> 00:35:27.543
I don't have the desire for it.
00:35:27.864 --> 00:35:29.126
I don't have the interest in it.
00:35:29.525 --> 00:35:31.809
Like, I'm sorry, but there is no way.
00:35:31.889 --> 00:35:33.951
Now, these docs aren't getting paid extra.
00:35:34.552 --> 00:35:36.454
There is no like benefit or
00:35:36.534 --> 00:35:37.875
bonus system for them.
00:35:39.016 --> 00:35:40.777
And think about how many
00:35:40.817 --> 00:35:42.536
patients in a day a doctor sees,
00:35:42.577 --> 00:35:44.157
how many patients on
00:35:44.237 --> 00:35:46.137
caseload a doctor manages,
00:35:46.518 --> 00:35:47.898
thousands of patients.
00:35:48.298 --> 00:35:50.659
That's hundreds of plans of care.
00:35:51.898 --> 00:35:53.440
When you sign that plan of care,
00:35:53.480 --> 00:35:55.320
you're saying effectively, yes,
00:35:55.480 --> 00:35:56.840
I agree with this plan of care.
00:35:56.860 --> 00:35:58.561
When they've never met me,
00:35:58.601 --> 00:35:59.862
they have no idea who I am.
00:35:59.902 --> 00:36:01.362
They have no idea what I'm doing.
00:36:01.402 --> 00:36:01.961
Most of the time,
00:36:01.981 --> 00:36:02.922
they don't understand what
00:36:02.961 --> 00:36:04.822
the plan of care even entails.
00:36:05.722 --> 00:36:06.684
I think this is a major
00:36:06.744 --> 00:36:08.164
issue that I've never seen
00:36:08.224 --> 00:36:09.545
discussed or addressed.
00:36:10.965 --> 00:36:13.706
And it's absurd that actual
00:36:13.746 --> 00:36:15.188
licensed therapists think
00:36:15.367 --> 00:36:16.788
doctors should be obligated
00:36:16.827 --> 00:36:18.188
to sign plans of care.
00:36:18.608 --> 00:36:19.929
What are your thoughts on this?
00:36:20.646 --> 00:36:21.106
Well,
00:36:21.126 --> 00:36:22.967
the one comment I saw from Joey Rossi
00:36:23.027 --> 00:36:25.088
was he said there's some
00:36:25.128 --> 00:36:26.250
physicians he's spoken with
00:36:26.309 --> 00:36:27.471
that are no longer
00:36:27.510 --> 00:36:28.911
referring to physical
00:36:28.952 --> 00:36:30.713
therapy because of this specifically.
00:36:31.333 --> 00:36:32.474
That's crazy.
00:36:33.876 --> 00:36:34.976
I think so.
00:36:34.996 --> 00:36:36.557
We're licensed physical therapists.
00:36:36.597 --> 00:36:38.920
We have to have, you know, licensure.
00:36:38.960 --> 00:36:41.882
We have to do continuing education.
00:36:42.242 --> 00:36:43.784
We're CPR certified.
00:36:44.344 --> 00:36:45.644
The fact that this is still
00:36:45.844 --> 00:36:48.728
even a part of CMS is ridiculous.
00:36:48.867 --> 00:36:49.309
I don't know.
00:36:50.048 --> 00:36:51.371
You might think it's a good, I don't know.
00:36:51.530 --> 00:36:51.951
I don't know.
00:36:51.971 --> 00:36:52.972
But I think, Tony,
00:36:53.072 --> 00:36:54.112
I think it's absolutely
00:36:54.152 --> 00:36:55.534
ridiculous that a plan of
00:36:55.554 --> 00:36:56.695
care even needs to be signed.
00:36:57.036 --> 00:36:58.896
So you're saying the first initial,
00:36:58.916 --> 00:36:59.577
so the first, what,
00:36:59.617 --> 00:37:00.679
nine days or what is it?
00:37:00.759 --> 00:37:01.659
Thirty days or what's the?
00:37:02.222 --> 00:37:04.704
So the way the law was developed,
00:37:05.664 --> 00:37:06.706
if you have a referral,
00:37:06.726 --> 00:37:08.266
because a lot of us have direct access.
00:37:08.286 --> 00:37:09.728
So I've got a guy coming in today.
00:37:10.748 --> 00:37:13.251
He's been a patient of mine for a decade.
00:37:13.351 --> 00:37:15.413
He travels back and forth to Florida.
00:37:15.512 --> 00:37:16.994
He just texted me this morning.
00:37:17.454 --> 00:37:18.755
He's like, hey, I got a muscle issue.
00:37:18.815 --> 00:37:19.836
I want to come in and see you.
00:37:20.757 --> 00:37:22.139
He's a Medicare beneficiary.
00:37:22.898 --> 00:37:24.340
He doesn't he's not coming
00:37:24.400 --> 00:37:25.460
in with a referral.
00:37:25.800 --> 00:37:27.021
Now I can see him.
00:37:27.081 --> 00:37:28.300
Medicare doesn't require a
00:37:28.360 --> 00:37:29.862
referral and my state
00:37:29.882 --> 00:37:31.302
allows direct access.
00:37:31.842 --> 00:37:34.583
But because I don't have a referral,
00:37:34.824 --> 00:37:36.425
I would still need even in
00:37:36.445 --> 00:37:37.505
twenty twenty five a
00:37:37.605 --> 00:37:38.726
signature on the plan of
00:37:38.766 --> 00:37:39.945
care if this is going to be
00:37:39.985 --> 00:37:41.047
paid for by Medicare.
00:37:41.806 --> 00:37:43.108
If I have a referral,
00:37:43.648 --> 00:37:45.048
I don't need a signature,
00:37:45.088 --> 00:37:47.110
but I do have to prove that
00:37:47.170 --> 00:37:48.791
I at least sent the plan of
00:37:48.851 --> 00:37:49.972
care to the physician.
00:37:50.012 --> 00:37:51.152
That's the new change.
00:37:51.333 --> 00:37:52.293
I don't need the signature,
00:37:52.333 --> 00:37:53.175
but I need proof that I
00:37:53.215 --> 00:37:56.317
sent it for the initial plan of care.
00:37:57.797 --> 00:38:00.380
If I make a plan of care for three weeks,
00:38:00.440 --> 00:38:01.981
two times a week, six visits,
00:38:02.481 --> 00:38:04.021
that's the initial plan of care.
00:38:04.061 --> 00:38:05.963
If I decide to extend it...
00:38:06.623 --> 00:38:08.344
then I need a signature.
00:38:08.965 --> 00:38:11.027
It can be the duration you
00:38:11.067 --> 00:38:13.628
prescribe or up to ninety days.
00:38:14.047 --> 00:38:16.210
So if I prescribe a six month plan of care,
00:38:16.809 --> 00:38:19.092
my initial is limited to ninety days.
00:38:19.572 --> 00:38:21.492
But if I do it shorter than ninety days,
00:38:21.873 --> 00:38:22.934
then that's my initial.
00:38:24.650 --> 00:38:25.110
And, you know,
00:38:26.431 --> 00:38:27.431
we joked about this across
00:38:27.452 --> 00:38:29.293
the country that most
00:38:29.313 --> 00:38:30.655
physical therapists are going to say,
00:38:30.715 --> 00:38:32.956
you know, three times a week for,
00:38:33.697 --> 00:38:35.900
you know, sixteen weeks or whatever.
00:38:36.179 --> 00:38:36.661
I'm joking.
00:38:36.701 --> 00:38:38.202
But like I oftentimes it's
00:38:38.222 --> 00:38:39.222
going to be like a really
00:38:39.302 --> 00:38:40.523
it's never going to be three weeks.
00:38:41.085 --> 00:38:42.045
It's going to be a bigger number.
00:38:43.106 --> 00:38:45.347
So, OK, so maximum ninety days.
00:38:45.668 --> 00:38:46.588
And at that point.
00:38:47.369 --> 00:38:49.672
What is a therapist's option?
00:38:49.931 --> 00:38:50.572
They have to send that
00:38:50.612 --> 00:38:51.492
patient to a different
00:38:51.512 --> 00:38:52.833
physician to get it signed.
00:38:53.634 --> 00:38:54.074
Say, hey,
00:38:54.114 --> 00:38:56.916
do you have your primary won't sign it,
00:38:56.936 --> 00:38:58.398
so I have to send you to a specialist.
00:38:58.438 --> 00:39:00.099
Or can they, through Medicare,
00:39:00.119 --> 00:39:01.860
can they then go visit an
00:39:01.920 --> 00:39:03.221
urgent care or some other
00:39:03.320 --> 00:39:04.282
primary care physician
00:39:04.302 --> 00:39:06.342
that's not their PCP on record?
00:39:06.762 --> 00:39:07.623
What are you going to do?
00:39:08.356 --> 00:39:12.159
If the main doctor refuses, then yeah,
00:39:12.219 --> 00:39:13.300
you start playing the game.
00:39:13.541 --> 00:39:14.541
You start saying, okay,
00:39:14.902 --> 00:39:16.123
do you have an oncologist?
00:39:16.143 --> 00:39:17.623
Do you have a nephrologist?
00:39:17.643 --> 00:39:20.105
Do you have a orthopedic that, you know,
00:39:20.144 --> 00:39:21.505
can I sneak it through
00:39:21.967 --> 00:39:23.288
someone else and try it?
00:39:23.327 --> 00:39:24.208
Someone that's not going to
00:39:24.228 --> 00:39:25.489
read it and just sign it.
00:39:25.509 --> 00:39:27.570
And this is where my
00:39:27.610 --> 00:39:30.472
frustration comes back in where I'm like,
00:39:30.853 --> 00:39:32.373
what's the whole intent of
00:39:32.414 --> 00:39:33.275
the law anyway?
00:39:33.355 --> 00:39:34.715
When was the law generated?
00:39:34.775 --> 00:39:36.376
When was the guideline created?
00:39:36.916 --> 00:39:38.677
it was probably created before we were,
00:39:39.119 --> 00:39:41.661
I'm not, but others were DPTs.
00:39:42.161 --> 00:39:43.621
It was created back when
00:39:43.722 --> 00:39:45.164
therapists were really
00:39:45.864 --> 00:39:48.186
glorified AIDS technicians.
00:39:48.585 --> 00:39:50.268
The doctor used to say,
00:39:50.688 --> 00:39:52.208
get this patient out of bed,
00:39:52.289 --> 00:39:53.530
walk this patient, you know,
00:39:53.710 --> 00:39:57.213
and ironically in the Medicare guideline,
00:39:57.373 --> 00:39:59.795
it specifically says if the referral is,
00:40:00.275 --> 00:40:01.835
contains all of the required
00:40:01.916 --> 00:40:03.576
elements for the plan of care.
00:40:04.036 --> 00:40:05.197
You don't need a separate
00:40:05.237 --> 00:40:06.717
plan of care and you don't
00:40:06.757 --> 00:40:07.898
need a separate signature.
00:40:08.318 --> 00:40:10.559
So back in the day when the doctor said,
00:40:10.778 --> 00:40:12.659
I want this patient to get a three,
00:40:13.059 --> 00:40:14.300
is it megahertz, whatever,
00:40:14.400 --> 00:40:16.400
ultrasound for seven
00:40:16.460 --> 00:40:20.302
minutes on left elbow, you know,
00:40:20.402 --> 00:40:22.384
we come from technicians.
00:40:22.804 --> 00:40:23.643
Like, guys,
00:40:23.724 --> 00:40:25.764
we are not the same therapists
00:40:26.485 --> 00:40:28.166
that we were thirty years ago.
00:40:29.141 --> 00:40:30.782
but the laws never change.
00:40:30.802 --> 00:40:31.963
The laws don't keep up.
00:40:32.003 --> 00:40:33.384
The laws don't advance as
00:40:33.443 --> 00:40:36.487
quickly as we believe we're advancing.
00:40:37.067 --> 00:40:38.628
That goes back to my argument.
00:40:39.108 --> 00:40:40.929
I think most of us have left
00:40:40.989 --> 00:40:42.331
physical therapy behind.
00:40:42.391 --> 00:40:44.193
We are no longer operating
00:40:44.773 --> 00:40:46.074
as the way the world
00:40:46.134 --> 00:40:47.635
perceives a physical therapist.
00:40:48.036 --> 00:40:49.376
We are no longer operating
00:40:49.396 --> 00:40:50.338
in that capacity.
00:40:50.818 --> 00:40:52.980
So you can fight to drag the
00:40:53.019 --> 00:40:54.221
credential with you
00:40:54.760 --> 00:40:56.342
Or you can just let the credential go.
00:40:56.684 --> 00:40:57.925
The letters are meaningless.
00:40:57.985 --> 00:40:59.588
They don't help us in
00:40:59.648 --> 00:41:01.351
virtually any way because
00:41:01.811 --> 00:41:03.052
we don't get compensation
00:41:03.072 --> 00:41:04.534
for the letters that are
00:41:04.596 --> 00:41:05.998
worth what we're doing.
00:41:06.438 --> 00:41:07.360
Just let them go.
00:41:07.599 --> 00:41:08.762
Like, forget it.
00:41:09.382 --> 00:41:10.184
What are your thoughts?
00:41:12.030 --> 00:41:13.751
Man, I always like to push back with this,
00:41:13.932 --> 00:41:16.074
because you're not letting them go,
00:41:16.153 --> 00:41:16.353
right?
00:41:16.373 --> 00:41:18.556
So a listener, a follower,
00:41:18.675 --> 00:41:19.356
someone who's watching or
00:41:19.396 --> 00:41:20.518
listening now or on the replay,
00:41:20.538 --> 00:41:21.739
they're going to say, well, Tony,
00:41:21.778 --> 00:41:22.458
are you doing that?
00:41:23.079 --> 00:41:23.900
And you're going to say no,
00:41:23.920 --> 00:41:24.621
because you guys are still
00:41:24.641 --> 00:41:25.601
licensing credential and
00:41:25.621 --> 00:41:26.442
billing Medicare and
00:41:26.481 --> 00:41:27.782
billing all the network insurances,
00:41:27.963 --> 00:41:28.304
right?
00:41:29.590 --> 00:41:31.391
So I had one guy and I can't
00:41:31.431 --> 00:41:32.112
remember his name.
00:41:32.152 --> 00:41:33.532
I wish I could give him credit.
00:41:34.492 --> 00:41:35.914
He gave me a great response.
00:41:36.713 --> 00:41:38.715
He said I was basically he
00:41:38.735 --> 00:41:39.556
said I was crazy,
00:41:39.596 --> 00:41:40.795
that I was completely wrong.
00:41:41.297 --> 00:41:42.456
He said that, you know,
00:41:42.496 --> 00:41:43.717
the credentialing allows
00:41:43.737 --> 00:41:45.498
them to do dry needling legally.
00:41:45.878 --> 00:41:48.019
The credentialing allows
00:41:48.039 --> 00:41:49.119
them to do all of these
00:41:49.159 --> 00:41:51.621
services within the law
00:41:51.681 --> 00:41:52.702
that he wouldn't be able to
00:41:52.742 --> 00:41:54.422
do if he let his license go.
00:41:55.538 --> 00:41:57.059
It dawned on me.
00:41:57.300 --> 00:41:58.842
I was like, yeah, you're right.
00:41:58.862 --> 00:41:59.985
He's a hundred percent right.
00:42:00.164 --> 00:42:01.306
I'm a hundred percent wrong
00:42:01.427 --> 00:42:03.128
relative to his situation.
00:42:03.650 --> 00:42:05.152
He wants to do those things.
00:42:05.452 --> 00:42:06.434
I don't want to do those things.
00:42:06.454 --> 00:42:08.896
I have zero interest in dry needling.
00:42:08.958 --> 00:42:10.079
I have zero interest in
00:42:10.940 --> 00:42:11.800
Pretty much any of the
00:42:11.820 --> 00:42:13.762
things that require my licensure.
00:42:14.302 --> 00:42:16.284
So to your point, Dave, well,
00:42:16.344 --> 00:42:17.565
why haven't I let it go?
00:42:17.846 --> 00:42:20.367
Why haven't I followed my own advice?
00:42:20.829 --> 00:42:20.949
Well,
00:42:20.989 --> 00:42:22.349
it's because I still have a
00:42:22.389 --> 00:42:23.710
successful business that
00:42:23.791 --> 00:42:26.273
runs on a thirty year old model.
00:42:27.894 --> 00:42:29.416
A new therapist coming into
00:42:29.456 --> 00:42:31.396
business today doesn't have
00:42:31.436 --> 00:42:32.898
the advantages that I have.
00:42:33.338 --> 00:42:34.878
And you hear this stuff in
00:42:34.938 --> 00:42:36.019
popular media when they
00:42:36.059 --> 00:42:37.721
talk about boomers versus
00:42:38.081 --> 00:42:39.161
younger generations.
00:42:39.942 --> 00:42:40.882
It's true, guys.
00:42:40.943 --> 00:42:45.025
I have zero, zero debt to any university.
00:42:46.085 --> 00:42:47.106
I have, you know,
00:42:47.306 --> 00:42:49.309
the history with the referral sources.
00:42:49.349 --> 00:42:51.269
So I have zero marketing expense.
00:42:51.851 --> 00:42:54.233
I have the history with my systems.
00:42:54.652 --> 00:42:56.454
I can operationally deliver
00:42:56.514 --> 00:42:57.954
services for a fraction of
00:42:57.994 --> 00:43:00.757
the cost of somebody new
00:43:00.797 --> 00:43:01.697
coming in and trying to
00:43:01.737 --> 00:43:03.059
build the business that I have.
00:43:03.699 --> 00:43:05.360
I have legacy experience.
00:43:05.574 --> 00:43:07.175
that nobody else in my area has.
00:43:07.255 --> 00:43:09.356
I have low overhead because
00:43:09.815 --> 00:43:10.835
I signed a lease and I've
00:43:10.876 --> 00:43:12.056
got a lease that hasn't
00:43:12.096 --> 00:43:14.516
gone up in monthly rate for
00:43:14.637 --> 00:43:15.597
like ten years.
00:43:16.737 --> 00:43:18.657
You can't do what I do.
00:43:19.018 --> 00:43:20.057
So I'm not going to.
00:43:20.137 --> 00:43:21.557
It's like the guy, me,
00:43:22.097 --> 00:43:23.239
who has a thirty year
00:43:23.278 --> 00:43:24.998
mortgage at a three percent
00:43:25.059 --> 00:43:25.559
interest rate.
00:43:25.619 --> 00:43:26.518
I'm not going to sell my
00:43:26.579 --> 00:43:28.559
house because of the
00:43:28.639 --> 00:43:29.880
interest rate on my mortgage.
00:43:29.920 --> 00:43:30.940
I'm not going to get rid of
00:43:30.960 --> 00:43:31.940
those credentials because
00:43:31.980 --> 00:43:33.081
those credentials are still
00:43:33.121 --> 00:43:34.340
profitable for me in the
00:43:34.360 --> 00:43:35.221
model that I have.
00:43:36.152 --> 00:43:38.353
But if I was a big time influencer,
00:43:38.414 --> 00:43:39.355
if I had hundreds of
00:43:39.394 --> 00:43:40.775
thousands of subscribers,
00:43:41.175 --> 00:43:42.036
that's where the original
00:43:42.097 --> 00:43:43.137
context came from.
00:43:43.617 --> 00:43:46.000
If I wanted to treat and I
00:43:46.039 --> 00:43:48.623
wanted to treat across state lines, man,
00:43:48.663 --> 00:43:49.543
the first thing I'd do is
00:43:49.603 --> 00:43:51.364
I'd get rid of the letters
00:43:51.425 --> 00:43:52.865
after my name and I would
00:43:52.885 --> 00:43:54.748
just go independence for true,
00:43:54.788 --> 00:43:55.728
full autonomy.
00:43:56.766 --> 00:43:58.606
That if you're doing virtual
00:43:58.806 --> 00:44:00.288
and you're doing, you know,
00:44:00.327 --> 00:44:01.228
the triaging we talked
00:44:01.248 --> 00:44:02.528
about before or the, you know,
00:44:02.889 --> 00:44:03.969
remote programming or
00:44:04.009 --> 00:44:05.150
you're kind of doing some
00:44:05.190 --> 00:44:06.030
telehealth or whatever
00:44:06.389 --> 00:44:07.150
across state lines.
00:44:07.951 --> 00:44:09.692
That is that that is I have
00:44:09.711 --> 00:44:10.391
to agree with you there.
00:44:10.431 --> 00:44:11.373
That is the easiest way to
00:44:11.432 --> 00:44:13.012
go because of the whole compact thing.
00:44:13.052 --> 00:44:14.094
And you got to, you know,
00:44:14.134 --> 00:44:15.574
get licensure in all these
00:44:15.954 --> 00:44:16.574
different states.
00:44:16.614 --> 00:44:17.916
And there's some states now
00:44:17.956 --> 00:44:18.556
that are what is it,
00:44:18.775 --> 00:44:20.976
fifteen or maybe twenty at the most.
00:44:21.016 --> 00:44:22.478
That's a compact you get.
00:44:22.958 --> 00:44:23.918
licensed in one of those
00:44:23.958 --> 00:44:25.219
states and now you have uh
00:44:25.438 --> 00:44:26.679
licensed reciprocity or
00:44:26.699 --> 00:44:27.880
whatever in the compact
00:44:27.900 --> 00:44:28.760
across all those states but
00:44:28.800 --> 00:44:30.681
not every state and if
00:44:30.740 --> 00:44:31.920
you're yeah if you have a
00:44:31.960 --> 00:44:32.860
social media following and
00:44:32.880 --> 00:44:33.460
you're going to be doing
00:44:33.481 --> 00:44:34.661
some of the triaging and
00:44:34.802 --> 00:44:35.961
some of the borderline
00:44:36.021 --> 00:44:37.922
therapy medical type
00:44:38.003 --> 00:44:39.483
questions and you know
00:44:39.884 --> 00:44:40.923
coaching or treatment or
00:44:40.943 --> 00:44:41.623
whatever you want to call
00:44:41.684 --> 00:44:44.264
it virtual care then yeah
00:44:44.284 --> 00:44:45.644
it does make sense to drop
00:44:45.684 --> 00:44:46.445
the license I a hundred
00:44:46.465 --> 00:44:47.146
percent agree with that
00:44:48.231 --> 00:44:49.311
And I think we've seen
00:44:49.391 --> 00:44:50.693
proven models from
00:44:51.873 --> 00:44:53.634
non-licensed PTs or
00:44:53.673 --> 00:44:54.894
clinicians that are working.
00:44:56.016 --> 00:44:57.297
In the finance world,
00:44:58.597 --> 00:45:00.579
we should get Will Butler back on.
00:45:00.619 --> 00:45:02.320
It's been forever since I've
00:45:02.360 --> 00:45:02.900
talked to him.
00:45:02.920 --> 00:45:03.820
Definitely.
00:45:04.371 --> 00:45:05.994
But every time I've pushed
00:45:06.034 --> 00:45:07.356
him to get on social media,
00:45:07.396 --> 00:45:08.597
he always says he can't
00:45:08.637 --> 00:45:10.059
because there's so much
00:45:10.099 --> 00:45:11.420
restriction on what he can
00:45:11.460 --> 00:45:12.501
say and what he can share.
00:45:13.041 --> 00:45:14.324
And when you look at Dave
00:45:14.364 --> 00:45:15.605
Ramsey and you look at the
00:45:15.724 --> 00:45:17.166
big social media
00:45:18.088 --> 00:45:20.230
influencers in the finance space,
00:45:20.670 --> 00:45:22.233
they've all let go of their
00:45:22.413 --> 00:45:23.833
their licensing.
00:45:24.335 --> 00:45:25.576
because they can't say the
00:45:25.596 --> 00:45:26.496
things that they want to
00:45:26.556 --> 00:45:28.878
say and still be compliant
00:45:28.918 --> 00:45:29.918
with the regulations.
00:45:30.318 --> 00:45:32.019
And I think the same applies
00:45:32.059 --> 00:45:32.860
to healthcare.
00:45:33.661 --> 00:45:34.681
There's a bunch of medical
00:45:34.742 --> 00:45:35.983
doctors and healthcare
00:45:36.023 --> 00:45:37.664
influencers that had to let
00:45:37.704 --> 00:45:38.864
go of their licensure
00:45:39.644 --> 00:45:41.545
But they're making ten
00:45:41.606 --> 00:45:44.206
million a year because of
00:45:44.286 --> 00:45:46.807
the social media reach that
00:45:46.827 --> 00:45:48.208
they've built and the
00:45:48.248 --> 00:45:50.289
businesses and the tools around that.
00:45:51.070 --> 00:45:53.972
So I just â With Dave Ramsey,
00:45:54.012 --> 00:45:56.032
was he a CPA or was he like
00:45:56.052 --> 00:45:59.346
a financial â what do you call it â
00:46:01.054 --> 00:46:01.855
CFA or whatever.
00:46:01.875 --> 00:46:03.617
Or yeah.
00:46:03.978 --> 00:46:04.097
Yeah.
00:46:05.318 --> 00:46:08.083
I think he had all of those licenses.
00:46:08.923 --> 00:46:11.186
He, I don't even know that world,
00:46:11.246 --> 00:46:13.469
but I had read interviews
00:46:13.509 --> 00:46:15.351
and looked into it.
00:46:16.132 --> 00:46:18.052
But a lot of the newer ones, too,
00:46:18.393 --> 00:46:18.853
same thing.
00:46:18.893 --> 00:46:20.394
They're attorneys, you know,
00:46:20.434 --> 00:46:22.376
attorneys that had their
00:46:22.817 --> 00:46:23.717
they passed the bar.
00:46:23.777 --> 00:46:25.318
They were licensed and then
00:46:25.619 --> 00:46:27.019
they let it go so they can
00:46:27.059 --> 00:46:28.360
go on to social media
00:46:28.920 --> 00:46:29.681
because that was the
00:46:29.702 --> 00:46:31.063
direction that they wanted to go.
00:46:31.123 --> 00:46:32.403
And they couldn't do it,
00:46:32.443 --> 00:46:33.985
but they still had their knowledge.
00:46:34.005 --> 00:46:35.666
And that's the same thing with us.
00:46:35.706 --> 00:46:35.867
Like,
00:46:35.887 --> 00:46:37.188
you're never going to take away my
00:46:37.288 --> 00:46:38.648
knowledge of physical therapy.
00:46:39.548 --> 00:46:42.632
I just I can't deliver one
00:46:42.713 --> 00:46:44.956
on one physical therapy advice,
00:46:45.516 --> 00:46:47.960
but I can basically provide education,
00:46:48.000 --> 00:46:49.842
information, influence, you know,
00:46:49.902 --> 00:46:51.565
all of those kinds of things,
00:46:52.025 --> 00:46:53.788
not practicing physical therapy.
00:46:55.416 --> 00:46:56.516
not having liability
00:46:56.577 --> 00:46:57.938
insurance for physical therapy,
00:46:58.018 --> 00:46:59.480
not having to do ridiculous
00:46:59.920 --> 00:47:01.302
waste of time continuing
00:47:01.402 --> 00:47:03.364
education for the twenty
00:47:03.385 --> 00:47:05.286
four hour credit hours that
00:47:05.806 --> 00:47:07.449
are virtually meaningless.
00:47:07.909 --> 00:47:09.231
Because, you know,
00:47:09.351 --> 00:47:13.235
we know so many people that just go there,
00:47:13.295 --> 00:47:14.836
check the box and they get the credit.
00:47:14.896 --> 00:47:17.278
Like none of this stuff has any impact.
00:47:17.298 --> 00:47:17.438
Agreed.
00:47:17.458 --> 00:47:17.599
Agreed.
00:47:18.219 --> 00:47:20.860
yeah I uh there's a there's
00:47:20.900 --> 00:47:21.641
a ton of therapists that
00:47:21.661 --> 00:47:22.521
just what is there's
00:47:22.541 --> 00:47:23.360
different websites that are
00:47:23.380 --> 00:47:24.902
like ninety nine dollars a
00:47:24.942 --> 00:47:26.081
year or something and you
00:47:26.101 --> 00:47:27.963
just the physical therapist
00:47:28.822 --> 00:47:29.643
I won't mention any names
00:47:29.762 --> 00:47:30.563
but go on there like the
00:47:30.603 --> 00:47:33.003
day before their ceus or uh
00:47:33.043 --> 00:47:34.384
you know your your license
00:47:34.423 --> 00:47:35.204
is about to be renewed or
00:47:35.224 --> 00:47:35.945
whatever they go on like
00:47:35.965 --> 00:47:37.204
the night before and they
00:47:37.244 --> 00:47:38.284
you know do a bunch of like
00:47:38.784 --> 00:47:40.126
whatever courses and just
00:47:40.146 --> 00:47:41.045
to just to get the
00:47:41.885 --> 00:47:42.947
amount of courses done for
00:47:43.007 --> 00:47:43.788
license renewal.
00:47:43.867 --> 00:47:44.768
And then I think I don't
00:47:44.789 --> 00:47:45.429
know about your state,
00:47:45.449 --> 00:47:46.269
but like our license
00:47:46.309 --> 00:47:48.431
renewal is like it's like
00:47:48.452 --> 00:47:49.211
the honor system.
00:47:49.391 --> 00:47:51.173
It's like, yes, I just click a box like,
00:47:51.233 --> 00:47:51.514
yes,
00:47:51.813 --> 00:47:53.735
I certify or I don't even know if it
00:47:53.755 --> 00:47:54.297
says certify.
00:47:54.416 --> 00:47:56.297
I agree or yes, I
00:47:57.159 --> 00:47:58.340
I don't know if it is.
00:47:58.360 --> 00:47:59.739
It doesn't say a test like I
00:47:59.760 --> 00:48:00.880
attest that I have or
00:48:00.920 --> 00:48:02.181
whatever that I have
00:48:02.442 --> 00:48:03.121
completed all the
00:48:03.202 --> 00:48:04.422
continuing education courses.
00:48:04.483 --> 00:48:06.623
And maybe if there's a random audit,
00:48:06.704 --> 00:48:07.585
I guess you have to show
00:48:07.625 --> 00:48:09.346
your content certificates
00:48:09.385 --> 00:48:10.827
or whatever to the board or
00:48:10.867 --> 00:48:12.228
the licensing body or
00:48:12.268 --> 00:48:13.148
whatever of your state.
00:48:14.608 --> 00:48:14.929
But yeah,
00:48:15.108 --> 00:48:16.389
I agree that whole thing is a joke too.
00:48:18.197 --> 00:48:21.838
Yeah, I mean, I use physicaltherapy.com.
00:48:21.898 --> 00:48:23.358
It's ninety nine dollars for
00:48:23.398 --> 00:48:24.199
twelve months.
00:48:24.719 --> 00:48:26.081
But if you do it, you know,
00:48:26.121 --> 00:48:28.561
like four months before they're due,
00:48:29.043 --> 00:48:30.123
you can get your twenty
00:48:30.163 --> 00:48:31.784
four credit hours and then
00:48:31.804 --> 00:48:33.184
you can do another twenty
00:48:33.204 --> 00:48:34.284
four credit hours in the
00:48:34.324 --> 00:48:36.025
next calendar year for the
00:48:36.065 --> 00:48:37.887
next two year period.
00:48:38.347 --> 00:48:39.507
So theoretically,
00:48:39.588 --> 00:48:41.188
it's forty nine dollars or
00:48:41.208 --> 00:48:43.851
whatever for each one.
00:48:45.070 --> 00:48:46.972
Now, look, I'm not against education.
00:48:47.112 --> 00:48:48.954
I work every single day to
00:48:49.034 --> 00:48:51.076
learn new stuff and I want
00:48:51.096 --> 00:48:52.056
to learn new stuff.
00:48:52.155 --> 00:48:53.998
My point in this is the
00:48:54.038 --> 00:48:55.137
person who doesn't care
00:48:55.177 --> 00:48:56.278
about learning new stuff
00:48:56.418 --> 00:48:57.599
isn't going to learn new stuff.
00:48:57.639 --> 00:48:58.701
You can't mandate it.
00:48:58.740 --> 00:48:59.681
You can't force it.
00:49:00.362 --> 00:49:02.304
And there's nothing worse
00:49:02.344 --> 00:49:05.068
than a law that has no real
00:49:05.248 --> 00:49:06.889
impact and no real effect.
00:49:07.331 --> 00:49:08.791
And the law just burdens the
00:49:08.811 --> 00:49:09.873
people who want to do a
00:49:09.893 --> 00:49:11.576
good job more because the
00:49:11.615 --> 00:49:12.436
people who don't care,
00:49:12.777 --> 00:49:14.478
they're not following the laws anyway.
00:49:15.601 --> 00:49:18.224
So it's just a waste of time, money,
00:49:18.364 --> 00:49:19.686
effort, compliance.
00:49:21.186 --> 00:49:22.626
Uh, that was great.
00:49:23.047 --> 00:49:24.108
I know we're a little bit early,
00:49:24.128 --> 00:49:25.728
but let's wrap up the episode.
00:49:25.809 --> 00:49:27.969
So what do you think?
00:49:28.050 --> 00:49:28.590
I want your,
00:49:28.670 --> 00:49:30.452
I'm going to give you your parting shot.
00:49:31.253 --> 00:49:33.094
What do you think is the
00:49:33.173 --> 00:49:36.295
most like emotional impact
00:49:36.755 --> 00:49:38.637
of finding a new therapist
00:49:38.657 --> 00:49:40.117
to join your organization?
00:49:40.679 --> 00:49:40.998
What is,
00:49:41.139 --> 00:49:42.400
what is the thing that's the most
00:49:42.500 --> 00:49:43.019
rewarding?
00:49:43.039 --> 00:49:46.262
That is the most meaningful in what you do,
00:49:46.302 --> 00:49:47.163
the way you do it.
00:49:49.869 --> 00:49:50.409
And I don't know if I'm
00:49:50.429 --> 00:49:51.070
going to get this right.
00:49:51.110 --> 00:49:52.269
I mean,
00:49:52.351 --> 00:49:54.211
it's not even for anybody else for you.
00:49:54.492 --> 00:49:54.632
Okay.
00:49:55.652 --> 00:49:57.173
No, I thought you were saying, Oh, for me,
00:49:57.193 --> 00:49:58.114
the emotional part of me
00:49:58.295 --> 00:49:59.876
finding a new staff, physical therapist.
00:50:00.516 --> 00:50:00.856
What?
00:50:00.916 --> 00:50:02.177
No, in your business,
00:50:02.418 --> 00:50:04.199
you as a therapist in your business,
00:50:04.239 --> 00:50:05.440
what's the most meaningful
00:50:05.460 --> 00:50:08.242
part of you doing your job for you?
00:50:08.262 --> 00:50:08.362
Uh,
00:50:11.586 --> 00:50:13.387
having the patient or client
00:50:14.028 --> 00:50:16.030
voice that they were able
00:50:16.050 --> 00:50:17.990
to do XYZ emotional thing
00:50:18.010 --> 00:50:20.632
like travel to their son's college in St.
00:50:20.672 --> 00:50:23.954
Louis or being able to walk
00:50:24.434 --> 00:50:27.137
confidently in public with
00:50:27.197 --> 00:50:28.498
less of a tremor or with
00:50:28.538 --> 00:50:30.458
better balance so that they
00:50:30.858 --> 00:50:32.380
are able to walk their dog
00:50:32.400 --> 00:50:33.860
in the park so that they
00:50:33.880 --> 00:50:37.423
can do something in the world better
00:50:38.675 --> 00:50:40.615
than they could without me,
00:50:40.635 --> 00:50:41.737
like before they met me.
00:50:41.797 --> 00:50:43.637
I think, I mean, that's one for sure.
00:50:44.398 --> 00:50:45.938
And I think you would say
00:50:46.679 --> 00:50:48.021
you would take a little
00:50:48.061 --> 00:50:51.202
less money a year to have
00:50:51.242 --> 00:50:52.824
that kind of meaningful
00:50:52.923 --> 00:50:54.585
impact on somebody's life
00:50:55.425 --> 00:50:57.485
versus maybe making a
00:50:57.525 --> 00:50:59.186
thousand or two more a year,
00:50:59.967 --> 00:51:02.009
but knowing that nothing
00:51:02.028 --> 00:51:03.929
you did all year had any
00:51:03.969 --> 00:51:05.630
benefit or any real impact
00:51:05.731 --> 00:51:07.192
on the patients you were working with.
00:51:07.652 --> 00:51:08.213
Don't you agree?
00:51:09.717 --> 00:51:10.777
I agree.
00:51:10.798 --> 00:51:11.199
Yeah.
00:51:11.239 --> 00:51:11.679
Same for me.
00:51:12.119 --> 00:51:14.280
Like my at this stage of my life,
00:51:14.320 --> 00:51:16.380
especially fifty years old,
00:51:16.400 --> 00:51:18.722
I am I am working for the
00:51:18.782 --> 00:51:20.483
meaningful impact more than
00:51:20.563 --> 00:51:22.844
I am working for the money, you know,
00:51:22.943 --> 00:51:25.304
and so I will do hard things.
00:51:25.806 --> 00:51:28.266
I will sacrifice more if I
00:51:28.306 --> 00:51:29.907
know the sacrifice has
00:51:30.007 --> 00:51:31.527
meaning on the other side,
00:51:32.148 --> 00:51:34.690
as opposed to just working harder daily.
00:51:35.429 --> 00:51:37.273
doing meaningless jobs,
00:51:37.432 --> 00:51:39.335
meaningless tasks for a
00:51:39.376 --> 00:51:40.177
little extra money.
00:51:40.418 --> 00:51:42.039
The extra money just isn't
00:51:42.079 --> 00:51:44.603
worth sacrificing the
00:51:44.643 --> 00:51:46.626
importance of having an
00:51:46.666 --> 00:51:47.527
impact on someone.
00:51:48.188 --> 00:51:48.989
So guys, we're done.
00:51:50.014 --> 00:51:51.255
And I think today is Tuesday.
00:51:51.436 --> 00:51:54.400
It is Tuesday, May thirteenth.
00:51:54.860 --> 00:51:55.880
Come back Thursday.
00:51:56.442 --> 00:51:58.164
Jimmy McKay will be back with us.
00:51:58.304 --> 00:51:59.186
Eight thirty a.m.
00:51:59.246 --> 00:52:00.387
Tuesday, Thursday morning.
00:52:00.447 --> 00:52:01.387
Dave Kittle show.
00:52:01.427 --> 00:52:04.411
Go check it out on iTunes and YouTube.
00:52:04.873 --> 00:52:06.474
And we will catch you guys next time.
00:52:06.514 --> 00:52:07.076
Thanks, Dave.
00:52:07.115 --> 00:52:08.137
Thanks, Tony.