May 17, 2025

Why You Should Drop Your PT License! (And Why It Matters)

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,

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probably three years,

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we outsourced as we continued to grow,

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outsourced our billing.

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But even there,

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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

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could just bring it in

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house and probably do it better.

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But at that point,

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we had replaced ourselves as clinicians.

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We were no longer treating

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every patient every day.

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So we had the capacity,

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the bandwidth to build a

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billing business.

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And we've actually spun off

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billing businesses as

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completely separate entities because

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Because we had the ability

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to not spend eight to ten

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hours treating patients and

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then try to work on the

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business afterward.

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Yeah, makes a ton of sense.

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I feel like for the small business owner,

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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

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serious business.

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Obviously, it is.

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You have five physical

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therapists outside of the owner.

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Like you said,

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that's a meaningful practice,

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even if they're in network.

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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

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some you know small

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business like uh dna or

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ethos or something where

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it's like my generation and

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and older uh and I like to

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include myself in in the

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you know put your head down

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like just grind it out like

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it might have stopped a

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little bit after my age but

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like kind of like you know

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your colleagues and your

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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

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independent to kind of put

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their head down, just grind it out until,

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you know,

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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.

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And it's not even it's not

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even that individual.

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It's not even that the practice owner,

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that's the physical

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therapist asking for help.

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So who knows if he or she

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even wants to help?

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Yeah.

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Yeah.

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Yeah.

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I think it is.

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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 – 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 – what do you call it –

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.