You’re the Boat: Why No One’s Coming to Save PT

0:02 Broadcasting way too early from three separate Wi-Fi connections. It's PT Breakfast Club with Tony Meritato, Dave Kittle, and Jimmy McKay. Man, it's a snow day. This is great. What do you do? The funny thing is you couldn't be dragged out of bed. it's a school day and then when it was a snow day you had like you were hulk you had hulk like energy and strength and you could do whatever you want and uh the funny part is when you're an adult you're like well i still have to go to work probably uh so what do you do when there's a snow day well first of all how are you tony wonderful welcome back from uh graham session we'll get into that we'll get into that uh but let's talk about what everybody's feeling right now we're doing i you know You're in Ohio.

0:57 So are you closed? Are you crushed? How many feet of snow did you get? We closed this morning. Right now we're closed until noon. We got about twelve to fourteen inches. But, you know, it came in Friday night, Saturday, Saturday, Saturday evening, Saturday afternoon. So it didn't really affect the business that much. We'll lose about ten visits. Okay. It started for me. I feel like your weather hits me almost twenty-four hours late. It just stopped in the overnight. I'm looking at, I don't know, mid shin, mid tibialis anterior. I don't know how PTs measure snow.

1:38 Is there a goniometer for snow? No, we don't have that. I mean, it's bad. That's what I should do. When I go into the clinic, I'm going to get the Goni out to measure the depth. That's what I want to see. I hit my driveway with a snowblower twice. After the first time, it looked like I'd never touched it. I went back a few hours later, looked outside. I was like, oh my God, I got to do it again. I should have waited. So first thoughts when something like this hits for PT owners, you had a week. I mean, it didn't surprise people. I saw a lot of people on LinkedIn saying, hey, I'm going to telehealth visits. A lot of people saying, I'll close and then I'll just call people. What's your mindset?

2:19 You said you're going to lose about ten visits. How do you shuffle those cards? How do you shuffle the deck? So the nice thing is it's Monday. We usually do a half a day on Friday. We just pushed everybody later in the week to make up what we lost. I'm of the mindset that I'm like, Hey, it's a day off. Let's go enjoy it. And my wife is of the mindset, Hey, that's a couple thousand dollars. Let's not give it up for nothing. Uh, so we compromise and, you know, we lose what we lose, but just like anything we, okay. So if we lose the visit this week, we extend the plan of care. We're still going to capture, uh, the revenue we're still going to get that patient what they need thankfully none of our patients are life our life or death so right yeah i mean this this goes without saying like you know someone doing inpatients a little bit different or whatever um i saw some people some some major franchises i won't say which ones but like we're like we're closed until noon and these have pretty big footprints so i thought that was i mean if you're gonna make a decision Making it clinic to clinic is probably, I don't know, probably a pain in the ass.

3:30 Like, well, we're good, but we're not good. We're on a hill. So even if there's no snow, you know what I mean? It's like, we're closed until noon. And then they said, we're going to have some later hours open for options for you over the next couple of days to make that back. That feels like a good compromise, right? Yeah. And again, every business is going to have breakage. Like you have to plan for breakage. You have to have enough profit in the margin that you can handle something like this. And it's not going to put you out of business. Yeah. Okay. Well, I'm sure we'll hear from more people dealing with the snow. I didn't have time this morning to make fake... I didn't have time to do the full soup to nuts because I slept in because I was at Graham Sessions this weekend.

4:17 Again, a reminder, this is like a very small private conference put on by private practice section. I now know what it feels like to work communications for APTA, I think. Because I was there as an independent human being talking about the conference. And then next thing you know, so many people were doing this to me. Finger wagging. Well, yeah. I was like, hold up. Who are you? John two forty seven. On Instagram, what are you talking about? I don't need to do Jack. What are you talking about? So let's talk about the conference.

4:57 Then we'll talk about the repercussions. So the conference is great. Again, these are the people that you see on LinkedIn or maybe you don't see on LinkedIn that go to CSM every year. APTA's private practice section started this conference nineteen years ago. I said twenty. It was nineteen years ago because they were like, hey, listen, can we get some actionable stuff? Let's get a bunch. CSM is huge. CSM is a circus. You can't have decisions at an NFL game. You know what I mean? Like with the, with everybody there, it's not how it works. So by no means, by the way, I want to preface this by no means is APTA private practice section saying like, we're coming together, we're making decisions. It's not what this was. This is a bunch of people who, by the way, paid their own money to go there.

5:39 People were like, I want to know what this thing costs. I'm like, it cost me three hundred dollars to go. Plus, I got to pay the New Jersey turnpike and I had to buy gas. Who is very funny to watch people immediately jump to. Well, who the hell are you? I'm like, I'm Jimmy. Nice to meet you. Slow your roll. Conference is great. I've had people that were there for that have been going to this for close to all the time. I hung out. I did an interview with Patrick Graham, who obviously the sessions are named after, who has some great insights being there almost, if not all. I think he skipped one or two years. This is a bunch of people, mostly private practice owners, but they are, in my opinion, getting smarter about like, well, where are the academics?

6:26 Because if we keep finger wagging at schools got to cost less or you got to give us better students, like if they're not in the room, it feels not productive. So there are some academics in the room. um someone did point out i won't say who because that's the deal you're allowed to say what was said but not who said it good someone said where are the payers man what if we got some people and then people were like aghast well they would never come and of course tony and jimmy i think did you ask yeah yeah are you sure what would happen if they did right so they're not in necessarily in the room uh the three biggest problems that we talked about because you it's a day and a half You could only have so much programming.

7:08 People were like, why wasn't reimbursement just talked about for a day and a half? I'm like, because I would have fell asleep and left. I don't know what to tell you, right? Again, we do not have magic wands. It's not like we said, we're going to get together and we're going to solve everything, which is a slippery slope, right? That's what people say. Well, you said you got together with smart people. Yes, I did. The three big ones that stuck with me were student debt. That was one of the session at the end where they brought a student up and she literally had a piece of paper and was like, oh, I checked my account this morning. I graduated four months ago and I owe one hundred and seventy five thousand dollars. And I'm making I forget what she said. Sixty seventy thousand dollars because she's in peds. And she's like, I will not be able to buy a house.

7:50 She's like, I have a financial planner because my parents made me get one. I'm not gonna be able to buy a house for the next whatever. I'll probably move out of this area because she's in Alexandria too. I'll probably move out of this area because there's no possible way I can afford to live here anymore. This doesn't make any sense. I thought it was funny that they brought up four people on that panel, student, academics, business, somebody else, policy. They introduced the student first. She did the big reveal, the big, ooh, this is how much money she owes. And everybody around the room, of course, was like, this sucks. We should stop it. And then the student didn't talk for forty two minutes because they didn't talk to her.

8:31 Sorry, I keep calling her a student. She graduated four months ago. She is a physical therapist. She didn't talk for forty two minutes. And I was like, oh, glad she took took a Saturday to come and not be addressed. And then we just talked around her for forty two minutes before she talked again at the end. I was like, but here's the problem. Here's the thing that people were up in arms about a post I had last week. I want to be very clear about what I think. Like loan forgiveness programs. Cool. Like if you do this, then you get that. Great. That's what I mean. Like PSLF. Like if you work for a nonprofit for ten years. Awesome. Do I think loans should be forgiven? No. So everyone's like, see, she signed up a dotted line. She got gut punched with one seventy five.

9:12 Screw her. OK. You're not going to have anybody to hire in six years. Oh, shit. Now it's a me problem. Oh, now we get the violin out. But I can't get anybody. You're telling... So the video I recorded, I think some people keep hearing emotions in my video, which is good. And then they assume what I'm saying. I'm not saying we should take pity on these poor adults who signed an agreement to pay back a loan. I'm saying if this keeps continuing... you won't have anybody to hire. And now all the business people are like, oh yeah, now it's a me problem. Now I'm intrigued. What do we do about this? So I'm saying, should we change the system in some way to make this less shitty?

9:56 There is a company out there that approached me a while ago and they essentially are like ROTC or PT. What they're saying is, if you sign this on this dotted line, more dotted lines, You're in PT. You sign the dotted line. We, as a company, will start paying back your loans right now. And we'll pay off your loans in... It's different for every student with the amount, whatever. Six years, if you work for us for six years. If you leave, you owe us the money. And I look at that like, that's a solution. I forget the name of the company I'll find. I'm like, that's a solution. ROTC, that model of if you... If, then...

10:39 The answer can't be, it's too much. Let's just wipe it all clean. But you can't also say it's because the government doesn't have money because we have buckets of money buying Greenland. So I think that ROTC angle is better, if then. If you work for a nonprofit for ten years and you make payments, whatever is left is... I hate the word forgiven. It's like, well, now it's a contract and we earned it. It's not forgiven. I paid it. You said, if you do this, you'll pay that. So that was problem number one. Reimbursement wasn't talked about. At all? No, not at all. I meant like it wasn't like a session because they're like, dude, we do it every...

11:19 We sort of do it every other year. It's like, otherwise, just have a separate conference for that. But it was talked about in every single discussion. I mean, this is a math conference, right, for PTs. The second one was... uh uh not direct primary care primary care so i took everything we talked about primary care access was one in utah i took everything that we said i only talked once like in the room most of the time i was in the hallway interviewing people because that's what i do but i was in the room for that and everybody was like we won and in my brain i'm like you're on mile nine of the marathon do you know what you get have you ever run a marathon tony I have not.

12:03 You've been to one or seen one. Yeah, yeah, yeah. You know what you get at Mile Nine? What? A cup of water and a granola bar. That's all you get. You're not done. You don't win anything. No T-shirt, no clappity-clap. You get a pat on the back. So, like, I stood up and I said, oh, here's the other thing. They put a card, like an index card, on every table. and it was the it was the definition of what prime because now it's going to become a and i might screw this up it's not a like an academy or a section it's going to become a something the primary care special interest group or whatever some group people can be able to belong to it and learn from each other which is great they put a definition because you have to define it now what is primary care physical therapy and they put an index card on the table of every on every table in the room before their talk great move so wait real quick are they calling it primary care physical therapy or are they calling it primary care or what are they calling it i would have to go back to the index card hang on i took a picture of it for a reason that tony is going to love in my opinion i took a picture of it oh there it is they're calling it defining primary care physical therapy apta's primary care special interest group definition And they talked about it.

13:18 If it's primary care physical therapy, then people need to say primary care physical therapy and stop saying primary care. That is destroying any movement in that direction. Right. Again, and I think most of the colleagues that are there understand what Jimmy does. I am not there to poop on you. I'm really not. Most of the time. I'll take a shot at someone in the comment section every once in a while if I think they're a douchebag. But most of the time, my questions are to get myself and the other person to think deeper. So I came up and I said, this is awesome. I don't understand the nuances of policy like other people, like Dana Strauss. I hang out with her. And then I also said, Dana, tone it down for me.

14:00 You got to talk to me. I understand you're here. So I walked to the front of the room and we're on the seventh floor of APTA's Avengers Tower. I mean, you can see the Capitol building. This is legit. And I said, this index card is awesome. You define primary care physical therapy. And I know that this is an internal definition. This is not what they're putting on a t-shirt. It wouldn't be able to be. And then I grabbed the mic. And I said, I want everybody in the room. Look at this view. Come on, everybody. Look at this view. It's just a wall of windows. And I'm like, I want you to look outside. Look outside. Everybody's still looking at me. I was like, stand up and look outside.

14:40 I'm not kidding. I was just repeating it, repeating it until people were like uncomfortable. And then I said, once half the room stood up and looked outside, I said, none of those people understand what this is. None of them care. They don't care. They don't understand it. Why? Because you put an eighty three word definition. of a thing, eighty three words of a definition on a on a table. My friend, if anybody here was part of writing that. I give you a million dollars if you can come up here and recite recite all eighty three words in order. You can't do it. That's OK. I know that's not the but I'm being facetious. I'm trying to draw them in. And I said, this is awesome. We're at mile nine of the marathon. You get a cup of water and a girl a bar. You need to answer three questions. If a patient sees primary care physical therapy written on a sign tomorrow in Utah or anywhere, Utah was where the decision was made, how would they know that's where they should go instead of urgent care, an orthopedist, a PCP, emergency room?

15:35 We're close. We're not there. Let's not celebrate yet. We're at mile nine. Question two, what's the one sentence we want the public to remember about primary care physical therapy five years from now? You have to put your words in their mouth. Well, first in their brain, then it'll come out of their mouth. You have to repeat that. And if you don't, you'll fail. And then the final question I asked, what do we think will cause this to fail? And then I paused for dramatic effect. And people were like, ooh, he's so edgy. I'm not edgy. This is not edgy. Not clinically, not policy-wise, but behaviorally. You're trying to change culture. No one said the word culture in the room. So I was like, that's a cool victory, but you're on mile nine. You cannot stop here.

16:17 But you also have to change sports because you went from a policy win to now a culture marketing. Now it's a triathlon, not a marathon. Ooh, look, there's the analogy. You now switch from the bike. You got to run now. It's a different sport. And if you're not good at it, hire a runner. Get an Olympian. Get someone who's awesome at it to close this door for you. Because if it doesn't go well, it fails. So did you get or do you have a single sentence kind of definition of it? Yeah, I wrote a couple down because, of course, I mean, I did all this in AI while I'm standing next to the stage as I'm about to go on there. So I'll find those in a second because I said, hey, tactical.

17:00 And then I read a bunch of the answers. I said, what if Apple were to roll this out? What if Amazon were to roll this out? What if Google were to roll this out? And that was my sort of pitch. So I'll look for that right now. Primary care one-liners. Here it is. I don't know. I don't love any of these. I don't hate them, but I don't love them. Front door care, which I was like, we can't use that. That's funny, but don't do that. First step care for pain and movement. Again, our profession is the problem is it's ambiguous. Do you know what I mean? Like, we're gonna run into the same.

17:41 This is simple, not easy. Start with movement primary care. I didn't love it. Primary care physical therapy is a policy name. Not. Yeah. I'll find some more suggestions. I mean, there is the choose PT or that's me. PT first or choose PT first. That's like saying buy wrench first. Get PT first. Buy wrench first. Because PT is a profession, not an intervention. First for what? When? Like just do it is great. Because like what's it? Doesn't matter. We're higher up. We're lower in the stream.

18:22 Yeah. Yeah. And what was the third thing I wrote about? Student debt. There was a bunch of things talked about. I'll think of the third big, hairy, scary problem. Was it hiring? Or was that still part of the student debt? I think the third one was just like the junk drawer, like hiring, business costs, costs are going up. And I'm like, guys, that's sort of what inspired me to make that video yesterday where I said, do you want to save five thousand dollars and not go to a marketing company? Weekend course, I'll save it for you right now. The fit VP principle. I've been saying this since I was a PT student. Frequency, intensity, time, type, volume, and progression are exercise principles.

19:05 They're marketing principles. They're relationship principles. It's anywhere a human meets a human. It's like, well, what should we do? What's not working? Well, then just do it every six seconds. Too much frequency, right? It's not just do it more. It's like, what's the right frequency? I don't know. We test it. That's what a good marketer is. Good marketers is a scientist who's like a social scientist. That's why I love running a radio station. You know how many times on a Friday night with all the guys that help me run the radio station, we're like, oh, we get drunk and come up with a funny idea. And we'd be like, this is a slam dunk. We'd do it. And a week later, we're like, that did not go well.

19:45 And then sometimes we're like, I have this idea. That's going to be all right. And that thing runs for six years. We're big, dumb animals. We have no idea. So I think it was hiring. I think it was policy and payment, all sort of a smorgasbord. You saw that in every talk. So while reimbursement wasn't said, it was everywhere. I had two questions. You answered one already. So it was at the APTA building. It wasn't at a convention center or something else. And then what was the... Go ahead. I was going to say, because APTA was smart enough, they made their top floor something anybody can rent out. So there's craft services. There's a great view. There's everything. So yeah, it was there.

20:26 But again, it was private practice section renting that from APTA and then inviting a hundred and fifty people who wanted to talk and listen. So that was number one. And then I was going to say, what was the criteria for who got invited? Not just to speak, but to attend. I have no idea. Okay. I could ask. I literally wrote to the... Because I know the people who put this on. I'm like, why did you invite me? I'm like, well, Jimmy, you think differently. I'm like, okay. So I think it's that. I think they're looking for people who think differently. And that's why I said, well, can I record there? I've recorded there before. And they're like, well, we don't know. And I'm like, well, then I can't come. Like... am i doing there like i could come there and just write stuff down but i don't do that yeah so that's who's picked i do here's the thing they are not trying to be exclusive like they're not like we're just going to keep inviting the same people they don't the people that when people push back and they say look this sucks and they're being elitist i say point to the person you're talking about well no not that not one person all of them all of them is made up of a bunch of one of them's right like keaton ray Graduated the same year as me.

21:34 She's running this with Sharon Dunn, who was APTA's president. They could go hang out with their friends anywhere. Why do they put their time, effort, and money into doing this? They honestly want things to change. What's the best solution? Who the hell knows? But get a bunch of motivated people from different backgrounds who would like to suggest good ideas in a room for two days. is a way right and that's what we do with that's what we do most of it that's what that's what this is like i'd even like to say like how could you do one of these twelve of these a year but online like So I saw one of your video posts recently and somebody laid out their action plan because they were complaining that there was no action plan.

22:19 Were there any ideas that came out or anything that really stood out? I was like, oh man, we never thought about that or we never consider that or we haven't tried that. Most of it is like, here's what we're doing. Or here's what we did. And then here, would that scale? It's that. But there's no one in the room who makes that decision. But here's my thing. No one at APTA can make that decision. So I understand if you're disinterested in APTA and you're like, Jimmy's over there at APTA. Well, what's the plan? What's the plan then? What's the plan? What's the plan? I'm like, the plan is we're all in this together, whether you're in the boat or not. And it's not like we're just not doing stuff.

23:02 So someone asked me, what would you suggest doing? Not join the APTA? I go, yeah, sure. Well, then what do you do? Join the UPTA or just sit back and take it? I was like, join the APTA or not. And if you join, you immediately start working on solving your own problems. And if you don't, you immediately start working on your own problems. It's not an easy button. It's not. It's a group of people who are trying to figure it out. Dude, we're outmanned and outgunned. You and I have said this. People have said, you have brought me over to the dark side. And by the dark side, I mean probably the smart side, which is reimbursement. Assume from today, January twenty sixth, until the day you die.

23:45 will not go up. And if it does, I'm not saying don't advocate. I'm not saying don't try. Someone else do that because I would smack my head against the concrete. I don't know how these people do it in advocacy. I don't know how they do it. God bless them. To ask for the thing that's very clearly deserved with statistics and all that stuff, and then just be like, all right, well, we're only going to cut you one and a half. That's a win. I would jump off a freaking bridge. I wouldn't last ten minutes. So good for you. I can't do it. Glad you are. I am going to now operate under the assumption it's never going to get better. Not because I doubt the advocates or think it's not good. I'm going to act as if. And then act as if educational costs will continue to rise forever ad nauseum, no matter how red your face gets.

24:30 Okay, now act like MacGyver. Given this, can you make a thing out of this? And this is all we got, people. There's no weapon we're not pulling out of our pocket. Like, get over yourself. So I do love when the people jump in my comments now and they're like, what would the big bad APT, what would the hundred and fifty elites decide? They decided that you troll posting in my comments ain't going to help anybody, but thanks for the boost in follower count and attention, I guess. But when I push back, when I say, that is a good point. We shouldn't have gone to the doctorate. That was a crappy idea, I think.

25:10 I don't know. Doesn't matter. We're there. You've seen bells. You cannot unring them. Okay. Now what? Now what? What would you do? Nothing, nothing is an option. I just think it's a shitty one. So you drive in home, six hours, I think it was. What was going through your head during that time? Kind of what it always is. Kind of what it was before I started a podcast. I was like, dude, the answer's in the room. And luck favors, not the bold. There's no luck. It's a lazy term. It favors the people who are just going to try stuff and risk stuff. And that's not most people. And that's okay. Right.

25:50 It really did solidify because I know people in academics. The people that I know, I don't know the people on the twelfth floor, though. I know the people on the sixth floor, like professors, program chairs, deans. I know them. Every time I meet someone who's a little bit of a higher level, I'm like, oh, you don't call the price shots either, huh? I'm like, where's that person? I'm like, not at APTA headquarters on a Saturday. Why would they come here? I think I used that quote from Upton Sinclair like six times, which is, you can't force a man to understand something that his salary depends on him not understanding it. It's like, if you're making decisions from a university-wide perspective, And you have eighty seats in your PT program and you have eighty one applications.

26:42 Why would you lower the cost? Right. Well, because in ten years, the profession, they're like, I don't I'm a university. I'm not a physical therapy profession. So I see from physical therapists or people who want to apply going, this is I can't do this. And I go, you're right. Now, make a decision with your head, not your heart, or else later you'll have to make one with both. And maybe the answer for you is don't do it. Like I look downstream at things I don't look at, which is, hey, with this cap on loans, like the cap, the whole nonprofessional thing, whatever. They're like, it's just going to be a bunch of rich white people in PT. Right? Because like, who can't afford it? So now I'm like, oh, I didn't think about that.

27:24 That sucks. So what does it look? So you're making decisions now that will affect people that are not you ten years from now. And you're like, well, if I'm a university president, I need to solve the university problem now. So the answer is a PT program is low cost to run. We have eighty one applications for eighty seats. What's the problem? From their position, no problem. No problem. Why would they go against their own nature? So when people's like, we'll get the APTA to tell the schools, not their boss. Doesn't work that way. So your answer, while emotionally makes sense, logically doesn't. APTA or CAPTI or any of these organizations, they can't tell a university, don't do that.

28:07 You can't. You said to be accredited, you need to do these things. The school said, gotcha. We did those things. Great. What are you gonna charge for it? Whatever we want. And then they do. And then you're shocked by it. So understand the physics. Now that you know that, bitch about it to yourself or to your friends, then move on and then solve, decide how to solve it. The same thing with reimbursement. Why would they, why would they, unless people are like, well, then we should strike. And I go, great idea. How are you going to do that? That's why people, that's why I annoy people. Because I don't just agree with them. I go, awesome. How? I will be the first person with a sign or something. But like, show me how we get enough people to make a difference.

28:50 And their answer usually is like, well, that's for someone else to decide. I go, oh, okay, cool. Got it. So is there any AI discussion? No, which shocked me. But then they said, oh, it was the entire thing last year. And I was like, got it. So you got to cool that off. Because some people do come back year to year. And some people, which is good, it's usually their first time and stuff like that. But they're like, everything's AI. Everything was AI last year. And I was like, sort of still a big deal, but keep going. But Stephen Cohen was there. Prompt was there. To me, those are the people in the room going, Don't talk about AI.

29:31 I have this part of AI. I have the AI using it as a solution for your actual... AI is not a problem. AI is the thing that gets you to the thing. So when Stephen Cohen is like, RTM, add eight grand a month. Plug in. This is how it works. He's like, that's a money problem. That's a problem that is being talked about in that room. So AI wasn't talked about, but was. It was. Very nice. Sounds like it was a good event. It sounds like... You know, you took something away from it. I did. Well, and then what I did differently was, because again, you got to ask yourself hard questions. In the past, ten years ago, I was there with a little handheld recorder as a new grad, just doing a bunch of whatever.

30:15 And now, fast forward to twenty twenty six, you know, a couple of years ago, I would have sat down with a camera and a microphone and I would have recorded. And then, you know, two weeks from now, because it takes a while to like edit and whatever. Now I'm just like, why not just go live? Yeah. So I did that. So I sat down with a little bit. People were way less nervous or apprehensive. They were just like, what are you going to ask me? I was like, here are the three questions. What's something you're excited to hear solutions for? What's something you didn't see on the docket that you want to see solutions for? And what's something that needs to be on the docket next year? Those were the first three questions I asked.

30:55 But then, of course, in any good conversation, it sort of branched off. And then I let it go because I had Philip Goldsmith from Home Health and this person from private practice. The same question to thirty different people from different backgrounds, wildly different answers. I was looking at it from a tech perspective, like, was their interaction live? know did youtube reward me or the platforms reward me for going live ten times in one day i'll be able to figure that data out prop you know today or the next couple weeks to figure that out but for me way easier right because well that's done i'll run the transcript through ai to get i did of course like go improve the thumbnail improve the description of the title afterwards because i know we're going to talk about so and then and then i'm flipping them to all podcast episodes But then on my grand scheme of things, my big, hairy, audacious goal in twenty twenty six that I told nobody about until I was doing it was I want three hundred and sixty five episodes minimum in three hundred sixty five days in twenty twenty six.

31:55 And I think I'm. Like six or seven episodes ahead, so on January twenty sixth, I'm scheduled through, I don't know, February tenth. And it's more and of course, now I'm doing more than one a day because I don't want these things to sit there because they do have a shelf life, right? If I drop something from Graham Sessions six weeks from now, it's like, dude, why don't you just do it faster? I also don't want to drop ten episodes in a day, so I'm just doing them one a day. Well, why do you want to drop ten episodes in a day? That's a great question. I don't know because the pundits don't do it, but maybe they're wrong. And that's a good maybe maybe I can I can go back and just make them all released today.

32:36 That's what I would do. I've been doing it. I've been doing it for a year. I know what people have said and then I've seen what happens. Um, generally, I mean, even if I'm going to drop five clips in a day, I just drop them all in one shot. I've also scheduled them every two hours. I see zero difference in the performance and the analytics. Um, and this became popular on TikTok. TikTok people started saying, look, just throw up thirty videos. Let the algorithm figure it out. It will serve up what needs to be served up when. For something like this that's relatively time sensitive, that it was an actual event, I would just hit them all.

33:19 I would just throw them all out there, make them all public. Screw it. All right. The first one was scheduled to come out at one o'clock. I'll just change them to all one o'clock today. And go back to human behavior. So we've been watching the pit. We watched all like we binge watched all of season one. They were all available. Now we're on season two. We're caught up and now we have to wait. Like it doesn't mean we're not going to watch them when they were all available. We watched all the season, all the episodes. Now they're spreading them out a week apart. It's frustrating. We'll still watch them, but it didn't change our behavior when they all dropped at once.

34:01 ah screw it i'm gonna do it all one o'clock then i'll do all of them i did ten and i'm still gonna be because i couldn't do um i didn't want to bring my stuff and set it up for the second day was a half day yeah and the funny part is a lot of a lot of people there had no idea who i was they're like i don't what do you want because there i am sitting at a table with a giant camera and and lights and a big mic and a headset microphone and people sort of do this like what is that right people who know me are like ah there's jimmy again being weird with a microphone and i'm like hey you got ten minutes if i didn't know people i'm like you got ten minutes and they're like no what are you doing and i'm like so no and then what are you doing right i want to say no and then i'm like just trying to get some of the ideas to leave the room they were like that's kind of cool like you have ideas well i don't want to what are we here for then like so i was sort of like poking people then i said how about this give me follow me on linkedin see what other people have done what i'm doing is i'm lowering the anxiety like they're like are you gonna like fire quite because they don't know me in their defense i'm gonna shove a microphone and start yelling maybe I was like, watch what other people have done.

35:15 Watch the roller coaster. Everybody who goes on gets off. It's safe. No one dies. And then in a week, if you're like, I would have done that, email me and we'll do a ten-minute with this. Colleen says, some of us work from home and binge listen to your podcast. Yeah, she's right. Yeah. And I know that. It's making me change my thinking, which I like. Yeah. Everything I said, spread it out. You have to have something once a week or whatever. So I think as long as you can have something once a week, good. And if you've got a lot, why are you Bogarting it? Like I was like, you know, in a week, Graham sessions is going to be gone in people's brain. Right. It was the thing. What's the new thing? I don't know this.

35:55 So yeah, you're right. So I'm going to, I'm going to release them all at one o'clock today. Beautiful. They're ready. Like, why wouldn't I? Yeah. All right. Uh, what else can we talk about? Colleen? I'm curious. What are you working with home? What are you doing from home? You got like sixty eight letters after him. I love that. Colleen P.T. D.P.T. W.C.S.C.L.T. Women's sports. I want to know what that is. I love some of these weird. I know a lot is the lymphedema. Oh, lymphedema. She said either or University of Minnesota. I don't know what you mean. Either you froze or I froze.

36:36 Yeah, you're frozen on my screen. I froze. There we go. Now we're back. What else? Pelvic and lymph. Yep, that makes sense. Working from home. Where from? I'm just curious, Colleen. We can also talk later so we don't have to have a weird one-person conversation. Oh, utilization management. Utilization management. Yeah. All right. Well, so I grew up... somewhat related to what we were just talking about i grabbed this screenshot before we came on this is um from meta business suites this is my business facebook page i forgot about this report until just this morning so this compares it says results based on businesses with similar organic twenty eight day reach in your category now my category is medical and health i think um But I put out a lot of content.

37:31 I mean, more than one a day. I probably put out three to four a day on average. I think I do fifty on average posts a month or twenty eight days. So that's almost two a day. Yeah. But some days it's going to be four or five. Like I did ten on Saturday and then I did three on Sunday. But I'm still lower than a lot of people. So can I see if I'm reading this right? So it's saying you in twenty eight days, you published one hundred and seventeen pieces of content, whatever that is, video picture. Yeah. And then it's saying it's compared. So the good thing is it's comparing you to other businesses with the same reach.

38:12 Maybe not, maybe not followers, but same reach. Yeah. And in terms of followers. So that's the bottom left one is a good number for you. You have lower followers than other people who have the same reach, which means you're doing more with less. You're doing less interactions than others. But again, that could be looked at like, well, you have less followers. I think you're punching above your weight in terms of reach. Uh, how often your business? Yes, it is. I'm sharing this more to say, look, your business. So I'm between the twenty fifth and the fiftieth percent. Oh, that's what that chart is. Got it. So it's showing you one seventeen. You are.

38:53 I published one hundred and seventeen posts in twenty eight days. I'm not even at the fiftieth percentile for the number of posts for other businesses with comparable reach. Dude, this just reinforces that idea that you did that we've talked about. So I was listening to a Hormozy video and he's flip-flopped. By flip-flopped, I mean he's tried stuff and been like, no, let's do this. I don't love Alex Hormozy, but he's right a lot of times. You can't listen to him a lot. He said something along the lines of, I used to do X number of days of content recording a month.

39:40 And then he said, number of days of planning and recording. And then he flip-flopped them. He was like, we prepare, prepare. So what they're doing is they're making not more stuff, a lot of better stuff. He's like, that's the better part. So I would say he can do that now because he made a lot of stuff before. Correct. So I think if you're here, if the bell curve is the hockey stick is here, make stuff. This is coming from me who used to run a radio station. Do you know how much stuff we used to make? Yeah. All we made was stuff. One hundred and sixty eight hours worth of stuff. Is this a quick strategy tip for those?

40:25 I know a lot of people watching this are like, I can't even stay consistent with one a week. How am I supposed to do for a day? Um, you know, part of it is you're looking at me with. Ten to fifteen years of content collected into a library. Like I will literally go on my desktop. go back to twenty seventeen, find clips, find still frames, grab pictures and repurpose them today. So like anything, you've got to take this with a grain of salt. I can't go to a college football athlete and expect my, you know, forty seven year old sedentary male to do what he's doing.

41:06 We have to have perspective. But at the same time, When should I have planted the oak tree? Twenty years ago. Start collecting the media now. Start collecting the assets now. Start building the digital real estate now, because ten years from now, you're going to need it. Yep. Mike Reinhold chiming in on Instagram saying, unfortunately, none of these problems are new. Agreed. Mike is not wrong. These problems I've been building for years. This isn't the first time we've outlined these problems. We spend a lot of time talking. So should we start trying to solve these? I know not easy.

41:47 Mike's not wrong. Yes. You've seen my chart, right? I throw this chart up whenever I'm talking to someone. You have to define the who. So when Mike is saying this, Mike is smart enough. He's like, Mike Reinhold has a clinic in Massachusetts somewhere. Mike solves Mike problems because he has to, because no one's coming to solve Mike problems. Tony solves Tony problems. An association is meant to solve the problems that we can't or won't. Well, I shouldn't say won't. We could easily won't solve a lot of problems, but no one's coming to help. I gave a talk to PT students about me being a lifeguard on the beach before PT school.

42:28 And we did a day's worth of like, this was the best day ever. We were like becoming beach lifeguards. Day number six is when they teach you how to run in slow motion, by the way, in case you're running, in case you're worrying. But day five, they were like, here's how you do jet skis and boats and do cool stuff. Stuff that we're probably never going to do. But it was cool. And then the next morning at five a.m., we're on the beach. And they're like, you see that buoy? like a thousand yards out, like at the horizon, like literally you're on the beach in South Carolina and you're looking out towards England or whatever's across from there. And they're like, hey, everybody put on your buoy and go swim and touch the buoy. And one of the guys was like, because we did boats the day before, was like, where's the boat?

43:09 And the instructor like took his like, Baywatch sunglasses and just brought it down and just like, you're the boat, start swimming. That's the greatest lesson ever. Dude, you're the boat. You're always the boat. You're always the boat. No one's coming. If you find people along the way to help you, use them. Read a book, listen to a podcast. You still need to go execute. You are still the boat, start swimming. That's it. But I do like... So you're... I was going to say cynical. I think you're realistic. Practical. What are your thoughts about two double-folded questions about meetings like Graham Sessions happening and meetings like Graham Sessions worth Tony himself going to it?

43:53 I think it's one of those deals and we see it constantly. And like what you said was exactly what I think a lot of therapists would say about most patients in the physical therapy clinic. Good example. It's a situation where people are coming. How many of those people are going to take the information, take the inspiration, take the ideas and go implement on it? Virtually none of them. The real value is somebody like you, you go, you maybe there's a spark of an idea and you take that and you do something with it, partly because you have the capacity to do it because you're not seeing forty to sixty patient visits a week. Partly because it's in your nature.

44:34 You're a builder, you're a creator, you're going to use this to kind of fuel. I get the impression that there was nothing like that that happened for you. So it's more just, hey, this confirms, this reiterates on the ideas that I'm already working toward. I'm just going to keep working toward that. You know, most of the time it's a waste of time. Most of the time there's nothing tangible that actually comes, but it's not the fault of the organization or the organizer. It's just, we hear it. Maybe we get a little excited and that inspiration wanes within the next seven to ten days. The exciting parts, and this is, of course, again, where my podcast came from, where I said, dude, the back of the napkin, the let's meet at the hotel lobby, two and a half drinks deep, and you make a connection with someone and you're like, yeah, we need to do this.

45:29 And you're like, I'm a computer programmer. I know how to do that. And you're like, you can do that? And you're like, all right, well, should we do this? That's where businesses are born. So it's almost like the problems and the presentations, those are just the pile of wood. It's like you got to go to the hotel lobby to start the fire, and then you got to follow up with it. You have to do the surprise part. The physical part of physical therapy is on you, the patient. But the problem solving solution part of a Graham Sessions or CSM or anything, it's on you. If you think the answers are going to be given by PowerPoint, they're not. You have to do something with them.

46:09 It's a good, I don't know the rule, eight and twenty probably, twenty percent learning, eighty percent doing. And I'm a guy who shares information. And I'm telling you, learning, it's probably twenty percent doing. Well, because there's a bunch of learning in doing, too. So you could get ready all you want. But once you start doing, it's not coming. So here's a crazy business idea. I even have the logo. This is Jimmy and Tony's. mobile studio. We're going to get... My brother has one of those like, twenty-foot trailers that he chose behind his truck. We're going to roll into Cincinnati, and then we're going to roll into Pittsburgh, and then we're going to roll into Philly, and then we're going to roll into Scranton. I'm just naming towns. We roll in with a studio that goes, you got a practice owner?

46:51 You can't put out sixty-eight pieces of content a month? Great. Tell us all about your practice. By the time we get to Philly, where you are, we're going to put you in front of a camera. We're just going to come in with a media team. You pay us ten grand. We give you six months worth of stuff, and then we leave. And then you tell us if it's worth it, and we come back. Is there a market for now? I mean, I see this even bigger now. People live in my town. There's a creator studio. You can go rent a podcast studio. My thing is you still need to know what to do with it. I don't think the renting of the studio... think that'll come and then go very quickly it's the here's what you have here's what you have right now if you're nodding and you're like i have to do okay yeah i get it if i put out to compete i have to put out a hundred and fifty things you start out with nothing that's the hardest page to start it's like there's nothing there what do i do ah i still think people need to have their hand held myself included is there a market for that I don't think there is.

47:50 And I say that not because people aren't going to say, yes, that's what I want. Yes, that's what I need. I need to lose twenty pounds like legitimately. I need to lose twenty pounds. I know how to do it. Theoretically, I know why it's important. It's the best gift my fifty year old self can give to my seventy year old self today. Like all of these things are in place yet. It hasn't happened. I go through the same cycle again. Nobody can make it happen. I know the drugs that are out there that I could use. I know the diet advice that I need to follow.

48:31 I know all of those things. I almost feel like it goes back to it's like the people who are already successful, the people who are already doing it, they're the ones that will take an idea like this and do it. But do you think there's a small enough audience of those people? Like I know if we're looking at a pyramid, it's the people. All right. So there's three types of people. There's lots of types of people. Maybe there's four types of people. There's the people who know this and they're already doing it. And they're like, I don't even listen to Jimmy and Tony right now because I'm doing I've been doing this. They're ahead of us. Yeah. There's the people who agree and they might turn, they might pull the trigger if you just held their hand. That is probably even, so it's super small, small, but a little bigger.

49:16 There's the people who would read a book by the camera. Just not take it out of the box. There's those people. Then there's people who are like, I'm never going to do this ever. So why bother? I'm talking about that second group who is like, all right, if you show up, And it's five grand and you're going to do it for me. I'll pay you. Right. I don't know. Yeah. There's probably for us, there is probably a big enough audience to make it worth the adventure, to make it worth the time and the money. Let's do it in Ohio. Your home field event. Not now. Cause there's a bunch of snow. Oh, it's snowing again here in New York. Awesome. That's what I like. That's what I like to see. I still, cause you've done this sort of.

49:58 Right. I mean, that was more teaching and less doing, but that was, I mean, they did a little bit while they were right. Explain that. Yeah. We, we had a handful of people come out, you know, and, and my main objective when I was laying this out, I kept hammering chat GPT with the same prompt, which is, I don't want a bunch of people come here, spend money to come here, go home and do nothing with it. I want people to make a material change. I want a measurable change. Now, some of them absolutely did. But this is my problem with patient care. It's like, how do I justify? How do I feel good? How do I go to sleep at night knowing whether it's the patient's money or the insurance company's money that they are going to take and get value from the hour they spent with me today?

50:49 Because I know that most of them are not. Most of them are going to appreciate the time, get the benefit temporarily. They're not going to follow up. They're not going to make the lifestyle change. And a week later, everything is wasted. They're no better than they were before they came to therapy. So I kept trying to hammer that idea into the AI so that I had the best possible chance of delivering sustainable results. And like I said, out of the roughly ten people, I know at least three took off like their business is doing amazing. Their social media is doing amazing. They've added likely tens of thousands of revenue just based on their what they were doing would they have done it without me yeah i think they probably would have you know and this goes to that point is the successful people are going to be successful no matter what But you might have made it sooner or faster or smoother or easier by making it less scary and more clear.

51:50 I've got a podcast cohort. I'm teaching a bunch of healthcare people how to launch a podcast. But really, I'm teaching them all of this, like content, whatever the hell you want to call it. And I said, you're all smart. You'll have freaking higher ed degrees. Why do you need me? You could Google this and download a checklist. You go to AI. I'm like, you're not here for information. You're here for clarity and you're here for, it's not motivation. You're here for accountability. Now, you still need to do it. Now, remember, that's what your listener is there for. If you think you're just here to read a chapter in a book to someone in a microphone and that's going to guarantee you a connection or listens or that bringing you business, I have news for you.

52:31 It's not. They are looking for clarity and accountability to something or someone other than themselves. And that was like lesson one or two. I haven't said the word microphone yet. I haven't said the word camera yet. And we're in week three or four. I'm like, I haven't said download yet, except to say downloads don't matter. I got a friend who launched a podcast for physical therapist assistants. She's in Ohio. Because I knew her for, at that point, five or six years. And she's like, well, I'm just a PTA. I'm just a PTA. I'm just a PTA. And I'm like, I like several of those words you're saying. And I dislike one. You keep saying PTA.

53:11 Big fan. You keep saying just. And I think it shits on everything after you. I'm just anything. It just undermines. To the point where I poked her enough and I was like... If more people knew about how great PTAs were, would more people become PTAs? Would more people, patients get helped? Would more businesses thrive? Because Tony's saying, hire more PTAs. They're more cost-effective. And she's like, yeah. And I go, then why don't you start a podcast for one? Because there really wasn't one. And she was super hesitant until I was like, I will show you what microphone to buy and how to do it. And now she's got ten thousand downloads. And I'm like, whoops, look what happened. How'd that happen? But PTA is a small market, Jimmy.

53:53 If your goal was downloads, aiming at a small market of PTAs would have been a bad idea. Her goal wasn't downloads. Her goal was impact. And she found it. Speaking of impact, the Gary Vee, let me see if I can pull this up here real quick. Oh, the one you share with me. What was it? Yeah. Oh yes, yes, yes. This is brilliant. so don't play it though because i keep getting don't play the audio because i keep getting dinged on whatever platform because of he okay i won't play it i'll just show it here uh this is gary v gary vaynerchuk talking about uh this chili's video yes we're just an influencer Talking about, you know, this appetizer.

54:38 She shares this. Do you remember the numbers? Because I don't remember the numbers. A bajillion, I believe. Yeah. So to the point where if you understand the Chili's franchise, they have restaurants all over the country. They could measure the impact of this one video on increased sales in their restaurants. Wow. What's that? Wild. It's crazy. Yeah. So, you know, going back to the top of the show, like primary care physical therapy, it's one of those deals where it just takes one. It takes one post. It takes one video. It takes one image. It takes one thing to go viral that launches this entire campaign.

55:20 And how many thousands of posts before and after this one just were dead, just had no real growth, no real following. Got to keep going. But it just took that one. Nobody knows which one it's going to be. And I really believe, as I've been in this world now for over a decade, there is no formula, right? There is no, well, post every three hours or find when your viewers are watching. No, it's a combination of... You put out a post, I have shared the same post, taking it down, put it up, taking it down, put it up, and on the third one, it hits a million views. Same exact video, same everything.

56:01 I think it's a combination of factors. What else is out there? What else is the algorithm pushing at that moment? Who by luck caught your video and watched it to the end? Like all of these things that you cannot possibly control for It just clicked at the right time. But that one video had a sizable impact on a multi-million dollar company that now we can see it just takes one post. It just takes one video. So the story was she walked, she's just a random, she wasn't paid by Chili's. She walked in and ordered the cheesy mozzarella sticks and shot a video. And kudos to the cook who was working that night because they did it right.

56:42 Because you can screw anything up in a kitchen. Trust me, I know. I know. Um, and it was like, she like pulled the mozzarella stick and the cheese was like chef's kiss. And then that thing popped off and people, people saw that and they did not think anything other than their own self-interest, which was where do I get some of that? And the answer was chilies. And it's not, it's not a hard math equation right there. So yes, this applies to you. And I know you don't sell mozzarella sticks, but you sell something you do. Yeah. I mean, my most viewed Instagram thing... Did you see the Avengers video that I made? If PTs... I essentially took the personality of all the Avengers and matched them to the specialties of PTs.

57:28 Like, Alpeche Northo is Captain America. Sports PTs are Tony Stark and Iron Man. And... i said i was like drinking my second coffee the morning my one eye wasn't even open yet and i was like huh that's a weird parallel and it's not like i invented this like people have done this but i was like who would be this or who would be that and then it took me six minutes to write the script or just the outline and i shot it and one of my friends was like way to have your most famous video which is well over a hundred thousand views from a couple weeks ago and like my hair wasn't combed Cause I just woke up, but I'm also like, maybe that made it better. Cause I was just like, you could tell, I just woke up and I was like, Hey, interesting thought experiment. What if this was that? And then I just popped off. Yeah.

58:08 I had some engaging visuals. I might've shared that on a random Tuesday that might not have gone anywhere, but I lucked out that it did. What platform did that video get the traction on? Instagram. Okay. Did you share that video to the other platforms? What did you do there? Yeah. Yeah. I'm trying to figure out. So I've got a couple different types of videos that I'm playing with. I was doing the Avengers for if this, then that videos they call. I'm doing like books that I like, like Robert Cialdini Persuasion or Seven Habits of Highly Successful People. But I'm not doing twelve minutes on it. I'm like one.

58:49 So I come in with like a strong hook. And then I say, here's the book, flash it on the screen. And I go, the main takeaway, I'll save you, you know, fourteen dollars in two days of your life instead of reading it. I give them the quick takeaway and then I just stop. And that was doing well for a while. And then it stopped. Why? I don't. Who the hell knows? And I might try to get in a week. And it's the it's the thing that defines my career. I know it doesn't work. It doesn't work until it does. right a quick strategy that's kind of interesting and you could use this because you have enough history behind you um There's an issue with duplicate content when you're just spamming the algorithm, putting tons of this stuff out there.

59:31 Nobody wants to see the same thing, you know, thirty seconds apart. But like Mr. Beast, there's a clip of Mr. Beast asking a guy how he got so many subscribers and he said he's posting like thousands of video clips a day. Yeah, it's just crazy numbers. What's the duplicative? Can they tell if it's the exact same video based on the waveform? What are you saying? Are you saying don't actually share the exact same video? Yes. Don't share the exact same video if the other video is still live, but through meta business suites, I think it is. I don't know if you use that at all, but there are so many great tools in that. i can go in i can go back i can set my date range so what i've been doing is i go back to january of i look at the videos i look at how they performed i find the video that i think will probably perform well whether it did then or not doesn't matter i download it because i don't have it i don't know where it is it's somewhere on a hard drive but you can download through meta the HD version of the video.

1:00:33 I download it. I go to the original post. I delete it. Then if I want, I will make some changes. Maybe I change something about it. I definitely change the post that goes along with it. And then I repost it. Now, you know, take it for what it is. I am not an expert on social media, but I haven't had any issues so far. And quite often those videos perform really well. I've got a whole new set of eyeballs, a whole new set of followers. It's not putting that video in front of the same people per se. But even if it is like I see the same video come through my feeds at times, it's still an interesting video.

1:01:14 If I watch it the first time, I'm probably going to watch at least some of it again. Right. Um, that's been a success. So you have so much content years ago that it's just not getting out there anymore. I would do the same on YouTube. I would download it from YouTube, delete it, make it unlisted, make it private, do whatever you want to do, and then re upload it and see how that kind of content performs. Shoot. I was just going to ask you something and then I forgot. Oh, I hate when that happens. I gotta write this stuff down. Um, We're at the top of the show. We're going live again tomorrow.

1:01:55 Normal PT Breakfast Club. Dave's back. I'm excited for that. And then I will be excited to have at least some preliminary data of dropping twelve episodes in one day. I'll see what that does. Usually need a few days to really see what the analytics shake out to. I remember in early podcasting ten years ago, I could hit refresh every twelve minutes or seventeen minutes and you could watch. Now, I got to wait like forty eight hours to see how something did, which just shows you the change in size and all that. It's kind of wild. All right. Parting shot. What's your parting shot? We talked about a lot. You know, the bottom line is I think the people watching this, listening to this, you guys are doers.

1:02:35 You guys are the kind of people that will get a piece of information, determine if it's useful. If it is, you will execute on that. That's why you're business owners. That's why you're successful. That's why you've done well your entire life. Keep doing that. That is the formula. There's no shortcut to it. I would say yes. And approach this from a scientific perspective, right? Like, twenty percent of the stuff that you do is going to give you eighty percent of the results. Which twenty percent, Jimmy? I don't know. Neither do you. None of the people in the big offices. You just don't know. So what's the lever I like to pull? Again, I mentioned the fit VP principle. I just did a video. Go look at it.

1:03:15 It'll save you five thousand dollars in a marketing weekend course. That one lever, you can adjust pretty easily, frequency. And it will teach you a lot. You will get a lot of information by doing. Do, inform, refine, do again. So FitVP is your marketing principle for the day. All right, we'll see you tomorrow morning. We'll have more fake sponsors on the live stream. Enjoy your snow day, everybody. Enjoy your snow day. Tony Maritano on YouTube at Total Therapy Solution. Find Dave Kittle at conciergepainrelief.com and on YouTube at The Dave Kittle Show. And follow Jimmy McKay at PT Podcasts on YouTube, the socials, and wherever you binge podcasts you pretend are for CEUs.

1:04:01 And hey, just a reminder, none of this was for advice. This was for entertainment only. Our lawyers say that counts. Thanks, Keith.