There it is.
We got the intro.
I like that intro.
Good morning, Tony.
Yeah, it works.
So, Jimmy, you're going to Chicago.
What's going on there?
Yeah, I like ideas.
I mean, people know this.
I was talking with Will
Humphries yesterday,
and he was explaining me to me.
I love when people do that.
I'm like, oh, that makes sense.
And he's like, yeah, he's like,
you and I are similar.
We like ideas.
So I'll bring it on screen
for those who are watching
the live stream.
But there's this idea of
this movement or event that
is put on several times.
I've been following this guy.
His name is Alex Kashiev.
I'm probably saying his name wrong,
but he'll correct me
because I'm going to
interview him in person in Chicago.
And he's a tech CEO.
He's a dude who loves...
being in and around tech and healthcare.
Good morning, Dave.
And he's got these events
called Health to Tech.
If you were around physical
therapy six or seven years ago, gosh,
it was that long,
there were things called PT Pub Nights.
Where you would just say,
I want to have a pub night
in my town and pub night
would put it on this
calendar and maybe like in
a Facebook group and post about it.
But that's it.
You were sort of on your own.
And this guy is sort of doing that,
but he sort of controls more of it.
And he just rotates.
He's got Chicago, New York, Boston.
I've seen Philly and D.C.
and Tel Aviv.
And he puts people in the
room who are at the intersection,
if you had a Venn diagram,
of health and technology.
And the event is like, go there.
You register just to see who's going.
You want to peep who's going, who's going,
who's going to be there.
And...
There's a presentation given, or like,
you know, a little presentation.
I'm going tonight.
The presentation is, I'll have to look,
a guest speaker,
a managing partner at
Wolcott and Winnemac, holds an MHA,
technology, and healthcare.
And the idea is the real magic,
obviously the presentation
might be of interest to you,
but it's who else is in the room.
These are mixers, man.
These are professional elbow
rubbing events.
I don't know if I should
strap on my hockey elbow pads.
Could be a lot of elbow rubbing going on.
And I was thinking,
this was the thing I was
kicking to you guys.
When my good ideas come is
usually like at nine forty
five when I'm sitting on
the couch and I'm like,
let me fire off some DMS or emails.
So here was the pitch.
Take Alex's idea,
but maybe twist it to more
healthcare technology.
And we'll stay within
physical therapy because
that's where I live right now, right?
That's where we all live.
And what if you picked some companies?
Now, you guys shout out some names.
Like Vauld comes to mind
because they've got really
great technology for
measuring things in clinics.
A little sport heavy, but yeah.
You've got your Shockwave.
We've got Athelos for their AI scribe.
That's like hands-on.
Hyperice would be great.
Things like that.
And now you could get a
little bit further away
from just tangible
technology and you could do
something like Sarah Health
for remote therapeutic monitoring.
And the same pitch would be, all right,
we're going to go.
You have to do it in
population dense centers.
East Coast is a little
easier if you were going to
make a tour because I want
to make a T-shirt like a
rock tour T-shirt.
This is where we're going.
We're going on tour.
And we would roll into Boston.
I would, I would get a van.
I would like,
cause we want to have the two
true rockstar experience.
And we would roll into
Boston and we'd throw an event,
same format as Alex.
But instead of one speaker, I would say,
okay, we're going to do like,
everybody gets like a ten minute.
Hey, here's who I am and what I do.
And I'll be over here
showing off my handheld dynamometer, yada,
yada.
And here's who I am and what I do.
I'll be over here.
And now it's elbow rubbing
time and shaking hands.
I don't know if Vauld
or these companies would do
an event in Boston just for themselves.
Maybe they would,
but if they could be part of it,
like none of them would be competitors.
Do you know what I mean?
Like I would do Hyperice,
but I wouldn't do like,
I don't even know who a
competitor of Hyperice is.
I don't know.
They're kind of Nike, but, um,
and this way you get hands on touch time.
So both parties win.
I want to, I want, um, um,
uh, a non-scary way,
no commitment to go test
this stuff out and really
ask questions and see who
else in my market is like doing, Oh,
who I, what did you see?
Well, I like this.
And if you're hyper ice or
vault or a Thelus, you're saying you're,
you're getting feedback, but you're,
I mean,
someone might close a deal right there.
You might say, you know what?
I want five, you know,
dozen pairs of Norma tech
boots for my eight clinics in Chicago,
because I'm the guy who
does this and I got hands on.
So what are your thoughts?
I mean, go ahead.
No, I was going to ask Dave.
Remind me, you're in Brooklyn?
Yep.
Where's Jerry Durham?
Nice to meet you, Tony.
Good morning.
Everybody outside of New York,
it's just New York.
New Yorkers are like, where are you?
In New York, you're like,
but where are you?
Is Jerry Durham in Philly or
is he in New York?
He's in Philly.
I don't know if you guys know,
he's moving back to Cali, Cali.
What?
Yeah, I don't know if I'm breaking news.
I'm sorry, Jerry.
Oh, boy.
I feel like we need a breaking news thing,
like breaking news.
Breaking, you heard it first.
I did not know that.
That is monumental.
All right.
So to Jimmy's point, yeah, I love it.
I've always loved it.
I think more of these
in-person live social events is awesome.
I think getting hands on, you know,
with physical product is great.
But like you said,
it's who else is in the room,
rubbing elbows and other
things with other
successful people is always
going to be the way to go.
So I'm going to get Dave to
host something in New York.
So I'm going to Chicago.
You'll love this.
I thought I booked my flight.
I don't know when I start
clicking around on flights and comparing.
That's not a Jimmy task.
Like I need a virtual assistant.
I thought I booked my flight
for Wednesday morning at nine fifty.
It is tonight,
Tuesday night at nine fifty p.m.
So I'm landing in Chicago at
one in the morning for no reason.
I'm like twelve hours early.
I'm like.
Whatever.
I've done the scroll thing.
Like when you're moving down
the page and then you use
the wheel and the wheel
changes your date and you
book the wrong flight.
I've done that before.
It's the worst.
The worst.
So, yeah.
So I'm going to Chicago.
I'm going to test one of these events out.
So I'm going to interview Alex,
who is like the founder,
Ukrainian immigrant, like fled Ukraine,
like cool backstory,
but pretty innovative because he's like,
how do I get...
people who are buyers and
sellers of this technology in the room,
he's like,
I'm going to be the real estate agent.
So he just rents real estate
bars or whatever he does
this bars and restaurants.
And he facilitates the
exchange and he probably
benefits because he's a tech CEO.
I don't even know what his
tech business is,
but I look at Alex and I'm like, dude,
you've, you've, you figured it out.
This is a good idea.
So I'm going to steal it.
Yeah.
So I want to go straight to Dave.
I want to talk about hiring
and payment structure salaries.
I shared a post on LinkedIn.
It's actually two posts that
kind of are the same thing.
What do you think, Dave,
in regards to what you're
offering your clinicians, your PTs?
I know you're not using PTAs.
Is there still any...
value to a PT with fifteen
years experience makes more
than a PT with one year experience.
Does experience have any
value if it's just the the
general experience?
You don't even know what
that experience could have been.
And then what about even
like a PTA earning more
than a PT for patient care?
I mean,
what's your personal philosophy on that?
So typically, yes,
but it's not what you think.
It's not it's not it's not
just years of experience.
It's typically the full
package of the person.
Right.
So if let's say there's
let's say there's a PT who
has never worked any service based.
They never worked in a restaurant.
They never they never did
like a service based
consumer facing job when
they were younger.
And then you have a PTA with
the same years of experience,
but they used to work at a restaurant.
They, I'm trying to like,
my first real job was
working in a batting cage
where we were fixing batting cages,
but also taking people's
money to sell them, you know, frozen,
frozen Slurpees and froze, you know,
poorly heated up pretzel,
but then also part of the
job at the Batting Cage was
helping the moms and the
dads with hosting birthday
parties with like twenty
kids running around.
Then you get, you know,
tips cash with that.
You know,
so I had a ton of consumer facing
jobs when I was younger.
If there's a PTA that has
done those things,
And then they come in to interview with me,
and some of that typically rubs off.
So the years of experience,
the clinical years of experience, no,
I agree, Tony,
doesn't necessarily
translate to more money.
But in the interview process,
In this case,
it could be a PTA that could
probably impress me or wow
me in terms of how they've
responded because we ask questions like,
tell me about a time when,
tell me about a time when
you had a challenging
patient or client in
rotations or your first job,
or tell me about a time
when you had a challenging
professor or an issue with
a coworker or a classmate or something.
So tell me about a time when.
And those are the best
interview questions because
those answers tell you
about the person's past and
how they've dealt with and
interacted with challenges
and struggles and
confrontation and settling
disputes and things like that.
uh you know like problem or
dispute resolution those
types of things those types
of things tell me a ton of
about that person so it
doesn't mean it doesn't
matter if that pta only has
three years of experience
and a pt has you know eight
years of experience
will we start the PT off at a higher rate?
Probably.
But if the PTA comes in and like,
they're getting all the
word of mouth referrals,
they're getting all the Google reviews,
whatever.
And then they turn to us and say, Hey,
I want you to pay me this much more.
It's easy for me to say, sure.
Yeah, of course.
Like you are demonstrating, not just,
we're not even talking
about the clinical competence.
We're not talking about like
getting people better in
less visits or whatever.
So does that make a little sense?
Yeah, for sure.
Jimmy, were you going to say something?
Yeah, I mean, number one,
I love that question.
That past question is great.
I would love to pair that up
with that question that I
learned from Jamie Schreier,
which is like,
if you were to leave five years from now,
what do you think the reason would be?
I think those two questions,
if you asked them back to back,
could get your past and
your vision and be like, got it.
This is a great fit or not fit.
But this is where I'm saying like,
Tony and Dave would have
totally different approaches,
not just because they're
totally Tony and Dave to this,
because you have to
understand who's paying you.
So would you pay someone
more if they have fifteen
years experience?
Tony knows who's paying him.
Insurance companies, do they care?
Nope.
They don't care.
Still, still, it's twenty twenty five.
They don't care where Dave,
I bet you is saying.
Could this person fit on my roster?
Like, could I charge a premium for this?
Would I pay for this?
Like, you're probably getting by.
You're like,
you're looking at them more
like PT Barnum.
Like, is this a showstopper?
Or is this someone who's, you know,
going to be out in the
crowd sort of doing a
little juggling and some sleight of hand?
Or is this somebody who's
going to be in the center ring?
So understanding who it is
that's paying attention.
how much of no of course
everyone's going to get
onboarded and coached and
mentored and all that um
but how much of my time and
effort and my my my time
and effort is still money
away from my family or
whatever or working out or
you know visiting you guys
or whatever so how much of
my time and effort and
money do I need to pour
into this person we're
going to pour into any new
therapist or clinician or
whatever regardless but do they need like
significant amount of hand
holding if so like we were
probably probably should
even hire them yeah how
many miles are you gonna
get per ounce of effort to
put in right and and I
could pay you more if you
require less hand holding
and support and you know I
can't mention names but
like I've had a a physical
therapist in the past who
uh you know was out of the gates like uh
in an excellent fashion but
then there was a bunch of
communication breakdowns or
a bunch of communication
issues they just weren't
following processes they
didn't have uh they didn't
have patients uh date and
time confirmed for the next
visit over email or text
message which is one of our
processes it was just
verbal you know oh yeah
tony like yeah we're
confirmed for wednesday at
you know five pm and then
like then the patient lay
canceled or something then then um
then the therapist is like, oh,
you're going to pay me for
that missed visit, right?
And it's like, well,
was the visit confirmed?
Like, can you show me, like,
is there a screenshot of
the email or text?
And then it's like no response.
And it's like, I mean, it's the process.
These are very clear, you know,
so that someone like that
requires more handholding.
They're less likely to get a raise.
They have no leverage or
less leverage to ask for a
higher level of
compensation or more
responsibilities or more
new cases and more evals or whatever.
Right.
So
Again, in my model,
in the beginning of the interview process,
just to go back to Tony's LinkedIn post,
a therapist shared,
I have fifteen years of experience,
but the company wants to
pay me the same rate as a new grad.
Well, that's the difference between,
you know,
an insurance in network based
model where like Tony
respectfully doesn't have
like he's going to look at
whoever is the clinician the same amount.
Right.
So like Tony's got his wife
treating patients.
But if it was someone else
from the outside, it's like,
they're the insurance is
paying for this you know
this bare minimum to be
completed x amount of you
know whatever units and
visits and we're billing
units and they're all paid
the same so in that world
in that ecosystem no like
it makes sense where
everyone potentially is paid the same.
In my world where we could
potentially charge more
over time or raise our rates or whatever,
like absolutely there's
more of a buffer and
someone can actually make
more money or demand more
money regardless of their
years out of school or in
their years working.
Yeah,
I think it's such an important aspect
to this is understanding the value.
Just like, you know,
if you're selling to the patient,
what do they care about?
What's important to them?
I've got an interesting
Facebook ad with some
comments that I can share
later if we want.
But when I'm looking at an employer,
employee in a third party payer system,
you know,
I've got very specific
expectations and it's not
you need to be the most skilled.
You need to be the most expert.
You need anything.
It's do your patients like coming?
Are your patients going to cancel less?
Are your plans of care going
to be completed?
They're very technical
things because I don't need
you to sell or convert a patient.
They're already coming, expecting to come.
It's just such a different
experience here.
And if I'm bringing you into a team,
like we stopped hiring
years ago because I didn't
want to deal with the
battles of I'm bringing you onto a team.
Every team is going to have politics,
no matter how much you try to avoid it,
even at its smallest.
So it's like...
Do I really want to deal
with those challenges?
Probably not.
But if I found somebody who
I knew had high retention rates,
high completed plans of care,
and could handle the
politics of my particular office,
I'd hire you in a second.
And I'd pay you more than
somebody who might be a
clinical specialist or an
expert in some area.
And maybe that person could
even generate more profit,
but it doesn't matter
because it's going to cause
so many problems in the
rest of the organization.
And as much as I'm saying that now,
I remember going back to
when we would apply for a
job at a hospital or we'd
apply for a job at some
other large organization.
It was less about
performance and it was more
about making the person
who's hiring us look good
to the person that they
want to impress above them.
There are just so many different dynamics.
But I keep seeing posts
around LinkedIn and Facebook about, well,
I have this much experience
and I have these
certifications and I have these other.
A lot of times it just
depends on where you're
trying to get the job,
what's important to that
person who is hiring you,
whether it's the owner or
the HR department or whoever.
I don't think I was ever taught this,
but I think I just understood it.
Or maybe I was taught,
but maybe someone showed me.
But I realized my job was always like,
this fits my personality as
I'm saying this out loud.
My job was always get my boss to be happy.
I was like, I want my boss to like me.
And like, make your boss's life easier.
And like,
then they'll go out of their way.
You'll be the last person cut, right?
The person you want to keep you around.
And it's like, so I figured that out.
Like, I don't think it was conscious.
I think it was like,
probably part of my personality was like,
I need people to like me.
But like, hey man, that fits.
That worked in business.
I remember one of the things
that caused my wife and I
to leave the hospital we worked for.
Now, we weren't married at the time.
We just kind of knew each other.
But we share similar
personality traits was we
realized it wasn't about
how good of a job we did.
We looked around and we
realized all of the people
leaving or getting fired
were amazing clinicians.
The ones who stayed in that
setting were good enough not to get fired,
but didn't rock the boat.
Yeah.
didn't introduce change,
didn't try to make things better,
didn't do anything that
would make supervisors or
managers put more effort
into keeping them employed.
Everybody who wanted things to be better,
they were gone because they
just made more work for management.
And that's the challenge to
working for a larger
organization like that.
This was a hospital.
They were not in growth mode.
They were not getting paid more.
Nothing is changing.
They want the status quo.
If you're going to mess that up,
that's not the place for you.
That's why when I went to go work at,
I won't say which hospital,
it doesn't really matter which hospital.
When I went to work at a hospital,
people were like, you will not work,
that will not work.
And I was like, sure it will.
I'll just bring my thing to
this big organization.
And it's like, it's great,
a bigger platform.
And spoiler, it did not work.
It was horrible.
It was a horrible idea.
It wasn't the size.
It was exactly what you just said.
What do they value?
What problems do they have?
Jimmy Rock, I was like,
I was brought here to gain attention.
well, can you do it like,
but more in line of the
standard operating procedure?
And I was like, that's not, you did that.
Why you, yeah, that explained it.
Where were you before I took that job?
Kendrick says people have no
idea what it takes to run
an organization.
Amen.
But I mean,
where are you taught that
you're taught that in your
one or two class,
like barely taught that in
a class in PT school.
But to Dave's credit, what he says,
did you ever work retail?
Have you ever worked food service?
Have you ever been told you
suck to your face,
even though you didn't do anything wrong?
You just delivered the
burger that sucked and you
have to smile and say, you're right.
I'll let me take that off your bill.
Let me get you another one like that.
Build some character in there.
How do you guys personally
respond to that kind of
very black and white objective?
Now, of course,
there is a level or a
threshold where it becomes demeaning,
belittling, like condescending.
But I'm just saying,
I just had this
conversation earlier this morning,
so it's fresh in my mind.
Multiple times in my career.
I've had conversations where,
and maybe I'm a little
spectrumy and I don't even realize it,
but I've had conversations
where there's no filter
because I thought I have a
level of connection and
trust with the person I'm
talking to where I could say very clearly,
very black and white, look,
here's the deal.
These are the objective numbers.
This is the situation.
How are we going to move
forward between you and I
in this situation?
I thought it was an
excellent conversation.
I thought it was emotionless.
I thought everything was
objective and there was no
way anybody could get upset
only to find out later, a week later,
a month later,
that this person was
slapped in the face in
their mind and that I
completely betrayed them or whatever.
We need more details here.
Was this the lady that wrote
you the one-star Google review last year?
No, no.
This is from an internal.
Yeah, yeah.
It's usually either an
employee conversation or
it's a tenant landlord conversation.
It's professional.
It's not a patient interaction.
But I'm just like for you guys personally,
I'm curious,
how do you respond to what
should be an objective conversation?
Discussion about just pure metrics.
Just these are the numbers.
It doesn't matter how you feel.
There is no there should be
no emotion connected to.
And this leads into a post
where I said the reason why
therapists have such a hard
time owning therapy
businesses is because we
are too emotional.
We're too connected to the business.
And another person came back
saying something about
being ridiculous and what
if I told my wife she was too emotional.
And the ultimate irony here
was the entire response was
all emotion-led.
You are clearly too
emotional to make a clear
objective decision.
But I just said, hey,
I'm not going to go down this road.
And I tried to bow out of the text thread.
Yeah, so Dave, what is your take?
Yeah.
I'm going to try to be as
impartial as possible.
What I mean is I will sometimes not,
if it's like, let's say if it's a patient,
a therapist, whatever,
I will be over communication, over text,
over phone, over email,
however we're communicating the issue.
is going to be like very
whatever is you know by the
books my whatever they
signed for like the
onboarding the standard
operating procedures like
whatever it is like very uh
black and white and without
the emotion at least in the
beginning I will then
handle the communication
then I'm going to go to
annie and be like you got
then I let the emotion out
and I'm like this
person is pissing me off and here's why.
And this is the fourth, fifth,
whatever time about
communication breakdown or whatever.
And, you know,
they know better and it's
pissing me off and they started great.
Right.
So I do let the emotion out.
You have to.
But I hold it together
somehow with some of these challenging,
annoying situations.
Another thing,
I can say it as discreet enough.
We have a patient that pays
a lot of money out of pocket.
And for whatever reason,
we charge them out of pocket.
But then they are able to
submit the super bills,
even though we're not
billing their insurance.
So they're submitting the
super bills for potential
reimbursement consideration.
And they live in an eight
million dollar apartment.
It's like, okay, so,
but one of the family
members will send me a million,
not a million,
a lot of texts and emails
about timely super bills to
be emailed to them for
reimbursement consideration.
And then, so I respond to them like, on it,
we'll have it sent by midnight tonight,
or it'll be sent in the
next fortieth hour or whatever.
But then I say to Annie, I'm like,
you gotta be like, this is BS.
And like, I let out the emotion elsewhere.
Hopefully that's healthy.
I'm letting it out somewhere.
But I don't allow it into
the therapist or the
patient or client communication.
I really, I don't know.
It's just the way I'm built.
Like I can, I can, I have thick skin.
I've had, you know, coaches,
baseball coaches over the years that were,
uh,
super aggressive in terms of language and,
you know, uh, repercussions and, you know,
that type of stuff.
And, you know, if we, in practice,
we make an error and the
whole team's got to go run
laps around the whole field,
like just stupid things like that.
And so, um,
when interacting with a
therapist or a patient or client,
I'm able to hold it together, be really,
really firm,
defend my position if it's a
conflict or whatever, or say,
here's my expectations,
our expectations as a practice is this,
and then you keep doing
down here or whatever,
however we're responding to
whatever the situation is.
But then externally or even
privately or publicly with you guys,
I let the emotion come out.
Jimmy.
Yeah.
Twenty five year old Jimmy
told you to stick it to
your face because I'm
awesome and you suck.
And forty five year old
Jimmy realizes it's not
even about like what is the
goal of the situation?
Is it to let others know you
suck and where I think I am
and where I think you are?
No.
Twenty five year old Jimmy
had no problem doing that.
Forty five years.
I mean,
it's like the purpose of this is to
convey information and to
get that person to know or
do something right.
Hopefully positive,
like an Adam Grant has a
great thirteen words.
Did you ever hear this thing?
He has he used were
Sorry, nineteen words.
This was this was done in research.
I'm giving you these were
scientifically proven to
improve receiving feedback.
You ready to write these down?
Receiving.
So if you're going to give
feedback to someone and
this is obviously internal
that you are superior to,
that you couldn't give this
to a client in that situation.
or,
but the client could give it to you
because you're working for them.
And here are the scientifically,
according to Adam Grant,
social psychologist at Penn,
I'm giving you these
comments because I have
very high expectations and
I'm confident that you can reach them.
And then whatever you say afterwards,
that's the spoonful of sugar.
Then you, oh, the spoonful of sugar.
I thought you were going to
say what comes after is the snap down.
Here's how you screwed up.
Here's how I'm pissed off at you.
The setup is sort of the
spoonful of sugar.
And then whatever you put in it,
it sets it up, which is like,
whatever you might hear
after this might be difficult.
You might not be expecting this.
You might not like it,
but it's because I have
high expectations of you.
And I think you can reach them,
which is why I'm giving you this.
Like I'm not holding it back now.
I didn't know those nights.
I didn't know those nineteen words,
but I will say I have said, you know,
I know you can do better.
I know you can achieve this.
I know this is within your capacity.
If I didn't, I wouldn't even care.
We wouldn't have this conversation.
I've said that to my kids.
I've said that to, you know,
employees and other people.
I just always find it
fascinating how people
respond to Dave's point.
I think I've never been a great athlete.
But I think sport gives us
so much exposure to
different coaching models
and different coaches,
different communication under pressure.
And, you know,
either you develop certain
coping mechanisms or don't.
But the idea is I watch my
kids go through sports that
I never went through.
I see them in situations
where high pressure, big expectations.
I see how they handle it.
And I just love it because I
know that this is going to
help them for the rest of their life.
These are the lessons that
they're going to take with
them to the end.
Sure.
One reason for sport.
It's humaning under pressure.
Dave?
I'm just rereading this quote.
I love it.
So I'm giving you these
comments because I have
very high expectations and
I know you can reach them.
Because as of right now,
the situation we're talking about,
you have not.
I'm not reaching them.
You have not reached these expectations.
I can reach them.
By the way, complete sidebar,
I don't want to get into it too deep,
but sometimes it happens
very infrequently.
But I've had a team member
here or there where they
don't acknowledge the shortcoming.
They don't take
responsibility or
accountability for the shortcoming.
And that is what has sent
me... That's where I'm
trying to hold the emotion in.
And that's where...
I have to say point blank,
like you have not taken
responsibility or accountability to,
or for this challenge, this,
this shortcoming and expectation.
Yeah.
And that person,
no matter how much energy
you put into them,
you will not get any mileage,
any more mileage out of them.
Right?
Like if you can't see it, like,
I'm real sorry,
but I don't know what to do with you.
Like, you know,
when you guys were start
talking about Tony,
when you were talking about
hiring and politics,
and I think I mentioned this before,
I did right with you or
maybe it was someone else.
I don't know.
I talk a lot,
but it's like the Herb Brooks
idea that was part of that
movie miracle on how he
recruited the team.
He wasn't looking for the
best players like he wasn't
ranking skill.
He was like, I need, I forget what,
nineteen or twenty one
players who can be.
I am recruiting the best team.
If he was doing track athletes,
he would look for who could
run the hundred yard dash the fastest.
But as soon as you enter a
baton into it or, you know,
famous Disney has all the good movies,
right?
Cool runnings.
I need four dudes who can
work together and push a
sled and pilot the sled and be a unit.
Business is not track athletes.
So that that's another way
of looking at like I have my S.S.C.S.
and I've got seventeen
publications and I'm like, cool story,
bro.
How do you interact when
stuff goes sideways?
Because it will.
Are you the glue guy?
Are you the twelfth man on an NBA team?
But why are you there?
Why are you getting two million a year?
You're the glue dude.
You're the guy who keeps the
star player from going to
the club at two in the morning.
Is that worth two million dollars?
Yes.
Yeah.
What was the thing we wanted
to talk about?
And we stopped short last time.
We need a virtual assistant.
Yeah.
We have to play back the tape.
Man, I can't.
We'll talk about your new segment.
I will go look because I
have tape from the last episode.
well and you were just you
were just mentioning a
couple couple things that
reminded me so I'm pitching
you guys a new potential
segment called when I say
profitability problems
profitability problems yeah
well do that do the name
last from my experience
find the name last so so
here here here's a here's a
couple stalkers okay you
guys know mark cuban right
owner yeah he previously
had owned the uh dallas
mavericks for about twenty three years
Guess how many years that
team was profitable?
Profitable, meaning they turned a profit.
Twenty-three years they owned the team.
This is public.
This is public data.
It's going to be like twenty
three or one like or zero.
Like it's a trick question.
Twenty three.
All of two.
Two years out of twenty three.
Which years?
The team.
I don't I don't know.
I don't know specifically.
Probably the last two after
they won the they won a
championship ring.
So probably after that with
the merch sales and that
means they lost money.
Like, I don't understand how profitability,
like when people use terms like that,
sometimes I'm like, wait,
so they lost money.
Or, or, or broke even or yeah.
Or close to it.
Yeah.
So they covered all their overhead expense,
their payroll, their whatever, you know,
the media rights, their, uh, the rent,
if they don't own the
stadium and all that type
of property taxes, whatever.
Um,
but they didn't have enough ticket
sales and merchandise sales
and income to have some
surplus in cash that then they can, uh,
uh either mark cuban could
have taken it out he could
have taken that cash out
and invested in other
companies with it he could
take that money out and put
it in to some other
financial vehicle he could
buy real estate he could do
whatever so there was none
left over um so he just he
just mentioned this I don't
know in the past week or
two and I wanted to bring
it up to you guys there's
some other examples um but
there's some folks from time
to time that reach out to
me in the physical therapy world.
And by the way,
this is not just physical therapy.
This is a ton of businesses.
This is, this is,
I think this is something
that's not talked about.
So you pay yourself some amount of money.
Uh,
typically if you have minimal to no
profit,
like you're going to be the last one, uh,
your income might actually be hit.
You're going to pay your
team whatever you pay.
Whether it's suppliers, it's overhead,
your lease, your property tax, whatever,
all your marketing, your payroll taxes,
all that type of stuff.
And then whatever's left
over at the end of the year,
whether it's a distribution,
an owner draw,
however you're set up with
a PLLC or an LLC or
whatever your business is,
It's wild that there's so
many businesses and
practices that are not profitable.
And I wish I could mention names.
I can't because I have folks
from time to time that reach out to me.
Small practices and also big practices.
Multi-multi number of practices.
Pretty big in the Northeast
region had reached out and had...
know they're declaring to
the irs that they have like
five or ten k in net income
five or ten but but their
top line is like somewhere
between five and ten
million dollars in top line revenue
It's insane.
It's like, where does the money go?
Where is the money?
Now, here's an example.
I don't know.
Josh Funk, he's awesome.
I've had him on my show.
I don't know anything about his finances.
We've not talked about any of this.
He keeps opening locations.
I think he's up to like,
fourteen or something locations.
just from outside externally
I'm just making a
guesstimation I'm assuming
so he's obviously they're
obviously profitable that
he takes profit and it
probably I'm assuming I
don't know josh but it's it
looks like this he takes
the profit from these other
locations and instead of
being taxed on that like
he'll get taxed on the
profit of the previous
locations that he already
opened and and that they're
profitable and they're generating money
and he's probably taking
some or all that cash and
then he opens the next
location the next location
the next location
potentially that's what it
looks like so he's in
growth mode and he's
growing but there's other
therapists as I mentioned
you guys in the in the
private chat here that like
they'll reach out and they
got five or ten or fifteen
or twenty thousand dollar
five or ten or fifteen or
twenty thousand instagram
followers they got a really
sleek awesome looking
instagram and they're not
profitable it's like
don't know like instead of
having like a kim
kardashian instagram why
don't you focus on actually
having profit like it's
it's insane what were you
gonna say jimmy yeah um I
wrote a post this morning
not not before we knew we
were gonna share this and I
said some people aren't
gonna like this but it's
true it's wild how many
brilliant healthcare
providers are stressed
about money like where's
all the money going in my
practice stress sometimes
can I make payroll and you look at that
Highlight reel.
And you're like,
that person must be rolling in dough.
And you don't understand
that that person might actually not.
Like some of the biggest organizations.
I mean, look at like huge organizations.
I won't mention them by name,
but like big ones, huge losses.
Like where did it go?
Somewhere.
Something in the system
wasn't designed right.
Because the system produces
a result that it's designed,
perfectly designed to produce.
And it does.
And if you're not looking at,
if you're going in with
heart and not numbers,
I've been guilty of this myself,
you can mess up numbers.
They're easy to mess up.
Yeah,
and I think we still have this false
comparison of, well, you're smart,
so you should be successful.
You're smart,
so you should make lots of money.
And we know that that's not how it works.
I mean,
we know that there's a poor
correlation between
intelligence and financial success.
So first we need to...
I really wrote,
I'm writing in Tony's voice
or Tony's speaking in my voice, right?
I said, because you're smart,
sometimes that intelligence
makes it harder to say,
I've always been the doctor.
I've always been the smart one.
Therefore,
I should be able to figure these
things out.
And you could,
but you only had to have a
hundred percent bandwidth.
Like I use this
demonstration with a flashlight.
I'm like,
you can only really be shining
your light on one thing at a time.
There's no such thing as multitasking.
There's multi-doing.
Hire someone to do this
because it's important.
Don't do it.
And sometimes you might need
some financial person.
Other times you might need
like a business coach.
Maybe you need Sturdy McKee.
Maybe you need Jamie Schreier.
Maybe you need someone that
has been where you're
trying to go and they can
be an external...
set of eyes on your books
and what they'll find
whether or your books or
your whole process right
and then they might they
might find like oh here's
your here's like your choke
points like here here's
where like here's the
bottleneck and so
oftentimes the bottleneck
is actually the actual
practice owner that's in
every single department and
how hard is that to wedge
out that's the hardest one
right it is impossible
that's how it's impossible
Do you just keep sending
them like the Spotify
playlist where it's just
Taylor Swift singing that song?
It's me.
I'm the problem.
It's me.
It's like, that's you.
You're the problem.
On loop.
Sorry.
The problems will continue
until you understand that
you're the problem.
Well, it takes a big, you know,
mature person.
I am not mature enough to
fix my own problems.
I openly admit that.
Yes, you are.
We have had many, many, many, many,
many non-profitable years.
You know,
I would be far more successful if
I was willing to turn the
spotlight on myself.
And I think first we have to admit, like,
there are things in our
blind spots that we just can't see.
There are things that we see
and choose to ignore.
Like,
there are plenty of things that we're
doing to ourselves.
But man, it's hard.
It takes a big person to let
somebody come in,
shine the light on all your flaws,
pop your pimples and clear this stuff up.
But once you get it done,
it's a completely different
world on the other side.
And so I love the segment.
I think it'd be great.
I used to mention zombie
clinics because I said, look,
if you guys weren't digging
into your own pocket,
your business would be out of business.
The fact that nobody wants
to buy your business,
it's reflective of saying
you don't have a business.
You have a money pit.
It's a hobby.
You're losing more money
than you're making.
But then the minute we get into,
and we can talk about this,
the minute we get into
making the changes that
would actually turn a
business into a business,
everybody freaks out.
So I had shared a post yesterday.
I said, look,
you could probably train a
cat to fetch a stick,
but it's way easier to
train a dog to fetch a stick.
And it's impossible to train
a fish to fetch a stick.
And my point in saying that was,
why are we browbeating
therapists who are not
natural born salespeople
into trying to sell things
that they would never buy themselves?
Most therapists, there are some out there.
Most will not spend one hundred and fifty,
two hundred,
three hundred dollars on a session.
Most will not.
I said there are some out there who will.
But your typical
insurance-based model
therapist is not going to
spend that money.
And so we're trying to get
them to sell cash services.
We're trying to get them to
sell self-pay shockwave and
new fit and all these other
technologies out there.
I bet if you just found a
salesperson that you could
bring in that's a true born salesperson,
your profitability and
revenue would explode.
And before you guys chime in,
the best example are these young kids.
And I've got one in my family.
I know it.
These young kids that are selling solar.
They're selling bug pest
removal or bug whatever.
They're selling grass.
Huh?
They're going door to door?
Yeah, yeah.
Door to door.
Selling lawn maintenance,
selling tree trimming.
These guys are doing three
to four hundred thousand a year,
working just the summers
between college classes.
But bring one of those guys
into our business and see what happens.
It would blow the doors off
of the business because
they're not emotionally attached to it.
They're not driven by these
insecurities that
like the therapist, me included are,
what do you guys think about that?
If you can, if you, if you can do that,
you know, like Tony said, you,
you have a family member
like that in your family,
those types of people will
never be out of a job.
Yeah,
I was at a large physical therapy
organization.
I was in a communications
role and I had three
managers in three years.
And the third manager was like,
I'm going to reign this kid in.
And we had a sit down and he was like,
Jimmy,
I like what you do.
I'm figuring it out.
I'm not a communications guy.
Probably a red flag.
I have a manager who doesn't
understand what I do.
He's figuring it out.
He's not asking me to help
him figure it out.
But he's like,
what I did notice is you're
not great at spreadsheets.
I shit you not.
This was the conversation.
He was like,
if you ever want to be VP of
communications at an
organization like this one
or similar to it,
you got to get better at spreadsheets.
And I said,
I never said I wanted to be VP
of communications.
You are assuming that
because you went to
business school and got
promoted and promoted and
promoted that I want that.
I want to do more of the
stuff that you are still figuring out.
Happy to explain it to you.
But okay,
I will take this constructive
criticism because he said,
he didn't say this,
but he should have said,
I'm giving you these
comments because I have
high expectations and I'm
confident you can reach them.
He didn't say that.
He was essentially saying,
with lack of a better term,
get your shit together and
be better at spreadsheets,
to which I said, okay,
I acknowledge I am crappy
at spreadsheets.
Counter, may I follow up with a question?
See,
what he really didn't understand is
I'm in the business of questions, right?
And I said,
are the spreadsheet people
getting better at communications?
Of course not.
And help me understand why
I'm getting better.
Couldn't,
since we already paid that
spreadsheet person and to them,
spreadsheets are like candy.
Like, hey, here's a spreadsheet guy.
And he's like, oh my God.
Just like that gif of the
cat jamming on the keyboard.
And they're like, I love this.
I can't wait to come on.
Do you have any more
spreadsheets for me tomorrow?
Meanwhile, you're giving me a spreadsheet.
I'd rather be kicked in a
place that you don't want to be kicked.
I just don't want it.
And his answer was,
but you should do this.
But what you didn't realize, Jimmy,
was he was opening a door for you.
Who's that girl on TikTok
and Instagram that makes
like millions of dollars on spreadsheets?
Oh, wait.
We're talking about
different girls on Instagram.
Which one's your girl?
There's a woman who has an account.
It's all short videos.
She makes a ridiculous
amount of money talking
about Microsoft Excel and
Google Sheets and formulas
and all that stuff.
Like seven-figure incomes
just from spreadsheets.
He was just trying to
prepare you for that.
Could care less.
This was the girl I was
talking about on Instagram,
which is how to say this professionally.
Someone's like...
Hey, someone would, in this situation,
I would go to her and I
would write to her and be like, Laura,
my boss just told me that
I'm better at spreadsheets,
but I'm not in a spreadsheet role.
And she'd be like, I love that, you know,
communication and that feedback.
And I will take that and,
and think on them.
I'm not doing a great job.
This is why Laura is great,
but she'd turn it around
where she'd put it right back on them,
but professionally.
So she has, this is her only job.
She just, how do you,
how do you say that professionally?
And how do you flip it around?
I did not last much longer
under this person's
tutelage because I learned nothing.
But neither did he.
So hey, nary the twain shall meet.
Good luck.
All right.
So are we still on the
profitability problems?
I mean,
we could come back to this more and
more in the future.
It's just it's crazy that
and maybe it's the model.
Maybe it's your maybe it's
your in-network contracts.
Maybe it's the way your
schedule is set up with
like one hour slots instead
of like thirty or forty
five minute slots.
Maybe you're overpaying folks,
maybe you're paying folks properly,
but they're not producing
enough over what the cost
is to have them as the
overhead of their
employment salary and all their expenses,
their software seats and
all that type of stuff.
They're maybe not producing enough.
And if they're not producing enough,
is there an issue with
completed plans of care?
if that's not the issue is
it like a marketing issue
are there not enough leads
and patients being
converted and being
evaluated that come in um
is it some of your
therapists are billing you
know four units on average
per visit across you know
months or years and some
therapists are billing you
know two point two five
units per visit on average across
three, six, nine,
twelve months or whatever,
those are the types of
things like I would
potentially do to like kind
of break down and find out
like what are what are the issues like?
Where is the issue?
How do we spot and find the issue?
And again, yeah,
if you're in that situation,
you probably you probably
need some coach or not me.
I'm not looking to do it,
but you're probably looking
to find some coach or
consultant or someone to
help you find out what the
issue is so that you might
be able to fix it because
owners think that they can
fix on their own,
but they've been Groundhog Day for two,
five, seven, whatever years.
So oftentimes you might need
some external support or
some external help on it.
the challenge go ahead so
are you we're pitching a
segment like you want to do
recurring this is like ask
dave are we having people
write in yeah we should
yeah I mean so many of
these things I see on the
internet or online or
whatever okay like another
example like independent
practice owners like that
have five ten thousand
whatever instagram
followers and then they
reach out to me for a job
but but online it looks
like they have their own
virtual coaching or or uh
I don't know,
like online job or online role or,
you know, telehealth PT or whatever.
And so like, what's up with that?
Like, like why they're, they're,
they're almost like they have that.
That person is selling
something that someone else
is probably like,
I know people who are
selling video production
services and their videos
are great because someone else does them.
And then they look in the
camera and they go,
follow me and I can teach
you how to do it.
They're not wrong.
Like,
They're showing you,
I can do this for you.
It doesn't mean they're
necessarily the expert in that.
They've just figured out the system,
right?
So let's do it.
Let's pitch it.
If you guys are watching, listening,
you have a business that's
got revenue but is not profitable enough,
not as profitable as it should be,
not as profitable as you want it to be.
Reach out.
Dave is the point man on this.
Reach out.
Send some information.
We'll keep it anonymous.
We'll keep it anonymous,
but we'll discuss it on the show.
The challenge I see in it,
and I love the segment.
I love the idea.
I love trying to do that.
The challenge that I've seen
over the last twenty five
years or so is we're going
to see problems immediately.
They're going to be glaring like huge,
huge levers that could be
pulled very easily.
But in my experience,
if you have those problems,
you're either not willing, not capable,
or just not going to pull
the levers that we recommend.
You know,
it's like the patient that walks
in my door
who they're coming because
they want to feel better,
but they're not interested
in doing the things that I
would recommend for them to feel better,
you know?
And so it's like, why are we here?
Why are we doing this?
What's going on?
The person who does best truthfully,
and I've got two or three
of them right now,
the person who comes to me with hip pain,
back pain, whatever,
They're already working out
and they love working out.
They're already eating well
and they love eating well.
They're already prioritizing
sleep and mindfulness and
family and they love it.
Those are the people that
come to my clinic and do amazing.
They're already doing the
stuff that they're supposed
to be doing and that they
need to be doing and they
want to do more of it, you know?
And so the person that needs
to do a one eighty,
they're the ones that are
going to be the most
challenging and probably
not going to get the best results.
But, um,
Other people will learn from
those experiences.
So if you guys want to send
your information in and
directly connect with us,
I know these guys, I know I,
we get a ton of inbound messaging.
We get a lot of questions.
We'll do our best to kind of
pick the ones that's going
to help the most people.
But I think it'd be a cool segment.
I would love to do it.
And you can do it anonymously.
Like, we're not going to, like... Like,
the people who are brave
enough to be like, dude,
I have a problem.
Like, number one,
you're closer to solving
that problem just by, like,
saying it out loud, right?
First step is admitting you
have a problem.
Those are the last people
I'm going to bag on.
Like, you can't.
Like, if you do, like, you're a douchebag.
Like,
those are the last people you should
bag on.
Like, oh, you've been doing that?
What are you, an idiot?
It's like, they didn't know, bro.
And at some point, you didn't know either.
So...
Zip it.
So yeah,
totally anonymous would not reveal
our sources.
That would not be the thing
that we would do.
I wouldn't do it.
These guys wouldn't do it.
What do we call it?
Now we need a name.
Let's have a naming contest.
Tell us what we should call it.
I like profitability
problems because it's very
simple and straightforward.
Profitability is a solution.
Get profitable.
If anyone in the audience has a suggestion,
let us know.
So when I hear profitability problems,
the first thing I thought
of was I'm having problems
because I'm too profitable.
That's just what came to my mind.
Which is so rare these days,
I'm telling you.
And the first thing I
thought was Dave the Profit,
but spelled P-R-O-P-H-E-T.
Oh.
Profit.
Oh.
But why is the argument?
The Profit David.
All right, real quick.
On Thursday's episode last week,
I shared some of the long form ad copy.
I know this is super tiny.
I don't know how to zoom in on it.
I've been doing more of this.
So context for this,
as we wrap up the show,
Jeremy Sutton shared a text
message that he received
where somebody had said
that they were able to go back to church.
And so, you know, it was great.
It was inspiring.
I grabbed Jeremy's
screenshot of the message.
I put it into chat GPT.
I did my usual prompting.
It generated a long form ad.
Then I said,
generate an image of a
geriatric woman walking to a church,
put a cane in her hand.
And this was the image that came up.
I'm not showing you guys the
ad or the image.
I already shared that.
What I'm trying to show you
guys is the responses that I got.
So this top one says, Tony,
what you're doing is awesome.
Right.
And then the next one says,
what a wonderful program.
My God, bless it.
Richly allow his sheep to
gather as a flock.
He intends them as he
intends them to be prayer,
worship and fellowships.
Okay.
So here, here's the deal.
Clearly this is resonating
with the people that are
seeing almost too much,
almost no such thing.
Um, what's really interesting though,
that first comment,
I covered up the names
because this is important.
That first comment comes
from a practice manager of
a primary care physician
group that has five or six
physicians in the group.
Oh, bingo.
Yes.
So the whole idea here is, you know,
This post, my Facebook page,
I just checked it before you jumped on,
is at like one point eight million views.
A couple of the videos and
reels just got like three
hundred thousand views,
one hundred thousand views.
Very quick.
Great growth.
Now I throw something like
this in front of it.
This one only has like a
couple thousand views.
But the point is,
these are views from the right people.
And what I also did with
that is I had ChatGPT
generate the ad copy.
I added context from real
life experiences.
I know people that from COVID,
they stopped going to church.
This is a huge part of their life.
These are individuals that
would go to mass every single day.
They don't go anymore.
I've talked to real patients who say,
I don't want to go in in a wheelchair.
I don't want people.
I've seen people fall at church.
I don't want to be one of
those people that falls at church.
I grab all of those real experiences.
I put it into chat GPT.
I allow it to process and
understand real situations
when it generates the long form post.
Then what I did was I read
that post to two women that
were in the clinic.
We were doing patient care.
I was working with them.
And I said, hey, take a look at this.
What do you guys think of this?
And it resonated.
It hit home with both of them.
Both of them said the same thing.
They were like, yeah, that's exactly me.
I stopped going to church
because I can't walk from
the car to get inside the building.
My church doesn't have a ramp.
And even the ones that do,
the ramp is too steep.
So I'm like, all right.
We've got the copy.
Now, it doesn't have to be church.
It could be sport.
It could be recreation.
It could be travel.
It could be anything that is
important to a specific demographic.
But the idea is if you're
not using the technology, the innovation,
the advancement we have out there,
You're just making life that much harder,
you know.
And so I wanted to share that because,
look,
it's it's I have not booked an
appointment because
somebody saw that post.
But I do have office
managers from very
influential referral
sources that are seeing and
commenting on my posts.
You write or share or say
something for you,
but if it resonates with someone else,
you're doing it for them.
There's that connection.
There's that media that's social,
not social media.
People want to do the social media.
That's not it.
It's media that's social.
Obviously, that resonated.
Sorry, Tony is now a shepherd.
We know Dave's the prophet.
We'll figure out what Jimmy is.
Tony the shepherd, Dave the prophet,
Jimmy the voice.
The voice.
We should have a church theme.
We should own a church.
Look at Kendrick's comment.
Thank you, Kendrick Taylor,
for commenting live and being here.
He said earlier, he said, LOL.
Yeah, there are so many business,
so many loopholes in business.
I've seen people in business
that are church owners.
They report as if profits
are donated to the church.
It blew my mind.
There was a big movement
back in the eighties, firemen and cops.
were getting ordained as
ministers and starting
their own churches.
Cause like,
so there was a dude that they
would pay to come to
different firehouses and be like,
here's what you say.
Here's what you do.
You fill out this paperwork to the,
to the point that the city was like,
this isn't it.
Like, stop it.
Like this is a loophole.
So yeah, I mean, it's a huge, I mean,
the funny thing is it's a
deduction or a write-off
when you agree with it.
And it's a loophole when you
think it sucks.
You don't like it when you
think it's someone else
getting away with something.
But if you're doing it, it's a write-off.
It's in the rules.
It's a rule when they're doing it, too.
You just don't like it,
so you call it a loophole.
All right, guys.
Let's wrap up the show.
I'm going to let Jimmy do the closing.
I'm going to do the parting shot first.
So I am hitting the road as
soon as I close this laptop.
Spring break, full family in effect.
I'm going to be out of
commission for a few days to a week.
But I just want to say, like...
We have access to technology
that would have been
sorcery a hundred years ago.
You know, I mean, there is so much.
And as much as you hear all
of the fear and all of the
stuff going on in media right now with,
you know,
stocks and investments and
tariffs and all, none of that.
Somebody, I think his name was Frank.
Yeah, Frank.
Frank shared a post about
tariffs and how they're
going to affect you.
they're not going to affect me at all.
Like it's not going to make
any difference.
The fact of the matter is we
live in the best time of
human history ever.
Let's appreciate that.
Let's take some time to reflect,
whether it's reflect on business,
reflect on family.
And, you know,
you guys either handle the
show without me or bring in a guest,
but I wish you the best and
I'm going to enjoy my trip.
Dave, what you got?
Oh man, first of all,
I was going to say Tony
next time on Thursday,
but now you're out for a week.
Then next time you're back,
I think the audience would love,
I would be interested to
see how you took that and
put it in the chat, GBT.
You share your screen, you say, hey,
I'm taking this Jeremy
Sutton text message.
And what are your prompts to
then get the copy for the ad?
I'm a nerd about that stuff.
Maybe no one cares about that,
but I think some PTs would
benefit from that.
Maybe in a week or two when you get back.
Another sidebar.
We previously talked about
acquiring or buying a
hospital for the hospital contracts.
Now we're talking about
maybe buying a church.
Maybe we can buy a Catholic
hospital and we buy both.
That's my parting shot.
Ooh, write that down.
Uh, I would say jump in and do the thing.
Uh, the, the concept is called eat,
eat the frog.
Have you ever heard of this one?
Yeah.
Eat the frog is like the
first thing you do when you
wake up in the morning is
like you do the thing that
you're going to avoid all day.
You know, you need to get it done.
So just avoid it.
We're saying eat the frog on tax day too,
right?
April fifteenth.
It's tax day.
So I was looking at this
event that I'm going to in
Chicago and I was like, I don't know.
I need to do something.
Is this the right thing?
And I was like, you know what?
Just decide and jump in.
It
Just eat it.
Get it out of the way.
Digest it.
Get it done,
and you'll be better off for it.
Tune in Thursday to see who
our secret guest is going to be.
It's so secret,
Dave and I don't even know who it is yet.
Or if we have juicy topics,
it might just be Jimmy and I. Roll on.
I will be live from Chicago,
so I might be in a deep dish pizza coma.
Although my hot take is
Chicago doesn't have deep dish pizza.
It has round lasagna.
It's not pizza.
It's lasagna.
It's not pizza.
On the socials, Dave Kittle, Tony Meritato,
and PT Pinecast.
We'll see you guys next time.
So serious.