WEBVTT 00:00:00.831 --> 00:00:01.772 Nick, welcome back to the show. 00:00:02.375 --> 00:00:03.056 Thanks for having me, Jimmy. 00:00:03.076 --> 00:00:03.478 Good to be here. 00:00:04.118 --> 00:00:05.222 I feel like every time you come, 00:00:05.442 --> 00:00:05.823 it's like, 00:00:07.115 --> 00:00:08.436 something's going on and I 00:00:08.457 --> 00:00:09.317 need you to pay attention 00:00:09.378 --> 00:00:10.417 and I need you to do something. 00:00:10.497 --> 00:00:12.259 And that's, that can't be easy, right? 00:00:12.300 --> 00:00:13.320 Like you're constantly 00:00:13.801 --> 00:00:15.702 listening to the profession, 00:00:15.762 --> 00:00:16.582 paying attention to what's 00:00:16.602 --> 00:00:17.603 going on in DC. 00:00:17.643 --> 00:00:18.903 I mean, just before we hit record, 00:00:18.923 --> 00:00:19.925 you said, Hey man, 00:00:19.945 --> 00:00:21.466 just got off a plane for DC 00:00:21.846 --> 00:00:23.266 and then next week I'm going back to DC. 00:00:23.567 --> 00:00:24.707 And that's where decisions 00:00:25.007 --> 00:00:26.009 are fortunately or 00:00:26.068 --> 00:00:27.410 unfortunately made like it or not. 00:00:27.449 --> 00:00:28.350 That's where things happen. 00:00:28.710 --> 00:00:29.370 So I feel like you're the 00:00:29.411 --> 00:00:31.271 guy who's always like, Hey everybody, 00:00:31.332 --> 00:00:32.393 I need you to pay attention to this. 00:00:32.453 --> 00:00:33.134 And then in a few weeks, 00:00:33.173 --> 00:00:33.933 it's this other thing. 00:00:33.973 --> 00:00:34.755 Things are always happening. 00:00:34.975 --> 00:00:35.915 That can't be easy for you. 00:00:38.078 --> 00:00:38.378 Easy? 00:00:38.518 --> 00:00:38.618 No, 00:00:38.679 --> 00:00:40.180 because no one can stay on top of 00:00:40.201 --> 00:00:40.881 what's going on in DC. 00:00:41.002 --> 00:00:42.923 So I don't think it would be 00:00:43.043 --> 00:00:43.905 easy for anybody. 00:00:44.625 --> 00:00:45.908 However, is it needed? 00:00:46.008 --> 00:00:46.268 Yeah. 00:00:46.548 --> 00:00:49.731 And is it something that we 00:00:49.771 --> 00:00:50.593 as a profession need to do 00:00:50.612 --> 00:00:51.613 a better job at it, right? 00:00:52.274 --> 00:00:54.658 Things happen all the time that affect us. 00:00:55.679 --> 00:00:57.320 as therapists or as 00:00:57.341 --> 00:00:58.942 healthcare providers from 00:00:59.061 --> 00:00:59.963 decisions that are made in 00:01:00.003 --> 00:01:01.825 Washington and other state 00:01:01.844 --> 00:01:02.865 houses around the country. 00:01:03.405 --> 00:01:04.606 And not being on top of 00:01:04.626 --> 00:01:05.787 those things sometimes can hurt you. 00:01:05.947 --> 00:01:08.990 And so, yeah, it's on all of us to say, 00:01:09.070 --> 00:01:10.152 hey, look at what's going on here. 00:01:10.352 --> 00:01:10.531 Hey, 00:01:10.591 --> 00:01:11.893 just find out this is going on and 00:01:12.873 --> 00:01:13.834 bring that out to the masses. 00:01:13.875 --> 00:01:15.596 And one of the beautiful things is, though, 00:01:15.656 --> 00:01:15.837 that 00:01:16.316 --> 00:01:16.557 You know, 00:01:16.596 --> 00:01:18.158 we're we got people like you 00:01:18.197 --> 00:01:19.718 who've got great reach and, you know, 00:01:19.737 --> 00:01:21.858 we can get on to do a podcast. 00:01:21.899 --> 00:01:24.099 We've got companies who are 00:01:24.120 --> 00:01:24.939 just killing on social 00:01:24.959 --> 00:01:26.560 media right now so we can 00:01:26.579 --> 00:01:27.781 get the message out much better. 00:01:27.801 --> 00:01:28.600 So we're learning and we're 00:01:28.620 --> 00:01:29.400 doing much better at it. 00:01:29.861 --> 00:01:30.182 All right. 00:01:30.242 --> 00:01:31.962 So of importance right now, 00:01:31.981 --> 00:01:33.123 we'll start off with the big stuff, 00:01:33.143 --> 00:01:34.003 the SAFE Act. 00:01:34.483 --> 00:01:35.364 That's H.R. 00:01:35.463 --> 00:01:36.564 eleven seventy one. 00:01:36.984 --> 00:01:37.965 And now that bill aims to 00:01:37.984 --> 00:01:39.365 prevent falls and reduce 00:01:39.606 --> 00:01:41.347 opioid use amongst older adults. 00:01:41.587 --> 00:01:42.948 So far, Nick, I'm all I'm all in. 00:01:43.069 --> 00:01:43.989 I like both of those things. 00:01:44.049 --> 00:01:44.730 I'd like both of those 00:01:44.750 --> 00:01:45.891 things to to go away. 00:01:46.570 --> 00:01:47.891 Why is it such a game changer? 00:01:47.992 --> 00:01:49.853 And what can physical therapists do? 00:01:49.974 --> 00:01:51.355 The people listening right 00:01:51.415 --> 00:01:52.956 now to help push this thing forward? 00:01:53.700 --> 00:01:53.840 Well, 00:01:53.879 --> 00:01:55.680 the reason it's a game changer is it 00:01:55.721 --> 00:01:59.043 positions therapists as 00:01:59.123 --> 00:02:01.165 really the experts in fall prevention. 00:02:01.204 --> 00:02:02.385 Because, I mean, that's what we are. 00:02:02.465 --> 00:02:03.566 And I think I've talked to 00:02:03.587 --> 00:02:04.326 you about this before, 00:02:04.346 --> 00:02:05.108 but I wish you could change 00:02:05.128 --> 00:02:06.388 your name to Fallologist, right? 00:02:06.429 --> 00:02:07.828 Because then everyone would 00:02:07.868 --> 00:02:09.069 know what we do and everyone would know, 00:02:09.110 --> 00:02:09.911 like, that's us. 00:02:11.151 --> 00:02:12.111 But the reason why it's 00:02:12.132 --> 00:02:14.234 important right now is because, you know, 00:02:14.274 --> 00:02:15.455 there's this stuff going on 00:02:15.474 --> 00:02:16.314 that you guys may have heard of, 00:02:16.335 --> 00:02:18.036 which is called a reconciliation bill. 00:02:18.597 --> 00:02:20.057 And the president wants to 00:02:20.138 --> 00:02:22.158 have this really huge bill 00:02:22.218 --> 00:02:23.240 that comes out that says, 00:02:24.300 --> 00:02:24.860 A lot of things. 00:02:24.881 --> 00:02:25.741 They're trying to put an 00:02:25.881 --> 00:02:27.421 extension of the tax brackets in there. 00:02:27.622 --> 00:02:29.383 That's a huge thing in and of itself. 00:02:29.443 --> 00:02:31.185 But they're trying to put 00:02:31.264 --> 00:02:32.346 Medicaid reform in there. 00:02:32.366 --> 00:02:33.026 There's going to be health 00:02:33.045 --> 00:02:33.667 care provisions. 00:02:33.687 --> 00:02:34.326 There's going to be 00:02:34.947 --> 00:02:37.188 provisions for things that 00:02:37.229 --> 00:02:38.689 stand way beyond taxes. 00:02:39.030 --> 00:02:40.431 We have a commitment. 00:02:41.852 --> 00:02:43.193 uh that they're also going 00:02:43.212 --> 00:02:43.993 to try to address fee 00:02:44.014 --> 00:02:44.914 schedule inside 00:02:44.974 --> 00:02:45.935 reconciliation but the 00:02:45.974 --> 00:02:46.955 problem is all this stuff 00:02:46.975 --> 00:02:48.336 costs money and where the 00:02:48.377 --> 00:02:49.557 safe act can be positioned 00:02:49.578 --> 00:02:50.879 and what I just basically 00:02:50.919 --> 00:02:51.860 spent the last few days in 00:02:51.900 --> 00:02:53.342 dc doing with some of our 00:02:53.361 --> 00:02:54.682 other aptqi board members 00:02:54.703 --> 00:02:56.063 was saying hey look we 00:02:56.084 --> 00:02:57.824 understand you have to pay 00:02:57.844 --> 00:02:58.725 for a lot of this stuff 00:02:58.746 --> 00:03:00.146 that's coming out and 00:03:00.227 --> 00:03:02.688 here's an idea we spend 00:03:02.990 --> 00:03:03.810 fifty billion dollars a 00:03:03.830 --> 00:03:05.472 year on falls it'll be a 00:03:05.611 --> 00:03:06.532 hundred billion by the end 00:03:06.552 --> 00:03:07.653 of the decade at the way 00:03:07.674 --> 00:03:08.735 the slope of the curve is going 00:03:09.574 --> 00:03:10.474 We can save some of that 00:03:10.534 --> 00:03:12.516 money because if we prevent 00:03:12.556 --> 00:03:13.657 some of these falls from happening, 00:03:13.957 --> 00:03:16.460 that ambulance ride, that ER visit, 00:03:16.740 --> 00:03:18.360 that hip replacement surgery, 00:03:18.701 --> 00:03:20.203 all those expenses start to 00:03:20.242 --> 00:03:21.304 dissipate and you spend 00:03:21.364 --> 00:03:23.164 less money on that all in 00:03:23.205 --> 00:03:24.425 exchange for a hundred and 00:03:24.466 --> 00:03:26.508 forty dollar PT or OT fall 00:03:26.527 --> 00:03:27.229 risk assessment. 00:03:27.429 --> 00:03:27.649 Right. 00:03:28.150 --> 00:03:29.770 So in the country right now 00:03:30.632 --> 00:03:31.412 with the current rates, 00:03:31.632 --> 00:03:32.372 this assessment we're 00:03:32.393 --> 00:03:33.313 talking about would cost 00:03:33.334 --> 00:03:34.275 about one hundred and forty bucks. 00:03:34.294 --> 00:03:35.596 We want to make that free to the patient. 00:03:36.496 --> 00:03:38.698 but one injury from a fall 00:03:38.717 --> 00:03:39.799 that results in medical 00:03:39.838 --> 00:03:41.719 costs is ten thousand dollars. 00:03:42.200 --> 00:03:43.981 So the premise is pretty simple. 00:03:44.603 --> 00:03:47.665 If a PT as a whole can bat 00:03:47.705 --> 00:03:48.967 better than one for seventy, 00:03:49.266 --> 00:03:50.828 this bill starts to save us money. 00:03:50.927 --> 00:03:51.788 And we know that we are 00:03:51.829 --> 00:03:52.750 better than one for seventy. 00:03:53.210 --> 00:03:55.673 So we're positioning this as a solution. 00:03:55.712 --> 00:03:56.614 So when we go to Congress, 00:03:56.633 --> 00:03:57.735 we're not saying pay us more, 00:03:57.775 --> 00:03:59.016 pay us more and get in line 00:03:59.037 --> 00:04:00.478 with everybody else who wants more money. 00:04:00.998 --> 00:04:02.341 We're saying here's 00:04:02.360 --> 00:04:03.581 something that you can use 00:04:03.842 --> 00:04:05.704 as an offset to save money. 00:04:06.025 --> 00:04:07.066 It's better for patients. 00:04:07.366 --> 00:04:07.847 One of the things we're 00:04:07.866 --> 00:04:09.048 really excited about is 00:04:09.968 --> 00:04:10.209 You know, 00:04:10.729 --> 00:04:11.990 it's easy to position this as 00:04:12.030 --> 00:04:12.870 it's good for therapists, 00:04:12.909 --> 00:04:14.070 but we're not going to have 00:04:14.091 --> 00:04:14.950 a windfall from this. 00:04:14.991 --> 00:04:15.951 But it's really great for 00:04:15.991 --> 00:04:17.692 patients and it's not just us saying so. 00:04:18.132 --> 00:04:19.132 We got a public statement of 00:04:19.153 --> 00:04:21.014 support from AARP saying 00:04:21.033 --> 00:04:22.033 that they support this bill. 00:04:22.394 --> 00:04:24.355 So it really is better for the patient. 00:04:24.454 --> 00:04:25.254 And oh, by the way, 00:04:25.295 --> 00:04:26.576 it happens to be helpful 00:04:26.615 --> 00:04:27.935 for what Congress is trying 00:04:27.956 --> 00:04:29.216 to do right now with the 00:04:29.257 --> 00:04:30.117 reconciliation bill. 00:04:30.276 --> 00:04:31.237 So that's why it's important. 00:04:31.557 --> 00:04:32.338 What can folks do? 00:04:34.158 --> 00:04:35.701 We've been talking about it constantly, 00:04:36.762 --> 00:04:37.603 contacting your members of 00:04:37.642 --> 00:04:39.704 Congress saying, here's the bill number, 00:04:39.764 --> 00:04:40.625 eleven seventy one. 00:04:41.026 --> 00:04:41.726 Please support it. 00:04:43.007 --> 00:04:44.288 Get your patients on board. 00:04:45.149 --> 00:04:48.233 You as a therapist, you're one person, 00:04:48.413 --> 00:04:50.995 but you treat dozens of people a day, 00:04:52.076 --> 00:04:53.137 multiple dozens a week. 00:04:53.819 --> 00:04:54.939 I'm sure all of them either 00:04:55.420 --> 00:04:56.261 are at risk for falling 00:04:56.300 --> 00:04:57.723 themselves or have a loved one that is. 00:04:58.163 --> 00:04:59.283 your father, your mother, 00:04:59.324 --> 00:05:01.305 your grandparents, your in-laws, 00:05:01.944 --> 00:05:02.906 this affects everybody. 00:05:03.185 --> 00:05:04.927 So start getting other people involved. 00:05:04.947 --> 00:05:06.047 You'll be surprised how easy 00:05:06.067 --> 00:05:07.687 it is to get some folks, you know, 00:05:08.769 --> 00:05:09.848 relating to this because 00:05:09.968 --> 00:05:10.829 everyone probably knows 00:05:10.870 --> 00:05:12.290 somebody who is at risk or 00:05:12.331 --> 00:05:13.331 has already fallen and that 00:05:13.370 --> 00:05:14.432 fall has completely changed 00:05:14.451 --> 00:05:15.031 somebody's life. 00:05:15.791 --> 00:05:16.012 Yeah. 00:05:16.572 --> 00:05:17.692 And with baseball season, 00:05:17.733 --> 00:05:19.254 just a couple of hours away, 00:05:19.975 --> 00:05:21.175 one for seventy is point 00:05:21.254 --> 00:05:22.295 zero one for two. 00:05:22.355 --> 00:05:23.255 I think we can bet better 00:05:23.295 --> 00:05:25.237 than I'm pretty sure I have faith. 00:05:25.637 --> 00:05:26.057 I have faith. 00:05:27.249 --> 00:05:28.771 So that is the way, like it or not, 00:05:28.971 --> 00:05:30.052 but contacting the people 00:05:30.072 --> 00:05:31.492 that represent you is the 00:05:31.512 --> 00:05:32.274 way to make change. 00:05:32.834 --> 00:05:32.973 Now, 00:05:33.053 --> 00:05:34.154 a little bit of a different 00:05:34.175 --> 00:05:36.357 organization or maybe some crossover, 00:05:36.377 --> 00:05:37.798 Medicare cuts in the future of PT. 00:05:37.958 --> 00:05:39.038 Ongoing reductions in 00:05:39.079 --> 00:05:40.040 Medicare reimbursement 00:05:40.079 --> 00:05:40.901 rates have been a huge 00:05:40.940 --> 00:05:42.442 concern for the profession. 00:05:42.482 --> 00:05:43.562 Just go into any Facebook 00:05:43.583 --> 00:05:44.963 group and you hear that left and right, 00:05:44.983 --> 00:05:45.985 people complaining about that. 00:05:46.564 --> 00:05:47.346 Can you break down the 00:05:47.365 --> 00:05:48.206 latest developments and 00:05:48.226 --> 00:05:50.127 what they mean for PT clinics and, 00:05:50.168 --> 00:05:51.889 of course, ultimately their patients? 00:05:52.641 --> 00:05:53.723 Yeah, where we are right now, 00:05:53.843 --> 00:05:55.165 it's a pretty precarious state. 00:05:55.985 --> 00:05:56.225 I mean, 00:05:56.266 --> 00:05:57.367 people are talking about it's a two 00:05:57.406 --> 00:05:58.949 point eight percent cut for this year, 00:05:59.048 --> 00:06:02.012 but that's just looking at it too narrow. 00:06:03.254 --> 00:06:04.956 In the last five years, 00:06:05.136 --> 00:06:05.877 we're talking about five 00:06:05.916 --> 00:06:07.117 consecutive years of cuts. 00:06:07.519 --> 00:06:09.800 This is like eleven percent cumulatively, 00:06:10.262 --> 00:06:11.523 and we've done nothing wrong. 00:06:13.584 --> 00:06:14.927 This is this is not in 00:06:14.966 --> 00:06:16.567 response to a punishment. 00:06:16.588 --> 00:06:17.649 This is that therapists are 00:06:17.689 --> 00:06:18.589 doing bad things. 00:06:18.970 --> 00:06:20.692 You hear these terms flung around, fraud, 00:06:20.711 --> 00:06:20.872 waste. 00:06:21.232 --> 00:06:22.273 We're not we're not part of 00:06:22.293 --> 00:06:23.254 the abuse of the fraud. 00:06:23.774 --> 00:06:24.475 That's not us. 00:06:24.535 --> 00:06:25.997 But we're still getting this huge cut. 00:06:26.637 --> 00:06:27.778 So where things currently 00:06:27.838 --> 00:06:28.598 stand as it comes to 00:06:28.619 --> 00:06:29.879 Medicare reimbursement is I 00:06:30.240 --> 00:06:31.240 was alluding to it earlier. 00:06:31.701 --> 00:06:32.622 We're trying to make sure 00:06:32.642 --> 00:06:33.564 that it's addressed in this 00:06:34.024 --> 00:06:35.464 huge bill that they're 00:06:35.485 --> 00:06:36.747 trying to put together on the tax cuts. 00:06:37.447 --> 00:06:38.747 And we received some 00:06:38.827 --> 00:06:39.949 commitments that they're 00:06:39.968 --> 00:06:41.211 trying their best to put it in there. 00:06:41.531 --> 00:06:42.372 However, again, 00:06:43.432 --> 00:06:44.634 it's not done until it's done. 00:06:45.113 --> 00:06:47.295 And it could still take a while. 00:06:47.355 --> 00:06:48.716 I don't think anything's imminent. 00:06:49.278 --> 00:06:49.997 This build they're trying to 00:06:50.017 --> 00:06:52.000 put together will likely 00:06:52.040 --> 00:06:53.380 drag on into the summer. 00:06:54.341 --> 00:06:55.262 And one of the messages that 00:06:55.302 --> 00:06:59.187 we took to the Hill this week was, hey, 00:06:59.346 --> 00:06:59.786 if you do... 00:07:00.987 --> 00:07:01.928 if you are able to come 00:07:01.949 --> 00:07:02.788 together to give us a 00:07:02.829 --> 00:07:03.949 little bit of a reprieve on 00:07:03.970 --> 00:07:06.050 the fee schedule for a 00:07:06.091 --> 00:07:07.471 short-term fix and a patch 00:07:07.492 --> 00:07:08.353 like they've done in the past, 00:07:09.317 --> 00:07:10.838 If it happens near the end of the year, 00:07:11.598 --> 00:07:11.778 like, 00:07:11.959 --> 00:07:13.139 should we just look at maybe making 00:07:13.180 --> 00:07:14.721 it for all of twenty twenty six too? 00:07:15.021 --> 00:07:16.000 Because why should we come 00:07:16.021 --> 00:07:17.601 right back in December and say, hey, 00:07:17.622 --> 00:07:18.242 we have a problem. 00:07:18.802 --> 00:07:19.182 And again, 00:07:19.223 --> 00:07:20.502 so we're getting we're getting 00:07:20.523 --> 00:07:22.204 that word out that like we 00:07:22.244 --> 00:07:23.345 understand these things take time. 00:07:23.365 --> 00:07:25.245 But then maybe the trade off 00:07:25.346 --> 00:07:26.266 is we didn't we didn't get 00:07:26.305 --> 00:07:27.266 relief in the first half of 00:07:27.307 --> 00:07:28.826 twenty twenty five to maybe 00:07:28.867 --> 00:07:29.648 try to take care of twenty 00:07:29.668 --> 00:07:30.627 twenty six while we're at 00:07:30.687 --> 00:07:31.488 it and just give us some 00:07:31.509 --> 00:07:32.168 more breathing room. 00:07:32.728 --> 00:07:33.889 Long-term, 00:07:34.370 --> 00:07:35.932 I think we've got to start 00:07:36.353 --> 00:07:37.112 looking at things like how 00:07:37.132 --> 00:07:38.173 do we protect ourselves 00:07:38.675 --> 00:07:39.536 from cuts in the future? 00:07:39.615 --> 00:07:41.057 Because we can't keep 00:07:41.076 --> 00:07:41.456 getting on this 00:07:41.516 --> 00:07:44.139 merry-go-round of we got cut bad, 00:07:44.420 --> 00:07:45.420 now let's try to get cut a 00:07:45.461 --> 00:07:46.401 little bit less and get a 00:07:46.422 --> 00:07:47.242 little bit money back. 00:07:47.262 --> 00:07:48.884 But at the end of the day, again, 00:07:49.084 --> 00:07:49.944 you look backwards and 00:07:49.985 --> 00:07:51.446 we're down double digits in 00:07:51.485 --> 00:07:52.586 a short amount of time. 00:07:53.595 --> 00:07:54.375 It's not sustainable. 00:07:54.456 --> 00:07:55.137 It's not fair to our 00:07:55.156 --> 00:07:57.559 therapists over the long term. 00:07:57.779 --> 00:07:58.399 Who's going to want to 00:07:58.439 --> 00:08:00.281 become a therapist at that 00:08:00.322 --> 00:08:01.803 rate and go to school for 00:08:01.824 --> 00:08:02.524 the length of time you have 00:08:02.545 --> 00:08:03.745 to go to school when you 00:08:03.786 --> 00:08:05.887 could do any number of 00:08:05.949 --> 00:08:06.548 other health care 00:08:06.569 --> 00:08:07.870 professions that are great 00:08:07.911 --> 00:08:08.851 professions and that help a 00:08:08.872 --> 00:08:09.432 lot of people. 00:08:10.372 --> 00:08:11.634 But the risk reward is a lot 00:08:11.675 --> 00:08:12.214 better for your degree. 00:08:13.516 --> 00:08:13.675 Right. 00:08:13.716 --> 00:08:14.596 The cost to get your degree. 00:08:14.677 --> 00:08:17.177 So we have a problem here 00:08:17.197 --> 00:08:17.798 and we need to start 00:08:17.838 --> 00:08:19.598 thinking long term about 00:08:20.420 --> 00:08:22.240 where do we go from here in 00:08:22.300 --> 00:08:24.281 terms of how do we solidify 00:08:24.862 --> 00:08:27.882 the value of therapy and in 00:08:27.923 --> 00:08:28.783 the eyes of the folks who 00:08:28.824 --> 00:08:29.843 make these decisions to say 00:08:29.884 --> 00:08:30.824 we should start protecting 00:08:31.404 --> 00:08:32.365 this service instead of 00:08:32.404 --> 00:08:33.706 looking for ways to cut it, 00:08:33.745 --> 00:08:35.365 especially when it's not much left. 00:08:35.745 --> 00:08:37.025 There's not much meat left in our bone, 00:08:37.086 --> 00:08:37.505 unfortunately. 00:08:37.525 --> 00:08:38.147 Yeah. 00:08:38.226 --> 00:08:39.307 Yeah, I think you're right. 00:08:39.346 --> 00:08:40.187 Let's go to a different bill, 00:08:40.206 --> 00:08:41.346 Medicare Patient Access and 00:08:41.386 --> 00:08:42.947 Practice Stabilization Act 00:08:42.967 --> 00:08:44.087 for those keeping score at home. 00:08:44.107 --> 00:08:44.727 That's H.R. 00:08:44.847 --> 00:08:45.807 eight seventy nine. 00:08:46.288 --> 00:08:46.389 Now, 00:08:46.408 --> 00:08:47.989 that bill has major implications for 00:08:48.009 --> 00:08:49.489 both practitioners and patients. 00:08:49.989 --> 00:08:51.149 What are the key points PT 00:08:51.169 --> 00:08:52.750 should understand and how 00:08:52.769 --> 00:08:53.809 can they help push it through? 00:08:54.429 --> 00:08:54.570 Yeah, 00:08:54.610 --> 00:08:55.750 this is a really important bill 00:08:56.171 --> 00:08:58.311 because it's highlighting the fact that, 00:08:58.750 --> 00:08:59.331 you know, like I said, 00:08:59.552 --> 00:09:00.471 we've had these cuts. 00:09:02.075 --> 00:09:04.383 at a time when inflation is 00:09:04.482 --> 00:09:06.249 run rampant and everyone's costs, 00:09:06.350 --> 00:09:07.253 if you run a clinic 00:09:08.846 --> 00:09:09.847 You're paying more for your rent. 00:09:10.489 --> 00:09:11.669 You're paying more for your supplies. 00:09:11.990 --> 00:09:13.191 You want to be a good employer. 00:09:13.270 --> 00:09:13.991 You're trying to give 00:09:14.032 --> 00:09:15.472 everyone as big a raise as 00:09:15.493 --> 00:09:16.453 possible for your wages. 00:09:18.196 --> 00:09:19.417 You can't run a business 00:09:19.437 --> 00:09:20.738 where your expense line is 00:09:20.758 --> 00:09:22.759 going straight up and your 00:09:22.799 --> 00:09:24.380 income line is going straight down. 00:09:24.760 --> 00:09:25.501 And that's what's happening. 00:09:25.542 --> 00:09:27.043 So what eight seventy nine 00:09:27.062 --> 00:09:28.504 is trying to bring to the 00:09:28.764 --> 00:09:30.725 to the to the masses is 00:09:31.226 --> 00:09:33.288 look for beyond the fact 00:09:33.308 --> 00:09:34.289 that we keep getting cut. 00:09:34.870 --> 00:09:35.309 We need to start 00:09:36.071 --> 00:09:37.071 incorporating inflation 00:09:37.270 --> 00:09:40.232 into the equation here 00:09:40.513 --> 00:09:41.894 because it has not occurred. 00:09:41.953 --> 00:09:43.173 And unfortunately, 00:09:43.215 --> 00:09:44.475 in the office space setting, 00:09:44.495 --> 00:09:45.336 so it's not just therapists, 00:09:45.355 --> 00:09:47.397 but anyone paid on that fee schedule, 00:09:47.417 --> 00:09:48.716 which is a lot of physicians as well. 00:09:49.918 --> 00:09:52.139 Our schedule has been frozen 00:09:52.178 --> 00:09:52.980 from any kind of 00:09:53.200 --> 00:09:54.921 inflationary update at all. 00:09:55.500 --> 00:09:56.923 So again, same thing. 00:09:57.562 --> 00:09:58.423 You have the bill number. 00:09:59.544 --> 00:10:00.725 We need to get folks to 00:10:00.745 --> 00:10:03.408 understand that our fee 00:10:03.448 --> 00:10:04.529 schedule is not keeping up 00:10:04.549 --> 00:10:05.150 with inflation. 00:10:05.230 --> 00:10:06.451 And again, for the long term, 00:10:07.533 --> 00:10:08.774 we have to at least start 00:10:08.813 --> 00:10:10.716 getting to where every year 00:10:11.636 --> 00:10:12.337 it's a given that 00:10:12.597 --> 00:10:13.839 providers' expenses are 00:10:13.859 --> 00:10:15.181 going up and that payment 00:10:15.201 --> 00:10:16.001 should go up to at least 00:10:16.022 --> 00:10:17.003 try to offset some of that. 00:10:17.503 --> 00:10:17.682 Yeah. 00:10:18.004 --> 00:10:18.624 And we'll reiterate, 00:10:18.663 --> 00:10:19.946 many PTs feel sometimes 00:10:19.985 --> 00:10:21.548 like policy is someone else's job. 00:10:21.567 --> 00:10:23.168 It's not just the job of big 00:10:23.208 --> 00:10:24.190 organizations or people 00:10:24.210 --> 00:10:25.272 whose job it is to go to the Hill. 00:10:25.312 --> 00:10:26.092 It's crucial for every 00:10:26.133 --> 00:10:27.995 clinician to get involved 00:10:28.134 --> 00:10:29.756 when representatives can 00:10:29.797 --> 00:10:30.957 hear these messages from 00:10:31.018 --> 00:10:32.580 multiple voices in their 00:10:32.620 --> 00:10:34.020 communities from patients 00:10:34.061 --> 00:10:35.263 that may or may not vote to 00:10:35.302 --> 00:10:36.364 get them back into office. 00:10:36.884 --> 00:10:37.823 They tend to they tend to 00:10:37.864 --> 00:10:38.784 pay attention and it is an 00:10:38.825 --> 00:10:40.245 effective way that they can 00:10:40.264 --> 00:10:40.946 make an impact. 00:10:41.846 --> 00:10:43.447 If I asked you to look into a crystal ball, 00:10:43.886 --> 00:10:46.967 if PTs and OTs don't take action now, 00:10:47.528 --> 00:10:48.707 where might you see our 00:10:48.748 --> 00:10:49.509 profession or our 00:10:49.528 --> 00:10:51.389 professions in five years? 00:10:51.408 --> 00:10:51.610 I mean, 00:10:51.769 --> 00:10:53.250 I don't want to I don't want to 00:10:53.289 --> 00:10:55.010 rattle the saber and fear monger, 00:10:55.030 --> 00:10:56.270 but you do want to make 00:10:56.291 --> 00:10:57.532 sure people understand the 00:10:57.591 --> 00:10:58.831 tension in the story over 00:10:58.871 --> 00:10:59.812 things that might happen. 00:11:00.153 --> 00:11:01.472 What's at stake if if some 00:11:01.493 --> 00:11:02.192 of these legislative 00:11:02.232 --> 00:11:03.254 efforts don't succeed? 00:11:04.092 --> 00:11:05.095 Well, here's what we're looking at, 00:11:05.875 --> 00:11:07.799 and I appreciate your point 00:11:07.820 --> 00:11:10.403 about let's not get too morose, 00:11:10.443 --> 00:11:12.567 but let's look at what the 00:11:12.628 --> 00:11:13.490 trends currently are. 00:11:14.010 --> 00:11:15.011 I mentioned this a little bit earlier. 00:11:16.476 --> 00:11:17.958 wants to go to pt school in 00:11:18.078 --> 00:11:20.701 in five years if uh um if 00:11:20.761 --> 00:11:22.443 the situation is that you 00:11:22.484 --> 00:11:24.306 continuously get cut and 00:11:24.645 --> 00:11:25.626 and and oh by the way in 00:11:25.667 --> 00:11:26.989 five years if anyone thinks 00:11:27.028 --> 00:11:28.250 that tuition will go down 00:11:28.269 --> 00:11:29.731 you're I'd love to talk to 00:11:29.772 --> 00:11:30.471 you I don't know how you 00:11:30.491 --> 00:11:31.953 would get that so whatever 00:11:32.114 --> 00:11:33.875 the cost is today every 00:11:33.916 --> 00:11:34.996 year from now in the next 00:11:35.037 --> 00:11:35.977 five years the cost to 00:11:35.998 --> 00:11:37.080 become a pt will go up 00:11:37.539 --> 00:11:39.601 But also every year or the next five years, 00:11:40.062 --> 00:11:42.544 the salaries to be a PT may 00:11:42.585 --> 00:11:43.846 not be moving much. 00:11:44.225 --> 00:11:45.748 And again, as those widen, 00:11:45.768 --> 00:11:47.428 we're going to have a workforce problem. 00:11:47.970 --> 00:11:50.111 And the APTA published a 00:11:50.131 --> 00:11:52.313 nice paper kind of highlighting that, hey, 00:11:52.333 --> 00:11:53.034 we're starting to see 00:11:53.434 --> 00:11:54.416 projecting shortages. 00:11:54.895 --> 00:11:56.898 And I think that will only exacerbate, 00:11:56.957 --> 00:11:59.581 actually, because we have a pipeline. 00:11:59.961 --> 00:12:00.802 that we're used to getting 00:12:00.841 --> 00:12:02.243 new grads every year to 00:12:02.283 --> 00:12:03.644 replace people who retire 00:12:03.803 --> 00:12:05.585 or cut back on their hours. 00:12:05.904 --> 00:12:06.686 But what happens when your 00:12:06.725 --> 00:12:07.566 pipeline dries up? 00:12:08.687 --> 00:12:12.769 And also, separate from the workforce, 00:12:12.789 --> 00:12:13.789 let's just talk about access. 00:12:16.751 --> 00:12:17.572 Our members are closing 00:12:17.613 --> 00:12:19.014 clinics that have twenty 00:12:19.053 --> 00:12:19.975 patients a day coming in. 00:12:20.514 --> 00:12:21.556 We're not we're not closing 00:12:21.596 --> 00:12:24.337 clinics because we have no 00:12:24.398 --> 00:12:25.259 one coming in and there's 00:12:25.278 --> 00:12:26.899 no there's no demand for 00:12:26.919 --> 00:12:28.721 our services in our country. 00:12:28.740 --> 00:12:31.703 There is absolutely a chunk 00:12:31.803 --> 00:12:32.945 of baby boomers coming into 00:12:32.985 --> 00:12:35.326 Medicare every single day, and they 00:12:36.027 --> 00:12:37.168 they will guzzle pt 00:12:37.207 --> 00:12:38.308 resources if they can and 00:12:38.328 --> 00:12:39.208 services if they can 00:12:39.490 --> 00:12:41.730 however if the payment we 00:12:41.750 --> 00:12:42.711 get for those services 00:12:42.772 --> 00:12:44.833 can't meet um our costs 00:12:45.173 --> 00:12:45.734 we're gonna have to shut 00:12:45.774 --> 00:12:47.535 down clinics so when you 00:12:47.556 --> 00:12:48.535 have a service that people 00:12:48.596 --> 00:12:51.158 want and will come in and 00:12:51.278 --> 00:12:52.919 you have the volume but you 00:12:52.960 --> 00:12:53.820 actually have to close the 00:12:53.840 --> 00:12:55.802 clinic anyway what's what's 00:12:55.822 --> 00:12:56.402 going to happen to your 00:12:56.442 --> 00:12:57.182 patients who need those 00:12:57.222 --> 00:12:58.464 low-cost services um 00:12:58.484 --> 00:12:59.244 they're going to fall more 00:12:59.825 --> 00:13:00.465 they're going to have more 00:13:00.504 --> 00:13:01.125 surgeries than they 00:13:01.166 --> 00:13:02.125 probably needed they're 00:13:02.145 --> 00:13:04.008 going to be less independent 00:13:04.830 --> 00:13:07.152 Maybe they're living with their kids more. 00:13:07.192 --> 00:13:09.572 Maybe they're living in nursing homes. 00:13:09.833 --> 00:13:11.475 I mean, think about this. 00:13:11.534 --> 00:13:12.495 If every household, 00:13:12.514 --> 00:13:13.176 there's not enough 00:13:13.216 --> 00:13:16.278 Generation X folks to tell the boomers, 00:13:16.298 --> 00:13:17.078 you can come live with me. 00:13:17.839 --> 00:13:18.679 And when someone does, 00:13:18.840 --> 00:13:19.360 if they're in that 00:13:19.500 --> 00:13:20.801 situation where they can do that, 00:13:21.522 --> 00:13:22.623 someone's got to stay at home with them. 00:13:22.663 --> 00:13:23.363 Now you're taking people out 00:13:23.383 --> 00:13:23.964 of the workforce. 00:13:23.984 --> 00:13:25.163 There's a whole add-on effect. 00:13:25.203 --> 00:13:27.105 And I know I'm maybe drawing 00:13:27.125 --> 00:13:28.206 some lines that you think, OK, 00:13:28.287 --> 00:13:29.807 that might be a stretch, but it's not. 00:13:29.908 --> 00:13:31.068 When we're talking about not 00:13:31.109 --> 00:13:32.490 having an independent, 00:13:32.549 --> 00:13:33.890 healthy senior population, 00:13:34.650 --> 00:13:35.552 these things happen and if 00:13:35.572 --> 00:13:36.773 you talk to anyone with an 00:13:36.893 --> 00:13:39.014 older uh a person in their 00:13:39.054 --> 00:13:40.076 home or they're they're a 00:13:40.115 --> 00:13:40.976 caretaker for someone 00:13:40.996 --> 00:13:42.097 elderly they are probably 00:13:42.138 --> 00:13:42.778 shaking their heads to know 00:13:42.817 --> 00:13:43.499 exactly what I'm talking 00:13:43.519 --> 00:13:45.341 about yeah yeah when access 00:13:45.380 --> 00:13:47.442 goes down uh when 00:13:47.523 --> 00:13:48.884 reimbursement goes down 00:13:49.083 --> 00:13:50.105 that is going to close 00:13:50.144 --> 00:13:51.245 clinics and that's going to 00:13:51.306 --> 00:13:52.326 reduce access and then 00:13:52.346 --> 00:13:53.368 quality of life I mean we 00:13:53.388 --> 00:13:54.729 want to start with finish 00:13:54.749 --> 00:13:55.370 with the end which is 00:13:55.409 --> 00:13:56.971 quality of life will go 00:13:57.010 --> 00:13:58.692 down for those who need it the most 00:13:59.613 --> 00:14:00.234 Some people, 00:14:00.573 --> 00:14:02.716 I ran into some bigwigs this 00:14:02.755 --> 00:14:03.176 last weekend. 00:14:03.196 --> 00:14:04.096 I was away at a conference. 00:14:04.336 --> 00:14:05.576 Some people actually, like bigwigs, 00:14:05.596 --> 00:14:06.298 people who run companies, 00:14:06.357 --> 00:14:07.177 listen to this show. 00:14:07.198 --> 00:14:08.779 Wow, amazing. 00:14:09.039 --> 00:14:09.379 Who knew? 00:14:09.960 --> 00:14:12.841 APTQI is an organization 00:14:12.861 --> 00:14:13.582 that brings together 00:14:13.623 --> 00:14:14.964 organizations to do a lot 00:14:14.984 --> 00:14:16.544 of the work that Nick is talking about. 00:14:16.585 --> 00:14:17.345 So Nick, I'll give you, 00:14:17.625 --> 00:14:18.706 since we know big fancy, 00:14:18.745 --> 00:14:19.767 sometimes big fancy people 00:14:19.787 --> 00:14:20.547 listen to this as well. 00:14:21.028 --> 00:14:22.008 What's your pitch for 00:14:22.188 --> 00:14:23.269 organizations who are not 00:14:23.308 --> 00:14:26.171 members of APTQI of why they should join? 00:14:26.270 --> 00:14:27.331 What would they get out of it? 00:14:27.371 --> 00:14:28.533 What would our profession get out of it? 00:14:29.133 --> 00:14:29.373 Sure. 00:14:29.413 --> 00:14:31.813 So if you're a leader of a 00:14:31.874 --> 00:14:33.455 company that and it doesn't 00:14:33.475 --> 00:14:34.676 even have to be a company 00:14:34.696 --> 00:14:35.976 that is a provider of care. 00:14:36.076 --> 00:14:36.736 If you're a leader of a 00:14:36.797 --> 00:14:38.317 company that has any stake 00:14:38.337 --> 00:14:38.918 in the profession, 00:14:38.957 --> 00:14:41.639 maybe you sell equipment to therapists, 00:14:41.658 --> 00:14:43.279 maybe you sell software to therapists, 00:14:44.061 --> 00:14:45.421 maybe you sell a platform 00:14:45.461 --> 00:14:46.461 or you have a digital platform. 00:14:47.101 --> 00:14:48.482 whatever it happens to be. 00:14:48.883 --> 00:14:51.484 If as therapy goes, your company goes, 00:14:51.764 --> 00:14:53.965 there's a place for you at APTQI. 00:14:54.404 --> 00:14:55.605 And what I mean by that is 00:14:55.686 --> 00:14:57.287 we have a structure to 00:14:57.307 --> 00:14:58.067 where we have membership. 00:14:58.147 --> 00:14:59.106 If you're a provider group, 00:14:59.187 --> 00:14:59.788 we have a structure. 00:15:00.927 --> 00:15:02.089 We have a membership tier if you're 00:15:02.828 --> 00:15:03.929 sort of like a vendor for 00:15:04.269 --> 00:15:05.171 therapy providers. 00:15:05.711 --> 00:15:07.732 And what we do with our members is one, 00:15:07.773 --> 00:15:09.073 we educate them on what's going on. 00:15:09.553 --> 00:15:10.014 But two, 00:15:10.615 --> 00:15:12.917 we take all of them to DC and we 00:15:12.956 --> 00:15:14.138 have them talk directly to 00:15:14.158 --> 00:15:14.938 lawmakers and say, 00:15:15.058 --> 00:15:15.999 this is what's going on. 00:15:16.038 --> 00:15:17.019 So you were mentioning, 00:15:17.039 --> 00:15:18.740 I just got back from DC yesterday. 00:15:19.341 --> 00:15:20.643 I was there with about seven 00:15:20.842 --> 00:15:23.524 of our CEOs and I'm going back next week. 00:15:23.565 --> 00:15:24.625 The plan is about, you know, 00:15:24.645 --> 00:15:26.167 another five or six of our 00:15:26.187 --> 00:15:27.768 companies are sending representatives to, 00:15:28.089 --> 00:15:29.649 and we will take you on a hill. 00:15:29.669 --> 00:15:30.850 What we do with your dues money is 00:15:31.370 --> 00:15:34.133 We, you know, we get materials. 00:15:34.173 --> 00:15:34.953 We get, you know, 00:15:36.754 --> 00:15:38.436 lobbyists that help push our cause. 00:15:38.495 --> 00:15:39.777 And we take you on the hill and we say, 00:15:40.057 --> 00:15:40.878 this is what we need to do. 00:15:41.278 --> 00:15:42.359 And this is we need to talk to you. 00:15:42.458 --> 00:15:43.440 And this is what we need to say. 00:15:43.460 --> 00:15:45.721 And it doesn't matter if 00:15:45.740 --> 00:15:46.442 you've never done it before. 00:15:46.682 --> 00:15:47.802 We will show you what to do. 00:15:49.908 --> 00:15:52.571 A-P-T-Q-I dot com is where 00:15:52.591 --> 00:15:53.792 you can find out more information. 00:15:54.371 --> 00:15:55.033 Always informative. 00:15:55.052 --> 00:15:55.692 Thanks for keeping us 00:15:55.732 --> 00:15:56.774 abreast of the situation. 00:15:57.875 --> 00:15:58.895 Would love to hear more. 00:15:58.916 --> 00:15:59.556 Maybe we'll bring you back 00:15:59.596 --> 00:16:01.217 in a couple of months to 00:16:01.258 --> 00:16:02.337 hear where these things 00:16:02.357 --> 00:16:03.739 that we talked about now, 00:16:03.980 --> 00:16:04.720 how they played out. 00:16:04.919 --> 00:16:05.400 Update, 00:16:05.721 --> 00:16:06.761 and then I know this is going to be 00:16:06.782 --> 00:16:07.461 a shock to the audience. 00:16:07.481 --> 00:16:08.283 I bet there'll be something 00:16:08.322 --> 00:16:09.323 new we need to pay attention to. 00:16:09.364 --> 00:16:09.543 Probably. 00:16:12.405 --> 00:16:13.566 Good job security for you, 00:16:13.586 --> 00:16:14.746 but that just highlights 00:16:14.767 --> 00:16:15.687 that there's always stuff 00:16:15.726 --> 00:16:16.467 going on that we need to 00:16:16.488 --> 00:16:17.368 pay attention to and we 00:16:17.427 --> 00:16:19.609 have to stay vigilant or we 00:16:19.629 --> 00:16:21.409 don't get represented. 00:16:21.831 --> 00:16:22.490 That's it in a nutshell.