And we are live.
Dave Kittle, Tony Meritato.
Dave, the hair is on point.
I love it.
The baseball locks are flowing.
You know, there is.
Oh, yes.
We've got a doubleheader
this weekend for our eighth graders.
I'm like, seriously, a doubleheader?
Okay.
I had a couple doubleheaders already,
and I get so sore.
I need to work more on recovery.
And my wife jokes that my my
thirty year old body does
not respond to
doubleheaders as well as they used to.
How many innings do you guys play?
If it's a doubleheader, it's fourteen.
So it's seven and seven.
Okay, that's what our kids are doing,
seven and seven.
But I'm also hitting and stealing bases,
sliding headfirst in the
second and home played and
sliding on the turf, getting ripped up.
So yeah, playing hard.
They're trying to pick me off at first.
I'm diving back in on my belly.
Well,
this this double header will be ugly
because our kids have pitch counts.
They can't pitch more than
so many pitches per inning per game.
And, you know,
we only have like three
pitchers on the team.
So it reminded me,
was it the Dodgers who put
that guy in who was clearly
not a pitcher?
This was all over social media recently.
Yeah,
the Dodgers' Quique Hernandez because
he wore the coaching of first base,
like the protective helmet
foam thing on the front.
So yeah,
that was a little bit of a viral thing.
He plays infield and outfield, but yeah,
he pitched and he always messes around.
All right.
So let's jump into today's topics.
We got two topics at least to start with.
I want to discuss because I
want to get your take on
Joseph Lowe from PT Supply.
He put out an AI analysis of
ATI's financial status.
Basically, we'll look at it,
but he's saying, you know,
when is ATI going to go bankrupt?
And then Lauren Meffin is a
SLP down in Florida, Gainesville.
She put out a long form
sales copy post that I thought, awesome,
great.
I love seeing therapists doing this,
but I want to get some perspective on,
because I know you have a
long history in copywriting.
I'm curious to see if you
see the same things that I
see that would be
recommendations to improve it.
So I'm going to share
Joseph's post from LinkedIn.
Now, Joseph has been on the podcast.
He knows us.
We know him.
Let me pull this out and bring it on.
Okay.
forgive my messages along the side,
but so let's see.
Joseph basically says,
I uploaded the ATI-XK into
ChatGPT and asked it to
what it thought of them going bankrupt.
So let's hit a couple.
So financial red flags from
said still deeply unprofitable net losses,
fifty four million,
slightly improved from
sixty six million net
losses in two thousand twenty three.
I'm going to hit a couple of
the top ones and then I'll
come back to you, Dave,
for some feedback.
Negative operating cash flow.
Two thousand twenty four
operating cash flow was negative.
Nineteen million dollars is
the second consecutive year
of negative cash flow.
I will say we've gone
through negative cash flow
multiple years in a row,
but we are not ATI.
Limited liquidity, cash on hand,
thirty nine million,
not enough to sustain them long.
If losses persist,
current liabilities are one
hundred and forty one
million high and rising debt.
So they're borrowing more
money long term and L-two.
I don't know what L-two debt is.
Five hundred and fifty million.
Any any feedback so far
before I keep going?
Yeah,
those are all pretty big factors in
terms of just their size
and the amount of risk that
they're carrying,
like the amount of financial risk.
So yeah, I mean,
if you have a negative
operational cash flow loss, I mean,
they're covering up the
current debt payments with
the cash that's coming in
from all their current
patients and all those
insurance claims and everything.
But certainly sounds like
skating on thin ice.
So, okay.
Heavily diluted capital structure,
raised twenty five million
in a series a declining
SG&A dropped by dropped to
nine hundred ninety or
ninety nine million.
What's SG&A?
The administrative expenses.
So the formal is selling
comma general comma and
administrative expenses.
So just admin costs.
Oh, okay.
Positive or neutral indicators.
Revenue growth,
net revenue growth grew
from six hundred ninety
nine million to seven
hundred and fifty three million.
So up seven percent.
Cost control,
SG&A and impairment costs are down.
Cash flow financing from two
thousand twenty four up
thirty five million.
They're still raising money.
So let me ask you as an investor.
Go ahead.
I was going to say that the SG&A,
it includes things like rent utilities,
the salaries of the employees,
the admin employees that
are not producing the revenue.
So it is kind of a big part
of any practice or company.
So it's anyone in the billing staff.
It's obviously the rent and the utilities.
So the overhead,
it's the rent of all these locations.
And they probably lease most of them out.
I don't think they, you know,
they're in a practice business.
They're not,
I doubt they own much of the
real estate of these practices.
So that's the SG&A component.
Maybe Jerry Durham's
listening and he heard you
say employees that are not
generating revenue.
His ears are burning.
Yeah, well, technically they're not.
I mean, they do, but they do indirectly.
They're not treating a patient,
filing a claim, get paid for that time,
that service.
I get it.
I know you do.
Yeah.
Burn rate net cash used in
operations and investing
roughly thirty three
million in twenty twenty
four at that pace.
Thirty nine million in cash
lasts just over twelve months.
So, you know,
they just they don't have the
sustainability in the deposits.
When might bankruptcy happen?
It's hard to say.
They run out of cash in Q
one Q two two thousand twenty six.
So, I mean, the big thing is, you know,
how are they still raising money?
And I'm asking you,
I generally don't know.
How are they still raising
money when they're in such
a kind of dire predicament?
I don't know, other than bankers who...
will somehow try to push
this through their
underwriting committee and
their you know the risk
tolerance and the bankers
who maybe care more about
this is this is real stuff
by the way what I'm about
to say yeah bank bankers
who get bonus every
december they get bonus
based off of how much money
they get out the door how
much money they lend
And so if a banker or
bankers are more focused on
their own personal bonuses,
maybe they're about to jump
jobs or whatever,
this is one potential way
on how this happens.
Bankers who care more about
their bonus and lending out
this money to a fairly risky company,
although the company ATI will say, well,
we have all these locations,
all these therapists, whatever, like,
yeah, we have some volatility,
but you know, we're huge,
so you can't kill us.
or it's going to be hard to
kill us so these bankers
are like all right we'll
lend out the money we'll
put you through the credit
committee whatever and then
the bankers get bonus
because they can somewhat
influence some of this
lending to occur uh or or
whatever investors and
That's one potential way.
Of course,
there's other folks that are
watching that might have other ideas.
And I'm sure the thing is
that there's gonna be many
different ways on how this could occur.
The risk tolerance and the
credit committees are gonna look at,
all right,
what's your cash and what's
your cash coming in?
And can you pay these
minimal debt service
payments moving forward?
Like if they get more debt,
they already have debt.
If they get more debt, like, hey,
with your current cashflow,
the way it is,
if it stays the same,
can you cover those debt
service payments of new
debt that you are asking for?
You're asking for more money
and more debt.
And if they're cashflow can
cover that debt service,
that's how more debt could be approved.
Right.
So if we put Dave Kittle,
I'm on the website right now.
We take Sharon Vitti out of CEO position.
We put Dave Kittle.
Are you sharing the screen?
No, I'm not sharing it.
This is just I'm talking.
I put Dave Kittle in its place.
A little bit of context,
a little bit of history.
It says ATI was created in
nineteen ninety six.
So we're looking at thirty years,
almost thirty years.
They've got eight hundred
and seventy eight locations
from when they publish some
information on their website.
So Dave comes in as the new interim CEO.
What are some of the first
things that you see on the horizon?
And there's just for fun.
But, you know, what are we looking at?
Please.
uh okay so I mean globally
at this size of a company
you need you need you need
more money coming in and
less money that you're
spending right now your
rents you already signed
those rents those leases
right so you sign that so
that that is what it is
you're not really gonna
although you could
negotiate lease by lease
and say hey can we get some
you know rent reduction
whatever because otherwise
you might have to have a
really tough conversation
with all of your landlords
and with your teams.
So if I were the CEO,
I would probably have a
tough conversation with all
the stakeholders,
everyone that's part of the business.
I'd go to the landlords.
I would say, hey,
We might be out of business
and you might not be able
to collect the next five to
ten years of rent, however,
or three years or whatever
the years are remaining on the rent.
If we totally go out of
business or if we go into bankruptcy,
you're not going to have anything.
So maybe can we...
re can we re-establish or
tear up this lease and make
a new lease you own real
estate I don't tony so you
could you have more insight
on that I would go to the
landlords I would try to do
that as much as possible
get some reduction I would
get maybe can we can we can
we just skip some payments
I don't know like can we
because if I push if I push
payments out in the future
like if we still have to
pay them anyway like
eventually that bills come
and do right so hey can we get
It's probably not gonna happen, but hey,
can we get twelve months?
Can we get twelve months where you just,
you know, within writing,
can we just not pay rent
for the next twelve months?
I think these are the dire
things that actually need to happen.
Then you gotta go to all
your therapists and you say, hey,
We're in a really tough situation.
It's not your fault.
It's our fault.
We put ourselves into this,
the corporate team, the C-suite,
whatever.
We put ourselves into this.
But here's what needs to happen.
We need to go to a fifty-fifty,
fifty percent salary,
fifty percent productivity.
So whatever your salary is now,
let's just say for easy numbers,
if you're at eighty K,
know your your salary your
next paycheck is going to
be you know half of it is
going to be guaranteed on
your pay stub and then the
other half is going to be
based off of legal and
compliant billing and
coding of your visits plus
the cash based services
which hopefully they have
some of the things the the
compression boots the uh
remote uh remote
therapeutic monitoring or
remote um remote workout
programming that is totally self-pay or
any other self-pay things
like soft tissue work, massage, cupping,
whatever.
So you got to go to your
therapist and try to get buy-in,
which is going to be
basically impossible because I don't,
how many therapists do they have?
Tens of thousands of therapists.
I don't know.
I mean,
if they have eight hundred and
something locations, you have to assume,
you know, they've got.
Yeah.
Multiple.
Yeah.
They have thousand therapists.
So you're going to you're
going to lose some
therapists because some of them are,
you know, probably.
I don't know.
Maybe a third.
I don't know.
Like maybe twenty five to
thirty percent are going to
take the resume and they're
going to go look for home health jobs,
sniff jobs, whatever.
so then you then you maybe
save some money there
unfortunately and then the
rest of the therapists have
to agree to some fifty
fifty compensation or if
you want to get you want to
get super aggressive and
really like if you are
about to take on water like
the titanic tomorrow you
could just say hey
No more salaries.
You are strictly on a paid per unit basis,
just like Fox Rehab.
We're going to pay you per unit,
whatever the dollar amount is.
Last I heard, Fox Rehab was around sixteen,
seventeen, eighteen dollars a unit.
I think that's what I've heard.
So that's another way to
decrease the fixed cost of salaries,
only pay people based off
of their production.
And maybe, I doubt it,
but maybe you could save
this Titanic from sinking.
All right, Justin, special guest.
Look at this guy.
Jeremy Sutton.
Jeremy, how's it going?
It's going great.
How are y'all?
Outstanding.
I want to finish that
conversation about ATI when
Jeremy is finished,
because I want to come back
to that and share some
alternative suggestions.
Jeremy is here because
before we started the show today,
Dave and I were talking about marketing,
marketing strategies.
And one of the things that
Jeremy is doing is he's
doing these interviews.
Just, you know,
people are asking what's
working for mobile therapy right now.
Now you're doing kind of a hybrid model,
Jeremy.
You've got mobile,
but you also are working
with a concierge physician.
Talk to us about anything
that you see right now
today that's working for
you in building your brand,
building your business and
getting new patient referrals.
Yeah, I'm sorry, Tony, that you cut out.
My earbuds weren't working,
but I think you said talk
to us about how you're
getting these referrals, right?
Absolutely.
Okay, perfect.
Yeah, so I've done podcasts.
I think I've interviewed
over three or four hundred
people at this point in the
last eight years.
So that's really my bread
and butter as far as
meeting people in schools.
and you know you had talked
about multiple times going
and talking to doctors and
so really really my kind of
my mo was just hey I'm
going to interview you for
forty five minutes and
we're going to talk about
whatever but I know with
these orthopedic surgeons
they may not have forty
five minutes so I started
reaching out to the ones I
kind of knew and said hey
do you have fifteen minutes
to answer four or five
questions and they were
like yeah absolutely and so
that's what I've done and um
gone to them and I've done
it with three or four
orthopedic surgeons.
And I think I've done four
concierge doctors.
But the third concierge
doctor I did was Dr. Natalia,
Dr. Natalia Laura Geese and her sister,
Dr. Victoria.
And we just hit it off.
I took my wife with me.
It was on a Saturday.
It was weird.
I think I've told you this, Tony.
I'm like,
you're not going with me to meet
another professional.
What's going on?
And she's like, we don't have kids.
So anyway, we went.
um they loved monica thank
god which everybody does
and uh and yeah we just hit
it off there like I told
him I did tai chi and uh
which was the truth but not
really because I hadn't
done it in a long time um
and so I I ended up leading
tai chi for five minutes at
a yoga uh seminar they were
doing and then they asked
me to come on and then it
turned into we you know see
some patients with us will
you come in our office will
you be here two or three
days a week so it really
just from that one interview
um man they have given me so
many patients in the last
year and I just looked
yesterday and I had I have
seventeen leads that I've
gotten since april the
first and I've closed
thirteen of them so it's
like amazing it's just it's
just been huge I mean I was
I was going from you know
not I was seeing six to
eight people a week or six
to eight visits a week and
then last week I had
eighteen or two weeks ago
at eighteen last week I had
twenty one this week I have
twenty three so it's just
been amazing wow
So shout out to Tony,
because this is Tony Meritato's.
He's been doing this for three, four,
five something years.
This is his idea.
And I just want to give him
a shout out because he's so humble.
But this is Tony,
you did this with
orthopedic surgeons in Ohio.
And Jeremy,
the reason why you're on today
is not only just because
you're a friend of the show
and you're one of our colleagues,
one of our tight colleagues,
but also because you take
these ideas and then you
actually implement them.
Yeah.
And you actually go out and do it.
And not everything works,
but this is obviously working.
Yeah.
Jeremy is the best example
of somebody who executes
and he's not afraid to try
stuff and he just goes out and does it.
Dave, this goes back to PT Tech Talks.
Rob Vining and Dave Kittle, the originals,
the OGs.
We talked about doing
physician interviews back in like.
Wow.
Two thousand seven or something.
It's crazy.
But Jeremy, back to you.
So give us the actual like you.
You kind of glossed over.
You reached out to physicians, orthopedic.
How did you reach out?
Did you call?
Did you send a letter?
Like, what exactly did you do?
yeah so most of them I sent
a facebook message to you
uh oh directly yeah
directly away from the
gatekeepers yeah I don't I
just bypassed the gate you
can't the gatekeepers and I
don't don't coincide very I
don't know um so the the
doctor dr natalia I had no
no connection with him
whatsoever so I just you
know did a google search
concierge because they it's
either concierge or direct
primary care here
And there used to be just two.
Now there's thirty, which is great for me.
So you're in you're you're in Louisiana.
There's two hundred and
fifty thousand people
around this area here.
But but small.
Wow.
Yeah.
So there's,
there's literally from where
I'm sitting at a park,
a half mile from my kid's school,
my concierge doctor is like
a hundred yards this way.
And there's two more in the
same complex that he's in.
Um, and it's, it's insane.
Um, but so yeah, with her,
I just reached out,
sent their business page,
a Facebook message.
And I learned this from Will Boyd,
who's the master at everything.
And it was so basically I
always give them an out.
I say, hey, my name is Jeremy Sutton.
I have this local podcast
where I interview the best doctors,
business owners here in town.
I would love to highlight
you on my podcast.
We're going to take five to thirty minutes,
however I say it.
And then I'm just going to
ask you questions.
I am perfectly fine sending
you the questions before time.
So you know what I'm going
to ask you so there's no surprises.
It's not live.
I will edit it if you have any issues.
And by the way,
I know you're super busy
trying to change the world
or trying to do total hips
or whatever it is they're doing.
So if you don't have time, no problem.
God bless you.
Have a great day.
And that's basically the
message I send every single person.
Because they have an out.
You're not trying to be overbearing.
Actually,
this is the first year that I've
had people say no.
In the past,
I don't think I asked anybody
that said no.
Well, maybe one or two,
but it's been more people
either just ignore me or say no,
but who cares?
I've got forty-something episodes.
It's working.
Dave, the screenshot yesterday,
somebody found one of the
concierge doctors here
locally through a short I
posted on YouTube.
And so Dave said,
I hope you screenshotted that.
I sent it to him and his wife, Dave,
because I knew he wouldn't respond.
And she was like, dude, you're awesome.
We love you.
So yeah, that's what I've been doing.
And it's been working.
And so what is the
distribution like for you?
You do this.
Well, let's do the mechanics of it.
Are you doing it in person?
Because I can't believe you do that.
I don't have the confidence to do that.
But for the listeners,
are you doing it in person?
Are you doing through Zoom?
Is it audio only video?
What is it?
Oh, it's whatever.
Most of them have been in person.
However,
I can get a conversation with these guys.
You know,
most of them have been in person.
And so I have a little
microphone that I hate.
I ordered a new one because
this one's horrible.
But I go the first orthopedic surgeon.
I sat on a stool and he sat
on a chair in one of his exam rooms.
I take my tripod that's in
the back of the truck right
now with my iPhone and
I record it on the iPhone
and then I record the sound
on my laptop because I lost
a podcast episode one time
and I still think it's the
greatest episode I ever recorded.
But but and I never got that guy back.
So I do offer an in-person.
And then also if they can't
make that happen, we'll do zoom.
So whatever is best for them,
because like I'm on their time.
Right.
I'm just, I'm trying, I am,
I am trying to get something from them,
but I am serving them as
well by talking about them
and posting it to everywhere.
Um, but yeah, I mean,
just whatever they need me to do,
I'm perfectly okay doing it.
I've had two people offer me, um,
podcast studios here in town and, um,
I haven't taken them up on
it because I have I have
trouble with like
committing to the same thing every day,
which is why I want to have
my own business.
I want to be able to do what
I want when I want it.
And so I have gotten rid of
all the things where I have
to be here Monday at twelve.
Um,
and so the podcast studio is kind of
the same thing.
And it's, um, honestly,
I've been so busy the last few weeks.
I haven't been able to do an episode.
And so I gotta, I gotta get somebody,
I have one,
but the doctor won't let me
release it for a couple more weeks.
Cause he's got something going on,
but it's cool.
It's cool.
And so the people that are
watching that are like, yeah,
but I don't have any subscribers.
I don't have any watchers or listeners.
Yeah.
What, what's your, where did you start?
What are you doing right now
in terms of like, what's your audience?
Oh my gosh.
So another,
another marketing type of
business person I met here
in town asked me,
what was my goal for my podcast?
And I was like,
meet doctors.
I mean, I don't, who cares?
And so she's like trying to
get me to do all this other
stuff to grow the audience.
So I would say that,
so I had the servant PT podcast.
I had two other podcasts.
This is the lowest
downloaded podcast I've ever had,
which bothers me to a certain extent,
but also,
not really but I started I
started a youtube channel
over probably like in
february of last year I
think I had forty
subscribers until we did
the march madness um I've
looked I've gained fifty
subscribers in the last
month so I'm starting to
get some momentum there uh
I think I'm up to one
hundred and thirty three.
You know, I'm starting to grow TikTok,
Facebook, Instagram, LinkedIn,
all this stuff.
And so I'm just shoving stuff out,
you know, two to three videos a day.
Very short, you know,
thirty seconds to four minutes.
And I just know it's going
to get momentum eventually.
And yeah, I mean,
I'm just trying to really
talk to local people.
Yeah.
jimmy mckay jumping in from
possibly thirty thousand
feet saying it's the
ultimate olive branch he
also said size doesn't
matter that's what she said
Jeremy,
are you posting these on YouTube
under a healthy SBC?
It looks like.
Yes.
And I haven't,
I haven't posted a podcast
video in a few weeks.
Um, I've still,
I've still been posting them on iTunes,
but, uh, to be honest,
my Mac book is a thousand
years old and it takes
forever to upload it at my house.
Um, but I need to get the rest of those,
but yes, it's all on healthy SBC.
Um,
Any of these physicians who
didn't reply the first time,
have you sent a second or
third outreach either different ways?
Like,
so if you went through Facebook Messenger,
have you tried different approaches?
LinkedIn, you know, I don't know,
through their gatekeepers,
have you tried other
approaches to try to send
them a second or third reach out?
And if so,
do you say the same thing or you
say something different?
Um, sometimes I say, no,
I usually say something different.
So I'll say, Hey, um, you know,
I know you're busy.
Like if I see that they've seen it,
Like I had one physician,
a concierge physician say, yeah,
I'd love to be on your
podcast and then kind of ghosted me.
And so I've reached back out
and he's just ignored it every time.
And so I've got a different approach.
I'm probably going to send
him a bobblehead of himself and say, hey,
I'd love to talk to you
about how I can help your
patients or what.
I don't know what I'm going to do.
That's my idea.
And I had that bobblehead
ordered and I didn't order it one day.
I don't know.
But anyway, to answer your question, so.
The two of the most recent
orthopedic surgeons are in
the same group.
And so basically,
I got the other one's
information from one.
And so sometimes I'll say, hey,
do you recommend anybody
else for me to interview?
There you go.
I always do that.
But yeah, I'll reach out.
Three-way text message.
Hey, Dr. A. Yes.
You were on my show.
You said you loved it and blah, blah,
blah.
And then, you know, you know, Dr. B,
you said that he would be good on video.
Can you send can you send us
a three way text message or
three way email to loop in Dr. B?
Now it's coming from Dr. A.
It's not even coming from you.
Yeah.
The second one in the group.
So I knew the first one that
I interviewed.
So he grew up with a good
friend of mine really close
to where I where I am.
And so that was kind of my end with him.
But I have seen all of their patients,
you know,
because I've been here for sixteen years.
So I've seen all their patients.
But these doctors that I
started interviewing have
only been practicing for
five years or less,
which is good because now
all the doctors that I've
been seeing patients for
years are starting to get
ready to retire.
So I want to build
relationships with the new guys.
And so that's really who I'm targeting.
And the second one said.
man,
I'd love for you to just interview the
whole staff at once.
And I was like, yes,
when can we set that up?
Like tomorrow?
Cause I can be right.
I can, we can do it now.
So, yeah.
Hey, so real quick, I just went on Amazon.
You can buy a custom bobble
head that matches the person.
It's seventy nine dollars.
Dave and I have talked about not bad,
not bad, not bad.
That I mean,
seventy dollars to get
something like that.
That's incredible.
Yeah.
I love that idea before we
let you go real quick.
So I've seen you posting and
I know you told me off air
some shockwave stuff that you're doing.
Tell tell us a little bit
about how that's going,
what you're doing with that.
Yeah.
So we just started that this week.
I just posted a just so
you're the gracious host.
Y'all had shared his Facebook ads with me.
So I'm going to start right now.
Will Boyd, the man, my brother,
who I text all the time and
tell him how much I love
him and how awesome he is.
But he shared the Facebook
ads he's running out in Phoenix.
And so I'm going to start.
I've run Facebook ads before here.
We didn't get a good response out of them.
That was actually took me to
a house and I texted a
picture of my wife.
I was like, hey, I'm going in this house.
That's where I am.
But we're going to start
doing that pretty heavily next week.
Either I'm going to run the
ads or the doctor.
So I'm partnering with
another concierge doctor
here in town who originally
bought it to treat ED.
And he's just not having a
very good response to marketing that.
And he's like,
it's been sitting in my
office for six months.
Nobody's touched it.
Wow.
So I went Wednesday.
I had somebody who's a
client of mine say he was coming,
but he was stuck at work.
And so I ended up treating
their front office staff.
He was having some knee issues.
And I did twelve hundred
shocks to her to the one to
the medial one to posterior knee.
And she was like,
I feel better because that
was that was the only time
I've ever used one.
So I said, hey, come in here.
Let's just see how this works.
But I'm excited about that.
I think that's going to turn
into something big because, you know,
the people that I see at
the other concierge at Dr.
Natalia's office,
they're doing all the med
spa things there.
And it's just it's a thing
that's tangible that I can
show people and say, hey,
this is really cool.
It click, click, click, click, click.
And, you know, you're feeling it.
And so I think it's going to be awesome.
And I'm honestly probably
that's the only marketing
I'm going to do as far as
running ads just to that
for a couple of months and
see how it goes.
But I think that could be
something where I partner
with him for maybe four to
six months and then end up
getting a machine myself because
you know, we're going to,
we're doing a fifty fifty
split and I'm super excited
that he's letting me use his machine.
But at the end of the day,
if we're marketing it and it's working,
then I'm like, well,
why would I take fifty?
And he knows that too.
So it's not a big deal.
But yeah, I'm excited about it.
All right, buddy.
Well, hey, I know you're busy.
I know you're in the car.
Go enjoy the rest of your day.
Thanks so much for joining us.
Thank you.
I finally made it on a morning show.
I'm big now.
See you guys later.
Dr. Jeremy Sutton.
Thank you so much.
All right.
What a great human that guy is.
Love the accent.
Absolutely.
Going back to ATI real quick,
I think the biggest thing,
and you hit it in a couple
of what you said, was, hey,
we need cash right now.
We need cash today.
I can go out and borrow cash,
but it's going to cost me a
crap ton of percentage
because we look so bad on
the balance sheet.
What can I do with
I took a concept from Seth Godin.
He had shared this years ago.
He said, you know, basically,
we're not in health care.
We are in finance.
We are financing.
We're taking patients.
We're delivering a service to the patient.
We are covering the cost of
that service in a third party payer model,
not your model.
We're financing the patient's recovery,
we're paying the therapist,
and then we're waiting
another fifteen to thirty
days before the insurance
company pays us.
So we are ultimately a finance company.
That's a failing model when
you're running out of cash.
I can't be a bank if I don't
have money to lend.
So how do I switch that to, okay,
now I need money now.
This is where you get into,
I'm selling packages.
I'm selling services.
I'm creating a digital footprint,
which they're doing some of that stuff.
I love the idea of looking
at what Weight Watchers did.
You know,
Weight Watchers was a failing
business model.
Their stock price went from
one hundred dollars a share
down to a dollar a share.
They made a pivot to say, hey,
we can't sustain.
Let's go out.
Let's get a bunch of physicians in.
Let's go GLP one or whatever GLP blockers.
And let's go where the money is.
And now they have people
that are coming in that are
driving payments first in
hundreds of dollars instead
of the ten or fifteen
dollar a month memberships
that they used to sell.
Their stock is at seventy
seven cents a share right now.
Holy moly.
So even that might not have helped.
I don't know.
It will too little too late, you know,
so like you're late to the party,
but there are, again,
going back to other models
that I think the physical
therapy business can look at and,
and kind of take lessons from, um,
But yeah,
I think the key to ATI is
turnaround if it ever happens.
And maybe it's a cultural thing.
That's not going to happen.
But it's, hey,
we need to stop financing
everybody else's service
and we need to get payments up front.
How do we do that?
How do we bring money in the
door today and then give
the services down the road?
And that's a big thing with
Alex Hermosi and a lot of
the guys on social media
and what they're preaching.
They're like, look,
you need high profit to sustain.
You need profit now to make this work.
So that would be probably where I go.
And I would just look at
we've got thousands,
tens of thousands of visits
going on weekly.
What do these people need right now?
They need supplements.
They need shockwave.
They need pain relief.
They need things that they
are willing to pay for
beyond just what insurance
is going to reimburse for.
That's where I would put all
of my efforts into.
But it's a big cultural shift.
I don't think therapists want to do it.
I think you get a lot of resistance.
Therapists aren't going to
be the salespeople.
So this is where you bring
in a sales force that is
dedicated to selling the
things that patients want
because the therapists are
not going to be the ones to do it.
And if you brought a Salesforce in,
you got to pay them,
although they would
probably be fine with a
hundred percent commission,
but then you're still
paying them whatever the commission is.
Then you got to pay the
therapist to actually do the service,
fulfill the service.
And so the admin staff that are indirectly,
but not producing revenue.
ATI, as of right now, today, May first,
twenty twenty five,
ATI stock price at eighty
four cents a share.
Over the past five years,
it's down ninety nine point
eighty three percent.
Holy moly.
I mean,
we've seen how many countless
businesses have we seen go that way?
You know,
they just they they shrink until
they eventually disappear.
All right.
And anything else about that
before we go off on to a
different post that Lauren
Meffin had shared?
Yeah, let's jump to that.
Shoot, I just had it up here.
Let me grab it real quick.
So I have been sharing,
just for context before I share my screen,
I've been sharing a bunch
of long form sales copy.
I'm going this direction a
little more heavily.
Jeremy Sutton's doing some
of this as well.
So the idea is building a narrative,
building a story.
Okay, I'm going to share this.
You guys already saw this screenshot,
I think, last time we were on.
Let me get it over here.
This is just talking about
spouses that fall,
non-emergency fall recovery,
things like that.
I had said publicly,
my goal is not to sell that,
but if somebody is going to buy it,
I will deliver it.
But my goal is just to get it out there.
I looked at the numbers yesterday,
and that post,
just a static photo
generated image by AI and long form,
over six thousand views, all organic,
nothing paid yet.
Lauren shared a post that she had created.
So Lauren is an amazing SLP.
She's down in Gainesville.
I won't read the whole thing,
but let me hit a little bit of it.
So it says, quote,
are you or a loved one
experiencing choking, coughing,
difficulty swallowing at home?
First, right off the bat,
what do you think of that opening line,
Dave?
Yeah.
Yeah, it's not the best.
It's more of a descriptor
instead of a question.
I mean, does it end in a question mark?
It does, a question mark.
So it says,
are you or a loved one
experiencing choking, coughing,
or difficulty swallowing at home?
I mean, well, one thing is like, you're,
you're asking like,
are the parents
experiencing the swallowing
issues or is it, you're asking the forty,
fifty year old that their,
their mother or father has
the coughing issue or is
this a pediatric thing?
Is this for your children?
So it's like, it's asking multiple,
it's asking the reader like
multiple different people
in their family.
Like instead of just like,
does your son or daughter cough?
Does your son or daughter
have coughing or swallowing issues?
Like this post, like,
is it for the pediatric
child or is it for the
parents of the decision maker who's forty,
fifty, sixty years old?
So right there,
like it's asking for you to
consider multiple people in your family.
So that's a little unclear.
Yeah, I agree.
I would say it's not specific enough.
I would look at it more
direct to have you noticed
your mom or dad choking
when they sip morning coffee?
Have you noticed, what does it say,
coughing difficulties?
Have you noticed your mom
gagging when she takes a
bite of a sandwich?
Or your mom who had a stroke,
is she now coughing more,
choking more when she's
trying to drink coffee?
I don't want to say thin liquids,
but that's what's coming to
my mind because thin
liquids is professional jargon.
You know,
it's something that they would
actually be drinking.
So I make it water, water, tea.
Yeah, yeah.
I make it person person specific, you know,
as much more granular.
So it says, quote,
are you or your or a loved
one experiencing choking, coughing,
difficulty swallowing at home?
Our comprehensive in-home
swallowing evaluation
brings expert care directly to you.
No travel, no wait time, no waiting rooms,
just personalized support
in your own environment.
just think it's too vague still.
You know, it's, it's too general.
It's, it's clearly an ad.
It's clearly like, give me the story.
And this is what I try to do when I'm,
when I'm coaxing chat GBT
to generate the sales copy,
I give it specific things.
So I never had a family
member who had a stroke,
but I did have a family member,
my mom who had fallen and
who had a brain bleed, who, you know,
had repeated falls.
And I know what I was
thinking when I was going through that.
I know that my mom would
never do fall prevention,
even if she had just fallen.
She had just tripped over something.
She would say, oh, it's no big deal.
It was just an accident.
Like,
these are the things that I would
want to bring into the narrative.
So for somebody,
I think you're talking and
I'm completely ignorant to this.
So forgive me.
OK, so what is important here?
Well, it's going to be a mom.
It's going to be a mom who had a stroke.
It's going to be a mom who's
choking when she drinks her
morning coffee with toast.
Why?
You know, why would she want to do this?
Because she's embarrassed.
She stopped going out with
her her gal pals.
She's not doing the things
that she used to do.
And she also, you know,
has never seen anybody.
She's never talked to
anybody about something like this.
These are the things that I
would bring in.
What what are you thinking
in related to relation to this?
I agree.
I do love the bringing in a story.
I think that might be the
biggest component where you're saying,
you know, either, you know, Mary,
we had a client, we had a family member,
you know, I know what this is like.
We had, you know,
someone in our family or whatever,
like you said.
Now, if you don't, then maybe you say,
okay,
we had a past patient or something
that agreed to do this or whatever.
But bringing in a story,
like we recently had a
client and they were
coughing on their you know
their tea and they try to
make the tea warmer they
try to make the tea cooler
they try to you know
thicken it with extra honey
no matter what they did
their mother or father or
themselves continued to
cough every time they had
their favorite drink and
they you know got upset and
they thought that you know
they could no longer enjoy
life if they couldn't have
their morning tea or coffee
or whatever it is and
They tried this, they tried this,
they tried calling their physician,
their primary care, they this, that,
and nothing seemed to work.
They tried whatever, allergy medication,
whatever the other alternatives are,
I don't know.
They tried this, this, this,
and they thought that there
was nothing to do, there was nothing,
they tried everything,
and that there was no hope.
Until they found until they
took me up on this offer or
whatever of the sleep or
the swelling study.
And what we found was this
simple little thing, whatever it is,
maybe it's not simple.
Maybe it's complex.
We found this.
thing this issue to be the
the biggest culprit or we
have this treatment or this
offering or solution that
is you know often
overlooked and uh you know
historically proven with
research but not utilized
enough because it's
overlooked and it was just
this one little thing and
it's not your fault you
know you you didn't know
but here's the here's the
solution that helped mary
And you continue on with the
story or end the story from there.
But I think the story is a
huge part of engaging.
Yeah, I as we're talking through this,
I was just thinking I can remember it.
a, a older individual in my family,
I want to say an aunt or an
uncle like talking or
coughing and food coming
out of their mouth and them
being so embarrassed at
Thanksgiving dinner, you know?
And so now that they're,
they're doing that, they're pulling away,
they're retracting their, uh,
whatever to themselves.
And they're missing out on
these family engagements.
Like,
I think that's something that most of
us can relate to.
I also remember,
and these are real stories.
I remember a woman,
she was not a family member.
I think she was a physical
therapy patient.
Drinking, coughing,
her dentures were coming out, you know,
and so like all of these
incredibly embarrassing stories,
but real stories that actually happen.
Those are the things that I
think would resonate a
little bit more strongly.
And they're so specific,
but they're very common.
So then the post goes into, okay,
what's included?
I think there are elements
here that we're missing, like the urgency,
all the other aspects that
are gonna make me like,
they've clearly been
dealing with this for a while.
Well,
why are they gonna go get it
addressed now?
But then when we get into what's included,
I just think it's too much
professional jargon.
Comprehensive swallow evaluation at home,
licensed speech therapist,
I don't think anyone cares.
Mobile swallow study,
like she has some equipment and here,
optional mobile instrument imaging.
I want to see that stuff.
This is the cool stuff.
This is the stuff that nobody else does.
This is the innovation and the technology.
I would emphasize the visual
aspect of this more.
Optional video and imaging.
I wouldn't make it optional.
I would just say, look,
this is what we do.
A thousand dollars,
fifteen hundred dollars,
whatever the cost of it is.
But we will bring this out to your house.
This is, again, what impresses the person.
This is what makes them realize, you know,
why didn't I get this before?
Oh,
maybe my doctor or whoever didn't have
this equipment, but you do.
Customized swallow exercise program,
diet recommendations,
recommended products.
It's fine.
I just don't know that that
adds much value.
Maybe because we don't have
the emotional trigger yet to say it.
Total investment.
She didn't use the word price or cost.
She said investment.
I love that.
Yep.
Includes one hundred and
twenty minute in-home session.
I would immediately get rid of the time.
Do not stick me with a time.
If I can deliver seven
hundred and fifty dollars
of value in ten minutes,
let me get out in ten minutes.
You know,
I was sitting there yesterday
thinking about this again.
I'm doing I had two
evaluations yesterday morning.
I'm like,
what in the world are therapists
doing that take more than twenty minutes?
I am struggling to find
things to do to spend more
time with this person.
And, you know, whatever.
Okay.
Includes a hundred and
twenty minute session, written summary,
individualized care plans.
I would just I would turn
this into no time frame.
And I would say this
includes the confidence and
the security of knowing
that the next time you're
sitting around the family table.
grandma or grandpa is not
going to choke and spit
food across the table.
You know,
it's going to bring the joy of
family back together.
Like that's what I want this to deliver.
Not a written summary,
not an individualized care plan,
not any of that stuff.
I want confidence and
security and family connection.
Those are the things that I
want it to deliver.
What do you think?
Yeah, a hundred percent.
I knew you were going to say
take the time out of there.
The only time people ask me
about our home visit duration,
it's typically when it's the forty, fifty,
sixty year old son or
daughter who's arranging it
for their mother or father,
but they're like already converted.
verbally on the phone and
they're they're thinking
about like like you know
week over week in the
future like how often are
we basically going to be
there and for them the time
they perceive it to be
important because they're
asking like how much for
what we're paying I guess
like how much are you
actually going to be there
to help them to take them
through movements or
exercise or you know
whatever transfers or whatever
But I agree with you a
hundred percent on that.
Take the time out of that
because people just want the solution.
They want their,
they want themselves or
their mother father to not
cough and choke when
they're having their
favorite drink or their, you know,
their breakfast or whatever.
Uh,
so just stay focused on what they care
about.
And if it takes
Yeah.
Any other thoughts just in
regards to like what Jeremy
shared with us and what he's doing,
what Lauren is doing here,
what you see on social media generally?
Well,
back to back to what Jeremy is doing
with with reaching out to
physicians to get them.
What is it?
A fifteen minute interview on his show?
Yeah.
I'm so glad that he's
sending second or third,
like follow up messages to
folks that are not answering.
But like we kind of covered,
like asking those other
physicians for an
introduction is like the
easiest thing ever.
Like that's the easiest way
to break through.
And sometimes we get caught,
like even myself,
like I think I could get
caught up with like,
sending a second or third
message to the person
that's not answering and
you still should do that
and that is part of
rejection that is part of
just like you know
marketing and just like
repetitions and you should
be asking those folks a
different approach but
asking them again even if
they don't answer and that's okay like
He gave them an out.
He said, hey, if you're busy,
don't even worry about it.
It's all good, whatever.
But approaching it dynamically,
hitting them up on LinkedIn,
because if they have their
own LinkedIn... He said he
does Facebook messaging.
So that's a little more personal, I think.
So the ones that are not answering...
look them up on LinkedIn,
send them an email or
connect with them on
LinkedIn and then send them a DM there.
And so Jeremy shared with me
that screenshot of a
patient in the wild that
commented on his YouTube video and said,
oh,
this doctor we heard about and we just
scheduled a visit with him, Dr. So-and-so,
thank you so much.
And he sent me the screenshot.
And then I said, dude,
I hope you sent that
screenshot to that physician.
He's like, absolutely, already did.
Awesome.
Take that screenshot,
and for the next physician
that has not answered your
previous outbound messages,
you take that screenshot and you say, hey,
Dr. Tony,
are you accepting more new patients?
Here's an example.
I interviewed Dr. Johnson,
and this person saw the
video and is basically
going to see him partly
because of my video,
because of our interview.
so the question you you
reach out to them hey are
you accepting more new
patients if they're super
busy they're not going to
care but if they're
concierge direct primary
care they are always going
to be accepting more new
patients or clients or now
they're calling them
members so you got to speak
their language do they care
about getting more new
members in their practice
lead with that hey this is a
digital evergreen asset
that if we do we knock it
out for five minutes ten
minutes fifteen minutes we
we knock out this interview
it's going to live on the
internet forever to help
drive traffic to your
practice we'll put the link
of your website in the
description of all the
videos and this will be
working for you and your
team even when you guys are
sleeping when you're on
vacation whatever this this
interview will be viewed
thousands or whatever,
hundreds of times or
whatever by local folks
that are looking for a
concierge direct primary solution,
like you got to like
position it to what they care about.
And if they're accepting and
they're looking for more
new members for their concierge practice,
leave with that.
And then it's like, oh,
you're not pitching your interview.
You're pitching like free
evergreen marketing
deliverable for this position.
What do you think?
Yeah, no, I totally agree.
And I love what you said
about understanding what
the motivation is on the physician side.
I think too many of us,
too many therapists,
because we are looking for patients think,
oh, the doc wants patients.
There isn't a single person
in my community with MD
after their name who needs
more new patients, not a single one.
So when I approach them,
if I approach them,
I'm not saying get more new patients.
What I'm saying is, hey,
we'll get you more of the
patients you want.
We'll get you more of the commercial,
not Medicare, not Medicaid.
I will bring you patients
that are your highest reimbursing,
lowest administrative burden,
highest potential for a positive outcome.
I'm not going to bring you
somebody like an orthopedic surgeon.
I'm not going to bring you
somebody who's got a list of patients
Comorbidities and complexity.
I'm going to give you the healthy, active,
you're going to have the
best outcome and it's going to show.
That's who I'm going to
bring to your office.
And they're going to be private insurance.
You're going to get paid the
most possible money for the
time you're investing.
And that came from...
Talking to surgeons, talking to physicians,
them telling me I am so
sick of primary care docs
or other referral sources for them,
sending them all the Medicaid referrals,
you know.
And so I quickly understood, oh,
these guys don't need more.
They need more of the right kind.
And so what I do when I was
reaching out and saying, hey,
let's do a ten minute interview.
I specifically tell them,
let me know who you want.
What is the best payer for you right now?
Let me know what specific
procedure you're doing that
you want me to ask you
about that you want me to promote.
If you're doing stem cell,
if you're doing PRP,
if you're doing high value
cash based services,
we'll talk about it all day long.
Because that's what they need.
Every new referral isn't
worth the same to them,
and I need to understand
where the value is for them.
And once they realize that I know that,
now I'm their advocate,
now I'm helping them,
now the reciprocity kicks in,
and now they want to start
sending me people too.
And that's really where the
value comes in here.
Even if you have no audience,
when I first started doing this,
I'd get twenty views,
but it didn't matter
because it's the
reciprocity of them knowing, hey,
this guy is looking out for me.
He understands what I need.
He's not just looking to
drain my resources on third
party payers that I can't afford to see.
Yeah.
Amen.
All right, let's do parting shots.
I'll go first.
So I am going to investigate
the bobblehead idea.
I think this is awesome.
Who would you send it to?
Who and why?
Come on.
Okay,
so I've got a handful of orthopedic
docs right now.
I want them sending me more
total knee replacements.
I don't know why every total
knee replacement isn't
coming to my clinic in my city.
I'm going to generate bobbleheads.
I'm going to create social
media content first,
and then I'm going to send
it to the surgeon along
with a link to the social
media video that I created
so that they could see what I'm doing.
Would it make sense for you
to mention in that that you
have such a big totally
replacement following on
YouTube or you don't think
they would care about that?
No, no, they would definitely care.
Yeah, I would mention it.
I'd have a link, you know,
to it so that when they get it,
they can go see it.
Absolutely.
I am leveraging every asset that I have.
So you would have a link out
like with a QR code because
you're going to send this
with the bobblehead or you
would do a digital message
with a bobblehead that
you're physically going to send.
QR code would be great.
I didn't think of that.
No,
I was just going to like mention the
YouTube channel,
mention the number of subscribers,
mention a couple of the
resources that I have.
I don't know.
QR code works well, too.
So maybe both of them.
I like the idea of you
sending the bobblehead to
grab their attention.
And then you mentioned your Facebook group,
but the YouTube following
for Total New Replacements.
And then also including what
you just mentioned a few
minutes ago about sending more...
total knee replacement
candidates to you that are, you know,
the healthiest candidates,
the most motivated
candidates with the least
comorbidities and the best insurance.
Although it sounds, as I'm saying it,
it sounds like it could be
a little sound to your snake oil,
but like, if that's what they care about,
then that's what you got to say.
Chat GPT will clean it up for me.
There you go.
What you got?
Parting shot for me is I
think I might have to start
a whole channel,
maybe have Nate or someone
else do it to do the
physician interviewing.
I've already spoken to a
bunch of physicians.
I have a buddy that's a podiatrist nearby.
Uh, he absolutely,
he would do this in a second.
He would start doing this.
We could do, you know, uh,
plantar fasciitis, bunionectomy, Achilles,
that type, those types of content.
And then just one by one
asking for referrals from him,
asking other physicians.
Uh, but again, they're, they're busy.
So, but ultimately, uh,
Doing this approach, I think it's time.
I think it's time and it'll
certainly help with referrals.
So I'm strongly considering it.
Watching Tony's success with it,
watching Jeremy Sutton's success with it,
I think it's time for me to
certainly consider it seriously.
All right.
Awesome, guys.
Go check out the Dave Kittle
show on YouTube and iTunes
and everywhere else.
Go check out P.T.
Pinecast.
Learn Medicare billing every Tuesday,
Thursday morning at eight thirty a.m.
Eastern time.
We'll be here.
See you guys later.
Thanks, Dave.
Thank you.