WEBVTT

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All right, we are live.

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I am back.

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I'm here with Dave Kittle, Tony Maritato.

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Jimmy may or may not jump on.

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He's got another meeting this morning.

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But I was just asking Dave

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before we started about

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Mother's Day in New York.

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So, you know, down here, down here,

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out here, southwest Ohio area.

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The tradition is always we mulch,

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we mulch the flower beds,

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we mulch the yard, we cut the grass,

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we edge, we clean it up,

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make it look pretty for mom.

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Tell me again what you guys did for,

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is this her first Mother's

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Day as a mother?

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No, second,

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because the baby was born last

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March twenty ninth.

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So the first Mother's Day

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was pretty quick last year,

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like in terms of like, you know,

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got on us quick.

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So this year,

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probably a little bit more

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time for her to soak it up and all that.

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And yeah, it was great.

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We just went out for an

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early dinner in the

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neighborhood here in

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Brooklyn and had a good time.

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Awesome.

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With the baby, of course.

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Yeah, of course.

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So lots to talk about.

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I was in D.C.

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last week.

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It was awesome.

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But you shared this

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screenshot and I think it

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resonates probably with

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every small private practice owner.

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So I've got it up on the screen.

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This comes from the physical

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therapy billing group.

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It's an awesome group.

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Shelly, Heidi,

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if you guys are PT practice owners,

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OT practice owners,

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go check out the group on Facebook.

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But it says, love some help.

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My husband, who's the owner,

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has been doing his own billing,

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a five therapist office.

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That's a boatload.

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That's a ton.

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Staying up until two a.m.

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every night,

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seeing eighteen patients a day himself,

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including Saturdays when

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things went kind of bad two years ago.

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So had some negative

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outcomes from a previous billing company.

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It sounds like says now with

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my aggressive scheduling,

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it's just getting to be too much for him.

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No time to deal with issues.

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Ideally,

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he'd love a full time person in

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the office.

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They're in South California, I think.

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But, like,

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maybe we look for a virtual

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company or in person.

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Any input or suggestions?

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So, Dave, you shared that with me.

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What are your thoughts about that?

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Yeah, so, I mean...

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You have to do something.

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You have to figure out something.

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And it's either going to be

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outsource it or you hire a

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billing person in-house.

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It depends on the total

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volume of claims and visits

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per week and per month and all that.

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But as an aside,

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This practice,

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you got to treat it like a business.

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I just did a solo episode

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screen share of Joe Lowe's

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post on LinkedIn about the

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physical therapy M&A market

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for twenty twenty five.

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And you commented on that.

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And I screen share that as

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part of my episode.

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And one of your comments, Tony, was,

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you know,

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basically like this will work or X, Y, Z,

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like with that market report,

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like the improvement or the

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ability for practices to

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grow or maintain

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profitability and all that.

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Your your comment said,

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basically like it'll work or

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this is possible if you

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treat the therapy practice

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like a business.

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And this screen share is no different.

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I think it's, respectfully, respectfully,

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I think it's crazy for a practice owner,

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a physical therapist

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practice owner that has

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five physical therapists

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to be treating eighteen

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patients per day and doing the billing.

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You need an intervention, respectfully.

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You need an intervention.

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You need Sturdy McKee, Jamie Schrier.

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You need a coach to help you

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delegate stuff.

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The first thing I'm thinking

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of is you need to just get out.

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I can't believe that there

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are small business owners

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that want to do all the stuff

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It's crazy.

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And then how do you have time to work out,

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go to the gym, go for a jog, I don't know,

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do leisurely stuff, mow the lawn,

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mulching,

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like Tony was just talking about.

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How do you have time to do any of that?

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You don't.

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And your head's spinning all the time.

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And then if you do some of these things,

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if you outsource it,

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or if you hire one or two

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billion people for the practice, yes,

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some of your income money

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goes to their salaries.

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but you have more time for

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clarity to think about self pay options,

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to think about hiring and

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recruiting other therapists

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to replace yourself.

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So I have a lot of thoughts

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obviously about this and I just,

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I don't know, like Tony, like how,

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how does this happen?

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Is this something that you

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see a lot or you've heard a

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lot with practice owners

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that like they want to do

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all this stuff and then the

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practice kind of gets

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bigger over time and they

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never get out of those initial jobs,

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roles or responsibilities?

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Yeah,

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I think it's one of those things where,

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like I said,

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the comment said two years

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ago they had a negative experience.

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So, you know, I always share this story.

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When we started, we hired a biller.

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We thought a biller was a biller.

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Like we didn't realize, well,

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there's physical therapy

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billers and non-physical therapy billers.

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So we hire this random biller.

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We we never get any of our claims paid.

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Thankfully,

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we still we started as a cash

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based business.

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So we had tons of income coming in.

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We fired that bill or hired

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a second bill or still no results.

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We lost about sixty thousand

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dollars back in two thousand one,

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two thousand two until we

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hired the third biller.

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Now, the third biller was awesome.

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He specialized in physical

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therapy billing.

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He reminds me actually now

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that I think of it of Heidi

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and Shelly and some of the

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billers that are in that Facebook group.

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It was just him and a partner.

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They were a small, you know,

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service provider.

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And he dug us out of a major hole there.

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But we still had such a

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negative experience.

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Now, I think for us,

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what made the difference

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because we were in the same boat.

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We were seeing tons of patients.

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We were busy.

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We didn't have five clinicians.

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We probably had two like myself,

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my my wife, another two other therapists.

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So let's say four in total.

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But we were treating a full

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caseload and running the

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business and doing everything.

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And I think you're just on

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that hamster wheel.

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It's going so fast.

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You don't have time to take

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a breath and step off.

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And as clinicians,

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we tend to think nobody can

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do it better than us, whatever it is.

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So we want to do it all.

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We're not approaching this

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like a business.

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We're approaching this like patient care.

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I will see more patients.

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I will build more units.

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I will do more stuff.

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And so you just can't do it anymore.

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For us, we read E-Myth, revisited it.

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We made the decision that

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we're going to treat this

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like a business and not a job.

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We took our self-worth and

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value away from having to

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do everything and being the

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best at everything.

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We went through some education,

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some consulting,

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and we actually learned how

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to structure a business and

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bring people in to put them

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into those roles that we had defined.

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And for the next, I don't know,

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probably three years,

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we outsourced as we continued to grow,

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outsourced our billing.

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But even there,

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we got to the point where like,

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why are we paying, you know,

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seven percent on a million

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in revenue when really we

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could just bring it in

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house and probably do it better.

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But at that point,

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we had replaced ourselves as clinicians.

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We were no longer treating

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every patient every day.

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So we had the capacity,

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the bandwidth to build a

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billing business.

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And we've actually spun off

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billing businesses as

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completely separate entities because

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Because we had the ability

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to not spend eight to ten

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hours treating patients and

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then try to work on the

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business afterward.

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Yeah, makes a ton of sense.

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I feel like for the small business owner,

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the practice owners out there, it's just,

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I think, a shame to not... Respectfully,

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we're not saying it's not a

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serious business.

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Obviously, it is.

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You have five physical

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therapists outside of the owner.

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Like you said,

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that's a meaningful practice,

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even if they're in network.

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And so...

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it's just a shame that I

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don't know like is it is it

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some you know small

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business like uh dna or

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ethos or something where

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it's like my generation and

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and older uh and I like to

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include myself in in the

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you know put your head down

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like just grind it out like

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it might have stopped a

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little bit after my age but

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like kind of like you know

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your colleagues and your

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friends and small business owners like

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Is it just easy for practice owners,

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business owners that are

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independent to kind of put

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their head down, just grind it out until,

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you know,

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your wife goes on a Facebook

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group and says like, hey,

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we need some help with this or that.

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And it's not even it's not

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even that individual.

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It's not even that the practice owner,

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that's the physical

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therapist asking for help.

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So who knows if he or she

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even wants to help?

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Yeah.

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Yeah.

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Yeah.

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I think it is.

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I think it's within our DNA,

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but then I think there's

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also a lot of baggage that

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we bring with us.

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You know, what did your parents do?

00:09:25.360 --> 00:09:26.400
What were your parents'

00:09:26.900 --> 00:09:28.280
mindsets around money?

00:09:29.682 --> 00:09:30.782
I know I've still got tons

00:09:30.802 --> 00:09:32.341
of baggage from mom and dad

00:09:32.381 --> 00:09:33.662
and how they addressed money,

00:09:33.721 --> 00:09:35.302
how your spouse addresses money,

00:09:35.383 --> 00:09:36.383
what money is.

00:09:37.023 --> 00:09:38.344
We were just, I mean,

00:09:38.504 --> 00:09:41.443
every chance I get with my four boys,

00:09:41.943 --> 00:09:43.924
I always try to instill in them

00:09:44.485 --> 00:09:45.025
Who cares?

00:09:45.145 --> 00:09:45.806
It's just money.

00:09:46.567 --> 00:09:49.109
It has zero value unless you spend it.

00:09:49.629 --> 00:09:51.410
You decide how you want to spend it.

00:09:51.451 --> 00:09:52.631
Spend it could be investing

00:09:52.711 --> 00:09:54.673
it or it could be just wasteful spending.

00:09:54.714 --> 00:09:55.475
It doesn't matter.

00:09:56.014 --> 00:09:56.936
But the point is,

00:09:57.476 --> 00:09:59.158
I want them to understand

00:09:59.677 --> 00:10:01.320
money can always be created.

00:10:01.399 --> 00:10:02.841
It can always be generated.

00:10:03.101 --> 00:10:05.484
There's no scarcity around money ever.

00:10:06.063 --> 00:10:07.765
You could have zero money

00:10:08.265 --> 00:10:09.547
and be completely happy.

00:10:09.707 --> 00:10:10.948
You could have millions of

00:10:11.009 --> 00:10:13.051
dollars and be completely miserable.

00:10:13.591 --> 00:10:15.153
So those are the lessons

00:10:15.192 --> 00:10:17.274
that I try to instill in my kids.

00:10:18.384 --> 00:10:20.684
But I recognize that I still

00:10:20.725 --> 00:10:22.846
have a ton of bad money

00:10:22.926 --> 00:10:25.265
habits from my parents who

00:10:25.285 --> 00:10:26.966
were successful in their own right.

00:10:27.047 --> 00:10:27.307
I mean,

00:10:27.346 --> 00:10:29.027
I'm not taking anything away from them.

00:10:29.586 --> 00:10:32.807
I'm just saying it's work to

00:10:32.888 --> 00:10:34.307
change the way we look at it.

00:10:34.347 --> 00:10:34.807
Plus,

00:10:35.408 --> 00:10:37.568
going back to I think a lot of

00:10:37.609 --> 00:10:39.708
therapists just tie their value,

00:10:39.769 --> 00:10:42.710
their identity to I'm a hard worker.

00:10:42.830 --> 00:10:44.669
I was successful in school.

00:10:44.730 --> 00:10:46.010
I checked all the boxes and

00:10:46.071 --> 00:10:46.990
I did the homework.

00:10:48.010 --> 00:10:49.751
I never saw value in any of that.

00:10:49.971 --> 00:10:51.952
So I came to therapy from

00:10:52.013 --> 00:10:53.474
kind of a different perspective.

00:10:54.933 --> 00:10:56.154
But there's a lot of

00:10:56.254 --> 00:10:58.755
identity tied to doing what

00:10:58.796 --> 00:11:00.657
you think you're supposed to do.

00:11:01.317 --> 00:11:03.438
So and a lot of people still think, well,

00:11:03.458 --> 00:11:04.178
I got to work hard.

00:11:04.399 --> 00:11:06.659
If I'm not working hard, I'm being lazy.

00:11:07.259 --> 00:11:08.321
It's just not true at all.

00:11:10.304 --> 00:11:10.924
Yeah, I love it.

00:11:11.385 --> 00:11:13.006
Um, so what are, what are some,

00:11:13.106 --> 00:11:14.067
I know there's a bunch of comments.

00:11:14.086 --> 00:11:15.427
I know Joey Albritton commented,

00:11:15.447 --> 00:11:17.408
a bunch of folks commented, what would be,

00:11:18.049 --> 00:11:18.750
uh, you know, not,

00:11:18.970 --> 00:11:20.530
not that they're asking for

00:11:20.671 --> 00:11:22.152
our unsolicited advice.

00:11:22.172 --> 00:11:23.472
They're asking that whole

00:11:23.513 --> 00:11:24.354
Facebook group or whatever.

00:11:24.913 --> 00:11:26.355
What would be like,

00:11:26.634 --> 00:11:28.296
what would be an idea or like,

00:11:28.475 --> 00:11:29.756
what would you do if you were that owner?

00:11:29.836 --> 00:11:30.236
And you know,

00:11:30.277 --> 00:11:31.217
your wife is going on the

00:11:31.238 --> 00:11:34.460
Facebook group and, uh, or what's,

00:11:34.559 --> 00:11:36.740
what suggestion would you have for, uh,

00:11:36.780 --> 00:11:37.562
for this practice owner?

00:11:38.143 --> 00:11:39.063
I think this is where you

00:11:39.124 --> 00:11:41.386
have to bring in a new set of eyes.

00:11:41.486 --> 00:11:42.567
This is where you have to

00:11:42.607 --> 00:11:44.230
bring in an outside consultant.

00:11:44.529 --> 00:11:45.931
And you have to step back

00:11:46.471 --> 00:11:48.474
and use the logical brain.

00:11:48.514 --> 00:11:49.696
You have a clinical brain.

00:11:49.735 --> 00:11:51.037
There's logic in that.

00:11:51.517 --> 00:11:52.477
It's like, well, wait a minute.

00:11:52.719 --> 00:11:53.879
If this person is doing

00:11:53.940 --> 00:11:55.000
eighteen visits a day.

00:11:55.922 --> 00:11:57.864
So let's say close to two

00:11:57.884 --> 00:11:59.505
thousand dollars in revenue

00:11:59.546 --> 00:12:02.207
generation a day, just this person.

00:12:02.889 --> 00:12:03.909
And then there's five,

00:12:04.269 --> 00:12:05.370
potentially five other

00:12:05.410 --> 00:12:07.072
people doing comparable.

00:12:07.592 --> 00:12:07.952
You know,

00:12:08.293 --> 00:12:09.835
this practice is doing a

00:12:09.894 --> 00:12:13.038
significant amount of revenue within this,

00:12:13.379 --> 00:12:14.639
probably upwards, you know,

00:12:14.720 --> 00:12:15.961
well over half.

00:12:16.341 --> 00:12:17.802
a five hundred thousand plus

00:12:17.841 --> 00:12:19.482
close to a million in revenue,

00:12:20.124 --> 00:12:21.585
you have to sit there and be like,

00:12:21.664 --> 00:12:24.167
wait a minute, something doesn't add up.

00:12:24.427 --> 00:12:25.967
We're generating, let's say,

00:12:26.008 --> 00:12:26.849
seven hundred and fifty

00:12:26.889 --> 00:12:28.210
thousand a year in revenue.

00:12:28.889 --> 00:12:31.231
And I'm I'm killing myself

00:12:31.392 --> 00:12:32.952
doing all this stuff like

00:12:33.753 --> 00:12:35.534
you have to acknowledge

00:12:35.554 --> 00:12:36.394
there's a problem.

00:12:36.916 --> 00:12:38.277
The wife acknowledges it.

00:12:38.356 --> 00:12:39.878
Other people around you see it.

00:12:40.717 --> 00:12:42.097
You have to acknowledge it

00:12:42.118 --> 00:12:42.859
and then you have to get a

00:12:42.899 --> 00:12:43.739
fresh set of eyes.

00:12:43.778 --> 00:12:43.999
You know,

00:12:44.038 --> 00:12:45.658
somebody to come in and look at this,

00:12:45.879 --> 00:12:48.600
give you their perspective

00:12:49.039 --> 00:12:50.240
from the outside looking in.

00:12:50.320 --> 00:12:51.921
And then you can decide like, all right,

00:12:52.301 --> 00:12:54.000
do I agree with their perspective?

00:12:54.160 --> 00:12:54.480
You know,

00:12:54.821 --> 00:12:56.542
we get patients and I tie

00:12:56.581 --> 00:12:57.841
everything back to patient care.

00:12:58.322 --> 00:12:59.522
Patient walks in the door.

00:12:59.961 --> 00:13:01.003
He loves smoking.

00:13:01.123 --> 00:13:02.163
He loves drinking.

00:13:02.302 --> 00:13:03.903
He loves eating whatever he wants,

00:13:03.982 --> 00:13:06.104
but his back pain doesn't get better.

00:13:06.844 --> 00:13:08.125
I can tell them, look,

00:13:08.144 --> 00:13:09.825
this isn't a mechanical problem.

00:13:09.965 --> 00:13:11.066
It's a chemical problem.

00:13:11.485 --> 00:13:14.267
Your body is dealing with chemical issues.

00:13:14.687 --> 00:13:16.288
If you really want to address this,

00:13:16.347 --> 00:13:17.808
we need lifestyle change.

00:13:18.308 --> 00:13:19.649
And then that that patient

00:13:19.688 --> 00:13:20.750
can make the decision.

00:13:21.190 --> 00:13:22.190
Yeah, I want to do this.

00:13:22.250 --> 00:13:22.671
I'm ready.

00:13:22.730 --> 00:13:24.051
I'm ready to make the change.

00:13:24.071 --> 00:13:25.292
I'm going to change my diet,

00:13:25.331 --> 00:13:26.331
change my lifestyle.

00:13:26.351 --> 00:13:27.712
I'm going to start to exercise.

00:13:28.493 --> 00:13:29.373
Or they're going to say, no,

00:13:29.432 --> 00:13:30.094
I don't want that.

00:13:30.394 --> 00:13:31.254
And they're going to they

00:13:31.274 --> 00:13:32.514
would rather deal with the

00:13:32.553 --> 00:13:34.475
pain of back back pain.

00:13:35.235 --> 00:13:36.375
This guy would rather deal

00:13:36.394 --> 00:13:37.775
with the pain of burnout

00:13:38.235 --> 00:13:40.196
than make these changes

00:13:40.216 --> 00:13:41.797
because they're so fearful

00:13:42.277 --> 00:13:44.378
of what those changes involve.

00:13:44.418 --> 00:13:45.658
And a lot of times those

00:13:45.697 --> 00:13:46.998
changes are more painful.

00:13:47.639 --> 00:13:49.379
Exercising daily and eating

00:13:49.438 --> 00:13:50.698
a different diet is more

00:13:50.739 --> 00:13:52.320
painful than the nuisance

00:13:52.340 --> 00:13:53.480
back pain he's dealing with.

00:13:53.519 --> 00:13:54.461
He'd rather just deal with

00:13:54.500 --> 00:13:55.341
the nuisance back pain.

00:13:56.124 --> 00:13:58.065
But you need an outside set of eyes,

00:13:58.105 --> 00:13:59.945
somebody like you or other

00:13:59.985 --> 00:14:01.145
people that are out there

00:14:01.206 --> 00:14:02.285
that have been down that

00:14:02.346 --> 00:14:04.267
road and have seen a

00:14:04.326 --> 00:14:06.168
hundred other business models.

00:14:06.748 --> 00:14:08.508
That's somebody that I would say, hey,

00:14:08.548 --> 00:14:09.389
take a look at this and

00:14:09.428 --> 00:14:10.168
tell me what you see.

00:14:11.673 --> 00:14:12.855
I love what you mentioned

00:14:12.934 --> 00:14:15.056
maybe ten or so minutes ago.

00:14:15.076 --> 00:14:15.996
I don't know how long we had

00:14:16.037 --> 00:14:16.717
a lot of five or ten

00:14:16.738 --> 00:14:17.697
minutes ago when you

00:14:17.758 --> 00:14:18.698
mentioned that you had

00:14:18.798 --> 00:14:20.639
tried several different billers.

00:14:21.240 --> 00:14:22.000
And this goes back to

00:14:22.081 --> 00:14:23.481
remember when we were searching,

00:14:23.522 --> 00:14:24.363
we were interviewing folks

00:14:24.442 --> 00:14:25.623
to do home cleaning.

00:14:26.203 --> 00:14:28.164
And I don't know if I mentioned this,

00:14:28.205 --> 00:14:29.245
but like the first person

00:14:29.865 --> 00:14:31.447
like we had her come twice

00:14:31.506 --> 00:14:33.568
and like it just she was super nice,

00:14:33.609 --> 00:14:34.870
but it just like took forever.

00:14:34.889 --> 00:14:36.350
It was like eight hours.

00:14:36.370 --> 00:14:36.971
Like our place,

00:14:37.831 --> 00:14:39.972
it's a condo apartment in Brooklyn.

00:14:41.614 --> 00:14:42.474
place for three hours.

00:14:42.494 --> 00:14:42.594
Now,

00:14:42.634 --> 00:14:44.394
were you paying by the hour or by the

00:14:44.455 --> 00:14:44.815
job?

00:14:45.195 --> 00:14:46.316
No, by the job.

00:14:46.375 --> 00:14:46.696
It's like,

00:14:47.515 --> 00:14:49.417
why would you not hustle to get

00:14:49.576 --> 00:14:51.138
out of here sooner?

00:14:51.177 --> 00:14:53.778
It was a flat rate for the whole job.

00:14:53.798 --> 00:14:56.179
And by the way, that was her idea.

00:14:56.960 --> 00:14:57.620
The reason I'm bringing this

00:14:57.679 --> 00:14:59.020
up is because we tried her

00:14:59.041 --> 00:15:01.061
a couple of times and we're like, yeah,

00:15:01.081 --> 00:15:04.363
we're going to pause and

00:15:04.722 --> 00:15:05.763
then we continue the search.

00:15:09.133 --> 00:15:10.313
I think certain business

00:15:10.374 --> 00:15:14.018
owners can get in the rut of like, well,

00:15:14.057 --> 00:15:15.519
we tried that, so that didn't work.

00:15:15.918 --> 00:15:17.821
It's like what you said and what I did,

00:15:17.860 --> 00:15:19.623
then we look for another cleaner.

00:15:19.643 --> 00:15:20.123
If that didn't work,

00:15:20.143 --> 00:15:20.663
we're going to look for

00:15:20.683 --> 00:15:21.585
another and another.

00:15:22.264 --> 00:15:23.066
It's the same thing with

00:15:23.125 --> 00:15:24.427
recruiting for therapists.

00:15:24.888 --> 00:15:26.469
Some are just not going to

00:15:26.489 --> 00:15:27.009
be the right fit.

00:15:27.110 --> 00:15:29.272
They're going to be too experienced,

00:15:29.331 --> 00:15:30.232
too inexperienced.

00:15:30.253 --> 00:15:31.394
They're just not going to be

00:15:31.413 --> 00:15:31.854
the right fit.

00:15:33.134 --> 00:15:34.336
um regardless of the

00:15:34.355 --> 00:15:35.056
challenges that this

00:15:35.096 --> 00:15:36.135
practice had with uh

00:15:36.176 --> 00:15:37.197
billing folks or billing

00:15:37.236 --> 00:15:38.657
companies or whatever like

00:15:38.996 --> 00:15:40.477
there absolutely is a great

00:15:40.498 --> 00:15:41.518
fit out there like you said

00:15:41.738 --> 00:15:42.798
you might need a coach or a

00:15:42.859 --> 00:15:44.599
consultant or some practice

00:15:44.658 --> 00:15:46.100
owner that has been there before

00:15:47.065 --> 00:15:48.505
that hired five or ten

00:15:48.546 --> 00:15:49.907
different billing companies

00:15:49.966 --> 00:15:50.506
over the years,

00:15:50.888 --> 00:15:52.808
they actually could give

00:15:52.828 --> 00:15:54.070
you maybe like a cheat

00:15:54.090 --> 00:15:55.190
sheet or a handout of like,

00:15:55.630 --> 00:15:57.331
here's the proper questions to ask.

00:15:57.371 --> 00:15:57.511
Like,

00:15:57.572 --> 00:16:00.553
here's the savvy questions to ask

00:16:00.634 --> 00:16:01.455
when you're interviewing

00:16:01.514 --> 00:16:02.916
business or when you're

00:16:02.956 --> 00:16:04.517
interviewing billing companies.

00:16:05.177 --> 00:16:05.817
Like, you know,

00:16:06.177 --> 00:16:07.157
those types of asking for

00:16:07.216 --> 00:16:08.457
referrals or asking for

00:16:09.817 --> 00:16:11.197
references and asking to

00:16:11.238 --> 00:16:11.899
speak with other business

00:16:11.958 --> 00:16:12.778
owners that they're already

00:16:12.798 --> 00:16:14.318
helping on the billing side.

00:16:14.379 --> 00:16:16.460
So I love that.

00:16:16.700 --> 00:16:18.759
I always want to echo that,

00:16:18.799 --> 00:16:20.220
which is like there's just

00:16:20.299 --> 00:16:21.900
always more to assess and

00:16:21.921 --> 00:16:23.140
check out and never think

00:16:23.160 --> 00:16:24.441
that just because the first

00:16:24.561 --> 00:16:26.922
option or two didn't work out,

00:16:26.961 --> 00:16:28.621
that that's like the whole

00:16:29.081 --> 00:16:29.942
route doesn't work.

00:16:30.023 --> 00:16:31.623
Obviously, billing companies work.

00:16:32.614 --> 00:16:33.554
And you would think this is

00:16:33.595 --> 00:16:35.775
a lesson we already understand.

00:16:35.796 --> 00:16:37.158
The patient who comes in and

00:16:37.177 --> 00:16:38.778
says physical therapy

00:16:38.798 --> 00:16:39.879
doesn't work because they

00:16:39.919 --> 00:16:41.900
went down the street and they didn't do,

00:16:42.221 --> 00:16:44.403
you know, well with that.

00:16:44.523 --> 00:16:45.663
And that same physical

00:16:45.703 --> 00:16:46.565
therapist will then go on

00:16:46.585 --> 00:16:47.164
Facebook and say,

00:16:47.345 --> 00:16:48.785
I can't believe these patients say,

00:16:48.806 --> 00:16:50.187
you know, physical therapy won't work.

00:16:50.267 --> 00:16:50.947
And, you know,

00:16:51.128 --> 00:16:52.589
get physical therapy first

00:16:52.629 --> 00:16:55.150
and get PT first or, you know, PT.

00:16:55.591 --> 00:16:57.952
What was your choose PT first?

00:16:59.394 --> 00:17:00.215
It's hilarious.

00:17:00.235 --> 00:17:00.475
Yes.

00:17:00.754 --> 00:17:01.336
What a conundrum.

00:17:02.168 --> 00:17:03.089
What's interesting about

00:17:03.229 --> 00:17:04.390
what you shared with the

00:17:04.410 --> 00:17:07.211
cleaning person is you,

00:17:07.330 --> 00:17:10.012
and correct me if I'm wrong,

00:17:10.153 --> 00:17:11.153
you were just at least a

00:17:11.213 --> 00:17:14.816
little bit more concerned

00:17:14.855 --> 00:17:16.277
with the amount of time it

00:17:16.317 --> 00:17:18.358
took than the quality of the job.

00:17:18.439 --> 00:17:20.961
Now, a lot of people will say- No, no, no.

00:17:21.020 --> 00:17:21.641
I'm sorry.

00:17:21.681 --> 00:17:24.403
It was like missing dusty,

00:17:25.222 --> 00:17:26.284
dirty spots or whatever.

00:17:26.304 --> 00:17:27.525
So it was both.

00:17:27.605 --> 00:17:29.806
It was low quality and it took too long.

00:17:29.866 --> 00:17:31.788
So it's like, how did that happen?

00:17:32.833 --> 00:17:34.634
Yeah.

00:17:34.653 --> 00:17:36.654
Okay, let's pivot a little bit.

00:17:36.835 --> 00:17:37.996
You've shared a ton of

00:17:38.056 --> 00:17:38.936
information about

00:17:39.096 --> 00:17:40.938
recruitment and hiring and

00:17:41.077 --> 00:17:42.378
ads that you're running and

00:17:42.778 --> 00:17:43.980
how to bring in staff.

00:17:45.460 --> 00:17:48.102
I was listening to Dan Ariely.

00:17:48.342 --> 00:17:49.542
Are you familiar with him at all?

00:17:51.269 --> 00:17:51.788
Love him.

00:17:52.369 --> 00:17:54.211
What is he like a behavioral economics?

00:17:54.452 --> 00:17:56.194
Yeah, behavioral economics.

00:17:56.674 --> 00:17:57.476
At Duke or something.

00:17:57.496 --> 00:17:58.317
He's an author.

00:17:58.498 --> 00:17:59.219
Excellent books.

00:17:59.519 --> 00:18:01.060
Predictably Irrational is

00:18:01.741 --> 00:18:03.784
probably in my top five of

00:18:03.845 --> 00:18:04.885
like favorite books of all time.

00:18:05.358 --> 00:18:06.559
So the last time I shared

00:18:06.599 --> 00:18:07.840
some of his content,

00:18:08.301 --> 00:18:09.942
maybe it was Joey Rossi or

00:18:10.163 --> 00:18:12.105
somebody had shared he had

00:18:12.164 --> 00:18:14.527
some questionable research

00:18:14.686 --> 00:18:16.387
ethic violations and people

00:18:16.409 --> 00:18:17.548
were investigating him

00:18:17.589 --> 00:18:18.509
because maybe he didn't

00:18:18.529 --> 00:18:19.431
really carry out the

00:18:19.471 --> 00:18:20.652
research or his findings

00:18:20.731 --> 00:18:22.273
were manipulated.

00:18:22.453 --> 00:18:22.814
I don't know.

00:18:24.234 --> 00:18:25.596
I read those opinions.

00:18:25.856 --> 00:18:26.576
Nonetheless,

00:18:26.797 --> 00:18:28.239
the idea behind the

00:18:28.298 --> 00:18:30.319
information is still valuable.

00:18:30.339 --> 00:18:30.560
Right.

00:18:31.121 --> 00:18:34.443
So one of the, the like, fifteen year ago,

00:18:34.523 --> 00:18:37.046
YouTube Ted Talks was why

00:18:37.125 --> 00:18:39.468
we enjoy the work that we do.

00:18:40.087 --> 00:18:41.348
And it got me thinking about

00:18:41.568 --> 00:18:42.630
your situation.

00:18:43.411 --> 00:18:45.613
So I'm going to share my chat GPT.

00:18:47.233 --> 00:18:48.454
And what I did.

00:18:48.835 --> 00:18:49.836
Folks, you got to jump over.

00:18:49.915 --> 00:18:51.156
You got to jump over to the YouTube.

00:18:51.176 --> 00:18:52.758
Jump over to Learn Medicare

00:18:52.778 --> 00:18:54.159
Billing or PT podcast or

00:18:54.180 --> 00:18:55.279
the Dave Kittle show on YouTube.

00:18:55.319 --> 00:18:56.500
If you're listening right

00:18:56.520 --> 00:18:58.323
now on iTunes or Spotify or

00:18:58.403 --> 00:18:59.644
LinkedIn or wherever you're watching.

00:19:00.252 --> 00:19:00.593
Yeah.

00:19:00.633 --> 00:19:02.233
So if you guys don't already do this,

00:19:02.273 --> 00:19:03.575
this is a cool little hack,

00:19:03.875 --> 00:19:05.455
but then we'll get into the main content.

00:19:05.836 --> 00:19:06.957
Let me get up here at the top.

00:19:07.278 --> 00:19:07.938
So basically,

00:19:08.939 --> 00:19:10.819
let's say you hear a YouTube

00:19:11.420 --> 00:19:12.540
interview and you're like, yeah,

00:19:12.560 --> 00:19:13.221
I love that idea.

00:19:13.261 --> 00:19:14.422
How can I apply that idea to

00:19:14.461 --> 00:19:15.242
physical therapy?

00:19:15.942 --> 00:19:17.324
So I put in a simple prompt.

00:19:17.423 --> 00:19:18.065
I just say, hey,

00:19:18.105 --> 00:19:19.486
Dan Ariely talks about the

00:19:19.506 --> 00:19:21.186
importance of meaningful work.

00:19:21.686 --> 00:19:24.367
This is coming from a TED Talk transcript.

00:19:24.807 --> 00:19:26.288
I want you to process this

00:19:26.388 --> 00:19:27.548
and then tell me how this

00:19:27.608 --> 00:19:28.949
applies to the physical

00:19:28.989 --> 00:19:30.210
therapy private practice.

00:19:30.890 --> 00:19:32.790
And on YouTube, you can copy and paste,

00:19:32.830 --> 00:19:33.951
if you're on a desktop,

00:19:34.431 --> 00:19:36.592
the full transcript of the interview.

00:19:37.451 --> 00:19:40.655
So I put it in and then chat GPT, you know,

00:19:40.715 --> 00:19:42.959
says, OK, here's the framework,

00:19:43.140 --> 00:19:45.281
the meaningful work magnet.

00:19:45.962 --> 00:19:46.483
The goal,

00:19:46.503 --> 00:19:48.465
create a job ad that's emotion

00:19:48.567 --> 00:19:49.748
that emotionally resonates

00:19:49.768 --> 00:19:51.269
with clinicians who crave

00:19:51.349 --> 00:19:52.551
more than just a paycheck.

00:19:53.132 --> 00:19:55.174
Therapists want their work to matter.

00:19:56.076 --> 00:19:57.977
And I'll just give you the headlines,

00:19:57.997 --> 00:20:00.398
you know, stop, start with the mission,

00:20:00.679 --> 00:20:01.440
not the money.

00:20:01.680 --> 00:20:02.700
So instead of saying we're

00:20:02.880 --> 00:20:05.402
hiring five thousand dollar sign on bonus,

00:20:05.442 --> 00:20:06.482
which we see everywhere,

00:20:07.022 --> 00:20:08.104
start with something like

00:20:08.183 --> 00:20:09.825
your work should mean something.

00:20:10.085 --> 00:20:12.727
Ours does every visit, every patient,

00:20:12.846 --> 00:20:13.988
every life we touch.

00:20:14.708 --> 00:20:16.348
And I was thinking about you

00:20:16.388 --> 00:20:17.609
because one of your main

00:20:17.730 --> 00:20:19.431
ads is talking about how

00:20:19.490 --> 00:20:21.251
much a therapist could make

00:20:21.751 --> 00:20:23.634
relative to how few visits

00:20:23.673 --> 00:20:25.054
they need to do to make that money.

00:20:25.074 --> 00:20:28.836
But anyway, tell a micro story of impact,

00:20:28.997 --> 00:20:31.438
acknowledge the trade-off transparently.

00:20:31.979 --> 00:20:32.618
I do that.

00:20:33.159 --> 00:20:33.900
I'm like, look, guys,

00:20:33.920 --> 00:20:34.840
you're not going to make as

00:20:34.901 --> 00:20:36.040
much money working for me

00:20:36.080 --> 00:20:37.241
as you would make working

00:20:37.422 --> 00:20:39.784
in home health or a skilled nursing.

00:20:40.443 --> 00:20:41.724
But it's because...

00:20:42.305 --> 00:20:45.128
The difference in the population we treat,

00:20:45.388 --> 00:20:47.371
you know, nothing will burn you out,

00:20:47.411 --> 00:20:48.051
chew you up,

00:20:48.112 --> 00:20:50.474
spit you out more than seeing

00:20:50.515 --> 00:20:52.156
the same person in a

00:20:52.196 --> 00:20:54.159
different body every single

00:20:54.199 --> 00:20:55.540
day and knowing that you're

00:20:55.601 --> 00:20:56.981
not really helping anybody.

00:20:57.563 --> 00:20:57.803
You know,

00:20:57.823 --> 00:21:00.984
somebody shared a post about a I

00:21:01.025 --> 00:21:02.125
don't know if this is the right word,

00:21:02.165 --> 00:21:04.208
a catatonic person on

00:21:04.268 --> 00:21:06.469
hospice who a physical

00:21:06.489 --> 00:21:08.691
therapist is supposed to be helping.

00:21:08.750 --> 00:21:10.551
Like there's just there's no

00:21:10.612 --> 00:21:12.153
meaning in that kind of work.

00:21:12.173 --> 00:21:14.474
A lot of times describe the

00:21:14.494 --> 00:21:16.715
challenge as a source of pride.

00:21:17.135 --> 00:21:17.376
Right.

00:21:17.436 --> 00:21:18.596
Why do we climb a mountain?

00:21:18.636 --> 00:21:20.999
Because it feels good to get to the top,

00:21:21.078 --> 00:21:21.940
even though it's hard.

00:21:22.826 --> 00:21:24.647
Give them ownership language,

00:21:25.269 --> 00:21:26.609
not ownership equity,

00:21:26.710 --> 00:21:28.310
just ownership language.

00:21:29.632 --> 00:21:32.093
Show that their work will be seen.

00:21:32.354 --> 00:21:34.855
Use emotional, resonant call to action.

00:21:34.994 --> 00:21:36.576
And then it gives a little sample ad.

00:21:37.257 --> 00:21:37.997
So first,

00:21:38.057 --> 00:21:39.999
what are some of your thoughts on this?

00:21:41.548 --> 00:21:42.990
Just a joke because I burst

00:21:43.049 --> 00:21:43.630
out in laughter.

00:21:44.210 --> 00:21:45.230
Give them ownership.

00:21:45.750 --> 00:21:46.711
Not of equity, though.

00:21:46.770 --> 00:21:47.510
Definitely not.

00:21:47.530 --> 00:21:49.411
That's so funny.

00:21:49.531 --> 00:21:51.392
It's the feeling of ownership,

00:21:51.412 --> 00:21:52.672
not actual ownership.

00:21:52.772 --> 00:21:55.073
Hey, I need to do better at that, man.

00:21:55.212 --> 00:21:57.673
If I can best or better

00:21:57.713 --> 00:22:00.615
convey the staff role

00:22:01.194 --> 00:22:02.895
that they get to take ownership of.

00:22:02.955 --> 00:22:03.215
Well, I,

00:22:03.316 --> 00:22:04.955
and my therapist somewhat do like

00:22:04.976 --> 00:22:06.576
they get to make their own schedule.

00:22:06.596 --> 00:22:07.376
They get to,

00:22:08.198 --> 00:22:08.938
they get to make like what

00:22:08.958 --> 00:22:11.019
time they're going to start and end, uh,

00:22:11.038 --> 00:22:11.499
per day.

00:22:12.199 --> 00:22:13.720
They get to fit in people, you know,

00:22:13.740 --> 00:22:14.680
clients, whatever they want,

00:22:14.960 --> 00:22:16.681
they can work weekends or not.

00:22:17.300 --> 00:22:17.580
Um,

00:22:17.921 --> 00:22:18.060
I mean,

00:22:18.141 --> 00:22:19.301
I have one therapist that's

00:22:19.383 --> 00:22:20.564
averaging like two point

00:22:20.844 --> 00:22:22.305
eight patients per day and

00:22:22.325 --> 00:22:24.247
he's making just two point eight.

00:22:24.267 --> 00:22:24.667
Now, of course,

00:22:24.807 --> 00:22:25.548
I know you got to travel in

00:22:25.588 --> 00:22:27.390
between the patients and all that.

00:22:27.410 --> 00:22:28.250
And you got to travel to the

00:22:28.270 --> 00:22:28.731
first patient.

00:22:28.751 --> 00:22:30.073
You got to travel to home

00:22:30.093 --> 00:22:30.834
from the last patient.

00:22:30.874 --> 00:22:32.375
So sometimes it might come

00:22:32.414 --> 00:22:35.097
out to like a more of a workday,

00:22:35.117 --> 00:22:37.440
but two point eight patients on average.

00:22:38.040 --> 00:22:39.362
And they're making like.

00:22:40.143 --> 00:22:41.443
They're on pace for like

00:22:41.483 --> 00:22:43.666
ninety K by treating two

00:22:43.707 --> 00:22:44.807
point eight patients per day.

00:22:44.968 --> 00:22:45.729
So it's pretty good deal.

00:22:46.088 --> 00:22:48.330
But I need to give them ownership of.

00:22:49.071 --> 00:22:50.133
Yeah, like like I don't know,

00:22:50.252 --> 00:22:51.173
like more of the is that

00:22:51.193 --> 00:22:52.295
like the touchy feely stuff?

00:22:52.315 --> 00:22:52.955
Would you say, Tony,

00:22:52.976 --> 00:22:55.337
like more ownership around that or what?

00:22:55.801 --> 00:22:56.082
Yeah.

00:22:56.462 --> 00:22:57.323
Own your schedule.

00:22:57.643 --> 00:22:59.404
You know, you, you have control.

00:23:00.005 --> 00:23:00.465
Autonomy.

00:23:00.586 --> 00:23:00.945
Yeah.

00:23:01.006 --> 00:23:01.926
Who you can treat,

00:23:02.007 --> 00:23:03.327
how you want to treat them.

00:23:03.387 --> 00:23:05.429
Like we all went to school

00:23:05.489 --> 00:23:06.910
to be professionals.

00:23:07.371 --> 00:23:08.270
I want to come into a

00:23:08.330 --> 00:23:10.212
position where I'm a professional.

00:23:10.813 --> 00:23:12.375
I think too many of us as

00:23:12.454 --> 00:23:14.476
business owners think, well,

00:23:14.516 --> 00:23:16.557
they want equity in the business.

00:23:16.698 --> 00:23:17.679
I don't think they want it.

00:23:17.759 --> 00:23:18.519
I don't think they care.

00:23:18.959 --> 00:23:20.500
Even me as an example of,

00:23:21.221 --> 00:23:22.480
I wouldn't want to come in

00:23:22.641 --> 00:23:23.942
as an equity partner

00:23:24.001 --> 00:23:25.382
because I don't want the

00:23:25.402 --> 00:23:27.762
liability associated with your problems,

00:23:28.083 --> 00:23:29.742
your baggage, you know,

00:23:29.843 --> 00:23:31.462
and we are as a profession

00:23:31.542 --> 00:23:32.923
so risk averse.

00:23:33.604 --> 00:23:34.784
I think of a therapist.

00:23:35.124 --> 00:23:36.085
It thinks that they're on

00:23:36.125 --> 00:23:37.505
the hook for mistakes that

00:23:37.565 --> 00:23:40.526
the bigger entity makes

00:23:40.945 --> 00:23:41.786
that freaks them out.

00:23:42.425 --> 00:23:44.907
So it's like as business owners, we think,

00:23:45.028 --> 00:23:47.390
oh, they want ownership in that respect.

00:23:47.490 --> 00:23:48.210
I don't think they do.

00:23:48.330 --> 00:23:49.351
I think they just they want

00:23:49.391 --> 00:23:50.832
the independency, autonomy.

00:23:51.252 --> 00:23:52.334
They want to feel good about

00:23:52.374 --> 00:23:53.453
the work that they're doing.

00:23:53.634 --> 00:23:55.476
And yours is a great example.

00:23:55.976 --> 00:23:57.738
Like you are working with a

00:23:57.778 --> 00:23:59.959
clientele that you can make

00:24:00.098 --> 00:24:01.319
real impact with.

00:24:01.740 --> 00:24:03.221
You can change that person's

00:24:03.281 --> 00:24:04.542
life fundamentally.

00:24:04.583 --> 00:24:05.743
You can keep them in their

00:24:05.784 --> 00:24:07.325
home or their apartment longer.

00:24:07.384 --> 00:24:08.685
You can improve their

00:24:08.726 --> 00:24:10.807
quality of life versus others.

00:24:11.815 --> 00:24:12.875
some of the other places

00:24:12.895 --> 00:24:17.259
that it's just that treadmill of CPT code,

00:24:17.298 --> 00:24:18.920
CPT code, CPT code.

00:24:19.240 --> 00:24:20.780
Nobody is going to get better anyway.

00:24:21.101 --> 00:24:22.041
If they do get better,

00:24:22.102 --> 00:24:22.541
you're going to get

00:24:22.602 --> 00:24:23.583
penalized because they're

00:24:23.603 --> 00:24:25.144
going to want to discharge early.

00:24:26.065 --> 00:24:28.266
The conventional system is

00:24:28.365 --> 00:24:32.548
designed to reward the most

00:24:32.709 --> 00:24:35.171
basic mediocre outcome.

00:24:35.931 --> 00:24:37.031
Don't get better quicker.

00:24:37.432 --> 00:24:38.833
Don't invest in innovation.

00:24:39.252 --> 00:24:40.874
Don't improve your education.

00:24:41.674 --> 00:24:42.855
That is what the system

00:24:42.894 --> 00:24:45.196
right now is designed to encourage.

00:24:45.737 --> 00:24:46.478
And so, yeah,

00:24:46.518 --> 00:24:48.298
you give them the opportunity

00:24:48.358 --> 00:24:50.720
to step out of that negative cycle.

00:24:51.280 --> 00:24:53.961
And I do think like those

00:24:54.021 --> 00:24:58.404
emotional triggers resonate deeply.

00:24:58.484 --> 00:24:59.365
Anything else for this topic

00:24:59.385 --> 00:25:00.046
or you want to move on?

00:25:00.605 --> 00:25:01.346
No, we can move on.

00:25:03.541 --> 00:25:04.563
I sent you a link for

00:25:04.623 --> 00:25:07.444
Instagram in Facebook Messenger,

00:25:07.545 --> 00:25:08.787
unless you have some other topics.

00:25:08.866 --> 00:25:10.847
I know Jimmy's not here,

00:25:10.867 --> 00:25:11.888
but we were joking last

00:25:11.949 --> 00:25:14.411
week that I know you were at your DC,

00:25:15.132 --> 00:25:16.993
your son's class trip,

00:25:17.334 --> 00:25:18.214
but you sent us a picture.

00:25:18.394 --> 00:25:19.435
I don't have it right now,

00:25:19.796 --> 00:25:21.436
but it did look like you

00:25:21.457 --> 00:25:22.097
were at the Vatican.

00:25:23.018 --> 00:25:23.397
Jimmy,

00:25:24.499 --> 00:25:25.499
he'll mention this the next time he

00:25:25.519 --> 00:25:25.959
comes back,

00:25:25.979 --> 00:25:27.480
but we had a good laugh as if

00:25:27.920 --> 00:25:29.700
you were at the Vatican and

00:25:29.720 --> 00:25:30.520
that you were actually

00:25:30.580 --> 00:25:32.320
becoming the next Pope.

00:25:32.520 --> 00:25:34.122
And you know what?

00:25:34.402 --> 00:25:35.281
You and the new Pope,

00:25:35.622 --> 00:25:36.942
you don't look that different.

00:25:37.202 --> 00:25:39.463
You got the same haircut and

00:25:39.723 --> 00:25:40.903
there's some similarities there.

00:25:40.943 --> 00:25:41.763
So we had a good laugh.

00:25:41.784 --> 00:25:42.884
All right,

00:25:42.944 --> 00:25:44.525
let me see if I can get this one

00:25:44.644 --> 00:25:45.685
up on the screen.

00:25:48.046 --> 00:25:49.666
Tell me what's going on with this.

00:25:49.707 --> 00:25:50.227
Okay.

00:25:50.583 --> 00:25:50.883
Okay.

00:25:50.903 --> 00:25:51.304
All right.

00:25:51.324 --> 00:25:53.525
So Jimmy McKay is not here.

00:25:53.625 --> 00:25:54.405
He's got an awesome new

00:25:54.486 --> 00:25:55.346
segment here on the show

00:25:55.405 --> 00:25:56.807
called steal the strategy.

00:25:57.288 --> 00:25:57.587
Jimmy,

00:25:57.827 --> 00:25:59.910
I hope I don't want to steal your

00:25:59.930 --> 00:26:00.769
strategy because you're not here.

00:26:00.789 --> 00:26:02.230
I just want to highlight this.

00:26:02.431 --> 00:26:03.652
I came up with this.

00:26:03.992 --> 00:26:05.394
I came across this guy's

00:26:05.453 --> 00:26:06.394
Instagram a couple of weeks ago,

00:26:06.433 --> 00:26:07.095
maybe a month ago.

00:26:07.394 --> 00:26:09.455
He had like fifteen thousand followers.

00:26:09.516 --> 00:26:10.416
Now he's got, I don't know,

00:26:10.436 --> 00:26:12.157
like twenty or thirty thousand followers.

00:26:12.499 --> 00:26:13.538
Thirty eight thousand.

00:26:13.778 --> 00:26:14.059
Thirty.

00:26:14.279 --> 00:26:15.240
This guy is.

00:26:16.181 --> 00:26:17.221
it's kind of weird he's

00:26:17.381 --> 00:26:19.142
adding like five thousand

00:26:19.182 --> 00:26:21.422
followers per week here's

00:26:21.481 --> 00:26:23.261
this so this guy does a

00:26:23.321 --> 00:26:24.803
joke right he he holds up

00:26:24.843 --> 00:26:26.022
his phone it's him and his

00:26:26.063 --> 00:26:27.863
wife shopping at walmart or

00:26:27.942 --> 00:26:28.962
they're getting pedicures

00:26:29.002 --> 00:26:30.743
at the nail salon wherever

00:26:30.784 --> 00:26:31.584
they're at at a restaurant

00:26:31.604 --> 00:26:32.624
nice restaurant he holds up

00:26:32.644 --> 00:26:33.864
his phone and he goes what

00:26:33.903 --> 00:26:35.684
up gang hey what's going on

00:26:35.744 --> 00:26:37.045
I'm here with tina we're

00:26:37.105 --> 00:26:37.944
checking out the deals

00:26:37.984 --> 00:26:39.625
today at walmart so he acts

00:26:39.644 --> 00:26:41.965
like a fake social media influencer

00:26:42.526 --> 00:26:44.247
And obviously his wife gets embarrassed.

00:26:44.267 --> 00:26:44.467
So like,

00:26:44.487 --> 00:26:46.086
that's the funny part is she gets like,

00:26:46.307 --> 00:26:46.988
she's like, no.

00:26:47.067 --> 00:26:48.347
And like, she like runs away.

00:26:48.667 --> 00:26:49.749
And then you could see like, yeah,

00:26:49.769 --> 00:26:50.588
like there, right there,

00:26:50.868 --> 00:26:53.329
that clip of him at the nail salon.

00:26:53.450 --> 00:26:55.190
And like the wife puts her

00:26:55.230 --> 00:26:56.131
hand in front of her face

00:26:56.171 --> 00:26:57.230
and all the women that are,

00:26:57.631 --> 00:26:58.352
that are working there,

00:26:58.612 --> 00:26:59.872
all the women that are in the nail salon,

00:26:59.892 --> 00:27:01.113
they're all covering their face.

00:27:01.772 --> 00:27:02.232
It's funny.

00:27:02.333 --> 00:27:02.732
It's funny.

00:27:03.032 --> 00:27:03.653
Here's the thing.

00:27:04.273 --> 00:27:05.693
This guy owns one or two

00:27:05.733 --> 00:27:07.375
different restaurants in Chicago.

00:27:07.934 --> 00:27:10.496
He links to the, the, uh,

00:27:11.597 --> 00:27:13.138
the restaurant on his profile.

00:27:13.179 --> 00:27:15.161
And I think the, the URL in the Instagram,

00:27:15.401 --> 00:27:18.383
the entire Instagram is a joke.

00:27:18.762 --> 00:27:20.003
He does, he just does jokes.

00:27:20.064 --> 00:27:21.766
He just, he just is a funny guy.

00:27:21.826 --> 00:27:23.067
He likes to do jokes.

00:27:23.326 --> 00:27:26.209
He goes up to the Starbucks line and he,

00:27:26.608 --> 00:27:26.828
you know,

00:27:27.250 --> 00:27:28.411
he does fake voices from

00:27:28.490 --> 00:27:29.290
different movies.

00:27:29.330 --> 00:27:30.392
Like when he goes up to the

00:27:30.412 --> 00:27:31.472
Starbucks line in the

00:27:31.492 --> 00:27:32.894
drive-through and he's like, you know,

00:27:32.973 --> 00:27:34.894
yeah, can I get a, can I get a large,

00:27:35.095 --> 00:27:35.336
you know,

00:27:35.855 --> 00:27:37.718
can I get a medium pike in a

00:27:37.837 --> 00:27:38.818
large venti cup?

00:27:39.259 --> 00:27:40.140
And then they asked for his

00:27:40.200 --> 00:27:41.461
name and he does like, you know,

00:27:41.520 --> 00:27:42.883
like an Al Pacino voice or

00:27:42.903 --> 00:27:45.525
he just does stupid, like, right.

00:27:45.545 --> 00:27:47.426
The point of sharing this is

00:27:47.467 --> 00:27:49.128
that he's adding like five

00:27:49.169 --> 00:27:51.130
thousand followers per week.

00:27:51.170 --> 00:27:51.611
Now, of course,

00:27:52.131 --> 00:27:53.752
many of them are not in the Chicago area,

00:27:53.833 --> 00:27:56.315
but he's got Johnny's

00:27:56.355 --> 00:27:58.136
heroes and subs or whatever

00:27:58.176 --> 00:27:59.878
his like restaurant is.

00:28:01.683 --> 00:28:02.905
And he's getting more

00:28:03.006 --> 00:28:06.030
eyeballs for his restaurant

00:28:06.732 --> 00:28:08.335
that is linked here in his bio.

00:28:09.156 --> 00:28:11.539
None of his posts are about the restaurant,

00:28:11.681 --> 00:28:12.762
about his business.

00:28:14.517 --> 00:28:16.398
And so that was part that was part one.

00:28:16.459 --> 00:28:17.619
And then part two was one of

00:28:17.640 --> 00:28:18.881
the recent posts while I

00:28:18.901 --> 00:28:20.682
was following him is he was

00:28:20.702 --> 00:28:22.884
featured on the news in Chicago.

00:28:23.464 --> 00:28:26.188
And then the news anchor is mentioning,

00:28:26.208 --> 00:28:26.607
you know, oh,

00:28:26.728 --> 00:28:29.250
Johnny Anastopoulos has this

00:28:29.290 --> 00:28:31.051
funny Instagram account and

00:28:31.092 --> 00:28:32.673
he's the owner of whatever it is,

00:28:32.693 --> 00:28:33.575
whatever the restaurant is.

00:28:34.576 --> 00:28:35.236
We don't we don't know.

00:28:35.276 --> 00:28:37.878
Johnny's beef, Johnny's gyros.

00:28:38.898 --> 00:28:41.619
Beef and Gyros in, you know, Lincoln Park,

00:28:42.480 --> 00:28:43.661
Chicago or whatever it is.

00:28:44.240 --> 00:28:45.701
So the local news anchors

00:28:46.201 --> 00:28:47.741
have featured him and his

00:28:47.801 --> 00:28:49.521
Instagram account a couple times,

00:28:49.862 --> 00:28:53.202
which then gets more exposure locally.

00:28:54.163 --> 00:28:56.324
And they even had him in the news,

00:28:56.364 --> 00:28:57.463
like a week or two ago,

00:28:57.564 --> 00:28:58.164
they brought him and

00:28:58.184 --> 00:28:59.085
invited him and his wife

00:28:59.184 --> 00:29:00.565
into the news station.

00:29:00.944 --> 00:29:02.746
And he was like on the live news.

00:29:03.430 --> 00:29:03.869
Yeah.

00:29:04.069 --> 00:29:04.349
Okay.

00:29:04.369 --> 00:29:05.611
This was, this is long winded.

00:29:05.651 --> 00:29:06.550
I'm going to cut to the chase.

00:29:06.951 --> 00:29:07.750
The question for Tony

00:29:07.770 --> 00:29:09.912
Meritato is could physical

00:29:09.951 --> 00:29:11.071
therapists steal the strategy?

00:29:11.112 --> 00:29:11.873
Could private practice

00:29:11.913 --> 00:29:12.873
owners steal the strategy

00:29:12.932 --> 00:29:13.732
where they make a,

00:29:14.113 --> 00:29:15.153
whether it's a personal account,

00:29:15.513 --> 00:29:16.574
a different account, whatever.

00:29:17.094 --> 00:29:17.354
And they,

00:29:17.714 --> 00:29:19.295
you do an amazing strategy of

00:29:19.355 --> 00:29:20.414
video inside your clinic.

00:29:20.835 --> 00:29:21.736
And maybe some therapists

00:29:21.756 --> 00:29:22.675
don't want to do that or

00:29:22.695 --> 00:29:23.915
they can't do it or they're

00:29:23.935 --> 00:29:24.777
afraid to do it or whatever.

00:29:25.997 --> 00:29:27.096
You also have to be kind of

00:29:27.357 --> 00:29:28.438
outgoing to even do this.

00:29:28.478 --> 00:29:29.698
I think to do like the selfie video,

00:29:29.718 --> 00:29:30.479
the way he's doing it,

00:29:30.499 --> 00:29:31.679
but maybe there's other ways to do it.

00:29:32.741 --> 00:29:34.202
Could or should physical

00:29:34.242 --> 00:29:35.182
therapy practice owners

00:29:35.243 --> 00:29:36.304
steal this strategy,

00:29:36.865 --> 00:29:37.585
create kind of like a

00:29:37.664 --> 00:29:41.386
humorous account that they capture funny,

00:29:41.727 --> 00:29:42.127
stupid,

00:29:42.188 --> 00:29:43.989
laughable things in their local area,

00:29:45.215 --> 00:29:45.936
then just link to their

00:29:45.957 --> 00:29:47.659
physical therapy profile at

00:29:47.679 --> 00:29:49.961
the top of the profile.

00:29:50.362 --> 00:29:51.784
But all the content has

00:29:51.903 --> 00:29:53.526
nothing to do with the actual business.

00:29:53.546 --> 00:29:54.125
What are your thoughts?

00:29:54.227 --> 00:29:55.268
Good, bad, indifferent?

00:29:55.768 --> 00:29:56.769
Yes, a hundred percent.

00:29:56.829 --> 00:29:57.631
Yes, you can do it.

00:29:57.671 --> 00:29:58.551
Yes, you should do it.

00:29:59.132 --> 00:30:00.253
What I think is interesting

00:30:00.294 --> 00:30:01.915
about that scenario though,

00:30:02.096 --> 00:30:03.416
and I don't know anything

00:30:03.597 --> 00:30:05.159
besides what you just shared,

00:30:05.720 --> 00:30:07.221
His personal profile on

00:30:07.301 --> 00:30:08.403
Instagram has thirty eight

00:30:08.423 --> 00:30:09.523
thousand followers.

00:30:09.604 --> 00:30:11.365
His business profile only

00:30:11.526 --> 00:30:14.028
has like thirty six hundred followers.

00:30:15.449 --> 00:30:17.471
The personal and that's what I do.

00:30:17.510 --> 00:30:17.771
You know,

00:30:17.832 --> 00:30:20.013
I grow my personal way more than

00:30:20.094 --> 00:30:23.656
I grow like branded business profiles.

00:30:25.474 --> 00:30:26.855
But the whole idea here is

00:30:27.476 --> 00:30:29.978
looking past just is this

00:30:30.018 --> 00:30:31.199
going to put more patients

00:30:31.338 --> 00:30:33.420
in my my physical therapy clinic?

00:30:33.460 --> 00:30:35.721
Because with a thirty eight

00:30:35.741 --> 00:30:37.323
thousand follower account,

00:30:37.702 --> 00:30:39.944
he can move into true influencing.

00:30:40.005 --> 00:30:41.246
He can get brand deals.

00:30:41.286 --> 00:30:42.767
He can do product endorsements.

00:30:42.807 --> 00:30:45.147
He can do so much more with that account,

00:30:45.709 --> 00:30:47.009
even if he never sells an

00:30:47.069 --> 00:30:48.471
extra sandwich because of it.

00:30:49.030 --> 00:30:50.431
So there's huge value in

00:30:50.471 --> 00:30:51.511
capturing attention.

00:30:51.751 --> 00:30:52.531
We know we're in an

00:30:52.731 --> 00:30:54.393
attention based economy.

00:30:55.512 --> 00:30:57.452
I still get pretty much two

00:30:57.472 --> 00:30:59.614
to three emails a week of

00:30:59.713 --> 00:31:00.973
product companies that want

00:31:01.013 --> 00:31:02.214
me to do videos and

00:31:02.275 --> 00:31:03.335
endorsements for them.

00:31:04.035 --> 00:31:05.036
I don't have to do them for

00:31:05.076 --> 00:31:06.076
free anymore unless I

00:31:06.256 --> 00:31:07.576
really want the product and

00:31:07.615 --> 00:31:08.596
it's a high ticket product.

00:31:10.509 --> 00:31:15.133
But a therapist who wants to build a brand,

00:31:15.153 --> 00:31:17.536
a personal brand, absolutely,

00:31:17.576 --> 00:31:18.896
this is a great strategy.

00:31:19.317 --> 00:31:20.538
And if you want to monetize

00:31:20.577 --> 00:31:21.638
that with patient care,

00:31:21.659 --> 00:31:22.720
you probably could.

00:31:23.080 --> 00:31:24.241
You could put out a product

00:31:24.301 --> 00:31:26.703
like Kelly Starrett has

00:31:26.864 --> 00:31:28.766
digital products for people

00:31:28.806 --> 00:31:31.008
that have physical conditions.

00:31:31.048 --> 00:31:31.949
He's never going to treat

00:31:31.969 --> 00:31:33.589
them as a physical therapy patient,

00:31:33.630 --> 00:31:34.912
but he sells these products.

00:31:35.531 --> 00:31:37.153
You could do product endorsements like,

00:31:37.433 --> 00:31:39.215
man, there's just so much you can do.

00:31:39.936 --> 00:31:41.999
And you don't have to be outgoing.

00:31:42.159 --> 00:31:43.319
Like, that's the funniest part.

00:31:43.759 --> 00:31:46.123
I hate I am an introvert

00:31:46.163 --> 00:31:46.863
through and through.

00:31:47.443 --> 00:31:48.704
I hate socializing.

00:31:48.885 --> 00:31:50.307
I love being silent.

00:31:50.426 --> 00:31:51.848
I love being by myself.

00:31:52.409 --> 00:31:54.009
But if I'm in front of the

00:31:54.049 --> 00:31:55.829
camera and I've got a job to do,

00:31:56.009 --> 00:31:57.070
I will do the job.

00:31:57.550 --> 00:31:57.891
You know,

00:31:57.931 --> 00:31:59.571
it's it's a different and I hear

00:31:59.612 --> 00:32:02.032
this a lot from a lot of influencers.

00:32:02.212 --> 00:32:03.932
It's like a switch that flips.

00:32:04.473 --> 00:32:06.973
You're a different person on

00:32:07.034 --> 00:32:09.035
camera than you are off camera.

00:32:10.135 --> 00:32:11.796
So it's something that we

00:32:11.875 --> 00:32:13.497
should be building for all of us.

00:32:15.171 --> 00:32:16.050
And we'll have to get

00:32:16.070 --> 00:32:17.551
Jimmy's feedback on this

00:32:17.571 --> 00:32:18.373
because I did want to share

00:32:18.393 --> 00:32:20.173
this at a time when both of

00:32:20.273 --> 00:32:21.294
you were here on the show.

00:32:21.334 --> 00:32:22.875
But yeah,

00:32:22.934 --> 00:32:24.615
so that's why I wanted to show it.

00:32:25.496 --> 00:32:25.836
Hopefully,

00:32:25.855 --> 00:32:27.217
Jimmy doesn't get upset that I'm

00:32:27.297 --> 00:32:29.137
stealing his segment on

00:32:29.238 --> 00:32:30.679
steal this strategy.

00:32:30.759 --> 00:32:32.079
I think his segment was

00:32:32.099 --> 00:32:32.759
steal the strategy.

00:32:32.819 --> 00:32:35.020
So I just wanted to share that.

00:32:35.080 --> 00:32:35.441
And you're right.

00:32:35.882 --> 00:32:36.122
Also,

00:32:37.021 --> 00:32:38.123
people want to follow more of the

00:32:38.143 --> 00:32:38.742
personal accounts.

00:32:38.762 --> 00:32:39.423
They don't want to follow

00:32:39.462 --> 00:32:40.824
like corporate and business accounts.

00:32:40.864 --> 00:32:41.023
Right.

00:32:41.044 --> 00:32:41.344
So that's,

00:32:41.544 --> 00:32:43.324
that's another reason why his

00:32:43.423 --> 00:32:45.365
personal one also it's, it's funny,

00:32:45.704 --> 00:32:45.825
right?

00:32:45.845 --> 00:32:46.845
Like it's, it's funny.

00:32:46.904 --> 00:32:47.506
Like you don't know what's

00:32:47.526 --> 00:32:48.046
going to happen.

00:32:48.086 --> 00:32:49.566
So you watch more and then

00:32:49.586 --> 00:32:50.346
you're more likely to like

00:32:50.365 --> 00:32:51.527
watch a second and a third video.

00:32:51.567 --> 00:32:52.326
Cause you don't know,

00:32:52.646 --> 00:32:53.606
like when he drives up to

00:32:53.646 --> 00:32:55.188
the drive-through at Starbucks or he,

00:32:55.708 --> 00:32:57.749
he walked into Starbucks and he ordered,

00:32:58.328 --> 00:32:58.489
um,

00:32:59.469 --> 00:33:01.029
With some Brad Pitt

00:33:01.069 --> 00:33:02.690
character from some movie, you know,

00:33:03.690 --> 00:33:05.050
any any order with the

00:33:05.070 --> 00:33:05.951
character's name and the

00:33:06.030 --> 00:33:06.770
accent or whatever.

00:33:07.192 --> 00:33:08.372
So you don't know what he's going to do.

00:33:08.491 --> 00:33:08.771
But yeah,

00:33:08.811 --> 00:33:09.751
more people want to follow the

00:33:09.791 --> 00:33:10.853
personal accounts and they

00:33:10.873 --> 00:33:12.512
don't want to follow like the corporate,

00:33:12.873 --> 00:33:13.854
you know, business accounts.

00:33:13.894 --> 00:33:15.673
And I guess, you know, I guess that's OK.

00:33:15.693 --> 00:33:16.615
That's just the way the

00:33:16.835 --> 00:33:17.694
attention economy is.

00:33:18.604 --> 00:33:19.064
There is a,

00:33:19.864 --> 00:33:21.765
I can't say the name because Jim,

00:33:21.785 --> 00:33:23.244
Jimmy's doing this interview.

00:33:23.305 --> 00:33:24.125
I don't know if he's done it

00:33:24.164 --> 00:33:25.566
already or it's on the books.

00:33:26.086 --> 00:33:28.266
It's part of the PT pint cast series,

00:33:28.846 --> 00:33:31.207
but I think this is a,

00:33:31.666 --> 00:33:32.307
it's a home health

00:33:32.346 --> 00:33:35.208
therapist who's doing funny videos.

00:33:35.647 --> 00:33:37.067
He is on par.

00:33:37.489 --> 00:33:38.628
He's on par with

00:33:39.449 --> 00:33:41.050
So medical doctors that are

00:33:41.131 --> 00:33:42.771
out there that have, you know,

00:33:42.892 --> 00:33:44.333
million subscriber accounts.

00:33:44.374 --> 00:33:44.614
Like,

00:33:44.854 --> 00:33:46.515
I think it's just a matter of time

00:33:46.535 --> 00:33:48.237
before this account blows up.

00:33:48.396 --> 00:33:49.978
If he doesn't quit before he

00:33:49.998 --> 00:33:52.019
hits that inflection point.

00:33:53.080 --> 00:33:53.701
He is awesome.

00:33:53.801 --> 00:33:54.722
I can't wait for that,

00:33:54.843 --> 00:33:57.484
that interview to go live and go public.

00:33:57.505 --> 00:33:58.144
And so.

00:34:00.181 --> 00:34:01.162
I wanted to talk about

00:34:01.682 --> 00:34:02.923
pivoting just a little bit.

00:34:03.784 --> 00:34:05.785
I shared a post that gains

00:34:05.845 --> 00:34:07.546
traction is gaining traction.

00:34:08.427 --> 00:34:09.867
You're not in this world,

00:34:10.288 --> 00:34:11.829
but in case you didn't know,

00:34:12.128 --> 00:34:14.911
so as a Medicare contractor provider,

00:34:15.291 --> 00:34:17.231
when I treat a Medicare beneficiary,

00:34:17.873 --> 00:34:20.753
my plan of care has to be certified.

00:34:20.793 --> 00:34:23.115
That means signed by the

00:34:23.175 --> 00:34:25.476
physician or non-physician practitioner.

00:34:25.516 --> 00:34:26.918
So it could be a physician assistant.

00:34:26.958 --> 00:34:28.159
It could be a nurse practitioner.

00:34:28.179 --> 00:34:29.420
There's a couple other options.

00:34:30.179 --> 00:34:32.161
providers who can certify a plan of care.

00:34:33.081 --> 00:34:34.360
In two thousand twenty five,

00:34:34.942 --> 00:34:37.282
Congress or whoever updated

00:34:37.342 --> 00:34:39.103
the laws made some changes

00:34:39.143 --> 00:34:41.603
that said as long as I have

00:34:41.643 --> 00:34:44.443
a referral and I have proof

00:34:44.603 --> 00:34:46.164
that I sent the plan of

00:34:46.224 --> 00:34:47.465
care for signature,

00:34:48.204 --> 00:34:49.826
I don't need a signature on

00:34:49.846 --> 00:34:51.485
the initial plan of care.

00:34:51.606 --> 00:34:53.226
But if I extend the plan of care,

00:34:53.266 --> 00:34:55.007
change the plan of care, do anything,

00:34:55.487 --> 00:34:56.847
then I do need a signature.

00:34:59.246 --> 00:35:02.068
I can't believe the comments

00:35:02.088 --> 00:35:03.148
that I'm seeing from

00:35:03.268 --> 00:35:05.289
physical therapists who

00:35:05.409 --> 00:35:09.112
think a physician should be

00:35:09.331 --> 00:35:11.432
obligated to sign my plan of care.

00:35:11.572 --> 00:35:12.833
I've said it repeatedly.

00:35:12.873 --> 00:35:14.074
I'm like, if I'm a doctor,

00:35:14.353 --> 00:35:15.835
if I have MD after my name,

00:35:16.635 --> 00:35:18.315
I am not referring patients

00:35:18.335 --> 00:35:20.637
to physical therapy simply because...

00:35:21.416 --> 00:35:24.179
I'm expected to sign plans of care.

00:35:24.541 --> 00:35:25.762
I don't have the time for it.

00:35:26.081 --> 00:35:27.543
I don't have the desire for it.

00:35:27.864 --> 00:35:29.126
I don't have the interest in it.

00:35:29.525 --> 00:35:31.809
Like, I'm sorry, but there is no way.

00:35:31.889 --> 00:35:33.951
Now, these docs aren't getting paid extra.

00:35:34.552 --> 00:35:36.454
There is no like benefit or

00:35:36.534 --> 00:35:37.875
bonus system for them.

00:35:39.016 --> 00:35:40.777
And think about how many

00:35:40.817 --> 00:35:42.536
patients in a day a doctor sees,

00:35:42.577 --> 00:35:44.157
how many patients on

00:35:44.237 --> 00:35:46.137
caseload a doctor manages,

00:35:46.518 --> 00:35:47.898
thousands of patients.

00:35:48.298 --> 00:35:50.659
That's hundreds of plans of care.

00:35:51.898 --> 00:35:53.440
When you sign that plan of care,

00:35:53.480 --> 00:35:55.320
you're saying effectively, yes,

00:35:55.480 --> 00:35:56.840
I agree with this plan of care.

00:35:56.860 --> 00:35:58.561
When they've never met me,

00:35:58.601 --> 00:35:59.862
they have no idea who I am.

00:35:59.902 --> 00:36:01.362
They have no idea what I'm doing.

00:36:01.402 --> 00:36:01.961
Most of the time,

00:36:01.981 --> 00:36:02.922
they don't understand what

00:36:02.961 --> 00:36:04.822
the plan of care even entails.

00:36:05.722 --> 00:36:06.684
I think this is a major

00:36:06.744 --> 00:36:08.164
issue that I've never seen

00:36:08.224 --> 00:36:09.545
discussed or addressed.

00:36:10.965 --> 00:36:13.706
And it's absurd that actual

00:36:13.746 --> 00:36:15.188
licensed therapists think

00:36:15.367 --> 00:36:16.788
doctors should be obligated

00:36:16.827 --> 00:36:18.188
to sign plans of care.

00:36:18.608 --> 00:36:19.929
What are your thoughts on this?

00:36:20.646 --> 00:36:21.106
Well,

00:36:21.126 --> 00:36:22.967
the one comment I saw from Joey Rossi

00:36:23.027 --> 00:36:25.088
was he said there's some

00:36:25.128 --> 00:36:26.250
physicians he's spoken with

00:36:26.309 --> 00:36:27.471
that are no longer

00:36:27.510 --> 00:36:28.911
referring to physical

00:36:28.952 --> 00:36:30.713
therapy because of this specifically.

00:36:31.333 --> 00:36:32.474
That's crazy.

00:36:33.876 --> 00:36:34.976
I think so.

00:36:34.996 --> 00:36:36.557
We're licensed physical therapists.

00:36:36.597 --> 00:36:38.920
We have to have, you know, licensure.

00:36:38.960 --> 00:36:41.882
We have to do continuing education.

00:36:42.242 --> 00:36:43.784
We're CPR certified.

00:36:44.344 --> 00:36:45.644
The fact that this is still

00:36:45.844 --> 00:36:48.728
even a part of CMS is ridiculous.

00:36:48.867 --> 00:36:49.309
I don't know.

00:36:50.048 --> 00:36:51.371
You might think it's a good, I don't know.

00:36:51.530 --> 00:36:51.951
I don't know.

00:36:51.971 --> 00:36:52.972
But I think, Tony,

00:36:53.072 --> 00:36:54.112
I think it's absolutely

00:36:54.152 --> 00:36:55.534
ridiculous that a plan of

00:36:55.554 --> 00:36:56.695
care even needs to be signed.

00:36:57.036 --> 00:36:58.896
So you're saying the first initial,

00:36:58.916 --> 00:36:59.577
so the first, what,

00:36:59.617 --> 00:37:00.679
nine days or what is it?

00:37:00.759 --> 00:37:01.659
Thirty days or what's the?

00:37:02.222 --> 00:37:04.704
So the way the law was developed,

00:37:05.664 --> 00:37:06.706
if you have a referral,

00:37:06.726 --> 00:37:08.266
because a lot of us have direct access.

00:37:08.286 --> 00:37:09.728
So I've got a guy coming in today.

00:37:10.748 --> 00:37:13.251
He's been a patient of mine for a decade.

00:37:13.351 --> 00:37:15.413
He travels back and forth to Florida.

00:37:15.512 --> 00:37:16.994
He just texted me this morning.

00:37:17.454 --> 00:37:18.755
He's like, hey, I got a muscle issue.

00:37:18.815 --> 00:37:19.836
I want to come in and see you.

00:37:20.757 --> 00:37:22.139
He's a Medicare beneficiary.

00:37:22.898 --> 00:37:24.340
He doesn't he's not coming

00:37:24.400 --> 00:37:25.460
in with a referral.

00:37:25.800 --> 00:37:27.021
Now I can see him.

00:37:27.081 --> 00:37:28.300
Medicare doesn't require a

00:37:28.360 --> 00:37:29.862
referral and my state

00:37:29.882 --> 00:37:31.302
allows direct access.

00:37:31.842 --> 00:37:34.583
But because I don't have a referral,

00:37:34.824 --> 00:37:36.425
I would still need even in

00:37:36.445 --> 00:37:37.505
twenty twenty five a

00:37:37.605 --> 00:37:38.726
signature on the plan of

00:37:38.766 --> 00:37:39.945
care if this is going to be

00:37:39.985 --> 00:37:41.047
paid for by Medicare.

00:37:41.806 --> 00:37:43.108
If I have a referral,

00:37:43.648 --> 00:37:45.048
I don't need a signature,

00:37:45.088 --> 00:37:47.110
but I do have to prove that

00:37:47.170 --> 00:37:48.791
I at least sent the plan of

00:37:48.851 --> 00:37:49.972
care to the physician.

00:37:50.012 --> 00:37:51.152
That's the new change.

00:37:51.333 --> 00:37:52.293
I don't need the signature,

00:37:52.333 --> 00:37:53.175
but I need proof that I

00:37:53.215 --> 00:37:56.317
sent it for the initial plan of care.

00:37:57.797 --> 00:38:00.380
If I make a plan of care for three weeks,

00:38:00.440 --> 00:38:01.981
two times a week, six visits,

00:38:02.481 --> 00:38:04.021
that's the initial plan of care.

00:38:04.061 --> 00:38:05.963
If I decide to extend it...

00:38:06.623 --> 00:38:08.344
then I need a signature.

00:38:08.965 --> 00:38:11.027
It can be the duration you

00:38:11.067 --> 00:38:13.628
prescribe or up to ninety days.

00:38:14.047 --> 00:38:16.210
So if I prescribe a six month plan of care,

00:38:16.809 --> 00:38:19.092
my initial is limited to ninety days.

00:38:19.572 --> 00:38:21.492
But if I do it shorter than ninety days,

00:38:21.873 --> 00:38:22.934
then that's my initial.

00:38:24.650 --> 00:38:25.110
And, you know,

00:38:26.431 --> 00:38:27.431
we joked about this across

00:38:27.452 --> 00:38:29.293
the country that most

00:38:29.313 --> 00:38:30.655
physical therapists are going to say,

00:38:30.715 --> 00:38:32.956
you know, three times a week for,

00:38:33.697 --> 00:38:35.900
you know, sixteen weeks or whatever.

00:38:36.179 --> 00:38:36.661
I'm joking.

00:38:36.701 --> 00:38:38.202
But like I oftentimes it's

00:38:38.222 --> 00:38:39.222
going to be like a really

00:38:39.302 --> 00:38:40.523
it's never going to be three weeks.

00:38:41.085 --> 00:38:42.045
It's going to be a bigger number.

00:38:43.106 --> 00:38:45.347
So, OK, so maximum ninety days.

00:38:45.668 --> 00:38:46.588
And at that point.

00:38:47.369 --> 00:38:49.672
What is a therapist's option?

00:38:49.931 --> 00:38:50.572
They have to send that

00:38:50.612 --> 00:38:51.492
patient to a different

00:38:51.512 --> 00:38:52.833
physician to get it signed.

00:38:53.634 --> 00:38:54.074
Say, hey,

00:38:54.114 --> 00:38:56.916
do you have your primary won't sign it,

00:38:56.936 --> 00:38:58.398
so I have to send you to a specialist.

00:38:58.438 --> 00:39:00.099
Or can they, through Medicare,

00:39:00.119 --> 00:39:01.860
can they then go visit an

00:39:01.920 --> 00:39:03.221
urgent care or some other

00:39:03.320 --> 00:39:04.282
primary care physician

00:39:04.302 --> 00:39:06.342
that's not their PCP on record?

00:39:06.762 --> 00:39:07.623
What are you going to do?

00:39:08.356 --> 00:39:12.159
If the main doctor refuses, then yeah,

00:39:12.219 --> 00:39:13.300
you start playing the game.

00:39:13.541 --> 00:39:14.541
You start saying, okay,

00:39:14.902 --> 00:39:16.123
do you have an oncologist?

00:39:16.143 --> 00:39:17.623
Do you have a nephrologist?

00:39:17.643 --> 00:39:20.105
Do you have a orthopedic that, you know,

00:39:20.144 --> 00:39:21.505
can I sneak it through

00:39:21.967 --> 00:39:23.288
someone else and try it?

00:39:23.327 --> 00:39:24.208
Someone that's not going to

00:39:24.228 --> 00:39:25.489
read it and just sign it.

00:39:25.509 --> 00:39:27.570
And this is where my

00:39:27.610 --> 00:39:30.472
frustration comes back in where I'm like,

00:39:30.853 --> 00:39:32.373
what's the whole intent of

00:39:32.414 --> 00:39:33.275
the law anyway?

00:39:33.355 --> 00:39:34.715
When was the law generated?

00:39:34.775 --> 00:39:36.376
When was the guideline created?

00:39:36.916 --> 00:39:38.677
it was probably created before we were,

00:39:39.119 --> 00:39:41.661
I'm not, but others were DPTs.

00:39:42.161 --> 00:39:43.621
It was created back when

00:39:43.722 --> 00:39:45.164
therapists were really

00:39:45.864 --> 00:39:48.186
glorified AIDS technicians.

00:39:48.585 --> 00:39:50.268
The doctor used to say,

00:39:50.688 --> 00:39:52.208
get this patient out of bed,

00:39:52.289 --> 00:39:53.530
walk this patient, you know,

00:39:53.710 --> 00:39:57.213
and ironically in the Medicare guideline,

00:39:57.373 --> 00:39:59.795
it specifically says if the referral is,

00:40:00.275 --> 00:40:01.835
contains all of the required

00:40:01.916 --> 00:40:03.576
elements for the plan of care.

00:40:04.036 --> 00:40:05.197
You don't need a separate

00:40:05.237 --> 00:40:06.717
plan of care and you don't

00:40:06.757 --> 00:40:07.898
need a separate signature.

00:40:08.318 --> 00:40:10.559
So back in the day when the doctor said,

00:40:10.778 --> 00:40:12.659
I want this patient to get a three,

00:40:13.059 --> 00:40:14.300
is it megahertz, whatever,

00:40:14.400 --> 00:40:16.400
ultrasound for seven

00:40:16.460 --> 00:40:20.302
minutes on left elbow, you know,

00:40:20.402 --> 00:40:22.384
we come from technicians.

00:40:22.804 --> 00:40:23.643
Like, guys,

00:40:23.724 --> 00:40:25.764
we are not the same therapists

00:40:26.485 --> 00:40:28.166
that we were thirty years ago.

00:40:29.141 --> 00:40:30.782
but the laws never change.

00:40:30.802 --> 00:40:31.963
The laws don't keep up.

00:40:32.003 --> 00:40:33.384
The laws don't advance as

00:40:33.443 --> 00:40:36.487
quickly as we believe we're advancing.

00:40:37.067 --> 00:40:38.628
That goes back to my argument.

00:40:39.108 --> 00:40:40.929
I think most of us have left

00:40:40.989 --> 00:40:42.331
physical therapy behind.

00:40:42.391 --> 00:40:44.193
We are no longer operating

00:40:44.773 --> 00:40:46.074
as the way the world

00:40:46.134 --> 00:40:47.635
perceives a physical therapist.

00:40:48.036 --> 00:40:49.376
We are no longer operating

00:40:49.396 --> 00:40:50.338
in that capacity.

00:40:50.818 --> 00:40:52.980
So you can fight to drag the

00:40:53.019 --> 00:40:54.221
credential with you

00:40:54.760 --> 00:40:56.342
Or you can just let the credential go.

00:40:56.684 --> 00:40:57.925
The letters are meaningless.

00:40:57.985 --> 00:40:59.588
They don't help us in

00:40:59.648 --> 00:41:01.351
virtually any way because

00:41:01.811 --> 00:41:03.052
we don't get compensation

00:41:03.072 --> 00:41:04.534
for the letters that are

00:41:04.596 --> 00:41:05.998
worth what we're doing.

00:41:06.438 --> 00:41:07.360
Just let them go.

00:41:07.599 --> 00:41:08.762
Like, forget it.

00:41:09.382 --> 00:41:10.184
What are your thoughts?

00:41:12.030 --> 00:41:13.751
Man, I always like to push back with this,

00:41:13.932 --> 00:41:16.074
because you're not letting them go,

00:41:16.153 --> 00:41:16.353
right?

00:41:16.373 --> 00:41:18.556
So a listener, a follower,

00:41:18.675 --> 00:41:19.356
someone who's watching or

00:41:19.396 --> 00:41:20.518
listening now or on the replay,

00:41:20.538 --> 00:41:21.739
they're going to say, well, Tony,

00:41:21.778 --> 00:41:22.458
are you doing that?

00:41:23.079 --> 00:41:23.900
And you're going to say no,

00:41:23.920 --> 00:41:24.621
because you guys are still

00:41:24.641 --> 00:41:25.601
licensing credential and

00:41:25.621 --> 00:41:26.442
billing Medicare and

00:41:26.481 --> 00:41:27.782
billing all the network insurances,

00:41:27.963 --> 00:41:28.304
right?

00:41:29.590 --> 00:41:31.391
So I had one guy and I can't

00:41:31.431 --> 00:41:32.112
remember his name.

00:41:32.152 --> 00:41:33.532
I wish I could give him credit.

00:41:34.492 --> 00:41:35.914
He gave me a great response.

00:41:36.713 --> 00:41:38.715
He said I was basically he

00:41:38.735 --> 00:41:39.556
said I was crazy,

00:41:39.596 --> 00:41:40.795
that I was completely wrong.

00:41:41.297 --> 00:41:42.456
He said that, you know,

00:41:42.496 --> 00:41:43.717
the credentialing allows

00:41:43.737 --> 00:41:45.498
them to do dry needling legally.

00:41:45.878 --> 00:41:48.019
The credentialing allows

00:41:48.039 --> 00:41:49.119
them to do all of these

00:41:49.159 --> 00:41:51.621
services within the law

00:41:51.681 --> 00:41:52.702
that he wouldn't be able to

00:41:52.742 --> 00:41:54.422
do if he let his license go.

00:41:55.538 --> 00:41:57.059
It dawned on me.

00:41:57.300 --> 00:41:58.842
I was like, yeah, you're right.

00:41:58.862 --> 00:41:59.985
He's a hundred percent right.

00:42:00.164 --> 00:42:01.306
I'm a hundred percent wrong

00:42:01.427 --> 00:42:03.128
relative to his situation.

00:42:03.650 --> 00:42:05.152
He wants to do those things.

00:42:05.452 --> 00:42:06.434
I don't want to do those things.

00:42:06.454 --> 00:42:08.896
I have zero interest in dry needling.

00:42:08.958 --> 00:42:10.079
I have zero interest in

00:42:10.940 --> 00:42:11.800
Pretty much any of the

00:42:11.820 --> 00:42:13.762
things that require my licensure.

00:42:14.302 --> 00:42:16.284
So to your point, Dave, well,

00:42:16.344 --> 00:42:17.565
why haven't I let it go?

00:42:17.846 --> 00:42:20.367
Why haven't I followed my own advice?

00:42:20.829 --> 00:42:20.949
Well,

00:42:20.989 --> 00:42:22.349
it's because I still have a

00:42:22.389 --> 00:42:23.710
successful business that

00:42:23.791 --> 00:42:26.273
runs on a thirty year old model.

00:42:27.894 --> 00:42:29.416
A new therapist coming into

00:42:29.456 --> 00:42:31.396
business today doesn't have

00:42:31.436 --> 00:42:32.898
the advantages that I have.

00:42:33.338 --> 00:42:34.878
And you hear this stuff in

00:42:34.938 --> 00:42:36.019
popular media when they

00:42:36.059 --> 00:42:37.721
talk about boomers versus

00:42:38.081 --> 00:42:39.161
younger generations.

00:42:39.942 --> 00:42:40.882
It's true, guys.

00:42:40.943 --> 00:42:45.025
I have zero, zero debt to any university.

00:42:46.085 --> 00:42:47.106
I have, you know,

00:42:47.306 --> 00:42:49.309
the history with the referral sources.

00:42:49.349 --> 00:42:51.269
So I have zero marketing expense.

00:42:51.851 --> 00:42:54.233
I have the history with my systems.

00:42:54.652 --> 00:42:56.454
I can operationally deliver

00:42:56.514 --> 00:42:57.954
services for a fraction of

00:42:57.994 --> 00:43:00.757
the cost of somebody new

00:43:00.797 --> 00:43:01.697
coming in and trying to

00:43:01.737 --> 00:43:03.059
build the business that I have.

00:43:03.699 --> 00:43:05.360
I have legacy experience.

00:43:05.574 --> 00:43:07.175
that nobody else in my area has.

00:43:07.255 --> 00:43:09.356
I have low overhead because

00:43:09.815 --> 00:43:10.835
I signed a lease and I've

00:43:10.876 --> 00:43:12.056
got a lease that hasn't

00:43:12.096 --> 00:43:14.516
gone up in monthly rate for

00:43:14.637 --> 00:43:15.597
like ten years.

00:43:16.737 --> 00:43:18.657
You can't do what I do.

00:43:19.018 --> 00:43:20.057
So I'm not going to.

00:43:20.137 --> 00:43:21.557
It's like the guy, me,

00:43:22.097 --> 00:43:23.239
who has a thirty year

00:43:23.278 --> 00:43:24.998
mortgage at a three percent

00:43:25.059 --> 00:43:25.559
interest rate.

00:43:25.619 --> 00:43:26.518
I'm not going to sell my

00:43:26.579 --> 00:43:28.559
house because of the

00:43:28.639 --> 00:43:29.880
interest rate on my mortgage.

00:43:29.920 --> 00:43:30.940
I'm not going to get rid of

00:43:30.960 --> 00:43:31.940
those credentials because

00:43:31.980 --> 00:43:33.081
those credentials are still

00:43:33.121 --> 00:43:34.340
profitable for me in the

00:43:34.360 --> 00:43:35.221
model that I have.

00:43:36.152 --> 00:43:38.353
But if I was a big time influencer,

00:43:38.414 --> 00:43:39.355
if I had hundreds of

00:43:39.394 --> 00:43:40.775
thousands of subscribers,

00:43:41.175 --> 00:43:42.036
that's where the original

00:43:42.097 --> 00:43:43.137
context came from.

00:43:43.617 --> 00:43:46.000
If I wanted to treat and I

00:43:46.039 --> 00:43:48.623
wanted to treat across state lines, man,

00:43:48.663 --> 00:43:49.543
the first thing I'd do is

00:43:49.603 --> 00:43:51.364
I'd get rid of the letters

00:43:51.425 --> 00:43:52.865
after my name and I would

00:43:52.885 --> 00:43:54.748
just go independence for true,

00:43:54.788 --> 00:43:55.728
full autonomy.

00:43:56.766 --> 00:43:58.606
That if you're doing virtual

00:43:58.806 --> 00:44:00.288
and you're doing, you know,

00:44:00.327 --> 00:44:01.228
the triaging we talked

00:44:01.248 --> 00:44:02.528
about before or the, you know,

00:44:02.889 --> 00:44:03.969
remote programming or

00:44:04.009 --> 00:44:05.150
you're kind of doing some

00:44:05.190 --> 00:44:06.030
telehealth or whatever

00:44:06.389 --> 00:44:07.150
across state lines.

00:44:07.951 --> 00:44:09.692
That is that that is I have

00:44:09.711 --> 00:44:10.391
to agree with you there.

00:44:10.431 --> 00:44:11.373
That is the easiest way to

00:44:11.432 --> 00:44:13.012
go because of the whole compact thing.

00:44:13.052 --> 00:44:14.094
And you got to, you know,

00:44:14.134 --> 00:44:15.574
get licensure in all these

00:44:15.954 --> 00:44:16.574
different states.

00:44:16.614 --> 00:44:17.916
And there's some states now

00:44:17.956 --> 00:44:18.556
that are what is it,

00:44:18.775 --> 00:44:20.976
fifteen or maybe twenty at the most.

00:44:21.016 --> 00:44:22.478
That's a compact you get.

00:44:22.958 --> 00:44:23.918
licensed in one of those

00:44:23.958 --> 00:44:25.219
states and now you have uh

00:44:25.438 --> 00:44:26.679
licensed reciprocity or

00:44:26.699 --> 00:44:27.880
whatever in the compact

00:44:27.900 --> 00:44:28.760
across all those states but

00:44:28.800 --> 00:44:30.681
not every state and if

00:44:30.740 --> 00:44:31.920
you're yeah if you have a

00:44:31.960 --> 00:44:32.860
social media following and

00:44:32.880 --> 00:44:33.460
you're going to be doing

00:44:33.481 --> 00:44:34.661
some of the triaging and

00:44:34.802 --> 00:44:35.961
some of the borderline

00:44:36.021 --> 00:44:37.922
therapy medical type

00:44:38.003 --> 00:44:39.483
questions and you know

00:44:39.884 --> 00:44:40.923
coaching or treatment or

00:44:40.943 --> 00:44:41.623
whatever you want to call

00:44:41.684 --> 00:44:44.264
it virtual care then yeah

00:44:44.284 --> 00:44:45.644
it does make sense to drop

00:44:45.684 --> 00:44:46.445
the license I a hundred

00:44:46.465 --> 00:44:47.146
percent agree with that

00:44:48.231 --> 00:44:49.311
And I think we've seen

00:44:49.391 --> 00:44:50.693
proven models from

00:44:51.873 --> 00:44:53.634
non-licensed PTs or

00:44:53.673 --> 00:44:54.894
clinicians that are working.

00:44:56.016 --> 00:44:57.297
In the finance world,

00:44:58.597 --> 00:45:00.579
we should get Will Butler back on.

00:45:00.619 --> 00:45:02.320
It's been forever since I've

00:45:02.360 --> 00:45:02.900
talked to him.

00:45:02.920 --> 00:45:03.820
Definitely.

00:45:04.371 --> 00:45:05.994
But every time I've pushed

00:45:06.034 --> 00:45:07.356
him to get on social media,

00:45:07.396 --> 00:45:08.597
he always says he can't

00:45:08.637 --> 00:45:10.059
because there's so much

00:45:10.099 --> 00:45:11.420
restriction on what he can

00:45:11.460 --> 00:45:12.501
say and what he can share.

00:45:13.041 --> 00:45:14.324
And when you look at Dave

00:45:14.364 --> 00:45:15.605
Ramsey and you look at the

00:45:15.724 --> 00:45:17.166
big social media

00:45:18.088 --> 00:45:20.230
influencers in the finance space,

00:45:20.670 --> 00:45:22.233
they've all let go of their

00:45:22.413 --> 00:45:23.833
their licensing.

00:45:24.335 --> 00:45:25.576
because they can't say the

00:45:25.596 --> 00:45:26.496
things that they want to

00:45:26.556 --> 00:45:28.878
say and still be compliant

00:45:28.918 --> 00:45:29.918
with the regulations.

00:45:30.318 --> 00:45:32.019
And I think the same applies

00:45:32.059 --> 00:45:32.860
to healthcare.

00:45:33.661 --> 00:45:34.681
There's a bunch of medical

00:45:34.742 --> 00:45:35.983
doctors and healthcare

00:45:36.023 --> 00:45:37.664
influencers that had to let

00:45:37.704 --> 00:45:38.864
go of their licensure

00:45:39.644 --> 00:45:41.545
But they're making ten

00:45:41.606 --> 00:45:44.206
million a year because of

00:45:44.286 --> 00:45:46.807
the social media reach that

00:45:46.827 --> 00:45:48.208
they've built and the

00:45:48.248 --> 00:45:50.289
businesses and the tools around that.

00:45:51.070 --> 00:45:53.972
So I just – With Dave Ramsey,

00:45:54.012 --> 00:45:56.032
was he a CPA or was he like

00:45:56.052 --> 00:45:59.346
a financial – what do you call it –

00:46:01.054 --> 00:46:01.855
CFA or whatever.

00:46:01.875 --> 00:46:03.617
Or yeah.

00:46:03.978 --> 00:46:04.097
Yeah.

00:46:05.318 --> 00:46:08.083
I think he had all of those licenses.

00:46:08.923 --> 00:46:11.186
He, I don't even know that world,

00:46:11.246 --> 00:46:13.469
but I had read interviews

00:46:13.509 --> 00:46:15.351
and looked into it.

00:46:16.132 --> 00:46:18.052
But a lot of the newer ones, too,

00:46:18.393 --> 00:46:18.853
same thing.

00:46:18.893 --> 00:46:20.394
They're attorneys, you know,

00:46:20.434 --> 00:46:22.376
attorneys that had their

00:46:22.817 --> 00:46:23.717
they passed the bar.

00:46:23.777 --> 00:46:25.318
They were licensed and then

00:46:25.619 --> 00:46:27.019
they let it go so they can

00:46:27.059 --> 00:46:28.360
go on to social media

00:46:28.920 --> 00:46:29.681
because that was the

00:46:29.702 --> 00:46:31.063
direction that they wanted to go.

00:46:31.123 --> 00:46:32.403
And they couldn't do it,

00:46:32.443 --> 00:46:33.985
but they still had their knowledge.

00:46:34.005 --> 00:46:35.666
And that's the same thing with us.

00:46:35.706 --> 00:46:35.867
Like,

00:46:35.887 --> 00:46:37.188
you're never going to take away my

00:46:37.288 --> 00:46:38.648
knowledge of physical therapy.

00:46:39.548 --> 00:46:42.632
I just I can't deliver one

00:46:42.713 --> 00:46:44.956
on one physical therapy advice,

00:46:45.516 --> 00:46:47.960
but I can basically provide education,

00:46:48.000 --> 00:46:49.842
information, influence, you know,

00:46:49.902 --> 00:46:51.565
all of those kinds of things,

00:46:52.025 --> 00:46:53.788
not practicing physical therapy.

00:46:55.416 --> 00:46:56.516
not having liability

00:46:56.577 --> 00:46:57.938
insurance for physical therapy,

00:46:58.018 --> 00:46:59.480
not having to do ridiculous

00:46:59.920 --> 00:47:01.302
waste of time continuing

00:47:01.402 --> 00:47:03.364
education for the twenty

00:47:03.385 --> 00:47:05.286
four hour credit hours that

00:47:05.806 --> 00:47:07.449
are virtually meaningless.

00:47:07.909 --> 00:47:09.231
Because, you know,

00:47:09.351 --> 00:47:13.235
we know so many people that just go there,

00:47:13.295 --> 00:47:14.836
check the box and they get the credit.

00:47:14.896 --> 00:47:17.278
Like none of this stuff has any impact.

00:47:17.298 --> 00:47:17.438
Agreed.

00:47:17.458 --> 00:47:17.599
Agreed.

00:47:18.219 --> 00:47:20.860
yeah I uh there's a there's

00:47:20.900 --> 00:47:21.641
a ton of therapists that

00:47:21.661 --> 00:47:22.521
just what is there's

00:47:22.541 --> 00:47:23.360
different websites that are

00:47:23.380 --> 00:47:24.902
like ninety nine dollars a

00:47:24.942 --> 00:47:26.081
year or something and you

00:47:26.101 --> 00:47:27.963
just the physical therapist

00:47:28.822 --> 00:47:29.643
I won't mention any names

00:47:29.762 --> 00:47:30.563
but go on there like the

00:47:30.603 --> 00:47:33.003
day before their ceus or uh

00:47:33.043 --> 00:47:34.384
you know your your license

00:47:34.423 --> 00:47:35.204
is about to be renewed or

00:47:35.224 --> 00:47:35.945
whatever they go on like

00:47:35.965 --> 00:47:37.204
the night before and they

00:47:37.244 --> 00:47:38.284
you know do a bunch of like

00:47:38.784 --> 00:47:40.126
whatever courses and just

00:47:40.146 --> 00:47:41.045
to just to get the

00:47:41.885 --> 00:47:42.947
amount of courses done for

00:47:43.007 --> 00:47:43.788
license renewal.

00:47:43.867 --> 00:47:44.768
And then I think I don't

00:47:44.789 --> 00:47:45.429
know about your state,

00:47:45.449 --> 00:47:46.269
but like our license

00:47:46.309 --> 00:47:48.431
renewal is like it's like

00:47:48.452 --> 00:47:49.211
the honor system.

00:47:49.391 --> 00:47:51.173
It's like, yes, I just click a box like,

00:47:51.233 --> 00:47:51.514
yes,

00:47:51.813 --> 00:47:53.735
I certify or I don't even know if it

00:47:53.755 --> 00:47:54.297
says certify.

00:47:54.416 --> 00:47:56.297
I agree or yes, I

00:47:57.159 --> 00:47:58.340
I don't know if it is.

00:47:58.360 --> 00:47:59.739
It doesn't say a test like I

00:47:59.760 --> 00:48:00.880
attest that I have or

00:48:00.920 --> 00:48:02.181
whatever that I have

00:48:02.442 --> 00:48:03.121
completed all the

00:48:03.202 --> 00:48:04.422
continuing education courses.

00:48:04.483 --> 00:48:06.623
And maybe if there's a random audit,

00:48:06.704 --> 00:48:07.585
I guess you have to show

00:48:07.625 --> 00:48:09.346
your content certificates

00:48:09.385 --> 00:48:10.827
or whatever to the board or

00:48:10.867 --> 00:48:12.228
the licensing body or

00:48:12.268 --> 00:48:13.148
whatever of your state.

00:48:14.608 --> 00:48:14.929
But yeah,

00:48:15.108 --> 00:48:16.389
I agree that whole thing is a joke too.

00:48:18.197 --> 00:48:21.838
Yeah, I mean, I use physicaltherapy.com.

00:48:21.898 --> 00:48:23.358
It's ninety nine dollars for

00:48:23.398 --> 00:48:24.199
twelve months.

00:48:24.719 --> 00:48:26.081
But if you do it, you know,

00:48:26.121 --> 00:48:28.561
like four months before they're due,

00:48:29.043 --> 00:48:30.123
you can get your twenty

00:48:30.163 --> 00:48:31.784
four credit hours and then

00:48:31.804 --> 00:48:33.184
you can do another twenty

00:48:33.204 --> 00:48:34.284
four credit hours in the

00:48:34.324 --> 00:48:36.025
next calendar year for the

00:48:36.065 --> 00:48:37.887
next two year period.

00:48:38.347 --> 00:48:39.507
So theoretically,

00:48:39.588 --> 00:48:41.188
it's forty nine dollars or

00:48:41.208 --> 00:48:43.851
whatever for each one.

00:48:45.070 --> 00:48:46.972
Now, look, I'm not against education.

00:48:47.112 --> 00:48:48.954
I work every single day to

00:48:49.034 --> 00:48:51.076
learn new stuff and I want

00:48:51.096 --> 00:48:52.056
to learn new stuff.

00:48:52.155 --> 00:48:53.998
My point in this is the

00:48:54.038 --> 00:48:55.137
person who doesn't care

00:48:55.177 --> 00:48:56.278
about learning new stuff

00:48:56.418 --> 00:48:57.599
isn't going to learn new stuff.

00:48:57.639 --> 00:48:58.701
You can't mandate it.

00:48:58.740 --> 00:48:59.681
You can't force it.

00:49:00.362 --> 00:49:02.304
And there's nothing worse

00:49:02.344 --> 00:49:05.068
than a law that has no real

00:49:05.248 --> 00:49:06.889
impact and no real effect.

00:49:07.331 --> 00:49:08.791
And the law just burdens the

00:49:08.811 --> 00:49:09.873
people who want to do a

00:49:09.893 --> 00:49:11.576
good job more because the

00:49:11.615 --> 00:49:12.436
people who don't care,

00:49:12.777 --> 00:49:14.478
they're not following the laws anyway.

00:49:15.601 --> 00:49:18.224
So it's just a waste of time, money,

00:49:18.364 --> 00:49:19.686
effort, compliance.

00:49:21.186 --> 00:49:22.626
Uh, that was great.

00:49:23.047 --> 00:49:24.108
I know we're a little bit early,

00:49:24.128 --> 00:49:25.728
but let's wrap up the episode.

00:49:25.809 --> 00:49:27.969
So what do you think?

00:49:28.050 --> 00:49:28.590
I want your,

00:49:28.670 --> 00:49:30.452
I'm going to give you your parting shot.

00:49:31.253 --> 00:49:33.094
What do you think is the

00:49:33.173 --> 00:49:36.295
most like emotional impact

00:49:36.755 --> 00:49:38.637
of finding a new therapist

00:49:38.657 --> 00:49:40.117
to join your organization?

00:49:40.679 --> 00:49:40.998
What is,

00:49:41.139 --> 00:49:42.400
what is the thing that's the most

00:49:42.500 --> 00:49:43.019
rewarding?

00:49:43.039 --> 00:49:46.262
That is the most meaningful in what you do,

00:49:46.302 --> 00:49:47.163
the way you do it.

00:49:49.869 --> 00:49:50.409
And I don't know if I'm

00:49:50.429 --> 00:49:51.070
going to get this right.

00:49:51.110 --> 00:49:52.269
I mean,

00:49:52.351 --> 00:49:54.211
it's not even for anybody else for you.

00:49:54.492 --> 00:49:54.632
Okay.

00:49:55.652 --> 00:49:57.173
No, I thought you were saying, Oh, for me,

00:49:57.193 --> 00:49:58.114
the emotional part of me

00:49:58.295 --> 00:49:59.876
finding a new staff, physical therapist.

00:50:00.516 --> 00:50:00.856
What?

00:50:00.916 --> 00:50:02.177
No, in your business,

00:50:02.418 --> 00:50:04.199
you as a therapist in your business,

00:50:04.239 --> 00:50:05.440
what's the most meaningful

00:50:05.460 --> 00:50:08.242
part of you doing your job for you?

00:50:08.262 --> 00:50:08.362
Uh,

00:50:11.586 --> 00:50:13.387
having the patient or client

00:50:14.028 --> 00:50:16.030
voice that they were able

00:50:16.050 --> 00:50:17.990
to do XYZ emotional thing

00:50:18.010 --> 00:50:20.632
like travel to their son's college in St.

00:50:20.672 --> 00:50:23.954
Louis or being able to walk

00:50:24.434 --> 00:50:27.137
confidently in public with

00:50:27.197 --> 00:50:28.498
less of a tremor or with

00:50:28.538 --> 00:50:30.458
better balance so that they

00:50:30.858 --> 00:50:32.380
are able to walk their dog

00:50:32.400 --> 00:50:33.860
in the park so that they

00:50:33.880 --> 00:50:37.423
can do something in the world better

00:50:38.675 --> 00:50:40.615
than they could without me,

00:50:40.635 --> 00:50:41.737
like before they met me.

00:50:41.797 --> 00:50:43.637
I think, I mean, that's one for sure.

00:50:44.398 --> 00:50:45.938
And I think you would say

00:50:46.679 --> 00:50:48.021
you would take a little

00:50:48.061 --> 00:50:51.202
less money a year to have

00:50:51.242 --> 00:50:52.824
that kind of meaningful

00:50:52.923 --> 00:50:54.585
impact on somebody's life

00:50:55.425 --> 00:50:57.485
versus maybe making a

00:50:57.525 --> 00:50:59.186
thousand or two more a year,

00:50:59.967 --> 00:51:02.009
but knowing that nothing

00:51:02.028 --> 00:51:03.929
you did all year had any

00:51:03.969 --> 00:51:05.630
benefit or any real impact

00:51:05.731 --> 00:51:07.192
on the patients you were working with.

00:51:07.652 --> 00:51:08.213
Don't you agree?

00:51:09.717 --> 00:51:10.777
I agree.

00:51:10.798 --> 00:51:11.199
Yeah.

00:51:11.239 --> 00:51:11.679
Same for me.

00:51:12.119 --> 00:51:14.280
Like my at this stage of my life,

00:51:14.320 --> 00:51:16.380
especially fifty years old,

00:51:16.400 --> 00:51:18.722
I am I am working for the

00:51:18.782 --> 00:51:20.483
meaningful impact more than

00:51:20.563 --> 00:51:22.844
I am working for the money, you know,

00:51:22.943 --> 00:51:25.304
and so I will do hard things.

00:51:25.806 --> 00:51:28.266
I will sacrifice more if I

00:51:28.306 --> 00:51:29.907
know the sacrifice has

00:51:30.007 --> 00:51:31.527
meaning on the other side,

00:51:32.148 --> 00:51:34.690
as opposed to just working harder daily.

00:51:35.429 --> 00:51:37.273
doing meaningless jobs,

00:51:37.432 --> 00:51:39.335
meaningless tasks for a

00:51:39.376 --> 00:51:40.177
little extra money.

00:51:40.418 --> 00:51:42.039
The extra money just isn't

00:51:42.079 --> 00:51:44.603
worth sacrificing the

00:51:44.643 --> 00:51:46.626
importance of having an

00:51:46.666 --> 00:51:47.527
impact on someone.

00:51:48.188 --> 00:51:48.989
So guys, we're done.

00:51:50.014 --> 00:51:51.255
And I think today is Tuesday.

00:51:51.436 --> 00:51:54.400
It is Tuesday, May thirteenth.

00:51:54.860 --> 00:51:55.880
Come back Thursday.

00:51:56.442 --> 00:51:58.164
Jimmy McKay will be back with us.

00:51:58.304 --> 00:51:59.186
Eight thirty a.m.

00:51:59.246 --> 00:52:00.387
Tuesday, Thursday morning.

00:52:00.447 --> 00:52:01.387
Dave Kittle show.

00:52:01.427 --> 00:52:04.411
Go check it out on iTunes and YouTube.

00:52:04.873 --> 00:52:06.474
And we will catch you guys next time.

00:52:06.514 --> 00:52:07.076
Thanks, Dave.

00:52:07.115 --> 00:52:08.137
Thanks, Tony.