And we're underway.
In the second we go live, Dave disappears.
He'll be back in a second,
because that's how the internet works.
Tony, good morning.
How are you doing today, man?
And you're all alone.
I don't know if this, there we go.
Today, we're going to bring in Dave.
He's back.
Tony will be back in a minute.
Maybe it's my internet.
Did I just boot you out of the live show?
No,
I hit like the done button on the top
right.
And I thought that was going
to make me go full screen,
but it just bounced me out.
That done means I'm out of here.
All right.
Well,
Tony must have hit the done button
too because he dipped.
But he'll be back because he
knows how technology works.
I shared this in the group chat yesterday.
Apple, every once in a while,
I don't know if they're
breaking the internet anymore.
but they definitely cause a
kerfuffle whenever they
announce new features or
new new hardware and there
there are some other things
out uh in terms of hardware
coming very very soon for
for apple but I had dropped
in the chat this ai health
coach did you guys look
into like what apple is
actually the project
mulberry which makes it
seem very very cloak and
dagger which I like love cloak and dagger
um but have you clicked into
this at all or do you guys
know anything about project
mulberry no you're gonna
have to tell me about it
all right so essentially
Apple is looking to leverage the data.
I mean, this was always coming.
This was always very obvious.
Leverage the data that people are openly,
willingly giving their
phone from a health perspective.
How many hours you sleep,
how many steps you take,
how often your heart rate is above this.
I mean, you can do heart rate,
you can do blood oxygen,
and some data purists might say, well,
the data's okay,
or it's measuring kind of good.
Here's the thing, like a B minus all day,
twenty four seven is pretty good,
in my opinion, in terms of data.
So essentially what they're
trying to do is how can we
give you behavioral nudges?
I mean,
your Apple Watch or my Apple Watch
does that already when I've
when I've been sitting down
too long and I tell it I
want to do I want to stand
eight hours a day, whatever that means.
I at least have to stand one
minute per day for eight hours,
which doesn't seem like a lot,
but it's behavioral nudges.
And we understand that
that's what it's like.
So Project Mulberry wants to
leverage these things and
be able to look like they
want to be your virtual doctor.
That's what that's what
Project Mulberry is
combining that data with
twenty four seven
personalization and
personalized health guidance.
They're looking to position themselves.
I mean, correct me if I'm wrong,
is the future of preventative care.
Like if it think of all the
things that we could think
of now and a billion that
we couldn't that.
Apple could use that data to
nudge you to do.
So I want to stop there just
by saying like, hey, listen, like,
what do you think about this?
Is this a competitive advantage?
Is Apple going to sell this
just to the consumer?
Do they sell it to the PT or
the doctor to harness their
technology to then be the virtual doctor?
Which would be the better option?
I mean,
they're probably selling it to
companies like, I don't know, like,
I don't want to say like Palantir.
Palantir is some company that does, like,
drones and, like,
protecting our borders and
stuff like that.
I was going to say sell to
pharmaceutical companies.
I don't know if they'll be able to,
if they would even want it or not.
I don't understand fully why
Apple is doing it.
I mean, like,
they have a very profitable...
hardware approach, then they sell the,
you know, iCloud and that type of stuff.
They, you know, sell new iPhones.
They have the iPad and other devices.
I get like this sounds great.
But I messaged you and Tony
in the chat yesterday my
already preconceived
notions around like nudges
are not going to change.
Nudges are not going to change someone.
They're not going to actually,
in my opinion,
like in mass across the country,
nudges are not going to
change people's behavior.
They're not going to get them to walk more,
move more, drink more water, sleep better,
exercise more.
I think for the most part,
you either need some remote
programming person that you pay
I paid Michael Laviolette to write up a,
we did three months and
then I think we did another three months,
six months total,
maybe nine months or something.
I paid him, he's a physical therapist.
I paid him for writing up a
workout for me.
Then he would check in with
me and it was a human
checking in with me.
If it's a push notification
that checks in with me, as a human,
I am numb to it.
Most folks are numb to it.
They're not gonna use it for
behavior change.
I don't really understand
why Apple would do this.
I think it is great,
it's a great initiative,
They're not going to make
money from the consumers
because no one puts value
in a push notification
nudge or whatever when it comes from AI.
So I don't think it's even
going to actually work,
but they might use the data
to then sell it to whoever
that you didn't even
approve of selling your data to.
That is my...
I don't know,
my my intro commentary to this so far.
Yeah, you said it was OK.
It was just in the terms of the four.
Yeah, yeah.
You scrolled fifty times and
you accept terms.
Yeah, yeah.
So I agree.
But like, all right.
So I think you can steal this from Apple.
and you don't even have to
hire developers I think the
idea here would be be more
of the coach not just the
clinician so this is where
I think the technology and
remote therapeutic
monitoring sort of come
into play which is I did
this when I had a triathlon
coach I I hired kevin who
was a pt student at the
time but a really really
great triathlete and he
would write up a week or
remember this a week or
two's worth of workouts
where I was like, well,
how come you just didn't
give me six months worth of workouts?
And, of course, he logically was like,
well,
I didn't see how you did on the
first week or two,
and I'm going to adjust the
week or two based on this.
Or like, hey, man,
I got to travel for work.
So I physically can't work
out on these days,
so he's going to modify that.
I look at this as how did
you do or how are we doing?
Show me.
So here's a cool upsell, I think,
when I was coming up with
this this morning and last
night that I think would
work well for Dave Kittle.
which is remote Dave,
like remote therapeutic monitoring.
We'll give it some name, right?
With it,
it's a package that you're going
to monitor.
Now there's therapeutic,
remote therapeutic monitoring, right?
But with it comes an Apple,
comes an Apple watch.
So now as the program is like, here,
you say you want to get better.
You want my eyes on you,
my professional expertise.
I have to see the data.
Just saying, yes,
I did my exercise three times,
exactly like you showed me, Dr. Dave.
Of course I did.
Precisely when you told me to do it,
how many times you told me.
Let's take a look at how
you're doing and what are the metrics.
So now instead of maybe the KPI being,
was compliant with a GP,
it was able to go X number
of steps or raise their
heart rate above this rate
for X number of minutes and days.
And now you can set.
More relatable, more specific, more
more valuable KPIs and you can prove it.
Right.
And like, there's that feedback loop.
So yeah,
the people who are never going to do it,
they're never going to do it.
Right.
But the people who are like,
I'm on the end of the diving board.
If you give me a ball to
chase or a thing to score, I will,
I'm more apt to do it.
So Tony, Dave, I was saying, Tony,
I was saying to Dave that a
package could be
Dave's going to now remotely
therapeutic monitor you.
With it comes an Apple Watch.
I'm going to have all this data.
Apple's big into it.
I'm going to be able to get
eyes on you even when you're not here.
And now the in-person visit
is more valuable.
Now it's not just let me
watch you do your bridges.
Let me watch you do your squats,
which everybody holds as low value anyway,
right?
People who've never
experienced PT come to a
clinic and they're like, what's like,
I mean,
I would love to know the common
thoughts going through people's heads,
but like, I could do this at home.
Why do I need you?
As Dave said, there's YouTube videos.
I could do this.
So make it valuable.
And now it feels more like I
have my PT unless I go to
PT or this is something I have to do.
So I don't think you need
Apple to do anything different.
I think if you harness the
fact that like Apple has
all this stuff and I can
use this with you for your specific goals,
this feels like a yes and to Apple.
Yeah, for sure.
I mean, all the technology exists.
We can track everything.
We've talked about this a
bunch over the years.
It just depends.
Like, whoop,
there's all these devices out there.
Everything from a five
dollar pedometer to take a
screenshot on your phone.
My iPhone has the health app
that you can see how many
steps to something like
you're talking about where
it's actually monitoring everything.
that stuff is there.
Just got to incorporate it.
Sam says that he has a program like this.
He likes a watch to track
aerobic exercise.
Personally, he likes Garmin.
Again,
these things are going to have
positives and negatives, right?
In terms of like data accuracy,
we're not getting into the weeds there,
but using it as a carrot and not a stick,
I think.
I believe in the U S it's
only going to work if there's some
There's another human that
is in the mix of this offering.
Why?
I agree, but why?
Because people need accountability.
People are more accountable
to another person.
Like if I have this,
like we've been doing it for so long now,
this is a habit every Tuesday,
Thursday morning.
But when we first started,
it was like a calendar invite.
And I would have not urgency,
but I would be like, oh,
like I have this call with
Tony and Jimmy.
And if I don't show up,
then I don't look good.
great or I'm leaving them
hanging or whatever but if
it's if it's a push
notification from apple
that says like hey why
don't you walk around the
block it's not going to
work it is right this this
one and I and I tony was
offline but I said it to
jimmy but the the messaging
that I sent yesterday which
is my already preconceived
notions around you know
whatever the whatever the
approximate stats are forty
percent of the united states is obese
probably sixty percent are
overweight or have blood
work that is out of the
normal ranges and so a push
notification from Apple
that says like hey are you
starting your day like
drink eight ounces of water
and then why don't you know
go walk around the block
and let me know how you
feel like people are
already numb to all these
push notifications and
emails and messages and
Whatever the mindfulness app
that comes on my Apple Watch,
and I get a notification on
my Apple Watch that says,
are you starting your day?
And it's like, eight a.m.,
and we've been up since six a.m.
It's like, I started my day two hours ago.
It doesn't even make sense.
But you're right, Jimmy.
I agree with you if there's
a package that says,
I'm going to,
a patient that has chronic back pain,
neuropathy, whatever,
total knee replacement, a year ago,
total knee replacement, whatever.
And, you know, Tony, Jimmy, or myself,
we sell this package of an
Apple Watch to track your stat,
to track your pedometer,
your steps per day, all of that,
and tied into the in-person
or a remote coaching
virtual programming component, then yes,
I believe it could work.
Watch is free as long as you
go through the twelve months.
Right.
Watch as long as like use
that like you want the watch.
So you have to do the thing
like a free watch.
My program is only two or three grand,
but it's a free watch.
Right.
You got to give the watch back.
So, Dave, let me ask you,
I've been meaning to talk
to you about this.
Have you seen the new videos
put out by the new Google
video AI video generator?
Uh,
one of the Gemini commercials or it's
not Gemini.
It's like VO or something.
I should know.
I was just looking at it this morning.
These videos are freaking me out.
So, so they're, they're videos.
They're there.
They have audio,
which I don't think any of
the other major video
platforms do their videos.
Just like this, you and I talking,
they're very real humans.
And they're like,
The, you know, I am not just a prompt,
I am a real person and it
is shockingly real.
You,
I feel like this is something that's
going to genuinely replace you, me,
all of us.
And the difference is when
AI is the one that's doing the motivation,
doing the accountability,
holding somebody's feet to the fire.
AI can pull all of our strings.
AI understands all of our fears,
all of our insecurities.
I think everything you're
saying is accurate,
but AI can do it better
than a human motivator can do it.
Especially an AI that's with us,
the whole idea that open AI
Got the guy, Ives,
I think his last name is,
from Apple to come on board
and design a new device,
whether it's a phone or
something that records
everything visually, audio.
It is going to be ridiculous
how much this device understands.
Just like we're talking about,
I want to buy a new bike.
And then I start seeing bike
ads through my social media,
following me on Google, on Facebook,
on all the platforms.
This is that times a thousand.
So I do think the AI is
going to do it better.
What source?
Go ahead.
So right now we're in is
June tenth of twenty twenty five.
And Billie Jean, you know, the guy,
Billie Jean, Billie Jean marketing,
Billie Jean, the genius, whatever,
you know, buy my stuff, whatever.
Yeah, he's a big he's a big marketer.
He runs leads for small businesses.
He's got I think he's in
like San Diego or whatever.
He posts videos on his Instagram and.
I'm watching them tony and
they're really good I agree
they're really good and
it's a selfie video of him
and he's talking and then
as the video is playing
eventually it says like
this is actually not me
this is an ai video and
then the caption says
something like can you
comment below like zero to
ten on the level of uh
reality or realness or
whatever like actually like
that you think it
looks like if ten is a real person,
or if zero is a real person and ten is AI,
whatever, pick a number.
And I'm watching these
videos in twenty twenty five.
And yes, they're good.
Yes, they're close.
But you could still see like, oh,
and then I get distracted.
Then I'm like, oh, this then I'm like,
this is actually not a real human.
And so then I miss this whole message on
I get the whole message,
but his message is like now
he's saying sell these
types of videos to business
owners for content, for social media,
and you can use Sona or
whatever these platforms
are to make videos.
So anyway, go ahead, Jimmy.
Yeah,
I was going to say like the
psychological levers we're
talking about a second ago,
which is if I know AI or my
phone is the one saying like,
good morning,
make sure to drink eight
glasses of water.
Apple sort of already baked
that into the cake on how to make it.
So I don't know if you,
do you guys use Apple watches with, okay.
So I'm connected to my buddy, Brian,
and I can tell when he starts a workout.
And I can tell when he
closes his rings and he he
can tell when I close mine.
So there is that element.
So you could quite simply
you would have to develop any program.
You could just say you
follow me on this watch.
Now I'm following now.
You might have to get a
separate account because if
you have a couple of patients,
you're doing this.
You don't want to be getting
dings all day.
But that's how you'd be able
to organize this and see their data.
And you can I'm sure there's
an easy way to be able to
swap the deeper data.
Yes,
I have another quick story that
confirms my bias around the
human component to this versus virtual.
I have a buddy, Juan Gonzalez.
He lives in, I think he's in Spain.
He was in Spain, then Germany,
and now he's back in Spain.
And we did the same thing on
Apple Watches.
We connected our workouts or whatever,
right?
So like, what is it?
They compare,
is it calories per day or
what's the main metric?
Yeah, something like that.
And so he said it to like, I don't know,
a thousand a day or
whatever the number was.
And we did like a challenge together.
So it's like he and I,
he versus I. And you guys know,
I don't know if you,
I think you guys know,
but if you don't know, now you know,
I'm super competitive.
And I absolutely did more.
on purpose when we were
doing these I made sure
like and he's ahead of us
whatever spain is like six
hours ahead or something so
I would wake up and he
would like already be doing
stuff and I'd be like oh
and like this is when I was
seeing patients so I was
walking around seeing
patients and coming home
and working out or running
extra just to beat him and
I beat him every single challenge
And he won.
If you're listening, I love you, man.
But do you want to hear a funny way of.
But real quick, if this was like, you know,
Marty, the Apple bot versus me,
like it's not going to move
me to run more or wake up
more and go walk and move more.
I don't think.
And I'm and I'm super active.
I will tell you, though,
Peloton and Apple have both
figured out that sometimes – well,
different levers motivate
different people because
there are awards.
There's medals you can win.
And I did the close your
move ring thirty-two times
in the last thirty-two days,
so I get that thing.
But do you want to hear a
funny way about – there was
a group of people who live on a street,
a cul-de-sac,
a bunch of families somewhere.
and they all connected their apps, right?
So they, all their watches are connected.
So when one of them starts to work out,
everybody knows.
And these people would connect.
And whenever a husband and
wife would be together,
they'd select wrestling.
So the whole neighborhood
knew who was wrestling and
how long and how many calories.
So it's just taking its
gamification of movement.
Yes.
So this segment,
we're talking about AI health coaches.
Is that what
yeah apple you know okay so
have you guys heard gary
v's position on by the the
people who are being born
right now like dave's kids
generation most likely
somebody in that generation
is going to marry
officially marry this is a like
have a marriage between a
human and some sort of
artificial intelligence.
Have you heard this position?
No, but it doesn't surprise me,
but it does creep me out.
I mean, I just don't understand.
Yeah, well, so, you know,
to think that a human, and I believe it,
can have such a deep
emotional connection to a robot,
a robot that understands the dopamine,
understands emotion,
understands physiology, can say things,
do things.
And of course, you know,
This is just like,
if you can have that kind of connection,
you can have a robot that
can motivate you to exercise more,
eat healthier, do whatever.
And like you, I agree.
I believe that humans are
going to connect.
There is a theory,
I think we discussed it
once a long time ago,
that why haven't other,
if you believe in aliens,
why haven't they populated the universe?
There is a theory that as
you grow technologically,
you don't go out.
You have no desire to go out anymore.
You go in.
And so if there are aliens
on other planets,
the whole idea is that they
are so satisfied and happy
that they just stay within themselves.
That's a whole different conversation.
But I definitely think that
you can have such a deep
connection to artificial
intelligence that you want to marry it.
Like, it's just incredible.
It's not creepy at all.
I want to use it to motivate
people to be a little healthier.
Maybe not wrestle with it.
What else is on your mind?
But I think the Apple, the Google,
the Amazons,
they do move the needle in
sort of everything.
So it's like, why is Apple, Dave,
I think you were saying a minute ago,
why Apple has iPad and phones?
Why are they getting into this?
I think they're smart enough
to know that they need to
be doing other things.
They need to have a project
mulberry in like every
vertical or crossing verticals.
Um, or else if someone else develops it,
if Amazon were to develop it,
you're light years behind
by the time I started.
So you need to sort of have
R and D running on all these things.
So, I mean,
didn't jobs say they're not a
computer company, right?
They're like an idea company
or something like that.
So like,
that's a little how you look at it.
And I think Bezos is a, you know,
disciple of jobs and philosophy.
They all sort of look at it like that.
So I think these technology
companies are like, we are human beings.
You know,
race companies and we have to be
all things to all people
because we don't know.
Maybe someone invents like
an implantable eye thing
where we don't need iPads
anymore because I have a
screen on my retina.
Like and then what do we do about iPads?
Nothing.
So there there is a contact
lens that has been developed.
that sits on the eyeball
that displays a screen that
you can see the limitation
to that right now is the
heat production and the battery life.
But like that already exists.
It's already there.
Going back real quick to a Gary V is, um,
He was the first person I
heard say Instagram is
probably the number one
most successful fitness app
ever created on the planet.
Because Instagram
understands and has gotten
humans to go do things in nature,
physical fitness activity
that if they couldn't share
the photo or the video,
they wouldn't do it.
You know, so again,
I think when we're thinking
about motivation,
we have to go outside of
what we're used to.
And there are going to be
motivators that we're not
even considering right now.
I mean, the event,
so I'm in Long Island right now.
And the event that I was at
yesterday is for a
nonprofit called Man Cave Health.
And Man Cave Health is just like, hey,
listen, prostate cancer is bad.
And getting tested for it is
actually not as bad as it used to be.
I mean, we used to, you know,
all the jokes.
I heard they don't do the finger anymore.
They don't do the finger anymore.
Yeah.
It's a PC.
I did a blood test yesterday.
I got tested.
It took me longer to sign
the waiver than it did to do the test,
to the blood test, right?
So Man Cave Health is so
smart because they
understand that sometimes
the direct route would be
hospitals should have marketing teams,
and they do.
So then why can't they market?
Because they're hospital marketing teams.
So Chris at Man Cave Health
sees this and is a smart guy.
Chris has no medical background.
Right.
Doesn't understand.
He doesn't care.
What he cares about is he's like, well,
where do dudes hang out?
Well,
we want dudes to come to the hospital.
We want them to get tested.
Chris is like, you got to go to dudes.
Let's go to the Pocono five hundred.
Let's go to the Rose Bowl.
Let's go to NBA games.
Let's go there.
And then what do we do?
Bring lab coats and
stethoscopes and needles.
No, dude, not yet.
Like,
let's do cool swag and people and
music and make it cool.
Hey, what are you about?
We're about making sure one
out of six dudes don't get
prostate cancer.
It's like, well, I'm about that.
But if you had a poster on
the wall at a hospital, it doesn't land.
So doing the direct route,
we have tried that pretty
much in everything, right?
We've over-signed science.
Sometimes you've got to gamify science.
Why is Instagram so great at that?
Because we didn't know it going in.
That wasn't the goal.
The goal was to share pictures.
Humans took it and they're like,
what do I want to make this about?
I want to make it about me.
And then what do I want to make it about?
So yeah,
I think going the direct route
doesn't work.
You have to bang it off the wall.
It's a ricochet idea.
Speaking of hospitals,
what do you guys think of
Dana Strauss's post on
LinkedIn yesterday?
She was talking about the
basically the hospital experience,
how it's working against
everything we want to do in health care,
how basically when you go
into the hospital,
you're admitted for some
sort of medical emergency or condition.
You're strapped to a bed.
You can't get up.
You can't move around.
I had commented on it saying, yeah,
it's true.
Every time I've got an older family member,
they get admitted for whatever.
The bed is as big as the room.
There's no place to move around.
You've got lights,
you've got people coming in and out,
like taking your blood,
doing all this stuff.
The hospital is virtually
the worst environment to
try to heal or recover.
The food's still terrible,
even though they're trying
hard to make it better.
When you let a hospital
create a healing experience,
they mess it up every single time.
And it's just,
it works against health and wellness and,
you know, independence.
It was a great post by Dana.
Yeah.
If you were to design a really good,
good hearing environment,
a healing environment,
it would not be a hospital.
It would be the opposite of a hospital.
Of course.
You can't get sunlight.
You can't go outside.
Yeah.
Asking someone.
I had parents, you know,
in the hospital last couple
of years and like asking, like,
can my dad go outside?
Like, absolutely not.
You want to know why?
Nothing to do with health.
Everything to do with lawyers.
Well, if he falls on the way out,
liability, right?
You don't get anything for
free in the hospital.
But what do you get for what
is the what are the two things you get?
You get pairs of them.
in the hospital for free.
You get those ridiculous, no skin socks.
Why?
Because my feet are cold.
No, because I don't want you to fall.
And if I have, we know that, you know,
we reduce fall rest by
forty percent or making numbers up.
But if you have the stupid socks on.
But yeah.
So so what?
So maybe we go down this rabbit hole.
What what would.
Well, they're doing this.
It would be smaller, private,
bougie hospitals that you
have to pay a concierge fee for.
That's the thing.
I was going to say, in a community,
and there's thousands or
tens of thousands or
hundreds of thousands of
people in certain communities or cities,
and the hospitals were
obviously created as a way like,
this is the location where
you go if you have an infection.
uh you fall you get hit by a
car fall out of a tree you
get a ma you know major
infection whatever and like
that's the location where
everyone goes and they just
like you said jokingly like
everyone kind of gets
strapped to the bed because
like sit here you we know
you're gonna be here for
whenever we need to like
run another test check your
blood pressure administer
medication whatever we we
know exactly where you're
gonna be you're in room two
oh one or whatever right
and just the way it is and
the only thing that's gonna
change is if yeah if you
have the financial resources to
you know, join some concierge practice.
Some of these concierge
practices in the city,
like they'll do home visits,
physicians doing home visits.
And I've walked into a
couple of times in the New
York City area.
I walked into a house call
and the patient has a full
on hospital bed, beeps, wires,
everything.
And I'm just blown away at
some of the money people
spend when their loved one is seventy,
eighty, ninety, whatever years old.
They're trying to keep them alive.
And it's basically like a
hospital room in their home.
Takes money, takes financial resources.
But that's, you know,
that's the only different
like that's the only way to
try to do it differently
other than like a big hospital.
You'd have to have like an
urban care sized mini
hospital for people that
can actually afford it.
And that would be expensive.
If you have money,
people will give it to you
if you give them a reason.
These are Ignite Medical Resorts.
So this is what we're talking about.
This is luxury recovery.
Yep.
They have results all over the place.
Looking like they're
starting in Texas in the Midwest.
And let's see what their
specialty clinic programs are.
State-of-the-art.
So this is like...
what any like forward
thinking PT or healthcare
provider would want,
but orthopedic recovery program,
state-of-the-art equipment.
It's not even saying like what,
what issues like rapid
stroke recovery program.
Okay.
This is good.
But yeah, if you have the money,
they're like, come here, look,
they're using neuro neuro rehab VR.
That's Vita Samarati cardiac recovery.
So orthopedics stroke,
cardiac pulmonary wound wound care,
right?
in-house dialysis so they're
saying these are these are
these are wellness spas
right medical spas if
you've got the money they
will take you so we have a
place people will pay a
hundred bucks to see a
physical therapist but
they'll pay thirty grand to
recover from something yes
we have a place like that
actually a mile and a half
down from my street
They promote exactly.
It's not that company, but it's very,
very similar.
You look on the website.
The photos are amazing.
The amenities are incredible.
You can't believe it.
Food's got to be good.
Food's got to be better.
They've changed ownership
like three or four times already.
Oh,
it's one of those things where the
concept is there,
but then they fill it with
a bunch of people who have
been in the health care
system for too long.
And they just turn it into
the model that we're trying
to get away from.
Like that's an example where
you need to go to the Ritz Carlton.
You need to recruit people
out of that environment.
You need to go to other
businesses that have
nothing to do with health care.
Pull the culture out.
Pull the people out.
Do not put doctors that have
been hospitalized.
Do not put nurses, aides.
Do not put people with
twenty years of experience
into that because they will destroy it.
You have to come at it
completely different.
And that's kind of what I've
said about physical therapy.
Like, don't go to, you know,
trying to create a new
model of care by pulling a
bunch of people from the
profession that already have it.
Yeah,
you have to go outside of the culture
of physical therapy to
create something that's
different and better than
what physical therapy is right now.
Yeah.
Otherwise, it's just it's it's blue.
It's the thing we knew,
but now it's blue or it's
green or it's lighter.
It's like that's not there's
no difference there.
If you really want innovation,
you have to go outside of
the organization.
What's kind of interesting is, like,
we're talking about that,
and then you have, like, Savannah Bananas,
right?
It's, like, not baseball.
Baseball purists, I believe, like,
it's not baseball.
It's a show.
It's, like, WWF, WWE, like, scripted.
Maybe they know who's going
to win the game.
Maybe they do it on purpose.
Maybe they don't know.
I don't know.
But, like, it's not baseball,
but it's different.
But Jesse Cole was a minor league pitcher,
the founder, the, you know, the emcee,
the leader of Savannah Bananas.
He was a baseball purist.
He was a minor league pitcher.
He was drafted.
He I think he blew out his
shoulder and then he could
no longer play.
And then eventually they, you know, risk,
you know,
mortgage mortgage their home or
whatever their whole lives
and bought the Savannah
Bananas and then eventually
turned into what it is now.
So I think sometimes it's like,
you do need a little bit of
the previous world and a
new direction and new folks
from other worlds to create
the new thing.
You need like a little bit
of the physical therapy or
the healthcare or the hospital experience
like maybe, I don't know, Tony,
you gotta like, maybe you pluck the,
you cherry pick the things
that are like tried and true and needed,
whatever needed.
And then, and then you,
but then you go into hospitality or you,
you know, you,
you recruit from other
worlds where they're all about clients,
customer service.
Wow.
You know, a wow experience,
a remarkable experience,
that type of stuff.
I think their story was if
they didn't do something,
they were going under.
So, so people are like, he's not baseball.
Okay.
Uh,
He just invented a new thing then,
which is baseball attainment, right?
Which is baseball.
Again,
my favorite sport growing up needed
to do something different.
They have a pitch clock.
They have a pitch calm.
They're innovating.
But for the longest time,
you didn't see highlight
clips of major league
baseball games on social
because MLB helped.
They were like, those are our clips.
You can't use them.
Dumbest move.
Baseball could have set them
back two decades.
There's,
there's going to be a real long pause.
Yeah.
Like when I'm sixty.
Right.
And the people who are
twenty now are forty of
people not going to games
because it wasn't where they were.
Right.
I mean,
I sat and almost missed the bus
every day in middle school
or high school.
Sorry,
because of the timing of ESPN's top ten.
I couldn't leave.
What am I going to talk
about at the locker?
Because I had to watch the top ten.
But it was so close.
I probably became a really
good sprinter those years
because I had to sprint to the bus.
But that's where baseball was for me.
I didn't have the speed of swipe.
But now that it is,
if baseball wasn't there
for a good chunk of time,
those people aren't going
to have that ingrained in their DNA.
What are the things we could
be ingraining in someone's
DNA to make us valuable in the future?
Oh, really, really quick.
Speaking about ingraining,
have you noticed Tony's
growing out his stubble?
He looks amazing.
I love it.
Speaking about the fine grain,
like it looks amazing.
Real Harrison Forty.
So two quick things.
That's where the outcast, you know,
you find the outcast.
Like I would say the three
of us are outcasts in the
PT profession because we're
not sitting here discussing, you know,
best interventions and
strategies and manipulations.
And we're we're talking
about the business of
physical therapy as a way
to improve patient care.
We're not talking about the
intervention of physical
therapy as a way to improve patient care.
The guy on stilts who's a pitcher,
he was an outcast.
He got you know, he couldn't make it yet.
They brought him back in.
So like you said, he had enough baseball,
but not so much baseball
that he was ingrained.
I've got a baseball question.
I was thinking about this on
the way in and I wanted to ask, why are.
Why is it a manager and not a head coach?
I don't understand that.
Where did that come from?
It's a great question.
I don't know.
Isn't the manager the coach?
Well, I'm going to guess.
Someone's going to GPT this for me.
But I believe back in the day,
the person who was in
charge was also a player.
It was like you were a player coach,
so you're a player manager.
So I think it was almost like a captaincy.
It was like, okay,
you're playing third base,
but you also make the calls
on who's coming in to pitch.
Because I think having an
extra person on a team who
just makes decisions –
was like, well,
let's just get the guy
who's the best at me.
Let's just get the nurse
who's already here to be
the charge nurse.
So I think that would be my guess.
Someone's going to look it up.
Yeah, I don't know.
Probably.
Now, talking about the stubble, so
Yes, bring it back.
Here's the thing.
There's a lesson behind this.
So a couple of years ago,
I switched to a safety razor,
straight razor.
Like I went with Manscaped,
paid thirty bucks, got this amazing,
like heavy duty.
Like it felt so good in my hand.
One blade shave.
It fell because usually after I shave,
I stick it on the top of the shower.
It fell off and broke.
So I was like, oh man, okay,
go back on Amazon.
The Manscaped was thirty dollars.
I go back on Amazon,
I buy a ten dollar knockoff
of the Manscaped.
I get it.
I'm like, this is a piece of junk.
It's cheap.
It's lightweight.
It doesn't feel good in my hand.
It's like a fork that you
get good like silver
heavy-duty fork to eat food.
It's such a better
experience than a cheap plastic fork,
right?
So I guess this thing is a piece of junk.
But I don't care.
I shave once a week.
So it falls off again, breaks again.
Now I go back to order my third, like,
razor.
Well,
we had a fraud alert thing called
Steam Engine.
A thousand dollar charge
came on our credit card.
Oh, my Lord.
So my Amazon account is tied
to a credit card.
That credit card got canceled.
I haven't gotten a new credit card.
I haven't gotten a razor.
I ordered in between.
an eighteen dollar razor it
hasn't come because
My point in this is, look, guys,
I can afford a razor.
I can go to the store.
I can go to Kroger and buy a razor.
But I don't.
Why don't I?
Because it's inconvenient.
When I'm there, I'm not thinking about it.
Just like physical therapy.
I can afford to self-pay for
a premium physical therapy experience.
Why didn't I buy another
thirty dollar handheld razor?
I love the experience of
shaving with that.
But there's something in my
DNA that's like,
why would you spend thirty
dollars when you can spend eighteen?
The outcome is the same.
I lose the facial hair either way.
Makes no difference.
So, you know,
I just think that Dave's
customer is paying a premium.
because they feel smart
paying for Dave's time or
Dave's employees' time.
And certainty.
Maybe.
I don't know.
Maybe some certainty.
For other consumers,
it's just not that important.
They're going to pay less.
I'm a consumer that when it comes to shoes,
when it comes to certain
products and certain things,
I am always gonna pay less,
even if it's a less enjoyable experience.
But when it comes to food,
I will buy the most expensive food.
I will buy the premium steak.
I will buy the premium vegetable.
I will buy organic,
even if it doesn't really
make me any healthier.
Because that's that's my bucket.
Ramit Sethi talks about
buckets where you put your
money and where you spend
your time and your emotions.
That's the bucket for me
that makes me feel good is
spending money on food.
Real quick, Jimmy.
So I spend about every I don't know,
every five or whatever
years I'll buy like an
electric razor and they're
like anywhere from like
eighty to one hundred or
like one hundred and something dollars.
I want the same outcome Tony wants.
I get the same outcome that Tony gets.
I want it to be efficient.
I don't want to have to slowly, like,
I don't want to have to
lean into the mirror, like,
make sure I don't, like, cut myself.
And then I'm bleeding,
and then I got to come on this show,
and I got, you know, I got, like,
blood going down my neck.
So I don't want that.
I've done the electric razors forever.
And I would absolutely never
skimp on the price,
because I know that if you
buy the ten dollar, thirty dollar,
whatever electric razor,
it's going to fall apart.
And then I got to spend the time,
the brain power to then say, OK,
I got to go look and look
at reviews and I got to go
back on Amazon.
No,
I want to buy a Gillette or whatever
the branding thing I have
that's electric.
I want to spend whatever
dollar amount that they're
charging for it.
I want it to last three, five, seven,
whatever years.
clean it in between and it's
just reliable.
If you plug it in, you charge it.
It always works.
Did your dad use an electric razor?
Well,
he definitely does now and has been
for the ten, twenty years at least.
Yeah.
I just wonder how you got
introduced to that and why
I don't use an electric razor.
I don't know why.
Yeah, I tried one.
I didn't love it.
So you do straight edge?
Yeah.
Wow.
I'm like outvoted here.
Wow.
All right.
Audience of men,
it's probably eighty
percent of the audience.
Let us know your razor decisions.
These are such fascinating
questions like what
introduces someone to an electric razor?
Why do they make the choice
to buy the electric razor?
But just as important,
why don't I use an electric razor?
Like, I don't know.
What's the psychology behind that?
Do I feel like it's less masculine?
You mentioned real quick,
you mentioned cuts.
I cut myself probably, you know,
every time.
But there's something about
cutting yourself while
shaving that has a
masculine connotation for me.
I don't know.
I remember my dad, he would bleed.
I make up for it when I play
baseball games.
I slide head first,
like Pete Rose and all the bases.
I cut up my arms and my elbows.
That's my blood.
I draw blood there.
But when I'm shaving,
I want the electric razor.
I want to clean, fast, efficient,
splash my face.
I don't want razor burn.
I don't want to have to, you know,
like I'm pruning, you know, the hedges.
I just, I want to shave and be done.
I don't want the whole
experience of shaving manually.
I think the simple but not
accurate answer is what
Seth Godin would say is
people like us do things like this.
Why do people in different
cultures do something
drastically different to us?
Apparently, there's a thing in Chicago,
I need someone to confirm,
where it is sack religion
to put ketchup on a hot dog.
You will get the stink eye.
I heard this on a podcast the other day.
It came from one guy who was outside of...
White Sox played Comiskey, right?
Yeah, Comiskey.
And he was like,
I got a hot dog so good you
never need ketchup.
And it became a thing.
It's like,
when did this thing become a thing?
All of a sudden, you're like, where is it?
Why are baseball managers
the only managers in
professional sports that wear a uniform?
NBA coaches, NHL coaches, they wear suits.
Why do we got Joe Torre over
here wearing a Yankee uniform?
He's got a number.
He's got a number?
Joe Torre has a number?
He's not a player.
Um,
people like somewhere it happened and
they probably questioned it then,
but they kept doing it.
Someone pushed through and
then eventually people like
us do things like this,
but that's not just culture.
That's your own thing, right?
A lot of times it comes from
people closest to you that
you want to assimilate with
and be just like them.
Or every once in a while you
want to break out of that mold.
So you do everything backwards or,
or weird.
You're New York guys, ketchup or mustard?
Ketchup.
I do both.
Oh, my God.
Like I remember my dad
dragging me through the
streets of New York.
So my mom was in the garment business.
She she did that.
We would go deliver clothes and do stuff.
Every time I got a hot dog
from a street vendor,
I would never imagine
putting ketchup on it.
It was disgusting to me.
You don't know how much it
took for me to let my kids
put ketchup on a hot dog
for the first time.
I'm going to smack it out of their hands.
So hard.
I'm a hardcore mustard guy.
This is a conversation
you're probably already having, Dave.
And which happens with a lot of families,
which is when a kid's old
enough to understand what a
sports franchise and a sports team is.
who's their favorite going to be?
And you nudge.
That was pre-birth already decided.
The fact that he got David
Michael Kittle Jr.
I got the naming rights.
And he got Mets, Knicks, Rangers.
And then football is up to him,
except we got him a bunch
of Eagles onesies,
and the Eagles just won the Super Bowl.
His first time on this earth,
the Eagles win the Super Bowl.
Apparently that's not his team.
I'm saying it's his team,
but apparently football he
gets to choose.
But that's already been pre-decided,
pre-negotiated.
My best friend is a New Yorker,
born and bred.
He's a Red Sox fan.
Why?
Was it because his dad told
him to or friends around us?
No, because in nineteen eighty six,
his brother was cheering
for the Mets and he's like,
who are the Mets playing Red Sox?
Great.
I like them.
I like anybody that you don't like.
That's who I'm with.
So sometimes and he's still a Red Sox fan.
So sometimes it's just because of that.
But how often do we get indoctrinated into,
well, this is how we do things.
And because my C.I.
did it this way, then I I like them.
Therefore, I want to adapt their habits.
I want to show them that I like them.
by replicating them by by
admiring them by repetition
we get caught in those
things until we're
photocopies of photocopies
of photocopies then someone
who actually has thought
and I asked chat gpt this a
minute ago when you guys
were talking what are the
industries we should be
looking to to actually
bring and inject some great
ideas in it and none of
these are going to shock
you and we've talked about
them before but I'll repeat them because
Maybe you have to hear it fifty times,
but fitness and coaching, in my opinion,
if PT and fitness coaching were similar,
they're pretty damn similar guys.
Right.
The difference is, in my opinion,
we come from we are learned
doctors of physical therapy
where a really great
trainer constantly looks at
themselves as a servant and
I need to over serve.
And I think that's a better
way to look at it.
Instead of I you do what I
say is I'm going to listen
to you and then
Figure out a way of what you
just told me to make it get
you to hit your goals.
Tech startups and software as a service.
They understand all the
friction points and then
they pay attention to how to solve them.
How many times do you have
somebody with an EMR?
It's like I just figured out
this is how I do it.
It's not actually we're not
actually changing the thing.
We're just duct taping
crappy solutions on top
until one day it breaks.
And it's because we have
fifteen things duct taped together.
Tech people or SAS people
would never do that.
They're just like scrap it, figure it out.
So looking to them,
hospitality and high end service.
Of course,
if you want to understand like
how to get someone to buy
in the Ritz Carlton of the four seasons,
they have MBA level
programs on this retail and e-commerce.
I like this and their health
care is so resistant to it.
But we've talked about this
Masters at Driving Action program.
through storytelling, offers, experience,
psychological levers like bundles,
memberships, and limited time offers.
Listen,
become Dave's patient for the next
twelve months.
You get a watch.
Follow through on all twelve months.
You keep the watch.
The watch is yours because
obviously you earned it, right?
Just how could you do that?
And professional sports,
performance training,
and music and entertainment.
Those are the industries we
should be looking to.
The answer most likely is
not in a CEU course at CSM.
CSM is for something else.
Dave,
do you take or any of your people
take students?
No.
OK.
Any reason why?
Sometimes we'll get asked by
students or even sometimes
we'll get like as we're
interviewing folks and some
will ask if they can kind
of shadow in the beginning.
And for the most part,
I've asked a lot of my
patients and they usually say no,
my clients.
Now, of course,
I can present it to them
like they don't have a choice.
But the fact that we're
going into their private
space and their apartments
that we're trying to
respect and ultimately they
get the decision.
I still have the one patient
that I'm seeing one time a week,
so four visits a month.
And I brought my top physical therapist,
Porus,
to him when I was treating someone else.
because the point was to try
to push that last patient
over to Porus and that
client wanted to stay with me.
So some clients will allow
like a physical therapist
to come shadow or whatever, but no,
we haven't done students.
I'm actually, as a coincidence,
I'm interviewing a PTA right now,
and he is doing really well
on the communication,
the first call that we had,
very impressive,
the way he communicated and
spoke and all that.
Looked on his LinkedIn,
he's got a history in the
hospitality world.
Shocker, right?
So could that be something?
And so I'll have to update
you guys more in the future if...
if he joins uh but no in
general like we just we
haven't done students same
thing like you know my my
business partner and coach
sturdy mckee back when they
had uh three or four
locations in san francisco
they were one-on-one always
self-pay or out of network
or whatever and
They didn't really take students either.
They would not hire new grads.
They always wanted to hire a
therapist that had two or
three years of experience.
They looked for therapists
that had the service-based history,
maybe hospitality, whatever.
They also would never hire a
physical therapist that
that was their first job.
They, they,
they would not hire a physical
therapist out of school.
So you had to go work
somewhere else and then
they would hire you.
And they would ask like, what did you,
where did you work in the
summers for high school?
Where did you work in the
summers during college or, you know,
what type of volunteer or
work or whatever?
So they would always dig into that, but no,
just to answer your question.
No, we, we haven't done students.
But what's the main reason
large organizations,
and we'll get to this,
this will be a tease
because we talk about this on Thursday.
This is a LinkedIn post I
dropped this morning and
it's already sort of blowing up.
And the question is, is this a PT mill?
We'll get to this.
But why would these
organizations that are larger
And I'm not making fun of,
I'm not knocking them, the ATIs, the IVs,
the athleticos.
Why do they have like
student engagement departments?
It's because they have a need, right?
Like I'm not knocking them.
I don't think it's, but let's be honest,
it's not clinical excellence.
Like you're not doing a resident,
like you're doing a
residency program because you're smart.
That says if you do a residency here,
that's a pipeline to
keeping people engaged and
keeping people here.
Dave doesn't really have that problem,
not at scale, right?
You don't need to hire sixty
people next month.
If you did,
you better have a we'll go back
to baseball.
You better have a farm system.
It's a farm system in a good way growing.
Right.
But if you don't have that
problem and also your model
makes it real hard, like, dude,
I'm I'm going at one
hundred miles an hour
because this person is paying for this.
This person is paying this for this.
And education has to slow is
going to slow you down in a good way.
It should it should slow you
down in some way.
But that's why I think
people like Dave don't take
students and probably
shouldn't and can't is
because they're busy doing the thing.
But but a different model
could can allow it.
where applicable.
But yeah, that post on LinkedIn,
take a look at that.
Essentially, I'm asking,
I've asked this question before.
I don't know why it's a question.
I love poking bears because
I love asking questions I
know there's no answer to.
The question is,
if you point your finger at
an organization that says,
they're a PT mill,
when are they and what could they do
What could they remove one
thing at a time until they're not?
So where's the line is what I'm asking.
Did you see my comment?
I comment on your post on LinkedIn.
No.
What'd you say?
So I said a physical therapy
practice that books and
completes four visits per hour.
So one therapist is booking
and treating four patients per hour.
Tony agree.
Disagree.
Is three okay?
I don't know that a mil is a bad thing.
I'm going to start there.
You imply that being a mil is negative.
I'm going to say it's not.
Before we get off the original topic,
though,
and if we're going to talk about
this on Thursday, that'd be awesome.
Yeah,
I think this is a serious problem in
the profession is people
who are doing things differently,
people who are doing things
potentially better,
whatever the better is defined as.
They're not taking students, you know.
And so how how do we address
this problem for students, new grads,
recent grads?
I took it as a personal
responsibility when I was a CI,
which I haven't been a CI for years.
When I was a CI, I loved taking students,
but it was almost like a
personal responsibility to
bust all of the myths that
you learn in school to show
why the ideas and the
concepts that these kids
are learning in school are
completely absurd, completely ridiculous.
And to break them of those
ideas and to show them a
different way that things could be done,
that how therapy could be different.
But I was, you know, we're a small,
even back then, we were a small group,
two, three locations.
We had a small team.
So I had the ability to do that.
And it was something that I enjoyed.
Now,
when you look at who is still
accepting students,
there is a characteristic
of that business,
why they're taking students,
how they're taking students,
what they're doing with these students.
And I don't think...
It's quite as, you know,
what it used to be.
So I want to talk about students more.
We'll save it for Thursday
because I think that's a great topic.
And I think that's one more
opportunity for disruption,
for innovation.
How can we change the
profession for the better?
How can we create a business
opportunity that helps both
sides of the business equation?
I think taking students into
a new kind of CI program is
right for the future of our profession.
All right.
That's a front tease on Thursday.
If we keep talking,
I'm going to keep talking
about this and I'm going to
give away the stuff I'm
going to talk about on Thursday.
So let's do parting shots.
Yeah, that sounds great.
What you got?
Man, parting shot,
I would say I'm going to
continue to focus on the concierge,
whether it's the remote
thing with the watch, whether it's,
you know,
the huge hospital system focused
down to a concierge
offering to whatever that
care or experience is that
I'm just going to continue
to focus on the thing that.
that we're doing, uh, not blinders on.
Cause I always like to hear
what you guys are doing or
thinking and others are, you know,
posting on LinkedIn or other places.
Um, but for me, it's just focused.
It's just like, we,
we know our ideal client or customer,
we know our ideal therapist,
and that's just main thing right now.
So focusing on that growth
with hiring with on the
growth of hiring therapists,
interviewing them, onboarding them,
keeping them, retaining them,
doing whatever it takes to
retain top talent.
And then also on the new
patient marketing side,
generating more leads that are engaged,
referral sources, partners, all that.
So that's my main focus.
That's my parting shot.
Yeah,
I think as if you're not deep into AI,
whether you choose to use
it or not in your practice,
in your documentation,
in your relationships, whatever,
Every part of our future involves AI.
There's zero chance that AI
is going to go away or disappear.
I just think you have to get
your hands into it,
start to play around with it.
And I'm going to get the
Google video generator to
generate some videos that
Dave is going to be blown
away by when you see it.
It is nothing like you've seen.
I guarantee it is freaky good.
We'll see.
All right.
I would say going back to
the first topic we started
on today is I don't think
AI is coming for your job.
I agree with Dave there.
It's not going to replace you.
But they are coming for your
patient's attention.
Yeah, Tony.
And they're coming for your
patient's attention and
your patient's data.
And your patients are going
to hand that data over.
So I don't think in the future to yes.
And here, both of you,
the clinics that win won't
be the ones with the
fanciest tools or the use of the biggest,
you know, the most CPGs, uh,
That's going to ruffle some feathers.
They'll be the ones that
show up like a coach, like a concierge,
that stay connected, like a friend,
not like automation.
So there needs to be some
middle ground here.
It can't just be a notification every day.
So you don't just fix people.
The goal is how can you guide them?
How can you use this ability
to connect in real time,
personalized to do that?
The ones, the businesses,
the organizations that do, those win.
That's it.
We'll see you on Thursday at,
at eight thirty a.m.
We'll talk about P.T.
Mills.
I want people to be able to define it.
You cannot just throw around
just words and labels
unless you can define those things.
Learn Medicare billing,
the Dave Kittle show, P.T.
Pinecast.
Do the follow.
Bang that bell,
as they say on the YouTubers.
We'll see you guys on.