WEBVTT

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All right.

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Good morning.

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PT Breakfast Club.

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Dave.

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Dave's out on a run.

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Did you get that on Instagram?

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He's at mile one of

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something like a half hour ago.

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So Dave's running back.

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Hurry up, Dave.

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Or he's the one person

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watching us live right now.

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What do you want to kick off with first?

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I didn't know this about Topgolf.

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I've been to Topgolf two or three times.

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You sent a video to us and

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you were giving me the

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beats a second ago.

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Topgolf was designed to turn

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non-golfers into golfers.

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Feels like a smart idea.

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Yeah.

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Did it work?

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Spoiler,

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I wouldn't be bringing up if it did.

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So if you I don't have access to it,

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if you share the link to

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that YouTube video.

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Yeah.

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Yeah.

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Before we hit go live,

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Jimmy and I were talking.

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I said, I listen to this.

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This is the stuff that I

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listen to when I'm on a run,

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when I'm doing anything.

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It's it's these like, you know,

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did you know about business

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kind of stuff?

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So when Topgolf first started,

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the original founders,

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they were totally failing at business.

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They were running up debt.

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They were using all of their

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personal savings.

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And the problem was they

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were trying to make Topgolf

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a way for real golfers to

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get better at golf.

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Nobody cared about it.

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Nobody wanted to do that.

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Eventually, they, you know,

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they did the radio frequency.

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They gamified it.

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They eventually pivoted to, hey,

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maybe we're wasting our time.

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This reminds me of therapy.

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We're wasting our time,

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forcing our ideal customer

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to want what we want them

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to want instead of serving

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them what they actually want.

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And so eventually they pivoted to, okay,

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this is a sports bar where

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you can hit golf balls

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rather than this is a golf

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training performance center.

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And that's when the idea blew up.

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All of a sudden you could

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take somebody that's never

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hit a golf ball before.

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And if you think about it,

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like I'm not a golfer, I will golf,

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but I am not a golfer.

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The only thing I enjoy about

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golf is smashing the ball

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as hard as I can,

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no matter where it goes.

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Um, the drinks, the hanging out, you know,

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like those are the elements,

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maybe the bedding.

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And so you pull those things out,

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you package it in an

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appealing way and you sell

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it to the consumer who wants to do that.

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So like you could take, um, you know,

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what used to be a four hour

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event and sell it by the hour.

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You don't have to get carts.

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You don't,

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I guess driving the golf cart's

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a fun part, but yeah.

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So basically, long story short,

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they were failing, failing,

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failing until they found

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the formula that their

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customer actually wanted.

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Eventually it was acquired by Callaway.

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Problem is when Callaway bought it,

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they bought it with the

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intent that we're going to

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turn non-golfers into golfers.

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If we can convert even a

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fraction of them into

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actual golfers who are buying equipment,

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we're going to explode our revenue.

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It just never happened

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because those people don't

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want to be golfers.

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Right.

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I love going to Topgolf.

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I don't want to go golf.

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Is there a parallel here to

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Savannah Bananas?

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Because it's not golf, it's not baseball,

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but for Savannah Bananas,

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they're solving a boredom problem.

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And that's what Topgolf did,

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but how often are you going to do that?

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Savannah Bananas is okay if

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you come out and see us

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once or twice a year.

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Topgolf needs you to come

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out once a month if they're

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going to be successful in a community.

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I think the underlying theme

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here is what are the best parts?

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What's the twenty percent, you know,

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that generates eighty

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percent of the revenue and profitability?

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What is the true product market fit?

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And let's just focus on that, you know.

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So Dave is back.

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Dave, how was your run?

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It was good.

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I'm still not showered,

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but you guys come first and

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shower and breakfast later.

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Smart man.

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Smart man.

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Well, it's not smell-o-vision,

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so we're good.

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So I had to steal this

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strategy if you want to kick this off.

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Or wait,

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we had something else we were

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going to talk about in the group chat.

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I always forget about it.

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We were going to talk about mills,

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but let's do steal this strategy.

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So the stealer strategy is a quick one,

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and it has to do with...

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Donuts.

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I do not live in a place

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that has Krispy Kreme right now,

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but someone taught me this

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weekend when I was

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traveling that there is a hot now sign.

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Are you familiar with the

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Krispy Kreme hot now sign, Tony?

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Tony's not.

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That's good.

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I wasn't.

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Dave is.

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All right.

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So how do you explain the

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hot now sign at a Krispy Kreme donut?

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So if it's lit up,

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I think more people

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potentially pull over because listen, I'm,

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I'm maybe some family

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members say I have a sweet tooth.

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I don't buy,

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I don't go out of my way to

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buy sweet stuff, but if it's there,

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if it's there,

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You know,

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I'm on the road with my family

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visiting South Jersey and like here,

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like a lemon icy cake, you know?

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Yeah.

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So, okay.

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So the Krispy Kreme sign, if it's lit up,

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it's like it attracts the way that,

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you know, a bug zapper attracts bugs.

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It will attract a human that

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has had Krispy Kreme donuts

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that are hot because there

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is a big difference between

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when they're hot off the

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press versus six or twelve hours later.

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Correct.

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So it essentially it is

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literally quite literally a

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neon sign that is in the

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window that is not lit

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unless they're like donuts

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are rolling off the line.

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So they're not making donuts

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as much as I wanted to

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believe the the Dunkin Donuts commercial.

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Time to make the donuts, right?

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But it's quite literally a beacon.

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And then I believe this is a

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smart move if you have the app.

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Yeah, here it is.

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This is exactly what it looks like.

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It's hot now,

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but it's off when they're not

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making donuts.

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So you drive by and you're like, hey, bro,

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hot now.

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I'm picking up a dozen and

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coming back to the office.

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So they're pulling levers of psychology.

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And they're saying like, why is it?

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Why does it work?

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Scarcity, it's better hot.

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It's hot now,

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but in twenty minutes it might not be.

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It quite literally is a Pavlovian trigger.

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It's the bell that is making

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your mouth water.

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FOMO and ritual.

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It's like, hey,

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I brought them in for the office.

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People like us do things like this.

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This is what we do when they're hot.

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Now we bring them into the office.

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And visibility,

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it makes the invisible visible.

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So how could healthcare or

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PT clinics steal this?

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And I wanted to do something

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with a rep counter.

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Imagine you had an analog,

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we're gonna talk about

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analog and paper in a

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digital world with AI,

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but imagine you could, you installed,

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you had a clinic,

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I got a buddy who has a

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clinic up the road on a

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decently busy road,

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and you had an analog counter,

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like the little,

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like the flip down counter.

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You could do a digital too, right?

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Digital billboards are expensive,

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but they're not that expensive.

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Could you have some sort of

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metric like squats, deadlifts?

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Could you have a group goal

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in the community to get to

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ten thousand squats in a month?

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And if we do,

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we'll help buy a new park

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down the street.

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So what you're doing is

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you're removing the black

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box mentality of.

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There's a PT clinic over there.

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What happens?

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PT.

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You can't use the word in the definition.

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What's PT?

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I don't know.

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Stuff.

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They do a little of this

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rubbing and then they make

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you move and they do bridges.

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This makes the invisible

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visible and I like it.

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It actually builds curiosity,

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especially for people driving by.

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What is going on in there?

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The best marketing you

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didn't have to pay for is

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you're having people do that.

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So the community challenge would be nice.

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Ten thousand reps this month

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and we'll donate to a local cause.

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You're probably going to do

00:07:43.964 --> 00:07:44.906
it to that cause anyway.

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But now you're helping

00:07:45.747 --> 00:07:47.728
people help you earn that thing.

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And it makes the clinic feel alive.

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Like,

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could you have this hot now mentality?

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P.T.

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is happening here.

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uh outside of the clinic you

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know bonus points is every

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time someone does something

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you know youtube is really

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great at this when you hit

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a milestone you get an

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email saying you hit number

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of views but they frame it

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up in a badge for you to

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share externally right

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which is so dumb and even

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when I know the trick is

00:08:11.538 --> 00:08:13.057
happening to me I still

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fall for it because I'm a

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big dumb animal so how

00:08:15.978 --> 00:08:17.939
could you steal the hot now

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strategy from krispy kreme

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my vote is make the

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invisible visible and put

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it out there somewhere.

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I actually like the digital version,

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right?

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Like posted on Instagram,

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but that's done so much.

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I like the analog thing.

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Like now bell bottoms are

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coming back in kids.

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And in two years,

00:08:34.749 --> 00:08:35.909
all bottles will be back in

00:08:35.929 --> 00:08:36.549
because they were in,

00:08:36.590 --> 00:08:37.350
then they were out and then

00:08:37.370 --> 00:08:38.091
they're back in again.

00:08:38.390 --> 00:08:39.652
So that's my still the strategy.

00:08:40.615 --> 00:08:41.894
I want to hear how Dave can

00:08:41.955 --> 00:08:44.235
roll that into a mobile kind of business.

00:08:44.336 --> 00:08:45.115
I know for me,

00:08:45.235 --> 00:08:46.975
like the easiest thing is always,

00:08:47.035 --> 00:08:49.616
you know, create a team, whether it's a,

00:08:49.897 --> 00:08:52.136
it's an actual team or a virtual team,

00:08:52.157 --> 00:08:53.957
but group patients together.

00:08:54.418 --> 00:08:56.038
Hey, you're purple, you're black,

00:08:56.077 --> 00:08:56.658
you're blue.

00:08:56.717 --> 00:08:58.318
We're going to compete against each other.

00:08:58.379 --> 00:09:00.078
We're going to achieve so many steps,

00:09:00.099 --> 00:09:02.139
so many reps, so many pounds lifted.

00:09:02.980 --> 00:09:05.580
Um, I think Strava and a couple other,

00:09:05.700 --> 00:09:06.980
you know, apps or do,

00:09:07.181 --> 00:09:09.020
do that kind of gamification, um,

00:09:09.866 --> 00:09:11.748
And then just run a monthly

00:09:12.008 --> 00:09:13.947
competition every twenty eight days,

00:09:14.008 --> 00:09:16.808
you know, which team won this this month.

00:09:17.528 --> 00:09:19.870
And if you do discharge a patient,

00:09:19.970 --> 00:09:20.990
then you fill that spot

00:09:21.029 --> 00:09:22.191
with another patient.

00:09:22.291 --> 00:09:23.130
You could even you could

00:09:23.191 --> 00:09:26.672
even go to like what the NFL does.

00:09:26.711 --> 00:09:28.732
You could have teams draft new patients.

00:09:28.773 --> 00:09:30.173
Like imagine you're a new

00:09:30.212 --> 00:09:31.293
patient coming into a

00:09:31.333 --> 00:09:32.453
physical therapy clinic.

00:09:32.793 --> 00:09:33.494
You're scared.

00:09:33.514 --> 00:09:34.335
You're in pain.

00:09:34.375 --> 00:09:36.394
You don't have any connection to anybody.

00:09:36.855 --> 00:09:37.794
And all of a sudden you're

00:09:37.855 --> 00:09:39.096
up on the draft board and

00:09:39.135 --> 00:09:40.775
like teams are battling for you.

00:09:40.836 --> 00:09:42.596
And we want John to be on our team.

00:09:42.636 --> 00:09:43.756
And, you know, you,

00:09:43.836 --> 00:09:45.418
you establish that culture.

00:09:45.758 --> 00:09:46.998
I think it's such a warm

00:09:47.057 --> 00:09:49.058
invitation into the community,

00:09:49.678 --> 00:09:51.458
but I would struggle to see

00:09:51.499 --> 00:09:53.440
how you do it in a mobile business.

00:09:54.977 --> 00:09:56.719
yeah I I was thinking tony

00:09:56.739 --> 00:09:58.039
would maybe not even like

00:09:58.320 --> 00:10:00.461
like it uh and and say uh

00:10:00.480 --> 00:10:01.981
jokingly like you know

00:10:02.001 --> 00:10:03.023
tallying up units like

00:10:03.062 --> 00:10:04.583
billable units and for us

00:10:04.663 --> 00:10:05.684
you know mobile visits like

00:10:06.065 --> 00:10:06.804
I guess it's more about

00:10:06.946 --> 00:10:08.505
visits and maybe less about

00:10:08.546 --> 00:10:10.126
reps because you can't uh

00:10:10.227 --> 00:10:11.008
group people together I

00:10:11.048 --> 00:10:13.068
think the the best idea so

00:10:13.089 --> 00:10:14.830
far from this is already

00:10:14.870 --> 00:10:15.650
what tony just said about

00:10:15.691 --> 00:10:16.871
groups there's something called

00:10:17.432 --> 00:10:19.052
uh the athletic I believe it

00:10:19.072 --> 00:10:19.932
started in new york city it

00:10:19.952 --> 00:10:21.513
was invested by um ann

00:10:21.552 --> 00:10:22.913
malum and was the one that

00:10:22.974 --> 00:10:24.234
sold solid core for like

00:10:24.553 --> 00:10:25.474
eighty million dollars or

00:10:25.514 --> 00:10:26.274
something she raised

00:10:26.394 --> 00:10:27.634
private equity money and

00:10:27.695 --> 00:10:29.134
she invested in a company

00:10:29.796 --> 00:10:30.895
in new york city it's like

00:10:30.956 --> 00:10:32.956
group fitness but it's like

00:10:33.596 --> 00:10:35.336
if I sign up I'm with the

00:10:35.397 --> 00:10:37.118
same people tuesday and

00:10:37.158 --> 00:10:38.658
thursday at six thirty pm

00:10:38.697 --> 00:10:40.038
it's the same six or eight

00:10:40.078 --> 00:10:40.818
or whatever people

00:10:41.658 --> 00:10:43.200
And obviously it builds community.

00:10:43.759 --> 00:10:45.421
And obviously people know

00:10:45.500 --> 00:10:47.643
like if I'm out and I'm not

00:10:47.663 --> 00:10:48.964
there at the workout class together.

00:10:49.443 --> 00:10:50.605
So I think the grouping

00:10:50.644 --> 00:10:51.424
patients together actually

00:10:51.445 --> 00:10:52.164
would be a great idea.

00:10:52.205 --> 00:10:52.946
Then you could, you know,

00:10:53.066 --> 00:10:55.427
maybe you could group

00:10:55.466 --> 00:10:56.347
people together based off

00:10:56.388 --> 00:10:57.227
of like conditions or

00:10:57.249 --> 00:10:58.489
diagnosis or whatever to

00:10:58.548 --> 00:10:59.610
make sure it's somewhat

00:10:59.730 --> 00:11:00.650
even or fair or whatever.

00:11:00.691 --> 00:11:00.890
But yeah.

00:11:01.530 --> 00:11:02.332
I think the group thing,

00:11:02.373 --> 00:11:03.774
like at Tony's clinic, Tony,

00:11:04.196 --> 00:11:04.996
do you think it would be,

00:11:05.116 --> 00:11:06.519
if you were to do this, would it be,

00:11:06.940 --> 00:11:07.240
you know,

00:11:07.400 --> 00:11:09.465
groups of two or four or six or like what,

00:11:09.544 --> 00:11:11.168
what type of number would that even like,

00:11:11.628 --> 00:11:12.308
how would it even make

00:11:12.350 --> 00:11:14.714
sense based off of like your volume?

00:11:15.345 --> 00:11:17.245
Yeah, it's totally arbitrary,

00:11:17.265 --> 00:11:18.606
but I would say groups of four,

00:11:18.706 --> 00:11:20.327
four seems to be a good number.

00:11:21.568 --> 00:11:23.288
When I look at our patient volume,

00:11:23.389 --> 00:11:25.650
I look at the actual physical space,

00:11:25.671 --> 00:11:26.750
like how many people could

00:11:26.791 --> 00:11:28.572
we fit into the physical space?

00:11:29.312 --> 00:11:31.474
And these groups form naturally, you know,

00:11:31.533 --> 00:11:33.414
so we have a non-covered

00:11:33.455 --> 00:11:35.755
maintenance program, a wellness program,

00:11:35.876 --> 00:11:36.917
independent exercise,

00:11:36.937 --> 00:11:38.018
whatever you want to call it.

00:11:38.618 --> 00:11:41.698
But these little subsets of individuals,

00:11:41.778 --> 00:11:43.200
we have our Tuesday morning,

00:11:44.059 --> 00:11:46.380
nine thirty to ten thirty a.m.

00:11:46.441 --> 00:11:46.760
group.

00:11:46.900 --> 00:11:48.241
They just they come together.

00:11:48.302 --> 00:11:49.221
They socialize.

00:11:49.241 --> 00:11:50.341
Some of them are neighbors.

00:11:50.721 --> 00:11:51.582
And then we have a different

00:11:51.602 --> 00:11:53.003
group on Monday, Wednesday,

00:11:53.043 --> 00:11:53.764
Friday mornings.

00:11:53.803 --> 00:11:55.783
We have a third group Tuesday,

00:11:55.823 --> 00:11:56.924
Thursday afternoon and a

00:11:56.965 --> 00:11:59.245
fourth group Monday, Monday,

00:11:59.285 --> 00:12:00.105
Wednesday afternoon.

00:12:00.981 --> 00:12:03.203
So they naturally kind of

00:12:03.264 --> 00:12:04.745
congregate and come in together.

00:12:04.764 --> 00:12:05.664
And once they've started

00:12:05.725 --> 00:12:07.166
seeing each other for a while,

00:12:07.586 --> 00:12:08.807
they're like, hey, where's John?

00:12:08.866 --> 00:12:09.648
Where's Dave?

00:12:09.847 --> 00:12:11.109
Where's Mary?

00:12:12.509 --> 00:12:13.591
But it seems to me just

00:12:13.750 --> 00:12:16.172
based on my experience, groups of four,

00:12:16.413 --> 00:12:17.413
probably ideal.

00:12:18.193 --> 00:12:20.495
I would do twenty, thirty minute sessions.

00:12:20.575 --> 00:12:21.615
I'd get them out of here.

00:12:22.255 --> 00:12:24.018
I shared that video with you guys.

00:12:24.238 --> 00:12:25.658
I don't know if we want to show it,

00:12:26.820 --> 00:12:27.220
but yeah.

00:12:28.880 --> 00:12:30.241
One of the features

00:12:30.302 --> 00:12:31.562
mentioned in that video,

00:12:31.582 --> 00:12:33.683
besides all the innovation and technology,

00:12:34.345 --> 00:12:36.466
a ten-minute session.

00:12:37.046 --> 00:12:37.826
I don't even remember the

00:12:37.846 --> 00:12:38.548
name of the company,

00:12:38.607 --> 00:12:39.847
but the girl was like, yeah,

00:12:39.888 --> 00:12:41.690
in ten minutes I get my workout in.

00:12:42.543 --> 00:12:44.985
People don't need sixty minutes.

00:12:45.205 --> 00:12:47.005
It depends on what you are selling.

00:12:47.405 --> 00:12:49.386
Topgolf became more popular

00:12:49.407 --> 00:12:50.628
than golf because you could

00:12:50.668 --> 00:12:52.109
do it in less than an hour.

00:12:52.129 --> 00:12:53.509
You could leave whenever you want.

00:12:53.549 --> 00:12:55.311
You could hit the balls and go.

00:12:55.652 --> 00:12:56.371
You don't have to be

00:12:56.412 --> 00:12:57.873
committed to a four hour,

00:12:58.013 --> 00:12:59.274
eighteen hole course.

00:12:59.889 --> 00:13:00.870
I played a six and a half

00:13:00.889 --> 00:13:02.671
hour round this week because of rain.

00:13:02.730 --> 00:13:03.750
And it was a charity tournament.

00:13:03.770 --> 00:13:04.631
So we're backed up a little bit,

00:13:04.672 --> 00:13:05.471
six and a half hours.

00:13:05.511 --> 00:13:06.513
Listen, I like golf.

00:13:06.832 --> 00:13:08.673
If golf had twelve to fourteen holes,

00:13:08.734 --> 00:13:10.274
I'd be more apt to play.

00:13:10.674 --> 00:13:11.995
When I hit like fifteen, I'm like,

00:13:12.216 --> 00:13:12.975
I turn to my best friend

00:13:13.015 --> 00:13:13.517
most of the time.

00:13:13.856 --> 00:13:14.957
How many more holes we got?

00:13:15.018 --> 00:13:16.698
He's like, he'd play thirty six.

00:13:17.078 --> 00:13:17.979
I want to play nine.

00:13:18.379 --> 00:13:18.679
Right.

00:13:18.919 --> 00:13:19.779
And I think more people are

00:13:19.820 --> 00:13:20.500
probably like me.

00:13:21.221 --> 00:13:22.863
yeah I'll play I'll play

00:13:22.942 --> 00:13:24.745
nine on an executive I

00:13:24.764 --> 00:13:26.606
would rather do six six

00:13:26.667 --> 00:13:28.448
holes on a par three I'm

00:13:28.568 --> 00:13:29.730
I'm in heaven like let's go

00:13:29.750 --> 00:13:30.770
get a drink now and hang

00:13:30.850 --> 00:13:31.871
out there's the tournament

00:13:31.892 --> 00:13:33.833
we do it's the it's the uh

00:13:33.894 --> 00:13:34.995
breck pc breakfast club

00:13:35.034 --> 00:13:37.298
invitational six holes you

00:13:37.337 --> 00:13:38.979
cannot start hole two until

00:13:38.999 --> 00:13:40.100
you finish your first beer

00:13:40.400 --> 00:13:41.542
so you finish a six pack

00:13:41.881 --> 00:13:44.264
and six holes in forty nine minutes

00:13:45.663 --> 00:13:46.582
Let's go do it down in

00:13:46.623 --> 00:13:49.644
Florida at the indoor facility.

00:13:49.683 --> 00:13:50.943
What, six-pack per person?

00:13:51.464 --> 00:13:51.984
A beer hole.

00:13:52.043 --> 00:13:52.703
In nine minutes?

00:13:53.144 --> 00:13:55.304
A beer hole.

00:13:55.325 --> 00:13:56.605
But a six-pack in an hour,

00:13:56.625 --> 00:13:58.166
that's chugging.

00:13:58.666 --> 00:13:58.926
Listen,

00:13:59.005 --> 00:14:00.566
we called it bad boy golf in college.

00:14:00.686 --> 00:14:01.265
This wasn't good.

00:14:01.446 --> 00:14:03.647
All right, I asked a question on Tuesday.

00:14:03.687 --> 00:14:04.846
This was Hot Take Tuesday,

00:14:05.307 --> 00:14:06.386
and this is what we wanted to talk about,

00:14:06.427 --> 00:14:06.626
right?

00:14:07.126 --> 00:14:08.048
And I brought this up before.

00:14:08.107 --> 00:14:09.128
It sounds like I'm nitpicking,

00:14:09.347 --> 00:14:10.508
and maybe I am, but that's what I do.

00:14:10.528 --> 00:14:11.508
I'm a professional nitpicker.

00:14:12.248 --> 00:14:14.188
Everybody in PT seems to

00:14:14.229 --> 00:14:15.089
hate mill clinics.

00:14:16.104 --> 00:14:18.184
but nobody can point to one.

00:14:18.205 --> 00:14:19.245
You can't actually tell me what it is.

00:14:19.265 --> 00:14:19.745
When I ask,

00:14:19.765 --> 00:14:20.826
the numbers are all over the place.

00:14:21.246 --> 00:14:22.427
Is it the number of locations,

00:14:22.467 --> 00:14:24.688
the volume of patients, or is it vibe?

00:14:25.690 --> 00:14:26.610
Is it cookie cutter?

00:14:26.951 --> 00:14:27.831
So is it objective?

00:14:27.871 --> 00:14:28.631
Is it subjective?

00:14:28.652 --> 00:14:30.013
Do you only know it when you see it?

00:14:30.232 --> 00:14:31.634
If so, hey,

00:14:31.854 --> 00:14:33.294
touch your ear when you're in

00:14:33.335 --> 00:14:34.515
front of one, show me one.

00:14:34.615 --> 00:14:36.037
I don't know what it is.

00:14:36.397 --> 00:14:37.116
So I was like, okay,

00:14:37.658 --> 00:14:38.999
let's create a checklist.

00:14:39.759 --> 00:14:40.840
Is it number of locations?

00:14:40.899 --> 00:14:42.842
Patients seen per hour by one PT?

00:14:42.962 --> 00:14:44.725
Average time spent per session?

00:14:44.764 --> 00:14:46.066
Everybody's in love or for a

00:14:46.105 --> 00:14:46.907
while I feel like they were

00:14:46.927 --> 00:14:49.250
in love with the one-on-one for an hour.

00:14:49.590 --> 00:14:50.971
Is it using text or aids?

00:14:51.611 --> 00:14:52.734
Is it plan of care driven

00:14:52.754 --> 00:14:53.615
more by insurance?

00:14:53.894 --> 00:14:54.836
Like what is it?

00:14:55.336 --> 00:14:56.096
And then how many do you

00:14:56.136 --> 00:14:58.460
need to check off of a list

00:14:58.519 --> 00:14:59.620
before you're deemed a mill?

00:15:00.402 --> 00:15:02.504
fun fact I had two different

00:15:02.543 --> 00:15:05.025
people who work for large

00:15:05.086 --> 00:15:07.028
pt organizations dm me I'm

00:15:07.048 --> 00:15:07.729
not going to say who they

00:15:07.749 --> 00:15:08.870
were and they were like

00:15:09.269 --> 00:15:10.591
thank you for saying this

00:15:10.850 --> 00:15:12.133
because that that person

00:15:12.173 --> 00:15:13.614
gets accused at working for

00:15:13.653 --> 00:15:15.154
a pt mill a lot and they're

00:15:15.174 --> 00:15:15.995
like but you can't tell me

00:15:16.015 --> 00:15:17.277
what it is so they agreed

00:15:17.297 --> 00:15:17.977
with me of course now

00:15:17.998 --> 00:15:18.938
they're getting they're

00:15:18.958 --> 00:15:20.360
getting called this spade

00:15:20.399 --> 00:15:21.260
is getting called a spade

00:15:21.280 --> 00:15:22.142
right I don't know if

00:15:22.682 --> 00:15:23.243
If there are milkers,

00:15:23.283 --> 00:15:24.124
I can't identify one.

00:15:24.423 --> 00:15:25.745
When you hear these questions,

00:15:26.186 --> 00:15:28.067
you guys are sort of opposites, right?

00:15:28.168 --> 00:15:29.589
Mobile one on one cash pay

00:15:29.609 --> 00:15:30.811
New York City and then

00:15:30.870 --> 00:15:32.192
Tony's brick and mortar in Ohio.

00:15:33.133 --> 00:15:34.254
What is this question or

00:15:34.293 --> 00:15:35.054
what does this prompt set

00:15:35.075 --> 00:15:37.336
off for both of you?

00:15:37.356 --> 00:15:38.678
Dave, why don't you go off?

00:15:39.895 --> 00:15:40.596
Well,

00:15:40.636 --> 00:15:42.538
I commented on Jimmy's post and I

00:15:42.577 --> 00:15:44.259
said a physical therapy

00:15:44.298 --> 00:15:46.541
practice that books and

00:15:46.740 --> 00:15:48.682
treats for patients per hour,

00:15:49.442 --> 00:15:51.043
I think could be defined as a mill.

00:15:51.104 --> 00:15:52.725
Now, the funny thing is,

00:15:52.764 --> 00:15:53.745
is like Tony always says,

00:15:53.785 --> 00:15:54.567
is there's a lot of

00:15:54.606 --> 00:15:55.647
patients across the country

00:15:56.008 --> 00:15:57.629
that are okay with that experience.

00:15:57.649 --> 00:15:58.509
They're fine with that.

00:15:58.850 --> 00:16:00.030
It's the therapists that are

00:16:00.211 --> 00:16:00.870
not okay with it.

00:16:00.890 --> 00:16:01.731
It's the therapists that

00:16:01.792 --> 00:16:02.511
actually have had

00:16:02.692 --> 00:16:03.513
challenges or issues

00:16:03.533 --> 00:16:04.913
because it's more documentation,

00:16:04.953 --> 00:16:05.575
it's more notes.

00:16:06.315 --> 00:16:07.535
uh management is you know

00:16:07.596 --> 00:16:08.895
forcing productivity and

00:16:09.576 --> 00:16:10.777
having them see twelve or

00:16:10.856 --> 00:16:11.917
sixteen or eighteen or

00:16:11.976 --> 00:16:13.618
twenty or thirty patients a

00:16:13.638 --> 00:16:14.477
day in some clinics it

00:16:14.498 --> 00:16:15.798
depends on obviously the

00:16:15.839 --> 00:16:17.479
clinic uh and and tony is

00:16:17.519 --> 00:16:18.620
brick and mortar in network

00:16:18.639 --> 00:16:19.960
but still very different

00:16:19.980 --> 00:16:21.801
than a lot of the uh bigger

00:16:21.841 --> 00:16:23.241
corporates out there so my

00:16:23.282 --> 00:16:24.642
comment was like I like

00:16:24.662 --> 00:16:26.222
jimmy posed as he usually

00:16:26.243 --> 00:16:28.202
does and oftentimes um tony

00:16:28.222 --> 00:16:30.504
does like a question and I

00:16:30.524 --> 00:16:31.605
was like here's an answer

00:16:31.625 --> 00:16:32.745
like no one in the comments

00:16:32.764 --> 00:16:33.806
was giving an actual answer

00:16:35.346 --> 00:16:36.346
and that's my opinion on an

00:16:36.447 --> 00:16:37.628
answer all the other things

00:16:37.648 --> 00:16:38.868
are kind of like you know

00:16:39.009 --> 00:16:41.309
symptoms of the thing but

00:16:41.350 --> 00:16:42.311
the thing is obviously it's

00:16:42.331 --> 00:16:43.510
like a productivity measure

00:16:43.551 --> 00:16:44.631
coming down from corporate

00:16:44.652 --> 00:16:46.133
or the ownership because

00:16:46.173 --> 00:16:47.354
reimbursement has plateaued

00:16:47.394 --> 00:16:48.615
or in some cases decreased

00:16:48.695 --> 00:16:49.956
from the last ten or

00:16:49.995 --> 00:16:50.916
fifteen or twenty or

00:16:50.936 --> 00:16:52.817
whatever years and so a

00:16:52.878 --> 00:16:53.918
really simple thing is like

00:16:53.977 --> 00:16:54.778
how is the schedule

00:16:54.798 --> 00:16:55.778
developed when I my first

00:16:55.798 --> 00:16:56.620
job out of school it was a

00:16:56.679 --> 00:16:57.520
physician-owned practice

00:16:57.561 --> 00:16:59.061
but a great mentor a

00:16:59.101 --> 00:16:59.782
physical therapist that

00:16:59.802 --> 00:17:00.942
brought me in there and it

00:17:00.962 --> 00:17:02.303
was three patients booked

00:17:03.104 --> 00:17:04.445
And typically arrive and treated,

00:17:04.486 --> 00:17:05.866
obviously, ten percent, cancel,

00:17:05.906 --> 00:17:06.708
no shorty or whatever.

00:17:07.189 --> 00:17:08.369
But the schedule was three

00:17:08.410 --> 00:17:09.510
patients an hour.

00:17:10.432 --> 00:17:12.394
But there was an aid and at

00:17:12.453 --> 00:17:13.375
times it was busy.

00:17:13.955 --> 00:17:16.038
And now more and more

00:17:16.057 --> 00:17:16.699
therapists coming out of

00:17:16.719 --> 00:17:18.340
school do not want to work in that model.

00:17:18.401 --> 00:17:19.801
And so therefore, that model has been.

00:17:21.084 --> 00:17:22.605
uh you know I don't know

00:17:22.665 --> 00:17:24.728
poked at it's been a part

00:17:24.748 --> 00:17:25.910
of the focus of the

00:17:25.930 --> 00:17:26.851
profession with therapists

00:17:27.230 --> 00:17:27.811
whether it's facebook

00:17:27.832 --> 00:17:28.532
groups it's linkedin

00:17:28.573 --> 00:17:29.954
whatever so that's my

00:17:29.994 --> 00:17:31.596
thought is like and now

00:17:31.616 --> 00:17:32.778
just because if tony's

00:17:32.858 --> 00:17:33.579
practice or some other

00:17:33.619 --> 00:17:35.162
practice does book and

00:17:35.182 --> 00:17:36.103
treat four patients per

00:17:36.123 --> 00:17:38.184
hour per therapist per pt or pta

00:17:39.557 --> 00:17:40.718
It's not necessarily a bad thing.

00:17:40.758 --> 00:17:41.538
I think it's a bad thing

00:17:41.598 --> 00:17:43.080
when all the patients are

00:17:43.101 --> 00:17:43.701
just getting the same

00:17:43.741 --> 00:17:45.903
exercise or they're all

00:17:45.923 --> 00:17:46.965
getting billed four units,

00:17:47.006 --> 00:17:47.826
but they're all being

00:17:47.886 --> 00:17:49.669
treated like simultaneously

00:17:49.689 --> 00:17:50.690
and it's not one-on-one and

00:17:50.730 --> 00:17:52.132
obviously that would be fraudulent.

00:17:52.192 --> 00:17:54.894
So I think four patients an

00:17:54.934 --> 00:17:56.656
hour booked and treated would be a mill,

00:17:56.737 --> 00:17:57.857
but I'm saying a mill is

00:17:57.897 --> 00:17:59.240
not necessarily a bad thing.

00:18:00.665 --> 00:18:01.987
Yeah, I love it.

00:18:02.086 --> 00:18:02.527
I agree.

00:18:02.567 --> 00:18:03.627
Like a mill is not

00:18:03.688 --> 00:18:04.988
necessarily a bad thing.

00:18:06.128 --> 00:18:07.490
We all want to complain

00:18:07.950 --> 00:18:10.672
about how expensive health care is.

00:18:11.352 --> 00:18:13.212
Yet once we develop an

00:18:13.252 --> 00:18:14.814
effective system to deliver

00:18:14.854 --> 00:18:16.795
an outcome for lower costs,

00:18:16.914 --> 00:18:17.875
everybody freaks out.

00:18:18.846 --> 00:18:21.108
It's one of those deals where it's like,

00:18:21.128 --> 00:18:23.089
all right, let's dig deeper.

00:18:23.130 --> 00:18:24.530
Let's go behind the question.

00:18:24.611 --> 00:18:25.991
What does this really mean?

00:18:26.832 --> 00:18:29.012
I've never heard a patient come in and say,

00:18:29.212 --> 00:18:30.814
oh, that place is a therapy mill.

00:18:30.854 --> 00:18:31.795
They don't know.

00:18:31.835 --> 00:18:32.515
They don't care.

00:18:33.536 --> 00:18:34.596
I've shared this story.

00:18:35.876 --> 00:18:37.719
I took a picture two days ago.

00:18:38.749 --> 00:18:39.769
Inside my clinic.

00:18:40.049 --> 00:18:41.230
So I took a picture because

00:18:41.289 --> 00:18:42.691
I was teaching my Medicare

00:18:42.730 --> 00:18:43.432
billing course.

00:18:43.451 --> 00:18:44.352
And I was like, look, guys,

00:18:44.392 --> 00:18:45.833
this is a scene inside my

00:18:45.873 --> 00:18:46.732
clinic this morning.

00:18:47.314 --> 00:18:49.934
I had a mother son to both patients.

00:18:50.635 --> 00:18:52.115
I had a husband and wife,

00:18:52.696 --> 00:18:54.397
both independent exercisers

00:18:54.417 --> 00:18:55.798
that had been patients now

00:18:55.837 --> 00:18:58.019
transition to a wellness program.

00:18:58.480 --> 00:19:00.701
And I had a third or yeah,

00:19:00.721 --> 00:19:01.821
I guess a third patient.

00:19:02.461 --> 00:19:05.604
So five people, one therapist.

00:19:06.259 --> 00:19:07.380
We had an amazing time.

00:19:07.661 --> 00:19:08.560
Everybody was happy.

00:19:08.621 --> 00:19:09.961
Everyone was having fun.

00:19:10.001 --> 00:19:11.422
Like everybody was getting better.

00:19:11.541 --> 00:19:13.522
And I would tell you that

00:19:13.982 --> 00:19:15.263
nobody felt ignored.

00:19:15.884 --> 00:19:18.464
Nobody felt like this is the real problem.

00:19:18.545 --> 00:19:19.705
Patients complain,

00:19:19.786 --> 00:19:21.546
not about too many people.

00:19:21.586 --> 00:19:23.507
They complain about feeling ignored.

00:19:23.547 --> 00:19:25.008
They complain about the

00:19:25.048 --> 00:19:26.608
therapist in the computer

00:19:26.769 --> 00:19:28.368
and not focused on, you know,

00:19:28.828 --> 00:19:30.609
making me feel paid

00:19:30.630 --> 00:19:32.770
attention to listen to their jokes,

00:19:32.830 --> 00:19:34.771
laugh at them, listen to their stories.

00:19:35.132 --> 00:19:36.992
connect people to each other,

00:19:37.532 --> 00:19:39.253
nobody feels like they're

00:19:39.273 --> 00:19:40.433
getting a bad experience.

00:19:41.694 --> 00:19:44.455
And so back to you bill appropriately,

00:19:44.496 --> 00:19:46.175
like Dave said, there are, you know,

00:19:46.236 --> 00:19:48.717
CPT codes, there's one on one services,

00:19:48.757 --> 00:19:49.877
there's this stuff.

00:19:50.698 --> 00:19:52.439
But if you can check those boxes,

00:19:53.483 --> 00:19:55.305
you can make a person in a

00:19:55.345 --> 00:19:57.486
group feel just as special

00:19:57.546 --> 00:19:59.548
as a person in an individual setting.

00:19:59.567 --> 00:20:01.087
And I would say there's

00:20:01.189 --> 00:20:03.890
probably more advantage to that group.

00:20:05.050 --> 00:20:06.912
So to Jimmy's question, you know,

00:20:07.112 --> 00:20:08.212
what is a mill first?

00:20:08.593 --> 00:20:09.153
Who cares?

00:20:09.272 --> 00:20:10.094
Why does it matter?

00:20:11.193 --> 00:20:11.674
Second,

00:20:12.515 --> 00:20:14.675
If you're delivering a negative experience,

00:20:14.715 --> 00:20:15.256
guess what?

00:20:15.576 --> 00:20:16.856
Those patients will leave.

00:20:17.217 --> 00:20:18.657
Those patients won't come back.

00:20:19.097 --> 00:20:20.097
I can't even tell you how

00:20:20.137 --> 00:20:21.679
many people come in my door

00:20:21.919 --> 00:20:23.319
every single week saying

00:20:23.720 --> 00:20:25.260
they tried to send me to the hospital.

00:20:25.280 --> 00:20:26.921
They tried to send me to NovaCare.

00:20:27.561 --> 00:20:28.241
And I said, no,

00:20:28.301 --> 00:20:29.663
I want to go to total therapy.

00:20:29.962 --> 00:20:32.483
I want to go see Tony and Jeremy, you know,

00:20:32.644 --> 00:20:33.784
and we're just as busy,

00:20:33.844 --> 00:20:35.625
probably more busy than everybody else,

00:20:35.684 --> 00:20:37.425
because we will let six

00:20:37.486 --> 00:20:39.126
people at a time come in

00:20:39.166 --> 00:20:40.186
with two clinicians.

00:20:40.907 --> 00:20:41.827
But the patients love it.

00:20:43.237 --> 00:20:45.117
Here's the kicker that I had also written,

00:20:45.238 --> 00:20:45.798
which is, go ahead, Dave.

00:20:45.818 --> 00:20:46.939
No, no, go ahead.

00:20:46.979 --> 00:20:49.941
I'll swing back.

00:20:50.381 --> 00:20:51.221
The kicker is if you run a

00:20:51.261 --> 00:20:52.201
clinic and pride yourself

00:20:52.241 --> 00:20:53.462
on being the opposite of a mill,

00:20:53.583 --> 00:20:54.163
shouldn't you actually

00:20:54.182 --> 00:20:55.523
appreciate that it exists?

00:20:55.964 --> 00:20:57.625
Without them, who are you the opposite of,

00:20:57.826 --> 00:20:58.086
right?

00:20:58.685 --> 00:21:00.207
But to Tony's point,

00:21:01.028 --> 00:21:02.147
I worked with someone who

00:21:02.268 --> 00:21:03.048
all they wanted to do is

00:21:03.088 --> 00:21:04.288
post about we're not a mill.

00:21:04.390 --> 00:21:04.809
And I was like,

00:21:04.829 --> 00:21:05.869
but you're talking to patients.

00:21:06.451 --> 00:21:08.152
That isn't a problem that they have.

00:21:08.291 --> 00:21:08.392
Now,

00:21:08.451 --> 00:21:09.712
that might be something for

00:21:09.772 --> 00:21:11.874
recruitment or retention, right?

00:21:12.034 --> 00:21:13.977
Hey, we're the opposite of this, right?

00:21:14.237 --> 00:21:16.420
But just be the thing that

00:21:16.461 --> 00:21:17.642
you are and people will

00:21:17.721 --> 00:21:19.384
either love it and stay or

00:21:19.424 --> 00:21:20.385
hate it and leave.

00:21:20.666 --> 00:21:22.108
But don't change for that.

00:21:22.328 --> 00:21:23.611
If this is how you want to operate,

00:21:23.790 --> 00:21:24.551
operate that way.

00:21:24.571 --> 00:21:25.513
You got to like it first.

00:21:27.058 --> 00:21:27.239
All right,

00:21:27.259 --> 00:21:28.739
I get the pushback on both of

00:21:28.778 --> 00:21:29.558
what you just said,

00:21:29.618 --> 00:21:33.319
because there are people that call us,

00:21:33.480 --> 00:21:34.599
now this is in the New York City area,

00:21:34.640 --> 00:21:35.480
but I'm assuming it's

00:21:35.519 --> 00:21:37.000
similar in most cities or metros.

00:21:37.381 --> 00:21:38.560
There are people that call

00:21:38.760 --> 00:21:41.060
us and they will specifically say,

00:21:41.922 --> 00:21:43.301
or sometimes we have to ask, like, oh,

00:21:43.541 --> 00:21:44.442
like you had back pain?

00:21:44.461 --> 00:21:44.642
Like,

00:21:44.682 --> 00:21:45.821
isn't this the first time you had it?

00:21:45.882 --> 00:21:46.461
Like, oh,

00:21:46.481 --> 00:21:48.383
you've had it on and off for ten years?

00:21:48.903 --> 00:21:49.823
What else have you done for it?

00:21:49.843 --> 00:21:52.262
Like, what other providers, procedures,

00:21:52.282 --> 00:21:52.742
what have you done?

00:21:53.063 --> 00:21:55.163
And if they say physical therapy, so...

00:21:56.084 --> 00:21:57.444
you had physical therapy

00:21:57.505 --> 00:21:59.207
like why aren't you calling

00:21:59.227 --> 00:22:00.166
them like I'm curious as to

00:22:00.207 --> 00:22:00.907
why you're not going back

00:22:00.928 --> 00:22:01.749
to where you were before or

00:22:01.769 --> 00:22:02.689
whatever so some people

00:22:02.709 --> 00:22:03.450
will either directly or

00:22:03.509 --> 00:22:05.391
indirectly call us and say

00:22:06.031 --> 00:22:06.833
I'm not going to that

00:22:06.952 --> 00:22:08.094
outpatient office and

00:22:08.114 --> 00:22:09.153
they'll mention names and

00:22:09.173 --> 00:22:09.755
sometimes they don't want

00:22:09.775 --> 00:22:10.295
to mention them because

00:22:10.315 --> 00:22:11.435
they don't want to you know

00:22:11.476 --> 00:22:12.497
bash people or whatever but

00:22:12.537 --> 00:22:14.137
they will say I'm not going

00:22:14.157 --> 00:22:15.799
back to that office because it was

00:22:16.420 --> 00:22:17.059
It was busy.

00:22:17.160 --> 00:22:17.980
It was a frenzy.

00:22:18.000 --> 00:22:19.340
They don't always say the word mill.

00:22:19.621 --> 00:22:21.101
The factory patients,

00:22:21.141 --> 00:22:22.401
the layman term is factory.

00:22:22.421 --> 00:22:24.402
They'll say there were too many patients.

00:22:24.821 --> 00:22:25.882
I want more attention.

00:22:26.402 --> 00:22:27.102
They weren't giving me

00:22:27.142 --> 00:22:28.122
enough attention or

00:22:28.162 --> 00:22:28.863
treatment or whatever.

00:22:29.002 --> 00:22:30.063
And it was they were

00:22:30.083 --> 00:22:31.022
treating three or four or

00:22:31.083 --> 00:22:32.163
more patients per hour at

00:22:32.182 --> 00:22:33.624
the same time as me.

00:22:33.663 --> 00:22:34.663
So I'm pushing back on both

00:22:34.683 --> 00:22:35.824
of you because there are at

00:22:35.864 --> 00:22:37.344
least folks that have had

00:22:37.384 --> 00:22:38.265
physical therapy elsewhere

00:22:38.565 --> 00:22:39.805
that then go on Google or

00:22:39.904 --> 00:22:40.785
Yelp or whatever.

00:22:40.805 --> 00:22:43.806
They find us online and or

00:22:43.826 --> 00:22:44.746
they ask their physician.

00:22:45.605 --> 00:22:46.287
And then when they want to

00:22:46.307 --> 00:22:46.906
want to experience.

00:22:46.946 --> 00:22:48.828
So there are some folks that

00:22:48.909 --> 00:22:50.250
have had that and look elsewhere.

00:22:50.351 --> 00:22:51.731
And if you're not hearing that, Tony,

00:22:51.751 --> 00:22:53.292
it's because maybe they

00:22:53.472 --> 00:22:54.413
like the folks that wanted

00:22:54.433 --> 00:22:55.255
the one on one care.

00:22:55.575 --> 00:22:56.296
They're looking at your

00:22:56.455 --> 00:22:57.958
offering first and you're

00:22:57.978 --> 00:22:58.597
not going to hear those

00:22:58.637 --> 00:23:00.200
calls the way I'm hearing, in my opinion.

00:23:01.029 --> 00:23:01.390
I agree.

00:23:01.450 --> 00:23:02.611
Confirmation bias,

00:23:02.691 --> 00:23:04.451
like absolutely no doubt.

00:23:04.912 --> 00:23:05.653
You're going to get the

00:23:05.692 --> 00:23:08.013
people that want the one on one attention,

00:23:08.354 --> 00:23:09.694
just like the manual therapy.

00:23:09.835 --> 00:23:10.474
You know, again,

00:23:10.915 --> 00:23:11.576
you're going to get the

00:23:11.615 --> 00:23:13.096
people that want manual.

00:23:13.136 --> 00:23:14.356
They want hands on.

00:23:14.617 --> 00:23:15.597
I might get the people who

00:23:15.637 --> 00:23:16.538
don't care about it,

00:23:16.578 --> 00:23:17.598
don't even know about it.

00:23:18.920 --> 00:23:20.280
And that's the whole idea

00:23:20.320 --> 00:23:22.082
behind find the gap in the

00:23:22.122 --> 00:23:23.942
market and go fill that gap.

00:23:24.471 --> 00:23:24.750
You know,

00:23:24.770 --> 00:23:26.673
when I was doing a lot of rehab

00:23:26.692 --> 00:23:27.554
for patients that had

00:23:27.594 --> 00:23:29.955
fibromyalgia and other chronic conditions,

00:23:30.395 --> 00:23:30.596
yeah,

00:23:30.616 --> 00:23:33.259
we tended to do more one-on-one private,

00:23:33.519 --> 00:23:34.680
you know, office,

00:23:34.760 --> 00:23:36.142
like go in the exam room.

00:23:36.582 --> 00:23:37.022
Today,

00:23:37.103 --> 00:23:38.824
I haven't been in an exam room for

00:23:38.864 --> 00:23:39.644
like ten years.

00:23:40.526 --> 00:23:42.748
It's just understand the

00:23:42.867 --> 00:23:45.069
audience you're serving and double down.

00:23:45.089 --> 00:23:47.071
Because you have motorcycles

00:23:47.132 --> 00:23:47.672
in your exam rooms.

00:23:47.692 --> 00:23:49.534
That's right.

00:23:49.554 --> 00:23:50.335
Makes complete sense.

00:23:52.159 --> 00:23:54.401
water water finds its level

00:23:54.840 --> 00:23:56.061
like people like and and

00:23:56.122 --> 00:23:57.483
dislike and that's good I

00:23:57.523 --> 00:23:58.324
think that's good it's

00:23:58.443 --> 00:24:00.905
choice and the choice is

00:24:01.006 --> 00:24:03.167
what you know we should I

00:24:03.188 --> 00:24:04.169
don't want to get political

00:24:04.328 --> 00:24:05.349
choices what we should be

00:24:05.410 --> 00:24:07.051
protecting in this example

00:24:07.571 --> 00:24:09.153
like if if you don't want

00:24:09.192 --> 00:24:10.554
to do what I do awesome

00:24:10.634 --> 00:24:11.694
don't freaking do it I

00:24:11.714 --> 00:24:12.596
don't care that's less

00:24:12.635 --> 00:24:14.538
competition for me but let me do

00:24:15.218 --> 00:24:16.538
what I think is best.

00:24:16.960 --> 00:24:18.980
Let me deliver a ten-minute visit.

00:24:19.422 --> 00:24:21.403
Let me, I don't know if you guys saw it,

00:24:21.502 --> 00:24:23.404
I'm curious to hear your perspective.

00:24:23.984 --> 00:24:26.067
Let me take a new patient

00:24:26.086 --> 00:24:28.248
phone call and convert them

00:24:28.388 --> 00:24:30.089
into a telehealth visit

00:24:30.369 --> 00:24:32.030
while they're on the phone

00:24:32.511 --> 00:24:33.772
to make that available

00:24:33.833 --> 00:24:35.153
event so I'm not giving

00:24:35.193 --> 00:24:37.174
away that time anymore.

00:24:38.496 --> 00:24:39.317
And the people who don't

00:24:39.336 --> 00:24:40.238
want to do telehealth,

00:24:40.478 --> 00:24:41.018
Don't do it.

00:24:41.578 --> 00:24:42.179
It's good.

00:24:42.618 --> 00:24:43.220
Who cares?

00:24:43.599 --> 00:24:44.780
But if I can offer a quick

00:24:44.820 --> 00:24:45.980
solution to somebody who's

00:24:46.020 --> 00:24:47.862
suffering right now and

00:24:47.942 --> 00:24:49.784
never be in person with them,

00:24:49.923 --> 00:24:53.105
I think I have the right to do that.

00:24:53.205 --> 00:24:55.166
Agreed.

00:24:55.186 --> 00:24:56.146
Did you guys see that post?

00:24:56.307 --> 00:24:58.229
What are your thoughts on that post?

00:24:58.348 --> 00:24:58.969
I didn't see the post.

00:24:59.009 --> 00:24:59.849
I want to talk more about it.

00:24:59.869 --> 00:25:02.550
Are there any other practices that do this,

00:25:03.011 --> 00:25:03.172
Tony?

00:25:03.192 --> 00:25:05.692
To my knowledge, so let me break it down.

00:25:05.873 --> 00:25:06.693
Why wouldn't they do that?

00:25:07.461 --> 00:25:10.144
Let me break it down kind of like I did,

00:25:10.304 --> 00:25:11.404
and then you guys can tell

00:25:11.444 --> 00:25:11.984
me what you think.

00:25:12.026 --> 00:25:13.126
So the whole idea is

00:25:13.586 --> 00:25:15.128
Medicare continues to pay

00:25:15.169 --> 00:25:16.670
for telehealth through the

00:25:16.750 --> 00:25:17.510
end of September,

00:25:17.550 --> 00:25:18.692
two thousand twenty five.

00:25:19.192 --> 00:25:21.575
Unless the laws change and extend,

00:25:22.115 --> 00:25:24.518
we lose that ability end of September,

00:25:24.557 --> 00:25:25.479
two thousand twenty five.

00:25:26.038 --> 00:25:27.380
When a new patient calls my

00:25:27.420 --> 00:25:28.861
clinic and the comparison I

00:25:28.901 --> 00:25:30.643
made in the video, as I said, look,

00:25:31.182 --> 00:25:33.243
imagine you've got a toothache.

00:25:33.744 --> 00:25:35.746
You call the dental practice.

00:25:36.106 --> 00:25:37.988
You're like, my tooth is killing me.

00:25:38.008 --> 00:25:40.289
Oh, yeah,

00:25:40.609 --> 00:25:41.770
that's a different version of the

00:25:41.810 --> 00:25:42.211
same thing.

00:25:42.250 --> 00:25:43.811
But my tooth is killing me.

00:25:44.031 --> 00:25:45.292
The dentist can't get you in

00:25:45.333 --> 00:25:46.574
for seventy two hours.

00:25:46.974 --> 00:25:49.056
But the person on the phone says, Tony,

00:25:49.096 --> 00:25:49.896
just hang on.

00:25:50.076 --> 00:25:52.218
If you want me to get Dr. Dave,

00:25:52.258 --> 00:25:53.700
the dentist on the phone.

00:25:54.579 --> 00:25:56.122
Switch to a video call.

00:25:56.521 --> 00:25:57.682
He can take a look at your

00:25:57.742 --> 00:25:59.105
situation and give you some

00:25:59.144 --> 00:26:01.006
recommendations for temporary relief.

00:26:01.646 --> 00:26:01.826
Now,

00:26:02.106 --> 00:26:04.189
I was talking to Michael Derry last

00:26:04.250 --> 00:26:04.569
night.

00:26:04.849 --> 00:26:06.471
Michael wrote a book.

00:26:06.511 --> 00:26:07.553
He's working on getting it

00:26:07.593 --> 00:26:08.814
published about sciatica.

00:26:09.535 --> 00:26:10.394
I think, Dave Kittle,

00:26:10.414 --> 00:26:11.777
you're probably in this world.

00:26:11.817 --> 00:26:13.198
There's probably things you

00:26:13.218 --> 00:26:14.199
can do for somebody

00:26:14.640 --> 00:26:17.702
suffering from sciatica who

00:26:17.742 --> 00:26:18.864
went to the emergency room.

00:26:19.664 --> 00:26:20.845
nothing they could do to help them,

00:26:20.904 --> 00:26:22.205
got them discharged with

00:26:22.286 --> 00:26:24.026
muscle relaxers and pain meds.

00:26:24.866 --> 00:26:26.866
And if they got on a video call with you,

00:26:27.067 --> 00:26:28.327
even if it wasn't as good

00:26:28.387 --> 00:26:29.748
as seeing you in person,

00:26:30.407 --> 00:26:32.189
they couldn't get your magic fingers.

00:26:32.528 --> 00:26:33.929
You could probably give them

00:26:33.969 --> 00:26:35.049
two or three things to do

00:26:35.089 --> 00:26:36.190
to manage the symptoms.

00:26:36.849 --> 00:26:39.131
So with Medicare guidelines,

00:26:39.171 --> 00:26:41.771
the way it is like absolutely right now,

00:26:41.852 --> 00:26:43.592
we could go from a voice

00:26:43.632 --> 00:26:44.972
call to book an appointment and

00:26:45.810 --> 00:26:47.172
Send them a link because

00:26:47.231 --> 00:26:48.053
most people are calling

00:26:48.073 --> 00:26:49.294
from a cell phone anyway.

00:26:49.933 --> 00:26:50.654
Send them a link,

00:26:51.075 --> 00:26:52.817
switch them to a video and

00:26:52.977 --> 00:26:55.578
audio live chat or live call,

00:26:55.618 --> 00:26:57.901
which is on a HIPAA compliant platform.

00:26:58.661 --> 00:26:59.541
And now that becomes a

00:26:59.642 --> 00:27:00.883
billable evaluation.

00:27:00.923 --> 00:27:01.743
And when you look at the

00:27:01.763 --> 00:27:04.184
Medicare guidelines, CMS chapter fifteen,

00:27:04.224 --> 00:27:05.105
section two twenty,

00:27:05.727 --> 00:27:07.948
it says very clearly all

00:27:07.988 --> 00:27:11.111
you need is a diagnosis, sciatica,

00:27:11.510 --> 00:27:12.471
shoulder pain, whatever,

00:27:13.272 --> 00:27:14.594
and a functional assessment.

00:27:15.272 --> 00:27:15.492
John,

00:27:15.532 --> 00:27:17.733
can you can you bend over and put on

00:27:17.773 --> 00:27:18.114
a sock?

00:27:18.173 --> 00:27:18.433
No.

00:27:18.733 --> 00:27:20.253
OK, my functional assessment is done.

00:27:20.775 --> 00:27:20.954
Now,

00:27:20.994 --> 00:27:22.394
let me give you something to help the

00:27:22.434 --> 00:27:24.135
sciatic pain right now.

00:27:24.675 --> 00:27:25.736
And then I'll be at your

00:27:25.776 --> 00:27:28.537
house tomorrow in a couple of days,

00:27:28.576 --> 00:27:29.436
whatever you need to do.

00:27:30.096 --> 00:27:31.057
You know, like this.

00:27:31.317 --> 00:27:32.218
Nobody is doing it.

00:27:32.317 --> 00:27:33.458
Nobody is considering it.

00:27:33.498 --> 00:27:34.818
Nobody is talking about it.

00:27:35.679 --> 00:27:37.398
I've shared this idea for a long time.

00:27:37.778 --> 00:27:38.599
I don't do it.

00:27:38.900 --> 00:27:39.539
Disclosure.

00:27:40.039 --> 00:27:41.181
Just because I'm too busy.

00:27:41.721 --> 00:27:43.701
But there are a lot of practice owners,

00:27:43.801 --> 00:27:44.583
new startups,

00:27:44.643 --> 00:27:46.463
small independents that are

00:27:46.523 --> 00:27:48.565
not too busy who could be

00:27:48.625 --> 00:27:52.768
doing this right now.

00:27:52.788 --> 00:27:53.087
Thoughts?

00:27:55.630 --> 00:27:56.490
Dave probably hates it

00:27:56.509 --> 00:27:57.911
because it has to do with his Zoom call.

00:27:58.432 --> 00:27:59.592
I think he loves it because

00:27:59.853 --> 00:28:01.353
he can use his knowledge.

00:28:03.315 --> 00:28:03.934
We did this,

00:28:03.994 --> 00:28:06.076
or I did this during COVID for

00:28:06.096 --> 00:28:06.717
folks that were like,

00:28:07.946 --> 00:28:09.768
too far away outside of the

00:28:09.788 --> 00:28:14.509
new york city area jimmy

00:28:14.568 --> 00:28:17.049
what do you think uh dave

00:28:17.069 --> 00:28:17.671
you're cutting out a little

00:28:17.691 --> 00:28:18.451
bit the audio is cutting

00:28:18.490 --> 00:28:19.391
out I think yeah I mean we

00:28:19.431 --> 00:28:20.432
did it but we would charge

00:28:20.451 --> 00:28:21.672
like at that time two fifty

00:28:21.692 --> 00:28:22.531
up front so they would have

00:28:22.551 --> 00:28:23.792
to have already paid two fifty

00:28:24.690 --> 00:28:25.009
Yeah.

00:28:25.109 --> 00:28:26.330
And that's, that's reasonable.

00:28:26.550 --> 00:28:28.590
I mean, it's, it's an emergency situation.

00:28:28.731 --> 00:28:30.231
I need help right now.

00:28:30.791 --> 00:28:32.472
If Medicare didn't cover it,

00:28:32.593 --> 00:28:34.073
it would be a self-pay service.

00:28:34.594 --> 00:28:35.054
Agreed.

00:28:35.074 --> 00:28:35.433
Yeah.

00:28:35.493 --> 00:28:35.653
I mean,

00:28:35.673 --> 00:28:37.535
this is an increasing to access and

00:28:37.575 --> 00:28:38.755
the audience is going to

00:28:38.954 --> 00:28:40.796
decide the water is going

00:28:40.816 --> 00:28:41.355
to find its level.

00:28:41.395 --> 00:28:42.396
If people hate this idea,

00:28:42.876 --> 00:28:43.896
your phone will say silent.

00:28:43.916 --> 00:28:44.817
If they like this idea,

00:28:44.856 --> 00:28:46.678
it'll ring or somewhere in the middle,

00:28:46.837 --> 00:28:47.038
right?

00:28:47.117 --> 00:28:48.419
Is this going to be only right?

00:28:49.058 --> 00:28:50.220
The quote I used just the other day,

00:28:50.359 --> 00:28:52.121
only a Sith deals in absolutes.

00:28:52.161 --> 00:28:53.061
That's Obi-Wan Kenobi.

00:28:53.221 --> 00:28:55.064
I know you're Star Wars fans.

00:28:55.144 --> 00:28:56.003
So I don't think it's an

00:28:57.184 --> 00:28:58.165
always or a never.

00:28:58.346 --> 00:28:59.787
I think it's when it fits, it's really,

00:28:59.826 --> 00:29:00.228
really great.

00:29:00.248 --> 00:29:03.029
And then the next layer to

00:29:03.069 --> 00:29:05.551
this is imagine the rapport,

00:29:05.592 --> 00:29:06.853
imagine the relationship,

00:29:06.893 --> 00:29:08.073
the trust that is built

00:29:08.193 --> 00:29:09.193
right then and there,

00:29:09.694 --> 00:29:10.816
because this person has a

00:29:10.875 --> 00:29:12.656
real problem with real urgency.

00:29:12.696 --> 00:29:13.438
And you're like, hey,

00:29:13.857 --> 00:29:15.898
I realize I can't make it, you know,

00:29:15.919 --> 00:29:17.299
get you in person right now.

00:29:18.000 --> 00:29:19.321
But I can help you a little bit.

00:29:19.461 --> 00:29:20.923
I can help you for now.

00:29:21.423 --> 00:29:23.345
And then when I'm in person with you,

00:29:23.384 --> 00:29:24.246
then we can take care of

00:29:24.266 --> 00:29:25.105
this permanently.

00:29:25.527 --> 00:29:25.807
You know,

00:29:25.846 --> 00:29:26.907
like that's a person that's a

00:29:26.948 --> 00:29:27.667
patient for life.

00:29:27.728 --> 00:29:28.828
That is somebody that is

00:29:28.868 --> 00:29:31.290
going to be so like deeply

00:29:31.351 --> 00:29:32.971
indebted to you because

00:29:33.153 --> 00:29:34.933
nobody else is even considering this.

00:29:35.334 --> 00:29:36.855
But this is an idea that can

00:29:36.894 --> 00:29:38.155
go out to any service

00:29:38.215 --> 00:29:39.416
professional plumbers.

00:29:39.837 --> 00:29:41.078
Hey, I got a leaky sink.

00:29:41.179 --> 00:29:42.259
Well, it's not an emergency.

00:29:42.339 --> 00:29:43.721
I can't get out there for a week.

00:29:43.901 --> 00:29:44.101
Sure.

00:29:44.280 --> 00:29:45.661
switch over to a video call,

00:29:45.721 --> 00:29:46.641
show me the sink.

00:29:46.740 --> 00:29:47.942
I'll tell you what you can

00:29:47.981 --> 00:29:50.281
do at home on your own to

00:29:50.342 --> 00:29:52.502
at least temporarily fix the problem.

00:29:53.002 --> 00:29:53.982
And then when I come out there,

00:29:54.002 --> 00:29:55.063
I'll fix it permanently.

00:29:55.563 --> 00:29:58.084
Like car, my, my car is, you know,

00:29:58.124 --> 00:29:59.064
making this weird noise.

00:29:59.084 --> 00:30:00.743
Well, let's switch over to a video call.

00:30:00.784 --> 00:30:01.804
Let me see what's going on.

00:30:01.864 --> 00:30:02.403
Let me hear it.

00:30:02.443 --> 00:30:03.144
Let me look at it.

00:30:03.605 --> 00:30:03.904
Okay.

00:30:03.944 --> 00:30:04.605
Try this, this,

00:30:04.644 --> 00:30:06.704
and this I'll get you in next week.

00:30:06.785 --> 00:30:08.566
Like everybody should be

00:30:08.605 --> 00:30:10.266
doing this across all services.

00:30:12.127 --> 00:30:15.068
Computers will create a paperless world.

00:30:15.288 --> 00:30:17.009
I heard that in second grade

00:30:17.449 --> 00:30:19.949
when I first was brought

00:30:19.989 --> 00:30:21.390
into computer class in

00:30:21.430 --> 00:30:22.670
second grade and we sat in

00:30:22.690 --> 00:30:23.589
front of a bunch of like

00:30:23.829 --> 00:30:26.790
Macs and yet we're gonna

00:30:26.830 --> 00:30:28.151
crack up because Tony just

00:30:28.171 --> 00:30:29.070
got a call from a local

00:30:29.131 --> 00:30:30.830
doctor's office right across the street,

00:30:31.270 --> 00:30:32.412
a hospital owned primary

00:30:32.432 --> 00:30:34.392
care physician group and he

00:30:34.531 --> 00:30:36.092
asked for paper referral pads.

00:30:36.551 --> 00:30:39.012
He wanted, so hit the,

00:30:39.032 --> 00:30:39.952
what did I miss in the story?

00:30:41.304 --> 00:30:43.625
So real quick backstory, you know,

00:30:44.164 --> 00:30:46.286
I've always done paper referral pads.

00:30:46.346 --> 00:30:47.826
I've done group referral pads.

00:30:47.846 --> 00:30:48.747
So like I'll get all the

00:30:48.767 --> 00:30:50.267
physical therapy providers

00:30:50.287 --> 00:30:51.627
within a geographic area,

00:30:51.688 --> 00:30:53.107
put them on my referral

00:30:53.147 --> 00:30:54.628
pads at my expense,

00:30:55.108 --> 00:30:56.608
send them to the doc office.

00:30:56.670 --> 00:30:58.049
I've done lots of different

00:30:58.089 --> 00:30:59.631
kind of things like this.

00:31:00.211 --> 00:31:01.711
And I really started to feel like,

00:31:01.851 --> 00:31:03.432
all right, it's probably, you know,

00:31:03.531 --> 00:31:04.372
run its course.

00:31:04.451 --> 00:31:06.133
Nobody cares about this anymore.

00:31:06.153 --> 00:31:06.173
A

00:31:09.673 --> 00:31:11.115
And so yesterday I'm sitting

00:31:11.154 --> 00:31:11.775
here at lunch.

00:31:11.875 --> 00:31:12.654
The phone rings.

00:31:12.815 --> 00:31:14.615
I know it's the doc group next door.

00:31:14.635 --> 00:31:16.797
And I'm like, I don't want to answer that.

00:31:16.896 --> 00:31:17.817
Either they're requesting

00:31:17.856 --> 00:31:19.117
medical records or they

00:31:19.137 --> 00:31:20.519
want to schedule an appointment.

00:31:20.558 --> 00:31:22.558
And I don't want more patients.

00:31:23.059 --> 00:31:24.200
So I just I let it ring.

00:31:24.960 --> 00:31:25.921
It went to voicemail,

00:31:25.941 --> 00:31:26.961
but they didn't leave a message.

00:31:27.020 --> 00:31:29.001
Five minutes later, rings again.

00:31:29.041 --> 00:31:29.682
I'm like, all right,

00:31:29.701 --> 00:31:31.163
I got to be a big boy.

00:31:31.343 --> 00:31:32.563
Put on my big boy pants.

00:31:33.003 --> 00:31:34.763
I answer the phone and they're like, hey,

00:31:34.804 --> 00:31:36.664
can you send us over more referral pads?

00:31:36.684 --> 00:31:37.546
We've got patients.

00:31:37.566 --> 00:31:38.246
And we ran out.

00:31:38.846 --> 00:31:40.686
I was like, oh, OK.

00:31:40.727 --> 00:31:41.788
I send my son who's doing a

00:31:41.827 --> 00:31:43.067
summer internship with us

00:31:43.469 --> 00:31:44.288
across the street.

00:31:44.409 --> 00:31:45.329
He drops them off.

00:31:46.130 --> 00:31:47.750
The point in that story, though,

00:31:47.851 --> 00:31:49.192
is these guys are all

00:31:49.271 --> 00:31:50.873
hospital owned physicians.

00:31:50.913 --> 00:31:52.053
They're great physicians.

00:31:52.094 --> 00:31:53.213
I've known them for years.

00:31:54.414 --> 00:31:55.915
They are pressured to send

00:31:55.955 --> 00:31:58.317
to to the hospital outpatient clinic.

00:31:58.336 --> 00:31:59.278
There's zero doubt,

00:31:59.978 --> 00:32:01.719
but they still need their

00:32:01.759 --> 00:32:02.859
patients to be seen.

00:32:02.920 --> 00:32:05.121
The hospital outpatient is full now.

00:32:05.982 --> 00:32:09.164
They give the patient the internal EMR,

00:32:09.204 --> 00:32:11.105
the Epic EMR referral,

00:32:11.727 --> 00:32:12.846
but they also wanted the

00:32:12.886 --> 00:32:13.788
referral that has our

00:32:13.827 --> 00:32:15.148
address and our information

00:32:15.189 --> 00:32:16.209
and the other stuff on it.

00:32:16.670 --> 00:32:19.191
So we sent over a handful of pads.

00:32:20.451 --> 00:32:22.673
It reminded me that this is still a thing.

00:32:23.054 --> 00:32:24.213
And now I'll go and I'll

00:32:24.233 --> 00:32:25.194
start sending them out to

00:32:25.295 --> 00:32:26.935
all the other docs in the area.

00:32:29.892 --> 00:32:31.113
Dave had a comment.

00:32:31.133 --> 00:32:31.773
Dave, you're grinning.

00:32:32.273 --> 00:32:34.895
No, Jimmy,

00:32:34.935 --> 00:32:36.657
you shared the screenshot with

00:32:36.678 --> 00:32:37.518
my comment that I had

00:32:37.577 --> 00:32:38.499
messaged you guys yesterday.

00:32:38.939 --> 00:32:39.839
I screenshotted that.

00:32:39.880 --> 00:32:40.980
I was going to post it publicly.

00:32:41.642 --> 00:32:43.502
But the comment under Tony's post,

00:32:43.583 --> 00:32:44.064
I didn't post it,

00:32:44.084 --> 00:32:45.744
but it had said something like,

00:32:47.086 --> 00:32:47.686
in health care,

00:32:47.727 --> 00:32:49.307
paper referral pads and fax

00:32:49.327 --> 00:32:50.568
machines are still used.

00:32:51.589 --> 00:32:52.911
But Tony Maritato thinks

00:32:52.951 --> 00:32:54.711
artificial intelligence is taking over.

00:32:55.373 --> 00:32:56.113
Think again.

00:32:57.314 --> 00:32:58.855
And I believe that.

00:32:58.914 --> 00:33:00.816
I know Tony has a lot of

00:33:00.875 --> 00:33:06.238
faith and enthusiasm for

00:33:06.278 --> 00:33:07.219
artificial intelligence.

00:33:08.086 --> 00:33:10.007
But we don't, I mean, our practice,

00:33:10.047 --> 00:33:10.846
we don't have a fax machine.

00:33:11.106 --> 00:33:12.047
We have referrals and people

00:33:12.087 --> 00:33:13.708
call up or nurses or whoever,

00:33:13.728 --> 00:33:14.909
and they're like, what's your fax number?

00:33:15.269 --> 00:33:16.868
I used to say our fax is down.

00:33:17.388 --> 00:33:17.990
Can you email it?

00:33:18.049 --> 00:33:19.410
Now I just say, can you just email it?

00:33:20.431 --> 00:33:24.471
So we have opted out of the fax machine.

00:33:24.872 --> 00:33:26.272
I've never had a fax line,

00:33:26.333 --> 00:33:26.952
even though you can have

00:33:27.012 --> 00:33:27.692
one for five dollars a

00:33:27.732 --> 00:33:29.973
month and have like a whatever over Wi-Fi,

00:33:29.993 --> 00:33:30.974
you can have a fax line.

00:33:31.875 --> 00:33:33.915
And I'm just like, I just don't do it,

00:33:34.036 --> 00:33:34.276
right?

00:33:35.596 --> 00:33:37.156
It's so funny, like Tony's,

00:33:37.797 --> 00:33:40.701
handing out paper for all

00:33:40.721 --> 00:33:42.142
pads that are still being requested.

00:33:43.123 --> 00:33:45.965
He may or may not have a fax machine,

00:33:46.846 --> 00:33:50.230
but he thinks artificial

00:33:50.250 --> 00:33:53.734
intelligence is taking over.

00:33:53.755 --> 00:33:54.635
It's very ironic.

00:33:56.057 --> 00:33:57.419
The thing with that is...

00:33:58.428 --> 00:34:00.669
AI is replacing the stuff

00:34:00.709 --> 00:34:02.549
that we thought would never be replaced,

00:34:02.970 --> 00:34:05.050
but it's not replacing stuff.

00:34:05.471 --> 00:34:06.730
Like you hear the people say,

00:34:06.871 --> 00:34:08.271
I don't need AI to do this.

00:34:08.371 --> 00:34:10.032
I need AI to vacuum my carpet.

00:34:10.353 --> 00:34:11.253
Like you're right.

00:34:12.793 --> 00:34:14.554
I will be replaced because

00:34:14.873 --> 00:34:16.795
my perception of value in

00:34:16.835 --> 00:34:18.215
the physical therapy world

00:34:18.356 --> 00:34:20.577
is my brain's ability to

00:34:20.637 --> 00:34:22.936
process dynamic information, right?

00:34:23.018 --> 00:34:23.797
Dave comes in,

00:34:24.338 --> 00:34:26.739
Dave's like, I play recreational baseball.

00:34:26.820 --> 00:34:28.221
My shoulder's been bugging me.

00:34:28.800 --> 00:34:31.023
Oh, I also got a COVID injection a couple,

00:34:31.123 --> 00:34:32.503
you know, whatever years ago.

00:34:32.563 --> 00:34:33.364
And ever since then,

00:34:33.403 --> 00:34:34.684
my shoulder's never been the same.

00:34:35.905 --> 00:34:36.967
Making the connection

00:34:37.007 --> 00:34:38.887
between the chemistry and

00:34:38.947 --> 00:34:39.869
all the other stuff,

00:34:39.909 --> 00:34:41.088
Dave came in thinking it

00:34:41.108 --> 00:34:42.130
was something related to

00:34:42.210 --> 00:34:43.431
mechanical pathology.

00:34:43.630 --> 00:34:45.472
I think it's more chemical pathology.

00:34:46.313 --> 00:34:47.333
I thought that was safe.

00:34:47.373 --> 00:34:47.914
That's gone.

00:34:48.134 --> 00:34:50.416
Like that is what AI is going to replace.

00:34:51.307 --> 00:34:52.168
What AI is not going to

00:34:52.188 --> 00:34:53.969
replace is the human who

00:34:54.028 --> 00:34:55.849
rubs Dave's shoulder while

00:34:56.190 --> 00:34:58.110
Dave tells him jokes and he

00:34:58.170 --> 00:34:59.291
laughs at those jokes.

00:34:59.331 --> 00:35:00.751
Like those are the things.

00:35:01.152 --> 00:35:04.614
So the fax machine, it's nineteen,

00:35:04.673 --> 00:35:07.275
you know, eighty seven technology.

00:35:07.815 --> 00:35:08.335
You're right.

00:35:08.556 --> 00:35:09.996
AI is not replacing that.

00:35:10.056 --> 00:35:12.177
Like there's still people on

00:35:12.356 --> 00:35:13.777
old systems that are using

00:35:13.858 --> 00:35:14.617
old technology.

00:35:14.677 --> 00:35:15.318
We're one of them.

00:35:15.458 --> 00:35:17.278
I have a fax machine in every office.

00:35:17.298 --> 00:35:18.659
I have a fax machine at home.

00:35:18.820 --> 00:35:20.420
I get faxes every single day.

00:35:21.961 --> 00:35:24.264
But what AI is replacing is

00:35:24.304 --> 00:35:25.244
the stuff that we thought

00:35:25.304 --> 00:35:26.445
was irreplaceable.

00:35:26.947 --> 00:35:29.389
Our intelligence, our analytical sense,

00:35:29.429 --> 00:35:31.311
our ability to put pieces

00:35:31.351 --> 00:35:32.632
of a puzzle together.

00:35:32.652 --> 00:35:33.132
That's gone.

00:35:34.994 --> 00:35:35.894
Yeah, I think it's the simple,

00:35:35.914 --> 00:35:37.315
tangible things that people like,

00:35:37.416 --> 00:35:38.096
like a reminder.

00:35:39.177 --> 00:35:41.177
How many times I take a business card,

00:35:41.278 --> 00:35:42.039
I actually still do.

00:35:42.139 --> 00:35:43.280
I do snap a picture of it,

00:35:43.559 --> 00:35:45.021
but I stick the card in my

00:35:45.081 --> 00:35:46.702
pocket because I know it's

00:35:46.742 --> 00:35:47.802
solving a forgetting

00:35:47.842 --> 00:35:50.204
problem or a losing it problem, right?

00:35:50.545 --> 00:35:51.746
I can store anything I want

00:35:51.766 --> 00:35:53.487
in Google Drive and I do,

00:35:53.688 --> 00:35:54.728
and then I can't find it.

00:35:55.208 --> 00:35:56.409
Have you guys ever used Notion?

00:35:57.670 --> 00:35:58.731
I have it now.

00:35:58.751 --> 00:35:59.411
Notion's essentially a

00:35:59.431 --> 00:36:00.632
little world you can create

00:36:00.992 --> 00:36:02.532
like an internal Wiki and

00:36:02.572 --> 00:36:03.773
companies I've worked for of like,

00:36:04.112 --> 00:36:05.494
that's over here, how to do that.

00:36:05.514 --> 00:36:06.514
A lot of SOPs,

00:36:06.534 --> 00:36:07.954
a lot of like internal data.

00:36:08.474 --> 00:36:09.074
And I, you know,

00:36:09.175 --> 00:36:10.195
use the phrase and I don't know,

00:36:10.235 --> 00:36:11.476
probably not the first person to use it.

00:36:11.496 --> 00:36:12.695
I'm like, it's in Notion.

00:36:12.835 --> 00:36:14.197
The answer kept, it's in Notion.

00:36:14.237 --> 00:36:15.197
Hey, does anybody know how to do this?

00:36:15.416 --> 00:36:16.016
It's in Notion.

00:36:16.036 --> 00:36:17.717
I'm like, yeah, but Notion's in Notion.

00:36:17.818 --> 00:36:19.318
Like I know it's in there

00:36:19.697 --> 00:36:20.518
and I'm here for you.

00:36:20.559 --> 00:36:21.759
Can you tell me how to do it?

00:36:21.778 --> 00:36:23.039
Or can you point to where that thing is?

00:36:23.079 --> 00:36:24.219
Cause I looked there already

00:36:24.579 --> 00:36:25.579
and I can't find it cause

00:36:25.599 --> 00:36:26.860
it's in a sea of everything.

00:36:27.320 --> 00:36:28.523
So when everything's important,

00:36:28.583 --> 00:36:29.324
nothing's important.

00:36:29.603 --> 00:36:30.525
And it's just a pendulum.

00:36:30.844 --> 00:36:31.405
But I think you're right.

00:36:31.706 --> 00:36:33.289
It's repetitive tasks.

00:36:33.708 --> 00:36:35.871
It's the things that just should be done.

00:36:36.231 --> 00:36:39.195
Seth Godin said this ten years ago.

00:36:39.576 --> 00:36:41.057
I'll go ask AI when the

00:36:41.097 --> 00:36:42.340
actual blog post was from

00:36:42.380 --> 00:36:43.460
Seth Godin when he said this.

00:36:43.822 --> 00:36:45.023
And it's something stunningly,

00:36:45.123 --> 00:36:45.983
stupidly simple.

00:36:47.025 --> 00:36:48.025
When you're buying something

00:36:48.045 --> 00:36:49.887
from an online retailer and

00:36:49.907 --> 00:36:51.168
I'm putting in my address

00:36:51.188 --> 00:36:52.429
to either have the product

00:36:52.471 --> 00:36:54.112
shipped to me or for my

00:36:54.172 --> 00:36:55.853
credit card information verification,

00:36:56.554 --> 00:36:58.195
I type in two pieces of information.

00:36:58.577 --> 00:36:59.577
And his question is why?

00:37:00.057 --> 00:37:02.460
I type in my zip code and then my state.

00:37:03.822 --> 00:37:05.003
You know what state I live

00:37:05.063 --> 00:37:06.445
in based on the zip code.

00:37:06.625 --> 00:37:07.965
That's how zip codes work.

00:37:08.385 --> 00:37:10.246
But I've been across very

00:37:10.286 --> 00:37:11.447
few websites in the last

00:37:11.547 --> 00:37:13.108
twenty five years of buying

00:37:13.148 --> 00:37:14.769
stuff online that actually

00:37:14.809 --> 00:37:15.990
just ask for the zip code

00:37:16.311 --> 00:37:18.532
and will auto fill the state.

00:37:18.891 --> 00:37:19.213
And now,

00:37:19.253 --> 00:37:20.713
since I read that from Godin ten

00:37:20.753 --> 00:37:22.414
years ago, every time I do it,

00:37:22.815 --> 00:37:24.476
I get a little bit more pissed off.

00:37:24.695 --> 00:37:25.956
Because someone hasn't taken

00:37:25.976 --> 00:37:26.737
that experience.

00:37:27.117 --> 00:37:27.838
Now,

00:37:28.139 --> 00:37:30.402
the paper referral pad to me is just a

00:37:30.501 --> 00:37:31.963
physical embodiment of that.

00:37:32.222 --> 00:37:34.125
That's a psychological nudge, right?

00:37:34.144 --> 00:37:34.766
You're probably going to

00:37:34.806 --> 00:37:35.646
lose that or throw it away.

00:37:35.686 --> 00:37:36.608
Or maybe you do actually

00:37:36.648 --> 00:37:38.429
tack it up on the refrigerator.

00:37:38.789 --> 00:37:41.552
But I think it's a yes and, right?

00:37:41.652 --> 00:37:43.114
Is AI going to take over everything?

00:37:43.253 --> 00:37:44.054
No.

00:37:44.135 --> 00:37:44.554
Hopefully,

00:37:44.574 --> 00:37:46.097
it's the repetitive tasks or

00:37:46.117 --> 00:37:47.197
filling in what state I

00:37:47.237 --> 00:37:48.179
live in after I tell you

00:37:48.219 --> 00:37:49.360
what zip code I live at.

00:37:50.925 --> 00:37:52.927
So that goes back to one of

00:37:52.967 --> 00:37:54.168
the things that when I

00:37:54.208 --> 00:37:55.608
started my business back in

00:37:55.648 --> 00:37:57.851
two thousand and one, I said,

00:37:58.010 --> 00:37:59.693
I am never going to do this.

00:38:00.373 --> 00:38:01.753
I am never going to give a

00:38:01.853 --> 00:38:03.114
patient a packet of new

00:38:03.155 --> 00:38:04.076
patient paperwork.

00:38:04.536 --> 00:38:05.637
I'm never going to give the

00:38:05.677 --> 00:38:06.418
patient a health

00:38:06.438 --> 00:38:07.338
questionnaire that they

00:38:07.358 --> 00:38:08.840
have to answer questions on

00:38:08.880 --> 00:38:10.262
and fill all this stuff out.

00:38:11.021 --> 00:38:11.983
one of the things that I do

00:38:12.003 --> 00:38:12.702
when I'm teaching my

00:38:12.742 --> 00:38:13.983
Medicare course is I go to

00:38:14.043 --> 00:38:15.844
random PT websites and I

00:38:15.885 --> 00:38:17.786
show their admission paperwork.

00:38:18.226 --> 00:38:18.547
And I'm like,

00:38:18.806 --> 00:38:20.827
why are we even asking these questions?

00:38:20.867 --> 00:38:23.010
Like these questions has have no relevance,

00:38:23.289 --> 00:38:25.871
or I can get all of this information.

00:38:25.931 --> 00:38:28.333
If I get this one piece, you know,

00:38:28.393 --> 00:38:30.393
give me your Medicare subscriber ID,

00:38:30.414 --> 00:38:31.614
your name and your date of birth.

00:38:32.074 --> 00:38:32.976
I'll get your address.

00:38:33.056 --> 00:38:33.715
I'll get your phone.

00:38:33.795 --> 00:38:35.396
I'll get all of these other things.

00:38:35.416 --> 00:38:36.097
And again,

00:38:37.132 --> 00:38:39.755
we don't do that because we're so used to,

00:38:39.976 --> 00:38:41.639
Oh, well you fill out the paperwork.

00:38:41.679 --> 00:38:43.942
You answer the, how many times I've,

00:38:43.961 --> 00:38:45.804
I'm asking you guys in real world,

00:38:46.505 --> 00:38:48.708
if you see a patient and you're like,

00:38:48.728 --> 00:38:50.250
do you have a hypertension?

00:38:50.329 --> 00:38:50.530
No.

00:38:50.670 --> 00:38:51.630
Do you have diabetes?

00:38:51.731 --> 00:38:51.911
No.

00:38:52.211 --> 00:38:53.494
What medications are you taking?

00:38:53.634 --> 00:38:53.773
Well,

00:38:53.813 --> 00:38:55.896
I take like Cinepryl and Metformin and,

00:38:56.317 --> 00:38:56.817
Well, wait a minute.

00:38:56.836 --> 00:38:58.637
You just said you don't have those.

00:38:59.137 --> 00:38:59.418
Well, no,

00:38:59.478 --> 00:39:00.518
I don't have those conditions

00:39:00.539 --> 00:39:01.818
because I'm taking those drugs.

00:39:01.858 --> 00:39:02.079
Right.

00:39:02.759 --> 00:39:04.639
To ask a patient to answer

00:39:04.699 --> 00:39:06.501
health care questions on a

00:39:06.561 --> 00:39:08.902
piece of paper makes no sense to me.

00:39:08.942 --> 00:39:09.961
They are not equipped to

00:39:10.041 --> 00:39:11.302
answer those questions.

00:39:12.023 --> 00:39:12.682
And you're going to have

00:39:12.742 --> 00:39:14.083
those conversations anyway.

00:39:14.844 --> 00:39:16.244
And so that's what made me

00:39:16.304 --> 00:39:18.186
rethink my whole patient experience.

00:39:18.226 --> 00:39:18.846
I'm like, look,

00:39:19.365 --> 00:39:21.387
this person pulled into the parking lot.

00:39:21.447 --> 00:39:22.887
I saw them get out of the car.

00:39:23.329 --> 00:39:24.989
Do I really have to sit here

00:39:25.110 --> 00:39:26.489
and go into an exam room?

00:39:27.070 --> 00:39:28.451
I watched them get out of the car,

00:39:28.510 --> 00:39:29.632
close the car door.

00:39:29.851 --> 00:39:31.572
I saw if they have an assistive device.

00:39:31.753 --> 00:39:33.114
I saw them come in my clinic

00:39:33.153 --> 00:39:34.755
like they're standing at the front desk.

00:39:35.175 --> 00:39:36.655
My evaluation is finished.

00:39:37.016 --> 00:39:38.737
Let's go start making you feel better.

00:39:39.356 --> 00:39:40.637
That's what I want to work on.

00:39:41.538 --> 00:39:43.358
But I don't think we either

00:39:43.418 --> 00:39:45.199
we don't teach these skills

00:39:45.380 --> 00:39:47.882
or we don't tell therapists like, hey,

00:39:47.942 --> 00:39:50.222
you your evaluation starts

00:39:50.282 --> 00:39:53.445
at that first moment of contact.

00:39:53.565 --> 00:39:53.844
Agreed.

00:39:53.925 --> 00:39:54.885
We do it at the airport.

00:39:55.166 --> 00:39:56.106
We watch people walk.

00:39:56.206 --> 00:39:57.206
We watch people move.

00:39:57.467 --> 00:39:59.188
We analyze all of their stuff.

00:39:59.248 --> 00:39:59.547
Right.

00:40:01.088 --> 00:40:01.889
The question is.

00:40:03.409 --> 00:40:04.431
I think the question is.

00:40:05.635 --> 00:40:06.715
how does this change?

00:40:07.195 --> 00:40:08.277
So how does that change?

00:40:08.317 --> 00:40:09.478
How does that model change?

00:40:09.677 --> 00:40:10.978
If this is the way it's always been,

00:40:10.998 --> 00:40:11.599
and these are the things

00:40:11.619 --> 00:40:12.599
that are always required?

00:40:13.121 --> 00:40:13.360
I mean,

00:40:14.041 --> 00:40:15.382
Craig's pointing out HIPAA makes

00:40:15.443 --> 00:40:16.864
facts or effects necessary

00:40:16.903 --> 00:40:17.744
for plan of cares when

00:40:17.784 --> 00:40:18.704
clients use insurance,

00:40:18.724 --> 00:40:20.987
like so is it chicken or the egg?

00:40:21.007 --> 00:40:22.407
Like, how does this thing actually change?

00:40:25.088 --> 00:40:26.210
Is that not doing it?

00:40:26.449 --> 00:40:28.331
Is it, you know, is it, is it the same?

00:40:28.471 --> 00:40:29.751
Is it the same question of like,

00:40:30.152 --> 00:40:31.572
how do PTs get paid more?

00:40:31.893 --> 00:40:32.014
Well,

00:40:32.034 --> 00:40:33.614
we all have to opt out at the same

00:40:33.675 --> 00:40:35.315
time and then we'll show them demand.

00:40:35.856 --> 00:40:37.077
And my, my response,

00:40:37.097 --> 00:40:37.898
whenever I see that is,

00:40:37.918 --> 00:40:38.898
have you tried to get eight

00:40:38.938 --> 00:40:40.219
people to go to dinner on

00:40:40.259 --> 00:40:41.599
time and agree on a restaurant?

00:40:41.940 --> 00:40:42.860
You're going to get a

00:40:42.920 --> 00:40:44.001
hundred thousand physical

00:40:44.021 --> 00:40:45.163
therapists to do all

00:40:45.222 --> 00:40:45.643
something that's

00:40:45.702 --> 00:40:46.103
threatening their

00:40:46.143 --> 00:40:47.583
livelihood at the same time.

00:40:48.085 --> 00:40:49.184
I mean, that's never going to happen.

00:40:49.505 --> 00:40:50.726
So the question is, how does this, this,

00:40:50.766 --> 00:40:51.547
how does this ever actually

00:40:51.586 --> 00:40:53.047
progress or does it?

00:40:54.351 --> 00:40:55.952
I think someone like Dave, you know,

00:40:56.012 --> 00:40:57.733
Dave starts laying the groundwork.

00:40:58.914 --> 00:40:59.514
I'm shocked.

00:40:59.713 --> 00:41:01.295
I am that Dave doesn't have

00:41:01.394 --> 00:41:02.755
any kind of fax system,

00:41:02.815 --> 00:41:04.416
not even an e-fax system.

00:41:05.576 --> 00:41:06.297
But it's either going to

00:41:06.336 --> 00:41:07.077
take somebody on the

00:41:07.117 --> 00:41:08.597
provider side or somebody

00:41:08.637 --> 00:41:10.257
on the consumer side who's

00:41:10.318 --> 00:41:11.378
going to be like, no,

00:41:11.438 --> 00:41:12.699
I'm not going to do this anymore.

00:41:13.159 --> 00:41:15.500
Why am I still giving you

00:41:15.599 --> 00:41:16.639
all filling out all of

00:41:16.679 --> 00:41:18.081
these forms when you have

00:41:18.161 --> 00:41:20.601
all of that information at your disposal?

00:41:22.132 --> 00:41:23.034
I think it'll only change

00:41:23.074 --> 00:41:24.855
when the people that are asking for it,

00:41:25.416 --> 00:41:26.896
so insurance companies, right?

00:41:27.356 --> 00:41:28.257
When they actually think

00:41:28.318 --> 00:41:29.458
it's either better or

00:41:29.498 --> 00:41:31.099
cheaper or more in their

00:41:31.219 --> 00:41:32.860
interest to not require it.

00:41:33.121 --> 00:41:34.422
But for them, it doesn't add anything.

00:41:34.762 --> 00:41:35.322
Like for me,

00:41:35.362 --> 00:41:36.623
like the more documentation a

00:41:36.664 --> 00:41:37.625
PT fills out or a

00:41:37.644 --> 00:41:39.166
healthcare provider fills out,

00:41:39.487 --> 00:41:40.668
the more opportunity there

00:41:40.708 --> 00:41:41.547
is to deny something.

00:41:42.148 --> 00:41:43.449
Like you're giving them ammunition.

00:41:43.610 --> 00:41:45.291
Like the line in radio that

00:41:45.331 --> 00:41:46.311
I was taught was hand them

00:41:46.331 --> 00:41:47.393
enough microphone cable and

00:41:47.432 --> 00:41:48.574
someone will hang themselves with it.

00:41:48.833 --> 00:41:49.393
Let them talk.

00:41:49.695 --> 00:41:51.115
They will talk themselves into a box.

00:41:51.983 --> 00:41:54.943
Um, I want to go to Dave and, um,

00:41:54.983 --> 00:41:57.965
the guy who was talking about, but last,

00:41:58.025 --> 00:42:00.565
last thing, closing thought on that topic,

00:42:01.306 --> 00:42:03.427
I literally tell therapists, I'm like,

00:42:03.507 --> 00:42:04.867
look, you've got a CMS,

00:42:04.887 --> 00:42:06.027
fifteen hundred claim form.

00:42:06.047 --> 00:42:06.969
You've got all of these

00:42:07.028 --> 00:42:09.429
forms are all of these fields.

00:42:09.889 --> 00:42:10.550
Leave them blank.

00:42:10.769 --> 00:42:13.170
Do not put something in a

00:42:13.190 --> 00:42:15.371
field that isn't absolutely required.

00:42:15.952 --> 00:42:17.452
And when you're doing an evaluation,

00:42:17.492 --> 00:42:18.012
guess what?

00:42:18.652 --> 00:42:20.014
More information doesn't

00:42:20.074 --> 00:42:21.153
help justification.

00:42:21.684 --> 00:42:23.405
Do not give them anything

00:42:23.445 --> 00:42:25.885
that isn't absolutely required.

00:42:26.425 --> 00:42:29.827
Because to Jimmy's point, like all that is,

00:42:29.927 --> 00:42:31.847
is increased justification to say, well,

00:42:31.867 --> 00:42:33.469
wait a minute, you said this.

00:42:33.909 --> 00:42:35.148
If this is related to that

00:42:35.190 --> 00:42:36.469
and that ties into that and

00:42:36.489 --> 00:42:37.690
then the other part comes in,

00:42:37.891 --> 00:42:39.190
that's not a covered benefit.

00:42:39.731 --> 00:42:40.831
You give them the bare

00:42:40.891 --> 00:42:42.913
minimum to get the job done.

00:42:43.632 --> 00:42:45.873
So I know Dave's not getting

00:42:45.914 --> 00:42:46.853
a good connection.

00:42:47.414 --> 00:42:48.034
Galloway.

00:42:49.161 --> 00:42:50.041
Yeah, I've seen this guy.

00:42:50.061 --> 00:42:51.242
I don't even know his backstory.

00:42:51.262 --> 00:42:52.342
Like he showed up on my

00:42:53.181 --> 00:42:54.922
algorithm probably because, you know,

00:42:54.963 --> 00:42:56.782
ten people that I follow watch him.

00:42:56.822 --> 00:42:58.023
But he's got some unique thoughts.

00:42:58.403 --> 00:43:00.244
And you said you agree with

00:43:00.324 --> 00:43:01.264
fifty percent of what he

00:43:01.284 --> 00:43:02.925
says and disagree staunchly

00:43:03.385 --> 00:43:05.045
with fifty percent of what he says.

00:43:05.505 --> 00:43:07.045
So what do you disagree with?

00:43:08.672 --> 00:43:09.893
Let's put that on hold

00:43:09.914 --> 00:43:11.494
because Dave was the one

00:43:11.514 --> 00:43:12.777
that brought it up first, right?

00:43:13.077 --> 00:43:13.277
Right.

00:43:13.777 --> 00:43:14.018
Yeah.

00:43:14.418 --> 00:43:16.000
I want to hear what Dave has to say.

00:43:16.079 --> 00:43:18.461
I mean, effectively, he's got, you know,

00:43:18.501 --> 00:43:20.204
a hundred plus million dollars.

00:43:21.244 --> 00:43:23.166
He has the freedom to talk

00:43:23.206 --> 00:43:24.387
about certain things and

00:43:24.527 --> 00:43:25.748
choose a certain path.

00:43:25.789 --> 00:43:28.630
And I'd be curious to see what Dave says.

00:43:29.371 --> 00:43:31.094
If Dave doesn't come back,

00:43:31.353 --> 00:43:31.934
what were you going to say?

00:43:32.434 --> 00:43:32.514
Well,

00:43:32.534 --> 00:43:33.315
I was going to go to the rundown

00:43:33.335 --> 00:43:34.896
because he did share a thread.

00:43:35.356 --> 00:43:36.398
And this was so it wasn't

00:43:36.458 --> 00:43:37.418
just about like who this

00:43:37.458 --> 00:43:38.579
guy is and do we agree with him?

00:43:38.940 --> 00:43:39.739
I was sort of trying to buy

00:43:39.760 --> 00:43:40.621
time there for Dave to get

00:43:40.740 --> 00:43:41.661
back on the Wi-Fi in the

00:43:41.681 --> 00:43:42.983
diner that he's at on vacation.

00:43:43.302 --> 00:43:44.483
But he but in this thread,

00:43:44.884 --> 00:43:46.164
he Scott Galloway is

00:43:46.184 --> 00:43:47.726
talking about the war on young people.

00:43:48.447 --> 00:43:50.809
And Dave in the group chat was saying, hey,

00:43:50.889 --> 00:43:53.130
maybe it's not a business

00:43:53.190 --> 00:43:54.871
model or PT making less.

00:43:56.331 --> 00:43:58.934
His view here was it's everybody.

00:43:59.333 --> 00:44:00.614
So since nineteen seventy four,

00:44:00.735 --> 00:44:02.476
the median in median labor

00:44:02.577 --> 00:44:04.278
income is up forty percent,

00:44:04.559 --> 00:44:05.840
but the S&P five hundred is

00:44:05.880 --> 00:44:07.501
up four thousand percent.

00:44:07.961 --> 00:44:09.103
So essentially he's saying

00:44:09.384 --> 00:44:12.346
the contract was work hard, go to school.

00:44:13.146 --> 00:44:15.889
you know, grind, play by the rules.

00:44:15.969 --> 00:44:16.750
And of course you'll do

00:44:16.789 --> 00:44:17.610
better than your parents

00:44:17.650 --> 00:44:18.411
because that's the way it

00:44:18.451 --> 00:44:19.911
was for a couple of generations.

00:44:20.331 --> 00:44:22.653
But today's youth or today's

00:44:22.713 --> 00:44:23.775
worker makes less than

00:44:23.795 --> 00:44:25.096
their parents did at the same age,

00:44:25.615 --> 00:44:26.836
even with a college degree.

00:44:26.856 --> 00:44:29.179
So deeper in debt and lower income.

00:44:29.438 --> 00:44:30.559
So we got bamboozled.

00:44:31.059 --> 00:44:32.320
So he's essentially saying

00:44:32.701 --> 00:44:34.101
that it's not a resource problem,

00:44:34.121 --> 00:44:35.043
it's a values problem.

00:44:36.097 --> 00:44:37.900
We have to fix it,

00:44:38.239 --> 00:44:39.121
but all these things that

00:44:39.161 --> 00:44:42.164
he lists is not a me fixing

00:44:42.184 --> 00:44:43.204
it for myself problem.

00:44:43.686 --> 00:44:45.827
Expanded public college access,

00:44:45.907 --> 00:44:47.889
reforming tax code to reward labor,

00:44:48.550 --> 00:44:50.532
loosening zoning to lower housing costs.

00:44:50.592 --> 00:44:51.432
All these things are things

00:44:51.452 --> 00:44:53.114
that a municipality or a

00:44:53.235 --> 00:44:54.235
government would need to do.

00:44:54.976 --> 00:44:57.197
Because right now in eighty three,

00:44:57.297 --> 00:44:58.818
sixty percent of thirty

00:44:58.878 --> 00:45:00.980
year olds had one child.

00:45:01.099 --> 00:45:02.161
Today it's twenty seven.

00:45:02.380 --> 00:45:04.101
So like we've we've halved

00:45:04.541 --> 00:45:05.902
and this is not like this

00:45:05.922 --> 00:45:07.503
is not a we're sterile

00:45:07.543 --> 00:45:09.264
problem or people don't enjoy sex.

00:45:09.704 --> 00:45:11.266
This is we understand math

00:45:11.306 --> 00:45:11.885
and we're saying,

00:45:12.246 --> 00:45:14.168
do I want to be child poor?

00:45:14.427 --> 00:45:14.588
Like,

00:45:14.648 --> 00:45:15.789
do I want to be able to really take

00:45:15.809 --> 00:45:18.349
care of one kid or sort of, OK,

00:45:18.389 --> 00:45:20.190
take care of two or three?

00:45:21.931 --> 00:45:23.072
Housing prices have three

00:45:23.132 --> 00:45:24.474
acts since nineteen sixty three.

00:45:24.793 --> 00:45:25.934
Student debt is over one

00:45:25.974 --> 00:45:27.496
point three trillion

00:45:27.536 --> 00:45:30.197
dollars and depression,

00:45:30.257 --> 00:45:31.237
self-harm and loneliness.

00:45:31.277 --> 00:45:31.978
So we're poorer.

00:45:32.298 --> 00:45:33.880
We're more unhappy and we're

00:45:33.920 --> 00:45:35.960
more in debt than the people before us.

00:45:36.081 --> 00:45:37.663
And I think over the last

00:45:37.682 --> 00:45:38.282
couple of years they've

00:45:38.322 --> 00:45:39.724
charted the average life

00:45:39.764 --> 00:45:41.445
expectancy has actually gone down,

00:45:41.905 --> 00:45:43.025
even though we're smarter.

00:45:43.186 --> 00:45:44.266
Why is this happening?

00:45:44.867 --> 00:45:46.288
And depending on who you talk to,

00:45:46.307 --> 00:45:47.588
they'll list the reasons why it is.

00:45:48.110 --> 00:45:49.349
But they're saying, well,

00:45:49.369 --> 00:45:50.490
who benefits from this?

00:45:50.990 --> 00:45:51.231
Well,

00:45:52.132 --> 00:45:53.853
Older Americans, people, seventy and up,

00:45:53.952 --> 00:45:54.653
got rich,

00:45:55.034 --> 00:45:56.295
but then closed the door behind

00:45:56.335 --> 00:45:58.235
them to secure themselves.

00:45:58.315 --> 00:45:59.596
Those are the people that were in power.

00:45:59.655 --> 00:46:02.157
So over seventies now hold

00:46:02.318 --> 00:46:03.418
thirty percent of US health

00:46:03.458 --> 00:46:04.079
called wealth.

00:46:04.498 --> 00:46:05.900
That's up from nineteen

00:46:05.920 --> 00:46:07.360
percent in nineteen eighty nine.

00:46:07.400 --> 00:46:08.722
That is a big, big difference.

00:46:09.422 --> 00:46:10.342
The example here is

00:46:10.422 --> 00:46:11.463
Harvard's endowment has

00:46:11.483 --> 00:46:12.523
grown five hundred percent.

00:46:13.043 --> 00:46:13.965
since eighty but their

00:46:13.985 --> 00:46:14.985
freshman class hasn't

00:46:15.005 --> 00:46:15.885
changed so they've gotten

00:46:15.945 --> 00:46:16.666
richer but they're not

00:46:16.686 --> 00:46:17.967
helping more people I would

00:46:17.987 --> 00:46:18.827
push back on the harvard

00:46:18.867 --> 00:46:19.708
thing they sort of like

00:46:20.047 --> 00:46:21.369
research a bunch of things

00:46:21.429 --> 00:46:22.730
that they sort of give away

00:46:22.769 --> 00:46:24.311
to the world and cure

00:46:24.351 --> 00:46:25.291
different things or figure

00:46:25.311 --> 00:46:27.012
things out um so

00:46:27.052 --> 00:46:28.494
essentially he was uh

00:46:28.574 --> 00:46:29.914
dave's reason for pointing

00:46:29.934 --> 00:46:31.255
this out with galloway was

00:46:31.856 --> 00:46:33.175
is it a we doing it wrong

00:46:33.215 --> 00:46:34.657
problem or is the system

00:46:34.697 --> 00:46:35.938
sort of stacked against us

00:46:36.338 --> 00:46:38.420
and pt and healthcare is

00:46:38.500 --> 00:46:39.659
not immune from all of this

00:46:39.721 --> 00:46:41.842
in every industry no matter what you are

00:46:42.903 --> 00:46:44.746
And so my issue with all of

00:46:44.786 --> 00:46:48.230
that is that that is a very

00:46:48.570 --> 00:46:50.132
victim mentality.

00:46:50.213 --> 00:46:51.614
That is a, hey,

00:46:51.775 --> 00:46:53.155
it makes you feel good

00:46:53.195 --> 00:46:54.418
because you're failing and

00:46:54.438 --> 00:46:55.059
I'm going to give you all

00:46:55.079 --> 00:46:55.980
the reasons why you're

00:46:56.019 --> 00:46:56.800
failing and you're going to

00:46:56.820 --> 00:46:58.523
blame all the successful people.

00:46:59.056 --> 00:47:01.617
for your insecurities and your failures,

00:47:01.958 --> 00:47:02.938
that doesn't help anyone.

00:47:02.978 --> 00:47:04.199
That doesn't help anything.

00:47:04.619 --> 00:47:06.000
I'm sure every generation

00:47:06.019 --> 00:47:07.141
can make the same argument

00:47:07.181 --> 00:47:09.442
in some capacity for that.

00:47:09.521 --> 00:47:11.563
The reality is there are

00:47:11.623 --> 00:47:13.523
successful young people in this world.

00:47:13.943 --> 00:47:16.025
Just because more are not

00:47:16.106 --> 00:47:17.485
successful doesn't mean

00:47:17.525 --> 00:47:19.768
that the system is sacked against them.

00:47:20.148 --> 00:47:20.708
And if you're going to

00:47:20.728 --> 00:47:21.688
cherry pick a whole bunch

00:47:21.728 --> 00:47:22.869
of stats on one side,

00:47:23.170 --> 00:47:24.170
let's cherry pick a whole

00:47:24.190 --> 00:47:25.550
bunch of stats on the other side.

00:47:26.130 --> 00:47:28.311
And so this is the

00:47:28.331 --> 00:47:29.652
fundamental problem that I

00:47:29.692 --> 00:47:32.052
have with his general content.

00:47:32.753 --> 00:47:33.273
I like him.

00:47:33.494 --> 00:47:34.353
I like his ideas.

00:47:34.474 --> 00:47:35.315
I've watched them on my

00:47:35.355 --> 00:47:37.195
first Million podcast and a

00:47:37.215 --> 00:47:38.235
bunch of other shows.

00:47:39.275 --> 00:47:40.516
I just try to balance the

00:47:40.556 --> 00:47:43.858
propaganda with what...

00:47:44.398 --> 00:47:45.938
the value that he might be

00:47:45.978 --> 00:47:47.420
able to deliver to some people.

00:47:47.840 --> 00:47:48.902
He's kind of crossed the

00:47:48.942 --> 00:47:50.063
tipping point for me.

00:47:50.643 --> 00:47:51.983
I don't even click on the

00:47:52.063 --> 00:47:53.164
interviews anymore because

00:47:53.204 --> 00:47:54.726
it's just too far down that

00:47:54.806 --> 00:47:56.007
victimhood mentality.

00:47:56.706 --> 00:47:57.987
I do like identifying a problem.

00:47:58.246 --> 00:47:59.128
Like, hey, listen,

00:47:59.148 --> 00:48:00.068
there are some things out

00:48:00.088 --> 00:48:01.148
there that are set up where

00:48:01.168 --> 00:48:02.268
if you try to fight against it,

00:48:02.307 --> 00:48:02.949
you're going to lose.

00:48:03.289 --> 00:48:04.349
So don't fight that.

00:48:04.409 --> 00:48:05.449
Figure it out somewhere else.

00:48:06.768 --> 00:48:08.329
I did the math a few months

00:48:08.369 --> 00:48:10.150
ago that said I was paying

00:48:10.190 --> 00:48:11.190
off my student loans at a

00:48:11.271 --> 00:48:12.891
pretty good clip, well above average.

00:48:12.911 --> 00:48:14.391
And I did the math and said,

00:48:14.510 --> 00:48:15.130
if I paid this,

00:48:15.692 --> 00:48:16.592
if I paid seventy two

00:48:16.612 --> 00:48:17.891
thousand dollars off at the

00:48:17.992 --> 00:48:18.891
interest rate I had,

00:48:18.931 --> 00:48:19.472
I was going to pay a

00:48:19.532 --> 00:48:21.032
quarter million dollars over ten years.

00:48:21.987 --> 00:48:22.809
Quarter million dollars,

00:48:22.829 --> 00:48:23.869
one hundred eighty thousand

00:48:23.889 --> 00:48:25.291
dollars in interest on seventy thousand.

00:48:25.590 --> 00:48:26.351
So I did the math that I'd

00:48:26.371 --> 00:48:27.211
rather be poor for two

00:48:27.231 --> 00:48:28.233
years and not go on

00:48:28.253 --> 00:48:29.494
vacations for the next two years.

00:48:30.134 --> 00:48:30.434
Jimmy,

00:48:30.494 --> 00:48:31.454
in twenty years is going to

00:48:31.474 --> 00:48:32.076
appreciate that.

00:48:32.496 --> 00:48:35.057
Like that wasn't that wasn't the way,

00:48:35.617 --> 00:48:36.398
you know, two decades,

00:48:36.438 --> 00:48:37.380
two generations ago.

00:48:37.460 --> 00:48:37.599
Right.

00:48:37.619 --> 00:48:38.701
People talked all about all

00:48:38.721 --> 00:48:40.001
the time about working a

00:48:40.061 --> 00:48:41.503
summer job to pay off college.

00:48:41.922 --> 00:48:42.063
Well,

00:48:42.123 --> 00:48:43.224
I could just get pissed off that

00:48:43.244 --> 00:48:44.266
college is expensive,

00:48:44.487 --> 00:48:45.447
but I signed into that.

00:48:45.768 --> 00:48:47.110
So I decided to be poor now

00:48:47.291 --> 00:48:48.411
and worked extra now.

00:48:48.853 --> 00:48:49.994
And I didn't, and I'm not going to,

00:48:50.235 --> 00:48:52.478
it's not the give up the latte a day,

00:48:52.538 --> 00:48:53.099
whatever it was.

00:48:53.199 --> 00:48:53.539
No, no, no.

00:48:53.579 --> 00:48:54.380
It was bite very,

00:48:54.420 --> 00:48:55.702
very hard on your bank

00:48:55.742 --> 00:48:57.003
account and understand that

00:48:57.704 --> 00:48:58.846
you want to make sure you're secure.

00:48:59.226 --> 00:49:00.706
I understand what he's saying here,

00:49:00.786 --> 00:49:01.407
but I agree.

00:49:01.788 --> 00:49:02.548
And, you know,

00:49:02.588 --> 00:49:03.710
sort of both sides

00:49:03.889 --> 00:49:05.650
understand how the game works.

00:49:05.690 --> 00:49:07.452
The game is get people riled up.

00:49:07.733 --> 00:49:08.472
If they're riled up,

00:49:08.492 --> 00:49:09.333
they love or hate you.

00:49:09.673 --> 00:49:10.655
And both of those things,

00:49:11.014 --> 00:49:11.795
both of those things are

00:49:12.096 --> 00:49:13.097
good for business.

00:49:13.416 --> 00:49:14.577
If you're in the attention business.

00:49:15.157 --> 00:49:16.838
yeah yeah and and I've

00:49:16.918 --> 00:49:17.778
played the game the other

00:49:17.818 --> 00:49:19.280
way you know I've put out

00:49:19.360 --> 00:49:20.842
posts where I'm like I

00:49:20.902 --> 00:49:22.422
understand everybody I just

00:49:22.463 --> 00:49:23.704
watched a little video clip

00:49:23.724 --> 00:49:24.485
where they were showing

00:49:24.525 --> 00:49:25.284
like a mcdonald's

00:49:25.324 --> 00:49:27.086
commercial and you get two

00:49:27.106 --> 00:49:28.427
big macs and drinks and

00:49:28.467 --> 00:49:30.108
fries for two dollars and

00:49:30.409 --> 00:49:32.650
fifty eight cents uh now

00:49:32.710 --> 00:49:33.831
it's twenty five dollars

00:49:33.871 --> 00:49:34.972
and sixty eight cents you

00:49:34.992 --> 00:49:36.753
know but on the flip side

00:49:37.614 --> 00:49:39.375
I was also the person who

00:49:39.414 --> 00:49:40.596
spent seven thousand

00:49:40.635 --> 00:49:41.936
dollars on one hundred

00:49:41.976 --> 00:49:43.635
thousand words of content

00:49:43.775 --> 00:49:44.936
in two thousand twenty

00:49:44.976 --> 00:49:47.677
three that I can now get

00:49:47.717 --> 00:49:48.797
for twenty dollars.

00:49:49.157 --> 00:49:51.398
You know, like there have been some.

00:49:51.478 --> 00:49:51.818
Yes,

00:49:52.018 --> 00:49:54.358
my house today is worth double what it

00:49:54.438 --> 00:49:56.778
was when I bought it in two thousand six.

00:49:57.358 --> 00:49:58.478
That's horrible if I want to

00:49:58.498 --> 00:49:59.338
buy a house today.

00:49:59.500 --> 00:49:59.900
Right.

00:49:59.940 --> 00:50:01.159
But on the flip side.

00:50:02.119 --> 00:50:03.862
There is access to AI and

00:50:03.882 --> 00:50:06.364
other technology that now I

00:50:06.384 --> 00:50:08.146
can run a clinic just as

00:50:08.206 --> 00:50:09.387
profitably with three

00:50:09.427 --> 00:50:10.949
people that I used to have

00:50:10.989 --> 00:50:13.530
to hire ten people for, you know.

00:50:13.610 --> 00:50:15.172
So there's always going to

00:50:15.213 --> 00:50:16.594
be opportunities and we see

00:50:16.653 --> 00:50:17.315
it all the time.

00:50:17.355 --> 00:50:19.896
We see young people that are doing things,

00:50:20.338 --> 00:50:21.639
generating millions of

00:50:21.699 --> 00:50:24.322
dollars that are no smarter

00:50:24.342 --> 00:50:26.143
than anyone watching this show right now.

00:50:27.344 --> 00:50:29.005
They just chose a different path.

00:50:29.065 --> 00:50:30.867
So we can acknowledge the

00:50:30.907 --> 00:50:31.786
golden handcuffs.

00:50:31.847 --> 00:50:32.608
We can say, look,

00:50:33.088 --> 00:50:34.088
I spent a lot of money on

00:50:34.108 --> 00:50:35.168
my college degree.

00:50:35.949 --> 00:50:37.150
I know that I've got these

00:50:37.210 --> 00:50:38.110
responsibilities,

00:50:38.170 --> 00:50:40.251
but if finance is important to me,

00:50:40.672 --> 00:50:41.853
financial security,

00:50:41.893 --> 00:50:43.054
financial independence,

00:50:43.474 --> 00:50:44.494
then maybe I'm going to go

00:50:44.514 --> 00:50:45.596
where the money is.

00:50:45.976 --> 00:50:47.817
And then I can come back to

00:50:47.836 --> 00:50:49.257
the thing that I'm passionate about.

00:50:49.697 --> 00:50:50.878
Like we all have to clean

00:50:50.898 --> 00:50:52.039
the toilet at some point.

00:50:52.639 --> 00:50:54.420
Nobody loves cleaning a toilet,

00:50:54.880 --> 00:50:55.681
but it's just something

00:50:55.702 --> 00:50:56.541
that needs to get done.

00:50:56.601 --> 00:50:58.782
So go do that and then come

00:50:58.802 --> 00:51:00.063
back to the thing that you love.

00:51:00.923 --> 00:51:02.144
You had a post every day

00:51:02.244 --> 00:51:04.826
about love and the way to

00:51:04.846 --> 00:51:06.547
get work life balance is to

00:51:06.586 --> 00:51:07.427
work on something you don't

00:51:07.467 --> 00:51:08.208
care that much about.

00:51:08.608 --> 00:51:09.789
And that pissed people off.

00:51:11.237 --> 00:51:12.717
tell, tell me why you wrote it.

00:51:12.898 --> 00:51:14.378
And I sort of agree with you.

00:51:14.940 --> 00:51:15.199
Yeah.

00:51:15.219 --> 00:51:15.420
Like,

00:51:15.559 --> 00:51:18.282
I mean how all this fantasy about like,

00:51:18.322 --> 00:51:19.302
do what you love and you'll

00:51:19.322 --> 00:51:20.623
never work a day in your life.

00:51:20.764 --> 00:51:21.445
Total BS.

00:51:21.585 --> 00:51:22.525
Like the,

00:51:23.045 --> 00:51:24.867
the best professional athletes

00:51:25.268 --> 00:51:26.528
spend the majority of their

00:51:26.588 --> 00:51:28.050
time doing things they hate

00:51:28.490 --> 00:51:29.490
just so they have a

00:51:29.570 --> 00:51:31.172
fraction of the time doing

00:51:31.233 --> 00:51:32.233
something that they love.

00:51:32.673 --> 00:51:35.016
But you know, if I don't want

00:51:35.969 --> 00:51:38.871
that emotion to control my existence,

00:51:38.891 --> 00:51:40.172
like the highs and the lows,

00:51:40.231 --> 00:51:41.413
if I wanna cut some of

00:51:41.452 --> 00:51:43.653
those peaks and troughs,

00:51:43.795 --> 00:51:45.215
you do something you're good at,

00:51:45.255 --> 00:51:46.275
but maybe not something

00:51:46.295 --> 00:51:47.916
you're crazy passionate about.

00:51:48.396 --> 00:51:50.898
Like I'm good at this, whatever,

00:51:50.938 --> 00:51:51.398
accounting.

00:51:52.018 --> 00:51:53.760
I've got a mind for organization.

00:51:54.161 --> 00:51:56.202
I don't love accounting, but I can do it.

00:51:56.342 --> 00:51:57.262
I can do it well.

00:51:57.402 --> 00:51:58.963
I can make a great living at it.

00:51:59.364 --> 00:52:01.744
So I spend my time making my

00:52:01.804 --> 00:52:02.985
money in accounting

00:52:03.666 --> 00:52:05.590
But then on the side, I have my passion.

00:52:06.492 --> 00:52:07.373
I always say cooking.

00:52:07.414 --> 00:52:08.094
I love cooking.

00:52:08.155 --> 00:52:08.936
I cook every day.

00:52:09.016 --> 00:52:10.059
I cook three meals a day.

00:52:10.099 --> 00:52:11.161
I'll cook six meals a day.

00:52:12.429 --> 00:52:14.172
I would never want to open a

00:52:14.271 --> 00:52:16.172
restaurant because I will

00:52:16.193 --> 00:52:17.614
immediately hate cooking

00:52:17.833 --> 00:52:19.255
when my mortgage and my

00:52:19.335 --> 00:52:21.157
livelihood is tied to cooking.

00:52:21.717 --> 00:52:23.039
And I'm not cooking because

00:52:23.099 --> 00:52:24.219
I love cooking anymore,

00:52:24.260 --> 00:52:25.681
but I'm cooking to make money.

00:52:25.920 --> 00:52:27.842
That is the worst thing to possibly do.

00:52:28.242 --> 00:52:30.043
So if you love helping people,

00:52:30.585 --> 00:52:31.826
maybe helping people for

00:52:31.885 --> 00:52:33.246
money is not the thing you

00:52:33.266 --> 00:52:35.128
should do and go do

00:52:35.188 --> 00:52:36.889
something else to fill the bank account.

00:52:37.355 --> 00:52:38.195
I told this story before

00:52:38.215 --> 00:52:39.074
when I was in college.

00:52:39.416 --> 00:52:40.735
I was like, you know what's cool?

00:52:41.315 --> 00:52:42.175
Bars are cool.

00:52:42.456 --> 00:52:43.257
I want to own a bar.

00:52:43.757 --> 00:52:44.996
And my Uncle Frank owned a bar.

00:52:45.336 --> 00:52:46.577
And I don't know if it was brilliance,

00:52:47.057 --> 00:52:47.577
genius,

00:52:47.677 --> 00:52:49.318
or just sheer accident that he said, well,

00:52:49.338 --> 00:52:49.518
hey,

00:52:49.538 --> 00:52:51.278
the summer between junior and senior year,

00:52:51.659 --> 00:52:54.079
I was interning at K-Rock

00:52:54.099 --> 00:52:54.840
where Howard Stern was an

00:52:54.880 --> 00:52:55.860
intern because I was also like,

00:52:55.920 --> 00:52:56.619
maybe radio.

00:52:56.920 --> 00:52:58.221
And I did both for a summer.

00:52:58.501 --> 00:52:59.460
At the end of the summer, I mean,

00:52:59.481 --> 00:53:00.880
I had a ton of fun doing both jobs.

00:53:01.282 --> 00:53:02.041
But at the end of the summer,

00:53:02.081 --> 00:53:03.001
Uncle Frank came to me and goes,

00:53:03.262 --> 00:53:04.521
so what are the thoughts on owning a bar?

00:53:04.581 --> 00:53:06.003
And I said, I want to go to bars.

00:53:06.123 --> 00:53:06.663
I think I want to go.

00:53:06.822 --> 00:53:07.503
go to bars.

00:53:07.523 --> 00:53:09.083
I want to hang out at bars

00:53:09.123 --> 00:53:10.045
for a little while and then

00:53:10.105 --> 00:53:10.905
go do other stuff.

00:53:11.364 --> 00:53:12.766
And that's what I wanted my outlet to be.

00:53:13.146 --> 00:53:13.967
Even though, I mean,

00:53:14.007 --> 00:53:15.166
at the time it was a pretty

00:53:15.206 --> 00:53:16.788
lucrative job to just be a bartender.

00:53:16.807 --> 00:53:17.788
It's a cash business.

00:53:18.268 --> 00:53:19.208
Cash was right in front of you.

00:53:19.228 --> 00:53:19.809
By the end of the night,

00:53:19.829 --> 00:53:21.269
you got paid every night on time.

00:53:21.670 --> 00:53:23.130
And even though I was like, you know,

00:53:23.170 --> 00:53:23.550
twenty,

00:53:23.771 --> 00:53:25.132
twenty years old knowing I don't

00:53:25.152 --> 00:53:25.711
want to do this when I'm

00:53:25.751 --> 00:53:27.813
forty one and to get what out of it,

00:53:27.833 --> 00:53:30.795
what I would need to put so much into it,

00:53:30.855 --> 00:53:31.894
I wouldn't get enough out of it.

00:53:31.976 --> 00:53:33.695
I said, not my thing.

00:53:33.735 --> 00:53:34.556
So I went and did another thing.

00:53:35.137 --> 00:53:36.641
Did I ever tell you about my

00:53:36.681 --> 00:53:37.503
mom's nightclub?

00:53:37.923 --> 00:53:39.467
No, your mom at a nightclub?

00:53:39.809 --> 00:53:39.949
Yeah.

00:53:41.152 --> 00:53:41.711
So this will be an

00:53:41.751 --> 00:53:43.193
interesting story for everyone.

00:53:43.853 --> 00:53:45.175
I've had such a random

00:53:46.315 --> 00:53:47.836
existence throughout my life.

00:53:48.237 --> 00:53:48.978
There was a phase.

00:53:49.458 --> 00:53:51.239
So my mom came from South America.

00:53:51.478 --> 00:53:53.019
She was the first in her family.

00:53:53.081 --> 00:53:54.400
She immigrated to the US.

00:53:54.420 --> 00:53:56.503
She got a job in Queens, New York,

00:53:57.202 --> 00:53:58.643
and then kind of grew and

00:53:58.764 --> 00:53:59.764
bought real estate.

00:53:59.844 --> 00:54:01.847
And this was a teenager coming,

00:54:02.226 --> 00:54:03.427
didn't even speak the language.

00:54:03.668 --> 00:54:05.869
So this was kind of her by nature.

00:54:06.489 --> 00:54:07.590
She always loved the business,

00:54:07.630 --> 00:54:08.672
was always an entrepreneur.

00:54:09.639 --> 00:54:11.641
Her dream had always been to

00:54:11.860 --> 00:54:13.123
own a Spanish nightclub.

00:54:13.682 --> 00:54:15.364
And so when she had kind of

00:54:15.385 --> 00:54:16.505
gotten out of the fashion

00:54:16.545 --> 00:54:17.668
industry and what she was

00:54:17.728 --> 00:54:19.929
doing for most of her life,

00:54:20.391 --> 00:54:22.552
she bought a restaurant down in Bradenton,

00:54:22.572 --> 00:54:23.072
Florida.

00:54:23.614 --> 00:54:25.036
It was a huge building.

00:54:25.835 --> 00:54:27.117
They converted it from

00:54:27.177 --> 00:54:28.840
full-time restaurant with a

00:54:28.920 --> 00:54:30.320
full liquor license into a

00:54:30.380 --> 00:54:31.181
Latin nightclub.

00:54:32.123 --> 00:54:33.623
And she tried to do what she

00:54:33.643 --> 00:54:34.824
thought everybody did.

00:54:34.864 --> 00:54:36.043
You're open seven days a

00:54:36.083 --> 00:54:37.184
week and you do all these things.

00:54:37.204 --> 00:54:38.385
And she was like, no, no, no, no,

00:54:38.425 --> 00:54:39.204
that's not working.

00:54:39.804 --> 00:54:41.266
She got rid of everything.

00:54:41.846 --> 00:54:44.186
She went to only one night a week.

00:54:45.047 --> 00:54:47.427
She could fit about six hundred occupancy,

00:54:47.487 --> 00:54:49.387
six hundred people in the building.

00:54:49.867 --> 00:54:51.188
She charged a twenty dollar

00:54:51.228 --> 00:54:53.228
cover so that she she had

00:54:53.268 --> 00:54:55.090
kind of a higher level clientele,

00:54:55.750 --> 00:54:59.590
but no glasses, no bottled beer.

00:55:00.150 --> 00:55:01.652
It was only canned beer.

00:55:02.152 --> 00:55:03.632
You only had three choices.

00:55:03.693 --> 00:55:05.614
It was like Corona, Bud Light,

00:55:05.655 --> 00:55:06.596
and something else.

00:55:07.896 --> 00:55:10.018
All mixed drinks came in plastic cups,

00:55:10.038 --> 00:55:11.418
so nobody got into fights

00:55:11.480 --> 00:55:12.659
and people weren't getting

00:55:13.001 --> 00:55:14.081
cut with glass.

00:55:15.422 --> 00:55:16.483
She hired a couple of local

00:55:16.523 --> 00:55:18.505
police and had a security team.

00:55:18.704 --> 00:55:20.527
And I mean, it was just...

00:55:21.086 --> 00:55:22.268
printing cash.

00:55:22.909 --> 00:55:24.831
I remember growing up as a kid,

00:55:25.132 --> 00:55:25.753
she'd be like, Hey,

00:55:25.773 --> 00:55:26.454
can you get me something

00:55:26.474 --> 00:55:27.215
out of the closet?

00:55:27.295 --> 00:55:28.717
I'd go in and it'd be a

00:55:28.817 --> 00:55:30.239
stack of five thousand

00:55:30.278 --> 00:55:32.161
dollars in twenties just

00:55:32.201 --> 00:55:34.804
because she had so much cash everywhere.

00:55:36.126 --> 00:55:37.327
And, you know,

00:55:37.447 --> 00:55:39.148
I learned so many lessons through that.

00:55:39.188 --> 00:55:40.527
I became a bartender and I

00:55:40.547 --> 00:55:42.007
would serve drinks and all

00:55:42.068 --> 00:55:42.989
of these different things.

00:55:43.048 --> 00:55:46.148
But I just think, like you said,

00:55:46.309 --> 00:55:48.469
you've got this idea of

00:55:48.670 --> 00:55:50.369
what you think you want and

00:55:50.389 --> 00:55:52.411
then you get into it and then you're like,

00:55:52.590 --> 00:55:54.751
oh, that's not actually what I want.

00:55:55.271 --> 00:55:55.931
Patient comes in.

00:55:55.972 --> 00:55:56.811
I've got shoulder pain.

00:55:56.851 --> 00:55:57.891
I want to throw the football.

00:55:58.251 --> 00:55:59.472
OK, let's start lifting weights.

00:55:59.532 --> 00:56:00.492
No, I don't want to do that.

00:56:01.693 --> 00:56:03.393
There's a disconnect between

00:56:03.434 --> 00:56:04.713
what we think we want and

00:56:04.753 --> 00:56:05.795
what we actually want.

00:56:05.855 --> 00:56:07.295
I think I want to throw a football.

00:56:07.655 --> 00:56:08.476
I actually just want my

00:56:08.496 --> 00:56:09.476
shoulder to stop hurting.

00:56:09.695 --> 00:56:09.876
Right.

00:56:10.155 --> 00:56:10.717
I don't care.

00:56:11.016 --> 00:56:12.036
I'm happy with the dream.

00:56:12.436 --> 00:56:12.697
Right.

00:56:13.358 --> 00:56:13.538
Yeah.

00:56:13.577 --> 00:56:14.478
People want the result,

00:56:14.498 --> 00:56:16.059
but not the process to get the result.

00:56:16.139 --> 00:56:16.699
I'm very sorry.

00:56:16.719 --> 00:56:18.239
That's what makes it unachievable,

00:56:18.440 --> 00:56:19.320
which is funny too,

00:56:19.340 --> 00:56:20.960
because now like the whole Ozempic

00:56:21.681 --> 00:56:23.460
And those things are coming out.

00:56:23.601 --> 00:56:24.802
And and there was, you know,

00:56:24.862 --> 00:56:25.902
Corey Doctorow.

00:56:26.541 --> 00:56:27.681
He writes like he writes

00:56:27.722 --> 00:56:29.762
like he wrote for like the

00:56:29.882 --> 00:56:31.802
website or still does for Boing Boing.

00:56:31.842 --> 00:56:33.242
Essentially, he's just like this tech guy.

00:56:33.884 --> 00:56:34.664
And I started reading some

00:56:34.684 --> 00:56:36.324
of his stuff ten to fifteen years ago,

00:56:36.403 --> 00:56:37.443
being like, this is cool.

00:56:37.483 --> 00:56:38.304
This is sci fi.

00:56:38.684 --> 00:56:40.465
And then slowly after I

00:56:40.485 --> 00:56:41.364
stopped reading his books,

00:56:41.425 --> 00:56:41.985
the stuff that he was

00:56:42.045 --> 00:56:43.626
talking about started happening.

00:56:43.786 --> 00:56:44.945
Like he was the first person

00:56:44.965 --> 00:56:46.606
I ever like read a fiction

00:56:46.646 --> 00:56:48.005
book about three printing

00:56:48.425 --> 00:56:49.527
before I ever heard any

00:56:49.626 --> 00:56:50.646
article on three printing.

00:56:51.146 --> 00:56:52.206
And he talked about.

00:56:53.068 --> 00:56:54.568
Three D printing and what would happen?

00:56:54.648 --> 00:56:55.188
Ten years.

00:56:55.829 --> 00:56:57.108
What will that do to the economy?

00:56:57.128 --> 00:56:58.449
What will that do to value?

00:56:58.489 --> 00:56:59.489
Where does value shift?

00:56:59.530 --> 00:57:01.670
If I can just steal a plan

00:57:02.050 --> 00:57:03.371
from an object that you

00:57:03.411 --> 00:57:04.431
took years to figure out

00:57:04.452 --> 00:57:05.632
how to make an ingenuity to make,

00:57:05.672 --> 00:57:06.672
I can just download it and

00:57:06.692 --> 00:57:07.411
then print it myself.

00:57:07.431 --> 00:57:08.193
I don't need you anymore.

00:57:09.112 --> 00:57:09.833
In parallel,

00:57:09.873 --> 00:57:10.514
he was talking about

00:57:10.554 --> 00:57:12.014
biohacking and talking

00:57:12.034 --> 00:57:13.014
about one of the characters

00:57:13.034 --> 00:57:14.956
was always was a genius,

00:57:14.996 --> 00:57:16.777
but always obese and overweight.

00:57:17.097 --> 00:57:18.157
But he started doing this

00:57:18.557 --> 00:57:19.717
biohacking thing.

00:57:20.139 --> 00:57:21.818
And of course, now he became this version,

00:57:21.938 --> 00:57:22.639
a good looking,

00:57:22.780 --> 00:57:24.960
a good looking guy in shape,

00:57:25.021 --> 00:57:26.621
but didn't have to do any of the stuff.

00:57:27.242 --> 00:57:28.063
He, in turn,

00:57:28.123 --> 00:57:29.864
had to ingest like six

00:57:29.905 --> 00:57:31.327
thousand calories a day or

00:57:31.367 --> 00:57:32.628
something to keep up with.

00:57:32.909 --> 00:57:34.690
It was an increased metabolism drug,

00:57:34.971 --> 00:57:35.472
essentially.

00:57:36.472 --> 00:57:37.434
But what that did to his

00:57:37.494 --> 00:57:39.496
life in the later years was not good.

00:57:39.657 --> 00:57:40.418
And I'm looking at this

00:57:40.438 --> 00:57:41.960
saying these people say parallel.

00:57:42.179 --> 00:57:43.101
They want the result,

00:57:43.161 --> 00:57:44.583
but aren't doing the work.

00:57:44.663 --> 00:57:45.784
But they're like, well, I can get a pill.

00:57:46.670 --> 00:57:48.271
or I can get a shot and I'll get that.

00:57:48.692 --> 00:57:49.251
Yes.

00:57:49.612 --> 00:57:51.273
We talk about what I, my right.

00:57:51.353 --> 00:57:53.295
I have the right to be in shape,

00:57:53.777 --> 00:57:55.177
but not the responsibilities.

00:57:55.257 --> 00:57:56.878
And this is political or this is,

00:57:57.260 --> 00:57:58.059
this is just math.

00:57:58.481 --> 00:57:58.800
Yes.

00:57:58.880 --> 00:57:59.842
You get rights.

00:58:00.161 --> 00:58:01.282
What people forget to talk

00:58:01.302 --> 00:58:02.724
about is the responsibility

00:58:02.744 --> 00:58:04.746
that you are actually you, uh,

00:58:04.766 --> 00:58:06.208
that you owe to that, whether that be,

00:58:06.628 --> 00:58:09.309
political and government or biology?

00:58:09.429 --> 00:58:09.791
Yes,

00:58:09.951 --> 00:58:11.411
I'm injecting something and it's going

00:58:11.452 --> 00:58:12.532
to make me lose weight.

00:58:12.952 --> 00:58:14.134
What else are you

00:58:14.213 --> 00:58:15.554
responsible for that it's

00:58:15.755 --> 00:58:16.876
also going to be doing?

00:58:16.976 --> 00:58:18.657
I think people rush in for those rights,

00:58:18.697 --> 00:58:19.378
the outcomes,

00:58:20.117 --> 00:58:21.820
and they don't stick around

00:58:21.840 --> 00:58:22.519
too long for those

00:58:22.559 --> 00:58:26.903
responsibilities or when the bill comes,

00:58:26.923 --> 00:58:28.003
when the check comes due,

00:58:28.224 --> 00:58:29.405
they don't want to pay it, of course.

00:58:29.826 --> 00:58:29.925
Yeah.

00:58:30.065 --> 00:58:30.346
All right.

00:58:30.365 --> 00:58:31.367
So Dave's somewhere in a

00:58:31.427 --> 00:58:32.387
diner in South Jersey.

00:58:32.407 --> 00:58:33.186
Want to do parting shots?

00:58:33.626 --> 00:58:34.447
Yeah, let's do it.

00:58:34.487 --> 00:58:38.989
So Larry Benz, I just saw his article.

00:58:39.088 --> 00:58:40.989
He's talking about Ozempic and how,

00:58:41.190 --> 00:58:41.429
you know,

00:58:41.449 --> 00:58:42.411
what the role physical

00:58:42.451 --> 00:58:43.251
therapists are going to

00:58:43.291 --> 00:58:46.391
play in that whole weight

00:58:46.431 --> 00:58:47.753
loss Ozempic world.

00:58:48.393 --> 00:58:50.293
Um, if you're not,

00:58:50.494 --> 00:58:51.494
my parting shot is if you

00:58:51.514 --> 00:58:52.795
guys aren't out there,

00:58:52.856 --> 00:58:53.896
like seeing what the

00:58:53.916 --> 00:58:55.016
thought leaders are talking

00:58:55.056 --> 00:58:57.539
about inside and outside the profession.

00:58:57.579 --> 00:58:57.639
Uh,

00:58:58.599 --> 00:59:00.601
I was on an interview yesterday with

00:59:00.681 --> 00:59:02.742
Neil Trickett from practice promotions,

00:59:02.902 --> 00:59:04.702
and we talked about, you know,

00:59:04.842 --> 00:59:05.824
who do I follow?

00:59:05.864 --> 00:59:06.744
Who do I look at?

00:59:06.864 --> 00:59:08.626
I don't look at anybody within the field.

00:59:09.786 --> 00:59:10.467
And they're great.

00:59:10.626 --> 00:59:13.409
I just I want new ideas, fresh ideas,

00:59:13.469 --> 00:59:14.670
different concepts.

00:59:15.130 --> 00:59:16.391
So I go outside the

00:59:16.431 --> 00:59:17.771
profession of physical therapy.

00:59:17.831 --> 00:59:19.152
I look at other business

00:59:19.213 --> 00:59:21.253
models and I reflect on that.

00:59:21.713 --> 00:59:22.894
And I think about how we can

00:59:22.934 --> 00:59:24.275
bring those concepts into

00:59:24.315 --> 00:59:25.657
what we we're doing to

00:59:25.717 --> 00:59:27.958
deliver a better patient care experience.

00:59:28.318 --> 00:59:29.619
So don't don't be afraid to

00:59:29.639 --> 00:59:30.679
go outside of PT.

00:59:31.460 --> 00:59:31.681
I would.

00:59:31.900 --> 00:59:32.121
Yes.

00:59:32.201 --> 00:59:33.161
And that which is don't be

00:59:33.202 --> 00:59:33.942
afraid to do it.

00:59:33.983 --> 00:59:34.963
I'm going to say you have to

00:59:35.202 --> 00:59:36.403
if you're just photocopying

00:59:36.423 --> 00:59:37.324
what everybody else is doing.

00:59:37.605 --> 00:59:38.565
I remember being in radio.

00:59:39.965 --> 00:59:41.686
And when I got to run my

00:59:41.706 --> 00:59:42.527
first radio station,

00:59:42.907 --> 00:59:43.387
there were all these

00:59:43.547 --> 00:59:45.568
industry conferences and stuff like that.

00:59:45.608 --> 00:59:46.429
And I remember my boss,

00:59:46.469 --> 00:59:47.309
the general manager, would be like,

00:59:47.329 --> 00:59:47.969
do you want to go to this?

00:59:47.989 --> 00:59:48.730
Do you want to go to this?

00:59:49.170 --> 00:59:51.251
And I got to be like, I was like, no,

00:59:51.431 --> 00:59:52.652
I'm figuring it out here.

00:59:52.731 --> 00:59:53.891
I'm watching commercials and

00:59:53.931 --> 00:59:54.913
figuring out what huge,

00:59:54.972 --> 00:59:56.333
huge corporations are doing.

00:59:56.773 --> 00:59:58.233
And then I'm stealing that idea.

00:59:58.293 --> 00:59:59.094
Or how can I?

00:59:59.434 --> 01:00:00.614
Or even just understanding it.

01:00:00.916 --> 01:00:01.775
I didn't steal everything

01:00:01.795 --> 01:00:03.556
that I saw because it wouldn't fit.

01:00:04.237 --> 01:00:05.617
Not because I was too proud

01:00:05.657 --> 01:00:06.358
to steal something.

01:00:06.697 --> 01:00:07.719
right I got I got a lesson

01:00:07.840 --> 01:00:09.221
early in my radio career it

01:00:09.242 --> 01:00:10.063
doesn't matter that it was

01:00:10.083 --> 01:00:11.164
a radio lesson which is

01:00:11.505 --> 01:00:12.885
good artist bardo great

01:00:12.925 --> 01:00:14.027
artists steal like every

01:00:14.208 --> 01:00:14.929
the thing that you're

01:00:15.349 --> 01:00:16.391
thinking about stealing but

01:00:16.411 --> 01:00:17.431
you don't want to they

01:00:17.472 --> 01:00:18.673
stole it from someone else

01:00:18.793 --> 01:00:19.715
they stole it from someone

01:00:19.755 --> 01:00:21.677
else in a different industry uh

01:00:21.838 --> 01:00:23.980
Staying within healthcare or PT,

01:00:24.360 --> 01:00:26.222
you will not find those

01:00:26.302 --> 01:00:27.382
ideas unless you're

01:00:27.402 --> 01:00:28.003
stealing from somebody

01:00:28.023 --> 01:00:29.224
who's already stolen from outside,

01:00:29.543 --> 01:00:30.425
and that's stealing from

01:00:30.485 --> 01:00:31.304
outside by proxy.

01:00:31.846 --> 01:00:32.706
We're back on Tuesday.

01:00:32.766 --> 01:00:33.726
Dave will be probably off

01:00:33.887 --> 01:00:34.788
vacation somewhere,

01:00:34.827 --> 01:00:35.708
not on the Jersey Shore.

01:00:36.610 --> 01:00:38.690
Take a listen and subscribe to everything.

01:00:38.992 --> 01:00:39.911
What do you got going on this weekend,

01:00:39.952 --> 01:00:40.172
Tony?

01:00:40.353 --> 01:00:40.713
Anything good?

01:00:41.820 --> 01:00:44.742
Oh man, kids, kids are getting into sports,

01:00:44.762 --> 01:00:44.942
you know,

01:00:44.961 --> 01:00:46.483
already like the next year

01:00:46.503 --> 01:00:47.443
hasn't even started.

01:00:47.463 --> 01:00:48.943
And we're, we've got basketball,

01:00:48.983 --> 01:00:49.864
we've got baseball,

01:00:49.923 --> 01:00:51.304
we've got some football starting.

01:00:51.384 --> 01:00:51.943
What about you?

01:00:52.945 --> 01:00:53.565
Father's day,

01:00:53.644 --> 01:00:55.505
hanging out with dad's steak.

01:00:55.806 --> 01:00:56.445
Probably that pool.

01:00:56.465 --> 01:00:57.505
It's going to be some good weather.

01:00:57.606 --> 01:00:59.186
Finally, in the first, first time,

01:00:59.226 --> 01:01:00.086
I think there were thirty

01:01:00.226 --> 01:01:01.467
one weekends in a row with

01:01:01.527 --> 01:01:03.588
some precipitation in New York state.

01:01:03.807 --> 01:01:05.108
So fingers crossed we get a

01:01:05.148 --> 01:01:07.090
father's day weekend without some rain.

01:01:07.570 --> 01:01:08.750
We'll see you guys here back next week.

01:01:08.769 --> 01:01:09.849
Thanks for spending time with us.

01:01:10.190 --> 01:01:10.570
We appreciate it.

01:01:10.590 --> 01:01:11.170
We'll see you.