Broadcasting way too early from three
separate Wi-Fi connections.
It's PT Breakfast Club with Tony Meritato,
Dave Kittle, and Jimmy McKay.
Hey!
Good morning, Tony Meritato.
I'm Jimmy McKay.
Dave Kittle is somewhere hanging out with
M-I-C-K-E-Y-M-O-U-S-E, Mickey Mouse,
Donald Duck, Mickey Mouse.
He's in Disney World,
which I think is a... Oh,
I didn't know that.
Didn't anybody say he's in Florida?
I just assume everybody who goes to
Florida is going to Disney World.
Maybe I'm making things up, which.
I mean, I know he was.
I didn't know if he was still there.
Pre eight thirty in the morning.
I'm telling you what.
We're going to Disney today.
I'm out this morning.
Yeah.
OK.
I didn't make that up.
He refuses to admit it.
He is going to be one of the
New Yorkers that is moving to Florida.
He is going to leave.
Who was I talking to yesterday?
I was talking to someone and I go,
I live in Florida.
I go, but where are you from?
He's like, Florida.
I go, where are you from?
He's like, Ohio.
Ohio, when I lived in,
I moved to South Carolina because I was
running a radio station and I was like,
I'm going to be a PT now.
And I was taking like one or two
classes at a time to get my prereqs
done.
And then my dad,
who didn't go to college, was like,
wanted to understand.
He's like, help me understand.
Like you're taking these classes so you
can take more classes.
I was like, yeah,
you got to like do this and then
get that.
And he's like, well,
why is it taking so long?
I was like, well,
I have a job and I'm taking one
or two.
I want to do,
I have to do well in these classes.
And he's like,
so if you quit and moved here with
me,
and live here for free in South Carolina,
you could do it faster?
And I was like, yup.
And he's like,
do you want to do that?
I was like, oh, I already,
I have boxes now.
Like I already,
I had like already just materialized.
I was like, sure.
So doing that,
and when I got to South Carolina,
I was like,
I can't wait to meet all these South
Carolina girls.
And there were none.
They were all from Ohio and Pennsylvania
and New York and New Jersey.
And I was like,
where are all the girls with the accents?
They did not exist.
They didn't exist.
All right.
So Dave's in Florida.
We are here.
How was your New Year's?
How was your Christmas?
We haven't done this in a while.
We did New Year's Eve,
New Year's Day episode.
So it was good.
Everything was awesome.
We had a great time.
Family is good.
Family is healthy.
You know,
I have officially hit that time in life
where I say every day,
where did my kids go?
Because now like they've grown into men.
They're taller than me.
They're like doing their own thing.
I barely see them.
um and i can now say cherish it
because it happens too fast yeah yeah
that's scary i hit the official age where
we had this like the same little group
of people i mean i'm still friends with
my my best friend since second grade and
he's like we're having a bunch of the
dudes over and the dudes are all friends
we were friends with since elementary
school and middle school high school and
their wives and their kids now who are
now in college and i'm like i'm weird
uncle jimmy who has no wife or kids
um
And I look at my buddy Brian,
who had just driven back from Florida,
that the more he got back at eight
a.m.,
now it's like ten o'clock and he's wasted
tired.
He's like, I'm barely hanging on.
And I go, I'm exhausted, too.
I slept at home.
I go, Do you mind?
What would happen if I just dipped out?
And he goes,
You're the only one who can.
Like, we're all living through you.
He's like, Run.
and i dipped out and i get a
text message from his wife as i'm pulling
in my driveway like you're a loser but
i was like it's ten thirty and i
don't want to be awake so i don't
have to what am i proving i know
what midnight looks like and i know how
to count backwards from ten um nothing
changes in the new year because uh we
still need to uh we still need to
pay some bills tony
We do.
Let's hear it.
Here's the thing.
One of our new sponsors for the new
year is BioFreeze Your Feelings.
For the clinician who's just got a
one-star review on Google and took it so
personally,
apply BioFreeze for your feelings.
It's not BioFreeze.
This is BioFreeze for your feelings.
Now in cryo-cucumber scent.
And this is what happens.
Just apply it directly to your feelings.
I'm not really sure anatomically where
your feelings are located,
but you just smush it all over the
place.
And it'll just take that one-star review
away from everybody.
So let's start with with that one
conversation that someone had where they
where they were thinking about made.
I almost want to make this a mail
mailbag segment.
Maybe we should make it a mailbag.
Let's do that.
It's mailbag time.
Real questions.
Real people.
No bots allowed.
gonna do the screenshot of the actual post
but like maybe we'll spare the person
because we we see these posts pretty often
and this person was essentially like um
i'm thinking about maybe starting a
business so i'm overwhelmed yeah they're
already that was the thing i'm already
overwhelmed thinking about it um uh i'm
looking for a mentor who can guide me
step by step
from paperwork to opening day,
little by little,
or advice on companies that can handle the
setup for me and make the process easier.
So you don't want to run a business,
it sounds like.
You want to have a business run for
you.
You want to skip running it to owning
it.
So I would take out a loan three
times the size as normal and then factor
in that loan someone to run the business
you would like to buy.
I don't know.
This person is obviously,
they're named Humble Sunflower.
So they're talking,
Dave would appreciate their speaking
anonymously.
But then, thirty people chime in.
Don't be discouraged by the naysayers.
There's still plenty of... This person,
from only the information we have,
this is the wrong person to start a
business, right?
Yeah.
I think you have to go from that
narrative of if you're overwhelmed now,
what's down the road?
Now, on the flip side, right?
Because I'm the one that shared that post
with you guys.
I knew Dave would go crazy.
Too bad he's not here to discuss it.
But then look, we're physical therapists,
right?
We understand baby steps and acclimating.
I know somebody who, you know,
wants to run their first five K,
wants to run their first marathon,
wants to take that first step,
like to an infant, to a toddler.
I guess it's a toddler.
Taking those first steps,
learning to crawl before you can walk like
I get it.
I don't know.
And I think this leads into the post
that both Jared Hall created and Richard
Severin kind of came on with, which is,
okay, you know,
we're in this field of physical therapy.
We're making decisions constantly.
People in a cognitively heavy,
I think that was kind of the way
they said it,
profession need mental rest breaks.
And I had to read the post a
bunch of times,
and I still can't put a coherent response
to it.
But basically, they were saying, well,
if you're making all these cognitive
decisions, you need breaks,
and maybe we do a three hour work,
like chunk of work,
and then we take forty five minutes off
and then we work another three and take
another hour off.
And they're looking for ways to change the
workload.
And my question is and this is where
my age obviously shows.
whether we're talking about somebody who
wants to start a business who feels
overwhelmed,
we're talking about a practicing clinician
who I think they're saying feels
overwhelmed,
is it that the situation is actually
overwhelming?
Or is it that the person hasn't developed
the skills and the capacity to handle the
cognitive load?
You know,
and that's where I go back to last
week.
I was in the clinic by myself.
I saw a full caseload that's normally
split between two therapists.
Like, was it hard?
Yeah, it was.
But it didn't feel like, you know...
Like I was going to collapse or I
was going to have a mental breakdown.
Now,
I couldn't have done that as a new
grad.
Like you build capacity.
I can't run, you know,
a mile if I haven't run a block.
But there's also humans that are running
twenty six miles.
Like there's there's a variation in all of
this.
I just think it kind of,
we have to take context into account and
I don't think we need to baby or
coddle or, you know,
tell people that they're too weak to
handle it.
Like build the reps.
What do you think?
I, of course,
have to sound like old man Jimmy and
default to what I knew because I never
ran a clinic,
but I did run a radio station.
And I understand those are similar,
not the same.
I kept waiting for the day when I'd
be ready to run the radio station until
my boss, who was leaving, was like, dude,
you've been doing it for six months.
I've been stepping away like stuff has
gone sideways.
So the only way for me to have
gotten there
was a mentor who essentially was like,
I'm not even gonna tell you that I'm
taking the training wheels off.
I'm just gonna start doing it.
You're never ready.
You're never ready, right?
But from the second one-on-one meeting I
had with this boss, he's like,
what do you really wanna do in your
career?
And I felt scary telling the guy,
I'd like to have your,
not necessarily your job,
but I'd like to have your job eventually.
And he was like, good,
say it out loud.
Otherwise it doesn't happen.
From then on, I think secretly,
he was like,
pushing me, pushing me, pushing me.
Cause he was like, that's my job.
But I, so I always wanted it.
I was, I never felt overwhelmed.
I always,
I always felt like a healthy respect for
while I'm not ready yet.
It wasn't like I'm overwhelmed.
It was like,
Well, Chris is super smart.
He's way smart.
I'll never be that smart,
but eventually I will.
Until he was like, dude,
it's running a radio station.
This is not rocket surgery.
No one's going to die if you screw
this up, right?
And I was like, oh, yeah.
My dad even said that to me.
My dad was a firefighter in New York
City.
He was like,
is anyone going to die if you have
a really bad day at work?
And when he said that, I was like,
uh, no.
Stress level went from here to like,
do you ever run a radio station?
Like, what's the point?
That was my immediate response when I read
Richard's post.
I was like, we're not generally speaking,
we're not making life or death situations.
Now again, it's context dependent.
You know,
he talks a lot about like vital signs
and he seems to work with a very
medically complex population.
And if I was in that world, yeah,
like I wanna take mental breaks.
my world is not that world my patients
are driving to the clinic they're dressing
bathing feeding themselves they're living
in the community yeah they just have
nuisance conditions that they want to work
through um so i think that's a big
part of it the other part is are
we in a situation where people are
verbalizing things that we all thought but
we didn't say i feel overwhelmed but i
don't have to tell people i feel it
i just internalize it and i work through
it like
They want a mentor.
I wanted a mentor.
The mentor didn't exist at that time.
This was pretty much pre-internet,
pre-social media, pre all that stuff.
So I don't know.
It's so hard to look at those situations.
And everybody says the same thing.
If I knew how challenging,
how hard it was going to be to
start a business,
I probably never would have done it.
But I just took the leap and I
dealt with it as the things were coming
at me.
Dan says,
person sounds like they don't have a
written business plan.
Yeah, it's fine.
Just a dream.
Yeah.
I mean,
you want someone else to do the work.
Ben's saying going through the steps of
learning brings the knowledge.
Yeah.
Like you don't.
I'm very like I'm all pro education,
but like there's a difference between
theory and practice.
And like even the people who teach you
theory are going to tell you like you
need to jump out of the nest.
So now we take this and we say,
okay,
is this another symptom of kind of the
modern education system?
Everybody wants to be taught everything.
Like, where are the innovators?
Where are the trailblazers?
Where are the people who look at this
and say, you know what?
Nobody's ever done what I want to do.
I am going to go do it and
figure it out.
I am going to cut the trail in
a virgin forest and I'm going to make
this work.
I feel like every single time I talk
to somebody, they're like, well,
show me how to do it.
Teach me how to do it.
And even if they're willing to do the
work,
like you have to do the you have
to lift the weight.
You have to do the thing.
And there isn't a teacher for everything.
But Ben has also said,
if you don't want the knowledge or the
wisdom,
or I would also say like some of
the stress, do a franchise.
Like that's like that's the middle ground.
Right.
Which is like this is clinic in a
box.
We've stepped on the landmines.
We've tripped over the mistakes that would
normally cost you money or cripple you.
So you jump in.
But now you you pay for that.
So you want all the freedom with none
of the risk.
I'm launching a course today that I've
been talking about.
You've been talking about me doing it for
three years, which is like,
you know how to run a podcast.
People want to run those now.
Five years ago,
I think I had to convince people to
launch a podcast.
Now I just like,
do we have enough podcasts?
I feel like we might.
But now people are like,
I don't know how to do it.
I'm like, great.
It's five hundred bucks for eight weeks,
which now if you do the math,
I'm still sort of like five hundred bucks
for eight weeks of one on one plus
I'm going to add all these other things.
You could Google all of the things I'm
going to teach you,
but I'm going to sit with you and
hold your hand and look over your shoulder
and then be like,
now explain it to me why you're afraid
again.
And you're going to go because of this.
I'm going to go, that doesn't matter.
And you're thinking about the wrong thing.
Remember two weeks ago,
I told you to think about A,
not B.
We're not worried about microphones.
It does not matter.
Right.
So,
but they want all the freedom with none
of the responsibility.
People love to talk about what rights they
have.
The other side of rights, I was taught,
is responsibilities.
You also have responsibilities, right?
This isn't going to end.
This is great fuel.
We'll always have something to talk about
on the podcast because this is never going
to go away.
This is a new generation.
Another group is going to walk in front
of the firing squad and do it.
Where are the people who are the
innovators?
Not in this Facebook group.
They're out doing stuff.
That's why we don't hear about them.
They do exist.
They're just doing them.
That's the thing.
They're not asking for permission.
I was asking for permission when I
launched my podcast.
Even though I was thirty three years old,
I still walked into my professor's office
and think about this thing.
And she's like, OK, I'm like,
but you're I'm sort of asking.
She's like,
are you going to do it during class?
I'm like, no, she's like, I don't care.
Like in a good way, like do it.
Now we need both, right?
So like my wife and I always talk
about this.
We started our practice in two thousand
one.
I was not a physical therapist.
I didn't even know her when I signed
the lease to rent the space.
And it was one of those deals where
we met, we built a relationship,
we got everything going and we were like,
hey, you know, here's here's the space.
I don't know what the storefront used to
be.
And almost as quickly as we were like,
well, let's do she got to do.
I already started to pull paneling off the
wall.
I'm like,
we got to just start doing this.
And so the joke between us is she
is the quintessential physical therapist.
You know,
she did all the proper stuff and followed
all the rules and did everything.
She was like,
I would still be thinking about if I
should remove the panel and you've already
ripped down the drywall.
Right, right.
You know, with zero plan on what's next.
Are you the original Alex and Layla
Hormozy?
Perhaps,
but we were never that successful.
Well,
I think you need in any good combo,
like a wow and a how,
like you've seen me talk to Andrea Chaney
a couple of times and she's a marketer,
but she's very much,
there's a Venn diagram.
Is she also a therapist?
No.
Okay.
But she's worked in the healthcare space
enough.
And she's like,
I like putting these efforts into
something I feel like is a good product.
but she's not a therapist.
She's very, how?
So she looked at me,
the first time we ever worked together,
we got like dropped in the room and
both of us were looking at each other
like, why are there two of us here?
And we didn't know why.
The person who put us in the same
room was like, just figure it out.
And then we looked at each other like,
what are we supposed to do?
And I remember it was like the Spider-Man
meme.
Like I'm pointing at her,
she's pointing at me.
And I remember being like,
I don't want your job.
I'm not going to be good at what
you're good at.
But conversely, I am a therapist.
It was a therapy company.
And I'm more all over the place.
And once we sniff each other around a
little bit, we're like, got it.
OK, yeah,
now this is how we work together.
We figured that out.
But that's a good team, I think.
You need to be able to operate
independently,
but also play well with others.
So back to the original post.
I think a situation like that,
what needs to happen is you don't know
what you don't know.
And agree, that's overwhelming.
You just accept the overwhelm.
You accept that feeling.
You accept the feeling of.
You're going to make mistakes.
You start doing stuff.
And as you start to do stuff,
now you have information because you can't
even go to somebody like I get questions
all the time.
I'm sure you it's the same.
What do I do?
How do I do this?
I'm like,
it doesn't matter if I even hand feed
like spoon feed you the information.
You don't know how to use it.
Right.
If you want to go down that road,
you start doing it.
You know, you're going to make mistakes.
As Jimmy said,
you're not going to kill anyone.
It's okay.
And you then have information when you
mess something up to go back.
I can't even tell you how many times
I do something and they're like,
you need a permit to do that.
I'm like, okay, I'll go get a permit.
You need a license to do that.
What?
That's stupid.
But okay.
That's what I need.
Like,
I will figure it out as I go.
Yeah.
Steven Johnson's this guy wrote a book
called I can't remember the name of the
book,
but his concept is called the adjacent
possible.
He's like the world is a giant chessboard,
just squares upon square in infinite
directions.
And wherever you're standing,
it's because
someone,
forty nine thousand squares before,
learned how to create electricity.
So now you're standing in a Jason Possible
and you have one, two, three, four, five,
six, you have eight options.
That's how chess boards work.
You're standing.
And then because I now is here,
I can take one step forward here and
now I have eight new options because now
these options I have I have go back
to where I was and I have go
forward and all these and you're just
continually.
But most of it is standing on the
shoulder of giants.
but I have to walk my own walk,
right?
We all have access to laptops and
electricity,
but somebody built Apple and somebody
didn't, right?
It's because they put their unique spin on
that adjacent possible.
You can only take one step.
That was his simplification of like how
innovation was made.
Where do good ideas come from?
Steven Johnson.
That was the end of the book.
Shoot, adjacent possible.
I actually wrote a note down, Tony,
and didn't just interrupt someone and
start talking.
That's my twenty twenty six.
So listen,
this person will or will not be good
at business and it's going to be
determined if they take the leap or not,
or they're going to be at a dinner
party six years from now saying,
I should have done it.
I would have done it.
I would have been great.
And like,
we're only going to know if you do
it.
And there is no perfect.
And I'm very sorry.
But that's our psychological analysis of
this anonymous person Facebook group for
eighteen and a half minutes.
Can we spend a couple of minutes talking
about EMRs?
Yes.
What do you want to talk about EMRs?
So again, this plays off of Jared Hall,
Richard Severin's post, you know,
they were saying how therapists are
overwhelmed with cognitive decisions and
all of this stuff.
And it got me thinking again, I'm like,
I shared,
I did finally squeak out a response.
And I said something along the lines of,
I think a lot of the decisions that
therapists are burdened with are not
decisions therapists should be making.
This stuff should all be automated,
which brings me back to the EMR.
Now, I am happy,
I'm satisfied with the EMR that I have.
I have nothing negative to say.
They've made great advances in EMRs
compared to what I had purchased back in
like the mid two thousands.
But even with that, I, gosh,
we went to Cheesecake Factory Sunday after
church to like celebrate the end of the
holiday and kids going back to school and
stuff.
I'm like, again,
I scan the barcode,
I scan the QR code and I pay
my bill.
I don't have to bother the server.
He's busy with other stuff.
Why do I not have that integrated into
the EMR already?
The EMR has so much information.
I just want to tease a couple of
things and see what you think about this.
My EMR already knows what visit number it
is.
It already knows the date.
So like if the patient,
it already knows the diagnosis code.
So if the patient is coming for left
shoulder pain, non-surgical case,
they haven't been seen for two weeks,
I might have a different treatment plan
scheduled for that day compared to the
patient who is just here,
forty eight hours ago with the same
condition.
My EMR knows when a payment is processed
through a third party payer.
It knows the allowed amount.
It knows the billed amount.
It knows the patient responsibility.
It also knows the plan name, the policy.
It has information and context.
Why is it not applying that information
forward?
Why is it not making recommendations?
And what it got me thinking about was,
An airline pilot has autopilot that's
making thousands of adjustments while it
flies the plane from New York to LAX.
Tesla can drive across the country making
thousands of life and death decisions
every second of the trip.
Why is my EMR still in two thousand
twenty six just collecting information and
not doing anything to make the therapist's
life better to support the clinical
decision making?
It has access to millions of data points.
And I still feel like it's a dumb
piece of software that just sits there and
collects information that could be so
valuable.
So if the therapist is overloaded,
maybe it's because we're not using
technology that already exists in multiple
different professions.
We're standing between the information and
the EMR and the use of the EMR.
It's like waiting for us to...
Do you want to know one of the
things that made me sweatiest when I was
in a clinic?
What?
Is doing the math on when someone had
surgery and how many days it had been.
Yes.
I was like,
because I got to be honest with you,
Tony.
You asked me what date it is.
Ninety eight point nine percent of time.
I know what month it is.
Date.
Not a not a clue.
Could be the second.
Could be the seventeenth.
I don't I don't know.
I know it's Tuesday.
I always know what day of the week
it is.
But what date?
That person knows when their surgery was.
They know that date.
It's important to them.
But yes, I would be like, well,
you're at two weeks from post-surgery.
They're like,
we're at six weeks post-surgery.
I'm like, yeah, yeah, totally.
Because it was April.
And I'm like, now it's June, July.
I don't know what month it is.
That's the bare minimum.
I'll give you one example that brought
this to light with me.
It was Seth Godin,
who asked a simple question.
Cover your ears if you don't wanna be
pissed off every time you buy something
now.
Seth Godin says,
when you're buying something online, name,
address, like street,
twenty-two Main Street, town name,
zip code, state.
He goes,
I'm gonna slap you across the face now.
If I put my zip code in,
mine's one, two, five, eight, six.
Can I live in Iowa?
I have to live in one town.
One, two, five, eight, six is Walden,
New York.
Thanks for coming.
Then why am I typing Walden,
then doing a dropdown in New York,
then typing in a secret code one, two,
five, eight, six?
Why is there not a plugin?
It's still not here.
This was a decade ago,
Seth Godin pointed this out.
Why is not one, two, five, eight,
six automatically go bing, bing, done,
move on?
Still does this, still does this.
EMR, same thing, right?
There's a bunch of things that as soon
as you do one thing,
seventy two other things are also true.
And we put that load on me having
to think about it, ask,
go go through this paper thing or scroll
backwards and do this dumb.
You know how dumb we look when we're
looking at spreadsheets on a computer like
that's the dumbest face ever.
So yes to everything that you just said.
So what's the problem?
Do EMR companies not know how to do
this?
Do they not want to do it?
Because where's the hitch in the giddy-up?
So,
and I don't want to beat up the
EMR companies because we know the guys
behind the companies.
I know they're working like crazy.
I know they're trying to make things
better constantly.
And I know they're smart guys.
They see this stuff.
So I don't know.
Is it, okay, Kodak had the digital camera,
but they weren't the ones that brought it
out.
The ice harvesters weren't the ones that
created the refrigerator.
I don't know.
I wonder if it's still that their focus
is someplace else because they're not
therapists, they're not in the clinic,
they're not dealing with the day-to-day.
Even the best of the best EMR companies,
they don't have that connection.
Like they don't,
they don't know how important it is or
how useful it would be,
or they physically can't be done.
I think that.
So what I've always been told is two,
two things.
One, they're working on other priorities.
They can't do everything.
And I get it.
I sent my EMR company a message the
other day.
I'm like, Hey guys.
You made a change.
I'm sure there's a reason for the change.
I'm sure people love this change.
I can't stand this change.
This change just put three or four more
clicks and three or four more screens
between me and getting the information
that I need.
I know you can't change everything for
every individual.
If there's a way for me to roll
back this change, I'll do it.
If not, I'll deal with it.
That's the customer experience, I think,
for most of us.
Give me the best you got.
I'll deal with it.
I'll figure out a way to work around
the changes you're making.
But every time I talk to them,
they say they're working on other things,
which I know they are.
I just don't think those are the things
that necessarily have the biggest impact
for me as the therapist.
Right.
Ben, Ben,
Ben brings up a good point for decades.
Oh, wait.
Oh,
so I want to do this one first
for ROI return on investment development.
What more do they make if they do
this versus they don't at some point,
where is the return from them?
Well, at some point when someone else,
my answer would be when someone else does
it and it's doing it smoother.
I'm going to start thinking of leaving.
So it's like I'm not married,
but like if I didn't pick up my
underpants enough times,
eventually I'd piss off the person I was
with.
They'd be like, you know what?
That guy over there picks up his
underpants.
So I'm going to go.
So you're right.
Nothing in the immediate time,
except most of the EMRs are pretty close,
right?
They're pretty close.
They're not crazy far apart.
There's not one on the market that has
an AI scribe and none of the others
do.
They're doing this.
This is an arms race.
For decades,
the only person in EMR was billing.
Therefore,
the focus is not of clinical or health
management.
Agreed.
except now we know how decisions are made
i was just watching a video with uh
what is rory's last name i never remember
it sutherland and he was like please stop
thinking we make logical decisions we make
emotional decisions and then we make up we
invent a logical story to justify that i
don't care if you're in the c-suite or
you're in the pit uh things are changing
newer systems older systems wrap around
will start to do what you're saying the
person who does it first will
do better.
I was gonna say win, but I'll say,
in my opinion,
the person who starts to pay attention to
the stuff that doesn't matter actually
wins.
Like the Microsoft Zune, are you familiar,
Tony?
No.
Microsoft had their own MP three player.
I don't, I can't remember,
a year before the iPod, it was out.
Like in all intents and purposes,
it had better sound.
If you asked like sound people,
sound of files, it had better sound.
It had better compression,
which made you hold more songs per Zoom
device.
It's a plugin device.
Do you want to know why it lost?
It was better at all intents and purposes.
Better battery life, better this,
better that.
Steve Jobs walked out on stage and said,
a thousand songs in your pocket.
And Bill Gates said,
one point twenty one gigawatt per blah,
blah, blah, blah, blah, blah.
Better sound.
I don't want, I mean,
better sound is negligible.
It's barely able,
but a thousand songs in my pocket,
and how do I access all those songs?
I could go down, down, down, down, down,
down, down, down, down, down, down, down,
down, down, down,
down
Someone didn't explain it right.
So my reason for bringing that up to
Ben is that's cool, bro,
except the one who does it will get
more people buying it.
There's your return on investment,
in my opinion.
And I agree because I think that's what
we see in health care.
I don't have to be much better,
if any better than the clinic across the
street.
There's a clinic across the street,
a clinic down the road.
As long as we all suck,
nobody has to get better.
And it's easy to run a sucky clinic.
Now, when somebody comes in who is like.
orders of magnitude better.
It is completely different experience.
Now we have to elevate.
Now we have to improve.
From my perspective,
the biggest innovation I saw in EMRs was
when Luna came out and a therapist could
just talk on the phone and do their
documentation that way.
That was blowing people's minds.
That was completely changing things.
The problem there is it's still, I think,
retro instead of proactive,
meaning I don't need an EMR to capture
information.
I need an EMR to be my predictive
assistant to look ahead,
to look at the past information and give
me resources like a true...
autopilot.
Even if you don't want to take away
my clinical decision-making,
you can make recommendations to say, Hey,
this is what's been done.
This is what's going on here.
Multiple data points that I recommend you
consider doing in the future.
You know, and like you said,
don't wait for me to try and figure
out how many weeks it's been since
surgery.
Tell me,
because this is a post-surgical case.
Like these are the things that are
important to me.
Give me those resources so I can see
a mile down the hill.
I got to be honest.
I know nothing about technology,
but my Peloton bike knows a lot.
ton about me.
It's like since in the last three weeks,
your average watts have gone up, blah,
blah, blah.
Like, oh,
so you did something with a date and
a delta of watts over a certain time.
And now you're giving me that result.
I don't disagree with what Ben is saying
here.
Leaving an EHR is painful operational
financially.
Here's the thing.
I don't know if anybody loves their EHR.
So we're all married.
But we're dating and we're looking for the
next one.
You talked about seeing into the future,
not just seeing into the past.
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we're all just guessing we're spray and
pray um i want to talk about golf
okay i don't remember what golf this is
some golf course land i don't even know
what golf course this was and this was
posted on like january first or january
second and this is some golf course it
looks very nice i'll describe the image
for the podcast audience
It's like a nice sand.
It's not a sand trap.
It's a waste area, but it's just sand.
It looks near the ocean.
It's just got that vibe.
Lush grass, one tree on the horizon.
And they're like, hey, everybody,
all tee times for twenty twenty six have
been filled.
Thanks for coming out.
January second.
What does that do for cash flow?
Let's talk about what that does for a
golf course for a second.
Cash flow.
We cannot accept any more people.
because you could only have,
I can't remember.
I used to know like the appropriate amount
of time between tee times.
Do you golf for Tony?
Not much.
I'll do it occasionally.
Yeah.
You understand the concept.
And I was,
I remember as a kid being like,
why are tee times seven?
and a half and it's like because they're
estimating and the goal is stack as many
foursomes so you keep the golf experience
you don't want someone up your ass and
you don't want to be up someone's ass
you want to be backed up but the
golf course is like want to get as
many guys through so that's why the right
the there's a dude who's like the mater
d who's at the front going okay mckay
up mckay four and you're like hey man
how you doing the guy's like get put
your ball put the ball in the t
Do the yippity yap later on.
Tee off.
Get out of here.
Boom.
We're moving along.
These guys are booked for twenty twenty
six.
I don't know the math on that,
but what does that do for a business?
Even if you know nothing about golf?
I mean,
it takes the peaks and the troughs away.
Basically,
you do cap your upside potential,
but then you also limit your downside
risk.
You know your budget for the year.
You have money in the bank like it
guarantees all.
It allows you to make forward-thinking
decisions.
Huge.
You are not playing catch-up.
Here's the thing.
They're all booked.
You know not everybody's going to show up.
Even better.
So if you knew your numbers well enough
and you have margin here,
you're already in the black.
Now you can get creative.
Now you can go, we know,
twenty six percent of people who have a
tee time don't show up because life or
whatever.
What do we do then?
I was thinking about this.
I was like, you fly standby.
Who wants to fly standby?
You do the same as a ski resort.
If I'm a solo skier,
I can sort of go on the shorter
line than if I'm with a group of
two or three other people.
And then you get paired with singles to
move it along.
I would invest in a fly standby app.
It's called, you know, it's tea time.
It's a flight app.
Right.
I would I would do a standby app.
I would maybe create a secondary market
for that because you're not only paying
for golf.
What do you do at hole nine and
eight after eight after nine and after
eighteen?
You go get some hot dogs and you
get some overpriced drinks and you load up
and then you stop by the pro shop.
Every one of those missed tee times is
missed revenue.
How do I?
They're already paid for.
How I fill them back up.
How do I dictate the secondary market if
there is one?
That's insane to me,
but this is big on tickets.
Maybe it's big on golf.
My first question would be, dude,
how did you do that?
That's the question.
I guess you get so damn good and
so damn popular,
and you live in an area where people
want to come and play that golf course,
and you have low supply and high demand,
and that's what you do.
So I guess my question is, man,
how do you do that?
Could you now,
you've talked about this before,
the five-fifteen appointment is really,
really valuable.
If you're in peds,
the three-forty-seven tee time is more
valuable because I don't want to go home
and then bring my kid to therapy.
I want to go to school,
bring them to therapy,
sit in the parking lot while they're doing
therapy,
then get them out of there and then
go home.
How do you structure this?
I know that golf courses will sometimes do
this,
which is like if you tee off late
in the day, they're like,
I will knock a couple bucks off of
it because most of the day is over.
So what do you think is in twenty
twenty six?
I think I think flexible pricing and
timing is definitely on the horizon.
Yeah, which kind of related to the EMR.
My EMR knows when I've got somebody who
cancels more frequently than somebody
else.
Why is my EMR not adjusting in real
time?
Why is my EMR not utilizing this schedule
management system to understand?
And back to how ridiculous.
Okay, if we're going to bill...
you know,
eight to twenty two minute CPT codes.
Why am I scheduling everybody on the forty
minute, the sixty minute?
Like, why is that?
Somebody asked a question and Jared and
Richard both said the same thing.
Like,
if we weren't billing on CPT code units,
what would the system look like?
How could we make this different?
If somebody's got a forty five dollar
copay,
is there an opportunity for me to come
in with shorter visits that would actually
cost less than a forty five dollar copay
that would still make me more per
minute of time,
but would allow us to kind of create
a win-win-win situation.
I can't do that if I don't have
a flexible scheduling system.
And if my front desk or my EMR
or everything is built around a thirty
minute spot, forty minute spot,
sixty minute spot without the seven and a
half minute spot,
You know, seven thirty one.
Why?
Why can't I schedule an appointment for
seven minutes and thirty one seconds if
it's the time rules?
I mean,
it's just we are not building efficient
systems.
it's uh it's it was very unique and
jarring to me when i started i'm gonna
make a point to come back to this
i promise it's gonna sound like i'm going
away but i'm gonna twist it i'm gonna
slice it on back don't worry about uh
coming going to pt conferences and then
being asked and then being asked to speak
at them hey jimmy we'd love to have
you speak at this conference for
whatever topic that you want.
And I remember the first time I did
that, I was like,
I don't have a ninety minute talk on
that.
I can't I could do a forty two
minute talk and then give someone else the
other the difference.
And they were like, no,
we need to fill ninety.
And that's when I was like, oh,
you're in the Phil ninety game.
I'm in the good talk per minute game
because I want the audience to leave
wanting more.
Here's how it worked in radio.
And I've said this to people who run
conferences.
but they're in the Phil ninety minute.
They want it.
They want to just get the thing filled
and then start putting butts in seats.
I'm in the put the better thing on
stage.
If Tony hosted the morning show and Jimmy
was a budding radio DJ,
I'd walk by Tony after he got off
the airs like that was really great show.
Tony step one kisses, but that was great,
man.
You guys are great.
Hey, I got an idea.
Hey,
Got an idea for you.
And you're like, all right, man, listen,
bro.
I got seven minutes.
What do you got?
I would now pitch the idea.
And then you're sitting there and you're
listening and you're envisioning how you
would pull this off because it's your
show.
Tony's got to fill five hours.
But the quality of the five hours,
he's got two choices.
Do something funny with a microphone or
shut up and play some Pearl Jam.
Figure out what math you want to do.
I'm now pitching because I want to get
on the show because the morning show is
more listened to.
And what I would not do is go,
Tony,
I got an idea for a fifteen minute
bit.
We're going to do this and this and
this.
Not how it works.
You give me the bit.
I then tell you, number one,
if it's on the air.
Number two, how much time you're getting.
And then I tell you,
I'm going to take your idea and mold
it.
We don't do that with conferences and we
don't do that in clinical.
You have to become a cat.
Do you ever notice how cats,
when they sit in a box,
they become the shape of a box or
they sit in a cylinder,
they become the cylinder.
That's not how it should work.
A nine-minute appointment should exist.
I'm agreeing with you.
Because it's better.
And now we have AI and we have
the ability to do a nine-minute
appointment.
Why don't we?
No one's asked for it enough.
We need more.
You know what we should start selling?
Pitchforks and torches.
we should show up where these decisions
are made and where it's done and then
things will get changed pitch to pitch
forks uh and torches um so that was
the golf course i thought it was brilliant
these guys are stacked up all t times
for twenty twenty six have been filled how
great would it be if your clinic was
close to that you asked a question i
thought it was attached to that post
saying should we call appointments
something different what were you thinking
i don't know um
When I go to book my haircut with
Rod down the street,
I book through an app now.
I love it.
Rod's cutting hair.
Why is he answering the phone and looking
at a book?
So I book.
And the last step is, hey, man,
if you don't come, it's thirty five.
You're paying for the haircut.
And I'm like, got it.
Rod's busy.
And I don't want a random dude cutting
my hair and be on a ride for
five years, six years.
This also goes into the cancellation fee,
which is like,
it's not a cancellation fee.
You already paid for this.
You paid for it.
There's a psychological difference there.
Rory Sutherland would have a field day
with this,
which is you don't charge a cancellation
fee.
You take the money when you book the
time.
Hair stylists do this,
and we do not bat an eye.
Massage therapists do this.
We do not bat an eye.
They understand.
I booked five to six.
Five to six is gone.
I cannot now make money.
And if I were right at the line
between breaking even and making money and
feeding my family,
you have now caused me to, oh, well,
sorry, little Timmy,
not enough coal to keep you warm tomorrow.
But for some reason in health care,
I think it's because there's a third
person in the room.
right that's probably the issue so yeah i
guess a t time is you have bought
the per the permission the right to stand
at hole one at seven oh three at
seven fifteen tough can't do it can't fit
you in look at all the people but
we don't do that so yeah i guess
my question is like what is it as
dumb as changing the name from an
appointment to uh something i don't know i
gotta buy a thesaurus or i mean no
one's buying the sources anymore just
going to ai but
Like,
I don't know what arose by any other
name feel different is my question.
Yeah, I mean, we've we've talked about,
you know,
requiring prepayment if and we know even
with Medicare,
you can have a cancellation fee,
you can have a no show policy,
you can charge Medicare beneficiaries.
What you can't do is you can't force
them to pay for something in order to
receive the Medicare covered service,
but you can have a policy in place
for cancellations and no-shows.
So then the question is, well,
can I have a refundable, you know,
something out there?
And I would go back and say,
Again, this is where smart technology,
me as the human,
maybe I can't keep track of a thousand
patients over a calendar year,
but if my AI can create a predictive
analysis of, hey,
this person based on these individual
features are likely to cancel,
maybe we can create scheduling systems
that accommodate for that.
And if I'm not in an insurance world,
hundred percent like taking payment before
the patient arrives taking patient to our
payment to book the appointment absolutely
like i can't imagine not doing something
like hotels airlines maybe your rocket
seven has an idea which is we call
it a pt time what yeah
It was sitting right there the whole time.
A P-T-E-E time for the podcast listeners.
It's been sitting right there the whole
time.
You understand this.
You know what I was mad about?
Do you ever ride one of those things?
Not a boat,
but a smaller individual one that you ride
in the water, personal water.
Jet ski?
Yeah, yeah.
Boater cycle was there the whole time.
No one named it that.
When someone pointed that out, I was like,
dude, jet ski?
That's not a jet ski.
That's a motorcycle.
But yeah, PT time.
Hotels.
I bet you if I asked JetGPT right
now,
create a list of industries where if I
say that I'm coming to receive a service
or a good,
and then I don't show up,
That industry sort of doesn't care
because, like, let me pay.
Hotel, past a certain time,
it doesn't matter.
Like, we'll let that room sit empty.
You paid for it.
Or we'll sell it again because you ain't
here, right?
And we sort of are pissed,
but we're like, I guess so.
But for some reason,
our time isn't worth it?
I don't, man, there's definitely,
this is not a logistics question.
This is a psychology question.
This is like, well.
Peace Corps, Gene.
I want to save everybody.
So that's the thing.
You know, in health care,
nobody ever wants to blame the patient for
the patient's situation.
And I totally get it.
what about blaming the provider for the
provider situation?
Like, when do we as the provider,
as the business owner, as the therapist,
when do we take the responsibility for not
implementing the systems that we see are
successful in so many other industries,
so many other professions?
They're not like us.
And what?
They're not like us.
Yeah.
And, you know,
I know what to do.
I see what should be done.
Jimmy and Tony are saying we should be
doing this, but I don't do it.
Like, when do we take that responsibility?
Now, I know we're coming down,
fifteen minutes.
I shared with you,
I don't have access to it in the
chat, reimbursement rates, right?
So, like,
everybody's celebrating this big win.
We got an increase in reimbursement rates,
which on an absolute basis,
I shared my Ohio Medicare rates from two
thousand twenty five to two thousand
twenty six.
Yes, in fact,
we did get a point five to two
and a half percent increase,
but inflation adjusted.
We're still losing money.
And I'm fine with that.
I don't mind because, you know,
as much as I'm the greedy,
horrible capitalist who wants to make a
profit in order to serve my community
better,
I also recognize that I'm working within a
system that's running out of money every
single year.
And so I want to prioritize bringing the
cost of care down.
That's where it becomes my responsibility
to say,
okay,
I need to make more efficient decisions.
I need to leverage technology.
I need to improve my systems so I
can deliver a unit of therapy to Medicare
beneficiaries for less cost,
which allows me to make a profit.
Or I need to make the profit on
something else layered on top.
So here are the actual numbers,
the absolute number plus the inflation
adjusted number.
We're still losing.
Yeah.
People do pay a lot of attention.
I don't think I have the graphic anymore.
I used to play it.
I think you and Dave used to laugh
where it's just the seesaw.
It's like we people will bitch about the
cost of something,
how much I have to pay.
But it's like, what if you did better?
This is where that app like Rocket Money
does great.
The cost of gas is going to be
the cost of gas,
but you're paying for seven subscriptions.
blindly like get rid of that so pay
attention to the other side of the
equation which is like medicare's paying
us less we're going to go underwater time
to decree time to figure out how to
make your boat that's what happens in
every war movie we're going down guys dump
the fuel get rid of all the things
that are heavy it's like get as light
as possible why are you not doing that's
the only side of the equation you can
actually affect you can yell at the other
side of the equation but tony i gotta
be honest yelling at the other side of
the equation hasn't i mean to be fair
it just hasn't worked yet
It just hasn't worked yet.
Maybe screaming at Medicare,
maybe bitching at the about the APTA will
work in twenty twenty six.
Hey, let's be optimistic, everybody.
I think it falls in like Ramit Sethi
talks about, you know,
stressing out about a latte on a daily
basis,
three bucks compared to making a bad
decision when you're financing a house.
You know, like,
let's look at the big things.
What has the big impact?
And I talked about this and I didn't
really get a response.
I said, look, okay,
I just realized I was today years old.
That's what people say.
When I'm like, you know what?
I understand professional organizations
are fighting to increase reimbursement.
But I'm like,
are we fighting for three percent or are
we fighting for one hundred and fifty
percent?
I can't get behind a three percent,
five percent,
ten percent increase in reimbursement from
Medicare and the like.
It's not going to matter.
It's going to disappear on the balance
sheet.
It's going to have a nominal or no
impact.
If you're telling me you're going to fight
to double reimbursement, OK,
maybe that's going to have some some
measurable change on how things are going.
We don't even know what they're fighting
for.
Yeah, I have not.
I mean, to be honest, I have not.
And by the time you win that,
are you already in the red?
Do you know what I mean?
Like we've been fighting for twelve years
and we got the three percent.
It's like, dude,
we've lost three percent over ten years.
So we're down thirty.
Thanks.
You know,
but what you're sort of advocating for is
and I was taught this once there was
a big housing company coming into my town
when I was like in high school and
they came in with these plans.
And they were like, we're going to,
we're going to build a thousand houses.
People were losing their minds.
They were like,
that's going to do this and this and
this and this.
And the housing company like did a town
hall or whatever.
And there was this dude who was in
my neighborhood.
It was just this smart old dude who
says they're not gonna build a thousand
houses.
He's like, and people were like, yeah,
cause we're bitching at the town hall.
He goes,
they want to build two hundred houses.
So they came with a thousand,
everyone got all riled up and then they'll
go, you know what?
You guys are right,
we're just gonna build two hundred.
So they asked for a thousand knowing they
were never gonna do a thousand.
It wasn't possible.
And then they were like,
I guess we'll settle on two hundred.
That's what they wanted all the time.
But you had to ask for the thousand
and get everybody like, what?
The problem is you're negotiating,
in my opinion,
and I know very little about advocacy,
there's no reason for Medicare to be like,
oh, I guess so.
They're like the TSA.
Someone was like,
when's the TSA going to get better?
And I was like, never.
Well, they need to.
Is there a different line somewhere at the
airport?
There's no Coke.
Sorry,
there's no Pepsi to come along to say
Coke better get their stuff together or
they're going to get run out of business.
Well, you've got Clear and PreCheck.
Yeah, it all leads to TSA.
It's just different routes to TSA, bro.
It's different shades of bad.
So there's no real reason.
So that's why like if you were looking
at it this way,
do you want to advocate for maybe someone
giving you
more soup sir or do you want to
do your own thing and lower the cost
even if you're going to still take
insurance okay that's i'm handcuffed
that's the system i'm in affect the side
of the equation you can this is this
goes back to the dumb saying which is
like control the controllables but we'll
still yell at the apta and medicare i'm
like they don't care when will they
Never.
Like they're not going to.
You're going to be dead before anything
changes.
And that's not me being morbid.
That's me being real.
And I would say everybody is doing their
thing.
APTA is working hard as they can on
the things that they're working on.
As they can.
As hard as they can.
Yes.
EMR companies are working hard as they can
on the things that they think are
important.
PTs are working as hard as they can
on the things that are important.
You know,
this is where I try to balance like,
okay, I would, yes,
I would love to pay everybody more.
I would love to have universal healthcare.
I would love to, you know,
everybody to get a personalized,
every kid in school to get a personalized
tutor that spends an hour on every single
subject.
I love it all.
It's not going to happen.
So let me affect the things that I
can actually change.
I can provide a better experience in my
clinic than the clinic across the street
for less money and more profit within the
scope of what I'm allowed to do legally.
If we remove the legal part of it,
I could do a whole lot more.
Adam Meekins did have a rant the other
day where he essentially said what you
said nine months ago, which he's like,
dude,
this guy over here is a personal trainer
who's unregulated,
can say whatever they want.
I can say – and do you know
Adam's story right now,
Adam Meekins' story?
He's like on – he's been on like
double,
quadruple secret probation for like seven
years.
Like his license is like –
potentially being taken away for dropping
F-bombs on the internet.
And I'm like, ah, sorry,
Jimmy comes in with the first amendment
again,
and I know we're talking about America or
Europe, but I'm like,
the social media is sort of its own
country.
Like, I guess within reason,
but I don't think Adams crossed that line.
Like he didn't advocate for anyone,
you know, things that I would,
that I would say, eh, first amendment,
not so great.
Like murdering someone, not great.
Anything, mostly anything with kids out,
not cool.
Adam's just like,
I think your opinion sucks.
And then he just adds colorful language
and he, and he doesn't stop.
Here's the thing.
He believes he's right.
Whether or not he's right or not,
but like now his livelihood is on the
line.
The reason I'm bringing this up is someone
who, well,
did you hear of a new thing with
Mel?
You know, Mel Robbins is.
Yeah.
Now she's selling like protein powder.
So people are like, oh God, it was,
it was write the book, get the attention.
Now here comes the grift.
And it's like, oh, okay.
In my mind, I'm like, what's she selling?
And like protein powder.
I'm like, all right.
Okay.
Like what's the problem?
Like,
is she saying it's protein powder and it's
not protein powder?
No, it's protein powder.
Okay.
But she's not a dietician.
All right,
I can go buy protein powder in my
gas station.
Now, if she were selling like, hey,
I think you should use this medication,
that's what a controlled substance is,
in my rudimentary explanation.
But she's selling plant-based protein
powder, as far as I know.
And I'm like, all right.
I'm sort of OK with that.
But she's doing it in public.
She's not selling magic beans that she's
saying is going to give you muscles and
get you swole.
I don't know.
I'm a little disappointed.
Go ahead.
I was just going to say, like,
I mean, yeah, I love Adam Eakins.
I fully support everything he does,
everything he says.
You know,
he's going to question convention,
but he's going to bring the research
behind it.
And just the fact that he is willing
to call people out and he gets sanctioned
essentially for it, whereas you have...
way loonier, way crazier,
way more absurd people who just keep quiet
and hang out in the shadows,
who are never gonna run into any issues.
And then in regards to the Mel Robbins
thing, like, yeah,
that's how business works.
Now, you know,
she's she is going to make her decision.
She's going to need to make money to
support the machine that she has created.
And I think this is where it gets
a little scary in health care because you
have this huge working population.
And we've got a couple of minutes.
I want to bounce this this off of
you because I'm trying to figure this out
for myself.
We always hear the people who say, well,
you you you know,
you can't have the business without the
workers, right?
get it like the people we're the workers
we're the ones that are treating the
patients we're the ones that are doing the
heavy lifting we're the bricklayers but
then you also can't have the business
without the owner and the investor and and
we're that too so i'm like as the
population increases of people who feel
cheated who believe that they're being
taken advantage of
They're obviously going to make decisions
that are not in the best interest of
the business and keeping the business
operational.
At some point,
there's no reason to have the business if
there's not a profit for the business
owner.
I don't know.
It's just like the loudest voice on social
media right now is the persecuted worker.
And this is gonna go full circle all
the way back to Jared Hall and Richard
Severin's post.
It's like, if Jimmy,
you tell me that I'm being taken advantage
of because I'm working harder than
everybody else and I'm not making as much
as I deserve,
that's an easy message for you to sell
to me.
And that's a message that's gonna resonate
with me and I'm gonna feel persecuted and
I'm gonna become the victim and you are
going to sell me that message
to a point where I can't even hear
the other side, which is,
what are we supposed to do?
This is what the service is valued at.
This is what people are willing to pay
for this service.
Now, on a small scale,
it's easy for me to just close the
clinic.
You know,
it's easy for me to shut down and
go do something else.
But that's not the answer.
Obviously, it hurts patients.
It hurts the profession.
It hurts everything.
I don't know.
Do you think about that?
Do you have any, like,
Yeah, I mean, quit.
You can do it better.
You just told me if you're the persecuted
worker and you're like,
I can run a business better.
It's like, have at it, do it.
So let's think of this as kind of
the closing.
What is the reason they're not?
Because this is the theme, today's theme.
Why aren't EMRs working on other things?
Why aren't APTA working on?
Why isn't the persecuted worker who feels
underpaid and overworked and taken
advantage of?
And somebody used the word the other day,
bullied.
This is not a bullying situation,
but why are they not quitting?
Why are they not?
Why do you think they're not?
Because I don't know why they're not.
Pain and fear.
It's always an emotion.
Pain and fear.
What do we want?
Change.
When do we want it?
Now.
What are we willing to do to get
it?
Sing this song instead of just going to
do it.
Pain and fear.
It's hard and scary,
so I won't do it,
but I'll complain about where I am.
I had several of those people on my
team before, and I'm like, you can go.
I know the guy at the other radio
station across the street.
Go work.
I will give you a glowing recommendation.
Go work there.
it's the same there all right well then
call the fcc get a license pay seventy
five thousand dollars two hundred fifty
thousand dollars for music rights uh rent
a building do it yourself so easy you
just explain to me how i'm exploiting you
So then does that put the business owner
in a situation of saying, look,
I know you're going to complain no matter
what I do.
Even if I give you,
I did it today.
Medicare gave us a two and a half
percent raise.
What did I do?
I complained about it because it doesn't
outpace inflation.
I am the employee complaining that I'm
overworked and underpaid and Medicare is
going to be enough.
And so Medicare doesn't care.
No.
Does the business owner then have to say,
look, this is the price of doing business.
I'm going to stay in business.
You're going to complain.
I'm going to do the best that I
can, despite you not feeling appreciated.
And we're just going to treat patients
today.
It's not show friends.
It's show business.
Go cut lawns.
Go cut hair.
Go walk dogs.
This is the physics of this environment,
and it is constantly changing.
Why don't you yell at gravity, Tony?
Dude, gravity is heavy.
It's been the same heavy.
You've never given us a break, gravity.
Even when my grandma was ninety-nine years
old,
she still had the same gravity that she
had when she was sixteen years old.
That feels unfair.
Tough shit!
No one cares.
Work harder or like I don't necessarily.
No one cares.
Work harder.
I go choose your heart.
Choose it.
Does this suck?
Yeah.
Is it unattainable?
Yes.
There's the door.
You can push or pull.
Doesn't matter.
Push or pull.
Do something else.
But the patients,
someone else will take care of them.
They're going to be OK.
It's not going to be you.
That's OK, though.
That's OK.
I left radio.
I loved it until it hit a point
where I was like, oh,
This is getting bad.
This is what I didn't want.
This is why I left radio when I
left.
I knew that I would have been the
guy who was holding pristine pitching,
screaming at clouds.
So I left.
But I looked for the door.
I went to go to law school.
I went to business school.
And then I settled on PT.
And now I just talk into microphones
again.
I chose my heart.
I know what I like to do.
I thought I could treat patients.
I didn't love it.
I didn't hate it,
but I didn't love it.
And I was like, well,
can I help people do it a different
way?
I invented it, for better or for worse.
Is it working?
I don't know.
The lights are on for now.
Who knows what the hell is gonna happen
in a .
Choose your heart.
If you don't like it,
go build your own clinic.
Or go walk dogs.
Do something else.
If you hate, this is it.
I'm very sorry.
This is it.
I wish we could just make it rain
for everybody who came out of school.
We can't.
Parting shot.
I think as physical therapists,
we understand better than anyone.
that we are in control of our own
decisions.
We can affect change in our own life,
not in anybody else's life.
And so just like I want to be
able to walk across the room,
I need to put the work in,
I need to make the adjustments.
And if I don't have the capacity to
do it,
I need to find another way to get
across the room.
But I'm always going to be working toward
getting across the room.
That is within my independence as a human.
What you got?
I would say I'll end what I ended
with, which is choose your heart.
Like if you honestly don't like it,
change settings.
And if it's still bad in the other
setting and you tried three settings,
maybe the profession is wrong.
Or maybe you're on the right team,
wrong position.
Choose your heart.
To me, right field was hard.
First base was not hard.
I chose my heart.
I didn't leave baseball.
But if baseball still sucked,
would have left baseball,
would have went swimming.
Like choose your heart.
The final thing I'll say is,
you're really never too old to change
whatever.
Listen, if Gary Vee had this line,
he's like,
if you truly have a bullshit job, quit.
There's bullshit jobs everywhere.
Right.
And then Jim Carrey,
I'll end on Jim Carrey.
He said his dad was funnier than him,
but decided to be an accountant or
whatever, and then got fired.
He was an accountant because it was safer
than being a comedian.
So you could fail at the thing you
freaking hate anyway.
Might as well choose your heart and choose
the right thing.
I hope Dave has fun on Space Mountain.
I want to see lots of pictures.
We'll be back on Thursday.
Tony, I'll talk to you soon.
That's it.
We're out.
Boys, what the hell are you doing?
Follow Tony Maritano on YouTube at Total
Therapy Solution.
Find Dave Kittle at
ConciergePainRelief.com and on YouTube at
The Dave Kittle Show.
And follow Jimmy McKay at PT Podcasts on
YouTube, the socials,
and wherever you binge podcasts you
pretend are for CEUs.
And hey, just a reminder,
none of this was for advice.
This was for entertainment only.
Our lawyers say that counts.
Thanks, Keith.