Broadcasting way too early from three
separate Wi-Fi connections.
It's PT Breakfast Club with Tony Meritato,
Dave Kittle, and Jimmy McKay.
good thursday morning to you all welcome
back to pt breakfast club the only
healthcare show that's a must listen
before you accidentally hand your patient
data to a chat bot you could easily
do that you could accidentally do that
before eight thirty in the morning uh
today this is called the front tease guy
we're gonna front tease forward let him
know this is like when you do a
short form video and you're like wait for
it uh ai just got access to your
patient's health data that's either great
or horrible or horribly great i'm not sure
yet
Medicare gave you a pay bump that's
actually a subtraction,
addition by subtraction.
We talked about that a little bit
yesterday,
but I feel like we've all got it
on the docket for today.
And I wanted to talk about Gold's Gym.
Gold's Gym in my area is doing something.
I don't even think it's...
what they're doing nationally but i think
it's important what they're doing and
they're doing it in plain sight and
healthcare in my opinion will look at it
and be like oh that doesn't apply to
us but it one thousand percent should
apply to us but most of us will
ignore it so let's dig in we have
to go first to uh to a sponsor
we got a sponsor
No, that's the wrong sponsor.
There we go.
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What would you do, Tony,
if that's what your hydroculator looked
like in your clinic?
By the way,
I called it a hydro collator for the
first year and a half of me.
No, correct me.
I'm like, also,
you don't say it a lot.
You're just like, bring me a hot pack.
But I was like,
it says it on the side.
Hydro collator.
I don't know what the hell it is.
I still love the condescending PTs that
want to make fun of their patients for
wanting hot packs, wanting ultrasound,
wanting things that feel good when they're
coming to you to feel better.
Oh, man.
We'll get into other stuff, too.
We got somebody debating me or not
debating me,
arguing with me in LinkedIn comments.
Remember to bring that up later.
But really, really quick.
I got some new swag.
I got it.
We got some new shirts in.
We got new.
I got it.
I got to ask you guys live.
How does the font look?
Can you see it?
Can you see the concierge pain relief?
The new gray, the new gray fit.
How you doing?
It looks good.
How you doing?
You asking if you like the font reminds
me of Patrick Bateman in American Psycho
where they all just keep showing each
other their business cards.
Like, ooh, look at that.
What color is that?
It's like, that's bone.
That's bone there.
Look at that font.
Sans Serif.
Or is it with Serif?
Something like that.
It looks good, Dave.
It looks good.
And then, Dave, remind me,
I rolled out a small marketing campaign
for you.
We'll get into that.
I still think the lead story is OpenAI.
OpenAI just launched ChatGPT Health.
a version of ChatGPT that connects to
patients' health records, Apple Health,
insurance information, and more.
The funny part is we're sitting here two
days ago talking about like, hey,
it'd be great if these EMRs could do
stuff and connect to stuff.
And OpenAI was like, hold my beer.
And you knew they were already doing this.
The funny part is I believe we also
mentioned,
or maybe I just said this in my
head,
whoever does this first is going to win.
Like when you bring the walls down and
make it more open access,
more people will lean into it.
So how much research,
this just happened yesterday.
How much did you guys even look into
this so far?
I haven't seen any of it.
I will say Google had Google health,
Google had an EMR,
Google had stuff a decade ago,
but the compliance and the regulation and
the burden of bureaucracy just completely
crushed it.
I don't know.
Yeah.
We'll see what happens.
Google canceled their EMR.
I mean,
who could have built a better EMR than
Google?
Look at what they did with docs and
cheats.
Here it is on the screen.
I'll just put it on there.
I'll just scroll around.
Go ahead, Dave.
Yeah,
so I just watched this intro video that
you sent us, I guess,
earlier this morning or yesterday,
last night.
My thought was it's giving different
patient accounts of like, hey, chat GPT,
I have ten minutes in between my babies
that are napping.
Give me a ten-minute workout that I can
do based off of I only have access
to ten-pound dumbbells.
And then there was another woman that was
like, I'm having an endometriosis flare.
And
XYZ, like, asking for, like,
some assistance or whatever.
There was another guy.
There was, like, these cases of, like,
using ChatGPT for assistance.
Oh,
the guy was taking pictures of his food
before and after the food,
and it was giving him, like,
the calories and, like,
an inflammation score.
I mean, there was some good.
There was some, like, cringey, bad stuff.
Like, I think people,
at least in the U.S.,
I think they're going to use ChatGPT
not all that different than how they're
already using Google.
They're looking for information.
But in terms of like
executing a plan.
Yes,
you can use ChatGPT to build a plan.
I told you guys before,
like writing plans and sending them to
prospective patients before ever meeting
them just based off of the intake phone
call.
So yes,
it can give you some high level of
a plan, health and wellness plan, health,
you know, action plan.
It could be a good thing in terms
of helping some folks be more empowered to
take control of their health.
That's awesome.
I'm sure, like, I know you guys all,
you know,
who wouldn't agree with that or who
wouldn't think that's a great thing.
But there were some other things of like,
why is this guy building some models for
himself where he's talking about like an
inflammation score?
So everything that you eat is like causing
inflammation.
So there's just, I don't know.
I don't know if we're just the video
and the framing of it,
but at the end of the day,
I think it's a net positive that I
think it'll empower some folks to do more
of their own health and wellness focus and
maybe ChatGBT can help leverage.
Yeah.
This came on the heels of there's always
statistics flying around,
but like there were two hundred and fifty
million health related chat GPT questions
like a week or if you had told
me a day, I would be like, yeah,
OK, that tracks.
I mean, I do it a lot.
in and outside of like, you know,
MSK realms.
Um,
it's made me a really good cook so
far.
Cause I'm like,
how do I not screw this up again?
Cause you know what I do?
I'll open the box or the bag,
put the food in the air fryer.
Then I'll have to go back to the
garbage to pull the bag out to then
read the instructions.
I don't know why they don't,
there's gotta be some better way.
Um,
But this is inevitable.
This is just removing one barrier of
friction.
Now they're saying it out loud.
People knew that they were doing this
already.
They're a search engine with AI in it.
They know what people are searching for,
right?
I mean,
this is the answer to the public on
steroids.
I had shared a post a couple of
days ago where I was saying,
I think there's a real legit opportunity
for us to create,
whether it's a custom GPT or an individual
basis,
because chat GPT is not HIPAA compliant.
Right.
I get a new patient in the clinic.
We're sitting there.
We're talking.
They're tech savvy.
They understand.
They're using, like me,
ChatGPT every single day.
They understand how it works.
I think the sweet spot right now,
this minute,
is patients don't know how to ask the
right questions and how to dig deeper.
We can help with that.
So if we create a twenty questions kind
of thing to guide the patient down the
road in the chat and then they use
the chat as a journal.
So I woke up today.
This is how my shoulder feels.
This is what I did when I did
that.
It got worse when I did this.
It actually felt a little better.
the chat is creating this log like a
journal interpreting those results.
And then if I see the patient next
week, they come in, they say, Hey,
give me a summary of all the information,
you know,
analyze the information I shared.
It communicates to me,
the therapist in twenty seconds,
what might take the patient twenty
minutes.
You could do this with doctors,
you could do it with so many other
situations,
but
The chat has to understand the questions
to ask.
And I don't think it's there yet.
That's why people get bad information
because they don't want to ask the right
questions.
Yeah, it'll get there, though,
because you could also ask it a good,
dumb question.
Do you understand what I'm saying?
Like, you could be like, my back hurts.
You don't have to say like, you know,
I've got soreness three inches above my SI
joint.
You can put my back hurts.
And then like good AI would be like,
well, where is it?
Let's help figure out where that is since
I can't see.
I decided to train my Misogi for the
year, which is like my big,
my BHAG is I want to do another
triathlon.
I'm gonna do another Ironman triathlon.
So I've got just a GPT.
I've told it all the data about me,
height, weight, my experience.
And now when I ride Peloton,
I don't even download the data.
I screenshot it and I go,
here's my ride today, analyze it,
adjust my training plan accordingly for
the next couple of days.
If I have sleep data,
I do the same thing.
If I had an aura ring,
I would be doing that.
But yes,
this is something that is able to read
and recognize.
This is not a stay-in-the-pocket
quarterback.
Chat should be the health.
Read and recognize.
Ben Galen said, yeah,
it's two hundred thirty million users,
not searches,
users asking about health each week.
You could have told me five hundred
million.
I wouldn't have been shocked.
Wouldn't have been shocked.
I'd be like, yeah, that tracks.
And look, that's right now.
That's right now.
Like there's still people that I know that
are very smart or like,
I'll get to the AI.
I really don't know what I'm doing.
And I'm like,
I feel like spending twenty minutes a day
might be might be a good investment.
Where's this go?
What's the next O expletive moment?
This is pretty O expletive.
It is and it isn't.
Now that they're actually saying it,
that to me is they're going to start
leaning in.
There's going to be different integrations
in my mind.
Where's this go next?
What's the next O moment?
I think the lowest hanging fruit,
the easiest is wipes out all the simple
musculoskeletal referrals going to
physical therapy.
Completely puts them all,
into the AI world.
It won't.
It absolutely will.
I mean, it's a smart YouTube.
I have a shoulder problem.
I go to YouTube.
I look for answers.
Now it's a smart version of YouTube.
And if it means paying fifty dollars to
go see Dave, an amazing therapist,
because that's my copay versus a five
minute chat search,
I'm going to do the chat search.
We just did this with where we're dog
sitting.
We're dog sitting for five months.
The dog's eating super healthy food,
but he's got some skin stuff going on
and he's got horrendous sulfur.
Like I feel like I'm living in a
volcano gas and we're,
we're using chat GPT to analyze his diet.
And why is he,
why is he stink so bad and what's
going on and why is he chewing and
what,
and it gave us the most amazing like
breakdown of dogs being sensitive to
chicken.
And even though we were doing a really,
really high quality blue Buffalo dog,
food, you know,
the chicken sensitivity is a common
problem.
He's not digesting the protein.
That's why you smell the sulfur in the
gas.
So switch to a single ingredient.
If you have the money for it,
do a prescription single ingredient.
If you want to be a little more
economical, go to, you know,
these recommendations.
This is how you switch from what he's
been eating to what he's going to eat.
This is the switching cadence.
And it's amazing, you know,
and like I would have gone to a
vet if I had not had access to
this.
I believe it more.
I trust it more.
It provides me the citations that I want.
If I ask for this will absolutely replace
most of what we do on a typical
outpatient level.
Do you think Sam Altman was sitting there
a couple years ago going,
someone somewhere eventually is going to
be typing in,
why do my dogs fart smell?
And they're going to get great answers.
They're going to get great answers.
And it's modify the chicken.
I will say this.
I want to make sure we understand
background before I'll come to you in a
second, Dave.
This is how they're explaining where they
get this information.
So OpenAI is saying that ChachiBG Health,
this specialized AI model,
was in collaboration with over...
Two hundred and sixty physician to help
shape the responses for safety,
clarity and appropriate care escalation
and develop the unique elevation tool
called health bench to test it.
So and they say they've been working on
it for two plus years.
So this wasn't like, hey,
let's aim this crazy thing at health now.
I'm not saying it's perfect.
Nothing is that.
That is how they're explaining their their
where the runway came.
So this was not overnight.
This was according to them for two years.
So I could see, Tony,
how this could help.
I could see how maybe right now there's
a bunch of people that are already like,
hold on, wouldn't already those folks,
Tony,
be using YouTube to do these regular
exercises and all the exercises that
physical therapists put out and maybe some
personal trainers that they put out.
But you're saying this will wipe out those
cases that are like easy musculoskeletal
cases that are going to physical therapy.
Like,
a video-based platform is not already
helping that.
Like, they type it in.
And this, I think,
what you just described with the dog,
the dog sitting and you're troubleshooting
all that, you don't realize it.
You're, like, at the top echelon of, like,
users who will use this type of a
tool.
What you're describing.
I agree with Dave.
I know what he was saying.
And he's right.
Like, yeah.
Yes,
we are in the top one percent of
users, most likely.
In fact,
I think when I looked at my year
in review,
it basically told me I was like in
the top three percent of users and
whatever they were measuring.
So Dave's right.
Once again, Dave is right.
But I think what you're saying is it's
going to weed out some of the bottom.
Hopefully the things that are coming there
are still really appropriate.
They're good, they're quality,
and they're hopefully the ones that will
follow through.
Find value.
I don't want to say follow through,
but see the value, believe the value,
follow through on the value,
get the value.
Yeah, Dave, I was saying you're right.
And I don't know if there's a lag.
We got a lag here?
No, you're good now.
You're good.
I was saying you're right.
Well, I'm just saying...
And Jeremy Sutton says, hey,
when Dave gets on a roll,
Tony cuts his feed.
It does look like that.
It feels like that show,
the one they just canceled on ESPN where
Tony Real used to be able to mute
people, muted for thirties,
minus three points.
We should do that.
We could do around the horn,
around the horn.
Listen, this was coming.
This is the internet of things plus AI
now.
And I don't know,
it feels more useful now.
Will it take over the world?
No, probably not.
Will it do nothing?
Absolutely not.
It's going to be doing something.
And if you're not paying attention,
you're going to get run over by this.
And I just want you paying attention.
You don't need to get a PhD in
GPT.
You do need to be paying attention to
it and understanding those things.
This is why you watch the news, right?
I didn't understand that when I was
eleven.
I was like,
why do we care what's happening in
wherever?
It's like, well, butterfly effect,
ripples.
And it's just good to be smart.
Um, so, uh, I don't know.
I think AI is a filter.
It's a tool.
We can point these things, right?
Like I'm, I still get caught though,
halfway through my day,
like doing things manually.
And I'm like, what am I doing?
Like, I'm still in my pattern.
Then I'm like, I have a second monitor.
I'm like,
that's all I put that chat GPT and
AI is only on that monitor.
And I'm like, okay.
So it's almost like a second computer
visually.
It's a second thing.
And I catch myself four or five times
a day not doing things the easier way
or the more effective way.
And that seems, I don't know,
stupid for me.
Has anybody brought up in clinic with you?
And when Dave comes back,
I'll ask him the same thing.
And this is for the audience as well.
This would be a great question.
Has, well,
I asked ChatGPT and it said this.
That's had to have come up already.
Really?
No?
No.
I don't think it has.
Um, I don't think it has,
but I haven't heard.
Yeah, no, I, no,
I don't think it has.
Yeah.
Ben game one saying that's population
health, low complexity, low acuity.
Don't need the full experience, right?
We sort of want that tree.
That's what triage is for.
It's why not everybody gets a bed in
the ER.
Uh, but for decades,
PT only offers the full experience.
Yeah.
There's no PT light, right?
This is where like PT and the ED
is all like, like everybody's like,
that's ridiculous.
I'm like, is it though?
Isn't that the greatest place for it?
Yeah.
Oh, he even said that.
I didn't know that PT light, uh,
ALB PT light and solve a lot of
issues and accessing costs.
How great would that be?
If you're like, yeah.
How many times have you seen someone?
You're like, you don't even need me, man.
I look, look, look, do these two things.
You're going to feel great.
And you're like, ah,
those are the people who are like,
come on, I'll give you, give me,
I'll give you, I'll give you like,
no man, it's not even worth it.
It was, it's not a real solution.
And, you know,
this this is where we go back to.
I think we lose contact with a huge
demographic simply because we're not
willing to offer PT light.
I used to offer the twenty minute sessions
for, you know, twenty years.
I used to offer lunch break PT,
like just come in, in and out.
Twenty minutes.
You will absolutely not even miss your
your lunch break from work.
There are so many people,
one time sessions, one visit plan of care.
Like I have no problem evaluating someone
and just telling them, hey,
you're doing great.
Peace of mind.
You're good.
Just keep doing what you're doing.
But, you know,
so many of us don't want to do
that.
We don't want to offer that.
Is it because the onboarding and the
getting them set up and in the door,
the juice isn't worth the squeeze, right?
It's like so much effort.
Yeah.
I think that's a big part of it.
And it's a lot of it's self-imposed.
Like I still go back to when I
was teaching my Medicare course, I'm like,
are you guys asking all referrals the same
questions, the same number of questions?
Because you know what?
If somebody is coming to me for one
to three visit episode of care,
I'm
I am not going through nine million past
medical history questions.
That's only if I expect this person to
be around for twelve months.
If it's a simple case, insidious onset,
you woke up with a kink in your
neck.
I don't care about your injury.
Thirty seven years ago,
we're just going to deal with the kink
in your neck.
But like therapists refuse to accept that.
Going back to the stuff I see on
TikTok where a guy, great therapist,
I'm not denigrating.
I don't know if that's the word.
But he was like, yeah,
I go through a fifty seven point checklist
for an upper quarter screen.
I'm like, why?
Why?
I just asked you to pick something up.
Let me see you pull this.
Let me see you push that.
Let me see you touch the top of
your head and the load back.
OK, I got enough information.
Let's just start doing stuff now.
I was going to share this in the
Facebook group,
but I felt a little sexual.
I want to go edgy.
It's not that sexual.
But like this is this is a great
example because.
I don't know what a photo shoot would
be for someone, an hour, two hours.
This is going to shock you, Tony.
I've never had professional photos taken
of me.
But this person is a photographer.
They're offering, first of all,
font choices, script, handwritten font,
horrible idea, but keep going.
It says, hello, Valentine's Day boudoir,
twenty to twenty five minute session.
And you get ten edited images and one
mini Polaroid.
I'm guessing that means like a physical.
You get ten like JPEGs and a hand
and a tangible thing.
Three hundred and fifty bucks.
Like there's...
I'm sure this photographer is like, yeah,
I've got a session that's like two hours
and you're going to get a thousand
pictures or whatever.
But they're also like, hey,
if you just want to bang this out
in twenty minutes...
Let's do that for Valentine's Day.
So I wasn't going to share that because
it's a little racy.
But I'm like, is it though?
Someone in their underpants.
I've walked in the mall.
Look at that.
There's a Victoria's Secret.
But that's an example of PT Lite.
Does everything have to be the full Monty?
See what I'm doing there?
No, it doesn't.
You can offer...
So I could develop a full advertising
campaign for you.
We could shoot videos and whatever,
whatever images.
But I've also got this session where...
Did you see what I did with Bo
Babanko?
Yeah.
Dr. Bo.
So Bo sat on StreamYard,
the app we're doing now.
I looked up his website, Bo,
and I know Bo already.
And then I sat down with Bo,
and he sat there with me,
and I asked him twenty questions,
all in alignment for his strategic goals.
And then I zhuzhed up the videos and
said, here you go, Bo.
There's the next couple weeks worth of
your Instagram content.
Bo showed up, and it was Bo.
But if I had said, Bo,
I'm going to fly there.
I'm going to bring in three videographers
and whoever the person is that holds the
light and angles it.
And we're going to do this.
It's going to be ten grand.
And he would get a lot more.
But he's like, I don't need too much.
You're trying to kill a fly with a
hammer.
So you have to, I mean,
I don't know, scale appropriate.
So I've got different options.
Which one's appropriate?
I don't know what your problem is yet.
That's where I think what Chachapit Health
is going to knock out a lot of
those that were never meant to be there
anyway.
I think this is net positive.
And I would say like all things,
we can have a place,
we can have a seat at that table.
So somebody, we market,
we explain to the population, we're like,
hey, this is an amazing resource.
PT, chat, health, whatever.
Go here, do this, ask these questions.
We create video content showing the
consumer how to use that tool.
And then if the consumer doesn't get what
they need,
guess who's going to be the first person
they're going to choose to go to for
that real life interaction?
That becomes us.
But like if we completely ignore it,
completely move away from it,
say how terrible it is,
it's not going to do anything.
We don't have a seat at the table
anymore.
We just gave up that opportunity to some
other profession, some other professional.
If you avoid it and pretend it doesn't
exist and be like, oh my gosh,
I don't want anybody to know about this
at all,
then you're going to get run over by
it.
I believe Dave's on the phone.
Good morning.
Sorry for the tech issue.
There you go.
All right.
Now we got you on the phone.
Now we go on the phone.
Dave Kettle.
First time caller, long time listener.
Long time co-host, first time caller.
So final questions before we move on from
this topic.
Just final, not parting shot,
but medium shot.
Do you guys think this creates more
informed patients or more confused ones?
You have to answer.
More informed or more confused?
Dave, we'll go with you first.
More informed or more confused?
ChatGPT Health.
I think they can be more important,
definitely.
More important.
And then the final one before we move
on.
What's one way a smart clinic can ride
this wave instead of getting run over by
it?
You know that's going to happen.
Standing still with your back at the wave,
you get killed.
What's one way, simple way?
I'll go first.
Dave, you missed it,
but I was just saying what we should
be doing is creating content,
teaching consumers how to use these tools
to get their answers because when they
don't get the answer,
then they're going to come to us for
the more detailed, more in-depth response.
Yes, yes.
I absolutely love that.
I can't even think of anything remotely
close to being even in that ballpark that
I agree a hundred percent with.
Because if they don't find the answers in
that pathway,
then they will look at someone like Tony
or I or some other practice and say,
you know what?
They sound like a confident professional.
Let me contact them because I was not
able to get my solution or my, yeah,
I wasn't able to figure it out with
ChatGPT.
So at the end of our content or
videos or whatever,
there could be that call to action that
says, hey,
if you're not finding what you're looking
for with ChatGPT,
if it's not resolving your situation,
not providing a customized enough plan for
you,
go ahead and reach out and then the
only experience the taste in their mouth
of you is there's that guy that's super
helpful all the time and yeah i can't
figure this damn thing out same thing as
the plumber who's like going to teach you
how to fix basic stuff that he's like
i couldn't it's going to be in the
ass anyway to come out there and fix
that basic thing i want the ten thousand
dollar job i don't want the thousand ten
dollar jobs i don't i don't maybe someone
does
Right.
Someone someone does.
It's it's not me.
Real quick,
before we go to the next one,
Dave is the consummate entrepreneur
problem solver.
I love what he did.
I did this yesterday.
So yesterday I was a third party observer
in a physical therapy session with a
patient therapist,
reached out friend of the pod.
He's probably watching right now,
asked me for some input on a situation
for a patient.
We did the video console and then we
kept getting like frozen and stuck.
And I was like, hey,
let's just kill the video.
I saw what I need to see.
Let's go to a voice call so we
don't have an interruption.
And it was just spur of the moment.
Dave did exactly that.
He's like, I see a problem.
I'm going to come up with a solution.
And now he's with us.
I love it.
Yep.
Agreed.
I want to make sure we pay the
bills.
Today's episode brought to you by the
compliance candle.
A lot of candles going around in PT.
I mean, a lot of like, you know,
feng shui, but the compliance candle,
the only aromatherapy designed for clinics
teetering on the edge of a Medicare audit
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And our best seller,
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hand poured by overworked staff during
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Burn one before you burn out.
That's a great tagline.
Burn one before you burn out.
And just before we move on,
I'm already securing the social media
handles for the chat G.
Capital P.T.
That'll be me.
I'll be the guy who explains everything.
So follow me on Instagram.
Someone's already grabbed it for the chat
GPT.
That is me.
Second topic today.
We'll move to this one.
We a little bit flirted with this
yesterday.
Sorry, on Tuesday.
And I could find the graphic that you
shared, Tony.
But Dave wasn't here.
Every major CPT code went up slightly
today.
but down in real dollars when inflation
adjusted.
So nine, seven, one, one, oh,
went from twenty seven dollars and fifty
six cents to buckle up kids.
Twenty eight dollars and one cent.
But keep in mind,
we don't have pennies anymore,
so we just round out anyway.
But now it's only worth now.
Now it's only worth twenty seven dollars
and twenty five cents.
So we're net down a quarter.
This is why I want to bring it
up again.
We can deep dive into the numbers.
I'm going to zone out after about eleven
seconds anyway.
I'm just going to not.
I'm going to believe what both of you
say.
But what are we going to do about
it?
So it's what, so what, now what?
And we've talked about this before,
and I feel like people are catching on.
Someone like Drew Cruz was like,
wait a minute.
Are you saying we could use insurance as
a loss leader?
And maybe we need to explain what loss
leaders are.
Not because we're talking down to people,
but because it's not a normal healthcare
term, especially in PT,
which is if we lose money on the
hot dog at Costco,
but you come and you're in the building
and we know for every hundred people that
walk in the front door,
they spend this much money.
Our job is actually get more people in
the door.
And then also...
How do we make buying seamless?
This is a process and a pipeline.
So how do you do that in MSK
care?
We'll go brick and mortar and we'll go
Dave concierge.
How can people understand this concept and
how do they do it better?
Well, I don't participate in these,
respectfully,
these low-paying insurance contracts.
And I think Tony might have better ideas
on how to potentially use these in-network
contracts as loss leaders to get people in
and then funnel them to what he has
as, I forget what he calls it,
but like the weekly or monthly membership
or like the continuity program.
The challenge,
the challenge I believe is that if he,
I mean, it's just a numbers game.
Like it depends on like,
I don't know how great the practice is
and how well they frame it and describe
it and the spacing that they have for
these members to kind of go from
insurance-based physical therapy to some
continuity or out-of-pocket services.
When people come into an in-network world
and they just want to pay their twenty
to fifty dollar copay per visit,
I think it's really challenging.
And I would love to hear rebuttals.
I would love to hear anyone that watches
the show, you know, send us a message,
comment below,
message us or comment somewhere on one of
our YouTube.
But
Let us know,
are there practices out there that are
in-network on the front end and then have
the whole process dialed in to convert
people
a twelve-visit plan of care through your
in-network insurance to a continuity
membership or some self-pay experience
where they're paying a hundred or two
hundred dollars per visit.
I just don't think it's possible because I
believe it's two different customers.
It's two different consumers and that's
the challenge.
So stop advertising for those customers,
right?
I mean,
you get what you attract or you attract
what you attract or, you know.
I agree with Dave.
There needs to be a new model.
There needs to be a business started from
the beginning where the seed planted for
the business is, okay,
we're going to use insurance to bring
people in.
Here's the thing.
So on what Dave is saying, it's like,
okay, McDonald's sells a cheap Happy Meal.
They're never going to convert the
customer buying the four dollar Happy Meal
into somebody who's going to pay eighty
dollars for a dry aged steak right so
like there's no reason to even try that
the thing is you're not going to get
somebody who doesn't want to pay for your
service to all of a sudden want to
pay for your service but wealthy
individuals who do see the value in
something premium they also have insurance
So the messaging can't be.
My messaging is, anyone, anywhere,
come into my clinic.
We're going to take care of you.
My messaging is not, hey,
we have a premium level service.
We have premium equipment.
We have the best everything in town.
And if you have insurance and you want
to use it,
come and we'll start with that.
Like that is a different business model,
but I think that's the business model of
the future.
That's where the combination of what Dave
does and what I do comes together is,
okay, who are the executives in my town?
So we have a couple publicly traded
companies.
Who are the executives?
What's their insurance?
What is the plan?
Now I'm going to start creating marketing
content focused on individuals with that
specific insurance plan.
And I'm going to deliver a premium service
so that they're coming in on the
insurance,
but then they're going to stay for the
self-pay stuff.
That's where I think it needs to go.
Yeah, I just hear that song.
My insurance brings all the boys to the
yard and their life is better.
It's going to bring them to the door.
But if you bring if you consistently bring
the wrong person to the door and that's
not the person that's ever going to
convert here.
And I know people are like these guys
are icky.
They're using words like convert and
upsell.
And I look at it as like,
because I know there are people with a
deep affliction of the Peace Corps gene.
I have a little bit.
It's not deep, but it's in there.
I promise.
I have a heart who are going to
say,
but then you can't give this to everybody.
Therefore, you should give it to nobody.
And I'm like, that doesn't feel right.
I feel like there's some logical
fallacies.
The funny part is I've had conversations
with these people.
on LinkedIn,
the entire time I've had like a chart
of logical fallacies out.
And I'm like, oh,
because what they're saying sounds right.
And I'm like, no, it's a logical fallacy.
Once I learned about what logical
fallacies were, I was like, oh,
this is how people can sound right,
but it doesn't hold water.
So you offering a more premium thing does
not diminish the things someone else can't
get.
I'm very sorry.
I'm into raising the floor and the
ceiling,
but you can't get mad at me for
doing either of those things.
But for some reason,
people in our profession get very mad at
it.
I can't believe you're offering cold
plunge.
And charging money for it.
I'm like, well,
you don't have to get in the tub.
I'm not getting in that tub,
by the way.
So that's the way I sort of look
at it.
I did a little prep,
but ten ways you could use.
I'm sure we could do an entire.
We should do a six pack episode on
this.
Ten ways that you can use insurance as
a loss leader.
But what are the other things?
One is like gym membership or upsells or
premiums.
Well, just real quick,
I want to hear Dave's perspective because
he and I,
we've never really talked in this
direction.
So Dave, you have insurance, I'm sure.
You know executives and wealthy
individuals that have insurance.
I think the key is targeting the marketing
to that individual with insurance and high
net worth who then would be on board
switching from, okay,
we're finished with what insurance will
pay.
Now I'm going to self-pay.
Does that sound right?
So I agree with that.
I mean,
I've even considered where we take
out-of-network insurance, which we do,
and we have a medical biller to facilitate
that.
And then after that patient comes and
experiences therapy with one of our
therapists for X amount of time,
then we eventually potentially would have
said, hey,
we're no longer going to be dealing your
insurance.
We'll provide you with a super bill.
And here's why we're doing it and provide
some chat GPT can response of patient
experience or efficiency or whatever.
And then eventually just segue them to
paying out of pocket and giving them some
super bill receipt for their reimbursement
consideration.
I've definitely thought about that where
we definitely do capture more people
that...
We bill through their out-of-network
insurance.
And then later,
it's basically like they've become our
ideal client.
But in the beginning,
they are a little bit... Some of them,
even if they're well-off,
are a little bit more insurance-minded.
And that is the challenge.
I think that's a lot more doable for
me as opposed to going from the in-network
to self-pay.
I think the out-of-network insurance is
easier because...
Let's say now we're in January.
So a lot of these,
pretty much all the out-of-network
deductibles, typically,
ninety seven percent of them are resetting
or have reset on January first.
So now the beneficiary has to hit even
their out-of-network deductible to then
have their insurance kick in and pay.
So they're going to pay us out of
pocket or they're going to pay some other
physician or the MRI or whatever.
They're going to pay out of pocket,
you know, five hundred, a thousand,
two thousand, whatever dollars.
sometimes way more, sometimes, you know,
four or five grand or even more than
that.
And then it gets covered by their
out-of-network insurances, right?
So then at that point,
they're already kind of like semi-self-pay
or out-of-pocket in some ways,
as opposed to going from in-network to
ripping the bandaid off.
And it's just a bigger gap that way.
All right,
so Stephen Dunn chiming in here.
I'll read it to you, Dave.
When he was in cash only,
it was easy to move people over to
our Pilates program.
I'll say that again.
Stephen Dunn says, when I was cash only,
it was easy to move people over to
our Pilates program.
That friction tracks.
I'm paying money,
and now I'm going to pay money for
this other thing.
It's all money.
It feels like paper money or invisible
money.
But with MC, is that managed care?
Is that MC?
Medicare.
Oh, Medicare.
With Medicare,
they never want to pay for wellness
services as they are used to paying for
nothing.
Yes.
They're used to... I agree with Steven,
a hundred percent.
They're used to it already being paid for.
And I'm using air quotes.
It's already paid for.
Why am I paying?
You're trying to get more money on me.
That's not...
This is a communications problem.
Do you know what I mean?
Because I feel the same way, right?
If I paid...
If there was money coming out of my
check every month for auto repair
insurance...
And then all of a sudden I had
to pay more.
I'd be like, whoa, whoa, whoa.
I look every two weeks and I see
that thing.
It says minus two hundred and seventy five
dollars.
I thought this was free.
No, not free.
Sorry.
But I already paid for it.
Well, you paid for auto insurance,
not auto repair.
There's the difference there.
So, yes, this is psychology.
This is psychology with communications.
This is where Tony needs to jump back
in because he's posted this a lot over
the previous years,
including the past year or two,
where he'll say things like Medicare
covers the bare minimum and it's kind of
like it is what it is.
But every other practice is, you know,
billing Medicare as if it's like the
complete panacea of like everything for
all people for all physical therapy.
Right, Tony?
Yeah.
Yeah, yeah, a hundred percent.
And this goes back to,
we are so desperate to deliver an
exceptional service.
We want to wow every single patient.
We want every single patient to be as
passionate about therapy as we are.
We are willing to take the food,
literally the drumstick out of our kids'
mouths and
and give it to somebody else because we
are so desperate for that approval and
that, that acclimation that, you know,
we're like, well,
the CPT code covers therapeutic.
The one I always use is CPT code
covers gate training.
Well,
gate training could be a belt in a
dirt floor.
But you want to spend eighty thousand
dollars on an advanced treadmill and all
of these different technologies.
You are doing that at your own expense.
You don't have to do that.
There's no expectation of that.
It's just this is why it's so dangerous
to give the keys to the clinic to
the therapist who just wants to be a
therapist.
You need the business owner.
You need the person that understands the
exchange of value to protect the therapist
from himself and to protect the patient
from herself.
And everybody comes out a winner when you
have an actual business person in charge
of it.
Yep.
All right.
So we'll change topics a little bit,
but I think this is a yes and
or this is another industry that's doing
something in parallel that we should be
copying,
but we're not because we have a bleeding
heart or we think we're too fancy and
we're not.
And the company I think we should copy
is Gold's Gym.
So the mall in my town,
which I remember opened when I was in
high school,
was like it was like walking into like
NASA's space station.
It was insane.
And now it looks exactly the same,
except it's thirty years old.
Right.
So, of course, who comes in?
Target jumps in all the other little
stores that used to be great.
But Gold's Gym has taken over two floors
of I think where Sears was.
So like two department store floors.
And I walked by the other day.
And I'll describe the map for the podcast
listeners.
I took a picture of this.
This is what's hanging on.
They close the doors,
pardon our dust while we renovate.
And this is what they're putting in there.
So this is like a Where's Waldo image.
Look at this layout.
First of all,
I see a logo I recognize in the
top left.
There is that Parisi Speed School.
You guys have heard of Parisi Speed School
before?
I don't think I have.
It's a company franchise.
It's some guy named Parisi who's like,
you want to be a high school athlete?
You want to run track?
You want to go to college?
You want to be faster?
It's a protocol.
It's great.
They make people faster.
People love them, right?
Have you ever heard of Frozen Ropes or
is that just a New York thing?
That's a national thing, right?
Frozen Ropes is like,
do you want to be great at baseball?
We have baseball centers with batting
cages and pitching and fielding.
It's just critical, right?
No PTs on board, though.
Oh, it must be bad.
No, they make people faster.
So at this Gold's Gym,
they're showing you what they're
renovating.
So they're putting in this long,
it looks like a hundred yard turf floor
for Parisi Speed School.
Top left-hand corner, Cairo and Nutrition.
There's like a room.
Notice how it says Cairo Nutrition in
parentheses future.
They built the space knowing they can put
someone in there because they're going to
build the rest of the environment that's
going to bring the right people,
bring the right boys to the yard because
their milkshake is better than yours.
They have baseball.
It looks like pitching lanes,
four pitching lanes there,
but it could easily be batting cages as
well.
Four of them,
turf floor right next to that speed
school.
Going around the horn,
they now have something called Swing,
which is, I looked it up,
it's a golf simulator.
So they're putting in a couple of twenty
thousand dollar golf simulators right next
to the indoor pickleball courts,
right next to the cornhole area,
which is right next to the locker rooms,
which is also next to the reception and
shake bar area.
Yes, this is a Gold's Gym,
so there's going to be a bunch of
racks and back and arm section and leg
section and a track and a cardio and
a group exercise for Pilates and a cycling
studio.
But now you start to see the different
things, right?
We've got turf, we've got pickleball,
we've got golf simulators.
This seems confusing.
There's all this stuff, Tony.
It's almost like they don't know what
they're doing or they're just designing
Disneyland for people who want to move.
What do they want to move?
I don't know.
Lots of things.
Golf on Tuesday, pickleball on Wednesday.
What do I do when I'm leaving?
I buy an eleven dollar protein shake.
And we could even touch on Mel.
We could even now touch on Mel Robbins
for a second because I got thoughts on
that.
But look,
why wouldn't this isn't a PT clinic?
These people are dumb,
except isn't this a better PT clinic
layout that I just described rather than a
bunch of plinths and beige paint?
What's the monthly membership?
I'll look while you keep going.
So, you know,
we have a Planet Fitness that took over
a big space in a mall that's just
a completely dead mall.
Same thing, like, ten,
twenty bucks for a Planet Fitness,
maybe a hundred bucks for Gold's Gym.
How are we still stuck?
We're doing a hundred bucks a session.
How are we stuck in this world?
I don't know a single PT who doesn't
look at that space and start drooling,
thinking about how amazing it would be for
us to own that.
Yet,
I don't know a single PT that owns
it.
I know some are getting close.
I know some are moving in that direction.
But this has been a frustration for twenty
five years that I've been in business.
Why?
How do we not have the budgets to
do something like that this year?
The answer is fear.
Here's the memberships.
I'll read it for Dave.
Basic, silver and gold.
Of course, options.
So basic,
you pay an enrollment fee and then basic
is nineteen dollars a month.
Silver is twenty five bucks a month.
Gold is thirty dollars a month.
I got to be honest,
if I'm doing three options,
they're going to be vastly different.
Right.
Why would you do twenty between twenty and
thirty dollars?
I don't know.
This is Gold's Gym.
Maybe I won't doubt them,
but it goes from twenty to twenty five
to thirty.
But what are you getting?
So let me let me like what are
you taking away?
That's the thing.
When you show the graphic of the layout
of the whole entire space,
this is probably just the gym part of
the Gold's Gym area that you showed.
They don't get access to the football or
the baseball cages or the Parisi Speed
School or any of that.
The difference is basic gets you the gym,
like you said,
but none of the cool pickleball, swing,
golf simulator, hydro massage,
recovery lounge,
which I didn't even mention.
So as soon as you go to the
second level up, you get all that.
And then the reason to get the platinum
version is you also get use of...
I live between Newburgh and Middletown,
New York, and there's a Gold's Gym,
and obviously they're owned by the...
You get access to both of them,
and the pool, and the jacuzzi spa,
and the racquetball,
and the basketball court.
So yeah, they understood.
increase scope just a little bit.
Take the super dangly thing and be like,
yeah, you can have that.
You got to pay more.
Why?
I get more.
The funny thing is people do this math.
No problem.
They're like, yeah,
they're either going to buy it or they're
not, but they're never offended by it.
For some reason,
they are at a PT clinic.
Isn't that funny?
You get the same thing.
Like,
you can't believe you're charging someone
more.
You already paid for it.
Give it to him for free.
And I'm like, I paid for it.
I'd like for it to pay itself off
and then make money so I can buy
cornflakes and food for my family.
Is that not OK?
Is an honest question.
And for some reason,
the answer is it's not OK.
You need to bleed.
You need to hurt.
So this is where the financial illiteracy,
like we spend so much time patting
ourselves on the back for how smart we
are.
But this is where the financial illiteracy
comes back to bite us in the butt.
Access to all of that stuff for thirty
dollars, forty dollars a month is unreal.
I was ready for a hundred bucks.
Yeah, it's unimaginable.
And yet we still have people that are
mad at corporations,
mad at greedy capitalists,
mad at all of this stuff.
We wouldn't have the standard of living.
We wouldn't have access to the resources.
We wouldn't have any of the stuff we
have if someone somewhere wasn't making a
profit that they then reinvested back into
the system to create this kind of resource
scale economy.
I mean, it just it blows my mind.
And, you know,
as much as we talked earlier about
inflation and Medicare paying us
functionally less because of inflation,
I don't want to just harp on how
little our dollar is actually worth,
because on the flip side,
you've got access to something like that.
I know homeless people.
I know homeless people that are paying a
Planet Fitness membership just to go take
showers.
Yes.
It's cheaper.
Like that wouldn't exist without the
capitalism and the profits and, you know,
all of the stuff we have around it.
And then, of course, access to chat GPT,
access to resources and technology that
would otherwise be unavailable.
Pricing every two weeks.
I guess I wasn't reading it right in
the pricings every two weeks.
That's a nice little flim flam every two
weeks.
So it's fifty it's forty bucks a month,
fifty bucks a month, sixty bucks a month.
It still feels low and still feels right.
That should be the cost per week,
not every two weeks.
Yeah, I mean,
I was at the JCC in the Upper
West Side in Manhattan.
That was a hundred and something a person
a month.
But I did my research.
I looked at Equinox and was like,
I know what I'm buying there.
I don't need lilac scented towels.
Like I need some heavy stuff.
But I also looked at like New York
sports clubs.
And for me, the difference was a pool.
That was it.
Cause I was training for tries and I
was like, I need a pool.
There was a pool at Equinox,
but I needed to wear a banana hammock.
It was banana hammock only.
And I was like, listen, I'm comfortable,
but I want to wear the Speedos to
my knees.
So I couldn't do it.
But I understood what I was buying.
And it was low, medium, high.
And I'm sure the JCC knew that they
were pricing themselves between Equinox
and New York Sports Club.
They understood that.
We as a profession...
don't feel that we do we're just like
well i'm worth this well we can talk
about the bullying i don't have the um
i don't have the graphic but somebody in
a facebook group we won't say who we
can't say who because they posted
anonymously that they were being bullied
by an insurance company and i get the
the essential gist of the conversation was
uh and feel free to jump in
UHC, were they clawing back money,
or someone didn't submit paperwork in a
timely manner,
and so we're taking our money back?
If I remember correctly,
and I'm the one who obviously shared the
image,
it was an out-of-network billing
situation.
I think they were requesting
documentation.
They were auditing the account,
something along those lines.
And, you know,
the end result was they were taking the
money back.
And it goes back to just how I
remember as a young person thinking your
perception is your reality.
And hearing these things, I'm like, no,
there's an actual reality.
There's an actual truth.
And so when I hear somebody say the
word bullying...
I tried to look up the definition.
I tried to understand it.
As an adult in this world, no,
you just made a mistake.
You didn't understand the regulations.
You didn't understand the agreement.
Whether you're out of network or not,
it doesn't matter.
There's an expectation for payment.
You document these things.
You track these things.
You deliver these things.
If you don't do that,
the insurance company does not pay you.
Wait,
does the insurance company write this down
somewhere and then make you sign it?
They have published policy.
Well, they explained it.
That's what I'm saying.
It's a contract.
They wrote it down and you read it,
supposedly, and signed it.
Sorry, it's not bullying anymore.
So I'm going to say for this case
out of network, they didn't sign a policy.
They didn't sign a contract with the
payer,
but they did submit a claim saying we
did this stuff in the expectation that we
satisfied the expectation.
So I go back.
I'm like, OK, I make the mistake.
I pay the price for my mistake.
It's not bullying me if you want to
take back your money.
But that language becomes so inflammatory.
And, of course,
we're not going to get into it,
but we see that across all of media
everywhere.
The language that people choose to use on
both sides,
it's not one side or the other.
It's both.
It's intentionally inflammatory language.
It generates likes.
It generates attention.
It makes you feel good.
But that is a very real threat to
everything.
Progress.
So bad news,
they're taking their money back.
Good news, it's twelve dollars.
They're taking twelve dollars back.
That's the upside, right?
Hey, all right, well,
they're taking their money back.
It's twelve dollars.
It wasn't worth the stamp and the envelope
you were going to put in the mail
for that.
We've got a few minutes.
Real quick, to fight that, what we do,
and I hope every other practice does this,
which is having patients on the front end
sign paperwork that says something around
this.
So for the out-of-network insurance,
and we have had some of the UHC
fallbacks and
um it it happens um whether it's we
didn't provide enough documentation or
whatever um but it we had it uh
during uh or we had like a couple
that was on uhc and it's we didn't
get paid for six months or twelve months
it was something crazy and we did have
them sign something where it said like hey
we already had your card on file for
your normal copay deductible whatever and
then
At some point, we're like, hey,
we need to charge you like whatever it
was, two, fifty, three, three hundred,
whatever per visit.
And it was like a lot of visits.
It was like it was like a thousand.
I think it was like a grand total
or something crazy.
So we said,
we're going to do you want to do
a payment plan or can we just,
you know, can we just, you know,
rip this card right now?
Obviously that.
So then all of a sudden the patient.
Help Leverage, they were frustrated,
but they were kind of mad at us.
But then I'm also like, hey,
this is UnitedHealthcare.
Your insurance company.
We were totally clear and transparent.
And the paperwork says,
if we're not paid within six months of
each of these dates of service,
you are on the hook for this dollar
amount.
And at the time, it was like, whatever,
it was like,
two fifty or something like that,
or three hundred.
So they were on the hook for all
these visits.
And then we said, hey,
we're going to start charging your card
for these visits starting tomorrow or next
week, whatever.
And then magically, one of the spouses,
one of the patients,
was our leverage inside of
UnitedHealthcare.
And magically, it got paid.
Ding, ding.
Because the patient didn't want to be on
the hook for this full amount.
Yep.
And if anyone's watching or listening...
Anytime that this stuff gets posted online
of like,
I'm getting bullied by the insurance or
whatever,
either have this in your new client
paperwork for patients to sign it up front
so that you will always be made whole.
You're always going to get paid somehow,
either from the insurance or from the
patient.
Or...
Just opt out.
Just be self-pay.
Just stop taking the insurance.
Whatever.
You have choices.
But the screenshots...
And back then when this happened,
I didn't go on social media and tag
Tony and screenshot this callback and say,
the insurance is bullying me.
Come on.
We have options.
We navigated it.
We got made whole.
All is good.
And I didn't talk bad about
UnitedHealthcare at all.
What?
Now I am.
But back then when it happened, I wasn't.
Dave, before we, we got six minutes.
Hey, hold on, hold on.
My new patient is pulling into the parking
lot.
I need to go do an eval.
I'm going to share my parting thought.
You know, today was a great episode.
We shared a lot of, I think, inspiration.
Like I saw so many opportunities in the
Gold Gym example and the other stuff that
we're doing.
I just think it goes back to we
as physical therapists understand better
than anyone.
If we want something good,
it takes a lot of hard work.
It takes a lot of failure.
It takes a lot of mistakes,
but if you keep working on it,
we can achieve great things.
That's it.
Like that,
that is a function of what we do
in the profession.
I'll see you guys next time.
All right.
Uh, Dave, before we wrap up,
I did this for you.
I'm not sure if you're,
are you able to see the screen?
Like, can you look at the live stream?
Cause I have some images for you or
I can just describe them.
It's a podcast anyway.
So I got bored last night.
I'm watching.
I'm watching right now.
I got bored last night and every once
in a while an idea hits me and
I was like, Ooh, Oh, okay,
let's do this.
So I was like,
how would I get more patients if I
were Dave Kittle?
And then I just... I like cute little...
I like cute little weird ways.
Like weird.
So I came up with this idea.
And I went to Canva and I mocked
a bunch of them up.
I'll send them to you.
And I even branded it.
I even used your logo.
Put them on the screen right now if
you want.
I think you should do door knockers like
in hotels.
I want the setup to be on side
one and I want the punchline.
I want someone to return to their
apartment in New York City and be like,
what the hell is this?
This is supposed to be...
It's juxtaposition.
It does not belong.
The do not disturb door hanger does not
belong in a residential thing.
It's a hotel thing.
So automatically, intrigue achieved,
right?
So for the people who are just listening,
it's a door knock campaign that I call
please disturb, not do not disturb,
please disturb.
So the front of the first one...
the front of the first one says imagine
you came home and you were like you
know you got groceries in your hand a
bag and you're looking you're getting your
key in the door and it says there's
a door hanger saying this door leads to
relief
And then one of those turnover arrows.
And then on the other side,
the punchline says,
your living room is our clinic,
concierge pain relief.
Phone number, call, twenty-four hours,
QR code.
So it's setup, punchline.
Setup, punchline.
So here's another setup.
This one is facing the consumer, right?
They come home and they're like, what?
And she says, checkout time.
What is this?
And they grab it off their door and
they turn it over and it says,
for pain relief.
Your living room is our clinic.
Concierge, pain relief.
We come to you.
QR code, phone number, twenty-four hours.
The next one.
This is not a hotel service.
You turn it over,
but we still come to your door.
Concierge, pain relief, physical therapy,
QR code, phone number, call,
twenty-four hours.
Set up.
What if pain was optional?
Turn it over.
Treatment at home.
Results that last.
Concierge pain relief.
Phone number.
Twenty four hours.
QR code.
I think I have one more.
Oh, yeah.
This door opens.
I love this.
I love it.
This door opens to better movement.
What is that?
What is this?
And you turn it over and it says
we bring physical therapy to you.
Concierge pain relief.
So you get the idea.
It doesn't.
It makes sense because it's the
anti-digital ad.
It's not digital.
It's not trying to get into your feed.
It's not doing those things.
In terms of legally doing this,
I think there would be some residents that
would get mad.
Sure.
Get mad or is it illegal?
That's the thing.
I would have to check the legalities of
this because some people might just
probably not in their own building but
some people in certain buildings but
It depends on the building and the people,
but some people might literally take it
off the door and throw it on the
floor,
which would then now create trash for the
people that work there.
I would, this is the assumption,
you're making the assumption that
myself or one of my therapists already
have a patient in this building, right?
Because we would have to have access to
the building.
Right.
Yeah.
My strategy was like, why would...
So then I start to shoot holes.
Like, why wouldn't this work?
That could be one of them.
I would want to know the legalities,
obviously, right?
Second would be like, well,
how are we going to deploy this?
Number one, they're cheap to produce.
but it still keeps it's still on brand
because a hotel sort of has this level
of cachet right do not disturb right so
it still keeps your concierge level of
brand you didn't have to sink this is
actually bringing like fancy hotel quality
to a red like my house like that's
kind of cool um you can carry a
lot of them and yes my my idea
was while you're treating mrs smith on
five f between you and the i'm not
asking your therapist to hit every door
but it's like between here and the
elevator
My next fleet of these would be playing
off somehow,
which was the bystander effect,
which is like someone in your building is
getting better right now.
Why not you?
Do you know what I mean?
Without saying who the neighbor is,
I've been in the building.
Someone else is doing this.
It's a reason there's a testimonial.
Or, ooh, all right,
we're live workshopping this.
Do you offer a free session to Mr.
Smith
the last session if you're like can we
put your your testimonial on a special run
of these door hangers for this building
Listen, here's what we're going to do.
With your permission,
your last session is zero dollars.
If we can write exactly this, Mr.
Smith said this, he's in three B,
ask him if it worked for him.
Almost like when someone cuts your lawn or
does siding on your house and they put
the side in your yard to be like,
look,
look what kind of work we could do.
That would be a twist because who'd be
like, yeah, okay, I don't care.
Yeah, so I've done some versions of this.
Okay.
You know, like in certain buildings,
before you get to the elevator,
there's like,
there's like a little table and it's got
like a little flower or a large bouquet
of flowers in certain buildings or like a
mirror.
There's something there.
And I'll throw like,
I'll just drop like a couple of business
cards on it.
And like sometimes over the years,
like I've been a little aggressive.
If there's like a spot in the elevator,
I'll like put my business card somewhere
like in the elevator or if there's like
a, there's like a little nine by eleven,
like, um, like, yeah, no,
like a cork board.
Like a little screen that's talking about
upcoming events or something in the
building.
Hilton wouldn't do that.
Hilton would do this.
I want you there.
That's great for John Q. Public PT.
Because they're like, I'll just jam.
That's what a real estate agent does.
They jam their card wherever.
I don't know what the ROI is on
that.
When I go to a coffee shop and
I see like, that makes sense for like,
handyman services.
For you, I'd want to bougie it up.
Custom door hangers?
Is this what they're called?
Doorknob hangers and door hangers?
Door hangers.
Yeah.
I mean,
I could send you the file through Canva.
You can buy them through Canva.
without having to take the artwork out
now.
Canva lets you print like Vistaprint or
whatever those things are.
You can just hit print and then the
hundred or five hundred or a thousand.
Yeah, I like it.
But now you can just play with it.
And I got this idea because I had
a woman do... She's like house cleaning.
And she cleaned my house two months ago
because I didn't seek her out.
A friend sent her to me.
And she was like,
I'll do it for free once.
And I'm like, well, I'm not an idiot.
So I happened to be sitting here and
I was talking to her.
And I was like,
how do you find new clients?
And she's like, well, Facebook groups,
but word of mouth.
And I had this idea for her.
I was like, this hat...
So I designed a whole fleet of these
for her.
I'm like,
so your advertising cost is a tank of
gas and printing, right?
And then you drive around and you put
them on a bunch of people's doors while
they're at work.
So when they come home, it's like,
wouldn't it be great if,
and then flip it over,
you stepped into a clean home,
ray of sunshine, housecleaning.
And I'm like, that's cute.
Because even if you batted three out of
a hundred,
because housecleaning is hopefully
recurring.
Like you get someone you like, know, like,
and trust, and then you keep that person.
And then you offer them deals.
Like it's three hundred bucks for me to
clean your house unless you, you know,
guarantee unless you sign up for twelve
months.
And then it's, you know,
two hundred bucks.
Like you give them a crazy deal.
And then I was explaining cash flow to
her.
I'm like,
now you get them to sign up,
not just agree to it.
You got pay up front.
So that's what the door hanger thing.
I don't know.
I'll send you the file.
It'd be cool to do different QR codes
on different cards to see which funny one
liners worked best.
Cause if, you know what I mean?
Like to see which of the,
which ones of the jokes landed,
I don't know.
And then where they came from.
All right.
Parting shots, Dave, what do you got?
Oh man.
I mean, we've covered an array of topics,
but in terms of the,
the big one about chat,
you can see in health.
I mean, the more models like that,
the more tools and resources,
the better with empowering folks around
their health and wellness.
I don't think there's any disagreement
there.
Will it result in more consumers becoming
a little more savvy about their health and
wellness and understanding what are their
options?
I think yes.
I think that's, like I said,
a net positive.
I think that could be totally a great
thing.
Could it help or result in some patients
or clients
going the route of conservative care and
physical therapy at the same time.
I think so too.
I think more of the,
we talked about it before with video and
YouTube and Instagram and Facebook and
TikTok and more video helping physical
therapy and everything, acupuncture,
chiropractic,
everything in the health and wellness
world.
So will this do the same?
I think it can.
Don't be Metallica.
Here's what I mean.
Metallica should have been the poster
child for like, screw the machine, man.
Screw the man.
The man's keeping us down.
But when Napster came out,
which for the younger part of the audience
was a free file sharing service that you
just go onto this app and you could
download any song.
They were hardcore against it.
Hardcore against it.
They were testifying in Congress.
And listen, I get it.
Except you're never going to legislate.
You can't rage against...
It's rage against the machine.
The machine being a bunch of people in
government.
That's what rage against the machine
meant.
It didn't mean rage against the computer.
The computer wasn't the machine.
You get a lot of shovels and a
lot of brooms.
Get everybody you've ever met and meet me
down at the beach.
The tide's still going to win.
We can shovel that water out as fast
as we want.
Tide's still going to tide.
Technology is tide.
You either get...
You either learn to float and navigate or
you get run over and drown.
The tide is coming.
It does not require you to believe in
it for it to come.
So you either get with it or you
get run over by it.
We'll see you guys on Tuesday.
For anybody in New Jersey,
I'll see you at Kean University with APTA
New Jersey's student conclave.
I'm actually not sure why in twenty twenty
six we still call student events the same
thing.
We call an event when we name a
pope.
I'm not sure why we're still calling
things conclaves.
But hey,
I'm going to be in a conclave.
I'll see you guys out there.
I'll see you on Tuesday.
That's it for this one,
but we're just getting warmed up.
Smash follow, send it to a friend,
or crank up the next episode.
Want to go deeper?
Hit us at pgpinecast.com.
Or find us on YouTube and socials at
pgpinecast.
And legally, none of this was advice.
It's for entertainment purposes only.
Bullshit!
See, Keith?
We read the script.
Happy now?