You're listening to the P.T.
Pinecast,
where smart people in health care come to
make noise.
Here's your host, Jimmy McKay.
You're listening to the P.T.
Pinecast,
where smart people in health care come to
make noise.
Here's your host, Jimmy McKay.
Before we kick things off,
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Today's conversation is live, unedited,
and intentional.
My guest is a clinic owner,
outspoken advocate,
and someone aligned with UPTA,
a new organization entering the advocacy
space in our profession of physical
therapy.
You may have seen some passionate threads
online, comments, words.
This episode is about slowing down,
asking direct questions,
and getting real clarity.
What exactly is UPT building?
How's it different?
What's the tactical plan,
not just the critique?
Today isn't about, like, right.
It's about making room for questions that
deserve real answers.
Let's bring in our guest, Dr.
Steve Rowland.
Steve, welcome to the show.
Hey, Jimmy.
Good morning.
Thank you.
I appreciate you having me on.
And you are in the sunny state of
Florida.
Do I have that right?
The sunny state of Florida.
You are smarter than me.
I'm in upstate New York,
so it's about freezing.
Let's kick this off with looking back a
little bit.
When did you start feeling like something
was missing from how PTs are represented
professionally?
Was there a moment?
Was it just an era?
When did you start to feel a shift
that whatever it is now,
it didn't feel like it used to be?
Yeah.
And I would say that was, you know,
I hate using the word pre-COVID,
but that would I would say pre-COVID,
you know, because let's be honest,
COVID really changed the trajectory of all
health care.
But, you know,
even before then started seeing something,
I think it was like back in the
mid, you know,
twenty fifteen timeframe when
You know,
that was when things were really changing
and dynamics were changing.
And, you know, I mean,
go all the way back to two thousand
eleven with, you know,
changing different things and policy with
Medicare.
And, you know.
That's basically it.
You know,
it's been coming on for over a decade.
So what was it?
I graduated in twenty sixteen.
So what what was it?
Was it culture?
Was it rules?
It's probably never going to be one thing.
Right.
It's got to be a mix.
Yeah.
You know, it's you talk to any,
you know, and I'll focus.
I've been in pretty much private practice.
I've run a inpatient rehab.
I was the CEO of a sixty nine
bed inpatient rehab facility.
I was the CEO of one hundred and
eighty bed facility.
acute hospital.
So, you know, I've done PT.
I've done the other side.
I've done a lot of admin.
I've treated a lot of patients through the
years.
And it really, it comes down to policy,
you know,
policy with these insurance carriers,
the way that we're, you know,
we're not allowed to dictate the care
anymore.
I feel like we've kind of lost connection
with that.
You know, a patient comes to our facility,
we're being told, you know,
you've got to get preauthorization.
You've got to get the, I mean,
we all know physical therapy.
There's,
there's no denying that physical therapy
saves money.
right why are we not getting the
recognition that we deserve and and you
know and i just want to make this
perfectly clear i've been very vocal about
the apta i support the apta not
financially but again i i just want to
give a shout out i know those guys
they're in the grunt like we are every
day they're fighting the good fight like
we are uh do i feel like there's
a
whole yeah and that and that's you know
nobody's perfect nobody's gonna hit it the
nail right on the head but you know
i think that's why the upta came to
light was we felt the the private practice
area you know we just felt like we
weren't you know hey we're over here you
know um things address this is my second
time doing private practice so when i came
back things were a lot different
especially reimbursement policies
reimbursement audits all-time hot
We can talk about that.
Yeah,
I don't know a single PT right now
in the last two years that is either
not in an audit or has gone through
a TPE audit.
So what was it that made you decide
that UPTA was the vehicle for that change
instead of working with APTA?
Because starting a new association is not
easy.
There's work involved.
This is effort.
There's a lot of effort.
So what made you decide UPTA is going
to be the vehicle for that change instead
of APTA?
I felt like they had a bigger hold
on what was going on.
Because UPTA is mostly made up of private
practice members.
We're the guys that are in the grunt
right now.
We're the guys.
dealing with the daily issues.
We're the ones going through the TPA
audits.
We're the ones training the Mac
contractors, believe it or not.
They call it TPE.
For those of you out there who haven't
been through a TPE,
it's targeted probe and educate.
Well,
the last part of that is the educate.
We're doing the educating.
Unfortunately,
the Macs still don't know what their own
policy is.
And that's sad.
So, you know, that's why, you know,
I started seeing Scott Gardner.
He's our president.
I started seeing some of his posts on
social media.
And, you know,
I reached out to Scott because, you know,
I went through an audit.
And one of the things, you know,
I believe it was an audio cast that
Scott had put out for the UPTA.
And on that audio cast,
they had their company from out west who
does compliance.
I'm sorry,
I can't remember the acronyms right now,
but I think it was BCMS.
And, you know, during that conversation,
Scott talked about, you know,
being through all these audits.
And I was like, holy moly,
here's a guy who's been, you know,
just beat up by his Mac contractor.
So I reached out to him, you know,
I got him and I had a phone
call.
And when we talked,
we just felt like we had a lot
of the same.
And I said, hey, if you ever need,
you know,
it wasn't him reaching out to me.
It was me reaching out to him.
I said, you know,
I'm going through an audit right now.
And he helped me with that.
I'm fortunate to say I came out of
that audit without any findings,
but it's not fun,
especially through Christmas.
It's like,
I want to enjoy Christmas with my family,
and I've got these Medicare auditors
asking me for all these charts.
Yeah, that can be frustrating.
So I see no disalignment there.
I think people are pretty aligned.
Many UPTA supporters, understandably,
have frustrations with these processes and
with APTA.
Yes.
Noticeably,
a lot of energy online isn't spent talking
about what UPTA is building.
It's spent criticizing what APTA is doing
or how it does it.
My question to you as a member,
don't you worry that that tone or constant
comparison could actually underline the
mission that you're on?
Yeah, and I get it, though,
because I'm one of them, so I understand.
There's emotion, right?
Yeah.
And sometimes we say things online that...
I've always told my staff,
if you have a problem,
don't send it an email,
don't send it a text message,
because it's very hard to understand the
tone of that.
Come to me in person.
Let's talk it out.
Let's hash it out.
So am I going to say we're not
guilty?
Absolutely not.
I'm not going to say that.
There's times where yesterday morning,
and I think that's what triggered this.
I saw something that the APTA posted and
I made a very reactionary post.
As you know, I deleted it.
But you, of course,
have seen it before I deleted it because
you responded to it.
But, you know,
there's times where emotion gets the
better of you.
And I think that's just the state of
private practice right now.
And I want to say this,
I believe it's more than, you know,
because, again,
I've been
in this position where I've not just been
in private practice.
I've been in other facilities and it's PT
in general.
And let's not discount occupational
therapists and speech therapists as well.
Absolutely.
We're all in this together.
And that's what I really want us to
get out of this.
So
it can be seen and it can be
portrayed as we're attacking the APTA,
but I can honestly tell you behind the
scenes now,
there's communication between the UPTA and
the APTA, and I think that's healthy.
I think that's really good.
And I think if we,
and that's what we need.
We need collaboration.
Yeah, agreed.
And I have to say, you know, honestly,
you and I may not see eye to
eye.
There's been time,
but I really appreciate you bringing me on
this.
And I really appreciate you being
professional and having me on here.
And I've listened to your podcast.
I like your podcast.
I think you're doing a great thing.
Thanks.
And I think we need to do this
more.
Cool.
I, I mean, listen,
this is what I do.
I'll do it more.
Don't threaten me with fun.
Um,
you've said burnout isn't a personal
failure.
It's a system design problem.
Can you remember a time in your career
when that became clear?
Like when you were like, Hey,
as a person doing practicing when that
happened.
So it's, you know,
I think that's a really bold statement.
Burnout isn't personal.
This is a result of a system problem
that we're unfortunately all in.
So do you remember when that became like
kind of clear and you sort of became
front, had that emotion?
Yeah, again, right, you know,
going back to, you know, again,
I'm going to go back to it.
Audits are, we are a hanging fruit,
you know.
Mac auditors do not see us as a
friend.
They're going to say that and they're
going to say, hey,
these targeted probe and educate.
We're here to help.
Let's be honest.
They're there to basically we're pickable
right now.
And they're picking on us because I can
tell you from being through it now,
I will say my back auditor here in
Florida,
we're first coast service options.
She was highly professional.
In fact, she called me.
She goes, listen,
I've been doing this for fifteen years.
you're the first time and you know again
i don't want to pat myself on the
back but i found this to be quite
intriguing she said you're the first
person in fifteen years that i haven't get
off had to get on the phone and
say hey you forgot to send me the
progress note for this date or hey you
forgot to send me the the sign she
said everything was organized everything
was together and she said no findings
congratulations you're free for a year
okay great i'm free for a year so
a year yeah i get to look forward
to it again yay right the fact that
you have to do it is still fresh
emotionally taxing and taxing on your
business
Yeah.
And I kept her number.
You know,
I appreciated that she gave me her
personal number and she said, you know,
if we can work together, let's do it.
But what I can tell you from a
PT standpoint is,
private practice that's not the case in
all of these you know there's other
therapists i talk to right now where
they're they're going through in fact i
got a friend right down the road who's
going through up in st augustine about two
hours north of me here um he reached
out to me uh late last night and
he's he just went through an audit but
he had to tell his you know unfortunately
let's go back to january first twenty
twenty five when everybody said hey let
you know
We got this win.
And don't get me wrong.
I know the intentions were good on this.
If you get a referral from a physician
or an NPP and it's got the date,
it's got the signature that's legible and
it says PT or OT or speech or
whatever you want to do for that patient.
And, you know,
that's you now do the eval,
you do your plan of care,
you send that plan of care.
Don't forget, that's the important part.
You have to send that plan of care
to that referring provider.
They don't have to sign it.
But you got to send it within thirty
days.
With that being said,
a lot of the Macs still don't know
that.
Where's your sign point of care?
That's that's a system problem.
So these are the frustrations.
I have a full time person sitting in
this office.
That's all they do is track down sign
point.
You pay that person and that's all they
do.
That's all they do.
Well, not only that, I mean,
we have a full compliance plan.
You know, I've been down this road.
So my,
and a shout out to Rick Wanda.
Wouldn't want to do his job.
Really would not want to do his job.
Rick and I have not always seen eye
to eye.
I'm still a gold member of Rick.
I still listen to Rick's stuff.
He has a job,
he serves a very important,
but why should we even be in that
arena?
Why should we be having to fight, fight,
fight?
And that's where I feel.
I feel like we're climbing up a rock
hill with no support and one slip and
we're gonna go.
Don't disagree.
So when all you have is a hammer,
the world is full of nails.
So Jimmy worked in radio for fifteen
years.
So I look at things.
I look at words.
I gave this lesson a mini lesson.
Not like I'm giving you a lesson,
but I'll just say what I taught.
I think a lot of disagreements that happen
in the comments section happen because of
something very basic.
And this is like almost kindergarten
level, which makes it simple, not easy.
When someone is expressing frustrations,
that's an emotion.
Yes.
And when someone else is coming back with
something tangible or logic,
both of those things can be true and
you are now talking past each other.
I love there's a GIF out there that
shows a chain link fence and two Dobermans
on one side barking at another dog,
a golden retriever on the other side.
And all of a sudden the chain link,
they're barking through the fence and all
of a sudden the chain link fence slides
out of the way.
And then they both just sort of stare
at each other.
Yep.
Neither is wrong,
except people want to be seen, heard,
and understood.
Yep.
So if I've been an APTA member for
a long time,
I hold them accountable every twelve
months, as you should.
I tell people all the time.
I was at an APTA New Jersey student
event this weekend and someone said,
why should I be a member?
And I said, you shouldn't.
And then I paused and said,
unless you understand what you are buying,
membership is a how, not a what.
Netflix isn't a membership organization.
Membership is how you get access to the
content.
Netflix is in the boredom reduction
business.
You're in the feeling business.
So if someone goes into and pays money
to APTA and says,
I need to make sure I get my,
and I think I did the math,
it's X number of dollars to be an
APTA national member and then a state
member.
And then if you want an academy or
whatever,
let's say it's five hundred bucks.
if you're waiting to draw the direct line
between pay five hundred bucks put five
hundred dollars in the coke machine and
get six hundred dollars worth of value out
i need to understand what you value i
do it because i'm a joiner that's in
my dna i like going to the events
i got buddies who were like couldn't
wouldn't catch me there on my worst on
my last day get it neither of us
are wrong but if i keep barking at
him because you got to join because it's
your duty
That's Newton's law, man.
You're pushing on the wrong pain point.
I think I said it this morning.
Someone asked me, Tony Meritato asked me,
why do people go to CSM?
And I said, great question.
I said, I think I said a lot.
It's more like a carnival.
it's not just roller coasters or teacups.
That's for the person who values...
Carnivals are smart.
They have teacups because they're like,
well, if someone values teacups,
we got those.
If someone values fried foods,
we got those.
If someone values games, we got those.
If you go into APTA because you're like,
I'm going to get my five hundred,
I'm going to pay five hundred bucks every
year.
I'm going to get this out.
I need to understand what you think you're
getting.
This is a misalignment.
I thought I was going to get immediate
relief from my billing.
Well, I don't know if APTA,
I don't work for APTA.
I don't know if APTA ever said that.
I'm pretty sure they didn't because this
system sucks.
I'll say it.
It sucks.
But so does gravity.
And I can't change it.
Right.
So let me ask you this.
This is an unfair question.
I'm using air quotes.
It's
Unfair question.
But if you had a magic wand,
what is the first system redesign that you
would make to actually relieve burnout and
frustration at a practical level?
You got a clean whiteboard.
What would you do?
Yes.
I mean, first and foremost, I think,
you know, let's not.
downplay who we are we are doctors of
physical therapy right the thing that
boggles my mind is why do we still
need a referral why do we still need
a signed plan of care that would that
would be my my first thing is let's
eliminate that because that's where a lot
of us in private practice we spend a
lot of our time tracking down planet cares
doctors don't read them
I haven't talked to a single doctor who
said, Hey, I read your plan of care.
I love it.
You know, and you know, there's a,
we have to track these plan of cares
down to make sure that we get them
signed within thirty days.
Right.
We walk into the office.
We're like, Hey, it's day twenty nine.
The little M.A.
sitting at the desk.
She scribbles it.
Here you go.
What would that remove?
A lot of burden.
Don't need a referral.
And I've talked to.
So I have a direct line.
to HHS right now.
So I got to tell you a little
funny story.
So seven, eight years ago,
let's call it seven, eight years ago,
a good friend of mine,
he's a car dealer in town.
Great guy.
He invited my wife and I to a
polo match.
Well, at that polo match, Dr. Oz.
Big fan of Dr. Oz.
So I walk up to Dr.
Oz like I normally do.
I'm not shy.
I'm like, hey, can we talk?
And he was very polite.
He sat down with me.
He talked to me.
We talked about wellness.
We talked about health care.
We talked about all kinds of things.
We hit it off.
And we remembered that moment.
And when he got appointed the head of
CMS, what's the first thing I did?
I reached out to him.
He remembered.
remember that conversation he's like oh
man i remember that day so what does
he do he puts me in charge with
his he puts me in contact with his
deputy director he's the guy that does
policy this is the guy you got to
talk to you have great ideas talk to
this guy so we've been in communication
like he gave me his email address he
gave me his phone number he's like hey
let's talk about these things so you know
that that's one of those moments where you
know okay
Use those moments to your advantage,
use the people that you've met through
your years of contact,
use that to your advantage.
But these guys,
when you're talking to them,
they have no idea what we do, none.
And it's not, and again,
I'm not putting blame on anybody,
What happens is these guys get replaced.
Right.
So let's say we're doing advocacy and
we're beating the bush and we're talking
to Congress people.
And, you know,
my best friend is Mike Caradopolis.
Shout out to Mike.
Mike is really attacking health care right
now.
He said, Steve, give me a year.
You know,
Mike used to be the president of the
Florida Senate.
Mike's a good guy.
Mike knows Mike gets stuff done.
Mike Mike's very hard to beat.
bought right so he's really pushing the
he's pushing the envelope now on health
care for me and he's he's working behind
the scenes and I talked to Mike at
least once a week and and his wife
now is now you know she walked into
a position she was a internal medicine
doctor so she's now the head she's
actually our acting Surgeon General of the
United States so okay had dinner with them
the other night you know she walked into
that position it's not going to be a
full-time position but again
She's got to be careful because she works
for HHS.
She's working directly at Kennedy Junior
side,
so she can't give me an unfair advantage.
But these are things that I can do
to meander the past.
But what I've found over the last year
since Mike's been in office,
Nobody in Congress,
nobody who's making these policy decisions
really has a fair shake as to what
we do.
We're still,
we're still looked at as an ancillary
provider.
We're still looked at, you know,
and I hate to use this word,
but I'm going to use it anyway.
Two words, three words,
glorified massage therapists.
That's the way.
Oh,
you guys are the people that rub people,
right?
So how do we change that?
Numbers.
We all have to start.
Numbers of what?
People.
Us.
Therapists.
We need to wake up.
We need a what and a how.
Yes.
So writing your congresspeople.
In those explanations,
we need to include this is what we
do.
We're movement specials.
We're not massage therapists.
We're not this.
And again,
let's go back to your question that you
asked me.
If there's one thing I could do.
So the Planet Cares, that's a simple fix,
right?
Got it.
my and i can't talk too much about
this because i'm in the early stages of
developing this right now i've got ndas
and all that stuff but we need to
prove outcomes and not just prove outcomes
because i can tell you our patients get
better and we say but how can we
extrapolate that to a dollar amount
downstream cost savings oh photo right i
mean there are ways to do that correct
but it has to go one step further
okay to what photo is great you know
we can say patient went from this to
this
let's look at data let's look at real
data if that patient was discharged and i
don't i don't even like doing the word
dish or i don't think patients should be
discharged from physical therapy i think
you go to your dentist every six months
for cleaning you should go to your
physical therapist for a checkup right
let's check your balance let's look
especially patients over sixty five high
fall risk you know they've got diabetes
they've got all the risk factors so hold
on a second before we go too far
down i want to make sure i understand
if so i don't get lost sure we
need
Physical therapists in the wild,
if they're associated with the group or
not,
we need a lot of people to do
a specific thing.
Yes.
Doesn't APTA do that?
They have apps.
They do something called a flash action
strategy.
They've been doing this.
I can only speak to you.
I've been in a PT for ten years.
They've been doing that.
But there's only one organization doing
it.
And I can't speak to it.
So is it the number of organizations or
the number of people?
Because the second you said people.
It's grassroots.
That's that's the only thing we get done.
And here's what I'm going to tell you
about the APTA.
So they may be fighting behind the scenes
for us.
They may be doing this.
They may be.
I don't know if they're fighting behind
the scenes.
They're they're pretty.
Yeah.
Well, you know what I mean?
You know what I mean?
We don't see everything they do when
they're in D.C.
Right.
We don't see the conversations.
We don't see what's being discussed at the
table, et cetera, et cetera.
We as we cannot.
So I'll tell you.
So in two thousand and four.
Right.
Let's go back to two thousand and four.
I just opened my private practices.
So I had three private practices,
opened them in two thousand wide,
three private practices.
We got hit back to back to back.
In six weeks we had three hurricanes.
All right.
just devastated this whole area.
I live on the Space Coast.
We're right near Elon Musk and Jeff Bezos
and all the rocket launch.
There's a rocket launch that pretty much
goes up every day now.
We're so immune to it.
We're like, oh, look, another rocket.
But three hurricanes back to back to back.
I remember watching the National Guard
coming in here in trucks and truckloads,
and people were walking around in a fog
waiting for the government to show up to
help them.
They tell, you know, you live in Florida,
they tell you prepare, prepare, prepare,
right?
Get water, get batteries, get a generator,
do this, do this.
I was prepared, right?
So I'm not walking around,
I'm walking around,
I'm driving around saying, you know,
my therapist,
we were out of work for almost three
weeks.
I told my therapist, hey,
if you want to,
if you want to work and get paid
come in here i had the water guy
zephyr hills i had him drop off big
shout out to them they came and dropped
off i don't know a hundred two hundred
big five gallon jugs of water and i
had my staff going around to our patients
and delivering and all that stuff but the
point of being is the amount of people
that were walking around in a fog bank
and that's where
We used to be an apathy.
I would say physical therapists,
we were in a state of apathy five
years ago, right?
I see anger and you see it in
the posts, right?
We're getting angry.
That's a step up and that's where we
need to be.
I disagree, not to split hairs.
Apathy is worse.
If I'm actually angry,
it shows I want to still engage.
Apathy is worse.
To me, that's what I'm saying.
We were in apathy.
We're in anger now.
That's better.
Oh, sorry, sorry, sorry.
I agree with that.
Yeah, my bad.
Yeah, we need to get angry.
We need to get angry.
So you're showing me, and this is good,
you're telling me and showing me a story
of what happens when we don't do a
thing and the result of.
Yes, exactly.
So what do we need to do?
Because so far it's get PTs to have
a voice.
So it's frequency, intensity, time, type,
volume, and progression.
These are exercise principles,
but those are also communications
principles.
So frequency, how often you do it,
intensity,
the passion with which you do it,
intensity, time, type, volume,
and progression.
APTA has been doing this.
Why hasn't it worked from your point of
view?
If that's what we need to do.
Yeah, without being inside the APTA,
I can't tell you.
But all I can say is,
from my chair looking in,
I don't see that anything has made that
change.
And the only thing I can put on
that is
you know,
people in those spots change every two
years, every four years,
every time a new administration, so.
You're saying on the receiving end of.
Yeah, so it's a constant,
it's a constantly evolving process.
The only constant is change.
Correct.
In terms of those people.
You get new people, you get new people.
So here's what I can tell you though,
as patients go,
Patients are waking up because what's the
first thing a patient does?
They call their doctor and they say, hey,
skip the MRI, skip the x-ray,
just send me to my therapist.
Right.
We've done a great job of waking up
patients.
Now we need to wake up the policymakers.
Right.
And how will you do that?
by communicating with the policymakers,
by getting the inside scoop.
These people are, you know,
it wasn't hard to find the deputy director
of CMS.
I'm not saying that we need to bombard
him.
So my question is,
so now you identify your audience.
Yes.
We go back to what I did, right?
I know who I'm talking to.
Yep.
I have to deeply understand what bothers
them, what their hopes and dreams are,
and what their frustrations are in terms
of the policymaker.
Typically,
and I don't have a lot of advocacy
experience.
I do have a lot of communication
experience.
I have to understand what makes you tick.
And then I have to understand what I
bring to the table.
And where your goals and frustrations
cross, if you look at a Venn diagram,
and what I can bring to the table,
that is our why.
That's where Simon Sinek starts.
He says, now that I have a why,
when I walk in,
now you hear your frustrations and goals
coming out of my mouth.
That's when the other person starts
nodding.
So I guess I'm just like,
would you do it more frequently,
more intensely, more often?
Yes.
All of the above.
Start with your local representatives.
So it just sounds like you're saying I
would just do it more and I would
do it better.
I don't understand how.
Yeah.
Emails, phone calls, getting involved.
Hold on a second.
So I'm a communications consultant.
Email.
Good.
That's specific.
what would you put in the email that
is different than what APTA?
Like I,
like when a CI used to look over
my shoulder and be like,
why are you doing that exercise?
I'm like, I don't know.
It's on the protocol.
Not a good answer.
So if I just said email, I'm like,
not enough.
I'm trying to see your,
what I'm trying to do is have you
show me your work,
like show me your thought process.
So email is great.
APTA does that,
but how would you do it differently?
More often, all capital letters?
No, not at all.
Yeah.
So good point.
The first thing I would do is start
asking them questions.
So
One of the things that I've done,
very successful action.
Let's talk about insurance companies.
Let's talk about Blue Cross Blue Shield.
I had a really hard time getting in
network with Blue Cross Blue Shield.
So what's the first thing I did?
I picked up the phone.
I said, hey,
you're down the road for me.
Can I come up there and talk to
you?
Who do you call at Blue Cross Blue
Shield to do that?
Like, what is that?
I mean,
you just you have it's a system.
You got to go through the numbers.
yep and you can find out who your
local rep is every insurance company has a
local rep that's assigned to your area
right so you get a hold of that
person you drive to them you meet with
them you here's what physical therapy does
hey can i give you a demonstration can
i look can i do an ergonomic assessment
for your desk
I'm here to help.
Oh, my God.
I never knew you guys did this.
I told Mike that.
I said, dude,
I'm going to get on a plane.
I'm going to come visit you and Stephanie.
You're going to take me into these
congressional offices, right?
These guys that sit on ways and means,
these guys that sit on energy and
commerce.
I'm going to do an ergonomic assessment
for them.
I'm going to sit down and talk to
them.
I just need fifteen minutes.
Let me tell them what physical therapy
does, because a lot of them don't think,
you know, and Mike didn't even know.
He didn't know.
He's like, damn,
I didn't know you guys did all that.
Yeah, that's what we do.
So to summarize,
your job is more face time with the
people who make decisions.
We really do.
We really got to get, you know,
we have to get more involved.
We've done it a very good angle with
patients.
Let's now do it with the people who
are writing policy.
So that's your how is face to face
and like, I like it.
Show, don't tell.
Ergonomic assessment is not a tell,
it's a show.
Love that.
So you are increasing frequency and
increasing the how.
Yep.
The question is,
how often is APTA doing this right now
and are they doing that?
So that's my point.
That's one of my points,
which was we have people from outside the
APTA complaining about what the APTA is
doing and they don't know what they're
doing.
Yep.
Yeah, I mean,
I'll give you that fair share.
I'm not going to disagree with you there.
But, you know, you call a complaint.
I call it, you know,
we really just want change of policy that
when it comes down to it.
I think everybody does.
Right.
Both sides agree.
That's what we agree on.
That's coming out.
Yeah.
And to be honest with you,
I keep reaching out to these guys.
You know, I put my contact at HHS.
Yeah.
And I did apply.
So right now,
for those of you out there,
I believe the APTA put somebody forward.
UPTA put me forward.
They have not yet selected the HACC
Committee,
the Healthcare Advisory Committee.
So Dr. Oz- HHS has not picked someone,
you mean?
Correct.
It's been delayed.
It was supposed to be end of November,
end of October, end of November.
We want a seat at that table.
So the APTA put a person forward.
UPTA put me forward.
You know, my communication with them is,
hey, Steve, that position,
that board has not yet been filled.
We're getting to it.
So, again, that's you know,
you talk about action.
These are the actions we need a seat
at the table.
Right.
IHI Institute for Health.
innovation does anybody know who the ihi
is it's a big organization in boston
they're the ones that write policy when
medicare wants to change policy they call
the ihi there's not a physical therapist
on the ihi board why let's get a
physical therapist on the ihi board if
medicare is talking if cms and hhs is
talking to ihi
We need to go to IHI, right?
You don't want to invest in Tesla.
You want to invest in the battery company
that's making the batteries for Tesla,
right?
So let's circle that.
Hold on a second.
I don't disagree with you.
Is this something you think
You're going to do,
UPTA is going to do,
APTA should be doing,
or we should be doing.
I hate we because I don't know who
that's talking to.
Let's be honest.
I'm not waiting for...
I'm on the board of UPTA,
but I'm not waiting for the UPTA to...
come to my rescue.
Now,
I'm going to be part of that rescue
plan,
and the UPTA is really taking some very
strong action right now.
I'm also not going to wait on the
APTA to solve my problems.
Because our problems are our problems.
This is where we most wholeheartedly
agree.
Yep.
I look at membership like I pay
membership.
Yeah.
I close that tab, take a deep breath,
and then I immediately continue to work on
solving my own problems.
This is what I'm talking about with logic
and emotion,
what I think I'm buying and what actually
APTA is selling.
If they're not aligned,
I can see why people are frustrated.
I understand that.
So it sounds like you and I understand
what the value or lack of value of
membership is and we're okay with having
it or not because it's a binary decision.
But it sounds like you join something and
then immediately start working on solving
your own problems too, right?
Where I am confused is when people aren't
a part of something,
which is one thousand percent OK.
And they complain about the lack of
results from that thing,
from that gym they don't belong to.
And they stand outside and yell,
I don't have abs.
It's your fault.
Which yelling, I don't have abs.
It's your fault is OK.
Right.
But I'm allowed to hold up a mirror
and say, this feels dumb.
Right.
And I agree with you.
And you know what?
And that was my,
I probably didn't convey that,
but my two thousand and four analogy with
the hurricanes, that was it.
You know,
people are standing around going, hello,
like, hello, you should have.
Hey, you should have prepped.
You should have been ready.
You should have known we were coming.
Where's the Publix is up there,
but Publix is the big grocery store down
here.
Publix isn't open.
You know,
they got back open when they had when
they could, but.
You know,
don't wait for somebody to come and help
you take action now.
And that's what I'm saying is as a
physical therapist,
I don't care if you're in a skilled
nursing facility.
I don't care if you collect a paycheck
because everybody should be asking right
now.
And I have this discussion with my
therapist and I'm like, dude,
I want to pay you more.
I really do.
You deserve so much more than you're
making.
But the policy right now does not allow
that.
Now we do have alternate, you know,
Hey guys,
if you want to start doing seminars or,
you know,
you want to work and do this and
I'll split that with you.
You know, it sounds like you're saying,
I will show you my math and,
Yes.
I will open my book.
But if you can help me increase the
left side of my equation,
I will help you increase the right side
of your equation.
If you can help me increase the input,
I will give you some of that output.
That is the rising tide that lifts all
ships.
Yeah.
And honestly,
we just had this meeting last year.
We do a staff meeting every year for
compliance.
We go over documentation and we follow
Rick's.
You got to have seven principles of a
compliance plan.
And that's the other thing I say to
physical therapists out there.
And I want to say to them, listen,
Don't give the auditors,
don't give the MAC contractors,
don't give them fire.
You know,
don't give them oxygen to fuel their fire.
You know,
make sure that you guys are staying on
top of compliance.
You know, have a compliance plan.
Update your policy.
I just posted this the other day on
the physical therapy site.
And I said, hey, guys,
don't forget it's end of the year.
Update your policies and procedures.
Things have changed.
So let me ask you this.
We'll switch,
but I'll sort of ask you the same
question.
You have described documentation as
compliance theater, which is a great term.
I mean, compliance theater.
Even as a PT student, I was like,
who am I writing this for?
I use a different term, self-pleasuring.
I was like,
this feels like this is for me.
It's not pleasurable for me and no one's
reading it.
It's pleasurable for me.
So you've described documentation as
compliance theater.
Great phrase.
If you could rebuild clinical notes from
scratch,
what's the thing,
what's the first thing you would change or
first or second thing?
What would you change?
If you could rebuild compliance,
if you could remove compliance theater,
what would you make it be?
Yeah.
And well, I, the,
the problem was there where, you know,
we had to search for words.
So, um,
I'm going to tell everybody out there,
listen,
I understand private practice is
struggling right now,
but if you're not using AI technology,
you really need to stay, you know,
AI is not going away.
It's not going anywhere.
And we use AI.
You know, I use prompt.
I'll just be transparent.
You know, I, I, I've done,
webinars for prompt discussing prompt,
you know,
there's other great programs out there.
Don't,
I don't think prompt is the only one
out there.
Sorry, prompt, but, um, you know,
they do have an all inclusive tool where,
you know, I,
so I've gone in and here's the other
thing too, is, um,
I don't claim to be a compliance expert
that that's Rick's smart enough to hire
Rick and listen to him.
Yes.
Yeah.
And I'll get, it's funny story.
So you're probably not, uh,
you haven't been in the profession long
enough to know Steve Levin.
Steve Levin was the Rick Gawanda before,
you know, Rick was still around,
but Steve was the, you know,
and Steve reached out to me.
Steve was from Florida and Steve reached
out to me and actually I reached out
to Steve.
Let's backtrack.
So I called Steve and first thing Steve
said when he picked up the phone,
you know,
his secretary got him on the phone.
He goes,
what letter did you get from Medicare?
They already know.
They know why you're calling.
Yeah.
I'm like, huh?
I didn't get a letter.
I said,
I want you to come up for a
couple of days and go through my practice
and tell me what I'm doing wrong.
So you were preempting the letter.
You were like,
how do I not get the letter?
I don't know what I'm doing.
I mean,
we're going back to two thousand and five
now.
But, you know,
and he drove up and he's like, man,
I got to salute you.
You're the first person I've ever called
me, you know,
before you received the letter.
But, you know, he spent two days.
He told me, you know,
you're doing ninety five percent right.
But, you know, do this, do this,
do this with those five percent.
Right.
And he helped me in and we stayed
in contact, unfortunately.
You know,
he passed away tragically in a car
accident in Costa Rica.
But, you know,
he was active with the APTA.
If you talk to the APTA guys,
they know who Steve was, you know,
but now Rick is filling that spot.
So I don't claim to know the compliance,
but I know enough to make myself
dangerous.
But if a physical therapist reaches out to
me and says, you know,
how do I do this?
How do we do this?
I feel compelled to help that person
because by helping them, it only helps me,
right?
I'm not doing the job for them,
but I'm going to say, hey,
if it's a compliance issue, call Rick,
right?
If it's something else, you know, hey,
I can help you with that.
You need, you know, hey, try this,
like prompt.
I told him the other day.
In and of itself, it's a vanilla shell,
right?
But if you go in and put the
compliance feature,
so there's a toggle in prompt that says
you wanna do custom documentation.
Well, as soon as they told me that,
I'm like, hell yeah, it's game on.
So I created templates for my therapists.
So when they're doing their evals,
they're doing their progress notes,
they're doing their daily notes,
they're doing their discharges.
It's got all the,
it's got all the Medicare stuff built into
it that the word salads that they're
looking for built into it so that the
AI technology then puts it into the notes.
So that's saying – it sounds like you're
saying, hey, listen,
make sure you're using a chainsaw because
we used to have an ax,
but now that there's a chainsaw,
you're not using it.
That's on you, right?
So that's how to go through this.
That's what power tool to use to get
the tree down now.
But if you were able to completely rebuild
clinical notes from scratch –
What would you do?
Japanese ideas are better.
For some reason, Americans are like,
what do we add to it?
It's like, what do we take away?
What does it mean to be there?
So if you can even go further upstream
to rebuild compliance theater,
or I should say, change, remove,
what would you do to compliance theater?
What only needs to be there?
OK,
so we all agree that physical therapy
saves money, right?
There's no disagreement there.
Now,
we can get in the argument of private
practice versus chain clinics versus
hospital based.
And again, I'm not
I'm not going to get into that discussion
right now,
but let's just talk as a whole, right?
So we know that we save insurance
companies money.
Insurance companies know that we save them
money, hopefully.
But if I could change documentation,
when I first got into this business,
documentation was so that if I called out
sick,
the therapist who came in after me knew
exactly what I was doing with that
patient, right?
It wasn't that I had to use the
word educate or I had to use the
word verbal cues or all this.
It's like, oh my God,
what do I gotta do?
It's very time consuming.
Now,
AI has helped with that because my
therapist,
when they walk out at the end of
the day,
their notes are done and I know those
notes are compliance and I can run reports
behind the scenes to see what they're
billing, how they're billing.
Are they under billing?
Are they over billing?
And I can have those conversations with
them.
But really, documentation, you know,
the tenth visit progress note,
let's go there.
Really?
Do we need a tenth visit progress note?
I mean, I get it.
So it sounds like everything you've said
so far, correct me, make it lighter,
simpler, make it more, like,
what are we doing?
Why are we doing this?
I was very confused when I was a
student.
I'm like, who am I writing this for?
And they're like, for the EMR.
And I was like, no, no,
that's not a who, that's a what.
What are we doing for?
And then I was explained in not so
many words.
In case, right?
I mean,
this is literally what I was taught.
Write as if you're going to read this
in court.
And I was like,
what are we talking about?
I'm going to write ten thousand notes in
my career.
Maybe two are read in court.
I don't know what my batting average would
be.
That's what I'm doing all this.
And that's where I think your phrase
compliance theater hits the nail on the
head.
Oh, this is performance.
So it sounds like.
Faster is the outcome,
but lighter and lighter is a good word.
Simple.
Like, what's the point?
Understand what the point is for first.
Who's the who is reading this?
It sounds like it's for and you can
make you can make one piece of content,
right?
I mean,
whoever called EMR or notes content,
but it is.
It should be for the next therapist.
It should be for the continuing medical
record for the patient.
So in case that follows them, the next,
next,
next therapist knows what's going on.
And tertiarily,
it should be to defend what... I mean,
really what it is,
it's defending what we're doing.
Not explaining it, right?
Because when someone says, write this...
as if you'd be okay with it being
read in court,
I feel like I'm immediately the defendant.
So it's change it from defense to not
offense, but explanation.
Like a useful rule instead of a necessary
compliance theater.
Right.
We should have...
the ability to put our hands more on
patients and educate our patients rather
than sitting there burying our face.
Because I do consulting.
I go around and I see,
I don't do as much of it as
I did previously,
but I'll go into clinics and what's the
therapist doing?
They're buried in their computer.
It's like, really?
Unfortunately,
it deters from what we're really trying to
accomplish.
Don't disagree.
All right.
That makes sense.
You said fragmentation is hurting the
profession.
I don't disagree.
But starting a new organization could be
seen as adding to that.
How do you reconcile that tension?
I don't disagree with starting a new
association.
I'm just trying to...
Yeah.
And I think in the UPTA,
we're not going away.
You know, there's been things that, oh,
you guys will be gone in a year.
You'll be gone in two years.
Now with the board of the UPTA,
you know, it's a constantly moving target.
There'll be people that drop off and
people that drop, drop, drop in.
But our intentions are good.
And, you know,
when you put a group of people together
who have the same goals, the same,
they want the same outcome and they're
working together.
you know, we're not going anywhere.
So the UPT, yes, does it,
but you know,
it's like the guy down the street that's
going to, I always tell my therapist,
I'm not going to make you sign a,
you know, people come in and go,
do you have a non-compete?
No.
You want to open a clinic?
I'll help you open the clinic.
Right.
Because competition is healthy.
And if you're going to do it right,
I'm going to show you how to do
it right.
And then we'll work together because
that's only going to help me in the
long run.
Initially,
I may lose patients to that clinic down
the road.
But overall, and I've seen this happen,
you know, when I first started this,
you know, the building I'm sitting in,
I started in two thousand and two.
There's now four more PT clinics within
three miles of me.
I'm seeing more numbers today than I was
back then.
It's a good thing, right?
People know physical therapy, right?
If it wasn't needed,
they wouldn't be able to open because they
have to pay overhead and people.
Yeah, right.
So what are the goals...
of UPTA.
They seem similar to APTA,
and even if they're the same, that's okay.
How will they do them differently?
So when UPTA was formed,
that is what I asked,
and I was told it's coming.
Yes.
And I don't...
And it might be somewhere that I haven't
seen, but as Katie asks,
does UPTA have a public-facing information
that all PTs and PTAs can access without
being a member about...
What will you do?
These three questions.
What will you do?
How will it make my life better?
In what ways?
And then what do I need to do
to get it?
I'm getting membership or whatever.
But how?
Vision without a plan is a dream, right?
So help me understand how we go from
frustrated to alleviated.
And this might be an unfair question to
ask you because you aren't an association.
This is a thing.
But why do you belong?
How do you see it as a road
to what you want to get to?
Yeah.
So our biggest goal right now, you know,
we have targets,
but our main goal right now is policy.
We want to we want to change policy.
Right.
So our first move that we did and
kudos to Scott for doing this.
But, you know,
he found a law firm that deals in
this.
And, you know,
we filed a we filed a federal lawsuit
against CMS, you know, welcome.
Hey, Scott.
Kennedy Jr., welcome to your new position.
Here's a lawsuit from...
And I'm sure he's not reading them.
It's some lawyer somewhere doing it or
whatever, but...
We don't have the ability to, you know,
we can say,
I don't want to take Medicare,
but we can't technically opt out of
Medicare.
Right.
So that that holds us accountable to still
being an ancillary provider.
Right.
So when the lawyers reviewed the policy
language, they said two things.
It violates the Commerce Act.
Right.
Free trade,
the ability to see patients without
restrictions.
And number two,
it violates the Fifth Amendment.
And they said,
this is kind of a no-brainer.
Now,
typically when these things happen with
CMS,
we're going to go to the table and
there's going to be some type of mediation
and we'll meet in the middle.
But hey,
if a doctor can opt out of Medicare
and not take Medicare and then still
charge what that doctor wants to
reasonably and necessary,
absolutely we should be able to do that.
So, you know, that was our first step.
Okay.
So let me ask you this.
So you've done that.
You've taken a very, very specific action.
Yeah.
Like no notes.
My question is, in three years...
If that lawsuit doesn't produce tangible
results that your members can see,
are you now in the same boat as
APTA where you're standing there saying,
we did stuff and the members are like,
keep dropping one hundred and fifty bucks
a year, but nothing happened.
And then you have to say,
don't hate the player, hate the game.
No, that's the risk.
You know, I'm a risk taker.
My wife,
we like to go to we like to
go to Vegas.
My wife's a gambler.
Right.
She'll sit at a blackjack table all night.
Is that what you would say?
Hey, like, yes.
No, I know.
I would not say that.
But, you know, again,
then what would you say?
we're not going to take, yeah,
we're not going to take no for an
answer.
We're going to get an answer on this.
The attorney's pretty, you know, it's,
it's going to go to mediation.
Something's going to happen.
It's not like, no,
it's nothing in life is guaranteed.
We may lose the case.
We may lose the case horribly and we
fall flat on our face and try this.
I'm down with it.
Yeah.
And we have other avenues behind the
scenes on where we're going to evoke
change.
You know, we just submitted a, um,
The CMMI, right?
So Center for Medicare and Medicaid
Innovation.
So to my knowledge,
somebody can correct me on this.
There's never been a innovation.
Basically,
I guess we could call it a test
pilot where does physical therapy save
money, right?
So I'm laying there one night and I'm
like, what I normally do.
staring at the ceiling going,
what can I do?
You know, what can we work on?
So I got up and I looked,
and that's how I found the IHI, right?
Because IHI works directly with CMMI.
And I sat there most of the evening
and typed up a CMMI where I want
to do a pilot study with physical
therapists, right?
I want physical therapy, private practice,
In the United States,
take a pilot project.
Now,
I don't know if this is going to
get approved, but again,
if first you don't succeed,
try and try again.
I'm not going to let it fall on
deaf ears.
I can keep resubmitting and resubmitting
and resubmitting.
So I ran it by the board and
the board said, yeah, this is great.
Let's do it.
So we submitted it on behalf of the
UPTA because we felt UPTA would be,
you know,
and we submitted it to the powers that
be.
And
ta-da it got submitted to cmmi now i
hope that goes through and then we can
start looking for private practices
because it's going to be very specific and
they're going to track data and we're
going to see does private practice versus
something else you know what are the
hospitalizations what are the opioid use
what are you know falls etc but these
are all the things that we're doing we're
navigating do i know if the apt is
doing it or not no i don't i
don't know what they're doing they may
have i know that they did put um
somebody forward for that HHS hack board,
which is good.
You know,
these are all good things that we can
do, but we have to keep chipping away.
We cannot, we cannot be complacent.
We cannot be complacent.
All right.
So let me ask a more fair question.
A young PT comes to you and says,
I'm disillusioned.
What's the point?
Why should they believe in UPTA and what
would you tell them it offers that another
organization doesn't?
Essentially, what do you do?
How does it make my life better?
And then what do we need to do
to get it?
How would you explain their terms?
Absolutely.
I actually just had this happen.
I take a lot of students, right?
So I just had two students.
My student just left in early December.
She's going to be a great therapist,
by the way,
and hopefully she's watching this.
But I just had this conversation and I
told her, do both.
Join the APTA, join the UPTA.
Join both.
There's no harm in that, right?
But again... And then do what, though?
Why?
That's not a normal response.
I like that.
Why do both?
What should she do next, though?
She's got to do something.
Taste.
Yes, and be active.
I tell people what organization you're in,
and then ask,
what are the free resources I can do?
Join every free committee,
get every email, and then just taste,
and then slowly unsubscribe to the ones
that you're liking.
Yeah.
So, you know,
she was at my side for twelve weeks.
So she I taught her through tangible
action.
Right.
She was in on the meetings.
I let her sit on some of the
discussions that I had with my contact up
at HHS.
And she got to see and she's like,
oh, my God,
there's so much that goes on behind the
scenes.
But it was awakening for her because,
you know, and nothing to the universities.
I mean, I'm not against that,
but she's like,
you guys should teach a class on this.
You guys should teach a class on,
and how many students, I don't know,
maybe you know this, Jimmy,
how many PT students do we have in
the country right now that are in school?
I think there's ten grand,
I think there's ten thousand graduating
every year.
Yeah,
could you imagine if every one of those
ten thousand were to, like,
write a letter or get involved?
And I know the APTA's working on doing
that with the students and stuff like
that.
Right, right, right.
So this is where I get to step
back in and say,
that is very simple to ask,
that is very difficult to do.
Yeah.
You've posted something on social media.
anybody has getting even people to click
like even if they agree with it so
you saw it you agreed with it but
you didn't do anything about it why
because attention and time are finite so
it is i do not disagree but i
will say it is simple it's just not
even if you have a hundred thousand do
the math on this i let's say we
have a hundred thousand paying apta
members go to their youtube channel
they don't have a hundred thousand
subscribers last time i checked they don't
have a hundred thousand anything because
getting people to do one extra thing is
simple just do this just do this one
thing because it's never one thing it's do
this one thing now and then another thing
another thing and eventually it's not that
easy
No, I get it.
I've got thirteen physical therapists.
Good luck trying to get them.
Hey, guys,
take time out of your day and hey,
I need you to send this email.
Right.
So behind the scenes,
that's what the UPT is doing.
We create links.
We make it easy.
And, you know, an APTA does this, too.
And by the way,
when APTA sends out that link,
I'm still filling out the APTA link as
well.
Yeah, because you said numbers.
It kind of doesn't matter who they're,
right.
Yeah, agreed.
Right, it's volume.
That's what we need to do.
We need volume.
And we need, and again, yes,
I agree with you.
And I think both organizations serve a
purpose.
I just want to see more collaboration.
That's my biggest thing is I just want
to see us come together as a profession.
I want to see, you know,
because here's what the policymakers want,
you know,
and the insurance companies want.
They want us to be disagreeing, right?
Because it causes weakness.
And when you have weakness,
they pretty much win, right?
These insurance carriers,
it's not getting easier.
You know,
I opted out of UHC and Optum and
I actually know physical therapists right
now that are getting audit.
This is disgusting.
And this is, you know,
another thing not to get into a legal
argument, but I got a therapist right now.
She's in Southern Georgia and the poor
thing, they're going back seven years.
So she's been out of network since day
one with UnitedHealthcare Optum.
they want retroactive payment.
They haven't even seen the damn notes,
but they're saying it wasn't medically
necessary and we want all this money back.
So she's like reaching out to me,
what do I do?
You gotta fight it.
You gotta fight it because if they get
what they want and I can tell her,
hey, just stop taking UHC patients,
but that's not a win.
It's like that's on the patient,
but that's where we need policy.
That's where we need to fight back and
say, and I told her, I said,
you know,
we need to band together and fight this.
You know,
there's basically what Optum is trying to
do is,
and I know this is coming for me
too.
I opted out of Optum UHC because I
didn't want to accept the,
the measly amount of money that they want
to pay me for a visit because it's
not worth my time, energy, or effort.
But I know now that,
Those patients are still coming to me
because they want a good quality service.
And UHC Optum is now paying me twice
what they would have paid me if they
would have just come to the table and
sat down and talked to me.
At some point,
they're going to audit me and they're
going to want retroactive payment because
that's their way to scare you away so
that you just drop them because they don't
want to pay that, right?
Let's be honest.
The insurance company's job is to keep the
money in their bank account.
That is right.
Understanding the physics of the
environment you're in is terribly
important.
And understanding what their goals are and
what your goals and where they are aligned
and where they are not aligned.
We got about six minutes left.
I want to be respectful of time.
Last question,
then we'll do the parting shot.
So last question is,
what does success look like in five years?
for you not just with upta but like
what what would success look like in five
years something like realistically right
like this is no magic wand but like
what when what would you sit down in
five years and say yes we have succeed
we have achieved success and i'm
purposefully leaving that open-ended
Yeah, I mean, honestly, I'm not stopping.
I've got another clinic I'm opening next
month, you know, February.
Hopefully, you know,
if the contractors can get the build out
done, we're opening.
So I'm not stopping.
I'm not letting reimbursement.
I'm not letting policy.
I'm not letting audits.
I'm not letting that get in my way.
I'm still doing what I'm doing and
providing good service.
And, you know,
we just have to keep fighting a good
fight.
And, you know,
my success for me is to not give
in.
You know, I left the profession.
For a reason, I felt burned out.
I was just like toast.
I wanted to go do something else.
I went and worked for a stem cell
company.
Then I ran an orthopedic company and then
I went to work for a hospital system.
And honestly, my true passion was like,
there's still work to be done.
So crazy me in twenty twenty two.
Hey,
let's scale three clinics in eight months.
You're out of line.
Right.
Got it done.
But but again, you know,
success for me is.
Taking care of the people.
We have a family here, right?
I've got therapists that worked for me
twenty years ago that as soon as I
popped my doors back up, they were like,
I want to come work for you.
To me, that's success.
I want to build an environment where
physical therapists can come in and this
they can treat autonomously.
They can treat the way they were taught
and we can continue.
I mean,
Nothing like the daughter who brings in
her mom, who's ninety four years old,
who's got her first case of vertigo.
And she's like, the world is ending.
And she walks out on visit number two
and she comes in on visit three and
she kisses you on the cheek and says,
you saved me.
I'm so much better.
Thank you.
You know,
that that's why we do what we do.
So to me,
success is putting my hands on more
patients,
spending more time with the patients,
less time documenting.
You know, these are all changes.
But, you know, really.
As a group,
that's where we need to come together.
We need to come together and say enough
is enough.
I'm not taking it anymore.
And I see lots of posts on these
different pages about we need to start a
union.
We need to start a union.
So that's something else I'm working on.
It's not a union.
It's an independent practice association.
And there's a few of them out there
right now, but.
we're in the process right now of building
that independent practice association,
but we have lawyers involved,
which takes time, energy,
and effort because we want to make sure,
because we know as soon as we start
that IPA,
and it's been done in general physicians,
it's been done with OBGYN,
my good friend who's an OBGYN down the
road,
he said best thing he ever did was
he joined that practice association.
The main thing you got to be careful
of with collective bargaining,
you can't just go for higher
reimbursement.
You got to do other things.
You got to do compliance.
That's where
We bring in other people who,
and we create a newsletter,
whatever we do,
but it's in the infancy stage now,
but we're gonna run that through as a
separate division of the UPTA so that we
can give something tangible to the
physical therapist and say, hey,
belong to this IPA and we're gonna go
to bat for you on reimbursement.
But it's a big,
as most people can tell you,
that's a huge uphill battle to take on.
So we wanna make sure that we have
all the infrastructure in place first,
that we have the attorney in place
That is, you know,
going to make sure because, you know,
when you start going when you start
hitting the insurance companies where it
counts in their pocketbook,
they're going to fight back.
So we know that.
But that's kind of it in a nutshell
is, you know, I'm not going to stop.
I'm going to I'm going to keep working
tirelessly.
All right.
This is the parting shot.
One last mic drop moment.
No pressure.
Just your legacy on the line.
All right, Parting Shop, powered by U.S.
Physical Therapy,
a nationwide network of clinics focused on
developing clinicians,
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and the stability to build your future in
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If you want a place that supports how
you want to practice, visit usph.com.
That is usph.com.
Also,
I do want to thank our nonprofit of
the episode, Team Gleason,
a nonprofit founded by former NFL player
Steve Gleason after his ALS diagnosis.
their mission to help people living with
als stay independent connected and
purposeful for as long as possible that
means providing advanced communication
devices mobility gear personalized tech
and even life experiences designed to give
people living with als more control over
their lives until there's a cure there's
team gleason no white flags learn more at
team gleason.org all right uh parting shot
your last trap uh chance for a mic
drop moment soapbox statement whatever you
want uh give it away
Yeah, it's all about collaboration.
It's all about, like I talked about,
we need to join together.
You're right.
When we take jabs at something on social
media, it's basically out of frustration.
And it's really what we want to do
is we want to evoke change.
We want to wake people up.
You know, it's not that we, again,
the APTA serves its purpose.
The UPTA serves its purpose.
We're all on the same path together.
But that's the main thing.
You know, dentists, doctors,
I see I'm friends with all these people
in the community.
They collaborate.
Yeah.
The PTs down the road,
they don't want to collaborate.
Why do we not do that?
There's plenty of business to go around.
We really need to start.
Every setting needs to come together.
We all need to come together.
We really need to just start waking up
and saying, we're done.
Real change is going to happen.
As the Beatles once said,
come together right now.
As former APTA president Sharon Dunn said,
we are better together.
Steve, appreciate the time.
Thanks for the hour.
I loved it.
Thanks, Jimmy.
Appreciate it.
Let's do it again.
All right.
That's it for this one.
We're just getting warmed up.
Smash, follow,
send it to a friend or crank up
the next episode.
Want to go deeper?
It is at PG podcast.com or find us
on YouTube and socials at PG podcast.
And legally, none of this was advice.
It's for entertainment purposes only.
See Keith, we read the script.
Happy now.