WEBVTT 00:00:00.009 --> 00:00:02.630 You're listening to the PT Pinecast, 00:00:02.650 --> 00:00:04.352 where smart people in healthcare come to 00:00:04.392 --> 00:00:05.392 make noise. 00:00:05.573 --> 00:00:09.635 Here's your host, Jimmy McKay. 00:00:09.656 --> 00:00:11.137 I'm pretty much just living live today 00:00:11.157 --> 00:00:12.077 here at Graham Sessions, 00:00:12.098 --> 00:00:14.199 the top APTA's headquarters, 00:00:14.480 --> 00:00:16.202 live streaming during Graham Sessions. 00:00:16.262 --> 00:00:17.742 And I'm telling people Graham Sessions is 00:00:17.763 --> 00:00:21.304 this annual event called the Cool Kids 00:00:21.324 --> 00:00:22.646 Lunch Table, super secret. 00:00:23.126 --> 00:00:24.388 But you know all these people. 00:00:25.329 --> 00:00:26.609 If you're rubbing elbows in the 00:00:26.649 --> 00:00:27.030 profession, 00:00:27.050 --> 00:00:27.190 you've 00:00:27.634 --> 00:00:29.475 met or heard of or at least you 00:00:29.495 --> 00:00:31.096 know know asymmetrically through linkedin 00:00:31.515 --> 00:00:33.137 a lot of these people alex benderski but 00:00:33.156 --> 00:00:34.878 i'm gonna show a bunch of times is 00:00:34.898 --> 00:00:37.478 this your how many gram sessions my number 00:00:37.619 --> 00:00:39.119 one is your first one it's my first 00:00:39.240 --> 00:00:41.682 one i'm grand session virgin really this 00:00:41.701 --> 00:00:44.463 is great we get purity uh so my 00:00:44.542 --> 00:00:47.265 big picture question would be uh what is 00:00:47.325 --> 00:00:49.765 something so far that's made you someone 00:00:49.786 --> 00:00:53.969 who thinks writes talks acts in this 00:00:54.009 --> 00:00:55.168 profession and we'll get to what you do 00:00:55.509 --> 00:00:56.289 but what's something that 00:00:57.529 --> 00:00:58.871 surprised you or excited you? 00:00:58.911 --> 00:01:00.012 Let's go with positive first. 00:01:00.954 --> 00:01:02.697 I think the panel sessions, 00:01:03.176 --> 00:01:05.540 the panel structure is actually very good. 00:01:05.600 --> 00:01:06.783 It's a good format to get different 00:01:07.003 --> 00:01:07.143 voices. 00:01:08.004 --> 00:01:08.745 Go topic-wise. 00:01:08.786 --> 00:01:10.748 Anything that either is on the docket for 00:01:10.787 --> 00:01:13.292 later today or tomorrow or already that's 00:01:13.331 --> 00:01:13.772 made you go? 00:01:14.052 --> 00:01:16.674 okay cool uh the the strength of numbers 00:01:16.975 --> 00:01:19.518 talk is is definitely pertinent uh there's 00:01:19.558 --> 00:01:22.840 a laws of scale that can't long lever 00:01:22.921 --> 00:01:25.804 arm yeah the levers and the arms and 00:01:25.823 --> 00:01:28.186 the leverage talking about i mean and 00:01:28.225 --> 00:01:29.947 again the rule that the rule about gram 00:01:29.966 --> 00:01:31.549 sessions is you can't say who said what 00:01:31.588 --> 00:01:33.090 right let's talk about the idea and the 00:01:33.150 --> 00:01:36.112 idea there is uh can you find ways 00:01:36.192 --> 00:01:38.394 to connect with colleagues or other 00:01:38.454 --> 00:01:39.475 businesses without 00:01:39.995 --> 00:01:41.335 being bought formally, right? 00:01:41.856 --> 00:01:43.917 And then how can you use those economies 00:01:43.956 --> 00:01:45.757 of scale to get things that are better, 00:01:45.878 --> 00:01:47.358 either better, 00:01:47.757 --> 00:01:49.337 higher payment or lower cost? 00:01:49.358 --> 00:01:51.838 I mean, think of the European Union, 00:01:51.938 --> 00:01:52.239 right? 00:01:52.259 --> 00:01:53.478 You retain your autonomy, 00:01:53.718 --> 00:01:54.700 you retain your borders, 00:01:54.739 --> 00:01:56.219 but you open them up so that you 00:01:56.239 --> 00:01:58.040 can have a collective bargaining, 00:01:58.079 --> 00:01:59.700 you can have collective currency, 00:02:00.281 --> 00:02:02.260 like just use that as a narrative for 00:02:02.281 --> 00:02:03.042 physical therapy practice. 00:02:03.102 --> 00:02:05.042 So you keep your autonomy and agency, 00:02:05.081 --> 00:02:06.561 but you are able to share some of 00:02:06.582 --> 00:02:08.263 the risk, able to share your borders. 00:02:08.923 --> 00:02:10.445 able to share some of their common 00:02:10.506 --> 00:02:10.985 expenses. 00:02:11.106 --> 00:02:12.228 So it's logical. 00:02:12.729 --> 00:02:14.330 Certainly there's movement in the right 00:02:14.350 --> 00:02:14.632 direction. 00:02:15.573 --> 00:02:16.835 It's not the only organization that's 00:02:16.875 --> 00:02:17.194 uniting. 00:02:17.294 --> 00:02:18.396 Hopefully there's going to be more of a 00:02:18.417 --> 00:02:19.878 grassroots movement around the country to 00:02:19.899 --> 00:02:20.219 do this, 00:02:20.300 --> 00:02:20.439 but 00:02:21.215 --> 00:02:22.836 It's still a fractured ecosystem. 00:02:23.076 --> 00:02:24.638 And so by majority, 00:02:24.737 --> 00:02:26.599 we either lose private practices because 00:02:26.639 --> 00:02:28.622 they sell or we lose them because they 00:02:28.662 --> 00:02:29.042 close. 00:02:30.663 --> 00:02:32.586 What is something, my second question, 00:02:32.626 --> 00:02:34.627 what is something that isn't on the 00:02:34.668 --> 00:02:35.087 docket? 00:02:35.527 --> 00:02:38.450 You're the guy who reads the instructions, 00:02:38.510 --> 00:02:39.891 is my guess on you. 00:02:40.372 --> 00:02:41.633 What's something that you were reading and 00:02:41.674 --> 00:02:43.354 going, why are we not talking about this? 00:02:45.257 --> 00:02:48.337 I think the theme of diamonds under 00:02:48.377 --> 00:02:48.758 pressure. 00:02:48.818 --> 00:02:50.237 That's the theme this year, yeah. 00:02:50.258 --> 00:02:52.079 I don't know if it's closely related to 00:02:52.098 --> 00:02:53.099 the actual topics that are being 00:02:53.120 --> 00:02:53.500 discussed. 00:02:53.520 --> 00:02:55.540 I think it was just the theme, yeah. 00:02:55.600 --> 00:02:56.200 It's a nice theme. 00:02:56.221 --> 00:02:56.841 It sounds good. 00:02:56.920 --> 00:02:58.361 It certainly gets a buy-in. 00:02:58.382 --> 00:02:59.322 It's like, yeah, we're hurting. 00:02:59.342 --> 00:03:00.703 Let's see how we can get better. 00:03:01.062 --> 00:03:02.603 Teaching resilience is a skill. 00:03:03.264 --> 00:03:04.524 I think to teach resilience, 00:03:04.584 --> 00:03:06.085 you have to have topics that actually 00:03:06.245 --> 00:03:06.824 empower you. 00:03:07.625 --> 00:03:09.706 to withstand some of that stress under 00:03:09.747 --> 00:03:10.127 pressure. 00:03:10.247 --> 00:03:12.368 And if you're going to turn this coal 00:03:12.389 --> 00:03:14.290 into a diamond, teach people how. 00:03:15.091 --> 00:03:16.611 Don't give them ten thousand years until 00:03:16.632 --> 00:03:17.932 they actually turn into that. 00:03:18.894 --> 00:03:19.854 We forgot to add that. 00:03:19.955 --> 00:03:21.336 It is pressure that turns coal into 00:03:21.376 --> 00:03:21.695 diamonds. 00:03:21.735 --> 00:03:23.016 It is also a long time. 00:03:23.318 --> 00:03:24.457 Yeah, for sure. 00:03:24.799 --> 00:03:25.939 It takes millennia. 00:03:25.979 --> 00:03:27.120 And if you want to expedite the process, 00:03:27.140 --> 00:03:28.300 you have to have an external source. 00:03:28.320 --> 00:03:30.543 You have to have that pressure source from 00:03:30.582 --> 00:03:31.183 somewhere else. 00:03:31.883 --> 00:03:32.524 So, yeah. 00:03:32.623 --> 00:03:34.064 If you were to talk next year, 00:03:34.264 --> 00:03:36.506 what would you say this needs to be 00:03:36.706 --> 00:03:38.447 on the docket, idea-wise? 00:03:38.467 --> 00:03:40.788 No, that's a terrific question. 00:03:41.389 --> 00:03:43.629 I think next year on the docket, 00:03:43.650 --> 00:03:46.031 you need to have a greater voice of 00:03:46.170 --> 00:03:48.171 other professions that are presented here. 00:03:48.231 --> 00:03:49.932 You need digital health providers to be 00:03:49.953 --> 00:03:50.152 present. 00:03:50.173 --> 00:03:50.693 That's interesting. 00:03:52.533 --> 00:03:55.055 Half of the economic equity in physical 00:03:55.094 --> 00:03:56.116 therapy is digital health, 00:03:56.496 --> 00:03:57.316 and they're not present. 00:03:57.996 --> 00:03:59.317 PTAs need to be here. 00:03:59.437 --> 00:04:01.777 PTAs are the troops on the ground. 00:04:01.798 --> 00:04:02.937 They're the ones delivering care. 00:04:03.358 --> 00:04:05.038 I don't see them represented in any 00:04:05.079 --> 00:04:05.519 panels. 00:04:06.058 --> 00:04:06.939 So if you're going to have someone 00:04:06.979 --> 00:04:08.020 delivering care for you, 00:04:08.539 --> 00:04:09.401 they should have voice. 00:04:09.561 --> 00:04:10.800 Yeah, PTAs, 00:04:11.681 --> 00:04:14.263 and I'm not the policy politics part of 00:04:14.483 --> 00:04:15.002 PT. 00:04:15.383 --> 00:04:16.762 I like the fact that some other people 00:04:16.783 --> 00:04:17.004 do it, 00:04:17.024 --> 00:04:19.944 but PTAs were just getting basic rights in 00:04:20.084 --> 00:04:20.704 a PTA environment. 00:04:21.511 --> 00:04:23.172 mean still working for basic for sure 00:04:23.192 --> 00:04:24.312 right of course it was like why don't 00:04:24.331 --> 00:04:25.831 the ptas show up i'm like would you 00:04:26.192 --> 00:04:29.153 no exactly but how do you expect it 00:04:29.252 --> 00:04:31.293 economically to give them a bigger burden 00:04:31.473 --> 00:04:33.394 of delivery care process without giving 00:04:33.415 --> 00:04:35.014 them representation and giving them voice 00:04:35.115 --> 00:04:37.396 so i would love to see a broader 00:04:37.495 --> 00:04:39.437 representation we can maintain this 00:04:39.476 --> 00:04:42.177 exclusive pt only club yeah and still 00:04:42.218 --> 00:04:43.218 expect equity yeah 00:04:43.798 --> 00:04:45.978 uh what's something that not a lot of 00:04:45.999 --> 00:04:48.439 people have on their bingo card right now 00:04:48.560 --> 00:04:52.062 as we record in january that will become 00:04:52.401 --> 00:04:54.903 a thing in the next twelve months like 00:04:54.923 --> 00:04:56.423 something that people are not gonna see 00:04:56.845 --> 00:04:58.625 we'll say most people aren't gonna see 00:04:58.685 --> 00:05:00.045 coming in his issue there's a lot of 00:05:00.086 --> 00:05:01.226 policy changes law 00:05:01.927 --> 00:05:03.327 And maybe they're like, well, 00:05:03.668 --> 00:05:04.428 I saw the law change, 00:05:04.468 --> 00:05:05.709 but I haven't felt that yet. 00:05:05.889 --> 00:05:07.250 What's something in the next twelve months 00:05:07.271 --> 00:05:09.091 that people are sleeping on that they're 00:05:09.112 --> 00:05:10.033 going to be affected by? 00:05:10.333 --> 00:05:12.334 So not to be a bearer of bad 00:05:12.353 --> 00:05:12.675 news, 00:05:12.714 --> 00:05:14.716 but your bread and butter of outpatient 00:05:14.735 --> 00:05:15.677 physical therapy business, 00:05:15.757 --> 00:05:17.398 your post-operative cases are going to 00:05:17.418 --> 00:05:18.259 start to disappear. 00:05:18.559 --> 00:05:19.499 Why is that? 00:05:19.519 --> 00:05:20.759 Your risk-based contracts, 00:05:20.899 --> 00:05:22.641 your hospitals become stakeholders in your 00:05:22.661 --> 00:05:22.901 risk. 00:05:23.442 --> 00:05:24.682 And when the hospital is a stakeholder in 00:05:24.702 --> 00:05:24.942 the risk, 00:05:24.963 --> 00:05:26.904 they will retain most of their delivery 00:05:26.944 --> 00:05:27.425 processes. 00:05:27.937 --> 00:05:29.598 So your mom and pop shop that is 00:05:29.658 --> 00:05:31.560 now taking care of your ACL high school 00:05:31.600 --> 00:05:32.060 population, 00:05:32.081 --> 00:05:33.682 which is great because it's like six 00:05:33.742 --> 00:05:35.182 months of guaranteed utilization. 00:05:35.783 --> 00:05:36.524 Once that disappears, 00:05:36.564 --> 00:05:37.665 what are you going to do to occupy 00:05:37.685 --> 00:05:38.545 your therapist time? 00:05:39.004 --> 00:05:44.028 So be aware of these models that are 00:05:44.069 --> 00:05:44.509 emerging. 00:05:44.548 --> 00:05:45.589 These are tenure models. 00:05:45.730 --> 00:05:46.911 And the reason why they're tenure models 00:05:46.951 --> 00:05:48.992 is they're not expected to be fully live 00:05:49.432 --> 00:05:50.552 until twenty, twenty seven, twenty, 00:05:50.572 --> 00:05:50.872 twenty eight. 00:05:50.892 --> 00:05:51.593 But they're here. 00:05:52.053 --> 00:05:53.415 So your team, your access, 00:05:53.495 --> 00:05:55.898 your wiser models, they're here. 00:05:56.317 --> 00:05:57.798 They're a ten-year roadmap. 00:05:57.980 --> 00:05:58.939 They have a runway. 00:05:59.420 --> 00:06:00.762 And right now, you're just taking off. 00:06:00.961 --> 00:06:02.644 So are you ready to deliver care? 00:06:02.704 --> 00:06:04.024 Are you ready to collect outcomes? 00:06:04.425 --> 00:06:05.386 Do you have the infrastructure? 00:06:05.406 --> 00:06:06.326 Do you have the technology? 00:06:08.589 --> 00:06:10.130 So yeah, I think that's... All right, 00:06:10.170 --> 00:06:11.250 well, someone who's like, you said, 00:06:11.271 --> 00:06:12.170 I hate to be the bearer of bad 00:06:12.211 --> 00:06:13.411 news, but you were. 00:06:14.531 --> 00:06:16.733 What should someone be doing, reading? 00:06:17.312 --> 00:06:18.774 Where should they be skating to? 00:06:19.673 --> 00:06:23.435 I think one positive effect of CMS is 00:06:23.896 --> 00:06:25.615 there's full transparency about it. 00:06:25.675 --> 00:06:26.497 Right, they put it in writing. 00:06:26.656 --> 00:06:28.117 It's a lot of writing, but it's there. 00:06:28.137 --> 00:06:28.677 It's a lot of writing, 00:06:28.737 --> 00:06:29.978 but we live in a day and age 00:06:29.997 --> 00:06:31.098 where you have Chet GPT. 00:06:31.237 --> 00:06:31.939 Right, right, right, right. 00:06:32.399 --> 00:06:33.478 Ask it to summarize it for you, 00:06:33.538 --> 00:06:35.060 and you become an educated consumer. 00:06:37.161 --> 00:06:39.382 I learned logical fallacies on the drive 00:06:39.423 --> 00:06:39.884 down here. 00:06:39.903 --> 00:06:40.184 I was like, 00:06:40.244 --> 00:06:41.084 I know they were a thing, 00:06:41.125 --> 00:06:42.526 but I'm like, teach this to me, 00:06:42.865 --> 00:06:44.007 then give me an example, 00:06:44.408 --> 00:06:46.048 then give me a multiple choice quiz. 00:06:46.069 --> 00:06:47.370 And I learned it in two hours. 00:06:47.509 --> 00:06:49.591 So it's democratization of information. 00:06:49.672 --> 00:06:50.192 It's wild. 00:06:50.312 --> 00:06:52.375 We are living in an age where knowledge 00:06:52.475 --> 00:06:53.415 is democratized. 00:06:53.435 --> 00:06:54.617 It's free, almost free. 00:06:55.117 --> 00:06:56.338 you just have to be a smart consumer 00:06:56.358 --> 00:06:59.701 so go to see a master website download 00:06:59.721 --> 00:07:01.141 those documents and ask chad gpt to 00:07:01.161 --> 00:07:03.903 summarize it for you step one step two 00:07:03.983 --> 00:07:05.704 look into your existing infrastructure are 00:07:05.745 --> 00:07:08.466 you ready to create a checklist create 00:07:08.487 --> 00:07:10.009 like go through the same chad gpt 00:07:10.028 --> 00:07:11.610 conversation and say what do i need to 00:07:12.029 --> 00:07:15.233 do exactly what i run an outpatient 00:07:15.252 --> 00:07:16.853 physical therapy practice in arkansas 00:07:17.394 --> 00:07:19.435 what are my steps to participate in these 00:07:19.476 --> 00:07:20.276 risk-based models? 00:07:20.396 --> 00:07:21.317 Give me a checklist. 00:07:22.819 --> 00:07:24.120 Now you are an educated consumer. 00:07:24.141 --> 00:07:24.882 Now you're prepared. 00:07:25.062 --> 00:07:26.463 And then start checking off those boxes. 00:07:26.944 --> 00:07:28.144 The last part is really important too, 00:07:28.466 --> 00:07:29.245 checking off the boxes. 00:07:29.266 --> 00:07:29.947 Oh, for sure. 00:07:31.007 --> 00:07:32.189 We always want the brochure. 00:07:32.309 --> 00:07:33.209 Give me the checklist. 00:07:33.391 --> 00:07:34.250 I now feel safe. 00:07:35.295 --> 00:07:36.697 still need to act on it yeah i 00:07:36.716 --> 00:07:37.836 need you we need you to act on 00:07:37.857 --> 00:07:41.598 it you remember those days when dating was 00:07:41.619 --> 00:07:43.240 a thing right i remember that like i've 00:07:43.259 --> 00:07:44.761 been married for too long so my memory 00:07:44.800 --> 00:07:47.341 is very faint but uh you if you 00:07:47.401 --> 00:07:49.223 wanted uh somebody to respond to your 00:07:49.242 --> 00:07:50.244 phone call you have to make a phone 00:07:50.283 --> 00:07:50.444 call 00:07:51.244 --> 00:07:52.644 um so you you have to be the 00:07:52.745 --> 00:07:54.146 one taking the initiative and you have to 00:07:54.165 --> 00:07:56.706 be prepared so if you're gonna want to 00:07:56.747 --> 00:07:58.728 future proof yourself then start 00:07:58.788 --> 00:08:01.110 acknowledging that where your shortcomings 00:08:01.269 --> 00:08:03.790 are and protect yourself from them yeah uh 00:08:03.810 --> 00:08:05.932 what do you think of the room uh 00:08:05.992 --> 00:08:07.392 in terms of who's in it being this 00:08:07.413 --> 00:08:09.915 your first uh gram sessions and it's hard 00:08:09.954 --> 00:08:11.136 to see everybody right we're just seeing 00:08:11.156 --> 00:08:14.577 people walk around um but there's business 00:08:15.478 --> 00:08:16.819 There's academia. 00:08:16.939 --> 00:08:18.281 There's small clinic owners. 00:08:18.300 --> 00:08:19.122 There's large clinic owners. 00:08:19.141 --> 00:08:20.122 There's product companies. 00:08:20.723 --> 00:08:21.223 Who else? 00:08:21.343 --> 00:08:22.545 You mentioned PTAs. 00:08:22.584 --> 00:08:23.786 You mentioned digital health. 00:08:24.807 --> 00:08:26.168 Who else needs to be in that room? 00:08:26.649 --> 00:08:28.149 I mean, peers need to be here. 00:08:28.290 --> 00:08:29.512 Why would they come? 00:08:31.814 --> 00:08:33.255 We're assuming that peers is one 00:08:33.296 --> 00:08:35.418 homogenous system. 00:08:35.677 --> 00:08:36.779 It's a heterogeneous system. 00:08:36.820 --> 00:08:38.761 There's parts of peer ecosystem, 00:08:38.841 --> 00:08:40.323 there's parts of their ecology that is 00:08:40.364 --> 00:08:41.465 interested in what we're doing. 00:08:41.664 --> 00:08:41.985 Really? 00:08:42.105 --> 00:08:43.466 They're just getting this information 00:08:43.486 --> 00:08:45.168 through a secondary resources and tertiary 00:08:45.188 --> 00:08:45.649 resources. 00:08:46.049 --> 00:08:46.730 Why not be here? 00:08:46.770 --> 00:08:48.331 Why not extend the invitation and see what 00:08:48.912 --> 00:08:49.152 will come? 00:08:49.172 --> 00:08:50.253 We don't extend the invitation. 00:08:50.273 --> 00:08:51.193 That's what Lincoln would do. 00:08:51.214 --> 00:08:52.554 We're looking at the Lincoln Monument over 00:08:52.575 --> 00:08:53.455 there, right over the hill. 00:08:53.695 --> 00:08:54.515 That's what Lincoln would do. 00:08:54.535 --> 00:08:55.336 Extend the invitation. 00:08:55.356 --> 00:08:56.397 There's no enemies here, right? 00:08:56.417 --> 00:08:57.998 We're looking at the same picture from 00:08:58.057 --> 00:08:59.799 different vantage points and expecting 00:08:59.860 --> 00:09:00.460 different results. 00:09:00.519 --> 00:09:01.260 It's not going to happen. 00:09:01.801 --> 00:09:03.062 So, yeah, start the conversation. 00:09:03.162 --> 00:09:04.902 Start the conversation that's not haggling 00:09:05.001 --> 00:09:05.682 over prices, 00:09:06.062 --> 00:09:07.322 because that's already step three. 00:09:07.383 --> 00:09:08.543 You're haggling over prices, 00:09:08.563 --> 00:09:10.284 but you haven't established ground truths. 00:09:11.304 --> 00:09:13.206 Get them here to establish ground truths. 00:09:13.245 --> 00:09:15.486 Get somebody who has knowledge of payer 00:09:15.527 --> 00:09:15.886 sources. 00:09:16.006 --> 00:09:16.226 Right now, 00:09:16.246 --> 00:09:18.028 we're talking about payer sources from a 00:09:18.067 --> 00:09:19.908 consumer side only. 00:09:19.948 --> 00:09:21.649 So are you really getting an equal 00:09:21.830 --> 00:09:22.669 representation here? 00:09:22.889 --> 00:09:23.129 Yeah. 00:09:23.149 --> 00:09:24.831 The thing that frustrated me sometimes 00:09:24.871 --> 00:09:27.855 with people is we're very people-y. 00:09:27.875 --> 00:09:29.975 My first Grime Sessions was ten years ago. 00:09:31.337 --> 00:09:33.219 And then I went back a year. 00:09:33.259 --> 00:09:34.461 So I did it in twenty sixteen, 00:09:34.480 --> 00:09:35.761 twenty seventeen, or twenty seven, 00:09:35.782 --> 00:09:36.763 twenty eighteen, whatever it was. 00:09:37.342 --> 00:09:38.663 And the problem was we were talking about 00:09:38.683 --> 00:09:40.025 the same thing the second time. 00:09:40.285 --> 00:09:42.086 And I don't have patience. 00:09:42.207 --> 00:09:43.107 You and I are right now in the 00:09:43.148 --> 00:09:44.929 hallway while the talk is going on. 00:09:44.950 --> 00:09:45.990 You and I are like, got it. 00:09:46.150 --> 00:09:46.892 I'm going to be outside. 00:09:46.932 --> 00:09:47.591 I need to walk around. 00:09:47.611 --> 00:09:48.773 I need to touch some grass. 00:09:49.714 --> 00:09:51.537 um why do we fail to do that 00:09:51.657 --> 00:09:53.840 sometimes well jimmy i i've been a 00:09:53.860 --> 00:09:56.043 physical therapist for i've been talking 00:09:56.884 --> 00:10:03.453 about the value we've been talking about 00:10:03.855 --> 00:10:05.817 identity this is not a new conversation 00:10:06.278 --> 00:10:07.557 it's funny because i come in and i 00:10:07.577 --> 00:10:09.318 go this is all so new and then 00:10:09.458 --> 00:10:11.200 yeah three six nine years later i'm like 00:10:11.320 --> 00:10:13.659 oh same thing yeah it's it it is 00:10:13.700 --> 00:10:15.280 the same thing there's it's almost 00:10:15.301 --> 00:10:17.360 ridiculous how reproducible this is and i 00:10:17.380 --> 00:10:19.081 fully expect in twenty twenty six twenty 00:10:19.101 --> 00:10:21.423 twenty seven uh nothing changes when 00:10:21.462 --> 00:10:23.822 nothing changes so and and we're in that 00:10:24.023 --> 00:10:25.823 same perpetual cycle of nothing changing 00:10:25.964 --> 00:10:27.845 yeah so and then we have agents of 00:10:27.884 --> 00:10:29.145 change so we have people calling for 00:10:29.166 --> 00:10:30.547 change but just calling for change without 00:10:30.567 --> 00:10:32.467 actually that's what it felt like it felt 00:10:32.508 --> 00:10:34.849 like what do we want change when do 00:10:34.869 --> 00:10:36.429 we want it now how will we get 00:10:36.490 --> 00:10:38.691 it someone else or i already did my 00:10:38.730 --> 00:10:40.451 part i said what should be changed but 00:10:40.812 --> 00:10:44.634 people are people are out there in clinics 00:10:44.693 --> 00:10:46.754 or satisfying right like you we want to 00:10:46.794 --> 00:10:48.816 maximize because ideally we want it all 00:10:48.917 --> 00:10:50.496 right but it's not a binary it's a 00:10:50.537 --> 00:10:50.878 spectral 00:10:51.658 --> 00:10:53.239 thing so you you have to satisfy so 00:10:53.259 --> 00:10:54.960 you have to accept suboptimal change but 00:10:55.000 --> 00:10:56.900 change is gonna come regardless whether 00:10:56.921 --> 00:10:57.741 you want it or not you can just 00:10:57.761 --> 00:10:59.143 drive the direction of change to a certain 00:10:59.182 --> 00:11:01.063 degree yeah do you remember that simpsons 00:11:01.104 --> 00:11:03.946 episode when uh homer or the mayor mayor 00:11:03.985 --> 00:11:05.966 was running for re-election and he came in 00:11:05.986 --> 00:11:07.327 the balcony and he said like all right 00:11:07.927 --> 00:11:10.429 people of springfield uh abortions for all 00:11:10.750 --> 00:11:12.510 and people were like boo and then he's 00:11:12.530 --> 00:11:13.390 like all right people never mind them 00:11:13.871 --> 00:11:15.793 abortions for none and they're like boo 00:11:16.432 --> 00:11:19.115 abortions for some yeah everything's man 00:11:19.174 --> 00:11:20.956 Yeah, it is, it is. 00:11:20.976 --> 00:11:21.717 You just expect, 00:11:22.418 --> 00:11:23.179 if you want to be the agent of 00:11:23.220 --> 00:11:23.440 change, 00:11:23.460 --> 00:11:24.620 you have to be the active ingredient. 00:11:24.660 --> 00:11:26.003 You have to drive energy into it. 00:11:27.004 --> 00:11:29.125 I've got a social experiment going on that 00:11:29.186 --> 00:11:30.827 I thought would have some reaction, 00:11:30.908 --> 00:11:32.529 and it turned out having no reaction. 00:11:32.870 --> 00:11:33.811 I'll talk to you about it. 00:11:34.744 --> 00:11:36.544 What I needed to do was go further 00:11:36.565 --> 00:11:37.466 with this, and I will. 00:11:37.546 --> 00:11:39.126 So I dropped this in a Facebook group 00:11:39.147 --> 00:11:41.828 that, are you in Tony's Facebook group? 00:11:42.109 --> 00:11:42.788 I'll get you in there. 00:11:43.809 --> 00:11:45.591 It's meant to be a bunch of people 00:11:45.610 --> 00:11:47.272 looking to create content, 00:11:48.092 --> 00:11:49.153 alternative revenue streams for 00:11:49.274 --> 00:11:49.653 practitioners. 00:11:49.874 --> 00:11:50.855 What it's turned into, 00:11:51.294 --> 00:11:52.655 a bunch of people trying to solve problems 00:11:52.676 --> 00:11:53.716 different ways, which I like. 00:11:54.317 --> 00:11:55.337 Tony Meritato, 00:11:55.437 --> 00:11:57.899 my normal co-host on our livestream, 00:11:58.820 --> 00:12:00.441 he tries to solve a thing a thousand 00:12:00.461 --> 00:12:03.081 different ways tony tries to fail as fast 00:12:03.121 --> 00:12:04.602 as possible which is good so i dropped 00:12:04.623 --> 00:12:06.024 this little social experiment i'm calling 00:12:06.083 --> 00:12:08.065 ninety nine problems pt edition and the 00:12:08.144 --> 00:12:09.885 idea was um 00:12:11.034 --> 00:12:13.756 We can't usually change the big thing 00:12:13.797 --> 00:12:14.957 first, right? 00:12:14.998 --> 00:12:16.278 Knock down a small domino, 00:12:16.340 --> 00:12:17.460 it'll loop to a second, third, 00:12:17.480 --> 00:12:18.500 then you get bigger. 00:12:19.501 --> 00:12:20.423 So my thing was, 00:12:20.503 --> 00:12:21.663 this came from an idea, 00:12:21.764 --> 00:12:24.225 I saw a guy talking in his community 00:12:25.287 --> 00:12:26.868 about medium problems. 00:12:27.369 --> 00:12:28.610 Medium problems are, 00:12:29.090 --> 00:12:30.971 first we need to describe large and small 00:12:31.032 --> 00:12:31.412 problems. 00:12:31.591 --> 00:12:32.393 Small problems are, 00:12:32.653 --> 00:12:33.974 you come out of your house and someone 00:12:33.994 --> 00:12:35.316 just left a bag of trash there. 00:12:36.840 --> 00:12:37.541 I just throw it away. 00:12:37.740 --> 00:12:39.121 I don't call the cops. 00:12:39.663 --> 00:12:40.263 I'll solve it. 00:12:40.283 --> 00:12:40.783 It's stupid. 00:12:40.803 --> 00:12:41.884 It's rude, but I'll just solve it. 00:12:42.044 --> 00:12:43.726 Big problems are someone drives a dumb 00:12:43.767 --> 00:12:46.429 truck through City Hall. 00:12:46.950 --> 00:12:47.551 That's big. 00:12:48.350 --> 00:12:49.832 The town is going to take care of 00:12:49.852 --> 00:12:50.013 that. 00:12:50.394 --> 00:12:52.375 The medium-sized problems are like it's 00:12:52.436 --> 00:12:53.576 too big for one person, 00:12:53.697 --> 00:12:56.659 but not big enough to ever hit the 00:12:56.700 --> 00:12:59.442 number one list on the town. 00:13:00.495 --> 00:13:02.898 So he gave an example of how they 00:13:02.937 --> 00:13:04.119 solved medium problems. 00:13:04.139 --> 00:13:04.619 And he's like, 00:13:04.940 --> 00:13:06.640 I'm giving you an example that you should 00:13:06.681 --> 00:13:07.942 take to other places. 00:13:08.062 --> 00:13:10.806 So the medium example was there were parts 00:13:11.206 --> 00:13:13.688 of the city infrastructure like sidewalks 00:13:13.889 --> 00:13:15.429 in neighborhoods that were just overgrown. 00:13:16.250 --> 00:13:17.351 It's not really big enough. 00:13:17.371 --> 00:13:18.173 It's not causing a fire. 00:13:18.192 --> 00:13:19.033 It's not causing a flood. 00:13:19.053 --> 00:13:20.034 So the town's not going to take care 00:13:20.054 --> 00:13:20.195 of it. 00:13:20.635 --> 00:13:22.798 But uncovering a sidewalk. 00:13:23.186 --> 00:13:24.067 is like a pain in the ass for 00:13:24.167 --> 00:13:24.626 one person. 00:13:24.667 --> 00:13:25.126 So he's like, 00:13:25.768 --> 00:13:26.847 we got a group of three people, 00:13:27.087 --> 00:13:28.489 and the three people all brought a friend, 00:13:28.548 --> 00:13:29.309 and now it's six. 00:13:29.809 --> 00:13:30.630 And then we did it, 00:13:31.030 --> 00:13:31.831 and while we were doing it, 00:13:31.850 --> 00:13:32.652 we shot a video, 00:13:33.032 --> 00:13:34.052 and then ten people were like, 00:13:34.092 --> 00:13:34.952 where's your next one? 00:13:35.033 --> 00:13:35.494 Next thing you know, 00:13:35.514 --> 00:13:36.293 you've got thirty people. 00:13:36.394 --> 00:13:37.514 So that was one problem. 00:13:37.934 --> 00:13:40.856 So the idea is, you've now got experience, 00:13:41.096 --> 00:13:41.918 you've got people who are like, 00:13:42.097 --> 00:13:42.837 that wasn't that hard, 00:13:43.318 --> 00:13:45.059 and there's more than one person, 00:13:45.440 --> 00:13:46.561 and now you've got cred. 00:13:47.341 --> 00:13:48.260 So this is one of the things he 00:13:48.280 --> 00:13:48.780 was talking about, 00:13:48.821 --> 00:13:51.302 the important aspects of what maybe talk 00:13:51.322 --> 00:13:53.582 about this was now you're like, 00:13:53.682 --> 00:13:54.763 we solve problems. 00:13:54.783 --> 00:13:55.962 So the next time you go to solve 00:13:56.023 --> 00:13:56.604 a problem, you're like, 00:13:57.043 --> 00:13:59.724 I have a resume of problems solved. 00:13:59.764 --> 00:14:00.644 I solved this little one, 00:14:00.745 --> 00:14:01.945 then a bigger one, then a bigger one. 00:14:02.205 --> 00:14:02.725 So I said, 00:14:02.764 --> 00:14:04.046 could we take this to PT? 00:14:04.505 --> 00:14:06.745 What are the ninety nine problems? 00:14:06.905 --> 00:14:08.586 Let's rank them small to big. 00:14:08.947 --> 00:14:10.527 And then who wants to help me help 00:14:10.547 --> 00:14:12.508 me solve the smallest one? 00:14:12.947 --> 00:14:14.587 And we don't move on until we solve 00:14:14.628 --> 00:14:15.548 the smallest one. 00:14:15.948 --> 00:14:16.249 And then. 00:14:16.928 --> 00:14:18.249 We solved the next biggest one. 00:14:18.288 --> 00:14:19.009 But along the way, 00:14:19.029 --> 00:14:20.710 we picked up three or four more people 00:14:20.750 --> 00:14:22.210 who were like, I'll solve that problem. 00:14:22.410 --> 00:14:24.270 And now you've got a team who are 00:14:24.311 --> 00:14:25.971 now skilled at problem solving. 00:14:26.831 --> 00:14:28.331 They have a variety of skill sets and 00:14:28.371 --> 00:14:28.951 experience. 00:14:29.533 --> 00:14:30.893 The problem was, Alex, 00:14:30.952 --> 00:14:31.712 I put this post in. 00:14:31.773 --> 00:14:34.173 I said, help me figure out the problems. 00:14:34.974 --> 00:14:36.333 Nobody suggested one problem. 00:14:36.474 --> 00:14:37.394 So you have to remember, 00:14:37.434 --> 00:14:37.975 there's a couple of... 00:14:38.674 --> 00:14:39.596 problems with your problem. 00:14:39.816 --> 00:14:40.296 Okay. 00:14:40.716 --> 00:14:41.898 I can't figure out what it is because 00:14:41.937 --> 00:14:42.498 I thought it was cool. 00:14:42.618 --> 00:14:44.120 A problem with your problem is that 00:14:44.159 --> 00:14:45.279 there's a selection bias. 00:14:45.299 --> 00:14:46.701 People who will react to that post are 00:14:46.721 --> 00:14:48.082 the people that are already problem 00:14:48.102 --> 00:14:48.243 solvers. 00:14:48.263 --> 00:14:48.903 You're probably right. 00:14:49.283 --> 00:14:49.903 Yes, yes. 00:14:49.923 --> 00:14:50.544 So you're not asking, 00:14:50.764 --> 00:14:52.326 like the problem solvers are the ones that 00:14:52.365 --> 00:14:53.647 will get a reaction out of it and 00:14:53.667 --> 00:14:55.128 the ones that actually do need to be 00:14:55.148 --> 00:14:56.369 the ones for solving problems are not the 00:14:56.409 --> 00:14:57.470 ones that are reacting. 00:14:57.509 --> 00:14:58.191 Yeah, I felt that trap. 00:14:58.490 --> 00:15:00.572 right right so the second one is like 00:15:00.653 --> 00:15:02.333 you're discussing thresholds right the 00:15:02.433 --> 00:15:04.576 threshold for change there's a really good 00:15:04.596 --> 00:15:06.457 book it's called cascades uh and the 00:15:06.477 --> 00:15:09.000 gentleman is a journalist and a uh i 00:15:09.019 --> 00:15:11.461 think political scientist but uh the point 00:15:11.481 --> 00:15:13.283 is he looks into the these environmental 00:15:13.302 --> 00:15:15.565 cascades that that are agents for change 00:15:15.605 --> 00:15:17.826 so essentially it's not linear uh change 00:15:17.866 --> 00:15:19.908 right and he talks about the eastern 00:15:19.967 --> 00:15:21.570 europe when the soviet bloc fell through 00:15:22.269 --> 00:15:23.811 and it didn't happen right away but 00:15:23.850 --> 00:15:25.390 initially there was a little protest and 00:15:25.410 --> 00:15:28.072 it was people who left then there was 00:15:28.091 --> 00:15:29.712 a little bit bigger protest and then the 00:15:29.753 --> 00:15:31.413 police instead of just letting people 00:15:31.432 --> 00:15:33.333 protest started reacting which caused even 00:15:33.354 --> 00:15:34.874 bigger changes so the cascade is that 00:15:34.994 --> 00:15:37.634 non-linear amplification of a response 00:15:37.654 --> 00:15:39.716 like a hockey stick until the certain and 00:15:39.735 --> 00:15:41.596 the threshold is past a certain threshold 00:15:41.616 --> 00:15:44.157 the cascade turns into change so what is 00:15:44.277 --> 00:15:46.057 the better question would be here is what 00:15:46.118 --> 00:15:48.158 is the threshold of stress on the system 00:15:48.999 --> 00:15:50.120 for the change to occur. 00:15:50.541 --> 00:15:52.182 When is our community going to be right 00:15:52.201 --> 00:15:52.722 at that point? 00:15:52.763 --> 00:15:54.625 We're going to be like, that's it. 00:15:54.664 --> 00:15:55.765 We have to do something different. 00:15:55.885 --> 00:15:56.605 We're not there yet. 00:15:56.645 --> 00:15:56.947 Right now, 00:15:56.966 --> 00:15:58.008 we're still talking about problems. 00:15:58.028 --> 00:15:59.109 We're not talking about solutions because 00:15:59.129 --> 00:16:00.549 we're not at that threshold of change. 00:16:00.610 --> 00:16:01.510 It's not scary enough? 00:16:01.951 --> 00:16:02.792 It's not pressing enough? 00:16:02.812 --> 00:16:03.352 It could be scary, 00:16:03.552 --> 00:16:04.673 but we're okay with scaries, right? 00:16:05.054 --> 00:16:06.995 Scary is not actionable. 00:16:07.356 --> 00:16:09.099 Actionable is when I actually don't have 00:16:09.399 --> 00:16:10.480 Brad to feed my family. 00:16:10.919 --> 00:16:11.780 Then it becomes actionable. 00:16:11.801 --> 00:16:12.400 So when you, 00:16:12.780 --> 00:16:15.482 there was scary that was actionable was in 00:16:15.503 --> 00:16:17.024 two thousand two when Medicare came up 00:16:17.043 --> 00:16:18.804 with a cap and fifty percent of physical 00:16:18.826 --> 00:16:19.745 therapists lost their jobs. 00:16:20.346 --> 00:16:21.967 All of a sudden that was scary because 00:16:21.988 --> 00:16:22.947 you are not employable. 00:16:23.408 --> 00:16:25.129 You have your student loans and you have 00:16:25.149 --> 00:16:25.730 to pay for them. 00:16:26.390 --> 00:16:27.490 That is actually actionable. 00:16:27.591 --> 00:16:28.711 That's when change occurred. 00:16:28.792 --> 00:16:30.173 If you look at the fundamental change in 00:16:30.212 --> 00:16:32.153 our profession early two thousands was 00:16:32.215 --> 00:16:32.495 good. 00:16:32.794 --> 00:16:34.336 Like we made a lot of positive change 00:16:34.836 --> 00:16:35.797 and then become complacent. 00:16:35.817 --> 00:16:35.996 Right. 00:16:36.216 --> 00:16:37.258 Then we have bread on the table. 00:16:37.337 --> 00:16:37.577 Right. 00:16:37.618 --> 00:16:38.438 I'm not hungry anymore. 00:16:38.578 --> 00:16:38.698 So. 00:16:38.999 --> 00:16:39.759 Oh, the line like, 00:16:39.820 --> 00:16:41.480 hard times create hard men, 00:16:41.520 --> 00:16:42.740 hard men create easy times, 00:16:42.821 --> 00:16:44.602 easy times create easy men. 00:16:44.923 --> 00:16:45.523 Now it's a cycle. 00:16:45.682 --> 00:16:46.384 That fable, right? 00:16:46.423 --> 00:16:47.804 Like it went to war, like came back. 00:16:48.065 --> 00:16:50.365 There's an entire Chinese fable that goes 00:16:50.405 --> 00:16:50.785 into that. 00:16:50.826 --> 00:16:51.927 Like each step of the cycle, 00:16:51.947 --> 00:16:52.947 there's a positive and a negative. 00:16:53.467 --> 00:16:55.428 But yeah, we're not there yet. 00:16:55.448 --> 00:16:56.710 So we're still just discussing this 00:16:56.750 --> 00:16:56.990 change. 00:16:57.009 --> 00:16:58.010 And we have been for years. 00:16:58.230 --> 00:16:58.530 Yeah. 00:17:00.172 --> 00:17:02.293 i foresee that the way the government is 00:17:02.313 --> 00:17:04.435 looking at our utilization matrix is 00:17:04.455 --> 00:17:06.397 they're going to try to cap our 00:17:06.438 --> 00:17:08.138 environment and we have a potential of 00:17:08.159 --> 00:17:10.721 becoming a very niche fringe industry 00:17:11.281 --> 00:17:12.903 unless we change and part of it is 00:17:12.942 --> 00:17:14.545 what we discussed about this risk-based 00:17:14.565 --> 00:17:15.625 contracts but part of it is 00:17:16.306 --> 00:17:18.067 just identifying that what you're doing is 00:17:18.087 --> 00:17:20.108 not good enough yet like it's it's good 00:17:20.128 --> 00:17:22.691 enough for you to satisfy the bare minimum 00:17:22.891 --> 00:17:24.932 now yeah when that changes you're in 00:17:24.992 --> 00:17:26.433 trouble unless you're prepared but the 00:17:26.453 --> 00:17:28.015 threshold of failure is based on your 00:17:28.115 --> 00:17:29.876 ability to handle the stress right like 00:17:30.076 --> 00:17:33.660 your your business resilience is dependent 00:17:33.720 --> 00:17:35.641 not on your execution right now it's 00:17:35.821 --> 00:17:38.163 dependent on how tolerant are you to when 00:17:38.182 --> 00:17:39.443 you fifty percent of your patient volume 00:17:39.463 --> 00:17:39.904 disappears 00:17:40.285 --> 00:17:42.506 can you still keep the doors open right 00:17:42.526 --> 00:17:43.705 or if the peers are going to turn 00:17:43.726 --> 00:17:44.906 away and say that you know we're just 00:17:44.926 --> 00:17:45.826 going to discount you another fifty 00:17:45.866 --> 00:17:47.267 percent and you're accepting these 00:17:47.287 --> 00:17:49.428 payments can you maintain that well and i 00:17:49.448 --> 00:17:51.288 think you can still operationalize it but 00:17:51.308 --> 00:17:52.769 are you ready i do you have these 00:17:52.949 --> 00:17:55.450 uh contingency plans and you're and you're 00:17:55.470 --> 00:17:58.010 prepared to until you're not and then you 00:17:58.030 --> 00:17:59.612 might not know what that point is but 00:17:59.632 --> 00:18:00.932 you'll know it when you get there the 00:18:00.991 --> 00:18:03.512 known unknowns and the unknown yeah like 00:18:03.532 --> 00:18:05.933 yeah so these are known unknowns but you 00:18:05.953 --> 00:18:07.273 have to protect yourself from unknown 00:18:07.334 --> 00:18:08.414 unknowns you have to have enough of a 00:18:08.494 --> 00:18:08.815 buffer 00:18:09.375 --> 00:18:10.816 That allows you to be more resilient to 00:18:10.836 --> 00:18:11.355 these changes. 00:18:11.576 --> 00:18:11.756 Yeah. 00:18:11.776 --> 00:18:12.717 All right. 00:18:12.737 --> 00:18:13.977 We're doing quick live streams. 00:18:14.897 --> 00:18:15.938 And every episode we have, 00:18:15.978 --> 00:18:17.398 we do something called the parting shot. 00:18:17.419 --> 00:18:20.480 This is the parting shot. 00:18:21.020 --> 00:18:22.422 One last mic drop moment. 00:18:23.082 --> 00:18:23.903 No pressure. 00:18:24.343 --> 00:18:26.443 Just your legacy on the line. 00:18:27.761 --> 00:18:27.942 All right. 00:18:27.981 --> 00:18:28.522 Parting shot. 00:18:28.542 --> 00:18:29.943 What do you want to leave with people? 00:18:29.963 --> 00:18:32.365 What's what's either words of scary or 00:18:32.424 --> 00:18:33.905 words of encouragement? 00:18:34.086 --> 00:18:35.146 Which way are we going to go? 00:18:35.166 --> 00:18:36.228 Oh, this is a huge opportunity. 00:18:36.807 --> 00:18:38.068 It has been a huge opportunity. 00:18:38.128 --> 00:18:39.309 I think now we just have to seize 00:18:39.329 --> 00:18:39.931 that opportunity. 00:18:40.330 --> 00:18:41.571 We have a chance that there's still 00:18:41.932 --> 00:18:43.192 probably fifty percent of the market has 00:18:43.212 --> 00:18:44.594 not been captured by anyone. 00:18:45.875 --> 00:18:47.115 Digital health providers came in and 00:18:47.155 --> 00:18:48.896 captured some parts of that market and now 00:18:48.916 --> 00:18:50.178 they have billion dollar valuation. 00:18:50.577 --> 00:18:51.699 and that's not even half of the market 00:18:51.719 --> 00:18:52.819 that's available if you look at the 00:18:52.900 --> 00:18:54.721 overall economic cost of musculoskeletal 00:18:54.740 --> 00:18:56.863 problems in a society it's a trillion 00:18:56.883 --> 00:18:59.345 dollar venture and we're capturing sixty 00:18:59.365 --> 00:19:02.046 five billion of it right uh so so 00:19:02.086 --> 00:19:04.989 the people who risk or the people who 00:19:05.108 --> 00:19:06.849 do the work who follow the last step 00:19:06.869 --> 00:19:08.651 give me the help me understand give me 00:19:08.671 --> 00:19:10.972 the checklist and follow the checklist 00:19:11.353 --> 00:19:13.234 will be the people who people there were 00:19:13.275 --> 00:19:15.375 the people are going to capture the other 00:19:15.977 --> 00:19:17.377 one billion dollars or one trillion 00:19:17.417 --> 00:19:17.698 dollars 00:19:18.038 --> 00:19:19.921 wow that is like it's it's just an 00:19:19.941 --> 00:19:22.265 immense financial and economic opportunity 00:19:22.926 --> 00:19:24.809 for those that are prepared yeah all right 00:19:24.890 --> 00:19:26.392 alex live from uh graham sessions 00:19:26.432 --> 00:19:28.095 appreciate your time thanks for doing this 00:19:28.395 --> 00:19:30.479 on your very first graham sessions amen 00:19:30.578 --> 00:19:31.019 thanks for being 00:19:32.405 --> 00:19:33.467 That's it for this one, 00:19:33.747 --> 00:19:35.409 but we're just getting warmed up. 00:19:35.888 --> 00:19:37.810 Smash follow, send it to a friend, 00:19:38.010 --> 00:19:39.672 or crank up the next episode. 00:19:40.192 --> 00:19:41.173 Want to go deeper? 00:19:41.574 --> 00:19:45.597 Hit us at pgpinecast.com or find us on 00:19:45.657 --> 00:19:48.180 YouTube and socials at pgpinecast. 00:19:48.619 --> 00:19:50.902 And legally, none of this was advice. 00:19:50.981 --> 00:19:52.703 It's for entertainment purposes only. 00:19:52.743 --> 00:19:54.365 Bullshit! 00:19:54.384 --> 00:19:54.965 See, Keith? 00:19:55.185 --> 00:19:56.247 We read the script. 00:19:56.547 --> 00:19:57.188 Happy now?