I'm gonna power way too early from three
separate Wi-Fi connection.
It's PT Breakfast Club with Tony Meritato,
Dave Kittle, and Jimmy McKay.
All right, good Tuesday morning to you.
Welcome back to PT Breakfast Club,
where every week feels like Groundhog Day,
and yet somehow reimbursement gets worse.
You figure if it was the same thing
over and over again,
it would just stay the same,
but it's not.
The Groundhog popped up this week.
I think we've got six more weeks of
low reimbursement.
Of course we do.
We've got six more generations.
Only if you choose lower reimbursement.
Ah, we'll get into that.
The Groundhog did pop up this week and
saw its shadow.
That's a bummer.
Which means six more weeks of prior auth
denials and Medicare audits.
See,
that's where I was going with the intro.
uh but we got the fire to warm
you up today i'm going to pitch an
idea so wild it just might work to
you this is a real idea i had
a conversation with someone in our
profession who's doing something outside
the box i'll pitch it to you tell
me where it sinks and where it fails
um you'll hear the pitch and then i
want you to judge it live plus we
got a hot proposal to shorten the dbt
degree i talked to larry ben's john
child's
and tim flynn yesterday i'll drop that
episode later today but i want to discuss
that a little bit uh plus some slippery
stare espn strategy stealing and a clinic
owner wondering if diagnostic tools are
innovation or just burnout with bluetooth
today we do want to thank our newest
sponsor this is going to be exciting if
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All events supervised by licensed PTs and
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Stairmaster Showdown will be on ESPN The
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It's not just a fall risk.
It's a ratings opportunity.
This inspired by something I'll talk about
in just a little bit.
But first, this one's big.
They're calling it back to the future.
Tim Flynn, John Childs,
and Larry Benz dropped a bomb just last
week.
Five-year DPT pathway to replace the
current model.
Why?
Debt is choking the profession,
enrollment is falling,
and students are asking,
is this even worth it anymore?
You would think this is about academics,
and all these guys have touched academics,
but they're also looking at this from a
business lens, which is,
if there are less workers to do the
thing,
organizations aren't going to be able to
do the thing.
So as much as we think we can
say academics is this isolated ivory
tower, like no.
So do you think a shorter DPT bath
would actually help or would it cheapen
the degree?
Like, I don't know.
What are your thoughts on that?
They have an entire structure ready for
this thing.
I think it would help.
And I think they have the resources to
make it happen.
Like we can say it as much as
we want.
It doesn't matter.
They actually have the levers to pull.
You got three guys who are in academics
industry.
I remember I said this, I think,
during the interview I recorded yesterday
that I will drop later on today that
I was doing interviews.
I think my first or second CSM.
And I remember John Childs walked by and
there was a big group around him.
And I was, of course, like,
I don't know who's that dude.
I'm a student.
And they're like, that's John Childs.
Don't talk to him.
He does weird stuff.
And in my brain, I go, cool.
That makes me want to talk to him.
And I was like, what's the weird stuff?
And they're like,
he wants to try to shorten the school
from three years to two years.
And I was in my second or third
year.
And I was like,
that feels like a good idea because I'd
already be out of school by now.
They have this entire...
This is going to be a series of
articles.
They're going to lay this out.
But this is sort of what it looks
like.
And they've mapped it out.
I mean...
if you're going to go at Larry Benz
with a counter idea or why this won't
work, like be prepared.
Like dude comes with citations, receipts,
the entire, the whole night.
He even has, uh,
the return on investment is a point nine.
He said,
that's the worst professional collegiate
degree outside of a few.
He didn't want to name them.
I would like theology,
like gets like a lower ROI,
but you kind of don't do it in
a theology to make bank.
I mean, I guess you could, um,
what do we lose if we cut a
year off of it if any i don't
know even some of the academics were like
i don't know not a whole lot but
what do we lose i mean you probably
you probably lose some of the advanced
stuff like pharmacology or maybe a little
less differential diagnosis or well you
you think all that's going to be in
the undergrad part or the how how much
how much can you fit in uh if
it so we're talking if if someone has
like the
they go to either the three year to
three year.
So then it would be five total or
it would be undergrad and then the three
year DPT.
So instead of three, it's two.
Yeah.
So they're saying like,
make it five years going straight through
it.
I'll bring that graphic back up.
I flicked it off.
Assuming,
assuming the student wants to commit and
make that decision when they're seventeen,
eighteen years old coming out of high
school, which is what I did.
But some people get into it and they're
like, oh, my gosh,
this is not what I thought it would
be.
So really,
really talking about is that really
talking about the DPT, the three year,
you know, over the summer,
like nonstop instead of that being three
years total, cutting it to two years.
Is that just to get clarity on where
we're
Correct.
Yeah.
Transitioning to three years of
undergraduate study,
two years of graduate work.
And you can see that in the bottom
there underneath the bridge.
This is infographic I made from Notebook
LM.
The reasoning being on the left,
enrollment is going down.
You're also going to see a,
what they call it, a demographics cliff.
There's just going to be less people of
college age,
nevermind what they're choosing.
There will be, there is a, you know,
we can track these things,
which I never thought about, right?
There's just going to be a bunch of
less, a group of less,
Less people coming.
So less people from the applicant pool to
even choose from.
Here's the best part.
If you see over on the right side,
just under five-year proposed pathway,
if you're watching a live stream,
this is successful in other countries.
Larry's even saying,
I'm not inventing this.
I'm just saying, hey, look at nursing.
Look at this.
Look at this country.
These things are being done successfully.
Yeah.
I think the position assistant degree is
two years.
Correct.
I was doing my lifeguarding as my
prerequisite when I was taking my prereqs
before between radio and PT school.
And I had lifeguard led Tower Forty-One in
North Myrtle Beach.
I remember there was a PA there and
his family renting a house for a week.
And the key was on Sunday, Monday,
when the people move in,
make friends and they bring you food and
snacks.
So I would make friends with people.
And he was like, what's your story, man?
And I'm like,
I'm going to be a physical therapist.
And he was like...
Be a PA.
One year less of school.
I'll hire you.
He's like, I'll hire you right now.
You're a hustler.
Have oversight forever.
Not be able to really open your practice
if you wanted to.
I mean, you can, but not easy.
Ben Wade in undergrad will have to be
willing to remove most of the BS fluff
core curriculum,
which should be all majors.
Yes.
Mary addressed this.
Can I just make a quick comment that,
you know,
I love anything that almost anything that
Larry puts out and I'm always going to
be receptive to it.
However,
we're talking about taking something
that's three years and cutting it down to
two years.
So we're talking about something that
people are paying for and it's
Are we also saying it's going to be
thirty three percent cheaper?
It's going to are we saying it's going
to be one third cheaper?
Do you think that do you think all
the DPT programs across the country are
going to with their committees and their
board meetings and all that and say,
all right, moving forward,
we're going to choose a route where we
now have thirty three percent less revenue
from our DPT students and our DPT program.
Do you think that that is what they
want?
Do you think that's what they care about?
Right.
Well, here's the problem.
And here's the lever that Larry mentions.
Because again,
these guys aren't looking at it in one
direction like me.
They're looking at it in three sixty
clinical sites.
So if industry starts saying, oh, yeah,
we can't hire anybody.
So we're going to start we're going to
stop taking clinical sites that you can't
graduate students.
So there are things that large
organizations and small organizations can
start to do.
Why would they have less clinical sites
because they can't hire?
They want that free labor as a DBT
student.
Even if I'm still taking the students,
and of course, yes,
we want this thing where everybody wins.
Schools are churning out great students.
There are clinical sites for them to
become great therapists.
But if there are less therapists,
what Larry is saying, and again,
they say it way better than me,
which is you would need coordination
between industry to say,
we now need to talk,
not schools and companies,
industry and academia.
We got to come to a table here
because we got a problem.
we're subsidizing your students or we're
not getting enough to actually run the
business.
There's not going to be a profession
anymore.
This was going to be a topic that
I talked about.
I think we sort of alluded to it.
Is there going to be a PT profession
in five, ten years?
I think I made a stupid remark about
this a year or two ago where I
go, what if you just Voltroned PT,
physiatry, OT, athletic training,
and you were like,
that's a rehab profession.
Voltron, whatever that is,
is that easier than it is these little
turf wars, right?
So what Larry's saying is we want to
have PT in a couple of years.
Like what if we just took the best
parts of all of them and mashed it
together?
So I don't know if I can answer
these questions,
but I'm going to bring Larry and John
and Tim back on the show a couple
of times.
Yeah.
I think there are a couple of interesting
elements here.
So to Dave's point,
I think Jimmy is saying the graduate
program would still be three years.
So you're not losing that tuition.
It's not going to be thirty three percent
cheaper because you're still keeping the
three years.
It's the undergrad programs that would be
giving up some of that time.
Now, I know when I went through school,
this was two thousand twenty three.
What made the decision for me was who
had the quickest path to graduation.
I applied to like five programs.
I think I got into three.
One of them had the quickest path,
and that's the one that I took.
I didn't take summer off.
I didn't waste time with other stuff.
But the other part,
Jimmy shared a post recently and I was
trying to think about this.
We were talking about like,
what's the one thing that can provide the
biggest impact to the profession moving
forward?
What do we have control over?
And I was like thinking to myself,
what if we just changed who we were
trying to bring into the profession?
What if we let go of this idea
that it's gotta be this kid in his
twenties who wants to help people
And we looked at people like us.
What if we looked at post-professional?
These are men and women who have already
achieved success.
Maybe their kids are out of the house.
They're looking for something to do.
What if we focused attracting fifty year
olds into the profession of physical
therapy?
They already have a bachelor's degree.
Most likely they already have some
post-secondary education.
We make the path easier.
And now they're coming in for a second
career.
And so I think that they don't have
the financial restrictions that a twenty
year old would have.
They've proven, you know,
that like they can do whatever they're
going to do.
It would change the culture of the
profession.
And I think it would bring a nuance
to it that we don't necessarily have right
now.
Just food for thought.
I like it.
I mean,
are you saying to clinicians or for owners
or just are you saying like that would
be the profession owners or clinicians,
not owners, staff, clinicians,
people who want to treat people who are
looking like, again, I am sitting here.
My youngest is in seventh grade.
within five years,
everybody's gonna be out of the house.
Now I have a business,
but if I didn't,
I'm gonna be looking for things to do.
And if I want a profession that I
take all of the good out of physical
therapy, I can interact, I can socialize,
I can make a change in somebody.
And I just don't have the financial
pressures.
I don't need to buy my first house.
I don't need to, I'm not going to,
we're not going to have more kids.
Like those are the things that are really
challenging for a younger person coming
into the profession that an older person
doesn't have.
I can't remember which one of the three
said it, but they said like,
why aren't we like, you know,
I think it was Tim was saying like,
we need to be recruiting bartenders.
Like we need retail and food service.
He's like, I, that, that can pass.
Amen.
He's like, the problem is you're,
you're recruiting people who then get out
and they're like,
I'd have no entrepreneurial or background
or desire.
And that's okay.
He's like,
but the problem is we need that or
we won't be a profession.
Dave, what were you going to say?
Historically,
the physical therapy degree and most other
degrees, it went from a I mean,
I'm sure at some point it was like
whatever, like a certificate or whatever.
And then eventually it became a bachelor's
degree.
And then in the maybe late nineties,
two thousands at some point in most of
the schools,
a transition from a bachelor's to a
master's.
And then in the in the two thousands
or the twenty tens,
there was kind of like this transition to
the degree.
And now are we so we're going to
retain the same terminal degree is what
we're talking about.
Right.
So it's still be the DPT,
but less but but less school,
but less schooling.
I just with with how universities and
institutions are.
Of course,
they want to keep the same tuition and
they'll say to us and they'll say to
Larry Benz and all that, sure,
we'll keep the same tuition and we'll make
it shorter because they actually will now
have more profit.
Their costs are already covered and
they're not going to ever, ever...
decrease tuition.
So let's talk about that.
If even if I was a new grad
coming in,
I got a option for a five year
terminal degree,
I get out a year or two sooner,
I start earning an income a year or
two sooner,
I will gladly pay the same tuition as
somebody who's going to sit in school for
seven years.
I don't care if it's not cheaper,
if I can get out two years quicker.
and start earning an income that will
raise the value of the degree so that
I will.
It's the same thing we talk about in
the clinic.
You get me into a clinic.
You make me better in ten minutes instead
of sixty minutes.
I will pay you the same rate as
the sixty minute therapist because I get
an extra fifty minutes of free time back.
Yeah, this just came to mind.
Who do we piss off when rehab aids
became a thing?
You know what I mean?
Who'd we unseat?
Nothing?
Were we a category creator?
There was nothing before Rehab Aids.
I don't think there was anything.
People just sat in hospital beds and
traction and it was bed rest.
The treatment was bed rest.
It's Reconstruction Aids.
That's what it was.
Sorry.
Reconstruction.
It's my bad.
I didn't know my history.
All right.
So listen to this.
This is a great forward tease.
Listen to the episode.
I'll drop that at noon today just after
we get off the air here.
And it's not going to be the last
time you're going to hear.
Larry's like,
this is going to be a five-part series.
And again, Larry,
it's not like he doesn't have any skin
in the game, but Larry's like,
he's moved on to dental.
And he's like,
I'm seeing the same problem in dental.
These are guys who don't have to be
solving this for their future.
They do not.
Like these guys are, they don't.
They're looking at this going, hey,
everybody.
These guys are the canaries in the coal
mine,
although these guys are not canaries.
What's a louder bird that is squawking and
warning us that stuff's going on?
An eagle or a hawk?
They're doing something,
but they're squawking.
But not as loud for this game.
Could you imagine?
Here's a revenue generator.
Want to thank Dodgeball for discharges for
sponsoring the show.
The new gold standard and PT discharge
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Forget subjective reports or functional
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cue up some limp biscuit and throw them
into a dodge ball arena to see if
they're ready for return to life.
Reactive agility,
check cardiovascular capacity,
check emotional processing from their
middle school trauma.
Remains to be seen.
Dodgeball for discharges because if they
dodge a ball,
they can probably navigate a Costco
parking lot.
Dodgeball for discharges.
All these are inspired by something I'll
talk about a little bit.
So here's the pitch that I teased.
I won't say the name of it yet,
but I had this conversation with this.
I like him.
I don't know.
We just met this young PT.
The organization wants to standardize MSK
testing.
Essentially, they want to become...
I'll say the name at the end.
I'm pitching a business on their behalf.
I'm going to throw it down Shark Tank
style-ish.
And then you tell me like,
I don't know if I see it or
whatever.
So this organization wants to standardize
MSK testing,
essentially become the quest diagnostics
of PT.
Instead of you having to have all these
crazy force plates or whatever in your lab
and then know how to use them,
This would be, in my mind,
it had to be city-based because you'd have
to have enough clinics.
You would pay a yearly fee and then
you would send all appropriate evals for
this lab testing.
And then the people there would be trained
in how to actually get that.
The report would be sent back to you
as the PT.
And you would then read the results and
then plan accordingly.
You refer patients,
they do the testing protocol,
send back a clean report, objective data,
third-party testing,
insurance-friendly formats.
So is this a good idea, bad idea?
I believe the cost was between ten and
twelve thousand dollars per clinic per
year.
So you're paying a thousand dollars a
month to send as many patients as you
want right now because they just want as
many people through the door.
I imagine this would change like there'll
be a cap on it or it would
go to per
per clinician per patient pricing but it's
called uh movique is the thing are you
gonna pull something up yeah you're gonna
you're gonna you're gonna show us i don't
know i don't know what we're talking about
here like what's what what's what's the
idea what's the idea i woke up this
morning that's vala nyquil the fact that
i'm still remaining vertical is beyond me
right at this point so it's called movique
essentially it's a clinical
biomechanics lab.
We've got to work on the website because
the first time I saw it,
I thought it was like an app.
Like, you know, now it's turned your...
But it's not.
Essentially,
this is a standalone building in Las Vegas
right now.
They've got more than...
They've got double digits clinics
paying...
To be able to have access to go
to send your clinic.
So you get somebody who's like,
I have pain when running.
And you're like, got it.
We'll do the rehab.
But you know what?
They have Doug Adams run Helix, run DNA.
So you don't have to buy Doug Adams
thing, which I'm sure Doug is like,
I want to sell fifty of these things.
But now he's going to sell it to
one.
Right.
You send your patient.
You're like, hey,
go over to Movique on whatever street.
They're going to run you through this
battery as a test.
They're going to give us the results.
We're going to plan.
Then we're going to do our eval and
plan accordingly.
What are your thoughts without me weighing
in?
Because I had a forty five minute
conversation with this kid.
I like him.
Dave, you go.
OK, this is a clinic.
Where did you say Las Vegas?
It's in Vegas.
They're going to have all the toys.
Yeah,
they're going to have the technology such
as the Doug Adams RunDNA and what else?
Like just motion capture stuff,
which nowadays is – Tony probably knows
better than I do – almost free.
Like it's more and more available.
If I was in Vegas,
if I had an outpatient clinic,
why would I send my client and customer
anywhere else?
Just go buy the RunDNA.
Go buy –
The motion capture,
I had a company on LinkedIn hit me
up about motion capture that requires no
physical products or anything,
no sensors or anything.
So the technology is getting better and
better and better.
As a business person,
it makes zero sense for me to send
my patient or client down the road to
some other clinic that will probably try
to keep them there or do some paid
virtual program or whatever.
Now, of course,
if that's what bets for the client,
then whatever.
you know, all the way do that.
But I don't understand why this would
remotely make sense if I'm a business
owner in Vegas.
I'm on Dave's team for this.
I don't see physical therapists being the
market for this.
I could see maybe like a personal training
studio or something like that.
It's one of those deals where I think
we as a profession tend to have either
we think we can do it all.
And I'm like,
why am I going to send them there
when I can just see it?
I can put them on my treadmill.
I can watch them do it myself.
Or if I like gadgets,
I'll just go buy the stuff myself,
do it myself.
I love the idea of, well,
why do I go get blood work at
a lab instead of blood work at my
doctor's office?
There's something there.
I'm not sure what it is other than,
you know, a lab does it cheaper, easier.
The doctor is too busy with other stuff.
So like if I was a clinic that
was just book solid,
too busy to waste time testing,
then maybe I could see an opportunity for
something like this.
But for most smaller individual kind of
practices,
I think they're just going to want to
do it themselves,
either with their own eyes and brain or
with their own equipment.
I'm just worried.
Number one, I forget the kid's name,
but I like him.
He's nice.
He's a hustler.
He's smart.
He's trying to tell the story,
and I appreciate it.
I don't know if there's margin there for
this.
The reason you don't do it as a
primary care and do the lab is it's
bandwidth.
That stuff's time and effort intensive and
equipment intensive,
and maybe it breaks down.
I don't know if there's margin in that
for PT.
If this thing were to take off,
this would need to be city-based only
because you're going to need I don't know
how many clinics to support it paying ten,
twelve,
fifteen grand a year to
I like the story aspect of it,
making it look like, hey,
I sort of said what I normally say,
which is like,
this feels like everybody's going to be an
NFL wide receiver and be a prospect.
But then I'm looking around going,
how many patients did I see that needed
to be treated like an NFL wide receiver?
Eight percent?
I don't know.
I wanted it to be more,
but it wasn't.
The comparison of Quest Diagnostics is a
little faulty, right?
Because if I go to a physician's office,
they take my blood,
they send it to Quest or some other
lab or whatever.
I, as the consumer, patient, customer,
whatever we want to call the healthcare
consumer these days...
i'm never going to quest diagnostics for
anything else i don't even need to go
to the brick and mortar office right it
they're sending a little vial of my blood
and then it comes back and then the
physician you know you have a follow visit
or you call them and then they tell
you like what's the recap on your blood
work or they send it to you or
there's a portal or whatever in this
example this place is a brick and mortar
office in las vegas right correct
This is why it doesn't make sense to
refer, if I have a practice nearby,
I should just buy this technology.
Why would I refer my patient or client
to this facility for the Quest Diagnostics
movement-based version of physical therapy
or just movement diagnostics?
Because then, I mean,
if they have an amazing facility,
they're gonna just win over my client,
which that's just competitive business.
And then the client could then do whatever
potential future program that they could
pitch the client because they're there in
the brick and mortar office and say, oh,
you want this, you want this,
back to running, back to golf, back,
whatever.
And if they have a nice facility with
equipment and all that, they could create,
you know,
Tony's wellness model and have an in-house
gym type of thing for their nearby
consumers.
Maybe they only want to stick with
diagnostics,
but it doesn't make sense business-wise.
What's the thing?
I would say their position is they don't
have physical therapists.
They don't have sports performance.
They just want to do the testing.
I've got two blood work orders sitting on
my desk for two of my kids.
The doctor will do the basic panel,
but like one is related to allergy
testing.
I literally have to go to the lab
corp or whatever it is.
The other one is related to some other
kind of specialized testing.
So to Dave's point, like, yeah,
the basic stuff,
the doc's just going to have somebody in
the office draw it.
This though,
I literally have to take my kids
physically to the testing site.
So I do understand.
And I think what this person would say
is, look, yeah,
you can buy the RunDNA equipment and you
can buy the other stuff and you can
buy the other stuff and you can buy
the other stuff.
But we have all four or five of
them here.
So instead of you going into that,
send your people to us.
I'm sure the idea behind it is, look,
we can give you objective measures to show
and track improvement,
to make your outcomes better,
to
improve patient buy-in to sell more
expensive plans of care.
I totally get all of that and the
appeal is there,
but I still think you're talking about the
clinicians around you adopting a new
business model that they're probably not
really that interested in adopting because
just like me real quick,
I can have a ten pound dumbbell or
I could buy a three thousand dollar tonal,
you know,
like I'm just going to stick with the
ten pound dumbbell and just go with that.
I'm shocked that neither of you kicked
this out.
This was my first thought of another
market to at least tide them over until
this pops or doesn't,
which is youth sports.
Yeah.
Oh, yeah.
I thought of that.
I was like,
but you know what I've seen?
Because I'm in youth sports.
All of my kids play all the sports.
None of the coaches want to send their
kids out to anything because the coaches
are like the time is so limited.
Right.
I do think there's a huge opportunity.
I'm surprised nobody's ever done this.
Dave,
I don't know if I ran this by
you years ago, but I'm like,
we've got all this information on
professional athletes getting injured.
We have information on college athletes
getting injured.
I can't believe somebody hasn't started a
database of high school and middle school
athletes.
What are they doing?
Injuries, you know,
analytics on all that stuff.
Because if you can predict an eighth
graders chances of making it through high
school and going to college without an
injury, there's real value in that.
So a company like this starting to track
those data points in sixth grade,
seventh grade,
eighth grade into high school.
That's where I think there's a huge
opportunity.
I like that.
I love it.
A good idea that I don't think I
heard any of us say at the end
of this little diatribe.
I love how Ben,
my vitamin on the show wants to be
a guest.
He's like, I don't have anything to say.
And then he writes, you know, Homer's.
He said in the.
I've seen this one yogurt.
Let's talk about it.
Go ahead.
Well, he's saying,
he's saying not all patients need such a
comprehensive eval.
And there are things that can do like
motion cap, markerless motion cap.
Like you don't need to like Xbox three
sixty camera.
I remember when I was in PT school
a decade ago, they're like,
we can measure twenty seven joints in real
time,
power and force estimations like good
enough, good enough.
But the second half of this thing is
in the personal injury world.
There are companies who come to your
practice like this once every other week
to do comprehensive measurements.
It's billable and see like their,
their movie health.
You're in Vegas.
There's a lot of dancers who get injured
in Vegas.
There's a lot of personal injury.
There could be your estimate.
There could be at least a side market,
right?
I love,
I love the ingenuity to try to solve
a problem.
I just don't know if it's a big
enough problem for outpatient PT clinics.
Average.
Now,
go to the fringes, personal injury,
youth sports, something like that.
Like, I don't know.
That could be a better, a better one.
Go ahead, Tony.
I was going to say,
what's the cost of run DNA and one
of these markerless motion captures?
Is it more than twelve K a year?
Because it's like,
just get the technology yourself.
Why would you,
why would you ever do this?
Costs.
I don't know what the helix costs.
Maybe I could look it up.
I don't know.
Don't quote me.
I want to say seventeen thousand.
It might be more.
It might be less.
So you got to, you know... Plus,
I think there's a monthly membership
because there's the analysis software and
stuff like that.
You know, I mean,
a lot of this equipment is expensive.
It's not cheap.
When you look at financing it, yes,
you can make it a real business.
But that's why I'm saying you're talking
about changing the business model.
If I purchased that system,
amazing system...
I am going into that line of business.
I am selling that test as my primary
revenue source.
There are, go ahead.
I was gonna say, and if you're not,
you're making a shitty investment because
now you're just buying something to sit in
the corner.
And like, my man,
that's not a great idea.
are plenty of therapists who will wait who
will spend the money I don't want to
say waste the money they will spend the
money without monetizing the equipment
just because they love gadgets and they
love that kind of stuff you know makes
them feel good real quick I swear you're
hitting all the things I've been thinking
about this this morning I was thinking
about pelvic floor therapists
Jimmy said dancers and Vegas,
which I imagine means strippers.
And I was like,
why don't we see a pelvic floor therapist
who specializes in certain industries that
require that kind of training?
Like there are sports performance
therapists, you know,
like golf therapists,
football-based therapists.
Why don't we have an OnlyFans-focused
therapist who is pelvic floor?
There's some real opportunity there.
Listen, I've told you guys before,
one of my dreams is to do,
I want to be the Mike Rowe of
PT.
I want to go dirty, dirty jobs.
I will investigate this for you.
I can hear them right now.
There are specific therapists who work
with like on Broadway, like hi, hi.
I think I interviewed someone before who
did Cirque du Soleil was her job.
Yeah, I remember.
And I remember being like,
what's normal range of, like,
do you just take a goniometer and just
throw it out the window?
You're like, there's no normal.
These people are not even close to above
average.
They are bananas.
So like it is, you know,
it's an industry within an industry.
Only gonies.
I'm trying to think of what the only
fans, only gonies, only, only,
I don't know, only MMTs.
I'm like, yeah,
there's gotta be an industry.
Your, your body's your money.
So cool business, cool idea,
but just like anything else.
Again, we've used this example.
Who would have thought strangers were
going to get in my car and pay
me to give them a ride home from
the bar?
Who would have thought strangers would
borrow or pay to rent my spare bedroom?
We're saying it's basically a bad idea,
but it doesn't mean anything.
Yeah, it doesn't mean anything.
Yeah.
Did you see this?
I'll find it.
Somebody had the video of the guys that
invented YouTube.
They were like, all right, all right,
we're live.
And they were like, two hours later,
they're like,
we had three videos uploaded.
And now, as I've said this sentence,
like four million videos have been
uploaded.
It's like, yeah.
You went in like Slack wasn't designed for
Slack.
It was designed for something else.
So I think you have elements of some
things.
Maybe you just haven't found your home.
I also like the kid behind it.
Like he's very he's I don't know.
I keep calling him a kid because he's
ten years younger than me,
but he is a jockey, not the horse.
Yeah, but I'm a jockey.
All right.
Who knows?
Who knows who watches this show?
That's them right there.
I love the idea.
Give us some pushback.
Give us some pushback in the comment
section.
Let us know.
What are we getting wrong?
What are we overlooking?
He's PRing.
That's why I like this kid.
Thanks for the great feedback.
He appreciates it.
I think they understand this.
I think they've got,
like if you were shark tanking this,
we'd be like, what are your numbers?
They have some clinics buying in.
So maybe they're seeing something.
He loves these smart people.
I mean,
the greatest example in the profession is
RTM is like free money just sitting out
there.
No one's touching it.
And yet therapists are not adopting it en
masse.
Like, how is that possible?
Because anything that is a distraction,
anything that takes even a moment of
attention, anything that, you know,
very few clinicians in my experience are
ever motivated by money.
Right.
And they're all short on time.
But they'll bitch about it.
Yeah.
When I came into this profession,
I was very...
I get yelled at for going too fast
in wherever, wherever the hell I am,
healthcare, whatever.
I came from an industry where however fast
you think Jimmy goes, I am slowing down.
You have to move faster.
The people who do...
break things.
And I'm not saying go all the way,
but try some things.
And we're like,
let's form a committee and let's do it.
And I'm like,
what the hell are you talking about?
What are we talking about?
The ship is sinking.
And we're like, is it though?
Is it sinking left or right?
I'm like, does not matter.
Ship go down.
We're a boat.
I don't know.
I think move faster.
And I like things like this because
they're trying to just pressure test
faster.
So I think I like the energy and
the emotion there.
I also like games,
and I like this game.
We all play this.
No one even ever needed to teach you
how to play this game.
Every kid comes hardwired with this game
in their brain operating system.
It is called The Floor is Lava,
Medicare edition.
The only balance training program where
the ground is literally lava,
and your reimbursement depends on your
patient's survival.
foam pads across the clinic and let your
seventy-year-olds fight for their lives
with flaming cones, unstable surfaces,
and two e-stim pads stuck to their calves
for motivation.
Clinically inappropriate?
Maybe.
Hilarious?
Always.
Check it out on ESPN eight, the Ocho.
The floor is lava because balance training
is more fun when it's life or fake
death.
This is where all the...
Have you seen the TV show version of
that?
Yeah, it's hysterical.
Yeah, it's awesome.
But this is where it came from.
So I think I, you know,
we have a group chat.
This is how we get in.
Ninety eight percent of what we talk about
on the show.
And I was, I don't know,
doing something on Saturday or Sunday.
And now is like the weird law.
Oh, I almost said the word.
The super large football party.
I'll get in trouble by this month,
but whatever.
The super large football party is this
coming weekend.
So this is the weekend between.
I think the Pro Bowl happened,
but like nobody wanted the Pro Bowl.
And there wasn't a lot on.
And I'm like, what's on ESPN?
And they had.
Slippery stairs competition.
It was a ballroom at like Disney World,
right?
Or the hotel.
And there was a large staircase covered in
latex.
people using those like water guns to make
them slip them up.
And they had adult male, adult female,
boy, girl competitions.
It was an hour and a half of
fake games.
They had, what was it called?
Oh, extreme archery.
So two people running around like almost
like a paintball course firing like
arrows, but they were like, you know,
nerf tip, but they were like legit.
Like they were zipping.
And people were watching this,
and they had an hour and a half
of the World Dodgeball Championship.
And this is why we make fun of
ESPN, the Ocho,
except their game is attention.
I watched it because it was dumb.
They had to put something on there.
And there was nobody playing, right?
College football's over.
College basketball wasn't on that time of
day.
So my question would be, gosh,
what's the steal here?
What do we steal from this?
Which is, again,
if we're in the attention business,
let's do some stuff.
I don't know.
high level how can we steal this is
they're putting a bunch of ridiculous
stuff on espn like cornhole and the the
omega soccer the three the three goals
faced each other and it's teams of like
four or five guys uh people you know
uh three teams against each other at the
same time they're just putting they're
just i i shared it to you guys
a while ago months ago
they're just putting a bunch of stuff on
TV and they're hoping one of these things
becomes Survivor or becomes, you know,
the Kardashians or whatever, right?
Like they're just putting a ton of stuff
on there.
I'm sure there was a show for,
you know, I don't know,
beer pong or just any type of game
now.
I mean, if the floor is lava,
I had no idea.
So this is a news break to me
this morning.
I didn't know that that was a TV
show.
So that's brand new for me.
But anything that...
espn or any of these other affiliates can
try to put on tv that's even remotely
similar to an in-person game that you play
at tailgate or a party or used to
play when you were a kid yeah it
makes sense they are literally testing in
real time they're kind of doing like
savannah bananas you know style testing
iterating and and they're hoping they find
they're hoping one of these tv shows or
games becomes like a savannah bananas yeah
I mean,
they understand that they're an attention
game, but they already have distribution.
So now you're like,
we got to put something.
This is inventory.
I looked at in radio and TV,
six a.m.
on a Saturday is inventory.
I got to put something on the air.
What is it?
Because that's inventory.
Tony, what are we going to say?
I don't remember.
I think you were talking about,
and I don't know why you don't want
to say the name of the game,
the big game coming up.
We used to joke in radio because in
radio, if you did that,
you could get sued by the NFL.
So we would make all these ridiculous,
like the Super Bowl promo day.
Like it was just tongue in cheek.
So, I mean, Victoria's Secret,
didn't they used to have like a halftime
show?
Animal Channel used to have a halftime
show.
why wouldn't like we,
you said ESPN has the distribution,
but if you made something that people
actually wanted to watch,
Facebook will give you the distribution.
YouTube will give you the distribution.
You have to earn it.
So with as much complaining as I see
in here about halftime shows and
performers and,
People don't want to watch it,
but they want to watch the game.
I could totally see somebody coming up
with their own thing from scratch,
promote it as we're going to run this
alternative halftime show and then run it
across the social media platforms.
Because again, what do you have to lose?
It is a lottery ticket that if it
hits, you will just do tremendous success.
I'm releasing three hundred and sixty five
podcast episodes and three hundred in
twenty twenty six.
I probably won't be doing one a day.
I did ten in one day from Graham
sessions last week.
I decided and this will land with most
P.T.'
's.
that the exercise principles, frequency,
intensity, time, type, volume,
and progression are also communication
principles, frequency.
I just decided to say,
what if in twenty twenty six I just
hammered frequency and I went bananas?
It costs me zero extra dollars to launch
a podcast episode.
My time, my effort, it's all right.
But I'm like, I'm OK with it.
Because everyone that I do might hit and
bring me a client to work with.
It already has.
It just does.
Us doing this ridiculous live stream for
two plus years.
I'm like,
I can't wait till we do this with
like an ESPN style desk at CSM and
not that we get invited,
that people are like, well,
we'll pay you to sit at our booth
because right now our best strategy is
drop twenty grand on a booth at CSM.
I'm looking at you, every industry,
every company that you're doing.
You are f***ing this up.
You spend twenty grand.
You're in a meeting and you're like,
I need twenty grand.
Why?
CSM.
Great.
No justification?
What are you going to do when you
get there?
Stand?
Pens?
Stress balls?
Oh,
we're going to go on LinkedIn and we're
going to mention it over and over
sixty-eight times.
What are you talking about?
That's your strategy?
That's signage.
That is a good strategy if you want
to tell people where the toilet is.
Like, yes,
the toilet is down and to the left,
down and to the left.
But your strategy for spending twenty,
thirty thousand dollars at the
conferences?
Well, we're going to be there.
Now we're in the room.
We have a chance.
OK,
how are you going to overcome the sea
of sameness?
I don't know.
I'm going to do a lot at CSM
this year.
I am going to be polished six percent
of the time.
Everything else is going to be run and
gun.
So here's my question.
Now, here's I want to add some spice.
Could we connect clinics in some way who
are not financially related?
CrossFit does it.
Set up a game,
and then everybody watches the
leaderboard, right?
There it is.
There's Hyrox.
There's the leader.
This month,
we're doing these three things that can be
performed in almost any clinic.
Where's our people?
And now we've gamified.
Now we take a stab back at the
Orange Theories.
Dude, respect.
I'm going to crap it on Orange Theory.
They're doing it well.
CrossFit.
How do we take...
ridiculous games and say,
let's standardize them.
And I'm using air quotes,
but like something we could do in any
clinic, but make it leave the clinic.
Now there's a reason I ride Peloton.
I see a leaderboard while I'm riding,
but I joined, I went on LinkedIn.
I was like, who's riding Peloton.
I need someone to fight with.
I need someone to feel like I'm behind.
And now I have a little like, um,
what do you call it?
Like a motivation group or a, you know,
um,
permissions group.
And I see where I stack against these
other PTs.
I'm like, all right,
I don't really care about beating them.
I want to make sure I'm not last.
Like you don't got to outrun the grizzly
bear.
You just got to,
you just can't be the,
you can't be last.
You don't have to be first.
So what,
if I throw that wrinkle in it,
is that a thing?
Would we care?
Does that help us make money?
It's got to help us make money.
I think it'd be, I love it.
I'm thinking like,
it's got me thinking about trivia.
When you go to the bar,
you go to BW threes or something like
that.
You know,
could my team can I put together a
team of all stars at Total Therapy
Solution that competes against Dave's
team?
Could we have like real time analytics
that are up on a TV screen,
you know,
just like in the pub where you're doing
trivia?
It doesn't have to be synchronous.
It doesn't have to be at the same
time.
We have performance metrics.
And then, of course,
you bring in a testing company like the
guys that you were just talking about.
And we're like,
could we have this objective testing?
So my kids run track.
They go to the track meet.
They you know,
all their timing and analytics is up.
They're looking at what other kids in the
state are doing.
I think it brings it brings your immediate
community together like a bowling team or
a softball team.
It gives you something to promote across
social media.
Hey, look what we just did.
You know, John just broke this record.
There's a lot of opportunity in something
like that.
I think the way to do it is
TVs.
I think there needs to be a scoreboard.
I need to know how close I was.
I play those stupid games on LinkedIn
every morning,
and it shows me where I rank with
the people that I'm connected to.
And do I care?
No.
I do.
I want to be...
I was like number one a couple days
last week, and I was like, yeah,
what's up?
Of course I'm bragging about that.
Dave?
I like Tony's idea...
with these types of things,
I always love him riffing first because
he's so creative and outside of the box.
So the thing of the,
what was the game we were just talking
about?
Like in bars, it's a trivia,
like a trivia night that they do.
So the, the,
I wasn't even thinking that the other
step, Tony of like,
then do Moviq and do the,
the movement diagnostic type component of
this.
What if it was just the first step,
the first part you just mentioned,
which is basically like the way that bars
do trivia.
They do that to get butts in seats.
They do that to get people in the
bar to buy more beer and maybe food
if they have food.
Just that across the country,
if it's my practice versus your practice
versus my practice and other practices
online,
anyone with movement impairments or
whatever,
now everyone is closer to the same playing
field because it's just your cognitive
recall of whatever.
It's just the trivia.
It has nothing to do with physical
therapy.
Now, of course,
there's some socialization and that could
be beneficial,
but it would help
each of these clinics kind of improve
their own, you know,
culture and morale and, and build like a,
whatever, a community or a tribe on,
I'm trying to stay away from some of
the buzzwords, but,
You could get some folks that like,
let's say I have five of our clients
versus five of Tony's clients.
And it doesn't matter if any of my
clients are, you know,
have they're in a Walker or wheelchair or
they're twenty five years old and they are
able to, you know, run a half marathon.
If it's just trivia,
that's something that could be filmed.
That could be content that has it's not
really anything to do with what we deliver
in terms of like the service fulfillment
side.
But it would be content.
And maybe the second thing would be like
the movement Olympics or the movie type of
component of it,
which then ties closer to the service,
the core offering that we offer.
But what about even just even just the
front end, just just the trivia,
the way that bars do it?
And I don't know, like, Jimmy,
have you ever seen on YouTube like two
bars ever film this or is it usually
never filmed?
I feel like I've never seen content of
trivia in a bar like this team versus
this team.
And it's funny because every team names
their own team like a funny, stupid name.
And that's a joke or an inside joke
or whatever.
Yeah.
I used to do a version of this
called the bar exam where I would go
with a recorder.
This is pre cameras and everything.
I would meet someone,
I'd meet Tony and like, I'm like, Tony,
introduce yourself.
And you can clearly hear how hammered he
is.
And then I'd have two people on the
phone live as I'm playing this back.
So I recorded Tony on Friday.
Now it's Monday.
And now I've got Dave and Steve on
the phone.
I'm like, all right,
we're going to hear a clip of this
guy I met on Friday.
Here's Tony.
Tony's like, hey, what's up?
Now you've gauged how drunk he is.
And then then I would play a clip
for Dave and Steve.
Here's the question.
You'd hear the question and then you'd bet
I stole from a TV show.
I'd say,
do you think Tony got that right or
wrong?
So I was able to bring the bar
onto the radio in a way that it
wasn't live and it was a game being
played live.
I like the movement aspect of it.
Like I would make up,
you could even just do like,
I would stay away from like weight lifted.
I would make it more repetition based
because I want it to be accessible and
You know what I mean?
And then you steal a page out of
the Olympics, the senior Olympics,
the Paralympics, the special Olympics,
like make it bracketable by ability level,
age, gender, however you want to do it.
And then you get somebody with a good
coding degree or me with chat GPT for
probably six weeks, but you know,
someone else smarter would get it done
faster.
And then you figure out a way to
be like, okay, input that person's thing.
And then it's constantly on the scroll.
Why do you keep putting money in Ms.
Pac-Man?
Because I want to put my three initials
at the top of the list.
We are big, dumb animals.
We want to score well.
I think the access is trivia or
competition.
How do I connect out of these walls?
Why am I doing this?
Is it to beat someone?
I ride like a moron when there's someone
close to me in Peloton.
I blow up my entire workout to beat
that person that I'll never see again.
I'm like, but that's right.
That's right.
You're three points behind me.
That's right.
And I get off the bike a little
taller.
Well, I have to think about it,
but I definitely think, you know,
like you said,
you can make this a cognitive game.
You can make it a physical game.
You can just bring games.
Like I bought a cornhole set years ago
for my shoulder patients because I wanted
them doing like a version of a pendulum
throwing a cornhole bag.
There are so many things that we could
do with it.
And then we're just talking outpatient
ortho because that's our world.
The stuff that I see neuro doing
outpatient neuro is just phenomenal.
And, you know,
you set up the overhead system so that
they can't fall because they have the
harness on.
you just build your own obstacle course
kind of stuff.
You know, there,
there is so much that's out there,
but like you said, you,
you have the leader,
you have the scoreboard,
you make it interactive,
you have the big TV.
So you'd have to be a way for
us to see it.
I would think a lie,
like some sort of live stream or website
that all you'd have to do is put
like a USB into a TV and then
go to a website and it just does
the thing, right?
This is also the,
have you guys ever seen the chive?
The TV channel, the TV channel, the chive.
Oh, this is brilliant.
You go into a sports bar at noon
on a Tuesday and it's playing like,
you know, there's seventy eight screens.
But what's on like you're just watching.
Oh, you mentioned this before.
Chive is essentially.
America's funniest home videos like just
wrap it, but just of like sports videos.
Dirt bikes, fails, not fails,
hockey shots.
It's a clip show.
It's ridiculousness,
twenty-four hours a day.
Now,
there's some sort of agreement I'd have to
look into it.
The bar gets to insert their own
commercials.
Now you're part of the chive.
Number one, you get to play it.
That's our content.
You can't just play it.
so we give that to you something to
put on the screens chive is making their
money because they get to insert net they
get to insert their own ads and then
they're like oh just drag and drop your
ad here we'll make it for you whatever
then you get your own so it's like
you have the personalized television
that's what you would need you would need
something like that maybe it's not clips
all the time but hey why wouldn't you
now there would also need to be an
easy interface
stupidly easy for Tony or Dave when their
patient did the sixty second sit to stand
challenge to just be like Tony this clinic
this patient name if they want to use
their name or fake name and this many
reps enter and now it computes where that
person stands there it would need to be
dumb easy for the clinician to get their
patient on the board
So rolling this together,
and I know we're getting close to the
hour.
What if we set up a situation where
we know that live sports is probably one
of the few times people will watch live
TV?
Nobody wants to record a game and watch
it later to cut out commercials.
We know that here,
everybody's watching the Reds, right?
During baseball season,
we're all watching the Reds.
We're all gonna see the same commercials
at the same time.
What if local physical therapy clinics
created an alternative network so that
when the Reds cut to commercial,
people bring out their phones anyway.
I'm watching the Reds on TV,
commercial hits,
I grab my phone and go to social
media.
We have a network of content that plays
live during the commercial between,
you know,
innings at the Reds game or whatever.
You bring that into the Super Bowl.
Obviously, if you don't want to watch,
I know Super Bowl,
you want to watch the commercials.
But like,
what if we can tie in some sort
of live media?
where we deliver our content,
specifically time to when the TV networks
cut to commercials that people don't want
to watch,
but that they could watch on their cell
phones, on their mobile devices,
things like that.
I used to listen to my competitors,
and then later on in my radio career,
I would have my interns listen to
competitors and write down in a notebook
and try to figure out my competition
locally, their clock.
Right.
Clock meaning...
What that radio station did, like, oh,
we start the hour and we play two
songs and we go to commercial.
We play three songs and we go to
commercial.
I would always try to not be in
commercial when they were in commercial.
And if they weren't, I was close.
I'm like, then I'm going to be this.
I'll push for half.
I was playing those games, dude.
I was like,
you will listen to them for five hours
and you tell me exactly when they break
every time.
So yes, timing, frequency, intensity,
time, type, volume, progression.
Time is one of them.
The when is important as well.
There used to be a TV network,
I can't remember,
that started their shows at the five
minute mark.
Yes.
Because you would be able to see what
the other shows were and then you would
go to them and their show hadn't started
yet.
You remember how long show intros used to
be?
Like the intro for like Family Matters
used to be like ninety seconds.
Now you get a cold open.
Like, it just starts mid-sentence in,
like, Modern Family.
It's, like, Phil falling down the stairs.
You're hooked.
Then they give you the first, like,
LOL giggle.
Then they hit you with, like,
a twelve-second Family Matters montage,
and we're back into the story.
Because they understand...
sunk cost fallacy.
If I'm already eight minutes in,
I've missed who killed the person in law
and order.
I missed it.
All right.
Well,
that's why the murder happens in the first
ninety seconds of law and order.
Now it's the whole ninety eight percent of
the rest of it is who done it.
These are all principles we have to
compete on now.
Let's tease a future episode.
We've talked about the hook and all that
stuff for marketing.
What about for the treatment?
What about the minute the patient walks in
the door for a treatment,
we open with a hook for the treatment
session.
And then we go through the psychology just
like we would run an ad.
But we do it for a treatment session.
We should do that.
Jenna Hoyos, who's the girl that Mr.
Beast has said can make any clip go
viral.
Jenna Hoyos.
And she's given away the formula and
people still ignore it.
I run it through that filter when I've
created my videos.
You see the video I sent you guys
with the dude with the six pack and
the ring light formula for that,
which is you have to hook me.
I see PTs online now turning the cameras
to themselves a lot.
I love this.
And the first ten seconds are high.
I'm Troy McClure and I have eleven
certifications and I live in Kansas and
I'm like, boop, they're gone, bro.
They're gone.
Maybe do that later or do that as
a lower third graphic.
Why?
Because it doesn't matter.
So yeah, what if we mimicked
a hook?
What if we mimicked the psychology of a
piece of viral content of a treatment
plan?
That is a side-by-side.
Okay, wait.
We'll do parting shots,
but we are getting fined by the NFL.
The commissioner just called because Tony
said...
The S word you said instead of the
big super game football game.
We do want to make sure we can
now pay for that fine with our sponsor,
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They're a bank credit union,
stretching your dollars and your
shoulders, parting shots.
What do we got?
Dave, what you got?
Uh, man.
Um,
I think more creativity is needed in the
physical therapy world to on the front
end,
start with how can we all as practice
owners and clinics get attention even
before marketing.
I've been so focused on marketing for the
past five or ten years that, um,
I'm now transitioning a little bit more to
different ideas and testing things around
attention and more of that to come.
And what we were just talking about is
really about attention first and then
everything else flows after that.
greed.
You're in the attention business.
The next time,
if I ever have a nine to five
again,
my title will be director of the attention
department.
That's what I want to work in.
I don't want to work in the marketing
department.
Chief attention officer.
Attention of C-A-O.
Cow.
Hey, pull that comment back up.
Parting shot.
So,
Movique says PT is the movement
profession,
yet movement still lacks standardized
diagnostic infrastructure.
Totally true.
The only thing I would question is,
does it matter?
Honestly, like, does...
Does it matter?
We all talk about, you know, posture.
Posture used to be the biggest thing.
Now it doesn't matter.
We used to talk about technique used to
be the biggest thing.
Now it doesn't matter.
Tell us why a standardized diagnostic
matters because people are going to move
differently.
And so that's I think what matters.
That's my parting shot.
Yeah.
Is it worth their time or money?
If you're saving me time, making me money,
or solving a problem that you can clearly
define, that's good.
I'm going to second Dave's parting shot.
Mine was also that, which is move fast,
break things.
You need to be creative.
We are getting more and more competitive.
This will not change.
This will only increase.
So you need to figure out how you
can gain attention first.
The letters after your name are after your
name for a reason because they don't
matter that much.
We'll be back on Thursday.
Maybe we'll do that Jenna Hoyos parallel
side-by-side.
I'll work on that now.
And I'll see a lot of you at
CSM next week.
I'll be at the U.S.
Physical Therapy booth doing a live
stream.
You can heckle me and throw things at
me while we're live.
All right, guys.
We'll see you later.
That's it.
We're out.
Boys, what the hell are you doing?
Follow Tony Meritato on YouTube at Total
Therapy Solution.
Find Dave Kittle at
conciergepainrelief.com and on YouTube at
The Dave Kittle Show.
And follow Jimmy McKay at PT Podcasts on
YouTube, the socials,
and wherever you binge podcasts you
pretend are for CEUs.
And hey, just a reminder,
none of this was for advice.
This was for entertainment only.
Our lawyers say that counts.
Thanks, Keith.