WEBVTT 00:00:01.843 --> 00:00:02.883 You're listening to the P.T. 00:00:02.903 --> 00:00:03.064 Pinecast, 00:00:03.084 --> 00:00:04.503 where smart people in healthcare come to 00:00:04.783 --> 00:00:05.524 make noise. 00:00:05.823 --> 00:00:10.205 Here's your host, Jimmy McKay. 00:00:10.224 --> 00:00:11.005 Thanks, Voice Guy. 00:00:11.425 --> 00:00:12.564 Yes, we are live from CSM. 00:00:12.585 --> 00:00:14.246 I do want to say thanks to one 00:00:14.266 --> 00:00:16.065 of our sponsors who's helping us support 00:00:16.106 --> 00:00:16.545 the show. 00:00:16.606 --> 00:00:16.925 Otherwise, 00:00:16.966 --> 00:00:18.687 we can't fly here and do things live 00:00:18.707 --> 00:00:19.227 from CSM. 00:00:19.707 --> 00:00:20.707 Empower EMR. 00:00:21.106 --> 00:00:21.827 They're just down there. 00:00:21.847 --> 00:00:22.146 I mean, 00:00:22.167 --> 00:00:23.987 I'm referencing a direction on a podcast, 00:00:24.007 --> 00:00:24.748 which doesn't make any sense. 00:00:25.248 --> 00:00:26.068 Empower EMR. 00:00:26.108 --> 00:00:27.568 If your clinic is stuck in an EMR 00:00:27.588 --> 00:00:28.928 that slows you down, 00:00:29.169 --> 00:00:30.109 that's a decision that you made. 00:00:30.609 --> 00:00:32.929 bad decision uh empower gives you speed 00:00:32.950 --> 00:00:35.192 clean workflows and features pt's actually 00:00:35.652 --> 00:00:37.033 asked for better notes faster 00:00:37.052 --> 00:00:39.134 documentation smoother operations all 00:00:39.173 --> 00:00:40.795 wrapped in customer support doesn't ghost 00:00:40.814 --> 00:00:42.335 you that's what you're looking for upgrade 00:00:42.356 --> 00:00:44.777 your clinic's brain with empower emr visit 00:00:44.796 --> 00:00:47.738 empoweremr.com or visit their booth 00:00:47.759 --> 00:00:49.020 whenever they're at a conference all right 00:00:49.100 --> 00:00:52.201 what if what if insurance ending wasn't 00:00:52.222 --> 00:00:54.383 the end of care pause for dramatic effect 00:00:54.783 --> 00:00:56.723 but the beginning of a different model you 00:00:56.744 --> 00:00:57.344 see how we're doing this 00:00:58.125 --> 00:01:00.045 Our next guest left traditional neuro 00:01:00.066 --> 00:01:02.247 rehab to build a nonprofit community-based 00:01:02.268 --> 00:01:04.289 wellness model serving thousands each 00:01:04.328 --> 00:01:04.569 year. 00:01:04.868 --> 00:01:06.269 Live from Anaheim, 00:01:06.290 --> 00:01:08.131 this is Melanie Brennan. 00:01:08.471 --> 00:01:09.512 Melanie, welcome to the show. 00:01:09.531 --> 00:01:11.132 Thank you for having me. 00:01:11.212 --> 00:01:12.493 How close did I do on the intro? 00:01:12.554 --> 00:01:12.873 It was great. 00:01:12.894 --> 00:01:14.034 All right. 00:01:14.075 --> 00:01:15.155 So walk me through this. 00:01:15.234 --> 00:01:16.256 What angered you? 00:01:16.355 --> 00:01:20.197 Because without a good anger or this 00:01:20.478 --> 00:01:21.519 shouldn't be like this, 00:01:21.558 --> 00:01:22.879 there's never a good story. 00:01:22.900 --> 00:01:24.001 And this sounds like the beginning of a 00:01:24.021 --> 00:01:24.501 good story. 00:01:24.884 --> 00:01:25.724 Absolutely. 00:01:25.745 --> 00:01:25.864 Yeah. 00:01:25.906 --> 00:01:27.388 I worked in outpatient rehab, 00:01:28.608 --> 00:01:30.331 inpatient and outpatient at the Mayo 00:01:30.352 --> 00:01:31.993 Clinic in Rochester, 00:01:32.034 --> 00:01:33.855 Minnesota for many years. 00:01:34.117 --> 00:01:36.019 And yeah, 00:01:36.319 --> 00:01:38.983 I had to stop seeing people that still 00:01:39.144 --> 00:01:40.284 needed care. 00:01:40.444 --> 00:01:41.587 You could see the runway and. 00:01:41.727 --> 00:01:43.388 They would go home. 00:01:44.289 --> 00:01:45.510 Mayo's a destination center, 00:01:45.531 --> 00:01:46.591 so a lot of people aren't from the 00:01:46.652 --> 00:01:46.951 area. 00:01:47.272 --> 00:01:48.033 They would go home. 00:01:48.713 --> 00:01:50.015 I would see them back in six months 00:01:50.034 --> 00:01:51.415 to a year, and I would say, 00:01:51.436 --> 00:01:52.177 how'd your therapy go? 00:01:52.197 --> 00:01:52.576 And they're like, 00:01:52.596 --> 00:01:54.618 I didn't get any where I was. 00:01:55.700 --> 00:01:56.921 We didn't do a very good job with 00:01:57.001 --> 00:01:58.162 our exercise program, 00:01:58.302 --> 00:02:00.825 and they would lose everything. 00:02:00.885 --> 00:02:01.906 If they were able to walk when they 00:02:01.926 --> 00:02:02.146 left, 00:02:02.186 --> 00:02:03.387 they weren't able to walk when they came 00:02:03.406 --> 00:02:03.647 back. 00:02:03.867 --> 00:02:04.447 They gained 00:02:07.090 --> 00:02:08.691 They were in much worse condition. 00:02:08.711 --> 00:02:11.393 And even our local people that would keep 00:02:11.432 --> 00:02:12.573 coming for outpatient, you know, 00:02:12.592 --> 00:02:13.734 there's that point where you're like, 00:02:14.215 --> 00:02:14.574 sorry, 00:02:14.594 --> 00:02:16.575 but insurance probably isn't going to pay 00:02:16.596 --> 00:02:18.116 for this because we don't really know. 00:02:19.277 --> 00:02:20.258 And so we'd stop. 00:02:20.579 --> 00:02:22.280 But they had so much potential and the 00:02:22.319 --> 00:02:24.441 research shows they can get better for 00:02:24.561 --> 00:02:25.502 years. 00:02:25.882 --> 00:02:28.163 And I was frustrated and I just told 00:02:28.203 --> 00:02:29.264 my husband I want to do something about 00:02:29.324 --> 00:02:30.745 it and start a practice. 00:02:30.905 --> 00:02:30.985 Yeah, 00:02:31.004 --> 00:02:32.145 but there's a big difference between 00:02:32.264 --> 00:02:33.705 wanting to do something about it and 00:02:33.866 --> 00:02:36.606 actually doing the thing because the world 00:02:37.187 --> 00:02:37.847 has inertia. 00:02:37.887 --> 00:02:39.247 The world doesn't want to change. 00:02:39.307 --> 00:02:40.707 And you need to if you need something 00:02:40.728 --> 00:02:41.228 to move an inch, 00:02:41.247 --> 00:02:43.049 you've got to give it so much energy 00:02:43.088 --> 00:02:44.149 to move it even that first inch. 00:02:45.069 --> 00:02:46.349 So what'd you do about it? 00:02:46.673 --> 00:02:47.272 Well, 00:02:47.473 --> 00:02:49.854 I think what really sparked me to do 00:02:49.933 --> 00:02:51.555 it was I had a patient tell me, 00:02:51.715 --> 00:02:52.735 you're really good at this. 00:02:52.775 --> 00:02:53.756 You think outside the box. 00:02:54.015 --> 00:02:56.317 You make me work harder than a lot 00:02:56.336 --> 00:02:56.757 of people. 00:02:57.276 --> 00:02:58.657 You should have a gym. 00:02:58.798 --> 00:02:59.497 You should start your own. 00:02:59.538 --> 00:03:00.798 I would comp if you had a gym. 00:03:01.157 --> 00:03:01.919 So I told my husband, 00:03:02.679 --> 00:03:03.799 I'm motivated to do this. 00:03:04.340 --> 00:03:05.840 It's a good time in our life. 00:03:05.879 --> 00:03:06.319 It was a good time. 00:03:06.340 --> 00:03:07.480 I was just working part time at the 00:03:07.520 --> 00:03:07.781 time. 00:03:08.200 --> 00:03:08.360 I said, 00:03:08.381 --> 00:03:10.262 can I try starting a private practice, 00:03:10.282 --> 00:03:11.201 which is super scary? 00:03:11.282 --> 00:03:12.943 And he's like, yeah, OK. 00:03:13.782 --> 00:03:14.024 Good. 00:03:14.084 --> 00:03:15.325 Yeah, let's do it. 00:03:15.627 --> 00:03:16.568 So how's yours different? 00:03:17.489 --> 00:03:18.949 How is my private practice different? 00:03:18.969 --> 00:03:19.770 Yeah, tell me about it. 00:03:19.811 --> 00:03:20.070 Yeah, 00:03:20.091 --> 00:03:23.173 so I knew that my ideology had to 00:03:23.193 --> 00:03:25.633 be that insurance was not what drove care, 00:03:26.175 --> 00:03:27.034 period. 00:03:27.115 --> 00:03:27.996 And I had to come up with a 00:03:28.015 --> 00:03:28.675 way to do that. 00:03:28.836 --> 00:03:29.097 Right. 00:03:29.157 --> 00:03:29.977 So that's nice, 00:03:30.016 --> 00:03:31.057 but you have to figure out how to 00:03:31.078 --> 00:03:31.418 do it. 00:03:31.437 --> 00:03:31.899 I had to. 00:03:31.979 --> 00:03:32.899 Yeah, I dug in. 00:03:32.959 --> 00:03:34.439 I just did all the research myself. 00:03:34.479 --> 00:03:35.760 I couldn't afford an attorney or a 00:03:35.800 --> 00:03:36.701 business coach or anything. 00:03:36.762 --> 00:03:38.483 And even back in two thousand eleven, 00:03:38.502 --> 00:03:40.144 there weren't business coaches for PT. 00:03:40.163 --> 00:03:42.004 We got business coaches falling off trees 00:03:42.025 --> 00:03:42.125 now. 00:03:42.145 --> 00:03:43.947 Yeah, it was such a different time. 00:03:44.366 --> 00:03:45.927 I actually had to get books at the 00:03:45.967 --> 00:03:47.368 library like there was nothing online. 00:03:47.468 --> 00:03:47.709 Kids, 00:03:47.729 --> 00:03:49.810 a library is a building where the Google 00:03:49.870 --> 00:03:50.790 files live. 00:03:50.811 --> 00:03:52.711 That was a long time ago. 00:03:53.532 --> 00:03:55.794 But yeah, I researched it, started it. 00:03:56.354 --> 00:03:57.594 I knew I needed to be a model 00:03:57.615 --> 00:03:59.635 that was not just PT driven and not 00:03:59.695 --> 00:04:00.637 just insurance driven. 00:04:01.116 --> 00:04:03.157 So I hired a trainer to work with 00:04:03.199 --> 00:04:06.419 me alongside, created a gym atmosphere. 00:04:06.540 --> 00:04:07.920 Not a clinic atmosphere. 00:04:08.100 --> 00:04:09.442 It was not a clinic atmosphere. 00:04:09.762 --> 00:04:11.743 No beige wall, like color. 00:04:11.804 --> 00:04:12.503 No, no. 00:04:12.644 --> 00:04:14.004 In fact, to get started, 00:04:14.025 --> 00:04:16.447 I actually rented space at the YMCA. 00:04:16.507 --> 00:04:16.887 Great. 00:04:17.829 --> 00:04:18.829 community already built in. 00:04:18.870 --> 00:04:19.790 Yeah, already built in. 00:04:20.571 --> 00:04:22.052 I use my minivan door to door a 00:04:22.072 --> 00:04:23.692 lot to get started that first year, 00:04:23.733 --> 00:04:25.274 but people heard about it. 00:04:25.374 --> 00:04:26.574 And all of a sudden I had ten, 00:04:26.673 --> 00:04:28.235 twelve clients and I was supposed to be 00:04:28.254 --> 00:04:29.035 working part time. 00:04:29.115 --> 00:04:30.995 I had my babies in the car seat 00:04:31.055 --> 00:04:31.456 with me. 00:04:31.576 --> 00:04:34.278 I had them playing in the pool alongside 00:04:34.317 --> 00:04:35.458 me at the YMCA. 00:04:36.238 --> 00:04:37.579 So I took I took them with me. 00:04:37.939 --> 00:04:40.081 But my clients like you need you need 00:04:40.100 --> 00:04:40.581 your own space. 00:04:41.581 --> 00:04:42.562 and you probably need some help. 00:04:42.802 --> 00:04:44.903 And so I hired that first person within 00:04:44.944 --> 00:04:45.803 my first year. 00:04:46.425 --> 00:04:47.925 And one of my clients had a strip 00:04:47.946 --> 00:04:48.985 mall that he owned. 00:04:49.307 --> 00:04:51.007 And he said, yeah. 00:04:51.028 --> 00:04:52.228 He's like, hey, I got a strip mall. 00:04:52.249 --> 00:04:52.769 You know what you need? 00:04:52.788 --> 00:04:53.649 I got an empty space. 00:04:53.769 --> 00:04:54.129 Space. 00:04:54.370 --> 00:04:54.790 Yeah. 00:04:55.069 --> 00:04:57.552 So him and I worked together back in 00:04:57.572 --> 00:04:58.533 two thousand twelve. 00:04:59.473 --> 00:05:02.697 built a gym in a two thousand square 00:05:02.716 --> 00:05:03.718 foot strip mall space. 00:05:05.180 --> 00:05:06.860 From two thousand twelve to two thousand 00:05:06.880 --> 00:05:07.541 fifteen, 00:05:07.882 --> 00:05:10.745 I added ten employees in that two thousand 00:05:10.764 --> 00:05:11.565 square foot space. 00:05:12.367 --> 00:05:15.029 We had one mat table for ten employees, 00:05:15.050 --> 00:05:16.711 which means ten patients. 00:05:17.271 --> 00:05:18.553 We had like four, 00:05:18.853 --> 00:05:21.276 five spinal cord injury patients on a mat. 00:05:21.976 --> 00:05:22.398 One mat. 00:05:22.899 --> 00:05:23.740 It was crazy. 00:05:24.560 --> 00:05:24.982 Yeah. 00:05:25.161 --> 00:05:26.543 And so, yeah. 00:05:27.045 --> 00:05:27.805 In two thousand seventeen, 00:05:27.846 --> 00:05:29.548 we've got a ten thousand square foot gym. 00:05:29.569 --> 00:05:30.971 It's large. 00:05:30.990 --> 00:05:31.651 Purchased it. 00:05:32.733 --> 00:05:33.435 I purchased it. 00:05:33.475 --> 00:05:34.295 Wasn't going to rent it. 00:05:36.689 --> 00:05:39.771 Twenty-four employees later. 00:05:39.831 --> 00:05:40.711 What's the name? 00:05:40.771 --> 00:05:41.812 Because people, of course, 00:05:41.833 --> 00:05:42.552 want to Google it next. 00:05:42.812 --> 00:05:43.533 Yeah, yeah. 00:05:43.653 --> 00:05:45.533 So originally the name was Exercise 00:05:45.553 --> 00:05:46.055 Abilities. 00:05:46.154 --> 00:05:46.555 Okay. 00:05:47.055 --> 00:05:49.636 Came to find that that's really hard to 00:05:49.716 --> 00:05:50.697 type in a website, 00:05:50.817 --> 00:05:52.718 really hard for people to spell correctly, 00:05:52.798 --> 00:05:53.918 really hard for people to say. 00:05:53.997 --> 00:05:54.959 Don't go multiple syllables. 00:05:55.158 --> 00:05:55.738 It was bad. 00:05:56.459 --> 00:05:56.939 Great name. 00:05:56.959 --> 00:05:58.300 People loved it. 00:05:58.319 --> 00:05:59.100 So we shortened it. 00:05:59.201 --> 00:06:00.000 Everybody shortened it. 00:06:00.021 --> 00:06:01.062 The world shortened it to EA. 00:06:01.281 --> 00:06:02.903 So it became, hey, I'm going to EA. 00:06:03.742 --> 00:06:04.665 I thought, hey, that works. 00:06:04.985 --> 00:06:07.689 So it's EA Therapeutic Health. 00:06:08.009 --> 00:06:08.951 Nice. 00:06:09.151 --> 00:06:11.055 We rebanded in twenty twenty two. 00:06:11.636 --> 00:06:12.297 It's the. 00:06:13.115 --> 00:06:14.254 What's the model look like? 00:06:14.615 --> 00:06:16.896 Someone needs you and they come and you're 00:06:16.935 --> 00:06:17.375 like, hey, 00:06:17.615 --> 00:06:18.915 we don't do that thing over there, 00:06:18.956 --> 00:06:19.836 which is insurance. 00:06:20.016 --> 00:06:20.755 So how does it work? 00:06:20.975 --> 00:06:24.396 Well, funny thing is we do take insurance. 00:06:24.536 --> 00:06:24.836 Got it. 00:06:25.177 --> 00:06:26.137 For a portion of what we do. 00:06:26.576 --> 00:06:28.577 So that's been an evolution. 00:06:28.677 --> 00:06:28.858 You know, 00:06:28.898 --> 00:06:30.437 we found that a lot of people in 00:06:30.458 --> 00:06:32.017 our area did not have funds to pay 00:06:32.038 --> 00:06:33.918 for what it takes to do a recovery. 00:06:34.798 --> 00:06:36.038 And so I kind of gave in and 00:06:36.259 --> 00:06:38.038 started taking Medicare and Medicaid and 00:06:38.098 --> 00:06:39.500 insurances in about twenty, 00:06:39.779 --> 00:06:41.100 twenty thirteen, twenty fourteen. 00:06:41.800 --> 00:06:44.401 Found out that you can't pay your staff 00:06:45.021 --> 00:06:47.281 for neuro recovery with Medicare and 00:06:47.322 --> 00:06:48.963 Medicaid reimbursement really fast. 00:06:49.182 --> 00:06:50.423 So in twenty fifteen, 00:06:50.524 --> 00:06:52.584 I converted my practice to a nonprofit. 00:06:53.264 --> 00:06:55.024 That's kind of where we shifted. 00:06:55.766 --> 00:06:57.146 And with that, 00:06:57.245 --> 00:06:59.107 we have really affordable rates for people 00:06:59.146 --> 00:07:01.187 to continue once insurance 00:07:01.990 --> 00:07:04.791 kind of that short standard therapy. 00:07:04.831 --> 00:07:05.512 So we do both. 00:07:05.851 --> 00:07:08.733 We charge cash for the extra hour that, 00:07:08.752 --> 00:07:09.994 you know, they're with us for two, 00:07:10.014 --> 00:07:10.694 three hours. 00:07:11.014 --> 00:07:13.535 So we have a PT see them for 00:07:13.754 --> 00:07:16.076 whatever PT they can be billable. 00:07:16.216 --> 00:07:18.096 And then the rest are personal trainers, 00:07:18.216 --> 00:07:19.057 rec therapists, 00:07:19.516 --> 00:07:22.918 athletic trainers that are working side by 00:07:22.978 --> 00:07:24.678 side with us for that cash based service. 00:07:24.699 --> 00:07:24.819 Sure. 00:07:25.038 --> 00:07:25.658 PT's in the room. 00:07:25.978 --> 00:07:29.242 pt's there it's pt informed yeah yeah um 00:07:29.742 --> 00:07:31.403 what is the uh what is the at 00:07:31.442 --> 00:07:34.266 where does advocacy play in sustaining a 00:07:34.305 --> 00:07:37.108 model like this huge i i'm real good 00:07:37.148 --> 00:07:39.550 friends with my local congress should be 00:07:39.610 --> 00:07:41.911 right you should know their name but even 00:07:41.951 --> 00:07:43.372 more important they should they should see 00:07:43.413 --> 00:07:44.713 you and know who you are and here 00:07:44.733 --> 00:07:46.235 she comes again she's gonna she's gonna 00:07:46.295 --> 00:07:48.177 bug me about this and that's their job 00:07:48.297 --> 00:07:49.557 they have to be bugged 00:07:49.978 --> 00:07:50.658 Absolutely. 00:07:50.737 --> 00:07:53.218 So I advocate for payment. 00:07:53.319 --> 00:07:56.800 I advocate for tax laws because we're a 00:07:56.841 --> 00:07:57.420 nonprofit, 00:07:57.440 --> 00:07:58.742 but we still have to pay sales tax 00:07:58.762 --> 00:07:59.661 in the state of Minnesota, 00:08:00.401 --> 00:08:02.083 which for Neuro, 00:08:02.122 --> 00:08:03.423 you have a forty thousand dollar piece of 00:08:03.463 --> 00:08:05.363 equipment that you get granted to you. 00:08:06.324 --> 00:08:07.064 They give you the money. 00:08:07.084 --> 00:08:07.745 You go buy it. 00:08:08.024 --> 00:08:09.326 I have to pay taxes on that, 00:08:09.365 --> 00:08:11.387 which is a real bummer as a nonprofit. 00:08:12.507 --> 00:08:15.848 So working with them on tax laws, yeah, 00:08:15.947 --> 00:08:17.228 payment and everything. 00:08:17.408 --> 00:08:18.829 It's all part of my APTA role, 00:08:19.009 --> 00:08:23.192 so I'm really busy with working for the 00:08:23.252 --> 00:08:24.233 association as well. 00:08:24.273 --> 00:08:25.194 Good radio segue. 00:08:25.254 --> 00:08:27.896 What's your role with APTA in Minnesota? 00:08:28.175 --> 00:08:29.096 I am the current president. 00:08:29.255 --> 00:08:30.076 Congratulations. 00:08:30.137 --> 00:08:30.437 Thank you. 00:08:30.516 --> 00:08:31.637 Six weeks in. 00:08:31.778 --> 00:08:32.938 Why do something like that? 00:08:34.039 --> 00:08:34.960 And not just for you, 00:08:35.000 --> 00:08:36.922 but we're sort of in the room where 00:08:36.942 --> 00:08:38.864 a lot of it is happening and people 00:08:38.923 --> 00:08:40.846 see APTA and they might have a pro 00:08:40.905 --> 00:08:41.066 or a... 00:08:42.586 --> 00:08:44.128 I always say they're either pro or they 00:08:44.989 --> 00:08:46.811 might not just be clear of what the 00:08:46.850 --> 00:08:47.591 value prop is, 00:08:47.631 --> 00:08:48.993 but why not only be a member? 00:08:49.052 --> 00:08:52.855 Why also do a lot of extra unpaid 00:08:52.916 --> 00:08:53.196 work? 00:08:53.797 --> 00:08:54.596 I don't know if you saw that. 00:08:54.636 --> 00:08:55.378 It's six weeks in. 00:08:55.398 --> 00:08:56.097 They're not paying you. 00:08:56.118 --> 00:08:57.538 No, no, it's very unfair. 00:08:57.557 --> 00:08:58.958 They're paying you in other ways. 00:08:59.538 --> 00:09:02.580 You know, in the year, 00:09:02.600 --> 00:09:07.442 I joined a profession and it was never 00:09:07.501 --> 00:09:08.961 an option for me to not be a 00:09:09.001 --> 00:09:10.602 part of my professional association 00:09:10.643 --> 00:09:12.783 because I understood right away because I 00:09:12.823 --> 00:09:13.524 got involved. 00:09:13.604 --> 00:09:13.844 I was... 00:09:14.663 --> 00:09:16.245 on the floor at the House of Delegates 00:09:16.264 --> 00:09:19.066 in Minneapolis in, I think it was, 00:09:19.145 --> 00:09:20.167 as a student runner. 00:09:20.986 --> 00:09:22.048 And I saw it happening. 00:09:22.227 --> 00:09:25.188 I knew that if we didn't have a 00:09:25.229 --> 00:09:25.708 voice, 00:09:26.208 --> 00:09:27.669 our profession could not move forward. 00:09:28.571 --> 00:09:29.910 And in collective action, 00:09:29.971 --> 00:09:30.971 I didn't want to be one of those 00:09:30.991 --> 00:09:34.773 people that weren't active or weren't 00:09:34.812 --> 00:09:35.614 participating. 00:09:35.653 --> 00:09:36.953 Because with the APTA, 00:09:38.554 --> 00:09:40.375 we're supporting all PTs and PTAs. 00:09:41.235 --> 00:09:42.216 Every one of them. 00:09:42.416 --> 00:09:43.557 You look at the new campaign, 00:09:43.616 --> 00:09:44.677 PT for Future Me. 00:09:45.076 --> 00:09:46.277 It's advertising physical therapy. 00:09:46.336 --> 00:09:49.278 It's not just advertising members. 00:09:49.398 --> 00:09:50.697 It's a collective action movement. 00:09:50.738 --> 00:09:51.738 And in collective action, 00:09:51.918 --> 00:09:53.698 there is always going to be people who 00:09:53.719 --> 00:09:54.859 don't participate. 00:09:55.599 --> 00:09:56.779 At whatever level that is. 00:09:56.899 --> 00:09:57.519 I didn't want to be that. 00:09:57.899 --> 00:10:00.679 I wanted to be a piece of our 00:10:00.700 --> 00:10:02.581 success as a profession. 00:10:02.660 --> 00:10:03.301 And it's important to me. 00:10:03.668 --> 00:10:06.309 What's your BHAG, your big, hairy, 00:10:06.350 --> 00:10:08.530 audacious goal in your presidency? 00:10:08.571 --> 00:10:09.571 What's the thing that you're like, hey, 00:10:09.591 --> 00:10:11.432 if I accomplish this or this or this, 00:10:11.912 --> 00:10:13.153 that will have been successful in your 00:10:13.192 --> 00:10:13.952 eyes? 00:10:14.013 --> 00:10:14.253 Well, 00:10:14.673 --> 00:10:16.374 when I sat down with our executive 00:10:16.394 --> 00:10:17.453 director and said, yeah, 00:10:17.953 --> 00:10:19.615 I'm going to run for president. 00:10:19.975 --> 00:10:21.515 I'll do that. 00:10:21.635 --> 00:10:22.336 I said one thing. 00:10:22.556 --> 00:10:24.216 I said our focus will be payment. 00:10:24.256 --> 00:10:24.397 Yeah. 00:10:25.547 --> 00:10:27.107 My whole world is revolved around that. 00:10:28.388 --> 00:10:30.589 Everything comes back to payment, 00:10:31.129 --> 00:10:32.809 whether we're cash-based or 00:10:32.889 --> 00:10:33.649 insurance-based. 00:10:33.750 --> 00:10:34.269 It's all cash. 00:10:34.309 --> 00:10:35.591 It's just whether you're paying it 00:10:35.610 --> 00:10:36.931 directly or it's someone else who's paying 00:10:36.951 --> 00:10:37.152 it for you. 00:10:37.172 --> 00:10:38.072 It's all payment. 00:10:38.351 --> 00:10:39.913 I've been on the board of directors in 00:10:40.052 --> 00:10:41.153 Minnesota for six years. 00:10:41.173 --> 00:10:42.533 We do strategic planning. 00:10:42.653 --> 00:10:43.714 I just sit there and be like, 00:10:44.474 --> 00:10:45.475 that problem is because of payment. 00:10:46.215 --> 00:10:47.216 That problem is because of payment. 00:10:47.235 --> 00:10:47.756 Go deeper. 00:10:48.277 --> 00:10:49.479 And, you know, 00:10:50.179 --> 00:10:51.541 unless you're in private practice and 00:10:51.561 --> 00:10:52.081 you're in, like, 00:10:52.282 --> 00:10:53.524 nonprofit where I'm trying to provide 00:10:53.563 --> 00:10:55.446 services to everyone at the most 00:10:55.485 --> 00:10:57.268 affordable rate that I can then pay my 00:10:57.288 --> 00:10:57.567 bills. 00:10:57.989 --> 00:10:58.809 That's it, right? 00:10:58.870 --> 00:10:59.951 That's why I'm nonprofit. 00:11:00.051 --> 00:11:00.311 You'll say, 00:11:00.370 --> 00:11:01.472 why did you sell out your business? 00:11:02.033 --> 00:11:04.395 Because I want to provide service to 00:11:04.556 --> 00:11:04.976 everyone. 00:11:05.057 --> 00:11:05.898 No margin, no mission. 00:11:06.097 --> 00:11:06.578 Yeah. 00:11:06.739 --> 00:11:07.759 And the payment's just not there. 00:11:07.840 --> 00:11:09.461 And so I fundraise four hundred thousand 00:11:09.480 --> 00:11:10.923 dollars to a million dollars every year. 00:11:11.682 --> 00:11:12.264 I do that, too. 00:11:12.364 --> 00:11:14.206 That's my job currently. 00:11:16.048 --> 00:11:16.148 Yeah. 00:11:16.168 --> 00:11:17.129 Where was I going with that payment? 00:11:17.469 --> 00:11:18.610 Everything's connected to payment. 00:11:19.110 --> 00:11:19.991 Everything. 00:11:20.091 --> 00:11:21.673 And so I just said that's going to 00:11:21.692 --> 00:11:23.495 be the one thing I'm probably not going 00:11:23.514 --> 00:11:25.197 to spend a lot of time reorging. 00:11:26.878 --> 00:11:28.058 I do this at work all the time, 00:11:28.078 --> 00:11:29.640 like having to rewrite job descriptions. 00:11:29.900 --> 00:11:30.861 Probably not going to spend a lot of 00:11:30.881 --> 00:11:32.043 time on that as a president. 00:11:32.464 --> 00:11:33.985 I'm going to be working on payments. 00:11:34.086 --> 00:11:35.427 That's it. 00:11:36.128 --> 00:11:37.850 So I was super excited to see the 00:11:37.889 --> 00:11:40.472 new strategic plan come out that Kyle 00:11:40.533 --> 00:11:41.594 really promoted. 00:11:41.693 --> 00:11:43.196 And what's on the top? 00:11:43.456 --> 00:11:43.817 Payment. 00:11:43.937 --> 00:11:44.998 Well, they said it was... 00:11:46.879 --> 00:11:48.061 Pulled the members, right? 00:11:48.120 --> 00:11:48.922 Always good to listen. 00:11:48.942 --> 00:11:51.023 And they said the number one issue was 00:11:51.082 --> 00:11:51.423 payment. 00:11:51.903 --> 00:11:54.186 And then there was four thousand miles of 00:11:54.245 --> 00:11:54.546 nothing. 00:11:54.625 --> 00:11:55.626 And then the number two thing. 00:11:55.927 --> 00:11:56.547 It was payment. 00:11:57.187 --> 00:11:57.687 Do that. 00:11:58.008 --> 00:11:58.249 Yeah. 00:11:58.288 --> 00:12:00.570 We just we have a survey right now 00:12:00.870 --> 00:12:02.971 that closes tomorrow in Minnesota. 00:12:03.812 --> 00:12:07.436 What's what's your top ten advocacy needs? 00:12:08.076 --> 00:12:08.917 Money at the top. 00:12:09.017 --> 00:12:09.317 Right. 00:12:10.897 --> 00:12:11.118 Payment. 00:12:11.138 --> 00:12:11.658 Again, everything. 00:12:11.697 --> 00:12:13.337 Payment's going to affect what happens. 00:12:13.357 --> 00:12:14.158 I mean, there's a lot of students. 00:12:14.177 --> 00:12:16.058 You can't shake a stick without hitting 00:12:16.099 --> 00:12:18.139 ten new grads or PT students here. 00:12:18.539 --> 00:12:20.419 Or apparently children. 00:12:20.480 --> 00:12:22.681 First time I've seen just a nine-year-old 00:12:22.721 --> 00:12:23.280 walking around. 00:12:23.740 --> 00:12:24.041 Maybe. 00:12:24.282 --> 00:12:25.162 There might be a PTA student. 00:12:25.201 --> 00:12:25.501 I'm not sure. 00:12:27.582 --> 00:12:30.024 But you can retain staff when they don't 00:12:30.065 --> 00:12:31.446 leave if you can pay them better. 00:12:32.506 --> 00:12:33.788 You can afford equipment better. 00:12:33.847 --> 00:12:35.370 You can open a second facility. 00:12:35.830 --> 00:12:36.169 Payment. 00:12:36.370 --> 00:12:37.792 Everything's payment. 00:12:37.912 --> 00:12:39.952 Are we just waking up to this? 00:12:40.813 --> 00:12:42.154 Or are we just deciding that we can 00:12:42.235 --> 00:12:43.475 actually... What is the deal? 00:12:43.515 --> 00:12:44.636 Because I've been in PT for ten years. 00:12:44.657 --> 00:12:46.538 I've never heard this much movement in 00:12:46.558 --> 00:12:47.158 that direction before. 00:12:47.158 --> 00:12:49.421 There's been an interesting resistance and 00:12:49.541 --> 00:12:50.301 all respect. 00:12:50.380 --> 00:12:50.761 Like I said, 00:12:50.802 --> 00:12:52.982 I've been for six years on the board 00:12:53.003 --> 00:12:54.384 meeting saying it's all because of 00:12:54.403 --> 00:12:54.724 payment. 00:12:54.844 --> 00:12:57.245 And there's an interesting, yeah, 00:12:57.326 --> 00:12:59.388 but we should really have more member 00:12:59.447 --> 00:13:00.087 engagement. 00:13:00.368 --> 00:13:02.590 So let's have a five K. Like, no, 00:13:02.669 --> 00:13:04.451 that's not helping us with our primary 00:13:04.530 --> 00:13:05.532 problem, which is payment. 00:13:05.552 --> 00:13:07.072 So I don't know. 00:13:07.092 --> 00:13:07.592 We're getting there. 00:13:07.913 --> 00:13:08.313 We're getting there. 00:13:08.433 --> 00:13:09.595 And those things are important to member 00:13:09.615 --> 00:13:10.034 engagements. 00:13:10.054 --> 00:13:10.414 Important. 00:13:10.534 --> 00:13:11.816 Having activities are important, 00:13:11.855 --> 00:13:13.717 but do you want to get member engagement? 00:13:14.197 --> 00:13:15.458 Show them you're working on payments. 00:13:15.479 --> 00:13:15.538 Yes. 00:13:16.119 --> 00:13:16.820 If I come with you, 00:13:16.860 --> 00:13:18.541 are we going to kick payments ass? 00:13:18.561 --> 00:13:19.522 Yeah, then I'm riding with you. 00:13:19.542 --> 00:13:20.542 This is what I'm saying. 00:13:20.562 --> 00:13:21.322 This is where our focus needs to be, 00:13:21.342 --> 00:13:24.205 and this is where it's going to be. 00:13:24.365 --> 00:13:28.947 Where's the biggest needle that's able to 00:13:28.988 --> 00:13:30.950 be moved, state level, national level? 00:13:31.009 --> 00:13:31.289 Because, like, 00:13:31.389 --> 00:13:32.331 it's obviously if you can move it to 00:13:32.350 --> 00:13:33.191 the national level, that's better. 00:13:33.431 --> 00:13:34.471 It doesn't mean it's easier to do. 00:13:34.851 --> 00:13:35.753 So where's, I mean, 00:13:36.153 --> 00:13:37.474 you're going to answer both because you're 00:13:37.494 --> 00:13:38.495 a state president, obviously. 00:13:38.815 --> 00:13:40.836 But I guess the question is, like, 00:13:40.876 --> 00:13:42.197 where are we most likely to have a 00:13:42.258 --> 00:13:42.638 touchdown? 00:13:43.504 --> 00:13:45.144 We are most likely to have a touchdown 00:13:45.164 --> 00:13:45.765 at the local level. 00:13:45.785 --> 00:13:46.365 Yeah, of course. 00:13:47.047 --> 00:13:49.729 And that's what I mentioned in some recent 00:13:49.749 --> 00:13:51.289 LinkedIn conversations. 00:13:51.330 --> 00:13:54.711 But what's what worries me about the kind 00:13:54.751 --> 00:13:57.013 of, you know, 00:13:57.153 --> 00:14:00.014 contingent relationship of APTA with 00:14:00.174 --> 00:14:01.836 others that aren't APTA supporters. 00:14:01.876 --> 00:14:04.778 And it's we are the only ones at 00:14:04.798 --> 00:14:07.440 the local level supporting the chapter. 00:14:07.559 --> 00:14:10.562 State chapters are supporting the local 00:14:10.601 --> 00:14:12.583 changes, which are state legislators. 00:14:14.465 --> 00:14:17.307 That's the biggest impact on our 00:14:17.326 --> 00:14:18.847 day-to-day lives is where we work, 00:14:18.868 --> 00:14:19.727 what state we live in, 00:14:19.807 --> 00:14:21.448 and the changes at the state level, 00:14:22.230 --> 00:14:23.350 whether it's legislative, 00:14:23.370 --> 00:14:25.131 whether it's Medicaid services, 00:14:25.172 --> 00:14:28.254 which drives a ton, and payment, 00:14:28.293 --> 00:14:30.195 like Blue Cross Blue Shield of Minnesota, 00:14:30.355 --> 00:14:31.196 that's local. 00:14:32.255 --> 00:14:34.457 um that we have some issues going on 00:14:34.477 --> 00:14:36.719 there and and you have to be tackling 00:14:36.739 --> 00:14:39.721 that local so if we don't support apta 00:14:39.980 --> 00:14:42.283 as a whole we're not supporting our local 00:14:42.302 --> 00:14:45.764 chapters and my worry is is that with 00:14:46.024 --> 00:14:48.966 declining membership people don't realize 00:14:49.527 --> 00:14:51.227 how that's going to be impacting them at 00:14:51.268 --> 00:14:53.509 the at the state level yeah weakening 00:14:53.529 --> 00:14:55.291 things yeah yeah yeah medicare is 00:14:55.331 --> 00:14:59.352 important yes um but this local advocacy 00:14:59.493 --> 00:14:59.893 effort 00:15:01.134 --> 00:15:02.195 I think if it goes away, 00:15:02.254 --> 00:15:08.596 people will be like, oh, 00:15:09.057 --> 00:15:10.038 I guess in Idaho right now, 00:15:10.097 --> 00:15:12.538 the state legislator seriously has a bill 00:15:12.578 --> 00:15:14.940 on the floor to stop paying PT, OT, 00:15:14.960 --> 00:15:15.379 and speech. 00:15:16.059 --> 00:15:16.179 Stop. 00:15:17.221 --> 00:15:17.561 Stop. 00:15:18.360 --> 00:15:19.501 They're having to fight that. 00:15:19.522 --> 00:15:19.601 Yeah. 00:15:21.129 --> 00:15:23.390 ABTA National provides us a lot of support 00:15:23.730 --> 00:15:26.092 from a state perspective, but no, 00:15:26.214 --> 00:15:27.855 it's your local volunteers. 00:15:28.414 --> 00:15:29.797 It's your local chapter. 00:15:30.136 --> 00:15:32.899 It's your peer that's going to the state 00:15:32.918 --> 00:15:33.580 capitol and fighting. 00:15:33.639 --> 00:15:35.041 So what if you went with your peer? 00:15:35.542 --> 00:15:37.984 And we sent, you know, in Idaho, 00:15:38.583 --> 00:15:42.327 they had all, you know, pick a number, 00:15:42.408 --> 00:15:44.490 five thousand registered PTs and PTAs. 00:15:44.990 --> 00:15:45.931 What if they all showed up at the 00:15:45.951 --> 00:15:46.171 capitol? 00:15:47.711 --> 00:15:49.393 But instead they have thirty showing up of 00:15:49.472 --> 00:15:50.173 active volunteers. 00:15:50.193 --> 00:15:51.333 So that's where collective action, 00:15:52.215 --> 00:15:53.554 I think we can do better because we're 00:15:53.735 --> 00:15:56.397 compassionate PTs and PTAs. 00:15:57.356 --> 00:15:58.758 I think we can do better and I 00:15:58.778 --> 00:15:59.359 think we need to. 00:15:59.379 --> 00:15:59.938 We need to show up. 00:16:00.423 --> 00:16:02.466 You haven't mentioned other professions, 00:16:02.525 --> 00:16:04.749 but you think that collaboration across 00:16:04.788 --> 00:16:06.831 professions is terribly important. 00:16:06.870 --> 00:16:10.115 Why and what's the secret sauce there? 00:16:10.735 --> 00:16:12.357 Collective action, again, needs numbers, 00:16:12.658 --> 00:16:13.938 power and numbers. 00:16:14.580 --> 00:16:16.282 We don't work enough with our OT and 00:16:16.302 --> 00:16:17.102 speech partners. 00:16:18.124 --> 00:16:19.304 And so that's the obvious, 00:16:19.345 --> 00:16:21.264 the first obvious collaboration that each 00:16:21.284 --> 00:16:22.245 state needs to do better. 00:16:22.285 --> 00:16:23.926 And there is a movement towards forming 00:16:23.946 --> 00:16:24.866 more trial alliances, 00:16:24.907 --> 00:16:26.447 which I'm working on getting going in 00:16:26.466 --> 00:16:28.827 Minnesota as a as a focus. 00:16:29.869 --> 00:16:30.509 Because, again, 00:16:30.729 --> 00:16:32.149 what if we did combined days on the 00:16:32.168 --> 00:16:34.789 Hill where there are four thousand OTs and 00:16:34.850 --> 00:16:38.251 our five thousand PTs and there, you know, 00:16:38.292 --> 00:16:39.451 two thousand speech therapists? 00:16:39.471 --> 00:16:40.673 What if we all showed up together? 00:16:42.114 --> 00:16:44.976 Because payment is DBT codes. 00:16:45.037 --> 00:16:45.837 It's not just PT. 00:16:45.857 --> 00:16:46.940 It's not limited to one of us. 00:16:46.960 --> 00:16:47.500 It's not just OT. 00:16:47.539 --> 00:16:48.260 It's not just speech. 00:16:48.662 --> 00:16:50.203 So that's the obvious one. 00:16:50.303 --> 00:16:52.986 And then also I'm seeing in other states, 00:16:53.027 --> 00:16:54.408 and we all need to do better on 00:16:54.428 --> 00:16:54.668 this, 00:16:54.828 --> 00:16:57.251 is do we have enough energy to worry 00:16:57.293 --> 00:16:58.573 about scope creep? 00:16:59.734 --> 00:17:02.176 Or if we're friends with everyone and we 00:17:02.235 --> 00:17:04.557 really understood their position of why, 00:17:04.577 --> 00:17:06.919 you know, whatever that other entity is, 00:17:07.579 --> 00:17:10.541 why they want to maybe expand their scope 00:17:10.561 --> 00:17:13.044 a little bit because they're needing to 00:17:13.064 --> 00:17:14.904 meet a need because there's not enough PTs 00:17:14.944 --> 00:17:15.224 out there. 00:17:16.566 --> 00:17:18.808 Maybe they'll listen to us and stop 00:17:18.868 --> 00:17:20.029 fighting our bills. 00:17:20.471 --> 00:17:21.711 And we have a lot of that at 00:17:21.751 --> 00:17:22.252 the state level. 00:17:22.292 --> 00:17:25.655 We have a lot of fighting from keeping 00:17:25.875 --> 00:17:27.377 our scope under control. 00:17:28.960 --> 00:17:29.641 And we don't like it. 00:17:30.361 --> 00:17:32.604 We don't like it when that profession 00:17:32.624 --> 00:17:34.266 comes out and says PTs shouldn't do that. 00:17:35.287 --> 00:17:35.926 We're doctors. 00:17:36.667 --> 00:17:37.269 Yes, we should. 00:17:39.861 --> 00:17:41.702 But when we show up and say that 00:17:41.943 --> 00:17:43.404 another profession can't do things. 00:17:43.424 --> 00:17:44.586 Now we're doing the thing that we just 00:17:44.606 --> 00:17:45.086 said we didn't. 00:17:45.146 --> 00:17:45.807 Yes, 00:17:46.028 --> 00:17:47.630 and we can get a bad name at 00:17:47.670 --> 00:17:48.290 the Capitol, 00:17:48.351 --> 00:17:49.792 and that's not helping our bills go 00:17:49.813 --> 00:17:50.433 forward either. 00:17:50.453 --> 00:17:51.634 It's helping nothing go anywhere. 00:17:51.755 --> 00:17:53.076 So can we all get along and be 00:17:53.116 --> 00:17:53.537 friends? 00:17:53.678 --> 00:17:55.599 I know that there's, you know, 00:17:56.921 --> 00:17:57.721 there's leverage. 00:17:57.741 --> 00:17:58.723 There's keeping some... 00:18:00.549 --> 00:18:02.111 eye on others, helps us with leverage, 00:18:02.131 --> 00:18:03.132 helps us with politics. 00:18:04.133 --> 00:18:05.113 But yeah, 00:18:05.212 --> 00:18:06.374 I think we can do a better job 00:18:06.594 --> 00:18:08.476 of supporting all of healthcare because 00:18:08.516 --> 00:18:10.096 we're all kind of struggling, right? 00:18:10.336 --> 00:18:11.498 And overlap's going to happen. 00:18:12.678 --> 00:18:13.679 And sometimes we need it to happen, 00:18:13.699 --> 00:18:14.859 especially in rural areas. 00:18:14.900 --> 00:18:16.520 Minnesota has a lot of rural area. 00:18:17.141 --> 00:18:18.001 There's not enough PTs. 00:18:18.382 --> 00:18:19.383 There's not enough ATs. 00:18:19.863 --> 00:18:20.884 There's not enough physicians. 00:18:21.523 --> 00:18:22.325 There's not enough PAs. 00:18:22.825 --> 00:18:24.946 And it's only gonna get more difficult, 00:18:24.987 --> 00:18:25.186 right? 00:18:25.207 --> 00:18:26.628 I mean- We have a lot of hospitals 00:18:26.669 --> 00:18:27.589 closing in Minnesota. 00:18:27.609 --> 00:18:28.349 I'm sure that's happening everywhere. 00:18:28.369 --> 00:18:28.971 We walk around this conference, 00:18:28.990 --> 00:18:29.731 how many are recruiting? 00:18:29.892 --> 00:18:31.574 It's recruiting and technology, right? 00:18:31.594 --> 00:18:32.074 That's what it is. 00:18:32.094 --> 00:18:32.575 Yeah, yeah. 00:18:32.694 --> 00:18:35.317 I have some open positions at my clinic. 00:18:35.497 --> 00:18:36.258 Put a plug in there. 00:18:36.858 --> 00:18:38.000 You know, they're hard to fill. 00:18:38.259 --> 00:18:39.020 Where in Minnesota? 00:18:39.260 --> 00:18:40.882 We're in Rochester, Minnesota, 00:18:41.221 --> 00:18:42.603 so home of Mayo Clinic. 00:18:42.843 --> 00:18:45.085 We're a private practice working 00:18:45.125 --> 00:18:46.506 alongside, very successfully, 00:18:46.546 --> 00:18:47.506 a large healthcare system. 00:18:47.726 --> 00:18:51.088 What mindset shift do PTs need to better 00:18:51.169 --> 00:18:54.090 serve underserved communities? 00:18:54.230 --> 00:18:54.431 I mean, 00:18:54.750 --> 00:18:57.752 let's say someone wants to eventually open 00:18:57.772 --> 00:18:59.153 a twenty thousand square foot thing, 00:18:59.173 --> 00:18:59.894 that might be a little bit in the 00:18:59.913 --> 00:19:00.234 future, 00:19:00.535 --> 00:19:02.936 but what can they do if someone's 00:19:02.957 --> 00:19:03.457 listening now? 00:19:03.839 --> 00:19:04.641 Yeah, yeah. 00:19:04.681 --> 00:19:05.741 Being, again, 00:19:05.761 --> 00:19:08.923 being open to this idea that not 00:19:08.963 --> 00:19:10.125 everything comes from insurance. 00:19:11.185 --> 00:19:14.229 And that's a mind shift that still exists, 00:19:14.269 --> 00:19:14.788 especially, 00:19:14.969 --> 00:19:16.049 I was just talking to somebody this 00:19:16.089 --> 00:19:17.951 morning where works at a large hospital 00:19:17.991 --> 00:19:18.392 system. 00:19:19.031 --> 00:19:21.193 And I told them about my model of 00:19:21.855 --> 00:19:24.416 enhanced programming that doesn't fit the 00:19:24.457 --> 00:19:25.176 insurance model. 00:19:25.198 --> 00:19:26.377 So you can do both, right? 00:19:26.397 --> 00:19:27.499 You can take insurance and you can take 00:19:27.519 --> 00:19:27.799 cash. 00:19:28.059 --> 00:19:29.240 Because if you look at the manuals, 00:19:29.280 --> 00:19:30.402 these enhanced programs, 00:19:30.442 --> 00:19:31.762 these neuro recovery programs, 00:19:32.123 --> 00:19:33.805 They don't fit what Medicare pays for. 00:19:34.164 --> 00:19:35.445 So therefore, we can take cash. 00:19:36.207 --> 00:19:36.907 And she said, 00:19:37.107 --> 00:19:38.068 but I work for a large system. 00:19:38.088 --> 00:19:40.190 We're not allowed to take cash. 00:19:40.590 --> 00:19:42.792 Right? 00:19:42.992 --> 00:19:45.494 Or I work with a low-income population, 00:19:45.535 --> 00:19:46.655 so I can't take cash. 00:19:47.116 --> 00:19:48.617 So this is true. 00:19:48.637 --> 00:19:49.959 They don't have a lot of funds. 00:19:50.019 --> 00:19:51.941 But there's things like GoFundMe. 00:19:53.061 --> 00:19:55.604 If you're open to a nonprofit arm or 00:19:55.624 --> 00:19:56.845 a nonprofit model, 00:19:57.986 --> 00:20:00.626 I write grants and I don't take any 00:20:00.686 --> 00:20:01.748 state or federal grants. 00:20:01.807 --> 00:20:03.648 It's all family foundations. 00:20:03.729 --> 00:20:05.128 It's banks. 00:20:05.210 --> 00:20:07.411 It's our local Rochester area foundation. 00:20:07.770 --> 00:20:09.550 They support what we do because they see 00:20:09.570 --> 00:20:10.531 the difference we're making. 00:20:10.632 --> 00:20:11.392 And you're in the community. 00:20:11.531 --> 00:20:13.313 And so then something that's one hundred 00:20:13.333 --> 00:20:14.294 and forty dollars an hour. 00:20:15.213 --> 00:20:17.535 becomes fifty dollars an hour or maybe 00:20:17.555 --> 00:20:19.714 even twenty five dollars an hour or maybe 00:20:19.734 --> 00:20:22.635 they have a gofundme that pays full right 00:20:22.855 --> 00:20:26.096 because i'm able to subsidize right the 00:20:26.175 --> 00:20:28.916 full cost pay my bills pay my staff 00:20:29.196 --> 00:20:31.637 they get health insurance they we but none 00:20:31.657 --> 00:20:32.837 of this is on the syllabus in pt 00:20:32.857 --> 00:20:35.117 school this is simple not easy this is 00:20:35.298 --> 00:20:37.239 not on the beaten path that's why you 00:20:37.278 --> 00:20:39.798 doing an episode on this is so rare 00:20:39.919 --> 00:20:41.180 right it's not that it's nowhere but it's 00:20:41.359 --> 00:20:42.619 it's not everywhere it's definitely not 00:20:42.660 --> 00:20:42.960 everywhere 00:20:43.180 --> 00:20:43.599 Very rare. 00:20:44.019 --> 00:20:45.961 I haven't actually met anyone that has a 00:20:46.000 --> 00:20:46.961 model like mine. 00:20:48.761 --> 00:20:50.182 And so, yeah, it's very rare, 00:20:50.221 --> 00:20:51.702 but it's doable, and it's possible. 00:20:52.262 --> 00:20:54.044 You have to have legal support. 00:20:54.144 --> 00:20:55.604 You have to have accounting support. 00:20:55.624 --> 00:20:56.424 I mean, I have an accountant. 00:20:56.505 --> 00:20:57.265 I have an attorney now. 00:20:57.605 --> 00:20:58.785 I didn't at first, actually. 00:20:58.805 --> 00:21:00.546 Yeah, how hard could it be? 00:21:00.566 --> 00:21:01.066 It's a bunch of math. 00:21:01.086 --> 00:21:02.106 It's a bunch of numbers. 00:21:02.126 --> 00:21:04.086 How hard could it be? 00:21:04.106 --> 00:21:04.867 I don't recommend it, 00:21:04.907 --> 00:21:07.167 but I wrote my own contracts, 00:21:07.208 --> 00:21:08.169 and I did a lot, you know. 00:21:09.815 --> 00:21:12.256 first to get going but now i would 00:21:12.316 --> 00:21:14.455 highly recommend legal support um lots of 00:21:14.496 --> 00:21:16.777 great consultants out there to help um you 00:21:16.797 --> 00:21:19.057 know we are a member member of pps 00:21:19.718 --> 00:21:21.498 even as a non-profit and i'm definitely 00:21:21.518 --> 00:21:23.618 the unicorn and i definitely sometimes 00:21:23.638 --> 00:21:25.459 when i talk but you can still steal 00:21:25.499 --> 00:21:28.180 and borrow ideas and spin and we are 00:21:28.200 --> 00:21:28.759 a private practice 00:21:29.440 --> 00:21:31.561 Yeah, we have to pay our bills. 00:21:32.402 --> 00:21:34.303 We actually have to make extra money for 00:21:34.323 --> 00:21:35.403 our savings account, right? 00:21:36.704 --> 00:21:38.645 Non-profit doesn't mean no income. 00:21:38.665 --> 00:21:39.145 No profit, right. 00:21:41.007 --> 00:21:43.288 And so I love to share that it's 00:21:43.328 --> 00:21:43.828 possible. 00:21:44.449 --> 00:21:47.851 My heart feels happy that I provide so 00:21:47.931 --> 00:21:50.992 much to the community and we have our 00:21:51.012 --> 00:21:52.973 goal is access for everyone. 00:21:52.993 --> 00:21:53.173 Good. 00:21:53.855 --> 00:21:54.875 And the website one more time. 00:21:54.994 --> 00:21:56.175 Oh, it's easy. 00:21:56.336 --> 00:21:57.497 ChooseEA.org. 00:21:57.817 --> 00:21:58.156 Smart. 00:21:58.497 --> 00:21:59.356 Rochester, Minnesota. 00:22:00.518 --> 00:22:01.998 I mean, by the time they get hired, 00:22:02.018 --> 00:22:02.738 it'll probably be spring. 00:22:02.758 --> 00:22:03.519 It'll be a little cooler. 00:22:03.638 --> 00:22:05.499 Sorry, a little warmer in Rochester, 00:22:05.519 --> 00:22:05.858 Minnesota. 00:22:05.939 --> 00:22:08.059 It is a beautiful, 00:22:08.220 --> 00:22:10.740 beautiful year-round state. 00:22:10.760 --> 00:22:12.701 But you do have to like some snow. 00:22:13.161 --> 00:22:13.740 Or curling. 00:22:13.941 --> 00:22:15.021 Your husband's taking up curling. 00:22:15.061 --> 00:22:15.701 Yeah, he'd like to. 00:22:15.721 --> 00:22:16.162 We'll see. 00:22:16.201 --> 00:22:19.363 The Olympics has sparked some interest. 00:22:19.442 --> 00:22:20.603 Melanie, we have a tradition on the show. 00:22:20.663 --> 00:22:21.163 Every episode, 00:22:21.182 --> 00:22:23.163 we do something called The Parting Shot. 00:22:24.166 --> 00:22:26.212 This is The Parting Shot. 00:22:26.733 --> 00:22:28.157 One last mic drop moment. 00:22:28.819 --> 00:22:29.622 No pressure. 00:22:30.063 --> 00:22:32.189 Just your legacy on the line. 00:22:33.669 --> 00:22:33.909 All right, 00:22:33.929 --> 00:22:35.550 Parting Shot brought to you by U.S. 00:22:35.671 --> 00:22:36.211 Physical Therapy. 00:22:36.230 --> 00:22:37.311 We're at the booth right now, U.S. 00:22:37.352 --> 00:22:38.012 Physical Therapy. 00:22:38.532 --> 00:22:39.894 National network of clinics focused on 00:22:39.913 --> 00:22:40.795 developing clinicians, 00:22:41.234 --> 00:22:41.895 not burning them out. 00:22:41.935 --> 00:22:43.297 Leadership tracks, mentorship, 00:22:43.317 --> 00:22:43.817 career growth. 00:22:43.856 --> 00:22:47.059 Find them online at usph.com or find them 00:22:47.119 --> 00:22:48.800 here if you're watching the live stream. 00:22:48.901 --> 00:22:50.422 I swear, this is not prerecorded. 00:22:50.742 --> 00:22:53.365 We are at the Expo Hall at USPH's 00:22:53.404 --> 00:22:54.326 booth, which is twelve... 00:22:55.026 --> 00:22:56.888 I might, I'm probably, 00:22:56.969 --> 00:22:58.711 look for the guy in the ridiculous tuxedo 00:22:58.731 --> 00:22:59.593 that I bought on Amazon. 00:22:59.792 --> 00:23:00.894 You buy tuxedos on Amazon. 00:23:01.315 --> 00:23:02.317 No, parting shot. 00:23:02.376 --> 00:23:03.218 What do you want to leave as your 00:23:03.238 --> 00:23:05.461 mic drop moment with the audience today? 00:23:06.854 --> 00:23:08.596 I would like to leave that private 00:23:08.655 --> 00:23:10.116 practice is not just for orthopedics. 00:23:10.136 --> 00:23:10.978 Yeah. 00:23:10.998 --> 00:23:13.440 That community wellness and neurologic 00:23:13.480 --> 00:23:13.980 recovery. 00:23:14.099 --> 00:23:15.922 We need a neuro gym in every town. 00:23:15.942 --> 00:23:16.261 Yeah. 00:23:16.962 --> 00:23:18.304 And but you might need to be open 00:23:18.324 --> 00:23:18.983 to a different model. 00:23:19.545 --> 00:23:19.845 Yeah. 00:23:20.005 --> 00:23:22.007 So it might you I would encourage looking 00:23:22.047 --> 00:23:24.709 at nonprofitness as one way to make that 00:23:24.729 --> 00:23:24.929 happen. 00:23:25.068 --> 00:23:25.689 But in the end, 00:23:26.009 --> 00:23:27.849 you're now able to provide great care for 00:23:27.910 --> 00:23:29.029 people who desperately need it. 00:23:29.109 --> 00:23:30.809 And isn't that why most of us showed 00:23:30.869 --> 00:23:30.950 up? 00:23:31.190 --> 00:23:32.891 It is why most of us showed up. 00:23:33.391 --> 00:23:33.730 Yeah, 00:23:33.790 --> 00:23:36.632 we need to also take on an ideology 00:23:36.652 --> 00:23:37.951 that insurance doesn't pay for everything. 00:23:38.451 --> 00:23:40.492 And people should continue to get care 00:23:40.772 --> 00:23:42.712 after ten, fourteen visits. 00:23:43.333 --> 00:23:45.473 Melanie Brennan, APTA Minnesota. 00:23:45.634 --> 00:23:47.153 Good luck in your presidency. 00:23:47.374 --> 00:23:49.115 We'll check back in before your presidency 00:23:49.295 --> 00:23:49.634 is over. 00:23:49.835 --> 00:23:50.275 Sounds good.