You're listening to the PT Pinecast,
where smart people in healthcare come to
make noise.
Here's your host, Jimmy McKay.
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I know people named Sarah are very
particular.
Sarah, Sarah with an H.
s-a-r-a health.com our guest today not new
to this show not new to the audience
she's been here i think she was like
episode twelve or twenty like something in
the first twenty um and she's been part
of the profession for a long time since
this show is still finding its footing i
don't know if we've found it yet but
we're still working on it um and we've
told her origin story before clinician
founder builder leader but today isn't
about really how she started today's about
And what you want to know,
where are we now?
And the big we is you listening or
watching, looking at you,
but also like the profession.
So her organization has been doing this
state of rehab therapy report,
which was just a really good idea,
still is.
But I remember thinking about it and
saying, yes,
you have access to all these people who
have similar problems.
And let's figure out,
not just by like sort of figuring out
which way the wind is blowing,
like actually asking them questions, data.
to clearly paint a picture, clinicians,
leaders,
might be experiencing two very different
realities inside the same clinics today.
Maybe burnout isn't the full story.
Maybe misalignment is.
Ooh, is that foreshadowing?
Yes, it's always foreshadowing.
So she's back, friend of the show,
co-founder of WebPT,
and someone who's never been afraid to
challenge this profession to do better.
Heidi Jananga,
welcome back for I don't even know how
many times to the show,
to the PT podcast, Heidi Jananga.
I stopped counting,
but it's always a pleasure.
Thank you so much for having me.
I watched a recent episode of Saturday
Night Live.
I think it's the Five Timers Club.
I know, it ain't a jacket.
They get a jacket.
It's a smoking jacket.
Steve Martin, Martin Short,
Justin Timberlake.
When you see who's in the Five Timers
Club, it's pretty legit.
You have to be well beyond.
The jacket's in the mail.
I'll get my assistant.
I think you should do some sort of
mug.
You are the pint cast, right?
It needs to be some kind of cool
mug.
That's what it is.
Just throwing it out there.
All right, good.
All right, so let's get to this data,
right?
So you guys,
how long have you been doing this,
the state of therapy rehab report?
You guys have been doing this for a
while now.
Yeah,
I want to say this is like year
twelve that we've actually done it and
pulled it together,
created this beautiful report and
published it for all of our members,
but also to the public to really access
this information and data.
It really shows, I mean,
even for twelve years where it used to
be twenty five years ago.
I don't know.
I'm making numbers up.
If you had information,
the goal was hoard it.
And if you wanted it,
you had to join.
And then all of a sudden somewhere because
of these things, smartphones,
it then became the absolute opposite,
which is the more you give away like
a boomerang, things come back.
And it's like a bell curve, right?
You got people who are never going to
buy from you or use you.
You got people who are already buying from
you and who are lifers who are always
going to buy from you.
And then you're just thinking it's the
middle.
The middle is a jump ball.
What can I give to that middle to
get them to go, huh,
let me see me in a different light.
And you guys chose sort of the state
of the union report for PT and give
it away.
Yeah.
Selfishly,
it was really for us to understand the
industry a little bit better because a lot
of where the data lay,
was behind firewalls, right?
That you had to have either an APTA
membership, which I do,
but a lot of people don't.
And so how do you get this information?
And frankly, we were one of the
the earliest organizations to really start
talking more about the business side of PT
and really how to run your business more
efficiently and not just only about the
clinical information,
clinical data that's going on with patient
care.
Okay.
All right.
So for someone who hasn't read it yet,
and we'll put the link in the show
notes and how they can get it.
What are things that now you, I mean,
you can now look at a report like
this and see similarities and differences.
What are a couple findings that pop up
that should make clinic owners pause?
What is the signal in the noise for
this twenty twenty five report that just
came out?
Well,
you did sort of drop some breadcrumbs at
your intro here.
We are hearing a lot about burnout in
the industry,
and we know that there have been a
lot of clinicians that have left patient
care.
They may still carry their license,
but they're not actually treating
patients,
or they may have left the industry as
a whole.
And so this year,
we really kind of wanted to dig a
little bit deeper into what are the
underlying causes of that.
And we found a couple of things that
were fairly glaring.
And you mentioned it,
like the audience that were able to take
this survey were leaders.
They were clinicians.
And in that clinician bucket,
there were more newer grads versus some
seasoned individuals.
And I think, you know,
maybe top three sort of things that stood
out was the sort of gap or as
you as you called it and we called
it this this malalignment between
leadership and, if you will,
the working class.
Right.
And I think for the most part.
we became physical therapists.
You go to school to become a physical
therapist because you want to treat
patients.
Um, and you know,
providers really cite the work itself,
like getting my hands dirty,
getting my patients, uh,
expressing my abilities and my, uh,
ability to treat patients, um,
is really what their top motivator is.
While, um,
Clinic leadership thinks a lot of the
burnout is that they're treating too many
patients and that they are really
underestimating the providers really want
to treat patients.
It's just the how they're having to treat
patients at this point in time.
And that's a huge gap.
It's like by a factor of forty six
percent where clinic leadership is
underestimating the importance of the work
itself.
Whereas the providers are saying, no, no,
this remains my top motivator.
It's not salary.
It's not these other things.
This still remains my top motivator.
So that was the first thing.
And then the second is really in the
salary misconception.
So owners and clinic leaders are
consistently over indexing on salary as
the demotivator.
Oh,
we can't we just can't pay people enough.
And yet what clinicians and staff are
reporting is that.
while salary still remains important it's
not our number one thing our number one
thing is about the bureaucracy in a
practice or the lack of decision making
the poor working condition poor working
conditions and in their eyes meaning a
little bit about work-life balance um
And also just do they have what they're
seeing out there or experiencing and
seeing at CSM, you know,
some of the latest and greatest in
technology?
Or are they still, you know,
very small percentage,
but are you still documenting on pen and
paper, right?
Some of these really obscure sort of
working conditions that you wouldn't
necessarily think still exist,
but it is out there.
The private equity funds that have come
into the industry over the last ten years,
we have a lot of practices that are
trying to scale,
trying to get multiple clinics and even
going from multiple clinics to a large
number of practices.
And so as as clinics try and do
scale,
the administrative complexity often grows,
which can lead to.
even higher levels of burnout in a decline
in patient experience if it's not done
well uh and so i think you know
what we're seeing is this uh unfortunate
you know coming together of
companies wanting to grow which which you
know costs money to do at the same
time as you've got uh uh reimbursements
continuing to decline and so you know when
margins are are are lower it's it's harder
to grow but you have this mandate to
grow uh and so
you're going to push forward with what
you're poised to do.
But oftentimes,
leaving in the wake are some of the
feel-good things that are necessary,
I can think at this moment,
from a retention standpoint,
clinician experience,
as well as patient experience.
Yeah,
so let's go into that a little bit.
There were a few presentations that were
actually at CSM about generations.
And I'm always interested in this,
and we should always be interested in
this,
because
these kids today i feel like you could
put that on a t-shirt and in one
minute you're the kid that that's saying
these kids today the next minute you're
the person saying these kids today as the
world changes generations change and
what's important to those genera different
generations is going to continually change
so the report showing clinicians are
motivated by things like purpose autonomy
meaning and meaningful work.
Yet sometimes leaders might assume,
and again,
we have this misalignment of an assumption
or reality,
that compensation might be their primary
driver.
Listen, we all want to get paid.
We want to make sure we can pay
rent and buy cornflakes.
Important.
So why does that
disconnect persists and why is someone who
understands it and reads this report and
acts on it going to have a better
position or going to going to probably do
well in in twenty twenty six and beyond
yeah so this is this is the inflection
point that we talk about right when you
if you don't truly understand what's
happening right now and the pressures that
practices are under from a financial
standpoint
And so you have the cost of living,
cost of everything going up,
while our reimbursement,
if you're utilizing insurance,
has significantly gone down over the
years.
We talk about this every year.
We had another two point eight percent
reduction in our overall Medicare
reimbursement this year,
which trickles down to all insurances.
We continue to have practices that
sign contracts to get paid less than what
it costs to do business.
And so we're sort of shooting ourselves in
the foot when now the only option that
you have is to increase volume in order
to offset and meet demands that you might
have from a revenue and a bottom line
standpoint.
And then you've got
your generation that this generation who
is looking for uh you know an autonomy
is earned let me let's just let's just
start there right so but you're coming
into a place where there's not a lot
of time to do mentorship because you're
having to treat a boatload of patients so
you know the the mentorship component that
people are looking for uh isn't always
there um and so what do we do
you have a lot of practices that are
now moving to more cash-based
uh practice or which is great moving to
towards technology to help offset some of
those administrative burden issues where
this is really where we're going again a
little bit of misalignment because
although this generation is very in tune
with technology
they still don't want to lose that patient
provider interaction.
And this is where hopefully AI is really,
and it's showing now,
showing up in a lot of different platforms
to hopefully solve some of that problem
where you've got the ambient,
you've got other types of technology that
are coming in to hopefully reduce the
administrative burden,
but still allow us to have that
secret sauce of us as physical therapists
that we get to do so much better
than everyone else is put hands on
patients, have that interaction,
that human interaction that both patients
and clinicians are craving.
Yeah.
A lot of the people in,
we'll call them pundits, right?
The Gary V's of the world are saying
the pendulum only swings two different
ways, right?
Bell-bottoms are
were super cool.
And then they were not.
And then they were cool again.
And then guess what happened after that?
Then they were not, right?
So we went real, we had to,
the world had to go digital everything out
of necessity.
Guess what's going to happen next?
We're going to crave that other thing.
And it sounds like you're saying,
how can we keep the efficiencies of a
scribe or some of this technology without
losing this other stuff as I rub my
hands together on a podcast to show you
that
That humanity part that we like to sort
of plant our flag in.
And so how do we gain without losing?
Which is a good way to think about
it.
So do you think with the disconnect
between clinicians and leaders,
it's probably a little bit all three,
right?
So it always, it depends, right?
It's always in the middle.
Is it communication?
Is it incentive structure?
Is it just plain generational?
Is it, are we talking past each other?
Like where can someone capitalize?
Like this information is good.
But if you were to wave a wand,
if you weren't working where you are,
if you weren't sitting where you are and
you were running a clinic,
how would you operationalize this
information?
What would you do with it?
Well,
the first step is to take a moment
to listen, right?
And not just be autocratic and think that
you know everything.
everything that this is how you're going
to do it in your practice out of
the gate.
Really, at this point in time, you know,
clinicians and which are, you know,
mostly in the younger generation or the
generation below leaders.
You've got to take time to listen.
It can't be command and control.
That autonomy, wanting autonomy is real.
Coming to the table with good ideas is
definitely happening,
but you've got to take time to listen
before you're acting.
So having more of a distributed leadership
sort of model, if you will,
to where you want people to feel like
they have...
some options to provide ideas like they
are in it with you,
not just working for you.
And so that sort of shared decision making
when it comes to, you know,
different possibilities in a practice,
I think is really important at this point
in time.
And that sort of bridges that generational
gap.
And then also every individual is
motivated differently.
And we can't forget that.
It's not just a blanket thing where all
PT is just one.
And this is, I think,
part of the the model alignment is that,
you know, perhaps in in our day,
like salary was was the thing.
And I will also say,
how did we get more salary in the
past was you had to move into the
administrative roles, right?
And what we're seeing in this report is
they love treating patients.
They don't want to have to only move
to administration and away from patient
care to earn more money.
So how do we create, you know,
a better compensation model around being
just an excellent, excellent clinician?
um and you know there's a there's a
lot of issues that are swirling around
that how this can be done um and
also why it's very difficult to be done
mainly because of the cost of education
right now people are coming out with
higher debt than ever before and they're
they are looking for paths and avenues to
be able to uh make more money right
and right now that's just really hard to
do when you're
reimbursement is not changing as a matter
of fact in the wrong direction right so
being creative in ways that you can uh
reward uh and allow people to become
better clinicians and at the same time
like we have got to continue to advocate
not just for more pay but how do
we change uh compensation with regard like
why do people get residency program or go
through a residency program
You're not making more money.
Somebody who's residency trained
definitely is not making any more money in
the eyes of an insurance company, right?
And so how do we change our model
to actually improve and advocate for
outcomes, right?
If you're going through residency,
the thought process should be that you
actually could treat patients better,
whether it's more efficiently or with
better outcomes.
How do we get to a place where
we're actually compensated for, you know,
the outcomes that we're actually having
with patients rather than just
Everybody gets paid the same,
no matter what level of PT you are.
Oh,
I had a post on LinkedIn last week
that said this.
And of course,
I like to poke the bear.
My job is not to be right.
My job is to ask people questions and
have them let's discuss,
as they did on a great Saturday Night
Live skit with Mike Myers, coffee talk.
And the thing that I was shining a
light on was you could give poor care
or great care and you get paid the
same.
And that's dot, dot, dot.
And that's not fair.
And that sucks.
One thing I'll say that I think I've
noticed is,
I think if I were to ask someone
early in their career,
describe or give me like a line,
a great leader.
And I think how I would have described
a great boss, fifteen years ago,
would have been, they're a great leader,
they're very knowledgeable,
and all those things still should be true.
What I hear more often is,
I feel like they get it.
And that sounds like a dumbing down of
a compliment,
But what I hear is that they get,
when someone says they get it,
what they mean,
what I take that for meaning is they
get me.
like when you sit down with a really
good leader and you walk out, you're like,
they get it.
It's like, whatever, whatever I said,
they heard me, they understand it.
Then hopefully they're going to
operationalize that.
And that's when people buy in.
That's when people feel like I don't need
autonomy.
I want autonomy in my little sphere,
like with my patients or my tasks.
I want to feel like whatever I'm doing
matters to the ship too.
Right.
Or where the ship is going in a
direction I'd like to go into.
We're on the rise here.
We go in the right direction.
So when I hear, when I hear,
They get it, right?
Like, why do you like your CEO,
your clinic director or your manager,
anybody, your coworker?
They get it.
Like that says that's a two way thing
and not a one way.
They're a great leader is great for the
organization.
They get it is great for both of
us.
And I think that's what it sounds like.
That's what people are looking for.
And they stick around.
I don't know what the data I would
bet.
We could have a whole gambling thing
before this, Heidi.
This could be like an inside thing.
We'll bet what the data is.
I bet that people who feel that stay
longer.
Oh yeah.
Clinic, uh,
clinician retention for sure has so much
to do with your liking people that you
work with.
That's been a staple in all of these
different surveys for a long time with
regard to why you stay in a position.
You may even take less money on a
salary basis if you really feel rewarded
in the work that you're doing and the
people that you're doing it with.
And so when you ask, you know,
what should owners be doing?
And I think at this point,
it's stop assuming and just start
listening.
And each individual person that's in the
practice might be motivated in a slightly
different way.
And, you know, as a leader,
we need to be thinking about people as
individuals and not necessarily just as a
customer in a group.
I mean,
I'm nodding along almost to the point
where I'm hurting my neck because when I
was in radio,
there were people at the radio station
that sold ad time and they drove BMWs.
And I didn't.
But I got to go to work every
day and play rock music loud and give
away beer and concert tickets.
And I was elated to do so.
I would have crawled through a mile of
broken glass to keep doing that because
the different things mattered to different
people.
And the people that pay attention to
those...
we'll keep the better people and better
meaning a better fit for you and them
when it's a two-way street man and i
never realized this i ran a radio station
i was just a radio guy how much
replacing someone costs because where i
worked i had fifty people outside that
would have again crawled through broken
class to take the job for less money
but that's not always the case i never
understood that until i came to healthcare
and realized what replacing
a good or bad employee actually costs and
how that can hurt an organization or a
business.
Absolutely.
Especially in our,
our world of relationships, right?
So somebody who's been with you,
it has physician relationships,
have community relationships,
those types of things.
If they go away and also they,
I mean,
I'm not saying that you have to retain
people just because they are, you know,
the, the rainmaker in your,
in your organization, especially if,
you know, they're not,
they somehow they're not all of those
things.
I'm definitely not saying that, but
For sure, you know,
those things need to be rewarded.
And again, reward is very personal.
And one of the things that I've been
really talking about is looking at when we
talk about
compensation which includes salary you
look at the total compensation and this is
an education for new grads and early uh
you know uh recent grads as well getting
their first jobs that it's it's not yes
you might motivate it for salary and you
definitely need to look at that when you
have a student debt you have to pay
off i i get it like you're looking
at how much cash is coming in right
and so if that's true
You also need to say, okay, well,
if they're gonna pay me upfront,
I need to also recognize that maybe some
of these other benefits
Health care is important.
Right.
But maybe you're not going to get the
health care that you only have a twenty
five dollar copay.
Right.
Maybe you're going to have to pay a
little bit more on the deductible side.
You know, your your your PTO,
everybody needs PTO,
but
Those are some things that might be
negotiable as well.
CEUs, right?
If we're going to pay you a bunch
of cash up front,
maybe we're not going to pay you as
much for the number of CEUs.
The full compensation package has to be
looked at.
And those are things for me that you're
able to sort of dial up or change.
I like the a la carte method.
Right.
There's obviously some bottom line,
baseline things like health care, I think,
is really important for everyone to have
the option.
And it's mandatory most of the time at
a certain size of the business.
But you can dial things up and down
across a line.
Right.
When you're thinking about,
let's just say, you know,
eighty five thousand dollars of total
compensation.
Maybe that equals a higher number of
salary up front.
And maybe it means a little bit less
of CEU funds on the backside of that.
Maybe in two years when you have paid
down your debt and you're much more about
trying to be a specialized clinician,
maybe those CEU dollars mean a lot more
to you, right?
So maybe we add more there rather than
just upping your salary.
Does that make sense?
Yeah.
so anyway i'm just i think owners need
to be a little bit more creative when
they think about total compensation you
just can't throw everything at people
because a um you know the research on
choice like when you give people too many
choices they're like and so and they're
going to over dig index on wanting
everything
Sure.
I guess this goes into...
As a business owner,
and Marcus Limonis is someone I found
later in life.
He's like, if you don't know your numbers,
I won't work with you.
Because if you don't know what it costs
to do all these things,
you can't have that conversation that
Heidi's talking about, which is okay.
So...
You value flexibility.
You can't work with me unless I'm flexible
because of your family situation.
Okay.
But you understand that now you working
less hours for me,
you're willing to take less salary.
If the answer is yes,
you have to know your numbers of what
each one of those hours is worth.
So you both win.
So you're able to cover that person's cost
and still make margin because the line
that I stole from someone else is usually
it's designed for nonprofits,
but it's for everything.
No margin, no mission.
If there's no money coming in above what
it costs to operate,
there's no lights or internet.
I promise I paid my internet.
It was just a power outage when I
cut out there.
But if there is no margin,
there is no mission.
So you have to be smart about this
data,
which is almost full circle to what we're
talking about is you could have a hundred
and fifty KPIs,
but that doesn't make them very K anymore.
It's not very,
you can't have a hundred and fifty keys.
That's a bad key.
That's a bad key ring.
Understanding,
knowing your numbers has to be step one.
Yeah.
And I'll just say on the flip side
of that, you know,
the new grads and the clinicians who just
want to jump to the next place because
they're willing to pay you, you know,
five dollars more an hour costs you.
It does cost you.
It costs you as an employer,
but it also is going to cost you
as a provider because there are tradeoffs
for that extra five bucks an hour.
Maybe you're going to see an extra three
patients, three patients in a day.
Right.
So really understanding what motivates you
coming to the table with with your truth.
Like, hey, these are the things.
Are we a good match?
But but not in recognition of, hey,
if I want to see less patients in
a day,
I'm going to have to do some sort
of tradeoff.
on what my total competition might be.
Yeah.
You said that technology used to feel like
a trade-off, efficiency versus human.
And I feel like we're not there anymore.
You've said it's no longer true.
Feels like these things are now pointed in
the same direction,
not against each other.
What changed to get us here?
Well, that's the promise.
And that's what we're starting to see
early with as as AI is starting to
mature and, you know,
more platforms and more technology is
coming into the health care space.
And it's looking more like at least it's
I think the hope is.
And I think we're in, like I said,
in the early sort of going,
it's starting to show this as a relief
valve.
uh for some of the documentation some of
the coding compliance burdens that you
know were so manual or still had to
be you know embedded in but still a
lot of manual process involved in it um
even scheduling today is getting a little
bit easier i think that's
I know everybody wants the auto
scheduling, but as we know,
especially if you are taking insurances,
how complicated that can be,
especially with multiple therapists in a
practice with specialty on each one.
But, you know,
these are the types of things that we're
looking to AI to really start to relieve
ourselves of the percentage of time that
we're spending on this administrative work
and allowing us to have more time for
actual patient care.
Yeah.
It's always a trade-off.
What's the pain that you're alleviating,
right?
I mean, Glenn Gary,
Glenn Ross taught us that someone's being
sold in any conversation.
You're either selling them or they're
selling you one while you're not.
And I think when you try to
overcomplicate,
and it's not to minimize everything to a
sale,
but are you helping me
better faster or cheaper because better
faster and cheaper can make things easier
for me i can do more or do
or do less in certain situations and it
feels like i got a palm i got
a palm pilot when i was in college
and i realized how many little clicks with
the little fake pen it took me to
put someone's phone number in a book i
was like i can write this down with
a pen faster or the famous story about
how the americans
tried to figure out how to make a
pen work in space and they're like to
the russians like how'd you figure it out
and they're like we used a pencil and
they were like oh yeah like we over
complicated that it feels like the tech
isn't a pen in space anymore it's even
simpler than the pencil now and that's
when we start working in the scene i
don't work for the tech the tech works
for me now
yeah i mean that's where we're we're
headed i think it's it's definitely um
it's happening um and it's learning uh and
i i think what you're gonna see in
the next eighteen months or so is is
a real shift in our ability uh to
be a little more hands-off of the computer
itself
um and a lot of things will be
happening where you're in edit mode um and
you're in review and assessment mode
versus having to do the the subjective the
the objective uh inputs um those will be
collected as you're doing them um and then
your where
our brains really need to be functioning
at the highest levels in the assessment
and even plan for this particular
individual and patient who's sitting in
front of you.
Even the concepts of clinical decision
support, right?
In learning how you do things with this
particular diagnosis and this patient's
past medical history.
I mean,
it's really going to be really freaking
cool.
Some of the things that are going to
be
out here and already starting to show up
in EMRs and other platforms today.
I agree.
It feels like it's the Wild West.
It's like the Oklahoma Sooners out there
staking claims, right?
The minute really AI became operational,
there was a hundred and fifty
Everybody was doing it, right?
Here's this scribe, this scribe,
this scribe, just focusing on scribe.
And I said,
I remember talking to someone who wasn't
in healthcare and they said, well,
how will this change how people do things?
And I said,
I think probably pretty minimally,
because I think we're already thinking
about these things.
They're already in our head.
Then we need to breathe and then type
them out.
Now we necessarily don't.
I said the only way I could see
it is you need to be more of
a verbal processor.
So now instead of having to sit down
and type it out,
if you're verbally processing while it's
going on,
you don't have to do that initial first
pass.
You are doing it.
You're doing it without your hands.
Right.
And Jimmy,
there's going to be growing pains.
Don't get me wrong because, you know,
People will want to,
and we see this already happening in
colleges and high schools and such,
where people want to be completely
hands-off and allow the AI to write things
for them and to do things for them.
And it's going to make mistakes.
It's not perfect.
And it is still a computer without
feelings and without empathy.
And so really making sure that we continue
to
be a part of the plan be a
part of and really exercise our knowledge
into that assessment um and you know just
like anything else bad inputs equal bad
outputs and so if you're not getting the
front end correct um those things are are
are going to spit out
bad things on the other side.
So there's going to be some learning that
as we move through this process,
but it looks very promising in terms of
that relief valve as people are looking at
it from an administrative burden side.
So let's flip.
So a minute ago, we talked about, hey,
if you're a leader,
you said your advice would be listen.
If you're a clinician working with
someone,
what would your advice for them be who
maybe you feel that unheard disconnected
from leadership?
What would your advice be for them?
If the advice for the leader is listen,
what's the advice for the clinician?
Yeah, for the clinician,
it's really formulate and understand what
your motivation factors are and what is
important to you to articulate.
It's not to complain.
Like it's action in a way that means
that, hey,
here's the things that motivate me.
Here's what I want.
Because I think that when you think about
the goal of what both the clinic leader
and a clinician at the end of the
day,
we want to treat patients and we want
to get people better.
Like those two things, you know,
while I think the clinic owner has to
always also think about financial issues.
um and i want to make money doing
it right which is what's fine we're
majority of us work in for-profit
companies um the thing i would say about
from the clinician side is is understand
be able to articulate what motivates you
but also understand what you don't know
and when you don't know and you don't
understand the business side take the time
to to spend some time with that clinic
owner to really understand
what it takes to run a business in
today's market.
It is not freaking easy.
And so while you may understand and all
of the student debt and all the things
that are happening on the clinician side
and new grad side,
just take a pause to really understand and
respect
what has transpired and allowed this
clinic owner to be in business,
to have had success over time,
but understand that the market forces
today and the constraints that we're under
are significantly different and causing a
lot of stress, right?
I'll give a nod to one of the
organizations I used to work for because
we just assume if it's a big company,
the people at the top are swimming around
Scrooge McDuck style in pools of money.
And I'm like,
I got to be honest with you, man.
That ain't it.
I worked for Fox Rehab for a while
and I was communications,
but they were overly transparent
in my viewpoint in how do we decide
what to pay you?
The goal is not to pay you as
little as possible.
The goal is pay you as much as
possible so we can still support this.
And they would show when the dollar comes
in,
how many different ways does it need to
be sliced before we get to you?
And having, I think,
more of that transparency and explanation
kept the right people around.
If you're not willing to understand that,
Um,
I can't make more money fall out unless
more money is falling in.
And let me show you.
I know if you're like,
but these are millions of dollars.
I'm like, yes, yes, yes.
Divided by how many different things or
people.
When you say you want a new laptop
every year,
it's a new laptop times a thousand
clinicians.
Or when you hit a certain level,
now your administration has to get wider
and why that costs something.
And these are simple things,
but not easy to understand.
But when you can start to understand them,
I think the people...
And this isn't a communication principle.
When there's no information,
we fill it in with bad information.
Well, then there's something nefarious,
right?
When you over-communicate,
those are the people who are better
leaders.
They're not actually better or worse.
They understand that no information breeds
contempt.
Somebody gave me a statistic.
Most mid-size organizations
under-communicate by a factor of four
hundred percent.
So when you think you've said it,
you're still four hundred percent behind.
When you think it's been understood,
we know how it is, you know,
like you're hearing it is not
understanding.
So I think,
I think from the leader side,
it's over communicate,
but from the clinician or the employee
side, it's ask, show up,
lean in to understand.
And then magically those people just wind
up doing in the magical,
those people wind up doing better in their
roles.
Absolutely.
And they feel connected.
They feel like they understand.
They know where the business is going.
They understand what the pain points are.
So you're all in it together.
It's a we, not just an I. Right.
And so when you when you actually have
that type of culture and you do get
that transparency now,
I will say you made a good point
that it's.
It's not just transparency because in the
presence of too much information that is
not understood, that can also,
when you see these millions of dollars,
then you can make assumptions about things
because you don't understand.
Well, if you look at the bottom line,
post all of those expenses.
Well,
maybe that number is not in the millions
anymore.
And then, yeah,
it's really important to also provide that
education in the spirit of transparency
comes education as well.
Yep.
Final question that we'll do.
We'll do parting shot.
Right.
So parting shot.
I'll set you up for this one.
I won't just leave you open ended.
You said the profession is really at an
inflection point.
You don't do these reports just to look
back, right?
That's nice to have.
You do them so we understand now and
five years from now.
So I'll just pick an arbitrary point in
the future.
Five years from now,
what decisions are we making today that
will actually help us
whether the profession becomes more human
centered or more commoditized.
I mean,
where you sit has never really been at
a company level.
You've always sort of looked at it from
professional level because where it goes,
where the profession goes,
we all goes right.
So what,
what is the decision or decisions that we
can start to make now that can make
that we, we,
the future is more human and less a
commodity.
Well,
let's just start first on producing
providers.
We know we have a shortage and we
have the lowest amount of applicants to
our PT programs that we ever had.
And we must make sure that we are
continuing to have the highest level of
expectation of our educational system for
the DPT program that we can have.
That means that people are getting
educated to be able to come out and
immediately start treating patients and
not believe that they still need to go
to residency program or, you know,
have additional education opportunities.
And granted,
everybody needs to continue to learn.
I'm not saying that.
But you should be able to come out
and feel confident in being able to
practice in an environment where you can
have your own caseload out of school.
Right.
And have high expectations for those
clinical affiliations and leaders that can
see eyes.
that are treating or that are teaching
right at the highest level.
So first and foremost, like, you know,
cost of education,
there's a lot of things going on in
the front end.
We're reaching lower and lower into the
applicant pool with people, you know,
having difficulty graduating,
having difficulty passing the licensure
exam that first time.
So we've got to really focus on the
front end of the clinicians that we're
producing.
in order to offset the shortage and also
maintain the level of expectation that not
only patients have,
but we should have for therapists coming
into the profession.
So that's first.
Second,
the decisions we're making to move into a
world of technology
because we want to offset the
administrative burden,
we have to make sure that we don't
lose that human centered care that we are
absolutely, you know,
still the best provider at giving where we
are able to see the patient for,
you know, multiple visits.
We develop those types of relationships.
If we go down the digital first,
you know, or, you know,
PTs as a human are only augmenting the
care of a digital first,
I think that's wrong.
We're going to lose ourselves and become a
commodity in a very short period of time.
You've got the
hinges and the swords and all of these
that are putting digital first and we're
just an adjunct to the AI,
we're going to lose our ability to
maintain ourselves as a primary physician.
On the positive side of us,
I do really believe in us putting a
lot more emphasis on being primary care
clinicians in the MSK world,
and I think we need to be doubling
down on that.
Similarly to us having a shortage of DPTs,
Primary care is also,
there is a dearth of primary care
providers,
and we need to be filling that gap
and elevating ourselves to be able to meet
those demands of what is happening.
More people want our services,
and yet we just don't have enough
clinicians right now to be able to do
that.
So by elevating,
trying to elevate ourselves to get those
patients cared for quicker,
I think is really important.
And then just on the final side,
I mean, I do believe, you know,
the adoption of the AI models and the
transformation of EMRs into like WebPT,
you know,
bringing in AI to alleviate the
administrative burden is going to allow us
to have more time for patients,
that more human-centered care that is so
critical to our profession.
So those are decisions I think we're
making all in the right direction at the
moment.
Yeah,
and they need to be decisions we're
consciously making.
These can't be nice to have.
These are to be directions we're moving
in.
You cannot leave until you at least give
a nod about Rising Tide.
More people need to know about it.
So let's talk about that for a hot
second before we let you get out of
here.
Yeah, thanks, Jimmy.
It's a foundation I started six years ago
now.
It's actually pretty incredible.
I know we've had ninety three scholars go
through our program.
We've deployed one point two million
dollars in scholarship funding.
we had such a blast at csm recently
where um we got to to see a
lot of our scholars in person not only
that but they are shining stars in our
profession up on stage i think if you
saw the uh the generation um uh
presentation then you saw two of our
scholars holly brown and um
Devin Morris up there on stage doing an
incredible job presenting.
So I could not be prouder and feel
more rewarded, um,
in this sort of give back era of,
of my, uh, professional life, uh,
as a physical therapist.
Um, and anyone, yeah, sorry.
And anybody, uh, you know, we're,
we're growing, um, we have, uh,
we're offering scholarships per year for
DPT students and five scholarships a year
for, um,
for residency students and so we're
obviously always looking to partner with
anyone and everyone who is um you know
on this wants to join in this mission
help build our community whether it's
through donation or or sponsorship where
we're always looking for for more folks to
to join in uh uh to support the
mission so thanks for the opportunity
who's the right person to apply for rising
tide like who are you who who who's
a great fit
Yeah,
so any DPT student from an
underrepresented background who is a first
year or you're about to start your first
year in DPT school,
you've been accepted to a DPT program or
a rising second year.
Our application cycle for our CRUS
scholarship,
which is worth up to fourteen thousand
dollars per year,
up to the two to three years that
you're in your program,
will open on April first and close at
the end of May.
Okay.
And then who's the...
Are you teaming with programs like you
just mentioned for tuition remission or
donations or both or...
Yeah,
so we actually provide scholarships for
those that win our scholarships through a
selection process.
And it doesn't matter what program you're
in as long as it's an accredited DPT
program.
And so we actually scholarship the student
to the program.
And, you know,
obviously always working with programs to
share our information,
share our data and feedback that we get
from our students to help them understand
the burden of the cost of education.
But, yeah,
we we actually just are we provide
scholarships.
And I don't want to say the word
just because we're so much more than that.
Even those that everyone who applies into
our program.
And even if you don't win,
the scholarship becomes part of our
community.
We just launched a platform called we call
our tide pool program.
which is essentially a technology platform
that allows people to network.
It has all of our resources.
We provide monthly webinars on all kinds
of fun things,
like what you just talked about.
Actually,
our next webinar is with Jean Shirakabad
and I,
and we are doing a webinar on the
life cycle of a dollar.
So exactly what we just talked about,
we are helping to educate our students at
an early time in their career
uh, to understand how does this work?
How do you actually get paid?
Where did those dollars come from along
the way?
And what does it really, uh, mean to,
or how do you actually talk about,
you know, your salary and, and, uh,
where that actually comes from?
Perfect.
Excellent.
Uh,
we'll put the information for rising tide,
uh,
as well as the report in the show
notes for this.
Heidi,
thanks so much for coming back on for
doing this,
for doing the heavy lift around the
profession and then for coming on here to
talk about it with us.
Always, always a pleasure, Jimmy.
Thanks so much for everything that you're
doing to elevate our profession in so many
different avenues.
So really appreciate the time.
Thanks.
That's it for this one,
but we're just getting warmed up.
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And legally, none of this was advice.
It's for entertainment purposes only.
Bulls**t!
See, Keith?
We read the script.
Happy now?