WEBVTT 00:00:01.895 --> 00:00:03.076 You're listening to the PT Pinecast, 00:00:03.176 --> 00:00:04.897 where smart people in healthcare come to 00:00:04.916 --> 00:00:05.738 make noise. 00:00:05.817 --> 00:00:10.320 Here's your host, Jimmy McKay. 00:00:10.340 --> 00:00:11.782 Big thanks to Empower EMR. 00:00:11.801 --> 00:00:13.563 If your clinic is stuck in an EMR 00:00:13.583 --> 00:00:14.284 that slows you down, 00:00:14.323 --> 00:00:16.225 Empower gives you speed, clean workflows, 00:00:16.245 --> 00:00:18.486 and features PTs actually asked for. 00:00:18.527 --> 00:00:20.288 Better notes, faster documentation, 00:00:20.327 --> 00:00:21.268 smoother operations, 00:00:21.689 --> 00:00:23.451 all wrapped up in customer support that 00:00:23.471 --> 00:00:25.332 doesn't ghost you because let's face it, 00:00:25.992 --> 00:00:27.036 Something's going to go wrong. 00:00:27.256 --> 00:00:28.018 Nothing's perfect. 00:00:28.239 --> 00:00:29.100 You just want to make sure you're going 00:00:29.120 --> 00:00:29.381 to get help. 00:00:29.803 --> 00:00:31.606 Upgrade your clinic's brain with Empower 00:00:31.746 --> 00:00:32.167 EMR. 00:00:32.869 --> 00:00:34.871 And again, we've said this before, 00:00:35.332 --> 00:00:37.433 transferring over, changing an EMR, 00:00:37.454 --> 00:00:38.115 it's a big deal. 00:00:38.936 --> 00:00:40.737 Kick the tires, see what they have. 00:00:40.777 --> 00:00:42.079 They make transferring easier. 00:00:42.399 --> 00:00:45.040 EmpowerEMR.com. 00:00:45.381 --> 00:00:48.423 Now, most of healthcare runs on numbers. 00:00:48.625 --> 00:00:49.204 Think about it. 00:00:49.325 --> 00:00:51.326 Blood work, numbers, imaging, 00:00:51.887 --> 00:00:53.389 measurements, cardiology, 00:00:53.908 --> 00:00:56.411 data down to the millisecond. 00:00:57.264 --> 00:00:58.384 But when it comes to movement, 00:00:58.924 --> 00:01:00.926 the thing we claim is our domain, 00:01:01.286 --> 00:01:03.088 we still say things like, looks better, 00:01:03.808 --> 00:01:06.210 improving, tolerance increased. 00:01:06.971 --> 00:01:09.212 Today's guest believes it's not good 00:01:09.253 --> 00:01:09.552 enough. 00:01:10.293 --> 00:01:12.415 He runs a referral-based clinical 00:01:12.495 --> 00:01:16.278 biomechanics lab in Vegas that turns 00:01:16.537 --> 00:01:18.019 walking, balance, 00:01:18.358 --> 00:01:22.242 and strength into objective numbers, 00:01:22.542 --> 00:01:24.102 the kind that make clinical skill 00:01:25.179 --> 00:01:26.959 invisible outside the treatment room. 00:01:27.159 --> 00:01:29.581 He says PTs aren't movement experts, 00:01:30.503 --> 00:01:31.022 not yet. 00:01:31.664 --> 00:01:34.025 He's building what he calls the quest 00:01:34.125 --> 00:01:36.746 diagnostics of human movement. 00:01:37.947 --> 00:01:40.189 Our guest today, Chana Wong. 00:01:40.290 --> 00:01:41.611 Chana, welcome to the show. 00:01:41.631 --> 00:01:42.570 We've talked about you before, 00:01:42.590 --> 00:01:43.191 but now you're here. 00:01:44.111 --> 00:01:45.813 Well, thank you for the great intro. 00:01:45.894 --> 00:01:46.974 I really appreciate it. 00:01:47.655 --> 00:01:47.715 I'm 00:01:48.325 --> 00:01:50.105 Happy to be here talking to the one 00:01:50.146 --> 00:01:52.067 and only Jimmy McKay, 00:01:52.207 --> 00:01:53.868 the voice of physical therapy. 00:01:54.469 --> 00:01:55.771 Well, it sure shouldn't be the face, 00:01:55.850 --> 00:01:56.650 but let's dig in. 00:01:56.771 --> 00:01:59.192 I love bold statements. 00:01:59.332 --> 00:02:00.634 And you are a physical therapist. 00:02:00.653 --> 00:02:01.534 I want to make sure the audience 00:02:01.594 --> 00:02:02.194 understands. 00:02:02.254 --> 00:02:02.975 Yes, I am. 00:02:03.115 --> 00:02:04.277 I am a physical therapist. 00:02:05.082 --> 00:02:06.665 This is why you can take shots because 00:02:06.685 --> 00:02:07.686 when you are one of us, 00:02:07.725 --> 00:02:09.046 you can say things, which is good. 00:02:09.467 --> 00:02:10.908 So I love bold statements, 00:02:11.030 --> 00:02:11.950 and I'm going to give you a chance 00:02:11.971 --> 00:02:13.111 to sort of explain what that means. 00:02:13.151 --> 00:02:16.575 You say PTs aren't movement experts yet. 00:02:17.256 --> 00:02:18.217 I love bold statements. 00:02:18.318 --> 00:02:19.878 What do you mean by that? 00:02:19.919 --> 00:02:21.600 Well, to be honest with you, 00:02:22.382 --> 00:02:24.003 we are trained in movements. 00:02:25.201 --> 00:02:26.943 But to be an expert, 00:02:27.903 --> 00:02:29.824 I think the bare minimum requirement is to 00:02:29.865 --> 00:02:35.028 be able to objectively measure, validate, 00:02:35.109 --> 00:02:36.949 and demonstrate movement. 00:02:37.711 --> 00:02:38.972 Oftentimes in clinics, 00:02:39.472 --> 00:02:41.993 physical therapists depend on 00:02:42.633 --> 00:02:44.936 observational data, inferred data, 00:02:45.717 --> 00:02:47.497 or non-standardized data. 00:02:48.358 --> 00:02:50.439 And what I want to push for 00:02:50.944 --> 00:02:55.092 or advocate for is that instead of relying 00:02:55.133 --> 00:02:56.514 on those data, 00:02:56.555 --> 00:02:59.219 we should actually standardize how 00:02:59.280 --> 00:03:01.705 movement is tested so that we use 00:03:01.745 --> 00:03:02.566 standardized data. 00:03:04.419 --> 00:03:06.221 So it sounds like that's a bold statement, 00:03:06.241 --> 00:03:08.462 but what you are and aren't saying, 00:03:08.943 --> 00:03:10.204 you're not saying the problem isn't lack 00:03:10.243 --> 00:03:12.865 of skill, it's lack of objective proof, 00:03:12.966 --> 00:03:14.066 sort of what I said in the intro. 00:03:14.105 --> 00:03:17.508 Infrastructure in physical therapy that, 00:03:18.508 --> 00:03:19.469 you know, clinics are busy. 00:03:19.789 --> 00:03:21.211 Standardizing data is hard. 00:03:21.751 --> 00:03:24.793 That's why it's important to create a 00:03:25.353 --> 00:03:28.254 structure where we can measure movement 00:03:28.936 --> 00:03:32.157 reliably and consistently all the time. 00:03:32.776 --> 00:03:33.316 Okay, 00:03:33.336 --> 00:03:34.557 so we'll get into the model in a 00:03:34.638 --> 00:03:36.778 second, but I like to spoil it. 00:03:36.818 --> 00:03:38.061 Let's get to the end first. 00:03:38.800 --> 00:03:41.764 What actually changes in a clinic when 00:03:41.883 --> 00:03:45.627 movement becomes measured objectively, 00:03:45.646 --> 00:03:48.169 when that becomes easier and simpler and 00:03:48.209 --> 00:03:48.870 more repeatably? 00:03:49.727 --> 00:03:52.108 Yeah, so one of the, 00:03:52.548 --> 00:03:54.929 when I first started Muvik Health, 00:03:55.008 --> 00:03:58.070 I guess that's best way to describe it. 00:03:58.570 --> 00:04:01.431 I spoke with a lot of physical therapists, 00:04:01.991 --> 00:04:03.693 spoke with a lot of medical doctors, 00:04:03.932 --> 00:04:05.394 spoke with a lot of patients and also 00:04:05.433 --> 00:04:06.674 the payers too. 00:04:07.574 --> 00:04:11.817 And the feedback was very unanimous. 00:04:12.396 --> 00:04:13.236 In healthcare, 00:04:13.497 --> 00:04:16.218 credibility and authority is actually 00:04:16.298 --> 00:04:17.379 linked to standard. 00:04:18.639 --> 00:04:19.079 Right now, 00:04:19.158 --> 00:04:22.901 physical therapists are doctorate degree 00:04:23.161 --> 00:04:27.524 professionals that practice without having 00:04:27.584 --> 00:04:29.725 standardized diagnostic infrastructure. 00:04:30.625 --> 00:04:34.288 So when I spoke with physical therapists, 00:04:34.548 --> 00:04:35.910 a lot of them were telling me that 00:04:35.949 --> 00:04:37.831 they were acting like a salesperson. 00:04:39.012 --> 00:04:40.473 In some ways, it's good. 00:04:41.134 --> 00:04:41.555 Some ways, 00:04:41.595 --> 00:04:43.795 it's not what we went to school for. 00:04:43.836 --> 00:04:45.798 We went to school to be the doctors 00:04:46.398 --> 00:04:47.439 of physical therapy. 00:04:49.060 --> 00:04:51.461 So they have to sell to the patients 00:04:51.762 --> 00:04:54.023 that they have to come back for the 00:04:54.083 --> 00:04:54.684 next visit, 00:04:55.064 --> 00:04:56.824 why they need to be in physical therapy 00:04:56.845 --> 00:04:58.786 and how physical therapy helps. 00:04:59.807 --> 00:05:02.288 Professions that use standardized data, 00:05:03.430 --> 00:05:06.071 whether it be outside of health care like 00:05:06.130 --> 00:05:06.711 pilots, 00:05:08.959 --> 00:05:11.879 pilots, forensic scientists, engineers, 00:05:12.500 --> 00:05:13.600 you never question them. 00:05:13.639 --> 00:05:16.560 You get that automatic buy-in that you 00:05:16.661 --> 00:05:17.742 trust them, right? 00:05:18.442 --> 00:05:24.403 So when you flew out to Anaheim past 00:05:24.444 --> 00:05:24.863 weekend, 00:05:25.684 --> 00:05:28.004 you probably never questioned the pilot. 00:05:29.894 --> 00:05:31.355 you just know that they're going to do 00:05:31.375 --> 00:05:31.975 the right thing. 00:05:32.596 --> 00:05:33.637 Same thing with the doctors, 00:05:33.978 --> 00:05:36.038 medical doctors, podiatrists, 00:05:36.459 --> 00:05:38.040 optometrists, dentists, 00:05:38.060 --> 00:05:43.144 they all use standardized data and you 00:05:43.184 --> 00:05:43.444 sort of 00:05:44.110 --> 00:05:46.413 patients or the consumers get automatic 00:05:46.452 --> 00:05:48.894 buy-in that they trust what they're doing. 00:05:49.536 --> 00:05:50.576 In physical therapy, 00:05:50.776 --> 00:05:51.798 it's a little bit different. 00:05:51.918 --> 00:05:52.459 Right now, 00:05:53.439 --> 00:05:56.803 there's about seventy percent of patients 00:05:57.324 --> 00:05:59.826 self-discharge because there's that big 00:06:00.187 --> 00:06:03.610 clarity gap that we don't really address. 00:06:04.853 --> 00:06:05.814 in physical therapy. 00:06:06.055 --> 00:06:08.055 So patients can't see the move, 00:06:08.555 --> 00:06:10.196 can't see the problem or progress 00:06:10.235 --> 00:06:10.875 objectively. 00:06:11.295 --> 00:06:12.396 So they default to, 00:06:12.896 --> 00:06:15.077 I feel better as a finish line. 00:06:17.178 --> 00:06:19.778 So that results in physical therapists 00:06:20.860 --> 00:06:22.980 getting pushed into earning the buy-in 00:06:23.021 --> 00:06:23.721 from the patients. 00:06:24.678 --> 00:06:27.019 So when we start using standardized data, 00:06:27.920 --> 00:06:29.779 it creates a familiar process for the 00:06:29.839 --> 00:06:32.380 patients and it creates, 00:06:32.581 --> 00:06:34.841 it fundamentally changes physical therapy 00:06:34.882 --> 00:06:38.122 from solution led profession to the 00:06:38.182 --> 00:06:39.843 diagnostic first profession. 00:06:40.502 --> 00:06:41.322 And when you do that, 00:06:41.382 --> 00:06:42.764 we have three things that change. 00:06:43.124 --> 00:06:44.423 Patients see their deficits, 00:06:45.124 --> 00:06:48.805 black and white, in detail, using numbers. 00:06:50.045 --> 00:06:51.725 Physical therapists can 00:06:52.230 --> 00:06:54.451 stop pitching and start meeting with 00:06:54.490 --> 00:06:57.732 clinical authority and payers actually 00:06:57.831 --> 00:07:01.733 will see objective data that they need to 00:07:01.793 --> 00:07:05.353 reward rather than just counting visits. 00:07:05.394 --> 00:07:07.673 So it sounds like some things I don't 00:07:07.694 --> 00:07:08.374 want to infer, 00:07:09.115 --> 00:07:11.675 but completion rates and patient buy-in, 00:07:11.694 --> 00:07:13.216 those two things are pretty tight, 00:07:13.276 --> 00:07:14.076 well tied together. 00:07:14.156 --> 00:07:15.115 That might increase. 00:07:15.516 --> 00:07:15.776 Yeah. 00:07:16.237 --> 00:07:16.997 Referrals. 00:07:17.975 --> 00:07:19.555 could also you could infer that it would 00:07:19.596 --> 00:07:21.036 increase documentation. 00:07:21.096 --> 00:07:24.158 Clarity is something that could increase. 00:07:24.598 --> 00:07:27.699 And then you mentioned reduced 00:07:27.740 --> 00:07:29.360 defensiveness with payers because you're 00:07:29.379 --> 00:07:29.620 able to. 00:07:30.701 --> 00:07:31.321 Of course, you know, 00:07:32.081 --> 00:07:33.862 I'm glad you mentioned that because our 00:07:33.923 --> 00:07:36.824 co-founder Akash Patel is also a physical 00:07:36.863 --> 00:07:37.363 therapist. 00:07:37.624 --> 00:07:39.324 He's a he's like a brother to me. 00:07:39.725 --> 00:07:40.605 He's the type of person. 00:07:41.687 --> 00:07:43.826 regardless of any field he went into, 00:07:44.107 --> 00:07:45.007 he would have succeeded. 00:07:45.088 --> 00:07:45.668 Like he could have been, 00:07:46.267 --> 00:07:47.387 if he went into medical field, 00:07:47.408 --> 00:07:48.747 he would have been the best doctor in 00:07:48.767 --> 00:07:49.507 the United States. 00:07:50.108 --> 00:07:51.408 If he went into engineering, 00:07:51.449 --> 00:07:52.749 he would have been the best engineer in 00:07:52.769 --> 00:07:53.689 the United States. 00:07:53.988 --> 00:07:54.149 Uh, 00:07:54.588 --> 00:07:56.629 but I'm glad I'm so happy he chose 00:07:56.649 --> 00:07:58.670 physical therapy, but, um, 00:07:58.709 --> 00:08:00.170 he actually worked with, uh, 00:08:00.470 --> 00:08:01.810 he actually partnered with the clinic 00:08:02.471 --> 00:08:04.031 where he reviewed. 00:08:04.050 --> 00:08:06.052 He partnered with the clinic, 00:08:06.872 --> 00:08:08.531 only made one change to the clinic. 00:08:09.237 --> 00:08:11.300 He reviewed the movement reports with the 00:08:11.339 --> 00:08:13.901 patients the same way the physicians 00:08:13.982 --> 00:08:15.502 review their lab report. 00:08:16.423 --> 00:08:17.603 No new exercises, 00:08:18.504 --> 00:08:21.226 just objective data and clear 00:08:21.266 --> 00:08:22.067 interpretation. 00:08:22.687 --> 00:08:23.588 Within one year, 00:08:23.649 --> 00:08:26.110 the plan of care completion rate for that 00:08:26.151 --> 00:08:28.973 clinic rose from fifty one percent to 00:08:29.052 --> 00:08:29.934 sixty eight percent. 00:08:34.317 --> 00:08:34.477 So, yeah. 00:08:34.538 --> 00:08:35.499 I mean, we know this, right? 00:08:35.538 --> 00:08:37.080 I got a Peloton downstairs. 00:08:37.500 --> 00:08:39.322 And when I can track my progress and 00:08:39.381 --> 00:08:41.043 I can see how things are improving, 00:08:41.504 --> 00:08:43.184 I can look how often I'm doing that. 00:08:43.404 --> 00:08:44.605 When they give me those stupid little 00:08:44.645 --> 00:08:45.167 badges, 00:08:45.307 --> 00:08:47.609 I fall for it every time because we 00:08:47.629 --> 00:08:48.909 want to earn the digital cred. 00:08:49.750 --> 00:08:51.351 But it's a feedback loop, right? 00:08:51.451 --> 00:08:53.013 And now we're able to see that. 00:08:53.432 --> 00:08:56.416 So we've dug into this conversation before 00:08:56.436 --> 00:08:57.976 because we spoke without recording. 00:08:59.311 --> 00:09:01.692 Now that we've gotten the attention of the 00:09:01.732 --> 00:09:02.533 person listening, 00:09:03.014 --> 00:09:05.375 now I want you to walk them through 00:09:05.975 --> 00:09:07.878 the business model of what Movique is 00:09:07.918 --> 00:09:08.558 doing now. 00:09:09.639 --> 00:09:10.379 In the intro I said, 00:09:11.041 --> 00:09:13.383 you started calling yourself 00:09:14.571 --> 00:09:18.374 like the quest diagnostics of human 00:09:18.413 --> 00:09:18.855 movement. 00:09:19.075 --> 00:09:22.136 So if pretend for a second that I 00:09:22.197 --> 00:09:23.118 don't know the model, 00:09:23.398 --> 00:09:24.899 I want you to walk people through, 00:09:25.159 --> 00:09:26.039 not theoretically, 00:09:26.059 --> 00:09:28.182 because you are doing this right now. 00:09:28.201 --> 00:09:29.182 This is not theoretical. 00:09:29.202 --> 00:09:30.104 This is practical. 00:09:30.403 --> 00:09:31.625 So walk people through this, 00:09:31.764 --> 00:09:35.548 walk PTs through what Movique is doing, 00:09:35.928 --> 00:09:37.929 and then we'll talk future state of what 00:09:37.950 --> 00:09:38.551 you're hoping to do. 00:09:39.238 --> 00:09:39.879 OK, yes. 00:09:41.080 --> 00:09:43.341 So we're a clinical biomechanics lab. 00:09:43.721 --> 00:09:45.243 We're not a physical therapy clinic. 00:09:47.210 --> 00:09:49.572 We partner with physical therapy clinics. 00:09:49.591 --> 00:09:51.493 We also partner with medical clinics as 00:09:51.533 --> 00:09:53.673 well in orthopedics, neurology, 00:09:53.933 --> 00:09:55.134 and podiatry. 00:09:55.895 --> 00:09:58.898 So when you identify somebody with 00:09:58.977 --> 00:09:59.878 movement deficits, 00:10:00.519 --> 00:10:03.860 you can refer your patient out to our 00:10:03.900 --> 00:10:04.280 clinic. 00:10:04.902 --> 00:10:09.845 It's as easy as filling out a form 00:10:09.924 --> 00:10:11.086 on our online dashboard. 00:10:12.355 --> 00:10:13.755 And just like Quest Diagnostics, 00:10:13.855 --> 00:10:16.217 we coordinate scheduling and we coordinate 00:10:16.278 --> 00:10:19.360 testing with the patient. 00:10:20.059 --> 00:10:20.720 They come in, 00:10:21.280 --> 00:10:24.923 they get tested using a motion capture, 00:10:25.683 --> 00:10:29.806 force plate, and balance plate. 00:10:30.667 --> 00:10:32.207 Once we get all the data, 00:10:32.368 --> 00:10:34.288 we input it into our dashboard. 00:10:35.190 --> 00:10:36.409 And on your end, 00:10:36.910 --> 00:10:38.152 on the physical therapist's end, 00:10:38.611 --> 00:10:39.913 you can open up that report. 00:10:40.924 --> 00:10:44.326 And you can see different metrics based on 00:10:44.386 --> 00:10:47.849 their gait, running, jumping, 00:10:48.850 --> 00:10:50.691 functional skills on fourth plate, 00:10:51.331 --> 00:10:52.312 and balance plates, 00:10:52.792 --> 00:10:55.734 such as limits of stability, 00:10:56.313 --> 00:11:01.037 weight distribution, et cetera. 00:11:01.716 --> 00:11:03.138 And you can use that report. 00:11:03.778 --> 00:11:06.039 You can speak with the clients. 00:11:06.080 --> 00:11:07.039 Here's the report. 00:11:07.240 --> 00:11:09.361 Each report contains the results. 00:11:11.504 --> 00:11:12.865 the clinical interpretation, 00:11:13.525 --> 00:11:17.326 what that metric means, and the reference, 00:11:17.687 --> 00:11:19.368 and whether it's within reference or out 00:11:19.408 --> 00:11:19.969 of reference. 00:11:21.710 --> 00:11:22.929 So that's like the blood test. 00:11:23.610 --> 00:11:23.791 Yeah. 00:11:23.850 --> 00:11:24.010 Right. 00:11:24.311 --> 00:11:26.192 So you're set up in Vegas and your 00:11:26.251 --> 00:11:27.131 model is, 00:11:27.432 --> 00:11:28.873 and I'm going to say it and you 00:11:28.913 --> 00:11:29.854 correct me where I'm wrong. 00:11:31.033 --> 00:11:32.294 I'll give it a good first draft. 00:11:33.250 --> 00:11:35.270 You're set up in Vegas and your goal 00:11:35.791 --> 00:11:38.611 is to be that blood testing lab. 00:11:38.672 --> 00:11:39.032 Listen, 00:11:39.331 --> 00:11:41.832 if you're a PT clinic for sports or 00:11:41.893 --> 00:11:42.933 outpatient orthopedics, 00:11:43.653 --> 00:11:44.573 it's going to cost you a lot of 00:11:44.594 --> 00:11:46.274 money to do these things and training in 00:11:46.335 --> 00:11:46.615 time. 00:11:47.495 --> 00:11:48.436 So why not? 00:11:49.096 --> 00:11:51.037 It takes space too. 00:11:51.057 --> 00:11:51.236 Sorry. 00:11:51.297 --> 00:11:51.716 Good point. 00:11:51.876 --> 00:11:52.537 Yeah. 00:11:52.557 --> 00:11:54.317 And which is a premium too in a 00:11:54.357 --> 00:11:56.078 larger metro. 00:11:56.119 --> 00:11:59.240 So why not utilize us because we've got 00:11:59.279 --> 00:12:01.640 equipment, space, and staff. 00:12:02.061 --> 00:12:02.260 Mm-hmm. 00:12:04.044 --> 00:12:08.288 You send us a patient pre-eval, post-eval? 00:12:08.347 --> 00:12:09.970 Mostly post-eval. 00:12:10.190 --> 00:12:12.030 I would love to get to pre-eval someday 00:12:12.051 --> 00:12:14.633 so that it's more like, yeah. 00:12:14.653 --> 00:12:15.594 And you send them to, 00:12:16.154 --> 00:12:18.416 they send them to MoVic and then you 00:12:18.456 --> 00:12:21.097 run them through whatever battery of tests 00:12:21.719 --> 00:12:23.841 that you have that the PT feels 00:12:23.880 --> 00:12:24.500 appropriate. 00:12:25.162 --> 00:12:27.243 And then the report goes to the PT. 00:12:27.683 --> 00:12:28.364 Now they're able to, 00:12:28.384 --> 00:12:29.825 the next time they see that patient in 00:12:29.924 --> 00:12:31.486 their clinic, because you're not a clinic, 00:12:31.506 --> 00:12:31.947 you said that. 00:12:32.346 --> 00:12:32.967 We're not a clinic. 00:12:33.533 --> 00:12:34.815 As soon as when they see them in 00:12:34.855 --> 00:12:35.556 their clinic, 00:12:35.676 --> 00:12:38.719 they are now able to have that blood 00:12:38.739 --> 00:12:41.903 panel results in front of them to help 00:12:41.962 --> 00:12:43.085 guide them. 00:12:43.105 --> 00:12:43.424 Yes. 00:12:44.245 --> 00:12:44.927 What did I miss? 00:12:45.047 --> 00:12:45.388 Anything? 00:12:45.947 --> 00:12:46.908 You haven't missed anything. 00:12:46.928 --> 00:12:47.971 That's exactly it. 00:12:48.375 --> 00:12:49.277 Well, you've told me this before, 00:12:49.297 --> 00:12:50.298 so I'm cheating, which is good. 00:12:50.317 --> 00:12:50.557 Okay. 00:12:50.577 --> 00:12:54.140 I don't think that's cheating. 00:12:54.240 --> 00:12:54.921 And then do your homework. 00:12:54.941 --> 00:12:55.442 That's not cheating. 00:12:56.663 --> 00:12:56.923 Okay. 00:12:57.222 --> 00:12:59.985 And then this is done on an annual 00:13:00.024 --> 00:13:01.767 retainer basis right now. 00:13:01.787 --> 00:13:01.907 Yes. 00:13:02.326 --> 00:13:04.067 So we partner with the clinics on an 00:13:04.148 --> 00:13:05.048 annual contract. 00:13:05.909 --> 00:13:07.610 Got it. 00:13:07.630 --> 00:13:08.111 Understood. 00:13:08.572 --> 00:13:10.072 Yeah. 00:13:10.113 --> 00:13:10.373 Well, 00:13:10.734 --> 00:13:13.054 the clinics can travel us out through the 00:13:13.096 --> 00:13:13.875 pilot program, too. 00:13:15.722 --> 00:13:17.543 So it's, there's a low cost effect, 00:13:18.464 --> 00:13:20.125 low cost way to trial moving cows. 00:13:20.144 --> 00:13:20.225 Yeah. 00:13:20.245 --> 00:13:25.788 To see where the right fit. 00:13:25.807 --> 00:13:26.067 Good. 00:13:26.307 --> 00:13:26.528 Okay. 00:13:27.369 --> 00:13:30.710 So why has physical therapy sort of 00:13:30.809 --> 00:13:34.172 tolerated subjective measurement, 00:13:34.412 --> 00:13:35.572 for lack of a better term, 00:13:35.613 --> 00:13:37.474 when we ask people how it feels, right? 00:13:37.734 --> 00:13:38.193 Why have we, 00:13:38.394 --> 00:13:39.835 why has our profession tolerated 00:13:39.875 --> 00:13:41.936 subjective measurement for so long? 00:13:42.035 --> 00:13:42.775 Why is this, how is, 00:13:42.916 --> 00:13:43.275 how are we still, 00:13:43.476 --> 00:13:44.216 how is this still okay? 00:13:44.871 --> 00:13:45.932 Well, to be honest with you, 00:13:45.952 --> 00:13:47.273 it's just my speculation, 00:13:47.953 --> 00:13:51.455 but standardizing data in clinic is very, 00:13:51.475 --> 00:13:52.296 very difficult. 00:13:53.535 --> 00:13:55.998 I think the biggest example that most of 00:13:56.018 --> 00:13:58.698 us use in outpatient clinic is five times 00:13:58.719 --> 00:13:59.339 set to stand. 00:14:00.639 --> 00:14:02.321 The proper way to do five times set 00:14:02.360 --> 00:14:04.942 to stand is to ensure that the chair 00:14:04.981 --> 00:14:06.883 height is between sixteen and seventeen 00:14:06.942 --> 00:14:07.263 inches. 00:14:08.303 --> 00:14:10.565 The chair cannot be anchored to the floor 00:14:12.225 --> 00:14:12.666 or the wall. 00:14:14.605 --> 00:14:16.628 And that's where sort of there's the 00:14:16.668 --> 00:14:17.548 variation of it. 00:14:18.928 --> 00:14:23.812 And when I was working as a clinician, 00:14:24.212 --> 00:14:26.754 I actually met with a retired internal 00:14:27.475 --> 00:14:28.556 medicine physician. 00:14:31.277 --> 00:14:32.717 I was taking a blood pressure, 00:14:33.198 --> 00:14:35.840 and I actually did it the way everyone 00:14:35.860 --> 00:14:38.182 does it, just arm hanging down, 00:14:39.363 --> 00:14:40.964 legs slightly off the floor, 00:14:40.984 --> 00:14:42.105 feet slightly off the floor. 00:14:43.346 --> 00:14:45.628 And she was pointing out to me, Chana, 00:14:46.089 --> 00:14:47.690 the way you're doing it is invalid. 00:14:47.750 --> 00:14:49.311 I won't take your results for it. 00:14:50.131 --> 00:14:51.913 And that's when I sort of learned that 00:14:52.653 --> 00:14:54.995 standardizing how we measure is very, 00:14:55.037 --> 00:14:57.979 very important, not just for patients, 00:14:57.999 --> 00:15:01.142 but also our referral partners who are 00:15:01.182 --> 00:15:02.102 mostly physicians. 00:15:03.466 --> 00:15:03.767 Understood. 00:15:03.787 --> 00:15:03.966 All right. 00:15:05.086 --> 00:15:05.586 Quick break. 00:15:06.368 --> 00:15:06.988 Thanks to U.S. 00:15:07.008 --> 00:15:07.768 Physical Therapy. 00:15:08.687 --> 00:15:09.947 You didn't start your clinic to sell it 00:15:10.048 --> 00:15:10.187 off. 00:15:10.227 --> 00:15:11.428 You built it to last. 00:15:11.548 --> 00:15:11.969 At U.S. 00:15:12.009 --> 00:15:12.649 Physical Therapy, 00:15:12.668 --> 00:15:14.269 they help clinic owners stay local, 00:15:14.769 --> 00:15:17.350 stay in control, and grow with confidence. 00:15:17.950 --> 00:15:19.190 They're not a private equity firm. 00:15:19.210 --> 00:15:21.009 They're physical therapists helping 00:15:21.070 --> 00:15:22.530 physical therapists grow. 00:15:22.890 --> 00:15:24.770 Visit them online at usph.com. 00:15:24.791 --> 00:15:28.371 That's usphpartnerships.com. 00:15:30.071 --> 00:15:31.371 And I do also wanna say thanks. 00:15:32.212 --> 00:15:34.414 This episode brought to you by one of 00:15:34.475 --> 00:15:36.537 our nonprofit partners, Team Gleason, 00:15:36.778 --> 00:15:39.039 supporting people living with ALS with 00:15:39.179 --> 00:15:40.780 access to care, mobility, 00:15:41.322 --> 00:15:42.383 and independence. 00:15:42.423 --> 00:15:43.884 If you wanna support a cause, 00:15:44.823 --> 00:15:46.303 that aligns directly with function and 00:15:46.323 --> 00:15:49.164 dignity, you check out teamgleason.org. 00:15:49.184 --> 00:15:54.365 All right, let me ask this. 00:15:54.605 --> 00:15:55.946 Why is standardized diagnostic 00:15:55.966 --> 00:15:57.405 infrastructure in physical therapy? 00:15:57.446 --> 00:15:58.265 Why is it needed? 00:15:58.886 --> 00:15:59.486 Is it needed? 00:15:59.586 --> 00:16:00.326 Where is it needed? 00:16:00.506 --> 00:16:01.326 Like answer those. 00:16:01.986 --> 00:16:02.886 Yeah, yeah, of course. 00:16:02.966 --> 00:16:05.467 I think that's actually the most common 00:16:05.508 --> 00:16:06.488 question that I get. 00:16:07.947 --> 00:16:08.947 Among physical therapists, 00:16:09.207 --> 00:16:11.589 the biggest pushback is everyone moves 00:16:11.629 --> 00:16:12.048 differently. 00:16:13.692 --> 00:16:15.234 And I agree, everyone moves differently. 00:16:15.394 --> 00:16:17.693 And that isn't actually an argument 00:16:17.774 --> 00:16:19.254 against standardization. 00:16:19.674 --> 00:16:22.394 It is actually the strongest reason for 00:16:22.455 --> 00:16:24.196 standardization. 00:16:24.216 --> 00:16:26.255 We don't say every heart rhythm is 00:16:26.336 --> 00:16:28.456 different, so ECGs are useless. 00:16:28.956 --> 00:16:30.017 We say it the other way. 00:16:30.557 --> 00:16:33.258 Because every heart is different, 00:16:33.717 --> 00:16:36.499 we need a consistent way to measure it 00:16:36.639 --> 00:16:37.418 using ECGs. 00:16:38.254 --> 00:16:41.897 The goal of standardized diagnostic 00:16:41.937 --> 00:16:44.739 infrastructure isn't to standardize the 00:16:44.879 --> 00:16:47.541 output or to make everyone move the same, 00:16:48.101 --> 00:16:50.923 it's to standardize the input the way 00:16:50.984 --> 00:16:53.505 testing is done because standardization 00:16:53.946 --> 00:16:56.908 controls for variability amongst humans 00:16:57.869 --> 00:17:00.672 and it creates a shared baseline that all 00:17:00.731 --> 00:17:02.092 physical therapists can use. 00:17:02.732 --> 00:17:04.755 So right now in physical therapy, 00:17:05.314 --> 00:17:06.334 hypothetically speaking, 00:17:07.095 --> 00:17:08.194 it's not a possibility, 00:17:08.214 --> 00:17:10.355 but it's hypothetical, two people, 00:17:10.655 --> 00:17:12.776 same age, same demographics, 00:17:13.236 --> 00:17:14.237 same left knee pain, 00:17:14.696 --> 00:17:17.176 can go into two different physical therapy 00:17:17.196 --> 00:17:20.778 clinics and walk out with different tests 00:17:20.798 --> 00:17:22.078 being done to them, 00:17:22.578 --> 00:17:24.818 different baselines established, 00:17:25.519 --> 00:17:28.681 and there's a possibility of different 00:17:28.760 --> 00:17:30.060 treatment plan or plan of care. 00:17:31.132 --> 00:17:32.972 For physical therapists like us, 00:17:33.093 --> 00:17:35.634 we like to call that individualized care. 00:17:36.795 --> 00:17:38.015 But at a higher level, 00:17:39.215 --> 00:17:41.297 at like a payer's level, 00:17:42.196 --> 00:17:43.778 they call that variability. 00:17:44.198 --> 00:17:48.940 If two people with the same diagnosis walk 00:17:49.000 --> 00:17:50.300 into physical therapy clinics, 00:17:50.441 --> 00:17:52.021 ideally they should be tested the same 00:17:52.061 --> 00:17:52.201 way. 00:17:53.071 --> 00:17:53.893 But it's not. 00:17:54.113 --> 00:17:58.715 And that creates the noise in whether the 00:17:58.756 --> 00:18:01.278 patient made true improvement or not. 00:18:02.138 --> 00:18:04.560 And the second reason for the importance 00:18:04.681 --> 00:18:08.143 of standardizing diagnostic infrastructure 00:18:08.743 --> 00:18:11.546 is that standardized data is the universal 00:18:11.586 --> 00:18:12.707 language of 00:18:13.472 --> 00:18:16.436 high stake decision making in any 00:18:16.477 --> 00:18:17.076 professions. 00:18:17.738 --> 00:18:19.279 So as I mentioned, 00:18:19.539 --> 00:18:21.561 professions that we trust with our lives, 00:18:22.042 --> 00:18:25.707 pilots, engineers, forensic scientists, 00:18:26.147 --> 00:18:28.631 they rely on objective standardized data 00:18:29.010 --> 00:18:31.554 because the stakes are too high for human 00:18:31.614 --> 00:18:31.814 error. 00:18:32.835 --> 00:18:34.856 Healthcare workers also work the same way. 00:18:35.116 --> 00:18:36.778 The professions that make critical and 00:18:36.798 --> 00:18:38.900 important decisions like, as I mentioned, 00:18:39.220 --> 00:18:42.343 physicians, dentists, eye doctors, 00:18:42.823 --> 00:18:45.184 they rely on standardized data because the 00:18:45.224 --> 00:18:47.866 cost of being wrong is too high. 00:18:48.827 --> 00:18:51.869 So for me, it's just my opinion. 00:18:52.931 --> 00:18:55.432 When we argue that physical therapy 00:18:55.512 --> 00:18:57.694 doesn't need standardized diagnostic 00:18:57.775 --> 00:18:58.474 infrastructure, 00:18:59.155 --> 00:19:01.577 we're making a dangerous claim that 00:19:02.365 --> 00:19:04.686 the consequences of being wrong are so low 00:19:04.707 --> 00:19:06.307 that it's okay to eyeball movements. 00:19:06.946 --> 00:19:08.527 And you and I know that's not true. 00:19:09.227 --> 00:19:10.788 And I know people don't mean it that 00:19:10.807 --> 00:19:11.028 way, 00:19:11.107 --> 00:19:13.748 but it's the way I infer it as 00:19:13.788 --> 00:19:14.048 well. 00:19:15.028 --> 00:19:16.209 Movement is a vital sign. 00:19:16.469 --> 00:19:19.529 It dictates independence, fall risk, 00:19:20.410 --> 00:19:22.490 chronic disease trajectory, 00:19:23.069 --> 00:19:25.671 return to work or activity. 00:19:26.532 --> 00:19:27.574 activities of the living, 00:19:28.273 --> 00:19:30.297 it reflects quality of life as well. 00:19:30.936 --> 00:19:32.459 So for me, 00:19:33.059 --> 00:19:35.201 if physical therapy wants to be seen as 00:19:35.241 --> 00:19:36.544 a high value profession, 00:19:37.785 --> 00:19:40.607 we need to anchor to the same thing 00:19:40.647 --> 00:19:42.990 that the rest of the rest of healthcare 00:19:43.111 --> 00:19:44.071 is anchored to, 00:19:44.472 --> 00:19:46.434 which is objective standardized data. 00:19:47.849 --> 00:19:48.430 If someone said, 00:19:48.470 --> 00:19:50.691 what's the difference between AI video 00:19:50.730 --> 00:19:52.932 analysis and what you're doing, 00:19:52.951 --> 00:19:54.553 like a clinical biomechanics lab, 00:19:54.593 --> 00:19:55.874 how would you explain that? 00:19:56.653 --> 00:19:58.134 Yeah. 00:19:58.174 --> 00:20:01.096 So for me, AI video analysis, 00:20:01.215 --> 00:20:02.916 like the movement analysis that we use 00:20:03.076 --> 00:20:05.557 through our smartphone, iPad, 00:20:05.657 --> 00:20:08.859 or even laptop, it's a powerful tool. 00:20:09.000 --> 00:20:09.660 I love it too. 00:20:10.040 --> 00:20:12.541 I personally use it for myself as well. 00:20:13.182 --> 00:20:15.123 But the core limitation is that it 00:20:15.182 --> 00:20:16.884 produces inferred data. 00:20:18.188 --> 00:20:21.830 So what that means is that the AI 00:20:21.871 --> 00:20:24.554 model doesn't actually directly measure 00:20:24.713 --> 00:20:25.234 movement. 00:20:26.435 --> 00:20:29.438 It estimates movement from the camera 00:20:29.578 --> 00:20:33.923 angle, lens distortion, phone placement. 00:20:35.084 --> 00:20:37.105 So in other words, 00:20:37.925 --> 00:20:39.007 it's not directly measuring it. 00:20:39.067 --> 00:20:42.611 It's measuring based on its previously 00:20:43.030 --> 00:20:43.811 trained models. 00:20:45.123 --> 00:20:46.023 Um, but you know, 00:20:46.044 --> 00:20:48.546 what's what AI video analysis or movement 00:20:48.605 --> 00:20:50.528 analysis is great for is it's great for 00:20:50.587 --> 00:20:51.648 engagement and coaching. 00:20:52.348 --> 00:20:53.390 Um, 00:20:53.470 --> 00:20:56.853 it's great for providing immediate visual 00:20:56.893 --> 00:21:00.296 feedback and it helps patients see the 00:21:00.336 --> 00:21:00.797 movement, 00:21:01.917 --> 00:21:05.361 but the greatest risk shows up in 00:21:05.540 --> 00:21:06.101 healthcare. 00:21:07.001 --> 00:21:09.824 When we use inferred data from movement, 00:21:10.065 --> 00:21:11.526 AI movement analysis, 00:21:12.546 --> 00:21:16.727 like a medical grade standard because 00:21:16.926 --> 00:21:19.948 inferred data can change with protocols or 00:21:20.048 --> 00:21:21.928 setups rather than the patient's 00:21:21.968 --> 00:21:24.288 physiology or their biomechanics. 00:21:24.989 --> 00:21:27.769 So it can create a false baseline and 00:21:27.869 --> 00:21:32.570 it can lead to misleading progress. 00:21:33.330 --> 00:21:36.991 So that's why AI video analysis positioned 00:21:37.031 --> 00:21:39.872 themselves as a wellness, fitness, 00:21:40.153 --> 00:21:41.952 or visualization tool. 00:21:43.289 --> 00:21:45.090 Um, yeah, go for it. 00:21:46.211 --> 00:21:46.391 Yeah. 00:21:46.490 --> 00:21:48.592 Movie tells clinical biomechanics. 00:21:48.612 --> 00:21:50.272 It's it's different. 00:21:50.932 --> 00:21:52.973 It's a completely different tool for 00:21:53.433 --> 00:21:54.914 that's used for different purposes. 00:21:55.115 --> 00:21:58.336 So where, so we produce standardized data, 00:21:59.076 --> 00:21:59.896 you know, uh, 00:21:59.916 --> 00:22:02.278 the sort of testing is completed in a 00:22:02.377 --> 00:22:04.739 controlled condition using the same 00:22:04.778 --> 00:22:07.240 equipment, same instruction, 00:22:07.920 --> 00:22:10.280 same tool on their same scoring system. 00:22:11.198 --> 00:22:14.340 So we remove the noise so that the 00:22:14.461 --> 00:22:18.483 baseline and the follow-up is a true 00:22:18.625 --> 00:22:20.846 apple-to-apple measurement. 00:22:21.686 --> 00:22:25.851 And that difference is really everything. 00:22:25.891 --> 00:22:28.232 And that's what separates AI video 00:22:28.272 --> 00:22:31.375 analysis and movie health or clinical 00:22:31.395 --> 00:22:32.336 biomechanics lab. 00:22:32.817 --> 00:22:34.838 Both can coexist. 00:22:35.358 --> 00:22:36.660 I don't think it's one or the other 00:22:36.721 --> 00:22:36.820 issue. 00:22:36.840 --> 00:22:37.441 Right, right. 00:22:37.500 --> 00:22:37.922 It can't be. 00:22:38.541 --> 00:22:38.721 Yeah, 00:22:38.882 --> 00:22:41.403 the best clinics in Las Vegas actually use 00:22:41.723 --> 00:22:42.124 both. 00:22:42.625 --> 00:22:46.366 So they use us to establish true baseline 00:22:46.547 --> 00:22:48.347 and true progress. 00:22:49.528 --> 00:22:51.730 And they use video analysis for 00:22:53.451 --> 00:22:56.553 in-the-moment coaching. 00:22:56.653 --> 00:23:00.195 So does the profession need... 00:23:01.499 --> 00:23:03.339 comprehensive testing like this? 00:23:03.599 --> 00:23:04.720 I mean, you're in Vegas now. 00:23:04.779 --> 00:23:06.621 I imagine the goal is to spread in 00:23:06.661 --> 00:23:08.261 other major cities and then see how this 00:23:08.301 --> 00:23:08.501 goes. 00:23:08.521 --> 00:23:10.663 But someone asked on our live stream, 00:23:10.722 --> 00:23:13.104 does the profession need comprehensive 00:23:13.144 --> 00:23:14.365 testing like this? 00:23:14.424 --> 00:23:16.806 Where do we need our quest diagnostics of 00:23:16.865 --> 00:23:17.165 movement? 00:23:18.119 --> 00:23:19.740 Well, I'm going to say yes. 00:23:19.760 --> 00:23:21.663 I think it is very important. 00:23:22.962 --> 00:23:25.924 The reason being is that in every other 00:23:26.006 --> 00:23:26.625 healthcare, 00:23:27.165 --> 00:23:28.487 every other branch of healthcare, 00:23:29.127 --> 00:23:31.509 comprehensive diagnostic testing is sort 00:23:31.528 --> 00:23:33.810 of like the non-negotiable bare minimum 00:23:33.971 --> 00:23:34.692 standard of care. 00:23:35.892 --> 00:23:37.192 It explains the mechanism, 00:23:37.693 --> 00:23:40.316 quantifies severity, 00:23:40.615 --> 00:23:43.238 and create a true baseline, 00:23:43.337 --> 00:23:45.159 objective standardized baseline that 00:23:45.953 --> 00:23:47.074 they can track over time. 00:23:47.815 --> 00:23:49.174 In physical therapy clinics, 00:23:50.154 --> 00:23:52.955 most of what we use for evaluation is 00:23:53.096 --> 00:23:54.936 fast, low-cost, 00:23:55.116 --> 00:23:57.657 minimal equipment tests that produce 00:23:58.258 --> 00:24:02.819 binary results or it's graded on a 00:24:02.859 --> 00:24:03.720 subjective scale. 00:24:04.640 --> 00:24:07.201 So the output is mostly observational 00:24:07.240 --> 00:24:08.580 data, inferred data, 00:24:08.801 --> 00:24:09.942 or non-standardized data. 00:24:11.323 --> 00:24:11.682 So, 00:24:12.083 --> 00:24:14.984 and another thing for me is if a 00:24:15.045 --> 00:24:18.366 patient can perform your test at home with 00:24:18.406 --> 00:24:22.489 the chair and a stopwatch, it's a screen, 00:24:22.909 --> 00:24:23.868 not a diagnostic. 00:24:24.088 --> 00:24:28.030 It lacks clinical authority and was never 00:24:28.171 --> 00:24:30.413 meant to carry the weight of clinical 00:24:30.452 --> 00:24:31.012 prescription. 00:24:31.073 --> 00:24:34.934 It was designed to triage more than to 00:24:35.555 --> 00:24:39.217 explain why and why is everything behind 00:24:40.364 --> 00:24:42.403 behind your plan of care. 00:24:44.744 --> 00:24:45.305 For me, 00:24:46.585 --> 00:24:49.865 physical therapy needs standardized 00:24:49.925 --> 00:24:52.965 diagnostic infrastructure or comprehensive 00:24:53.006 --> 00:24:53.506 testing, 00:24:54.426 --> 00:24:56.446 not to replace clinical judgments, 00:24:56.787 --> 00:24:58.307 but to strengthen it. 00:24:58.926 --> 00:25:02.067 We need something that we can anchor that 00:25:02.127 --> 00:25:05.188 we own in physical therapy so that people 00:25:05.667 --> 00:25:08.009 appreciate physical therapists for what 00:25:08.048 --> 00:25:08.269 they do. 00:25:10.176 --> 00:25:10.696 Understood. 00:25:10.817 --> 00:25:11.037 All right. 00:25:11.076 --> 00:25:12.758 So to the clinic owners listening right 00:25:12.798 --> 00:25:12.877 now, 00:25:12.897 --> 00:25:14.058 because that's what you want to talk to, 00:25:14.138 --> 00:25:14.398 right? 00:25:14.439 --> 00:25:16.700 That's the audiences that you're serving 00:25:16.740 --> 00:25:18.161 now and want to continue to serve. 00:25:18.641 --> 00:25:20.162 If you're a clinic owner listening right 00:25:20.201 --> 00:25:25.325 now, what's their first practical step? 00:25:25.625 --> 00:25:27.705 Like what, what would you have people, 00:25:27.726 --> 00:25:28.905 you know, what's, what's the goal? 00:25:28.945 --> 00:25:30.106 Would you want them to do or no? 00:25:31.444 --> 00:25:34.548 Can you rephrase the question again one 00:25:34.608 --> 00:25:35.148 more time? 00:25:35.169 --> 00:25:36.451 I guess if a clinic owner is out 00:25:36.471 --> 00:25:38.593 there and they're in the Vegas area, 00:25:39.294 --> 00:25:41.015 you want them to test drive, right? 00:25:41.035 --> 00:25:42.317 You want them to come in there and 00:25:42.356 --> 00:25:42.977 take a look. 00:25:43.538 --> 00:25:45.519 But if someone isn't in the Las Vegas 00:25:45.579 --> 00:25:49.364 area, what's their first practical step? 00:25:49.463 --> 00:25:52.607 I think they should try to use 00:25:52.647 --> 00:25:53.469 standardized data. 00:25:54.272 --> 00:25:56.394 practice using standardized data as much 00:25:56.434 --> 00:25:57.295 as they can. 00:25:57.494 --> 00:25:58.615 I think most clinics, 00:25:59.175 --> 00:26:01.538 I would love for all clinics to invest 00:26:01.617 --> 00:26:02.417 in technology. 00:26:03.138 --> 00:26:05.359 I think physical therapy should move on 00:26:05.420 --> 00:26:08.582 from visual or manual to more towards 00:26:08.622 --> 00:26:12.263 technology-driven healthcare. 00:26:12.403 --> 00:26:14.885 And really test out the equipment that 00:26:14.905 --> 00:26:15.445 we're using. 00:26:15.987 --> 00:26:18.367 RunDNA, my favorite company. 00:26:19.048 --> 00:26:19.449 Vault, 00:26:19.888 --> 00:26:21.890 probably my second favorite company out 00:26:21.910 --> 00:26:22.089 there. 00:26:24.606 --> 00:26:26.127 Balance tracking system is great for 00:26:26.167 --> 00:26:26.969 tracking balance. 00:26:27.308 --> 00:26:29.089 And I think they should try all these 00:26:30.009 --> 00:26:30.611 companies out, 00:26:30.671 --> 00:26:32.491 reach out to the companies and find out 00:26:32.592 --> 00:26:34.153 more about what they do. 00:26:34.932 --> 00:26:36.713 Yeah. 00:26:36.794 --> 00:26:38.154 All right. 00:26:38.174 --> 00:26:39.596 Is there anything I didn't ask that you 00:26:39.615 --> 00:26:40.936 wanted me to dig into or anything that 00:26:40.977 --> 00:26:42.038 you think that, I mean, 00:26:42.597 --> 00:26:44.459 because you're answering frequently asked 00:26:44.499 --> 00:26:46.299 questions when you're doing outreach to 00:26:46.339 --> 00:26:46.920 clinics, right? 00:26:47.240 --> 00:26:48.560 Is there anything that you typically get 00:26:48.801 --> 00:26:50.342 asked that I didn't give you a chance 00:26:50.682 --> 00:26:51.002 to share? 00:26:52.219 --> 00:26:54.640 They usually ask how difficult this is, 00:26:54.720 --> 00:26:58.281 like in a sense that most physical 00:26:58.321 --> 00:27:01.502 therapists are not trained in biomechanics 00:27:02.022 --> 00:27:04.483 as extensively as we think we are. 00:27:04.723 --> 00:27:05.825 Even when I went to school, 00:27:05.845 --> 00:27:07.365 I had a great professor. 00:27:07.925 --> 00:27:10.626 But for clinical biomechanics, 00:27:10.686 --> 00:27:14.528 we're learning F equals MA and those 00:27:14.568 --> 00:27:15.048 formulas. 00:27:16.634 --> 00:27:19.116 So the biggest concern is that for clinic 00:27:19.176 --> 00:27:20.519 owners that they won't know how to 00:27:20.578 --> 00:27:22.701 interpret these results. 00:27:24.282 --> 00:27:27.807 So it's all in the report. 00:27:28.928 --> 00:27:30.128 That's the easiest way to say it. 00:27:31.990 --> 00:27:32.672 It's pretty much... 00:27:33.886 --> 00:27:35.828 reading through the report and going into 00:27:35.848 --> 00:27:38.849 details with the clients or customers, 00:27:39.010 --> 00:27:41.551 patients, sorry, one-on-one. 00:27:42.073 --> 00:27:44.834 And you can go on our website and 00:27:44.854 --> 00:27:47.175 download the sample report that you get. 00:27:47.816 --> 00:27:49.576 And it gives you a pretty good 00:27:49.636 --> 00:27:50.178 explanation. 00:27:50.238 --> 00:27:52.159 And most physical therapists, 00:27:52.558 --> 00:27:53.420 we're very smart. 00:27:54.019 --> 00:27:56.402 And they really have no issues with it. 00:27:56.642 --> 00:27:57.742 But that's their biggest concern. 00:28:00.082 --> 00:28:00.342 Sure. 00:28:00.823 --> 00:28:04.482 We'll share the website in the show notes, 00:28:04.502 --> 00:28:06.943 but movichealth.com. 00:28:08.203 --> 00:28:09.723 Are you ready for your parting shot? 00:28:10.444 --> 00:28:11.444 Yes, I am. 00:28:11.505 --> 00:28:13.744 Let's do the parting shot. 00:28:14.265 --> 00:28:15.405 This is the parting shot. 00:28:15.965 --> 00:28:17.346 One last mic drop moment. 00:28:18.046 --> 00:28:18.846 No pressure. 00:28:19.287 --> 00:28:21.386 Just your legacy on the line. 00:28:22.898 --> 00:28:24.079 Thanks to Sarah Health, 00:28:24.099 --> 00:28:26.381 the remote care platform helping clinics 00:28:26.421 --> 00:28:28.280 boost revenue without having to add staff. 00:28:28.320 --> 00:28:30.182 Sarah automates daily patient check-ins 00:28:30.682 --> 00:28:33.323 via text, which means no app, no logins, 00:28:33.343 --> 00:28:34.743 just better outcomes. 00:28:34.824 --> 00:28:36.664 A simple way to meet RTM requirements, 00:28:36.704 --> 00:28:37.585 improve follow-through, 00:28:37.605 --> 00:28:40.046 and actually get reimbursed for care 00:28:40.086 --> 00:28:41.227 between visits. 00:28:41.366 --> 00:28:43.307 Easy to set up, simple to use, 00:28:43.347 --> 00:28:44.528 and patients love it. 00:28:44.688 --> 00:28:45.669 SarahHealth.com. 00:28:45.689 --> 00:28:49.170 It's S-A-R-A-Health.com. 00:28:49.230 --> 00:28:50.330 All right, you're parting shot. 00:28:50.351 --> 00:28:51.211 Shana, what do you got for me? 00:28:52.328 --> 00:28:52.749 All right, 00:28:53.750 --> 00:28:57.392 every innovation in a profession does one 00:28:57.412 --> 00:28:58.153 of the two things. 00:28:58.953 --> 00:29:02.115 It either raises the ceiling or it raises 00:29:02.155 --> 00:29:02.635 the floor. 00:29:03.477 --> 00:29:05.417 So raising the ceiling is about 00:29:05.935 --> 00:29:07.116 expanding what's possible. 00:29:07.277 --> 00:29:09.897 It's the new technology, new product. 00:29:10.337 --> 00:29:11.077 It's exciting. 00:29:11.617 --> 00:29:12.398 It's impressive. 00:29:12.919 --> 00:29:16.140 Even I love new technology coming out in 00:29:16.180 --> 00:29:17.820 physical therapy. 00:29:18.901 --> 00:29:20.622 But raising the floor is different. 00:29:21.021 --> 00:29:22.083 When you raise the floor, 00:29:22.282 --> 00:29:24.544 you elevate the minimum standard of care. 00:29:25.163 --> 00:29:27.105 It's about reducing variability and 00:29:27.144 --> 00:29:29.945 ensuring that a patient gets high value 00:29:30.843 --> 00:29:33.243 service regardless of which clinic they're 00:29:33.304 --> 00:29:33.463 in. 00:29:34.164 --> 00:29:35.164 Probably not as fun, 00:29:36.546 --> 00:29:37.886 not as exciting for most people. 00:29:39.146 --> 00:29:41.828 The space between the floor and the 00:29:41.888 --> 00:29:44.250 ceiling is the variability. 00:29:44.710 --> 00:29:46.790 It's how different we are from one or 00:29:46.810 --> 00:29:47.211 the other. 00:29:48.071 --> 00:29:50.593 Every physical therapy or every physical 00:29:50.613 --> 00:29:52.874 therapist starts on the floor, 00:29:53.953 --> 00:29:56.435 but only a elite few will ever reach 00:29:57.511 --> 00:30:00.194 the ceiling and I can think of great 00:30:00.214 --> 00:30:04.381 names, Jimmy McKay, Dave, 00:30:04.901 --> 00:30:06.482 my co-founder Akash Patel. 00:30:06.923 --> 00:30:08.885 They all reached the ceiling already, 00:30:09.027 --> 00:30:11.930 but most of us are unfortunately down here 00:30:11.970 --> 00:30:12.351 at the floor. 00:30:13.722 --> 00:30:16.243 A profession isn't defined by its ceiling. 00:30:16.743 --> 00:30:18.364 It's defined by its floor. 00:30:19.105 --> 00:30:19.904 And right now, 00:30:20.085 --> 00:30:21.845 when I see physical therapy, 00:30:22.306 --> 00:30:24.226 we have a very, very high ceiling. 00:30:25.606 --> 00:30:29.468 So some practice at the level of 00:30:30.008 --> 00:30:30.528 physicians. 00:30:31.607 --> 00:30:34.949 We also have very, very low floor. 00:30:35.528 --> 00:30:39.471 So some people act as more as a 00:30:39.911 --> 00:30:40.671 personal trainer. 00:30:41.488 --> 00:30:43.388 Or glorified personal trainer, 00:30:43.648 --> 00:30:45.670 with quotation, or coaches. 00:30:47.050 --> 00:30:48.892 If we want to build a skyscraper, 00:30:49.231 --> 00:30:51.373 you don't build a skyscraper only by 00:30:51.432 --> 00:30:52.253 raising the ceiling. 00:30:52.953 --> 00:30:54.515 You have to build the floors. 00:30:54.615 --> 00:30:57.036 You have to create the infrastructure that 00:30:57.176 --> 00:30:58.017 everyone stands on. 00:30:59.578 --> 00:31:00.720 And in physical therapy, 00:31:00.859 --> 00:31:03.040 we see leaders doing this quietly. 00:31:03.401 --> 00:31:05.501 They're probably not as vocal as I am, 00:31:06.241 --> 00:31:08.202 but one person I really want to highlight 00:31:08.303 --> 00:31:09.123 is Brian Warner. 00:31:09.462 --> 00:31:11.824 He was a founder of Physical Therapy and 00:31:11.845 --> 00:31:12.265 Balance. 00:31:12.825 --> 00:31:15.746 He's raising the floor in vestibular care, 00:31:15.885 --> 00:31:18.547 creating a standardized benchmark so that 00:31:18.586 --> 00:31:20.367 balance and dissonance treatment in 00:31:20.407 --> 00:31:22.788 physical therapy isn't a guessing game. 00:31:23.710 --> 00:31:24.309 Personally, I'm 00:31:25.105 --> 00:31:26.926 more excited about raising the floor than 00:31:27.307 --> 00:31:28.067 raising the ceiling. 00:31:28.627 --> 00:31:32.470 Because raising the ceiling will only help 00:31:33.230 --> 00:31:34.391 those who are elite few. 00:31:35.491 --> 00:31:36.532 But when you raise the floor, 00:31:37.133 --> 00:31:38.594 you help everyone. 00:31:39.253 --> 00:31:41.174 You move the needle for the entire 00:31:41.295 --> 00:31:44.497 profession within the healthcare system. 00:31:44.636 --> 00:31:47.538 You shift industry towards a profession 00:31:47.558 --> 00:31:51.060 that is valued, respected, defensible, 00:31:51.361 --> 00:31:52.342 and indispensable. 00:31:52.882 --> 00:31:53.862 And that is my parting shot. 00:31:54.001 --> 00:31:54.462 Thank you, Jimmy. 00:31:55.479 --> 00:31:56.299 website again, 00:31:56.460 --> 00:31:57.280 I'll put it in the show notes, 00:31:57.320 --> 00:32:00.242 but it's movichealth.com. 00:32:01.182 --> 00:32:03.085 I'm curious to see where this thing goes. 00:32:03.305 --> 00:32:03.865 I'm interested. 00:32:03.884 --> 00:32:04.705 I like the fact that you're doing it 00:32:04.726 --> 00:32:07.407 in Vegas too, but appreciate your time. 00:32:07.428 --> 00:32:08.528 Thanks for doing this and walking us 00:32:08.548 --> 00:32:08.888 through it. 00:32:10.029 --> 00:32:10.509 You're welcome. 00:32:10.630 --> 00:32:12.692 Thank you for inviting me onto your show. 00:32:14.573 --> 00:32:17.555 Sometimes being in this new field, 00:32:18.016 --> 00:32:20.698 it makes me feel like I'm talking, 00:32:20.857 --> 00:32:22.338 I'm like a chihuahua talking to 00:32:23.306 --> 00:32:25.708 barking at lions right now but i feel 00:32:25.728 --> 00:32:27.689 like i roar today so thank you for 00:32:28.028 --> 00:32:29.789 the platform and thank you for giving 00:32:30.109 --> 00:32:31.070 small people like us 00:32:32.221 --> 00:32:34.102 a platform to talk on. 00:32:34.442 --> 00:32:35.082 Appreciate it, Sean. 00:32:35.102 --> 00:32:36.002 Well, thanks for the time, man. 00:32:36.042 --> 00:32:38.604 You're welcome. 00:32:38.703 --> 00:32:39.804 That's it for this one. 00:32:40.284 --> 00:32:41.724 We're just getting warmed up. 00:32:42.224 --> 00:32:44.145 Smash follow, send it to a friend, 00:32:44.346 --> 00:32:46.007 or crank up the next episode. 00:32:46.527 --> 00:32:47.547 Want to go deeper? 00:32:47.866 --> 00:32:51.949 Hit us at pgpinecast.com or find us on 00:32:51.969 --> 00:32:54.509 YouTube and socials at pgpinecast. 00:32:54.930 --> 00:32:57.191 And legally, none of this was advice. 00:32:57.270 --> 00:32:58.892 It's for entertainment purposes only. 00:33:00.693 --> 00:33:01.336 See, Keith? 00:33:01.476 --> 00:33:02.578 We read the script. 00:33:02.838 --> 00:33:03.480 Happy now?