WEBVTT

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You're listening to the PT Pinecast,

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where smart people in healthcare come to

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make noise.

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Here's your host, Jimmy McKay.

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All right, some people build careers.

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Some people build programs.

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Some people build platforms.

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Some people build podcasts.

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Tonight's guest builds communities,

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and that's different.

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She's a physical therapist by trade,

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but she refuses to accept that access to

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care is accidental.

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She believes neighborhoods actually shape

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health.

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She believes education shapes workforce.

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And she believes we cannot complain about

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workforce shortages while gatekeeping

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Who gets into the profession?

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She talks about rehabilitation deserts,

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about isolation,

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about the cost of forgetting that we

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belong to each other.

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And she designs education the way urban

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planners design cities.

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And that's with intentionality,

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I just screwed up.

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I'll edit this out.

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Intentionality and with the future in

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mind.

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She's the founder of the Ujima Institute

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and she's here to both inspire and

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irritate you in the best ways.

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Let's welcome to the show Lisa Van Hoose.

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Lisa, welcome to the show.

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Did you like that one?

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I did like that one.

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I was like, I want to meet her.

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I was like, who is that?

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I want to go have a cup of

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coffee with her.

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Wouldn't that be a cool exercise to do

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with like a seventeen-year-old and be like

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write a bio

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of a man or a woman that you

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would love to meet in twenty years and

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then see what they describe and then go,

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why did you describe that?

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Well,

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that's because that's what we kind of do.

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Right.

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I'm sure psychologists would psychologize

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what I just did and be like, well,

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yeah, we will become the thing you needed.

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Right.

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That's what we hopefully we become.

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Right.

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And then and then the exercise is how

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do you go from here to there?

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Now that you have the end,

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how do you where you're not going to

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do it overnight?

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That person did not become that person

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overnight.

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What are the three things you need to

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do in the next three years?

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What are the things you need to do

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in the next twenty years?

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Yes.

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And what is the delayed gratification that

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has to happen right for you to be

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able to become that thing?

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Because we're so consumed with I want to

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feel good right now.

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And so then when things get hard,

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people get a little nervous when you get

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to the messy middle.

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But that's where the development happens.

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Seth Godin calls it the dip.

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Some other writer calls it the suck.

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They're like, it's going to suck.

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I worked in a radio station.

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My job was hang out, play music,

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be fun, give away concert tickets.

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And there were still hard parts of the

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job,

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parts that other people didn't see all the

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time.

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But I'll tell you, because we liked it,

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we got through the suck.

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You're able to show up.

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put on a happy face,

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and continue to do the things that needed

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to be done when things aren't going right.

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And that's sort of when you know you

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found the thing that you're aligned with

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or good at is it's always a job.

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It's always difficult.

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But when you're like, okay,

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what do I need?

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I need a big inhale.

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I need a big exhale.

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And I'll just keep doing it.

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That's it.

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All right.

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So we lost you for a second.

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Do we have you back?

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Hold on just for a second.

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That's so crazy.

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So we lost you for a second.

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But what I was saying was...

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You know you're in a good spot or

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you're doing a job that you're aligned to

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do or good to do or want to

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do when the suck shows up or the

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dip shows up and you're still like,

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this is hard,

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but there's a reason for it.

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I was having a call with a guy

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yesterday.

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He's a career coach.

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Do you know Lucas Van Etten?

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He's cool.

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He's from Michigan.

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He's a PT.

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He does wild things.

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He was just asking me questions.

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He was motivational interviewing me.

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And he was like, well,

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what are you willing to like?

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What if it was really heavy,

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would you still lift it?

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And he asked me this question because I'm

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looking for like,

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what do I do with my next twenty

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years?

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What job do I do?

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And he was like,

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if I checked like four out of five

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boxes for you in terms of like how

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much do you make,

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what your day to day, whatever.

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But you work for Samsung.

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And I'm like, the TV company goes, yeah.

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Would you take that job?

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And I was like, no.

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And he's like, why?

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I'm like, there's no fight there.

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Like there's no heart there.

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There's nothing more.

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I don't know.

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Does the world need more TVs?

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I don't care.

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Like me.

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I don't know.

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No, I don't think so.

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Like I have a TV, but that's it.

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So it's like, I need,

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I need there to be a thing.

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I'm sure someone out there is like,

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I love selling TVs and that's good for

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that person.

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That is not enough for me.

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Yeah.

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And I think like in Eastern cultures,

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they talk about that, right?

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That for longevity,

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you have to have a purpose, right?

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And sometimes in America,

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we try to make purpose into like this

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huge, big thing.

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Right.

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But they're like, no,

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just what is it that brings you joy

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every day?

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And like you said,

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it might be selling TVs.

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But for you, it's this, you know,

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connecting with people and being able to

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spread messages.

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But everybody's got to do the self-work to

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figure out what their why is.

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Why do they get out of bed?

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I shared a post and this wasn't the

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direction of what we were going to talk

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about.

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I didn't know it was,

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but I have this slide always haltered.

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You've heard about this, right?

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The Aiki guy?

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Yeah.

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The reason for being, right?

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And so it's three interlocking circles.

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And let me see if I can do

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it without looking at it.

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It's what you're good at.

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what the world needs,

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what you can get paid for.

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We'll get back to that one.

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And then what you're good at,

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what you love.

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So being good at something doesn't mean

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you love it.

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Like I might be the world's best

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bartender, but if I'm like, whatever.

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So those two things are different.

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And some people might poo-poo to get paid

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for.

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And I'm like, well,

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you have to be able to support yourself.

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Like good vibes doesn't pay the mortgage

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and put food on the table.

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So like,

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are you providing something of value?

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to get value out so you can support

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yourself.

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And the idea of the ikigai,

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which anybody can Google it,

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four interlocking circles,

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those four things I just said,

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where it crosses.

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I don't even know if I'm saying this

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right.

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I need to talk to a Japanese person

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because I keep calling it ikigai.

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Ikigai, ikigai.

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it's reason for being it's like when you

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find the center of all four of those

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that's your jam and that is a very

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simple equation to say but it's not

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necessarily easy to do because the world

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is always the world is just changing like

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a rubik's cube all the time and finding

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where that spot is for you was always

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different very true very true because i

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mean like you know and simon sinek talks

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about asking your friends right

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Ask the people around you what you're good

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at,

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because we often most of us have been

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conditioned through our trauma stories to

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always think negative about ourselves.

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So he's like, ask some other people like,

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why are you my friend?

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Why are you my neighbor?

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Yeah.

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Why are you my therapist?

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Yeah.

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I brought this up on LinkedIn for a

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while,

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sort of like pointing out to healthcare

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providers,

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because that's usually who I talk to or

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I like to talk to on the internet.

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And the pitch or the angle was like,

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I see you talking about features of what

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you bring.

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And I want to not nitpick,

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but I want to show you the difference

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between features and benefits.

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Nobody hangs out with Jimmy because he has

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brown hair and he's five foot nine and

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drives a Toyota.

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I don't think so anyway.

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That doesn't really bring my friends who

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choose or not choose to hang out with

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me.

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That's not why.

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But in healthcare, we're like,

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I have a doctoral degree and I have

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twelve years of experience and this.

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I'm like, that is valid and logical,

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but that's not why people come to you.

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You are exactly correct, right?

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Exactly correct.

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I hang out

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with you because of your shirt.

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Like that is true.

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I do love the shirt.

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I do love the shirt.

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But I think we forget that we are

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relational beings.

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Yes.

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And some of that I think is because

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of the way in which we gate people

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into health care professions where we only

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allow you in if you have certain features.

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Correct.

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Correct.

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But then we know that those features don't

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translate to bedside manner.

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which is what the consumers are looking

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for, right?

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And that's what patients are looking at.

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Exactly.

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So it dictates outcomes more than

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anything, your relational capacity.

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Yeah, it's wild.

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But I'm not in education.

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You've been in education.

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How would you include that in the process?

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How would you do that?

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So, Jimmy, let me tell you how.

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Here we go.

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I think that academic metrics are

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important, right?

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Because there is a correlation between

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those and passing the MPTE.

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But I really think a third of that

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admissions has got to be what service

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opportunities have you done?

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Like, I'm like...

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Admit every waitress, every busboy,

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every porter that you know,

00:09:27.442 --> 00:09:28.763
childcare workers,

00:09:29.062 --> 00:09:30.823
like the people that have had to serve

00:09:30.903 --> 00:09:31.323
others.

00:09:31.563 --> 00:09:33.365
So if you've had to be a formal

00:09:33.445 --> 00:09:35.005
or an informal caregiver,

00:09:35.405 --> 00:09:38.287
like we need to value that commitment to

00:09:38.366 --> 00:09:38.927
service.

00:09:39.868 --> 00:09:43.190
Because that actually might be what turns

00:09:43.230 --> 00:09:45.751
the tide between a good clinician and an

00:09:45.892 --> 00:09:47.072
excellent clinician.

00:09:47.932 --> 00:09:50.575
It's that ability to recognize and attend

00:09:50.615 --> 00:09:51.615
to the needs of others.

00:09:51.936 --> 00:09:53.296
And you're not always going to see that

00:09:53.355 --> 00:09:55.477
in a GPA.

00:09:55.817 --> 00:09:56.738
I did the things.

00:09:56.798 --> 00:09:57.859
I brought the meal.

00:09:58.499 --> 00:10:00.039
Why was that not a good service?

00:10:00.080 --> 00:10:01.640
It's like, if you were a waiter,

00:10:01.760 --> 00:10:02.302
you know.

00:10:02.741 --> 00:10:03.763
I never made eye contact.

00:10:03.783 --> 00:10:04.763
I never said anything.

00:10:04.903 --> 00:10:06.524
My mood sucked.

00:10:06.563 --> 00:10:07.325
You learn that.

00:10:08.327 --> 00:10:10.634
quickly or you get beaten you get thrown

00:10:10.714 --> 00:10:12.057
out like you're not i don't want you

00:10:12.097 --> 00:10:13.522
here because that's really what you're

00:10:13.562 --> 00:10:15.346
selling i can get a bowl of ziti

00:10:15.366 --> 00:10:16.208
kind of anywhere

00:10:17.471 --> 00:10:19.274
Um, I forget who was talking about that.

00:10:19.354 --> 00:10:20.335
Oh, John Taffer.

00:10:20.634 --> 00:10:22.076
He runs that show bar rescue.

00:10:22.116 --> 00:10:23.398
So he's like a food and beverage guy

00:10:23.418 --> 00:10:23.938
in Vegas.

00:10:23.979 --> 00:10:24.458
And he's just,

00:10:24.899 --> 00:10:26.160
he's like understanding the science.

00:10:26.181 --> 00:10:28.482
And he's like the difference between good

00:10:28.503 --> 00:10:31.865
food and great food is, is so small.

00:10:32.027 --> 00:10:32.287
Right.

00:10:32.326 --> 00:10:33.587
In terms of, of overall,

00:10:33.927 --> 00:10:36.130
like what people view as a restaurant and

00:10:36.150 --> 00:10:36.991
they go, but the different,

00:10:37.052 --> 00:10:38.773
if you have great food with shitty

00:10:38.812 --> 00:10:40.274
service, I'm never coming back.

00:10:41.274 --> 00:10:41.654
Exactly.

00:10:41.695 --> 00:10:43.917
Great service with like crappy food.

00:10:43.976 --> 00:10:45.918
I'll give you another chance, right?

00:10:45.977 --> 00:10:47.719
So I'm not discounting the quality of a

00:10:47.818 --> 00:10:50.201
chef, but like even the chefs know,

00:10:50.902 --> 00:10:52.081
if I put out this great meal and

00:10:52.142 --> 00:10:55.644
you act like a jerk, I got nothing.

00:10:55.784 --> 00:10:59.027
Why do we treat healthcare differently?

00:10:59.106 --> 00:11:00.207
Is it because it's formal?

00:11:00.227 --> 00:11:01.347
Because it's science-y?

00:11:01.389 --> 00:11:02.889
Because it's more, I don't know.

00:11:02.950 --> 00:11:03.289
Why?

00:11:03.450 --> 00:11:04.110
Why is that?

00:11:04.791 --> 00:11:07.292
Well, I think somewhere during history,

00:11:07.413 --> 00:11:11.054
we tied healthcare with mobility, right?

00:11:11.522 --> 00:11:13.903
It kind of became this artificial royalty

00:11:14.384 --> 00:11:16.907
to, you know, this person is the doctor.

00:11:16.947 --> 00:11:18.668
It doesn't matter how they treat me

00:11:18.969 --> 00:11:20.471
because I'm just getting seen by the

00:11:20.510 --> 00:11:20.870
doctor.

00:11:20.890 --> 00:11:22.793
It's kind of like I'm getting to go

00:11:22.852 --> 00:11:23.894
to the king, right?

00:11:25.294 --> 00:11:27.596
And unfortunately, right now, health care,

00:11:27.636 --> 00:11:28.758
just like education,

00:11:28.857 --> 00:11:30.139
you get paid regardless.

00:11:30.159 --> 00:11:31.081
Yeah.

00:11:31.100 --> 00:11:32.341
If it's crappy care or not,

00:11:32.642 --> 00:11:33.802
you get paid regardless.

00:11:33.822 --> 00:11:34.484
Uh-huh.

00:11:35.005 --> 00:11:36.967
I had an article about that not long

00:11:36.989 --> 00:11:37.509
ago on LinkedIn,

00:11:37.528 --> 00:11:38.850
and I got a lot of I agrees,

00:11:38.890 --> 00:11:40.111
and I got a few like, well,

00:11:40.131 --> 00:11:41.693
that's not the case because...

00:11:41.975 --> 00:11:43.155
And they were going one level deeper.

00:11:43.176 --> 00:11:44.417
They were like, well,

00:11:45.097 --> 00:11:47.240
if I give good care or quality care

00:11:47.260 --> 00:11:48.062
or good experience,

00:11:48.081 --> 00:11:49.464
people will come back more often.

00:11:49.864 --> 00:11:51.405
Yes, agreed.

00:11:51.966 --> 00:11:52.868
But then the person giving...

00:11:53.995 --> 00:11:55.397
mediocre care will just be like,

00:11:55.456 --> 00:11:56.798
I'll just spend a little more on ads

00:11:56.837 --> 00:11:58.458
and I'll just keep giving mediocre care.

00:11:58.479 --> 00:12:00.120
And I understand I'm going to put nothing

00:12:00.181 --> 00:12:00.640
into it.

00:12:00.721 --> 00:12:02.081
So my margins are going to be better.

00:12:02.802 --> 00:12:03.702
And it sucks.

00:12:03.964 --> 00:12:04.384
I was trying,

00:12:04.703 --> 00:12:05.985
I wasn't trying to dunk on anybody.

00:12:06.004 --> 00:12:06.706
I was trying to show you like,

00:12:06.745 --> 00:12:07.365
this sucks.

00:12:07.405 --> 00:12:09.027
Like I can do a crap,

00:12:09.106 --> 00:12:10.427
a C minus job and you could do

00:12:10.467 --> 00:12:11.028
an A plus job.

00:12:11.048 --> 00:12:11.729
We get paid the same.

00:12:11.749 --> 00:12:13.431
And that, that isn't okay.

00:12:13.471 --> 00:12:14.692
We should be mad about this.

00:12:14.831 --> 00:12:16.133
Not trying to find the fault in my

00:12:16.173 --> 00:12:16.552
arguments.

00:12:17.490 --> 00:12:19.251
And we should be mad about it because

00:12:19.673 --> 00:12:21.916
where those mediocre and sometimes not

00:12:21.975 --> 00:12:22.856
even mediocre,

00:12:22.897 --> 00:12:25.940
just subpar clinicians end up is in rural

00:12:25.980 --> 00:12:28.562
and underserved areas where, you know,

00:12:28.643 --> 00:12:30.164
if you were to just think about,

00:12:30.985 --> 00:12:32.488
you know, just basic things,

00:12:33.700 --> 00:12:34.740
You know, equity.

00:12:35.582 --> 00:12:37.705
If you've got an area that has higher

00:12:37.745 --> 00:12:39.388
complexity and acuity,

00:12:39.528 --> 00:12:41.750
you would want the best practitioners to

00:12:41.811 --> 00:12:44.214
be there because they're going to be more

00:12:44.234 --> 00:12:47.158
effective and it's going to ultimately end

00:12:47.197 --> 00:12:48.519
up costing us less.

00:12:49.240 --> 00:12:51.361
But if you keep sending mediocre and

00:12:51.402 --> 00:12:53.721
subpar clinicians and practitioners to

00:12:53.761 --> 00:12:55.863
those areas, then, yeah,

00:12:55.903 --> 00:12:57.903
health care is going to be trillions of

00:12:57.964 --> 00:13:00.884
dollars in debt because those people

00:13:01.105 --> 00:13:03.245
aren't incentivized to be effective and

00:13:03.264 --> 00:13:03.804
efficient.

00:13:03.884 --> 00:13:05.005
They get paid regardless.

00:13:05.046 --> 00:13:05.326
Right.

00:13:05.686 --> 00:13:07.626
So if you are out here in Joe

00:13:07.647 --> 00:13:09.006
Schmo, you know,

00:13:09.187 --> 00:13:11.628
Louisiana and there's one cardiologist,

00:13:11.748 --> 00:13:12.408
it doesn't matter.

00:13:14.052 --> 00:13:16.015
Because that one cardiologist is still

00:13:16.035 --> 00:13:18.217
going to have a full caseload and they're

00:13:18.258 --> 00:13:19.860
still going to bend over their back to

00:13:19.900 --> 00:13:21.802
make sure that that cardiologist is taken

00:13:21.842 --> 00:13:22.303
care of.

00:13:22.583 --> 00:13:24.365
Because they're going to say some service

00:13:24.446 --> 00:13:25.707
is better than no service.

00:13:26.107 --> 00:13:27.590
And I am of the belief that no,

00:13:27.629 --> 00:13:28.110
it is not.

00:13:28.792 --> 00:13:29.452
No, it is not.

00:13:31.072 --> 00:13:33.472
You've talked about something that I don't

00:13:33.732 --> 00:13:35.972
even think I learned about this term until

00:13:36.113 --> 00:13:36.972
after I graduated.

00:13:37.013 --> 00:13:39.333
I think it was Patrick Berner who taught

00:13:39.374 --> 00:13:40.313
me a couple of these terms.

00:13:40.974 --> 00:13:43.394
And the term was, he used food desert.

00:13:43.735 --> 00:13:45.754
We're going to talk about rehabilitation

00:13:45.794 --> 00:13:46.174
desert.

00:13:47.434 --> 00:13:48.076
First of all,

00:13:48.875 --> 00:13:50.235
define it because I don't want to act

00:13:50.275 --> 00:13:51.975
like everybody knows what it means because

00:13:52.216 --> 00:13:53.797
I had never heard those two words put

00:13:53.817 --> 00:13:54.856
together for a long time.

00:13:55.287 --> 00:13:57.707
So what is a rehabilitation desert?

00:13:57.727 --> 00:13:58.408
What does it mean?

00:13:59.187 --> 00:14:00.548
And how are we or how is the

00:14:00.587 --> 00:14:02.428
system contributing to it right now?

00:14:02.448 --> 00:14:03.568
Right.

00:14:03.948 --> 00:14:07.809
So deserts basically are and you can use

00:14:07.850 --> 00:14:09.650
it with any adjective on the front end.

00:14:09.691 --> 00:14:09.890
Right.

00:14:09.931 --> 00:14:11.831
So you'll hear people talk about medical

00:14:11.871 --> 00:14:12.231
deserts.

00:14:12.251 --> 00:14:13.451
You'll hear food deserts.

00:14:13.471 --> 00:14:15.131
You'll hear transportation deserts,

00:14:15.513 --> 00:14:16.393
rehab deserts.

00:14:16.852 --> 00:14:19.754
But any time there is an area where

00:14:19.953 --> 00:14:20.553
access

00:14:21.326 --> 00:14:23.466
is either limited or not available.

00:14:23.726 --> 00:14:27.207
And so the individual has an unusual

00:14:27.268 --> 00:14:29.408
burden to be able to try to access

00:14:29.447 --> 00:14:29.768
care.

00:14:30.188 --> 00:14:32.408
And we know that there's a sweet spot.

00:14:32.889 --> 00:14:35.289
So people will normally tolerate about

00:14:35.370 --> 00:14:36.970
twenty minutes of commute.

00:14:37.510 --> 00:14:38.931
So if I want to go see a

00:14:38.990 --> 00:14:39.630
PT,

00:14:40.350 --> 00:14:42.192
if they're within a twenty minute drive,

00:14:42.251 --> 00:14:42.731
I will go.

00:14:43.172 --> 00:14:44.732
But if it gets to twenty five,

00:14:44.773 --> 00:14:45.653
thirty minutes,

00:14:46.092 --> 00:14:48.653
my brain starts to think this is too

00:14:48.693 --> 00:14:48.953
much.

00:14:49.974 --> 00:14:52.135
And so we know that there are areas

00:14:52.235 --> 00:14:53.275
where people,

00:14:53.937 --> 00:14:56.798
they may have to travel hours to see

00:14:56.837 --> 00:14:57.479
a PT.

00:14:58.198 --> 00:15:00.039
Or if you start talking about PTs with

00:15:00.100 --> 00:15:01.821
specialty or advanced practice,

00:15:02.461 --> 00:15:04.462
I know that there were times I would

00:15:04.503 --> 00:15:06.464
have clients that would drive four hours

00:15:06.604 --> 00:15:08.745
one way to see me because I was

00:15:08.784 --> 00:15:10.125
an oncologist specialist.

00:15:10.785 --> 00:15:11.986
And like here in Louisiana,

00:15:12.027 --> 00:15:13.868
I think there are two of us for

00:15:13.908 --> 00:15:14.948
the entire state.

00:15:16.509 --> 00:15:16.830
Why?

00:15:18.041 --> 00:15:19.881
When I'm thinking about where we're

00:15:19.922 --> 00:15:21.783
putting future PT programs,

00:15:22.143 --> 00:15:24.124
they need to be in areas where we

00:15:24.163 --> 00:15:25.565
can address rehab deserts.

00:15:26.325 --> 00:15:28.745
Or even if they're hybrid programs,

00:15:29.106 --> 00:15:31.508
then programs need to be able to say,

00:15:31.668 --> 00:15:33.989
how are you intentionally admitting people

00:15:34.308 --> 00:15:36.409
that are going to help us address these

00:15:36.470 --> 00:15:38.350
rehab deserts?

00:15:38.370 --> 00:15:39.751
Well, they need to be able to stay,

00:15:39.871 --> 00:15:41.173
right?

00:15:41.513 --> 00:15:42.393
You've obviously thought about this,

00:15:42.452 --> 00:15:43.833
so I can ask you questions left, right,

00:15:43.854 --> 00:15:44.533
and up and down.

00:15:44.575 --> 00:15:45.315
Let's say you put

00:15:46.860 --> 00:15:47.321
a rehab,

00:15:47.400 --> 00:15:49.462
a PT program somewhere where they need

00:15:49.482 --> 00:15:49.623
PTs.

00:15:49.743 --> 00:15:50.003
Right.

00:15:51.043 --> 00:15:52.504
And then you get people from that

00:15:52.543 --> 00:15:55.966
community to go to that program and pass.

00:15:57.886 --> 00:15:59.347
What's to stop them from going, hey,

00:15:59.408 --> 00:16:00.369
I just got out.

00:16:00.708 --> 00:16:04.571
I have now the ability to leave.

00:16:05.152 --> 00:16:06.032
Would I not take it?

00:16:06.052 --> 00:16:06.731
How do you get them?

00:16:07.452 --> 00:16:09.173
How do you incentivize them to stay?

00:16:09.214 --> 00:16:09.474
Exactly.

00:16:10.071 --> 00:16:10.711
Yeah.

00:16:10.772 --> 00:16:13.193
So what we've learned from medicine and

00:16:13.234 --> 00:16:15.735
what they're doing with rural health is,

00:16:15.836 --> 00:16:17.917
is number one, from your admissions,

00:16:17.937 --> 00:16:20.399
you need to admit people from those areas

00:16:20.759 --> 00:16:22.520
because they've already got an anchor,

00:16:22.801 --> 00:16:24.221
a root in those areas.

00:16:24.822 --> 00:16:27.625
And then their clinical education needs to

00:16:27.664 --> 00:16:29.326
be back in that area.

00:16:29.787 --> 00:16:30.067
Right.

00:16:30.407 --> 00:16:32.808
So if you can recruit from that area,

00:16:33.250 --> 00:16:34.691
educate them in that area,

00:16:34.730 --> 00:16:36.812
they are eighty three times more likely to

00:16:36.952 --> 00:16:38.413
stay in that area.

00:16:38.514 --> 00:16:38.793
Right.

00:16:39.601 --> 00:16:41.442
Eighty three times more likely to stay in

00:16:41.462 --> 00:16:42.003
that area.

00:16:42.524 --> 00:16:44.365
And then what we know from neighborhood

00:16:44.404 --> 00:16:47.466
science is that what most people want,

00:16:47.645 --> 00:16:47.926
right,

00:16:47.985 --> 00:16:51.408
is they want decent education for them and

00:16:51.427 --> 00:16:52.048
their children.

00:16:52.589 --> 00:16:53.908
They want a grocery store.

00:16:54.090 --> 00:16:54.970
They want a bank.

00:16:55.190 --> 00:16:56.711
They want health care access.

00:16:57.171 --> 00:17:01.092
So that's where PTs and PT educators,

00:17:01.133 --> 00:17:02.313
when we're thinking about where we're

00:17:02.433 --> 00:17:03.975
placing our programs and placing our

00:17:03.995 --> 00:17:06.135
clinics, we're just like we just got to.

00:17:07.298 --> 00:17:07.917
think about us.

00:17:08.337 --> 00:17:08.498
No,

00:17:08.557 --> 00:17:10.378
you've got to think about the environment

00:17:10.419 --> 00:17:12.140
as well, right?

00:17:12.240 --> 00:17:13.700
And what it is that you need to

00:17:13.720 --> 00:17:16.060
do as an educator or a clinician to

00:17:16.141 --> 00:17:17.902
make sure that there are things in that

00:17:17.961 --> 00:17:19.942
neighborhood or in that community that

00:17:19.981 --> 00:17:23.723
will make those graduates want to stay.

00:17:23.763 --> 00:17:26.204
So it's hard for us as PTs to

00:17:26.244 --> 00:17:29.226
talk about mobilizing society if we don't

00:17:29.266 --> 00:17:31.747
think about a bigger society than what we

00:17:31.807 --> 00:17:32.646
do as PTs.

00:17:35.724 --> 00:17:38.026
That's talking a lot about who feels

00:17:38.086 --> 00:17:39.026
welcome in PT.

00:17:39.246 --> 00:17:40.606
We talked about this years ago.

00:17:40.646 --> 00:17:42.248
If you don't see someone who looks like

00:17:42.288 --> 00:17:43.847
you, walks like you, talks like you,

00:17:44.327 --> 00:17:45.848
why would you ever think that that's a

00:17:45.909 --> 00:17:47.009
place for you to be?

00:17:47.348 --> 00:17:50.151
Putting a program there probably opens

00:17:50.191 --> 00:17:50.611
that door.

00:17:51.270 --> 00:17:52.751
But there's a lot that goes into that.

00:17:53.092 --> 00:17:53.432
Money.

00:17:53.531 --> 00:17:55.232
Who's going to be the people who you

00:17:55.314 --> 00:17:57.595
now move to that area to teach the

00:17:57.634 --> 00:17:58.095
program?

00:17:58.414 --> 00:18:01.557
If it's truly rural and care is scattered,

00:18:01.877 --> 00:18:02.978
where are they going to do their clinical

00:18:03.018 --> 00:18:03.798
rotations, right?

00:18:03.818 --> 00:18:05.460
Are they going to have to travel two

00:18:05.500 --> 00:18:07.141
hours one way or are they going to

00:18:07.161 --> 00:18:08.461
have to move to do a clinical?

00:18:08.501 --> 00:18:09.481
And then you've sort of defeated the

00:18:09.521 --> 00:18:09.923
purpose.

00:18:10.262 --> 00:18:12.023
So this feels simple but not easy.

00:18:12.849 --> 00:18:14.592
Yeah, it's not easy.

00:18:15.271 --> 00:18:16.813
So it takes a lot of planning on

00:18:16.853 --> 00:18:17.673
the front end.

00:18:18.674 --> 00:18:23.298
But that also is part of the experience

00:18:23.358 --> 00:18:25.260
of those clinicians that are providing

00:18:25.280 --> 00:18:27.702
care to rural and underserved areas is

00:18:27.742 --> 00:18:29.564
you'll hear many of them say that a

00:18:29.644 --> 00:18:32.747
lot of their job duty is traveling, right?

00:18:33.171 --> 00:18:34.892
to the next county over,

00:18:34.951 --> 00:18:36.273
to the next city over.

00:18:36.973 --> 00:18:39.935
And so there's a part of training, right,

00:18:39.976 --> 00:18:42.198
this workforce that's gonna take care of

00:18:42.218 --> 00:18:45.040
the underserved to understand that that's

00:18:45.080 --> 00:18:47.643
gonna be part of the burden until we

00:18:47.682 --> 00:18:50.365
can get enough people interested in rural

00:18:50.384 --> 00:18:53.346
and underserved so that you don't have to

00:18:53.386 --> 00:18:55.229
travel more than twenty minutes as the

00:18:55.269 --> 00:18:57.450
practitioner or as the consumer.

00:18:58.351 --> 00:19:00.452
But I also think that we're not leveraging

00:19:00.512 --> 00:19:01.273
technology.

00:19:01.933 --> 00:19:04.575
Because like telehealth,

00:19:04.634 --> 00:19:05.796
remote monitoring,

00:19:06.076 --> 00:19:07.576
there are all these other ways in which

00:19:07.615 --> 00:19:11.617
PTs are providing care and also

00:19:12.097 --> 00:19:14.259
community-based rehab, right?

00:19:14.558 --> 00:19:17.079
So all PT doesn't have to occur within

00:19:17.119 --> 00:19:17.700
a clinic.

00:19:17.759 --> 00:19:19.381
It can occur in a patient's home.

00:19:19.760 --> 00:19:22.021
It can occur within a community center.

00:19:22.342 --> 00:19:24.363
So I think we've got to get ourselves

00:19:24.423 --> 00:19:25.942
out of a box because a lot of

00:19:25.962 --> 00:19:27.483
this we've created ourselves.

00:19:28.410 --> 00:19:30.391
Where do we steal the innovative ideas?

00:19:30.451 --> 00:19:31.771
Like when you're mentioning some of that,

00:19:31.932 --> 00:19:33.112
I've done some, you know,

00:19:33.231 --> 00:19:35.252
interviews with people who work in Alaska

00:19:35.874 --> 00:19:36.693
or, you know,

00:19:36.713 --> 00:19:39.955
in the Pacific Northwest where being rural

00:19:39.976 --> 00:19:40.915
is just way of life.

00:19:41.777 --> 00:19:43.498
It's like, you know,

00:19:43.538 --> 00:19:44.877
necessity is the mother of invention.

00:19:44.938 --> 00:19:45.417
It's like, well,

00:19:45.438 --> 00:19:46.338
if you want to figure out how to

00:19:46.358 --> 00:19:46.939
solve a problem,

00:19:47.239 --> 00:19:49.319
go watch people who've had to solve it

00:19:50.121 --> 00:19:51.040
as a way of life.

00:19:51.121 --> 00:19:53.782
So are we able to steal some ideas

00:19:54.442 --> 00:19:56.304
from those types of practitioners?

00:19:57.377 --> 00:19:57.858
Oh, yeah.

00:19:57.878 --> 00:20:00.122
I think if we were to have conversations

00:20:00.142 --> 00:20:00.903
with nurses,

00:20:01.103 --> 00:20:03.066
I think nurses have been really innovative

00:20:03.526 --> 00:20:04.867
in how to deliver care.

00:20:05.028 --> 00:20:07.971
I think your old school rural health

00:20:08.853 --> 00:20:10.154
primary care providers,

00:20:10.536 --> 00:20:11.876
they know you got to be boots on

00:20:11.896 --> 00:20:12.298
the ground.

00:20:12.846 --> 00:20:13.967
But ultimately,

00:20:14.166 --> 00:20:16.887
I think having conversations with the

00:20:16.968 --> 00:20:19.068
community members, with the neighbors,

00:20:19.729 --> 00:20:22.069
because community knows what it needs.

00:20:22.430 --> 00:20:23.309
What happens is,

00:20:23.349 --> 00:20:25.130
is we will go have a conversation with

00:20:25.150 --> 00:20:26.270
them and then we go, oh no,

00:20:26.310 --> 00:20:28.211
they just don't understand how we do what

00:20:28.250 --> 00:20:29.551
we do, right?

00:20:30.051 --> 00:20:31.852
But a community member will tell you,

00:20:31.951 --> 00:20:33.752
why can't the PT be in the barbershop?

00:20:34.453 --> 00:20:34.993
Right.

00:20:35.013 --> 00:20:35.114
Right.

00:20:35.134 --> 00:20:36.595
Because I'm going to go get my hair

00:20:36.635 --> 00:20:38.277
cut and I'm probably going to have to

00:20:38.336 --> 00:20:40.117
sit there and wait thirty, forty minutes.

00:20:40.438 --> 00:20:40.998
Guess what?

00:20:41.019 --> 00:20:42.199
I could be doing my I could be

00:20:42.239 --> 00:20:44.300
doing my treatment while I'm waiting.

00:20:44.421 --> 00:20:44.701
Right.

00:20:44.721 --> 00:20:45.280
Yeah.

00:20:46.882 --> 00:20:47.063
Why?

00:20:47.462 --> 00:20:49.243
Why do I got to go down the

00:20:49.263 --> 00:20:51.085
street to you and then come back and

00:20:51.125 --> 00:20:51.945
sit in the barbershop?

00:20:52.286 --> 00:20:52.486
I mean,

00:20:52.506 --> 00:20:55.147
like community will tell you how to

00:20:55.188 --> 00:20:56.088
improve access.

00:20:56.169 --> 00:20:57.509
It's just whether or not if we'll be

00:20:57.609 --> 00:20:59.171
humble enough to listen.

00:20:59.846 --> 00:21:02.008
If you pay attention and if you're willing

00:21:02.028 --> 00:21:05.087
to change to it versus asking or demanding

00:21:05.107 --> 00:21:05.989
that it changed to you.

00:21:06.028 --> 00:21:07.969
I remember learning this lesson about a

00:21:08.088 --> 00:21:09.769
bicycle when I was in PT school.

00:21:10.410 --> 00:21:13.951
I bought a bike on Craigslist because I

00:21:13.990 --> 00:21:14.871
couldn't afford a new bike.

00:21:14.891 --> 00:21:16.392
So I bought someone else's old bike.

00:21:16.412 --> 00:21:17.571
I was like, I'll buy your mistake.

00:21:17.652 --> 00:21:18.352
Like, no problem.

00:21:18.372 --> 00:21:19.853
I'll get a three thousand dollar bike for

00:21:20.012 --> 00:21:20.853
nine hundred bucks.

00:21:20.893 --> 00:21:21.353
I'm not an idiot.

00:21:22.074 --> 00:21:24.935
And I rode that bike for two years

00:21:25.135 --> 00:21:25.796
in races.

00:21:25.915 --> 00:21:27.656
And then someone watched me on the bike

00:21:27.696 --> 00:21:28.758
and they were like, why do you,

00:21:28.917 --> 00:21:29.097
you know,

00:21:29.117 --> 00:21:30.159
it's one of those like where you lay

00:21:30.179 --> 00:21:31.239
down triathlon bike.

00:21:31.660 --> 00:21:32.519
Like, why do you,

00:21:32.799 --> 00:21:33.800
why are you like this?

00:21:33.820 --> 00:21:35.061
And your wrists are like this.

00:21:35.281 --> 00:21:35.602
And I'm like,

00:21:35.662 --> 00:21:37.603
cause I have to touch the controllers and

00:21:37.623 --> 00:21:37.903
they go,

00:21:38.423 --> 00:21:40.144
there's a screw right there that would

00:21:40.184 --> 00:21:41.484
make those arms longer.

00:21:41.644 --> 00:21:42.286
And I was like,

00:21:42.306 --> 00:21:45.988
I've been doing this for two years.

00:21:46.347 --> 00:21:47.008
I adapted.

00:21:47.169 --> 00:21:49.089
I got smaller for the bike and,

00:21:49.875 --> 00:21:51.497
without knowing the bike was already

00:21:51.537 --> 00:21:53.719
designed to adapt to me.

00:21:54.160 --> 00:21:55.480
And I remember I was going through,

00:21:55.520 --> 00:21:57.063
I think neuro and PT school.

00:21:57.083 --> 00:21:57.603
And they were like,

00:21:58.223 --> 00:21:59.766
you don't ask someone to adapt to the

00:21:59.885 --> 00:22:00.846
power wheelchair.

00:22:01.428 --> 00:22:03.210
You adapt the wheelchair to them.

00:22:03.329 --> 00:22:04.371
It works for you.

00:22:04.471 --> 00:22:05.432
You don't work for it.

00:22:05.471 --> 00:22:07.294
I remember like as dumb as a bike

00:22:07.334 --> 00:22:08.875
metaphor being like, Oh,

00:22:08.915 --> 00:22:10.336
you should look at this for everything.

00:22:10.376 --> 00:22:10.557
Like,

00:22:11.057 --> 00:22:12.419
This should work for the person.

00:22:12.598 --> 00:22:14.381
The person should not have to bend or

00:22:14.780 --> 00:22:18.443
shrink or twist or turn for the system,

00:22:18.624 --> 00:22:20.205
for the bike, for the wheelchair,

00:22:20.246 --> 00:22:23.868
for the curb cut, for those things.

00:22:24.108 --> 00:22:25.630
Is medicine or is healthcare,

00:22:25.670 --> 00:22:27.412
are we just this big establishment that

00:22:27.432 --> 00:22:27.932
we're just like,

00:22:28.633 --> 00:22:29.773
this is how we provide it and you

00:22:29.794 --> 00:22:31.875
will be glad how we give it and

00:22:31.915 --> 00:22:33.817
you will say thank you and you will

00:22:33.836 --> 00:22:34.478
go on your way?

00:22:34.597 --> 00:22:35.538
I mean, is that it?

00:22:36.723 --> 00:22:38.647
So I think that is it.

00:22:39.087 --> 00:22:41.973
And I go back and forth because I

00:22:42.013 --> 00:22:44.258
feel like some of that is rooted in

00:22:44.298 --> 00:22:47.423
this philosophy of what it means to be

00:22:47.463 --> 00:22:48.685
a great American, right?

00:22:49.416 --> 00:22:51.557
because we tell people that the American

00:22:51.577 --> 00:22:54.779
dream is all about individualism and you

00:22:54.819 --> 00:22:56.820
pulling yourself up by the bootstraps,

00:22:56.882 --> 00:22:57.162
right?

00:22:57.561 --> 00:22:58.623
So yeah,

00:22:58.643 --> 00:23:00.263
you've got this healthcare system,

00:23:00.304 --> 00:23:00.824
guess what?

00:23:00.943 --> 00:23:02.545
If you're a good enough American,

00:23:02.585 --> 00:23:04.205
if you're a good enough individual,

00:23:04.526 --> 00:23:05.926
you'll figure out how to make it work

00:23:05.946 --> 00:23:07.028
for you, right?

00:23:07.827 --> 00:23:11.690
But in my learning more about Blue Zones

00:23:11.769 --> 00:23:13.790
and the research around it,

00:23:14.311 --> 00:23:16.173
what they are talking about is that that

00:23:16.212 --> 00:23:17.292
is such a fallacy.

00:23:17.673 --> 00:23:19.855
It's not the fact that these people are

00:23:20.075 --> 00:23:22.256
uniquely different than the rest of us,

00:23:22.615 --> 00:23:24.176
and that's why they're living to be a

00:23:24.217 --> 00:23:24.977
hundred years.

00:23:25.317 --> 00:23:26.959
It's because their environment is

00:23:27.019 --> 00:23:27.459
different.

00:23:27.878 --> 00:23:28.159
Right.

00:23:28.500 --> 00:23:29.220
So they're like,

00:23:29.580 --> 00:23:31.582
why can we not learn how to adapt

00:23:31.642 --> 00:23:34.684
environments so that then we make healthy

00:23:34.904 --> 00:23:37.327
lifestyles easy for people?

00:23:37.688 --> 00:23:39.269
And it's the same thing with education.

00:23:39.368 --> 00:23:41.631
Why can we not adapt the educational

00:23:41.671 --> 00:23:42.231
environment?

00:23:42.778 --> 00:23:45.700
to make learning easier for the learning.

00:23:46.059 --> 00:23:48.420
Why can we not adapt the healthcare system

00:23:48.700 --> 00:23:50.361
so that it works better for the

00:23:50.441 --> 00:23:51.141
individual?

00:23:51.500 --> 00:23:54.280
But we have this fragmented healthcare

00:23:54.320 --> 00:23:56.162
system that we go, this is great.

00:23:56.942 --> 00:23:58.001
You go figure it out.

00:23:58.902 --> 00:24:00.163
And if you can't figure it out,

00:24:00.182 --> 00:24:01.742
then you get to die or you get

00:24:01.762 --> 00:24:04.143
to be sick or you get to not

00:24:04.323 --> 00:24:05.663
have your quality of life.

00:24:05.983 --> 00:24:06.723
It's your fault.

00:24:07.644 --> 00:24:09.564
I remember when someone pointed out that

00:24:09.644 --> 00:24:11.684
phrase, because like cliches,

00:24:13.105 --> 00:24:14.646
become cliches because they get repeated

00:24:14.686 --> 00:24:15.847
so much right doesn't mean they're

00:24:15.867 --> 00:24:17.769
necessarily true but the fact that like

00:24:18.210 --> 00:24:21.633
can you show me how you could sit

00:24:21.653 --> 00:24:24.035
on the floor and elevate yourself by

00:24:24.095 --> 00:24:26.596
pulling your own bootstraps up that

00:24:26.656 --> 00:24:28.778
doesn't work give me the best Cirque du

00:24:28.838 --> 00:24:32.582
Soleil athlete and that does not work you

00:24:32.622 --> 00:24:35.423
cannot do that like that does not work

00:24:36.203 --> 00:24:37.905
I get the sentiment I'm not trying to

00:24:37.965 --> 00:24:40.567
nitpick the cliche but

00:24:42.155 --> 00:24:42.636
People,

00:24:42.757 --> 00:24:44.038
if everything you're saying is true,

00:24:44.057 --> 00:24:45.359
which I also agree with,

00:24:46.361 --> 00:24:48.063
design the community where they don't have

00:24:48.083 --> 00:24:49.104
to pull themselves up,

00:24:49.223 --> 00:24:51.906
that there's a path to walk that's simple

00:24:52.188 --> 00:24:53.909
that also benefits themselves and others.

00:24:54.329 --> 00:24:55.731
That seems like an easier way to do

00:24:55.811 --> 00:24:55.872
it.

00:24:56.865 --> 00:24:58.645
It makes sense to me because I'm like,

00:24:58.685 --> 00:25:00.807
if we're all out here pulling ourselves

00:25:00.906 --> 00:25:02.626
up, then why are there country clubs?

00:25:03.008 --> 00:25:04.008
Why is there golfing?

00:25:04.488 --> 00:25:04.827
Right.

00:25:04.988 --> 00:25:06.268
Why are there cigar bars?

00:25:06.708 --> 00:25:08.949
Because what those things signify is that

00:25:08.989 --> 00:25:10.808
there are places where people come into

00:25:10.848 --> 00:25:13.509
community and then they network and they

00:25:13.549 --> 00:25:14.470
help each other out.

00:25:14.809 --> 00:25:15.089
Right.

00:25:16.691 --> 00:25:17.131
So I'm like,

00:25:17.290 --> 00:25:19.771
so just normalize the fact that no one

00:25:19.852 --> 00:25:21.432
really is doing this on their own.

00:25:22.192 --> 00:25:22.532
Right.

00:25:22.593 --> 00:25:25.953
So but if we can keep telling people

00:25:26.074 --> 00:25:28.315
that they just need to keep you just

00:25:28.335 --> 00:25:30.674
keep doing more, then, you know,

00:25:30.714 --> 00:25:32.796
people will keep striving to do that and

00:25:32.816 --> 00:25:36.176
then they'll pay for all of these services

00:25:36.376 --> 00:25:38.517
or processes that don't really work.

00:25:38.997 --> 00:25:39.737
So I'm just like,

00:25:39.957 --> 00:25:41.337
we just need to be honest about the

00:25:41.377 --> 00:25:43.117
fact that our health care system is

00:25:43.178 --> 00:25:43.897
fragmented.

00:25:44.398 --> 00:25:46.219
It does not work for most of us.

00:25:46.398 --> 00:25:48.880
It costs us way too much money and

00:25:48.920 --> 00:25:49.799
it's ineffective.

00:25:51.407 --> 00:25:54.309
And we do need to have an honest

00:25:54.329 --> 00:25:55.390
conversation about that.

00:25:56.010 --> 00:25:57.211
Because we created it.

00:25:57.291 --> 00:25:58.352
And if we created it,

00:25:58.392 --> 00:26:00.814
we could fix it if we wanted to.

00:26:01.413 --> 00:26:03.115
It's one of my new favorite quotes I

00:26:03.154 --> 00:26:05.656
got from a guest, Rob Pinarello.

00:26:05.696 --> 00:26:07.238
He said, it might not be our fault,

00:26:07.258 --> 00:26:08.798
but it sure is our problem.

00:26:09.700 --> 00:26:10.200
Which is like,

00:26:10.220 --> 00:26:11.820
you might not have created it,

00:26:11.941 --> 00:26:13.682
but you still have to deal with it.

00:26:13.982 --> 00:26:14.742
Which also means,

00:26:14.782 --> 00:26:15.804
but if you can deal with it,

00:26:16.929 --> 00:26:18.650
If enough of us decide to change it,

00:26:18.750 --> 00:26:20.549
that's the only time that something

00:26:20.630 --> 00:26:22.891
actually gets changed is when enough of us

00:26:22.931 --> 00:26:24.230
decide that it gets changed.

00:26:24.270 --> 00:26:25.771
Yeah.

00:26:25.832 --> 00:26:26.192
And see,

00:26:26.271 --> 00:26:29.532
and I kind of see it as binary.

00:26:30.752 --> 00:26:32.534
And this might be way too simplistic

00:26:32.854 --> 00:26:34.374
because I kind of see it like life,

00:26:34.453 --> 00:26:34.753
right?

00:26:35.173 --> 00:26:36.295
So either you're living,

00:26:36.595 --> 00:26:38.335
you're either actively living or you're

00:26:38.394 --> 00:26:39.855
actively dying.

00:26:39.915 --> 00:26:40.776
Shawshank Redemption.

00:26:42.291 --> 00:26:43.814
And so to me,

00:26:43.894 --> 00:26:46.476
you're either actively creating it,

00:26:46.936 --> 00:26:49.098
even if it's bystander creation,

00:26:49.839 --> 00:26:51.441
or you're actively changing it.

00:26:52.021 --> 00:26:52.863
Which one are you doing?

00:26:53.743 --> 00:26:55.526
You're going to let it continue to exist

00:26:55.605 --> 00:26:57.448
as it is and you're like, that works,

00:26:57.688 --> 00:26:58.548
or you're going to change it.

00:26:59.243 --> 00:27:00.845
Yep.

00:27:00.865 --> 00:27:06.488
This also works against clinicians in the

00:27:06.607 --> 00:27:09.909
healthcare profession, right?

00:27:09.949 --> 00:27:14.811
Like this lack of connectivity or

00:27:14.932 --> 00:27:17.532
isolation or individualism,

00:27:17.573 --> 00:27:21.115
like staff culture or like, so, I mean,

00:27:21.134 --> 00:27:23.195
we have, I forget what the statistic was,

00:27:23.236 --> 00:27:25.156
but a large number of our colleagues come

00:27:25.176 --> 00:27:26.596
into this profession and I think it's

00:27:26.656 --> 00:27:27.958
seven years later

00:27:28.755 --> 00:27:29.894
they last seven years.

00:27:30.075 --> 00:27:30.275
It's like,

00:27:30.315 --> 00:27:31.855
you just went to school for essentially

00:27:31.915 --> 00:27:34.996
seven years to hang out for seven years

00:27:35.796 --> 00:27:36.477
and then leave.

00:27:36.896 --> 00:27:40.396
And that's a lot of wasted effort and,

00:27:40.837 --> 00:27:42.698
and skill and insight.

00:27:43.817 --> 00:27:45.519
And that feels like we could,

00:27:45.838 --> 00:27:46.898
we should fix that.

00:27:46.919 --> 00:27:48.838
Yeah.

00:27:48.919 --> 00:27:49.939
And it's interesting,

00:27:50.019 --> 00:27:52.440
like why people are leaving and that

00:27:52.500 --> 00:27:56.260
number may even get lower based on what

00:27:56.280 --> 00:27:56.881
we're seeing in, in,

00:27:57.522 --> 00:28:00.164
these last two youngest generations of

00:28:00.224 --> 00:28:02.306
PTs, that number may continue to drop.

00:28:02.826 --> 00:28:04.788
But it's like people are leaving, right?

00:28:04.847 --> 00:28:06.588
Sometimes it's, you know,

00:28:06.628 --> 00:28:08.190
family obligations, right?

00:28:08.210 --> 00:28:09.530
They're at a different season in their

00:28:09.550 --> 00:28:09.852
life.

00:28:10.311 --> 00:28:11.772
But a lot of times it's pay.

00:28:11.992 --> 00:28:15.275
A lot of times it's the workplace

00:28:15.394 --> 00:28:18.377
environment, productivity,

00:28:19.298 --> 00:28:21.339
insurance burdens, administrative burden.

00:28:21.920 --> 00:28:24.040
But all of those things we could change

00:28:24.162 --> 00:28:25.623
because at the end of the day,

00:28:26.666 --> 00:28:28.250
There is a PT manager.

00:28:29.011 --> 00:28:30.675
A lot of times there is a PT

00:28:30.796 --> 00:28:31.017
owner.

00:28:32.135 --> 00:28:34.356
And then even in these larger companies,

00:28:34.396 --> 00:28:37.478
there still are PTs in the C-suite, right?

00:28:39.219 --> 00:28:40.058
So once again,

00:28:40.118 --> 00:28:41.378
I keep coming back to the fact that

00:28:41.439 --> 00:28:42.960
I'm not going to say that everything's

00:28:43.099 --> 00:28:44.599
easy, but I'm going to say,

00:28:44.619 --> 00:28:48.102
but we still are in change agent seats

00:28:48.521 --> 00:28:50.321
where we could change it if we so

00:28:50.362 --> 00:28:50.883
wanted to.

00:28:51.383 --> 00:28:52.462
Is it going to be painful?

00:28:52.563 --> 00:28:52.923
Yes.

00:28:53.083 --> 00:28:54.844
Are some people going to have lower

00:28:54.963 --> 00:28:55.503
margins?

00:28:55.644 --> 00:28:57.204
Yes, for a little while.

00:28:58.375 --> 00:28:58.896
But it's like,

00:28:58.936 --> 00:29:00.858
are you willing to have some short-term

00:29:00.919 --> 00:29:03.882
discomfort to protect the profession?

00:29:05.022 --> 00:29:08.988
And also to just be kinder to that

00:29:09.028 --> 00:29:10.308
fellow human, right?

00:29:10.650 --> 00:29:13.752
So you've had a graduate work seven years

00:29:13.792 --> 00:29:15.255
to be part of the profession.

00:29:15.595 --> 00:29:17.057
They get out, they graduate,

00:29:17.096 --> 00:29:18.778
and then they only work seven years.

00:29:20.147 --> 00:29:21.888
I'm like, come on, right?

00:29:22.170 --> 00:29:24.070
Like we're missing out on so much

00:29:24.131 --> 00:29:27.253
potential because we're losing these

00:29:27.933 --> 00:29:30.676
amazing humans that might be our future

00:29:30.737 --> 00:29:31.116
leaders.

00:29:31.156 --> 00:29:32.858
They might innovate something for the

00:29:32.878 --> 00:29:33.419
profession,

00:29:33.739 --> 00:29:36.060
but we end up losing them because we

00:29:36.101 --> 00:29:38.123
want them to see sixteen patients in one

00:29:38.163 --> 00:29:40.305
day.

00:29:40.325 --> 00:29:41.025
I'm just like,

00:29:42.454 --> 00:29:44.096
That instant gratification.

00:29:44.317 --> 00:29:44.836
I'm just like,

00:29:44.916 --> 00:29:47.961
could we not be reasonable with

00:29:48.000 --> 00:29:49.422
productivity expectations?

00:29:49.442 --> 00:29:54.446
Could we not be flexible with work hours?

00:29:54.467 --> 00:29:56.449
Because it's going to cost you more to

00:29:56.489 --> 00:29:57.109
replace them.

00:29:57.130 --> 00:29:58.631
I was going to say, if you don't,

00:29:58.851 --> 00:29:59.811
what is the cost?

00:30:00.232 --> 00:30:00.972
You've said this,

00:30:01.354 --> 00:30:04.076
we're gatekeeping the profession while

00:30:04.116 --> 00:30:05.377
complaining about the shortage.

00:30:06.161 --> 00:30:06.601
Yeah.

00:30:06.641 --> 00:30:08.481
That feels like we're talking in circles,

00:30:08.541 --> 00:30:08.721
right?

00:30:08.741 --> 00:30:09.762
It's talking out of both sides of your

00:30:09.803 --> 00:30:10.042
mouth.

00:30:10.063 --> 00:30:11.063
There's not enough people,

00:30:11.623 --> 00:30:12.604
but we're gatekeeping.

00:30:13.104 --> 00:30:14.904
So what do we... Well,

00:30:15.105 --> 00:30:15.944
and then there's the middle part,

00:30:15.964 --> 00:30:16.765
which is how do we keep people in

00:30:16.785 --> 00:30:17.665
the profession longer?

00:30:17.925 --> 00:30:20.106
So you have input, you have throughput,

00:30:20.166 --> 00:30:21.227
you have output, right?

00:30:21.267 --> 00:30:23.647
In terms of someone's career span.

00:30:26.449 --> 00:30:28.329
You're focused on input because you're in

00:30:28.369 --> 00:30:29.009
education.

00:30:29.411 --> 00:30:29.570
Well,

00:30:29.611 --> 00:30:30.790
I shouldn't say just focused on input,

00:30:30.810 --> 00:30:31.211
but you're like,

00:30:31.230 --> 00:30:33.932
how do we get more right people into

00:30:34.292 --> 00:30:34.932
the profession?

00:30:35.557 --> 00:30:37.598
Because more right people is better than

00:30:37.699 --> 00:30:38.680
more not right people.

00:30:38.720 --> 00:30:39.759
Because if those people aren't right,

00:30:39.779 --> 00:30:42.402
they might not stick around and prevent

00:30:42.422 --> 00:30:43.602
them from leaving the profession.

00:30:43.662 --> 00:30:45.482
Yeah.

00:30:45.603 --> 00:30:47.284
And I am of the belief now,

00:30:48.265 --> 00:30:49.425
and this is where people will get

00:30:49.526 --> 00:30:50.546
irritable with me,

00:30:51.247 --> 00:30:53.087
every four point O student is not the

00:30:53.127 --> 00:30:53.688
right person.

00:30:55.217 --> 00:30:55.537
Right.

00:30:57.357 --> 00:30:59.498
I think there is some beauty in having

00:30:59.538 --> 00:31:01.798
conversations about those people that

00:31:01.858 --> 00:31:03.838
represent the three point three point

00:31:03.878 --> 00:31:06.440
three because their drive is different.

00:31:07.279 --> 00:31:07.680
Right.

00:31:08.099 --> 00:31:10.221
Their passion about the profession is

00:31:10.260 --> 00:31:11.240
different because.

00:31:13.080 --> 00:31:16.201
There's just a gratefulness to being

00:31:16.261 --> 00:31:17.461
allowed access.

00:31:18.663 --> 00:31:20.182
That then they're like, you know what,

00:31:20.282 --> 00:31:22.303
I'm going to stay in this because I

00:31:22.323 --> 00:31:24.344
am grateful to have been able to be

00:31:24.384 --> 00:31:24.604
here.

00:31:25.059 --> 00:31:25.539
I, you know,

00:31:25.680 --> 00:31:28.122
I know what I've had to do to

00:31:28.162 --> 00:31:30.303
be able to get to this point where

00:31:30.343 --> 00:31:32.784
we tend to only think about the three

00:31:32.824 --> 00:31:34.384
point eights and the three point and the

00:31:34.424 --> 00:31:35.925
four point O's is on my, you know,

00:31:35.965 --> 00:31:37.066
think about all they've done.

00:31:38.467 --> 00:31:38.707
Yeah,

00:31:38.747 --> 00:31:40.627
they've done a lot from an academic

00:31:40.647 --> 00:31:45.070
standpoint, but that that drive, right,

00:31:45.111 --> 00:31:47.112
that I don't even know what to call

00:31:47.152 --> 00:31:48.511
it, but that grittiness,

00:31:49.853 --> 00:31:51.413
I tend to see that more in the

00:31:51.453 --> 00:31:53.255
three point O's to the three point threes.

00:31:54.096 --> 00:31:56.096
And I also tend to see them stay

00:31:56.156 --> 00:31:59.919
longer within the profession because they

00:32:00.019 --> 00:32:01.880
feel a commitment to the profession.

00:32:02.160 --> 00:32:04.461
They feel like the profession took,

00:32:05.261 --> 00:32:07.083
you know, they, they took one for them.

00:32:07.123 --> 00:32:07.303
What,

00:32:07.363 --> 00:32:08.983
what would be a better word for Jimmy?

00:32:09.084 --> 00:32:11.204
But I'm not saying that something was

00:32:11.285 --> 00:32:12.945
given to them, but they just,

00:32:12.965 --> 00:32:15.508
there's a different sense about being

00:32:16.167 --> 00:32:17.929
accepted into the professions.

00:32:18.516 --> 00:32:20.499
Well, for a second there,

00:32:20.519 --> 00:32:23.241
I was going to say it's an effect

00:32:23.281 --> 00:32:24.403
called the IKEA effect.

00:32:24.423 --> 00:32:25.785
Have you ever heard of the IKEA effect?

00:32:25.944 --> 00:32:26.586
Lego effect?

00:32:27.346 --> 00:32:28.469
Because I had more...

00:32:30.076 --> 00:32:33.157
I had to construct this coffee table.

00:32:33.798 --> 00:32:35.397
I actually valued the coffee table.

00:32:35.998 --> 00:32:42.000
It was in Betty Crocker cake mix.

00:32:42.900 --> 00:32:44.819
All you used to have to do was

00:32:44.920 --> 00:32:46.500
add water and people said,

00:32:46.579 --> 00:32:47.740
it didn't feel like I was doing enough.

00:32:47.780 --> 00:32:48.520
They literally said,

00:32:48.780 --> 00:32:51.040
you have to add water and egg and

00:32:51.161 --> 00:32:51.981
adoption went up.

00:32:52.382 --> 00:32:52.741
So it was like,

00:32:52.781 --> 00:32:54.281
if you have to do a little more,

00:32:54.321 --> 00:32:55.642
if you had to sort of sweat a

00:32:55.662 --> 00:32:57.663
little more or put a little more work

00:32:57.682 --> 00:32:58.163
into it,

00:32:59.644 --> 00:33:02.205
you might feel like it's worth more to

00:33:02.326 --> 00:33:03.267
you.

00:33:03.586 --> 00:33:03.826
Right.

00:33:03.846 --> 00:33:06.388
Personally.

00:33:06.890 --> 00:33:08.211
That's a great way to put it.

00:33:10.011 --> 00:33:12.493
Because I do want humans to feel like

00:33:12.513 --> 00:33:13.674
they are the gift, right?

00:33:13.714 --> 00:33:16.017
We all have been called into existence for

00:33:16.037 --> 00:33:16.616
a reason.

00:33:17.698 --> 00:33:20.519
But I also think that your profession,

00:33:20.641 --> 00:33:22.261
and especially professions that have

00:33:22.321 --> 00:33:23.442
selective admission,

00:33:24.348 --> 00:33:27.191
recognizing the gift that has been given

00:33:27.230 --> 00:33:27.651
to you.

00:33:28.151 --> 00:33:30.432
And I do sometimes find that those

00:33:30.471 --> 00:33:32.573
candidates with the higher GPAs,

00:33:33.013 --> 00:33:34.894
they feel like they're the gift.

00:33:35.154 --> 00:33:37.576
And if things don't go a particular way,

00:33:37.615 --> 00:33:39.297
then they're ready to go.

00:33:39.376 --> 00:33:41.817
And granted, many of them do have options.

00:33:42.198 --> 00:33:44.138
So yes, utilize your options.

00:33:44.159 --> 00:33:45.160
That's not what I'm saying.

00:33:45.720 --> 00:33:47.881
But I just find that the persistence and

00:33:47.901 --> 00:33:49.701
the perseverance is not the same.

00:33:49.741 --> 00:33:51.403
And I realize I'm speaking in

00:33:51.442 --> 00:33:52.284
generalizations.

00:33:52.304 --> 00:33:52.923
Right, right, right, right.

00:33:53.023 --> 00:33:55.184
But I just hear so many educational

00:33:55.224 --> 00:33:57.385
programs talking about they want the

00:33:57.445 --> 00:33:58.886
qualified student.

00:33:59.007 --> 00:33:59.767
And in their mind,

00:33:59.787 --> 00:34:01.647
the qualified student is three point five

00:34:01.688 --> 00:34:02.189
or greater.

00:34:02.808 --> 00:34:05.911
I'm like, no, the qualified student,

00:34:06.010 --> 00:34:08.032
if your document says it is three point

00:34:08.172 --> 00:34:08.371
oh,

00:34:08.711 --> 00:34:10.293
then it's the three point oh student as

00:34:10.333 --> 00:34:10.733
well.

00:34:11.132 --> 00:34:12.713
So you need to wrap your arms around

00:34:12.753 --> 00:34:13.134
them.

00:34:13.835 --> 00:34:15.235
And what I have just found is that

00:34:15.275 --> 00:34:17.076
they come with a different set of

00:34:17.155 --> 00:34:20.257
attributes that actually ends up.

00:34:21.175 --> 00:34:22.896
being better for the profession.

00:34:22.936 --> 00:34:24.597
There's just a resilience there.

00:34:24.637 --> 00:34:26.739
There's just a hunger there that's

00:34:26.778 --> 00:34:27.659
slightly different.

00:34:29.201 --> 00:34:31.543
What would it look like if PT education

00:34:31.583 --> 00:34:35.385
truly centered community instead of

00:34:36.025 --> 00:34:36.927
competition,

00:34:37.206 --> 00:34:39.528
instead of a four is better than a

00:34:39.608 --> 00:34:40.208
three five?

00:34:41.030 --> 00:34:42.130
Oh, you know,

00:34:42.570 --> 00:34:44.152
I would love for it to get to

00:34:44.192 --> 00:34:47.414
the point where if you've got the academic

00:34:47.454 --> 00:34:47.974
metrics,

00:34:48.476 --> 00:34:48.615
then

00:34:49.266 --> 00:34:51.407
Good we're done with that part right

00:34:51.507 --> 00:34:52.487
that's your screening,

00:34:53.048 --> 00:34:55.409
then the rest of the admissions process is

00:34:55.469 --> 00:34:57.371
really looking at those attributes that

00:34:57.411 --> 00:34:59.793
you have towards the ability to build

00:34:59.833 --> 00:35:01.134
community right.

00:35:02.619 --> 00:35:05.581
So even I would love to see community

00:35:05.621 --> 00:35:07.922
members participating in the admissions

00:35:07.963 --> 00:35:08.483
process.

00:35:08.543 --> 00:35:08.782
Right.

00:35:09.202 --> 00:35:11.123
What would that look like to have patients

00:35:11.224 --> 00:35:14.364
sitting on the admissions process to be

00:35:14.405 --> 00:35:14.985
like, oh, yeah,

00:35:15.025 --> 00:35:16.927
that person could be my therapist or oh,

00:35:16.987 --> 00:35:17.367
no.

00:35:17.447 --> 00:35:19.527
Did you notice the way in which they

00:35:19.568 --> 00:35:20.228
spoke to us?

00:35:20.648 --> 00:35:20.887
Right.

00:35:21.369 --> 00:35:22.809
I think I would love to see the

00:35:22.969 --> 00:35:25.311
end users helping us select the future

00:35:25.510 --> 00:35:26.170
clinicians.

00:35:26.655 --> 00:35:27.115
Yeah.

00:35:27.135 --> 00:35:27.315
I mean,

00:35:27.456 --> 00:35:28.936
I learned that in a different way when

00:35:28.956 --> 00:35:30.536
I worked for Mount Sinai Hospital and

00:35:31.257 --> 00:35:33.157
David Petrino was in charge of a research

00:35:33.197 --> 00:35:35.818
lab and he used to use this phrase,

00:35:35.838 --> 00:35:36.978
which he didn't coin, but he said,

00:35:37.057 --> 00:35:39.458
nothing about us without us.

00:35:39.538 --> 00:35:42.719
And that was from the disability movement

00:35:43.219 --> 00:35:44.958
back in the sixties and seventies,

00:35:44.998 --> 00:35:46.519
which is you have people making decisions

00:35:46.860 --> 00:35:49.059
about other people and no one in that

00:35:49.099 --> 00:35:51.780
decision-making process has the disability

00:35:51.820 --> 00:35:52.940
that we are deciding on.

00:35:53.041 --> 00:35:54.501
And that doesn't make any sense.

00:35:55.385 --> 00:35:56.184
Right, it doesn't.

00:35:58.085 --> 00:35:59.266
And that kind of comes from

00:35:59.967 --> 00:36:01.527
community-based research.

00:36:01.847 --> 00:36:03.849
Some people call it community empowerment

00:36:03.889 --> 00:36:04.489
research.

00:36:04.509 --> 00:36:06.710
You're now hearing terms like asset-based

00:36:07.530 --> 00:36:08.070
models.

00:36:08.471 --> 00:36:11.251
But this concept of if the end product

00:36:11.351 --> 00:36:13.333
is a practitioner,

00:36:14.512 --> 00:36:16.514
then I think there needs to be some

00:36:16.534 --> 00:36:18.695
changes in our processes to say,

00:36:18.994 --> 00:36:20.735
and be it education or clinical,

00:36:21.815 --> 00:36:23.376
at every time point,

00:36:24.375 --> 00:36:26.637
Where is community part of this

00:36:26.677 --> 00:36:27.438
decision-making?

00:36:27.858 --> 00:36:29.641
And so there is an organization called

00:36:29.681 --> 00:36:30.362
PCORI,

00:36:30.382 --> 00:36:33.686
which is Patient-Centered Outcome Research

00:36:33.726 --> 00:36:34.266
Institute.

00:36:34.867 --> 00:36:37.389
What I love about that organization is if

00:36:37.469 --> 00:36:39.452
you are designing a research project,

00:36:39.932 --> 00:36:41.795
community's got to be involved from

00:36:41.855 --> 00:36:43.737
conceptualization all the way to

00:36:43.797 --> 00:36:44.538
dissemination.

00:36:45.528 --> 00:36:47.471
And I think that PCORI model,

00:36:47.590 --> 00:36:49.713
we need to embrace that in healthcare and

00:36:49.733 --> 00:36:50.775
clinical services.

00:36:51.175 --> 00:36:53.197
We also need to embrace it in education

00:36:53.277 --> 00:36:55.900
where if you're designing this and

00:36:55.940 --> 00:36:58.443
communities who it's going to impact at

00:36:58.623 --> 00:36:59.826
every timestamp,

00:37:00.226 --> 00:37:01.648
where's your community member?

00:37:02.047 --> 00:37:03.150
Where's your public member?

00:37:05.539 --> 00:37:07.240
I saw it in practice when I said

00:37:07.762 --> 00:37:08.521
at Mount Sinai,

00:37:09.103 --> 00:37:10.965
we'd have technology companies come and

00:37:11.025 --> 00:37:15.349
say, we've solved insert disability here,

00:37:15.409 --> 00:37:18.592
or we've solved this problem for this

00:37:18.632 --> 00:37:19.934
subset of the population here.

00:37:20.853 --> 00:37:23.315
And David, he was also Australian.

00:37:23.436 --> 00:37:24.155
So whenever he talked,

00:37:24.175 --> 00:37:25.135
it just sounded cooler.

00:37:25.657 --> 00:37:26.416
He'd just be like,

00:37:27.498 --> 00:37:29.719
he would ask just like stunningly simple

00:37:29.759 --> 00:37:30.159
questions.

00:37:30.800 --> 00:37:32.981
Who from that community is on your board

00:37:33.021 --> 00:37:35.121
who's actively been in the process of

00:37:35.181 --> 00:37:35.561
this?

00:37:36.262 --> 00:37:37.063
And a lot of times,

00:37:37.523 --> 00:37:38.684
these were David's words, not mine.

00:37:38.724 --> 00:37:39.003
He was like,

00:37:39.184 --> 00:37:40.786
it's a bunch of tech bros going,

00:37:40.826 --> 00:37:41.606
we figured it out.

00:37:41.826 --> 00:37:43.007
And the answer is nobody.

00:37:43.961 --> 00:37:44.461
Right.

00:37:44.963 --> 00:37:45.583
And then he,

00:37:45.623 --> 00:37:47.385
David would then just simply turn to

00:37:47.445 --> 00:37:49.427
people who had that disability and say,

00:37:49.947 --> 00:37:53.150
is this in your top twenty five problems

00:37:53.630 --> 00:37:54.791
that you face every day?

00:37:55.452 --> 00:37:55.992
And they'd be like,

00:37:56.152 --> 00:37:57.213
not even in my top fifty.

00:37:57.414 --> 00:37:58.614
And they're like, what are we doing here?

00:37:58.855 --> 00:38:02.018
You've solved nothing.

00:38:02.157 --> 00:38:04.559
And from and from like psychology and

00:38:04.599 --> 00:38:05.601
sociology research,

00:38:05.621 --> 00:38:06.802
we call that saviorism.

00:38:06.862 --> 00:38:07.161
Right.

00:38:07.862 --> 00:38:10.644
Where it's totally you thought there was a

00:38:10.704 --> 00:38:11.164
problem.

00:38:12.873 --> 00:38:13.554
and you were like,

00:38:13.653 --> 00:38:15.054
I'm gonna come up with a solution.

00:38:15.155 --> 00:38:16.615
And then you take it back to community

00:38:16.635 --> 00:38:18.277
and you're like, I'm the best.

00:38:18.896 --> 00:38:20.177
I fixed this for you, right?

00:38:20.659 --> 00:38:22.960
And we also do that in education where

00:38:23.039 --> 00:38:25.762
faculty will get together and be like,

00:38:25.802 --> 00:38:27.563
this is what's wrong with this course or

00:38:27.603 --> 00:38:28.384
this curriculum.

00:38:29.284 --> 00:38:31.806
and very seldom do we get feedback from

00:38:31.826 --> 00:38:34.329
the students like really good feedback not

00:38:34.369 --> 00:38:36.471
just the student eval at the end of

00:38:36.490 --> 00:38:38.632
the year but sitting with students to talk

00:38:38.652 --> 00:38:41.235
about curriculum and then we go we fixed

00:38:41.295 --> 00:38:43.197
it and the students are like no it

00:38:43.237 --> 00:38:46.378
still sucks right and then when you think

00:38:46.398 --> 00:38:49.322
about like clinics and patient care like

00:38:49.802 --> 00:38:51.463
often you'll hear people say we have

00:38:51.523 --> 00:38:53.646
community advisory meetings yes but they

00:38:53.686 --> 00:38:54.567
meet once a quarter

00:38:55.663 --> 00:38:56.503
Right.

00:38:56.583 --> 00:38:59.643
How often do you invite community members

00:38:59.864 --> 00:39:02.023
into your staff meetings to talk about,

00:39:02.083 --> 00:39:03.625
hey, how is this really going?

00:39:03.945 --> 00:39:05.864
Like, sit down and have conversations.

00:39:07.465 --> 00:39:09.286
But a lot of times we're doing things

00:39:09.326 --> 00:39:10.905
because it feels good for us,

00:39:11.847 --> 00:39:14.186
not that it really helps the situation.

00:39:15.007 --> 00:39:15.427
Yeah.

00:39:15.467 --> 00:39:18.807
Because I have a use case where I

00:39:19.088 --> 00:39:20.327
think it happens.

00:39:20.889 --> 00:39:22.409
I don't think it's on purpose.

00:39:23.507 --> 00:39:24.128
A lot of times.

00:39:25.068 --> 00:39:26.989
APTA state chapters and academies.

00:39:27.409 --> 00:39:28.108
I see you.

00:39:28.268 --> 00:39:28.668
I love you.

00:39:28.849 --> 00:39:29.829
I want you to succeed.

00:39:29.969 --> 00:39:31.550
It might seem I'm harsh on you online.

00:39:31.630 --> 00:39:32.949
That's because I'm trying to push you.

00:39:33.510 --> 00:39:34.829
Some of them will do town halls.

00:39:34.951 --> 00:39:35.351
And I'm like,

00:39:36.731 --> 00:39:38.210
I don't know if that's the greatest way

00:39:38.251 --> 00:39:40.632
to get feedback because a person has to

00:39:40.711 --> 00:39:41.692
stand up in front of a group of

00:39:41.731 --> 00:39:44.192
peers and say something that might be

00:39:44.231 --> 00:39:44.893
super personal.

00:39:45.032 --> 00:39:45.853
The funny part is...

00:39:46.809 --> 00:39:48.130
It's probably more than that person

00:39:48.170 --> 00:39:48.730
thinking it,

00:39:49.210 --> 00:39:50.791
but is that the best way to get

00:39:50.831 --> 00:39:51.431
feedback?

00:39:51.751 --> 00:39:52.811
Probably not.

00:39:53.431 --> 00:39:56.552
And here's my non-scientific way.

00:39:56.853 --> 00:39:58.213
We've all been to presentations.

00:39:58.273 --> 00:39:59.693
We just came back from CSM.

00:40:00.134 --> 00:40:01.554
Someone talks for sixty minutes.

00:40:01.974 --> 00:40:03.795
Everyone says, clap, clap, clap.

00:40:03.974 --> 00:40:04.655
Any questions?

00:40:04.956 --> 00:40:05.795
Maybe one or two.

00:40:05.856 --> 00:40:06.596
Clap, clap, clap.

00:40:06.956 --> 00:40:07.456
Thank you.

00:40:07.856 --> 00:40:08.297
I'm done.

00:40:08.436 --> 00:40:10.057
And then twelve people rush the stage to

00:40:10.137 --> 00:40:10.757
ask a question.

00:40:11.956 --> 00:40:12.416
Where was that?

00:40:12.458 --> 00:40:13.418
Forty eight seconds ago.

00:40:13.478 --> 00:40:13.818
Why?

00:40:14.139 --> 00:40:14.780
I know why.

00:40:15.019 --> 00:40:16.782
Because they didn't want the spotlight.

00:40:17.242 --> 00:40:19.965
But that's where really interesting things

00:40:20.525 --> 00:40:21.005
happen.

00:40:21.365 --> 00:40:21.947
So, yes,

00:40:22.568 --> 00:40:24.469
asking for a survey at work or at

00:40:24.590 --> 00:40:28.574
school isn't the best way to get the

00:40:28.753 --> 00:40:30.255
right feedback.

00:40:30.335 --> 00:40:31.496
No, no.

00:40:32.105 --> 00:40:35.050
It's that one-on-one small group.

00:40:35.490 --> 00:40:36.512
I mean, and people are like,

00:40:36.532 --> 00:40:38.036
but do we have time for that?

00:40:38.135 --> 00:40:38.936
If you want to know the,

00:40:39.197 --> 00:40:40.179
if you want the answers,

00:40:40.239 --> 00:40:41.242
you have time for it.

00:40:41.302 --> 00:40:41.601
Right.

00:40:41.661 --> 00:40:43.284
And do you have time to not do

00:40:43.364 --> 00:40:43.465
it?

00:40:44.297 --> 00:40:44.918
That part.

00:40:45.539 --> 00:40:48.440
And nowadays, even with technology, right?

00:40:48.480 --> 00:40:51.101
So there's so many audience engagement

00:40:51.141 --> 00:40:54.302
systems that you can still protect

00:40:54.342 --> 00:40:58.023
someone's need to feel safe and allow them

00:40:58.043 --> 00:40:59.503
to still give you feedback.

00:40:59.623 --> 00:41:00.304
I'm just like,

00:41:00.945 --> 00:41:03.925
but we often design things in a rush

00:41:04.005 --> 00:41:05.606
or either we're just thinking about how

00:41:05.646 --> 00:41:06.786
we've always done them.

00:41:07.126 --> 00:41:09.248
We're not really thinking about universal

00:41:09.288 --> 00:41:10.148
design of, okay,

00:41:10.208 --> 00:41:12.849
how can I engage as many people as

00:41:12.909 --> 00:41:13.389
possible?

00:41:13.746 --> 00:41:17.230
Because if you want as many perspectives

00:41:17.289 --> 00:41:17.851
as possible,

00:41:17.871 --> 00:41:20.193
you've got to be much more intentional in

00:41:20.353 --> 00:41:22.617
every aspect of the human condition.

00:41:23.097 --> 00:41:28.023
I would say these are communication

00:41:28.063 --> 00:41:28.844
principles, right?

00:41:29.204 --> 00:41:32.530
And I love stealing that fit VP model.

00:41:33.737 --> 00:41:34.878
Everybody's like, oh, frequency,

00:41:34.898 --> 00:41:36.041
intensity, time, type, volume,

00:41:36.061 --> 00:41:36.360
progression.

00:41:36.380 --> 00:41:38.043
I go, those are exercise principles.

00:41:38.324 --> 00:41:40.407
Those are also communication principles.

00:41:40.588 --> 00:41:41.949
Those are relationship principles.

00:41:42.311 --> 00:41:44.213
Those are all the principles.

00:41:45.096 --> 00:41:46.338
Those are the only levers you can pull.

00:41:47.081 --> 00:41:48.103
Oh, that's good.

00:41:48.123 --> 00:41:49.663
I had not thought about that in that

00:41:49.682 --> 00:41:51.063
way, but that's really good.

00:41:51.083 --> 00:41:52.925
You would say low frequency,

00:41:52.965 --> 00:41:53.965
but high intensity.

00:41:54.025 --> 00:41:54.925
That's a town hall.

00:41:55.365 --> 00:41:56.425
So that might be good.

00:41:56.485 --> 00:41:57.126
It might be good.

00:41:57.746 --> 00:42:00.327
But would you need small groups quarterly?

00:42:00.648 --> 00:42:02.829
That's more frequency, but less intensity.

00:42:03.409 --> 00:42:06.630
What about a one-on-one that meets every

00:42:06.990 --> 00:42:08.452
three weeks or monthly?

00:42:08.751 --> 00:42:11.733
That's higher frequency, less stakes,

00:42:12.253 --> 00:42:12.454
right?

00:42:12.474 --> 00:42:12.893
Yeah.

00:42:13.755 --> 00:42:13.934
And...

00:42:15.262 --> 00:42:17.143
I come from the land of frequency,

00:42:17.463 --> 00:42:19.744
like quite literally radio frequency,

00:42:19.844 --> 00:42:21.184
but like, that's not what it,

00:42:21.224 --> 00:42:22.804
that's not the frequency has to do with

00:42:22.844 --> 00:42:23.405
wavelength,

00:42:23.425 --> 00:42:25.905
but how frequently do you show up and

00:42:26.186 --> 00:42:26.586
ask?

00:42:26.606 --> 00:42:28.266
Yeah.

00:42:28.347 --> 00:42:29.728
If it's once a year,

00:42:29.947 --> 00:42:31.568
are you shocked when you don't get good

00:42:31.628 --> 00:42:32.367
responses?

00:42:32.748 --> 00:42:34.009
And when you put it like that,

00:42:34.028 --> 00:42:34.548
you're like, well,

00:42:34.608 --> 00:42:37.909
obviously my door is always open.

00:42:37.929 --> 00:42:40.590
That might check a box, but,

00:42:42.641 --> 00:42:43.621
But if I don't know,

00:42:43.942 --> 00:42:45.663
if I feel weird about walking through the

00:42:45.702 --> 00:42:45.963
door,

00:42:46.003 --> 00:42:46.844
I don't know how to start that

00:42:46.884 --> 00:42:47.304
conversation.

00:42:47.563 --> 00:42:48.704
Hi, I'm here to complain.

00:42:48.744 --> 00:42:50.385
Like, no, I don't want to do it.

00:42:50.445 --> 00:42:52.405
But if you're asking, I don't know.

00:42:52.726 --> 00:42:55.286
Like frequency is always the lever in my

00:42:55.347 --> 00:42:58.708
mind that I like to pull on first.

00:42:58.907 --> 00:43:00.228
No, that's a great point.

00:43:00.327 --> 00:43:01.768
That's a really great point.

00:43:02.235 --> 00:43:03.237
Really?

00:43:03.777 --> 00:43:04.898
I didn't think that was,

00:43:05.059 --> 00:43:05.559
but I'll take it.

00:43:05.619 --> 00:43:06.099
No, it was fabulous.

00:43:06.159 --> 00:43:07.661
And I teach electrofizz,

00:43:07.701 --> 00:43:09.623
so it so made sense to me, right?

00:43:10.184 --> 00:43:10.985
Because I'm like,

00:43:11.445 --> 00:43:13.067
I can have the electrodes on you,

00:43:13.447 --> 00:43:15.289
but if there's not enough beats coming in

00:43:15.309 --> 00:43:17.451
or enough hertz, I'm not going to get,

00:43:17.971 --> 00:43:19.132
yeah, it's not going to do anything.

00:43:19.432 --> 00:43:20.853
So I felt that.

00:43:21.094 --> 00:43:21.454
Great job.

00:43:22.525 --> 00:43:25.487
You said we will not survive if we

00:43:25.547 --> 00:43:27.507
focus only on self.

00:43:28.088 --> 00:43:29.208
So let's look to the future.

00:43:30.748 --> 00:43:32.108
There's no good story unless there's

00:43:32.148 --> 00:43:32.568
tension.

00:43:33.429 --> 00:43:35.250
What happens if we don't change?

00:43:36.150 --> 00:43:36.891
For the profession,

00:43:37.311 --> 00:43:38.170
I'll frame it that way.

00:43:38.271 --> 00:43:39.012
As the profession,

00:43:39.251 --> 00:43:41.231
if we continue down the path we're doing

00:43:41.692 --> 00:43:43.072
and we don't take any of these things,

00:43:43.793 --> 00:43:44.813
heat of any of the things that we

00:43:44.833 --> 00:43:47.434
just talked about, what is the fallout?

00:43:47.454 --> 00:43:48.494
What does it look like when we fall

00:43:48.534 --> 00:43:48.954
off a cliff?

00:43:50.153 --> 00:43:52.655
So here's the world according to Lisa Van

00:43:52.695 --> 00:43:52.914
Hoose.

00:43:52.934 --> 00:43:54.695
So this is just my opinion.

00:43:55.016 --> 00:43:57.496
I do recognize that I represent other

00:43:57.536 --> 00:43:59.378
organizations, but this is my opinion.

00:43:59.918 --> 00:44:01.458
From an education standpoint,

00:44:01.498 --> 00:44:04.639
PT programs are going to close.

00:44:04.659 --> 00:44:06.039
There's just not going to be enough

00:44:06.119 --> 00:44:06.539
interest.

00:44:07.059 --> 00:44:09.440
If we cannot figure out a way to

00:44:09.561 --> 00:44:14.563
lower costs, lower the cognitive load,

00:44:14.742 --> 00:44:17.284
I'm not saying decrease your credit hours,

00:44:18.184 --> 00:44:18.405
but

00:44:19.547 --> 00:44:21.608
You've got to make sure that instruction

00:44:21.668 --> 00:44:23.449
is delivered in such a way that it

00:44:23.510 --> 00:44:26.510
reduces cognitive load and reduces the

00:44:26.570 --> 00:44:28.811
trauma during the learning process.

00:44:29.411 --> 00:44:31.072
If we cannot figure out a way,

00:44:31.612 --> 00:44:32.833
students just aren't going to come to our

00:44:32.893 --> 00:44:35.135
classes, right?

00:44:35.614 --> 00:44:37.356
And I feel very strongly about that

00:44:37.376 --> 00:44:39.396
because there's too many options now,

00:44:39.797 --> 00:44:40.697
right?

00:44:40.737 --> 00:44:42.257
This is not the nineteen fifties.

00:44:42.318 --> 00:44:43.518
It's not the sixties.

00:44:43.577 --> 00:44:44.998
It's not that, you know, there's only

00:44:45.539 --> 00:44:47.240
Fifty disciplines in health care.

00:44:47.521 --> 00:44:49.101
There's over two hundred disciplines in

00:44:49.161 --> 00:44:49.623
health care.

00:44:49.663 --> 00:44:51.264
So if somebody wanted to be in health

00:44:51.284 --> 00:44:51.603
care,

00:44:51.943 --> 00:44:53.324
there's all different kind of ways they

00:44:53.364 --> 00:44:54.065
can participate.

00:44:54.465 --> 00:44:56.606
So we've got to get more attractive from

00:44:56.628 --> 00:44:59.068
an educational standpoint.

00:44:59.690 --> 00:45:01.231
From a clinical standpoint,

00:45:01.951 --> 00:45:05.172
I think we are saying the wrong message

00:45:05.713 --> 00:45:07.875
because right now the message is about our

00:45:07.934 --> 00:45:08.476
features.

00:45:08.556 --> 00:45:09.795
So I'm going to use what you said

00:45:09.876 --> 00:45:10.597
earlier, right?

00:45:11.201 --> 00:45:13.061
We are a doctoring profession.

00:45:13.581 --> 00:45:17.103
We have done seven years of training.

00:45:17.364 --> 00:45:19.204
We are in the community, right?

00:45:19.284 --> 00:45:20.826
It's a lot of we messaging.

00:45:22.806 --> 00:45:24.827
People do not, like,

00:45:25.248 --> 00:45:27.047
even if you're in a room with another

00:45:27.108 --> 00:45:28.929
individual and all you hear them saying is

00:45:29.188 --> 00:45:30.530
I, I, I, like,

00:45:30.630 --> 00:45:32.170
we don't like talking to that person.

00:45:32.934 --> 00:45:34.478
It gets creepy, right?

00:45:35.358 --> 00:45:38.184
So if the message was, you know what?

00:45:38.724 --> 00:45:43.273
Here's how PT is changing lives.

00:45:44.266 --> 00:45:46.806
Every state has a state health improvement

00:45:46.827 --> 00:45:47.246
plan.

00:45:47.967 --> 00:45:50.708
If we made sure that every clinic was

00:45:50.768 --> 00:45:53.108
addressing at least one measure from the

00:45:53.148 --> 00:45:54.708
state health improvement plan,

00:45:55.269 --> 00:45:56.829
then we can say back to states,

00:45:56.849 --> 00:45:58.510
you know what, we see you.

00:45:58.751 --> 00:46:00.570
We heard that this was a priority.

00:46:00.990 --> 00:46:02.512
This is how we're contributing.

00:46:03.632 --> 00:46:06.733
That's a different message than we've done

00:46:06.795 --> 00:46:07.335
all these things.

00:46:07.375 --> 00:46:08.175
And for that reason,

00:46:08.195 --> 00:46:09.516
you need to take care of us.

00:46:10.056 --> 00:46:12.239
It's like, no, we are an asset.

00:46:12.659 --> 00:46:14.199
You said this was your problem.

00:46:14.280 --> 00:46:16.141
Here's the assets we're bringing to the

00:46:16.181 --> 00:46:16.641
table.

00:46:17.163 --> 00:46:19.403
And then naturally people will want to

00:46:19.443 --> 00:46:21.085
partner with you and people will want to

00:46:21.126 --> 00:46:23.226
make sure that they take care of you

00:46:23.266 --> 00:46:26.449
because you brought value.

00:46:26.570 --> 00:46:29.211
I think sometimes our doubling down on

00:46:29.271 --> 00:46:32.295
self-advocacy makes us come off as really

00:46:32.335 --> 00:46:32.755
selfish.

00:46:34.405 --> 00:46:37.829
And it's hard to sell a selfish message.

00:46:38.289 --> 00:46:40.331
So I really would love to see us

00:46:40.431 --> 00:46:42.733
focus more on public health community

00:46:42.773 --> 00:46:43.373
messaging.

00:46:45.335 --> 00:46:46.876
And I think that would do us better.

00:46:48.469 --> 00:46:52.650
so i am afraid that within the next

00:46:52.690 --> 00:46:54.771
five years if we don't do some things

00:46:54.831 --> 00:46:57.152
quickly we're going to see pt programs

00:46:57.192 --> 00:46:59.293
closed down some people are excited about

00:46:59.333 --> 00:47:00.972
that because they're like supply and

00:47:00.992 --> 00:47:04.313
demand i also think that if our messaging

00:47:04.353 --> 00:47:07.155
does not change then what we're going to

00:47:07.195 --> 00:47:08.355
see is we're going to see other

00:47:08.434 --> 00:47:10.376
disciplines that have better messaging

00:47:11.536 --> 00:47:13.697
they're going to get to move into spaces.

00:47:13.777 --> 00:47:14.478
And we're going to be like,

00:47:14.538 --> 00:47:16.378
why is the athletic trainers there?

00:47:16.778 --> 00:47:18.780
Why is the exercise business there?

00:47:19.079 --> 00:47:19.280
Well,

00:47:19.320 --> 00:47:21.541
because they had a community facing

00:47:21.581 --> 00:47:22.021
message.

00:47:23.543 --> 00:47:25.304
The other thing that makes me really

00:47:25.344 --> 00:47:28.706
concerned is there's this big push to

00:47:28.786 --> 00:47:32.829
create PTs faster.

00:47:32.849 --> 00:47:34.889
We're not making widgets.

00:47:35.349 --> 00:47:38.492
We're not making, I don't know,

00:47:39.820 --> 00:47:42.063
Something production wise we're not making

00:47:42.103 --> 00:47:46.666
tires right you're making humans who have

00:47:46.686 --> 00:47:48.248
to have a certain amount of relational

00:47:48.268 --> 00:47:49.088
capacity.

00:47:49.969 --> 00:47:53.333
And we already are taking them from

00:47:53.373 --> 00:47:55.253
bachelor's degree right to doctoral

00:47:55.273 --> 00:47:55.695
degree,

00:47:56.114 --> 00:47:58.436
we know from neuroscience that there are

00:47:58.496 --> 00:48:01.159
parts of their brains that control empathy

00:48:01.639 --> 00:48:03.882
and compassion are not fully developed

00:48:03.942 --> 00:48:05.382
until they're somewhere between.

00:48:05.422 --> 00:48:05.463
To.

00:48:07.458 --> 00:48:10.159
So why are we moving so fast, right?

00:48:10.719 --> 00:48:12.561
If the issue is that we need to

00:48:12.601 --> 00:48:14.722
get practitioners out into the clinic

00:48:14.802 --> 00:48:18.083
earlier, then let's talk about that,

00:48:18.204 --> 00:48:18.463
right?

00:48:18.503 --> 00:48:20.284
So maybe it is time that we start

00:48:20.324 --> 00:48:21.585
talking about, you know,

00:48:21.646 --> 00:48:24.608
some type of tiered licensure setup so

00:48:24.668 --> 00:48:24.987
that

00:48:26.003 --> 00:48:27.525
They get their bachelor's degree.

00:48:27.585 --> 00:48:29.927
Maybe they do their first year PT school.

00:48:30.286 --> 00:48:30.967
Then after that,

00:48:30.987 --> 00:48:32.467
they go to work or maybe they,

00:48:33.289 --> 00:48:34.369
while they're getting their bachelor's

00:48:34.389 --> 00:48:34.809
degree,

00:48:34.849 --> 00:48:37.070
they become a PTA so they can go

00:48:37.150 --> 00:48:37.532
work.

00:48:37.931 --> 00:48:38.231
Right.

00:48:38.751 --> 00:48:41.074
And then once they've been in the field

00:48:41.094 --> 00:48:41.594
for a while,

00:48:41.673 --> 00:48:43.074
then they come back and work on their

00:48:43.114 --> 00:48:43.795
DPT.

00:48:44.255 --> 00:48:45.996
But this fact that we're going to take

00:48:46.077 --> 00:48:48.518
an eighteen year old and in five years

00:48:48.619 --> 00:48:49.860
at the age of twenty three,

00:48:49.960 --> 00:48:51.280
turn them into a doctor or PT.

00:48:52.115 --> 00:48:54.657
and they're going to be a safe clinician,

00:48:54.737 --> 00:48:56.679
and safe clinicians is not just about

00:48:56.739 --> 00:48:57.719
technical skills,

00:48:58.079 --> 00:49:00.079
it's also about relational skills.

00:49:00.561 --> 00:49:01.820
I'm not sure if that's true.

00:49:02.382 --> 00:49:04.483
We just are not respecting the social,

00:49:05.143 --> 00:49:08.505
what they call socio-emotional literature,

00:49:08.664 --> 00:49:10.766
that there has to be time for development.

00:49:10.846 --> 00:49:12.626
We know that from a rehabilitation

00:49:12.666 --> 00:49:13.648
standpoint, right?

00:49:14.288 --> 00:49:17.530
Where we will respect some six and twelve

00:49:17.570 --> 00:49:18.811
weeks of healing time,

00:49:19.530 --> 00:49:21.231
But then we don't want to respect that

00:49:21.271 --> 00:49:23.771
from a brain development and a cognitive

00:49:23.831 --> 00:49:25.492
learning time.

00:49:25.532 --> 00:49:27.193
So I think there are other ways we

00:49:27.233 --> 00:49:29.434
could address the practitioner need

00:49:29.474 --> 00:49:32.454
question without Russian half-baked

00:49:32.494 --> 00:49:33.815
clinicians to the clinic.

00:49:34.215 --> 00:49:37.197
But that's my take on it.

00:49:37.237 --> 00:49:37.436
Like,

00:49:37.456 --> 00:49:38.496
I once want to hit a gavel and

00:49:38.516 --> 00:49:42.278
be like, Lisa has spoken.

00:49:42.358 --> 00:49:43.778
If I had a microphone, I'd drop it.

00:49:43.798 --> 00:49:44.458
I don't want to drop it.

00:49:44.619 --> 00:49:45.039
I'm like,

00:49:45.260 --> 00:49:47.800
nobody likes half-baked anything.

00:49:48.081 --> 00:49:48.920
So stop it.

00:49:50.440 --> 00:49:53.206
Um, we were together at CSM in, uh,

00:49:53.226 --> 00:49:54.688
just a couple of weeks ago and you,

00:49:54.708 --> 00:49:54.849
uh,

00:49:55.731 --> 00:49:58.217
got an award and I like talking about

00:49:58.257 --> 00:49:58.759
awards.

00:49:59.371 --> 00:50:00.672
I like talking about awards for what we

00:50:00.713 --> 00:50:02.434
did to get, like, what was the thing?

00:50:02.474 --> 00:50:05.356
What was the purpose?

00:50:05.396 --> 00:50:07.059
Share what you did to get,

00:50:07.099 --> 00:50:09.139
because you didn't do the thing to get

00:50:09.179 --> 00:50:09.800
the award.

00:50:10.280 --> 00:50:11.702
You did the thing to do the thing.

00:50:11.782 --> 00:50:13.664
And then the Academy of Leadership and

00:50:13.684 --> 00:50:15.405
Innovation was nice enough to recognize

00:50:15.445 --> 00:50:15.686
that.

00:50:16.025 --> 00:50:16.706
And here's why.

00:50:16.987 --> 00:50:17.407
Number one,

00:50:17.688 --> 00:50:19.768
you deserve some accolades for doing that.

00:50:19.989 --> 00:50:20.570
But also,

00:50:20.789 --> 00:50:22.291
we want other people in the audience to

00:50:22.311 --> 00:50:24.213
be like, oh, look at that.

00:50:24.353 --> 00:50:26.414
How do I do that in my way?

00:50:26.534 --> 00:50:27.536
So talk about what you did.

00:50:28.516 --> 00:50:28.916
Yeah,

00:50:28.996 --> 00:50:32.338
so I was super honored to be recognized

00:50:32.538 --> 00:50:35.898
by my peers for helping to build an

00:50:35.958 --> 00:50:38.860
environment that supports mobility, right?

00:50:38.900 --> 00:50:40.681
From all the domains of mobility,

00:50:41.081 --> 00:50:43.943
physical mobility, emotional mobility,

00:50:44.003 --> 00:50:45.903
social mobility, financial mobility.

00:50:45.963 --> 00:50:48.965
So what the Ujima Institute does is we

00:50:49.005 --> 00:50:51.166
partner with communities to say, hey,

00:50:51.306 --> 00:50:53.186
what are the problems, right?

00:50:53.748 --> 00:50:55.547
What is keeping you from being able to

00:50:55.588 --> 00:50:56.708
live your best life?

00:50:57.454 --> 00:50:59.755
And what we found in our neighborhood was

00:50:59.835 --> 00:51:02.056
it was childcare, youth services,

00:51:02.115 --> 00:51:03.356
food insecurity,

00:51:03.896 --> 00:51:06.476
and then just basic health literacy.

00:51:07.496 --> 00:51:10.097
And so we went about doing those things.

00:51:10.157 --> 00:51:13.458
So we offered a childcare service.

00:51:13.518 --> 00:51:15.157
We had youth programmings.

00:51:16.018 --> 00:51:19.579
We trained young teenagers how to take

00:51:19.619 --> 00:51:21.778
vital signs and how to serve as healthcare

00:51:21.818 --> 00:51:23.239
workers so that they could go to

00:51:23.280 --> 00:51:24.840
appointments with their loved ones.

00:51:25.259 --> 00:51:26.099
and be able to be like,

00:51:26.139 --> 00:51:28.119
this is what these words mean, right?

00:51:28.579 --> 00:51:30.740
Because we, ooh,

00:51:31.782 --> 00:51:33.503
this is finna get political for a minute.

00:51:33.943 --> 00:51:38.085
So we know that when people have improved

00:51:38.144 --> 00:51:40.585
health literacy and they go into a

00:51:40.646 --> 00:51:42.646
clinical appointment and they say

00:51:42.686 --> 00:51:43.387
hypertension,

00:51:44.309 --> 00:51:44.608
Right.

00:51:44.949 --> 00:51:46.130
Not high blood pressure.

00:51:46.530 --> 00:51:48.050
Health care workers pay attention.

00:51:48.512 --> 00:51:50.012
It's just like with your children.

00:51:50.152 --> 00:51:52.014
What we know is that if your children

00:51:52.034 --> 00:51:55.655
knows the word vagina, penis, vulva,

00:51:56.016 --> 00:51:57.896
they are less likely to be sexually

00:51:57.936 --> 00:52:00.478
assaulted because the predator knows that.

00:52:00.539 --> 00:52:01.079
Wait a minute.

00:52:01.099 --> 00:52:02.800
That child is talking to somebody who's

00:52:02.860 --> 00:52:04.661
talking to them about their body parts.

00:52:05.141 --> 00:52:05.461
Right.

00:52:06.262 --> 00:52:08.963
So it was really important to us that

00:52:09.003 --> 00:52:11.164
community members knew the words.

00:52:11.791 --> 00:52:13.514
so that then they would get the attention

00:52:13.574 --> 00:52:15.956
of the healthcare worker because then at

00:52:15.996 --> 00:52:17.657
that point they got better care.

00:52:18.177 --> 00:52:20.320
And what was crazy about it was that

00:52:20.380 --> 00:52:22.702
community members would come back and go,

00:52:23.563 --> 00:52:25.565
I've gone to that doctor for ten years.

00:52:25.766 --> 00:52:27.487
That was the first time that person sat

00:52:27.507 --> 00:52:28.909
down and listened to me.

00:52:29.469 --> 00:52:32.492
So we created a healthcare worker system

00:52:32.532 --> 00:52:32.811
where

00:52:33.846 --> 00:52:34.967
Someone could call.

00:52:35.027 --> 00:52:35.867
They could say, hey,

00:52:35.967 --> 00:52:37.748
I'm going to go meet with my cardiologist.

00:52:37.789 --> 00:52:38.789
This is what's going on.

00:52:38.889 --> 00:52:40.550
What questions should I ask?

00:52:40.931 --> 00:52:42.231
And we would help them come up with

00:52:42.271 --> 00:52:43.811
the questions and help them come up with

00:52:43.831 --> 00:52:46.434
the words or find the guidelines, right?

00:52:46.793 --> 00:52:47.695
That's the other thing.

00:52:47.875 --> 00:52:48.414
We were like,

00:52:48.494 --> 00:52:50.175
start asking your health care workers,

00:52:50.235 --> 00:52:52.077
what guidelines are you using, right?

00:52:52.737 --> 00:52:54.179
So your mom's had a stroke.

00:52:54.378 --> 00:52:55.940
Ask them which stroke guidelines they're

00:52:55.980 --> 00:52:57.001
going to follow, right?

00:52:57.701 --> 00:52:59.342
That gets the attention of health care

00:52:59.382 --> 00:52:59.722
workers.

00:52:59.762 --> 00:53:00.103
And so

00:53:01.380 --> 00:53:03.240
These were things that the typical person

00:53:03.260 --> 00:53:05.661
would say, but that's not PT service,

00:53:06.242 --> 00:53:08.724
but it is, it falls underneath self-care,

00:53:08.903 --> 00:53:09.304
right?

00:53:10.125 --> 00:53:13.025
So if people can't live in environments

00:53:13.045 --> 00:53:15.268
that support their life,

00:53:16.407 --> 00:53:18.228
then it's hard to have a conversation

00:53:18.268 --> 00:53:18.809
about, yeah,

00:53:18.829 --> 00:53:20.090
come see me in the clinic two to

00:53:20.110 --> 00:53:21.670
three times a week for your low back

00:53:21.710 --> 00:53:21.951
pain.

00:53:21.990 --> 00:53:25.293
And they're like, I'm trying to, you know,

00:53:25.373 --> 00:53:26.994
have enough food and make sure my kids

00:53:27.034 --> 00:53:28.275
are safe and everything else.

00:53:28.335 --> 00:53:28.514
So

00:53:29.300 --> 00:53:30.481
Is maslow's law,

00:53:30.661 --> 00:53:31.862
you know you got to deal with those

00:53:31.902 --> 00:53:33.724
basic needs first before you can start

00:53:33.764 --> 00:53:35.764
talking about tertiary care and so.

00:53:36.646 --> 00:53:38.827
we've been able to work with Community to

00:53:38.907 --> 00:53:40.809
do those things and so like now we've

00:53:40.829 --> 00:53:43.510
got a Community garden we're trying to

00:53:43.530 --> 00:53:45.652
figure out our summer youth programming

00:53:46.132 --> 00:53:47.333
and we just finished.

00:53:48.422 --> 00:53:50.443
because we just had a pretty bad ice

00:53:50.463 --> 00:53:51.083
storm here.

00:53:51.123 --> 00:53:53.485
And so Ujima was able to mobilize with

00:53:54.005 --> 00:53:55.346
three other organizations.

00:53:55.405 --> 00:53:57.085
And over the course of four days,

00:53:57.166 --> 00:53:59.688
we were able to deliver four thousand

00:53:59.728 --> 00:54:02.108
meals to people when they were without

00:54:02.168 --> 00:54:02.668
power.

00:54:02.989 --> 00:54:05.070
And that like if you want to talk

00:54:05.090 --> 00:54:07.311
about bringing value to the profession,

00:54:07.351 --> 00:54:09.592
people are like that physical therapist

00:54:09.632 --> 00:54:11.253
over there, like that's Lisa.

00:54:11.474 --> 00:54:12.574
And if you have a need,

00:54:12.594 --> 00:54:13.255
she can help you.

00:54:13.315 --> 00:54:13.594
Right.

00:54:14.195 --> 00:54:15.775
So it's not just about

00:54:16.670 --> 00:54:18.391
you just come see me if your knee

00:54:18.431 --> 00:54:18.672
hurts.

00:54:18.771 --> 00:54:20.333
It's like, if you got a need,

00:54:21.132 --> 00:54:22.775
that's a healthcare person that can help.

00:54:23.574 --> 00:54:27.938
And that, that is you, that's invaluable.

00:54:28.518 --> 00:54:29.400
That's invaluable.

00:54:29.699 --> 00:54:30.541
So, yeah.

00:54:30.681 --> 00:54:32.021
I can't let you leave without giving a

00:54:32.081 --> 00:54:32.961
nod to Ujima.

00:54:34.724 --> 00:54:36.164
Just give a quick mention about what is

00:54:36.244 --> 00:54:36.385
it.

00:54:36.585 --> 00:54:38.567
And then we'll put the website in the

00:54:38.606 --> 00:54:39.007
show notes.

00:54:39.594 --> 00:54:42.556
yeah so ujima is basically the third

00:54:42.596 --> 00:54:44.797
principle of kwanzaa um it means

00:54:44.856 --> 00:54:47.398
collective work and responsibility so in

00:54:47.478 --> 00:54:50.420
layman's terms my brother's problems are

00:54:50.460 --> 00:54:52.481
my problems my sister's problems are my

00:54:52.521 --> 00:54:54.422
problems that humans problems are my

00:54:54.461 --> 00:54:57.762
problems um so don't turn a blind eye

00:54:57.782 --> 00:55:02.806
to people so and then and do what

00:55:02.846 --> 00:55:06.407
you can every little bit helps i'll share

00:55:06.427 --> 00:55:07.547
the uh the website there well hey

00:55:07.568 --> 00:55:09.028
congratulations on your award

00:55:09.702 --> 00:55:10.983
I knew you wouldn't want to come on

00:55:11.003 --> 00:55:12.563
the podcast to talk about an award,

00:55:12.943 --> 00:55:14.405
but we'll talk about other things and then

00:55:14.425 --> 00:55:16.646
the work that went into the award.

00:55:16.666 --> 00:55:17.047
Yes.

00:55:17.626 --> 00:55:20.608
Now, here is where Ujima needs help.

00:55:21.869 --> 00:55:23.311
So let me tell y'all where we need

00:55:23.331 --> 00:55:23.570
help.

00:55:24.052 --> 00:55:25.753
So as I said...

00:55:26.465 --> 00:55:28.025
one of the things that community has said

00:55:28.065 --> 00:55:30.005
that they needed is childcare services.

00:55:30.545 --> 00:55:32.027
So what we did in the past is

00:55:32.067 --> 00:55:34.427
we actually did like your traditional

00:55:34.626 --> 00:55:36.347
childcare set up, right?

00:55:36.807 --> 00:55:38.327
So when you think about childcare,

00:55:38.387 --> 00:55:40.088
you know, you take them to a center,

00:55:40.128 --> 00:55:41.608
they're with you from seven to five,

00:55:41.648 --> 00:55:43.630
you've got childcare work, um,

00:55:43.809 --> 00:55:44.670
childcare workers.

00:55:45.309 --> 00:55:47.931
Margins in childcare centers are very

00:55:47.990 --> 00:55:49.030
small, right?

00:55:49.070 --> 00:55:50.692
They're anywhere between five to fifteen

00:55:50.731 --> 00:55:51.211
percent.

00:55:52.152 --> 00:55:52.311
Um,

00:55:52.833 --> 00:55:56.114
And that is not manageable because what we

00:55:56.155 --> 00:55:58.896
tried to do different in Ujima was we

00:55:58.976 --> 00:56:00.496
knew that the household,

00:56:00.536 --> 00:56:02.237
the median household income.

00:56:02.838 --> 00:56:05.500
So typically your child care should be

00:56:05.539 --> 00:56:07.221
between five to ten percent of your

00:56:07.260 --> 00:56:08.360
disposable income.

00:56:08.860 --> 00:56:11.583
That meant that weekly child care roughly

00:56:12.123 --> 00:56:13.304
needed to be between one hundred and

00:56:13.324 --> 00:56:14.523
twenty five to one hundred and fifty

00:56:14.563 --> 00:56:15.324
dollars a week.

00:56:15.445 --> 00:56:15.664
Right.

00:56:16.373 --> 00:56:19.297
That is half the price of what other

00:56:19.317 --> 00:56:20.697
child care centers.

00:56:20.797 --> 00:56:22.018
Yeah.

00:56:22.478 --> 00:56:24.721
So that was not a sustainable model.

00:56:25.081 --> 00:56:29.625
So you have a group of amazing,

00:56:29.744 --> 00:56:31.907
brilliant people that follow your show.

00:56:32.947 --> 00:56:35.510
What would be a model where we could

00:56:35.570 --> 00:56:39.532
still provide all day services for

00:56:39.552 --> 00:56:42.554
families, but it not be child care?

00:56:42.594 --> 00:56:44.376
So like some of the things we've thought

00:56:44.396 --> 00:56:45.996
about is could we offer it as a

00:56:46.056 --> 00:56:47.137
wellness model, right?

00:56:47.458 --> 00:56:49.418
That you drop your child off at seven

00:56:49.438 --> 00:56:50.840
o'clock in the morning and you can pick

00:56:50.860 --> 00:56:52.760
them up at five and we're going to

00:56:52.820 --> 00:56:54.501
work with them on their wellness and

00:56:54.521 --> 00:56:55.742
physical activity, right?

00:56:56.483 --> 00:56:59.625
Something where it's not child care.

00:57:00.826 --> 00:57:04.188
um because the child care industry is so

00:57:04.309 --> 00:57:06.250
over regulated so that's the other part of

00:57:06.309 --> 00:57:08.050
it is that there's so many fees and

00:57:08.110 --> 00:57:10.233
everything else associated with that that

00:57:10.253 --> 00:57:11.693
that's part of the reason why it has

00:57:11.713 --> 00:57:15.056
to be so expensive um so we're trying

00:57:15.076 --> 00:57:16.536
to figure out is there another way to

00:57:16.577 --> 00:57:18.318
do that some people have talked about you

00:57:18.338 --> 00:57:21.360
know could we do a parent co-op right

00:57:21.400 --> 00:57:23.601
where parents then become the co-workers

00:57:23.981 --> 00:57:26.423
but if y'all got ideas about how we

00:57:26.443 --> 00:57:29.045
could provide all-day child care services

00:57:30.184 --> 00:57:33.045
for that pre-K through four-year-old group

00:57:33.164 --> 00:57:35.306
or even infants to four-year-old groups.

00:57:35.346 --> 00:57:36.826
That would be greatly appreciated.

00:57:37.365 --> 00:57:39.206
What's some innovative ideas out there?

00:57:39.726 --> 00:57:40.467
I'll get on it.

00:57:41.827 --> 00:57:43.007
I'll call you back soon.

00:57:43.168 --> 00:57:43.748
I'll be on it.

00:57:43.768 --> 00:57:48.009
I got faith in you.

00:57:48.048 --> 00:57:48.349
Yeah.

00:57:49.349 --> 00:57:50.090
Last thing we do, Lisa,

00:57:50.110 --> 00:57:51.110
is called the parting shot.

00:57:51.369 --> 00:57:52.530
What's the thing you'd want to leave as

00:57:52.570 --> 00:57:54.070
your mic drop moment or your soapbox

00:57:54.090 --> 00:57:54.971
statement as we wrap?

00:57:56.248 --> 00:57:58.731
Yeah, if you're not part of the solution,

00:57:58.751 --> 00:57:59.650
you're part of the problem.

00:58:00.771 --> 00:58:02.853
Either you're in the boat and you're

00:58:02.893 --> 00:58:04.635
rowing or you're an anchor.

00:58:05.434 --> 00:58:06.016
Lisa Van Hoose,

00:58:06.036 --> 00:58:06.795
thanks for doing what you do.

00:58:07.496 --> 00:58:08.097
Thank you.

00:58:08.257 --> 00:58:09.577
Thank you always for your time.

00:58:11.617 --> 00:58:12.697
That's it for this one,

00:58:12.958 --> 00:58:14.639
but we're just getting warmed up.

00:58:15.099 --> 00:58:17.018
Smash follow, send it to a friend,

00:58:17.219 --> 00:58:18.898
or crank up the next episode.

00:58:19.400 --> 00:58:20.320
Want to go deeper?

00:58:20.780 --> 00:58:24.800
Hit us at pgpinecast.com or find us on

00:58:24.860 --> 00:58:27.400
YouTube and socials at pgpinecast.

00:58:27.820 --> 00:58:30.101
And legally, none of this was advice.

00:58:30.161 --> 00:58:32.081
It's for entertainment purposes only.

00:58:32.561 --> 00:58:33.541
Bulls**t!

00:58:33.581 --> 00:58:34.161
See, Keith?

00:58:34.382 --> 00:58:35.443
We read the script.

00:58:35.742 --> 00:58:36.382
Happy now?